bluuebunny/crossref_metadata_2025 huggingface dataset:
Utilization and Associated Factors of Insecticide Treated Bed Net among Pregnant Women Attending Antenatal Clinic of Addis Zemen Hospital, North-Western Ethiopia: An Institutional Based Study
Authors: Yitayew Azeb Ewinetu , Enyew Habtamu Demelash , Goshu Yitayal Ayalew
Published: December 2018

Introduction. Insecticide treated bed net (ITN) is one type of cost-effective vector control approach for the prevention of malaria. It has to be treated with insecticide and needs ongoing treatment with chemicals. Malaria infcetion during pregnancy is a amajor health problem in Ethiopia. Little is known about the utilization of ITN by pregnant women in the study area. This study was aimed to assess utilization and associated factors of insecticide-treated nets among pregnant women in Adis Zemen Hospital. Methods. This hospital based cross-sectional study was conducted in Adis Zemen from May 1 to 30, 2018, among 226 pregnant mothers. After obtaining informed consent, data were collected using a pretested structured questionnaire via face to face interview. To reach the study unit, a systematic random sampling technique was used. The collected data were entered, cleaned, checked using Epi data version 3.1, and finally analyzed using SPSS version 20. Binary and multivariable logistic regressions were computed to identify significantly associated variables at 95% confidence interval. Result. A total of 226 pregnant mothers attending antenatal clinics participated in making the response rate 100%. Among a total 226 subjects, 160(70.8%) of mothers had good utilization of insecticide bet net. Mothers who had an educational status of college and above were 2.8 times more likely to utilize insecticide-treated bed net than mothers who could not read and write (AOR; 2. 8: CI; 1.9, 6.5). Mothers whose age was >30 were 70% times less likely utilized insecticide-treated bed net than mothers whose age was 30 and less (AOR;.3: CI;.2,.6). Conclusion and Recommendation. Utilization of insecticide-treated bed net by pregnant women is low in the study area. The participants’ age, educational status, household monthly income, and husband educational status were significantly associated with utilization of insecticide-treated bed net. Different stakeholders shall give a special attention to awareness creation on advantageous of insecticide bed net.
Quiescent Human Mesenchymal Stem Cells Are More Resistant to Heat Stress than Cycling Cells
Authors: Alekseenko L. L. , Shilina M. A. , Lyublinskaya O. G. , Kornienko J. S. , Anatskaya O. V. , Vinogradov A. E. , Grinchuk T. M. , Fridlyanskaya I. I. , Nikolsky N. N.
Published: December 2018

Quiescence is the prevailing state of many cell types under homeostatic conditions. Yet, surprisingly, little is known about how quiescent cells respond to environmental challenges. The aim of the present study is to compare stress responses of cycling and quiescent mesenchymal stem cells (MSC). Human endometrial mesenchymal cells (eMSС) were employed as adult stem cells. eMSC quiescence was modeled by serum starvation. Sublethal heat shock (HS) was used as a stress factor. Both quiescent and cycling cells were heated at 45°C for 30 min and then returned to standard culture conditions for their recovery. HS response was monitored by DNA damage response, stress-induced premature senescence (SIPS), cell proliferation activity, and oxidative metabolism. It has been found that quiescent cells repair DNA more rapidly, resume proliferation, and undergo SIPS less than proliferating cells. HS-enforced ROS production in heated cycling cells was accompanied with increased expression of genes regulating redox-active proteins. Quiescent cells exposed to HS did not intensify the ROS production, and genes involved in antioxidant defense were mostly silent. Altogether, the results have shown that quiescent cells are more resistant to heat stress than cycling cells. Next-generation sequencing (NGS) demonstrates that HS-survived cells retain differentiation capacity and do not exhibit signs of spontaneous transformation.
A New Biomedical Passage Retrieval Framework for Laboratory Medicine: Leveraging Domain-specific Ontology, Multilevel PRF, and Negation Differential Weighting
Authors: Han Keejun , Shim Hyoeun , Yi Mun Y.
Published: December 2018

Clinical decision support (CDS) search is performed to retrieve key medical literature that can assist the practice of medical experts by offering appropriate medical information relevant to the medical case in hand. In this paper, we present a novel CDS search framework designed for passage retrieval from biomedical textbooks in order to support clinical decision-making using laboratory test results. The framework utilizes two unique characteristics of the textual reports derived from the test results, which are syntax variation and negation information. The proposed framework consists of three components: domain ontology, index repository, and query processing engine. We first created a domain ontology to resolve syntax variation by applying the ontology to detect medical concepts from the test results with language translation. We then preprocessed and performed indexing of biomedical textbooks recommended by clinicians for passage retrieval. We finally built the query-processing engine tailored for CDS, including translation, concept detection, query expansion, pseudo-relevance feedback at the local and global levels, and ranking with differential weighting of negation information. To evaluate the effectiveness of the proposed framework, we followed the standard information retrieval evaluation procedure. An evaluation dataset was created, including 28,581 textual reports for 30 laboratory test results and 56,228 passages from widely used biomedical textbooks, recommended by clinicians. Overall, our proposed passage retrieval framework, GPRF-NEG, outperforms the baseline by 36.2, 100.5, and 69.7 percent for MRR,R-precision, and Precision at 5, respectively. Our study results indicate that the proposed CDS search framework specifically designed for passage retrieval of biomedical literature represents a practically viable choice for clinicians as it supports their decision-making processes by providing relevant passages extracted from the sources that they prefer to refer to, with improved performances.
M1-Polarized Macrophages Promote Self-Renewing Phenotype of Hepatic Progenitor Cells with Jagged1-Notch Signalling Involved: Relevance in Primary Sclerosing Cholangitis
Authors: Li Heli , Sun Shiran , Lei Qing , Lei Ping , Cai Xiong , Wan Chidan , Shen Guanxin
Published: December 2018

The immunologic interaction between parenchyma cells and encircling inflammatory cells is thought to be the most important mechanism of biliary damage and repair in primary sclerosing cholangitis (PSC). Monocytes/macrophages as master regulators of hepatic inflammation have been demonstrated to contribute to PSC pathogenesis. Macrophages coordinate with liver regeneration, and multiple phenotypes have been identified with diverse expressions of surface proteins and cytokine productions. We analyzed the expression of Notch ligand Jagged1 in polarized macrophages and investigated the relevance of Notch signalling activation in liver regeneration. M1 or M2 macrophages were generated from mouse bone marrow-derived macrophages (BMDMs) by classical or alternative activation, respectively. Then, the expression levels of Jagged1 (Jag1) of each phenotype were measured. The effects of polarized BMDMs on the expression of hepatic progenitor cell- (HPC-) specific markers and hairy and enhancer of split-1 (HES1) in HPCs in coculture were also analyzed. Monocyte-macrophage and Notch signalling-associated gene signatures were evaluated in the GEO database (access ID: GSE61260) by gene set enrichment analysis (GSEA). M1 macrophages were found associated with elevated Jag1 expression, which increased the fraction of HPC with self-renewing phenotypes (CD326+CD44+ or CD324+CD44+) and HES1 expression level in cocultured HPC. Blocking Jagged1 by siRNA or antibody in the coculture system attenuates HPC self-renewing phenotypes as well as HES1 expression in HPC. GSEA data show that macrophage activation and Notch signalling-associated gene signatures are enriched in PSC patients. These findings suggest that M1 macrophages promote an HPC self-renewing phenotype which is associated with Notch signalling activation within HPC. In the liver of PSC patients, the prevalence of activated macrophages, with M1 polarized accounting for the main part, is associated with increment of Notch signalling and enhancement of HPC self-renewal.
A Two-Stage Chance Constrained Approach with Application to Stochastic Intermodal Service Network Design Problems
Authors: Zhao Yi , Xue Qingwan , Cao Zhichao , Zhang Xi
Published: December 2018

Compared with traditional freight transportation, intermodal freight transportation is more competitive which can combine the advantages of different transportation modes. As a consequence, operational research on intermodal freight transportation has received more attention and developed rapidly, but it is still a young research field. In this paper, a stochastic intermodal service network design problem is introduced in a sea-rail transportation system, which considers stochastic travel time, stochastic transfer time, and stochastic container demand. Given candidate train and ship services, we develop a two-stage chance constrained programming model for this problem with the objective of minimising the expected total cost. The first stage allows for the selection of operated services, while the second stage focuses on the determination of intermodal container routes where capacity and on-time delivery chance constraints are presented. A hybrid heuristic algorithm, incorporating sample average approximation and ant colony optimisation, is employed to solve this model. The proposed model is applied to a realistic intermodal sea-rail network, which demonstrates the performance of the model and algorithm as well as the influence of stochasticity on transportation plans. Hence, the proposed methodology can improve effectively the performance of intermodal service network design scheme under stochastic conditions and provide managerial insights for decision-makers.
Study on Cooling Effect and Pavement Performance of Thermal‐Resistant Asphalt Mixture
Authors: Wang Jiarong , Zhang Zhengqi , Guo Datong , Xu Cheng , Zhang Ke
Published: December 2018

To reduce the temperature of asphalt pavement and improve the antirutting performance of asphalt mixture, a thermal‐resistant asphalt mixture (TRAM) was produced, in which a certain proportion of mineral aggregate was replaced by ceramic (CE) or floating beads (FB) featuring low thermal conductivity. Firstly, a parallel plate test was developed to test the thermal conductivity of asphalt mixture added with different thermal‐resistant materials. Secondly, the illumination test system was designed to study the visual cooling effect of different TRAM by imitating the natural environment. Finally, the effect of different thermal‐resistant materials on asphalt pavement performance was evaluated. The results show that the addition of thermal‐resistant materials can reduce the thermal conductivity and the temperature of asphalt mixture. The cooling effect of CE75 and CE100 (coarse aggregate substituted by 75% and 100% CE, respectively) is superior to other aggregates. The temperature reduction rates of CE75 and CE100 reache 6.6°C and 6.8°C, respectively. For FB50 and FB75 (fine aggregate substituted with 50 and 75% FB, respectively), the cooling effect of them reaches 3.9°C and 4.5°C, respectively. In addition, the CE and FB can improve the antirutting performance of asphalt mixture by reducing the temperature inside the pavement. The high‐temperature performance of CE75 and FB75 is the best. With the increase of thermal resistance materials, the low‐temperature cracking resistance of asphalt mixture decreases gradually. The failure strain of mixture added with 100% thermal resistance materials is close to the lower limit of Chinese specification. The water stability of different TRAM changes with various test methods. Taking into account the results of pavement performance and the cooling effect, the substitution proportion of CE and FB for TRAM is proposed as 50%∼75%, respectively.
Multidrug-Resistant Bacteria Associated with Cell Phones of Healthcare Professionals in Selected Hospitals in Saudi Arabia
Authors: Banawas Saeed , Abdel-Hadi Ahmed , Alaidarous Mohammed , Alshehri Bader , Bin Dukhyil Abdul Aziz , Alsaweed Mohammed , Aboamer Mohamed
Published: December 2018

Cell phones may be an ideal habitat for colonization by bacterial pathogens, especially in hot climates, and may be a reservoir or vehicle in transmitting nosocomial infections. We investigated bacterial contamination on cell phones of healthcare workers in three hospitals in Saudi Arabia and determined antibacterial resistance of selected bacteria. A questionnaire was submitted to 285 healthcare workers in three hospitals, and information was collected on cell phone usage at the work area and in the toilet, cell phone cleaning and sharing, and awareness of cell phones being a source of infection. Screening on the Vitek 2 Compact system (bioMérieux Inc., USA) was done to characterize bacterial isolates. Of the 60 samples collected from three hospitals, 38 (63.3%) were positive with 38 bacterial isolates (4 Gram-negative and 34 Gram-positive bacteria). We found 38.3% of cell phones were contaminated with coagulase-negative staphylococci, particularly Staphylococcus epidermidis (10 isolates). Other bacterial agents identified were S. aureus, S. hominis, Alloiococcus otitis, Vibrio fluvialis, and Pseudomonas stutzeri. Antimicrobial susceptibility testing showed that most coagulase-negative staphylococci were resistant to benzylpenicillin, erythromycin, and rifampicin. Eight isolates were resistant to oxacillin, specifically S. epidermidis (3), S. hominis (2), and S. warneri (2). A. otitis, a cause of acute otitis media showed multidrug resistance. One isolate, a confirmed hetero-vancomycin intermediate-resistant S. aureus, was resistant to antibiotics, commonly used to treat skin infection. There was a significant correlation between the level of contamination and usage of cell phone at toilet and sharing. Our findings emphasize the importance of hygiene practices in cell phone usage among healthcare workers in preventing the transmission of multidrug-resistant microbes.
Phosphorus Flame Retardants for Polymeric Materials from Gallic Acid and Other Naturally Occurring Multihydroxybenzoic Acids
Authors: Howell Bob A. , Oberdorfer Kendahl L. , Ostrander Eric A.
Published: December 2018

The development of polymer and polymer additives from renewable biosources is becoming increasingly prominent. This reflects increasing concerns about sustainability, environmental quality, and human health. Bioproducts produced in nature are generally inexpensive and benign in the environment. Moreover, degradation of derivatives does not yield toxic products. Gallic acid (3,4,5-trihydroxybenzoic acid) is found widely in nature and has long been touted for its medicinal qualities. 3,5-Dihydroxybenzoic acid is also produced by several plants, most notably buckwheat. Both compounds, as the anilide and methyl ester, respectively, have been converted to a series of phosphorus esters, both phosphonate and phosphate. Esters have been fully characterized using spectroscopic and thermal methods. These compounds display good flame retardancy at low loadings in DGEBA epoxy resin.
Relationship of Circulating Fetuin-A Levels with Body Size and Metabolic Phenotypes
Authors: Chung Hye Soo , Lee Hyun Jung , Hwang Soon Young , Choi Ju-Hee , Yoo Hye Jin , Seo Ji A. , Kim Sin Gon , Kim Nan Hee , Choi Dong Seop , Baik Sei Hyun , Choi Kyung Mook
Published: December 2018

Background. Previous studies have suggested the existence of distinct body size subgroups according to metabolic health referred to as metabolically healthy obesity (MHO) and metabolically abnormal but normal weight (MANW) patients. Although nonalcoholic fatty liver disease (NAFLD) is strongly associated with obesity and metabolic syndrome, the relationship between these phenotypes and fetuin-A, a representative hepatokine, has not been explored. Methods. We examined the association between circulating fetuin-A levels, metabolic health phenotypes, cardiometabolic risk parameters, and subclinical atherosclerosis in 290 subjects who were randomly selected from an ongoing cohort study. Results. Fetuin-A concentrations were significantly associated with detrimental anthropometric and laboratory measurements, including increased waist circumference, blood pressure, alanine aminotransferase, fasting plasma glucose, and triglyceride levels. Furthermore, fetuin-A levels were significantly increased in the metabolically abnormal (MA) group compared to the metabolically healthy (MH) group in subjects without obesity (717.1 [632.1, 769.7] vs. 599.5 [502.0, 709.3], P=0.001) and subjects with obesity (704.1 [595.5-880.9] vs. 612.2 [547.9-802.1], P=0.016). In addition, brachial-ankle pulse wave velocity (baPWV), which reflects arterial stiffness, was higher in MA individuals compared to MH individuals. Multiple logistic regression analysis revealed that both individuals without obesity (P for trend = 0.017) and with obesity (P for trend = 0.028) in the higher tertiles of fetuin-A had an increased risk of MA than those in the lowest tertile. Conclusions. This study demonstrates that fetuin-A levels are significantly associated with metabolic health phenotypes, such as MHO and MANW, in Korean adults.
A Case of Parvovirus-Related Haemophagocytic Lymphohistiocytosis in a Patient with HbH Disease
Authors: Aravamudan Veeraraghavan Meyyur , Er Chaozer , Hussain Ikram , Cheong Nicholas wong wai , Chern Hao Chong , Kuthah Navin , En-Xian Tan Emily , Fan Bingwen Eugene
Published: December 2018

Hemophagocytic lymphohistiocytosis (HLH) is rare and life-threatening medical emergency. Parvovirus infection is rarely associated with HLH. We report a case of parvovirus-related HLH in a patient with alpha thalassaemia (HbH disease). The patient responded well to a course of dexamethasone without the need of etoposide. Based on our literature search, this is the first case of parvovirus related HLH in a patient with HbH disease in the medical literature.
Group Sparse Regression-Based Learning Model for Real-Time Depth-Based Human Action Prediction
Authors: Li Meng , Yan Liang , Wang Qianying
Published: December 2018

This paper addresses the problem of predicting human actions in depth videos. Due to the complex spatiotemporal structure of human actions, it is difficult to infer ongoing human actions before they are fully executed. To handle this challenging issue, we first propose two new depth-based features called pairwise relative joint orientations (PRJOs) and depth patch motion maps (DPMMs) to represent the relative movements between each pair of joints and human-object interactions, respectively. The two proposed depth-based features are suitable for recognizing and predicting human actions in real-time fashion. Then, we propose a regression-based learning approach with a group sparsity inducing regularizer to learn action predictor based on the combination of PRJOs and DPMMs for a sparse set of joints. Experimental results on benchmark datasets have demonstrated that our proposed approach significantly outperforms existing methods for real-time human action recognition and prediction from depth data.
Association between a Genetic Risk Score Based on Single Nucleotide Polymorphisms of Coronary Artery Disease-Related Genes and Left Main Coronary Artery Disease
Authors: Xu Zhengxi , Liu Hanning , Sun Cheng , Si Ke , Zhao Yan , Zheng Zhe
Published: December 2018

Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Left main coronary artery disease (LMCAD) is a severe phenotype of CAD and has a genetic component. Previous studies identified 3 inflammation-related single nucleotide polymorphisms (SNPs) contributing to the development of LMCAD. We integrated these SNPs into a genetic risk score for the prediction of LMCAD. We enrolled 1544 patients with CAD between 2007 and 2011. The individual associations of the 3 SNPs with LMCAD were assessed. We then calculated the genetic risk score for each patient and stratified patients into low-risk, intermediate-risk, and high-risk categories of genetic risk. In univariable logistic regression analysis, the odds of LMCAD for the high-risk group were 2.81 (95% confidence interval [CI]: 1.72-4.60; P = 0.02) times those of the low-risk group. After adjustment for CAD-related clinical variables, the high-risk group (adjusted OR: 2.78; 95% CI: 1.69-4.58; P = 0.02) had increased odds of LMCAD when compared with the low-risk group. Comparison of model c-statistics showed greater predictive value with regard to LMCAD for the genetic risk score model than the models including single SNPs.
Constitutive Changes in Circulating Follicular Helper T Cells and Their Subsets in Patients with Graves’ Disease
Authors: Liu Yan , Yuan Xinwang , Li Xiaofang , Cui Dawei , Xie Jue
Published: December 2018

Background. Follicular helper T (Tfh) cells are critical for high-affinity antibody generation and B cell maturation and differentiation, which play important roles in autoimmune diseases. Graves’ disease (GD) is one prototype of common organ-specific autoimmune thyroid diseases (AITD) characterized by autoreactive antibodies, suggesting a possible role for Tfh cells in the pathogenesis of GD. Our objective was to explore the role of circulating Tfh cell subsets and associated plasma cells (PCs) in patients with GD. Methods. Thirty-six patients with GD and 20 healthy controls (HC) were enrolled in this study. The frequencies of circulating Tfh cell subsets and PCs were determined by flow cytometry, and plasma cytokines, including interleukin- (IL-) 21, IL-4, IL-17A, and interferon- (IFN-) γ, were measured using an enzyme-linked immunosorbent assay (ELISA). The mRNA expression of transcription factors (Bcl-6, T-bet, GATA-3, and RORγt) in peripheral blood mononuclear cells (PBMCs) was evaluated by real-time quantitative PCR. Results. Compared with HC, the frequencies of circulating CD4+CXCR5+CD45RA−Tfh (cTfh) cells with ICOS and PD-1 expression, the Tfh2 subset (CXCR3−CCR6−Tfh) cells, and PCs (CD19+CD27highCD38high) were significantly increased in the GD patients, but the frequencies of Tfh1 (CXCR3+CCR6−Tfh) and Tfh17 (CXCR3−CCR6+Tfh) subset cells among CD4+T cells were significantly decreased in GD patients. The plasma concentrations of IL-21, IL-4, and IL-17A were elevated in GD patients. Additionally, a positive correlation was found between the frequency of PD-1+Tfh cells (Tfh2 or PCs) and plasma IL-21 concentration (or serum TPO-Ab levels). The mRNA levels of transcription factors (GATA-3 and RORγt) were significantly increased, but T-bet and Bcl-6 mRNA expression was not obviously varied in PBMCs from GD patients. Interestingly, Tfh cell subsets and PCs from GD patients were partly normalized by treatment. Conclusion. Circulating Tfh cell subsets and PCs might play an important role in the pathogenesis of GD, which are potential clues for GD patients’ interventions.
Pentavalent Antimonials Combined with Other Therapeutic Alternatives for the Treatment of Cutaneous and Mucocutaneous Leishmaniasis: A Systematic Review
Authors: Berbert Taisa Rocha Navasconi , Mello Tatiane França Perles de , Wolf Nassif Priscila , Mota Camila Alves , Silveira Aline Verzignassi , Duarte Giovana Chiqueto , Demarchi Izabel Galhardo , Aristides Sandra Mara Alessi , Lonardoni Maria Valdrinez Campana , Vieira Teixeira Jorge Juarez , Silveira Thaís Gomes Verziganassi
Published: December 2018

The first choice drugs for the treatment of cutaneous and mucocutaneous leishmaniasis are pentavalent antimonials, sodium stibogluconate, or meglumine antimoniate. However, the treatment with these drugs is expensive, can cause serious adverse effects, and is not always effective. The combination of two drugs by different routes or the combination of an alternative therapy with systemic therapy can increase the efficacy and decrease the collateral effects caused by the reference drugs. In this systematic review we investigated publications that described a combination of nonconventional treatment for cutaneous and mucocutaneous with pentavalent antimonials. A literature review was performed in the databases Web of Knowledge and PubMed in the period from01stof December 2004 to01stof June 2017, according to Prisma statement. Only clinical trials involving the treatment for cutaneous or mucocutaneous leishmaniasis, in English, and with available abstract were added. Other types of publications, such as reviews, case reports, comments to the editor, letters, interviews, guidelines, and errata, were excluded. Sixteen articles were selected and the pentavalent antimonials were administered in combination with pentoxifylline, granulocyte macrophage colony-stimulating factor, imiquimod, intralesional sodium stibogluconate, ketoconazole, silver-containing polyester dressing, lyophilized LEISH-F1 protein, cryotherapy, topical honey, and omeprazole. In general, the combined therapy resulted in high rates of clinical cure and when relapse or recurrence was reported, it was higher in the groups treated with pentavalent antimonials alone. The majority of the articles included in this review showed that cure rate ranged from 70 to 100% in patients treated with the combinations. Serious adverse effects were not observed in patients treated with drugs combination. The combination of other drugs or treatment modalities with pentavalent antimonials has proved to be effective for cutaneous and mucocutaneous leishmaniasis and for most seemed to be safe. However, new randomized, controlled, and multicentric clinical trials with more robust samples should be performed, especially the combination with immunomodulators.
High‐Temperature Low‐Cycle Fatigue Behaviour of MAR‐M247 Coated with Newly Developed Thermal and Environmental Barrier Coating
Authors: Šulák Ivo , Obrtlík Karel , Čelko Ladislav , Gejdoš Pavel , Jech David
Published: December 2018

This study investigates the strain‐controlled low‐cycle fatigue (LCF) behaviour of an untreated and surface‐treated MAR‐M247 superalloy in a symmetrical push‐pull cycle with a constant strain rate at 900°C in laboratory air. A newly developed experimental thermal and environmental barrier coating (TEBC) system, consisting of a 170 μm thick CoNiCrAlY bond coat (BC) and a bilayer ceramic top coat (TC), with an interlayer and an upper layer, was deposited using air plasma spray techniques. The ceramic interlayer with an average thickness of 77 μm was formed from agglomerated and sintered yttria‐stabilized zirconia. An experimental mixture of mullite (Al6Si2O13) and hexacelsian (BaAl2Si2O8) at a ratio of 70/30 vol.% was sprayed as the upper layer. The average thickness of the TC was 244 μm. The specimen sections were investigated using a TESCAN Lyra3 XMU scanning electron microscope (SEM) to characterise the microstructure of both the TEBC and the substrate material. The fatigue damage mechanisms in the TEBC‐coated superalloy were studied. The fatigue life curves in the representation of the total strain amplitude versus the number of cycles to failure of the TEBC‐coated and uncoated superalloy were assessed. TEBC was found to have a slight, positive effect on the fatigue life of MAR‐M247.
Efficacy and Safety of Different Maintenance Doses of Caffeine Citrate for Treatment of Apnea in Premature Infants: A Systematic Review and Meta-Analysis
Authors: Chen Jing , Jin Lu , Chen Xiao
Published: December 2018

Background. Caffeine is widely used for the treatment of neonatal apnea, but there is no agreement on the optimum maintenance dose for preterm infants. Objective. The aims of this meta-analysis were to compare the efficacy and safety of high versus low maintenance doses of caffeine citrate for the treatment of apnea in premature infants. Methods. Literature searches were conducted using PubMed, Cochrane Library, OVID, Embase, Web of Science, Chinese Biomedical Literature, Weipu Journal, Wanfang, and CNKI databases up to September 2018. Only randomized controlled trials (RCTs) of caffeine citrate for apnea treatment in premature infants were included. Trials were divided into those testing high maintenance doses (10−20 mg/kg daily) and low maintenance doses (5−10 mg/kg daily) for comparison. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Results. Among the 345 studies initially identified, thirteen RCTs involving 1515 patients were included. Compared to the low-dose group, the high-dose group exhibited greater effective treatment rate (RR: 1.37, 95%CI: 1.18 to 1.60, P<0.0001) and success rate for ventilator removal (RR: 1.74, 95%CI: 1.04 to 2.90, P=0.03), but higher incidence of tachycardia (RR: 2.02, 5%CI: 1.30 to 3.12, P=0.002). The high-dose group also demonstrated lower extubation failure rate (RR: 0.5, 95%CI: 0.35 to 0.71, P=0.0001), frequency of apnea (WMD: -1.55, 95%CI: -2.72 to -0.39, P=0.009), apnea duration (WMD: -4.85, 95%CI: -8.29 to -1.40, P=0.006), and incidence of bronchopulmonary dysplasia (RR: 0.79, 95%CI: 0.68 to 0.91, P=0.002). There were no significant group differences in other adverse events including in-hospital death (P>0.05). Conclusions. Higher maintenance doses of caffeine citrate appear more effective and safer than low maintenance doses for treatment of premature apnea, despite a higher incidence of tachycardia.
Longitudinal Change in Peripheral Anterior Chamber Depth of Eyes with Angle Closure after Laser Iridotomy
Authors: Furuya Toshie , Kashiwagi Kenji
Published: December 2018

Purpose. To investigate longitudinal changes in peripheral anterior chamber depth (pACD) of eyes with angle closure after laser iridotomy (LI) and factors related to prognosis. Design. Retrospective cohort study. Methods. Eyes with primary angle closure (PAC), acute PAC, or chronic angle closure glaucoma (CACG) that underwent LI (LI group) and eyes that underwent phacoemulsification and intraocular lens insertion (PEA + IOL group) were employed. Longitudinal changes in pACD were evaluated with a scanning peripheral anterior chamber depth analyzer (SPAC) in addition to routine ophthalmic examination. Results. Forty-eight eyes of LI groups (69.8 ± 8.5 years) and 21 eyes of PEA + IOL group (65.6 ± 12.7 years) were enrolled. Mean follow-up times of LI group and PEA + IOL group were 43.4 ± 12.7 months and 36.5 ± 2.5 months, respectively. LI significantly increased pACD as indicated by the SPAC grade change from 3.8 ± 1.1 to 4.6 ± 1.2 (p<0.001). However, SPAC grade was gradually reduced and reached the pre-LI level by the third year of follow up. PEA + IOL also significantly increased SPAC grade from 6.7 ± 1.6 to 8.7 ± 2.0 (p<0.001), but no time-related change was observed. Twenty-three cases of LI group presented with deterioration of glaucoma control. The type of angle closure, plateau iris configuration, peripheral anterior synechia, and glaucomatous visual field defects were significantly associated with prognosis of glaucoma after LI. Conclusions. Peripheral ACD is temporarily deepened by LI, but returns to the pre-LI level in approximately three years. The type of angle closure and some factors may be related to glaucoma prognosis after LI.
Prevalence of Anemia and Iron Deficiency among Palestinian Pregnant Women and Its Association with Pregnancy Outcome
Authors: Srour Mahmoud A. , Aqel Samah S. , Srour Khaled M. , Younis Khalid R. , Samarah Fekri
Published: December 2018

Background. Anemia is a public health problem especially among pregnant women. This study aimed to investigate the prevalence of anemia and iron deficiency among pregnant women and its association with pregnancy outcome in Hebron Governorate in southern Palestine.Methods. This is a cross-sectional study that included 300 pregnant women in their first trimester and 163 babies. Maternal anthropometric and socioeconomic and newborns’ data were collected. Complete blood count for study subjects and maternal serum ferritin were measured.Results. The prevalence of iron deficiency anemia among pregnant women was 25.7% and 52% of them had depleted iron stores. When pregnant women were grouped into three hemoglobin (Hb) tertile groups, a significant difference was observed between maternal Hb and newborns’ birth weight (P= 0.009), height (P= 0.022), head circumference (P= 0.017), and gestational age (P= 0.012). There was a significant association between maternal serum ferritin and frequency of low birth weight (P= 0.001) and frequency of preterm delivery (P= 0.003). No significant association was observed between maternal anthropometric measures or the socioeconomic status and pregnancy outcomes.Conclusion. Iron deficiency is a moderate public health problem among the study subjects. Maternal Hb and serum ferritin significantly affect pregnancy outcomes.
Genetic-Based Optimization of the Manufacturing Process of a Robotic Arm under Fuzziness
Authors: Zacharia Paraskevi T. , Tsirkas Sotirios A. , Kabouridis Georgios , Yiannopoulos Andreas Ch. , Giannopoulos Georgios I.
Published: December 2018

Fuzziness is a key concern in modern industry and, thus, its implementation in manufacturing process modeling is of high practical importance for a wide industrial audience. The scientific contribution of the present attempt lies on the fact that the assembly line balancing problem of type 2 (SALBP-2) is approached for a real manufacturing process by introducing fuzzy processing times. The main scope of this work is the solution of the SALBP-2, which is an NP-hard problem, for a real manufacturing process considering fuzziness in the processing times. Since the data obtained from realistic situations are imprecise and uncertain, the consideration of fuzziness for the solution of SALBP-2 is of great interest. Thus, real data values for the processing times are gathered and estimated with uncertainty. Then, fuzzy processing times are used for finding the optimum cycle time. The optimization tool for the solution of the fuzzy SALBP-2 is a Genetic Algorithm (GA). The validity of the proposed approach is tested on the construction process of a metallic robotic arm. The experimental results demonstrate the effectiveness and efficiency of the proposed GA in determining the optimum sequence of the tasks assigned to workstations which provides the optimum fuzzy cycle time.
Procalcitonin Value Is an Early Prognostic Factor Related to Mortality in Admission to Pediatric Intensive Care Unit
Authors: Aygun Fatih
Published: December 2018

Introduction. Procalcitonin (PCT) and C-reactive protein (CRP) are already known predictive markers in serious bacterial infections, and it is emphasized that these biomarkers can be used as a marker of increased mortality in critically ill patients. Herein, we aimed to evaluate the initial serum PCT and CRP levels on the outcome of patients in pediatric intensive care units (PICUs) and find out if these biomarkers can be used to predict mortality. Materials and Methods. The relationship between the initial serum PCT and CRP levels and invasive mechanical ventilation (IMV) and noninvasive mechanical ventilation (NIV) support, inotropic drug need, acute renal kidney injury (AKI), continuous renal replacement therapy (CRRT), mortality, and hospitalization period was investigated retrospectively. Results. In total, 418 suitable patients (226 males and 192 females) were included in the study. Age distributions of patients ranged from 1 month to 17 years. There was a statistically significant relationship between PCT levels in the first biochemical analysis performed during admission and MV support, inotropic drug use, mortality, ARF, hospitalization in the intensive care unit, CRRT and blood component transfusion. There was a statistically significant relationship between CRP levels and MV support, NIV, inotropic drug use, mortality, AKI, hospitalization in the intensive care unit, CRRT, and blood component transfusion. Conclusion. We suggest that the initial PCT and CRP levels during admission can be used to predict the outcome of patients in PICU.
An Efficient High-Throughput and Low-Latency SYN Flood Defender for High-Speed Networks
Authors: Ngo Duc-Minh , Pham-Quoc Cuong , Ngoc Thinh Tran
Published: December 2018

As one of the main types of Distributed Denial of Service (DDoS) attacks, SYN flood attacks have caused serious issues for servers when legitimate clients may be denied connections. There is an essential demand for a sufficient approach to mitigate SYN flood attacks. In this paper, we introduce an efficient high-throughput and low-latency SYN flood defender architecture, carefully designed with a pipeline model. A mathematical model is also introduced with the architecture for estimating SYN flood protection throughput and latency. The first prototype version based on the architecture with Verilog-HDL can function as standalone to alleviate high-rate SYN flood attacks and can be integrated into an OpenFlow switch for handling network packets. Our experiments with NetFPGA-10G platforms show that the core can protect servers against SYN flood attacks by up to 28+ millions packets per second that outperforms most well-known hardware-based approaches in the literature.
Intensive Blood Pressure Treatment for Resistant Hypertension
Authors: Tsujimoto Tetsuro , Kajio Hiroshi
Published: December 2018

Evidence about the target blood pressure (BP) in patients with resistant hypertension is limited. The present study aimed to assess the efficacy of intensive BP treatment (systolic BP target, <120 mm Hg) versus standard BP treatment (systolic BP target, <140 mm Hg) in patients with resistant hypertension. This is a secondary analysis using data from SPRINT (Systolic Blood Pressure Intervention Trial). This study included 1397 patients with resistant hypertension and 7698 without resistant hypertension. Using the Cox proportional hazards model, we compared time to first occurrence of a major adverse cardiovascular event (cardiovascular death, myocardial infarction, and stroke) between the intensive and standard BP treatment groups. Mean follow-up was 3.1 years; major adverse cardiovascular events was confirmed in 381 patients. Risk of major adverse cardiovascular events was significantly lower in the intensive treatment group than in the standard treatment group (hazard ratio, 0.62; 95% CI, 0.40–0.96;
P
=0.03). Risks of all-cause and cardiovascular death in patients with resistant hypertension were also significantly lower in the intensive treatment group than in the standard treatment group (hazard ratio for all-cause death: 0.60; 95% CI, 0.38–0.97;
P
=0.03; hazard ratio for cardiovascular death: 0.34; 95% CI, 0.15–0.81;
P
=0.01). Similar associations were observed in various subgroups. Intensive BP treatment was significantly associated with a decreased risk of major adverse cardiovascular events in patients with resistant hypertension.
Utility of Different Blood Pressure Measurement Components in Childhood to Predict Adult Carotid Intima-Media Thickness
Authors: Koskinen Juha , Juonala Markus , Dwyer Terence , Venn Alison , Petkeviciene Janina , Čeponienė Indrė , Bazzano Lydia , Chen Wei , Sabin Matthew A. , Burns Trudy L. , Viikari Jorma S.A. , Woo Jessica G. , Urbina Elaine M. , Prineas Ronald , Hutri-Kähönen Nina , Sinaiko Alan , Jacobs David R. , Steinberger Julia , Daniels Stephen , Raitakari Olli , Magnussen Costan G.
Published: December 2018

Childhood blood pressure (BP) levels predict adult subclinical atherosclerosis. However, the best childhood BP component for prediction has not been determined. This study comprised 5925 participants aged 3 to 18 years from 6 cohorts who were followed into adulthood (mean follow-up 25.8±6.2 years). Childhood BP was measured by using a standard mercury sphygmomanometer in all cohorts. Study-specific carotid intima-media thickness ≥90th percentile was used to define subclinical atherosclerosis. Per SD change in the predictor, childhood systolic BP (SBP; age- and sex-adjusted odds ratio [95% CI], 1.24 [1.13–1.37]), mean arterial pressure (1.10 [1.07–1.13]), and pulse pressure (1.15 [1.05–1.27]) were associated with increased adulthood intima-media thickness. In age- and sex-adjusted analyses, area under the receiver operating characteristic curves for SBP (
C
value [95% CI], 0.677 [0.657–0.704]) showed significantly improved prediction compared with diastolic BP (0.669 [0.646–0.693],
P
=0.006) or mean arterial pressure (0.674 [0.653–0.699],
P
=0.01). Pulse pressure provided a
C
value that was not different from SBP (0.676 [0.653–0.699],
P
=0.16). Combining different BP components did not improve prediction over SBP measurement alone. Based on the associations with adult carotid intima-media thickness, cut points for elevated SBP were 105 mm Hg for 3- to 6-year-old boys, 108 mm Hg for 3- to 6-year-old girls, 108 mm Hg for 7- to 12-year-old boys, 106 mm Hg for 7- to 12-year-old girls, 123 mm Hg for 13- to 18-year-old boys, and 115 mm Hg for 13- to 18-year-old girls. Our analyses suggest that several childhood BP measurement components are related to adulthood carotid intima-media thickness. Of these, SBP provided the best predictive ability.
Diffusion-Weighted Imaging Hyperintensities in Subtypes of Acute Intracerebral Hemorrhage
Authors: Boulanger Marion , Schneckenburger Romain , Join-Lambert Claire , Werring David J. , Wilson Duncan , Hodel Jérome , Zuber Mathieu , Touzé Emmanuel
Published: December 2018

Background and Purpose—

Diffusion-weighted imaging (DWI) hyperintensities in intracerebral hemorrhage (ICH) are associated with increased risk of recurrent ICH, cognitive impairment, and death, but whether these lesions are specific to a subtype of ICH remains uncertain. We investigated the association between DWI lesions and ICH subtype and explored the risk factors for DWI lesions.

Methods—

In a systematic review of ICH studies, we identified those reporting prevalence of DWI lesions. Two reviewers independently assessed study eligibility and risk of bias and collected data. We determined the pooled prevalence of DWI lesions within 90 days after ICH onset for cerebral amyloid angiopathy- and hypertensive angiopathy-related ICH using random-effects meta-analysis. We calculated odds ratios to compare prevalence of DWI lesions by ICH subtype and to assess risk factors for DWI lesions.

Results—

Eleven studies (1910 patients) were included. The pooled prevalence of DWI lesions was 18.9% (95% CI, 11.1–26.7) in cerebral amyloid angiopathy- and 21.0% (95% CI, 15.3–26.6) in hypertensive angiopathy-related ICH. There was no difference in the prevalence of DWI lesions between cerebral amyloid angiopathy- (64/292 [21.9%]) and hypertensive angiopathy-related ICH (79/370 [21.4%]; odds ratio, 1.25; 95% CI, 0.73–2.15) in the 5 studies reporting data on both ICH pathogeneses. In all ICH, presence of DWI lesions was associated with neuroimaging features of microangiopathy (leukoaraiosis extension, previous ICH, and presence, and number of microbleeds) but not with vascular risk factors or the use of antithrombotic therapies.

Conclusions—

Prevalence of DWI lesions in acute ICH averages 20%, with no difference between cerebral amyloid angiopathy- and hypertensive angiopathy-related ICH. Detection of DWI lesions may add valuable information to assess the progression of the underlying microangiopathy.
Change in Cardiorespiratory Fitness and Risk of Stroke and Death
Authors: Prestgaard Erik , Mariampillai Julian , Engeseth Kristian , Erikssen Jan , Bodegård Johan , Liestøl Knut , Gjesdal Knut , Kjeldsen Sverre , Grundvold Irene , Berge Eivind
Published: December 2018

Background and Purpose—

Low cardiorespiratory fitness is associated with increased risk of cardiovascular disease. The present study aims to assess whether change of fitness over time has any impact on long-term risk of stroke and death.

Methods—

We recruited healthy men aged 40 to 59 years in 1972 to 1975, and followed them until 2007. Physical fitness was assessed with a bicycle ECG test at baseline and again at 7 years, by dividing the total exercise work by body weight. Participants were categorized as remained fit, became unfit, remained unfit, or became fit, depending on whether fitness remained or crossed the median values from baseline to the 7-year visit. Outcome data were collected up to 35 years, from study visits, hospital records, and the National Cause of Death Registry. Risks of stroke and death were estimated by Cox regression analyses and expressed as hazard ratios (HRs) with 95% CIs.

Results—

Of 2014 participants, 1403 were assessed both at baseline and again at 7 years, and were followed for a mean of 23.6 years. Compared with the became unfit group, risk of stroke was 0.85 (0.54–1.36) for the remained unfit, 0.43 (0.28–0.67) for the remained fit, and 0.34 (0.17–0.67) for the became fit group. For all-cause death, risks were 0.99 (0.76–1.29), 0.57 (0.45–0.74), and 0.65 (0.46–0.90), respectively. Among those with high fitness at baseline, the became unfit group had a significantly higher risk of stroke (HR, 2.35; CI, 1.49–3.63) and death (HR, 1.74; CI, 1.35–2.23) than those who remained fit. Among those who had low fitness at baseline, the became fit group had a significantly lower risk of stroke (HR, 0.40; CI, 0.21–0.72) and death (HR, 0.66; CI, 0.50–0.85) than participants in the remained unfit group.

Conclusions—

Cardiorespiratory fitness at baseline and change in fitness was associated with large changes in long-term risk of stroke and death. These findings support the encouragement of regular exercise as a stroke prevention strategy.
Loss of Ribosomal RACK1 (Receptor for Activated Protein Kinase C 1) Induced by Phosphorylation at T50 Alleviates Cerebral Ischemia-Reperfusion Injury in Rats
Authors: Li Xiang , Li Jinquan , Qian Jinhong , Zhang Dongping , Shen Haitao , Li Xiang , Li Haiying , Chen Gang
Published: December 2018

Background and Purpose—

RACK1 (receptor for activated protein kinase C 1) is an integral component of ribosomes with neuroprotective functions. The goal of this study was to determine the role of RACK1 in cerebral ischemia-reperfusion (I/R) injury and the underlying mechanisms.

Methods—

A middle cerebral artery occlusion/reperfusion model in adult male Sprague Dawley rats (250–280 g) was established, and cultured neurons were exposed to oxygen-glucose deprivation/reoxygenation to mimic I/R injury in vitro. Expression vectors encoding wild-type RACK1 and RACK1 with T50A mutation (T50A) were constructed and administered to rats by intracerebroventricular injection.

Results—

The potential role of RACK1 in cerebral I/R injury was confirmed by the decreased protein levels of RACK1 within penumbra tissue, especially of neurons. Second, there was an increase in the phosphorylation ratio of RACK1 at the threonine/serine residues at 1.5 hours after middle cerebral artery occlusion onset. Third, based on site-specific mutagenesis, we identified T50 as a key site for RACK1 phosphorylation during I/R. Fourth, wild-type RACK1 overexpression reduced infarct size, neuronal death, neuronal tissue loss, and neurobehavioral dysfunction, while RACK1 (T50A) overexpression exerted opposite effects. Finally, we found that RACK1 phosphorylation at T50 induced a loss of ribosomal RACK1, which switched RACK1 from beclin-1 translation inhibition to autophagy induction following I/R.

Conclusions—

RACK1 phosphorylation may be a potential intervention target for neurons during I/R; thus, exogenous supplementation of RACK1 may be a novel approach for ameliorating I/R injury.