bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of the Physical Training on Muscle Function and Walking Distance in Symptomatic Peripheral Arterial Disease in Elderly
Authors: Kropielnicka Katarzyna , Dziubek Wioletta , Bulińska Katarzyna , Stefańska Małgorzata , Wojcieszczyk-Latos Joanna , Jasiński Ryszard , Pilch Urszula , Dąbrowska Grażyna , Skórkowska-Telichowska Katarzyna , Kałka Dariusz , Janus Agnieszka , Zywar Katarzyna , Paszkowski Rafał , Rachwalik Anna , Woźniewski Marek , Szuba Andrzej
Published: September 2018

Introduction. A typical symptom of chronic lower-limb ischaemia is lower-limb pain, which occurs during walking forcing the patient to stop, intermittent claudication (IC). Exercise rehabilitation is the basic form of treatment for these patients. Aim. The aim of this study was to compare the effectiveness of three types of physical training programmes conducted over a 12-week period in patients with chronic lower-limb arterial insufficiency. Materials and Methods. Ninety-five people qualified for the 3-month supervised motor rehabilitation programme, conducted three times a week. The respondents were assigned to three types of rehabilitation programmes using a pseudo-randomization method: Group I (TW), subjects undertaking treadmill walking training; Group II (NW), subjects undertaking Nordic walking training; Group III (RES+NW), subjects undertaking resistance and Nordic walking training. Treadmill test, 6 Minute Walk Test (6MWT), and isokinetic test were repeated after 3 months of rehabilitation, which 80 people completed. Results. Combined training (RES+NW) is more effective than Nordic walking alone and supervised treadmill training alone for improving ankle force-velocity parameters (p<0.05) in patients with intermittent claudication. Each of the proposed exercise rehabilitation programmes increased walking distance of patients with intermittent claudication (p<0.05), especially in 6MWT (p=0.001). Significant relationships of force-velocity parameters are observed in the maximum distance obtained in 6MWT, both in Group III (RES + NW) and in Group II (NW) at the level of moderate and strong correlation strength, which indicates that if the lower limbs are stronger the walking distance achieved in 6MWT is longer. Conclusions. Given both the force-velocity parameters and the covered distance, the training RES + NW gives the most beneficial changes compared to training TW alone and NW alone. All types of training increased walking distance, which is an important aspect of the everyday functioning of people with IC.
Early Changes in Visual Quality and Corneal Structure after DMEK: Does DMEK Approach Optical Quality of a Healthy Cornea?
Authors: Satue Maria , Idoipe Miriam , Gavin Alicia , Romero-Sanz Maria , Liarakos Vasilios S. , Mateo Antonio , Garcia-Martin Elena , Blasco-Martinez Alejandro , Sanchez-Perez Antonio
Published: September 2018

Purpose. To evaluate early changes in visual function and visual quality parameters after Descemet membrane endothelial keratoplasty (DMEK) and to compare the outcomes with healthy controls. Methods. Thirteen patients who underwent DMEK and 14 controls were evaluated. All subjects underwent visual function evaluation, including visual acuity under photopic and mesopic lighting conditions and contrast sensitivity (CSV) tests CSV 1000 and Pelli-Robson. Corneal parameters were assessed with Oculus Pentacam. Corneal mean keratometry (Km), corneal densitometry values, and low and high order aberrations (LOA and HOA) were recorded. In DMEK patients, all tests were performed before surgery and 1 and 6 months after surgery. Results. In patients who underwent DMEK, photopic visual acuity improved from 0.59 to 0.31 at 1 month (p=0.013) and 0.13 at 6 months (p=0.008); mesopic visual acuity and all contrast sensitivity values (both CSV and Pelli-Robson test) improved significantly in the first month (p<0.005). A significant decrease was observed in corneal density in the 0–2 mm ring (from 43.83 to 35.60, p=0.043) and mean posterior Km (from −5.84 to −6.80, p=0.005) in the first month. Corneal HOAs and all corneal densities improved at 6 months after DMEK (p<0.05). All visual function parameters and corneal aberrations remained lower and higher, respectively, compared with healthy controls (p<0.05). Corneal densities were comparable with controls at 6 months after DMEK (p>0.05). Conclusions. Patients undergoing DMEK present visual function improvement and a decrease in corneal density at 1 month after surgery. Decrease in corneal posterior HOAs can be observed at 6 months. However, visual function outcomes and corneal aberrations remained worse compared with healthy controls.
Chronic Myeloid Leukemia Relapsing 25 Years after Allogenic Stem Cell Transplantation
Authors: Reikvam Håkon , Skavland Jørn , Gullaksen Stein-Erik , Hovland Randi , Gedde-Dahl Tobias , Bruserud Øystein , Gjertsen Bjørn Tore
Published: September 2018

Chronic myeloid leukemia (CML) is a myeloproliferative disorder in which neoplastic cells exhibit the Philadelphia chromosome and the related oncoproteinBCR-ABL1. Allogeneic stem cell transplantation (allo-SCT) was considered the first-line treatment for CML, before the introduction of tyrosine kinase inhibitors (TKIs). However, patients are at risk for relapse years after transplantation. We present a patient who relapsed 25 years after allo-SCT for chronic phase CML. Polymerase chain reaction (PCR) detected gradually evaluated levels ofBCR-ABL1transcripts, eventually leading to the diagnosis of relapsed disease. Additional mutational analyses did not reveal mutations in theBCR-ABL1gene, or other cooperating mutations. The patient was successfully treated with imatinib 400 mg daily, leading to new molecular remission. The case presentation emphasizes the need for long-term follow-up of such patients and the potential benefit of initiating TKI treatment with early signs of relapse.
Experimental Study of Influence of Support Failures on Rockbursts under True‐Triaxial Condition
Authors: Su Guoshao , Li Tianbin , Jiang Jianqing , Chen Guoqing , Mo Jinghai
Published: September 2018

Supports can effectively reinforce the surrounding rock after excavation in underground engineering. However, a support failure may cause an extremely intense rockburst. Hence, the influences of support failures, including support forces, support failure timings, and support failure rates, on rockbursts were systematically investigated in the present study. Unloading tests on rock specimens, using a true‐triaxial rockburst test system, were performed to simulate rockbursts induced by support failure. The experimental results indicate that increasing support forces increased the prepeak accumulated elastic strain energy, the kinetic energy of the ejection fragment, and the ratio between the kinetic energy and release strain energy, whereas the damage to the rock specimens declined. During the testing process, the longer it took to unload the minimum stresses was, which means that the later the support failed, the greater the prepeak accumulated elastic strain energy was, the kinetic energies of the ejection fragments were, and the ratio of the kinetic energy and release strain energy was. Furthermore, as the support failure rate incremented, the kinetic energies of the ejection fragments of the rockbursts linearly increased, the failure mode of the rock changed from static failure to dynamic rockbursts, and the intensities of the rockbursts increased.
One‐Step Synthesis of Conductive BNC/PPy·CuCl2 Hybrid Flexible Nanocomposites by In Situ Polymerization
Authors: Müller Daliana , Wesling Bruno N. , Dias Gabriella M.V. , Bernardes Joseane C. , Porto Luismar M. , Rambo Carlos R. , Hotza Dachamir
Published: September 2018

This work reports the one‐step synthesis of bacterial nanocellulose (BNC) incorporated with polypyrrole (PPy) by chemical in situ polymerization of pyrrole (Py) using CuCl2·2H2O as both oxidant agent and functional component, varying the concentration and molar ratio. Electrical, morphological, and physical‐chemical properties of these nanocomposites were investigated. The results revealed that with the increase of Py concentration and molar ratio, the nanocomposites presented traces of copper chloride and copper oxide as shown by Raman and XRD analysis. The quality of bacterial cellulose nanofibers coating by the polymer and the electrical conductivity of the nanocomposites was directly affected by those variables. The combination of the conducting polymer with the oxidant agent offers possibilities for different applications such as electronic devices and sensors.
An Evaluation of Rapidly Progressive Dementia Culminating in a Diagnosis of Creutzfeldt–Jakob Disease
Authors: Parmar Parmvir , Cooper Curtis L. , Kobewka Daniel
Published: September 2018

Rapidly progressive dementia is a curious and elusive clinical description of a pattern of cognitive deficits that progresses faster than typical dementia syndromes. The differential diagnosis and clinical workup for rapidly progressive dementia are quite extensive and involve searching for infectious, inflammatory, autoimmune, neoplastic, metabolic, and neurodegenerative causes. We present the case of a previously highly functional 76-year-old individual who presented with a 6-month history of rapidly progressive dementia. His most prominent symptoms were cognitive impairment, aphasia, visual hallucinations, and ataxia. Following an extensive battery of tests in hospital, the differential diagnosis remained probable CJD versus autoimmune encephalitis. He clinically deteriorated and progressed to akinetic mutism and myoclonus. He passed away 8 weeks after his initial presentation to hospital, and an autopsy confirmed a diagnosis of sporadic CJD. We use this illustrative case as a framework to discuss the clinical and diagnostic considerations in the workup for rapidly progressive dementia. We also discuss CJD and autoimmune encephalitis, the two main diagnostic possibilities in our patient, in more detail.
The Fate of Allogeneic Pancreatic Islets following Intraportal Transplantation: Challenges and Solutions
Authors: Li Xinyu , Meng Qiang , Zhang Lei
Published: September 2018

Pancreatic islet transplantation as a therapeutic option for type 1 diabetes mellitus is gaining widespread attention because this approach can restore physiological insulin secretion, minimize the risk of hypoglycemic unawareness, and reduce the risk of death due to severe hypoglycemia. However, there are many obstacles contributing to the early mass loss of the islets and progressive islet loss in the late stages of clinical islet transplantation, including hypoxia injury, instant blood-mediated inflammatory reactions, inflammatory cytokines, immune rejection, metabolic exhaustion, and immunosuppression-related toxicity that is detrimental to the islet allograft. Here, we discuss the fate of intrahepatic islets infused through the portal vein and propose potential interventions to promote islet allograft survival and improve long-term graft function.
Effects of a Novel Formulation on Oral Biofilm, pH Buffering, and Gingival Health in Patients with Dry Mouth
Authors: Takesh Thair , Ho Jessica , Firmalino Miracle Vania , Islip Delaney , Anbarani Afarin , Wilder-Smith Petra
Published: September 2018

Goal. To identify in patients with dry mouth the effects of a novel test agent (Oral Essentials Hydrating Formula Mouthwash, Beverly Hills, CA) versus a control agent (Biotène Dry Mouth Oral Rinse, GlaxoSmithKline Consumer Healthcare L.P., Moon Township, PA, USA) versus no treatment on dry mouth, plaque, salivary pH and buffering capacity, gingival health, and tooth sensitivity. Materials and Methods. In this cross-over study, ten subjects with dry mouth used test and control dry mouth interventions, as well as no dry mouth intervention in randomized sequence. Plaque Index, Gingival Index, Sulcus Bleeding Index, Plaque staining, and photographs were recorded at baseline and end of each study arm. Salivary volume, pH, and buffering capacity were also recorded at these time points. Additionally, subjects completed a questionnaire for dry mouth and dentinal sensitivity at each visit. Results. Reductions in plaque presence and clinical indices were similar after use of test or control products (p<0.05). Saliva volume and pH buffering improved significantly after use of test and control products (p<0.05). Conclusions. The effects of a novel dry mouth intervention are similar to those of an existing OTC remedy and are significantly better than no intervention.
Serum Metabolomics Analysis of Asthma in Different Inflammatory Phenotypes: A Cross-Sectional Study in Northeast China
Authors: Pang Zhiqiang , Wang Guoqiang , Wang Cuizhu , Zhang Weijie , Liu Jinping , Wang Fang
Published: September 2018

Background and Objective. Asthma as a chronic heterogeneous disease seriously affects the quality of life. Incorrect identification for its clinical phenotypes lead to a huge waste of medical resources. Metabolomic technique as a novel approach to explore the pathogenesis of diseases have not been used to study asthma based on their clear defined inflammatory phenotypes. This study is aimed to distinguish the divergent metabolic profile in different asthma phenotypes and clarify the pathogenesis of them.Methods. Participants including eosinophilic asthmatics (EA, n=13), noneosinophilic asthmatics (NEA, n=16), and healthy controls (HC, n=15) were enrolled. A global profile of untargeted serum metabolomics was identified with Ultra Performance Liquid Chromatography–Mass Spectrometry technique.Results. Multivariate analysis was performed and showed a clear distinction between EA, NEA, and HC. A total of 18 different metabolites were recognized between the three groups based on OPLS-DA model and involved in 10 perturbed metabolic pathways. Glycerophospholipid metabolism, retinol metabolism, and sphingolipid metabolism were identified as the most significant changed three pathways (impact > 0.1 and -log(P) > 4) between the phenotypes.Conclusions. We showed that the different inflammatory phenotypes of asthma involve the immune regulation, energy, and nutrients metabolism. The clarified metabolic profile contributes to understanding the pathophysiology of asthma phenotypes and optimizing the therapeutic strategy against asthma heterogeneity.
Psoriasis and Respiratory Comorbidities: The Added Value of Fraction of Exhaled Nitric Oxide as a New Method to Detect, Evaluate, and Monitor Psoriatic Systemic Involvement and Therapeutic Efficacy
Authors: Santus Pierachille , Rizzi Maurizio , Radovanovic Dejan , Airoldi Andrea , Cristiano Andrea , Conic Rosalynn , Petrou Stephen , Pigatto Paolo Daniele Maria , Bragazzi Nicola , Colombo Delia , Goldust Mohamad , Damiani Giovanni
Published: September 2018

Psoriasis is a chronic inflammatory systemic disease characterized by a wide range of comorbidities. Respiratory comorbidities are currently poorly characterized and with discordant results. The systemic state of inflammation caused by psoriasis acts de novo on respiratory tissues and amplifies preexisting inflammation from asthma or chronic obstructive pulmonary disease. Because the lungs act as a gas exchanger between the internal and external environment, the impact of chronic psoriasis inflammation may be easily assessed through the analysis of exhaled breath. The fraction of exhaled nitric oxide test (FeNO) is a potential noninvasive solution that can provide quantitative and qualitative indices of respiratory airway inflammation. FeNO is routinely used to screen and manage asthmatic patients. Recent pilot studies contain encouraging data that underscore its possible use with systemic inflammatory nonpulmonary diseases, such as psoriasis. FeNO may therefore be a useful tool to evaluate underestimated airway inflammation and at the same time globally evaluate the impact of systemically antipsoriatic therapies.
Formation of Surface Ultrafine Grain Structure and Their Physical and Mechanical Characteristics Using Vibration‐Centrifugal Hardening
Authors: Kyryliv Volodymyr , Kyryliv Yaroslav , Sas Nataliya
Published: September 2018

The vibration‐centrifugal hardening forms a gradient ultrafine grain structure of the ferritic class with a grain size of 190 nm and a surface microhardness of 8.9 GPa and a depth of up to 6 mm on the surface of 40 Kh steel of the ferritic‐pearlitic structure. These parameters are formed due to an increase in the mass of the tool that acts on the processed surface through the balls and depend on the treatment modes. This surface ultrafine grain structure increases the wear resistance properties of steel in oil and oil‐abrasive environment and improves the electrochemical characteristics.
Detection of Adulteration in Canola Oil by Using GC-IMS and Chemometric Analysis
Authors: Chen Tong , Chen Xinyu , Lu Daoli , Chen Bin
Published: September 2018

The aim of the present study was to detect adulteration of canola oil with other vegetable oils such as sunflower, soybean, and peanut oils and to build models for predicting the content of adulterant oil in canola oil. In this work, 147 adulterated samples were detected by gas chromatography-ion mobility spectrometry (GC-IMS) and chemometric analysis, and two methods of feature extraction, histogram of oriented gradient (HOG) and multiway principal component analysis (MPCA), were combined to pretreat the data set. The results evaluated by canonical discriminant analysis (CDA) algorithm indicated that the HOG-MPCA-CDA model was feasible to discriminate the canola oil adulterated with other oils and to precisely classify different levels of each adulterant oil. Partial least square analysis (PLS) was used to build prediction models for adulterant oil level in canola oil. The model built by PLS was proven to be effective and precise for predicting adulteration with good regression (R2>0.95) and low errors (RMSE ≤ 3.23).
Challenges and Complication Management in Novel Artificial Iris Implantation
Authors: Mayer Christian S. , Laubichler Andrea E. , Khoramnia Ramin , Tandogan Tamer , Prahs Philipp , Zapp Daniel , Reznicek Lukas
Published: September 2018

Purpose. Evaluation of postoperative artificial iris prosthesis-related complications. Design. Retrospective cohort study. Methods. Fifty-one consecutive patients underwent pupillary reconstruction using an artificial iris implant made from silicone between 2011 and 2015. Quantity and quality of complications were subclassified into three groups including mild, moderate, and severe complications. Their management and the learning curve were evaluated. Results. In total, 13 (25.5%) of 51 included artificial iris implantations showed unexpected events in various degrees: mild complications: recurrent bleeding (n=1, 2.0%), slight but stable iris deviation (n=1, 2.0%), capsular fibrosis (n=2, 3.9%); moderate complications: suture cutting through the residual iris (n=1, 2.0%), glaucoma (n=3, 5.9%), and corneal decompensation (n=3, 5.9%); severe complications: artificial iris suture loosening (n=2, 3.9%) and dislocation (n=3, 5.9%), synechiae (n=2, 3.9%), glaucoma (n=2, 3.9%), and corneal decompensation (n=5, 9.8%) with the need for surgery, cystoid macular edema (n=3, 5.9%) and retinal detachment (n=1, 2.0%). The complication rate decreased from 83.3% (5 of 6 implantations) in the first year to 13.3% (2 of 15 implantations) in the 4th year. Nineteen of 45 evaluated patients showed a significant gain in best-corrected visual acuity (BCVA) from 1.09 ± 0.56 logMAR to 0.54 ± 0.48 logMAR (p<0.001), and 13 of 45 eyes had a significant BCVA loss from 0.48 ± 0.39 logMAR to 0.93 ± 0.41 logMAR after surgery (p<0.001). Conclusions. The artificial iris is a feasible option in the treatment of iris defects with a wide spectrum of postoperative complications. The significant reduction of complications after twelve implantations implicates that the procedure is not to be recommended in low volume settings.
Analysis of Treatment and Prognosis of 863 Patients with Spinal Tuberculosis in Guizhou Province
Authors: Cao Guangru , Rao JingCheng , Cai Yuqiang , Wang Chong , Liao Wenbo , Chen Taiyong , Qin Jianpu , Yuan Hao , Wang Peng
Published: September 2018

The objective of this study was to investigate the treatment and prognosis of patients with spinal tuberculosis in Guizhou province. A total of 863 patients with spinal tuberculosis admitted to our hospital from 2006 to 2017 were included in this study. All patients underwent standardized quadruple antituberculosis treatment. Eighty patients were lost to follow-up due to a change of their contact information or noncompliance. A total of 783 patients completed the follow-up. The average follow-up period was 20.33 ± 8.77 months (range: 6 to 38 months). Among these patients, 145 patients underwent conservative treatment, while 638 patients underwent surgical treatment. All patients in the surgery group were treated with lesion removal, bone graft fusion, and internal fixation. Preoperative and postoperative standard quadruple antituberculosis treatment was administered. The clinical efficacy was evaluated according to erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), visual analogue scale (VAS), Cobb angle correction, neurological functional recovery, and interbody fusion with bone graft and tuberculosis outcome. A total of 608 patients achieved clinical cure. The symptoms, physical signs, blood tests and imaging findings were improved in 143 patients. Twenty patients showed refractory clinical symptoms, and 12 patients had local tuberculosis recurrence. Conservative and surgical treatments are the mainstream treatments for spinal tuberculosis. According to the patients’ individual conditions, individualized treatments should be used to achieve good efficacy. Standardized antituberculosis treatment should be applied over the course of spinal tuberculosis.
Experimental and Theoretical Study of a New Technique for Mixing Self‐Compacting Concrete with Marble Sludge Grout
Authors: Alyousef Rayed , Khadimallah Mohamed Amine , Soussi Chokri , Benjeddou Omrane , Jedidi Malek
Published: September 2018

Currently, marble waste is valued by incorporating powders, obtained by drying and grinding sludge resulting from marble blocks cutting operation, or the aggregates, obtained by crushing the solid waste, on self‐compacting concrete. These two procedures require a lot of energy. This experimental and theoretical work focuses on the direct incorporation of marble sludge in self‐compacting concrete. The first part needs the study of the rheological behavior of the marble sludge grout (MSG) as a function of the added water amount. For this, different grouts were prepared and tested by varying the water/sludge ratio. In the second part, four self‐compacting concretes (SCCs) were mixed with MSG having different water/sludge ratios in order to validate a new technique of gassing self‐compacting concrete with MSG. The test results show that the marble grains of grout is totally dispersed when the water/sludge ratio was equal to 1.2. The results also show that the gassing with MSG allows us to obtain SCC having both self‐compacting property and self‐leveling property compared to SCC made by adding marble filler to the cementitious matrix.
Experimental and Numerical Study on the Behavior of Energy Piles Subjected to Thermal Cycles
Authors: Fei Kang , Dai Di
Published: September 2018

A laboratory‐scale model test is conducted to improve the understanding of the effects of thermal cycles on the mechanical behavior of energy piles. The model pile is composed of cement mortar and dry sand with a relative density of 30% is used for the model ground. After applying the working load to the pile head, the pile is subjected to three thermal cycles with a magnitude of 15°C. The measured temperature response and mechanical behavior are analyzed and used to validate the proposed numerical approach. In the numerical analysis, the temperature variation due to thermal cycles is calculated using uncoupled heat transfer analysis. Then, the computed temperature field is used as the boundary condition in the sequence stress analysis. A series of numerical sensitivity analyses are carried out using the sequentially coupled method to investigate the long‐term performance of energy piles under different soil and pile head restraint conditions. The numerical results suggest that the restraint condition at the pile head plays an important role in the mechanical response of energy piles. The ultimate pile resistance after thermal cycles does not decrease significantly. The accumulation of settlement of the free head pile and the reduction in the axial force of the restrained head pile should be considered in the design.
Consensus Control of Second-Order Multiagent Systems with Particle Swarm Optimization Algorithm
Authors: Deng Xiongfeng , Sun Xiuxia , Liu Ri , Liu Shuguang
Published: September 2018

This paper considers the consensus problem of second-order multiagent systems. Firstly, an improved consensus control protocol is proposed. Then, the convergence of the proposed control protocol is analyzed by applying Lyapunov stability theory. In order to improve the control effect of a given system, the particle swarm optimization (PSO) algorithm is introduced and an improved PSO algorithm is proposed. Additionally, a mapping relationship with agents and the individuals of PSO algorithm is designed. Finally, two simulation examples are provided to illustrate the effectiveness of proposed control protocol and the control effect of PSO algorithm.
Outcome in Patients with Isolated Moderate to Severe Traumatic Brain Injury
Authors: Jochems D. , van Wessem K. J. P. , Houwert R. M. , Brouwers H. B. , Dankbaar J. W. , van Es M. A. , Geurts M. , Slooter A. J. C. , Leenen L. P. H.
Published: September 2018

Introduction. Traumatic brain injury (TBI) remains a major cause of death. Withdrawal of life-sustaining treatment (WLST) can be initiated if there is little anticipated chance of recovery to an acceptable quality of life. The aim of this study was firstly to investigate WLST rates in patients with moderate to severe isolated TBI and secondly to assess outcome data in the survivor group. Material and Methods. A retrospective cohort study was performed. Patients aged ≥ 18 years with moderate or severe isolated TBI admitted to the ICU of a single academic hospital between 2011 and 2015 were included. Exclusion criteria were isolated spinal cord injury and referrals to and from other hospitals. Gathered data included demographics, mortality, cause of death, WLST, and Glasgow Outcome Scale (GOS) score after three months. Good functional outcome was defined as GOS > 3. Results. Of 367 patients, 179 patients were included after applying inclusion and exclusion criteria. 55 died during admission (33%), of whom 45 (82%) after WLST. Patients undergoing WLST were older, had worse neurological performance at presentation, and had more radiological abnormalities than patients without WLST. The decision to withdraw life-sustaining treatment was made on the day of admission in 40% of patients. In 33% of these patients, this decision was made while the patient was in the Emergency Department. 71% of survivors had a good functional outcome after three months. No patient left hospital with an unresponsive wakefulness syndrome (UWS) or suffered from UWS after three months. One patient died within three months of discharge. Conclusion. In-hospital mortality in isolated brain injured patients was 33%. The vast majority died after a decision to withdraw life-sustaining treatment. None of the patients were discharged with an unresponsive wakefulness syndrome.
EM‐Based Monitoring and Probabilistic Analysis of Prestress Loss of Bonded Tendons in PSC Beams
Authors: Chen Zheheng , Zhang Shanwen
Published: September 2018

The prestress level is a key factor of prestressed concrete (PSC) beams, affecting their long‐term serviceability and safety. Existing monitoring methods, however, are not effective in obtaining the force or stress of embedded tendons. This paper investigates the feasibility of elastomagnetic (EM) sensors, which have been used for external tendons, in monitoring the long‐term prestress loss of bonded tendons. The influence of ambient temperature, water, eccentricity ratio, plastic duct, and cement grouts on the test results of EM sensors is experimentally examined. Based on the calibrated EM sensors, prestress loss of a group of PSC beams was monitored for one year. In order to further consider the high randomness in material, environment, and construction, probabilistic analysis of prestress loss is conducted. Finally, the variation range of prestress loss with a certain confidence level is obtained and is compared with the monitored data, which provides a basis for the determination of prestress level in the design of PSC beams.
An Unusual Presentation of Acute Weakness: Acute Inflammatory Demyelinating Polyneuropathy in a Patient with Psychiatric Illness
Authors: Lombardi Eric , Misek Ryan , Patel Krishna
Published: September 2018

We report an unusual presentation of Guillain-Barré wherein a patient with an extensive history of psychiatric illness had a dream that his legs were crushed in an earthquake and awoke from the dream with paresthesias and rapid paralysis of bilateral lower extremities. This article discusses an atypical presentation of pathology and diagnostic evaluation for a form of Guillain-Barré called Acute Inflammatory Demyelinating Polyneuropathy (AIDP).
Contribution of OqxAB Efflux Pump in Selection of Fluoroquinolone-Resistant Klebsiella pneumoniae
Authors: Szabo Orsolya , Kocsis Bela , Szabo Nikolett , Kristof Katalin , Szabo Dora
Published: September 2018

The role of OqxAB efflux pump in Klebsiella pneumoniae was investigated in correlation with ciprofloxacin exposure. K. pneumoniae SE23 and K. pneumoniae SE191 were isolated from urinary tract infections and were analyzed in this study. Each carried oqxAB resistance determinant and exhibited ciprofloxacin MIC of 0.06 and 0.5 mg/L, respectively. Tested strains were initially exposed to their ciprofloxacin MIC values for 24 hours. Later on, the ciprofloxacin exposition has been increased to a daily 1, 2, 4, and to a final 8 mg/L. Total cellular RNA was extracted at 30, 60, 90, and 120 minutes of initial exposure and after every 24 hours. Quantitative reverse-transcriptase PCR was performed from each RNA sample. Mutation in gyrA and parC genes was analyzed in each strain and multilocus sequence typing (MLST) was performed. Ciprofloxacin exposure selected resistant strain from K. pneumoniae SE191; by contrast, K. pneumoniae SE23 was not adjustable to the increasing ciprofloxacin concentrations. During initial exposure, both oqxA and oqxB expression remained low (2−ΔCt = 1-2.03). However, increasing ciprofloxacin promoted oqxB expression as it reached fold increase of 15.8–22.8, while oqxA expression was maintained (2−ΔCt = 2-2.15). An amino acid substitution Ser83Tyr in gyrA was detected in K. pneumoniae SE191, but no additional mutations occurred as consequence to ciprofloxacin exposure. MLST identified K. pneumoniae SE191 as ST274, while K. pneumoniae SE23 belonged to the novel ST2567. Ciprofloxacin concentration-dependent upregulation of oqxAB efflux pump in K. pneumoniae is clonally related and contributes to selection for higher level of fluoroquinolone resistance.
Sepsis and Pleural Empyema Caused by Streptococcus pyogenes after Influenza A Virus Infection
Authors: Ochi Fumihiro , Tauchi Hisamichi , Jogamoto Toshihiro , Miura Hiromitsu , Moritani Tomozo , Nagai Kozo , Ishii Eiichi
Published: September 2018

Streptococcus pyogenes (also referred to as group A streptococci, GAS) causes severe invasive diseases such as bacteremia, necrotizing fasciitis, pneumonia, osteomyelitis, septic arthritis, and toxic shock syndrome in children. However, there are only a few reports on pleural empyema caused by GAS in children. Here, we report the case of a 4-year-old boy who presented with pleural empyema due to GAS after influenza A virus infection. With intravenous antibiotic administration and continuous chest-tube drainage, followed by video-assisted thoracoscopic surgery, his condition improved. During the clinical course, cytokines induced in response to the influenza virus, especially IL-1β and IL-10, were elevated 1 week after influenza A infection, but these decreased as the symptoms improved. Reportedly, the IL-10 production increases during influenza virus-bacteria superinfection. These observations suggest that the immunological mechanisms induced by the influenza virus can play an important role in influencing the susceptibility to secondary bacterial infections, such as GAS, in children.
Contactless Monitoring of Breathing Patterns and Respiratory Rate at the Pit of the Neck: A Single Camera Approach
Authors: Massaroni Carlo , Lopes Daniel Simões , Lo Presti Daniela , Schena Emiliano , Silvestri Sergio
Published: September 2018

Vital signs monitoring is pivotal not only in clinical settings but also in home environments. Remote monitoring devices, systems, and services are emerging as tracking vital signs must be performed on a daily basis. Different types of sensors can be used to monitor breathing patterns and respiratory rate. However, the latter remains the least measured vital sign in several scenarios due to the intrusiveness of most adopted sensors. In this paper, we propose an inexpensive, off-the-shelf, and contactless measuring system for respiration signals taking as region of interest the pit of the neck. The system analyses video recorded by a single RGB camera and extracts the respiratory pattern from intensity variations of reflected light at the level of the collar bones and above the sternum. Breath-by-breath respiratory rate is then estimated from the processed breathing pattern. In addition, the effect of image resolution on monitoring breathing patterns and respiratory rate has been investigated. The proposed system was tested on twelve healthy volunteers (males and females) during quiet breathing at different sensor resolution (i.e., HD 720, PAL, WVGA, VGA, SVGA, and NTSC). Signals collected with the proposed system have been compared against a reference signal in both the frequency domain and time domain. By using the HD 720 resolution, frequency domain analysis showed perfect agreement between average breathing frequency values gathered by the proposed measuring system and reference instrument. An average mean absolute error (MAE) of 0.55 breaths/min was assessed in breath-by-breath monitoring in the time domain, while Bland-Altman showed a bias of −0.03 ± 1.78 breaths/min. Even in the case of lower camera resolution setting (i.e., NTSC), the system demonstrated good performances (MAE of 1.53 breaths/min, bias of −0.06 ± 2.08 breaths/min) for contactless monitoring of both breathing pattern and breath-by-breath respiratory rate over time.
Long-Lasting Symptomatic Cerebral Hyperperfusion Syndrome following Superficial Temporal Artery-Middle Cerebral Artery Bypass in a Patient with Stenosis of Middle Cerebral Artery
Authors: Shimato Shinji , Nishizawa Toshihisa , Yamanouchi Takashi , Mamiya Takashi , Ishikawa Kojiro , Kato Kyozo
Published: September 2018

Cerebral hyperperfusion syndrome (CHPS) is a complication that can occur after cerebral revascularization surgeries such as superficial temporal artery- (STA-) middle cerebral artery (MCA) anastomosis, and it can lead to neurological deteriorations. CHPS is usually temporary and disappears within two weeks. The authors present a case in which speech disturbance due to CHPS lasted unexpectedly long and three months was taken for full recovery. A 40-year-old woman, with a history of medication of quetiapine, dopamine 2 receptor antagonist as an antipsychotics for depression, underwent STA-MCA anastomosis for symptomatic left MCA stenosis. On the second day after surgery, the patient exhibited mild speech disturbance which deteriorated into complete motor aphasia and persisted for one month. SPECT showed the increase of cerebral blood flow (CBF) in left cerebrum, verifying the diagnosis of CHPS. Although CBF increase disappeared one month after surgery, speech disturbance continued for additionally two months with a slow improvement. This case represents a rare clinical course of CHPS. The presumable mechanisms of the prolongation of CHPS are discussed, and the medication of quetiapine might be one possible cause by its effect on cerebral vessels as dopamine 2 receptor antagonist, posing the caution against antipsychotics in cerebrovascular surgeries.
Closed Loop Obstruction from Epiploic Appendage Adhesion Mimicking Pericecal Internal Hernia
Authors: Sharif Fatima , Sander Paul Samuel , Sharif Ali , Montenegro Grace , Garrett Robert
Published: September 2018

Internal hernias involve herniation of viscera into an abdominal compartment through a defect in the mesentery or peritoneum. Herniation may occur through normal anatomic structures or through pathologic defects secondary to congenital abnormality, inflammation, trauma, or surgery. Patients with an internal hernia most commonly present with acute bowel obstruction. While internal hernia is an uncommon cause of bowel obstruction, making up approximately 0.2-0.9% of cases (Choi, 2017), the incidence is increasing due to greater use of techniques such as Roux-en-Y for liver transplant and gastric bypass. There are multiple types of internal hernia, including paraduodenal, Foramen of Winslow, sigmoid mesocolon, pericecal, transmesenteric, transomental, supravesical, and pelvic. We present a case in which a transverse colon epiploic appendage adhesion to the ascending colon mesentery resulted in a closed loop obstruction mimicking a pericecal internal hernia. Radiologists should be aware of the imaging findings of closed loop obstruction related to internal hernia and maintain a high index of suspicion in patients with history of prior abdominal surgery presenting with bowel obstruction. It is useful for radiologists to understand that adhesions may result in internal hernias, which mimic the classically described categories.
Exosomes Regulate the Transformation of Cancer Cells in Cancer Stem Cell Homeostasis
Authors: Xu Jiasheng , Liao Kaili , Zhou Weimin
Published: September 2018

In different biological model systems, exosomes are considered mediators of cell-cell communication between different cell populations. Exosomes, as extracellular vesicles, participate in physiological and pathological processes by transmitting signaling molecules such as proteins, nucleic acids, and lipids. The tumor’s microenvironment consists of many types of cells, including cancer stem cells and mesenchymal cells. It is well known that these cells communicate with each other and thereby regulate the progression of the tumor. Recent studies have provided evidence that exosomes mediate the interactions between different types of cells in the tumor microenvironment, providing further insight into how these cells interact through exosome signaling. Cancer stem cells are a small kind of heterogeneous cells that existed in tumor tissues or cancer cell lines. These cells possess a stemness phenotype with a self-renewal ability and multipotential differentiation which was considered the reason for the failure of conventional cancer therapies and tumor recurrence. However, a highly dynamic equilibrium was found between cancer stem cells and cancer cells, and this indicates that cancer stem cells are no more special target and blocking the transformation of cancer stem cells and cancer cells seem to be a more significant therapy strategy. Whether exosomes, as an information transforming carrier between cells, regulated cancer cell transformation in cancer stem cell dynamic equilibrium and targeting exosome signaling attenuated the formation of cancer stem cells and finally cure cancers is worthy of further study.
Nonuniformly Loaded Stack of Antiplane Shear Cracks in One‐Dimensional Piezoelectric Quasicrystals
Authors: Tupholme G. E.
Published: September 2018

Representations in a closed form are derived, using an extension to the method of dislocation layers, for the phonon and phason stress and electric displacement components in the deformation of one‐dimensional piezoelectric quasicrystals by a nonuniformly loaded stack of parallel antiplane shear cracks. Their dependence upon the polar angle in the region close to the tip of a crack is deduced, and the field intensity factors then follow. These exhibit that the phenomenon of crack shielding is dependent upon the relative spacing of the cracks. The analogous analyses, that have not been given previously, involving non‐piezoelectric or non‐quasicrystalline or simply elastic materials can be straightforwardly considered as special cases. Even when the loading is uniform and the crack is embedded in a purely elastic isotropic solid, no explicit representations have been available before for the components of the field at points other than directly ahead of a crack. Typical numerical results are graphically displayed.
Overlap Anastomosis for Digestive Reconstruction during Laparoscopic Distal Gastrectomy with Intensive Regional Lymph Node Dissection: Physiological Impact of Preserving the Mesenteric Autonomic Nerves in the Lifted Jejunal Limb
Authors: Kitano Taku , Yasukawa Daiki , Aisu Yuki , Hori Tomohide
Published: September 2018

Laparoscopic gastrectomy is a treatment for gastric cancer, and isoperistaltic side-to-side reconstruction is called “overlap anastomosis.” The physiological advantages of preserving the autonomic nerves in the jejunal limb for digestive reconstruction are well known. Here, we focused on overlap anastomosis with autonomic nerve-preserved mesojejunum of the lifted jejunal limb for laparoscopic distal gastrectomy with intentional lymph node dissection. Our surgical techniques and technical pitfalls were described in detail. The jejunum was partially sacrificed to preserve the autonomic nerves in the lifted jejunal limb. The length of the staple line was 35 – 40 mm. The endostapler entry was carefully closed to avoid even subtle stenosis. Twelve patients were retrospectively evaluated with a follow-up of 5.0 ± 0.6 years. Histological findings according to the Japanese classification were stage IA or IB. Dietary intake and postoperative ambulation occurred at 3.3 ± 1.0 and 1.3 ± 0.5 days after surgery, respectively. Postoperative complications according to Clavien–Dindo classification were one each of grade I and grade II. Postoperative hospital stay was 6.7 ± 1.6 days. Five patients were medication-free at final follow-up, with no recurrence in any patient. Overlap anastomosis with autonomic nerve-preserved jejunal limb was safe and feasible for laparoscopic distal gastrectomy with lymph node dissection.
Backwards Asymptotically Autonomous Dynamics for 2D MHD Equations
Authors: Yu Jiali , Su Wenhuo , Xu Dongmei
Published: September 2018

We consider the backwards topological property of pullback attractors for the nonautonomous MHD equations. Under some backwards assumptions of the nonautonomous force, it is shown that the theoretical existence result for such an attractor is derived from an increasing, bounded pullback absorbing and the backwards pullback flattening property. Meanwhile, some abstract results on the convergence of nonautonomous pullback attractors in asymptotically autonomous problems are established and applied to MHD equations.
Quality Changes and Discoloration of Basa (Pangasius bocourti) Fillet during Frozen Storage
Authors: Sriket Pornpimol , La-ongnual Thamarak
Published: September 2018

Physicochemical changes of Basa fish (Pangasius bocourti) fillet during frozen storage at −20°C for 0–20 weeks were studied. The content of thiobarbituric acid reactive substances (TBARS) of fish samples suddenly increased when the samples were stored longer than 8 weeks (p<0.05). The increase in TBARS value of the fish fillet was concomitant with the increase inb∗value (yellow color). Marked decreases in Ca2+-ATPase activity, sulfhydryl content, and protein solubility of the fish fillet after 8 weeks of storage were observed. Those decreasing values were well correlated with the increasing of disulfide bond content and surface hydrophobicity content (p<0.05). Increases in shear force of fish meat during storage were also observed (p<0.05). The results indicated that frozen storage at −20°C affected on Basa fillet qualities, especially after 8 weeks of storage. These data could be useful for consumer and food industry.
Modulation of Oxidative Status by Normoxia and Hypoxia on Cultures of Human Dermal Fibroblasts: How Does It Affect Cell Aging?
Authors: Damiani Elisabetta , Brugè Francesca , Cirilli Ilenia , Marcheggiani Fabio , Olivieri Fabiola , Armeni Tatiana , Cianfruglia Laura , Giuliani Angelica , Orlando Patrick , Tiano Luca
Published: September 2018

Reactive oxygen species (ROS) production in the skin is among the highest compared to other organs, and a clear correlation exists between ROS production and skin aging. Many attempts are underway to reduce oxidative stress in the skin by topical treatment or supplementation with antioxidants/cosmeceuticals, and cultures of human dermal fibroblasts (HDF) are widely used for these studies. Here, we examined the influence of oxygen tension on cell aging in HDF and how this impacted ROS production, the enzymatic and nonenzymatic antioxidant response system, and the efficacy of this defense system in limiting DNA damage and in modulating gene expression of proteins involved in the extracellular matrix, linked to skin aging. We investigated a selection of parameters that represent and reflect the behavior of cellular responses to aging and oxygen tension. Serial passaging of HDF under normoxia (21%) and hypoxia (5%) leads to cell aging as confirmed by β‐galactosidase activity, p16 expression, and proliferation rate. However, in HDF under 21% O2, markers of aging were significantly increased compared to those under 5% O2 at matched cell passages despite having lower levels of intracellular ROS and higher levels of CoQ10, total GSH, SOD1, SOD3, and mitochondrial superoxide anion. miRNA‐181a, which is known to be upregulated in HDF senescence, was also analyzed, and indeed, its expression was significantly increased in old cells at 21% O2 compared to those at 5% O2. Upregulation of MMP1 and downregulation of COL1A1 along with increased DNA damage were also observed under 21% O2 vs 5% O2. The data highlight that chronic exposure to atmospheric 21% O2 is able to trigger hormetic adaptive responses in HDF that however fail, in the long term, to prevent cellular aging. This information could be useful in further investigating molecular mechanisms involved in adaptation of skin fibroblasts to oxidative stress and may provide useful hints in addressing antiaging strategies.
A Malignant Squeeze: A Rare Cause of Cardiac Tamponade
Authors: Quiroz Elisa , Hafeez Adam , Mando Ramy , Yu Zhou , Momin Feroze
Published: September 2018

Primary cardiac lymphoma (PCL) is a rare condition described as a lymphoma localized to the heart or pericardium. Although cardiac involvement is seen in 10–20% of non-Hodgkin’s lymphomas, PCL is extremely rare. It comprises merely 0.5% of all lymphomas and 1.3–2% of cardiac malignancies. Early detection is essential to avoid potentially fatal complications, and prognosis is highly dependent on the management of cardiac complications. The etiology of PCL is still unknown, and molecular characterization has yet to be studied leaving a great deal of research to be done in order to gain a better understanding of this rare disease process. We discuss the case of an 85-year-old female presenting with dyspnea and chest pain. Computed tomography of the chest revealed a pericardial effusion, and subsequent echocardiogram demonstrated a large circumferential effusion. She underwent emergent pericardiocentesis. Morphologic and immunophenotypic features were consistent with high-grade B-cell lymphoma with t8;14, and the patient was started on rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) with excellent response.