bluuebunny/crossref_metadata_2025 huggingface dataset:
Tracking tumor boundary in MV‐EPID images without implanted markers: A feasibility study
Authors: Zhang Xiaoyong , Homma Noriyasu , Ichiji Kei , Takai Yoshihiro , Yoshizawa Makoto
Published: April 2015

Purpose:

To develop a markerless tracking algorithm to track the tumor boundary in megavoltage (MV)‐electronic portal imaging device (EPID) images for image‐guided radiation therapy.

Methods:

A level set method (LSM)‐based algorithm is developed to track tumor boundary in EPID image sequences. Given an EPID image sequence, an initial curve is manually specified in the first frame. Driven by a region‐scalable energy fitting function, the initial curve automatically evolves toward the tumor boundary and stops on the desired boundary while the energy function reaches its minimum. For the subsequent frames, the tracking algorithm updates the initial curve by using the tracking result in the previous frame and reuses the LSM to detect the tumor boundary in the subsequent frame so that the tracking processing can be continued without user intervention. The tracking algorithm is tested on three image datasets, including a 4‐D phantom EPID image sequence, four digitally deformable phantom image sequences with different noise levels, and four clinical EPID image sequences acquired in lung cancer treatment. The tracking accuracy is evaluated based on two metrics: centroid localization error (CLE) and volume overlap index (VOI) between the tracking result and the ground truth.

Results:

For the 4‐D phantom image sequence, the CLE is 0.23 ± 0.20 mm, and VOI is 95.6% ± 0.2%. For the digital phantom image sequences, the total CLE and VOI are 0.11 ± 0.08 mm and 96.7% ± 0.7%, respectively. In addition, for the clinical EPID image sequences, the proposed algorithm achieves 0.32 ± 0.77 mm in the CLE and 72.1% ± 5.5% in the VOI. These results demonstrate the effectiveness of the authors’ proposed method both in tumor localization and boundary tracking in EPID images. In addition, compared with two existing tracking algorithms, the proposed method achieves a higher accuracy in tumor localization.

Conclusions:

In this paper, the authors presented a feasibility study of tracking tumor boundary in EPID images by using a LSM‐based algorithm. Experimental results conducted on phantom and clinical EPID images demonstrated the effectiveness of the tracking algorithm for visible tumor target. Compared with previous tracking methods, the authors’ algorithm has the potential to improve the tracking accuracy in radiation therapy. In addition, real‐time tumor boundary information within the irradiation field will be potentially useful for further applications, such as adaptive beam delivery, dose evaluation.
Half Empty or Half Full?
Authors: Rohr Tyler , Rohr Jim
Published: April 2015

Previously appearing in this journal1 were photographs of a physics apparatus, developed circa 1880, that was believed to be used to demonstrate the “Bernoulli effect.” Drawings of these photographs appear here and show that when there is no flow, the water level hPT2in the piezometer tube at location (2) is at the same level as in the head tank [Fig. 1(a)], but drops to about half the previous level when there is flow [Fig. 1(b)]. We are in agreement that the drop in static pressure at the base of the piezometer tube is associated with the Bernoulli effect, i.e., the qualitative behavior of the lowering of fluid pressure in regions where the flow velocity is increased. However, we also believe that the height of water in the piezometer tube has an equally rich story, a story that better unfolds by addressing the following questions: What does the presence of water in the piezometer tube indicate? What water level would the Bernoulli equation, which is derived for flows where viscous friction is negligible, predict? Qualitatively, how do the exit velocities and piezometer tube water levels vary for inviscid (no friction) and viscous (friction) flows, and the following exit geometries: straight [Fig. 1(ci)], diverging [Fig. 1(cii)], and converging [Fig. 1(ciiii)]?
On using planar microcontractions for extensional rheometry
Authors: Lubansky Alex S. , Matthews Miccal T.
Published: April 2015

Planar contractions within a microfluidic environment have shown some potential to be used as a simple, cheap extensional rheometer. In this article, flow within a planar contraction is analyzed using an energy minimization calculation with a measure of slip included. The effect of slip on the calculated flow-field is used to show how the apparent extensional viscosity compares with the true extensional viscosity. In particular, it was found that the apparent planar extensional viscosity would be difficult to determine reliably at either low or high Weissenberg numbers but could be distinguished to some extent at moderate Weissenberg numbers between 0.25 and 1. It was also shown, however, that an unknown extent of slip at the vortex boundary would cause an uncertainty of a factor of 2 in any apparent measure of rheological properties.
An implantable microdevice to perform high-throughput in vivo drug sensitivity testing in tumors
Authors: Jonas Oliver , Landry Heather M. , Fuller Jason E. , Santini John T. , Baselga Jose , Tepper Robert I. , Cima Michael J. , Langer Robert
Published: April 2015

An implantable microdevice is demonstrated to release microdoses of multiple drugs into confined regions of tumors and allows for assessment of each drug’s efficacy to identify optimal therapy.
Monoclonal antibodies against GARP/TGF-β1 complexes inhibit the immunosuppressive activity of human regulatory T cells in vivo
Authors: Cuende Julia , Liénart Stéphanie , Dedobbeleer Olivier , van der Woning Bas , De Boeck Gitte , Stockis Julie , Huygens Caroline , Colau Didier , Somja Joan , Delvenne Philippe , Hannon Muriel , Baron Frédéric , Dumoutier Laure , Renauld Jean-Christophe , De Haard Hans , Saunders Michael , Coulie Pierre G. , Lucas Sophie
Published: April 2015

Monoclonal antibodies that inhibit human T
reg
function in vivo may be used therapeutically in cancer or infections.
CRISPR Immunity Drives Rapid Phage Genome Evolution in Streptococcus thermophilus
Authors: Paez-Espino David , Sharon Itai , Morovic Wesley , Stahl Buffy , Thomas Brian C. , Barrangou Rodolphe , Banfield Jillian F.
Published: April 2015

Many bacteria rely on CRISPR-Cas systems to provide adaptive immunity against phages, predation by which can shape the ecology and functioning of microbial communities. To characterize the impact of CRISPR immunization on phage genome evolution, we performed long-term bacterium-phage (
Streptococcus thermophilus
-phage 2972) coevolution experiments. We found that in this species, CRISPR immunity drives fixation of single nucleotide polymorphisms that accumulate exclusively in phage genome regions targeted by CRISPR. Mutation rates in phage genomes highly exceed those of the host. The presence of multiple phages increased phage persistence by enabling recombination-based formation of chimeric phage genomes in which sequences heavily targeted by CRISPR were replaced. Collectively, our results establish CRISPR-Cas adaptive immunity as a key driver of phage genome evolution under the conditions studied and highlight the importance of multiple coexisting phages for persistence in natural systems.

IMPORTANCE
Phages remain an enigmatic part of the biosphere. As predators, they challenge the survival of host bacteria and archaea and set off an “arms race” involving host immunization countered by phage mutation. The CRISPR-Cas system is adaptive: by capturing fragments of a phage genome upon exposure, the host is positioned to counteract future infections. To investigate this process, we initiated massive deep-sequencing experiments with a host and infective phage and tracked the coevolution of both populations over hundreds of days. In the present study, we found that CRISPR immunity drives the accumulation of phage genome rearrangements (which enable longer phage survival) and escape mutations, establishing CRISPR as one of the fundamental drivers of phage evolution.
Acupuncture for Melasma in Women: A Systematic Review of Randomised Controlled Trials
Authors: Chai Qianyun , Fei Yutong , Cao Huijuan , Wang Congcong , Tian Jinzhou , Liu Jianping
Published: April 2015

Background

Melasma is a common facial skin disorder seen in women. Manual acupuncture (MA) is widely used alone or in combination with conventional treatments for melasma in China.

Objectives

To assess the effectiveness and safety of MA for melasma, and explore the range of treatments applied.

Methods

Six databases were searched systematically for randomised controlled trials (RCTs) on acupuncture for melasma in women up to November 2014. RevMan software was used for data analysis. The Cochrane tool of Risk of Bias was used to assess the methodological quality of the RCTs.

Results

Eight RCTs involving 587 women were included. Seven studies used the encircling needling method, four studies used the quick needling method and four studies used intensive needle manipulations. Five studies provided individualised acupuncture treatments. Points used with highest frequency were SP6, ST36 and SP10. MA was compared with oral tranexamic acid, vitamin C and E, vitamin C and tamoxifen, topical 20% azelaic acid, hydroquinone, vitamin A and no treatment. Studies were too heterogeneous to conduct a meta-analysis. For global outcome measures, seven trials showed that MA groups were significantly better than the conventional treatments either with a better cure rate or with a better combined cure rate and markedly effective rate, and one trial did not (MA vs vitamin A). No acupuncture-related adverse events were reported.

Conclusions

MA appeared to be beneficial and safe for women with melasma, but insufficient evidence was found to reach conclusions. The encircling needling method, the quick needling method, intensive needle manipulations and individualised points’ selection were widely used. Well-designed trials are required.

Trial Registration Number

PROSPERO Systematic review registration: CRD42013006396.
Imaging in suspected child abuse: necessity or radiation hazard?
Authors: Bajaj Monika , Offiah Amaka C
Published: April 2015

Imaging has many uses, but in cases of suspected child abuse, radiographs and CT scans are vital in identifying fractures and head injury that may not be clinically obvious. There are growing concerns about the small but potential adverse effects of radiation, including cancer, in the paediatric population as a result of imaging. The vast majority of general paediatricians undertaking child abuse assessments request skeletal surveys and CT scans, subjecting children to significant amounts of radiation. Informed consent must be taken from parents for these procedures and therefore this paper aims to look at evidence of the dangers of radiation in children and raise awareness among paediatricians.
Laparoscopic management of Bouveret syndrome
Authors: Newton Richard Charles , Loizides Sofronis , Penney Nicholas , Singh Krishna Kumar
Published: April 2015

Bouveret syndrome is a proximal form of gallstone ileus where a large gallstone lodges in the pylorus or proximal duodenum, having passed through a bilioenteric fistula that has formed secondary to previous cholecystitis. We describe the laparoscopic extraction of a giant ‘Bouveret’ gallstone from the duodenum of an elderly man with morbid obesity.
The lifetime cost to English students of borrowing to invest in a medical degree: a gender comparison using data from the Office for National Statistics
Authors: Ercolani Marco G , Vohra Ravinder S , Carmichael Fiona , Mangat Karanjit , Alderson Derek
Published: April 2015

Objective

To evaluate this impact on male and female English medical graduates by estimating the total time and amount repaid on loans taken out with the UK's Student Loans Company (SLC).

Setting

UK.

Participants

4286 respondents with a medical degree in the Labour Force Surveys administered by the Office for National Statistics (ONS) between 1997 and 2014.

Outcomes

Age-salary profiles were generated to estimate the repayment profiles for different levels of initial graduate debt.

Results

2195 female and 2149 male medical graduates were interviewed by the ONS. Those working full-time (73.1% females and 96.1% males) were analysed in greater depth. Following standardisation to 2014 prices, average full-time male graduates earned up to 35% more than females by the age of 55. The initial graduate debt from tuition fees alone amounts to £39 945.69. Owing to interest charges on this debt the average full-time male graduate repays £57 303 over 20 years, while the average female earns less and so repays £61 809 over 26 years. When additional SLC loans are required for maintenance, the initial graduate debt can be as high as £81 916 and, as SLC debt is written off 30 years after graduation, the average female repays £75 786 while the average male repays £110 644.

Conclusions

Medical graduates on an average salary are unlikely to repay their SLC debt in full. This is a consequence of higher university fees and as SLC debt is written off 30 years after graduation. This results in the average female graduate repaying more when debt is low, but a lower amount when debt is high compared to male graduates.
Antiseptic effect of vicenin-2 and scolymoside from Cyclopia subternata (honeybush) in response to HMGB1 as a late sepsis mediator in vitro and in vivo
Authors: Lee Wonhwa , Yoon Eun-Kyung , Kim Kyung-Min , Park Dong Ho , Bae Jong-Sup
Published: April 2015

Cyclopia subternata is a medicinal plant commonly used in traditional medicine to relieve pain. In this study, we investigated the antiseptic effects and underlying mechanisms of vicenin-2 and scolymoside, which are 2 active compounds from C. subternata that act against high mobility group box 1 (HMGB1)-mediated septic responses in human umbilical vein endothelial cells (HUVECs) and mice. The antiseptic activities of vicenin-2 and scolymoside were determined by measuring permeability, neutrophil adhesion and migration, and activation of proinflammatory proteins in HMGB1-activated HUVECs and mice. According to the results, vicenin-2 and scolymoside effectively inhibited lipopolysaccharide-induced release of HMGB1, and suppressed HMGB1-mediated septic responses such as hyperpermeability, the adhesion and migration of leukocytes, and the expression of cell adhesion molecules. In addition, vicenin-2 and scolymoside suppressed the production of tumor necrosis factor-α and interleukin 6, and activation of nuclear factor-κB and extracellular regulated kinases 1/2 by HMGB1. Collectively, these results indicate that vicenin-2 and scolymoside could be a potential therapeutic agents for the treatment of various severe vascular inflammatory diseases via inhibition of the HMGB1 signaling pathway.
Status report on universal extra dimensions after LHC8
Authors: Servant Géraldine
Published: April 2015

Although they do not address the hierarchy problem, models with Universal Extra Dimensions have attracted a lot of attention as simple benchmark models characterized by small mass splittings and a dark matter (DM) WIMP played by the Lightest Kaluza–Klein particle (LKP). We review their status, with emphasis on minimal implementation in five dimensions (MUED) in which the LKP is a massive hypercharge gauge boson. In this case, the mass range accounting for the correct DM abundance (around 1.4 TeV) remains untouched by LHC8 and is out of reach of present DM direct detection experiments. However, LHC14 can probe the relevant region in the 3-lepton channel.
Higgs bosons in extra dimensions
Authors: Quiros Mariano
Published: April 2015

In this paper, motivated by the recent discovery of a Higgs-like boson at the Large Hadron Collider (LHC) with a mass mH≃125 GeV , we review different models where the hierarchy problem is solved by means of a warped extra dimension. In the Randall–Sundrum (RS) model electroweak observables provide very strong bounds on the mass of KK modes which motivates extensions to overcome this problem. Two extensions are briefly discussed. One particular extension is based on the deformation of the metric such that it strongly departs from the AdS5 structure in the IR region while it goes asymptotically to AdS5 in the UV brane. This model has the IR brane close to a naked metric singularity (which is outside the physical interval) characteristic of soft-walls constructions. The proximity of the singularity provides a strong wave function renormalization for the Higgs field which suppresses the T and S parameters. The second class of considered extensions are based on the introduction of an extra gauge group in the bulk such that the custodial SU (2)R symmetry is gauged and protects the T parameter. By further enlarging the bulk gauge symmetry one can find models where the Higgs is identified with the fifth component of gauge fields and for which the Higgs potential along with the Higgs mass can be dynamically determined by the Coleman–Weinberg mechanism.
Flavor physics in warped space
Authors: von Gersdorff Gero
Published: April 2015

We review constraints from quark and lepton flavor violation on extra dimensional models with warped geometry, both in the minimal and the custodial model. For both scenarios, Kaluza–Klein (KK) masses that are large enough to suppress constraints from electroweak precision tests (EWPT) also sufficiently suppress all quark flavor and CP violation, with the exception of CP violation in [Formula: see text] mixing and (to a lesser extend) in [Formula: see text] mixing. In the lepton sector the minimal scenario leads to excessively large contributions to μ→eγ transitions, requiring KK masses of at least 20 TeV or larger.
Thermal expansion and heat capacities of AgBr and AgCl at solid and liquid phases from molecular dynamics simulation
Authors: Akdere Ü.
Published: April 2015

Classical molecular dynamics simulation calculations of silver bromide, AgBr, and silver chloride, AgCl. in constant volume–energy (NVE) and constant pressure–temperature (NPT) ensembles have been performed. The temperature dependence of linear thermal expansion and molar heat capacities at constant volume and pressure have been presented at solid and liquid phases. The anomalous behavior of these properties about 200 K below the melting temperatures has been analyzed within the frame of the onset of the transition to the superionic phase.
Novel null-test for the Λ cold dark matter model with growth-rate data
Authors: Nesseris Savvas , Sapone Domenico
Published: April 2015

Current and upcoming surveys will measure the cosmological parameters with an extremely high accuracy. The primary goal of these observations is to eliminate some of the currently viable cosmological models created to explain the late-time accelerated expansion (either real or only inferred). However, most of the statistical tests used in cosmology have a strong requirement: the use of a model to fit the data. Recently there has been an increased interest on finding tests that are model independent, i.e. to have a function that depends entirely on observed quantities and not on the model, see for instance [C. Clarkson, B. Bassett and T. H. C. Lu, Phys. Rev. Lett.101 (2008) 011301, arXiv:0712.3457 [astro-ph]]. In this paper, we present an alternative consistency check at the perturbative level for a homogeneous and isotropic Universe filled with a dark energy component. This test makes use of the growth of matter perturbations data and it is able to detect a deviation from the standard cosmological model, which could later be attributed to a clustering dark energy component, a tension in the data or a modification of gravity, within the framework of a Friedmann–Lemaître–Robertson–Walker (FLRW) universe.
GAS DIFFUSION COEFFICIENT OF FRACTAL POROUS MEDIA BY MONTE CARLO SIMULATIONS
Authors: ZHENG QIAN , LI XIANGPENG
Published: April 2015

Gas diffusion behavior in fractal porous media is simulated by Monte Carlo technique in this work. Based on the fractal character of pore size in porous media, the probability model of the effective gas diffusion coefficient is derived. The proposed model of the effective gas diffusion coefficient is explicitly expressed as a function of structural parameters of porous media, such as porosity, pore size, the fractal dimensions for pore area and tortuosity. The effect of structural parameters of porous media has been studied in detail. The results show that the present results from the Monte Carlo simulations present a good agreement with those from the available analytical model and the available experimental data. The proposed Monte Carlo simulation technique may have the potential in predictions of other gas transport properties in fractal porous media.
Multilingual Distant Supervised Relation Extractors Combining Multiple Feature Types
Authors: Nunes Thiago , Schwabe Daniel
Published: April 2015

A well-known drawback in building machine learning semantic relation detectors for natural language is the lack of a large number of qualified training instances for the target relations in multiple languages. Even when good results are achieved, the datasets used by the state-of-the-art approaches are rarely published. In order to address these problems, this work presents an automatic approach to build multilingual semantic relation detectors through distant supervision combining two of the largest resources of structured and unstructured content available on the Web, DBpedia and Wikipedia. We map the DBpedia ontology back to the Wikipedia text to extract more than 100.000 training instances for more than 90 DBpedia relations for English and Portuguese languages without human intervention. First, we mine Wikipedia articles to find candidate instances for relations described in the DBpedia ontology. Second, we preprocess and normalize the data filtering out irrelevant instances. Finally, we use the normalized data to construct regularized logistic regression detectors that achieve an F-Measure above 80% for both English and Portuguese languages. In this paper, we also compare the impact of different types of features on the accuracy of the trained detector, demonstrating significant performance improvements when combining lexical, syntactic and semantic features. Both the datasets and the code used in this research are available online.
Mining Semantics Structures from Syntactic Structures in Web Document Corpora
Authors: Mousavi Hamid , Gao Shi , Kerr Deirdre , Iseli Markus , Zaniolo Carlo
Published: April 2015

The Web is making possible many advanced text-mining applications, such as news summarization, essay grading, question answering, semantic search and structured queries on corpora of Web documents. For many of such applications, statistical text-mining techniques are of limited effectiveness since they do not utilize the morphological structure of the text. On the other hand, many approaches use NLP-based techniques that parse the text into parse trees, and then use patterns to mine and analyze parse trees which are often unnecessarily complex. To reduce this complexity and ease the entire process of text mining, we propose a weighted-graph representation of text, called TextGraphs, which captures the grammatical and semantic relations between words and terms in the text. TextGraphs are generated using a new text mining framework which is the main focus of this paper. Our framework, SemScape, uses a statistical parser to generate few of the most probable parse trees for each sentence and employs a novel two-step pattern-based technique to extract from parse trees candidate terms and their grammatical relations. Moreover, SemScape resolves coreferences by a novel technique, generates domain-specific TextGraphs by consulting ontologies, and provides a SPARQL-like query language and an optimized engine for semantically querying and mining TextGraphs.
Secondary Spectrum Auctions for Symmetric and Submodular Bidders
Authors: Hoefer Martin , Kesselheim Thomas
Published: April 2015

We study truthful auctions for secondary spectrum usage in wireless networks. In this scenario,
n
communication requests need to be allocated to
k
available channels that are subject to interference and noise. We present the first truthful mechanisms for secondary spectrum auctions with symmetric or submodular valuations. Our approach to model interference uses an edge-weighted conflict graph, and our algorithms provide asymptotically almost optimal approximation bounds for conflict graphs with a small inductive independence number
ρ
<<
n
. This approach covers a large variety of interference models such as, for instance, the protocol model or the recently popular physical model of interference. For unweighted conflict graphs and symmetric valuations we use LP-rounding to obtain
O
(
ρ
)-approximate mechanisms; for weighted conflict graphs we get a factor of
O
(
ρ
· (log
n
+ log
k
)). For submodular users we combine the convex rounding framework of Dughmi et al. [2011] with randomized metarounding to obtain
O
(
ρ
)-approximate mechanisms for matroid-rank-sum valuations; for weighted conflict graphs we can fully drop the dependence on
k
to get
O
(
ρ
· log
n
). We conclude with promising initial results for deterministically truthful mechanisms that allow approximation factors based on
ρ
.
Injection of testosterone may be safer and more effective than transdermal administration for combating loss of muscle and bone in older men
Authors: Borst Stephen E. , Yarrow Joshua F.
Published: April 2015

The value of testosterone replacement therapy (TRT) for older men is currently a topic of intense debate. While US testosterone prescriptions have tripled in the past decade (9), debate continues over the risks and benefits of TRT. TRT is currently prescribed for older men with either low serum testosterone (T) or low T plus accompanying symptoms of hypogonadism. The normal range for serum testosterone is 300 to 1,000 ng/dl. Serum T ≤ 300 ng/dl is considered to be low, and T ≤ 250 is considered to be frank hypogonadism. Most experts support TRT for older men with frank hypogonadism and symptoms. Treatment for men who simply have low T remains somewhat controversial. TRT is most frequently administered by intramuscular (im) injection of long-acting T esters or transdermally via patch or gel preparations and infrequently via oral administration. TRT produces a number of established benefits in hypogonadal men, including increased muscle mass and strength, decreased fat mass, increased bone mineral density, and improved sexual function, and in some cases those benefits are dose dependent. For example, doses of TRT administered by im injection are typically higher than those administered transdermally, which results in greater musculoskeletal benefits. TRT also produces known risks including development of polycythemia (Hct >50) in 6% of those treated, decrease in HDL, breast tenderness and enlargement, prostate enlargement, increases in serum PSA, and prostate-related events and may cause suppression of the hypothalamic-pituitary-gonadal axis. Importantly, TRT does not increase the risk of prostate cancer. Putative risks include edema and worsening of sleep apnea. Several recent reports have also indicated that TRT may produce cardiovascular (CV) risks, while others report no risk or even benefit. To address the potential CV risks of TRT, we have recently reported via meta-analysis that oral TRT increases CV risk and suggested that the CV risk profile for im TRT may be better than that for oral or transdermal TRT.
Identification of quantitative trait transcripts for growth traits in the large scales of liver and muscle samples
Authors: Xiong Xinwei , Yang Hui , Yang Bin , Chen Congying , Huang Lusheng
Published: April 2015

Growth-related traits are economically important traits to the pig industry. Identification of causative gene and mutation responsible for growth-related QTL will facilitate the improvement of pig growth through marker-assisted selection. In this study, we applied whole genome gene expression and quantitative trait transcript (QTT) analyses in 497 liver and 586 longissimus dorsi muscle samples to identify candidate genes and dissect the genetic basis of pig growth in a white Duroc × Erhualian F2resource population. A total of 20,108 transcripts in liver and 23,728 transcripts in muscle with expression values were used for association analysis between gene expression level and phenotypic value. At the significance threshold of P < 0.0005, we identified a total of 169 and 168 QTTs for nine growth-related traits in liver and muscle, respectively. We also found that some QTTs were correlated to more than one trait. The QTTs identified here showed high tissue specificity. We did not identify any QTTs that were associated with one trait in both liver and muscle. Through an integrative genomic approach, we identified SDR16C5 as the important candidate gene in pig growth trait. These findings contribute to further identification of the causative genes for porcine growth traits and facilitate improvement of pig breeding.
Intramucosal Carcinoma of the Appendix Arising from Traditional Serrated Adenoma
Authors: Martinez Carlos Augusto Real , Cutovoi Júlia , Rossi Debora Helena , Meirelles Luciana Rodrigues , Ayrizono Maria de Lourdes Setsuko , Leal Raquel Franco , Coy Cláudio Saddy Rodrigues
Published: April 2015

Introduction. Serrated adenomas of the appendix are rare and usually found during appendectomy or autopsies. The preoperative diagnosis of these tumors is uncommon. This report describes a case of a sessile serrated adenoma located in the appendix diagnosed by a screening colonoscopy and successfully treated by laparoscopic removal.Presentation of Case. An 86-year-old woman underwent colonoscopy to investigate the cause of her diarrhea, weight loss, and anemia. During the colonoscopy, an expansive and vegetating mass of 1.5 cm in diameter was identified, protruding through the appendicular ostium with slightly lateral growth to the cecum. The patient was referred for laparoscopic surgical resection due to the location of the lesion, which did not allow its removal by colonoscopy. She underwent wedge removal of the cecum without complications and was discharged on the 4th postoperative day. Histopathological examination showed the presence of a sessile serrated adenoma with an intramucosal adenocarcinoma. The patient is currently well one year after surgery, without endoscopic signs of relapse.Conclusion. Despite serrated adenomas being a possibility rarely described in appendix it should be recognized and properly treated because it is presenting a higher risk of cancer.
Hardy-Littlewood-Sobolev Inequalities onp-Adic Central Morrey Spaces
Authors: Wu Qing Yan , Fu Zun Wei
Published: April 2015

We establish the Hardy-Littlewood-Sobolev inequalities onp-adic central Morrey spaces. Furthermore, we obtain theλ-central BMO estimates for commutators ofp-adic Riesz potential onp-adic central Morrey spaces.
High Variability of Fabry Disease Manifestations in an Extended Italian Family
Authors: Cammarata Giuseppe , Fatuzzo Pasquale , Rodolico Margherita Stefania , Colomba Paolo , Sicurella Luigi , Iemolo Francesco , Zizzo Carmela , Alessandro Riccardo , Bartolotta Caterina , Duro Giovanni , Monte Ines
Published: April 2015

Fabry disease (FD) is an inherited metabolic disorder caused by partial or full inactivation of the lysosomal hydrolaseα-galactosidase A (α-GAL). The impairment ofα-GAL results in the accumulation of undegraded glycosphingolipids in lysosomes and subsequent cell and microvascular dysfunctions. This study reports the clinical, biochemical, and molecular characterization of 15 members of the same family. Eight members showed the exonic mutation M51I in the GLA gene, a disease-causing mutation associated with the atypical phenotype. The clinical history of this family highlights a wide phenotypic variability, in terms of involved organs and severity. The phenotypic variability of two male patients is not related to differences inα-GAL enzymatic activity: though both have no enzymatic activity, the youngest shows severe symptoms, while the eldest is asymptomatic. It is noticeable that for two female patients with the M51I mutation the initial clinical diagnosis was different from FD. One of them was diagnosed with Familial Mediterranean Fever, the other with Multiple Sclerosis. Overall, this study confirms that the extreme variability of the clinical manifestations of FD is not entirely attributable to different mutations in the GLA gene and emphasizes the need to consider other factors or mechanisms involved in the pathogenesis of Fabry Disease.
MRI Brain Images Healthy and Pathological Tissues Classification with the Aid of Improved Particle Swarm Optimization and Neural Network
Authors: Sheejakumari V. , Sankara Gomathi B.
Published: April 2015

The advantages of magnetic resonance imaging (MRI) over other diagnostic imaging modalities are its higher spatial resolution and its better discrimination of soft tissue. In the previous tissues classification method, the healthy and pathological tissues are classified from the MRI brain images using HGANN. But the method lacks sensitivity and accuracy measures. The classification method is inadequate in its performance in terms of these two parameters. So, to avoid these drawbacks, a new classification method is proposed in this paper. Here, new tissues classification method is proposed with improved particle swarm optimization (IPSO) technique to classify the healthy and pathological tissues from the given MRI images. Our proposed classification method includes the same four stages, namely, tissue segmentation, feature extraction, heuristic feature selection, and tissue classification. The method is implemented and the results are analyzed in terms of various statistical performance measures. The results show the effectiveness of the proposed classification method in classifying the tissues and the achieved improvement in sensitivity and accuracy measures. Furthermore, the performance of the proposed technique is evaluated by comparing it with the other segmentation methods.
Targeting Wnts at the Source—New Mechanisms, New Biomarkers, New Drugs
Authors: Madan Babita , Virshup David M.
Published: April 2015

Wnt signaling is dysregulated in many cancers and is therefore an attractive therapeutic target. The focus of drug development has recently shifted away from downstream inhibitors of β-catenin. Active inhibitors of Wnt secretion and Wnt/receptor interactions have been developed that are now entering clinical trials. Such agents include inhibitors of Wnt secretion, as well as recombinant proteins that minimize Wnt–Frizzled interactions. These new therapies arrive together with the recent insight that cancer-specific upregulation of Wnt receptors at the cell surface regulates cellular sensitivity to Wnts. Loss-of-function mutations in RNF43 or ZNRF3 and gain-of-function chromosome translocations involving RSPO2 and RSPO3 are surprisingly common and markedly increase Wnt/β-catenin signaling in response to secreted Wnts. These mutations may be predictive biomarkers to select patients responsive to newly developed upstream Wnt inhibitors. Mol Cancer Ther; 14(5); 1087–94. ©2015 AACR.
Safety of Therapeutic Doses of Tinzaparin During Pregnancy
Authors: Parent Florence , Deruelle Philippe , Sanchez Olivier , Meyer Guy , Girard Philippe , Jilwan Fadia , Boyer-Neumann Catherine , Wolf Martine , Simonneau Gerald
Published: April 2015

Background/Aims: Low molecular weight heparin is recommended for the treatment of venous thromboembolism (VTE) during pregnancy. However, there are few reliable data regarding the safety of therapeutic doses of tinzaparin in this setting. The objective of this study was to assess the safety of once-daily therapeutic doses of tinzaparin for the treatment of VTE during pregnancy. Methods: A retrospective study was carried out in 3 tertiary care centres in France, from 1998 to 2009, including consecutive pregnant women who received once-daily therapeutic doses of tinzaparin (175 IU/kg/day). Results: We analyzed 87 pregnancies in 83 women, representing a total of 13,320 patient-days of treatment. Live-birth rate was 97.8%, with one case of miscarriage (<20 weeks of gestation) and one case of intrauterine foetal death (≥20 weeks). There was no antenatal major bleeding. Major bleeding occurred in 4 women during an emergency caesarean section. No case of heparin-induced thrombocytopenia and no maternal death were reported. There was no neonatal haemorrhage and no case of congenital abnormality. VTE recurred on treatment in one patient and after treatment interruption for several days in 2 other patients. Conclusions: These results support the safety of once-daily tinzaparin at therapeutic dose for the treatment of VTE during pregnancy.
Gut Microbiota and Colorectal Cancer
Authors: Yu Ya-Nan , Fang Jing-Yuan
Published: April 2015

Background: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide whose incidence has increased rapidly in recent years. There is growing evidence that the complex gut microbiota community plays an important role in the development of intestinal tumorigenesis. Summary: This review aimed to explore the correlation between gut microbiota and CRC as well as to identify the pathogens and their metabolites that affect CRC and the potential models of gut microbiota action. It promotes our understanding of the correlation between gut microbiota and CRC. Key Message: Our knowledge of the risk factors associated with gut microbiota for CRC development, as well as of the mechanism how intestinal bacteria act on colorectal tumorigenesis, has improved, leading to a better understanding of the correlation between gut microbiota and CRC. Practical Implications: The intestinal microbiota community has a close relationship with CRC by influencing the mechanism of the body and by regulating the physiological function of the colorectum and even the entire digestive system. Gut microbiota have been linked to CRC based upon their toxic and genotoxic metabolites production by fermentation of dietary ingredients. These metabolites could bind specific intestinal cell surface receptors and subsequently affect intracellular signal transduction. The mechanisms by which gut microbiota affect CRC development include the ‘Alpha-bug' model, the ‘driver-passenger' model and the ‘intestinal microbiota adaptions' model. This review promotes our understanding of the correlation between gut microbiota and CRC.
Gut Microbiota and Hepatocellular Carcinoma
Authors: Tao Xuemei , Wang Ning , Qin Wenxin
Published: April 2015

Background: Hepatocellular carcinoma (HCC) is a common complication of liver diseases such as those related to viral hepatitis and liver cirrhosis. The gut-liver axis is gaining increasing attention as a key pathophysiological mechanism responsible for the progression of HCC. Here, we will review the data from the published literature to address the association between HCC and gut microbiota. Summary: The presence of high levels of endotoxemia in the blood results in portal hypertension and ensuing hepatocyte damage, thus leading to the development of HCC. Probiotics can be used to treat or prevent the progression of HCC, because they may decrease the counts of gut microbiota and thus improve the endotoxemia. Key Message: Increased bacterial translocation can result in endotoxemia, which may play a critical role in the progression of HCC. Modulation of the gut microbiota by probiotics may represent a new avenue for therapeutic intervention in HCC. Practical Implications: Breakdown in intestinal barrier function and bacterial overgrowth are main events in the development of HCC. When the intestinal barrier function is disrupted, large amounts of bacterial products can enter the liver and induce inflammation through their receptors, leading to liver diseases. Altering the gut microflora has been proposed as an adjunctive therapy to reduce bacterial translocation and prevent progression of HCC. The purpose of this review is to discuss the relationship between gut microbiota and HCC in both pathogenesis and treatment by probiotics.
Absence of Mesangial C1q Deposition Is Associated with Resolution of Proteinuria and Hematuria after Tonsillectomy Plus Steroid Pulse Therapy for Immunoglobulin A Nephropathy
Authors: Nishiwaki Hiroki , Hasegawa Takeshi , Nagayama Yoshikuni , Kaneshima Nobuharu , Takayasu Mamiko , Hirose Makoto , Komukai Daisuke , Inoue Yoshihiko , Koiwa Fumihiko , Yoshimura Ashio
Published: April 2015

Introduction and Aims: Deposition of C1q occurs in 0 to 45% of patients with IgAN. In order to identify whether mesangial C1q deposition in IgAN is a novel marker for the response to tonsillectomy plus steroid pulse therapy (TSP), we studied the association between mesangial C1q deposition in IgAN and the remission rate after TSP therapy for IgAN. Methods: We conducted a retrospective cohort study at a single Japanese center. We analyzed data on 110 patients diagnosed with IgA nephropathy who received TSP between January 2003 and December 2012. Positive C1q findings were defined as diffuse mesangial C1q deposition. The study outcome was the resolution of abnormal urinary findings and was defined as negative proteinuria and negative occult blood 1 year after steroid pulse therapy. Results: In all enrolled cases, 69 patients (62.7%) went into remission. Ten out of 24 (41.7%) C1q-positive patients experienced remission, and 59 out of 86 (68.6%) C1q-negative patients experienced remission. Multiple logistic regression model analysis showed that the absence of C1q deposition increased the odds ratio for remission (odds ratio 4.41; 95% confidence interval 1.33-15.75, p = 0.017). Conclusions: These results suggest that the absence of diffuse C1q deposition in the mesangial area of the glomerulus in patients with IgA nephropathy is a positive predictive sign for a response to TSP and is associated with the resolution of urinary abnormalities 1 year after TSP.
Efficacy and Safety of Intravitreal Dexamethasone Implant in Patients with Diabetic Macular Edema
Authors: Guigou Sebastien , Pommier Stephan , Meyer Franck , Hajjar Christian , Merite Pierre Yves , Parrat Eric , Rouhette Herve , Rebollo Olivier , Matonti Frederic
Published: April 2015

Purpose: To evaluate the efficacy and safety of intravitreal implant of dexamethasone (Ozurdex®) in diabetic macular edema (DME). Methods: This was a retrospective multicenter noncomparative study. Seventy-eight patients with DME followed for at least 6 months were included (P1.5 Network). Best-corrected visual acuity (BCVA), central retinal thickness (CRT), intraocular pressure (IOP) and cataract progression were studied at baseline and then at 1, 2, 4 and 6 months. Results: The mean CRT decrease from baseline was 145.2 µm at 6 months. The mean BCVA improvement from baseline was 6.7 at 6 months. An increase in IOP was observed for 11.7% of patients, and all patients were managed by topical treatment. No glaucoma or cataract surgery was necessary, and no endophthalmitis was reported. Conclusions: One injection of Ozurdex has an anatomical and functional effectiveness for the treatment of DME. Side effects were rare and manageable in our practice.
Bipolar Patients' Quality of Life in Mixed States: A Preliminary Qualitative Study
Authors: Lee Mortensen Gitte , Vinberg Maj , Lee Mortensen Steen , Balslev Jørgensen Martin , Eberhard Jonas
Published: April 2015

Background: Approximately 20% of patients with bipolar disorder experience mixed states. Mixed states are associated with more comorbidity, poorer treatment response and prognosis, increased relapse rate, and decreased functioning. This study aimed to produce in-depth knowledge about bipolar patients' quality of life (QoL) and functioning related to mixed states. Sampling and Methods: This study used qualitative research methods. A semi-structured interview guide based on a literature study was applied in interviews with 6 remitted bipolar I patients having experienced mixed states. A medical anthropological approach was applied to analyse the data. Results: Participants described mixed states as worse than other bipolar disorder states and their residual symptoms were prolonged. Mixed states affected the functioning of patients in key life domains such as self-esteem, family, love and social life, physical well-being, and working capability. Conclusions: Mixed states may severely affect the QoL and functioning of bipolar patients. Our results indicate that improving these should be a main goal of patient treatment. With an aim of adequately identifying and treating mixed states, our findings highlight the need for knowledge about this particularly severe expression of bipolar disorder. These results should be confirmed in a larger sample of patients with varying socioeconomic status.
Cerebral Computed Tomography-Graded White Matter Lesions Are Associated With Worse Outcome After Thrombolysis in Patients With Stroke
Authors: Curtze Sami , Melkas Susanna , Sibolt Gerli , Haapaniemi Elena , Mustanoja Satu , Putaala Jukka , Sairanen Tiina , Tiainen Marjaana , Tatlisumak Turgut , Strbian Daniel
Published: April 2015

Background and Purpose—

Compared with other stroke causes, small-vessel disease is associated with better 3-month outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis. Another question is the impact of coexisting cerebral white matter lesions (WMLs; a surrogate marker of small-vessel disease) on outcome, which was addressed in the current study.

Methods—

We analyzed 2485 consecutive intravenous thrombolysis–treated patients at the Helsinki University Central Hospital, 2001 to 2014. WMLs were scored according to 4 previously published computed tomographic visual rating scales from all baseline head scans. The inter-rater agreement was calculated. The primary outcome measure was shift analysis, and the secondary examined all possible binary cutoffs in the modified Rankin Scale at 3 months. The associations of modified Rankin Scale with nominal, ordinal, and continuous variables were analyzed in univariate and adjusted in multivariate binary and ordinal regression (shift analysis) models.

Results—

In univariate and multivariate regression analyses, all 4 tested visual WML rating scales (as continuous variables, or dichotomized at different cutoff points) were associated with worse outcome at all binary levels and in shift analyses of the modified Rankin Scale. After adjusting for confounders, the statistically strongest association in shift analyses remained for the Blennow scale dichotomized at >3 points, reflecting at least moderate WMLs (odds ratio, 1.90; 95% confidence interval, 1.48–2.44).

Conclusions—

WMLs on admission computed tomographic scan are independently associated with worse outcome in intravenous thrombolysis–treated patients with stroke.
A redescription of Yoyetta landsboroughi (Distant) and Y. tristrigata (Goding and Froggatt) (Hemiptera: Cicadidae) and description of four new related species
Authors: EMERY NATHAN J. , EMERY DAVID L. , POPPLE LINDSAY W.
Published: April 2015

This study provides redescriptions of two small cicada species, Yoyetta landsboroughi (Distant) and Y. tristrigata (Goding and Froggatt), from eastern Australia, based on a detailed morphological examination of available material. The status of Y. toowoombae (Distant) is re-examined and it is now formally recognised to be a junior synonym of Y. landsboroughi. Four new species of Yoyetta are described, also from eastern Australia. These are: Y. cumberlandi sp. nov., Y. fluviatilis sp. nov., Y. nigrimontana sp. nov., and Y. repetens sp. nov.. Within each species (re)description, sections on distinguishing features, distribution, habitat and behaviour, and calling song structures are described and illustrated where appropriate.
Revision of the Palaearctic brood parasitic genus Nipponodipogon Ishikawa, 1965 of spider wasps (Hymenoptera: Pompilidae: Pepsinae)
Authors: SHIMIZU AKIRA , LELEJ ARKADY S. , LOKTIONOV VALERY M.
Published: April 2015

The systematics and bionomics of the Palaearctic brood parasitic genus Nipponodipogon Ishikawa, 1965 are revised. Seven species are listed. A new species N. sudai Shimizu, sp. nov. (Japan, Honshu) and the hitherto unknown males of N. iwatai (Ishikawa, 1965) and N. nagasei (Ishikawa, 1965) are described and illustrated. Six species from Japan and the Russian Far East are redescribed. A key to species is provided.