bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis and management of bile acid diarrhoea: a survey of UK expert opinion and practice
Authors: Walters Julian R F , Arasaradnam Ramesh , Andreyev H Jervoise N ,   for the UK Bile Acid Related Diarrhoea Network
Published: September 2019

Objective

Bile acid diarrhoea (BAD), which includes bile acid malabsorption, causes a variety of digestive symptoms. Diagnostic rates and management vary considerably. We conducted a survey of current practice to review expert opinion and provide guidance on diagnosis and management.

Design/method

An online survey was conducted of clinical members of the UK Bile Acid Related Diarrhoea Network, who had all published research on BAD (n=21). Most were National Health Service consultants who had diagnosed over 50 patients with the condition.

Results

The preferred terminology was to use BAD, with primary and secondary to classify causes. A wide range of presenting symptoms and associated conditions were recognised. SeHCAT (tauroselcholic acid) was the preferred diagnostic test, and 50% of respondents thought general practitioners should have access to this. Patients who met the Rome IV diagnostic criteria for functional diarrhoea, irritable bowel syndrome (IBS) with predominant diarrhoea or postcholecystectomy diarrhoea were usually investigated by SeHCAT, which was used sometimes in other types of IBS. Treatment with a bile acid sequestrant was offered to patients with low SeHCAT values, with expected response rates >70% in the most severe. Colestyramine was the usual sequestrant, starting between 2 g and 8 g daily; colesevelam was an alternative. In patients who had an incomplete response, increasing the dose, changing to an alternative sequestrant, use of loperamide and a low fat diet were suggested. Recommendations for follow-up and to improve the overall patient experience were made.

Conclusion

This expert survey indicates current best practice in the diagnosis and management of BAD.
Area Under the Expiratory Flow–Volume Curve (AEX): Actual versus Approximated Values
Authors: Ioachimescu Octavian C , Stoller James K
Published: September 2019

Previous work has shown that area under the expiratory flow–volume curve (AEX) performs well in diagnosing and stratifying respiratory physiologic impairment, thereby lessening the need to measure lung volumes. Extending this prior work, the current study assesses the accuracy and utility of several geometric approximations of AEX based on standard instantaneous flows. These approximations can be used in spirometry interpretation when actual AEX measurements are not available. We analysed 15 308 spirometry tests performed on subjects who underwent same-day lung volume assessments in the Pulmonary Function Laboratory. Diagnostic performance of four AEX approximations (AEX1–4) was compared with that of actual AEX. All four computations included forced vital capacity (FVC) and various instantaneous flows: AEX1 was derived from peak expiratoryflow (PEF); AEX2 from PEF and forced expiratoryflow at 50% FVC (FEF50); AEX3 from FVC, PEF, FEF at 25% FVC (FEF25) and at 75% FVC (FEF75), while AEX4 was computed from all four flows, PEF, FEF25, FEF50 and FEF75. Mean AEX, AEX1, AEX2, AEX3 and AEX4 were 6.6, 8.3, 6.7, 6.3 and 6.1 L2/s, respectively. All four approximations had strong correlations with AEX, that is, 0.95–0.99. Differences were the smallest for AEX–AEX4, with a mean of 0.52 (95% CI 0.51 to 0.54) and a SD of 0.75 (95% CI 0.74 to 0.76) L2/s. In the absence of AEX and in addition to the usual spirometric variables used for assessing functional impairments, parameters such as AEX4 can provide reasonable approximations of AEX and become useful new tools in future interpretative strategies.
Why not common morality?
Authors: Rhodes Rosamond
Published: September 2019

This paper challenges the leading common morality accounts of medical ethics which hold that medical ethics is nothing but the ethics of everyday life applied to today’s high-tech medicine. Using illustrative examples, the paper shows that neither the Beauchamp and Childress four-principle account of medical ethics nor the Gertet al10-rule version is an adequate and appropriate guide for physicians’ actions. By demonstrating that medical ethics is distinctly different from the ethics of everyday life and cannot be derived from it, the paper argues that medical professionals need a touchstone other than common morality for guiding their professional decisions. That conclusion implies that a new theory of medical ethics is needed to replace common morality as the standard for understanding how medical professionals should behave and what medical professionalism entails. En route to making this argument, the paper addresses fundamental issues that require clarification: what is a profession? how is a profession different from a role? how is medical ethics related to medical professionalism? The paper concludes with a preliminary sketch for a theory of medical ethics.
Use of mode shape ratios for pier scour monitoring in two-span integral bridges under changing environmental conditions
Authors: Malekjafarian A. , Prendergast L.J. , OBrien E.
Published: September 2019

In this paper, a novel pier scour indicator is introduced, which uses the ratio between mode shape amplitudes identified at two points on an integral bridge structure to monitor the progression of scour erosion. The mode shape ratio (MSR) is investigated as an additional parameter to complement the use of changes in natural frequency as a scour indicator. The approach is demonstrated using numerical modelling and the MSR is extracted from acceleration signals arising in the structure due to modelled ambient and vehicle-induced vibrations. The MSR shows higher sensitivity to scour erosion than the more commonly researched natural frequency. Furthermore, the variation in MSR under temperature fluctuations is inversely related to that of frequency, in that it increases with increasing temperature whereas frequency decreases with increasing temperature. This inverse relationship potentially enables the separation of the scour effect from the temperature influence on the dynamics of the system.
Revisiting RV Tauri stars: first ionization potential (FIP) effect
Authors: Yolalan G. , Şahin T.
Published: September 2019

We have derived elemental abundances of eight RV Tauri-type post-asymptotic giant branch stars: AR Sgr, CE Vir, DY Aql, HP Lyr, SS Gem, SZ Mon, TT Oph, and UZ Oph. The abundance analysis of these luminous stars is based on the high-resolution (R ≈ 55 000) optical echelle spectra obtained with the 2.1 m Struve reflector telescope and the CCD-equipped Sandiford Cassegrain echelle spectrograph at the McDonald Observatory. Standard 1D local thermodynamic equilibrium analysis provides a fresh determination of the atmospheric parameters and elemental abundances for 17 species including C, Na, Si, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Y, and Nd. Then, the computed up-to-date abundances are used to investigate FIP in the program stars, as seen in the Sun and sun-like stars. Also, we scrutinize their behavior for dust–gas separation as an alternative mechanism to the FIP. For the first time, we provide atomic line lists with up-to-date atomic data employed in the analysis for AR Sgr, HP Lyr, SZ Mon, TT Oph, and UZ Oph.
Comparison of deep learning techniques on content based image retrieval
Authors: Garg Meenakshi , Malhotra Manisha , Singh Harpal
Published: September 2019

Content based Image Retrieval is mostly utilized to extract the pictures from large database. CBIR, which is additionally known as “Query by image” is a technology allowing organizing the computerized Images by their visible attributes. Or, in other words, CBIR is a method for retrieving pictures dependent not on annotations or keywords, but dependent on the feature taken out straightly from the pictures database. CBIR systems are dependent on the utilizations of computer vision methods to the image retrieval issue in huge databases. CBIR is technology of recovering the utmost visually identical pictures to a specified query picture from a cluster or database of pictures. It is useful in a lot of areas like Photography to search images from the database, medical diagnosis etc. Physically annotating the pictures by inputting the metadata or keywords in a huge database can be laborious and might not capture the keyword anticipated to define that picture. CBIR supports in recovering identical pictures from an database of pictures deprived of pictures annotation. In this paper, we are compare the Deep Neural Networks and Neuro-Fuzzy Classifier, both have different outcomes and different results to predict the image. The comparison of our proposed methods Neuro-fuzzy classification and deep neural network shows that the improvement in accuracy. The accuracy values 71.6% and 73.4% for DNN and Neuro-Fuzzy Classifier[Formula: see text] method. The visual and qualitative results are presented for validation of the proposed method.
Bidirectional controlled remote state preparation in three-dimensional system
Authors: Bai Yuan , Ma Peng-Cheng , Chen Gui-Bin , Li Xiao-Wei , Zhan You-Bang
Published: September 2019

We present a novel scheme for bidirectional controlled remote state preparation (BCRSP) in a three-dimensional system with a six-qutrit entangled state as the quantum channel. In this scheme, two distant parties, Alice and Bob, are not only senders but also receivers. Alice wants to remotely prepare a single-qutrit equatorial state at Bob’s site, while at the same time, Bob wishes to help Alice by remotely preparing another single-qutrit equatorial state. It is shown that, only if the two senders and the controller collaborate with each other, the BCRSP can be completed successfully.
Charged cylindrical collapse in f(𝒢) gravity
Authors: Sharif M. , Naz Saba
Published: September 2019

The aim of this paper is to study the gravitational collapse of charged cylindrical star in [Formula: see text] gravity. For this purpose, we derive dynamical equations by applying Misner–Sharp formalism and examine the effects of effective pressure and charge on the collapse rate. We also construct a relationship between matter variables, Gauss–Bonnet (GB) terms, and the Weyl tensor. For the constant value of [Formula: see text], it is found that spacetime is conformally flat if and only if the energy density is homogeneous. We conclude that the rate of collapse slows down in [Formula: see text] gravity due to anti-gravitational effects.
New model and dynamics of higher-dimensional nonlinear Rossby waves
Authors: Zhang Ruigang , Liu Quansheng , Yang Liangui
Published: September 2019

In this work, the propagation of higher-dimensional nonlinear Rossby waves under the generalized beta effect is considered. Using the methods of weak nonlinear perturbation expansions and the multiple scales, we obtain a new (2 + 1)-dimensional generalized Boussinesq equation from the barotropic potential vorticity equation for the first time. Furthermore, a new dispersion relation for the linear Rossby waves is given corresponding to the linearized Boussinesq equation. More importantly, based on the methods of the traveling wave setting and the Jacobi elliptic function expansions, several kinds of exact traveling wave solutions for the higher-dimensional nonlinear Rossby waves, including the periodic solutions, solitary solutions and others are obtained. Finally, we simulate the solitary solutions obtained by using the method of the Jacobi elliptic function. The numerical results show that the amplitude of the Rossby solitary waves is decreasing with the increase of generalized beta effect.
Design of metalloporphyrins fused to imidazolium rings for binding DNA G-quadruplexes
Authors: Caporaletti Francesca , Rubio-Magnieto Jenifer , Lo Mamadou , Longevial Jean-François , Rose Clémence , Clément Sébastien , van der Lee Arie , Surin Mathieu , Richeter Sébastien
Published: September 2019

Synthesis and characterization of nickel(II) meso-tetraarylporphyrins fused to imidazolium rings across [Formula: see text],[Formula: see text]-pyrrolic positions and X-ray structure of the porphyrin where two opposed pyrrole units are fused to an imidazolium ring are presented. The interactions between these mono-, bis-, tris- and tetrakis(imidazolium) porphyrins with human telomeric DNA G-quadruplexes (G4) were investigated using UV-vis absorption spectroscopy, Circular Dichroism (CD) spectroscopy and Fluorescence Resonance Energy Transfer (FRET) melting assay. Possible binding modes between cationic porphyrins and a selected G4 sequence (d[AG3(T2AG[Formula: see text]]), and relative stabilities of porphyrin/G4 complexes are discussed. Excepting porphyrins fused to one imidazolium ring, the other derivatives interact with G4 structures and their stabilization strongly depends on the porphyrin structure (number and localization of the imidazolium rings).
A Survey on Adaptive Authentication
Authors: Arias-Cabarcos Patricia , Krupitzer Christian , Becker Christian
Published: September 2019

Adaptive Authentication allows a system to dynamically select the best mechanism(s) for authenticating a user depending on contextual factors, such as location, proximity to devices, and other attributes. Though this technology has the potential to change the current password-dominated authentication landscape, research to date has not led to practical solutions that transcend to our daily lives. Motivated to find out how to improve adaptive authentication design, we provide a structured survey of the existing literature to date and analyze it to identify and discuss current research challenges and future directions.
cGMP-dependent protein kinase II determines β-catenin accumulation that is essential for uterine decidualization in mice
Authors: Zhang Yang , Yan Lu , Liu Jiali , Cui Sheng , Qiu Jingtao
Published: September 2019

In the early phase of pregnancy, decidualization is an indispensable event after mammal embryo implantation, accompanied by proliferation and differentiation of uterine stromal cells. Type II cGMP-dependent protein kinase (Prkg2) belongs to the family of serine/threonine kinase, which plays multiple roles in cellular signaling pathways to control proliferation and differentiation. However, the regulatory function and molecular mechanism of Prkg2 in decidualization are still unknown. In this study, we show that Prkg2 has a gradually increased expression pattern during peri-implantation and artificial decidualization, and the expression of Prkg2 is induced by estrogen and progesterone in the ovariectomized mouse uteri and primary cultured uterine stromal cells, the process of which is blocked by treating with estrogen receptor (ER) antagonist (ICI-182,780) and progesterone receptor (PR) antagonist (RU-486). Inhibition of Prkg2 activity by HA-100 promotes uterine stromal cell proliferation but compromises decidualization with decreased expression of prolactin family 8, subfamily a, member 2. In addition, the functional regulation of decidualization by Prkg2 is accomplished by its induced phosphorylation of glycogen synthase kinase-3β (GSK-3β) at serine-9, which results in accumulation of β-catenin in the decidual cells. Taken together, our findings demonstrate that estrogen and progesterone upregulate the expression of Prkg2 in uterine stromal cells depending on ER and PR; Prkg2 promotes phosphorylation of GSK-3β at serine-9 and inactivates it, leading to the accumulation of β-catenin and promoting the process of decidualization. In addition to revealing the regulatory mechanism of Prkg2 that ensures the success of uterine decidualization, our findings will contribute to the understanding in the maintenance of early pregnancy.
Hemoglobin alters vitamin carrier uptake and vitamin D metabolism in proximal tubule cells: implications for sickle cell disease
Authors: Gliozzi Megan L. , Rbaibi Youssef , Long Kimberly R. , Vitturi Dario A. , Weisz Ora A.
Published: September 2019

Kidney disease, including proximal tubule (PT) dysfunction, and vitamin D deficiency are among the most prevalent complications in sickle cell disease (SCD) patients. Although these two comorbidities have never been linked in SCD, the PT is the primary site for activation of vitamin D. Precursor 25-hydroxyvitamin D [25(OH)D] bound to vitamin D-binding protein (DBP) is taken up by PT cells via megalin/cubilin receptors, hydroxylated to the active 1,25-dihydroxyvitamin D [1,25(OH)2D] form, and released into the bloodstream. We tested the hypothesis that cell-free hemoglobin (Hb) filtered into the PT lumen impairs vitamin D uptake and metabolism. Hb at concentrations expected to be chronically present in the ultrafiltrate of SCD patients competed directly with DBP for apical uptake by PT cells. By contrast, uptake of retinol binding protein was impaired only at considerably higher Hb concentrations. Prolonged exposure to Hb led to increased oxidative stress in PT cells and to a selective increase in mRNA levels of the CYP27B1 hydroxylase, although protein levels were unchanged. Hb exposure also impaired vitamin D metabolism in PT cells, resulting in reduced ratio of 1,25(OH)2D:25(OH)D. Moreover, plasma levels of 1,25(OH)2D were reduced in a mouse model of SCD. Together, our data suggest that Hb released by chronic hemolysis has multiple effects on PT function that contribute to vitamin D deficiency in SCD patients.
Statin administration activates system xC− in skeletal muscle: a potential mechanism explaining statin-induced muscle pain
Authors: Rebalka Irena A. , Cao Andrew W. , May Linda L. , Tarnopolsky Mark A. , Hawke Thomas J.
Published: September 2019

Statins are a cholesterol-lowering drug class that significantly reduce cardiovascular disease risk. Despite their safety and effectiveness, musculoskeletal side-effects, particularly myalgia, are prominent and the most common reason for discontinuance. The cause of statin-induced myalgia is unknown, so defining the underlying mechanism(s) and potential therapeutic strategies is of clinical importance. Here we tested the hypothesis that statin administration activates skeletal muscle system xC−, a cystine/glutamate antiporter, to increase intracellular cysteine and therefore glutathione synthesis to attenuate statin-induced oxidative stress. Increased system xC− activity would increase interstitial glutamate; an amino acid associated with peripheral nociception. Consistent with our hypothesis, atorvastatin treatment significantly increased mitochondrial reactive oxygen species (ROS; 41%) and glutamate efflux (up to 122%) in C2C12 mouse skeletal muscle myotubes. Statin-induced glutamate efflux was confirmed to be the result of system xC− activation, as cotreatment with sulfasalazine (system xC− inhibitor) negated this rise in extracellular glutamate. These findings were reproduced in primary human myotubes but, consistent with being muscle-specific, were not observed in primary human dermal fibroblasts. To further demonstrate that statin-induced increases in ROS triggered glutamate efflux, C2C12 myotubes were cotreated with atorvastatin and various antioxidants. α-Tocopherol and cysteamine bitartrate reversed the increase in statin-induced glutamate efflux, bringing glutamate levels between 50 and 92% of control-treated levels. N-acetylcysteine (a system xC− substrate) increased glutamate efflux above statin treatment alone: up to 732% greater than control treatment. Taken together, we provide a mechanistic foundation for statin-induced myalgia and offer therapeutic insights to alleviate this particular statin-associated side-effect.
Possible application of melatonin treatment in human diseases of the biliary tract
Authors: Baiocchi Leonardo , Zhou Tianhao , Liangpunsakul Suthat , Ilaria Lenci , Milana Martina , Meng Fanyin , Kennedy Lindsey , Kusumanchi Praveen , Yang Zhihong , Ceci Ludovica , Glaser Shannon , Francis Heather , Alpini Gianfranco
Published: September 2019

Melatonin was discovered in 1958 by Aaron Lerner. Its name comes from the ability of melatonin to change the shape of amphibian melanophores from stellate to roundish. Starting from the 1980s, the role of melatonin in the regulation of mammalian circadian and seasonal clocks has been elucidated. Presently, several other effects have been identified in different organs. For example, the beneficial effects of melatonin in models of liver damage have been described. This review gives first a general background on experimental and clinical data on the use of melatonin in liver damage. The second part of the review focuses on the findings related to the role of melatonin in biliary functions, suggesting a possible use of melatonin therapy in human diseases of the biliary tree.
The PVN enhances cardiorespiratory responses to acute hypoxia via input to the nTS
Authors: Ruyle Brian C. , Martinez Diana , Heesch Cheryl M. , Kline David D. , Hasser Eileen M.
Published: September 2019

Chemoreflex neurocircuitry includes the paraventricular nucleus (PVN), but the role of PVN efferent projections to specific cardiorespiratory nuclei is unclear. We hypothesized that the PVN contributes to cardiorespiratory responses to hypoxia via projections to the nucleus tractus solitarii (nTS). Rats received bilateral PVN microinjections of adeno-associated virus expressing inhibitory designer receptor exclusively activated by designer drug (GiDREADD) or green fluorescent protein (GFP) control. Efficacy of GiDREADD inhibition by the designer receptor exclusively activated by designer drug (DREADD) agonist Compound 21 (C21) was verified in PVN slices; C21 reduced evoked action potential discharge by reducing excitability to injected current in GiDREADD-expressing PVN neurons. We evaluated hypoxic ventilatory responses (plethysmography) and PVN and nTS neuronal activation (cFos immunoreactivity) to 2 h hypoxia (10% O2) in conscious GFP and GiDREADD rats after intraperitoneal C21 injection. Generalized PVN inhibition via systemic C21 blunted hypoxic ventilatory responses and reduced PVN and also nTS neuronal activation during hypoxia. To determine if the PVN-nTS pathway contributes to these effects, we evaluated cardiorespiratory responses to hypoxia during selective PVN terminal inhibition in the nTS. Anesthetized GFP and GiDREADD rats exposed to brief hypoxia (10% O2, 45 s) exhibited depressor and tachycardic responses and increased sympathetic and phrenic nerve activity. C21 was then microinjected into the nTS, followed after 60 min by another hypoxic episode. In GiDREADD but not GFP rats, PVN terminal inhibition by nTS C21 strongly attenuated the phrenic amplitude response to hypoxia. Interestingly, C21 augmented tachycardic and sympathetic responses without altering the coupling of splanchnic sympathetic nerve activity to phrenic nerve activity during hypoxia. Data demonstrate that the PVN, including projections to the nTS, is critical in shaping sympathetic and respiratory responses to hypoxia.
Regulation of mitochondria function by natriuretic peptides
Authors: Domondon Mark , Nikiforova Anna B. , DeLeon-Pennell Kristine Y. , Ilatovskaya Daria V.
Published: September 2019

Natriuretic peptides (NPs) are well known to promote renal Na+ excretion, counteracting the effects of the renin-angiotensin-aldosterone system. Thus, NPs serve as a key component in the maintenance of blood pressure, influencing fluid retention capabilities via osmoregulation. Recently, NPs have been shown to affect lipolysis and enhance lipid oxidation and mitochondrial respiration. Here, we provide an overview of current knowledge about the relationship between NPs and mitochondria-mediated processes such as reactive oxygen species production, Ca2+ signaling, and apoptosis. Establishing a clear physiological and mechanistic connection between NPs and mitochondria in the cardiovascular system will open new avenues of research aimed at understanding and potentially using it as a therapeutic target from a completely new angle.
Multimodal stimuli modulate rapid visual responses during reaching
Authors: Glover Isabel S. , Baker Stuart N.
Published: September 2019

The reticulospinal tract plays an important role in primate upper limb function, but methods for assessing its activity are limited. One promising approach is to measure rapid visual responses (RVRs) in arm muscle activity during a visually cued reaching task; these may arise from a tecto-reticulospinal pathway. We investigated whether changes in reticulospinal excitability can be assessed noninvasively using RVRs, by pairing the visual stimuli of the reaching task with electrical stimulation of the median nerve, galvanic vestibular stimulation, or loud sounds, all of which are known to activate the reticular formation. Surface electromyogram (EMG) recordings were made from the right deltoid of healthy human subjects as they performed fast reaching movements toward visual targets. Stimuli were delivered up to 200 ms before target appearance, and RVR was quantified as the EMG amplitude in a window 75–125 ms after visual target onset. Median nerve, vestibular, and auditory stimuli all consistently facilitated the RVRs, as well as reducing the latency of responses. We propose that this facilitation reflects modulation of tecto-reticulospinal excitability, which is consistent with the idea that the amplitude of RVRs can be used to assess changes in brain stem excitability noninvasively in humans.

NEW & NOTEWORTHY Short-latency responses in arm muscles evoked during a visually driven reaching task have previously been proposed to be tecto-reticulospinal in origin. We demonstrate that these responses can be facilitated by pairing the appearance of a visual target with stimuli that activate the reticular formation: median nerve, vestibular, and auditory stimuli. We propose that this reflects noninvasive measurement and modulation of reticulospinal excitability.
Voluntary and tremorogenic inputs to motor neuron pools of agonist/antagonist muscles in essential tremor patients
Authors: Puttaraksa Gonthicha , Muceli Silvia , Gallego Juan Álvaro , Holobar Ales , Charles Steven K. , Pons Jose L. , Farina Dario
Published: September 2019

Pathological tremor is an oscillation of body parts at 3–10 Hz, determined by the output of spinal motor neurons (MNs), which receive synaptic inputs from supraspinal centers and muscle afferents. The behavior of spinal MNs during tremor is not well understood, especially in relation to the activation of the multiple muscles involved. Recent studies on patients with essential tremor have shown that antagonist MN pools receive shared input at the tremor frequency. In this study, we investigated the synaptic inputs related to tremor and voluntary movement, and their coordination across antagonist muscles. We analyzed the spike trains of motor units (MUs) identified from high-density surface electromyography from the forearm extensor and flexor muscles in 15 patients with essential tremor during postural tremor. The shared synaptic input was quantified by coherence and phase difference analysis of the spike trains. All pairs of spike trains in each muscle showed coherence peaks at the voluntary drive frequency (1–3 Hz, 0.2 ± 0.2, mean ± SD) and tremor frequency (3–10 Hz, 0.6 ± 0.3) and were synchronized with small phase differences (3.3 ± 25.2° and 3.9 ± 22.0° for the voluntary drive and tremor frequencies, respectively). The coherence between MN spike trains of antagonist muscle groups at the tremor frequency was significantly smaller than intramuscular coherence. We predominantly observed in-phase activation of MUs between agonist/antagonist muscles at the voluntary frequency band (0.6 ± 48.8°) and out-of-phase activation at the tremor frequency band (126.9 ± 75.6°). Thus MNs innervating agonist/antagonist muscles concurrently receive synaptic inputs with different phase shifts in the voluntary and tremor frequency bands.

NEW & NOTEWORTHY Although the mechanical characteristics of tremor have been widely studied, the activation of the affected muscles is still poorly understood. We analyzed the behavior of motor units of pairs of antagonistic wrist muscle groups in patients with essential tremor and studied their activity at voluntary movement- and tremor-related frequencies. We found that the phase relation between inputs to antagonistic muscles is different at the voluntary and tremor frequency bands.
Biomonitoring of Acetylcholinesterase (AChE) Activity among Smallholder Horticultural Farmers Occupationally Exposed to Mixtures of Pesticides in Tanzania
Authors: Kapeleka Jones A. , Sauli Elingarami , Sadik Omowunmi , Ndakidemi Patrick A.
Published: September 2019

Biomonitoring of pesticides exposure has currently become a matter of great public concern due to the potential health effects of pesticides. This study assessed levels of acetylcholinesterase (AChE) inhibition and associated health effects in uncontrolled smallholder farming systems in rural Tanzania. A cross-sectional study was conducted of 90 exposed farmers and 61 nonexposed controls from horticultural zones. A structured questionnaire was administered, and a capillary blood sample of 10 μl was used to measure AChE activity using an Erythrocyte Acetylcholinesterase Test Mate Photometric Analyzer kit (Model 400). A multiple logistic regression model was used to investigate determinants of pesticide exposure. The study revealed that smallholder farmers are occupationally exposed to pesticides. Exposed farmers had significantly lower AChE levels. The use of personal protective equipment (PPE) did not significantly reduce the likelihood of AChE inhibition. Women, younger and older farmers, and underweight, overweight, and obese farmers were at increased risk of AChE inhibition. Increase in age (10 years) increased likelihood of AChE inhibition by 6.7%, while decrease in BMI increased likelihood of AChE inhibition by 86.7% while increased pesticides contact hours increased risk of having lower AChE at about 3 times. The number of exposure symptoms (14.10 ± 7.70) was higher in exposed farmers than unexposed. Self-reported symptoms are confirmed to correlate to lower AChE. Prevalence of tiredness (71.6% against 15.5%), fatigue (64.8% against 27.6%), soreness in joints (59.1% against 20.7%), thirst (52.3% against 12.1%), skin irritation (52.1% against 17.2%), salivation and abdominal pain (50% against 8.6% and 31.0%, respectively), muscle weakness (47.7% against 24.1%), and memory loss (47.7% against and 29.3%) differed significantly between exposed and control. This study provides useful information regarding the level of occupational and environmental exposure to pesticides in smallholder horticultural production systems. Pesticides use needs to be controlled at farm level by developing pesticides monitoring and surveillance systems.
Signet Ring Cell Carcinoma of the Colon in Young Adults: A Case Report and Literature Review
Authors: Farraj Farida Abi , Sabbagh Hadi , Aridi Tarek , Fakhruddin Najla , Farhat Fadi
Published: September 2019

Colorectal cancer (CRC), one of the leading causes of cancer-related deaths, presents with challenging features related to its diagnosis and management. The incidence of CRC in the adolescent and young adult (AYA) population has increased over the past couple of decades despite the decline in the overall occurrence of CRC in the general population. Signet ring cell carcinoma is one of the rare histopathologic subtypes of CRC; however, it is more prevalent in AYA patients than in older adults and presents with unconventional histologic characteristics, a distinct clinical behavior, and a poor prognosis. We report a case of a primary signet ring cell adenocarcinoma of the ascending colon in a 19-year-old male who presented with unusual signs and symptoms and was diagnosed with stage IVA (T4a N0 M1, with peritoneal seeding). The unusual presentation and location of the tumor in this case warrant further investigation.
Bioinspired Implementation and Assessment of a Remote-Controlled Robot
Authors: Rybarczyk Yves , Carvalho Diogo Gil
Published: September 2019

Daily activities are characterized by an increasing interaction with smart machines that present a certain level of autonomy. However, the intelligence of such electronic devices is not always transparent for the end user. This study is aimed at assessing the quality of the remote control of a mobile robot whether the artefact exhibits a human-like behavior or not. The bioinspired behavior implemented in the robot is the well-described two-thirds power law. The performance of participants who teleoperate the semiautonomous vehicle implementing the biological law is compared to a manual and nonbiological mode of control. The results show that the time required to complete the path and the number of collisions with obstacles are significantly lower in the biological condition than in the two other conditions. Also, the highest percentage of occurrences of curvilinear or smooth trajectories are obtained when the steering is assisted by an integration of the power law in the robot’s way of working. This advanced analysis of the performance based on the naturalness of the movement kinematics provides a refined evaluation of the quality of the Human-Machine Interaction (HMI). This finding is consistent with the hypothesis of a relationship between the power law and jerk minimization. In addition, the outcome of this study supports the theory of a CNS origin of the power law. The discussion addresses the implications of the anthropocentric approach to enhance the HMI.
Efficacy of Brazilian Propolis Supplementation for Japanese Lactating Women for Atopic Sensitization and Nonspecific Symptoms in Their Offspring: A Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Igarashi Gen , Segawa Takaaki , Akiyama Naoe , Nishino Tamon , Ito Takeru , Tachimoto Hiroshi , Urashima Mitsuyoshi
Published: September 2019

Propolis is a natural product collected from several plants by honeybees and mixed with beeswax and salivary enzymes. In animal models, propolis suppressed IgE-mediated allergies. However, there is no clinical evidence that propolis prevents human atopic sensitization, to the best of our knowledge. Therefore, a randomized, double-blind, placebo-controlled trial was conducted to assess whether propolis supplementation for lactating women increases or decreases the level of total IgE and antigen-specific IgE in the serum of their offspring (i.e., atopic sensitization) at the time of their first birthday. In addition, whether propolis supplementation improves or worsens nonspecific symptoms (e.g., eczema) in the lactating women and their offspring was also investigated. This trial is registered with UMIN000020794. Eligible pairs of mothers and their offspring (n=80) were randomized to two groups: propolis (n=40) and placebo (n=40). Participants were evaluated every month, and 31 (78%) of the propolis group and 23 (58%) of the placebo group underwent blood tests at the first birthday of the offspring. Total IgE ≥ 10 UA/ml was seen in 26 (84%) infants whose mothers were given propolis, which was not significantly different from the 19 (86%) given placebo (P=0.80). Total IgE as a continuous variable was not significantly different between the propolis and placebo groups (P=0.70). Antigen-specific IgE levels for mites, egg white, cow’s milk, and wheat, as both dichotomous and continuous variables, were not significantly different between the two groups. Both in mothers and their offspring, there were no significant differences in the subjective improvements of nonspecific symptoms between the two groups. Except for one mother who had transient and mild nausea, none of the other mothers or their offspring developed severe adverse events during the follow-up period. In conclusion, compared with placebo, Brazilian propolis supplementation did not influence the risk of atopic sensitization in infants and neither did it improve nor worsen nonspecific symptoms in either mothers or their infants.
Mutated RAS: Targeting the “Untargetable” with T Cells
Authors: Chatani Praveen D. , Yang James C.
Published: September 2019

The RAS family of proteins is at the apex of several pathways implicated in a multitude of epithelial cancers but has remained stubbornly resistant to the wave of targeted small molecules and antibodies that have revolutionized clinical oncology. KRAS, the most commonly mutated of the isoforms, represents an attractive target for treatment, given its ubiquity, central role as a driver mutation, and association with poor prognosis. This review is a comprehensive summary of the existing approaches to targeting KRAS spanning small-molecule inhibitors, cancer vaccines, and with a focus on trials in adoptive cell therapy. Here we explain how the limitations of existing drugs and nonspecific immune-based therapies are circumvented with techniques in modern immunotherapy. The successes outlined represent the most promising path to finally targeting the prototypical “undruggable” RAS oncogene family.
Gonadal Tissue Cryopreservation for Children with Differences of Sex Development
Authors: Johnson Emilie K. , Finlayson Courtney , Finney Esther L. , Harris Courtney J. , Tan Serena Y. , Laronda Monica M. , Lockart Barbara A. , Chen Diane , Rowell Erin E. , Cheng Earl Y. , Yerkes Elizabeth B.
Published: September 2019

Introduction: Infertility is common for individuals with differences of sex development (DSD) and is a significant concern to these individuals. Fertility potential in many DSD conditions is poorly understood. Gonadal tissue cryopreservation (GTC) for fertility preservation (FP) is offered to children with cancer undergoing gonadotoxic therapy. Our team sought to expand the field of FP by offering and evaluating the success of GTC for individuals with DSD. Materials and Methods: GTC was offered to patients with DSD undergoing prophylactic gonadectomy, after extensive multidisciplinary counseling. For those who elected to attempt GTC, data were retrospectively abstracted, including: DSD diagnosis, age at gonadectomy, indication for gonadectomy, pathology results, and final decision about long-term gonadal tissue storage. Results: Ten patients were enrolled to attempt GTC, with a mean age of 11.5 years (range 1–18). Five of the 10 patients had germ cells (GCs) present. Diagnoses (age at gonadectomy) for patients with GCs included ovotesticular DSD (13 months), mixed gonadal dysgenesis (17 months), partial gonadal dysgenesis (3 years), partial androgen insensitivity syndrome (11 years), and mixed gonadal dysgenesis (12 years). Four of the 5 subjects with GCs elected for GTC. One opted against GTC, citing immature gametes that did not match gender identity. Conclusion: GTC at the time of gonadectomy for patients with DSD is feasible. In many patients, GCs are present. While questions remain about the timing of gonadectomy, quality of GCs, and future success for use of the tissue based on technological advancement, GTC represents a novel approach to experimental FP for individuals with DSD.
Muscular Abnormalities as a Cause of the Tarsal Tunnel Syndrome: An Infrequent Bilateral Clinical Case
Authors: Di Marco Marco , De Martinis Silvia Elena , Truzzi Marcello , Viganò Roberto
Published: September 2019

A clinical case of a female patient affected by bilateral tarsal tunnel syndrome is described. The peculiarity of this case is the difference in the observed anatomopathological muscular abnormalities between the two feet. On one side, an accessory muscular venter of the toes’ long flexor was identified. On the other side, posterior tibial nerve compression was determined by an accessory venter of the hallux long flexor, associated with an abnormal venter of the toes’ long flexor, with a minor extent if compared to contralateral findings.
Management of Epilepsy among Children in the Gaza Strip: A Multicenter Clinical Audit
Authors: Afifi Tayseer , Elessi Khamis , Samaan Mosab , Alaqad Alaa , Abu Elhatal Hassan , Abu-Lamzi Ahmed
Published: September 2019

Introduction: Seizures are scary phenomena but are quite common especially among children: about 8% will have had at least one seizure by 15 years of age. Most acute seizures in children are brief, terminating spontaneously and do not need any treatment. Seizures that persist beyond 5 min may not stop spontaneously and necessitate comprehensive clinical evaluation and medical care. Seizure control then becomes a matter of urgency for the patient and his family, as the longer the duration of the seizure, the greater the bad effects on body systems especially the brain and the more difficult control is likely to become. Methods: A retrospective, multicenter clinical audit was undertaken simultaneously at the three largest centers for epilepsy management in Gaza. A total of 190 medical records were included in our audit from January 1, 2017, to April 30, 2018. Aims and Objectives: Our audit aims to evaluate the care provided for patients with epilepsy from diagnosis to treatment and follow-up and to compare it against the latest National Institute for Health and Care Excellence (2017) guidelines and AACC (American Association for Clinical Chemistry) (January 7, 2018). Results: Among 190 reviewed medical records, 61% patients were males and the median age was 9 ranging from 6 to 13 years. 31.5% (n = 60) of cases suffered from various comorbidities. The overall adherence of health care professionals to audit standards was moderate. There was severe dearth of information in the medical records. Most records (n = 147, 77.4%) did not include the seizure type, frequency, and duration. Drug therapy was inconsistent with seizure type in 16 cases (8.4%). Investigations were underutilized generally. There were marked differences in the practice among health care centers. Conclusion: The vast majority of files (n = 138, 72.6%) suffered from poor documentation of seizure type, frequency, and duration which needs to be improved. Drug prescription was inconsistent and highly variable and dependent on the treating doctor’s memory and diligence. Moreover, electroencephalogram, electrocardiogram, and drug level testing were highly suboptimal. Health professionals should modify and adopt the AACC recommendations to improve diagnostic and therapeutic service and reduce potential complications and sufferings of epileptic patients.
Zona de tatuagem: um carimbo do estado no corpo do favelado
Authors: Farias Juliana
Published: September 2019

Tendo como combustível de criação os acontecimentos da 1ª Guerra Mundial, surge uma ficção literária sobre a construção e a utilização de uma máquina estatal que tatuava no corpo do condenado o texto da sua sentença até que as perfurações o levassem à morte. Escrita por Kafka, a ficção Na colônia penal (1919) mostra uma máquina tatuadora enquanto aparelho judiciário, cuja operação ficava nas mãos de um único agente de Estado. Tal ficção foi lida por Clastres (2003) como um anúncio da mais contemporânea das realidades. Compartilhando do mesmo entendimento, encaminho a discussão tomando como referência o aparelho judiciário da ficção para refletir sobre a produção da zona de tatuagem nos corpos dos moradores de favelas. Aciono para a elaboração do debate as reflexões de Pierre Clastres (2003) sobre a tríplice aliança entre a lei, a escrita e o corpo e de Letícia Ferreira (2009) sobre a trajetória burocrática de corpos.
A expansão paulista em Afonso de Taunay e Sérgio Buarque de Holanda
Authors: Schneider Alberto Luiz , Martins Renato
Published: September 2019

O artigo discute as relações de proximidade e distância intelectual e institucional entre os historiadores Afonso de Taunay e Sérgio Buarque de Holanda. Um e outro, em períodos diferentes, engajaram-se na produção historiográfica acerca da expansão paulista no período colonial. Como se sabe, o chamado “bandeirismo” foi um dos mais importantes temas da historiografia brasileira – particularmente da historiografia paulista – na primeira metade do século XX. Taunay interpretou o fenômeno como um capítulo da construção do território e da própria nacionalidade brasileira. Sérgio Buarque compreendeu a expansão paulista a partir do apresamento indígena para as lavouras dos campos de Piratininga. A despeito das diferenças teóricas e metodológicas, as relações entre os dois historiadores foi intensa. Não menos importante, interessa ao artigo observar a inserção institucional dos historiadores em questão. Ambos, em períodos diversos, dirigiram o Museu Paulista e ocuparam a cadeira de História da Civilização Brasileira na Universidade de São Paulo.
O Rio de Janeiro à mesa
Authors: Karls Thaina Schwan
Published: September 2019

O Brasil, em toda a sua história e de diferentes maneiras, foi local de convergência de distintas relações étnicas que destacaram sua contribuição na formação do país. O Rio de Janeiro, sua cidade mais importante no século XIX, era também um emaranhado de sabores, cheiros, culturas e gente de todos os tipos. A capital do Império traduzia, nos seus estabelecimentos de alimentação, a complexidade e variedade do seu significado para o país. O objetivo deste estudo é identificar as produções comercializadas nos restaurantes e confeitarias da Corte no século XIX – especificamente entre 1854-1890 – procurando apontar aspectos acerca das influências e referências culturais, assim como as adaptações e acomodações utilizadas na alimentação desenvolvida por ambos os espaços no Rio de Janeiro.
Levantamento Arquitetônico: experiência didática integrada na FAUUSP
Authors: Kühl Beatriz Mugayar , Salvo Simona
Published: September 2019

Este texto aborda as atividades didáticas desenvolvidas na Faculdade de Arquitetura e Urbanismo da Universidade de São Paulo em julho de 2018 relacionadas ao restauro e ao levantamento métrico. As ações articularam, no âmbito dos acordos de cooperação internacional com a Sapienza Università di Roma, disciplina de graduação, disciplina de pós-graduação e evento aberto a um público mais amplo. O curso apresentou a noção do restauro na atualidade, debatendo questões de método e evidenciando as necessárias interrelações do restauro – entendido como campo disciplinar que tem autonomia, mas não é isolado, pois necessita da articulação de várioscampos do saber – com outras áreas do conhecimento e com o projeto arquitetônico. As discussões foram aprofundadas em torno de um eixo específico, centrado em questões de método e na interface entre História – Levantamento – Restauro (projeto), tomando comoobjeto de estudo e tema de exercício, para ampliar o conhecimento e para oferecer a possibilidade de experimentar na prática alguns dos procedimentos, o edifício da FAU-Maranhão.
Effects of an Equine-Assisted Therapy Program for Military Veterans with Self-Reported PTSD
Authors: Monroe Mänette , Whitworth James D. , Wharton Tracy , Turner Joanne
Published: September 2019

This study evaluated the use of an 8-week Equine Assisted Activities and Therapy (EAAT) program for trauma-impacted veterans. There were 48 participants. EAAT programs have emerged as one alternative intervention for veterans who may have declined or dropped out of more traditional research-supported approaches. The EAAT program examined here incorporates CPT techniques in conjunction with guided interactions with horses. Program completers reported decreased PTSD symptoms and reduced signs of depression. Participants’ assessment of their quality of life improved significantly after the EAAT program. They also described a significantly increased ability to depend on others when needing help that was accompanied with a significant sense of relationship anxiety. The results provide evidence that EAAT may be effective for veterans with trauma-related mood, anxiety, and functioning difficulties. They also show that trauma-impacted veterans are more willing to initiate and continue to participate in EAAT programs in contrast to traditional trauma interventions.