bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Mind your Moles’ study: protocol of a prospective cohort study of melanocytic naevi
Authors: Koh Uyen , Janda Monika , Aitken Joanne F , Duffy David L , Menzies Scott , Sturm Richard A , Schaider Helmut , Betz-Stablein Brigid , Prow Tarl , Soyer H Peter , Green Adele C
Published: September 2018

Introduction

Having many melanocytic naevi or ‘moles’ on the skin is the strongest predictor of melanoma; thus, much can be learnt from investigating naevi in the general population. We aim to improve the understanding of the epidemiology and biology of naevi by conducting a 3-year prospective study of melanocytic naevi in adults.

Methods and analysis

This is a population-based cohort study of melanocytic naevi in 200 adults aged 20–69 years recruited via the Australian electoral roll. At baseline, participants will complete a questionnaire on their sun behaviour and health and undergo a clinical examination. Three-dimensional (3D) total-body photography will be used to record the images of skin lesions. Pigmented naevi will be analysed in terms of number, diameter, colour and border irregularity using automated analysis software (excluding scalp, beneath underwear and soles of feet). All naevi ≥5 mm will be recorded using the integrated dermoscopy photographic system. A saliva sample will be obtained at baseline for genomic DNA analysis of pigmentation, naevus and melanoma-associated genes using the Illumina HumanCoreExome platform. The sun behaviour and health follow-up questionnaire, clinical examination and 3D total-body photography will be repeated every 6 months for 3 years. The first 50 participants will also undergo manual counts of naevi ≥2 mm and ≥5 mm at baseline, 6-month and 12-month follow-ups. Microbiopsy and excision of naevi of research interest is planned to commence at the 18-month time point among those who agree to donate samples for detailed histopathological and molecular assessment.

Ethics and dissemination

This study was approved by the Metro South Health Human Research Ethics Committee in April 2016 (approval number: HREC/16/QPAH/125). The findings will be disseminated through peer-reviewed and non-peer-reviewed publications and presentations at conferences.
Selectfluor-mediated oxidative methylenation of amide with N,N-dimethylpropanamide for N,N′-methylenebisamide synthesis
Authors: Cao Yue , Zhou Dongheng , Ma Yongmin
Published: September 2018

A simple and efficient approach for the synthesis of N,N′-methylenebisamides through a Selectfluor-mediated oxidative reaction of aromatic amides and N,N-dimethylpropanamide (DMP) is described. Remarkable results clearly reveal that DMP plays a dual role in this reaction, as both a one-carbon source and an environment-friendly solvent. Moreover, the process provides new strategies for the synthesis of bisamides with advantages of operationally simple, insensitive to atmospheric conditions, and good to high yields.
Estimating the benefits of widespread floodplain reconnection for Columbia River Chinook salmon
Authors: Bond Morgan H. , Nodine Tyler G. , Beechie Tim J. , Zabel Richard W.
Published: September 2018

In the Pacific Northwest, widespread stream channel simplification has led to a loss of habitat area and diversity for rearing salmon. Subsequent efforts throughout the Columbia River basin (CRB) have attempted to restore habitats altered through land development to recover imperiled salmon populations. However, there is scant evidence for demographic change in salmon populations following restoration. We used a process-based approach to estimate the potential benefit of floodplain reconnection throughout the CRB to Chinook salmon (Oncorhynchus tshawytscha) parr. Using satellite imagery, we measured stream habitats at 2093 CRB stream reaches to construct random forest models of habitat based on geomorphic and regional characteristics. Connected floodplain width was the most important factor for determining side channel presence. We estimated a current CRB-wide decrease in side channel habitat area of 26% from historical conditions. Reconnection of historical floodplains currently used for agriculture could increase side channel habitat by 25% and spring Chinook salmon parr total rearing capacity by 9% over current estimates. Individual watersheds vary greatly in habitat factors that limit salmon recovery, and large-scale estimates of restoration potential like these are needed to make decisions about long-term restoration goals among imperiled populations.
Natural convection of power-law nanofluid in a square enclosure with a circular cylinder: An immersed boundary-lattice Boltzmann study
Authors: Li Dinggen , Zhang Haifeng , Ye Peixin , Yu Zihao
Published: September 2018

In this paper, natural convection of power-law Al2O3-water nanofluids with temperature-dependent properties in a square enclosure with a circular cylinder is studied. The governing equations of the flow and temperature fields are solved by the lattice Boltzmann method (LBM), and the curved velocity and thermal boundary conditions are treated by immersed boundary method (IBM). The effects of Rayleigh number, power-law index, nanoparticle volume fractions, radius of circular cylinder, nanoparticle diameter and temperature difference on flow and heat transfer characteristics are discussed in detail. The results indicate that the heat transfer rate is increased with the increases of Rayleigh number, radius of circular cylinder and temperature difference, while it generally decreases with an increase in power-law index and nanoparticle diameter. Additionally, it is observed that there is an optimal volume fraction at which the maximum heat transfer enhancement is obtained, and the value of it is found to increase slightly with decreasing the nanoparticle diameter, and to increase remarkably with increasing the temperature difference.
The epidemic network construction and immunization based on node strength
Authors: Nian Fuzhong , Wang Longjing , Dang Zhongkai
Published: September 2018

In this paper, a new spreading network was constructed and the corresponding immunizations were proposed. The social ability of individuals in the real human social networks was reflected by the node strength. The negativity and positivity degrees were also introduced. And the edge weights were calculated by the negativity and positivity degrees, respectively. Based on these concepts, a new asymmetric edge weights scale-free network which was more close to the real world was established. The comparing experiments indicate that the proposed immunization is priority to the acquaintance immunization, and close to the target immunization.
Minimizing the deep coalescence cost
Authors: Dąbkowski Dawid , Tabaszewski Paweł , Górecki Paweł
Published: September 2018

Metagenomic studies identify the species present in an environmental sample usually by using procedures that match molecular sequences, e.g. genes, with the species taxonomy. Here, we first formulate the problem of gene-species matching in the parsimony framework using binary phylogenetic gene and species trees under the deep coalescence cost and the assumption that each gene is paired uniquely with one species. In particular, we solve the problem in the cases when one of the trees is a caterpillar. Next, we propose a dynamic programming algorithm, which solves the problem exactly, however, its time and space complexity is exponential. Next, we generalize the problem to include non-binary trees and show the solution for caterpillar trees. We then propose time and space-efficient heuristic algorithms for solving the gene-species matching problem for any input trees. Finally, we present the results of computational experiments on simulated and empirical datasets consisting of binary tree pairs.
Convergence of manifolds and metric spaces with boundary
Authors: Perales Raquel
Published: September 2018

We study sequences of oriented Riemannian manifolds with boundary and, more generally, integral current spaces and metric spaces with boundary. We prove theorems demonstrating when the Gromov–Hausdorff (GH) and Sormani–Wenger Intrinsic Flat (SWIF) limits of sequences of such metric spaces agree. Thus in particular the limit spaces are countably [Formula: see text] rectifiable spaces. From these theorems we derive compactness theorems for sequences of Riemannian manifolds with boundary where both the GH and SWIF limits agree. For sequences of Riemannian manifolds with boundary we only require non-negative Ricci curvature, upper bounds on volume, noncollapsing conditions on the interior of the manifold and diameter controls on the level sets near the boundary.
Archibald Geikie and landscape painting
Authors: Morrison John
Published: September 2018

Archibald Geikie was interested in art and produced
c.
700 images in various media. Geikie's drawings and watercolours evolved in relation to the tradition of links between geology and fine art. This tradition is important in considering Geikie's visual output. His work in the Highlands and Lowlands of Scotland, in England and in France both related to that tradition and responded to differing visual codes of representation in these locations at the time he worked. Specifically, Geikie utilized a Romantic aesthetic while painting in the Scottish Highlands and adopted a more Realist approach in the Lowlands. In France and in England, his visual language can be related to well-established contemporary modes of expression. The significance of these adaptations is discussed.
Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess
Authors: Dahlberg Ryan K. , Lyvers Mary Elizabeth , Dahlberg Thomas K.
Published: September 2018

Salmonella vertebral discitis/osteomyelitis is a rare manifestation of Salmonella infection. Here, we report a case of a 54-year-old Caucasian male who presented with five weeks of progressively worsening bilateral low back, buttock, and lower extremity pain following an 8-foot fall onto concrete from a ladder. Initial workup following the fall included hip X-ray and MRI of the lumbar spine and revealed only mild lumbar facet arthropathy and moderate left neural foraminal stenosis at L3-L4 without any concomitant hip or spine fracture. The patient’s pain continued to increase in severity over the next several weeks, and he was evaluated by multiple healthcare professionals with no discovered pathology. Approximately 5 weeks following the fall, repeat CT scan and MRI were conducted which then revealed extensive findings of discitis/osteomyelitis at L5–S1 as well as an epidural abscess resulting in severe narrowing of the central spinal canal. Patient underwent emergent decompression laminectomy and discectomy at L5–S1 with evacuation of the epidural abscess. Intraoperative tissue and wound cultures revealed Salmonella enterica serovar Agbeni. The patient recovered well and was discharged on an eight-week regimen of IV ceftriaxone. He has since recovered appropriately with no neurologic deficits. Important takeaways from this case include continuing to work up patients whose pain or condition is not consistent with radiographic findings and the importance of clinical intuition. This case also highlights the use of intraoperative cultures and sensitivities to correctly direct antibiotic management. Lastly, this report adds to the paucity of literature surrounding Salmonella Agbeni-related discitis and epidural abscesses and makes the suggestion that traumatic incidents such as a fall may instigate these infections.
Applying Adaptive Neural Fuzzy Inference System to Improve Concrete Strength Estimation in Ultrasonic Pulse Velocity Tests
Authors: Ngo Loan T. Q. , Wang Yu-Ren , Chen Yi-Ming
Published: September 2018

When inspecting the property of material, nondestructive testing methods are more preferable than destructive testing since they do not damage the test sample. Nondestructive testing methods, however, might not yield the same accurate results in examining the property of material when compared with destructive testing. To improve the result of nondestructive testing methods, this research applies artificial neural networks and adaptive neural fuzzy inference system in predicting the concrete strength estimation using nondestructive testing method, the ultrasonic pulse velocity test. In this research, data from a total of 312 cylinder concrete samples were collected. Ultrasonic pulse velocity test was applied to those 312 samples in the lab, following the ASTM procedure. Then, the testing results of 312 samples were used to develop and validate two artificial intelligence prediction models. The research results show that artificial intelligence prediction models are more accurate than statistical regression models in terms of the mean absolute percentage error.
Plasma Energy-Balance Metabolites Discriminate Asymptomatic Patients with Peripheral Artery Disease
Authors: Hernández-Aguilera Anna , Fernández-Arroyo Salvador , Cabre Noemí , Luciano-Mateo Fedra , Baiges-Gaya Gerard , Fibla Montserrat , Martín-Paredero Vicente , Menendez Javier A. , Camps Jordi , Joven Jorge
Published: September 2018

Peripheral artery disease (PAD) is a common disease affecting 20–25% of population over 60 years old. Early diagnosis is difficult because symptoms only become evident in advanced stages of the disease. Inflammation, impaired metabolism, and mitochondrial dysfunction predispose to PAD, which is normally associated with other highly prevalent and related conditions, such as diabetes, dyslipidemia, and hypertension. We have measured energy-balance-associated metabolite concentrations in the plasma of PAD patients segregated by the severity of the disease and in plasma of healthy volunteers using a quantitative and targeted metabolomic approach. We found relevant associations between several metabolites (3-hydroxybutirate, aconitate, (iso)citrate, glutamate, and serine) with markers of oxidative stress and inflammation. Metabolomic profiling also revealed that (iso)citrate and glutamate are metabolites with high ability to discriminate between healthy participants and PAD patients without symptoms. Collectively, our data suggest that metabolomics provide significant information on the pathogenesis of PAD and useful biomarkers for the diagnosis and assessment of progression.
Risk Factors for Vaginal Colonization and Relationship between Bacterial Vaginal Colonization and In-Hospital Outcomes in Women with Obstructed Labor in a Ugandan Regional Referral Hospital
Authors: Ngonzi Joseph , Bebell Lisa M. , Bazira Joel , Fajardo Yarine , Nyehangane Dan , Boum Yap , Nanjebe Deborah , Boatin Adeline , Kabakyenga Jerome , Jacquemyn Yves , Van Geertruyden Jean-Pierre , Riley Laura E.
Published: September 2018

Introduction. The proportion of women with severe maternal morbidity from obstructed labor is between 2 and 12% in resource-limited settings. Maternal vaginal colonization with group B streptococcus (GBS), Escherichia coli, and Enterococcus spp. is associated with maternal and neonatal morbidity. It is unknown if vaginal colonization with these organisms in obstructed labor women is associated with poor outcomes. Objectives. To determine whether vaginal colonization with GBS, E. coli, or Enterococcus is associated with increased morbidity among women with obstructed labor and to determine the risk factors for colonization and antibiotic susceptibility patterns. Methods. We screened all women presenting in labor to Uganda’s Mbarara Regional Referral Hospital maternity ward from April to October 2015 for obstructed labor. Those meeting criteria had vaginal swabs collected prior to Cesarean delivery and surgical antibiotic prophylaxis. Swabs were inoculated onto sterile media for routine bacterial culture and antimicrobial susceptibility testing. Results. Overall, 2,168 women were screened and 276 (13%) women met criteria for obstructed labor. Vaginal swabs were collected from 272 women (99%), and 170 (64%) were colonized with a potential pathogen: 49% with E. coli, 5% with GBS, and 8% with Enterococcus. There was no difference in maternal and fetal clinical outcomes between those colonized and not colonized. The number of hours in labor was a significant independent risk factor for vaginal colonization (aOR 1.02, 95% CI 1.00–1.03, P=0.04). Overall, 38% of GBS was resistant to penicillin; 61% of E. coli was resistant to ampicillin, 4% to gentamicin, and 5% to ceftriaxone and cefepime. All enterococci were ampicillin and vancomycin susceptible. Conclusion. There was no difference in maternal or neonatal morbidity between women with vaginal colonization with E. coli, GBS, and Enterococcus and those who were not colonized. Duration of labor was associated with increased risk of vaginal colonization in women with obstructed labor.
Effects of Acupuncture on the Outcomes of Assisted Reproductive Technology: An Overview of Systematic Reviews
Authors: Xi Jin , Chen Hao , Peng Zhi-hang , Tang Zong-xiang , Song Xiang , Xia You-bing
Published: September 2018

Objectives. To conclude the evidence from systematic reviews (SRs) and meta‐analyses assessing the effectiveness of acupuncture to treat couples with subfertility undergoing ART. Methods. We searched the major databases from their inception to March 2018: PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chongqing VIP, and Sino‐Med (the Chinese database). The primary outcomes of the overview were live birth and clinical pregnancy, and secondary outcomes were ongoing pregnancy, miscarriage, and adverse events. Study selection, quality assessment, and data extraction were performed independently by two review authors. Review methodological quality was assessed by using the AMSTAR tool, and the quality of the evidence was rated by GRADE methods. Results. Eleven systematic reviews were included and published between 2009 and 2017. Our study showed that the acupuncture treatment seems to be a useful tool to improve the clinical pregnancy rate in patients who undergo assisted reproduction therapy. However, there was no evidence that acupuncture had any effect on live birth rate, ongoing pregnancy rates, or miscarriage regardless of whether acupuncture was performed around the time of oocyte retrieval or around the day of embryo transfer; this evidence is inconclusive because of the low quality of the included studies. Conclusions. The evidence for acupuncture to treat couples with subfertility undergoing ART remains unclear. Further research is needed, with high‐quality trials undertaken and reported.
Albizia Adianthifolia: Botany, Medicinal Uses, Phytochemistry, and Pharmacological Properties
Authors: Maroyi Alfred
Published: September 2018

The bark, leaves, and roots ofAlbizia adianthifoliaare highly sought after in tropical Africa as herbal medicines. Therefore, the aim of this study was to review the botany, medicinal uses, phytochemistry, and pharmacological properties ofA. adianthifoliaso as to provide baseline data required for evaluating the therapeutic potential of the species. Information on the botanical profile, medicinal uses, phytochemistry, and pharmacological properties ofA. adianthifoliawas undertaken using databases such as ScienceDirect, SciFinder, Pubmed, Google Scholar, Medline, SCOPUS, EThOS, ProQuest, OATD, and Open-thesis. Preelectronic literature search of conference papers, scientific articles, books, book chapters, dissertations, and theses was carried out at the University library. Literature search revealed thatA. adianthifoliais used as purgative and herbal medicine for diabetes, eye problems, gastrointestinal problems, haemorrhoids, headache, neurodegenerative disorders, reproductive problems in women, respiratory problems, wounds and pain, skin diseases, sexually transmitted infections, and ethnoveterinary medicine. Phytochemical compounds identified from the species include apocarotenoids, chalcone, dipeptide, elliptosides, essential oils, fatty acids, flavonoids, histamine, imidazolyl carboxylic acid, prosapogenins, steroids, triterpene saponins, and triterpenoids. Pharmacological studies revealed thatA. adianthifoliaextracts and compounds have acetylcholinesterase enzyme inhibitory, anthelmintic, antiamoebic, antibacterial, antimycobacterial, anti-sexually transmitted infections, antifungal, anti-inflammatory, antioxidant, anxiolytic, and antidepressant, cognitive-enhancing, haemolytic, hypoglycemic and antihyperglycemic, immunomodulatory, and cytotoxicity activities. Detailed studies on the pharmacokinetics, in vivo,and clinical research involving compounds isolated fromA. adianthifoliaand extracts of the species are required.
Predictors of Stunting among School-Age Children in Northwestern Ethiopia
Authors: Lisanu Mazengia Amare , Andargie Biks Gashaw
Published: September 2018

Background. Stunting is a major public health problem in most developing countries, and it increases the risk of illness and death throughout childhood. It is also a major public health problem in Ethiopia. Most of the few studies done in Ethiopia were done in schools. However, the prevalence of stunting of school-age children at the community level is largely unknown. Objective. To assess prevalence and predictors of stunting among school-age children in Mecha District, Amhara Regional State, Ethiopia. Methods. A community-based cross-sectional study was conducted from August 28, 2017, to October 10, 2017. Target population for the study was school-age children (children of age 5–15). A total of 802 children were included in the study. The multistage sampling procedure was applied. Data were collected through face-to-face interview using the structured questionnaire. Anthropometric measurement was performed and analyzed using ENA SMART software. Association was assessed using logistic regression (backward LR). Statistical significance was measured using adjusted odds ratio at 95% CI and P value less than 0.05. Results. About 37.9%, with 95% CI (34.6, 41.3), of children were stunted. The predictors of stunting were child age with AOR (95% CI) 1.4 (1.02, 1.91), family size with AOR (95% CI) 1.83 (1.21, 2.75), mother’s education with AOR (95% CI) 1.81 (1.01, 3.24), father’s occupation with AOR (95% CI) 5.23 (1.55, 17.64), and child’s immunization status with AOR (95% CI) 5.6 (2.90, 10.82). Conclusion. Stunting is still an important problem among children in the age of 5–15 years. Therefore, special attention should be given to child’s full immunization, limiting of family size, continued promotion of female education, and appropriate feeding practice of children depending on their age.
Impact System Dynamic Characteristics of Hydraulic Rock Drill Based on an Overlapped Reversing Valve
Authors: Li Yelin , Luo Youxin , Wu Xiao
Published: September 2018

For the phenomenon of a hydraulic rock drill based on an underlapped reversing valve, the mechanical structure of the overlapped reversing form was proposed, which affected the pressure pulsation of the impact system, and motion of the impact piston was analyzed. The model of a hydraulic rock drill was built based on Newton’s laws. The initial lead size of the reversing point was calculated by the equilibrium position of the damping piston and final velocity of the impact piston. The size of the overlapped reversing valve was designed and the best impact interval was calculated, according to pressure characteristic curves in the piston of the front‐rear chamber and in the reversing valve of the left‐right chamber, and the damping piston floating feature had an impact on initial lead size of the reversing point. The advantages of the overlapped reversing valve were analyzed, by contrasting the pressure pulsation of the impact system and motion of the impact piston with the underlapped reversing valve. The inner mechanism experiment of the hydraulic rock drill was designed to test the pressure characteristic curves in the piston of the front‐rear chamber and in the reversing valve of the left‐right chamber. The model of the overlapped reversing valve was verified by the experiment.
Channel Characterization and Path Loss Modeling in Indoor Environment at 4.5, 28, and 38 GHz for 5G Cellular Networks
Authors: Majed Mohammed Bahjat , Rahman Tharek Abd , Aziz Omar Abdul , Hindia Mohammad Nour , Hanafi Effariza
Published: September 2018

The current propagation models used for frequency bands less than 6 GHz are not appropriate and cannot be applied for path loss modeling and channel characteristics for frequency bands above 6 GHz millimeter wave (mmWave) bands, due to the difference of signal propagation characteristics between existing frequency bands and mmWave frequency bands. Thus, extensive studies on channel characterization and path loss modeling are required to develop a general and appropriate channel model that can be suitable for a wide range of mmWave frequency bands in its modeling parameter. This paper presents a study of well-known channel models for an indoor environment on the 4.5, 28, and 38 GHz frequency bands. A new path loss model is proposed for the 28 GHz and 38 GHz frequency bands. Measurements for the indoor line-of-sight (LOS) and non-line-of-sight (NLOS) scenarios were taken every meter over a separation distance of 23 m between the TX and RX antenna locations to compare the well-known and the new large-scale generic path loss models. This measurement was conducted in a new wireless communication center WCC block P15a at Universiti Teknologi Malaysia UTM Johor, Malaysia, and the results were analyzed based on the well-known and proposed path loss models for single-frequency and multifrequency models and for directional and omnidirectional path loss models. Results show that the large-scale path loss over distance could be modeled better with good accuracy by using the simple proposed model with one parameter path loss exponent PLE (n) that is physically based to the transmitter power, rather than using the well-known models that have no physical base to the transmitted power, more complications (require more parameters), and lack of anticipation when explaining model parameters. The PLE values for the LOS scenario were 0.92, 0.90, and 1.07 for the V-V, V-H, and V-Omni antenna polarizations, respectively, at the 28 GHz frequency and were 2.30, 2.24, and 2.40 for the V-V, V-H, and V-Omni antenna polarizations, respectively, at the 38 GHz frequency.
Adaptive Fuzzy Command Filtered Control for Chua’s Chaotic System
Authors: Wang Lin , Wei Hui , Yang Chunzhi
Published: September 2018

In this paper, we propose the command filtered adaptive fuzzy backstepping control (AFBC) approach for Chua’s chaotic system with external disturbance. Based on two proposed first-order command filters, the convergence of tracking errors as well as the problem of “explosion of complexity” in traditional backstepping design procedure is solved. In the command filtered AFBC design, we do not need to calculate the complicated partial derivatives of the virtual control inputs. Fuzzy logic systems (FLSs) are used to identify the system uncertainties in real time. Based on Lyapunov stability criterion, the proposed controller can guarantee that all signals in the closed-loop system keep bounded, and the tracking errors converge to a small region eventually. Finally, simulation studies have been provided to verify the effectiveness of the proposed method.
Methylation of High-Risk Human Papillomavirus Genomes Are Associated with Cervical Precancer in HIV-Positive Women
Authors: Gradissimo Ana , Lam Jessica , Attonito John D. , Palefsky Joel , Massad L. Stewart , Xie Xianhong , Eltoum Isam-Eldin , Rahangdale Lisa , Fischl Margaret A. , Anastos Kathryn , Minkoff Howard , Xue Xiaonan , D'Souza Gypsyamber , Flowers Lisa C. , Colie Christine , Shrestha Sadeep , Hessol Nancy A. , Strickler Howard D. , Burk Robert D.
Published: September 2018

Background:

HIV-positive women are at substantial risk of HPV-associated cervical neoplasia caused by high-risk (HR) HPVs. Methylation of the HPV genome is associated with cervical intraepithelial neoplasia grade 3 (CIN3) in HIV-negative women, yet it is unknown whether this holds true for HIV-positive women.

Methods:

We designed a case–control study within the Women's Interagency HIV Study (WIHS) cohort comparing HIV-positive CIN3 cases (N = 72) to HIV-positive controls without detectable CIN2+. The unit of analysis and matching was HPV-type infection. Cases with ≥2 HR-HPV types (N = 23; 32%) had a separate control for each HR-HPV type. We developed and utilized next-generation sequencing (NGS) methylation assays for 12 different HR-HPVs, focusing on CpG sites in the L1/L2 regions.

Results:

Significant case–control differences in individual CpG site methylation levels were observed for multiple alpha-9 (HPV16/31/35/58) and alpha-7 HPV (HPV18/39/45) types, based on dichotomization of tertile levels (T3 vs. T1 and T2). Analyses combining homologous CpG sites [e.g., HPV16-L1-5608/HPV31-L1-5521/HPV35-L2L1-5570; OR = 7.28; 95% confidence interval (CI): 2.75–19.3], and (e.g., HPV18-L1-7062/HPV45-L1-7066; OR = 6.94; 95% CI: 1.23–39.3) were significant in separate case–control comparisons. In cases with multiple HR-HPVs, we tested and confirmed the hypothesis that one HR-HPV type would have higher methylation than other types detected, consistent with there being a single HR-HPV causally related to a lesion.

Conclusions:

CIN3 is associated with elevated L1/L2 CpG methylation levels in HIV-positive women.

Impact:

HPV DNA CpG methylation is a promising triage option in HIV-positive women testing positive for HR-HPV types and provides risk attribution in women with multiple HPV type infections.
A Highly Advanced Gastric Cancer Maintaining a Clinical Complete Response after Chemoradiotherapy Comprising S-1 and Cisplatin
Authors: Yura Masahiro , Takahashi Tsunehiro , Fukuda Kazumasa , Nakamura Rieko , Wada Norihito , Fukada Junichi , Kawakubo Hirofumi , Takeuchi Hiroya , Shigematsu Naoyuki , Kitagawa Yuko
Published: September 2018

We report a patient with highly advanced gastric carcinoma who was treated successfully with chemoradiotherapy (CRT) comprising S-1 and cisplatin. The patient was a 71-year-old male who was diagnosed with advanced gastric carcinoma by esophagogastroduodenoscopy (EGD) by medical examination. EGD demonstrated type 3 advanced gastric carcinoma in the posterior wall of the upper gastric body. An abdominal computed tomography (CT) scan showed that the gastric wall was thickened due to gastric primary tumor, and large lymph nodes (LNs) including the lesser curvature LN, anterosuperior LN along the common hepatic artery and some para-aortic LNs were detected. The patient was diagnosed with stage IV advanced gastric carcinoma according to the Japanese classification of gastric carcinoma (cT4a, cN3, cM1 [para-aortic LN], cStage IV). Preoperative CRT was carried out in an attempt to downstage the disease. Remarkable reduction of the primary tumor and metastatic LNs was observed after initial CRT, and radiological examination determined that a partial response had been achieved. Adverse effects included grade 2 anorexia and grade 3 ALP elevation (919 U/ml). No grade 4 or more severe adverse event was observed. After CRT, although we recommended curative surgery, the patient refused surgical treatment and opted for conservative treatment. Thus, we continued S-1 oral administration for 1 year. Five months after beginning CRT, upper endoscopy showed that the tumor had maintained regression and scar formation, in which no cancer cells were detected by endoscopic biopsy. The patient is doing well and has maintained a clinical complete response for more than 42 months without curative surgery. CRT could be considered as an option for treatment of patients with locally advanced gastric carcinoma diagnosed as unresectable, or for those who refuse surgical treatment.
Repeated Plastic Stentings of Common Hepatic Duct for Portal Vein Aneurysm Compression in a Patient Unsuitable for Surgery
Authors: Sun Jeffrey , Sun Cheuk-Kwan , Sun Cheuk-Kay
Published: September 2018

Portal vein aneurysms are rare vascular malformations with unclear etiologies and optimal treatment guidelines. Although Doppler ultrasonography is the most commonly used diagnostic tool, there is no gold standard imaging modality. Despite recommendations of surgical treatment for symptomatic aneurysms, there are limited options in the management of portal vein aneurysm-related complications in patients unfit for surgical intervention. We describe an 85-year-old man who presented with abdominal pain and low-grade fever with clinical signs consistent with cholangitis. Endoscopic retrograde cholangiopancreatography revealed a common hepatic duct stricture and concomitant intraductal ultrasonography identified adjacent aneurysmal portal vein dilatation. The final diagnosis of portal vein aneurysm was made using contrast computerized tomography scan. The patient was considered unsuitable for surgery due to his advanced age and multiple comorbidities. Instead, an endoscopic biliary plastic stent was inserted as a therapeutic alternative, which successfully achieved complete resolution of symptoms 3 days after the procedure. The patient was regularly followed at the outpatient clinic with repeated stent replacements every 3 to 4 months. After a follow-up of over 3.5 years, the patient remained symptom-free without signs of portal vein aneurysm compression. The result suggests that repeated stent replacements may be a therapeutic option for biliary compression by portal vein aneurysm in patients contraindicated for surgical intervention.
Use of the Endometriosis Fertility Index to Predict Natural Pregnancy after Endometriosis Surgery: A Single-Center Study
Authors: Kim Jeong Sook , Lee Chung Won , Yun Jisun , Lee Jae Hoon , Yun Bo Hyun , Park Joo Hyun , Seo Seok Kyo , Cho SiHyun , Choi Young Sik , Lee Byung Seok
Published: September 2018

Aims: Our objective was to predict natural pregnancy after endometriosis surgery using the endometriosis fertility index (EFI). Methods: A retrospective medical records review was conducted, examining patients surgically treated for endometriosis at a single center in Korea between January 2009 and February 2015. In total, 68 women attempting natural conception were analyzed by assessing age, preoperative serum CA-125, body mass index, revised American Fertility Society (rAFS) stage, EFI, and pregnancy outcome. Kaplan-Meier estimates and log-rank tests were used to generate cumulative natural pregnancy rate curves based on an EFI cut-point. A receiver-operating characteristic (ROC) curve was plotted for EFI. Results: Seventy-seven patients attempted conceptions, resulting in 33 natural and 9 assisted conceptions. Excluding assisted conceptions, the mean EFI scores of 68 women who were not pregnant and pregnant were 5.43 ± 0.36 and 6.88 ± 0.28 respectively. The relation between EFI and natural pregnancy was significant (cumulative overall pregnancy rate, p = 0.006), whereas rAFS stage was not (univariate logistics, p = 0.853). The cut-point for maximum natural pregnancy outcomes was 6 (area under ROC curve = 0.710, 95% CI 0.586–0.835). Conclusion: The EFI is a reliable staging system for predicting natural pregnancy after endometriosis surgery. EFI scores can be used to guide postoperative treatment of women with endometriosis.
Cardiac Troponin T Risk Stratification Model Predicts All-Cause Mortality Following Kidney Transplant
Authors: Firth Christine , Shamoun Fadi , Cha Stephen , Zhang Nan , Patel Salma , Wennberg Paul , Amer Hatem , Wadei Hani , Heilman Raymond , Keddis Mira
Published: September 2018

Background: We evaluated the role of increased cardiac troponin T (cTnT), vascular, and cardiac diseases in predicting 5 and 10-year all-cause mortality after kidney transplantation. Methods: We reviewed a cohort of 764 kidney transplant recipients and analyzed pertinent cardiovascular risk factors at the time of transplant evaluation. Proportional hazards regression analysis with bootstrapping method was utilized to provide a risk stratification score for mortality. Results: Mean age was 58.8 years (SD 12.1) and median follow-up was 7.0 years (range 1 day to 18.0 years). Fifty-four percent of patients (n = 415) had cTnT measured (median 0.02 ng/mL, range 0.01–4.91). Fifty-three percent (n = 407) had vascular disease, 59% (n = 448) had diabetes, and 44% (n = 336) had cardiac disease pre-transplant. Sixty percent (n = 460) required dialysis. Older age, increased cTnT, pre-transplant vascular and cardiac diseases predicted mortality in multivariate analysis. We derived 2 scoring systems with and without cTnT – the ACV and ACTV scores (age, cardiac disease, elevated cTnT, and vascular disease) – as predictors of mortality after kidney transplant. Point assignments were: age 60–69 years (1), age ≥70 years (2), cardiac disease (1), cTnT ≥0.04 ng/mL (1), and vascular disease (1). Both scoring systems significantly predicted mortality. The ACTV score better delineated risk stratification across score levels (0–2, 3–4, and 5 points). Conclusions: We developed a risk schema predictive of all-cause mortality after kidney transplant in a derivation cohort. The ACTV score, including an elevated cTnT, provided superior prediction compared to a scoring system without cTnT. Further studies to validate these findings are needed.
Evaluating Guideline Adherence for T1 Bladder Cancer Treatment and Surveillance: A Retrospective German Multicenter Observation
Authors: Vetterlein Malte W. , Gild Philipp , Marks Phillip , Roschinski Julia , Doh Ousman , Höppner Wolfgang , Wagner Walter , Isbarn Hendrik , Büscheck Franziska , Sauter Guido , Dahlem Roland , Soave Armin , Fisch Margit , Rink Michael
Published: September 2018

Introduction: To mirror guideline-adherence for pT1 bladder cancer treatment in Northern Germany. Materials and Methods: Overall, 111 patients with pT1 diagnosis were treated at 4 institutions. Guideline-adherence was defined as repeat resection, instillation, and quarterly cystoscopy. Patient characteristics and pathological parameters were assessed. We summarized patients using descriptive analyses and evaluated guideline-adherence within selected subgroups. We created a multivariable model to identify predictors of guideline-adherence. Results: Median age was 75 years (range 39–94 years), multifocal tumors were found in 44.1%, early instillation was performed in 33.3%, and repeat resection was performed in 77.5%. Of 62.2% who underwent instillation, 59.4% received BCG, while 40.6% received Mitomycin C or other agents. Cystoscopic follow-up was performed in 81.8%. Guideline-adherence was met in 56.8%. Patients aged below the median met adherence metrics more often compared to those above the median (66.7 vs. 46.3%; p = 0.030). Men more frequently met adherence metrics compared to women (62.1 vs. 37.5%; p = 0.038). More patients with multifocal tumors met all 3 adherence metrics (69.4 vs. 48.0%; p = 0.050), as compared to those with unifocal lesions. In multivariable analyses, age-adjusted comorbidity (OR 0.75; 95% CI 0.59–0.94; p = 0.011) and multifocality (OR 2.62; 95% CI 1.09–6.27; p = 0.031) were predictors of guideline-adherence. Conclusions: We found non-adherence in more than one-third of patients and disparities among patients of different age and according to tumor focality. Larger samples and prospective studies are needed to delineate and eradicate treatment disadvantages in these high-risk patients.
miR-191 Inhibition Induces Apoptosis Through Reactivating Secreted Frizzled-Related Protein-1 in Cholangiocarcinoma
Authors: Kang Peng-Cheng , Leng Kai-Ming , Liu Yue-Ping , Liu Yang , Xu Yi , Qin Wei , Gao Jian-Jun , Wang Zhi-Dong , Tai Sheng , Zhong Xiang-Yu , Cui Yun-Fu
Published: September 2018

Background/Aims: Cholangiocarcinoma (CCA) is one of the most common malignant tumors of the biliary tract originating from biliary epithelial cells. Although many therapeutic strategies have been developed to treat CCA, the survival rate for CCA patients is still quite low. Thus it is urgent to elucidate the pathogenesis of CCA and to explore novel therapeutic targets. miR-191 has been shown to be associated with many human solid cancers, but the function of miR-191 in CCA is still poorly understood. Methods: We first investigated the expression level of miR-191 in human CCA tissues and cell lines with quantitative real-time PCR (qRT-PCR). The effects of miR-191 on CCA cells were determined by Cell Counting Kit-8 assay, colony formation assay and acridine orange/ethidium bromide staining. Finally, we utilized qRT-PCR, western blot and luciferase reporter assays to verify the miR-191 target gene. Results: We showed that miR-191 was up-regulated in CCA cell lines and patients. Knockdown of miR-191 by transfection of its inhibitor sequence blocked RBE cells viability and induced apoptosis of RBE cells. Both qRT-PCR and western blot analysis showed that the secreted frizzled-related protein-1 (sFRP1) level was negatively correlated with that of miR-191. Luciferase assay validated that sFRP1 was a direct target of miR-191. Moreover, knockdown of miR-191 led to suppression of Wnt/β-catenin signaling activation. Co-transfection of sFRP1 small interfering RNA (siRNA) and miR-191 inhibitor re-activated the Wnt/β-catenin signaling pathway as detected by an increased level of β-catenin and phosphorylation of GSK-3β, and restored the expression of survivin and c-myc in RBE cells. Co-transfection of sFRP1 siRNA with miR-191 inhibitor restored the colony formation ability and viability of RBE cells. Conclusion: Taken together, our results demonstrate a novel insight into miR-191 biological function in CCA. Our findings suggest that miR-191 is a potential therapeutic target of CCA treatment.
Clinical Characteristics and Prognostic Factors of Primary Splenic Angiosarcoma: A Retrospective Clinical Analysis from China
Authors: Li Rong , Li Ming , Zhang Lin-fang , Liu Xiao-ming , Hu Ting-zi , Xia Xiu-Juan , Chi Jing-shu , Jiang Xiao-xia , Xu Can-xia
Published: September 2018

Background/Aims: Primary splenic angiosarcoma is an aggressive malignancy originating from endothelial cells with a particularly poor outcome despite radical therapy. Owing to its extremely low incidence, available data for splenic angiosarcoma are limited. The present study aimed to address this limitation by presenting a thorough retrospective analysis of Chinese primary splenic angiosarcoma patients over a 53-year period (1963-2016). Methods: To determine the characteristics of Chinese primary splenic angiosarcoma and identify factors that impact the outcomes of this histology, we retrospectively retrieved reports of 110 Chinese primary splenic angiosarcoma cases published between 1963-2012. Results: In total, 61 males and 49 females diagnosed with primary splenic angiosarcoma were included in the present study. The median age at diagnosis was 50 years (range 2.5–76 years). Of these patients, 25.5% had received prior radiotherapy. The rate of splenic rupture was 59.11%. The 1-year overall survival rate was 19.1% with a median overall survival time of 8.1 months. Age, gender, and radiation history showed no correlation with survival rate. However, by univariate analysis, we found that significant adverse predictors of survival were splenic rupture before surgery and large tumor size (> 5 cm), while adjuvant chemotherapy was a favorable predictor. Furthermore, multivariate analysis revealed that splenic rupture and adjuvant chemotherapy were independent adverse and favorable predictors, respectively. Conclusion: Our large series describes and confirms the characteristics and poor prognosis of Chinese primary splenic angiosarcoma, thus indicating a critical role for early diagnosis and surgical intervention (prior to rupture) in management, and highlights the promising potential of adjuvant chemotherapy for improving the outcome in these cases.
Kidney Response to Heart Failure: Proteomic Analysis of Cardiorenal Syndrome
Authors: Melenovsky Vojtech , Cervenka Ludek , Viklicky Ondrej , Franekova Janka , Havlenova Tereza , Behounek Matej , Chmel Martin , Petrak Jiri
Published: September 2018

Background/Aims: Chronic heart failure (HF) disrupts normal kidney function and leads to cardiorenal syndrome that further promotes HF progression. To identify potential participants in HF-related injury, we analyzed kidney proteome in an established HF model. Methods: HF was induced by chronic volume overload in male HanSD rats using aorto-caval fistula. After 21 weeks, cardiac and renal functions (in-situ kidney study) and renal proteomics were studied in sham-operated (controls) and HF rats, using iTRAQ labeling and LC-MS with Orbitrap Fusion, leading to identification and quantification of almost 4000 proteins. Results: Compared to controls, HF rats had cardiac hypertrophy, systemic and pulmonary congestion. Kidneys of HF rats had reduced renal blood flow, sodium excretion and urine production. While glomerular filtration rate, serum cystatin C and creatinine were still normal compared to controls, HF kidneys showed albuminuria and markedly increased tissue angiotensin-II levels (5-fold). HF kidneys (versus controls) displayed differential expression (˃1.5-fold) of 67 proteins. The most upregulated were angiotensin-converting enzyme (ACE, ˃20-fold), advanced glycosylation product-specific receptor (RAGE, 14-fold), periostin (6.8-fold), caveolin-1 (4.5-fold) and other proteins implicated in endothelial function (vWF, cavins 1-3, T-kininogen 2), proinflammatory ECM activation (MFAP4, collagen-VI, galectin-3, FHL-1, calponin) and proteins involved in glomerular filtration membrane integrity (CLIC5, ZO-1). Carboxylesterase-1D (CES1D), an enzyme that converts ACE inhibitors or sacubitril into active drugs, was also upregulated in HF kidneys. Conclusion: Chronic HF leads to latent kidney injury, associated with deep changes in kidney protein composition. These alterations may act in concert with intrarenal renin-angiotensin system activation and may serve as markers and/or targets to tackle cardiorenal syndrome.
O Estado republicano democrático e o ensino público da moral segundo Kant
Authors: Klein Joel Thiago
Published: September 2018

Este artigo defende três teses intrinsecamente relacionadas sobre a filosofia política de Kant: 1. Que a filosofia da história, a antropologia e a política são interconectadas a partir de um princípio de conformidade a fins prática; 2. Que a filosofia prática de Kant tem em vista um estado republicano democrático que assume para si a responsabilidade de educar moralmente os seus futuros cidadãos; 3. Que esse projeto de uma educação moral deve respeitar ao menos três princípios, a saber, deve basear-se sobre o conceito de dever, deve envolver reflexão, e finalmente depende do aprendizado dos cidadãos acerca de como efetivar a liberdade do uso público da sua razão.
Purificação da experiência e conhecimento absoluto do real: a metafísica como intuição da duração
Authors: Pinto Débora Cristina Morato
Published: September 2018

Pretendemos aqui mostrar que o vínculo indissociável entre crítica da inteligência e intuição da duração acarreta a nova definição da metafísica: “experiência integral”, segundo Bergson. A relação entre o trabalho de desqualificação de ilusões racionais e a redescoberta do ser como duração expõe, desse modo, como a consciência pode voltar a seus próprios dados e neles encontrar uma experiência real e inegável, a da presença do ser e de nosso pertencimento ao ser. A filosofia bergsoniana procura, nesse âmbito, conjugar reflexibilidade e sensibilidade. Em suas duas primeiras obras, pelo estudo profundo e detalhado dos processos psicológicos, Bergson defende que a consciência à qual a duração apareceria é a mesma que se toma como objeto, “espectadora e atriz”. A consciência age e vê, é o ver do fazer — ou, antes, do fazer-se. A duração que apareceria à consciência é a própria consciência: a consciência da duração e a duração da consciência estariam identificadas nessa visão.