bluuebunny/crossref_metadata_2025 huggingface dataset:
Goniometry and Limb Girth in Miniature Dachshunds
Authors: Thomovsky Stephanie A. , Chen Annie V. , Kiszonas Alecia M. , Lutskas Lori A.
Published: June 2016

Purpose.To report the mean and median pelvic limb joint angles and girth measurements in miniature Dachshunds presenting with varying degrees of pelvic limb weakness secondary to thoracolumbar intervertebral disc extrusion.Methods.15 miniature Dachshunds who presented to WSU-VTH for thoracolumbar disc extrusion. Dachshunds varied in neurologic status from ambulatory paraparetic to paraplegic at the time of measurements.Results.There were no significant differences in joint angles or girth among the three groups (ambulatory paraparetic, nonambulatory paraparetic, or paraplegic) (P>0.05). When group was disregarded and values for extension, flexion, and girth combined, no differences existed.Conclusions.Goniometry and limb girth measurements can successfully be made in the miniature Dachshund; however, the shape of the Dachshund leg makes obtaining these values challenging. There were no differences in joint angle or girth measurements between dogs with varying neurologic dysfunction at the time of measurement.
Open-Porous Hydroxyapatite Scaffolds for Three-Dimensional Culture of Human Adult Liver Cells
Authors: Finoli Anthony , Schmelzer Eva , Over Patrick , Nettleship Ian , Gerlach Joerg C.
Published: June 2016

Liver cell culture within three-dimensional structures provides an improved culture system for various applications in basic research, pharmacological screening, and implantable or extracorporeal liver support. Biodegradable calcium-based scaffolds in such systems could enhance liver cell functionality by providing endothelial and hepatic cell support through locally elevated calcium levels, increased surface area for cell attachment, and allowing three-dimensional tissue restructuring. Open-porous hydroxyapatite scaffolds were fabricated and seeded with primary adult human liver cells, which were embedded within or without gels of extracellular matrix protein collagen-1 or hyaluronan. Metabolic functions were assessed after 5, 15, and 28 days. Longer-term cultures exhibited highest cell numbers and liver specific gene expression when cultured on hydroxyapatite scaffolds in collagen-1. Endothelial gene expression was induced in cells cultured on scaffolds without extracellular matrix proteins. Hydroxyapatite induced gene expression for cytokeratin-19 when cells were cultured in collagen-1 gel while culture in hyaluronan increased cytokeratin-19 gene expression independent of the use of scaffold in long-term culture. The implementation of hydroxyapatite composites with extracellular matrices affected liver cell cultures and cell differentiation depending on the type of matrix protein and the presence of a scaffold. The hydroxyapatite scaffolds enable scale-up of hepatic three-dimensional culture models for regenerative medicine applications.
Calculation of a Health Index of Oil-Paper Transformers Insulation with Binary Logistic Regression
Authors: Zuo Weijie , Yuan Haiwen , Shang Yuwei , Liu Yingyi , Chen Tao
Published: June 2016

This paper presents a new method for calculating the insulation health index (HI) of oil-paper transformers rated under 110 kV to provide a snapshot of health condition using binary logistic regression. Oil breakdown voltage (BDV), total acidity of oil, 2-Furfuraldehyde content, and dissolved gas analysis (DGA) are singled out in this method as the input data for determining HI. A sample of transformers is used to test the proposed method. The results are compared with the results calculated for the same set of transformers using fuzzy logic. The comparison results show that the proposed method is reliable and effective in evaluating transformer health condition.
Usefulness of Multiplex Real-Time PCR for Simultaneous Pathogen Detection and Resistance Profiling of Staphylococcal Bacteremia
Authors: Chung Yousun , Kim Taek Soo , Min Young Gi , Hong Yun Ji , Park Jeong Su , Hwang Sang Mee , Song Kyoung-Ho , Kim Eu Suk , Park Kyoung Un , Kim Hong Bin , Song Junghan , Kim Eui-Chong
Published: June 2016

Staphylococci are the leading cause of nosocomial blood stream infections. Fast and accurate identification of staphylococci and confirmation of their methicillin resistance are crucial for immediate treatment with effective antibiotics. A multiplex real-time PCR assay that targetsmecA,femAspecific forS. aureus,femAspecific forS. epidermidis,16S rRNAfor universal bacteria, and16S rRNAspecific for staphylococci was developed and evaluated with 290 clinical blood culture samples containing Gram-positive cocci in clusters (GPCC). For the 262 blood cultures identified to the species level with the MicroScan WalkAway system (Siemens Healthcare Diagnostics, USA), the direct real-time PCR assay of positive blood cultures showed very good agreement for the categorization of staphylococci into methicillin-resistantS. aureus(MRSA), methicillin-susceptibleS. aureus(MSSA), methicillin-resistantS. epidermidis(MRSE), methicillin-susceptibleS. epidermidis(MSSE), methicillin-resistant non-S. epidermidisCoNS (MRCoNS), and methicillin-susceptible non-S. epidermidisCoNS (MSCoNS) (κ=0.9313). The direct multiplex real-time PCR assay of positive blood cultures containing GPCC can provide essential information at the critical point of infection with a turnaround time of no more than 4 h. Further studies should evaluate the clinical outcome of using this rapid real-time PCR assay in glycopeptide antibiotic therapy in clinical settings.
Sparse Frequency Waveform Design for Radar-Embedded Communication
Authors: Mai Chaoyun , Sun Jinping , Zhou Rui , Wang Guohua
Published: June 2016

According to the Tag application with function of covert communication, a method for sparse frequency waveform design based on radar-embedded communication is proposed. Firstly, sparse frequency waveforms are designed based on power spectral density fitting and quasi-Newton method. Secondly, the eigenvalue decomposition of the sparse frequency waveform sequence is used to get the dominant space. Finally the communication waveforms are designed through the projection of orthogonal pseudorandom vectors in the vertical subspace. Compared with the linear frequency modulation waveform, the sparse frequency waveform can further improve the bandwidth occupation of communication signals, thus achieving higher communication rate. A certain correlation exists between the reciprocally orthogonal communication signals samples and the sparse frequency waveform, which guarantees the low SER (signal error rate) and LPI (low probability of intercept). The simulation results verify the effectiveness of this method.
The Photometric Investigation of V921 Her Using the Lunar-Based Ultraviolet Telescope of Chang’e-3 Mission
Authors: Zhou Xiao , Qian Sheng-Bang , Zhang Jia , Li Lin-Jia , Wang Qi-Shan
Published: June 2016

The light curve of V921 Her in ultraviolet band observed by the Lunar-based Ultraviolet Telescope (LUT) is analyzed by the Wilson-Devinney code. Our solutions conclude that V921 Her is an early type marginal contact binary system with an additional close-in component. The binary system is under poor thermal contact with a temperature difference of nearly 700 K between the two components. The close-in component contributes about 19% of the total luminosity in the triple system. Combining the radial velocity study together with our photometric solutions, the mass of the primary star and secondary one is calculated to beM1=1.784  (±0.055)M⊙,M2=0.403  (±0.012)M⊙. The evolutionary scenario of V921 Her is discussed. All times of light minimum of V921 Her available in the bibliography are taken into account and theO-Ccurve is analyzed for the first time. The most probable fitting results are discussed in the paper, which also confirm the existence of a third component (P3=10.2year) around the binary system. The period of V921 Her is also undergoing a continuously rapid increase at a rate ofdP/dt=+2.79×10-7  day·year-1, which may be due to mass transfer from the less massive component to the more massive one.
Formulation Design and Development of a Unani Transdermal Patch for Antiemetic Therapy and Its Pharmaceutical Evaluation
Authors: Saleem Mohd Nauman , Idris Mohammad
Published: June 2016

The Transdermal Drug Delivery System (TDDS) is one of the novel routes for systemic delivery of drugs through intact skin. A transdermal patch (TP) is a medicated patch that is placed on skin for delivery of medication through skin into the blood stream. The aim of present study was to formulate and evaluate a Unani transdermal patch that could be used for antiemetic therapy. The incorporation of Unani ingredients, namely, Khardal (Brassica nigra), Zanjabeel (Zingiber officinale), Podina (Mentha arvensis), and Sirka (Vinegar) were envisaged. The TP was prepared by solvent evaporation technique and was evaluated for organoleptic characteristics and other physicochemical properties, such as thickness, weight uniformity, folding endurance, moisture content, drug content, and tolerability and acceptability of patch. Thein vitropermeation study of the patch was carried out through Franz diffusion cell using egg shell membrane as barrier membrane. Phosphate buffer pH 7.4 was used as dissolution medium and the temperature was maintained at 37 ± 1°C. Thein vitropermeation study of the prepared TP indicated a time dependent increase in drug release throughout the study. The percentage of cumulative drug release was found to be 77.38% in 24 hours. The study shows a new approach to work in Unani pharmaceutics.
New Stability Criterion for Discrete-Time Genetic Regulatory Networks with Time-Varying Delays and Stochastic Disturbances
Authors: Zhao Yanfeng , Shen Jihong , Chen Dongyan
Published: June 2016

We propose an improved stability condition for a class of discrete-time genetic regulatory networks (GRNs) with interval time-varying delays and stochastic disturbances. By choosing an augmented novel Lyapunov-Krasovskii functional which contains some triple summation terms, a less conservative sufficient condition is obtained in terms of linear matrix inequalities (LMIs) by using the combination of the lower bound lemma, the discrete-time Jensen inequality, and the free-weighting matrix method. It is shown that the proposed results can be readily solved by using the Matlab software. Finally, two numerical examples are provided to illustrate the effectiveness and advantages of the theoretical results.
Stability and Persistence of an Avian Influenza Epidemic Model with Impacts of Climate Change
Authors: Zhao Xiao-Yan , Guo Shu-Min , Ghosh Mini , Li Xue-Zhi
Published: June 2016

The growing number of reported avian influenza cases has prompted awareness of the importance of research methods to control the spread of the disease. Seasonal variation is one of the important factors that affect the spread of avian influenza. This paper presents a “nonautonomous” model to analyze the transmission dynamics of avian influenza with the effects of climate change. We obtain and discuss the global stability conditions of the disease-free equilibrium; the threshold conditions for persistence, permanence, and extinction of the disease; and the parameters with periodicity for controlling and eliminating the avian influenza.
Design of Fixed Wideband Beamformer through Improved Maximum Energy Approach
Authors: Du Rui , Fan Yangyu , Wang Jianshu
Published: June 2016

A maximum energy approach is investigated in this paper to design fixed wideband beamformer. This approach has been improved by integrating response variation (RV) into the target function to maintain the frequency invariant property of wideband beamformer over the whole passband. Two methods for designing null to suppress interference signal also have been proposed to make the wideband beamformer robust in complicated environment. Comparisons among other methods are provided to illustrate the effectiveness and enhancement of performance of the new approaches.
Clinical Significance of miR-149 in the Survival of Patients with Laryngeal Squamous Cell Carcinoma
Authors: Xu Yi , Lin Yun-Peng , Yang Dong , Zhang Geng , Zhou Hui-Fang
Published: June 2016

MicroRNAs (miRNAs) play critical roles in the progression of laryngeal cancer (LC). In this study, we aimed to investigate whether miR-149 is associated with the prognosis of patients with LC. A total of 97 laryngeal squamous cell carcinoma patients who underwent tumor resection were included in our follow-up study.In vitrostudies was performed in cancer cell line Hep-2 to explore the antitumor role of miR-149 in LC. We found that the expression of miR-149 was significantly lower in tumor tissues, compared with vocal cord polyp tissues (P<0.05). Kaplan-Meier analysis revealed that miR-149 expression status is significantly associated with survival duration (log rank test,P<0.05), and multivariate Cox regression analysis revealed that patients with low miR-149 expression had shorter survival times compared with patients with high miR-149 expression.In vitrostudies revealed that the exogenous expression of miRNA-149 inhibits the proliferation of human Hep-2 cells and induces cell apoptosis. Our study suggests that miR-149 expression in laryngeal squamous cell carcinoma tissues is critically associated with the prognosis of patients, and the ectopic expression of miR-149 in Hep-2 cells inhibits proliferation and cell cycle progression.
Hypoxis hemerocallidea Significantly Reduced Hyperglycaemia and Hyperglycaemic‐Induced Oxidative Stress in the Liver and Kidney Tissues of Streptozotocin‐Induced Diabetic Male Wistar Rats
Authors: Oguntibeju Oluwafemi O. , Meyer Samantha , Aboua Yapo G. , Goboza Mediline
Published: June 2016

Background. Hypoxis hemerocallidea is a native plant that grows in the Southern African regions and is well known for its beneficial medicinal effects in the treatment of diabetes, cancer, and high blood pressure. Aim. This study evaluated the effects of Hypoxis hemerocallidea on oxidative stress biomarkers, hepatic injury, and other selected biomarkers in the liver and kidneys of healthy nondiabetic and streptozotocin‐ (STZ‐) induced diabetic male Wistar rats. Materials and Methods. Rats were injected intraperitoneally with 50 mg/kg of STZ to induce diabetes. The plant extract‐Hypoxis hemerocallidea (200 mg/kg or 800 mg/kg) aqueous solution was administered (daily) orally for 6 weeks. Antioxidant activities were analysed using a Multiskan Spectrum plate reader while other serum biomarkers were measured using the RANDOX chemistry analyser. Results. Both dosages (200 mg/kg and 800 mg/kg) of Hypoxis hemerocallidea significantly reduced the blood glucose levels in STZ‐induced diabetic groups. Activities of liver enzymes were increased in the diabetic control and in the diabetic group treated with 800 mg/kg, whereas the 200 mg/kg dosage ameliorated hepatic injury. In the hepatic tissue, the oxygen radical absorbance capacity (ORAC), ferric reducing antioxidant power (FRAP), catalase, and total glutathione were reduced in the diabetic control group. However treatment with both doses improved the antioxidant status. The FRAP and the catalase activities in the kidney were elevated in the STZ‐induced diabetic group treated with 800 mg/kg of the extract possibly due to compensatory responses. Conclusion. Hypoxis hemerocallidea demonstrated antihyperglycemic and antioxidant effects especially in the liver tissue.
Platelet Activation: The Mechanisms and Potential Biomarkers
Authors: Yun Seong-Hoon , Sim Eun-Hye , Goh Ri-Young , Park Joo-In , Han Jin-Yeong
Published: June 2016

Beyond hemostasis and thrombosis, an increasing number of studies indicate that platelets play an integral role in intercellular communication, mediating inflammatory and immunomodulatory activities. Our knowledge about how platelets modulate inflammatory and immunity has greatly improved in recent years. In this review, we discuss recent advances in the pathways of platelet activation and potential application of platelet activation biomarkers to diagnosis and prediction of disease states.
Dynamic Output Feedback Stabilization of Singular Fractional-Order Systems
Authors: Liu Yanchai , Cui Liu , Duan Dengping
Published: June 2016

This paper is concerned with dynamic output feedback controller (DOFC) design problem for singular fractional-order systems with the fractional-orderαsatisfying0<α<2. Based on the stability theory of fractional-order system, sufficient and necessary conditions are derived for the admissibility of the systems, which are more convenient to analytical design of stabilizing controllers than the existing results. A full-order DOFC is then synthesized based on the obtained conditions and the characteristics of Moore-Penrose inverse. Finally, a numerical example is presented to show the effectiveness of the proposed methods.
The Hospitalization Costs of Diabetes and Hypertension Complications in Zimbabwe: Estimations and Correlations
Authors: Mutowo Mutsa P. , Lorgelly Paula K. , Laxy Michael , Renzaho Andre M. N. , Mangwiro John C. , Owen Alice J.
Published: June 2016

Objective. Treating complications associated with diabetes and hypertension imposes significant costs on health care systems. This study estimated the hospitalization costs for inpatients in a public hospital in Zimbabwe.Methods. The study was retrospective and utilized secondary data from medical records. Total hospitalization costs were estimated using generalized linear models.Results. The median cost and interquartile range (IQR) for patients with diabetes, $994 (385–1553) mean $1319 (95% CI: 981–1657), was higher than patients with hypertension, $759 (494–1147) mean $914 (95% CI: 825–1003). Female patients aged below 65 years with diabetes had the highest estimated mean costs ($1467 (95% CI: 1177–1828)). Wound care had the highest estimated mean cost of all procedures, $2884 (95% CI: 2004–4149) for patients with diabetes and $2239 (95% CI: 1589–3156) for patients with hypertension. Age below 65 years, medical procedures (amputation, wound care, dialysis, and physiotherapy), the presence of two or more comorbidities, and being prescribed two or more drugs were associated with significantly higher hospitalization costs.Conclusion. Our estimated costs could be used to evaluate and improve current inpatient treatment and management of patients with diabetes and hypertension and determine the most cost-effective interventions to prevent complications and comorbidities.
The Adsorption Capacity, Pore Structure, and Thermal Behavior of the Modified Clay Containing SSA
Authors: Lu Haijun , Zhang Qian , Dong Yiqie , Li Jixiang , Zhang Xiong
Published: June 2016

Sewage sludge ash (SSA) was created by burning municipal sludge. The potential of clay containing 1 or 3 or 5% SSA was assessed for use as a landfill liner-soil material. Batch adsorption, low temperature N2adsorption, and TG-DTA tests were performed to evaluate the adsorption capacity, micropore structure, thermostability, and components of soils under Cr(VI) and Pb(II) chemical solutions. With the increasing amount of SSA in modified clay, the adsorption capacity of Cr(VI) and Pb(II) to the modified clay increases gradually. After absorption, the pore size of modified clay ranges from 2 nm to 8 nm. With the increasing amount of absorption, the pore volume decreases and the specific surface area increases. With the increasing of adsorption concentration of Cr(VI) and Pb(II), the mass loss percentage of modified clay increases to 23.4% and 12.6%, respectively. The modified clay containing SSA may be used as a good barrier material to attenuate contamination of Cr(VI) and Pb(II) in landfills.
Integrated Classification of Prostate Cancer Reveals a Novel Luminal Subtype with Poor Outcome
Authors: You Sungyong , Knudsen Beatrice S. , Erho Nicholas , Alshalalfa Mohammed , Takhar Mandeep , Al-deen Ashab Hussam , Davicioni Elai , Karnes R. Jeffrey , Klein Eric A. , Den Robert B. , Ross Ashley E. , Schaeffer Edward M. , Garraway Isla P. , Kim Jayoung , Freeman Michael R.
Published: June 2016

Prostate cancer is a biologically heterogeneous disease with variable molecular alterations underlying cancer initiation and progression. Despite recent advances in understanding prostate cancer heterogeneity, better methods for classification of prostate cancer are still needed to improve prognostic accuracy and therapeutic outcomes. In this study, we computationally assembled a large virtual cohort (n = 1,321) of human prostate cancer transcriptome profiles from 38 distinct cohorts and, using pathway activation signatures of known relevance to prostate cancer, developed a novel classification system consisting of three distinct subtypes (named PCS1–3). We validated this subtyping scheme in 10 independent patient cohorts and 19 laboratory models of prostate cancer, including cell lines and genetically engineered mouse models. Analysis of subtype-specific gene expression patterns in independent datasets derived from luminal and basal cell models provides evidence that PCS1 and PCS2 tumors reflect luminal subtypes, while PCS3 represents a basal subtype. We show that PCS1 tumors progress more rapidly to metastatic disease in comparison with PCS2 or PCS3, including PSC1 tumors of low Gleason grade. To apply this finding clinically, we developed a 37-gene panel that accurately assigns individual tumors to one of the three PCS subtypes. This panel was also applied to circulating tumor cells (CTC) and provided evidence that PCS1 CTCs may reflect enzalutamide resistance. In summary, PCS subtyping may improve accuracy in predicting the likelihood of clinical progression and permit treatment stratification at early and late disease stages. Cancer Res; 76(17); 4948–58. ©2016 AACR.
Analysis of Immune Signatures in Longitudinal Tumor Samples Yields Insight into Biomarkers of Response and Mechanisms of Resistance to Immune Checkpoint Blockade
Authors: Chen Pei-Ling , Roh Whijae , Reuben Alexandre , Cooper Zachary A. , Spencer Christine N. , Prieto Peter A. , Miller John P. , Bassett Roland L. , Gopalakrishnan Vancheswaran , Wani Khalida , De Macedo Mariana Petaccia , Austin-Breneman Jacob L. , Jiang Hong , Chang Qing , Reddy Sangeetha M. , Chen Wei-Shen , Tetzlaff Michael T. , Broaddus Russell J. , Davies Michael A. , Gershenwald Jeffrey E. , Haydu Lauren , Lazar Alexander J. , Patel Sapna P. , Hwu Patrick , Hwu Wen-Jen , Diab Adi , Glitza Isabella C. , Woodman Scott E. , Vence Luis M. , Wistuba Ignacio I. , Amaria Rodabe N. , Kwong Lawrence N. , Prieto Victor , Davis R. Eric , Ma Wencai , Overwijk Willem W. , Sharpe Arlene H. , Hu Jianhua , Futreal P. Andrew , Blando Jorge , Sharma Padmanee , Allison James P. , Chin Lynda , Wargo Jennifer A.
Published: June 2016

Immune checkpoint blockade represents a major breakthrough in cancer therapy; however, responses are not universal. Genomic and immune features in pretreatment tumor biopsies have been reported to correlate with response in patients with melanoma and other cancers, but robust biomarkers have not been identified. We studied a cohort of patients with metastatic melanoma initially treated with cytotoxic T-lymphocyte–associated antigen-4 (CTLA4) blockade (n = 53) followed by programmed death-1 (PD-1) blockade at progression (n = 46), and analyzed immune signatures in longitudinal tissue samples collected at multiple time points during therapy. In this study, we demonstrate that adaptive immune signatures in tumor biopsy samples obtained early during the course of treatment are highly predictive of response to immune checkpoint blockade and also demonstrate differential effects on the tumor microenvironment induced by CTLA4 and PD-1 blockade. Importantly, potential mechanisms of therapeutic resistance to immune checkpoint blockade were also identified.

Significance: These studies demonstrate that adaptive immune signatures in early on-treatment tumor biopsies are predictive of response to checkpoint blockade and yield insight into mechanisms of therapeutic resistance. These concepts have far-reaching implications in this age of precision medicine and should be explored in immune checkpoint blockade treatment across cancer types. Cancer Discov; 6(8); 827–37. ©2016 AACR.

See related commentary by Teng et al., p. 818.

This article is highlighted in the In This Issue feature, p. 803
Pre- and Postnatal Diagnosis of 10p14 Deletion and 22q11.2 Deletion Syndrome and Significance of Non-Cardiac Markers
Authors: Shetty Mitesh , Srikanth Ambika , Kadandale Jayarama , Hegde Sridevi
Published: June 2016

Congenital heart defect (CHD) is the most common form of birth defects. There is a high association between increased nuchal translucency and CHD in fetuses, and CHD in the antenatal period has a high incidence of 22q11.2 deletion syndrome (22q11.2DS). Apart from 22q11.2DS, the BRUNOL3 gene at 10p14 is also associated with DiGeorge-like features. We studied a total of 110 pre- and postnatal CHD cases with FISH probes. 22q11.2DS was detected in 5 cases and 10p14 deletion in 1 case. Antenatally diagnosed cases of CHD should be investigated by karyotyping and 22q11.2DS testing. Cases with increased nuchal translucency, intrauterine growth retardation, and other non-cardiac malformations because of 22q11.2DS should be screened carefully for thymus dysgenesis. It is also advisable to screen patients referred for 22q11.2DS for a 10p14 deletion, therefore enabling appropriate parental counseling.
Pain-Related Reactions among Premature Infants with Gestational Age Less than 26 Weeks: An Observational Cohort Study
Authors: Martakis Kyriakos , Hünseler Christoph , Thangavelu Kruthika , Kribs Angela , Roth Bernhard
Published: June 2016

Introduction: There is insufficient information regarding acute pain reactions among premature infants with a gestational age of less than 26 weeks and no appropriate scale for pain measurement in this age group. We hypothesized that these infants present specific reactions to a standardized pain stimulus within the first 3 days of life. Methodology: Mixed-methods, prospective, open-label, single-arm, observational study. Routine capillary or peripheral blood takes were filmed. The model consisting of a baseline, a preparatory, an interventional and a return-to-baseline phase was filmed. After a pilot evaluation, experienced medical and nursing neonatal intensive care unit (NICU) staff analysed the videos. Results: Twenty infants with gestational ages ranging from 22 weeks and 3 days to 26 weeks (mean 24 weeks) were recruited. Nineteen infants showed pain reactions, with a mean latency of 8.3 s (range 2-30). The majority presented eye movements, changes of the breath pattern and a slight increase in the mean SpO2 value. A high degree of interrater and intrarater reliability was found. Discussion: Premature infants with a gestational age of up to 26 weeks can present a variety of discrete reactions as response to a pain stimulus within the first 72 h of life. Experienced NICU staff can perform a valid and reliable evaluation of these reactions.
Relevance of Assessment Methods for Fluid Intake
Authors: Gandy Joan , Martinez Homero , Guelinckx Isabelle , Moreno Luis A. , Bardosono Saptawati , Salas-Salvadó Jordi , Kavouras Stavros A.
Published: June 2016

Reliable data at population level are essential to firmly establish links between fluid intake, hydration and health, investigate dose-response relationships and develop meaningful public health strategies or reference intake values. However, limited research exists regarding the most appropriate methodology for assessing beverage or total fluid intake (TFI). To date, methodologies have been developed to assess food and nutrient intake without due consideration of water or fluid intake behavior. A recent crossover study showed that a 24-hour food recall significantly underestimated mean TFI by 382 ml (95% CI 299-465) compared with a fluid specific 7-day record. The authors postulated that this average difference was mainly the result of missed drinking acts between meals a 24-hour recall was used. Using a 7-day record administered in paper form or on-line has also been shown to lead to a significantly different mean TFI of 129 ml. Therefore, the choice of methodology might result in measurement errors that limit between-survey or between-country comparisons. Such errors may contribute to variations in estimates of TFI that cannot be explained by differences in climate, physical activity or cultural habits. A recent survey confirmed the variation in methodologies used in European national dietary surveys. Since these surveys form the basis for setting adequate intakes for total water intake, measurement error between surveys should be limited, highlighting the need for the development of a consistent methodology that is validated for water and TFI estimation.
Harmonized Cross-Sectional Surveys Focused on Fluid Intake in Children, Adolescents and Adults: The Liq.In7 Initiative
Authors: Martinez Homero , Guelinckx Isabelle , Salas-Salvadó Jordi , Gandy Joan , Kavouras Stavros A. , Moreno Luis A.
Published: June 2016

Objective: To assess the intake of water and all other beverages in children, adolescents and adults. Methods: Three thousand six hundred eleven children (8 ± 2 years), 8,109 adolescents (13 ± 2 years) and 16,276 adults (40 ± 14 years) (47% men) were recruited in 15 cross-sectional surveys (liquid intake across 7 days, Liq.In7 study) and completed a 7-day fluid-specific record to assess total fluid intake (TFI), where TFI was defined as the sum of drinking water and other type of beverages. Results: The median TFI was 1.2, 1.2 and 1.8 liters/day in children, adolescents and adults respectively, with important differences observed between countries. Only 39% of children, 25% of adolescents and 51% of adults met the European Food Safety Authority adequate intake (AI) recommendations of water from fluids. In the surveys of Spain, France, Belgium, Germany, Turkey, Iran, Indonesia and China, water was the major contributor (47-78%) to TFI. In the adult surveys of UK, Poland, Japan and Argentina, hot beverages were the highest contributor to TFI. The fluid intake of children and adolescents in Mexico, Brazil, Argentina and Uruguay was characterized by a contribution of juices and sweet beverages that was as important as the contribution of water to TFI. Conclusion: Given that a relatively high proportion of subjects, especially children and adolescents, failed to meet the recommended AI of water from fluids and that water intake was not the highest contributor to TFI in all countries, undertaking actions to increase water intake are warranted.
The ISN 0by25 Global Snapshot Study
Authors: Feehally John
Published: June 2016

The International Society of Nephrology's (ISN) 0by25 initiative aims to prevent avoidable deaths from acute kidney injury (AKI) by 2025, most of which occur in low and lower middle-income countries (LLMICs). To increase evidence about the epidemiology of AKI, especially in LLMICs, ISN conducted a ‘Global Snapshot', a multinational, cross-sectional study in which 322 physicians from 72 countries in 6 continents identified 3,664 adults and 354 children with AKI who were under their care of which 45% were from LLMICs, nevertheless low-income countries were under-represented. In LLMICs, patients with AKI were younger, and community acquired AKI was more common. Hypotension (40%) and dehydration (39%) were the most common causes of AKI. Dehydration was a more common cause in LLMIC, as were sepsis, pregnancy-related AKI and animal envenomation. Acute dialysis was performed in 23% of patients. Eight percent had a clinical indication for this but were not dialyzed. In LLMICs, lack of resources (16%) and inability to afford therapy (30%) accounted for almost half of these cases. Overall mortality at 7 days was 11% and was higher in LLMICs. Complete recovery from AKI occurred in 30% of patients and partial recovery 37%, and was more often complete in LLMICs. The 0by25 Global Snapshot provides new information about the worldwide epidemiology of AKI, helping to identify elements that would be amenable in intervention to reduce preventable deaths.
Tackling Health Inequities and Reducing Obesity Prevalence: The EPODE Community-Based Approach
Authors: Borys Jean-Michel , Richard Pierre , Ruault du Plessis Hugues , Harper Pauline , Levy Emile
Published: June 2016

Background: Tackling inequalities in overweight, obesity and related complications has become a top priority for European research and policy agendas. It is well-known that the health message often does not reach disadvantaged populations, a phenomenon that widens health inequalities. Ensemble Prévenons l'Obésité des Enfants (EPODE) methodology is an innovative approach to counteract obesity and improve health equity. EPODE for the Promotion of Health Equity (EPHE) has assessed the impact and sustainability of the EPODE methodology to diminish inequalities in childhood obesity prevention. The current data represent the results of the intermediate measurements that were obtained following EPHE interventions in 7 European communities across different countries. Methods: A total of 1,062 children aged 6-8 years and their parents from different socioeconomic backgrounds were observed for 2 years. A self-administrated questionnaire was sent to parents to measure the children's energy balance-related behaviors and their determinants. The Wilcoxon signed-rank test was used to test differences between baseline and intermediate measurements for each socioeconomic group. Results: We observed changes in behaviors (fruit and vegetable consumption, sugary sweetened beverage consumption, screen exposure) and their related determinants, within the low and high education groups, which were associated with identified inequity gaps at baseline. Although statistical significance was not reached in most of the cases, greater improvements in behaviors were evident within the low education groups. Conclusions: Our findings show that, after EPODE interventions, the low socioeconomic groups improved their behavior compared to the other socio-economic groups. This indicates that the EPODE methodology has the capacity not only to reduce obesity prevalence but also to decrease health inequities.
A Novel Mutation in OTX2 Causes Combined Pituitary Hormone Deficiency, Bilateral Microphthalmia, and Agenesis of the Left Internal Carotid Artery
Authors: Shimada Aya , Takagi Masaki , Nagashima Yuka , Miyai Kentaro , Hasegawa Yukihiro
Published: June 2016

Background: Mutations in OTX2 cause hypopituitarism, ranging from isolated growth hormone deficiency to combined pituitary hormone deficiency (CPHD), which are commonly detected in association with severe eye abnormalities, including anophthalmia or microphthalmia. Pituitary phenotypes of OTX2 mutation carriers are highly variable; however, ACTH deficiency during the neonatal period is not common in previous reports. Objective: We report a novel missense OTX2 (R89P) mutation in a CPHD patient with severe hypoglycemia in the neonatal period due to ACTH deficiency, bilateral microphthalmia, and agenesis of the left internal carotid artery (ICA). Results: We identified a novel heterozygous mutation in OTX2 (c.266G>C, p.R89P). R89P OTX2 showed markedly reduced transcriptional activity of HESX1 and POU1F1 reporters compared with wild-type OTX2. A dominant negative effect was noted only in the transcription analysis with POU1F1 promoter. Electrophoretic mobility shift assay experiments showed that R89P OTX2 abrogated DNA-binding ability. Conclusion:OTX2 mutations can cause ACTH deficiency in the neonatal period. Our study also shows that OTX2 mutations are associated with agenesis of the ICA. To the best of our knowledge, this is the first report of a transcription factor gene mutation, which was identified due to agenesis of the ICA of a patient with CPHD. This study extends our understanding of the phenotypic features, molecular mechanism, and developmental course associated with mutations in OTX2.
Cardiovascular Outcomes Trials in Type 2 Diabetes Mellitus
Authors: Kapoor Karan , George Praveen , Miller Michael
Published: June 2016

Objectives: To review the spectrum of contemporary cardiovascular outcomes trials (CVOTS) in type 2 diabetes mellitus (T2DM), spanning both the pre- and post-ACCORD eras. Methods: We reviewed a total of 12 CVOTs and delineated the two eras in accordance with the 2008 US Food and Drug Administration (FDA) mandate requiring completion of CVOTs prior the licensing of new glucose-lowering agents. The salient implications regarding macrovascular disease complications were summarized. Results: Five trials in the pre-ACCORD and 7 in the post-ACCORD era were identified. Heterogeneous results pertaining to the degree of glycemic control associated with optimal macrovascular disease risk reduction, as well as the safest pharmacologic means to do so, were observed. Conclusions: The post-ACCORD era is representative of a significant shift in the landscape of CVOTs in T2DM, with an emphasis on safety of glucose-lowering agents. Recently completed and ongoing trials of dipeptidyl peptidase-4 inhibitors and sodium-glucose cotransporter 2 inhibitors will continue to inform clinical practice on safe and effective ways to reduce CV risk in T2DM.
Rapid Intracranial Response to Osimertinib in a Patient with Epidermal Growth Factor Receptor T790M-Positive Adenocarcinoma of the Lung
Authors: Reichegger Hermann , Jochum Wolfram , Förbs Diana , Hader Claudia , Früh Martin
Published: June 2016

Background: Osimertinib (AZD9291, Tagrisso) is a potent, irreversible third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). Case Report: Our report demonstrates that osimertinib is able to inhibit the growth of a radiotherapy- and surgery-refractory EGFR T790M-positive brain metastasis in a patient with lung adenocarcinoma. Conclusion: These data show that re-biopsy in EGFR-mutated non-small cell lung cancer patients with acquired TKI resistance should be performed.
Influences of Pregnancy on Different Genetic Subtypes of Non-Dystrophic Myotonia and Periodic Paralysis
Authors: Rudnik-Schöneborn Sabine , Witsch-Baumgartner Martina , Zerres Klaus
Published: June 2016

Background: There are only few reports of pregnancy and delivery in non-dystrophic myotonia or periodic paralysis caused by CLCN1 or SCN4A gene mutations. Methods: We report the medical histories and personal attitudes of 5 unrelated German patients, 2 following autosomal recessive inheritance (case 1; most likely and case 2; confirmed Becker disease) and 3 following autosomal dominant inheritance (case 3; CLCN1 mutation, cases 4-5; SCN4A mutations), who delivered a total of 9 children. Results: Apart from case 5 with periodic paralysis, who had 5 early miscarriages and pre-eclampsia resulting in cesarean delivery, there was no evidence of increased obstetric complication rates, and neonatal outcome was favorable. In all patients, there was aggravation of myotonia or weakness in pregnancy, followed by a short-term improvement after delivery in cases 2 and 3. Mexiletine medication improved the clinical features significantly in case 2 but was unable to control pregnancy-related deterioration. In case 4 (and her sister) and case 5, there was a clear disease aggravation in pregnancy resulting in hospitalization or repeated neurological examinations. Conclusion: Pregnancy can be regarded as a strong triggering factor in inherited non-dystrophic myotonias and periodic paralysis, regardless of the underlying gene defect.
Clinical Significance and Characteristic Clinical Differences of Cytolytic Vaginosis in Recurrent Vulvovaginitis
Authors: Yang Shuhua , Zhang Yuexiang , Liu Ying , Wang Jianhong , Chen Shuqin , Li Shuxia
Published: June 2016

Aim: The study aimed to evaluate whether cytolytic vaginosis (CV) has important clinical implications for recurrent vulvovaginitis and to identify clinical differences between CV and vulvovaginal candidosis (VVC). Methods: Medical histories, physical examinations and laboratory findings were used to diagnose and assess the prevalence rates of various vulvovaginal infections among 536 women with recurrent vulvovaginitis. Chi-square and Fisher exact tests were used to compare age, menstrual cycle phase at episode onset, symptoms/signs of infection and discharge characteristics between CV and VVC with single infection. Results: Among the 484 women with a single-infection recurrent vulvovaginitis, the prevalence of CV (n = 143; 26.7%) was second only to VVC (n = 196; 36.6%). CV symptoms occurred predominantly during the ovulatory and luteal phases. Meanwhile, VVC episodes were not concentrated premenstrually, but rather occurred throughout the menstrual cycle. Significant differences were found in the vaginal pH, discharge characteristics and frequency of inflammatory symptoms between the 2 groups. Conclusions: CV is clinically important, because it is a common cause of recurrent vulvovaginitis. To distinguish CV from VVC, gynecologists should consider the patient's medical history, physical and laboratory findings, vaginal pH and vaginal discharge characteristics.
Is Maternal Blood Procalcitonin Level a Reliable Predictor for Early Onset Neonatal Sepsis in Preterm Premature Rupture of Membranes?
Authors: Cetin Orkun , Aydın Zuhal Dilek , Verit Fatma Ferda , Zebitay Ali Galip , Karaman Erbil , Elasan Sadi , Turfan Mehtap , Yucel Oguz
Published: June 2016

Background: This study is aimed at comparing the early diagnostic accuracy of maternal blood white blood cell (WBC) count, C-reactive protein (CRP) and procalcitonin in predicting early onset neonatal sepsis (EONS) among early preterm premature rupture of membrane (PPROM) pregnancies. Methods: A total of 57 consecutive pregnancies, complicated with PPROM, between 24 and 34 gestational weeks were recruited to the study at Suleymaniye Maternity Education and Research Hospital, Istanbul, Turkey between January 2012 and January 2013. All patients were hospitalized and followed up with expectant management. Maternal blood WBC count, CRP and procalcitonin levels were measured in the first 12 h of membrane rupture. EONS was diagnosed using clinical and laboratory findings, and obstetric and neonatal outcomes were noted. Results: The cutoff value for maternal blood CRP was ≥9.49 mg/dl. This value predicted EONS with 77.8% sensitivity, 80.0% specificity, 77.8% positive predictive value (PPV) and 80.0% negative predictive value (NPV). The cutoff value for maternal blood procalcitonin was 0.071 ng/ml. This value predicted EONS with 85.2% sensitivity, 86.7% specificity, 85.2% PPV and 86.7% NPV. Conclusion: Maternal blood procalcitonin levels were superior to maternal blood CRP and WBC count in predicting EONS. Consequently, the maternal blood procalcitonin level is a clinically useful, non-invasive and reliable biomarker in antenatal prediction of EONS.
Clinical and Neuroimaging Features of Acute Ischemic Stroke in Cancer Patients
Authors: Sun Binbin , Fan Shuangyi , Li Zhifang , Guo Wanshen , Liu Lixue , Zhou Youping , Ji Luyan , Zhang Leshi , Huang Xusheng
Published: June 2016

Background: The occurrence of acute ischemic stroke in cancer patients is not unusual. In clinical practice, acute ischemic stroke with cancer usually cannot be diagnosed promptly due to lack of specific markers. But for cancer patients, advanced prevention, accurate diagnosis and proper treatment of acute ischemic stroke are very important. The aim of the present study was to investigate the clinical and neuroimaging features of acute ischemic stroke in patients with cancer. Methods: We conducted a retrospective review of all cancer-associated acute ischemic stroke patients (n = 46) admitted to the Affiliated Hospital of Academy of Military Medical Sciences between October 2011 and March 2015. A group of non-cancer acute ischemic stroke patients (n = 50) at the same period were selected randomly as control. The clinical and neuroimaging data were collected and compared between the 2 groups. Results: Patients with cancer-associated stroke (CS) had a lower body mass index (23.26 ± 3.70 vs. 24.88 ± 2.83, p = 0.021) compared to non-cancer stroke (NC) patients. A lower proportion of CS patients suffered from hypertension (45.7 vs. 68.0%, p = 0.039) and hyperlipidemia (10.9 vs. 72.0%, p = 0.000) than the NC group. A higher proportion of CS patients had deep vein catheter (24.0 vs. 0%) before the onset of stoke than that of the NC group. Levels of hemoglobin, albumin and triglyceride were lower in CS groups compared with that of the NC group (p < 0.05). The prothrombin time, international normalized ratio, D-dimer and fibrinogen levels were significantly higher in the CS group than in the NC group (p < 0.05). As to the neuroimaging patterns, disperse lesions (OR 7.01; 95% CI 1.17-42.12; p < 0.05) was independently associated with CS. Conclusions: Cancer-associated ischemic stroke was different form conventional ischemic stroke in the aspect of clinical and neuroimaging manifestation. This phenomenon might be because of the embolic etiology of CS. These features together could become a clue to CS.
Assessment of a Potential Pharmacokinetic Interaction between Nebivolol and Bupropion in Healthy Volunteers
Authors: Gheldiu Ana-Maria , Popa Adina , Neag Maria , Muntean Dana , Bocsan Corina , Buzoianu Anca , Vlase Laurian , Tomuta Ioan , Briciu Corina
Published: June 2016

Background/Aims: The study aimed at investigating the effects of multiple-dose bupropion (potent inhibitor of CYP2D6) on the pharmacokinetics (PKs) of single-dose nebivolol (CYP2D6 substrate) and to evaluate the clinical relevance of this potential drug interaction. Methods: This open-label, nonrandomized clinical study had a 2-period design: during period 1 (reference), a single dose of 5 mg nebivolol was administered, while during period 2 (test), 5 mg nebivolol + 300 mg bupropion were ingested concomitantly, after a pretreatment regimen with bupropion (7 days). The PK parameters of nebivolol and its active metabolite were analyzed by noncompartmental modeling, while the pharmacodynamic (PD) parameters (blood pressure and heart rate) were assessed at rest. Results: Bupropion plus nebivolol increased the mean peak plasma concentrations (Cmax) of nebivolol (1.67 ± 0.69 vs. 3.80 ± 1.70 ng/ml) and its active metabolite (0.68 ± 0.22 vs. 1.13 ± 0.38 ng/ml) compared to nebivolol alone. After bupropion pretreatment, the exposure to nebivolol was increased by 7.2-fold for the parent drug and 4-fold for the hydroxylated active metabolite. The difference between the PD parameters measured during the 2 periods was not significant. Conclusion: The study concluded that bupropion influenced the PKs of nebivolol in healthy volunteers, but a clinical relevance was not established. However, this latter aspect requires further investigation.