bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a New Piezoelectric Actuator with Slits
Authors: Uetsuji Yasutomo , Kuramae Hiroyuki , Tsuchiya Kazuyoshi , Sakamoto Hidetoshi
Published: July 2013

A piezoelectric actuator was developed for fluid pumps in health monitoring systems. We devised a piezoelectric actuator with some slits, which allows the stretching and contracting deformation in in-plane direction and creates large deflection in out-of-plane direction. The static behaviors under uniform electric field have been analyzed by finite element method. And then, the optimum geometry of slits was searched by response surface methodology for unimorph and bimorph actuators to output the largest deflection under various fixed conditions. The computational results indicated that a bimorph actuator with cross-shaped slit under outside-fixed condition has superior performance for fluid pumps. The proposed slit-inserted actuators have been manufactured as an experiment. As a result, it was verified that the developed actuator can amplify the deflection compared with conventional nonslit actuators.
Growth and Survival of BaggedLucilia sericataMaggots in Wounds of Patients Undergoing Maggot Debridement Therapy
Authors: Čičková Helena , Čambal Marek , Kozánek Milan , Takáč Peter
Published: July 2013

Maggot debridement therapy (MDT) is an established method of debridement of nonhealing wounds. Despite intense clinical research about its efficacy and effects of substances produced by the larvae, growth and development of maggots in the wounds remain largely unexplored. In the present study, the bags with larvae (n=52), which had been used to debride traumatic, ischemic, diabetic and venous ulcers, were collected and examined. Survival, length, width and larval instar of the maggots within each bag were recorded and analyzed with respect to the wound type and duration of the treatment. Survival of maggots after a 48-h cycle of MDT ranged between 63.6 and 82.7%. Maggots in venous ulcers had on average 9–19% higher mortality than maggots within traumatic, ischemic, and diabetic ulcers. Length of larvae after 48 h cycle of MDT reached on average 7.09–9.68 mm, and average width varied between 1.77 and 2.26 mm. Larvae in venous ulcers were significantly smaller after 48 h, but not after 72 h treatment compared to the other wound types. Further studies should be aimed to identify other patient-associated factors which might influence growth and survival of the larvae during maggot debridement therapy.
Hematological Disorders following Gastric Bypass Surgery: Emerging Concepts of the Interplay between Nutritional Deficiency and Inflammation
Authors: Chen Mingyi , Krishnamurthy Amrita , Mohamed Ali R. , Green Ralph
Published: July 2013

Obesity and the associated metabolic syndrome are among the most common and detrimental metabolic diseases of the modern era, affecting over 50% of the adult population in the United States. Surgeries designed to promote weight loss, known as bariatric surgery, typically involve a gastric bypass procedure and have shown high success rates for treating morbid obesity. However, following gastric bypass surgery, many patients develop chronic anemia, most commonly due to iron deficiency. Deficiencies of vitamins B1, B12, folate, A, K, D, and E and copper have also been reported after surgery. Copper deficiency can cause hematological abnormalities with or without neurological complications. Despite oral supplementation and normal serum concentrations of iron, copper, folate, and vitamin B12, some patients present with persistent anemia after surgery. The evaluation of hematologic disorders after gastric bypass surgery must take into account issues unique to the postsurgery setting that influence the development of anemia and other cytopenias. In this paper, the clinical characteristics and differential diagnosis of the hematological disorders associated with gastric bypass surgery are reviewed, and the underlying molecular mechanisms are discussed.
Autoimmune Lymphoproliferative Syndrome and Epstein-Barr Virus-Associated Lymphoma: An Adjunctive Diagnostic Role for Monitoring EBV Viremia?
Authors: Pace Romina , Vinh Donald C.
Published: July 2013

Background. Autoimmune lymphoproliferative syndrome (ALPS) is a genetic disorder of lymphocyte homeostasis due to defects in FAS-mediated apoptosis. ALPS is characterized by childhood onset of chronic lymphadenopathy and splenomegaly, autoimmunity, an expanded population of double-negative T cells (DNTCs), and an increased risk of lymphoma. This propensity for lymphoma in ALPS is not well understood. It is possible that lymphomagenesis in some of these patients may result from Epstein-Barr virus (EBV) infection exploiting the defective T-cell surveillance resulting from impaired FAS-mediated apoptosis.Case Presentation. We report the first case, to our knowledge, of lymphoma in a patient with ALPS that was clinically heralded by progressively increasing EBV viremia. We discuss its practical implications and the possible immune pathways involved in the increased risk for EBV-associated lymphoproliferative disorders in ALPS patients.Conclusion. In patients with ALPS, distinguishing chronic lymphadenopathy from emerging lymphoma is difficult, with few practical recommendations available. This case illustrates that, at least for some patients, monitoring for progressively increasing EBV viremia may be useful.
Genetics of Alzheimer’s Disease
Authors: Ridge Perry G. , Ebbert Mark T. W. , Kauwe John S. K.
Published: July 2013

Alzheimer’s disease is the most common form of dementia and is the only top 10 cause of death in the United States that lacks disease-altering treatments. It is a complex disorder with environmental and genetic components. There are two major types of Alzheimer’s disease, early onset and the more common late onset. The genetics of early-onset Alzheimer’s disease are largely understood with variants in three different genes leading to disease. In contrast, while several common alleles associated with late-onset Alzheimer’s disease, including APOE, have been identified using association studies, the genetics of late-onset Alzheimer’s disease are not fully understood. Here we review the known genetics of early- and late-onset Alzheimer’s disease.
IL-17 in the Rheumatologist’s Line of Sight
Authors: Truchetet Marie-Elise , Mossalayi M. Djavad , Boniface Katia
Published: July 2013

Over the past decades, the identification of several new cytokines, including interleukin (IL)-17 and IL-23, and of new T helper cell subsets, including Th17 cells, has changed the vision of immunological processes. The IL-17/Th17 pathway plays a critical role during the development of inflammation and autoimmunity, and targeting this pathway has become an attractive strategy for a number of diseases. This review aims to describe the effects of IL-17 in the joint and its roles in the development of autoimmune and inflammatory arthritis. Furthermore, biotherapies targeting directly or indirectly IL-17 in inflammatory rheumatisms will be developed.
INF-αand Ototoxicity
Authors: Sharifian Mohammad Reza , Kamandi Shima , Sima Hamid Reza , Zaringhalam Mohammad Ali , Bakhshaee Mehdi
Published: July 2013

Introduction. INF-αis a common drug for the treatment of hepatitis B and C. Although a variety of related complications are discussed, possible ototoxic effects of this mediation are not well described.Methods and Materials. In a before-after control study, 24 patients who received INF-αfor the treatment of hepatitis B and C and 30 normal controls were included. Subjective and objective ototoxicity evaluations via questionnaire, high frequency audiometry, and measuring transiently evoked otoacoustic emissions (TEOAEs) were performed one week before and one month after the prescription of the drug.Results. Subjective hearing complaint, tinnitus, and vertigo were seen in just 3 cases, which was not statistically significant (). In the frequency range of 4000 to 8000 Hz before (9.38 ± 1.0 and 10.7 ± 1.2, resp.) and after (17.9 ± 2.6 and 17.6 ± 2.6, resp.) one month of treatment, a significant difference () was detected. Progressive decreases in amplitude of the OAE during TEOAE measurement in 1, 2, and 4 frequencies among 41.66%, 18.75 %, and 43.75% were observed, respectively. The hearing loss was seen more among older and male cases significantly. Conclusion. The results showed ototoxicity of INF-αthat may encourage planning hearing monitoring in patients receiving this drug.
Further Evidence of Mutational Heterogeneity of theXPCGene in Tunisian Families: A Spectrum of Private and Ethnic Specific Mutations
Authors: Ben Rekaya Mariem , Jerbi Manel , Messaoud Olfa , Ben Brick Ahlem Sabrine , Zghal Mohamed , Mbarek Chiraz , Chadli-Debbiche Ashraf , Jones Meriem , Mokni Mourad , Boussen Hamouda , Boubaker Mohamed Samir , Fazaa Becima , Yacoub-Youssef Houda , Abdelhak Sonia
Published: July 2013

Xeroderma Pigmentosum(XP) is a rare recessive autosomal cancer prone disease, characterized by UV hypersensitivity and early appearance of cutaneous and ocular malignancies. We investigated four unrelated patients suspected to be XP-C. To confirm linkage toXPCgene, genotyping and direct sequencing ofXPCgene were performed. Pathogenic effect of novel mutations was confirmed by reverse Transciptase PCR. Mutation screening revealed the presence of two novel mutations g.18246G>A and g.18810G>T in theXPCgene (NG_011763.1). The first is present in one patient XP50NEF, but the second is present in three unrelated patients (XP16KEB, XP28SFA, and XP45GB). These 3 patients are from three different cities of Southern Tunisia and bear the same haplotype, suggesting a founder effect. Reverse Transciptase PCR revealed the absence of theXPCmRNA. In Tunisia, as observed in an other severe genodermatosis, the mutational spectrum of XP-C group seems to be homogeneous with some clusters of heterogeneity that should be taken into account to improve molecular diagnosis of this disease.
Preserved Transcallosal Inhibition to Transcranial Magnetic Stimulation in Nondemented Elderly Patients with Leukoaraiosis
Authors: Lanza Giuseppe , Bella Rita , Giuffrida Salvatore , Cantone Mariagiovanna , Pennisi Giovanni , Spampinato Concetto , Giordano Daniela , Malaguarnera Giulia , Raggi Alberto , Pennisi Manuela
Published: July 2013

Structural corpus callosum (CC) changes in patients with leukoaraiosis (LA) are significantly associated with cognitive and motor impairment. The aim of this study is to investigate the transcallosal fibers functioning by means of transcranial magnetic stimulation (TMS) in elderly patients with LA. The resting motor threshold (rMT), the motor-evoked potentials (MEPs), and the controlateral (cSP) and ipsilateral silent periods (iSP) were determined using single-pulse TMS in 15 patients and 15 age-matched controls. The neuropsychological profile and the vascular burden at brain magnetic resonance imaging (MRI) were concomitantly explored. Patients reported abnormal scores at tests evaluating executive control functions. No significant difference was found in TMS measures of intra- and intercortical excitability. No CC lesion was evident at MRI. Transcallosal inhibitory mechanisms to TMS seem to be spared in LA patients, a finding which is in line with neuroimaging features and suggests a functional integrity of the CC despite the ischemic interruption of corticosubcortical loops implicated in cognition and behavior. The observed neurophysiological finding differs from that reported in degenerative dementia, even in the preclinical or early stage. In our group of patients, the pure extent of LA is more related to impairment of frontal lobe abilities rather than functional callosal changes.
Distribution of Hairs on the Phalanges of Hands among Ghanaians
Authors: Aboagye Benjamin , Tsegah Korantema Mawuena , Ussif Abdala Mumuni
Published: July 2013

Aim. The study intended to observe the frequency and pattern of distribution of phalangeal hairs on the hands of Ghanaians.
Material and Methods. A total of 1040 healthy consenting individuals (529 females and 511 males) aged between 18 and 45 years were randomly selected from the University of Cape Coast Community. Presence or absence of phalangeal hairs was observed with the aid of a pocket lens.
Results. Hairs were observed on the proximal phalanges of 98.24% of the males and 96.22% of the females. The most common hair pattern observed on the proximal digits was 2-3-4-5 (65.95% males and 70.32% females). The highest frequency of midphalangeal hairs occurred in the group with hair on the 4th digit alone (3.33% males and 2.27% females) followed by the 3-4-5 group (2.54% males and 1.89% females). Conclusion. Females have lower frequency of phalangeal hairs than males. The outcome of this study may be significant medicolegally and in anthropological racial and gender studies.
Sulforaphane as a Potential Protective Phytochemical against Neurodegenerative Diseases
Authors: Tarozzi Andrea , Angeloni Cristina , Malaguti Marco , Morroni Fabiana , Hrelia Silvana , Hrelia Patrizia
Published: July 2013

A wide variety of acute and chronic neurodegenerative diseases, including ischemic/traumatic brain injury, Alzheimer’s disease, and Parkinson's disease, share common characteristics such as oxidative stress, misfolded proteins, excitotoxicity, inflammation, and neuronal loss. As no drugs are available to prevent the progression of these neurological disorders, intervention strategies using phytochemicals have been proposed as an alternative form of treatment. Among phytochemicals, isothiocyanate sulforaphane, derived from the hydrolysis of the glucosinolate glucoraphanin mainly present inBrassicavegetables, has demonstrated neuroprotective effects in several in vitro and in vivo studies. In particular, evidence suggests that sulforaphane beneficial effects could be mainly ascribed to its peculiar ability to activate the Nrf2/ARE pathway. Therefore, sulforaphane appears to be a promising compound with neuroprotective properties that may play an important role in preventing neurodegeneration.
A New Type of Distributed Parameter Control Systems: Two-Point Boundary Value Problems for Infinite-Dimensional Dynamical Systems
Authors: Kong De-Xing , Wu Fa
Published: July 2013

This survey note describes a new type of distributed parameter control systems—the two-point boundary value problems for infinite-dimensional dynamical systems, particularly, for hyperbolic systems of partial differential equations of second order, some of the discoveries that have been done about it and some unresolved questions.
Species Classification and Quality Assessment of Cangzhu (Atractylodis Rhizoma) by High-Performance Liquid Chromatography and Chemometric Methods
Authors: Xia Yong-Gang , Yang Bing-You , Wang Qiu-Hong , Liang Jun , Wang Di , Kuang Hai-Xue
Published: July 2013

Fast and sensitive high-performance liquid chromatography (HPLC) coupled with chemometric methods was utilized to assist in the quality assessment of Cangzhu (Atractylodis Rhizoma). By comparative analysis of chromatographic profiles, twelve common peaks were selected for multivariate analysis. Principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) of the chromatographic data demonstrated that 16 batches of Cangzhu samples could be welldifferentiated and categorized into two groups, which were closely related to their species (Atractylodes chinensis and A. lancea). By loading plots of PCA and OPLS-DA, the “common peaks” 2, 10, and 12 were defined as “marker peaks,” which were identified as atractylodinol, (4E,6E,12E)-tetradecatriene-8,10-diyne-1,3-diyl diacetate, and atractylodin, respectively. These three “marker peaks” were then simultaneously quantified for further controlling the quality of Cangzhu, which showed acceptable linearity, both intraday and interday precisions (RSD ≤ 2.30%), repeatability (RSD ≤ 2.82%), and the recoveries of the three analytes in the range of 96.57–100.16%, with RSDs less than 1.46%. Finally, linear discriminant analysis (LDA) was successfully used to build predictive models of the group membership based on the contents of three marker peaks. Results of the present study demonstrated that HPLC-based metabolic profiling coupled with chemometric methods and quantificational determination was a very flexible, reliable, and effective way for homogeneity evaluation and quality assessment of traditional Chinese medicine.
Applications of the MVWG Multivariable Stochastic Weather Generator
Authors: Fodor Nándor , Dobi Ildikó , Mika János , Szeidl László
Published: July 2013

Weather generators (WG) became significant modules of crop models and decision support systems in the past decade. Using a large meteorological database from North America; two basic problems, related to the applicability of WGs in case of short or lacking data series, were investigated in the framework of the Multivariable weather generator (MVWG). First, the minimum data series length, required for adequate parameterization of the WG, was determined. Our results suggest that 15 years of observed data are enough for adequate parameterization of the MVWG. We then investigated a possibility of spatial interpolation of WG parameters using the outputs of the WG for sites with no meteorological observations. Coupled with the presented interpolation technique, MVWG was able to generate realistic weather data for sites with no measurements situated in climatically and geographically homogeneous regions.
Role of -FDG PET Scan in Rheumatoid Lung Nodule: Case Report and Review of the Literature
Authors: Chhakchhuak Christine L. , Khosravi Mehdi , Lohr Kristine M.
Published: July 2013

Flourine-18 fluoro-2-deoxy-glucose (18F-FDG) positron emission tomography combined with computed tomography (PET/CT) is a useful test for the management of malignant conditions. Inflammatory and infectious processes, however, can cause increased uptake on PET scanning, often causing diagnostic dilemmas. This knowledge is important to the rheumatologist not only because of the inflammatory conditions we treat but also because certain rheumatic diseases impose an increased risk of malignancy either due to the disease itself or as a consequence of medications used to treat the rheumatic diseases. There is an increasing body of evidence investigating the role of PET scans in inflammatory conditions. This paper describes a patient with rheumatoid arthritis who developed pulmonary nodules that showed increased uptake on PET/CT scan and reviews the use of PET scanning in the diagnosis and management of rheumatoid arthritis.
Object Individuation or Object Movement as Attractor? A Replication of the Wide-Screen/Narrow-Screen Study by Means of (a) Standard Looking Time Methodology and (b) Eye Tracking
Authors: Krøjgaard Peter , Kingo Osman S. , Staugaard Søren R.
Published: July 2013

We report a replication experiment of a mechanized version of the seminal wide-screen/narrow-screen design of Wilcox and Baillargeon (1998) with 9.5-month-old infants (N=80). Two different methodologies were employed simultaneously: (a) the standard looking time paradigm and (b) eye tracking. Across conditions with three different screen sizes, the results from both methodologies revealed a clear and interesting pattern: the looking times increased as a significantly linear function of reduced screen sizes, that is, independently of the number of different objects involved. There was no indication in the data that the infants made use of the featural differences between the different-looking objects involved. The results suggest a simple, novel, and thought-provoking interpretation of the infants’ looking behavior in the wide-screen/narrow-screen design: moving objects are attractors, and the more space left for visible object movement in the visual field, the longer are infants’ looks. Consequently, no cognitive interpretation may be needed.
The Current State and Needs of North American Movement Disorders Fellowship Programs
Authors: Shih Ludy C. , Tarsy Daniel , Okun Michael S.
Published: July 2013

Background. Movement disorders fellowships are an important source of future clinician-specialists and clinician-scientists for the field. Scant published information exists on the number and characteristics of North American movement disorders fellowship training programs.Methods. A 31-item internet-based survey was formulated and distributed to academic movement disorders listed in the American Academy of Neurology (AAN) directory as having a movement disorders fellowship and to all National Parkinson Foundation Centers of Excellence and Care Centers in North America.Results. There was a 77% response rate among academic movement disorders centers. Broad similarities in clinical training were identified. The two most important rated missions of maintaining a movement disorders fellowship were contributions to scholarly activities and to fulfilling a critical need for specialists. Almost a quarter of fellowship programs did not offer a fellowship slot during the most recent academic year. Fellowship directors cited a wide variety of funding sources, but their top concern was lack of available funding for fellowship programs.Conclusions. North American movement disorders fellowship training programs currently offer similar methods of clinical training and education. Lack of funding was the most important obstacle to maintaining fellowship programs and should be made a priority for discussion in the field.
UCAV Path Planning by Fitness-Scaling Adaptive Chaotic Particle Swarm Optimization
Authors: Zhang Yudong , Wu Lenan , Wang Shuihua
Published: July 2013

Path planning plays an extremely important role in the design of UCAVs to accomplish the air combat task fleetly and reliably. The planned path should ensure that UCAVs reach the destination along the optimal path with minimum probability of being found and minimal consumed fuel. Traditional methods tend to find local best solutions due to the large search space. In this paper, a Fitness-scaling Adaptive Chaotic Particle Swarm Optimization (FAC-PSO) approach was proposed as a fast and robust approach for the task of path planning of UCAVs. The FAC-PSO employed the fitness-scaling method, the adaptive parameter mechanism, and the chaotic theory. Experiments show that the FAC-PSO is more robust and costs less time than elite genetic algorithm with migration, simulated annealing, and chaotic artificial bee colony. Moreover, the FAC-PSO performs well on the application of dynamic path planning when the threats cruise randomly and on the application of 3D path planning.
Piecewise Convex Technique for the Stability Analysis of Delayed Neural Network
Authors: Liu Zixin , Yu Jian , Xu Daoyun , Peng Dingtao
Published: July 2013

On the basis of the fact that the neuron activation function is sector bounded, this paper transforms the researched original delayed neural network into a linear uncertain system. Combined with delay partitioning technique, by using the convex combination between decomposed time delay and positive matrix, this paper constructs a novel Lyapunov function to derive new less conservative stability criteria. The benefit of the method used in this paper is that it can utilize more information on slope of the activations and time delays. To illustrate the effectiveness of the new established stable criteria, one numerical example and an application example are proposed to compare with some recent results.
Cyclosporine Regimens in Plaque Psoriasis: An Overview with Special Emphasis on Dose, Duration, and Old and New Treatment Approaches
Authors: Colombo M. D. , Cassano N. , Bellia G. , Vena G. A.
Published: July 2013

Cyclosporine A (CsA) is one of the most effective systemic drugs available for the treatment of psoriasis, as evidenced by the results of several randomized studies and by a prolonged experience in dermatological setting. In clinical practice, CsA is usually used for the induction of psoriasis remission at a daily dose included in the range of 2.5–5 mg/kg and with intermittent short‐term regimens, lasting on average 3–6 months. The magnitude and rapidity of response are dose dependent, as well as the risk of development of adverse events. Therefore, the dose should be tailored to patient’s needs and general characteristics and adjusted during the treatment course according to both the efficacy and tolerability. Some studies support the feasibility of pulse administration of CsA for a few days per week for both the induction and the maintenance of response in psoriasis patients. This paper will review the data on CsA regimens for plaque‐type psoriasis and will focus the attention on dose, treatment duration, novel schedules, and role in combination therapies, including the association with biologicals.
Redundant-Path Scheme for Efficient Interworking between a Wireless Sensor Network and the Internet
Authors: Kim Kyuhyung , Kim Dongkyun , Kim Dongwon
Published: July 2013

A wireless sensor network (WSN) has become an important technology and has been deployed in many emerging applications, including home automation, health care, and precision agriculture. To deploy more service applications, the WSN must solve the internetworking problem (difference in speed, protocol stack, beacon collision etc.). In this study, we propose a redundant-path scheme based on a multichannel WSN for an efficient interworking among the heterogeneous networks. We evaluate the performance of our proposed scheme through a real-world simulation, and the results show an improvement in data throughput, packet delay, and beacon loss ratio.
Vitamin C Intake Reduces the Cytotoxicity Associated with Hyperglycemia in Prediabetes and Type 2 Diabetes
Authors: Franke Silvia Isabel Rech , Müller Luiza Louzada , Santos Maria Carolina , Fishborn Arcênio , Hermes Liziane , Molz Patrícia , Pereira Camila Schreiner , Wichmann Francisca Maria Assmann , Horta Jorge André , Maluf Sharbel Weidner , Prá Daniel
Published: July 2013

Hyperglycemia leads to the formation of free radicals and advanced glycation end-products (AGEs). Antioxidants can reduce the level of protein glycation and DNA damage. In this study, we compared the levels of vitamin C intake, which is among the most abundant antioxidants obtained from diet, with the levels of fasting plasma glucose (FPG), glycated hemoglobin (A1C), DNA damage, and cytotoxicity in prediabetic subjects and type 2 diabetic subjects. Our results indicated that there was no significant correlation between FPG or A1C and DNA damage parameters (micronuclei, nucleoplasmic bridges, and nuclear buds). FPG and A1C correlated with necrosis (r=0.294;P=0.013andr=0.401;P=0.001, resp.). Vitamin C intake correlated negatively with necrosis and apoptosis (r=-0.246;P=0.040, andr=-0.276;P=0.021, resp.). The lack of a correlation between the FPG and A1C and DNA damage could be explained, at least in part, by the elimination of cells with DNA damage by either necrosis or apoptosis (cytotoxicity). Vitamin C appeared to improve cell survival by reducing cytotoxicity. Therefore, the present results indicate the need for clinical studies to evaluate the effect of low-dose vitamin C supplementation in type 2 diabetes.
Extraction of Transmission Parameters for Siting and Sizing of Distributed Energy Sources in Distribution Network
Authors: Kalambe Shilpa , Agnihotri Ganga
Published: July 2013

This paper introduces a novel method for sitting and sizing the grid connected distributed generator (DG) for installation in distribution system at any input load condition, which is based on two port transmission equations, named as modified transmission parameters (MTP) method by considering the loss minimization as a constraint. If properly organized, with the help of various transmission parameters optimal DG allocation with minimum transmission losses, contribution of DG as well as the main supply source to each load, type of DG required to handle the existing power flow scenario, and operating power factor at which DG should operate can be easily investigated. Apart from this the author has also investigated the worst location for DG installation and referred to it as Consecutive Bus. The method has been tested on two test distribution systems with varying sizes and intricacy and the results have been compared with the two established methods reported earlier. Relative study presented has shown that the proposed method leads existing methods in terms of its simplicity, computational time, and handling less number of variables.
A Partial Backlogging Inventory Model for Deteriorating Item under Fuzzy Inflation and Discounting over Random Planning Horizon: A Fuzzy Genetic Algorithm Approach
Authors: Jana Dipak Kumar , Das Barun , Roy Tapan Kumar
Published: July 2013

An inventory model for deteriorating item is considered in a random planning horizon under inflation and time value money. The model is described in two different environments: random and fuzzy random. The proposed model allows stock-dependent consumption rate and shortages with partial backlogging. In the fuzzy stochastic model, possibility chance constraints are used for defuzzification of imprecise expected total profit. Finally, genetic algorithm (GA) and fuzzy simulation-based genetic algorithm (FSGA) are used to make decisions for the above inventory models. The models are illustrated with some numerical data. Sensitivity analysis on expected profit function is also presented.Scope and Purpose. The traditional inventory model considers the ideal case in which depletion of inventory is caused by a constant demand rate. However, to keep sales higher, the inventory level would need to remain high. Of course, this would also result in higher holding or procurement cost. Also, in many real situations, during a longer-shortage period some of the customers may refuse the management. For instance, for fashionable commodities and high-tech products with short product life cycle, the willingness for a customer to wait for backlogging is diminishing with the length of the waiting time. Most of the classical inventory models did not take into account the effects of inflation and time value of money. But in the past, the economic situation of most of the countries has changed to such an extent due to large-scale inflation and consequent sharp decline in the purchasing power of money. So, it has not been possible to ignore the effects of inflation and time value of money any more. The purpose of this paper is to maximize the expected profit in the random planning horizon.
A Phantom-Node Method with Edge-Based Strain Smoothing for Linear Elastic Fracture Mechanics
Authors: Vu-Bac N. , Nguyen-Xuan H. , Chen L. , Lee C. K. , Zi G. , Zhuang X. , Liu G. R. , Rabczuk T.
Published: July 2013

This paper presents a novel numerical procedure based on the combination of an edge-based smoothed finite element (ES-FEM) with a phantom-node method for 2D linear elastic fracture mechanics. In the standard phantom-node method, the cracks are formulated by adding phantom nodes, and the cracked element is replaced by two new superimposed elements. This approach is quite simple to implement into existing explicit finite element programs. The shape functions associated with discontinuous elements are similar to those of the standard finite elements, which leads to certain simplification with implementing in the existing codes. The phantom-node method allows modeling discontinuities at an arbitrary location in the mesh. The ES-FEM model owns a close-to-exact stiffness that is much softer than lower-order finite element methods (FEM). Taking advantage of both the ES-FEM and the phantom-node method, we introduce an edge-based strain smoothing technique for the phantom-node method. Numerical results show that the proposed method achieves high accuracy compared with the extended finite element method (XFEM) and other reference solutions.
Investigation of Epstein–Barr Virus as a Potential Cause of B-Cell Non-Hodgkin Lymphoma in a Prospective Cohort
Authors: De Roos Anneclaire J. , Martínez-Maza Otoniel , Jerome Keith R. , Mirick Dana K. , Kopecky Kenneth J. , Madeleine Margaret M. , Magpantay Larry , Edlefsen Kerstin L. , LaCroix Andrea Z.
Published: July 2013

Background: We hypothesized that poor control of Epstein–Barr virus (EBV) infection, leading to reactivation of the virus, increases the risk of non-Hodgkin lymphoma (NHL) in the general population of primarily immunocompetent persons.

Methods: We conducted a case–control study nested within the Women's Health Initiative Observational Study cohort in which we measured antibodies to EBV antigens [immunoglobulin G (IgG) to viral capsid antigen (VCA), nuclear antigen (EBNA1), and early antigen-diffuse (EA-D)] and EBV DNA load in prediagnostic samples of 491 B-cell NHL cases and 491 controls.

Results: We found no association with established EBV infection, based on seropositivity for VCA. Seropositivity for EBNA1 was associated with decreased risk of B-cell NHL, overall [OR = 0.5; 95% confidence interval (CI), 0.3–0.8] and for each of the histologic subtypes examined. Increased risk of chronic lymphocytic leukemia (CLL) and related subtypes was observed with higher levels of EBV DNA and antibody to EA-D, both markers reflective of reactivation. These associations were strongest for cases with the shortest time interval between blood draw and diagnosis.

Conclusions: In balance, these results do not provide strong evidence of EBV playing a causal role in B-cell NHL in general population women. The associations we observed may reflect increased risk of NHL with underlying immune impairment or could be due to reverse causation.

Impact: Further characterization of the subtype-specific association with CLL is warranted. Exclusion of cases with preclinical disease markers (such as monoclonal B-lymphocytosis for CLL) may help rule out reverse causation in future studies. Cancer Epidemiol Biomarkers Prev; 22(10); 1747–55. ©2013 AACR.
Doppler Pulsatility Index in Spontaneous Intracerebral Hemorrhage
Authors: Kiphuth Ines C. , Huttner Hagen B. , Dörfler Arnd , Schwab Stefan , Köhrmann Martin
Published: July 2013

Background and Purpose: Elevated intracranial pressure (ICP) as a result of intracerebral hemorrhage (ICH) and perihematomal edema often leads to tissue shift, which can be identified in cross-sectional imaging and presents a known predictor of functional outcome. Pulsatility indices (PIs) of the intracranial arteries as measured by transcranial Doppler sonography (TCD) may serve as surrogate parameters for ICP. This study aims to investigate whether PI correlates with ICP and midline shift and serves as a reliable predictor of functional outcome in patients with ICH. Methods: Within a 1-year period between April 2009 and April 2010, 136 patients with acute spontaneous, supratentorial ICH were admitted to our tertiary care hospital. One-hundred and twenty-four patients fulfilled the inclusion criteria and were eligible for analysis. TCD and transcranial duplex sonography were performed on admission and at least once more during hospital stay. Functional outcome was assessed 6 months after discharge. Correlation analyses, logistic regression analyses and receiver operating characteristic curves were calculated. Results: One-hundred and twenty-four patients were included in the analysis. Six-month mortality amounted to 39.5%. The ICH score and PIs of the middle cerebral artery were independent predictors of outcome 6 months after discharge. Conclusions: Early PI monitoring by TCD correlated with ICP and may be used to predict the outcome after 6 months.
Identifying the Patient at Risk of Acute Kidney Injury: A Predictive Scoring System for the Development of Acute Kidney Injury in Acute Medical Patients
Authors: Forni Lui G. , Dawes Thomas , Sinclair Hamish , Cheek Elizabeth , Bewick Vivien , Dennis Mark , Venn Richard
Published: July 2013

Background: Acute kidney injury (AKI) in hospitalized patients has significant implications in terms of morbidity and mortality, length of hospital stay and associated costs. To date, no interventions are proven to prevent the development of AKI but this is hampered in part by the lack of early recognition of patients at risk. We aimed to determine whether a simple system could be devised from both physiological and demographic data in order to identify individuals at increased risk from the development of inpatient AKI. Method: Our observational, population-based single-centred study took place in an 870-bed associated university hospital. All patients admitted to the acute medical admissions unit on the Worthing site of the Western Sussex Hospitals Trust during the study period were included. Results: Multivariate logistic regression analysis demonstrated that age, respiratory rate and disturbed consciousness together with a history of chronic kidney disease, diabetes mellitus, congestive cardiac failure and liver disease were associated with an increased risk of developing AKI within 7 days of admission. We derived a simple scoring system to identify acute medical patients at greater risk of developing AKI. Conclusions: The incidence of AKI complicating inpatient admissions remains high, however with the application of the derived AKI prediction score it is hoped that early recognition will translate to improved outcomes.
Patient-Reported Outcomes in Spanish Patients Diagnosed with Bilateral Age-Related Macular Degeneration
Authors: López-Miguel Alberto , Coco-Martín María B. , Martínez-Fernández Rosa , Gómez-Ramírez Ana M. , García-Ayuso Diego , Sobrado-Calvo Paloma , Maldonado Miguel J.
Published: July 2013

Purpose: To evaluate the patient-reported outcomes (PRO) in age-related macular degeneration (AMD) patients by using instruments for eliciting health status and vision specific issues. Methods: PRO were assessed using the 25-item National Eye Institute Visual Function Questionnaire (NEIVFQ-25) and the Short-Form General Health Survey (SF-12). Results: The mean age and corrected distance visual acuity (CDVA) in the better eye of the AMD patients were 82.53 ± 5.17 years and 0.82 ± 0.43 logMAR, respectively. The overall NEIVFQ-25 composite score was 57.89. SF-12 physical and mental component summary scores were 37.28 and 57.25, respectively. There were significant correlations (p ≤ 0.05) between CDVA and the following NEIVFQ-25 subscales: general (r = -0.73), near (r = -0.40) and distance vision (r = -0.60), role limitations (r = -0.40), social function (r = -0.48) and mental health (r = -0.38). Conclusions: Visual function is severely affected in AMD patients. It hampers their daily living without, however, deeply disturbing their social function. This may help them retain adequate mental health despite their poor physical status.
Appetite Is Associated with the Time of Recovery after the Dialytic Session in Patients on Chronic Hemodialysis
Authors: Bossola Maurizio , Tazza Luigi
Published: July 2013

Aim: The aim of this cross-sectional study was to assess the correlation between self-reported appetite and the time of recovery after the hemodialysis session (TIRD). Methods: All patients on chronic hemodialysis at the Hemodialysis Service of the Catholic University of Rome underwent assessment of appetite through the first three questions of the Hemodialysis Study Appetite questionnaire, TIRD (through the question ‘How long does it take you to recover from a dialysis session?'), number and severity of comorbidities according to the Charlson Comorbidity Index (CCI), and daily activities through the ADL (activities of daily living) and the IADL (instrumental activities of daily living). Results: We studied 106 patients. According to the appetite questionnaire, in 45 patients appetite was very good or good (group 1), in 33 fair (group 2) and in 28 poor or very poor (group 3). Age, CCI, TIRD and serum parathyroid hormone levels were significantly higher in group 3 than in groups 1 and 2, while the IADL was significantly lower. Age, CCI, TIRD, IADL and serum parathyroid hormone were significantly correlated with appetite. At multiple regression analysis, TIRD and CCI only were independently correlated with appetite. Conclusion: Poor appetite is independently associated with the time of recovery after the hemodialysis session.
Non-Invasive Prenatal Testing for Down's Syndrome: Pregnant Women's Views and Likely Uptake
Authors: Lewis C. , Silcock C. , Chitty L.S.
Published: July 2013

Background: The introduction of non-invasive prenatal testing (NIPT) for Down's syndrome into routine state-funded antenatal care in the UK is approaching. Methods: We conducted qualitative one-to-one interviews with 40 pregnant women to ascertain their views on using NIPT for Down's syndrome. Results: The overwhelming majority of women viewed NIPT as a positive advancement in prenatal care, highlighting numerous practical and psychological advantages of a safe test that was highly accurate and could be conducted early in pregnancy. Concerns raised were that testing could become routinised, and that pressure to test might occur with women feeling less justified in declining a blood test that is available and offered by trusted health professionals; the impact on the disabled community and stigma for women who decline testing was also noted. Nevertheless, the vast majority of women said they would be likely to use NIPT, including half of the women who currently decline screening. Women's preference was for pre- and post-test counselling to be delivered by a midwife. Conclusion: The successful introduction of NIPT into routine prenatal care will require guidelines and counselling strategies which ensure women are offered this test in a way which safeguards informed consent.
Serum Uric Acid Levels and Endothelial Dysfunction in Patients with Autosomal Dominant Polycystic Kidney Disease
Authors: Kocyigit Ismail , Yilmaz Mahmut Ilker , Orscelik Ozcan , Sipahioglu Murat Hayri , Unal Aydin , Eroglu Eray , Kalay Nihat , Tokgoz Bulent , Axelsson Jonas , Oymak Oktay
Published: July 2013

Background/Aims: Patients with autosomal dominant polycystic kidney disease (ADPKD) exhibit endothelial dysfunction (ED) despite normal levels of renal function. Hyperuricemia occurs in these patients and has been postulated to affect ED through the generation of oxidative stress. We therefore investigated the prevalence of ED and its association with serum uric acid levels in early-stage ADPKD. Methods: A cross-sectional design was used for the assessment of prevalent patients with early-stage (normal renal function) ADPKD (n = 91) from two academic medical centers. ED was assessed using ischemia-induced forearm flow-mediated vasodilation (FMD). Serum uric acid levels were evaluated using an Olympus AU2700 autoanalyzer. Results: ADPKD patients with higher serum uric acid levels had a higher asymmetric dimethylarginine (ADMA) level (1.19 ± 0.2 vs. 1.47 ± 0.3, p < 0.001) and lower FMD rates (8.1 ± 1.3 vs. 6.8 ± 0.7, p < 0.001). In multiple regression analysis for predictors of cohort FMD, uric acid (β = -0.32, p < 0.001), ADMA (β = -0.36, p < 0.001), high-sensitivity C reactive protein (CRP; β = -0.32, p < 0.001) and estimated glomerular filtration rate (eGFR; β = 0.33, p < 0.001) all predicted FMD. Conclusions: In early-stage ADPKD patients, uric acid levels, serum ADMA and eGFR all independently predict ED in a similar manner. Future studies are needed to investigate the causes of elevated serum uric acid, ADMA and CRP in these patients.
Use of clopidogrel and proton pump inhibitors after a serious acute coronary event: Risk of coronary events and peptic ulcer bleeding
Authors: Rodríguez Luis , Johansson Saga , Soriano Lucía Cea
Published: July 2013

Some pharmacokinetic studies have reported that proton pump inhibitors (PPIs) reduce the activity of clopidogrel, but the results of studies assessing clinical outcomes in patients receiving both drugs are inconsistent. We have therefore carried out a population-based cohort study with nested case–control analysis, in order to evaluate changes in the risk of cardiovascular and peptic ulcer bleeding (PUB) events associated with PPI use in patients receiving clopidogrel. A total of 42,542 patients aged 50–84 years in 2000–2007 who survived an acute coronary event were identified in two UK-based primary care databases (The Health Improvement Network and the General Practice Research Database). Individuals were followed up to identify incident cases of non-fatal myocardial infarction/coronary death (n = 2,546) and PUB (n = 194). Controls were frequency matched to cases by age, sex and calendar year. Compared with PPI non-use, current continuous PPI use was not associated with a significant change in risk of non-fatal myocardial infarction/coronary death among current continuous users of clopidogrel monotherapy (relative risk [RR], 1.06; 95% confidence interval [95% CI], 0.47 to 2.36) or dual antiplatelet therapy (DAT; RR, 0.80; 95% CI, 0.47 to 1.37) who initiated their antiplatelet therapy shortly after their coronary event. Among patients prescribed DAT at the start date, the RR of PUB events associated with current PPI use initiated at the start date was 0.66 (95% CI, 0.27 to 1.60).
T-Type Calcium Current Contributes to Escape Automaticity and Governs the Occurrence of Lethal Arrhythmias After Atrioventricular Block in Mice
Authors: Le Quang Khai , Benito Begoña , Naud Patrice , Qi Xiao Yan , Shi Yan Fen , Tardif Jean-Claude , Gillis Marc-Antoine , Dobrev Dobromir , Charpentier Flavien , Nattel Stanley
Published: July 2013

Background—

When complete atrioventricular block (AVB) occurs, infranodal escape rhythms are essential to prevent bradycardic death. The role of T-type Ca
2+
channels in pacemaking outside the sinus node is unknown. We investigated the role of T-type Ca
2+
channels in escape rhythms and bradycardia-related ventricular tachyarrhythmias after AVB in mice.

Methods and Results—

Adult male mice lacking the main T-type Ca
2+
channel subunit Cav3.1 (Cav3.1
−/−
) and wild-type (WT) controls implanted with ECG telemetry devices underwent radiofrequency atrioventricular node ablation to produce AVB. Before ablation, Cav3.1
−/−
mice showed sinus bradycardia (mean±SEM; RR intervals, 148±3 versus 128±2 ms WT;
P
<0.001). Immediately after AVB, Cav3.1
−/−
mice had slower escape rhythms (RR intervals, 650±75 versus 402±26 ms in WT;
P
<0.01) but a preserved heart-rate response to isoproterenol. Over the next 24 hours, mortality was markedly greater in Cav3.1
−/−
mice (19/31; 61%) versus WT (8/26; 31%;
P
<0.05), and Torsades de Pointes occurred more frequently (73% Cav3.1
−/−
versus 35% WT;
P
<0.05). Escape rhythms improved in both groups during the next 4 weeks but remained significantly slower in Cav3.1
−/−
. At 4 weeks after AVB, ventricular tachycardia was more frequent in Cav3.1
−/−
than in WT mice (746±116 versus 214±78 episodes/24 hours;
P
<0.01). Ventricular function remodeling was similar in Cav3.1
−/−
and WT, except for smaller post-AVB fractional-shortening increase in Cav3.1
−/−
. Expression changes were seen post-AVB for a variety of genes; these tended to be greater in Cav3.1
−/−
mice, and overexpression of fetal and profibrotic genes occurred only in Cav3.1
−/−
.

Conclusions—

This study suggests that T-type Ca
2+
channels play an important role in infranodal escape automaticity. Loss of T-type Ca
2+
channels worsens bradycardia-related mortality, increases bradycardia-associated adverse remodeling, and enhances the risk of malignant ventricular tachyarrhythmias complicating AVB.