bluuebunny/crossref_metadata_2025 huggingface dataset:
Marijuana-associated ST-elevation myocardial infarction: is this a benign drug
Authors: Kumar Sundeep , Srinivasamurthy Ruthvik , Karasik Olga , Javaid Aamir
Published: December 2018

Marijuana is the most commonly used psychoactive drug in the USA. A 35-year-old man with a medical history of marijuana abuse is admitted to the hospital due to crushing substernal chest pain. ECG shows evolving ST-segment elevation with a rise in cardiac enzymes, consistent with ST-elevation myocardial infarction. A urine toxicology screen is positive for cannabis and negative for cocaine and other stimulant drugs. An emergent cardiac catheterisation reveals no evidence of coronary artery disease or thrombosis. A diagnosis of coronary vasospasm is strongly considered, and the patient is started on calcium channel blocker, with a resolution of symptoms and ECG changes. Marijuana-induced coronary spasm causing myocardial infarction has rarely been reported. Marijuana is becoming a social norm in adolescents and there remains a misconception that it is harmless and even beneficial. Increasing drug abuse remains a public health concern, necessitating population education by physicians for safer healthcare practices.
Skull base aspergillosis in an immunocompetent elderly man with early response to steroid
Authors: Sarkar Pamela , Price Christopher , Fish Mark , Bennetto Luke
Published: December 2018

We report the case of a previously well 80-year-old man who presented with subacute bilateral painful optic neuropathy with initial response to corticosteroids but ultimately progressed to a fatal skull base syndrome. Initial presentation of steroid-responsive painful bilateral posterior optic neuropathy, preliminary normal enhanced MRI, normal cerebrospinal fluid and inflammatory markers indicated atypical optic neuritis. However, this progressed to a bilateral orbital apex syndrome with ophthalmoplegia and evidence of abnormal skull base enhancement on subsequent MRI. Biopsy of radiologically abnormal dura was non-diagnostic and negative for fungal stains. He deteriorated and died 8 months after initial presentation. At postmortem, fungal skull base infection was diagnosed. This case demonstrates that chronic skull base fungal infection can: (1) present in elderly immunocompetent patients, (2) show initial improvement with corticosteroids and (3) evade diagnosis on biopsy. We encourage a high index of suspicion for fungal skull base infection in similar cases.
Acute severe monarthritis: a rare manifestation of scrub typhus
Authors: Handattu Koushik , Bhat Yellanthoor Ramesh , Konda Kalyan Chakravarthy , Kini Sandesh
Published: December 2018

Scrub typhus caused byOrientia tsutsugamushiis an important cause for fever of unknown origin in endemic areas including India. The vasculitis associated with the disease leads to a variety of clinical manifestations. However, the joint involvement is quite rare and not reported in children. We present severe arthritis of hip joint associated with scrub typhus causing a diagnostic and management challenges in a 4-year-old girl.
Exclusively plant, whole-food diet for polypharmacy due to persistent atrial fibrillation, ischaemic cardiomyopathy, hyperlipidaemia and hypertension in an octogenarian
Authors: Beauchesne Andrew B , Goldhamer Alan C , Myers Toshia R
Published: December 2018

Polypharmacy is common and associated with negative health outcomes in the elderly. We report the case of an 82-year-old man with a history of polypharmacy due to coronary artery disease, myocardial infarction, ischaemic cardiomyopathy, hyperlipidaemia, hypertension and persistent atrial fibrillation who presented with memory loss, cognitive impairment, fatigue and weakness. His treatment plan included an exclusively plant, whole-food diet and moderate physical activity which resulted in a rapid reduction of hyperlipidaemia and high blood pressure and the discontinuation of statin, antihypertensive and beta blocker drug therapy. The patient also reported reversal of impaired cognition and symptoms associated with atrial fibrillation and ischaemic cardiomyopathy, including light-headedness, fatigue and weakness. This case demonstrates that dietary and lifestyle modifications have the potential to improve symptoms of cardiovascular disease and reduce polypharmacy along with associated negative consequences in the elderly.
Neuroleptic malignant-like syndrome causing thrombocytopaenia: a rare association
Authors: Sahu Harsh , Manjunath Mouna Bidarguppe , Ray Animesh , Vikram Naval Kishore
Published: December 2018

Neuroleptic malignant-like syndrome is a rare but potentially fatal complication of sudden withdrawal of dopaminergic drugs. Clinical features are similar to that of neuroleptic malignant syndrome (NMS) like hyperthermia, autonomic dysfunction, altered sensorium, muscle rigidity; but instead of history of neuroleptic use, there is history of withdrawal of dopaminergic drugs. Laboratory examination generally show elevated creatine phosphokinase levels and may show elevated total leucocyte count. Thrombocytopaenia has been very rarely reported with NMS but it has not been reported with NM-like syndrome. Here, we discuss a case of Parkinson’s disease which presented with typical clinical features and risk factors of NM-like syndrome associated with thrombocytopaenia and type 1 respiratory failure. He was treated with bromocriptine and supportive care. Thrombocytopaenia and respiratory failure resolved with above treatment. The patient improved clinically and was successfully discharged on day 12 of admission.
Idiopathic hypereosinophilic syndrome with cutaneous involvement: a comparative review of 32 cases
Authors: Inayat Faisal , O’Neill Stacey S , Zafar Fahad , Marupudi Sindhuja , Vasim Izzah
Published: December 2018

Although idiopathic hypereosinophilic syndrome (HES) is uncommon, we studied the clinical characteristics of this disorder in patients with cutaneous involvement. We chronicle the case of a patient with diffuse skin rash due to idiopathic HES from our clinical experience. Furthermore, a systematic literature search of the medical databases PubMed and Google Scholar was conducted. A total of 32 cases fulfilled the inclusion criteria. The data on patients’ characteristics, epidemiology, clinical features, diagnosis, treatment and outcome were collected and analysed. This review illustrates that physicians should maintain a high index of clinical suspicion for idiopathic HES in patients presenting with dermatological lesions and hypereosinophilia, without an obvious cause. Randomised clinical trials are warranted to outline a generalised and efficient therapeutic approach in these patients. Additionally, this paper highlights the need for population-based studies to delineate the magnitude and scope of this association.
Dexmedetomidine-assisted drug interviews: an observation in psychiatric setting
Authors: Goswami Devalina , Garg Harshit , Carounagarane Hamsenandinie , Deb Koushik Sinha
Published: December 2018

Drug-assisted interviews are an effective tool in the management of various psychiatric illnesses where psychopharmacological, as well as routine psychological interventions, do not prove beneficial. These have most commonly been done by using barbiturates and benzodiazepines that have given favourable results for a long time. However, they carry the risk of respiratory depression and difficulty in maintaining the plane of sedation where the patient is amenable to interviewing. In our experience of drug-assisted interviews with two patients we used intravenous dexmedetomidine, which is being used in anaesthesia practice for conscious sedation or sedation in the intensive care unit. We found dexmedetomidine to be superior to thiopentone in achieving a level of conscious sedation where the patients were amenable for an interview, with no significant adverse events and faster post-anaesthetic recovery.
Non-compressive postoperative cauda equina syndrome following decompression and transforaminal interbody fusion surgery
Authors: Jain Mantu , Das Sudhanshu Sekhar , Behera Sudarsan , Tirpude Amit
Published: December 2018

Postoperative cauda equina syndrome (CES) is a known rare complication following lumbar disc surgery. Seldom are they seen following decompression for spinal stenosis and may be actually more frequent and under-reported? Emergent surgical exploration remains the mainstay of management as the factors responsible for postop CES remains a variety of compressive forces. Yet many a time postoperative imaging or surgical exploration fails to identify a pathology and this leads to an ischaemic theory responsible for CES. Our article highlights conservative management in these selective group. We share our experience in two cases of incomplete CES during our routine transforaminal interbody fusion which we followed closely without re-exploration eventually ending in a favourable outcome.Key messages: The factors responsible for postop CES remains mostly a variety of compressive forces though in some instances postoperative imaging or surgical exploration fails to identify such in some cases. This leads to an ischaemic theory responsible for CES. The role of conservative management of postoperative CES in certain selective cases has a favourable outcome as illustrated in our cases.
Atrial myxoma presenting as acute ischaemic stroke and chronic right lower leg claudication
Authors: Jawaid Anas , Naqvi Syed Yaseen , Wiener Roy
Published: December 2018

A 48-year-old man presented with acute onset of left facial numbness, ataxic gait and double vision. He also complained of chronic right lower leg pain with acute onset a year prior to presentation. His vital signs were within normal limits. Physical exam was notable for right-sided intranuclear opthalmoplegia, decreased sensation to light touch on the left side of his body, left-sided dysmetria and ataxic gait. Neuroimaging showed evidence of acute stroke in the cerebellum and brainstem, for which he was treated with thrombolytics. An echocardiogram revealed a 5×3 cm left atrial myxoma, which was surgically resected. Subsequent imaging of his lower extremity revealed a chronic common iliac artery occlusion for which he underwent angioplasty. His claudication symptoms resolved, and he was without any neurological deficits at a 2-year follow-up visit.
Choroidal melanoma masquerading as orbital cellulitis
Authors: Singh Pallavi , Sen Sagnik , Banerjee Mousumi , Meel Rachna
Published: December 2018

Orbital cellulitis is the most common subset of orbital inflammatory disease. We describe a patient with necrotic choroidal melanoma who presented with orbital cellulitis. MRI revealed a mass lesion suggesting intraocular melanoma with no extrascleral extension. There was no metastasis on positron emission tomography-CT scan. Enucleation with orbital implant was performed. Histopathological analysis of the specimen revealed intraocular necrotic melanoma with very few recognisable melanoma cells. The necrotic subtype is more commonly associated with extrascleral extension, distant metastasis and poorer prognosis than other melanoma types. Sterile orbital cellulitis may rarely be a manifestation of ocular tumours in adults, and a high index of suspicion should be maintained to rule out the same.
Chryseobacterium indologenesperitonitis in a peritoneal dialysis patient
Authors: Carvalho Tiago J , Branco Patrícia Quadros , Martins Ana Rita , Gaspar Augusta
Published: December 2018

Peritonitis remains an important complication of peritoneal dialysis. The Gram-negative bacillusChryseobacterium indologenescauses infection mostly in immunocompromised patients with severe underlying disease, mainly in Asia. Herein, we report the first case in Europe and the second case in an immunocompetent patient of peritoneal dialysis-associatedC. indologenesperitonitis. Our patient presented with abdominal pain and a cloudy effluent and was started on intraperitoneal antibiotics. The organism cultured from the peritoneal fluid was later identified asC. indologenesand antibiotic therapy was adjusted accordingly. Despite this, the peritonitis followed a relapsing course, requiring Tenckhoff catheter removal, temporary transfer to haemodialysis and intravenous antibiotics. Subsequently, a new Tenckhoff catheter was inserted and peritoneal dialysis was restarted. The patient remains peritonitis free after 18 months of follow-up. This case highlights the need to consider rare causes of peritonitis in peritoneal dialysis patients as well as the heterogeneous clinical course ofC. indologenesperitonitis.
Use of continuous glucose monitoring for sport in type 1 diabetes
Authors: Abdulrahman Alif , Manhas Janisha , Linane Hannah , Gurney Mark , Fitzgerald Catriona , O'Sullivan Esther
Published: December 2018

Background

The benefits of exercise for patients with type 1 diabetes (T1D) are difficult to balance with associated glycaemic excursions. The aim of this cohort study was to show that continuous glucose monitoring (CGM) could reduce glycaemic excursions in patients with T1D already using insulin pumps, exercising at moderate to high intensity.

Methods

Questionnaires were used to identify patients with T1D using insulin pumps and naive to CGM use, who reported regular exercise. Six were enrolled and trained on Enlite sensor use with Medtronic Minimed Paradigm Veo system and given activity trackers and written advice on adjustment of insulin or carbohydrate intake for exercise. Resting heart rate (HR) and age were used to determine HR surrogates of moderate and high-intensity exercise. They were to exercise as usual for 3 weeks (run-in week, week 1 and week 2) using the activity trackers and heart rate monitors. Problem areas in Diabetes, Hypoglycaemia fear survey II, Diabetes Technology Questionnaire and Gold scores were completed prior to run-in and at the end. The downloaded sensor glucose data were used to compare the change in time in range (glucose 3.9–10.0 mmol/L) from week 1 to week 2.

Results

For the duration of exercise, this time in glucose range increased from 72±20 to 88%±16 %, p=0.05. The time in hypoglycaemia range (glucose < 3.9 mmol/L) went from 3.9±7.9 to 2.4%±4.8 %, p=0.39. The time in hyperglycaemia range (> 10 mmol/L) reduced from 24±19 to 10%±17%, p=0.04.

Conclusion

These results demonstrate the benefit of CGM use for patients with T1DM doing moderate-intensity to high-intensity exercise.
Dual Kinect v2 system can capture lower limb kinematics reasonably well in a clinical setting: concurrent validity of a dual camera markerless motion capture system in professional football players
Authors: Kotsifaki Argyro , Whiteley Rodney , Hansen Clint
Published: December 2018

Objectives

To determine whether a dual-camera markerless motion capture system can be used for lower limb kinematic evaluation in athletes in a preseason screening setting.

Design

Descriptive laboratory study.

Setting

Laboratory setting.

Participants

Thirty-four (n=34) healthy athletes.

Main outcome measures

Three dimensional lower limb kinematics during three functional tests: Single Leg Squat (SLS), Single Leg Jump, Modified Counter-movement Jump. The tests were simultaneously recorded using both a marker-based motion capture system and two Kinect v2 cameras using iPi Mocap Studio software.

Results

Excellent agreement between systems for the flexion/extension range of motion of the shin during all tests and for the thigh abduction/adduction during SLS were seen. For peak angles, results showed excellent agreement for knee flexion. Poor correlation was seen for the rotation movements.

Conclusions

This study supports the use of dual Kinect v2 configuration with the iPi software as a valid tool for assessment of sagittal and frontal plane hip and knee kinematic parameters but not axial rotation in athletes.
What do Sport and Exercise Medicine (SEM) doctors look like online? A cross-sectional exploration of the social media presence of SEM doctors in the UK
Authors: Shurlock Jonathan , Marino Katherine , Ahmed Osman
Published: December 2018

Objectives

To explore the social media presence of Sport and Exercise Medicine (SEM) doctors from the UK. Secondary aims were to identify whether there were any differences in years since qualification or specialisation between those with and without social media profiles and websites.

Methods

A cross-sectional design was used to investigate the social media presence of UK-based doctors listed as Fellows of the Faculty of Sport and Exercise Medicine. These SEM doctors were identified via their presence on publicly available member lists. Data collected for each SEM Fellow included the presence of profiles on major social media platforms (Twitter, LinkedIn, YouTube and professional Facebook profiles) demonstrated by active profile use and the number of followers/subscribers per platform. The ownership of professional websites and websites hosted by private healthcare providers was also examined.

Results

A total of 175 SEM Fellows were identified and included for analysis. LinkedIn was the most popular platform for this cohort (n=115), followed by Twitter (n=73), while YouTube had far fewer profiles among the SEM Fellows (n=9). No professional Facebook profiles were identified for the SEM Doctors in this study. Almost a third (n=49) of SEM Fellows did not have a profile on any of the social media platforms examined in this study.

Conclusion

Social media is a powerful tool for health promotion and education. The use of these platforms by SEM Doctors and healthcare organisations warrants ongoing guidance and support to enable these practitioners to maximise the utility of these innovative technologies.
Empowering the health of retired professional footballers: the systematic development of an After Career Consultation and its feasibility
Authors: Gouttebarge Vincent , Goedhart Edwin , Kerkhoffs Gino
Published: December 2018

Objectives

This article describes (1) the systematic development of the intervention and (2) the assessment of its feasibility (in terms of relevancy, suitability, satisfaction and added value).

Methods

The intervention was developed based on the first four steps of the Intervention Mapping and Knowledge Transfer Scheme processes. Subsequently, a qualitative research based on a one-group post-test cross-sectional design was conducted. Eight retired professional footballers underwent the developed intervention and its feasibility (operationalised in relevancy, suitability, satisfaction and added value) was assessed by means of a questionnaire and interview.

Results

An After Career Consultation (ACC) was developed with a focus on five main domains: (1) detraining from professional football; (2) remission of osteoarthritis; (3) promotion of healthy lifestyle; (4) preventing mental and cognitive health problems; and (5) employment and education. The ACC relies on three components: (1) raising self-awareness about potential physical, mental and social health problems after a career in professional football; (2) medical examination (60 min) with thorough medical history and general physical examination; and (3) follow-up during 3 months (if necessary) about optimal skills and strategies to empower physical, mental and social health and quality of life. The relevancy, suitability, satisfaction and added value of the ACC were positively evaluated by the retired professional footballers.

Conclusion

The ACC was developed with a focus on five main health-related domains. The feasibility of the ACC was positively assessed by retired professional footballers, while the suggestion was made to repeat the ACC in the initial years after football retirement.
The photosynthetic apparatus ofConocarpus lancifoliusEngl. (Combretaceae) suffers damage in soil contaminated with heavy metals
Authors: Redha Amina , Al-Hasan Redah , Jose Jacquilion , Saju Divya , Afzal Mohammad
Published: December 2018

Conocarpus lancifolius Engl. (Combretaceae), a heat tolerant plant, has potential for use in the phytoremediation of polluted soil. We analyzed the physiological changes in C. lancifolius exposed to single and mixed heavy metals (HMs; cadmium, nickel, and lead). For 30 days under controlled growth conditions, we exposed some groups of plants to a single HM at concentrations of 25 or 50 μmol·L–1and other groups were exposed to 25 μmol·L–1of a mixture of HMs. Photosynthetic parameters such as electron transport rate, photosynthetic rate, chlorophyll fluorescence, chlorophyll content index, and photosynthetic pigments were measured. Chloroplast morphology was studied by transmission electron microscopy (TEM). In plants exposed to 25 μmol·L–1of HMs, the photosynthetic parameters were unaffected, whereas at 50 μmol·L–1of HMs, all parameters significantly decreased up to 20 days of exposure, followed by an increase up to 30 days, indicating a slow adaptation of plants to HM under stress. Compared with the single HMs, mixtures of HMs were more toxic at the same concentration. All parameters indicated damage to the photosynthetic apparatus due to stress from 25 μmol·L–1of the HM mixtures and 50 μmol·L–1of the single HMs. TEM analyses showed a dispersion of grana in the chloroplast of the affected C. lancifolius plants.
Vortex identification in turbulent flows past plates using the Lagrangian method
Authors: Attiya Bashar , Liu I-Han , Altimemy Muhannad , Daskiran Cosan , Oztekin Alparslan
Published: December 2018

Vortex identifications in turbulent flows past arrays of tandem plates are performed by employing the velocity field obtained by high-fidelity large eddy simulations. Lagrangian coherent structures (LCSs) are extracted to examine the evolution and the nonlinear interaction of vortices and to characterize the spatial and temporal characteristics of the flow. LCSs’ identification method is based on the finite-time Lyapunov exponent (FTLE), which is evaluated using the instantaneous velocity data. The simulations are performed in three-dimensional geometries to understand the physics of fluid motion and the vortex dynamics in the vicinity of plates and surfaces at Reynolds number of 50 000. The instantaneous vorticity fields, Eulerian Q-criterion, and LCSs are presented to interpret and understand complex turbulent flow structures. The three-dimensional FTLE fields provide valuable information about the vortex generation, spatial location, evolution, shedding, decaying, and dissipation of vortices. It is demonstrated here that FTLE can be used together with Eulerian vortex identifiers to characterize the turbulent flow field effectively.
Mechanistic investigation for shape factor analysis of SiO2/MoS2 – ethylene glycol inside a vertical channel influenced by oscillatory temperature gradient
Authors: Akbar N.S. , Iqbal Z. , Ahmad Bilal , Maraj E.N.
Published: December 2018

The present article aims to examine shape factor effects of SiO2/MoS2 hybrid nanoparticles suspended in ethylene glycol (EG) confined in a vertical rotating channel under the combined influence of mixed convection, thermal radiation, magnetohydodynamics, and periodic temperature. This study provides exact closed-form solutions for velocity and temperature distributions. Mathematical investigation is carried out by formulating the physical problem in Cartesian coordinates. Effect of significant emerging parameters is displayed and examined through graphs. It is concluded that the magnitude of velocity is higher in the case of small rotations than it is in the case of large rotations. It is noted that velocities upsurge for increasing values of the pressure gradient. The simple fluid has the lowest temperature distribution and the temperature is an increasing function of [Formula: see text]. Hybrid nanofluid having blade-like nanoparticles has a high temperature profile. Moreover, it is observed that temperature distribution is higher for SiO2/MoS2–EG hybrid nanofluid than for MoS2–EG nanofluid. Skin friction phase angle is a decreasing function of Ω, Gr, Re, and N while it is an increasing function of M and A. Magnitude of skin friction decreases with an increase in Ω, Re, M, N, and favorable pressure gradient; however, it increases with an increase in Gr. Nusselt number phase angle is an increasing function of N and [Formula: see text] for SiO2/MoS2–EG hybrid nanofluid. Nusselt number amplitude is a decreasing function of N but it has an increasing trend for rising values of [Formula: see text].
The role of aspirin and inflammation on reproduction: the EAGeR trial
Authors: Levine Lindsay D. , Holland Tiffany L. , Kim Keewan , Sjaarda Lindsey A. , Mumford Sunni L. , Schisterman Enrique F.
Published: December 2018

Inflammation has been linked to several complications in pregnancy, including pregnancy loss. Due to its anti-inflammatory properties, aspirin, a widely available and inexpensive therapy, has potential to help mitigate the negative effects of inflammation along the reproductive pathway. Therefore, the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial was designed to elucidate whether preconception-initiated daily low-dose aspirin would increase the live birth rate in women with 1–2 prior pregnancy losses and no infertility diagnosis and attempting unassisted conception. Here, we present an overview of the collected findings. Low-dose aspirin was associated with an increased live birth rate among women with a single loss at <20 weeks gestation within the past year. When stratified by tertile of C-reactive protein (CRP), a biomarker of inflammation, treatment with aspirin restored a decrement in the live birth rate in women in the highest CRP tertile (relative risk 1.35, 95% confidence interval 1.08–1.67), increasing to similar rates as women of the lower and mid-CRP tertiles. The same effect modification by inflammation status was observed when examining the effect of low-dose aspirin on offspring sex ratio. These results suggest that inflammation plays an important role in reproduction, and that chronic, low-grade inflammation may be amenable to aspirin treatment.
A Joint Optimized Robust Acoustic Echo Cancellation Algorithm
Authors: Li Hongyan , Feng Jianghao , Wang Yue , Zhang Xueying
Published: December 2018

When the input signals for acoustic echo cancellation (AEC) are related signals, the convergence speed of the traditional normalized least mean square (NLMS) algorithms is significantly reduced. In this paper, a joint optimization robust AEC algorithm is proposed to solve this problem. Based on the analysis of the convergence of the normalized subband adaptive filtering (NSAF) algorithm, the algorithm is optimized by minimizing the mean square error (MSE) of the NSAF algorithm, combining sub-band time-varying step factor and time-varying regularization parameter to update the filter weight vectors. And when the impulse noise occurs, the sub-band cut-off parameter is updated in a recursive manner, which makes the algorithm achieve fast convergence speed and low steady-state error, and has strong robustness to impulse noise. In a series of experiments on AEC, simulation results show that the performance of the algorithm is better than the existing algorithms.
Recurrent Visual Relationship Recognition with Triplet Unit for Diversity
Authors: Masui Kento , Ochiai Akiyoshi , Yoshizawa Shintaro , Nakayama Hideki
Published: December 2018

The task of visual relationship recognition (VRR) is to recognize multiple objects and their relationships in an image. A fundamental difficulty of this task is class–number scalability, since the number of possible relationships we need to consider causes combinatorial explosion. Another difficulty of this task is modeling how to avoid outputting semantically redundant relationships. To overcome these challenges, this paper proposes a novel architecture with a recurrent neural network (RNN) and triplet unit (TU). The RNN allows our model to be optimized for outputting a sequence of relationships. By optimizing our model to a semantically diverse relationship sequence, we increase the variety in output relationships. At each step of the RNN, our TU enables the model to classify a relationship while achieving class–number scalability by decomposing a relationship into a subject–predicate–object (SPO) triplet. We evaluate our model on various datasets and compare the results to a baseline. These experimental results show our model’s superior recall and precision with fewer predictions compared to the baseline, even as it produces greater variety in relationships.
A Tool for Digital Education
Authors: Papadakis Nikos , Filiopoulou Eirini , Papadakis Kostas , Chatzakis Ilias
Published: December 2018

A method for enhancing the communication between instructor and student is to automate the procedure of replying to the student’s questions. In order to achieve that, techniques of textual case-based reasoning are used, benefiting both the instructor and the student. The automation of this procedure significantly decreases the workload and involvement required by the tutor. In addition to that, the time required for the students to receive an answer is greatly decreased. In this paper we present such a system, based on pre-existing knowledge, in order to provide answers quickly, for the questions asked by the students.
Stochastic modelling of flow sequences for improved prediction of fluvial flood hazards
Authors: Patidar Sandhya , Allen Deonie , Haynes Rick , Haynes Heather
Published: December 2018

The availability of historical streamflow data of the desired length is often limited and, in these situations, the ability to synthetically generate statistically significant datasets becomes important. We previously developed a highly efficient stochastic modelling approach for the synthetic generation of daily streamflow sequences using the systematic combination of a hidden Markov model with the generalized Pareto distribution (the HMM-GP model). Daily streamflow sequences provide limited information on various significant small duration flooding events exceeding the peak over threshold values, but these are averaged out in the daily datasets. These small duration intense flooding events are often capable of causing significant damage and are important in conducting thorough flood risk management and flood risk assessment studies. This paper presents upgrades to our HMM-GP stochastic modelling approach and examines its efficiency in simulating streamflow at a temporal resolution of 15 minutes. The potential of the HMM-GP model in simulating a synthetic 15-minute streamflow series is investigated by comparing various statistical characteristics (e.g. percentiles, the probability density distribution and the autocorrelation function) of the observed streamflow records with 100 synthetically simulated streamflow time series. The proposed modelling schematics are robustly validated across case studies in four UK rivers (the Don, Nith, Dee and Tweed).
EP4 receptor-associated protein regulates gluconeogenesis in the liver and is associated with hyperglycemia in diabetic mice
Authors: Higuchi Sei , Fujikawa Risako , Nakatsuji Masato , Yasui Mika , Ikedo Taichi , Nagata Manabu , Mishima Kenji , Irie Keiichi , Matsumoto Michihiro , Yokode Masayuki , Minami Manabu
Published: December 2018

Prostaglandin E2 receptor 4–associated protein (EPRAP) is a key molecule in suppressing inflammatory responses in macrophages. EPRAP is expressed not only in macrophages but also in hepatocytes; however, the role of EPRAP in hepatocytes has not yet been defined. To examine the physiological role of hepatic EPRAP in mice, we performed the glucose tolerance test and the hyperinsulinemic-euglycemic clamp in high-fat sucrose diet (HFSD)-fed wild-type (WT) and Eprap null mice. We evaluated the contribution of EPRAP to gluconeogenesis by pyruvate tolerance test and primary hepatocyte experiments. Furthermore, lentivirus-expressing Eprap-specific small-hairpin RNA was injected in db/ db mice. HFSD-fed Eprap null mice had significantly lower blood glucose levels than HFSD-fed WT mice. Eprap null mice also had low glucose levels after fasting or pyruvic acid injection. Moreover, primary hepatocytes from Eprap-deficient mice showed decreased glucose production and lower expression of the Phosphoenol pyruvate carboxykinase and Glucose 6-phosphatase genes. Lentivirus-mediated hepatic Eprap suppression decreased glucose levels and the expression of gluconeogenic genes in db/ db mice. We conclude that EPRAP regulates gluconeogenesis in hepatocytes and is associated with hyperglycemia in diabetic mice. Our data suggest that suppression of EPRAP could be a novel strategy for the treatment of diabetes.
Arsenic modifies serotonin metabolism through glucuronidation in pancreatic β-cells
Authors: Carmean Christopher M. , Yokoi Norihide , Takahashi Harumi , Oduori Okechi S. , Kang Christie , Kanagawa Akiko , Kirkley Andrew G. , Han Guirong , Landeche Michael , Hidaka Shihomi , Katoh Miki , Sargis Robert M. , Seino Susumu
Published: December 2018

In arsenic-endemic regions of the world, arsenic exposure correlates with diabetes mellitus. Multiple animal models of inorganic arsenic (iAs, as As3+) exposure have revealed that iAs-induced glucose intolerance manifests as a result of pancreatic β-cell dysfunction. To define the mechanisms responsible for this β-cell defect, the MIN6-K8 mouse β-cell line was exposed to environmentally relevant doses of iAs. Exposure to 0.1–1 µM iAs for 3 days significantly decreased glucose-induced insulin secretion (GIIS). Serotonin and its precursor, 5-hydroxytryptophan (5-HTP), were both decreased. Supplementation with 5-HTP, which loads the system with bioavailable 5-HTP and serotonin, rescued GIIS, suggesting that recovery of this pathway was sufficient to restore function. Exposure to iAs was accompanied by an increase in mRNA expression of UDP-glucuronosyltransferase 1 family, polypeptide a6a ( Ugt1a6a), a phase-II detoxification enzyme that facilitates the disposal of cyclic amines, including serotonin, via glucuronidation. Elevated Ugt1a6a and UGT1A6 expression levels were observed in mouse and human islets, respectively, following 3 days of iAs exposure. Consistent with this finding, the enzymatic rate of serotonin glucuronidation was increased in iAs-exposed cells. Knockdown by siRNA of Ugt1a6a during iAs exposure restored GIIS in MIN6-K8 cells. This effect was prevented by blockade of serotonin biosynthesis, suggesting that the observed iAs-induced increase in Ugt1a6a affects GIIS by targeting serotonin or serotonin-related metabolites. Although it is not yet clear exactly which element(s) of the serotonin pathway is/are most responsible for iAs-induced GIIS dysfunction, this study provides evidence that UGT1A6A, acting on the serotonin pathway, regulates GIIS under both normal and pathological conditions.
Microbial fermentation of flaxseed fibers modulates the transcriptome of GPR41-expressing enteroendocrine cells and protects mice against diet-induced obesity
Authors: Arora Tulika , Rudenko Olga , Egerod Kristoffer Lihme , Husted Anna Sofie , Kovatcheva-Datchary Petia , Akrami Rozita , Kristensen Mette , Schwartz Thue W. , Bäckhed Fredrik
Published: December 2018

Dietary fibers, an integral part of the human diet, require the enzymatic activity of the gut microbiota for complete metabolism into short-chain fatty acids (SCFAs). SCFAs are important modulators of host metabolism and physiology and act in part as signaling molecules by activating G protein-coupled receptors (GPCRs), such as GPR41. Flaxseed fibers improve metabolism in rodents and mice, but their fermentation profiles, effects on enteroendocrine cells, and associated metabolic benefits are unknown. We fed GPR41-red fluorescent protein mice, an enteroendocrine reporter mouse strain, chow, high-fat diet (HFD), or HFD supplemented either with 10% nonfermentable fiber cellulose or fermentable flaxseed fibers for 12 wk to assess changes in cecal gut microbiota, enteroendocrine cell transcriptome in the ileum and colon, and physiological parameters. We observed that flaxseed fibers restructured the gut microbiota and promoted proliferation of the genera Bifidobacterium and Akkermansia compared with HFD. The shifts in cecal bacterial composition restored levels of the SCFAs butyrate similar to the chow diet, resulting in colonic but not ileal enteroendocrine cell transcriptional changes in genes related to cell cycle, mRNA, and protein transport compared with HFD. Consistent with the effects on enteroendocrine functions, flaxseed fibers also protected mice from diet-induced obesity, potentially by preventing a reduction in energy expenditure induced by an HFD. Our study shows that flaxseed fibers alter cecal microbial ecology, are fermented to SCFAs in the cecum, and modulate enteroendocrine cell transcriptome in the colon, which may contribute to their metabolically favorable phenotype.
Autoimmune Diseases in Patients with Cushing’s Syndrome after Resolution of Hypercortisolism: Case Reports and Literature Review
Authors: Petramala Luigi , Olmati Federica , Conforti Maria Gabriella , Concistré Antonio , Bisogni Valeria , Alfieri Nikita , Iannucci Gino , de Toma Giorgio , Letizia Claudio
Published: December 2018

Introduction. Cushing’s syndrome (CS) is a clinical condition characterized by excessive cortisol production, associated with metabolic complications, such as diabetes mellitus, dyslipidemia, metabolic syndrome, hypertension, and cardiovascular diseases. Nowadays, the occurrence of autoimmune diseases in CS have not been completely evaluated in the previous studies. Objective. The aim of this study was to evaluate the occurrence of autoimmune diseases in CS patients after successfully treated. Materials and Methods. From January 2001 to December 2017, in our Secondary Hypertension Unit, we evaluated 147 CS patients (91 with ACTH-independent disease, 54 with ACTH-dependent disease, and 2 patients with ectopic ACTH production. Results. 109 CS patients (74.1%) were surgically treated (67 ACTH-independent CS patients (61.5%) undergone adrenalectomy and 42 ACTH-dependent CS (38.5%) undergone transsphenoidal surgery) and evaluated after 6, 12, and 24 months after clinical and biochemical remission of disease. In 9 (8.3%) of overall treated CS patients (8.3%), during follow-up, we observed the onset of some manifestations of autoimmune diseases. In particular, one patient had a systemic lupus erythematosus, one patient had rheumatoid arthritis, 4 patients reported autoimmune thyroiditis (Basedow-Graves’ disease and Hashimoto’s thyroiditis), one patient had clinical features of psoriasis, one patient showed myasthenia gravis, and one patient had giant cell arteritis. Conclusions. Our results demonstrate that patients successfully treated for CS could develop autoimmune diseases. Therefore, after treatment, CS patients need to be strictly monitored in order to evaluate the possible onset of autoimmune diseases.
Spectral Photon-Counting Molecular Imaging for Quantification of Monoclonal Antibody-Conjugated Gold Nanoparticles Targeted to Lymphoma and Breast Cancer: AnIn VitroStudy
Authors: Moghiseh Mahdieh , Lowe Chiara , Lewis John G. , Kumar Dhiraj , Butler Anthony , Anderson Nigel , Raja Aamir
Published: December 2018

The purpose of the present study was to demonstrate anin vitroproof of principle that spectral photon-counting CT can measure gold-labelled specific antibodies targeted to specific cancer cells. A crossover study was performed with Raji lymphoma cancer cells and HER2-positive SKBR3 breast cancer cells using a MARS spectral CT scanner. Raji cells were incubated with monoclonal antibody-labelled gold, rituximab (specific antibody to Raji cells), and trastuzumab (as a control); HER2-positive SKBR3 breast cancer cells were incubated with monoclonal antibody-labelled gold, trastuzumab (specific antibody to HER2-positive cancer cells), and rituximab (as a control). The calibration vials with multiple concentrations of nonfunctionalised gold nanoparticles were used to calibrate spectral CT. Spectral imaging results showed that the Raji cells-rituximab-gold and HER2-positive cells-trastuzumab-gold had a quantifiable amount of gold, 5.97 mg and 0.78 mg, respectively. In contrast, both cell lines incubated with control antibody-labelled gold nanoparticles had less gold attached (1.22 mg and 0.15 mg, respectively). These results demonstrate the proof of principle that spectral molecular CT imaging can identify and quantify specific monoclonal antibody-labelled gold nanoparticles taken up by Raji cells and HER2-positive SKBR3 breast cancer cells. The present study reports the future potential of spectral molecular imaging in detecting tumour heterogeneity so that treatment can be tuned accordingly, leading to more effective personalised medicine.
Damage Characteristics and Mechanism of a Strong Water Inrush Disaster at the Wangjialing Coal Mine, Shanxi Province, China
Authors: Fangpeng Cui , Qiang Wu , Shuai Zhang , Ningan Wu , Yuan Ji
Published: December 2018

A serious groundwater inrush occurred at the Wangjialing coal mine on March 28, 2010. Great effort from all over the country was taken during the postaccident rescue. However, triggered by accumulated water in the upper abandoned tunnels and goafs of a nearby closed individually owned coal mine, it caused great damage, including 38 deaths and direct economic losses of over 49 million yuan. The inrush water was from the abandoned tunnels and goafs, which were filled subsequently by groundwater from the sandstone aquifer in the roof of the coal seam. The passage formed in the west roof of the heading face of the air return tunnel in the 20101 first mining face. Unidentified distribution and water-filled degree of the abandoned tunnels and goafs are critical bases for the accident. That important regulations for abundant groundwater exploration and release were not carried out thoroughly was another fatal cause leading to the accident. The poor awareness of water hazard controlling also contributed to the accident to a large extent.
Improved Simulated Annealing Based Network Model for E-Recycling Reverse Logistics Decisions under Uncertainty
Authors: Wang Lei , Goh Mark , Ding Ronggui , Mishra Vikas Kumar
Published: December 2018

Electronic waste recycle (e-recycling) is gaining increasing importance due to greater environmental concerns, legislation, and corporate social responsibility. A novel approach is explored for designing the e-recycling reverse logistics network (RLN) under uncertainty. The goal is to obtain a solution, i.e., increasing the storage capacity of the logistics node, to achieve optimal or near-optimal profit under the collection requirement set by the government and the investment from the enterprise. The approach comprises two parts: a matrix-based simulation model of RLN formed for the uncertainty of demand and reverse logistics collection which calculates the profit under a given candidate solution and simulated annealing (SA) algorithm that is tailored to generating solution using the output of RLN model. To increase the efficiency of the SA algorithm, network static analysis is proposed for getting the quantitative importance of each node in RLN, including the static network generation process and index design. Accordingly, the quantitative importance is applied to increase the likelihood of generating a better candidate solution in the neighborhood search of SA. Numerical experimentation is conducted to validate the RLN model as well as the efficiency of the improved SA.
New Bridge Weigh‐in‐Motion System Using Piezo‐Bearing
Authors: Choo Jinkyo F. , Ha Dong-Ho , Chang Seok-Gi , Lee Dong-Ho , Cho Chang-Beck
Published: December 2018

The traditional BWIM (bridge weigh‐in‐motion) system measures the deformation of the bridge by means of sensors and uses these measurements to estimate the characteristics of passing traffic by means of dedicated algorithms. However, the application of the BWIM system is subordinated to the type of superstructure, composition, geometry, materials, and shape of the bridge, the location of the strain sensors used in the system, and the need to calibrate the measured strain curve and of a precise model of the structure at hand. In order to be free from these constraints, this paper proposes a simpler BWIM system using the bridge bearings as a weighing scale to measure the reaction forces at the supports resulting from the passing traffic. To that goal, the piezocomposite element known for its durability and responsiveness to external loading is embedded appropriately in the bridge bearing to achieve the piezo‐bearing. This paper presents the BWIM system constituted by the so‐called piezo‐bearing, the results of a series of tests conducted to verify the responsiveness of the system to external dynamic excitation, and a numerical example to validate the feasibility of the proposed BWIM system. The numerical example shows that the identification of the characteristics of the vehicle crossing the bridge can be realized based simply upon the theory of mechanics using the time histories of the measured reaction forces instead of the deformation of the bridge.
The Effect and Mechanism of TLR9/KLF4 in FFA-Induced Adipocyte Inflammation
Authors: Wang Cuizhe , Zhang Meixiu , Wu Jinxiu , Li Wei , Ha Xiaodan , Gu Yajuan , Han Bo , Xie Jianxin , Zhang Jun
Published: December 2018

Objective. Current research has reported that obesity is a chronic inflammatory state, which is closely related with excessive accumulation of free fatty acid, while the specific mechanism that high level of FFA causes inflammation is not very clear. Thus, our research intended to observe the high FFA effects on TLR9/KLF4 expression and the downstream inflammatory factors, to explore the mechanism of inflammatory response suppressed by TLR9/KLF4. Methods. qRT-PCR and Western blot were used to detect the mRNA and protein expression levels of TLR9, KLF4, and key inflammation-related factors. ELISA was used to detect the release level of inflammatory cytokines. The triglyceride (TG) and glucose (GLU) testing cassettes were used to detect the TG and GLU levels in culture medium. Results. In the omental tissue of obese individuals (OB), we found that TLR9, KLF4, mRNA, and the protein expression levels were lower than those of the normal weight control (NC) group. Similarly, in the omental tissue of high-fat diet (HFD) rats, we found that the mRNA expression levels of TLR9 and KLF4 were lower than those of the normal diet control group. In mature adipocytes, we found that KLF4 played an important anti-inflammatory role; moreover, PA can promote the development of inflammation by inhibiting KLF4 expression; TLR9 has a positive regulation function on KLF4 expression, but unrelated to PA. Conclusions. TLR9/KLF4 is involved in regulating FFA-induced adipocyte inflammation.
TASG: An Augmented Classification Method for Impersonal HAR
Authors: Zheng Zengwei , Du Junjie , Sun Lin , Huo Meimei , Chen Yuanyi
Published: December 2018

Human activity recognition (HAR) systems are widely used in our lives, such as healthcare, security, and entertainment. Most of the activity recognition models are tested in the personal mode, and the performance is quite good. However, HAR in the impersonal mode is still a great challenge. In this paper, we propose a two-layer activity sparse grouping (TASG) model, in which the first layer clusters the activities into 2–4 groups roughly and the second layer identifies the specific type of activities. A new feature selection metric inspired by the Fisher criterion is designed to measure the importance of the features. We perform the experiment using the TASG model with SVM, KNN, Random Forest, and RNN, respectively. The experiments are tested on HAPT, MobiAct, and HASC-PAC2016 datasets. The experimental results show that the performance of standard classifiers has been improved while combining the TASG method. The features selected by the proposed metric are more effective than other FS methods.