bluuebunny/crossref_metadata_2025 huggingface dataset:
Accelerator physics design in the interaction region for CEPC double ring scheme
Authors: Bai Sha , Yu Chenghui , Wang Yiwei , Zhu Yingshun , Gao Jie
Published: April 2019

With the discovery of the Higgs boson at around 125 GeV, a circular Higgs factory design with high luminosity [Formula: see text] is becoming more popular in the accelerator world. The CEPC project in China is one of them. Machine Detector Interface (MDI) is the key research area in electron–positron colliders, especially in CEPC; it is one of the criteria to measure the accelerator and detector design performance. Because of the limited space available in the designed tunnel, many equipment including magnets, beam diagnostic instruments, masks, vacuum pumps, and components of the detector must coexist in a very small region. In this paper, some important MDI issues will be reported for the Interaction Region (IR) design, e.g. the final doublet quadrupoles physics design parameters, beam-stay-clear region and beam pipe, synchrotron radiation power and critical energy are also calculated.
CEPC Linac design
Authors: Meng Cai , Zhang Jingru , Li Xiaoping , Pei Guoxi , Wang Dou , Pei Shilun , Gao Jie , Chi Yunlong
Published: April 2019

The Circular Electron–Positron Collider (CEPC) is a 100-km ring [Formula: see text] collider for a Higgs factory. The injector of CEPC is composed of Linac and Booster. The Linac is a normal conducting S-band Linac with a frequency of 2860 MHz; it provides electron and positron beams at an energy of up to 10 GeV with 100 Hz repetition frequency of 100 Hz. The Linac design and dynamic simulation results are discussed in detail in this paper, including electron bunching system, positron source, electron bypass transport line, damping ring and main Linacs.
Design of CEPC superconducting RF system
Authors: Zhai Jiyuan , Gong Dianjun , Zheng Hongjuan , Sha Peng , Ma Qiang , Mi Zhenghui , Han Ruixiong , Meng Fanbo , Liu Baiqi , Gao Jie , Chi Yunlong
Published: April 2019

CEPC is a 100-km double-ring circular electron–positron collider operating at 90–240 GeV center-of-mass energy of Z-pole, WW-pair production threshold and Higgs resonance. The conceptual design report (CDR) of CEPC has been published as an important step to move the project forward. The superconducting RF (SRF) system is one of the most important and challenging accelerator systems due to the wide range of beam energy and current. In this paper, the layout, parameters and configuration of the superconducting RF system for the CEPC collider ring will be introduced. Issues of beam cavity interactions including transient beam loading and coupled-bunch instabilities of accelerating mode are discussed.
Quantum field formalism for the higher-derivative nonrelativistic electrodynamics in 1+1 dimensions
Authors: Manavella E. C.
Published: April 2019

Starting from the classical nonrelativistic electrodynamics in 1[Formula: see text]+[Formula: see text]1 dimensions, a higher-derivative version is proposed. This is made by adding a suitable higher-derivative term for the electromagnetic field to the Lagrangian of the original electrodynamics, preserving its gauge invariance. By following the usual Hamiltonian method for singular higher-derivative systems, the canonical quantization for the higher-derivative model is developed. By extending the Faddeev–Senjanovic algorithm, the path integral quantization is carried out. Hence, the Feynman rules are established and the diagrammatic structure is analyzed. The use of the higher-derivative term eliminates in the Landau gauge the ultraviolet divergence of the primitively divergent Feynman diagrams of the original model, where the electromagnetic field propagator is present. A generalization of the BRST quantization is also considered.
Interactions of modified Gemini surfactants: Interactions with direct dyes and dyeing properties in cotton fabrics
Authors: Lai Chiu-Chun , Huang Kuo-Shien , Su Po-Wei , Wu Chang-Mou , Huang Ching-Nan
Published: April 2019

This study investigated dye–surfactant interactions between a series of modified Gemini surfactants and commercial direct dyes in aqueous solution and their corresponding effects on cotton fabric dyeing. A surface tension meter was also used to measure surface activities of compounds containing electrolyte under conditions similar to those in dyeing processes. The surface tension measurements showed lower than normal surface tension in surfactant solutions containing electrolyte. From the UV-Vis spectra, the isosbestic point indicated that dye–surfactant complexes had formed and existed as hydrophilic interaction between direct dyes and modified Gemini surfactants. When dyeing cotton fabric with red dye and orange dye, the presence of these surfactants decreased dye uptake rate but increased for blue dye because the dye–surfactant interaction had formed a hydrophilic complex.
Evaluation of 3D measurement using CT-TDLAS
Authors: Jeon Min-Gyu , Doh Deog-Hee , Deguchi Yoshihiro , Kamimoto Takahiro , Cui Minchao
Published: April 2019

In order to satisfy the requirements of high quality and optimal material manufacturing process, it is important to control the environment of the manufacturing process. Depending on these processes, it is possible to improve the quality of the product by adjusting various gases. With the advent of the tunable laser absorption spectroscopy (TDLAS) technique, the temperature and concentration of the gases can be measured simultaneously. Among them, computed tomography-tunable diode laser absorption spectroscopy (CT-TDLAS) is the most important technique for measuring the distributions of temperature and concentration across the two-dimensional planes. This study suggests a three-dimensional measurement to consider the irregular flow of supplying gases. The simultaneous multiplicative algebraic reconstruction technique (SMART) algorithm was used among the CT algorithms. Phantom datasets have been generated by using Gaussian distribution method. It can show expected temperature and concentration distributions. The (HITRAN) database in which the thermo-dynamical properties and the light spectra of H2O are listed were used for the numerical test. The relative average temperature error ratio in the results obtained by the SMART algorithm was about 3.2% for temperature. The maximum error was 86.8 K.
Macroscale synthesis of CuO nanowires on FTO plane substrate
Authors: Mabuchi Yota , Mohamed Rashid Norhana , Li Xuyang , Liang Jianbo , Kishi Naoki , Soga Tetsuo
Published: April 2019

This study aims to fabricate copper oxide (CuO) nanowires by annealing a copper film formed on a charged film of fluorine-doped tin oxide (FTO). However, from the viewpoint of stress and growth of nanowires, it is difficult to mass-produce CuO nanowires on the entire region of the macro area on the plane substrate. In the proposed study, this was made possible by modifying the substrate’s structure.
A simple proof of the strong integrality for full colored HOMFLYPT invariants
Authors: Zhu Shengmao
Published: April 2019

By using the HOMFLY skein theory, we prove a strong integrality theorem for the reduced colored HOMFLYPT invariants defined by a basis in the full HOMFLY skein of the annulus.
Derivation of Schubert normal forms of 2-bridge knots from (1,1)-diagrams
Authors: Cho Hyeran , Lee Sang Youl , Song Hyun-Jong
Published: April 2019

In this paper, we show that the dual [Formula: see text]-diagram of a [Formula: see text]-diagram (a.k.a. a two-pointed genus one Heegaard diagram) [Formula: see text] with [Formula: see text] and [Formula: see text] is given by [Formula: see text] where [Formula: see text] is the multiplicative inverse of [Formula: see text] modulo [Formula: see text] with [Formula: see text]. We also present explicitly how to derive a Schubert normal form of a [Formula: see text]-bridge knot from the dual [Formula: see text]-diagram of [Formula: see text] using weakly K-reducibility of [Formula: see text]-decompositions. This gives an alternative proof of Grasselli and Mulazzani’s result asserting that [Formula: see text] is a [Formula: see text]-diagram of the [Formula: see text]-bridge knot with a Schubert normal form [Formula: see text].
Compact dictionary pair learning and refining based on principal components analysis
Authors: Yu Yibin , Yang Min , Zhang Yulan , Yuan Shifang
Published: April 2019

Although traditional dictionary learning (DL) methods have made great success in pattern recognition and machine learning, it is extremely time-consuming, especially in the training stage. The projective dictionary pair learning (DPL) learned the synthesis dictionary and the analysis dictionary jointly to achieve a fast and accurate classifier. However, the dictionary pair is initialized as random matrices without using any data samples information, it required many iterations to ensure convergence. In this paper, we propose a novel compact DPL and refining method based on the observation that the eigenvalue curve of sample data covariance matrix usually decrease very fast, which means we can compact the synthesis dictionary and analysis dictionary. For each class of the data samples, we utilize the principal components analysis (PCA) to retain global important information and compact the row space of a synthesis dictionary and the column space of an analysis dictionary in the first stage. We further refine the learned dictionary pair to achieve a more accurate classifier during compact dictionary pair refining, which combines the orthogonality of PCA with the redundancy of DL. We solve this refining problem in closed-form completely, naturally reducing the computation complexity significantly. Experimental results on the Extended YaleB database and AR database show that the proposed method achieves competitive accuracy and low computational complexity compared with other state-of-the-art methods.
Statistics of traces of high powers of the Frobenius for biquadratic function fields over finite fields
Authors: Bae Sunghan
Published: April 2019

We investigate statistics of trace of high powers of the Frobenius class for biquadratic function fields over finite fields, which generalizes the result of Lorenzo, Meleleo and Milione on the trace of the Frobenius class for biquadratic covers of the projective line. Then we compare our result with Meisner’s result on the expected value of high powers of trace of Frobenius of biquadratic curves.
An investigation on partitions with equal products
Authors: Cha Byungchul , Claman Adam , Harrington Joshua , Liu Ziyu , Maldonado Barbara , Miller Alexander , Palma Ann , Wong Tony W. H. , Yi Hongkwon
Published: April 2019

An ordered triple [Formula: see text] is called admissible if there exist two different multisets [Formula: see text] and [Formula: see text] such that [Formula: see text] and [Formula: see text] share the same sum [Formula: see text], the same product [Formula: see text], and the same size [Formula: see text]. We first count the number of [Formula: see text] such that [Formula: see text] are admissible for a fixed [Formula: see text]. We also fully characterize the values [Formula: see text] such that [Formula: see text] is admissible. Finally, we consider the situation where [Formula: see text] different multisets are needed, instead of just two. This project is also related to John Conway’s wizard puzzle from the 1960s.
On longest matching consecutive subsequence
Authors: Li Jinjun , Yang Xiangfeng
Published: April 2019

The longest matching consecutive subsequence between two [Formula: see text]-ary expansions found applications in information theory and molecular biology. In this paper, we establish an almost sure limit theorem for the longest matching consecutive subsequence, and investigate the size of the set of points violating the limit in terms of Hausdorff dimension.
Tests for high-dimensional covariance matrices
Authors: Chen Jing , Wang Xiaoyi , Zheng Shurong , Liu Baisen , Shi Ning-Zhong
Published: April 2019

In this paper, we propose some new tests for high-dimensional covariance matrices that are applicable to generally distributed populations with finite fourth moments. The proposed test statistics are the maximum of the likelihood ratio test statistic and the statistic based on the Frobenius norm. The advantage of the new tests is the good performance in terms of power for both the traditional case, in which the dimension is much smaller than the sample size, and the high-dimensional case, in which the dimension is large compared to the sample size. In the one-sample case, the new test is proposed for testing the hypothesis that the high-dimensional covariance matrix equals an identity matrix. In the two-sample case, the new test is developed for testing the equality of two high-dimensional covariance matrices. By using the random matrix theory, the asymptotic distributions of the proposed new tests are derived under the assumption that the dimension and the sample size proportionally tend toward infinity. Finally, numerical studies are conducted to investigate the finite sample performance of the proposed new tests.
Website Visual Design Qualities
Authors: Hartono Edward , Holsapple Clyde W.
Published: April 2019

The present study aims to contribute to the information systems (IS) literature by developing a new theoretical perspective that integrates three dimensions of artifact visual design quality—namely aesthetic, functional, and symbolic dimensions—in the investigation of website visual design qualities that influence visitors’ attitudes and behaviors. Results suggest that website aesthetic, functional, and symbolic qualities positively influence intention to use the website and positive word of mouth and that website aesthetic quality positively influences website functional and symbolic qualities. Results also demonstrate that functional and symbolic qualities mediate the relationships between aesthetic quality and intention to use and positive word of mouth.
BlueIO
Authors: Jiang Zhe , Audsley Neil , Dong Pan
Published: April 2019

In safety-critical systems, time predictability is vital. This extends to I/O operations that require predictability, timing-accuracy, parallel access, scalability, and isolation. Currently, existing approaches cannot achieve all these requirements at the same time. In this article, we propose a framework of hardware framework for real-time I/O virtualization—termed
BlueIO
—to meet all these requirements simultaneously.

BlueIO integrates the functionalities of I/O virtualization, low-layer I/O drivers, and a clock cycle level timing-accurate I/O controller (using the GPIOCP [36]). BlueIO provides this functionality in the hardware layer, supporting abstract virtualized access to I/O from the software domain. The hardware implementation includes I/O virtualization and I/O drivers, provides isolation and parallel (concurrent) access to I/O operations, and improves I/O performance. Furthermore, the approach includes the previously proposed GPIOCP to guarantee that I/O operations will occur at a specific clock cycle (i.e., be timing-accurate and predictable).

In this article, we present a hardware consumption analysis of BlueIO to show that it linearly scales with the number of CPUs and I/O devices, which is evidenced by our implementation in VLSI and FPGA. We also describe the design and implementation of BlueIO and demonstrate how a BlueIO-based system can be exploited to meet real-time requirements with significant improvements in I/O performance and a low running cost on different OSs.
Co-creating the future of work: Lessons from workplace automation
Authors: Wolf Christine T.
Published: April 2019

What sociology and ethnography can teach us about designing the workplace technologies of tomorrow.
The AI revolution
Authors: Kohen Talia
Published: April 2019

This article explores the areas of bias in natural language processing, from the tools that are used to analyze the data to the fundamental theories in the field. It delves deeper into the very idea that the data that is analyzed (language) itself shapes human perception of reality, and evolves over time.
MaMaDroid
Authors: Onwuzurike Lucky , Mariconti Enrico , Andriotis Panagiotis , Cristofaro Emiliano De , Ross Gordon , Stringhini Gianluca
Published: April 2019

As Android has become increasingly popular, so has malware targeting it, thus motivating the research community to propose different detection techniques. However, the constant evolution of the Android ecosystem, and of malware itself, makes it hard to design robust tools that can operate for long periods of time without the need for modifications or costly re-training. Aiming to address this issue, we set to detect malware from a behavioral point of view, modeled as the sequence of abstracted API calls. We introduce M
A
M
A
D
ROID
, a static-analysis-based system that abstracts app’s API calls to their class, package, or family, and builds a model from their sequences obtained from the call graph of an app as Markov chains. This ensures that the model is more resilient to API changes and the features set is of manageable size. We evaluate M
A
M
A
D
ROID
using a dataset of 8.5K benign and 35.5K malicious apps collected over a period of 6 years, showing that it effectively detects malware (with up to 0.99 F-measure) and keeps its detection capabilities for long periods of time (up to 0.87 F-measure 2 years after training). We also show that M
A
M
A
D
ROID
remarkably overperforms D
ROID
APIM
INER
, a state-of-the-art detection system that relies on the frequency of (
raw
) API calls. Aiming to assess whether M
A
M
A
D
ROID
’s effectiveness mainly stems from the API abstraction or from the sequencing modeling, we also evaluate a variant of it that uses frequency (instead of sequences), of abstracted API calls. We find that it is not as accurate, failing to capture maliciousness when trained on malware samples that include API calls that are equally or more frequently used by benign apps.
Relationship between maternal global nutrient restriction during pregnancy and offspring kidney structure and function: a systematic review of animal studies
Authors: Lee Yu Qi , Beckett Emma L. , Sculley Dean V. , Rae Kym M. , Collins Clare E. , Pringle Kirsty G.
Published: April 2019

Maternal undernutrition during pregnancy is prevalent across the globe, and the origins of many chronic diseases can be traced back to in utero conditions. This systematic review considers the current evidence in animal models regarding the relationship between maternal global nutrient restriction during pregnancy and offspring kidney structure and function. CINAHL, Cochrane, EMBASE, MEDLINE, and Scopus were searched to November 2017. Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed, and articles were screened by two independent reviewers. Twenty-eight studies met the inclusion criteria: 16 studies were on rats, 9 on sheep, 2 on baboons, and 1 on goats. The majority of the rat studies had maternal global nutrient restriction during pregnancy at 50% of ad libitum while restriction for sheep and baboon studies ranged from 50% to 75%. Because of the heterogeneity of outcome measures and the large variation in the age of offspring at followup, no meta-analysis was possible. Common outcome measures included kidney weight, nephron number, glomerular size, glomerular filtration rate, and creatinine clearance. To date, there have been no studies assessing kidney function in large animal models. Most studies were rated as having a high or unknown risk of bias. The current body of evidence in animals suggests that exposure to maternal global nutrient restriction during pregnancy has detrimental effects on offspring kidney structure and function, such as lower kidney weight, lower nephron endowment, larger glomerular size, and lower glomerular filtration rate. Further long-term followup of studies in large animal models investigating kidney function through to adulthood are warranted.
Hepatic Insulin Clearance: Mechanism and Physiology
Authors: Najjar Sonia M. , Perdomo Germán
Published: April 2019

Upon its secretion from pancreatic β-cells, insulin reaches the liver through the portal circulation to exert its action and eventually undergo clearance in the hepatocytes. In addition to insulin secretion, hepatic insulin clearance regulates the homeostatic level of insulin that is required to reach peripheral insulin target tissues to elicit proper insulin action. Receptor-mediated insulin uptake followed by its degradation constitutes the basic mechanism of insulin clearance. Upon its phosphorylation by the insulin receptor tyrosine kinase, carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) takes part in the insulin-insulin receptor complex to increase the rate of its endocytosis and targeting to the degradation pathways. This review summarizes how this process is regulated and how it is associated with insulin-degrading enzyme in the liver. It also discusses the physiological implications of impaired hepatic insulin clearance: Whereas reduced insulin clearance cooperates with increased insulin secretion to compensate for insulin resistance, it can also cause hepatic insulin resistance. Because chronic hyperinsulinemia stimulates hepatic de novo lipogenesis, impaired insulin clearance also causes hepatic steatosis. Thus impaired insulin clearance can underlie the link between hepatic insulin resistance and hepatic steatosis. Delineating these regulatory pathways should lead to building more effective therapeutic strategies against metabolic syndrome.
Allelic Switching of DLX5, GRB10, and SVOPL during Colorectal Cancer Tumorigenesis
Authors: Boot Arnoud , Oosting Jan , Doorn Saskia , Ouahoud Sarah , Ventayol Garcia Marina , Ruano Dina , Morreau Hans , van Wezel Tom
Published: April 2019

Allele-specific expression (ASE) is found in approximately 20-30% of human genes. During tumorigenesis, ASE changes due to somatic alterations that change the regulatory landscape. In colorectal cancer (CRC), many chromosomes show frequent gains or losses while homozygosity of chromosome 7 is rare. We hypothesized that genes essential to survival show allele-specific expression (ASE) on both alleles of chromosome 7. Using a panel of 21 recently established low-passage CRC cell lines, we performed ASE analysis by hybridizing DNA and cDNA to Infinium HumanExome-12 v1 BeadChips containing cSNPs in 392 chromosome 7 genes. The results of this initial analysis were extended and validated in a set of 89 paired normal mucosa and CRC samples. We found that 14% of genes showed ASE in one or more cell lines and identified allelic switching of the potential cell survival genes DLX5, GRB10, and SVOPL on chromosome 7, whereby the most abundantly expressed allele in the normal tissue is the lowest expressed allele in the tumor and vice versa. We established that this allelic switch does not result from loss of imprinting. The allelic switching of SVOPL may be a result of transcriptional downregulation, while the exact mechanisms resulting in the allelic switching of DLX5 and GRB10 remain to be elucidated. In conclusion, our results show that profound changes take place in allelic transcriptional regulation during the tumorigenesis of CRC.
Intergreen Time Calculation Method of Signalized Intersections Based on Safety Reliability Theory: A Monte-Carlo Simulation Approach
Authors: Jiang Ze-hao , Wang Tao
Published: April 2019

In China, around ninety percent of the traffic accidents at signalized intersections occur within the signal change intervals, especially during signal change from green to red. Hence, intergreen time (IGT), that is, yellow change interval plus red clearance interval, is of great significance to the safety at signalized intersections. The conventional calculation method of IGT ignores the randomness of drivers’ behaviors, which we believe is an important factor in calculation of IGT. Therefore, the purpose of this research is to investigate a new approach to calculate the IGT based on safety reliability theory. Firstly, a comprehensive literature review concerning the conventional calculation methods of IGT is conducted. Secondly, a theoretical calculation method of IGT based on safety reliability theory is put forward; different from the conventional methods, this model accounts for the uncertainty of driving behavior parameters. Thirdly, a Monte-Carlo simulation is employed to simulate the interactive process of perception-reaction time (PRT) and vehicular deceleration and solve the proposed model. Finally, according to the Monte-Carlo simulation results, the curve clusters describing the relationship between IGT, safety reliability (50%-90%), and intersection width (15-35m) are drawn. Results show that the IGT of a signalized intersection, obeying the normal distribution, is influenced by multiple factors and most sensitive to the PRT and vehicular deceleration. Our method thus successfully incorporates the probabilistic nature of driving behavior. Taking the safety reliability into consideration can provide a more reasonable method to calculate the IGT of signalized intersections.
Diagnostic Yield of Fluorescence and Ziehl-Neelsen Staining Techniques in the Diagnosis of Pulmonary Tuberculosis: A Comparative Study in a District Health Facility
Authors: Dzodanu Eben Godsway , Afrifa Justice , Acheampong Desmond Omane , Dadzie Isaac
Published: April 2019

Background. Despite the recent advancement in diagnostic methods, the smear microscopy remains the gold standard for the diagnosis of pulmonary tuberculosis in high burden countries like Ghana. Notwithstanding, fluorescence staining technique provides a more efficient option for the detection of Mycobacterium tuberculosis positive smears. This study therefore aimed at assessing the diagnostic performance of fluorescence microscopy (FM) and Ziehl-Neelsen (ZN) staining techniques in the diagnosis of pulmonary tuberculosis. Methods. A comparative study was carried out on 100 patients who reported at the Out Patients Department (OPD) or the Directly Observed Therapy (DOT) center of the Kade Government Hospital and were suspected of having pulmonary tuberculosis. Two (2) sputum samples each were collected. This included one spot and one morning sample. The smears were prepared and stained with FM and ZN staining techniques. Xpert MTB/RIF assay was also performed. Results. Of the 200 samples analyzed, 71 (35.5%), 46 (23.0%), and 84 (42.0%) were positive for pulmonary tuberculosis when FM, ZN, and XPERT MTB/RIF assays were used, respectively. The mean reading time of FM was three times faster than the ZN technique with very good acceptance (1.5min: 4.6min). The sensitivity and specificity of fluorescent staining to that of XPERT MTB/RIF assay were 84.5% and 100%, respectively, while those of ZN staining were 54.8% and 100%, respectively. Conclusion. For a routine laboratory test in a resource-limited setting, our study has demonstrated that fluorescence staining technique is a more sensitive test for the diagnosis of pulmonary tuberculosis as compared to the conventional ZN technique.
Integration of HIV-Sexual Reproductive Health Services for Young People and the Barriers at Public Health Facilities in Mbarara Municipality, Southwestern Uganda: A Qualitative Assessment
Authors: Akatukwasa Cecilia , Bajunirwe Francis , Nuwamanya Simpson , Kansime Noel , Aheebwe Emmanuel , Tamwesigire Imelda K.
Published: April 2019

Background. Sexual and Reproductive Health (SRH) and HIV risk behaviors for young people are intertwined. This rationalizes the need for integration of HIV and SRH services within the health care system, especially in countries with high HIV burden. In this study, we explored the current status of HIV-SRH integration for young people and barriers of integration from different stakeholders at public health facilities in Mbarara Municipality, southwestern Uganda. Methods. We conducted an exploratory qualitative study at public health facilities in Mbarara district of southwestern Uganda. Data were collected among young people (n=48), health care providers (n=63), and key informants (n=11). We used in-depth interviews and focus group discussions to collect the data. Coding and analysis of qualitative data were done using Atlas.ti. Results. Overall there was no differentiation of HIV-SRH services between adults and young people. Integration of HIV-SRH services was reported at all facility levels; however, there was poor differentiation of services for the young persons and adults. Integrated HIV and SRH services for young people were acknowledged to improve access to information and risk perception, improve continuity of care, and reduce cost of services and would also lead to improved client-health worker relationships. The potential barriers to achieving HIV-SRH integration included individual provider characteristics like lack of training and attitudes, generic health system challenges like low staffing levels, poor infrastructure with lack of space and privacy to deliver these services. At the policy level vertical programing and unclear policies and guidelines were identified as challenges. Conclusion. Our study shows integration of HIV and SRH services exists in general but services for adults and young people are blended or poorly differentiated. Significant health system barriers need to be overcome to achieve differentiation of the services for young people and adults.
Multisystemic Benign Metastasizing Leiomyoma: An Unusual Condition with an Atypical Clinical Presentation
Authors: Matos Fernando , Santiago Cristina , Silva Duarte
Published: April 2019

Benign metastasizing leiomyoma (BML) is a rarely found entity with few documented cases in the literature, usually occurring in women of reproductive age with a history of myomectomy or hysterectomy. The leiomyomas can metastasize to several organs, the lungs being the most commonly affected. We report a case of a 40-year-old female patient who presented at our institution with low back pain. She underwent a lumbar MR that revealed the presence of an expansive and compressive mass in the body of L4. This mass was biopsied, corresponding to a metastasizing leiomyoma with no malignant characteristics. Subsequently, a CT examination showed several soft tissue density round masses in both lungs, but the most striking feature was a 12 cm mass located in the left iliac crest. There was asymmetrical uterus enlargement, caused by the presence of several leiomyomas. Since the lesions were estrogen and progesterone positive, hormone suppression consisting of oophorectomy followed by anastrozole was the chosen treatment. No signs of progression were observed at the 6-month follow-up. This case is one of the very few that occurred in a woman with no previous uterine intervention, adding further evidence that surgery is not an essential condition for this entity to develop.
A Novel Neutrosophic Method for Automatic Seed Point Selection in Thyroid Nodule Images
Authors: Haji S. O. , Yousif R. Z.
Published: April 2019

The thyroid nodule is one of the endocrine issues caused by an irregular cell development. This rate of survival can be improved by earlier nodule detection. Accordingly, the accurate recognition of the nodule is of the utmost importance in providing powerful results in building the survival rate. The reduction in the accuracy of manual or semiautomatic segmentation methods for thyroid nodule detection is due to many factors, basically, the lack of experience of the sonographer and latency of operation. Most lesion regions in ultrasound images are homogeneous. Therefore, the value of entropy in these regions is high compared to its neighbours. Based on this criterion, a novel procedure for automatically selecting the seed point in thyroid nodule images is proposed. The proposed system consists of three components: neutrosophic image enhancement and speckle reduction to reduce speckle noise and automatic seed selection algorithm extracted from the centre of candidate block in ultrasound thyroid images based on the principle that most of its Higher Order Spectra Entropies (HOSE) from Radon Transform (RT) at different angles are within the range between average and maximum entropies, and the region growing image segmentation is applied with the constant threshold. The performance of proposed automatic segmentation method is compared with other methods in terms of calculating, True Positive (TP) value (96.44 ± 3.01%), False Positive (FP) value (3.55 ± 1.45%), Dice Coefficient (DC) value (92.24 ± 6.47%), Similarity Index (SI) (80.57 ± 1.06%), and Hausdroff Distance (HD) (0.42 ± 0.24 pixels). The proposed system can be considered as an added value to the malignancy diagnosis in thyroid nodule by an endocrinologist.
Complete Response to R-EPOCH in Primary Cardiac Lymphoma
Authors: Anand Kartik , Pingali Sai Ravi , Trachtenberg Barry , Iyer Swaminathan Padmanabhan
Published: April 2019

Primary cardiac lymphoma (PCL) is a rare extranodal lymphoma involving only the heart and/or the pericardium. Most common presenting signs and symptoms are nonspecific including dyspnea, pericardial effusion, and arrhythmia. Prognosis of PCL patients remain poor compared to non‐cardiac lymphoma patients. Since most of the information about PCL comes from case reports or case series, there is no treatment consensus. Anthracycline containing chemotherapy remains main treatment modality which is potentially cardiotoxic. We present a case of PCL that achieved complete remission using R-EPOCH (rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin). We also used dexrazoxane in an effort to reduce cardiotoxicity of chemotherapy.
Incidentally Diagnosed Alport Syndrome in a Patient with Drug-Induced Vasculitis
Authors: Lai D. , Dave N. , Raghavan R.
Published: April 2019

A 53-year-old woman is admitted with a serum creatinine of 16 mg/dl. Seven months earlier, she was diagnosed with heart failure and started on several medications, including Hydralazine. Laboratory studies revealed the presence of dual Anti-Neutrophil Cytoplasmic Antibodies (anti-MPO and anti-PR3), anti-nuclear and anti-histone antibodies. The clinical diagnosis was Drug-Induced ANCA Vasculitis (DIAV). Kidney histology, however, did not reveal crescents, but showed characteristic features of Alport’s syndrome.
Iron Deficiency Anemia in Chronic Kidney Disease
Authors: Gafter-Gvili Anat , Schechter Amir , Rozen-Zvi Benaya
Published: April 2019

Iron deficiency anemia is a common complication of chronic kidney disease (CKD). CKD patients suffer from both absolute and functional iron deficiency. Absolute iron deficiency is defined by severely reduced or absent iron stores, while functional iron deficiency is defined by adequate iron stores but insufficient iron availability for incorporation into erythroid precursors. This is due to increased levels of hepcidin. Anemia in CKD is associated with an increased risk of morbidity and mortality. The association between anemia and mortality may be related to the severity of anemia. All CKD patients should be screened for anemia during the initial evaluation for CKD. Criteria used to define iron deficiency are different among CKD compared to normal renal function. Among CKD patients, absolute iron deficiency is defined when the transferrin saturation (TSAT) is ≤20% and the serum ferritin concentration is ≤100 ng/mL among predialysis and peritoneal dialysis patients or ≤200 ng/mL among hemodialysis patients. Functional iron deficiency, also known as iron-restricted erythropoiesis, is characterized by TSAT ≤20% and elevated ferritin levels. Iron supplementation is recommended for all CKD patients with anemia. There is general agreement according to guidelines that intravenous (i.v.) iron supplementation is the preferred method for CKD patients on dialysis (CKD stage 5D) and either i.v. or oral iron is recommended for patients with CKD ND (CKD stages 3–5). In this review we discuss the evidence base for these recommendations.
Management of Iron Deficiency Anaemia in Inflammatory Bowel Disease
Authors: Jimenez Kristine Michelle , Gasche Christoph
Published: April 2019

Inflammatory bowel disease (IBD) is a group of chronic relapsing inflammatory disorders affecting the large and small intestine, with a rising worldwide incidence and prevalence. Anaemia is the most common extraintestinal manifestation of IBD, correlating with disease activity, and tending to relapse even after successful therapy. Iron deficiency is the most common cause; however, it often manifests in combination with anaemia of inflammation. As such, multiple parameters are used for the diagnosis of iron deficiency anaemia in IBD. Timely recognition and selection of appropriate therapy leads to an improvement in the quality of life and prevention of potential sequelae. Oral iron can be effective under specific circumstances; however, as luminal iron changes microbiota and bacterial metabolism, oral administration should be avoided. Intravenous iron is preferred as it bypasses the sites of inflammation. Nevertheless, the optimization of IBD treatment should occur simultaneously, as this improves both patient condition and response to iron therapy. Herein, we discuss the screening, diagnosis, selection of therapy, and follow-up for iron deficiency anaemia in IBD.
Sensitization to Cat: When Is Nasal Challenge Needed?
Authors: Al-Ahmad Mona , Jusufovic Edin , Arifhodzic Nermina , Nurkic Jasmina , Hanoun Abdul Latif
Published: April 2019

Introduction: Although the skin prick test (SPT) is a reliable diagnostic tool in perennial allergic rhinitis (PER) for patients allergic to cats, the minimum necessary SPT wheal size required to distinguish cat sensitization from true allergy remains controversial. The cat nasal challenge test (cNCT) could be considered the gold standard for detecting true cat allergy. Aims: To assess the difference in the frequency of cNCT positivity between cat owners and non-owners and to determine an appropriate cut-off level for SPT wheal size in detecting positive cNCT in PER patients who are candidates for allergen immunotherapy (AIT) with cat allergen extracts. Subjects and Methods: cNCT in the form of a nasal spray was administered to 60 adult patients with PER, i.e., cat owners (n = 19) and cat non-owners (n = 41) with positive SPT to cat fur allergen (Diater, Spain). Subjective (total nasal symptom score [TNSS]) and objective measurements (peak nasal inspiratory flow [PNIF]) for assessment of nasal patency and nasal eosinophil count [NEo]) were used to assess the nasal response. Peak expiratory flow (PEF) was used as a safety parameter during cNCT. Results: No differences were obtained in SPT wheal size and cNCT positivity between cat owners and non-owners. Positive cNCT detecting true cat allergy could be predicted by a cat SPT wheal size > 6.5 mm with 71.11% sensitivity and 100% specificity. Conclusions: In adult patients with PER, the frequency of cat allergy was similar among cat owners and non-owners. A cat SPT wheal size ≥6.5 mm could be helpful in detecting true cat allergy by avoiding the demanding, time-consuming, and often unavailable cNCT when cat AIT is needed.
Management of Perioperative Iron Deficiency Anemia
Authors: Gómez-Ramírez Susana , Bisbe Elvira , Shander Aryeh , Spahn Donat R. , Muñoz Manuel
Published: April 2019

Preoperative anemia affects 30–40% of patients undergoing major surgery and is an independent risk factor for perioperative blood transfusion, morbidity, and mortality. Absolute or functional iron deficiency is its leading cause. Nonanemic hematinic deficiencies are also prevalent and may hamper preoperative hemoglobin optimization and/or recovery from postoperative anemia. As modifiable risk factors, anemia and hematinic deficiencies should be detected and corrected prior to major surgical procedures. Postoperative anemia is even more common (up to 80–90%) due to surgery-associated blood loss, inflammation-induced blunted erythropoiesis, and/or preexisting anemia. Preoperative oral iron may have a role in mild-to-moderate anemia, provided there is sufficient time (6–8 weeks) and adequate tolerance of oral preparations. Postoperative oral iron is of little value and rife with gastrointestinal adverse events. Intravenous iron should preferentially be used in cases of moderate-to-severe iron deficiency anemia, concomitant use of erythropoiesis-stimulating agents, short time to surgery or nonelective procedures, and for postoperative anemia management. Minor infusion reactions to intravenous iron are rare, the incidence of severe anaphylactic reactions is extremely low, and there is no increase in infections with intravenous iron. Currently available intravenous iron formulations allowing administration of large single doses are preferred.
Genetic Polymorphisms Associated with Idiopathic Short Stature and First-Year Response to Growth Hormone Treatment
Authors: Quigley Charmian A. , Li Ying Grace , Brown Milton R. , Pillai Sreekumar G. , Banerjee Poulabi , Scott Robin S. , Blum Werner F. , Parks John S.
Published: April 2019

Background/Aims: The term idiopathic short stature (ISS) describes short stature of unknown, but likely polygenic, etiology. This study aimed to identify genetic polymorphisms associated with the ISS phenotype, and with growth response to supplemental GH. Methods: Using a case-control analysis we compared the prevalence of “tall” versus “short” alleles at 52 polymorphic loci (17 in growth-related candidate genes, 35 identified in prior genome-wide association studies of adult height) in 94 children with ISS followed in the Genetics and Neuroendocrinology of Short Stature International Study, versus 143 controls from the Fels Longitudinal Study. Results: Four variants were nominally associated with ISS using a genotypic model, confirmed by a simultaneous confident inference approach: compared with controls children with ISS had lower odds of “tall” alleles (odds ratio, 95% CI) for GHR (0.52, 0.29–0.96); rs2234693/ESR1 (0.50, 0.25–0.98); rs967417/BMP2 (0.39, 0.17–0.93), and rs4743034/ZNF462 (0.40, 0.18–0.89). Children with ISS also had lower odds of the “tall” allele (A) at the IGFBP3 –202 promoter polymorphism (rs2855744; 0.40, 0.20–0.80) in the simultaneous confident inference analysis. A significant association with 1st-year height SD score increase during GH treatment was observed with rs11205277, located near 4 known genes: MTMR11, SV2A, HIST2H2AA3, and SF3B4; the latter, in which heterozygous mutations occur in Nager acrofacial dysostosis, appears the most relevant gene. Conclusions: In children with ISS we identified associations with “short” alleles at a number of height-related loci. In addition, a polymorphic variant located near SF3B4 was associated with the GH treatment response in our cohort. The findings in our small study warrant further investigation.
Ancillary Techniques in Cytologic Specimens Obtained from Solid Lesions of the Pancreas: A Review
Authors: Heymann Jonas J. , Siddiqui Momin T.
Published: April 2019

Advanced methods of molecular characterization have elucidated the genetic, epigenetic, and proteomic alterations associated with the broad spectrum of pancreatic disease, particularly neoplasia. Next-generation sequencing, in particular, has revealed the genomic diversity among pancreatic ductal adenocarcinoma, neuroendocrine and acinar tumors, solid pseudopapillary neoplasm, and other pancreatico-biliary neoplasms. Differentiating these entities from one another by morphologic analysis alone may be challenging, especially when examining the small quantities of diagnostic material inherent to cytologic specimens. In order to enhance the sensitivity and specificity of pancreatic cytomorphology, multiple diagnostic, prognostic, and predictive ancillary tests have been and continue to be developed. Although a great number of such tests have been developed for evaluation of specimens collected from cystic lesions and strictures, ancillary techniques also play a significant role in the evaluation of cytologic specimens obtained from solid lesions of the pancreas. Furthermore, while some tests have been developed to differentiate diagnostic entities from one another, others have been developed to simply identify dysplasia and malignancy. Ancillary studies are particularly important in the subset of cases for which cytomorphologic analysis provides a result that is equivocal or insufficient to guide clinical management. Selection of appropriate ancillary testing modalities requires familiarity with both their methodology and the molecular basis of the pancreatic diseases for which testing is being performed.
Interventional Bronchoscopy for the Treatment of Malignant Central Airway Stenosis: An Expert Recommendation for China
Authors: Jin Faguang , Li Qiang , Li Shiyue , Wang Hongwu , Bai Chong , Zeng Yiming , Zhou Rui , Cai Zhigang , Chen Liangan , Feng Jing , Feng Qixiao , Guo Shuliang , Hou Gang , Huang Haidong , Lai Guoxiang , Li Wangping , Wang Changhui , Zhang Nan , Zhou Yunzhi
Published: April 2019

Malignant central airway stenosis refers to airway stenosis caused by primary or metastatic malignant tumors which may lead to different levels of dyspnea or asphyxia in patients. With the rapid development of interventional pulmonology, therapeutic bronchoscopy has become one of the main methods for the diagnosis and treatment of malignant central airway stenosis. However, the level of diagnosis and treatment of respiratory intervention techniques in China is uneven at present, the treatment methods are not uniform, the treatment effects vary greatly, and some treatments even lead to serious complications. The interventional treatment technology for malignant central airway stenosis in China needs to be standardized. Therefore, the relevant experts of the Beijing Health Promotion Association Respiratory and Oncology Intervention and Treatment Alliance have formulated this consensus after several rounds of full discussion.
Examination of Kynurenine Toxicity on Corneal and Conjunctival Epithelium: In vitro and in vivo Studies
Authors: Matysik-Woźniak Anna , Turski Waldemar A. , Turska Monika , Paduch Roman , Łańcut Mirosław , Piwowarczyk Paweł , Czuczwar Mirosław , Jünemann Anselm , Rejdak Robert
Published: April 2019

Kynurenine (KYN) is a metabolite of tryptophan, proposed for the treatment of corneal diseases. Our goal was to evaluate the effects of KYN on normal human corneal and conjunctival epithelial cells in vitro and the re-epithelization of corneal erosion in rabbits. In our study, we used corneal (10.014 pRSV-T) and conjunctival (HC0597) epithelium cell cultures. KYN was applied at a concentration range of 1–100 µM for 24 and 48 h. We examined the effects on cellular metabolism, viability, interleukin-1β (IL-1β), IL-6, IL-10 secretion, cytoskeleton organization and transwell migration ability. Following a bilateral corneal de-epithelialization, the rabbits received drops containing 1% KYN and a saline solution to the contralateral control eye, 5 times daily. Digital images were analyzed using the EPCO 2000 software. The metabolic activity of cells was slightly decreased by KYN in the corneal but not in the conjunctival epithelium. The viability of both epithelia was improved by KYN; it caused alterations in the secretion of IL-6 and IL-10 but not IL-1β. It had no impact on both epithelia morphology and the organization of the cellular cytoskeleton. KYN stimulated the formation of pseudopodia projections in both epithelia in vitro, which may be important in terms of wound healing. However, there were no differences in the re-epithelization rate in vivo. At the tested concentrations, KYN was not toxic for the corneal and the conjunctival epithelium in vitro and did not affect corneal re-epithelization in rabbits in vivo. Our results suggest that KYN may be taken into consideration for the treatment of ocular disorders.