bluuebunny/crossref_metadata_2025 huggingface dataset:
Review of the Dynamics of Coalescence and Demulsification by High-Voltage Pulsed Electric Fields
Authors: Peng Ye , Liu Tao , Gong Haifeng , Zhang Xianming
Published: April 2016

The coalescence of droplets in oil can be implemented rapidly by high-voltage pulse electric field, which is an effective demulsification dehydration technological method. At present, it is widely believed that the main reason of pulse electric field promoting droplets coalescence is the dipole coalescence and oscillation coalescence in pulse electric field, and the optimal coalescence pulse electric field parameters exist. Around the above content, the dynamics of high-voltage pulse electric field promoting the coalescence of emulsified droplets is studied by researchers domestically and abroad. By review, the progress of high-voltage pulse electric field demulsification technology can get a better understanding, which has an effect of throwing a sprat to catch a whale on promoting the industrial application.
Evolution of Experience of Care of Patients with and without Chronic Diseases following a Québec Primary Healthcare Reform
Authors: Pineault Raynald , Borgès Da Silva Roxane , Provost Sylvie , Breton Mylaine , Tousignant Pierre , Fournier Michel , Prud’homme Alexandre , Levesque Jean-Frédéric
Published: April 2016

Objectives. To assess the extent to which new primary healthcare (PHC) models implemented in two regions of Quebec have improved patient experience of care, unmet needs, and use of services for individuals with and without chronic diseases, compared with other forms of PHC practices.Methods. In 2005 and 2010, we carried out population and organization surveys. We divided PHC organizations into new model practices and other practices and followed the evolution over time of patient experience of care.Results. Patients with chronic diseases had better accessibility but worse continuity of care in the new model practices than in the other practices at both time periods. Through the reform, accessibility decreased evenly in both groups, but continuity and perceived outcomes improved more in the other practices. Use of primary care services decreased more in the new model practices. Among patients without chronic disease, accessibility decreased much less in the new models and responsiveness increased more. There was no significant change in ER attendance and hospitalization.Conclusion. The evolution of patient experience of care has been more favorable for patients without chronic diseases. These findings raise concerns about equity since the aim of the PHC reform was targeting in priority individuals with the greatest needs.
Effect of Yi Gong San Decoction on Iron Homeostasis in a Mouse Model of Acute Inflammation
Authors: Zheng Qin , Guan Yu , Xia Lemin , Wang Zhicheng , Jiang Yiling , Zhang Xiaofeng , Wang Jianying , Wang Guohua , Pu Yiqiong , Xia Jing , Luo Meihong
Published: April 2016

We investigated the effect of Yi Gong San (YGS) decoction on iron homeostasis and the possible underlying mechanisms in a mouse model of acute inflammation in this study. Our findings suggest that YGS regulates iron homeostasis by downregulating the level of HAMP mRNA, which may depend on regulation of the IL‐6/STAT3 or BMP/HJV/SMAD pathway during acute inflammation.
Analysis and Enhancements of a Prolific Macroscopic Model of Epilepsy
Authors: Fietkiewicz Christopher , Loparo Kenneth A.
Published: April 2016

Macroscopic models of epilepsy can deliver surprisingly realistic EEG simulations. In the present study, a prolific series of models is evaluated with regard to theoretical and computational concerns, and enhancements are developed. Specifically, we analyze three aspects of the models: (1) Using dynamical systems analysis, we demonstrate and explain the presence of direct current potentials in the simulated EEG that were previously undocumented. (2) We explain how the system was not ideally formulated for numerical integration of stochastic differential equations. A reformulated system is developed to support proper methodology. (3) We explain an unreported contradiction in the published model specification regarding the use of a mathematical reduction method. We then use the method to reduce the number of equations and further improve the computational efficiency. The intent of our critique is to enhance the evolution of macroscopic modeling of epilepsy and assist others who wish to explore this exciting class of models further.
Coca: The History and Medical Significance of an Ancient Andean Tradition
Authors: Biondich Amy Sue , Joslin Jeremy David
Published: April 2016

Coca leaf products are an integral part of the lives of the Andean peoples from both a cultural and traditional medicine perspective. Coca is also the whole plant from which cocaine is derived. Coca products are thought to be a panacea for health troubles in regions of South America. This review will examine the toxicology of whole coca and will also look at medicinal applications of this plant, past, present, and future.
New Conditions for the Exponential Stability of Pseudolinear Difference Equations in Banach Spaces
Authors: Medina Rigoberto
Published: April 2016

We study the local exponential stability of evolution difference systems with slowly varying coefficients and nonlinear perturbations. We establish the robustness of the exponential stability in infinite-dimensional Banach spaces, in the sense that the exponential stability for a given pseudolinear equation persists under sufficiently small perturbations. The main methodology is based on a combined use of new norm estimates for operator-valued functions with the “freezing” method.
Using Operational Analysis to Improve Access to Pulmonary Function Testing
Authors: Ip Ada , Asamoah-Barnieh Raymond , Bischak Diane P. , Davidson Warren J. , Flemons W. Ward , Pendharkar Sachin R.
Published: April 2016

Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access.Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources.Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15), with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements.Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment.
An FPGA-Based Quantum Computing Emulation Framework Based on Serial-Parallel Architecture
Authors: Lee Y. H. , Khalil-Hani M. , Marsono M. N.
Published: April 2016

Hardware emulation of quantum systems can mimic more efficiently the parallel behaviour of quantum computations, thus allowing higher processing speed-up than software simulations. In this paper, an efficient hardware emulation method that employs a serial-parallel hardware architecture targeted for field programmable gate array (FPGA) is proposed. Quantum Fourier transform and Grover’s search are chosen as case studies in this work since they are the core of many useful quantum algorithms. Experimental work shows that, with the proposed emulation architecture, a linear reduction in resource utilization is attained against the pipeline implementations proposed in prior works. The proposed work contributes to the formulation of a proof-of-concept baseline FPGA emulation framework with optimization on datapath designs that can be extended to emulate practical large-scale quantum circuits.
Detection of OSR2, VAV3, and PPFIA3 Methylation in the Serum of Patients with Gastric Cancer
Authors: Li Wen-han , Zhou Zhang-jian , Huang Tian-he , Guo Kun , Chen Wei , Wang Ying , Zhang Hao , Song Yong-chun , Chang Dong-min
Published: April 2016

Aim. This study was to evaluate the diagnostic value of OSR2, VAV3, and PPFIA3 hypermethylation in gastric cancer (GC) patients. Patients and Methods. By using methylation-specific polymerase chain reaction (MSP), we detected the methylation status in tissue and serum samples from 48 gastric cancer (GC) patients and 25 normal individuals. Results. We found that OSR2, VAV3, and PPFIA3 were methylated in 70.8% (34/48), 54.2% (26/48), and 60.4% (29/48) of GC tissue, respectively. On the contrary, those genes were barely methylated in their paired paracancerous histological normal tissues (PCHNTs) (all P values < 0.01). We next analyzed the methylated OSR2, VAV3, and PPFIA3 in serum DNA. Compared with 25 normal individuals, those three genes were significantly hypermethylated in GC patients serum samples (all P values < 0.01). Regarding their diagnostic value in serum samples, the combined sensitivity of at least one positive among the three markers in serum was 83.3%, with a specificity of 88%. Conclusion. Our test suggested that methylation of OSR2, VAV3, and PPFIA3 genes in serum sample may offer a good alternative in a simple, promising, and noninvasive detection of GC.
Cost-Effectiveness between Double and Single Fecal Immunochemical Test(s) in a Mass Colorectal Cancer Screening
Authors: Cai Shan-Rong , Zhu Hong-Hong , Huang Yan-Qin , Li Qi-Long , Ma Xin-Yuan , Zhang Su-Zhan , Zheng Shu
Published: April 2016

This study investigated the cost-effectiveness between double and single Fecal Immunochemical Test(s) (FIT) in a mass CRC screening. A two-stage sequential screening was conducted. FIT was used as a primary screening test and recommended twice by an interval of one week at the first screening stage. We defined the first-time FIT as FIT1 and the second-time FIT as FIT2. If either FIT1 or FIT2 was positive (+), then a colonoscopy was recommended at the second stage. Costs were recorded and analyzed. A total of 24,419 participants completed either FIT1 or FIT2. The detection rate of advanced neoplasm was 19.2% among both FIT1+ and FIT2+, especially high among men with age ≥55 (27.4%). About 15.4% CRC, 18.9% advanced neoplasm, and 29.9% adenoma missed by FIT1 were detected by FIT2 alone. Average cost was $2,935 for double FITs and $2,121 for FIT1 to detect each CRC and $901 for double FITs and $680 for FIT1 to detect each advanced neoplasm. Double FITs are overall more cost-effective, having significantly higher positive and detection rates with an acceptable higher cost, than single FIT. Double FITs should be encouraged for the first screening in a mass CRC screening, especially in economically and medically underserved populations/areas/countries.
Endothelial‐Mesenchymal Transition in Regenerative Medicine
Authors: Medici Damian
Published: April 2016

Endothelial‐mesenchymal transition (EndMT) is a fundamental cellular mechanism that regulates embryonic development and diseases such as cancer and fibrosis. Recent developments in biomedical research have shown remarkable potential to harness the EndMT process for tissue engineering and regeneration. As an alternative to traditional or artificial stem cell therapies, EndMT may represent a safe method for engineering new tissues to treat degenerative diseases by mimicking a process that occurs in nature. This review discusses the signaling mechanisms and therapeutic inhibitors of EndMT, as well as the role of EndMT in development, disease, acquiring stem cell properties and generating connective tissues, and its potential as a novel mechanism for tissue regeneration.
Effect of Different Denture Base Materials and Changed Mouth Temperature on Dimensional Stability of Complete Dentures
Authors: Arafa Khalid A. O.
Published: April 2016

Background. Type of materials used in fabrication of denture base has an effect on dimension during denture base material processing and other factors related to clinical use.Objective. The study aims were to assess the dimensional stability including thermal changes of three different denture base materials.Methods. Ninety patients were selected to construct complete dentures with different denture base materials. They were randomly divided into three groups: group 1, patients with cobalt chrome metallic base; group 2, patients with heat curing acrylic resin fabricated by injection moulding technique; and group 3, patients with denture bases fabricated by conventional heat curing acrylic resin. The dimensional changes were assessed using digital caliper.Results. After the twelfth month, injection moulding acrylic resin had significantly the highest dimensional change followed by the conventional heat curing acrylic resin. There were no significant differences in the dimensions between the three types of denture base materials at normal mouth temperature, while, after hot tea drinking at 45°C, the dimensional change was significantly the highest in cobalt chrome metallic denture base group.Conclusion. Cobalt chrome metallic denture base has stable dimension compared to denture bases fabricated of acrylic resin but it was more affected by altered mouth temperature. The study was registered in the International Standard Randomized Controlled Trials Number (ISRCTN) registry with study ID (ISRCTN94238244).
The Quality of Sampling from Geographic Networks
Authors: Matta John , Ercal Gunes , Stimson William
Published: April 2016

We empirically investigate the factors affecting the quality of information obtained by randomly sampling nodes from a network embedded in two-dimensional space. The motivation for this work is that wireless and other physical networks do in fact have embedding of their nodes in space, although analyses of random walks on such networks often only consider the link structure while ignoring node locations. Of independent interest is the measure we propose to evaluate the quality of sampling: the rate of decrease in the area of the largest empty circle remaining.
HLA Haplotype Mismatch Transplants and Posttransplant Cyclophosphamide
Authors: Bacigalupo Andrea , Sica Simona
Published: April 2016

The use of high dose posttransplant cyclophosphamide (PT-CY) introduced by the Baltimore group approximately 10 years ago has been rapidly adopted worldwide and is becoming a standard for patients undergoing unmanipulated haploidentical (HAPLO) transplants. PT-CY has been used following nonmyeloablative as well as myeloablative conditioning regimens, for bone marrow or peripheral blood grafts, for patients with malignant and nonmalignant disorders. Retrospective comparisons of HAPLO grafts with conventional sibling and unrelated donor grafts have been published and suggest comparable outcome. The current questions to be answered include the use of PT-CY for sibling and unrelated donors transplant, possibly in the context of prospective randomized trial.
Mediastinal Mature Teratoma Revealed by Empyema
Authors: Raoufi Mohammed , Herrak Laila , Benali Anas , Achaachi Leila , El Ftouh Mustapha , Bellarbi Salma , Tilfine Charaf , Taouarsa Firdaous
Published: April 2016

Teratomas are germ cell tumors, manifested with a great variety of clinical features; the most common extragonadal site is the anterior mediastinum. In this case, we report the patient with a large mature mediastinal teratoma with several components of ectodermal and endothermal epithelium. A 24-year-old female patient presented with history of persistent chest pain and progressively aggravating dyspnea for the previous 3 months. A chest X-ray showed a large opacity of the entire left hemithorax. Transcutaneous needle aspiration revealed a purulent fluid. The tube thoracostomy was introduced and the effusion was evacuated. Some weeks later, patient was seen in emergency for persistent cough and lateral chest pain. CT scan revealed a mass of the left hemithorax. The mass showed heterogeneous density, without compressing mediastinum great vessels and left hilar structures. Lipase value was elevated in needle aspiration. The patient underwent a total resection of the mediastinum mass via a left posterolateral thoracotomy. Microscopy revealed a mature teratoma with cystic structures. The patient subsequently made a full recovery. This case provide benign mediastinal teratoma with total atelectasis of left lung and elevated lipase value in needle transcutaneous aspiration; this event is explained by pancreatic component in the cystic tumor. Total removal of the tumor is adequate treatment for this type of teratoma and the prognosis is excellent.
A Prospective Cohort Study Evaluating the Ability of Anticipated Pain, Perceived Analgesic Needs, and Psychological Traits to Predict Pain and Analgesic Usage following Cesarean Delivery
Authors: Carvalho Brendan , Zheng Ming , Harter Scott , Sultan Pervez
Published: April 2016

Introduction. This study aimed to determine if preoperative psychological tests combined with simple pain prediction ratings could predict pain intensity and analgesic usage following cesarean delivery (CD).Methods. 50 healthy women undergoing scheduled CD with spinal anesthesia comprised the prospective study cohort. Preoperative predictors included 4 validated psychological questionnaires (Anxiety Sensitivity Index (ASI), Fear of Pain (FPQ), Pain Catastrophizing Scale, and Eysenck Personality Questionnaire) and 3 simple ratings: expected postoperative pain (0–10), anticipated analgesic threshold (0–10), and perceived analgesic needs (0–10). Postoperative outcome measures included post-CD pain (combined rest and movement) and opioid used for the 48-hour study period.Results. Bivariate correlations were significant with expected pain and opioid usage (r=0.349), anticipated analgesic threshold and post-CD pain (r=-0.349), and perceived analgesic needs and post-CD pain (r=0.313). Multiple linear regression analysis found that expected postoperative pain and anticipated analgesic needs contributed to post-CD pain prediction modeling (R2=0.443,p<0.0001); expected postoperative pain, ASI, and FPQ were associated with opioid usage (R2=0.421,p<0.0001).Conclusion. Preoperative psychological tests combined with simple pain prediction ratings accounted for 44% and 42% of pain and analgesic use variance, respectively. Preoperatively determined expected postoperative pain and perceived analgesic needs appear to be useful predictors for post-CD pain and analgesic requirements.
Reducing Shoulder by Vertical Traction: A One-Man Method for Shoulder Reduction
Authors: Khan Hayat Ahmad , Kamal Younis , Khan Mohammad Ashraf , Farooq Munir , Gani Naseemul , Hassan Nazia , Shah Adil Bashir , Bhat Mohammad Shahid
Published: April 2016

Fifty percent of joint dislocations reported to the emergency department are of shoulder joint. Various techniques are used to reduce the shoulder and Spaso technique is the least known to the orthopaedic residents which is a simple one-man vertical traction method of shoulder reduction. We evaluated the effectiveness of vertical traction method for anterior shoulder dislocation by orthopaedic residents. Sixty consecutive patients of anterior glenohumeral dislocation attending the emergency department of our hospital were taken up for the study. The reduction was done using Spaso technique. Right shoulder was dislocated in 40 patients and 31 patients had recurrent shoulder dislocation. In 55 patients, shoulder was reduced without the use of any anaesthesia. In patients where no anaesthesia was used, the time of traction ranged from 45 seconds to 5 minutes, while under anaesthesia the time of traction ranged from 1 to 4 minutes. Twenty-one patients had associated greater tuberosity fracture which did not affect the method of reduction and all of them were reducible. No complication was reported, and all the patients were satisfied with the method. In conclusion vertical traction method is a good technique for reducing anterior shoulder dislocation with an easy learning curve among the residents and no complication has been reported so far.
Impact of Apolipoprotein B on Hepatosteatosis in a Population Infected with Hepatitis C Virus: A Cross-Sectional Observational Study
Authors: Lin Ming-Shyan , Guo Su-Er , Lin Huang-Shen , Hsu Jen-Te , Lin Yu-Sheng , Lin Tsai-Hui , Huang Tung-Jung , Chen Mei-Yen , Chung Chang-Min
Published: April 2016

Objective: Non-alcoholic fatty liver disease (NAFLD) is an established risk factor for diabetes, cardiovascular disease, antiviral treatment resistance, and progression of chronic hepatitis C virus (HCV) infection to fibrosis. Apolipoprotein-B 100 (ApoB-100) is a dyslipidemia marker and steatosis predictor. We assess the correlation between ApoB-100 and hepatosteatosis. Methods: This cross-sectional study enrolled 1,218 HCV-seropositive participants from a 2012-2013 health checkup in Taiwan. NAFLD was detected using ultrasound. All anthropometric and laboratory studies that included ApoB-100 were evaluated whether or not ApoB-100 predicts NAFLD. Logistic regression was also used to examine the association between ApoB-100 and NAFLD. Results: Participants were 47.16 ± 16.08 years old (mean age). The overall prevalence of NAFLD was 35.8% (n = 436; 32.8% men, 38.1% women). Participants with ApoB-100 ≥ 8 had a significantly higher incidence of NAFLD (39.4 vs. 29.4%; 95% CI 0.044-0.156; p < 0.001). After confounding factors had been adjusted for, ApoB-100 was significantly associated with NAFLD (OR 5.45; 95% CI 1.64-18.06; p = 0.006) and high-grade hepatosteatosis (OR 7.73; 95% CI 1.74-34.35; p = 0.007). Conclusion: ApoB-100 is strongly associated with NAFLD in people with non-genotype 3 HCV; greater ApoB-100 content is significantly correlated with higher-grade hepatosteatosis.
Event-Related Potentials Correlate with the Severity of Child and Adolescent Patients with Attention Deficit/Hyperactivity Disorder
Authors: Yamamuro Kazuhiko , Ota Toyosaku , Iida Junzo , Nakanishi Yoko , Suehiro Yuko , Matsuura Hiroki , Uratani Mitsuhiro , Okazaki Kosuke , Kishimoto Naoko , Tanaka Shohei , Iwasaka Hidemi , Kishimoto Toshifumi
Published: April 2016

Background: Attention deficit/hyperactivity disorder (ADHD) symptoms can continue through adolescence and adulthood, including difficulty in staying focused, paying attention, and controlling behavior, as well as hyperactivity. While children and adolescents with ADHD have functional impairments at multiple dimensions, there are no objective biological indicators to assess the severity of ADHD. Event-related potentials (ERPs) are widely used as a noninvasive method for evaluating sensory and cognitive processes involved in attention tasks. Previous studies have shown that P300 amplitude or latency, a main component in ERPs, is altered in patients with ADHD. However, little is known about the relationship between P300 and the severity of ADHD symptoms. Method: We sought to measure both P300 amplitude and latency in ERPs during auditory oddball tasks in 44 patients with ADHD (mean age ± SD 10.28 ± 3.43 years) and 15 age- and gender-matched normally developing children (11.40 ± 3.02 years). In ADHD patients, we also assessed symptom severity using the ADHD rating scale-IV-Japanese version. Result: In ADHD groups, P300 amplitude and latency were attenuated and prolonged compared to controls at the frontocentral, centroparietal, and parietal positions. Furthermore, levels of P300 latency at these positions are positively correlated with the inattention subscale scores measured by the ADHD rating scale-IV-Japanese version. Conclusions: The present study revealed that the degree of P300 latency might reflect the severity of ADHD symptoms with children and adolescents, suggesting that ERPs are a useful technique to evaluate the severity of ADHD symptoms.
Omalizumab in Chronic Spontaneous Urticaria: A Brazilian Real-Life Experience
Authors: Ensina Luis Felipe , Valle Solange Oliveira Rodrigues , Juliani Ana Paula , Galeane Michel , Vieira dos Santos Rosaly , Arruda Luisa Karla , Melo Janaina Michelle Lima , de Souza Patrícia Karla , Serpa Faradiba Sarquis , de Andrade Djanira Martins , França Alfeu Tavares , Campos Régis Albuquerque , Camelo-Nunes Inês , Solé Dirceu
Published: April 2016

Background: Current guidelines on chronic spontaneous urticaria (CSU) suggest a treatment based on a 3-step approach that aims at total symptom control, starting with H1-antihistamines. However, a significant number of patients present an antihistamine-resistant urticaria that must be treated with an alternative third-line therapy such as omalizumab. Methods: Patients with a history of CSU who did not respond to treatment with high doses of modern antihistamines were treated with 150 or 300 mg of omalizumab every 4 weeks. The response to treatment was recorded as complete (CR), partial (PR) or no response. A dose adjustment was proposed according to response. Results: We treated 47 CSU patients with omalizumab (40 females), of whom 39.5% had evidence of autoimmunity. The average number of treatments was 11.4 (range 2-87). All patients had been refractory to high-dose modern antihistamines. A CR was seen in 84.6% of patients who started with 300 mg and in 60% of those who started with 150 mg. Only 1 patient had no response to both the 150- and 300-mg doses. In 6 of the PR patients with 150 mg, a higher dose of 300 mg was proposed and 4 had a CR. Four patients discontinued the treatment. No severe adverse events were reported in the patients who finished the study. Discussion: Although good results were seen in both groups, CR rates were higher in those under a high-dose initial treatment. Our data strongly suggest that the therapy should be individualized.
The Basophil Activation Test Is Not a Useful Screening Tool for Hymenoptera Venom-Related Anaphylaxis in Patients with Systemic Mastocytosis
Authors: Rietveld Mark J.A. , Schreurs Marco W.J. , Gerth van Wijk Roy , van Daele Paul L.A. , Hermans Maud A.W.
Published: April 2016

Background: Systemic mastocytosis (SM) patients are at a high risk for anaphylaxis, with Hymenoptera as the main culprit. A screening instrument to identify which patients are sensitized to Hymenoptera before they experience anaphylaxis would therefore be of great value. The basophil activation test (BAT) is proposed as a possible tool for diagnosing Hymenoptera venom-related allergy (HVA), especially in patients in whom conventional allergy tests yield contradictory results. Methods: We included outpatients with SM, according to WHO criteria, from September 2011 to January 2012. Next, to obtain various clinical data including intradermal test results, specific immunoglobulin E (sIgE) measurements and BAT were performed. Results: We included 29 patients, 9 of whom had a history of HVA and 4 of whom had experienced anaphylaxis due to other triggers. Sixteen patients had no history of anaphylaxis. sIgE was detected in 6 patients with HVA and in 2 patients with anaphylaxis due to other triggers. The BAT was positive in only 1 patient, in whom the skin test and sIgE were also positive. Compared to patients with skin lesions, those without skin lesions had significantly more anaphylaxis and sIgE to Hymenoptera. During a 3-year follow-up, no one experienced new anaphylactic episodes. Conclusion: The BAT is not a reliable tool for randomly screening SM patients for HVA.
Pre- and Post-Transplant Antiviral Therapy (HBV, HCV)
Authors: Welker Martin-Walter , Zeuzem Stefan
Published: April 2016

Background: Hepatitis B virus (HBV)- and hepatitis C virus (HCV)-associated liver cirrhosis is a major indication for liver transplantation. This concise review gives an overview about current interferon (IFN)-free treatment options before and after liver transplantation in HBV- or HCV-associated liver disease. Methods: A PubMed database search using the terms hepatitis B, hepatitis C, cirrhosis, and liver transplantation was performed to identify significant clinical studies as well as national and international guidelines. Results: Studies investigating IFN-free treatment in patients with decompensated HBV as well as in HCV-associated cirrhosis are scarce. Hepatic recompensation during antiviral therapy seems more frequent in patients with HBV than in those with HCV-associated cirrhosis. Graft hepatitis B or C is characterized by an accelerated and unfavorable course. Graft infection prophylaxis is safe and efficacious in HBV-related liver transplantation. Eradication of HCV prior to liver transplantation prevents HCV graft infection, and IFN-free treatment of established HCV graft infection is safe and associated with high sustained virologic response rates. Conclusion: Patients with HBV-associated cirrhosis should be treated prior to liver transplantation, and receive a continuing graft infection prophylaxis thereafter. Patients with HCV-associated decompensated cirrhosis may be considered as candidates for antiviral therapy prior to liver transplantation or may be treated subsequently.
A New Approach to the Treatment of Uncomplicated Cystitis: Results of a Randomized Placebo-Controlled Clinical Trial
Authors: Salvatorelli Nicola , García-Larrosa Alejandro , Allegrini Alessandro , Pavone Daniele
Published: April 2016

Objective: To assess the efficacy and safety of a new medical device (MD; a capsule whose main component is a cross-linked protein) in the prevention of uncomplicated cystitis recurrences. Methods: Adult women with acute cystitis symptoms and a ciprofloxacin-susceptible isolate in urine culture were included in a randomized, double-blind clinical trial. Patients were treated with ciprofloxacin 500 mg/day and 1 capsule/day or matched placebo for 5 days, 1 capsule/day or placebo for 15 additional days, and 2 additional cycles of 1 capsule/day or placebo for 15 days on months 1 and 2 after initial treatment. Results: No recurrence was observed after the first month of follow-up in the MD-treated group. In addition, symptomatic recurrence was reduced by 19.4% compared with placebo after 6 months. Conclusions: The new MD can help prevent the recurrence of uncomplicated cystitis as well as help to reduce antibiotic use in management of urinary tract infection in women.
Risk Factors for Barrett's Oesophagus
Authors: Sharma Neel , Ho Khek Yu
Published: April 2016

Background: Barrett's oesophagus (BO) is a premalignant condition associated with the development of oesophageal adenocarcinoma (OAC). Globally, the incidence of OAC is rising. Furthermore, the prognosis regarding the morbidity and mortality of OAC is bleak, with an estimated 5-year survival of 10-15%. Hence, detection of the premalignant phase is paramount. Endoscopy and biopsy sampling is the mainstay of diagnosis. Patients may present with symptoms of gastro-oesophageal reflux disease (GORD) or be completely asymptomatic. Therefore, symptomatology alone is a poor indicator of this condition. Summary: This review highlights the current risk factors associated with the development of BO. Key Message: Primary risk factors for BO include male gender, increased age, a family history of the disease, long-standing GORD, smoking, obesity (specifically determined by the waist-to-hip ratio as opposed to BMI), and Caucasian race. Alcohol consumption and Helicobacter pylori are not associated with the condition. Practical Implications: By ensuring an appropriate understanding of the risk factors, clinicians can discern at-risk patients for endoscopic diagnosis and surveillance.
A CpG-SNP Located within the ARPC3 Gene Promoter Is Associated with Hypertriglyceridemia in Severely Obese Patients
Authors: de Toro-Martín Juan , Guénard Frédéric , Tchernof André , Deshaies Yves , Pérusse Louis , Biron Simon , Lescelleur Odette , Biertho Laurent , Marceau Simon , Vohl Marie-Claude
Published: April 2016

Aims: To test the potential association of cytosine-phosphate-guanine dinucleotides (CpG)-single-nucleotide polymorphisms (SNPs) located within actin-related protein 2/3 complex subunit 3 (ARPC3), a gene recently linked to adipogenesis and lipid accumulation, with metabolic syndrome (MetS) features in severely obese patients. Methods: Prioritized SNPs within the ARPC3 locus were genotyped and tested for associations with MetS features in a cohort of 1,749 obese patients with and without MetS. Association testing with CpG methylation levels was performed in a methylation sub-cohort of 16 obese men. Results: A significant association was found between the CpG-SNP rs3759384 (C>T) and plasma triglyceride (TG) levels (false discovery rate-corrected p = 3.5 × 10-2), with 0.6% of the phenotypic variance explained by the CpG-SNP, and with TT homozygotes showing the highest plasma TG levels (1.89 mmol/l). The carriers of the rs3759384 T allele also showed a significant decrease in methylation levels of the ARPC3 promoter-associated CpG site cg10738648 in both visceral adipose tissue and blood. ARPC3 expression levels showed a strong correlation with plasma TG levels (r = 0.70; p = 0.02). Conclusions: The increased plasma TG levels found in homozygous rs3759384 T allele carriers argue for a relevant role of this CpG-SNP in lipid management among obese individuals, which may be driven by an epigenetic-mediated mechanism.
Surveillance of Hepatocellular Carcinoma and Diagnostic Algorithms in Patients with Liver Cirrhosis
Authors: Marquardt Jens U. , Nguyen-Tat Marc , Galle Peter R. , Wörns Marcus A.
Published: April 2016

Background: Hepatocellular carcinoma (HCC) is the most deadly complication of all major chronic liver diseases. Since early detection is the most significant determinant of overall survival, intense screening is of major importance. Methods: This overview is based on a systematic review of the available literature on HCC screening and surveillance in the PubMed database. Results: Over the last decades, major etiological risk factors were identified and the population at highest risk for the development of HCC was clearly defined. Screening in these patients has been repeatedly demonstrated to detect early tumor stages and to be cost-effective. Therefore, screening is recommended by all current guidelines and usually comprises a bi-annual ultrasound examination in Western countries. In some Asian countries biomarkers are also used; however, their efficiency for Western HCCs remains to be determined. The detection of lesions >1 cm during routine screening requires subsequent confirmation of HCC. The diagnosis can be accurately established by modern imaging techniques, i.e. computed tomography or magnetic resonance imaging, in the majority of patients. In ambiguous cases and if radiological criteria are not met by two imaging techniques, biopsies remain the gold standard for diagnosis. Furthermore, histology is of key importance for the development of new diagnostic and predictive biomarkers. Conclusion: Screening and detection algorithms for patients at risk for HCC are effective and should be rigorously implemented in clinical routine.
Predialysis Vitamin D Receptor Activator Treatment and Cardiovascular Events after Dialysis Initiation: A Multicenter Observational Study
Authors: Inaguma Daijo , Tanaka Akihito , Shinjo Hibiki , Kato Akiko , Murata Minako ,   Aichi cohort study of prognosis in patients newly initiated into dialysis (AICOPP) group
Published: April 2016

Background: Vitamin D receptor activator (VDRA) administration has been linked with a reduced incidence of cardiovascular disease (CVD). However, it is unclear whether VDRA administration during the predialysis stage is associated with CVD incidence after dialysis initiation in patients with chronic kidney disease. Therefore, we examined the association between VDRA use and CVD events. Methods: This multicenter observational study included 1,516 patients; they were divided into 2 groups: those who did and did not receive oral VDRA for at least 3 months before dialysis initiation. The CVD incidence was compared between these groups. Factors that impacted CVD incidence were extracted through a multivariate analysis. Subgroups were created based on prior CVD history and serum CRP levels. Results: The incidence of CVD was significantly lower in the VDRA group (log-rank test, p = 0.014). Stepwise multivariate analyses identified age, gender, diabetes, CVD history, calcium-channel blockers, beta-blockers, loop diuretics, anti-platelet agents, phosphate binders, VDRA, erythropoiesis stimulating agents, and cardiothoracic ratio as factors affecting CVD incidence. In the group with no CVD history, VDRA use was associated with a low incidence of CVD (HR 0.35). In the group with serum CRP levels <1.0 mg/dl, VDRA use was associated with a low incidence of CVD (HR 0.47). Conclusion: Administration of VDRA during predialysis was associated with a low incidence of CVD onset after dialysis initiation.
Quantitative Sonographic Differences in Mid-Urethra between Postmenopausal Women with and without Stress Urinary Incontinence
Authors: Olgan Safak , Mantar Ozge Piri , Okyay Recep Emre , Gulekli Bulent
Published: April 2016

Aim: The aim of this study was to evaluate midurethral tissue characteristics in continent and stress urinary incontinent postmenopausal women by using transvaginal ultrasound gray-level histogram. Methods: Thirty-seven patients with stress urinary incontinence (SUI) and 77 patients without SUI were evaluated. Vaginal ultrasound gray-level histograms were performed by 2 gynecologists blinded to patients' SUI statuses. The mean gray-level (MGL) of ultrasound gray-level histogram, representing the echogenicity of a region of interest, was measured in the anterior and posterior midurethral wall along a vertical ultrasound beam. The difference in MGL between anterior and posterior (AP difference) midurethra was calculated. Results: The MGL value of SUI patients was found to be lower in posterior (p = 0.008) and higher in anterior midurethral region (p = 0.001) when compared with control group. In addition, the difference in MGL between anterior and posterior midurethra (AP difference) was found to be higher in SUI group (p < 0.001). Multivariate analysis by logistic regression including confounding factors revealed that AP difference was independently associated with presence of SUI (adjusted OR 1.14, 95% CI 1.08-1.20, p < 0.001). Intra- and inter-observer reproducibility was found to be high with intraclass correlation coefficient of 0.83 and 0.78, respectively. Conclusion: Postmenopausal SUI patients might have a distinct midurethral echogenicity pattern with the quantitative ultrasonography.
Amygdala Kisspeptin Neurons: Putative Mediators of Olfactory Control of the Gonadotropic Axis
Authors: Pineda Rafael , Plaisier Fabrice , Millar Robert P. , Ludwig Mike
Published: April 2016

Kisspeptins and their receptors are potent regulators of the gonadotropic axis. Kisspeptin neurons are found mainly in the hypothalamic arcuate nucleus and the anteroventral periventricular nucleus. However, there is also a third population of kisspeptin neurons, located in the amygdala. We used fluorescence immunohistochemistry to quantify and localize the amygdala kisspeptin neurons and to reveal close apposition and putative innervations by vasopressinergic and tyrosine hydroxylase-positive dopaminergic neurons. Using microinjections of retro- and anterograde tracers, and viral transfection systems in rats and transgenic mice, we showed reciprocal connectivity between the accessory olfactory bulb and the amygdala kisspeptin neurons. In vitro recordings indicate an inhibitory action of kisspeptin on mitral cells in the accessory olfactory bulb. Using viral specific-cell gene expression in transgenic mice in combination with double immunofluorescence histochemistry, we found that the amygdala kisspeptin neurons also project to gonadotropin-releasing hormone (GnRH) neurons in the preoptic area. Our neuroanatomical and electrophysiological data suggest that amygdala kisspeptin neurons integrate social behaviour and odour information into GnRH neurons in the preoptic area to coordinate the gonadotropic axis and the appropriate output behaviour to odour cues.
Processos e mudanças em abreviaturas mineiras setecentistas: regularidade e ruptura
Authors: Duchowny Aléxia Teles , Ramos Jania Martins , Coelho Sueli Maria
Published: April 2016

Este trabalho analisou abreviaturas de documentos setecentistas escritos no Arraial do Tijuco, hoje cidade de Diamantina-MG. Cotejaram- se recursos braquigráficos empregados em compromissos de irmandades religiosas de estratos sociais distintos para testar duas hipóteses: (i) as abreviaturas refletem diferenças diastráticas e, portanto, (ii) permitem identificar o grau de letramento do escrevente. As análises empreendidas não atestam a correção das hipóteses, mas as generalizações alcançadas sinalizam que as abreviaturas, como qualquer outro fenômeno linguístico, sofrem processos de mudança sistemáticos, organizados e múltiplos, diferentemente do que prevê a parca literatura sobre o tema.
Emprego de vírgula e prosódia do Português Brasileiro: aspectos teórico-analíticos e implicações didáticas
Authors: Soncin Geovana , Tenani Luciani
Published: April 2016

Neste artigo, estabelecemos relações entre o emprego de vírgula em textos de alunos concluintes do Ensino Fundamental e a organização prosódica do Português Brasileiro. Por meio da análise realizada, mostramos que, embora a convenção para o uso da vírgula seja prioritariamente de base sintática, os usos encontrados apresentam regularidades prosódicas que, ao mesmo tempo, organizam a segmentação do enunciado e contribuem para a constituição dos sentidos dos textos. Do ponto de vista teórico, defendemos, por um lado, que a prosódia atua como estrutura significante na escrita e, desse modo, não é particularidade da fala e, por outro, que os usos de vírgula, ao marcar a estruturação prosódica da língua na escrita, faz remissão, por meio de um processo simbólico, ao modo como os fenômenos prosódicos produzem sentidos em diferentes enunciados no interior de práticas de oralidade. Como desdobramento da discussão teórica, propomos que, na prática didática, enfrentar a complexidade do emprego da vírgula poderia ser mais produtivo para o ensino do que considerá-lo em sua suposta homogeneidade sintática.
Distinct Longitudinal Associations of MBL, MASP-1, MASP-2, MASP-3, and MAp44 With Endothelial Dysfunction and Intima–Media Thickness
Authors: Hertle Elisabeth , Arts Ilja C.W. , van der Kallen Carla J.H. , Feskens Edith J.M. , Schalkwijk Casper G. , Hoffmann-Petersen Ingeborg T. , Thiel Steffen , Stehouwer Coen D.A. , van Greevenbroek Marleen M.J.
Published: April 2016

Objective—

Previous studies suggested that the lectin-complement pathway plays a complex role in cardiovascular disease (CVD). To date, no prospective human studies have investigated the relationship between the initiating factor of the lectin pathway, that is, mannose-binding lectin (MBL), and low-grade inflammation, endothelial dysfunction, or carotid intima–media thickness (cIMT). Moreover, MBL-associated proteases (MASPs) and MBL-associated proteins (MAps), which mediate downstream complement activation, have not been studied in the development of CVD.

Approach and Results—

In a prospective cohort (n=574; age 60±7 years; 7-year follow-up), we investigated longitudinal associations of plasma MBL, MASP-1, MASP-2, MASP-3, and MAp44 with biomarker scores that reflect low-grade inflammation and endothelial dysfunction, respectively, and with cIMT. We also investigated their associations with incident CVD (n=73). In adjusted analyses, low-grade inflammation was lowest in the middle tertile (T
Middle
) of MBL, that is, T
Middle
was 0.19 SD (0.03 to 0.34) lower than T
Low
, and 0.15 SD (−0.02 to 0.31) lower than T
High
. cIMT was 28 μm (−50 to −5) lower in the highest MBL tertile (T
High
) than in T
Middle
and did not differ between T
Low
and T
Middle
. MBL was not associated with endothelial dysfunction or CVD. MASP-1 and MASP-2 were not associated with any cardiovascular outcomes. MASP-3 and MAp44 were, independently of MBL levels, associated with endothelial dysfunction (per 1 SD higher MASP-3: β=0.10 SD [0.02 to 0.18]; per 1 SD higher MAp44 β=0.12 SD [0.04 to 0.20]) but not with low-grade inflammation, cIMT, or CVD.

Conclusions—

High MBL may contribute to low cIMT, whereas the association of MBL with low-grade inflammation was nonlinear. MASP-1 and MASP-2 were not associated with adverse cardiovascular outcomes. MASP-3 and MAp44 may play a role in endothelial dysfunction, potentially independent of lectin-pathway activation.
Prognostic Relevance of Left Atrial Dysfunction in Heart Failure With Preserved Ejection Fraction
Authors: Santos Angela B.S. , Roca Gabriela Querejeta , Claggett Brian , Sweitzer Nancy K. , Shah Sanjiv J. , Anand Inder S. , Fang James C. , Zile Michael R. , Pitt Bertram , Solomon Scott D. , Shah Amil M.
Published: April 2016

Background—

Left atrial (LA) size is an established marker of risk for adverse outcomes in heart failure with preserved ejection fraction (HFpEF). However, the independent prognostic importance of LA function in HFpEF is not known.

Methods and Results—

We assessed LA function measured by speckle-tracking echocardiography in 357 patients with HFpEF enrolled in the Treatment Of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial who were in sinus rhythm at the time of echocardiography. Lower peak LA strain, indicating LA dysfunction, was associated with older age, higher prevalence of atrial fibrillation and left ventricular (LV) hypertrophy, worse LV and right ventricular systolic function, and worse LV diastolic function. At a mean follow-up of 31 months (interquartile range, 18–43months), 91 patients (25.5%) experienced the primary composite end point of cardiovascular death, HF hospitalization, and aborted sudden death. Lower peak LA strain was associated with a higher risk of the composite end point (hazard ratio, 0.96 per unit of reduction in strain; 95% confidence interval, 0.94–0.99;
P
=0.009) and of HF hospitalization alone (hazard ratio, 0.95 per unit of reduction in strain; 95% confidence interval, 0.92–0.98;
P
=0.003). The association of LA strain with incident HF hospitalization remained significant after adjustment for clinical confounders, but not after further adjustment for LV global longitudinal strain and the E/E′ ratio, parameters of LV systolic and diastolic function, respectively.

Conclusions—

LA dysfunction in HFpEF is associated with a higher risk of HF hospitalization independent of potential clinical confounders, but not independent of LV strain and filling pressure. Impairment in LV systolic and diastolic function largely explains the association between impaired LA function and higher risk of HF hospitalization in HFpEF.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00094302.