bluuebunny/crossref_metadata_2025 huggingface dataset:
Medicinal Plants Used by a Mbyá-Guarani Tribe against Infections: Activity on KPC-Producing Isolates and Biofilm-Forming Bacteria
Authors: Brandelli Clara Lia Costa , Ribeiro Vanessa Bley , Zimmer Karine Rigon , Barth Afonso Luís , Tasca Tiana , Macedo Alexandre José
Published: March 2019

The traditional use of medicinal plants for treatment of infectious diseases by an indigenous Mbyá-Guarani tribe from South Brazil was assessed by evaluating the antibiotic and antibiofilm activities against relevant bacterial pathogens. Aqueous extracts from 10 medicinal plants were prepared according to indigenous Mbyá-Guarani traditional uses. To evaluate antibiotic (OD600) and antibiofilm (crystal violet method) activities, Pseudomonas aeruginosa ATCC 27853, Staphylococcus epidermidis ATCC 35984 and seven multi-drug resistant Klebsiella pneumoniae carbapenemase (KPC)-producing bacterial clinical isolates were challenged with the extracts. Furthermore, the susceptibility profile of KPC-producing bacteria and the ability of these isolates to form biofilm were evaluated. The plants Campomanesia xanthocarpa, Maytenus ilicifolia, Bidens pilosa and Verbena sp. showed the best activity against bacterial growth and biofilm formation. The majority of KPC-producing isolates, which showed strong ability to form biofilm and a multidrug resistance profile, was inhibited by more than 50% by some extracts. The Enterobacter cloacae (KPC 05) clinical isolate was the only one resistant to all extracts. This study confirms the importance of indigenous traditional medicinal knowledge and describes for the first time the ability of these plants to inhibit biofilm formation and/or bacterial growth of multi-drug resistant KPC-producing isolates.
Structure Revision of (22E)-Ergosta-7,22-diene-3β,5α,6β,9α,14α-pentol from the Spores of the Medicinal Mushroom Ganoderma Lucidum
Authors: Yaoita Yasunori , Machida Koichi
Published: March 2019

Careful reexamination of the published 1H and 13C NMR spectral data of (22 E)-ergosta-7,22-diene-3β,5α,6β,9α,14α-pentol (1), isolated from the spores of the medicinal mushroom Ganoderma lucidum, indicates that, in reality, the compound is (22 E)-ergosta-7,22-diene-3β,5α,6β,9α,14β-pentol (5).
Stereospecific Oxidation of Diacetoxyheterobetulin with Ozone and Dimethyldioxirane
Authors: Khusnutdinova El'mira F. , Medvedeva Natalya I. , Kazakov Dmitri V. , Kukovinets Olga S. , Lobov Alexander N. , Suponitsky Kirill Yu. , Kazakova Oxana B.
Published: March 2019

Stereospecific oxidation of diacetoxyheterobetulin with ozone and dimethyldioxirane led to 3β,28-diacetoxy-18α,19pH-urs-20α,21α-epoxide with yields of 79% and 87%, respectively. Oxidation with ozone was not selective and gave two minor products containing 21α-hydroxy-20(30)-ene and 21α-hydroxy-20β,28-epoxy- fragments in ring E. The structures of 3β,28-diacetoxy-18α,19pH-urs-20α,21α-epoxide and 3β-diacetoxy-21α-hydroxy-20β,28-epoxy-18α,19βH-ursane were confirmed by X-ray analysis for the first time.
Composition, in vitro Anti-inflammatory, Antioxidant and Antimicrobial Activities of the Leaf Essential Oil of Machilus konishii from Taiwan
Authors: Su Yu-Chang , Hsu Kuan-Ping , Ho Chen-Lung
Published: March 2019

The chemical composition and in vitro anti-inflammatory, antioxidant and antimicrobial activities of the leaf essential oil of Machilus konishii has been investigated. The essential oil was isolated using hydrodistillation in a Clevenger-type apparatus, and characterized by GC–FID and GC–MS. Sixty-six compounds were identified, representing 100% of the oil. The main components identified were α-pinene (33.9%), β-pinene (13.9%), and thymol (12.0%). The leaf oil was able to reduce nitric oxide production by lipopolysaccharide-activated murine macrophages RAW 264.7 without reducing the cell viability. In addition, the leaf oil showed strong antioxidant and antimicrobial activities. The major ingredient of the oil that was responsible for the anti-inflammatory, antioxidant and antimicrobial activities was thymol.
Phytotoxic Fungal Exopolysaccharides Produced by Fungi Involved in Grapevine Trunk Diseases
Authors: Cimmino Alessio , Cinelli Tamara , Evidente Marco , Masi Marco , Mugnai Laura , Silva Marcondes A. , Michereff Sami J. , Surico Giuseppe , Evidente Antonio
Published: March 2019

This paper reports the isolation and chemical and biological characterization of exopolysaccharides produced by phytopathogenic fungi belonging to different genera and inducing various diseases on grapevine. Their role in the phytopathogenic processes is also discussed.
Characterization of Cyclodepsipeptides from the Mycelium of Isaria Japonica from Vietnam
Authors: Tuan Nguyen Ngoc , Ngan Nguyen Thi , Kuo Ping-Chung , Hung Hsin-Yi , Lan Tran Ngoc , Thanh Nguyen Tan , Xuan Dao Thi Thanh , Thang Tran Dinh , Wu Tian-Shung
Published: March 2019

A new cyclodepsipeptide, isarin (1), was isolated from the insect pathogenic fungus Isaria japonica Yasuda, together with one known compound, beauveriolide I (2). The structure of this new compound was characterized using a combination of spectroscopic and spectrometric analyses.
Ochroborbone, A New Cytotoxic Indole Alkaloid from Ochrosia borbonica
Authors: Liu Yan-Ping , Chen A-Hong , Li Ruo-Heng , Yang Hui-Wen , Bao Hai-Nan , Lai Liang , Zong Kang , Fu Yan-Hui
Published: March 2019

A new monoterpenoid indole alkaloid, ochroborbone (1), along with five known alkaloids (2–6), were isolated from the stems and leaves of Ochrosia borbonica. Among them, ochroborbone (1) is a rare C17-nor monoterpenoid indole alkaloid, and the known compounds (2-6) were isolated from Ochrosia for the first time. These structures were established on the basis of extensive spectroscopic methods. All isolated compounds were evaluated for their cytotoxicities against five human cancer cell lines: HL-60, SMMC-7721, A-549, MCF-7 and SW480 in vitro. Compounds 1 and 2 exhibited inhibitory effects with IC50 values comparable with those of cisplatin.
Phenolic Components from the Aerial Parts of Agrimonia pilosa
Authors: Van Linh Nguyen , Anh Hoang Le Tuan , Yen Duong Thi Hai , Ky Pham Thanh , Hung Vu Manh , Hien Nguyen Thi Thu , Hung Trieu Quy , Cuc Nguyen Thi , Dung Duong Thi , Tai Bui Huu , Van Kiem Phan
Published: March 2019

Two new resorcinol derivatives, named agrimopilosides A and B (1 and 2), along with two known compounds, (2 S, 3 S)-aromadendrin 3-O-β-D-glucopyranoside (3), (2 S, 3 S)-glucodistylin (4) were isolated from the aerial parts of Agrimonia pilosa. Their chemical structures were determined by mean of HRMS, NMR, CD spectra, and as well as by comparison with the reported data. At concentration of 20 μM, compounds 1–4 modestly inhibited NO production in LPS-stimulated RAW264.7 cells, with the inhibitory rates in the range of 9.55–33.73%. None of them showed cytotoxicity toward HepG2, MCF-7, and SK-LU-1 human cancer cells by MTT assay.
Alkaloids from the Bulbs of Boophone disticha
Authors: van Rensburg Elmarie , Zietsman Pieter C. , Bonnet Susan L. , Wilhelm Anke
Published: March 2019

Boophone disticha is widely used in South African traditional medicine. Several of its biological properties can be corroborated via its alkaloid constituents. Previous research on this plant led to the isolation of several alkaloids, mainly of the crinane alkaloid group of the Amaryllidaceae. In the present study, one new compound 1- O-acetylbuphanamine (1) and four known crinane alkaloids were isolated chromatographically from the ethanol extract of the bulbs of B. disticha. Their structures were determined via spectroscopic methods, including 1D and 2D NMR, ESI-MS, HRMS and IR data.
Phytochemical Analysis and Antimicrobial Activity of Origanum dictamnus Traditional Herbal Tea (decoction)
Authors: Varsani Myrto , Graikou Konstantia , Velegraki Aristea , Chinou Ioanna
Published: March 2019

In the framework of the re-evaluation of chemistry and biological properties of Greek herbal teas (decoctions), the objective of this study was the estimation of the total phenolic content and the antimicrobial activity as well as the chemical analysis of the water extracts (decoction) of three samples of Cretan dittany ( Origanum dictamnus L) prepared in the traditional way to be used (drunk). Ten secondary metabolites were isolated and elucidated on the basis of spectral evidence for the first time from O. dictamnus drinkable decoction: carvacrol (1), β-sitosterol (2), uvaol (3), ursolic acid (4), rosmarinic acid (5), lithospermic acid (6), ferulic acid (7), cafeic acid (8), p-coumaric acid (9) and apigenin-7- O-glucoside (10). The samples showed a high total phenolic content (185.5-139.7 mg CAE/g) and an interesting antibacterial profile against Gram positive and negative human pathogenic microorganisms. Furthermore, the bioactivity against a panel of Malassezia strains was estimated.
Two Nitrogen-containing Compounds from Pseudostellaria heterophylla
Authors: Liao Xiang-Ming , He Xun , Xu Guo-Bo , Wang Zhen , Li Jing , Guan Huan-Yu , Zhou Meng , Li Yong-Jun , Wang Yong-Lin , Gan Li-She , Liao Shang-Gao
Published: March 2019

Two new nitrogen-containing compounds, pseudosteheterins A (1) and B (2), were isolated from the glycosides-enriched cardioprotective fraction of the 70% EtOH extract of the roots of Pseudostellaria heterophylla. Their structures were elucidated by spectroscopic methods, and the absolute configuration of 1 was established by quantum chemical TDDFT calculation of the ECD spectrum of its model compound. Pseudosteheterin B showed significant protective effects in H9c2 myocardial cells against CoCl2-induced injury.
Phytochemical Composition and Antimicrobial Activity of Essential Oils of Wild Growing Cistus species in Croatia
Authors: Politeo Olivera , Maravić Ana , Burčul Franko , Carev Ivana , Kamenjarin Jure
Published: March 2019

Members of the Cistus genus have been traditionally used in folk medicine since ancient times as a remedy for various infections and diseases. In this paper essential oils of four wild growing Cistus species in Croatia were examined for their chemical composition and antimicrobial activity against both ATCC and multiple-resistant clinical strains of opportunistic pathogens associated with skin, nail, gastrointestinal, bloodstream and respiratory infections. The results showed that C. villosus and C. salviifolius essential oils have nonterpene compounds as dominant ones, particularly nonterpene acids and derivatives, while C. creticus and C. monspeliensis essential oils have labdane-type diterpene compounds as dominant ones. Tested Cistus oils have a broad spectrum of antimicrobial activities which are dose dependent. C. salviifolius and C. creticus oils were found to be the most potent ones, particularly against leading skin pathogens such as Staphylococcus aureus, Acinetobacter baumannii and Candida albicans. The data presented here presented evidence for biological and aromatical potential of the Cistus essential oils for their further use in traditional medicine.
Anti-invasive Activity of Lawsonia inermis Branch and Its Potential Target Protein
Authors: Nakashima Souichi , Oda Yoshimi , Kishimoto Mariko , Uno Miyako , Aoki Mako , Nakamura Seikou , Tanaka Hiroki , Matsuda Hisashi
Published: March 2019

The methanolic extract from the branch of Lawsonia inermis was found to inhibit the invasion of HT1080 cells strongly. The extract and its EtOAc- and 1-BuOH-soluble fractions strongly inhibited the enzyme activities and the secretions of MMPs from HT1080 cells. We, therefore, tried to examine and estimate the active constituents among the constituents isolated. However, there are no active compound among the isolated compounds. Next, we tried to identify the selective binding protein of whole constituents of their extracts. As a result, ribosomal protein S18 (RPs S18, human), 60S ribosomal protein L18 isoform 1 (60S RPs L18 i1, human) and eukaryotic elongation factor 2 (eEF2, human) were detected as their selective binding and potential target proteins. To confirm that the proteins are target proteins or not, we examined the effects of their proteins on synthesis of MMPs using siRNA method. With the treatment of siRNA for RPs S18, 60S RPs L18 i1 and eEF2 proteins, the MMP-2 protein synthesis were downregulated in HT1080 cells. MMP-9 productions were also downregulated with the treatment of siRNA for RPs S18 and eEF2. From the results, we reached a conclusion that the extract was considered to have the potential to inhibit the production of MMPs proteins via inhibition of RPs S18 and eEF2 proteins, leading to inhibit the invasion in HT1080 cells.
Primary Hip Arthroscopic Surgery With Labral Reconstruction: Is There a Difference Between an Autograft and Allograft?
Authors: Maldonado David R. , Lall Ajay C. , Laseter Joseph R. , Kyin Cynthia , Chen Jeffrey W. , Go Cammille C. , Domb Benjamin G.
Published: March 2019

Background:

Labral reconstruction has been described as a solution for the irreparable labrum. Initial techniques employed autografts, while more recent procedures have utilized allografts. No study, to our knowledge, has compared graft types.

Purpose:

To compare outcomes between patients who underwent primary labral reconstruction with a hamstring allograft versus hamstring autograft.

Hypothesis:

No significant differences in outcomes will be found between patients who underwent primary labral reconstruction with an allograft versus autograft.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data from September 2010 to March 2015 were reviewed. Inclusion criteria were primary hip arthroscopic surgery with labral reconstruction using either a hamstring allograft (ALLO group) or autograft (AUTO group), with minimum 2-year follow-up scores for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Exclusion criteria were previous ipsilateral hip surgery, previous hip conditions, preoperative Tönnis osteoarthritis grade >1, and workers’ compensation claims. Significance was set at P = .05.

Results:

Twenty-nine patients (29 hips) were included (85.3% follow-up). There were 17 patients (17 hips) in the ALLO group and 12 patients (12 hips) in the AUTO group. All patient-reported outcome scores demonstrated significant improvements at latest follow-up except for the mHHS for the AUTO group ( P = .064). Comparisons between the ALLO and AUTO groups at the preoperative and latest follow-up time points showed no significant differences (preoperative mean [range]: mHHS, 67.5 [33.0-100.0] and 65.8 [29.0-96.0], respectively [ P = .826]; NAHS, 65.6 [26.3-92.5] and 58.5 [35.0-79.0], respectively [ P = .322]; HOS-SSS, 43.7 [12.5-100.0] and 40.1 [19.0-78.0], respectively [ P = .707]) (latest follow-up mean [range]: mHHS, 86.4 [56.0-100.0] and 81.4 [57.0-100.0], respectively [ P = .46]; NAHS, 87.7 [60.0-100.0] and 82.4 [56.3-100.0], respectively [ P = .396]; HOS-SSS, 81.7 [0.0-100.0] and 70.9 [27.8-100.0], respectively [ P = .423]).

Conclusion:

Primary arthroscopic hip labral reconstruction yielded improvements in patient-reported outcome scores and high patient satisfaction. In this small series, no differences were found in clinical outcomes between hamstring allografts and autografts. Based on these results, hamstring allografts and autografts may be considered comparable graft choices for primary reconstruction. Because of the avoidance of donor site morbidity and the possible increase in patient satisfaction, allografts may be the preferred choice in a surgical setting when they are accessible.
Women’s Values and Preferences Regarding Osteoporosis Treatments: A Systematic Review
Authors: Barrionuevo Patricia , Gionfriddo Michael R , Castaneda-Guarderas Ana , Zeballos-Palacios Claudia , Bora Pavithra , Mohammed Khaled , Benkhadra Khalid , Sarigianni Maria , Murad Mohammad Hassan
Published: March 2019

Background

Several treatments are available to reduce the risk of fragility fractures associated with osteoporosis. The choice of treatment requires knowledge of patients’ values and preferences. The aim of the present study was to summarize what is known about the values and preferences relevant to the management of osteoporosis in women.

Methods

We conducted a comprehensive search of several databases for studies reported in any language that had included women who had already started or were about to start any pharmacological therapy for osteoporosis. Pairs of reviewers independently selected the studies and extracted the data. The results were synthesized narratively.

Results

We included 26 studies reporting on 15,348 women (mean age, 66 years). The women considered the effectiveness and adverse events equally, followed by the convenience of taking the drug and its effect on daily routine (less frequent dosing was preferred, the oral route was preferred, and the injectable route was preferred over oral if given less frequently). The treatment cost and duration were less important factors for decision making. Fear of breast cancer and fear of resuming uterine bleeding were common reasons for not choosing estrogen therapy. Calcium and vitamin D were viewed as safe and natural. Across the studies, the preferences were not affected by age, previous drug exposure, or employment status.

Conclusions

Women starting osteoporosis medications value effectiveness and side effects equally and prefer medications given less frequently. Injectable drugs appear acceptable if given less frequently. More research on patient values and preferences is needed to guide decision making in osteoporosis.
Lipid-Lowering Agents in Older Individuals: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Authors: Ponce Oscar J , Larrea-Mantilla Laura , Hemmingsen Bianca , Serrano Valentina , Rodriguez-Gutierrez Rene , Spencer-Bonilla Gabriela , Alvarez-Villalobos Neri , Benkhadra Khaled , Haddad Abdullah , Gionfriddo Michael R , Prokop Larry J , Brito Juan P , Murad Mohammad Hassan
Published: March 2019

Background

The efficacy of lipid-lowering agents on patient-important outcomes in older individuals is unclear.

Methods

We included randomized trials that enrolled individuals aged 65 years or older and that included at least 1 year of follow-up.

Pairs of reviewers selected and appraised the trials.

Results

We included 23 trials that enrolled 60,194 elderly patients. For primary prevention, statins reduced the risk of coronary artery disease [CAD; relative risk (RR): 0.79, 95% CI: 0.68 to 0.91] and myocardial infarction (MI; RR: 0.45, 95% CI: 0.31 to 0.66) but not all-cause or cardiovascular mortality or stroke. These effects were imprecise in patients with diabetes, but there was no significant interaction between diabetes status and the intervention effect. For secondary prevention, statins reduced all-cause mortality (RR: 0.80, 95% CI: 0.73 to 0.89), cardiovascular mortality (RR: 0.68, 95% CI: 0.58 to 0.79), CAD (RR: 0.68, 95% CI: 0.61 to 0.77), MI (RR: 0.68, 95% CI: 0.59 to 0.79), and revascularization (RR: 0.68, 95% CI: 0.61 to 0.77). Intensive (vs less-intensive) statin therapy reduced the risk of CAD and heart failure. Niacin did not reduce the risk of revascularization, and fibrates did not reduce the risk of stroke, cardiovascular mortality, or CAD.

Conclusion

High-certainty evidence supports statin use for secondary prevention in older individuals. Evidence for primary prevention is less certain. Data in older individuals with diabetes are limited; however, no empirical evidence has shown a significant difference based on diabetes status.
Procedural Challenges During Intubation in Patients With Oropharyngeal Masses: A Prospective Observational Study
Authors: Bryan Yvon F. , Morgan Amelia G. , Johnson Kathleen N. , Harris Hannah M. , May Joseph , Whelan Deborah M. , Tung Avery
Published: March 2019

BACKGROUND:

In patients who undergo surgery for oropharyngeal masses, intubation is almost always successful. However, technical aspects of airway management, including bag mask ventilation and oxygenation, may still be difficult. Although rates of airway difficulty and intubation success in these patients have been studied, these data may not reflect difficulty with individual components of the intubation process. We hypothesized that rates of complications with individual elements of the intubation process would not be reflected in the rate of eventual intubation success. To test our hypothesis, we observed the process of airway management and resulting complications with oxygenation and bag mask ventilation in patients with oropharyngeal masses undergoing otorhinolaryngology procedures under general anesthesia.

METHODS:

Forty-four patients with oropharyngeal masses scheduled for surgery were observed during the process of airway management. Observers recorded the number of airway devices used, the overall number of intubation attempts, the number and type of manual maneuvers required during bag mask ventilation, and the incidence of oxygen desaturation. The eventual intubation success rate was also recorded.

RESULTS:

All 44 patients (100%; 95% CI, 92%–100%) were successfully intubated. Thirty-six (81.8%) of 44 patients were intubated asleep and 8 (18.2%) of 44 were intubated awake using flexible fiberoptic bronchoscopy. Thirty-one (86.1%) of 36 patients who were intubated asleep received bag mask ventilation before intubation, while the other 5 patients underwent a rapid sequence induction. Twenty-seven (61.4%) of 44 patients (95% CI, 45%–75%) had ≥1 complication during airway management. Ten (23%) of 44 patients (95% CI, 11%–37%) required ≥3 attempts to intubate, 21 (68%) of 31 patients (95% CI, 49%–83%) had difficult mask ventilation, and 15 patients (34%; 95% CI, 20%–50%) experienced desaturation (oxygen saturation measured by pulse oximetry, <95%).

CONCLUSIONS:

We found that, although all patients were successfully intubated, clinicians frequently encountered complications with both intubation and mask ventilation. These complications required frequent use of additional manual maneuvers during mask ventilation and a high incidence of oxygen desaturation. The difficulty of airway management in patients with oropharyngeal masses may not be effectively assessed by success rate alone.
Considerations for Clock Drawing Scoring Systems in Perioperative Anesthesia Settings
Authors: Frei Bailey W. , Woodward Kristen T. , Zhang Mitchell Y. , Amini Shawna , Tighe Patrick , Garvan Cynthia W. , Giordano Chris , Price Catherine C.
Published: March 2019

The Clock Drawing Test is a cognitive screening tool gaining popularity in the perioperative setting. We compared 3 common scoring systems: (1) the Montreal Cognitive Assessment; (2) the Mini-Cog; and (3) the Libon scale. Three novice raters acquired interrater and intrarater reliability for each scoring system and then scored 738 preoperative clock drawings with each scoring system. Final scores correlated with each other but with notable discrepancies, indicating the need to attend to interrater and intrarater reliability when implementing any scoring approach in a clinical setting.
Association of Testosterone Replacement Therapy and the Incidence of a Composite of Postoperative In-Hospital Mortality and Cardiovascular Events in Men Undergoing Cardiac Surgery
Authors: Argalious Maged Y. , Steib John , Daskalakis Nikolas , Mao Guangmei , Li Minwei , Armanyous Sherif , Roselli Eric
Published: March 2019

BACKGROUND:

Data on testosterone replacement therapy and cardiovascular outcomes are conflicting, with the Food and Drug Administration requiring prescription testosterone preparations to indicate a possible increased cardiovascular risk. Whether patients on testosterone replacement therapy undergoing cardiac surgery have an increased risk of postoperative in-hospital mortality and cardiovascular events remains unknown. We therefore sought to identify the impact of testosterone replacement on the incidence of a composite of postoperative in-hospital mortality and cardiovascular events in men undergoing cardiac surgery.

METHODS:

After institutional review board approval, data from male American Society of Anesthesiologists III/IV patients ≥40 years of age who underwent cardiac surgery between May 2005 and March 2017 at the Cleveland Clinic (Cleveland, OH) main campus were included. The primary exposure was preoperative testosterone use. The primary outcome was a collapsed composite of postoperative in-hospital mortality and cardiovascular events, including myocardial infarction, stroke, and pulmonary embolism. The secondary outcome was a collapsed composite of minor cardiovascular events, including postoperative rhythm disturbance requiring permanent device, atrial fibrillation, and deep venous thrombosis. We compared patients who received testosterone and those who did not, using propensity score matching within surgical procedure matches. Moreover, as a sensitivity analysis, we used a multivariable logistic regression model to assess the association between testosterone replacement therapy and major or minor cardiovascular events adjusted for potential baseline and intraoperative confounders by including all eligible patients.

RESULTS:

Among 20,604 patients who met inclusion and exclusion criteria, 301 patients who used testosterone routinely within 1 month before the surgery were matched to 1505 of 20,303 patients who did not use testosterone. Among the matched cohort, 8 (2.7%) patients in the testosterone group and 45 (3.0%) in the nontestosterone group had ≥1 major cardiovascular adverse event after surgery. The adjusted odds ratio was 0.89 (95% CI, 0.41–1.90; P = .756), comparing testosterone to nontestosterone patients. As for the secondary outcomes, 89 (30%) patients in the testosterone group and 525 (35%) patients in the nontestosterone group had ≥1 minor cardiovascular event. The odds of minor events were not significantly different, with an odds ratio of 0.78 (95% CI, 0.60–1.02; P = .074) comparing testosterone to nontestosterone patients.

CONCLUSIONS:

Preoperative testosterone is not associated with a statistically significant increased incidence of a composite of postoperative in-hospital mortality and cardiovascular events after cardiac surgery.
Preferred walking speed on rough terrain; is it all about energetics?
Authors: Gast Koren , Kram Rodger , Riemer Raziel
Published: March 2019

Humans have evolved the ability to walk very efficiently. Further, humans prefer to walk at speeds that approximately minimize their metabolic energy expenditure per unit distance (i.e. gross cost of transport, COT). This has been found in a variety of population groups and other species. However, these studies were mostly performed on smooth, level ground or on treadmills. We hypothesized that the objective function for walking is more complex than only minimizing the COT. To test this idea, we compared the preferred speeds and the relationships between COT and speed for people walking on both a smooth, level floor and a rough, natural terrain trail. Rough terrain presumably introduces other factors, such as stability, to the objective function. 10 healthy men walked on both a straight, flat, smooth floor and on an outdoor trail strewn with rocks and boulders. In both locations, subjects performed 5-7 trials at different speeds relative to their preferred speed. The COT-speed relationships were similarly U-shaped for both surfaces, but the COT values on rough terrain were approximately 115% greater. On the smooth surface, the preferred speed (1.24+/−0.17 m/sec) was found to be statistically not different (p-value =0.09) than the speed that minimized COT (1.34 +/− 0.03 m/sec). On rough terrain, the preferred speed (1.07+/−0.05 m/sec) was slower than the COT minimum speed (1.13 +/− 0.07 m/sec) and was statistical significant (p-value=0.02). Since near the optimum speed the COT function is very shallow, these changes in speed result in small change in COT (0.5%). It appears that the objective function for speed preference when walking on rough terrain includes COT and additional factors such as stability.
Natural polymorphism in protein kinase G modulates functional senescence in D. melanogaster
Authors: Kelly Stephanie P. , Dawson-Scully Ken
Published: March 2019

The common fruit fly, Drosophila melanogaster, is a well-characterized model for neurological disorders and is widely used to investigate the biology of aging, stress tolerance, and pleiotropy. The foraging (for) gene encodes a cGMP-dependent protein kinase (PKG), which has been implicated in several behavioral phenotypes including feeding, sleep, learning and memory, and environmental stress tolerance. We used the well-established Drosophila Activity Monitor (DAM) to investigate the effects of the conserved NO/cGMP/PKG signaling pathway on functional senescence. Our results show that the polymorphic for gene confers protection during low oxygen stress at the expense of longevity and a decline in locomotor activity with age in D. melanogaster which suggests a novel role for the PKG pathway in healthy aging and senescence.
One-ecosystem analysis for environmental conservation and sustainable livelihood
Authors: Yap Helen T.
Published: March 2019

In order to achieve the objectives of resource conservation, it is important to recognize that habitats are connected by material and energy flows, and that humans often play a central role, directly or indirectly. Hence, ecological research should be designed that treats all interlinked habitats, including human populations, as one ecosystem. Examples would be coastal habitats that are impacted by effluent from the upland, which in turn can be generated by deforestation and harmful agricultural practices. All of these aspects, including the river systems that deliver run-off, should be included in the investigation. This approach entails a carefully articulated hypothesis or set of hypotheses drawing on the natural as well as social sciences, and an appropriate sampling and statistical design. It clearly imposes high demands on resources, financial and otherwise. But the continued compartmentalization of efforts along disciplines and specializations will likely slow down progress in environmental conservation.
Radtools: R utilities for convenient extraction of medical image metadata
Authors: Russell Pamela H. , Ghosh Debashis
Published: March 2019

The radiology community has adopted several widely used standards for medical image files, including the popular DICOM (Digital Imaging and Communication in Medicine) and NIfTI (Neuroimaging Informatics Technology Initiative) standards. These file formats include image intensities as well as potentially extensive metadata. The NIfTI standard specifies a particular set of header fields describing the image and minimal information about the scan. DICOM headers can include any of >4,000 available metadata attributes spanning a variety of topics. NIfTI files contain all slices for an image series, while DICOM files capture single slices and image series are typically organized into a directory. Each DICOM file contains metadata for the image series as well as the individual image slice.

The programming environment R is popular for data analysis due to its free and open code, active ecosystem of tools and users, and excellent system of contributed packages. Currently, many published radiological image analyses are performed with proprietary software or custom unpublished scripts. However, R is increasing in popularity in this area due to several packages for processing and analysis of image files. While these R packages handle image import and processing, no existing package makes image metadata conveniently accessible. Extracting image metadata, combining across slices, and converting to useful formats can be prohibitively cumbersome, especially for DICOM files.

We present radtools, an R package for convenient extraction of medical image metadata. Radtools provides simple functions to explore and return metadata in familiar R data structures. For convenience, radtools also includes wrappers of existing tools for extraction of pixel data and viewing of image slices. The package is freely available under the MIT license at GitHub and is easily installable from the Comprehensive R Archive Network.
Case Report: Unprovoked venous thromboembolism in a young adult male
Authors: Dhabhar Jeyhan , Mehta Varshil , Desai Nimit , Dawoodi Sameer , Zaman Sojib Bin
Published: March 2019

A 24-year-old male was presented to us with sudden onset of chest pain and dyspnea for the past one hour. There was no history of calf pain, trauma, surgery, prolonged immobilization, long-haul air travel, bleeding diathesis or any other co-morbidity. The patient denied any addiction history. The heart rate was 114 beats/min, and blood pressure was 106/90 mmHg. Electrocardiogram showed tachycardia with S 1Q 3T 3 pattern. The left arterio-venous Doppler study was suggestive of a thrombus in popliteal vein and sapheno-popliteal junction. The CT-Pulmonary Angiogram scan was suggestive of a massive pulmonary thromboembolism. The patient was thrombolysed with Intravenous Alteplase immediately and was put on tab Rivaroxaban for maintenance. He was later discharged after being stable.

Unprovoked venous thromboembolism (VTE) is very rare and has the potential to lead to pulmonary embolism which could be disastrous, especially in young adults. We present such a case where unprovoked VTE was diagnosed and treated. This case suggests that high clinical suspicion is the key for the diagnosis of acute pulmonary embolism, especially in the absence of history suggestive of deep vein thrombosis.
Solid state fluorescence of proteins in high throughput mode and its applications
Authors: Gautam Saurabh , Gupta Munishwar N
Published: March 2019

Direct comparison between fluorescence spectra of a sample in solution and solid state form is valuable to monitor the changes in protein structure when it is “dried” or immobilized on a solid surface (for biocatalysis or sensor applications). We describe here a simple method for recording fluorescence emission spectra of protein powders without using any dedicated accessory for solid samples in a high-throughput format. The 96-well plate used in our studies, was coated black from all the sides and the excitation and emission paths are identical and are from the top of the well. These two features minimize scatter and provide fairly noise free spectra. Even then the fluorescence intensity may be dependent upon many factors such as the extent of protein aggregation, morphology and sizes of the protein particles. Hence, (changes in) λmax emission may be a more reliable metric in the case of fluorescence spectra of proteins in the solid state. However, any large changes in the intensity could indicate changes in the microenvironment of the fluorophore. The fluorescence emission spectra were blue-shifted (4 to 9 nm), showed an increase in the intensity for different proteins studied upon lyophilization, and were similar to what has been reported by others using available commercial accessories for solid state samples. After validating that our method worked just as well as the dedicated accessories, we applied the method to compare the fluorescence emission spectra of α-chymotrypsin in solution, precipitated form, and the lyophilized powder form. We further examined the fluorescence emission spectra of green fluorescent protein (GFP) in solution and solid form. We also analyzed fluorescence resonance energy transfer (FRET) between tryptophan (Trp57) and the cyclic chromophore of GFP. These findings pointed towards the change in the microenvironment around the cyclic chromophore in GFP upon lyophilization.
Mobile Targeting Using Customer Trajectory Patterns
Authors: Ghose Anindya , Li Beibei , Liu Siyuan
Published: March 2019

Rapid improvements in the precision of mobile technologies now make it possible for advertisers to go beyond real-time static location and contextual information on consumers. In this paper we propose a novel “trajectory-based” targeting strategy for mobile recommendation that leverages detailed information on consumers’ physical-movement trajectories using fine-grained behavioral information from different mobility dimensions. To analyze the effectiveness of this new strategy, we designed a large-scale randomized field experiment in a large shopping mall that involved 83,370 unique user responses for a 14-day period in June 2014. We found that trajectory-based mobile targeting can, as compared with other baselines, lead to higher redemption probability, faster redemption behavior, and higher transaction amounts. It can also facilitate higher revenues for the focal store as well as the overall shopping mall. Moreover, the effect of trajectory-based targeting comes not only from improvements in the efficiency of customers’ current shopping processes but also from its ability to nudge customers toward changing their future shopping patterns and, thereby, generate additional revenues. Finally, we found significant heterogeneity in the impact of trajectory-based targeting. It is especially effective in influencing high-income consumers. Interestingly, however, it becomes less effective in boosting the revenues of the shopping mall during the weekends and for those shoppers who like to explore across products categories. Our overall findings suggest that highly targeted mobile promotions can have the inadvertent impact of reducing impulse-purchasing behavior by customers who are in an exploratory shopping stage. On a broader note, our work can be viewed as a first step toward the study of large-scale, fine-grained digital traces of individual physical behavior and how they can be used to predict—and market according to—individuals’ anticipated future behavior.

This paper was accepted by Anandhi Bharadwaj, information systems.
The importance of obtaining a sputum sample and how it can aid diagnosis and treatment
Authors: Blakeborough Leanne , Watson Jane S
Published: March 2019

Respiratory disease has a major impact on the NHS and continues to be a growing problem as each year passes. However, through improving diagnosis and management of respiratory disease the problem could be lessened. Taking a sputum sample is common practice within respiratory medicine especially for patients with chronic obstructive pulmonary disease (COPD) and helps to diagnose, confirm infection and offer correct treatment. It is important that the multidisciplinary team are aware of how to appropriately obtain sputum samples and when to request them. It is important as a respiratory health professional to understand the patient's usual sputum history including colour, amount and viscosity. Antibiotic stewardship aims to reduce antibiotic resistance through offering the most appropriate antibiotics for those with a bacterial infection and to discourage antibiotic prescribing for those that have not. This should result in better patient outcomes and lower healthcare costs.
Electronic records, confidentiality and data security: the nurse's responsibility
Authors: Griffith Richard
Published: March 2019

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the need for data security and a nurse's duty of confidentiality in relation to electronic records
A clinical view on health and safety
Authors: Foster Sam
Published: March 2019

Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on the need for risk assessment as an integral part of providing safe, quality care
The oral surgery specialist list: what will happen as the ‘grandfathers’ disappear?
Authors: Fullarton Marnie , Jadun Sarah , Begley Anne , Magennis Patrick
Published: March 2019

This article reviews the current makeup of the specialist list and considers how it might change with time.
Current Status of Endoscopic Resection of Gastric Subepithelial Tumors
Authors: Chen Huimin , Li Baiwen , Li Lianyong , Vachaparambil Cicily T. , Lamm Vladimir , Chu Yuan , Xu Meidong , Cai Qiang
Published: March 2019

Most gastrointestinal (GI) subepithelial tumors (SETs) are identified incidentally during endoscopic examination and are located in the stomach. Some SETs are malignant or have the potential to become malignant. Tumors originating from deeper layers, such as the muscularis propria or serosa, are not easy to diagnose and resect. Current guidelines recommend yearly endoscopic surveillance of SETs smaller than 2 cm. This recommendation may not be cost-effective in managing GI SETs. Endoscopic resection results not only in obtaining sufficient tissue for pathological diagnosis but also in resection and curing the tumor. Many different endoscopic methods for resection of GI SETs have been published in the literature. To avoid confusion, we have divided these methods into standard endoscopic submucosal dissection, modified endoscopic submucosal dissection, submucosal tunneling endoscopic resection, and nonexposed and exposed endoscopic full-thickness resection. These procedures offer less invasive approaches than surgery for resection of GI SETs and may be the most cost-effective in taking care of patients with GI SETs.
Análise da variação espacial físico-química de materiais superficiais da bacia hidrográfica do córrego do Glória-Uberlândia-MG
Authors: Dos Santos Fabiana Cristina , Rodrigues Silvio Carlos
Published: March 2019

A distribuição dos materiais superficiais nas vertentes em ambiente de Cerrado dispõe de particularidades intrínsecas, que estão relacionadas com o posicionamento topográfico, formato das vertentes e com escoamento superficial da água. Todos estes aspectos estão associados com a sazonalidade climática, típica deste ambiente. Dessa forma, este trabalho objetiva investigar, os atributos físicos e químicos dos materiais superficiais, concernentes com as características geomorfológicas, influenciadas por sua variabilidade espacial, a qual exerce papel preponderante na qualidade destes ecossistemas. A área de estudo trata-se de uma bacia hidrográfica localizada no município de Uberlândia, na região sudeste do Triângulo Mineiro. A metodologia baseou-se na análise das propriedades físicas, químicas e mapeamento da distribuição espacial dos mesmos através de técnicas de Krigagem. Foram analisados: textura; densidade aparente; porosidade total; matéria orgânica; CTC, V, H+Al, pH, K+, hipsometria e uso e cobertura da terra, além de três mapas contendo as porcentagens de argila, silte e areia para a elaboração do mapa exploratório do terreno para toda bacia hidrográfica. Cerca de 80% da bacia está ocupada por agropecuária e ação antrópica. A análise prognóstica correlacionou os atributos físico-químico de forma subjetiva, por se tratar de um estudo embasado em probabilidades, considerando o conhecimento disponível sobre cada atributo na literatura especializada. A análise dos materiais superficiais, somada aos atributos mapeados oferece informações importantes, dotada de grande valor geográfico, seja no âmbito da geomorfologia, seja no que se refere aos estudos do meio físico integrados aos setores de planejamento e gestão ambiental.
What is the origin of the black film in the sculpture "Death of Cleopatra"?
Authors: Azevedo Pedro , Macedo Maria Filomena , Dionísio Amélia
Published: March 2019

This work arises from the need to identify the origin of a black film which is currently covering a large area of the sculpture Death of Cleopatra, promoting its disfiguration. This piece, sculpted in Carrara marble, belongs to Tropical Botanic Garden, in Lisbon. In situ works involved colorimetric measurements, adhesion tests and mapping of decay patterns. Samples of the black film were taken from the sculpture and also from black areas present in botanic species surrounding the sculpture, which were observed macro and microscopically. Individual samples of the black film were analysed by Fourier-transform infrared spectroscopy. The results obtained show the collected samples possess saccharides such as sucrose, found in honeydew exemplars. Therefore, it is proposed that black film formation is due to sooty mould. This black film is responsible for aesthetic damage, as well as stone corrosion processes, which was observed by scanning electron microscopy.
Kieślowski, the mysteries of screens and God
Authors: Lis Marek
Published: March 2019

The computer seems like a privileged personage in Decalogue 1 (Dekalog, jeden, 1987/88, prem. 1989, dir. K. Kieślowski): it is used by Paweł and his father to solve mathematical questions about Miss Piggy, to calculate the durability of the ice on the pond, to know what Mum is doing, and to control domestic devices. For Kieślowski the computer is not just a gadget: Krzysztof ’s lecture describes its potential and its possible autonomy. Independent from man (the computer switches itself on), it becomes his rival: Kieślowski proposes a critical interpretation of the computer as a new idol, promising unlimited memory and knowledge. A similar preoccupation can be found in the Black Mirror series, where new technologies, existing or as yet still fantastic, are becoming more and more intrusive in the lives of their human protagonists. The computer seems also to be a rival of God, present in symbols in Decalogue 1: a sign of him is not only the metaphysical man played by Artur Barciś, but also the biblical symbol of fire and the Madonna’s tears.
Kieślowski Re-read: On Reality, Realism and Cinema
Authors: Parmeggiani Francesca
Published: March 2019

By referencing Italian auteurs Ermanno Olmi and Federico Fellini, this paper offers a re-reading of Krzysztof Kieślowski’s reflections on cinema that places the practice of describing reality and uttering “a statement of fact” about people’s lives and the world as a long-lasting, structuring foundation of his episteme and workshop.
Krzysztof Kieślowski and Ingmar Bergman – once again about a certain artistic relationship
Authors: Dąbrowski Radosław
Published: March 2019

Krzysztof Kieślowski and Ingmar Bergman belonged to different generations of film authors, but there was a certain artistic kinship between them. They were both interested in issues related to human existence, but their films also seem similar in terms of their aesthetic dimensions, in particular, their cinematographic style. Both directors also created films deriving from their private experience, often creating characters on screen who seem to be in some respect their alter egos. This articles deals with various similarities between the cinema of Kieślowski and Bergman.
Krzysztof Kieślowski’s “Camera Buff”: a revised version of “First Love”
Authors: Lubelski Tadeusz
Published: March 2019

The article develops its title thesis, which proposes interpreting Kieślowski’s Camera Buff (Amator, 1979), his second full-length feature film, as a revised version of his documentary First Love, made five years earlier. Both films have similar starting points ‒ the story of a couple expecting the birth of their first child. But the conclusion in each case also has something in common and results in the abandoning of a film project. The latter similarity meant that Kieślowski changed the character of the main protagonist in his full-length movie. It is no longer a documentary hero but the film auteur himself. This was probably the essence of the director’s artistic discovery made while shooting Camera Buff. It meant the abandonment of the documentary character when the prolonged relationship with him (and her) proved to be ethically dubious and his (and her) development predictable. At the same time, Kieślowski expressed his own creative experience as the film’s author creating a fictitious character in Camera Buff, inspired by various figures of real ‘prototypes’.