bluuebunny/crossref_metadata_2025 huggingface dataset:
High-fat diet promotes experimental colitis by inducing oxidative stress in the colon
Authors: Li Xue , Wei Xinzhi , Sun Yue , Du Jie , Li Xin , Xun Zhe , Li Yan Chun
Published: August 2019

Diets high in animal fats are associated with increased risks of inflammatory bowel disease, but the mechanism remains unclear. In this study, we investigated the effect of high-fat diet (HFD) on the development of experimental colitis in mice. Relative to mice fed low-fat diet (LFD), HFD feeding for 4 wk increased the levels of triglyceride, cholesterol, and free fatty acids in the plasma as well as within the colonic mucosa. In an experimental colitis model induced by 2,4,6-trinitrobenzenesulfonic acid (TNBS), mice on 4-wk HFD exhibited more severe colonic inflammation and developed more severe colitis compared with the LFD counterparts. HFD feeding resulted in higher production of mucosal pro-inflammatory cytokines, greater activation of the myosin light chain kinase (MLCK) tight junction regulatory pathway, and greater increases in mucosal barrier permeability in mice following TNBS induction. HFD feeding also induced gp91, an NADPH oxidase subunit, and promoted reactive oxygen species (ROS) production in both colonic epithelial cells and lamina propria cells. In HCT116 cell culture, palmitic acid or palmitic acid and TNF-α combination markedly increased ROS production and induced the MLCK pathway, and these effects were markedly diminished in the presence of a ROS scavenger. Taken together, these data suggest that HFD promotes colitis by aggravating mucosal oxidative stress, which rapidly drives mucosal inflammation and increases intestinal mucosal barrier permeability.

NEW & NOTEWORTHY This study demonstrates high-fat diet feeding promotes colitis in a 2,4,6-trinitrobenzenesulfonic acid-induced experimental colitis model in mice. The underlying mechanism is that high-fat diet induces oxidative stress in the colonic mucosa, which increases colonic epithelial barrier permeability and drives colonic mucosal inflammation. These observations provide molecular evidence that diets high in saturated fats are detrimental to patients with inflammatory bowel diseases.
Sacral nerve stimulation with appropriate parameters improves constipation in rats by enhancing colon motility mediated via the autonomic-cholinergic mechanisms
Authors: Huang Zhihui , Li Shiying , Foreman Robert D. , Yin Jieyun , Dai Ning , Chen Jiande D. Z.
Published: August 2019

Although sacral nerve stimulation (SNS) has been applied for treating constipation, its parameters were adopted from SNS for fecal incontinence, its effects are limited, and mechanisms are largely unknown. We investigated the effects and mechanism of SNS with appropriate parameters on constipation in rats treated with loperamide. First, using rectal compliance as an outcome measure, an experiment was performed to derive effective SNS parameters. Then, a 7-day SNS was performed in rats with constipation induced by loperamide. Autonomic functions were assessed by spectral analysis of heart rate variability (HRV) derived from an electrocardiogram. Serum levels of pancreatic polypeptide (PP), norepinephrine (NE), and acetylcholine (ACh) in colon were assessed. 1) Acute SNS at 5 Hz, 100 µs was found effective in enhancing rectal compliance and accelerating distal colon transit ( P < 0.05 vs. sham SNS). 2) The 7-day SNS normalized loperamide-induced constipation, assessed by the number, weight, and water content of fecal pellets, and accelerated the distal colon transit (29.4 ± 3.7 min with sham SNS vs. 16.4 ± 5.3 min with SNS but not gastric emptying or intestinal transit. 3) SNS significantly increased vagal activity ( P = 0.035) and decreased sympathetic activity ( P = 0.012), assessed by spectral analysis of HRV as well as by the serum PP. 4) SNS increased ACh in the colon tissue; atropine blocked the accelerative effect of SNS on distal colon transit. We concluded that SNS with appropriate parameters improves constipation induced by loperamide by accelerating distal colon motility, mediated via the autonomic-cholinergic function.

NEW & NOTEWORTHY Although sacral nerve stimulation (SNS) has been applied for treating constipation, its parameters were adopted from SNS for fecal incontinence, effects are limited, and mechanisms are largely unknown. This paper shows that SNS with appropriate parameters improves constipation induced by loperamide by accelerating distal colon motility mediated via the autonomic-cholinergic function.
Impact of leptin deficiency compared with neuronal-specific leptin receptor deletion on cardiometabolic regulation
Authors: do Carmo Jussara M. , da Silva Alexandre A. , Gava Fabio N. , Moak Sydney P. , Dai Xuemei , Hall John E.
Published: August 2019

The main goal of this study was to compare the impact of total body leptin deficiency with neuronal-specific leptin receptor (LR) deletion on metabolic and cardiovascular regulation. Liver fat, diacylglycerol acyltransferase-2 (DGTA2), and CD36 protein content were measured in wild-type (WT), nervous system LR-deficient (LR/Nestin-Cre), and leptin deficient ( ob/ob) mice. Blood pressure (BP) and heart rate (HR) were recorded by telemetry, and motor activity (MA) and oxygen consumption (V̇o2) were monitored at 24 wk of age. Female and male LR/Nestin-Cre and ob/ob mice were heavier than WT mice (62 ± 5 and 61 ± 3 vs. 31 ± 1 g) and hyperphagic (6.2 ± 0.5 and 6.1 ± 0.7 vs. 3.5 ± 1.0 g/day), with reduced V̇o2 (27 ± 1 and 33 ± 1 vs 49 ± 3 ml·kg−1·min−1) and decreased MA (3 ± 1 and 7 ± 2 vs 676 ± 105 cm/h). They were also hyperinsulinemic and hyperglycemic compared with WT mice. LR/Nestin-Cre mice had high levels of plasma leptin, while ob/ob mice had undetectable leptin levels. Despite comparable obesity, LR/Nestin-Cre mice had lower liver fat content, DGTA2, and CD36 protein levels than ob/ob mice. Male WT, LR/Nestin-Cre, and ob/ob mice exhibited similar BP (111 ± 3, 110 ± 1 and 109 ± 2 mmHg). Female LR/Nestin-Cre and ob/ob mice, however, had higher BP than WT females despite similar metabolic phenotypes compared with male LR/Nestin-Cre and ob/ob mice. These results indicate that although nervous system LRs play a crucial role in regulating body weight and glucose homeostasis, peripheral LRs regulate liver fat deposition. In addition, our results suggest potential sex differences in the impact of obesity on BP regulation.
Obesity causes renal mitochondrial dysfunction and energy imbalance and accelerates chronic kidney disease in mice
Authors: Andres-Hernando Ana , Lanaspa Miguel A. , Kuwabara Masanari , Orlicky David J. , Cicerchi Christina , Bales Elise , Garcia Gabriela E. , Roncal-Jimenez Carlos A. , Sato Yuka , Johnson Richard J.
Published: August 2019

Obesity and metabolic syndrome are well-known risk factors for chronic kidney disease (CKD); however, less is known about the mechanism(s) by which metabolic syndrome might accelerate kidney disease. We hypothesized that metabolic syndrome should accelerate the development of kidney disease and that it might be associated with alterations in energy metabolism. We studied the pound mouse (which develops early metabolic syndrome due to a leptin receptor deletion) and wild-type littermates and compared the level of renal injury and muscle wasting after equivalent injury with oral adenine. Renal function, histology, and biochemical analyses were performed. The presence of metabolic syndrome was associated with earlier development of renal disease (12 mo) and earlier mortality in pound mice compared with controls. After administration of adenine, kidney disease was worse in pound mice, and this was associated with greater tubular injury with a decrease in kidney mitochondria, lower tissue ATP levels, and worse oxidative stress. Pound mice with similar levels of renal function as adenine-treated wild-type mice also showed worse sarcopenia, with lower tissue ATP and intracellular phosphate levels. In summary, our data demonstrate that obesity and metabolic syndrome accelerate the progression of CKD and worsen CKD-dependent sarcopenia. Both conditions are associated with renal alterations in energy metabolism and lower tissue ATP levels secondary to mitochondrial dysfunction and reduced mitochondrial number.
Prognostic Value of Combined Analysis of CTLA-4 and PLR in Esophageal Squamous Cell Carcinoma (ESCC) Patients
Authors: Zhang Cui-Ying , Zhang Juan , Ma Yun-Fan , Zhe Hong , Zhao Ren , Wang Yan-Yang
Published: August 2019

Objective. The purpose of this study was to evaluate the prognostic role of the cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) expression level and the platelet lymphocyte ratio (PLR) level in esophageal squamous cell carcinoma (ESCC) patients. Methods. 84 ESCC patients who received surgical treatment in our hospital were enrolled in the study. The correlation of each biomarker’s level with ESCC patients’ clinicopathological characteristics and overall survival (OS) was assessed. Results. The elevated expression rate of T-CTLA-4 (tumor cell CTLA-4) and I-CTLA-4 (interstitial lymphocyte CTLA-4) was 48.8% and 44.0%, respectively. The number of enrolled patients with a higher PLR level (≥119) was 48. The prognostic value of T-CTLA-4, I-CTLA-4, and PLR in ESCC patients was not detected. However, patients with both a low T-CTLA-4 expression level and a low PLR level that had longer OS (p=0.023) were found. The prognostic role of T-CTLA-4(-) +PLR (-) status in ESCC patients was also confirmed in multivariate analyses (p=0.027). Conclusion. These results demonstrated the potential prognostic value of combined analysis of CTLA-4 and PLR in ESCC patients.
Dovitinib Triggers Apoptosis and Autophagic Cell Death by Targeting SHP-1/p-STAT3 Signaling in Human Breast Cancers
Authors: Chiu Yi-Han , Lee Yi-Yen , Huang Kuo-Chin , Liu Cheng-Chi , Lin Chen-Si
Published: August 2019

Breast cancer is the most common cancer and the leading cause of cancer deaths in women worldwide. The rising incidence rate and female mortality make it a significant public health concern in recent years. Dovitinib is a novel multitarget receptor tyrosine kinase inhibitor, which has been enrolled in several clinical trials in different cancers. However, its antitumor efficacy has not been well determined in breast cancers. Our results demonstrated that dovitinib showed significant antitumor activity in human breast cancer cell lines with dose- and time-dependent manners. Downregulation of phosphor-(p)-STAT3 and its subsequent effectors Mcl-1 and cyclin D1 was responsible for this drug effect. Ectopic expression of STAT3 rescued the breast cancer cells from cell apoptosis induced by dovitinib. Moreover, SHP-1 inhibitor reversed the downregulation of p-STAT3 induced by dovitinib, indicating that SHP-1 mediated the STAT3 inhibition effect of dovitinib. In addition to apoptosis, we found for the first time that dovitinib also activated autophagy to promote cell death in breast cancer cells. In conclusion, dovitinib induced both apoptosis and autophagy to block the growth of breast cancer cells by regulating the SHP-1-dependent STAT3 inhibition.
Decreased Expression of Urinary Mammalian Target of Rapamycin mRNA Is Related to Chronic Renal Fibrosis in IgAN
Authors: Cao Yuhan , Wang Yuwei , Liu Yinhua , Zhu Xinjian , Zhang Guifa , Wang Sufen , Chen Xiaomei , Liu Daoqin , Fu Cong
Published: August 2019

Background. Renal fibrosis is a common outcome of all pathological types of chronic kidney disease (CKD). However, the noninvasive detection of renal fibrosis remains a challenge. Methods. We collected urine samples from 154 biopsy-proven IgA nephropathy (IgAN) patients and 61 healthy controls. The expression of mTOR was measured and the correlation with renal function parameter and pathological indicators. The receiver operating characteristic (ROC) curve for the diagnosis of IgAN and renal fibrosis was calculated. Results. The urinary mammalian target of rapamycin (mTOR) expression was decreased in IgAN patients. The expression of mTOR was correlated with serum creatinine, blood urea nitrogen, estimated glomerular filtration rate, 24 h proteinuria, and cystatin C. Further, the urinary mTOR expression was significantly decreased in severe renal fibrosis patients compared with mild or moderate renal fibrosis patients. Urinary mTOR expression was correlated with score of tubulointerstitial fibrosis (TIF) and score of glomerular sclerosis. The ROC curve showed that mTOR can diagnose IgAN at a cut-off value of 0.930 with the sensitivity of 90.2% and specificity of 73.8% and renal fibrosis at a cut-off value of 0.301 with the sensitivity of 71.7% and specificity of 64.8%. Conclusion. Urinary mTOR mRNA expression was a potential biomarker for diagnosis of IgAN and renal fibrosis in IgAN patients.
Propulsion and Thermodynamic Parameters of van der Waals Gases in Rocket Nozzles
Authors: Costa Fernando S. , Fischer Gustavo A. A.
Published: August 2019

Propellants or combustion products can reach high pressures and temperatures in advanced or conventional propulsion systems. Variations in flow properties and the effects of real gases along a nozzle can become significant and influence the calculation of propulsion and thermodynamic parameters used in performance analysis and design of rockets. This work derives new analytical solutions for propulsion parameters, considering gases obeying the van der Waals equation of state with specific heats varying with pressure and temperature. Steady isentropic one-dimensional flows through a nozzle are assumed for the determination of specific impulse, characteristic velocity, thrust coefficient, critical flow constant, and exit and throat flow properties of He, H2, N2, H2O, and CO2 gases. Errors of ideal gas solutions for calorically perfect and thermally perfect gases are determined with respect to van der Waals gases, for chamber temperatures varying from 1000 to 4000 K and chamber pressures from 5 to 35 MPa. The effects of covolumes and intermolecular attraction forces on flow and propulsion parameters are analyzed.
sFlt-1/PlGF Ratio as a Predictive Marker in Women with Suspected Preeclampsia: An Economic Evaluation from a Swiss Perspective
Authors: Hodel Markus , Blank Patricia R. , Marty Petra , Lapaire Olav
Published: August 2019

In Switzerland, 2.3% of pregnant women develop preeclampsia. Quantification of the soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) ratio has shown a diagnostic value in the second and third trimesters of pregnancy, in particular in ruling out preeclampsia within one week. We estimated the economic impact of implementing sFlt-1/PlGF ratio evaluation, in addition to the standard of care (SOC), for women with suspected preeclampsia from a Swiss healthcare system’s perspective. A decision tree model was developed to estimate direct medical costs of diagnosis and management of a simulated cohort of Swiss pregnant women with suspected preeclampsia (median week of gestation: 32) until delivery. The model compared SOC vs. SOC plus sFlt-1/PlGF ratio, using clinical inputs from a large multicenter study (PROGNOSIS). Resource use data and unit costs were obtained from hospital records and public sources. The assumed cost for sFlt-1/PlGF evaluation was €141. Input parameters were validated by clinical experts in Switzerland. The model utilized a simulated cohort of 6084 pregnant women with suspected preeclampsia (representing 7% of all births in Switzerland in 2015, n=86,919). In a SOC scenario, 36% of women were hospitalized, of whom 27% developed preeclampsia and remained hospitalized until birth. In a sFlt-1/PlGF test scenario, 76% of women had a sFlt-1/PlGF ratio of ≤38 (2% hospitalized), 11% had a sFlt-1/PlGF ratio of >38-<85 (55% hospitalized), and 13% had a sFlt-1/PlGF ratio of ≥85 (65% hospitalized). Total average costs/pregnant woman (including birth) were €10,925 vs. €10,579 (sFlt-1/PlGF), and total costs were €66,469,362 vs. €64,363,060 (sFlt-1/PlGF). Implementation of sFlt-1/PlGF evaluation would potentially achieve annual savings of €2,105,064 (€346/patient), mainly due to reduction in unnecessary hospitalization. sFlt-1/PlGF evaluation appears economically promising in predicting short-term absence of preeclampsia in Swiss practice. Improved diagnostic accuracy and reduction in unnecessary hospitalization could lead to significant cost savings in the Swiss healthcare system.
Missed Registration of Disease Codes for Pediatric Anaphylaxis at the Emergency Department
Authors: Choi Byungho , Kim Sun Hyu , Lee Hyeji
Published: August 2019

Background. It is important to register anaphylaxis codes correctly to study the exact prevalence of anaphylaxis. The purpose of this study was to analyze the clinical characteristics and disease codes of inaccurately registered groups in pediatric anaphylaxis patients. Methods. This study reviewed the medical records of all pediatric patients who presented to the university hospital emergency department over a 5-year period. Study subjects were divided into 2 groups: the accurate group, including those registered under anaphylaxis codes, and the inaccurate coding group, including those registered under other codes. Results. From a total of 79,676 pediatric patients, 184 (0.23%) had anaphylaxis. Of these, 23 (12.5%) and 161 (87.5%) patients were classified to the accurate and inaccurate coding groups, respectively. Average age, time from symptom onset to emergency department presentation, past history of allergy, and penicillin and cephalosporin as causes of anaphylaxis differed between the 2 groups. Cardiovascular (39.1% vs. 5.6%, p=0.001) and respiratory symptoms (65.2% vs. 42.2%, p=0.038) manifested more frequently in the accurate group, while gastrointestinal symptoms (68.3% vs. 26.1%, p=0.001) were more frequently observed in the inaccurate coding group. Fluid administration (82.6% vs. 28.0%, p=0.001), steroid use (60.9% vs. 23.0%, p=0.001), and epinephrine use (65.2% vs. 13.0% p=0.001) were more common treatments for anaphylaxis in the emergency department in the accurate group. Anaphylaxis patients with cardiovascular symptoms, steroid use, and epinephrine use were more likely to be accurately registered with anaphylaxis disease codes. Conclusions. In the case of pediatric anaphylaxis, more patients were registered inaccurately under other allergy-related codes and simple symptom codes, rather than under anaphylaxis codes. Therefore, future research on anaphylaxis should consider inaccurately registered anaphylactic patients, as shown in this study.
Procalcitonin Is a Prognostic Marker of Hospital Outcomes in Patients with Critical Limb Ischemia and Diabetic Foot Infection
Authors: Meloni Marco , Izzo Valentina , Giurato Laura , Brocco Enrico , Ferrannini Michele , Gandini Roberto , Uccioli Luigi
Published: August 2019

Aim. To evaluate the prognostic role of procalcitonin (PCT) in patients with diabetic foot infection (DFI) and critical limb ischemia (CLI). Materials and Methods. The study group was composed of diabetic patients with DFI and CLI. All patients were treated according to a preset limb salvage protocol which includes revascularization, wound debridement, antibiotic therapy, and offloading. Inflammatory markers, including PCT, were evaluated at admission. Only positive values of PCT, greater than 0.5 ng/ml, were considered. Hospital outcomes were categorized as limb salvage (discharge with preserved limb), major amputation (amputation above the ankle), and mortality. Results. Eighty-six patients were included. The mean age was 67.3±11.4 years, 80.7% were male, 95.1% had type 2 diabetes, and the mean diabetes duration was 20.5±11.1 with a mean HbA1c of 67±16 mmol/mol. 66/86 (76.8%) of patients had limb salvage, 7/86 (8.1%) had major amputation, and 13/86 (15.1%) died. Patients with positive PCT baseline values in comparison to those with normal values showed a lower rate of limb salvage (30.4 versus 93.6%, p=0.0001), a higher rate of major amputation (13 versus 6.3%, p=0.3), and a higher rate of hospital mortality (56.5 versus 0%, p<0.0001). At the multivariate analysis of independent predictors found at univariate analysis, positive PCT was an independent predictor of major amputation [OR 3.3 (CI 95% 2.0-5.3), p=0.0001] and mortality [OR 4.1 (CI 95% 2.2-8.3), p<0.0001]. Discussion. Positive PCT at admission increased the risk of major amputation and mortality in hospital patients with DFI and CLI.
Angiopoietins in Diabetic Retinopathy: Current Understanding and Therapeutic Potential
Authors: Whitehead Michael , Osborne Andrew , Widdowson Peter S. , Yu-Wai-Man Patrick , Martin Keith R.
Published: August 2019

Diabetic retinopathy (DR) is the commonest cause of blindness in the working-age population of the developed world. The molecular pathophysiology of DR is complex, and a complete spatiotemporal model of the disease is still being elucidated. Recently, a role for angiopoietin (Ang) proteins in the pathophysiology of DR has been proposed by several research groups, and several aspects of Ang signalling are being explored as novel therapeutic strategies. Here, we review the role of the Ang proteins in two important forms of DR, diabetic macular oedema and proliferative diabetic retinopathy. The function of the Ang proteins in regulating blood vessel permeability and neovascularisation is discussed, and we also evaluate recent preclinical and clinical studies highlighting the potential benefits of modulating Ang signalling as a treatment for DR.
Improved Healing of Diabetic Foot Ulcer upon Oxygenation Therapeutics through Oxygen-Loading Nanoperfluorocarbon Triggered by Radial Extracorporeal Shock Wave
Authors: Wang Shunhao , Yin Chunyang , Han Xiaoguang , Guo Anyi , Chen Xiaodong , Liu Sijin , Liu Yajun
Published: August 2019

Diabetic foot ulcers (DFUs), the most serious complication of diabetes mellitus, can induce high morbidity, the need to amputate lower extremities, and even death. Although many adjunctive strategies have been applied for the treatment of DFUs, the low treatment efficiency, potential side effects, and high cost are still huge challenges. Recently, nanomaterial-based drug delivery systems (NDDSs) have achieved targeted drug delivery and controlled drug release, offering great promises in various therapeutics for diverse disorders. Additionally, the radial extracorporeal shock wave (rESW) has been shown to function as a robust trigger source for the NDDS to release its contents, as the rESW harbors a potent capability in generating pressure waves and in creating the cavitation effect. Here, we explored the performance of oxygen-loaded nanoperfluorocarbon (Nano-PFC) combined with the rESW as a treatment for DFUs. Prior toin vivoassessment, we first demonstrated the high oxygen affinityin vitroand great biocompatibility of Nano-PFC. Moreover, the rESW-responsive oxygen release behavior from oxygen-saturated Nano-PFC was also successfully verifiedin vitroandin vivo. Importantly, the wound healing of DFUs was significantly accelerated due to improved blood microcirculation, which was a result of rESW therapy (rESWT), and the targeted release of oxygen into the wound from oxygen-loaded Nano-PFC, which was triggered by the rESW. Collectively, the oxygen-saturated Nano-PFC and rESW provide a completely new approach to treat DFUs, and this study highlights the advantages of combining nanotechnology with rESW in therapeutics.
Pregnancy Hypertension and a Commonly Inherited IGF1R Variant (rs2016347) Reduce Breast Cancer Risk by Enhancing Mammary Gland Involution
Authors: Powell Mark J. , Dufault Suzanne M. , Henry Jill E. , Allison Anna C. , Cora Renata , Benz Christopher C.
Published: August 2019

Background. Terminal duct lobular units (TDLUs) are the anatomic sites of breast cancer initiation, and breast tissue involution resulting in lower TDLU counts has been associated with decreased breast cancer risk. The insulin-like growth factor (IGF) pathway plays a role in breast involution, and systemic changes in this developmental pathway occur with hypertensive disorders of pregnancy (HDP), which have also been associated with lower breast cancer risk, especially in women carrying a functional variant of IGF1R SNP rs2016347. We proposed that this breast cancer protective effect might be explained by increased breast tissue involution. Materials and Methods. We conducted a retrospective cohort study utilizing the Komen Tissue Bank, which collects breast tissue core biopsies from women without a history of breast cancer. Eighty white non-Hispanic women with a history of HDP were selected along with 120 nonexposed participants, and after genotyping for rs2016347, TDLU parameters were histologically measured blinded to participant characteristics from fixed biopsy sections. Results. Stratified models by HDP status demonstrated that among HDP+ participants, those carrying two T alleles of rs2016347 had a decrease in TDLU counts of 53.2% when compared to those with no T alleles (p=0.049). Trend analysis demonstrated a multiplicative decrease in counts of 31.6% per T allele (p=0.050). Although no statistically significant interaction was seen between HDP status and T alleles, interaction terms showed increasingly negative values reaching a p value of 0.124 for HDP × 2T alleles. Conclusions. The observed statistically significant decrease in TDLU counts signifies increased breast epithelial involution in women with prior HDP who inherited the TT genotype of IGF1R SNP rs2016347. The increasing degree of breast involution with greater rs2016347 T allele copy number is consistent with the known progressive reduction in IGF1R expression in breast and other normal tissues.
Actor–Critic-Algorithm-Based Accurate Spectrum Sensing and Transmission Framework and Energy Conservation in Energy-Constrained Wireless Sensor Network-Based Cognitive Radios
Authors: Shah Hurmat Ali , Koo Insoo , Kwak Kyung Sup
Published: August 2019

Spectrum sensing is of the utmost importance to the workings of a cognitive radio network (CRN). The spectrum has to be sensed to decide whether the cognitive radio (CR) user can transmit or not. Transmitting on unoccupied spectrum becomes a hard task if energy-constrained networks are considered. CRNs are ad hoc networks, and thus, they are energy-limited, but energy harvesting can ensure that enough energy is available for transmission, thus enabling the CRN to have a theoretically infinite lifetime. The residual energy, along with the sensing decision, determines the action in the current time slot. The transmission decision has to be grounded on the sensing outcome, and thus, a combined sensing–transmission framework for the CRN has to be considered. The sensing–transmission framework forms a Markov decision process (MDP), and solving the MDP problem exhaustively through conventional methods cannot be a plausible solution for ad hoc networks such as a CRN. In this paper, to solve the MDP problem, an actor–critic-algorithm-based solution for optimizing the action taken in a sensing–transmission framework is proposed. The proposed scheme solves an optimization problem on the basis of the actor–critic algorithm, and the action that brings the highest reward is selected. The optimal policy is determined by updating the optimization problem parameters. The reward is calculated by the critic component through interaction with the environment, and the value function for each state is updated, which then updates the policy function. Simulation results show that the proposed scheme closely follows the exhaustive search scheme and outperforms a myopic scheme in terms of average throughput achieved.
Successful Use of Renal Replacement Therapy for Refractory Hypokalemia in a Diabetic Ketoacidosis Patient
Authors: Syed Zainab , Kimball Thomas , Ismail Mourad
Published: August 2019

A 39-year-old African-American female presented to the emergency department with a seven-day history of right upper quadrant abdominal pain accompanied by nausea, vomiting, and diarrhea. She was noted to be alert and following commands, but tachypneic with Kussmaul respirations; and initial laboratory testing supported a diagnosis of diabetic ketoacidosis (DKA) and hypokalemia. To avoid hypokalemia-induced arrhythmias, insulin administration was withheld until a serum potassium (K) level of 3.3 mEq/L could be achieved. Efforts to increase the patient’s potassium level via intravenous repletion were ineffectual; hence, an attempt was made at more aggressive potassium repletion via hemodialysis using a 4 mEq/L K dialysate bath. The patient was started on Aldactone and continuous veno-venous hemodialysis (CVVH) with ongoing low-dose insulin infusion. This regimen was continued over 24 h resulting in normalization of the patient’s potassium levels, resolution of acidosis, and improvement in mental status. Upon resolution of her acidemia, the patient was transitioned from insulin infusion to treatment with a subcutaneous insulin aspart and insulin detemir, and did not experience further hypokalemia. Considering our success, we propose CVVH as a tool for potassium repletion when aggressive intravenous (IV) repletion has failed.
Identification of Psychological Factors Associated with Adherence to Self-Care Behaviors amongst Patients with Type 1 Diabetes
Authors: Alvarado-Martel Dácil , Ruiz Fernández M. Ángeles , Cuadrado Vigaray Maribel , Carrillo Armando , Boronat Mauro , Expósito Montesdeoca Ana , Wägner Ana M.
Published: August 2019

Purpose. To explore the factors involved in adherence to self-care behaviors in patients with type 1 diabetes. Materials and Methods. Patients with type 1 diabetes (age range: 14-71 years) were invited to participate at seven Spanish hospitals. They completed a dossier which recorded sociodemographic and clinical variables and also measured personality variables, emotional state, beliefs, and concerns regarding the illness, by means of questionnaires. Results. A total of 428 patients with type 1 diabetes were included (58% women, age 36 (11.8) years, diabetes duration 18.3 (10.2) years, HbA1c 7.9 +/-1.3%). A total of 60.1% of patients found it difficult to follow the treatment recommendations for the care of their disease. The reasons given were mood (25.2%), lack of motivation (13.4%), work (12%), and economic difficulties (3.8%). Other personal reasons were reported by 5.7%. Motivation, training in diabetes management, importance the patient attributed to the disease, and self-efficacy were the variables that predicted adherence to self-care behaviors, together accounting for 32% of its variance. Anxiety and depression were highly prevalent in this study population (57.1% and 23.1%, respectively) and were associated with lower adherence. Conclusion. In the present study assessing patients with type 1 diabetes, motivation, training in diabetes management, beliefs regarding the disease, and self-efficacy were the main contributors to adherence to self-care behaviors. On the other hand, anxiety and depression were highly prevalent and associated with lower adherence. Thus, supplementing therapeutic education with strategies designed to raise levels of motivation, discussion of beliefs about the disease, and encouragement of self-efficacy might be a useful way to increase patient involvement in self-care.
Antibiotic Resistance Profiles of Haemophilus influenzae Isolates from Children in 2016: A Multicenter Study in China
Authors: Wang Hong-Jiao , Wang Chuan-Qing , Hua Chun-Zhen , Yu Hui , Zhang Ting , Zhang Hong , Wang Shi-Fu , Lin Ai-Wei , Cao Qing , Huang Wei-Chun , Deng Hui-Ling , Cao Shan-Cheng , Chen Xue-jun
Published: August 2019

Background and Objective. Haemophilus influenzae (HI) is a common cause of community-acquired pneumonia in children. In many countries, HI strains are increasingly resistant to ampicillin and other commonly prescribed antibiotics, posing a challenge for effective clinical treatment. This study was undertaken to determine the antibiotic resistance profiles of HI isolates from Chinese children and to provide guidelines for clinical treatment. Methods. Our Infectious Disease Surveillance of Pediatrics (ISPED) collaboration group includes six children’s hospitals in different regions of China. The same protocols and guidelines were used by all collaborators for the culture and identification of HI. The Kirby–Bauer method was used to test antibiotic susceptibility, and a cefinase disc was used to detect β-lactamase activity. Results. We isolated 2073 HI strains in 2016: 83.9% from the respiratory tract, 11.1% from vaginal secretions, and 0.5% from blood. Patients with respiratory isolates were significantly younger than nonrespiratory patients (P<0.001). Of all 2073 strains, 50.3% were positive for β-lactamase and 58.1% were resistant to ampicillin; 9.3% were β-lactamase-negative and ampicillin-resistant. The resistance rates of the HI isolates to trimethoprim-sulfamethoxazole, azithromycin, cefuroxime, ampicillin-sulbactam, cefotaxime, and meropenem were 71.1%, 32.0%, 31.2%, 17.6%, 5.9%, and 0.2%, respectively. Conclusions. More than half of the HI strains isolated from Chinese children were resistant to ampicillin, primarily due to the production of β-lactamase. Cefotaxime and other third-generation cephalosporins could be the first choice for the treatment of ampicillin-resistant HI infections.
Functional Superior Mesenteric Artery Syndrome Induced by an Optional IVC Filter
Authors: Shen Adam , Tabello Dina , Merchant Nishant , Portereiko Joseph V. , Croteau Alfred , Gates Jonathan D.
Published: August 2019

This patient suffered multiple injuries in a motor vehicle crash. She had an optional IVC filter placed in the usual fashion and location which resulted in a functional obstruction of the third part of the duodenum much as one would expect with a Superior Mesenteric Artery (SMA) syndrome. The symptoms persisted over the sixteen-day filter dwell time and resolved completely with the retrieval of the filter.
Can Disturbed Liver Perfusion Revealed in p-CT on the First Day of Acute Pancreatitis Provide Information about the Expected Severity of the Disease?
Authors: Pieńkowska Joanna , Gwoździewicz Katarzyna , Skrobisz Katarzyna , Czarnowska-Cubała Monika , Kozak Oliwia , Hać Stanisław , Studniarek Michał , Szurowska Edyta
Published: August 2019

Background. The aim of the study was to evaluate the prognostic properties of perfusion parameters of liver parenchyma based on computed tomography (CT) of patients with acute pancreatitis (AP) made on the first day of onset of symptoms, to assess their usefulness in identifying patients with increased risk of the development of severe AP. Methods. 79 patients with clinical symptoms and biochemical criteria indicative of AP underwent perfusion computed tomography (p-CT) within 24 hours after onset of the symptoms. Perfusion parameters in 41 people who developed a severe form of AP were compared with parameters in 38 patients in whom the course of AP was mild. Results. Statistical differences in the liver perfusion parameters between the group of patients with mild and severe AP were shown. The permeability-surface area product was significantly lower, and the hepatic arterial fraction was significantly higher in the group of patients with progression of AP. Conclusions. Based on the results, it seems that p-CT performed on the first day from the onset of AP is a method that, by revealing disturbances in hepatic perfusion, can help in identifying patients with increased risk of the development of severe AP.
Constant Ductility Site‐Specific Yield Point Spectra for Seismic Design
Authors: Ji Duofa , Wen Weiping , Zhai Changhai
Published: August 2019

Displacement‐based seismic design (DBSD) is an iterative process because the strength and stiffness of a structure are needed to be adjusted in order to achieve a specific performance level, which is extremely inconvenient for designers in practice. Yield point spectra‐based seismic design is treated as an alternative design method in which yield displacement as a basic parameter will not lead to an iterative process even though the lateral strength or stiffness of a structure changes during the whole design process. Along this line, this study focuses on investigating the yield point spectra (YPS) for structures located at different soil sites. YPS are computed for EPP systems under 601 earthquake ground motions. YPS for four soil sites are quantitatively analyzed by considering the influence of the vibration period, ductility factor, damping ratio, postyield stiffness ratio, and P‐delta effect. The results indicate that compared with the effects of the damping ratio, the effects of the postyield stiffness ratio and P‐delta effect on YPS are more profound. Finally, a prediction equation is proposed accounting for four soil sites and six ductility factors.
Improvement on Structural Forms of Pile Group Foundations of Deepwater Bridges
Authors: Yu Enbo , Ren Sen , Tang Haojun , Li Yongle , Fang Chen
Published: August 2019

As long‐span cross‐sea bridges extend to deeper sea areas, the bridge pile tends to increase in its slenderness ratio and becomes more susceptible to waves. To improve the structural stability at the construction stage, this study analyses wave‐induced response of foundations. The wave theory and the method used for computing wave forces on foundations are first introduced. Then, a pile group foundation is taken as the research object, and different pile lengths ranging from 16 m to 46 m are considered. The wave‐induced response of the piles and the cap is calculated. After understanding the effect of the pile length, three optimized foundations are proposed with the aim of reducing the free length of the pile, and the corresponding finite element models are established to compare their wave‐induced response. The results show that the displacement at the top of the foundation increases with the increase in the pile length until the cap partly emerges from water and so does the internal force at the bottom. Setting a constraint in the middle of the piles can reduce their free lengths and is favourable to the wave‐induced response of the foundation except for the shearing force. A stronger constraint shows better effects on improvement of the stability of the foundation. The conclusions provide reference for optimization on pile foundations of deepwater bridges.
An Improved Statistical Damage Constitutive Model for Granite under Impact Loading
Authors: Zhao Zhenwei , Wu Bo , Yang Xin , Zhang Zhenya , Li Zhantao
Published: August 2019

To study the impact properties of granite, the parameters (including the stress‐strain curve, elasticity modulus, peak strength, and peak strain) of the test pieces in each group were determined via standard split‐Hopkinson pressure bar tests. The results revealed that the prepeak stress‐strain curves are approximately linear; the postpeak stress‐strain curve declined sharply and exhibited the characteristics of brittle material failure after the stress exceeded the peak strength. In terms of the specimen form following failure, for increasing strain rate, the granite specimen became increasingly fragmented after failure. In addition, the single‐parameter statistical damage constitutive model was improved, and a double‐parameter statistical damage constitutive model for describing the total stress‐strain curve of granite under the action of impact loading was proposed. The parameters of the statistical damage model, m and a, were obtained via fitting. The results revealed that the parameter m decreases with increasing elasticity modulus, whereas the parameter a increases. Similarly, the peak strength and the peak strain increased (in general) with increasing strain rate.
Associations between TAB2 Gene Polymorphisms and Epithelial Ovarian Cancer in a Chinese Population
Authors: Huang Xingming , Shen Can , Zhang Yan , Li Qin , Li Kai , Wang Yanyun , Song Yaping , Su Min , Zhou Bin , Wang Wei
Published: August 2019

Background. Epithelial ovarian cancer (EOC) is highly lethal worldwide. Factors involved in the inflammation and hormone-associated signaling pathway play vital roles in EOC carcinogenesis. The transforming growth factor-β- (TGF-β-) activated kinase 1 (MAP3K7) binding protein 2 (TAB2), mediating convergence of inflammatory and estrogen, may be implicated in EOC. The present study is aimed at exploring the association between the TAB2 gene polymorphisms and EOC. Methods. Three single nucleotide polymorphisms (SNPs) (rs237028, rs521845, and rs652921) of TAB2 were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 221 patients and 252 healthy controls. Associations between SNPs and clinical characteristics were performed either with the χ2 test or with Fisher’s exact test. The Kaplan-Meier method and Cox proportional hazard models were used to detect associations between genotypes and overall survival. Results. The rs237028 polymorphism was significantly associated with an increased risk of EOC with an allelic genetic model (A vs. G; OR=1.45; 95%CI=1.07–1.96; P=0.016), dominant genetic model (AA vs. AG-GG; OR=1.66; CI 1.14–2.41; P=0.008), and overdominant genetic model (AA-GG vs. AG; OR=1.60; CI 1.08–2.36; P=0.017). However, no significant association was observed between rs237028 polymorphism and overall survival. Conclusions. Our study indicated that the rs237028 polymorphism in the TAB2 gene was associated with EOC susceptibility and the TAB2 gene might contribute to the initiation of EOC.
Differential Modulation of NF-κB in Neurons and Astrocytes Underlies Neuroprotection and Antigliosis Activity of Natural Antioxidant Molecules
Authors: Martorana Francesca , Foti Maria , Virtuoso Assunta , Gaglio Daniela , Aprea Federica , Latronico Tiziana , Rossano Rocco , Riccio Paolo , Papa Michele , Alberghina Lilia , Colangelo Anna Maria
Published: August 2019

Neuroinflammation, a hallmark of chronic neurodegenerative disorders, is characterized by sustained glial activation and the generation of an inflammatory loop, through the release of cytokines and other neurotoxic mediators that cause oxidative stress and limit functional repair of brain parenchyma. Dietary antioxidants may protect against neurodegenerative diseases by counteracting chronic neuroinflammation and reducing oxidative stress. Here, we describe the effects of a number of natural antioxidants (polyphenols, carotenoids, and thiolic molecules) in rescuing astrocytic function and neuronal viability following glial activation by reducing astrocyte proliferation and restoring astrocytic and neuronal survival and basal levels of reactive oxygen species (ROS). All antioxidant molecules are also effective under conditions of oxidative stress and glutamate toxicity, two maladaptive components of neuroinflammatory processes. Moreover, it is remarkable that their antioxidant and anti-inflammatory activity occurs through differential modulation of NF-κB binding activity in neurons and astrocytes. In fact, we show that inflammatory stimuli promote a significant induction of NF-κB binding activity in astrocytes and its concomitant reduction in neurons. These changes are prevented in astrocytes and neurons pretreated with the antioxidant molecules, suggesting that NF-κB plays a key role in the modulation of survival and anti-inflammatory responses. Finally, we newly demonstrate that effective antigliosis and neuroprotective activity is achieved with a defined cocktail of four natural antioxidants at very low concentrations, suggesting a promising strategy to reduce inflammatory and oxidative damage in neurodegenerative diseases with limited side effects.
Quantitative Analysis of Eight Triterpenoids and Two Sesquiterpenoids in Rhizoma Alismatis by Using UPLC-ESI/APCI-MS/MS and Its Application to Optimisation of Best Harvest Time and Crude Processing Temperature
Authors: Tai Yanni , Zou Fuxian , Zhang Qiurong , Wang Jia , Rao Ronghui , Xie Ruihua , Wu Shuisheng , Chu Kedan , Xu Wen , Li Xiaoyan , Huang Mingqing
Published: August 2019

Rhizoma Alismatis (RA), widely known as “Ze-Xie” in China, is the tuber of Alisma orientale (Sam.) Juzep (Alismaceae), a Chinese herbal medicine that has been used to treat hyperlipidemia, diabetes, hypertension, dysuria, and inflammation. In this study, a sensitive and reliable method based on an ultra-performance liquid chromatography (UPLC) couple with two ionisation modes, including electrospray ionisation (ESI) and atmospheric pressure chemical ionisation (APCI) tandem mass spectrometry (MS), namely, UPLC-ESI/APCI-MS/MS was developed and validated to simultaneously determine 8 triterpenoids (ESI mode) and 2 sesquiterpenoids (APCI mode) in RA. Ten marker compounds were analysed with a Waters’ CORTECS UPLC C18 column (200 mm × 2.1 m, 1.6 μm) and gradient elution with water (contained 0.1% formic) and acetonitrile within 7 min. The established method was validated for linearity, intra- and interday precisions, accuracy, recovery, and stability. The calibration curve for 10 marker compounds showed good linear regression (r > 0.9971). The limits of detection and quantification for analytes were 0.14–1.67 ng/mL and 0.44–5.65 ng/mL, respectively. The relative standard deviations (RSD, %) and accuracy (RE, %) of intra- and interday precisions were less than 3.83% and 1.21% and 3.22% and 1.46%, repeatability and stability for real samples were less than 2.78% and 3.19%, respectively. All recoveries of the 10 marker compounds ranged from 97.24% to 102.49% with RSDs less than 4.05%. The developed method efficiently determined the 10 marker compounds in RA and was subsequently applied to optimise harvest time and crude processing temperature. The result indicated the 90% wilted phase and 70°C (or lower) may be the best harvest time and the processing temperature of RA.
Esthetic Rehabilitation with Direct Composite Resin in a Patient with Amelogenesis Imperfecta: A 2-Year Follow-Up
Authors: Rizzo Nathaly Stephania Palacios , da Cunha Leonardo Fernandes , Sotelo Bruno Vinueza , Gonzaga Carla Castiglia , Correr Gisele Maria , Gaião Ubiracy
Published: August 2019

Amelogenesis imperfecta is a group of conditions caused by over 15 different genes that affects the development of dental enamel and poses some challenges to dentists. An adult patient with amelogenesis imperfecta with severe changes in tooth color and reduction of occlusal vertical dimension sought dental treatment. Diagnostic wax-up was carried out to guide the stratification of a nanoparticulate resin for the restorative treatment. Direct composite resin restorations were applied on all teeth for modification of both esthetics and occlusion. After a 2-year follow-up, the findings appear to suggest that composite resin is a low-cost alternative when compared with indirect ceramic restorations, provides a good esthetic outcome, and offers considerable longevity for cases like the one reported herein.
Oxidative Stress as the Main Target in Diabetic Retinopathy Pathophysiology
Authors: Cecilia Olvera-Montaño , José Alberto Castellanos-González , José Navarro-Partida , Ernesto Germán Cardona-Muñoz , Ana Karen López-Contreras , Luis Miguel Roman-Pintos , Ricardo Raúl Robles-Rivera , Adolfo Daniel Rodríguez-Carrizalez
Published: August 2019

Diabetic retinopathy (DR) is one of the most common complications of diabetes mellitus (DM) causing vision impairment even at young ages. There are numerous mechanisms involved in its development such as inflammation and cellular degeneration leading to endothelial and neural damage. These mechanisms are interlinked thus worsening the diabetic retinopathy outcome. In this review, we propose oxidative stress as the focus point of this complication onset.
Numerical Study on Deformation Capacity of Steel Plate Reinforced Concrete Shear Walls
Authors: Zhou Zhi , Qian Jiang , Huang Wei
Published: August 2019

Steel plate reinforced concrete (SPRC) shear wall consists of steel plate encased in the concrete, in which the material advantages of both concrete and steel are utilized. The lateral resistance and deformation capacity of the shear wall are greatly improved. This paper investigates the deformation capacity of the SPRC shear wall under cyclic loads. A nonlinear 3‐D finite element model in ABAQUS was developed and validated against published experimental results. Then, a parametric study was conducted to obtain the yield and ultimate rotation of SPRC shear walls with flexural failure. By statistical analyses, formulas for the yield and ultimate rotation of SPRC shear wall were proposed.