bluuebunny/crossref_metadata_2025 huggingface dataset:
Deletion of a 19-Amino-Acid Region in Clostridioides difficile TcdB2 Results in Spontaneous Autoprocessing and Reduced Cell Binding and Provides a Nontoxic Immunogen for Vaccination
Authors: Bland Sarah J. , Larabee Jason L. , Shadid Tyler M. , Lang Mark L. , Ballard Jimmy D.
Published: May 2019

Clostridioides difficile
toxin B (TcdB) is an intracellular toxin responsible for many of the pathologies of
C. difficile
infection. The two variant forms of TcdB (TcdB1 and TcdB2) share 92% sequence identity but have reported differences in rates of cell entry, autoprocessing, and overall toxicity. This 2,366-amino-acid, multidomain bacterial toxin glucosylates and inactivates small GTPases in the cytosol of target cells, ultimately leading to cell death.
Complete Genome Sequence of Klebsiella pneumoniae Podophage Patroon
Authors: Tran Rainie , Kongari Rohit , Lessor Lauren , Gill Jason J. , Liu Mei
Published: May 2019

Klebsiella pneumoniaeinfection is a serious concern in hospital settings due to the continuing emergence of multidrug-resistant strains. The study ofK. pneumoniaephages may help the development of new treatment strategies.
Complete Genome Sequence of the Plantaricin-Sensitive Strain Lactobacillus plantarum NCIMB 700965
Authors: Heeney Dustin D. , Marco Maria L.
Published: May 2019

Lactobacillus plantarum
NCIMB 700965 was isolated from cheese in 1939 and is used as an indicator strain for plantaricin production. The complete genome was determined using both long (PacBio) and short (Illumina) read data resulting in a single, circular chromosome with 3,015,426 bp, a G+C content of 45%, and five plasmids.
Sequence stratigraphy and depositional history of the Baranof Fan: Insights for Cordilleran Ice Sheet outflow to the Gulf of Alaska
Authors: Zhang Jiajia , Gulick Sean P.S.
Published: May 2019

The Baranof Fan is one of three large Alaska deep-sea fans that preserve sedimentary records reflecting both tectonic and climatic processes. However, lack of drill sites in the Baranof Fan makes the depositional history across the southeastern Alaska margin still poorly understood. Sequence correlation from the adjacent Surveyor Fan to the Baranof Fan provides updated age constraints on the Baranof Fan evolution history. Results show that both the Baranof and Surveyor Fans are dominantly glacial and initiated ca. 2.8 Ma and expanded rapidly since ca. 1.2 Ma in response to the major glaciation events; these results place the deposition of the Baranof Fan younger than previously thought (ca. 7 Ma). The glacially influenced Baranof Fan contains two sub-fans that are laterally stacked with their depocenters migrating southeastward. Each sub-fan developed multiple channels that young southeastward as channel avulsion, coevolution, and tectonic beheading progressed over the past ∼2.8 m.y. Tectonic reconstruction suggests that the Baranof Fan is sourced from the Coast Range via shelf-crossing troughs near the Chatham Strait and Dixon Entrance and thus represents a major outflow for the Cordilleran Ice Sheet during glaciations; the Chatham Strait is the major conduit that has fed most of the Baranof Fan channels. Comparatively, the Surveyor Fan is sourced predominantly from the St. Elias Range where a confluence of orogenesis and glaciations are a coupled system and only partly from the Coast Range via the Icy Strait. It is concluded that the formation and expansion of the Cordilleran Ice Sheet has determined the timing of the Baranof Fan deposition, yet Pacific–North America strike-slip motion has influenced the Baranof Fan sediment distribution, as previously suggested, via a series of southeastward avulsing channels and resultant southeastward migration of deep-sea depocenters.
Supereruption quartz crystals and the hollow reentrants
Authors: Befus Kenneth S. , Manga Michael
Published: May 2019

Hollow reentrants in quartz phenocrysts from Yellowstone (western United States) caldera’s Lava Creek Tuff are preserved vestiges of bubbles in the supereruption’s pre-eruptive magma reservoir. We characterized the reentrants using a combination of petrographic techniques, synchrotron X-ray microtomography, and cathodoluminescence imagery. One or more reentrants occur in ∼20% of quartz, and up to ∼90% of those reentrants are hollow. The earliest-erupted parts of the Lava Creek Tuff have the most empty reentrants. The hollow reentrants provide direct, physical evidence for volatile saturation, exsolution, and retention in a magma reservoir. Quartz-melt surface tension permits bubbles to attach to quartz only when bubbles have been able to nucleate and grow in the melt. Prior to eruption, the Lava Creek Tuff existed as a bubbly, volatile-saturated magma reservoir. The exsolved volatiles increased magma compressibility, helping to prevent the ever-accumulating magma from reaching a critical, eruptive overpressure until it reached a tremendous volume.
Natural fracture propping and earthquake-induced oil migration in fractured basement reservoirs
Authors: Holdsworth R.E. , McCaffrey K.J.W. , Dempsey E. , Roberts N.M.W. , Hardman K. , Morton A. , Feely M. , Hunt J. , Conway A. , Robertson A.
Published: May 2019

The geological processes that create fluid storage capacity and connectivity in global fractured basement reservoirs are poorly understood compared to conventional hydrocarbon plays. Hosting potentially multibillion barrels of oil, the upfaulted Precambrian basement of the Rona Ridge, offshore west of Shetland, UK, gives key insights into how such reservoirs form. Oil presence is everywhere associated with sub-millimeter- to meter-thickness mineralized fracture systems cutting both basement and local preseal cover sequences. Mineral textures and fluid inclusion geothermometry suggest a low-temperature (90–220 °C), near-surface hydrothermal system, as does the preservation of clastic sediments in the same fractures. These fills act as permanent props holding fractures open, forming long-term fissures in the basement that permit oil ingress and storage. Calcite-fill U-Pb dating constrains the onset of mineralization and contemporaneous oil charge to the Late Cretaceous. The additional preservation of oil-stained injected sediment slurries and silica gels along basement faults suggests that rift-related seismogenic faulting initiated lateral oil migration from Jurassic source rocks into the adjacent upfaulted ridge. Subsidence below sea level in the latest Cretaceous sealed the ridge with shales, and buoyancy-driven migration of oil into the preexisting propped fracture systems continued long after the cessation of rifting. These new observations provide an explanation for the viability of sub-unconformity fractured basement reservoirs worldwide, and have wider implications for subsurface fluid migration processes generally.
Childhood acute lymphoblastic leukaemia relapse with atypical localised presentation mimicking ankle trauma in a 28-year-old man
Authors: Zhao Charlie Weige , Singh Vinit , Singh Vasundhara
Published: May 2019

Acute lymphoblastic leukaemia (ALL) is a common paediatric cancer with a tendency to relapse, usually within 3 years of remission. Most patients present with hepatomegaly, splenomegaly, pallor, fever and bruising. Localised muskuloskeletal presentation is extremely rare. Here, we present a case of leukaemia relapse in the bone marrow of a 28-year-old man 9 years after achieving remission, presenting only with ankle pain and normal routine labs besides mild hypercalcemia, and no signs of disease in common bone marrow biopsy sites. This highly localised presentation is unusual and would hopefully inform clinicians to have a high index of suspicion for relapse in an adult patient who has had childhood ALL.
Vogt-Koyanagi-Harada syndrome presenting with bilateral optic disc swelling and leptomeningeal enhancement
Authors: Le Thanh-Thao Adriana , Simon Sumu , Gilhotra Jagjit , Hissaria Pravin
Published: May 2019

Vogt-Koynagi-Harada (VKH) disease is a clinical syndrome with classical ocular and extraocular findings that is not uncommonly described in Asian, Middle-Eastern and South American populations. We describe a case of VKH in an elderly Polish-Australian distinguished by prominent bilateral disc swelling rather than uveitis and marked leptomeningeal enhancement on MRI which led to extensive investigation including brain biopsy. Both disc oedema and MRI abnormalities improved dramatically with systemic steroid therapy. VKH disease is an important differential to consider in older patients with an uveo-meningeal picture and atypical eye findings where other causes have been excluded.
Autologous limbal stem cell transplantation: a systematic review of clinical outcomes with different surgical techniques
Authors: Shanbhag Swapna S , Nikpoor Neda , Rao Donthineni Pragnya , Singh Vivek , Chodosh James , Basu Sayan
Published: May 2019

Purpose

To conduct a systematic review on outcomes of three different techniques of autologous limbal stem cell transplantation (LSCT): conjunctival-limbal autografting (CLAu), cultivated limbal epithelial transplantation (CLET) and simple limbal epithelial transplantation (SLET), in unilateral limbal stem cell deficiency (LSCD).

Methods

Literature searches were conducted in MEDLINE (Ovid), Embase, Web of Science and Cochrane Central Register. Standard systematic review methodology was followed using Meta-analysis of Observational Studies in Epidemiology guidelines. Studies with a sample size of more than 10 eyes were included. The primary outcome measure of efficacy was restoration of a completely epithelised, stable and avascular corneal surface (anatomical success). The secondary outcome measure of efficacy was improvement in best-corrected visual acuity of two-lines or greater (functional success).

Results

The review identified 22 non-comparative case series, which included 1023 eyes. Ocular burns were the major (88%) indication for surgery. Overall, at a median postoperative follow-up of 1.75 years, autologous LSCT for unilateral LSCD showed anatomical and functional success rates of 69% and 60%, respectively, without any serious adverse events in the donor eye. The follow-up duration and indications for surgery were comparable across all groups (p>0.05). The anatomical and functional success rates of SLET (78%; 68.6%) and CLAu (81%; 74.4%) were comparable, and significantly better than those of CLET (61.4%; 53%; p=0.0048).

Conclusion

Autologous LSCT is a safe and effective treatment for unilateral LSCD. In the absence of randomised controlled trials, existing evidence clearly suggests that clinical outcomes are better with SLET and CLAu as compared with CLET.
How are we measuring physical activity and sedentary behaviour in the four home nations of the UK? A narrative review of current surveillance measures and future directions
Authors: Strain Tessa , Milton Karen , Dall Philippa , Standage Martyn , Mutrie Nanette
Published: May 2019

Background/objectives

To explore and describe the comparability between the surveys of the UK home nations (England, Northern Ireland, Scotland, Wales) that monitor compliance with the Chief Medical Officers’ physical activity (PA) recommendations. We also suggest ways to improve the UK national PA and sedentary behaviour (SB) surveillance systems.

Methods

We identified national surveys that monitor PA and SB through searching UK-wide and devolved administration websites, the Global Observatory for Physical Activity Country Cards and the Active Healthy Kids Report Cards. Subsequently, we extracted information from survey documentation on the survey commissioners and contractors, method of administration, current questionnaire details relevant to the PA recommendations, questionnaire changes over the previous decade and the most recent prevalence figures.

Results

For adults and older adults, five surveys assess the moderate-to-vigorous PA (MVPA) recommendation, three assess muscle strengthening and three assess SB. For older adults only, three assess balance and co-ordination. For children, seven assess MVPA, none assess muscle strengthening and five assess SB. Only one survey reports on the under 5 PA recommendation. There is no part of the recommendations for which comparable estimates can be calculated across all four home nations. The greatest variation is among the SB questions and reporting. No survey has regularly used device-based measures.

Conclusion

UK surveillance of the PA recommendations is complex, undertaken separately in the home nations, using multiple surveys that cover adults and children separately. We recommend that the costs and benefits of harmonising the existing questionnaires are considered, along with the potential introduction of device-based measures.
High rate of hypertension control among treated patients attending a teaching primary healthcare centre in Jordan
Authors: Beni Yonis Othman , Khader Yousef , Okour Abdulhakeem , Al Omari Mousa , Al Quran Thekraiat , Khassawneh Adi , Al-Mashikhi Baha , Shawkat Mohamid
Published: May 2019

Introduction

The purpose of this study was to determine the hypertension control rate and its associated factors among treated patients attending a teaching primary healthcare centre in Jordan.

Study design

We conducted a retrospective cohort study of 286 patients with HTN, treated with medications, who attended Jordan University of Science and Technology primary healthcare centre in Irbid, Jordan, from July through September 2018. Data were abstracted from the patient’s medical records and personal interviews. Multivariate logistic regression analysis was used to examine independent factors associated with hypertension control.

Results

Blood pressure control rate was 90.9% and was significantly higher among patients who were married (p=0.02), with higher income level (p<0.01), non-smokers (p=0.01), free of diabetes mellitus or dyslipidaemia (p=0.048), highly consuming fruits and vegetables (p<0.01), non-obese (p<0.01), adherent to blood pressure medications (p=0.02) and among patients on lower number of antihypertensive medications (p=0.01). Multivariate analysis with adjusted OR of factors associated with hypertension control were higher fruit and vegetable intake (p<0.01), higher income level (p=0.02) and medication adherence (p<0.01).

Conclusion

Participants in this study achieved a relatively high rate of blood pressure control. Associated factors with this rate were higher fruit and vegetable intake, higher income level and medication adherence. For better hypertension control, patients should be advised to adhere to their medications and consume more fruits and vegetables besides other lifestyle changes.
Era of biosimilars in rheumatology: reshaping the healthcare environment
Authors: Smolen Josef S , Goncalves Joao , Quinn Mark , Benedetti Fabrizio , Lee Jake Yongkwon
Published: May 2019

Compared with the original approved biological drug on which it is based, a biosimilar has highly similar physicochemical characteristics and biological activity, as well as equivalent efficacy and no clinically meaningful differences in safety and immunogenicity. Before they are approved, biosimilars must undergo a rigorous development process using state-of-the-art technologies to establish biosimilarity to the reference biological product. After approval, biosimilars must comply with good pharmacological practices for biological drugs. Several biosimilar disease-modifying antirheumatic drugs (bsDMARDs) based on the tumour necrosis factor inhibitors adalimumab, etanercept and infliximab have been approved for use in patients with rheumatic diseases. Substantial cost savings can be made if biological-naive patients begin treatment with bsDMARDs, and patients receiving original biological DMARDs (bDMARDs) are switched to bsDMARDs. Despite the consistently similar efficacy, safety and immunogenicity of bsDMARDs relative to their respective original bDMARDs, switching from a reference bDMARD to a bsDMARD can result in nocebo responses, such as subjective increase of disease activity and pain-related adverse events. This may have a negative impact on adherence to bsDMARDs in clinical trials and clinical practice. To ensure optimal and rational integration of bsDMARDs into rheumatology practice and realise the full cost-saving efficacy of these drugs, rheumatologists must be aware that careful communication of the cost-saving efficacy and safety of bsDMARDs to their patients is the key to a successful long-term switch to bsDMARD therapy.
Simulation and experiment of vibrational or acoustic communication in mining and oil-gas drill strings
Authors: Islam Md Shahriar , Peter Nathan , Wiens Travis
Published: May 2019

Drilling for exploration and mineral extraction purposes is generally an invisible process, that is, there is a lack of real-time information available from the tool head. The borehole mining and oil-gas drilling industries both face tremendous challenges because of this invisibility. Lack of data has impacts on extraction quantity and quality, process efficiencies, and is a major factor in overall program costs. This is why a communication method between the drill head and the surface has been under research. Different communication methods have enabled industries to establish more control over the drill bit. Low data transmission rate is one of the most concerning drawbacks of existing communication methods. Acoustic, also known as vibrational telemetry, is the most recent method used in transferring data through drill pipe at the highest data transmission rate. The proper use of acoustic tools and communication schemes will successfully establish a fast data transmission rate and is expected to become a popular method. This paper will introduce a simulation model for transmission of data through drill pipes and will extrapolate a practical case of a large number of pipes that is usually used in oil-gas extraction. It will also demonstrate an experimental setup of a new acoustic transducer.
Everolimus induces G1 cell cycle arrest through autophagy-mediated protein degradation of cyclin D1 in breast cancer cells
Authors: Chen Guang , Ding Xiao-Fei , Bouamar Hakim , Pressley Kyle , Sun Lu-Zhe
Published: May 2019

Everolimus inhibits mammalian target of rapamycin complex 1 (mTORC1) and is known to cause induction of autophagy and G1 cell cycle arrest. However, it remains unknown whether everolimus-induced autophagy plays a critical role in its regulation of the cell cycle. We, for the first time, suggested that everolimus could stimulate autophagy-mediated cyclin D1 degradation in breast cancer cells. Everolimus-induced cyclin D1 degradation through the autophagy pathway was investigated in MCF-10DCIS.COM and MCF-7 cell lines upon autophagy inhibitor treatment using Western blot assay. Everolimus-stimulated autophagy and decrease in cyclin D1 were also tested in explant human breast tissue. Inhibiting mTORC1 with everolimus rapidly increased cyclin D1 degradation, whereas 3-methyladenine, chloroquine, and bafilomycin A1, the classic autophagy inhibitors, could attenuate everolimus-induced cyclin D1 degradation. Similarly, knockdown of autophagy-related 7 (Atg-7) also repressed everolimus-triggered cyclin D1 degradation. In addition, everolimus-induced autophagy occurred earlier than everolimus-induced G1 arrest, and blockade of autophagy attenuated everolimus-induced G1 arrest. We also found that everolimus stimulated autophagy and decreased cyclin D1 levels in explant human breast tissue. These data support the conclusion that the autophagy induced by everolimus in human mammary epithelial cells appears to cause cyclin D1 degradation resulting in G1 cell cycle arrest. Our findings contribute to our knowledge of the interplay between autophagy and cell cycle regulation mediated by mTORC1 signaling and cyclin D1 regulation.
Muscle length and joint angle influence spinal but not corticospinal excitability to the biceps brachii across forearm postures
Authors: Forman Davis A. , Abdel-Malek Daniel , Bunce Christopher M. F. , Holmes Michael W. R.
Published: May 2019

Forearm rotation (supination/pronation) alters corticospinal excitability to the biceps brachii, but it is unclear whether corticospinal excitability is influenced by joint angle, muscle length, or both. Thus the purpose of this study was to separately examine elbow joint angle and muscle length on corticospinal excitability. Corticospinal excitability to the biceps and triceps brachii was measured using motor evoked potentials (MEPs) elicited via transcranial magnetic stimulation. Spinal excitability was measured using cervicomedullary motor evoked potentials (CMEPs) elicited via transmastoid electrical stimulation. Elbow angles were manipulated with a fixed biceps brachii muscle length (and vice versa) across five unique postures: 1) forearm neutral, elbow flexion 90°; 2) forearm supinated, elbow flexion 90°; 3) forearm pronated, elbow flexion 90°; 4) forearm supinated, elbow flexion 78°; and 5) forearm pronated, elbow flexion 113°. A musculoskeletal model determined biceps brachii muscle length for postures 1–3, and elbow joint angles ( postures 4–5) were selected to maintain biceps length across forearm orientations. MEPs and CMEPs were elicited at rest and during an isometric contraction of 10% of maximal biceps muscle activity. At rest, MEP amplitudes to the biceps were largest during supination, which was independent of elbow joint angle. CMEP amplitudes were not different when the elbow was fixed at 90° but were largest in pronation when muscle length was controlled. During an isometric contraction, there were no significant differences across forearm postures for either MEP or CMEP amplitudes. These results highlight that elbow joint angle and biceps brachii muscle length can each independently influence spinal excitability.

NEW & NOTEWORTHY Changes in upper limb posture can influence the responsiveness of the central nervous system to artificial stimulations. We established a novel approach integrating neurophysiology techniques with biomechanical modeling. Through this approach, the effects of elbow joint angle and biceps brachii muscle length on corticospinal and spinal excitability were assessed. We demonstrate that spinal excitability is uniquely influenced by joint angle and muscle length, and this highlights the importance of accounting for muscle length in neurophysiological studies.
Complications of Self-Injected Facial Fillers: A Treatment Conundrum in the UK
Authors: Blanchard Jessica , Palmer Julia , Ali Enamul , Cheng Leo
Published: May 2019

There has been a rise in nonsurgical cosmetic procedures seen within the UK population in the past decade. A change in legislation has placed restrictions on the distribution and provision of such treatments. Therefore, patients may seek alternative methods to bring about a change to their appearance, such as self-injection of a filler. Complications may include oral ulceration, foreign body tissue reaction, and infection due to a lack in sterility during injection. Such presentations may mimic that of oral cancer and can lead to misdiagnoses and undue cost to the National Health Service. This case highlights the common features leading to correct identification of patients self-injecting with facial fillers and discusses the controversy surrounding the economic aspects of their care. We would like to report one such case presenting to our oral and maxillofacial surgical unit.
Sustained-Release Fillers for Dentin Disinfection: An Ex Vivo Study
Authors: Funk Bernhard , Sahar-Helft Sharonit , Kirmayer David , Friedman Michael , Steinberg Doron
Published: May 2019

Enterococcus faecalis is the most commonly recovered species from failed root canal treatments. In this study, we tested the capability of a novel intracanal sustained-release filler (SRF) containing cetylpyridinium chloride (CPC) to disinfect dentinal tubules of segmented human tooth specimens. Human dental root specimens were infected with E. faecalis V583 for 3 weeks in a static environment. The tested intracanal medicaments were SRF-CPC and calcium hydroxide (CH). Each medicament was introduced into the canal of the dental specimen and incubated for 7 days. The bacteriological samples were taken by shaving the dentine surrounding the root canal with dental burs ranging in size from ISO 014-020. The obtained dentine powder was collected in test tubes containing phosphate-buffered saline, sonicated, and plated on agar plates. Colony-forming units were counted after 48 h of incubation. Random specimens were also examined under confocal laser scanning microscopy and scanning electron microscopy. A statistical difference was found in the bacterial counts obtained from all layers of infected dentin between the control and the SRF-CPC groups. CH reduced bacterial viability significantly only in the first layer of the infected dentin, up to 150 μm into the dentinal tubules. CLSM images showed that SRF-CPC killed most bacteria throughout the infected dentin up to 700 μm of penetration. SEM images demonstrated the adhesion ability of SRF-CPC to the dentinal wall. In conclusion, SRF-CPC is a potential intracanal medicament for disinfecting dentinal tubules.
Development of an Empirically Calibrated Model of Esophageal Squamous Cell Carcinoma in High-Risk Regions
Authors: Wang Zhenhua , Zhang Qiang , Wu Bin
Published: May 2019

Objective. This study constructs, calibrates, and verifies a mathematical simulation model designed to project the natural history of ESCC and is intended to serve as a platform for testing the benefits and cost-effectiveness of primary and secondary ESCC prevention alternatives.Methods. The mathematical model illustrates the natural history of ESCC as a sequence of transitions among health states, including the primary health states (e.g., normal mucosa, precancerous lesions, and undetected and detected cancer). Using established calibration approaches, the parameter sets related to progression rates between health states were optimized to lead the model outputs to match the observed data (specifically, the prevalence of precancerous lesions and incidence of ESCC from the published literature in Chinese high-risk regions). As illustrative examples of clinical and policy application, the calibrated and validated model retrospectively simulate the potential benefit of two reported ESCC screening programs.Results. Nearly 1,000 good-fitting parameter sets were identified from 1,000,000 simulated sets. Model outcomes had sufficient calibration fit to the calibration targets. Additionally, the verification analyses showed reasonable external consistency between the model-predicted effectiveness of ESCC screening and the reported data from clinical trials.Conclusions. This parameterized mathematical model offers a tool for future research investigating benefits, costs, and cost-effectiveness related to ESCC prevention and treatment.
The Characteristic Transient Response of a Pressurized Cantilever Pipe Subjected to Transverse Impact at Its Tip
Authors: Liu Feng , Yang Yuchao , Wu Yuelei
Published: May 2019

This paper describes an experimental study on the pure bending mechanical behavior of a pressurized pipe and adoption of a measured moment‐curvature relationship under different working conditions in numerical simulations for transient pipe‐whip prediction. To describe the effects of pipe contents and internal pressure, the governing equations were derived based on large deformation theory. Bending moment and axial force were uncoupled in the constitutive equation, and an experiment‐based relationship between moment and curvature was adopted. The numerical simulations show that the present model can simulate the mechanical processes of elasticity, plastic hardening, and softening behavior in the initial, middle, and late stages of whole response, respectively. In addition, it was shown that kinks may occur at several positions along an empty cantilever pipe due to the collapse of sections under intense dynamic loading. However, this behavior did not occur for the full pressurized pipe, indicating that the contents and internal pressure are able to effectively impede the partial flattening of the pipe section, improving its critical curvature and changing its plastic dynamic response behavior.
Critical Illness Associated Fatal Hypoglycemia in a Nondiabetic Male
Authors: Toor Amit , Toor Anika , Krishnamurthy Mahesh
Published: May 2019

We present here the case of a 55-year-old male who presented to the emergency department with severe abdominal pain and respiratory distress secondary to mesenteric ischemia. His critical illness on preexisting chronic kidney disease, previously undiagnosed alcoholic cirrhosis, and congestive heart failure led to a rare yet fatal consequence of refractory hypoglycemia. Critical illness associated hypoglycemia generally occurs as a result of high metabolic consumption with relative insulin excess and insufficient nutritional intake that is seen frequently in critically ill patients. This, along with reduced hepatic and renal gluconeogenesis seen in preexisting liver and renal disease, can cumulate to life-threatening hypoglycemia and is seen as a poor prognostic factor in the ICU setting.
Multiparameter Analysis for Efficiency Improvement of Single‐Phase Capacitor Motor
Authors: Sarac Vasilija , Atanasova-Pacemska Tatjana
Published: May 2019

Single‐phase motors are known for their small power ratings and their usage in various household appliances. Although they are not large electricity consumers, their widespread application contributes to the overall electricity consumption. In addition, standard IEC 60034‐30‐1:214 defines the efficiency levels for single‐ and three‐phase motors and stipulates the increased electrical efficiency for the electrical motors. Therefore, this paper sets the parametric analysis of permanently split capacitor motor with five different design parameters that have impact on the efficiency of the motor. As an output from the parametric analysis, two different optimized motor models are obtained with increased efficiency. The impact of each parameter on motor efficiency—as well as on the other operating characteristics, like starting torque, overloading capacity, rated current, starting current, total losses, and power factor—is analyzed and adequate conclusions are derived. The obtained motor models are verified with Finite Element Method (FEM) for magnetic flux density distribution.
An Ad Hoc Random Initialization Deep Neural Network Architecture for Discriminating Malignant Breast Cancer Lesions in Mammographic Images
Authors: Duggento Andrea , Aiello Marco , Cavaliere Carlo , Cascella Giuseppe L. , Cascella Davide , Conte Giovanni , Guerrisi Maria , Toschi Nicola
Published: May 2019

Breast cancer is one of the most common cancers in women, with more than 1,300,000 cases and 450,000 deaths each year worldwide. In this context, recent studies showed that early breast cancer detection, along with suitable treatment, could significantly reduce breast cancer death rates in the long term. X-ray mammography is still the instrument of choice in breast cancer screening. In this context, the false-positive and false-negative rates commonly achieved by radiologists are extremely arduous to estimate and control although some authors have estimated figures of up to 20% of total diagnoses or more. The introduction of novel artificial intelligence (AI) technologies applied to the diagnosis and, possibly, prognosis of breast cancer could revolutionize the current status of the management of the breast cancer patient by assisting the radiologist in clinical image interpretation. Lately, a breakthrough in the AI field has been brought about by the introduction of deep learning techniques in general and of convolutional neural networks in particular. Such techniques require no a priori feature space definition from the operator and are able to achieve classification performances which can even surpass human experts. In this paper, we design and validate an ad hoc CNN architecture specialized in breast lesion classification from imaging data only. We explore a total of 260 model architectures in a train-validation-test split in order to propose a model selection criterion which can pose the emphasis on reducing false negatives while still retaining acceptable accuracy. We achieve an area under the receiver operatic characteristics curve of 0.785 (accuracy 71.19%) on the test set, demonstrating how an ad hoc random initialization architecture can and should be fine tuned to a specific problem, especially in biomedical applications.
A Review of Characterization Approaches for Smallholder Farmers: Towards Predictive Farm Typologies
Authors: Nyambo Devotha G. , Luhanga Edith T. , Yonah Zaipuna Q.
Published: May 2019

Characterization of smallholder farmers has been conducted in various researches by using machine learning algorithms, participatory and expert-based methods. All approaches used end up with the development of some subgroups known as farm typologies. The main purpose of this paper is to highlight the main approaches used to characterize smallholder farmers, presenting the pros and cons of the approaches. By understanding the nature and key advantages of the reviewed approaches, the paper recommends a hybrid approach towards having predictive farm typologies. Search of relevant research articles published between 2007 and 2018 was done on ScienceDirect and Google Scholar. By using a generated search query, 20 research articles related to characterization of smallholder farmers were retained. Cluster-based algorithms appeared to be the mostly used in characterizing smallholder farmers. However, being highly unpredictable and inconsistent, use of clustering methods calls in for a discussion on how well the developed farm typologies can be used to predict future trends of the farmers. A thorough discussion is presented and recommends use of supervised models to validate unsupervised models. In order to achieve predictive farm typologies, three stages in characterization are recommended as tested in smallholder dairy farmers datasets: (a) develop farm types from a comparative analysis of more than two unsupervised learning algorithms by using training models, (b) assess the training models’ robustness in predicting farm types for a testing dataset, and (c) assess the predictive power of the developed farm types from each algorithm by predicting the trend of several response variables.
Resistant Ventricular Arrhythmia and the Role of Overdrive Pacing in the Suppression of the Electrical Storm
Authors: Magdi Mohamed , Mubasher Mahmood , Alzaeem Hakam , Hamid Tahir
Published: May 2019

Ventricular arrhythmia storm is a state of cardiac instability characterized by multiple ventricular arrhythmias or multiple ICD therapies within a 24-hour duration. Management of this life-threatening state depends on the reversal of the cause besides either electrical or medical management of the arrhythmia. We report a case of a 54-year-old male who underwent a percutaneous coronary intervention following massive acute myocardial infarction. Afterwards, he developed frequent life-threatening ventricular arrhythmias that required multiple shocks and antiarrhythmic medications. Despite all these interventions, it was very difficult to control the electrical instability, but after overdrive ventricular pacing, the storm subsided and within a few days the case was stabilized. Overdrive pacing is an easy temporary modality to control the resistant arrhythmia following myocardial infarction.
A Boolean Network Approach to Estrogen Transcriptional Regulation
Authors: Anda-Jáuregui Guillermo de , Espinal-Enríquez Jesús , Sandoval-Motta Santiago , Hernández-Lemus Enrique
Published: May 2019

Gene expression governs important biological processes such as the cell’s growth cycle and its response to environmental signals. Alterations of this complex network of transcriptional interactions often lead to unstable expression states and disease. Estrogen is a sex hormone known for its roles in cell proliferation. Its expression has been involved in several physiological functions such as regulating the menstrual and reproduction cycles in women. Altered expression states where estrogen levels are atypically high have been associated with an increased incidence of breast, ovarian, and cervix cancer. To better understand the implications of deregulation of the estrogen and estrogen receptor regulatory networks, in this work we generated a dynamical model of gene regulation of the estrogen receptor transcription network based on known regulatory interactions. By using an adaptation to classical Boolean Networks dynamics we identified proliferative and antiproliferative gene expression states of the network and also to identify key players that promote these altered states when perturbed. We also modeled how pairwise gene alterations may contribute to shifts between these two proliferative states and found that the coordinated subexpression of E2F1 and SMAD4 is the most important combination in terms of promoting proliferative states in the network.
A Modeling Method of Stochastic Parameters’ Inverse Gauss Process Considering Measurement Error under Accelerated Degradation Test
Authors: Liu Xiaoping , Wu Zhenyu , Cui Dejun , Guo Bin , Zhang Lijie
Published: May 2019

To solve the problem that the individual differences and the measurement errors affect the accuracy of life estimation in accelerated degradation test, the inverse Gauss process with stochastic parameters is applied in the accelerated degradation test with the consideration of the influence of individual differences, and the analysis of measurement uncertainty is carried out. An inverse Gauss accelerated degradation model considering both individual differences and measurement errors is established. In the maximum likelihood estimation of parameters, Genetic Algorithm and Monte Carlo integral are used to solve the problems caused by complex integral and the unobservable measurement errors in the calculation process. Finally, the proposed method is verified by the Monte Carlo simulation under the constant accelerated stress and step accelerated stress and the illustrative example of electrical connectors under the constant acceleration stress, respectively. The results show that the modeling tool is useful for improving the accuracy of the life prediction and the reliability evaluation.
Toward Personalized Computer Simulation of Breast Cancer Treatment: A Multiscale Pharmacokinetic and Pharmacodynamic Model Informed by Multitype Patient Data
Authors: Lai Xiaoran , Geier Oliver M. , Fleischer Thomas , Garred Øystein , Borgen Elin , Funke Simon W. , Kumar Surendra , Rognes Marie E. , Seierstad Therese , Børresen-Dale Anne-Lise , Kristensen Vessela N. , Engebraaten Olav , Köhn-Luque Alvaro , Frigessi Arnoldo
Published: May 2019

The usefulness of mechanistic models to disentangle complex multiscale cancer processes, such as treatment response, has been widely acknowledged. However, a major barrier for multiscale models to predict treatment outcomes in individual patients lies in their initialization and parametrization, which needs to reflect individual cancer characteristics accurately. In this study, we use multitype measurements acquired routinely on a single breast tumor, including histopathology, MRI, and molecular profiling, to personalize parts of a complex multiscale model of breast cancer treated with chemotherapeutic and antiangiogenic agents. The model accounts for drug pharmacokinetics and pharmacodynamics. We developed an open-source computer program that simulates cross-sections of tumors under 12-week therapy regimens and used it to individually reproduce and elucidate treatment outcomes of 4 patients. Two of the tumors did not respond to therapy, and model simulations were used to suggest alternative regimens with improved outcomes dependent on the tumor's individual characteristics. It was determined that more frequent and lower doses of chemotherapy reduce tumor burden in a low proliferative tumor while lower doses of antiangiogenic agents improve drug penetration in a poorly perfused tumor. Furthermore, using this model, we were able to correctly predict the outcome in another patient after 12 weeks of treatment. In summary, our model bridges multitype clinical data to shed light on individual treatment outcomes.

Significance:

Mathematical modeling is used to validate possible mechanisms of tumor growth, resistance, and treatment outcome.
Chemotherapy-Induced Extracellular Vesicle miRNAs Promote Breast Cancer Stemness by Targeting ONECUT2
Authors: Shen Meng , Dong Chuan , Ruan Xianhui , Yan Wei , Cao Minghui , Pizzo Donald , Wu Xiwei , Yang Lin , Liu Liang , Ren Xiubao , Wang Shizhen Emily
Published: May 2019

Cancer-secreted, extracellular vesicle (EV)–encapsulated miRNAs enable cancer cells to communicate with each other and with noncancerous cells in tumor pathogenesis and response to therapies. Here, we show that treatment with a sublethal dose of chemotherapeutic agents induces breast cancer cells to secrete EV with the capacity to stimulate a cancer stem-like cell (CSC) phenotype, rendering cancer cells resistance to therapy. Chemotherapy induced breast cancer cells to secrete multiple EV miRNAs, including miR-9-5p, miR-195-5p, and miR-203a-3p, which simultaneously targeted the transcription factor One Cut Homeobox 2 (ONECUT2), leading to induction of CSC traits and expression of stemness-associated genes, including NOTCH1, SOX9, NANOG, OCT4, and SOX2. Inhibition of these miRNAs or restoration of ONECUT2 expression abolished the CSC-stimulating effect of EV from chemotherapy-treated cancer cells. In mice bearing xenograft mammary tumors, docetaxel treatment caused elevations of miR-9-5p, miR-195-5p, and miR-203a-3p in circulating EV and decreased ONECUT2 expression and increased levels of stemness-associated genes. These effects following chemotherapy were diminished in tumors deficient in exosome secretion. In human breast tumors, neoadjuvant chemotherapy decreased ONECUT2 expression in tumor cells. Our results indicate a mechanism by which cancer cells communicate with each other and self-adapt to survive in response to cytotoxic treatment. Targeting these adaptation mechanisms along with chemotherapy, such as by blocking the EV miRNA–ONECUT2 axis, represents a potential strategy to maximize the anticancer effect of chemotherapy and to reduce chemoresistance in cancer management.

Significance:

These findings reveal a critical mechanism of resistance to chemotherapy by which breast cancer cells secrete miRNA-containing extracellular vesicles to stimulate cancer stem cell-like features.
Epstein-Barr Virus Seroprevalence and Primary Infection at the University Hospital Luigi Vanvitelli of Naples from 2007 to 2017
Authors: Franci Gianluigi , Crudele Valeria , Della Rocca Maria Teresa , Melardo Colombina , Chianese Annalisa , Finamore Emiliana , Bencivenga Francesco , Astorri Roberta , Vitiello Mariateresa , Galdiero Emilia , Galdiero Massimiliano
Published: May 2019

Epstein-Barr virus (EBV) is a common herpesvirus that may cause asymptomatic infection or various diseases, such as mononucleosis, lymphoproliferative disorders and several cancers. Our objective was to estimate the prevalence of EBV among patients hospitalized in “Luigi Vanvitelli” University Hospital in the last 10 years. Our results showed that EBV seroprevalence in our geographical area was 65%. Seroprevalence increased gradually with age with no significant difference between females (49.42%) and males (50.58%). The seropositivity for primary infection was higher in patients about 5 years old, while seropositivity for past infection was predominant in patients of about 35 years old. These results underline that children in our country are still exposed to EBV. The development and the deeper use of an EBV vaccine in the early years of life could represent the solution for this infection.
Automated Speech Recognition in Adult Stroke Survivors: Comparing Human and Computer Transcriptions
Authors: Jacks Adam , Haley Katarina L. , Bishop Gary , Harmon Tyson G.
Published: May 2019

Objective: Speech sound errors are common in people with a variety of communication disorders and can result in impaired message transmission to listeners. Valid and reliable metrics exist to quantify this problem, but they are rarely used in clinical settings due to the time-intensive nature of speech transcription by humans. Automated speech recognition (ASR) technologies have advanced substantially in recent years, enabling them to serve as realistic proxies for human listeners. This study aimed to determine how closely transcription scores from human listeners correspond to scores from an ASR system. Patients and Methods: Sentence recordings from 10 stroke survivors with aphasia and apraxia of speech were transcribed orthographically by 3 listeners and a web-based ASR service. Adjusted transcription scores were calculated for all samples based on accuracy of transcribed content words. Results: As expected, transcription scores were significantly higher for the humans than for ASR. However, intraclass correlations revealed excellent agreement among the humans and ASR systems, and the systematically lower scores for computer speech recognition were effectively equalized simply by adding the regression intercept. Conclusions: The results suggest the clinical feasibility of supplementing or substituting human transcriptions with computer-generated scores, though extension to other speech disorders requires further research.
Posttraumatic Stress Disorder Is a Risk Factor for Multiple Addictions in Police Officers Hospitalized for Alcohol
Authors: Brunault Paul , Lebigre Kevin , Idbrik Fatima , Maugé Damien , Adam Philippe , El Ayoubi Hussein , Hingray Coraline , Barrault Servane , Grall-Bronnec Marie , Ballon Nicolas , El-Hage Wissam
Published: May 2019

Background: In police officers, posttraumatic stress disorder (PTSD) is associated with alcohol use disorder (AUD), but we lack data on the association between PTSD and other substance-related and addictive disorders. Objectives: We assessed whether PTSD could be a risk factor for different substance-related and addictive disorders in police officers, including alcohol, tobacco, cannabis, and gambling. Method: This cross-sectional study included all police officers admitted consecutively for alcohol to an inpatient ward dedicated to police officers (Le Courbat rehabilitation center, France; n= 133). Each patient completed self-administered questionnaires that assessed lifetime exposure to potentially traumatic events (Life Event Checklist for DSM-5), PTSD severity and diagnosis (PTSD Checklist for DSM-5), AUD severity (Alcohol Use Disorder Identification Test [AUDIT]), tobacco dependence (Fagerström test for Nicotine Dependence), cannabis dependence (Cannabis Abuse Screening test), and gambling disorder (Canadian Problem Gambling Index). Results: Mean AUDIT score was 23.7 ± 8.0; 66.2% had an AUDIT score ≥20. Our sample comprised a high prevalence for PTSD (38.3%) and for substance-related and addictive disorders: tobacco dependence (68.4%), cannabis dependence (3.8%), and pathological gambling (3%). Patients with PTSD experienced higher lifetime exposure to traumatic experiences: physical assault, severe human suffering, sudden accidental death of another person, and other types of stressful events/experiences. In multiple linear regressions adjusted for age, sex, and marital status, PTSD was a significant predictor of the severity of AUD and tobacco use disorder, but not of the severity of cannabis use disorder nor gambling disorder. Conclusions: PTSD is common in police officers hospitalized for alcohol and associated with a higher severity of some addictive disorders (alcohol/tobacco). PTSD and its comorbid addictive disorders should be systematically screened and treated in this population.