bluuebunny/crossref_metadata_2025 huggingface dataset:
Recurrent Complete Pharyngo-Oesophageal Stricture Treated by Multidisciplinary Anterograde-Retrograde Endoscopic Dilation
Authors: Castro Soares Paulo , Bouayed Salim , Dulguerov Pavel , Frossard Jean-Louis
Published: October 2016

Complete pharyngo-oesophageal stricture (PES) after radiotherapy for head and neck cancer is a relatively rare and difficult complication to manage. Historically this condition has been treated surgically, but endoscopic approaches are now available. We present a 61-year-old man with an epidermoid carcinoma of the supraglottic stage and a micro-invasive epidermoid carcinoma of the oropharynx treated surgically and subsequently by adjuvant radiotherapy. Eight months after the end of the radiotherapy, a complete PES was diagnosed and treated with a combined anterograde-retrograde endoscopic dilation (CARD). The procedure was performed using a transoral anterograde progression with a rigid pharyngoscope and a retrograde progression with an extra-slim nasal endoscope using the percutaneous gastrostomy already in place. Using both transillumination and direct visualisation from both sides of the complete stenosis patency was restored between the neopharynx and the oesophagus. Despite the use of an endoprosthesis, the complete PES recurred and the technique had to be performed a second time. Illustrating the complexity of the case different types of endoprosthesis and several dilations had to be performed for our patient to achieve and maintain a normal oral intake. This case report illustrates that even in complicated recurrent radiation-induced complete PES a CARD can be performed safely and successfully using different types of endoprosthesis.
Ectopic Intrathyroidal Thymus in Childhood: A Sonographic Finding Leading to Misdiagnosis
Authors: Vlachopapadopoulou Elpis-Athina , Vakaki Marina , Karachaliou Fotini-Eleni , Kaloumenou Irene , Kalogerakou Kleanthi , Gali Christina , Michalacos Stefanos
Published: October 2016

Background: During gestation, the primordial thymus migrates from the pharynx to the anterior mediastinum, thus thymic tissue can remain at any point along this path. Intrathyroidal thymic remnants are rare, and their sonographic patterns have only recently been described. This retrospective study presents the sonographic appearance of ectopic intrathyroidal thymus and emphasizes the role of sonography in order to avoid misdiagnosis. Methods: The population consisted of 42 children, 3.5-14 years old, who had a thyroid sonogram performed due to a positive family history or symptoms indicative of thyroid disease, and ectopic intrathyroidal thymus was recognized. Results: In all patients, the same pattern was revealed: a fusiform intrathyroidal lesion, with no mass effect, homogeneously hypoechoic, with diffuse bright internal echoes. The similarity to the characteristic sonographic pattern of the normal mediastinal thymus was crucial for the diagnosis of ectopic intrathyroidal thymic tissue. In 8 cases, a normal elongated thymus was found connected to the thyroid with an accessory lobe embedded in the lower thyroid pole. The above sonographic appearances mimicked a thyroid nodule. Conclusions: Awareness of the sonographic patterns of the ectopic intrathyroidal thymus is mandatory to avoid misdiagnosis. In most cases, further investigation is unnecessary, but sonographic follow-up should be recommended.
Transcriptomic Analysis Reveals Novel Transcription Factors Associated With Renin–Angiotensin–Aldosterone System in Human Atheroma
Authors: Nehme Ali , Cerutti Catherine , Zibara Kazem
Published: October 2016

Despite the well-known role of the renin–angiotensin–aldosterone system (RAAS) in atheroma, its global local organization is poorly understood. In this study, we used transcriptomic meta-analysis to reveal the local transcriptional organization and regulation of 37 extended RAAS (extRAAS) genes in atheroma. Expression analysis and hierarchical clustering were done on extRAAS genes in 32 paired early and advanced atherosclerotic lesions. Contrary to receptor-coding transcripts, multiple angiotensin-metabolizing enzymes showed higher expression in advance, in comparison to early lesions. Interestingly, similar results were obtained from GEO data sets containing human (n=839) and mouse (n=18) atherosclerotic samples, but different from normal human (n=11) arterial tissues. The expression and coordination patterns were then used to construct transcriptional maps of extRAAS, displaying favored pathways in atheroma. Three coexpression modules (M1, M2, and M3) with >80% reproducibility across human atheroma data sets were identified. M1 and M3 contained angiotensin-metabolizing enzymes transcripts, whereas M2 contained proatherogenic receptor-coding transcripts. Interestingly, M1 and M2 were negatively correlated. A total of 21 transcription factors with enriched binding sites in the promoters of coordinated genes were extracted, among which
IRF5, MAX
, and
ETV5
showed significant positive correlations with M1, but negative correlations with M2. However,
ETS1
and
SMAD1
transcripts were positively correlated to receptor-coding genes in M2. Despite sharing some similarities in extRAAS organization with kidney and adipose, atheroma showed specific correlations between extRAAS and transcription factors. In conclusion, our transcriptional map helps in designing more efficient treatments for atherosclerosis. In addition, the identified transcription factors provide a basis for the discovery of atheroma-specific modulators of extRAAS.
Central Hemodynamics and Arterial Stiffness in Systemic Sclerosis
Authors: Bartoloni Elena , Pucci Giacomo , Cannarile Francesca , Battista Francesca , Alunno Alessia , Giuliani Marco , Cafaro Giacomo , Gerli Roberto , Schillaci Giuseppe
Published: October 2016

Although microvascular disease is a hallmark of systemic sclerosis (SSc), a higher prevalence of macrovascular disease and a poorer related prognosis have been reported in SSc than in the general population. The simultaneous assessment of prognostically relevant functional properties of larger and smaller arteries, and their effects on central hemodynamics, has never been performed in SSc using the state-of-the-art techniques. Thirty-four women with SSc (aged 61±15 years, disease duration 17±12 years, and blood pressure 123/70±18/11 mm Hg) and 34 healthy women individually matched by age and mean arterial pressure underwent the determination of carotid-femoral (aortic) and carotid-radial (upper limb) pulse wave velocity (a direct measure of arterial stiffness), aortic augmentation (a measure of the contribution of reflected wave to central pulse pressure), and aortobrachial pulse pressure amplification (brachial/aortic pulse pressure) through applanation tonometry (SphygmoCor). Patients and controls did not differ by carotid-femoral or carotid-radial pulse wave velocity. Aortic augmentation index corrected for a heart rate of 75 bpm (AIx@75) was higher in women with SSc (30.9±16% versus 22.2±12%;
P
=0.012). Patients also had a lower aortobrachial amplification of pulse pressure (1.22±0.18 versus 1.33±0.25;
P
=0.041). SSc was an independent predictor of AIx@75 (direct) and pulse pressure amplification (inverse). Among patients, age, mean arterial pressure, and C-reactive protein independently predicted carotid-femoral pulse wave velocity. Age and mean arterial pressure were the only predictors of AIx@75. Women with SSc have increased aortic augmentation and decreased pulse pressure amplification (both measures of the contribution of reflected wave to central waveform) but no changes in aortic or upper limb arterial stiffness. Microvascular involvement occurs earlier than large artery stiffening in SSc.
Subsequent Shockable Rhythm During Out‐of‐Hospital Cardiac Arrest in Children With Initial Non‐Shockable Rhythms: A Nationwide Population‐Based Observational Study
Authors: Goto Yoshikazu , Funada Akira , Goto Yumiko
Published: October 2016

Background

The effect of a subsequent treated shockable rhythm during cardiopulmonary resuscitation on the outcome of children who suffer out‐of‐hospital cardiac arrest with initial nonshockable rhythm is unclear. We hypothesized that subsequent treated shockable rhythm in children with out‐of‐hospital cardiac arrest would improve survival with favorable neurological outcomes (Cerebral Performance Category scale 1–2).

Methods and Results

From the All‐Japan Utstein Registry, we analyzed the records of 12 402 children (aged <18 years) with out‐of‐hospital cardiac arrest and initial nonshockable rhythms. Patients were divided into 2 cohorts: subsequent treated shockable rhythm (
YES
; n=239) and subsequent treated shockable rhythm (
NO
; n=12 163). The rate of 1‐month cerebral performance category 1 to 2 in the subsequent treated shockable rhythm (
YES
) cohort was significantly higher when compared to the subsequent treated shockable rhythm (
NO
) cohort (4.6% [11 of 239] vs 1.3% [155 of 12 163]; adjusted odds ratio, 2.90; 95% CI, 1.42–5.36; all
P
<0.001). In the subsequent treated shockable rhythm (
YES
) cohort, the rate of 1‐month cerebral performance category 1 to 2 decreased significantly as time to shock delivery increased (17.7% [3 of 17] for patients with shock‐delivery time 0–9 minutes, 7.3% [8 of 109] for 10–19 minutes, and 0% [0 of 109] for 20–59 minutes;
P
<0.001 [for trend]). Age‐stratified outcomes showed no significant differences between the 2 cohorts in the group aged <7 years old: 1.3% versus 1.4%,
P
=0.62.

Conclusions

In children with out‐of‐hospital cardiac arrest and initial nonshockable rhythms, subsequent treated shockable rhythm was associated with improved 1‐month survival with favorable neurological outcomes. In the cohort of older children (7–17 years), these outcomes worsened as time to shock delivery increased.
Sulfur Dioxide Protects Against Collagen Accumulation in Pulmonary Artery in Association With Downregulation of the Transforming Growth Factor β1/Smad Pathway in Pulmonary Hypertensive Rats
Authors: Yu Wen , Liu Die , Liang Chen , Ochs Todd , Chen Stella , Chen Selena , Du Shuxu , Tang Chaoshu , Huang Yaqian , Du Junbao , Jin Hongfang
Published: October 2016

Background

We aimed to explore the role of endogenous sulfur dioxide (
SO
2
) in pulmonary vascular collagen remodeling induced by monocrotaline and its mechanisms.

Methods and Results

A rat model of monocrotaline‐induced pulmonary vascular collagen remodeling was developed and administered with
l
‐aspartate‐β‐hydroxamate or
SO
2
donor. The morphology of small pulmonary arteries and collagen metabolism were examined. Cultured pulmonary arterial fibroblasts stimulated by transforming growth factor β1 (
TGF
‐β1) were used to explore the mechanism. The results showed that in monocrotaline‐treated rats, mean pulmonary artery pressure increased markedly, small pulmonary arterial remodeling developed, and collagen deposition in lung tissue and pulmonary arteries increased significantly in association with elevated
SO
2
content, aspartate aminotransferase (AAT) activity, and expression of AAT1 compared with control rats. Interestingly,
l
‐aspartate‐β‐hydroxamate, an inhibitor of
SO
2
generation, further aggravated pulmonary vascular collagen remodeling in monocrotaline‐treated rats, and inhibition of
SO
2
in pulmonary artery smooth muscle cells activated collagen accumulation in pulmonary arterial fibroblasts.
SO
2
donor, however, alleviated pulmonary vascular collagen remodeling with inhibited collagen synthesis, augmented collagen degradation, and decreased
TGF
‐β1 expression of pulmonary arteries. Mechanistically, overexpression of AAT1, a key enzyme of
SO
2
production, prevented the activation of the
TGF
‐β/type I
TGF
‐β receptor/Smad2/3 signaling pathway and abnormal collagen synthesis in pulmonary arterial fibroblasts. In contrast, knockdown of AAT1 exacerbated Smad2/3 phosphorylation and deposition of collagen types I and
III
in
TGF
‐β1–treated pulmonary arterial fibroblasts.

Conclusions

Endogenous
SO
2
plays a protective role in pulmonary artery collagen accumulation induced by monocrotaline via inhibition of the
TGF
‐β/type I
TGF
‐β receptor/Smad2/3 pathway.
Early Christianity in Light of New Religious Movements
Authors: Regev Eyal
Published: October 2016

Comparing early Christian groups with modern new religious movements (nrms) and cults enables us to identify and analyze indicative social and religious attributes that defined the self-identity of the early Christians (as reflected in the letters of Paul, Acts, and the Gospel of John), made them stand out as different, and, ultimately, led to their rejection by outside society.

The devotion to Jesus as Christ and the inclusion of Gentiles among these early Christian groups were novel features that, by definition, created a new religious movement rejected by both Jews and Romans. The intense recruitment of converts by early Christians, also a characteristic ofnrms, was seen as a direct threat by their contemporaries. Early Christian groups lacked social separation from mainstream society, strong demands on their members along with sanctions against deviant ones, and systematic organization — all characteristics which are particular to certain cults, such as Scientology in its early years and the Sōka Gakkai. Taken together, these three social features demonstrate that early Christianity was not a segregated sect but, rather, a cult that aimed to penetrate mainstream society, gain legitimacy, and recruit converts.
The Irreligiousness of Fascism
Authors: Severino Valerio S.
Published: October 2016

This essay aims to reexamine the debate on the impact of Fascism on religious studies, by reconstructing what Raffaele Pettazzoni, one of the founding fathers of this field of research in Italy in the first half of the twentieth century, meant by “religion of the state.” His research on the origin of the religious state in Iranian history and in the Greek polytheistic prototype of thepolisoffers a key to the interpretation of his further analysis of the religious Fascist phenomenon. Mingling approaches of both political science and history of religions, this study constitutes an introduction to a new understanding — which remained hidden in Pettazzoni’s texts — of Fascism as a degeneration of state religiousness. While Fascism is an example of the sacralization of politics (according to one of the leading historians of Fascist ideology, Emilio Gentile), Pettazzoni showed how in other ways Fascism perpetuated the pre-Christian crisis of the religious state.
How Talking about Indigenous Religion May Change Things
Authors: Tafjord Bjørn Ola
Published: October 2016

A decade ago, Bribris, an indigenous community in Costa Rica, used to operate with a distinction between “indigenous traditions” and “religions.” More recently, some of them have begun to talk about an “indigenous religion.” This article is about uses of the category “religion” and especially new uses of a globalizing concept of “indigenous religion.” Some of the consequences of the shift in discourse are also discussed. The main point made is this: the adoption and adaptation of a concept of “indigenous religion” enable some Bribris to defend better some of their interests, but it also contributes to an increased influx of foreign ideas, practices, and bodies to previously more sheltered domains of Talamancan society. It testifies to new creativity and new transactions in the struggles for control of identities, activities, and territories, but it also alters the balance between local and trans-local dynamics.
An Interactional World Trade Law
Authors: Altamimi Abdulmalik M.
Published: October 2016

This article undertakes an innovative analysis of the theoretical and practical bases of world trade law by employing the interactional international law theory developed by Jutta Brunnée and Stephen Toope, and the jurisprudence of Lon L. Fuller. There are two main reasons for choosing an interactional approach. Firstly, through the constructivist notion of shared understandings, it offers a suitable framework for identifying the social foundations of world trade in terms of economic and legal inputs into the system. Secondly, Fuller’s contributions are acutely relevant to world trade law because of the economics foundation of his morality of law thesis, and his insightful reflections on fidelity to law, legality, and adjudication. Fuller’s jurisprudence pays close attention to the limits of adjudicating institutional rules that apply to the allocation of economic resources. This makes it useful for discussing the procedural challenges facing the World Trade Organization compliance regime.
A Conceptual and Practical Evaluation of Intergenerational Equity in International Environmental Law
Authors: Hadjiargyrou Zena
Published: October 2016

The article addresses the unfolding of the concept of intergenerational equity, which aims to ensure the conservation of planetary resources amongst generations within the realm of the law of trusts. The article explicates the concept’s ambiguities through confronting its conflicting understandings in academia whilst elucidating how it operates and expresses itself in legal documents, constitutions and national and international courts. An afterthought follows which envisages intergenerational equity as a multifarious utopia, which is to be addressed uniformly for its potential attainment.
Key to Holarctic species of Epitrix flea beetles (Coleoptera: Chrysomelidae: Galerucinae: Alticini) with review of their distribution, host plants and history of invasions
Authors: BIEŃKOWSKI ANDRZEJ O. , ORLOVA-BIENKOWSKAJA MARINA J.
Published: October 2016

The genus Epitrix Foudras, 1860a has a worldwide distribution. Some species of Epitrix are major pests of potato, tomato, eggplant, tobacco and other plants in North America and Europe. Some pest species have been inadvertently introduced from North America to Europe, from Europe to North America and from both continents to some islands in Atlantic and Pacific oceans. Therefore, a key for the identification of all Holarctic species is necessary for plant quarantine and protection services. We have compiled the key for distinguishing Epitrix from genera that could be confused with it and a key for all Holarctic species of Epitrix with the figures of spermathecae and aedeagi and the checklist with a review of the geographical distribution, host plants and history of invasions. The following species are included: E. abeillei (Bauduer), E. allardii (Wollaston), E. atropae Foudras, E. brevis Schwarz, E. caucasica (Heikertinger), E. cucumeris (Harris), E. dieckmanni (Mohr), E. ermischi (Mohr), E. fasciata Blatchley, E. flavotestacea Horn, E. fuscula Crotch, E. hirtipennis (Melsheimer), E. humeralis Dury, E. intermedia Foudras, E. krali Döberl, E. lobata Crotch, E. muehlei Döberl, E. priesneri (Heikertinger), E. pubescens (Koch), E. ogloblini (Iablokov-Khnzorian), E. robusta Jacoby, E. setosella (Fairmaire), E. similaris Gentner, E. solani (Blatchley), E. subcrinita (LeConte), E. tuberis Gentner, E. warchalowskii (Mohr) and E. papa Orlova-Bienkowskaja.
Three new species of Nazeris Fauvel in Xizang, China (Coleoptera, Staphylinidae, Paederinae)
Authors: HU JIA-YAO , PAN ZHAO-HUI , LI LI-ZHEN
Published: October 2016

The paederine genus Nazeris Fauvel, 1873 previously included 241 described species and seven subspecies (Assing, 2016). As many as 49 species have been recorded from the Himalaya (Assing, 2014). In China, Yunnan has the greatest diversity of Nazeris (45 species). Xizang is the second largest province of China, and adjacent to Yunnan and the Himalaya. But only two Nazeris species have been described from this area: N. motuensis Hu, Li & Zhao, 2008 and N. tangi Hu, Li & Zhao, 2008. Both of them were found in eastern Xizang. Three additional species in the insect collection of the Shanghai Normal University are described in this paper.
Range extension of Pseudotorinia phorcysi (Gastropoda: Architectonicidae) from the SW Atlantic, with remarks on its ontogeny
Authors: CAVALLARI DANIEL C. , SALVADOR RODRIGO B.
Published: October 2016

Architectonicidae is a diverse family of heterobranch sea snails comprising over 11 genera and 140 extant species distributed worldwide (Bieler & Petit, 2005). They live in shallow to deep water, and have turbinate to discoidal shells, with a typically wide umbilicus and a downward-pointing (heterostrophic) protoconch (Healy, 1998). Pseudotorinia phorcysi Cavallari, Salvador & Simone, 2013 is a deep-water species known only from its type locality in the SW Atlantic, off Cabo Frio, Rio de Janeiro state, Brazil (23°41'S 42°06'W, 430–450 m depth). Its original description was based on a single eroded juvenile specimen collected by the French-Brazilian expedition “Marion Dufresne” MD55 in the late 1980s (Cavallari et al., 2014).
State Dependence of Atmospheric Response to Extratropical North Pacific SST Anomalies
Authors: Zhou Guidi , Latif Mojib , Greatbatch Richard J. , Park Wonsun
Published: October 2016

By performing two sets of high-resolution atmospheric general circulation model (AGCM) experiments, the authors find that the atmospheric response to a sea surface temperature (SST) anomaly in the extratropical North Pacific is sensitive to decadal variations of the background SST on which the SST anomaly is superimposed. The response in the first set of experiments, in which the SST anomaly is superimposed on the observed daily SST of 1981–90, strongly differs from the response in the second experiment, in which the same SST anomaly is superimposed on the observed daily SST of 1991–2000. The atmospheric response over the North Pacific during 1981–90 is eddy mediated, equivalent barotropic, and concentrated in the east. In contrast, the atmospheric response during 1991–2000 is weaker and strongest in the west. The results are discussed in terms of Rossby wave dynamics, with the proposed primary wave source switching from baroclinic eddy vorticity forcing over the eastern North Pacific in 1981–90 to mean-flow divergence over the western North Pacific in 1991–2000. The wave source changes are linked to the decadal reduction of daily SST variability over the eastern North Pacific and strengthening of the Oyashio Extension front over the western North Pacific. Thus, both daily and frontal aspects of the background SST variability in determining the atmospheric response to extratropical North Pacific SST anomalies are emphasized by these AGCM experiments.
The Role of Ocean Dynamical Thermostat in Delaying the El Niño–Like Response over the Equatorial Pacific to Climate Warming
Authors: Luo Yiyong , Lu Jian , Liu Fukai , Garuba Oluwayemi
Published: October 2016

The role of ocean dynamics in the response of the equatorial Pacific Ocean to climate warming is investigated using both an atmosphere–ocean coupled climate system and its ocean component. Results show that the initial response (fast pattern) to an uniform heating imposed on the ocean is a warming centered to the west of the date line owing to the conventional ocean dynamical thermostat (ODT) mechanism in the eastern equatorial Pacific—a cooling effect arising from the up-gradient upwelling. In time, the warming pattern gradually propagates eastward, becoming more El Niño–like (slow pattern). The transition from the fast to the slow pattern likely results from 1) the gradual warming of the equatorial thermocline temperature, which is associated with the arrival of the relatively warmer extratropical waters advected along the subsurface branch of the subtropical cells (STCs), and 2) the reduction of the STC strength itself. A mixed layer heat budget analysis finds that it is the total ocean dynamical effect rather than the conventional ODT that holds the key for understanding the pattern of the SST in the equatorial Pacific and that the surface heat flux works mainly to compensate the ocean dynamics. Further passive tracer experiments with the ocean component of the coupled system verify the role of the ocean dynamical processes in initiating a La Niña–like SST warming and in setting the pace of the transition to an El Niño–like warming and identify an oceanic origin for the slow eastern Pacific warming independent of the weakening trade wind.
Structure and Evolution of a Warm Frontal Precipitation Band during the GPM Cold Season Precipitation Experiment (GCPEx)
Authors: Colle Brian A. , Naeger Aaron R. , Molthan Andrew
Published: October 2016

This paper describes the evolution of an intense precipitation band associated with a relatively weak warm front observed during the Global Precipitation Measurement (GPM) Mission Cold Season Precipitation Experiment (GCPEx) over southern Ontario, Canada, on 18 February 2012. The warm frontal precipitation band went through genesis, maturity, and decay over a 5–6-h period. The Weather Research and Forecasting (WRF) Model nested down to 1-km grid spacing was able to realistically predict the precipitation band evolution, albeit somewhat weaker and slightly farther south than observed. Band genesis began in an area of precipitation with embedded convection to the north of the warm front in a region of weak frontogenetical forcing at low levels and a weakly positive to slightly negative moist potential vorticity (MPV*) from 900 to 650 hPa. A midlevel dry intrusion helped reduce the midlevel stability, while the precipitation band intensified as the low-level frontogenesis intensified in a sloping layer with the warm front. Aggregates of unrimed snow occurred within the band during early maturity, while more supercooled water and graupel occurred as the upward motion increased because of the frontogenetical circulation. As the low-level cyclone moved east, the low-level deformation decreased and the column stabilized for vertical and slantwise ascent, and the warm frontal band weakened. A WRF experiment turning off latent heating resulted in limited precipitation band development and a weaker warm front, while turning off latent cooling only intensified the frontal precipitation band as additional midlevel instability compensated for the small decrease in frontogenetical forcing.
Reservation-based dispatching rule for make-to-order wafer FAB with high-priority lots
Authors: Chung Yong H , Seo Jeong C , Kim Chong Man , Kim Byung H , Park Sang C
Published: October 2016

Make-to-order wafer Fabrications (FABs) have to deal with two different types of lots: high priority and normal. High-priority lots have shorter cycle times, tighter target due dates, and higher margins than normal lots. This article presents a dispatching rule for on-time delivery of high-priority lots with low tardiness for normal lots. The proposed dispatching rule uses the concept of reservation, which refers to the provisional allocation of capacity for high-priority lots. The reservation policy has been applied to ensure capacity for high-priority lots in real FABs. The reservations of high-priority lots may cause considerable tardiness of normal lots. To cope with the problem, the proposed dispatching rule considers tool utilization as well as the on-time delivery of high-priority lots. Also, we introduce the concept of reservation depth to control the influence level of the reservation. The proposed dispatching rule has been implemented and outperforms conventional dispatching rules and conventional reservation policy.
Capsule retention related to small bowel capsule endoscopy: a large European single‐center 10‐year clinical experience
Authors: Nemeth Artur , Wurm Johansson Gabriele , Nielsen Jörgen , Thorlacius Henrik , Toth Ervin
Published: October 2016

Background

The most concerning complication of video capsule endoscopy (VCE) is capsule retention (CR) in the gastrointestinal (GI) tract although clinical outcome and management of patients with CR are still uncertain in a large single center material.

Objectives

The aim of this retrospective study was to investigate incidence, causes, risk factors, management and clinical outcomes of CR in a large single center between 2001 and 2011.

Results

2401 consecutive small‐bowel (SB) VCEs were performed. CR was detected in 25 cases (1%). CR in patients with suspected and known Crohn’s disease (CD) undergoing VCE occurred in 14/1370 (1%) including known CD 9/390 (2.3%) and suspected CD 5/980 (0.5%). CR in patients with obscure GI bleeding was observed in 11/816 (1.3%) cases. The SB was the most common site of CR with 17 cases followed by the esophagus (4 cases), colon (2 cases), and stomach (2 cases). Emergency endoscopic intervention (3 cases) and surgery (2 cases) was needed in 5 cases of CR. Elective capsule removal was performed by surgery in 6 cases and endoscopically in 8 cases. Three retained capsules dislodged after steroid treatment and another 3 cases of CR resolved without any intervention.

Conclusion

This large clinical material demonstrates that CR is a rare complication with a favorable clinical outcome. Most patients with CR can be electively managed with non‐surgical intervention.
Phosphodiesterase 4 inhibitors have wide-ranging activity in B-cell malignancies
Authors: Cooney Jeffrey D. , Aguiar Ricardo C. T.
Published: October 2016

Phosphodiesterase 4 (PDE4) inhibition restores the suppressive effects of 3′,5′-cyclic adenosine monophosphate in lymphocytes. In this concise review, we detail how PDE4 inhibition downmodulates the B-cell receptor (BCR)-related kinases spleen tyrosine kinase and phosphatidylinositol 3-kinase and inhibits vascular endothelial growth factor A secretion by tumor cells, inducing cancer cell apoptosis and blocking angiogenesis in the microenvironment. We describe the successful clinical repurposing of PDE4 inhibitors in B-cell malignancies, and propose that given their anti-inflammatory/immunomodulatory activity, these agents will suppress BCR signals without the toxicity associated with other targeted biological doublets.
Identifying biomarkers of dementia prevalent among amnestic mild cognitively impaired ethnic female patients
Authors: Grewal Rinko , Haghighi Mona , Huang Shuai , Smith Amanda G. , Cao Chuanhai , Lin Xiaoyang , Lee Daniel C. , Teten Nancy , Hill Angela M. , Selenica Maj-Linda B.
Published: October 2016

Background

There is a need to investigate biomarkers that are indicative of the progression of dementia in ethnic patient populations. The disparity of information in these populations has been the focus of many clinical and academic centers, including ours, to contribute to a higher success rate in clinical trials. In this study, we have investigated plasma biomarkers in amnestic mild cognitively impaired (aMCI) female patient cohorts in the context of ethnicity and cognitive status.

Method

A panel of 12 biomarkers involved in the progression of brain pathology, inflammation, and cardiovascular disorders were investigated in female cohorts of African American, Hispanic, and White aMCI patients. Both biochemical and algorithmic analyses were applied to correlate biomarker levels measured during the early stages of the disease for each ethnicity.

Results

We report elevated plasma Aβ40, Aβ42, YKL-40, and cystatin C levels in the Hispanic cohort at early aMCI status. In addition, elevated plasma Aβ40 levels were associated with the aMCI status in both White and African American patient cohorts by the decision tree algorithm. Eotaxin-1 levels, as determined by the decision tree algorithm and biochemically measured total tau levels, were associated with the aMCI status in the African American cohort.

Conclusions

Overall, our data displayed novel differences in the plasma biomarkers of the aMCI female cohorts where the plasma levels of several biomarkers distinguished between each ethnicity at an early aMCI stage. Identification of these plasma biomarkers encourages new areas of investigation among aMCI ethnic populations, including larger patient cohorts and longitudinal study designs.
Formation of reciprocal appreciation patterns in small groups: an agent-based model
Authors: Koponen Ismo T. , Nousiainen Maija
Published: October 2016

Purpose

In small cooperative and collaborative groups, patterns of interaction, discourse and dialogue are often strongly bidirectional; ties are reciprocal and reciprocated. This reciprocation of ties leads to the formation of interaction patterns that are reciprocated dyads (two individuals connected reciprocally) and triads (three individuals connected reciprocally). In this study, we use an agent-based model to explore how such reciprocated dyadic and triadic patterns emerge from self-reinforced appreciation between peers in a small group.

Methods

The model assumes that the agents’ decisions to interact depend on how their self-appreciation compares to their appreciations of their peers (peer-appreciation). These comparisons are competitive in that an agent seek to increase its appreciation in relation to its peers. As a consequence, agents change their self-appreciation and appreciation towards their peers depending on their sensitivity to the competitive comparison.

Results

When agents’ sensitivity to competitive comparisons is low, the most common patterns of appreciation are egalitarian triads (all three agents appreciate each other), while for moderate sensitivity, leadership-type patterns emerge (one agent connected strongly to two other unconnected agents). When sensitivity is high, strong reciprocally connected dyads emerge. The model thus predicts thus a transition from egalitarian triads to strong dyads as agents’ sensitivity to competitive comparisons increases.

Conclusions

The structural similarity between patterns emerging as model results and patterns reported in empirical research suggests that: (1) reciprocation based on appreciation is a strong candidate for explaining the formation of such patterns, and (2) individual sensitivity to competitive comparisons of appreciation may be a key factor that can be used to the tune dynamics of interaction in small groups.
Chylothorax in thyroid surgery: A very rare case and systematic review of the literature
Authors: Merki Verena , Pichler Juliane , Giger Roland , Mantokoudis Georgios
Published: October 2016

Background

Chylothorax is a very rare but major complication in thyroid surgery and should be apparent to clinicians in this field.

Case presentation

We report a case with chylothrax after thyroid surgery in our department that drew our attention.

Methods

Systematic review of the literature to evaluate the incidence and the contributing factors of chylothorax after thyroid surgery. Database (PubMed) and hand searches to identify patients with thyroid surgery and postoperative chylothorax. Keywords included chylothorax, thyroidectomy, thyroid surgery and complications. Two independent reviewers screened studies against inclusion and exclusion criteria. Patient characteristics, risk factors, symptoms, treatments and etiopathogenesis were investigated.

Results

We identified 13 articles in the literature describing 19 patients with chylothorax after thyroidectomy and described our own case. Ninety percent of the patients underwent thyroidectomy for thyroid cancer. Sixteen patients (80%) underwent thyroidectomy with at least a left lateral neck dissection, 2 patients (10%) underwent thyroidectomy with sternotomy, and in the remaining 2 patients (10%), thyroidectomy with lateral neck dissection on both sides was performed with partial sternotomy. Our calculated incidence for chylothorax with total thyroidectomy and neck dissection was 1.85%; for a thoracic approach the calculated incidence was 7.3%.

Conclusions

There are no reports of chylothorax after thyroidectomy without at least a left lateral neck dissection due to advanced thyroid cancer and/or sternotomy due to the thyroid size. The extension of thyroid surgery seems to be the main risk factor in developing chylothorax either through direct surgical trauma or through increased intraductal pressure after thoracic duct ligation. An early diagnosis of chylothorax may avoid severe metabolic or cardiopulmonary complications.
CXCL12-induced macropinocytosis modulates two distinct pathways to activate mTORC1 in macrophages
Authors: Pacitto Regina , Gaeta Isabella , Swanson Joel A , Yoshida Sei
Published: October 2016

Although growth factors and chemokines elicit different overall effects on cells—growth and chemotaxis, respectively—and activate distinct classes of cell-surface receptors, nonetheless, they trigger similar cellular activities and signaling pathways. The growth factor M-CSF and the chemokine CXCL12 both stimulate the endocytic process of macropinocytosis, and both activate the mechanistic target of rapamycin complex 1 (mTORC1), a protein complex that regulates cell metabolism. Recent studies of signaling by M-CSF in macrophages identified a role for macropinocytosis in the activation of mTORC1, in which delivery of extracellular amino acids into lysosomes via macropinocytosis was required for activation of mTORC1. Here, we analyzed the regulation of macropinosome (MP) formation in response to CXCL12 and identified 2 roles for macropinocytosis in the activation of mTORC1. Within 5 min of adding CXCL12, murine macrophages increased ruffling, macropinocytosis and amino acid-dependent activation of mTORC1. Inhibitors of macropinocytosis blocked activation of mTORC1, and various isoform-specific inhibitors of type 1 PI3K and protein kinase C (PKC) showed similar patterns of inhibition of macropinocytosis and mTORC1 activity. However, unlike the response to M-CSF, Akt phosphorylation (pAkt) in response to CXCL12 required the actin cytoskeleton and the formation of macropinocytic cups. Quantitative fluorescence microscopy showed that phosphatidylinositol (3,4,5)-trisphosphate (PIP3), a product of PI3K and an upstream activator of Akt, localized to macropinocytic cups and that pAkt occurred primarily in cups. These results indicate that CXCL12 activates mTORC1 via 2 mechanisms: 1) that the macropinocytic cup localizes Akt signaling and 2) that MPs convey extracellular nutrients to lysosomes.
Maternal Low Protein Isocaloric Diet Suppresses Pancreatic β-Cell Proliferation in Mouse Offspring via miR-15b
Authors: Su Yutong , Jiang Xiuli , Li Yanli , Li Feng , Cheng Yulong , Peng Ying , Song Dalong , Hong Jie , Ning Guang , Cao Yanan , Wang Weiqing
Published: October 2016

The mechanism underlying the increased susceptibility of type 2 diabetes in offspring of maternal malnutrition is poorly determined. Here we tested the hypothesis that functional microRNAs (miRNAs) mediated the maternal low-protein (LP) isocaloric diet induced pancreatic β-cell impairment. We performed miRNA profiling in the islets from offspring of LP and control diet mothers to explore the potential functional miRNAs responsible for β-cell dysfunction. We found that LP offspring exhibited impaired glucose tolerance due to decreased β-cell mass and insulin secretion. Reduction in the β-cell proliferation rate and cell size contributed to the decreased β-cell mass. MiR-15b was up-regulated in the islets of LP offspring. The up-regulated miR-15b inhibited pancreatic β-cell proliferation via targeting cyclin D1 and cyclin D2. Inhibition of miR-15b in LP islet cells restored β-cell proliferation and insulin secretion. Our findings demonstrate that miR-15b is critical for the regulation of pancreatic β-cells in offspring of maternal protein restriction, which may provide a further insight for β-cell exhaustion originated from intrauterine growth restriction.
Specification of osteoblast cell fate by canonical Wnt signaling requires Bmp2
Authors: Salazar Valerie S. , Ohte Satoshi , Capelo Luciane P. , Gamer Laura , Rosen Vicki
Published: October 2016

Enhanced BMP or canonical Wnt (cWnt) signaling are therapeutic strategies employed to enhance bone formation and fracture repair, but the mechanisms each pathway utilizes to specify cell fate of bone-forming osteoblasts remain poorly understood. Among all BMPs expressed in bone, we find that singular deficiency of Bmp2 blocks the ability of cWnt signaling to specify osteoblasts from limb bud or bone marrow progenitors. When exposed to cWnts, Bmp2-deficient cells fail to progress through the Runx2/Osx1 checkpoint and thus do not upregulate multiple genes controlling mineral metabolism in osteoblasts. Cells lacking Bmp2 after induction of Osx1 differentiate normally in response to cWnts, suggesting that pre-Osx1+ osteoprogenitors are an essential source and a target of BMP2. Our analysis furthermore reveals Grainyhead-like 3 (Grhl3) as a transcription factor in the osteoblast gene regulatory network induced during bone development and bone repair, which acts upstream of Osx1 in a BMP2-dependent manner. The Runx2/Osx1 transition therefore receives crucial regulatory inputs from BMP2 that are not compensated for by cWnt signaling, and this is mediated at least in part by induction and activation of Grhl3.
Nutrition in critical illness: a current conundrum
Authors: Hoffer L. John , Bistrian Bruce R.
Published: October 2016

Critically ill people are unable to eat. What’s the best way to feed them? Nutrition authorities have long recommended providing generous amounts of protein and calories to critically ill patients, either intravenously or through feeding tubes, in order to counteract the catabolic state associated with this condition. In practice, however, patients in modern intensive care units are substantially underfed. Several large randomized clinical trials were recently carried out to determine the clinical implications of this situation. Contradicting decades of physiological, clinical, and observational data, the results of these trials have been claimed to justify the current practice of systematic underfeeding in the intensive care unit. This article explains and suggests how to resolve this conundrum.
Priority directions to attract investment and development of the real sector of economy in 2016
Authors: Бударин  , Budarin A.
Published: October 2016

The article presents an assessment of the development of the Orel region. The main directions and prospects of state support of investment activity in the Orel region are presented. Among the priority activities it is proposed to implement a system of special investment contracts and project management and to create the Center of Cluster Development based on Entrepreneurship Support Fund.
A construction possibility of organizational model of territorial accessibility of complex rehabilitation for children with disabilities in the orel region
Authors: Семянников  , Semyannikov Dmitriy
Published: October 2016

The article analyzes the statistics on the number of disabled children in the Orel region in 2012-2015, that allowed to offer the construction possibility of organizational model of territorial accessibility of complex rehabilitation for children with disabilities in the Orel region, based on the experience of the Kostroma region. The author provides a regional system of social protection of children with disabilities; the reasons for the development of this model of territorial accessibility of complex rehabilitation of children with disabilities are presented.
The self-adjustable organizations in the mechanism of realization of constitutional freedom of economic activities
Authors: Башкатов  , Bashkatov Aleksandr
Published: October 2016

Clause is devoted to research of a legal regulation of the organization and activity of the self-adjustable organizations on sense of constitutional freedom of economic activities. In opinion of the author, the institute of the self-adjustable organizations favourably differs from the state intervention in market economy as it allows the most enterprise community to supervise this sphere in the form of standardization of corporate behaviour, establishments of special and not state rules and procedures.
Rank Centrality: Ranking from Pairwise Comparisons
Authors: Negahban Sahand , Oh Sewoong , Shah Devavrat
Published: October 2016

The question of aggregating pairwise comparisons to obtain a global ranking over a collection of objects has been of interest for a very long time: be it ranking of online gamers (e.g., MSR’s TrueSkill system) and chess players, aggregating social opinions, or deciding which product to sell based on transactions. In most settings, in addition to obtaining a ranking, finding ‘scores’ for each object (e.g., player’s rating) is of interest for understanding the intensity of the preferences.

In this paper, we propose Rank Centrality, an iterative rank aggregation algorithm for discovering scores for objects (or items) from pairwise comparisons. The algorithm has a natural random walk interpretation over the graph of objects with an edge present between a pair of objects if they are compared; the score, which we call Rank Centrality, of an object turns out to be its stationary probability under this random walk.

To study the efficacy of the algorithm, we consider the popular Bradley-Terry-Luce (BTL) model (equivalent to the Multinomial Logit (MNL) for pairwise comparisons) in which each object has an associated score that determines the probabilistic outcomes of pairwise comparisons between objects. In terms of the pairwise marginal probabilities, which is the main subject of this paper, the MNL model and the BTL model are identical. We bound the finite sample error rates between the scores assumed by the BTL model and those estimated by our algorithm. In particular, the number of samples required to learn the score well with high probability depends on the structure of the comparison graph. When the Laplacian of the comparison graph has a strictly positive spectral gap, e.g., each item is compared to a subset of randomly chosen items, this leads to dependence on the number of samples that is nearly order optimal.

Experimental evaluations on synthetic data sets generated according to the BTL model show that our algorithm performs as well as the maximum likelihood estimator for that model and outperforms other popular ranking algorithms.
3. Treatment of diabetes mellitus type 2
Authors: Nazarko Linda
Published: October 2016

More than three million pople in the UK have diabetes mellitus type 2 (DMT2). Prevalance rises in line with body mass index. Present guidance ( National Institute for Health and Care Excellence (NICE), 2015 ) recommends a four-step approach to treatment. This article explains all four steps, examines which oral and injectable medication is required and looks at the clinical indications for each treatment.
The power of relationships in bringing hope to patients in difficult times. Part 1/2
Authors: Higham Nic , Martynchyk Nina
Published: October 2016

Star Wards is a charity that provides practical ideas and inspiring examples of mental health best care practice, from and for mental health care staff working within inpatient settings. Its overall objective is to support staff in enabling patients to make the most of their time away from their usual lives. Prior to joining Star Wards, Nic spent ten years working as both a healthcare support worker and a therapeutic liaison worker, a role he pioneered. Nic now works as the Star Wards inpatient care project manager, using his experience to develop resources for ward staff.

Nina brings to her work as Star Wards service user consultant for CAMHeleon her experience of being treated under both outpatient and inpatient child and adolescent mental health services (CAMHS)—CAMHeleon is a collection of best practice ideas for ward staff working with children and adolescents.

CAMHS are specialist NHS services provided to children and young people who struggle with their emotional and/or behavioural wellbeing. Within the text, Nina responds to quotes taken from and inspired by the various themes of CAMHeleon, telling us her story and explaining how the compassion and care of the staff were some of the key factors that led her onto the path of recovery.