bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eicosapentaenoic and Docosahexaenoic Acids Attenuate Progression of Albuminuria in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease
Authors: Elajami Tarec K. , Alfaddagh Abdulhamied , Lakshminarayan Dharshan , Soliman Michael , Chandnani Madhuri , Welty Francine K. 
Published: July 2017

Background

Albuminuria is a marker of inflammation and an independent predictor of cardiovascular morbidity and mortality. The current study evaluated whether eicosapentaenoic acid (
EPA
) and docosahexaenoic acid (
DHA
) supplementation attenuates progression of albuminuria in subjects with coronary artery disease.

Methods and Results

Two‐hundred sixty‐two subjects with stable coronary artery disease were randomized to either Lovaza (1.86 g of EPA and 1.5 g of DHA daily) or no Lovaza (control) for 1 year. Percent change in urine albumin‐to‐creatinine ratio (
ACR
) was compared. Mean (
SD
) age was 63.3 (7.6) years; 17% were women and 30% had type 2 diabetes mellitus. In nondiabetic subjects, no change in urine
ACR
occurred in either the Lovaza or control groups. In contrast,
ACR
increased 72.3% (
P
<0.001) in diabetic subjects not receiving Lovaza, whereas those receiving Lovaza had no change. In diabetic subjects on an angiotensin‐converting enzyme‐inhibitor or angiotensin‐receptor blocker, those receiving Lovaza had no change in urine
ACR
, whereas those not receiving Lovaza had a 64.2% increase (
P
<0.001). Change in
ACR
was directly correlated with change in systolic blood pressure (
r
=0.394,
P
=0.01).

Conclusions

EPA
and
DHA
supplementation attenuated progression of albuminuria in subjects with type 2 diabetes mellitus and coronary artery disease, most of whom were on an angiotensin‐converting enzyme‐inhibitor or angiotensin‐receptor blocker. Thus,
EPA
and
DHA
supplementation should be considered as additional therapy to an angiotensin‐converting enzyme‐inhibitor or angiotensin‐receptor blocker in subjects with type 2 diabetes mellitus and coronary artery disease.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
01624727.
Elevation of B‐Type Natriuretic Peptide at Discharge is Associated With 2‐Year Mortality After Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis: Insights From a Multicenter Prospective OCEAN‐TAVI (Optimized Transcatheter Valvular Intervention–Transcatheter Aortic Valve Implantation) Registry
Authors: Mizutani Kazuki , Hara Masahiko , Iwata Shinichi , Murakami Takashi , Shibata Toshihiko , Yoshiyama Minoru , Naganuma Toru , Yamanaka Futoshi , Higashimori Akihiro , Tada Norio , Takagi Kensuke , Araki Motoharu , Ueno Hiroshi , Tabata Minoru , Shirai Shinichi , Watanabe Yusuke , Yamamoto Masanori , Hayashida Kentaro 
Published: July 2017

Background

In this study, we sought to investigate the 2‐year prognostic impact of B‐type natriuretic peptide (
BNP
) levels at discharge, following transcatheter aortic valve replacement.

Methods and Results

We enrolled 1094 consecutive patients who underwent transcatheter aortic valve replacement between 2013 and 2016. Study patients were stratified into 2 groups according to survival classification and regression tree analysis (high versus low
BNP
groups). We evaluated the impact of high
BNP
on 2‐year mortality compared with that of low
BNP
using a multivariable Cox model, and assessed whether this stratification would improve predictive accuracy for determining 2‐year mortality by assessing time‐dependent net reclassification improvement and integrated discrimination improvement. The median age of patients was 85 years (quartile 82–88), and 29.2% of the study population were men. The median Society of Thoracic Surgeons score was 6.8 (4.7–9.5), and
BNP
at discharge was 186 (93–378) pg/mL. All‐cause mortality following discharge was 7.9% (95% CI, 5.8–9.9%) at 1 year and 15.4% (95% CI, 11.6–19.0%) at 2 years. The survival classification and regression tree analysis revealed that the discriminating
BNP
level to discern 2‐year mortality was 202 pg/mL, and that elevated
BNP
had a statistically significant impact on outcomes, with an adjusted hazard ratio of 2.28 (1.36–3.82,
P
=0.002). The time‐dependent net reclassification improvement (
P
=0.047) and integrated discrimination improvement (
P
=0.029) analysis revealed that the incorporation of
BNP
stratification with other clinical variables significantly improved predictive accuracy for 2‐year mortality.

Conclusions

Elevation of
BNP
at discharge is associated with 2‐year mortality after transcatheter aortic valve replacement.
Longitudinal Shear Loading of a Unidirectional Composite
Authors: Adams Donald F. , Doner Douglas R. 
Published: July 2017

The behavior of a unidirectional fiber-reinforced composite ma terial subjected to a shear loading in the direction of the filaments is of fundamental importance in the understanding of composite material behavior. The shear stiffness and strength values asso ciated with this type of loading can be considered as fundamental properties characterizing the material. The problem of a doubly periodic rectangular array of parallel elastic filaments of doubly symmetric but otherwise arbitrary shape contained in an elastic matrix material subjected to shear stress components in the directions of the filament axes has been formulated using a theory of elasticity analysis. A finite difference representation of the governing partial differential equations of equilibrium and stress-displacement equations has been utilized in obtaining a solution by a systematic over-relaxation procedure. Numerical results have been obtained for a variety of filament cross-sectional shapes, various filament-to-matrix shear modulus ratios (ranging from zero to infinity), and a range of filament spacings varying from filaments nearly in contact to extremely wide spacings in which interaction effects between filaments are essentially zero. Theoretical results have been compared with the limited experimental data presently available. The results obtained permit a detailed description of the micro mechanical behavior of a composite material subjected to longitudinal shear loading. A study of local stress distributions in the composite provides a means of predicting shear strength as well as stiffness as a function of the material properties of the constituents and their geometry. 1. S. W. Tsai, "Strength Characteristics of Composite Materials," NASA Contractor Report NASA CR-224, April 1965. 2. S. W. Tsai, D. F. Adams, and D. R. Doner, "Effect of Constituent Material Properties on the Strength of Fiber-Reinforced Composite Materials," Air Force Materials Laboratory Contractor Report AFML-TR-66-190, August 1966. 3. Z. Hashin and B. W. Rosen, "The Elastic Moduli of Fiber-reinforced Materials," J. Applied Mechanics, Vol. 31E (1964), p. 223. 4. C. H. Chen and Shun Cheng, "Mechanical Properties of Fiber-reinforced Com posites and of Perforated Solids," J. Composite Materials, Vol. 1 (1967), p. 30. 5. H. B. Wilson, Jr. and J. G. Goree, "Transverse Shear Loading in an Elastic Matrix Containing Two Elastic Circular Cylindrical Inclusions," Mathematical Studies of Composite Materials III, Rohm and Haas Company Report, Hunts ville, Alabama, June 1966.
Evidence for Chemical Bond Formation at Silane Coupling Agent Interfaces
Authors: Johannson O.K. , Stark F.O. , Vogel G.E. , Fleischmann R.M. 
Published: July 2017

An investigation of the physical chemical role of silane coupling agents at the glass-resin interface has been conducted. Radio actively labeled coupling agents were synthesized and purified, and their adsorption on E-glass and aerosil surfaces studied. The infor mation obtained from these tracer studies and from electron photo micrographic examination of fiber surfaces indicate that coupling agents form continuous films on E-glass surfaces with covalent bonding occurring at the interface. Failure of the glass-coupling agent interface in the presence of boiling water occurs by attack on the glass substrate itself. Using radioactive tracer techniques, it was also determined that copolymerization can occur at the coupling agent-resin interface.
Aluminum Phosphide Fatalities, New Local Experience
Authors: Abder-Rahman H A , Battah A H , Ibraheem Y M , Shomaf M S , Ei-Batainch N 
Published: July 2017

Aluminum phosphide (AlP) pesticide is a highly toxic, low cost, and easily accessible rodenticidal agent. Its toxicity results from the liberation of phosphine gas upon exposure to moisture, which leads to multisystem involvement, resulting in serious consequences. The highly toxic parathion insecticide was a common cause of mortality in pesticide fatalities, prior to its banning. Its toxicity was familiar to the public as well as to physicians. Recently, ten fatalities due to AlP were encountered within a three-month period during spring, when it was used as a rodenticide in the vicinity of grain stores. The victims' ages ranged from 1–34 years. The circumstances of death were accidental in six cases, suicidal in two and possibly homicidal in two cases. Retrospectively, the clinical manifestations, scene investigation, autopsy, histological and toxicological findings supported the diagnosis of AlP intoxication. Immediate recognition was difficult due to unfamiliarity of the agent to the physicians. The occurrence of these fatalities might suggest changes of pattern in pesticide poisoning. This should raise the attention of the physician to the problem of AlP poisoning and also necessitates the awareness of the public to the hazards of this poison. Education, proper handling, strict observation and abiding by the regulations controlling this material are good protective measures against AlP poisoning.
Environment: Physical and Social Aspects
Authors: Banks A. Leslie 
Published: July 2017

If crime is mainly due to environmental influences, it follows that a high proportion is preventable, with a “hard core” composed of the mentally backward, mentally ill, personality disorders and misfits. It is suggested that intensive research is required to bring the problem into focus, that the probation service should be built up to produce a cadre of experienced officers capable of mobilising the other community services in the prevention of crime, that the hard core should be dealt with by the appropriate experts, and that public opinion must be influenced to accept responsibility for the maintenance of discipline.
The Quantitative Assessment of Violence in Adult and Young Offenders
Authors: Nicol A. R. , Gunn J. C. , Foggitt R. H. , Gristwood J. 
Published: July 2017

The reliability and validity of a method of estimating violent behaviour at an interview is explored and discussed. Methods of studying violent behaviour have tended at one extreme to be by analysis of official statistics and at the other by a non-quantitative casework style of approach to the individual offender. Attempts to measure violent behaviour from interview accounts have been far less frequent and the present paper describes the use of this method in groups of men in prison and boys in Borstal.
Pathology of Suicide
Authors: Patel N. S. 
Published: July 2017

From approximately fifteen thousand consecutive medicolegal autopsies, a series of 764 completed ‘suicides’ have been collected and studied. When analysed, this series revealed 3 principal types of self-destruction. Over 50 per cent of the cases, irrespective of age and sex, changed the methods employed for subsequent suicide attempts and 30 per cent of the men and 40 per cent of the women, irrespective of age, had made attempts prior to the final act. Mental illness was noted in 76 per cent of those cases with previous suicide attempts compared with 40 per cent of those without a history of previous attempts, in whom other factors, such as physical and social, were predominant. Medical treatment, gastric casts, and missed suicides are also discussed, so as to reveal their significance in lowering the suicide rate at a time when it has been escalating.
The Medicolegal Implications of the Terms ‘Psychopath’, ‘Psychopathic Personality’ and ‘Psychopathic Disorder’
Authors: Blair Donald 
Published: July 2017

The difficulty in diagnosing various types of personality is considerable. What are the dividing lines between the so-called ‘ordinary personality’, ‘trend disturbances of personality’, ‘trait disorders of personality’ and ‘psychopathic disorders of personality’. There are no border lines and the qualities of one may shade into those of another. From the medicolegal point of view, however, it is obviously essential to determine which disorders of personality, if any, make sufferers not legally fully responsible for their actions. It is evident that only psychopathic disorders qualify for legal disposals that recognize their lack of legal responsibility to one degree or another. On the other hand, the latitude of interpretation of this diagnosis since it was recognized legally in the Mental Health Act 1959, has led to its use in the courts being in many cases of nebulous and doubtful value. If the conception of this entity is not to be abolished altogether there will in my estimation have to be a more exclusive and narrow meaning signified by psychopathic disorder and this article presents provocative suggestions how this may be achieved as well as a precise description of all aspects of psychopathy. The snags and illusions which have so far resulted in the mêlée of opinion regarding the whole of this matter and the influence this has had on the custodial and therapeutic disposal of this group of antisocial offenders and criminals will be discussed in a further article to be published in a subsequent issue of this journal.
Estimation of Stature from Parts of Bones—Lower End of Femur and Upper End of Radius
Authors: Mysorekar V. L. , Verma P. K. , Mandedkar A. N. , Sarmat T. C. S. R. 
Published: July 2017

A hundred and one right and 109 left dry, fully ossified, human femora have been studied to derive regression formulae for the establishment of the total length of the femur from the length of the lower end taken from the adductor tubercle. The formulae are statistically significant and their validity has been tested on 62 right and 59 left femora. A hundred and fifteen right and 106 left dry, fully ossified radii have been studied to derive regression formulae for establishment of the total length of the radius from the length of the upper end taken to the lower level of insertion of the biceps brachii muscle on the radial tuberosity. The validity of the formulae which are statistically significant has been tested on 51 right and 56 left dry and fully ossified random radii. All the regression formulae have a high degree of prediction, and are valuable in establishing the stature of an individual.
Detection of Cocaine in Rats from Analysis of Hair
Authors: Michalodimitrakis M. 
Published: July 2017

The detection of benzoylecgonine in the hair of cocainetreated rats is studied with the use of RIA technique. The cocaine metabolite can be determined in whole hair of rats up to ten days after the last administration of the drug. Benzoylecgonine can be detected in the hair of cocaine-treated rats with the use of the radioimmunoassay technique after sample extraction. After a period of ten days, cocaine metabolites could be detected under the conditions described in the experimental procedure. The concentrations of benzoylecgonine ranged between 23,94 and 47,56 ng/g. The analysis of hair by means of a sensitive and specific method such as radioimmunoassay would be highly advantageous since hair samples are easily accessible, stable and retain the drug for long periods of time.
Gamma-Glutamyl Transferase: Applications in Forensic Pathology: I: Study of Blood Serum Recovered from Human Bodies
Authors: Piette M. , Schrijver G. De 
Published: July 2017

In order to appreciate more adequately chronic alcohol use by the deceased in the course of a medico-legal autopsy we studied the usefulness of a determination of gamma-glutamyl transferase (GGT) activity in cadaver serum. Some preliminary tests were performed to check the post-mortem stability of this enzyme, the influence of post-mortem haemolysis upon enzyme determination, the influence of the sampling site upon the enzyme activity and the suitability of vitreous humour as an alternative body fluid for GGT determination. Secondly, correlations between GGT activity and the degree of fatty liver degeneration and fibrosis (both possibly alcohol-induced tissue lesions) were searched for. Finally, a comparison was made between strictly selected groups of alcoholics and non-alcoholics. We concluded that, keeping in mind the necessary precautions to avoid typical post-mortem fallacies, a GGT determination in cadaver serum provides a useful parameter for detecting chronic alcoholism at the forensic autopsy.
Suicidal Stab Wounds of the Throat
Authors: Chadly A , Marc B , Paraire F , Durigon M 
Published: July 2017

Suicide by stabbing one's throat remains very rare and very few cases have been reported in the forensic literature. In such cases, the important distinction is between suicide and homicide. The direction of stab wounds, their depth, site and number have particular importance in helping to recognize suicide. Suicide when attempted by transfixion of the neck in middle aged and elderly adults often reveals a definite resolution to kill oneself.
Suicide in Wolverhampton (1976–1990)
Authors: Scott K W M 
Published: July 2017

A total of 394 individuals died by their own hand in Wolverhampton from the years 1976 to 1990. The rate of suicide was 10.5/100, 000 per year, compared with the official statistics returned by HM Coroner of 232 cases in this 15-year period, or 6.2/100, 000 per year. Suicide does not appear to have increased in the Borough of Wolverhampton over these 15 years but the Coroner's Rules, which at present apply, have the effect of concealing the true numbers of suicides. The Coroner's figures in this series only reflected 59% of the probable true suicide rate. The ratio of males to females was 1.96:1 and there was no significant difference in the average ages of male and female suicides. Drowning was found to be a common cause of suicide in the elderly population (over 60 years of age) and there was an increased incidence of hanging in Asians, especially young Asian females, as compared with their numbers in the population of the borough. A positive psychiatric history was present in 64.5% of suicides and such a history was more common in deaths due to drug overdose and drowning. There was no obvious seasonal variation found in the suicide rate.
Fatal Haemorrhage following Intra-Aortic Balloon Counterpulsation: A Case Report and a Brief Review of its Clinico-Pathological and Medico-Legal Aspects
Authors: Lau G 
Published: July 2017

Intra-aortic balloon counterpulsation may result in serious and possibly fatal vascular complications, such as arterial dissection, in as many as 20 per cent of cases. A significant proportion of these complications may go unrecognized clinically. The following is an account of such a case from Singapore in which an elderly patient with a history of severe ischaemic heart disease died within 25 hours of coronary bypass surgery (resulting from massive intraperitoneal haemorrhage), as a consequence of post-operative intra-aortic balloon counterpulsation. The clinico-pathological and medicolegal aspects of the case are also discussed, together with a brief mention of the role of post-mortem coronary angiography in assessing venous graft patency and integrity.
1. Prosthetic Valve Dysfunction and the Law: A Case Presentation from Nigeria
Authors: Obasohan A O , Ogiamien T B E 
Published: July 2017

The possible legal implications of the failure of a mechanical prosthetic cardiac valve have been reviewed within the framework of the Nigerian legal system. This is the sequel to a clinical case we had recently, of primary mechanical failure of a cardiac prosthesis which led to the death of a 19-year-old medical student. A short account of the case as reported by the physicians is presented. As there has been no such case before any Nigerian Court, this review draws heavily upon salutary lessons from the USA and the UK, where such, or related, cases are more prevalent.
Aflatoxin Exposure in Singapore: Blood Aflatoxin Levels in Normal Subjects, Hepatitis B Virus Carriers and Primary Hepatocellular Carcinoma Patients
Authors: Chao Tzee Cheng , Lo Dst , Bloodworth B Chen , Gunasegaram R , Koh T H , Ng Han Seong 
Published: July 2017

Blood screening conducted on Singaporeans over 1991–1992 showed exposure to predominately aflatoxin B1 and to a lesser extent G1. The extent of exposure to B1 among three groups of residents in Singapore, namely normal subjects (n = 423), hepatitis B virus carriers (n = 302) and primary hepatocellular carcinoma (PHC) patients (n = 58) were extensive as reflected by the positive rates of 15.1, 0.7 and 1.7 per cent respectively. However, the degree of individual exposure to this toxin among the three groups was considered low as shown by the low respective mean blood levels of 5.4 ± 3.2 (range 3.0–17), 7.7 (range 7.5–7.9) and 7.5 picogrammes per ml of blood. It is not immediately clear whether or not such low levels would precipitate an undesirable health effect. The higher positive rate seen in normal subjects as compared with the other groups could be due to differences in dietary intake of aflatoxin B1, differences in metabolic patterns or both. About 70 per cent of PHC patients studied were carriers. The degree of aflatoxin B1 exposure among normal subjects in Singapore was a factor of 22.1 times less than that in Japan, 40.9 times less than that in Indonesia and 51.3 times less than that in the Philippines. Similarly, the extent of exposure among hepatitis B carriers in Singapore was a factor of 8.2 times, 39.6 times and 24.2 times less than those in the other three Asiatic countries respectively. The results reflected stringent Government control over the quality of food stuff imported into this country. As Singapore imports almost all its dietary needs from elsewhere, it can afford to be selective at a cost. Aflatoxin M1, a metabolite of B1, was most commonly encountered in the liver tissues of deceased (n = 154) who died of causes other than sickness or disease in 1992–93, consistent with our blood findings of prevalence of aflatoxin Bl. High performance liquid chromatography (HPLC) with fluorescence detection using one of the aflatoxins G2 or B2 as an internal standard was used for the detection and quantification of aflatoxins. The use of an internal standard structurally and chemically similar to those required to be quantified minimizes errors in quantifications. This is because differences in the quenching of fluorescence between specimen extracts and spiked-standard extracts were internally standardized and compensated for. The presence of an internal standard also helped to locate aflatoxins of interest more accurately. Strict decontamination procedures for cleaning glassware and apparatus were adhered to, to reduce cross-contaminations. Only duplicate-positive results were taken to be positive.