Ιατρικά Άρθρα Αλέξανδρος Γ. Σφακιανάκης: 06/06/16

Δευτέρα 6 Ιουνίου 2016

Prognostic Significance of Sleep Apnea Syndrome on False Lumen Aortic Expansion in Post-Acute Aortic Syndrome.

Prognostic Significance of Sleep Apnea Syndrome on False Lumen Aortic Expansion in Post-Acute Aortic Syndrome.

Ann Thorac Surg. 2016 Jun 1;

Authors: Delsart P, Juthier F, Clough RE, Sobocinski J, Azzaoui R, Ramstein J, Devos P, Rousse N, Jegou B, Fayad G, Modine T, Mallart A, Vincentelli A, Mounier-Vehier C, Haulon S

Abstract
BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is a risk factor for resistant arterial hypertension and aortic dilatation. We assessed the value of systematic screening for OSAS in patients soon after the onset of acute aortic syndrome (AAS).
METHODS: Between January 2010 and June 2014, patients were prospectively screened for post AAS OSAS. The severity of OSAS was defined by the Apnea-Hypopnea Index (AHI) and the Oxygen Desaturation Index (ODI). Blood pressure control was assessed with 24-h ambulatory monitoring.
RESULTS: The study population comprised 71 patients (males: 64.7%; median age [interquartile range]: 57 [49 to 64] years; type A AAS: 49.3%; type B AAS: 50.7%). According to the AHI, 58 patients (81.7%) had OSAS and 31 (43.6%) had severe OSAS. A prognostic analysis revealed that the descending thoracic false lumen dilatation rate rose significantly with the severity of OSAS (p = 0.0008 for the AHI and p = 0.0284 for the ODI). The median rate of increase was 7.5 (5 to 10) mm/year in the AHI greater than 30 events/h group and 5.0 (0 to 8) mm/year in the ODI greater than 30 events/h group. With regard to blood pressure control, the diastolic blood pressure varied as function of the ODI category (p = 0.0074).
CONCLUSIONS: Our results suggest that systematic screening for post-ASS OSAS is of value. The false lumen dilatation rate appears to be related to the severity of OSAS. It remains to be seen whether treatment of OSAS would modify the false lumen dilatation rate.

PMID: 27262915 [PubMed - as supplied by publisher]

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The Reliability of Oral and Pharyngeal Dimensions Captured with Acoustic Pharyngometry.

The Reliability of Oral and Pharyngeal Dimensions Captured with Acoustic Pharyngometry.

Dysphagia. 2016 Jun 4;

Authors: Molfenter SM

Abstract
Acoustic Pharyngometry (APh) is a method for quantifying oropharyngeal tract configuration using sound wave reflection and is commonly used in diagnostics and research of sleep apnea. The standard preset output of APh (minimal cross-sectional area) has been established as reliable. However, by conducting post-processing measures on specific breathing tasks, APh data can also reveal oral length, oral volume, pharyngeal length, and pharyngeal volume. Given that these measures may have utility in dysphagia research, the reliability of these measures is unknown and is the focus of the current study. Ten young healthy female volunteers completed two sessions of APh data collection to obtain measures of oral length, oral volume, pharyngeal length, and pharyngeal volume 1 week apart. Two-way mixed intraclass correlation coefficients were calculated to establish intra-rater reliability, inter-rater reliability, and test-retest reliability. Results revealed excellent levels of agreement within and across raters for all oropharyngeal tract parameters. Levels of test-retest agreement for oral length and oral volume indicated these parameters are appropriate for monitoring change within an individual. All parameters were deemed to have acceptable test-retest values as outcome measures in group-level analysis.

PMID: 27262868 [PubMed - as supplied by publisher]

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Obstructive Sleep Apnoea: Children are not little Adults.

Obstructive Sleep Apnoea: Children are not little Adults.

Paediatr Respir Rev. 2016 Apr 21;

Authors: Alsubie HS, BaHammam AS

Abstract
During a child's development, several important developmental physiological sleep processes occur, and, occasionally, pathological disorders occur, which results in differences between obstructive sleep apnoea (OSA) in adults and children. There are major differences in sleep and respiratory physiology as well as OSA symptoms and treatment options between children and adults. Many practitioners do not realize these differences, which results in delays in the diagnosis and treatment of OSA in children. The treatment options for OSA in children are markedly different compared with adults, effective in most children. The use of positive airway pressure (PAP) therapy delivered through continuous or bi-level positive airway pressure modes is successful in children and even in infants; however, there are several challenges facing parents and practitioners to achieve good compliance. The early recognition and treatment of paediatric OSA are essential to prevent deleterious consequences. This article discusses the major differences between paediatric and adult OSA and demonstrates why children are not little adults.

PMID: 27262609 [PubMed - as supplied by publisher]

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Sleep Ecophysiology: Integrating Neuroscience and Ecology.

Sleep Ecophysiology: Integrating Neuroscience and Ecology.

Trends Ecol Evol. 2016 Jun 1;

Authors: Aulsebrook AE, Jones TM, Rattenborg NC, Roth TC, Lesku JA

Abstract
Here, we propose an original approach to explain one of the great unresolved questions in animal biology: what is the function of sleep? Existing ecological and neurological approaches to this question have become roadblocks to an answer. Ecologists typically treat sleep as a simple behavior, instead of a heterogeneous neurophysiological state, while neuroscientists generally fail to appreciate the critical insights offered by the consideration of ecology and evolutionary history. Redressing these shortfalls requires cross-disciplinary integration. By bringing together aspects of behavioral ecology, evolution, and conservation with neurophysiology, we can achieve a more comprehensive understanding of sleep, including its implications for adaptive waking behavior and fitness.

PMID: 27262386 [PubMed - as supplied by publisher]

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Frequency and risk factors of functional gastro-intestinal disorders in a rural Indian population.

Frequency and risk factors of functional gastro-intestinal disorders in a rural Indian population.

J Gastroenterol Hepatol. 2016 Jun 5;

Authors: Ghoshal UC, Singh R

Abstract
BACKGROUND: As best estimates on functional gastrointestinal disorders (FGIDs) prevalence are expected from community studies, which are scanty from Asia, we evaluated the prevalence and risk factors of FGIDs in a rural Indian community.
METHODS: House-to-house survey was undertaken by trained interviewers using translated-validated Rome III and hospital anxiety and depression questionnaires.
RESULT: Among 3426 subjects ≥ 18-year (y) old from 3 villages in Uttar Pradesh, 84% participated, of whom 80% were finally analyzed. Of these 2774 subjects (age 38.4 ± 16.5-y, 1573 [56.7%] male), 2654 [95.7%] were vegetarian and 120 [4.3%] non-vegetarian. Socioeconomic classes were upper (16.7%), upper middle (15.1%), lower middle (22%), upper lower (22.2%) and lower (24%) using Prasad's Classification; 603 (21.7%) had FGIDs (413 [14.9%] dyspepsia, 75 [2.7%] IBS and 115 [4.1%] dyspepsia-IBS overlap), by Rome III criteria. In subjects with dyspepsia, 49/528 (9%) had epigastric pain, 141 (27%) post-prandial distress syndromes (EPS, PDS) and 338 (64%) EPS-PDS overlap. IBS was more often diarrhea than constipation-predominant subtype. On univariate analysis, chewing tobacco, aerated drink, tea/coffee, disturbed sleep, vegetarianism, and anxiety parameters and presence of dyspepsia predicting occurrence of IBS were associated with FGIDs. On multivariate analysis, chewing tobacco, aerated soft drink, tea/coffee, vegetarianism, anxiety parameters and presence of dyspepsia predicting IBS were significant.
CONCLUSION: FGIDs, particularly dyspepsia-IBS overlap, are common in rural Indian population; the risk factors included chewing tobacco, aerated soft drink, tea/coffee, vegetarian diet, disturbed sleep, anxiety and dyspepsia predicting occurrence of IBS.

PMID: 27262283 [PubMed - as supplied by publisher]

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Opioids and Sleep Disordered Breathing.

Opioids and Sleep Disordered Breathing.

Chest. 2016 Jun 1;

Authors: Van Ryswyk E, Antic N

Abstract
Opioid use for chronic pain analgesia, particularly chronic non-cancer pain (CNCP), has increased greatly since the late 1990s, resulting in an increase in opioid-associated morbidity and mortality. A clear link between opioid use and sleep disordered breathing (SDB) has been established, with the majority of chronic opioid users being affected by the condition, and dose dependent severity apparent for some opioids. More evidence is currently needed on how to effectively manage opioid-induced SDB. This review summarizes the current state of knowledge relating to management of patients on chronic opioid therapy who have SDB. Initial management of the patient on chronic opioid therapy with SDB requires thorough biopsychosocial assessment of their need for opioid therapy, consideration of reduction, or cessation of the opioid if possible and alternative therapies for treatment of their pain. If opioid therapy must be continued, then management of the associated SDB may be important. Several small-medium scale studies have examined the efficacy of non-invasive ventilation, particularly adaptive servo ventilation (ASV) for treatment of opioid-associated SDB. This is particularly because opioids predispose predominantly to central sleep apnoea (CSA), and also, to a lesser extent, to obstructive sleep apnoea (OSA). Generally, these studies have found positive results in treating opioid-associated SDB with ASV in terms of improving outcome measures such as central apnoea index and apnoea hypopnoea index. However, larger studies that measure longer term health outcomes, patient sleepiness and compliance are needed. Registries of health outcomes of ASV treated patients may assist with future treatment planning.

PMID: 27262224 [PubMed - as supplied by publisher]

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Regulation of the Pacemaker Activity of Colonic Interstitial Cells of Cajal by Protease-Activated Receptors: Involvement of Hyperpolarization-Activated Cyclic Nucleotide Channels

Background and Purpose: The exact mechanism of protease-activated receptors (PARs) on pacemaker activity of interstitial cells of Cajal (ICCs) has not been reported. We investigated the effects on pacemaker activity by the activation of PARs and its signal mechanisms in colonic ICCs. Methods: The whole-cell patch-clamp technique, RT-PCR and Ca²⁺ imaging were used in cultured ICCs from mouse colon. Results: PAR-1 and PAR-2 were expressed in Ano-1 positive ICCs. TFLLR-NH₂ (a PAR-1 agonist) and trypsin (a PAR-2 agonist) depolarized the membrane and increased the pacemaker potential frequency. U-73122 (a phospholipase C (PLC) inhibitor) and thapsigargin (a Ca²⁺ ATPase inhibitor) suppressed the TFLLR-NH₂- and trypsin-induced effects on pacemaker potential. TFLLR-NH₂ and trypsin also increased intracellular Ca²⁺ ([Ca²⁺]_i) intensity with increasing of Ca²⁺ oscillations. Genistein (a tyrosine kinase inhibitor), SP600125 (a JNK inhibitor), CsCl, ZD7288, clonidine (hyperpolarization-activated cyclic nucleotide (HCN) channel blockers), SQ-22536 and dideoxyadenosine (adenylate cyclase inhibitors) suppressed the increased pacemaker potential frequency without effects on depolarization of the membrane induced by TFLLR-NH₂ and trypsin. Conclusion: These results suggest that activation of PAR-1 and PAR-2 modulates the pacemaker activity of colonic ICCs through the PLC-dependent [Ca²⁺]_i release pathway. The increased pacemaker potential frequency by PAR-1 and PAR-2 was also dependent on tyrosine kinase, JNK, and HCN activation.
Pharmacology 2016;98:171-182

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The relationship of modern health worries to non-specific physical symptoms and perceived environmental sensitivity: A study combining self-reported and general practice data.

http:--linkinghub.elsevier.com-ihub-imag

The relationship of modern health worries to non-specific physical symptoms and perceived environmental sensitivity: A study combining self-reported and general practice data.

J Psychosom Res. 2015 Nov;79(5):355-61

Authors: Baliatsas C, van Kamp I, Hooiveld M, Lebret E, Yzermans J

Abstract
OBJECTIVE: The present study investigates the association of modern health worries (MHW) with self-reported as well as general practitioner (GP)-registered non-specific physical symptoms (NSPS), medication use, alternative therapy consultations, sleep quality and quality of life. The interrelation between MHW, general environmental sensitivity and the aforementioned outcomes is also explored.
METHODS: Self-reported questionnaires and data from electronic medical records from 21 general practices in The Netherlands were combined in a sample of 5933 adult participants.
RESULTS: The majority of the participants reported increased worries about potential health effects from environmental exposures. The highest worry scores were reported by people who perceived themselves as more vulnerable to environmental stressors. After adjustment for socio-demographic characteristics and diagnosed psychiatric morbidity, higher MHW were significantly associated with increased self-reported prevalence and duration of NSPS, symptom-related healthcare utilization, GP-registered NSPS, alternative therapy consultations and lower sleep quality and quality of life. These associations were statistically mediated by perceived environmental sensitivity. No association was observed between worries and GP-registered medication prescriptions.
CONCLUSION: Modern health worries are very common in the general population. They are associated with self-reported as well as clinically defined NSPS and as such might play a key role in the process of developing and maintaining environmental sensitivities and related symptoms. A large cross-cultural longitudinal study would help to determine important aspects such as temporal precedence and stability of MHW and the relevant psychosocial context within which symptomatic conditions occur.

PMID: 26526308 [PubMed - indexed for MEDLINE]

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Three job stress models and their relationship with musculoskeletal pain in blue- and white-collar workers.

Three job stress models and their relationship with musculoskeletal pain in blue- and white-collar workers.

J Psychosom Res. 2015 Nov;79(5):340-7

Authors: Herr RM, Bosch JA, Loerbroks A, van Vianen AE, Jarczok MN, Fischer JE, Schmidt B

Abstract
OBJECTIVES: Musculoskeletal pain has been found to co-occur with psychosocial job stress. However, different conceptualizations of job stress exist, each emphasizing different aspects of the work environment, and it is unknown which of these aspects show the strongest associations with musculoskeletal pain. Further, these associations may differ for white-collar vs. blue-collar job types, but this has not been tested. The present study examined the independent and combined contributions of Effort-RewardImbalance (ERI), Job-Demand-Control (JDC) and Organizational Justice (OJ) to musculoskeletal pain symptoms among white- and blue-collar workers.
METHODS: Participants of a cross-sectional study (n=1634) completed validated questionnaires measuring ERI, JDC, and OJ, and reported the frequency of pain during the previous year at four anatomical locations (lower back, neck or shoulder, arms and hands, and knees/feet). Pain reports were summarized into a single musculoskeletal symptom score (MSS). Analyses were stratified for white- and blue-collar workers.
RESULTS: Among white-collar workers, ERI and OJ were independently associated with MSS. In addition to these additive effects, significant 2-way and 3-way interactions indicated a synergistic effect of job stressors in relation to reported pain. In blue-collar workers, ERI and JDC independently associated with MSS, and a significant 3-way interaction was observed showing that the combination of job stressors exceeded an additive effect.
CONCLUSION: ERI influences pain symptoms in both occupational groups. OJ was independent significant predictor only among white-collar workers, whereas JDC had additive predictive utility exclusively among blue-collar workers. Simultaneous exposure to multiple job stress factors appeared to synergize pain symptom reporting.

PMID: 26526306 [PubMed - indexed for MEDLINE]

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Mortality study of employees at a chemical manufacturing plant using administrative databases

Background

This study investigated mortality in a cohort of 1,988 male workers at a chemical manufacturing plant (1981–2011) and evaluated the quality of the results obtained using administrative databases.

Methods

Information about the workers was obtained from the archives of the Italian National Institute for Social Insurance. Vital status and causes of death were ascertained through record linkage with electronic archives and follow-up mailing. Regional reference rates were used to calculate standardized mortality ratios (SMRs) and 90% confidence intervals (CI).

Results

The analysis showed increased SMR for selected cancers of a priori interest: respiratory system (SMR: 126.8; 90%CI: 105–152), pleura (330.5; 90%CI 164–596), and non-Hodgkin lymphoma (196.1; 90%CI 102–342).

Conclusions

The results indicate an effect of hazardous exposures among workers in this chemical manufacturing plant. Using administrative databases to construct historical cohorts is an efficient method in time and resources, for estimating the risk of mortality and generating hypotheses. Am. J. Ind. Med. 9999:XX–XX, © 2016 Wiley Periodicals, Inc.

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Servizio Civile Nazionale in Istituto, aperto il bando 2016 per la selezione dei volontari

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Incontriamoci INTram con il Tram della Ricerca

Incontriamoci INTram con il tram della Ricerca
Fondazione IRCCS Istituto Nazionale dei Tumori
Via G. Venezian, 1 - 20133 Milano

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Effect of Water Salinity on the External Morphology of Ovarian Maturation Stages of Orange Mud Crab, Scylla olivacea (Herbst, 1796) in Captivity

Background and Objective: Mud crab from the genus Scylla are considered as one of the most demanded seafood items nowadays as their flesh has high quality, tasty and higher growth rate thus support and boosted expansion in aquaculture sector especially in Malaysia. Present study was designed to focus on the effect of water salinity on the ovarian maturation of orange mud crab, Scylla olivacea based on morphological characteristics. Methodology: Samples were collected from Setiu wetlands, Terengganu, Malaysia from July-September, 2015. Ovarian maturation of S. olivacea was classified into four stages based on previous study which were: Immature (Stage 1), early mature (Stage 2), late mature (Stage 3) and fully mature (Stage 4). Results: Morphologically as the ovary develop the colouration start to change from translucent or whitish in colour and sometimes creamy to pale yellow, follow by light orange and lastly reddish orange. Stage 1 ovary was translucent and whitish in colour, stage 2 ovary was pale yellow in colour, stage 3 was light orange and stage 4 ovary was reddish orange in colour. Gonad Somatic Index (GSI) of S. olivacea remained low at stage 1 and 2 and began to increase started at stage 3. This present study involved three different salinities treatments, which treatment 1 (10 ppt), treatment 2 (20 ppt) and treatment 3 (30 ppt). Treatment 2 produce the highest number of stage 4 ovarian maturation based on colouration and the highest GSI recorded, follow by treatment 1 and lastly treatment 3. Conclusion: This present study proved that salinity does affected the ovarian maturation of S. olivacea in captivity and provides important information regarding the effect of water salinity on ovarian maturation for further studies on reproductive biology of this species.

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Influence of L-carnitine on the Expression Level of Adipose Tissue miRNAs Related to Weight Changes in Obese Rats

Background and Objective: Molecular mechanisms of most anti-obesity drugs are remained to be clear. MicroRNAs that are noncoding RNA molecules supposed to regulate biological processes concomitant to obesity and have attracted a lot of attention to themselves. The miR-27a and miR-143 expression levels in obese and non-obese rats during weight changes and L-carnitine (LC) effects on them was investigated in this study. Materials and Methods: In the present study 12 male Wistar rats were randomly divided into normal fat diet and high fat diet groups to develop obesity. After 8 weeks rats were weighted and half of diet induced obese rats were randomly selected to receive 200 mg LC kg¹ b.wt. for 4 weeks. At the end epididymal fat was isolated to investigate expression level of microRNAs by real-time PCR. Results: After 12 weeks, high fat diet in comparison with normal fat diet mediated significant decrease and increase in expression levels of miR-27a and miR-143 , respectively. These changes were modified in groups, which had received LC in a 4 weeks period. Furthermore, rats in this group gained less weight. Conclusion: Findings of this study suggest that the changes of microRNAs expression probably play a role in pathogenesis of obesity, might be modulated by means of dietary agents and supplements and modify weight gain trend.

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Promoting Health for All Kansans Through Mass Media: Lessons Learned From a Pilot Assessment of Student Ebola Perceptions

Brief Report
Amy K. Chesser, Nikki Keene Woods, Jennifer Mattar, Timothy Craig
Disaster Medicine and Public Health Preparedness,FirstView Article(s), 3 pages

Abstract

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Enough With Polio: It’s Measles’ Turn Now in Pakistan

Letter
Inayat Ur Rehman, Tahir Mehmood Khan
Disaster Medicine and Public Health Preparedness,FirstView Article(s), 1 page

Abstract

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Modulation of Circulating MicroRNAs Levels during the Switch from Clopidogrel to Ticagrelor

Background. Circulating microRNAs are appealing biomarkers to monitor several processes underlying cardiovascular diseases. Platelets are a major source for circulating microRNAs. Interestingly, the levels of specific microRNAs were reported to correlate with the level of platelet activation. The aim of the present study was to test whether the treatment with the novel antiplatelet agent, ticagrelor, is associated with modulation in the levels of key platelet-derived microRNAs. Methods and Results. Patients were randomly selected from those participating in the SHIFT-OVER study, in which we had previously evaluated the effect of the therapeutic switch from clopidogrel to ticagrelor on platelet aggregation. Circulating levels of selected microRNAs were measured before and after the therapeutic switch from a dual antiplatelet therapy including acetylsalicylic acid (ASA) and clopidogrel to the more potent ticagrelor. Interestingly, the circulating levels of miR-126 (), miR-223 (), and miR-150 () were significantly reduced, while the levels of miR-96 were increased (). No substantial differences were observed for the remaining microRNAs. Conclusions. Switching from a dual antiplatelet treatment with clopidogrel to ticagrelor is associated with significant modulation in the circulating levels of specific microRNAs. If confirmed in larger, independent cohorts, our results pave the way for the use of circulating microRNAs as biomarkers of platelets activity in response to specific pharmacological treatments.

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Influence of a 10-Day Mimic of Our Ancient Lifestyle on Anthropometrics and Parameters of Metabolism and Inflammation: The “Study of Origin”

Chronic low-grade inflammation and insulin resistance are intimately related entities that are common to most, if not all, chronic diseases of affluence. We hypothesized that a short-term intervention based on “ancient stress factors” may improve anthropometrics and clinical chemical indices. We executed a pilot study of whether a 10-day mimic of a hunter-gatherer lifestyle favorably affects anthropometrics and clinical chemical indices. Fifty-five apparently healthy subjects, in 5 groups, engaged in a 10-day trip through the Pyrenees. They walked 14 km/day on average, carrying an 8-kilo backpack. Raw food was provided and self-prepared and water was obtained from waterholes. They slept outside in sleeping bags and were exposed to temperatures ranging from 12 to 42°C. Anthropometric data and fasting blood samples were collected at baseline and the study end. We found important significant changes in most outcomes favoring better metabolic functioning and improved anthropometrics. Coping with “ancient mild stress factors,” including physical exercise, thirst, hunger, and climate, may influence immune status and improve anthropometrics and metabolic indices in healthy subjects and possibly patients suffering from metabolic and immunological disorders.

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Assessment of Diagnostic and Prognostic Role of Copeptin in the Clinical Setting of Sepsis

The diagnostic and prognostic usefulness of copeptin were evaluated in septic patients, as compared to procalcitonin assessment. In this single centre and observational study 105 patients were enrolled: 24 with sepsis, 25 with severe sepsis, 15 with septic shock, and 41 controls, divided in two subgroups (15 patients with gastrointestinal bleeding and 26 with suspected SIRS secondary to trauma, acute coronary syndrome, and pulmonary embolism). Biomarkers were determined at the first medical evaluation and thereafter 24, 48, and 72 hours after admission. Definitive diagnosis and in-hospital survival rates at 30 days were obtained through analysis of medical records. At entry, copeptin proved to be able to distinguish cases from controls and also sepsis group from septic shock group, while procalcitonin could distinguish also severe sepsis from septic shock group. Areas under the ROC curve for copeptin and procalcitonin were 0.845 and 0.861, respectively. Noteworthy, patients with copeptin concentrations higher than the threshold value (23.2 pmol/L), calculated from the ROC curve, at admission presented higher 30-day mortality. No significant differences were found in copeptin temporal profile among different subgroups. Copeptin showed promising diagnostic and prognostic role in the management of sepsis, together with its possible role in monitoring the response to treatment.

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A Three-Phase Multiobjective Mechanism for Selecting Retail Stores to Close

To operate a successful and growing business, a retail store manager has to make tough decisions about selectively closing underperforming stores. In this paper, we propose using a three-phase multiobjective mechanism to help retail industry practitioners determine which stores to close. In the first phase, a geographic information system (GIS) and -means clustering algorithm are used to divide all the stores into clusters. In the second phase, stores can be strategically selected according to the requirements of the company and the attributes of the stores. In the third phase, a neighborhood-based multiobjective genetic algorithm (NBMOGA) is utilized to determine which stores to close. To examine the effectiveness of the proposed three-phase mechanism, a variety of experiments are performed, based partly on a real dataset from a stock-list company in Taiwan. Results from the experiments show that the proposed three-phase mechanism can help efficiently decide which store locations to close. In addition, the neighborhood radius has a considerable influence on the results.

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Fault Diagnosis for Actuators in a Class of Nonlinear Systems Based on an Adaptive Fault Detection Observer

The problem of actuators’ fault diagnosis is pursued for a class of nonlinear control systems that are affected by bounded measurement noise and external disturbances. A novel fault diagnosis algorithm has been proposed by combining the idea of adaptive control theory and the approach of fault detection observer. The asymptotical stability of the fault detection observer is guaranteed by setting the adaptive adjusting law of the unknown fault vector. A theoretically rigorous proof of asymptotical stability has been given. Under the condition that random measurement noise generated by the sensors of control systems and external disturbances exist simultaneously, the designed fault diagnosis algorithm is able to successfully give specific estimated values of state variables and failures rather than just giving a simple fault warning. Moreover, the proposed algorithm is very simple and concise and is easy to be applied to practical engineering. Numerical experiments are carried out to evaluate the performance of the fault diagnosis algorithm. Experimental results show that the proposed diagnostic strategy has a satisfactory estimation effect.

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Esophageal Microperforation due to Calcified Mediastinal Lymph Node Leading to Tracheoesophageal Fistula

A 42-year-old male presented with worsening gastroesophageal reflux disease symptoms and cough. The clinical symptoms during the early course of illness were striking for aspiration pneumonia. He was given a prescription of proton pump inhibitors and antibiotics. Rapid decline in the clinical condition with worsening respiratory status was noted. Worsening symptoms of fever, cough, and chest pain prompted further diagnostic work-up suggesting esophageal microperforation. Esophagogram was found to be suggestive of tracheoesophageal fistula. The tracheoesophageal fistula was due to subcarinal lymph node of nontuberculous origin.

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Assessment of Prediction Capabilities of COCOSYS and CFX Code for Simplified Containment

The acceptable accuracy for simulation of severe accident scenarios in containments of nuclear power plants is required to investigate the consequences of severe accidents and effectiveness of potential counter measures. For this purpose, the actual capability of CFX tool and COCOSYS code is assessed in prototypical geometries for simplified physical process-plume (due to a heat source) under adiabatic and convection boundary condition, respectively. Results of the comparison under adiabatic boundary condition show that good agreement is obtained among the analytical solution, COCOSYS prediction, and CFX prediction for zone temperature. The general trend of the temperature distribution along the vertical direction predicted by COCOSYS agrees with the CFX prediction except in dome, and this phenomenon is predicted well by CFX and failed to be reproduced by COCOSYS. Both COCOSYS and CFX indicate that there is no temperature stratification inside dome. CFX prediction shows that temperature stratification area occurs beneath the dome and away from the heat source. Temperature stratification area under adiabatic boundary condition is bigger than that under convection boundary condition. The results indicate that the average temperature inside containment predicted with COCOSYS model is overestimated under adiabatic boundary condition, while it is underestimated under convection boundary condition compared to CFX prediction.

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Overconfidence in the Credit Card Market

High credit card debt default has been symptomatic for the U.S. and other countries in the last decades. Different explanations for this situation exist in the literature. One explanation is overconfidence, which has become a key concept in behavioural economics for explaining anomalies in financial markets such excessive trading volume. There is also the idea that overconfidence is to blame for high credit card debt. In this paper, an agent-based model is presented that examines the effects of overconfidence on credit card usage. Overconfidence is used here to explain why people who never intend to borrow on their credit card(s) do so anyway.The model contains consumption, two means of payment (credit card and cash), and a distortion to agents' income expectations via overconfidence. It was found that overconfidence leads to more “accidental” borrowing and higher interest rates.

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Embryonen und embryo-ähnliche Organismen: Definitionsprobleme im Entwurf zum Embryonenforschungsgesetz

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Interaktive Wertschöpfung durch Dienstleistungen – Eine Einführung in die theoretischen und praktischen Problemstellungen

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Teilweise Gewährung der unentgeltlichen Rechtspflege, Besprechung von BGE 139 III 396 (BGer 4A_105/2013) vom 5. August 2013

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Keine Nichtigkeit der von einer örtlich unzuständigen Schlichtungsbehörde ausgestellten Klagebewilligung, Besprechung von OGer ZH NP130005 vom 10. Juli 2013

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Geoarchäologischer Report: eine kurze Geschichte des Rheins - geologische und archäologische Impressionen aus Basel

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Utbredt antibiotikaresistens ved urinveisinfeksjoner

Resistens mot de mest brukte legemidlene mot urinveisinfeksjoner hos barn er svært utbredt.

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A Gauged Open 2-Brane String in the -Brane Background

We make a gauge theory from the Open -brane system and map it into the Open 2-Brane one. Due to the presence of second-class constraints in this model, we encounter some problems during the procedure of quantization. In this regard, considering boundary conditions as Dirac conditions, one can drive the constrained structure of the model at first. Then, with the help of BFT formalism of constraint systems, the Open 2-Brane model is embedded into an extended phase space. For this purpose, we introduce some tensor fields to convert ungauged theory into the gauged one. This is the novel part of our research, while mostly scalar and vector fields are used to convert second-class constraints into first ones.

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Optimal Control Applied to an Irrigation Planning Problem

We propose a mathematical model to study the water usage for the irrigation of given farmland to guarantee that the field crop is kept in a good state of preservation. This problem is formulated as an optimal control problem. The lack of analytic solution leads us to turn to numerical methods to solve the problem numerically. We then apply necessary conditions of optimality to validate the numerical solution. To deal with the high degree of unpredictability of water inflow due to weather, we further propose a replan strategy and we implement it.

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Study on the Seismic Active Earth Pressure by Variational Limit Equilibrium Method

In the framework of limit equilibrium theory, the isoperimetric model of functional extremum regarding the seismic active earth pressure is deduced according to the variational method. On this basis, Lagrange multipliers are introduced to convert the problem of seismic active earth pressure into the problem on the functional extremum of two undetermined function arguments. Based on the necessary conditions required for the existence of functional extremum, the function of the slip surface and the normal stress distribution on the slip surface is obtained, and the functional extremum problem is further converted into a function optimization problem with two undetermined Lagrange multipliers. The calculated results show that the slip surface is a plane and the seismic active earth pressure is minimal when the action point is at the lower limit position. As the action point moves upward, the slip surface becomes a logarithmic spiral and the corresponding value of seismic active earth pressure increases in a nonlinear manner. And the seismic active earth pressure is maximal at the upper limit position. The interval estimation constructed by the minimum and maximum values of seismic active earth pressure can provide a reference for the aseismic design of gravity retaining walls.

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Effects of Anthocyanin and Flavanol Compounds on Lipid Metabolism and Adipose Tissue Associated Systemic Inflammation in Diet-Induced Obesity

Background. Naturally occurring substances from the flavanol and anthocyanin family of polyphenols have been proposed to exert beneficial effects in the course of obesity. We hypothesized that their effects on attenuating obesity-induced dyslipidemia as well as the associated inflammatory sequelae especially have health-promoting potential. Methods. Male C57BL/6J mice () received a control low-fat diet (LFD; 10 kcal% fat) for 6 weeks followed by 24 weeks of either LFD () or high-fat diet (HFD; 45 kcal% fat; ) or HFD supplemented with 0.1% w/w of the flavanol compound epicatechin (HFD+E; ) or an anthocyanin-rich bilberry extract (HFD+B; ). Energy substrate utilization was determined by indirect calorimetry in a subset of mice following the dietary switch and at the end of the experiment. Blood samples were collected at baseline and at 3 days and 4, 12, and 20 weeks after dietary switch and analyzed for systemic lipids and proinflammatory cytokines. Adipose tissue (AT) histopathology and inflammatory gene expression as well as hepatic lipid content were analyzed after sacrifice. Results. The switch from a LFD to a HFD lowered the respiratory exchange ratio and increased plasma cholesterol and hepatic lipid content. These changes were not attenuated by HFD+E or HFD+B. Furthermore, the polyphenol compounds could not prevent HFD-induced systemic rise of TNF-α levels. Interestingly, a significant reduction in Tnf gene expression in HFD+B mice was observed in the AT. Furthermore, HFD+B, but not HFD+E, significantly prevented the early upregulation of circulating neutrophil chemoattractant mKC. However, no differences in AT histopathology were observed between the HFD types. Conclusion. Supplementation of HFD with an anthocyanin-rich bilberry extract but not with the flavanol epicatechin may exert beneficial effects on the systemic early inflammatory response associated with diet-induced obesity. These systemic effects were transient and not observed after prolongation of HFD-feeding (24 weeks). On the tissue level, long-term treatment with bilberry attenuated TNF-α expression in adipose tissue.

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On Internet Traffic Classification: A Two-Phased Machine Learning Approach

Traffic classification utilizing flow measurement enables operators to perform essential network management. Flow accounting methods such as NetFlow are, however, considered inadequate for classification requiring additional packet-level information, host behaviour analysis, and specialized hardware limiting their practical adoption. This paper aims to overcome these challenges by proposing two-phased machine learning classification mechanism with NetFlow as input. The individual flow classes are derived per application through -means and are further used to train a C5.0 decision tree classifier. As part of validation, the initial unsupervised phase used flow records of fifteen popular Internet applications that were collected and independently subjected to -means clustering to determine unique flow classes generated per application. The derived flow classes were afterwards used to train and test a supervised C5.0 based decision tree. The resulting classifier reported an average accuracy of 92.37% on approximately 3.4 million test cases increasing to 96.67% with adaptive boosting. The classifier specificity factor which accounted for differentiating content specific from supplementary flows ranged between 98.37% and 99.57%. Furthermore, the computational performance and accuracy of the proposed methodology in comparison with similar machine learning techniques lead us to recommend its extension to other applications in achieving highly granular real-time traffic classification.

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On Harvesting Energy from Tree Trunks for Environmental Monitoring

This work describes an experimental study on the possibilities of harvesting energy from tree trunks in order to power sensor nodes for environmental monitoring, particularly in wild forests. As the trunk of a living tree can be divided into isothermal subvolumes, which are generally referred to as annual rings, and the trunk is a good heat storage material, depending on the tree dimensions and its species, it can potentially offer different temperature gradients according to the tree trunk depths. The hypothesis is to consider the application of this temperature gradient on the faces of a Peltier cell to obtain electrical energy. In order to evaluate this hypothesis, a wireless sensor network was developed for measuring internal temperature of trunks from different trees. The experimental results show that it is possible to obtain a sufficient temperature gradient to harvest energy from tree trunks. Additionally, it is also shown that it is possible to harvest thermal energy during the day and during the night while photovoltaic cell only works under sunlight.

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Does hepatobiliary phase sequence qualitatively outperform unenhanced T1-weighted imaging in assessment of the ablation margin 24 hours after thermal ablation of hepatocellular carcinomas?

Abstract

Purpose

To retrospectively determine whether hepatobiliary phase (HBP) sequence outperforms unenhanced T1-weighted imaging (uT1wI) in distinguishing the ablation margin (AM) from hepatocellular carcinoma (HCC) 24 h after thermoablation.

Material and methods

Ninety-one patients [mean age, 65.7 years; 68 M/23F] with 138 HCCs (>6 months follow-up) underwent pre- and postablation gadoxetate disodium-enhanced MRI. AM showed a hyperintense middle zone (MZ) surrounding central hypo- or hyperintense HCCs on uT1wI, and an intermediate-intense MZ encompassing central hypo- or hyperintense HCCs during HBP. The visible AM was defined as persistent MZ around HCCs, which were demarcated from MZ, or peripherally band encompassing MZ, which were not demarcated from HCC. The indefinite AM was defined as no demarcating HCCs from MZ. The ability to distinguish AM from HCC was classified as visible or indefinite on axial (ax)-uT1wI, ax-HBP, coronal (cor)-HBP, and combined all images. To investigate the AM visibility during HBP, significance of differences upon comparison of ax-uT1wI with combined images was analyzed. Preablation liver-tumor contrast ratio (LTCR) on ax-uT1wI and ax-HBP sequence is compared between the visible and indefinite AM.