bluuebunny/crossref_metadata_2025 huggingface dataset:
Melatonin attenuates osteosarcoma cell invasion by suppression of C‐C motif chemokine ligand 24 through inhibition of the c‐Jun N‐terminal kinase pathway
Authors: Lu Ko‐Hsiu , Su Shih‐Chi , Lin Chiao‐Wen , Hsieh Yi‐Hsien , Lin Ya‐Chiu , Chien Ming‐Hsien , Reiter Russel J. , Yang Shun‐Fa
Published: May 2018

Osteosarcoma, with its high metastatic potential, is the most prevalent malignant bone tumor in children and adolescents. Melatonin possesses multiple tumor‐suppressing properties for a myriad of tumors, but little is known about the effects of melatonin on osteosarcoma metastasis. In this study, we demonstrated that melatonin elicited very low cytotoxicity and significantly inhibited cellular motility, migration, and invasion in human osteosarcoma U2OS and HOS cells. Moreover, using RNA sequencing technology, we revealed that melatonin repressed C‐C motif chemokine ligand 24 (CCL24) gene expression in U2OS cells. Manipulation of CCL24 levels influenced the motility of osteosarcoma cells as cell migration and invasion were enhanced by the addition of recombinant human CCL24 and attenuated by the silencing of CCL24. Moreover, melatonin increased and decreased the activation of extracellular signal‐regulated kinase (ERK) 1/2 and c‐Jun N‐terminal kinase (JNK) 1/2, respectively, in a dose‐dependent manner in U2OS and HOS cells while exerting no evident influence on the level and activation of p38, Akt, FAK, steroid receptor coactivator, or Raf. In further functional experiments, the use of JNK inhibitors (SP600125 and DN‐JNK) confirmed that the pharmaceutic inhibition of JNK augmented the melatonin‐mediated CCL24 suppression and migration of U2OS cells. Overall, our results revealed that melatonin attenuated chemokine CCL24 levels through inhibition of the JNK pathway to hinder human osteosarcoma cell invasion, thereby highlighting the therapeutic potential of melatonin for osteosarcoma metastasis.
Melatonin improves endothelial function in vitro and prolongs pregnancy in women with early‐onset preeclampsia
Authors: Hobson Sebastian R. , Gurusinghe Seshi , Lim Rebecca , Alers Nicole O. , Miller Suzanne L. , Kingdom John C. , Wallace Euan M.
Published: May 2018

Preeclampsia remains a leading cause of maternal and perinatal morbidity and mortality. There have been no material advances in the treatment of preeclampsia for nearly 50 years. Combining in vitro studies and a clinical trial, we aimed to determine whether melatonin could be a useful adjuvant therapy. In a xanthine/xanthine oxidase (X/XO) placental explant model, melatonin reduced oxidative stress (8‐isoprostane) and enhanced antioxidant markers (Nrf2 translocation, HO‐1), but did not affect explant production of anti‐angiogenic factors (sFlt, sEng, activin A). In cultured HUVECs, melatonin mitigated TNFα‐induced vascular cell adhesion molecule expression and rescued the subsequent disruption to endothelial monolayer integrity but did not affect other markers for endothelial activation and dysfunction. In a phase I trial of melatonin in 20 women with preeclampsia, we assessed the safety and efficacy of melatonin on (i) preeclampsia progression, (ii) clinical outcomes, and (iii) oxidative stress, matching outcomes with recent historical controls receiving similar care. Melatonin therapy was safe for mothers and their fetuses. Compared to controls, melatonin administration extended the mean ± SEM diagnosis to delivery interval by 6 ± 2.3 days reduced the need for increasing antihypertensive medication on days 3‐4 (13% vs 71%), days 6‐7 (8% vs 51%), and at delivery (26% vs 75%). All other clinical and biochemical measures of disease severity were unaffected by melatonin. We have shown that melatonin has the potential to mitigate maternal endothelial pro‐oxidant injury and could therefore provide effective adjuvant therapy to extend pregnancy duration to deliver improved clinical outcomes for women with severe preeclampsia.
Evolution and persistence of resistance‐associated substitutions of hepatitis C virus after direct‐acting antiviral treatment failures
Authors: Jeong Y. , Jin B. , Lee H. W. , Park H. J. , Park J. Y. , Kim D. Y. , Han K.‐H. , Ahn S. H. , Kim S.
Published: May 2018

Daclatasvir plus asunaprevir (DCV+ASV) treatment is an all‐oral direct‐acting antiviral (DAA) therapy for the genotype 1b HCV‐infected patients. In this study, we investigated how resistance‐associated substitutions (RASs) evolved after treatment failures and assessed the effect of those substitutions on viral fitness. Sequencing of NS5A and NS3 revealed typical RASs after treatment failures. Interestingly, the RASs of NS3 reverted to the wild‐type amino acid within 1 year after treatment failures. However, the RASs of NS5A were stable and did not change. The effect of NS5A and NS3 RASs on viral RNA replication was assessed after mutagenic substitution in the genotype 1b HCV RNA. Among single substitutions, the effect of D168V was more substantial than the others and the effect of the triple mutant combination (D168V+L31V+Y93H) was the most severe. The RAS at NS5A Y93 affected both viral RNA replication and virus production. Finally, the effect of trans‐complementation of NS5A was demonstrated in our co‐transfection experiments and these results suggest that such a trans‐complementation effect of NS5A may help maintain the NS5A RASs for a long time even after cessation of the DAA treatment. In conclusion, the results from this investigation would help understand the emergence and persistence of RASs.
Gingival tissue reaction to direct adhesive restoration: A preliminary study
Authors: Bertoldi Carlo , Zaffe Davide , Generali Luigi , Lucchi Andrea , Cortellini Pierpaolo , Monari Emanuela
Published: May 2018

Introduction

It is debated whether composite resin marginal/submarginal direct restoration can be usefully performed without inflammatory consequences. This histological study is the first human analysis aimed to compare, in the same tooth, the gingival tissue close to composite resin restorations with gingival tissue close to hard tissue.

Methods

Eight healthy patients with almost a residual strategic tooth needing endodontic therapy, and post‐and‐core restoration, then indirect prosthetic restoration, were selected. Direct margin relocation with composite resin was necessary to perform endodontic treatment. The crown lengthening with a secondary flap harvested was necessary to perform prosthetic rehabilitation. Three months after marginal relocation, the secondary flap was harvested, embedded in PMMA, 4‐μm sectioned, and stained to analyze the inflammation degree.

Results

All patients completed post‐and‐core reconstruction and the planned prosthetic therapy, maintaining the stringent hygienic protocol plan. The inflammation level comparison, slightly lower in gingiva close to the teeth (3.62 ± 0.38) than in gingiva close to the composite (3.75 ± 0.26), results in a p‐value of 0.11 after Wilcoxon test.

Conclusions

Results highlight a minimal, statistically not significant difference in the inflammation degree after margin relocation, conceivably due to patients, teeth and cases selection, together with adopted stringent methodological and supportive measures.
Dermal non‐neural granular cell tumor in a 3‐year‐old child
Authors: Kabir Bilaal , Ramien Michele , Al Shammary Mofeedah , de Nanassy Joseph , El Demellawy Dina
Published: May 2018

Dermal non‐neural granular cell tumors, also known as primitive polypoid granular cell tumors, are a rare group of distinct cutaneous non‐neural granular cell tumors. Pediatric cases are rare, and to the best of our knowledge, we report the youngest patient with dermal non‐neural granular cell tumors.
Abscisic acid prevents pollen abortion under high‐temperature stress by mediating sugar metabolism in rice spikelets
Authors: Rezaul Islam Md. , Baohua Feng , Tingting Chen , Weimeng Fu , Caixia Zhang , Longxing Tao , Guanfu Fu
Published: May 2018

Heat stress at the pollen mother cell (PMC) meiotic stage leads to pollen sterility in rice, in which the reactive oxygen species (ROS) and sugar homeostasis are always adversely affected. This damage is reversed by abscisic acid (ABA), but the mechanisms underlying the interactions among the ABA, sugar metabolism, ROS and heat shock proteins in rice spikelets under heat stress are unclear. Two rice genotypes, Zhefu802 (a recurrent parent) and fgl (its near‐isogenic line) were subjected to heat stress of 40°C after pre‐foliage sprayed with ABA and its biosynthetic inhibitor fluridone at the meiotic stage of PMC. The results revealed that exogenous application of ABA reduced pollen sterility caused by heat stress. This was achieved through various means, including: increased levels of soluble sugars, starch and non‐structural carbohydrates, markedly higher relative expression levels of heat shock proteins (HSP24.1 and HSP71.1) and genes related to sugar metabolism and transport, such as sucrose transporters (SUT) genes, sucrose synthase (SUS) genes and invertase (INV) genes as well as increased antioxidant activities and increased content of adenosine triphosphate and endogenous ABA in spikelets. In short, exogenous application of ABA prior to heat stress enhanced sucrose transport and accelerated sucrose metabolism to maintain the carbon balance and energy homeostasis, thus ABA contributed to heat tolerance in rice.
Desiring Diversity: The Limits of White Settler Multiculturalism in Queer Organizations
Authors: Greensmith Cameron
Published: May 2018

Multiculturalism in Canada is touted as an all‐inclusive policy and practice that celebrates difference and welcomes diversity. In 2012, gays and lesbians were included in the Discover Canada document amongst various cultural, racial, and ethnic groups, marking such inclusion as foundational in Canada's imagining of itself as tolerant and accepting. Despite these narratives of multicultural diversity, people of colour and Indigenous peoples continue to experience strife, violence, and erasure. This paper looks to the ways Canadian multiculturalism is utilized by queer and trans people as part of their understandings and imaginings of queer politics. In particular, it discusses the queer service sector and the ways queer and trans service providers do diversity and multiculturalism within their work. Findings highlight the complex ways in which queer and trans service providers utilize diversity as a tactic to create further exclusion and direct attention towards wanting, needing, and desiring diversity. The paper highlights the ways diversity is desired within the institutional walls of queer service provision and draws attention to the ways the whiteness and colonialism of the organizations themselves goes unquestioned and unexamined.
An SSP‐PCR method for the rapid detection of disease‐associated alleles HLA‐A*29 and HLA‐B*51
Authors: Amstutz U. , Schaerer D. , Andrey G. , Wirthmueller U. , Largiadèr C. R.
Published: May 2018

HLA‐A*29 and HLA‐B*51 are associated with birdshot uveitis and Behçet's disease, respectively, and are used as a diagnostic criterion in patients with suspected disease, requiring their detection in diagnostic laboratories. While commercial tests for individual HLA alleles are available for other disease‐associated HLA variants, no similar allele‐specific assays are available for HLA‐A*29 and HLA‐B*51. Here, we report sequence‐specific priming‐polymerase chain reaction (SSP‐PCR) methods for the detection of HLA‐A*29 and HLA‐B*51 using a single PCR reaction per allele. The assays were tested in 30 and 32 previously HLA‐typed samples, respectively, representing >97% of HLA‐A alleles and >93% of HLA‐B alleles in a European population. A concordance of 100% was observed with previous typing results, validating these methods for use in a diagnostic or research context.
Insane in the apical membrane: Trafficking events mediating apicobasal epithelial polarity during tube morphogenesis
Authors: Jewett Cayla E. , Prekeris Rytis
Published: May 2018

The creation of cellular tubes is one of the most vital developmental processes, resulting in the formation of most organ types. Cells have co‐opted a number of different mechanisms for tube morphogenesis that vary among tissues and organisms; however, generation and maintenance of cell polarity is fundamental for successful lumenogenesis. Polarized membrane transport has emerged as a key driver not only for establishing individual epithelial cell polarity, but also for coordination of epithelial polarization during apical lumen formation and tissue morphogenesis. In recent years, much work has been dedicated to identifying membrane trafficking regulators required for lumenogenesis. In this review we will summarize the findings from the past couple of decades in defining the molecular machinery governing lumenogenesis both in 3D tissue culture models and during organ development in vivo.
Heteroepitaxial growth of self-assembled BaTiO3-Fe2O3 nanostructures
Authors: Tyagi Shekhar , Sharma Gaurav , Dwij Vivek , Krishna De Binoy , Sathe Vasant G. , Reddy Varimalla R. , Choudhary Ram J. , Phase Deodatta M. , Ganesan Vedachalaiyer
Published: May 2018

The self-assembled growth of vertically aligned nanostructures of BaTiO3 in the matrix of Fe2O3 is described. The arrays of well controlled and systematically ordered nanostructures of composite phases were grown on MgO and SrTiO3 single crystalline substrate by using the pulse laser deposition technique under optimized conditions. The phase purities of the composite structures were characterized by using x-ray diffraction and Raman spectroscopy. The surface topographical and morphological measurements were carried out for confirming the growth on nanostructures in the composite thin films. The ferroelectric properties of these composite films were probed by electrical polarization versus electric field (P-E) measurements. The electronic and magnetic properties of the composite were studied by employing x-ray absorption spectroscopy and magnetization measurements. The presence of strain state in nanostructures is found to play an important role in modifying the crystal field effects as well as the magnetic properties of the composite compound. It is shown that the vertical self-assembly of nanorods of BaTiO3 can be grown in the matrix layer of Fe2O3 on the MgO substrate by coablation.
Source localization using deep neural networks in a shallow water environment
Authors: Huang Zhaoqiong , Xu Ji , Gong Zaixiao , Wang Haibin , Yan Yonghong
Published: May 2018

Deep neural networks (DNNs) are advantageous for representing complex nonlinear relationships. This paper applies DNNs to source localization in a shallow water environment. Two methods are proposed to estimate the range and depth of a broadband source through different neural network architectures. The first adopts the classical two-stage scheme, in which feature extraction and DNN analysis are independent steps. The eigenvectors associated with the modal signal space are extracted as the input feature. Then, the time delay neural network is exploited to model the long term feature representation and constructs the regression model. The second concerns a convolutional neural network−feed-forward neural network (CNN–FNN) architecture, which trains the network directly by taking the raw multi-channel waveforms as input. The CNNs are expected to perform spatial filtering for multi-channel signals, in an operation analogous to time domain filters. The outputs of CNNs are summed as the input to FNN. Several experiments are conducted on the simulated and experimental data to evaluate the performance of the proposed methods. The results demonstrate that DNNs are effective for source localization in complex and varied water environments, especially when there is little precise environmental information.
Targeted inhibition of histone H3K27 demethylation is effective in high-risk neuroblastoma
Authors: Lochmann Timothy L. , Powell Krista M. , Ham Jungoh , Floros Konstantinos V. , Heisey Daniel A. R. , Kurupi Richard I. J. , Calbert Marissa L. , Ghotra Maninderjit S. , Greninger Patricia , Dozmorov Mikhail , Gowda Madhu , Souers Andrew J. , Reynolds C. Patrick , Benes Cyril H. , Faber Anthony C.
Published: May 2018

High-throughput screening identified hypersensitivity of neuroblastomas to H3K27 demethylation inhibition.
A change of heart: Altered cardiac reactivity in frontotemporal dementia
Authors: Tully Hannah M.
Published: May 2018

Cardiac response to emotional stimuli differs by frontotemporal dementia subtype.
First Complete Genome Sequence of Yersinia massiliensis
Authors: Thomas Matthew C. , Arling Victoria , Goji Noriko , Janzen Timothy W. , Duceppe Marc-Olivier , Mathews Amit , Carrillo Catherine , Amoako Kingsley K.
Published: May 2018

Using a combination of Illumina paired-end sequencing, Pacific Biosciences RS II sequencing, and OpGen Argus whole-genome optical mapping, we report here the first complete genome sequence of
Yersinia massiliensis
. The completed genome consists of a 4.99-Mb chromosome, a 121-kb megaplasmid, and a 57-kb plasmid.
Complete Genome Sequence of Oyster Isolate Vibrio vulnificus Env1
Authors: Noorian Parisa , Sun Shuyang , McDougald Diane
Published: May 2018

Vibrio vulnificus
, a ubiquitous inhabitant of coastal marine environments, has been isolated from a variety of sources. It is an opportunistic pathogen of both marine animals and humans. Here, the genome sequence of
V. vulnificus
Env1, an environmental isolate resistant to predation by the ciliate
Tetrahymena pyriformis
, is reported.
Draft Genome Sequence of the Fish Pathogen Flavobacterium columnare Strain MS-FC-4
Authors: Bartelme Ryan P. , Barbier Paul , Lipscomb Ryan S. , LaPatra Scott E. , Newton Ryan J. , Evenhuis Jason P. , McBride Mark J.
Published: May 2018

Flavobacterium columnare
MS-FC-4 is a highly virulent genetic group 1 (formerly genomovar I) strain isolated from rainbow trout (
Oncorhynchus mykiss
). The draft genome consists of three contigs totaling 3,449,277 bp with 2,811 predicted open reading frames.
F. columnare
MS-FC-4 is a model strain for functional genomic analyses.
Molecular Diagnosis of Bacterial Vaginosis: an Update
Authors: Coleman Jenell S. , Gaydos Charlotte A.
Published: May 2018

Bacterial vaginosis (BV) is the most common cause of vaginal discharge in reproductive-age women. BV has been associated with poor reproductive outcomes such as preterm delivery, the acquisition of sexually transmitted infections, including HIV, and pelvic inflammatory disease.
Microbial Interactions in the Cystic Fibrosis Airway
Authors: Granchelli Ann M. , Adler Frederick R. , Keogh Ruth H. , Kartsonaki Christiana , Cox David R. , Liou Theodore G.
Published: May 2018

Interactions in the airway ecology of cystic fibrosis may alter organism persistence and clinical outcomes. Better understanding of such interactions could guide clinical decisions.
Porcine Deltacoronavirus Accessory Protein NS6 Antagonizes Interferon Beta Production by Interfering with the Binding of RIG-I/MDA5 to Double-Stranded RNA
Authors: Fang Puxian , Fang Liurong , Ren Jie , Hong Yingying , Liu Xiaorong , Zhao Yunyang , Wang Dang , Peng Guiqing , Xiao Shaobo
Published: May 2018

Porcine deltacoronavirus (PDCoV) has recently emerged as an enteric pathogen that can cause serious vomiting and diarrhea in suckling piglets. The first outbreak of PDCoV occurred in the United States in 2014 and was followed by reports of PDCoV in South Korea, China, Thailand, Lao People's Democratic Republic, and Vietnam, leading to economic losses for pig farms and posing a considerable threat to the swine industry worldwide. Our previous studies have shown that PDCoV encodes three accessory proteins, NS6, NS7, and NS7a, but the functions of these proteins in viral replication, pathogenesis, and immune regulation remain unclear. Here, we found that ectopic expression of accessory protein NS6 significantly inhibits Sendai virus-induced interferon beta (IFN-β) production as well as the activation of transcription factors IRF3 and NF-κB. Interestingly, NS6 does not impede the IFN-β promoter activation mediated via key molecules in the RIG-I-like receptor (RLR) signaling pathway, specifically RIG-I, MDA5, and their downstream molecules MAVS, TBK1, IKKε, and IRF3. Further analyses revealed that NS6 is not an RNA-binding protein; however, it interacts with RIG-I/MDA5. This interaction attenuates the binding of double-stranded RNA by RIG-I/MDA5, resulting in the reduction of RLR-mediated IFN-β production. Taken together, our results demonstrate that ectopic expression of NS6 antagonizes IFN-β production by interfering with the binding of RIG-I/MDA5 to double-stranded RNA, revealing a new strategy employed by PDCoV accessory proteins to counteract the host innate antiviral immune response.

IMPORTANCE
Coronavirus accessory proteins are species specific, and they perform multiple functions in viral pathogenicity and immunity, such as acting as IFN antagonists and cell death inducers. Our previous studies have shown that PDCoV encodes three accessory proteins. Here, we demonstrated for the first time that PDCoV accessory protein NS6 antagonizes IFN-β production by interacting with RIG-I and MDA5 to impede their association with double-stranded RNA. This is an efficient strategy of antagonizing type I IFN production by disrupting the binding of host pattern recognition receptors (PRRs) and pathogen-associated molecular patterns (PAMPs). These findings deepen our understanding of the function of accessory protein NS6, and they may direct us toward novel therapeutic targets and lead to the development of more effective vaccines against PDCoV infection.
Optimum hospice at home services for end-of-life care: protocol of a mixed-methods study employing realist evaluation
Authors: Butler Claire , Brigden Charlotte , Gage Heather , Williams Peter , Holdsworth Laura , Greene Kay , Wee Bee , Barclay Stephen , Wilson Patricia
Published: May 2018

Introduction

Hospice at home (HAH) services aim to enable patients to be cared for and die in their place of choice, if that is at home, and to achieve a ‘good death’. There is a considerable range of HAH services operating in England. The published evidence focuses on evaluations of individual services which vary considerably, and there is a lack of consistency in terms of the outcome measures reported. The evidence, therefore, does not provide generalisable information, so the question ‘What are the features of hospice at home service models that work, for whom, and under what circumstances?’ remains unanswered. The study aims to answer this question.

Methods and analysis

This is a mixed-methods study in three phases informed by realist evaluation methodology. All HAH services in England will be invited to participate in a telephone survey to enable the development of a typology of services. In the second phase, case study sites representing the different service types will collect patient data and recruit carers, service managers and commissioners to gather quantitative and qualitative data about service provision and outcomes. A third phase will synthesise and refine the results through consensus workshops.

Ethics and dissemination

The first survey phase has university ethics approval and the second phase, Integrated Research Application System (IRAS) and Health Research Authority (HRA) approval (IRAS ID:205986, REC:17/LO/0880); the third phase does not require ethics approval. Dissemination will be facilitated by project coapplicants with established connections to national policy-making forums, in addition to publications, conference presentations and reports targeted to service providers and commissioners.
Comparison of severe trauma treatment standards in civilian China with current practice in the Chinese military peacekeeping Level 2 Military Hospital in Gao, Mali
Authors: Li Jian , Tian J , Wang Y B , Zhang H
Published: May 2018

Introduction

The People’s Republic of China has been successfully deploying medical teams to support the peacekeeping mission at the Level 2 Military Hospital in Mali since December 2013. The aim of this paper was to compare the current practice in Chinese Peacekeeping Level 2 Military Hospital with the severe trauma treatment standards reported in China.

Methods

A retrospective analysis was conducted between 26 April 2014 and 18 May 2016 using records stored in the Chinese Peacekeeping Level 2 Hospital (CHN L2). From 19 May 2016 to 31 March 2017, the data were prospectively collected for all casualties presenting in the hospital. Emergency response time, prehospital transit time, emergency rescue time, consultation call time and mortality were compared with the data from a study that evaluated the effects of standard rescue procedure (SRP) in improving severe trauma treatment in different hospitals across China.

Results

Indexes obtained from the analysis of CHN L2 data were equal or surpassed indexes reported in the study evaluating the implementation of SRP in Chinese hospitals.

Conclusion

The deployed CHN L2 delivered a high standard of care in Gao, Mali, and generally surpasses the Chinese standards. This can mostly be attributed to an efficient coordination of work during both prehospital and in-hospital stages of rescue.
How are we currently training and maintaining clinical readiness of US and UK military surgeons responsible for managing head, face and neck wounds on deployment?
Authors: Breeze John , Combes J G , DuBose J , Powers D B
Published: May 2018

Introduction

The conflicts in Iraq and Afghanistan provided military surgeons from the USA and the UK with extensive experience into the management of injuries to the head, face and neck (HFN) from high energy bullets and explosive weaponry. The challenge is now to maintain the expertise in managing such injuries for future military deployments.

Methods

The manner in which each country approaches four parameters required for a surgeon to competently treat HFN wounds in deployed military environments was compared. These comprised initial surgical training (residency/registrar training), surgical fellowships, hospital type and appointment as an attending (USA) or consultant (UK) and predeployment training.

Results

Neither country has residents/registrars undertaking surgical training that is military specific. The Major Trauma and Reconstructive Fellowship based in Birmingham UK and the Craniomaxillofacial Trauma fellowship at Duke University USA provide additional training directly applicable to managing HFN trauma on deployment. Placement in level 1 trauma/major trauma centres is encouraged by both countries but is not mandatory. US surgeons attend one of three single-service predeployment courses, of which HFN skills are taught on both cadavers and in a 1-week clinical placement in a level 1 trauma centre. UK surgeons attend the Military Operational Surgical Training programme, a 1-week course that includes 1 day dedicated to teaching HFN injury management on cadavers.

Conclusions

Multiple specialties of surgeon seen in the civilian environment are unlikely to be present, necessitating development of extended competencies. Military-tailored fellowships are capable of generating most of these skills early in a career. Regular training courses including simulation are required to maintain such skills and should not be given only immediately prior to deployment. Strong evidence exists that military consultants and attendings should only work at level 1/major trauma centres.
The Reconstructive Trauma Surgery Interface Fellowship and its applicability to military and civilian trainees
Authors: Hammond Douglas , Breeze J , Evriviades D
Published: May 2018

The Reconstructive Trauma Surgery Fellowship is a based at the Queen Elizabeth Hospital, Birmingham, and focuses on the multidisciplinary management of major trauma from presentation to discharge. It is unique to the UK in that it provides both management and leadership experience as well as operative surgical skills particularly in terms of reconstruction on complex trauma patients including those from the military. This paper describes the relevance of fellowships in modern surgical training, composition of the reconstructive trauma fellowship and the relevance for both civilian and military trainees.
Obesity is associated with impaired long-term success of pulmonary vein isolation: a plea for risk factor management before ablation
Authors: De Maat Gijs E , Mulder Bart , Berretty Wouter L , Al-Jazairi Meelad I H , Tan Yong E S , Wiesfeld Ans C P , Mariani Massimo A , Van Gelder Isabelle C , Rienstra Michiel , Blaauw Yuri
Published: May 2018

Aims

Obesity is an increasing health problem and is an important risk factor for the development of atrial fibrillation (AF). We investigated the association of body mass index (BMI) on the safety and long-term efficacy of pulmonary vein isolation (PVI) for drug-refractory AF.

Methods

414 consecutive patients who underwent transcatheter PVI for AF between 2003 and 2013 were included. Successful PVI was defined as absence of atrial arrhythmia on Holter monitoring or ECG, without and with antiarrhythmic drugs during follow-up. Obesity was defined as BMI≥30 kg/m².

Results

Mean age was 56±10 years, 316 (76%) were male, 311 (75%) had paroxysmal AF and 111 (27%) were obese. After a mean follow-up of 46±32 months (1590 patient-years), freedom from atrial arrhythmia and antiarrhythmic drugs was significantly lower in patients with obesity compared with non-obese patients (30% vs 46%, respectively, P=0.005, log-rank 0.016). With antiarrhythmic drugs, freedom from atrial arrhythmia was 56% vs 68% (P=0.036). No differences in minor and major adverse events were observed between patients with obesity and non-obese patients (major 6% vs 3%, P=0.105, and minor 5% vs 5%, P=0.512). Sensitivity analyses demonstrated that BMI (as continuous variable) was associated with PVI outcome (HR 1.08, 95% CI 1.02 to 1.14, P=0.012).

Conclusion

Obesity is associated with reduced efficacy of PVI for drug-refractory AF. No relation between obesity and adverse events was found.
Gastric dilatation volvulus with concurrent peritoneopericardial diaphragmatic hernia in a dog
Authors: French Emily D
Published: May 2018

A seven‐year‐old male neutered labrador retriever presented for acute onset of retching, distended abdomen and suspicion of gastric dilatation volvulus (GDV). Physical exam findings were consistent with GDV and included tachycardia and a distended abdomen. Preoperative abdominal radiographs were consistent with GDV, but found a lack of additional abdominal viscera. Radiographic views of the thorax revealed an incidental peritoneopericardial diaphragmatic hernia (PPDH). The patient was immediately taken to surgery for derotation of the stomach, repair of the PPDH and gastropexy. The patient was anorexic postoperatively and remained hospitalised for four days on intravenous fluids, gastric protectants and analgesics, and was then discharged. At 10‐month follow‐up, the patient was doing well.
mTOR signalling: jack-of-all-trades
Authors: El Hiani Yassine , Egom Emmanuel Eroume-A , Dong Xian-Ping
Published: May 2018

The mechanistic target of rapamycin (mTOR) is an evolutionarily conserved serine/threonine kinase that senses and integrates environmental information into cellular regulation and homeostasis. Accumulating evidence has suggested a master role of mTOR signalling in many fundamental aspects of cell biology and organismal development. mTOR deregulation is implicated in a broad range of pathological conditions, including diabetes, cancer, neurodegenerative diseases, myopathies, inflammatory, infectious, and autoimmune conditions. Here, we review recent advances in our knowledge of mTOR signalling in mammalian physiology. We also discuss the impact of mTOR alteration in human diseases and how targeting mTOR function can treat human diseases.
Determination of effective atomic numbers and electron densities for some synthesized triazoles from the measured total mass attenuation coefficients at different energies
Authors: Akman F. , Geçibesler I.H. , Demirkol I. , Çetin A.
Published: May 2018

The effective atomic numbers and electron densities of some synthesized triazoles were determined using the experimental values of total mass attenuation coefficients at 13.93, 17.77, 26.34, and 59.54 keV photon energies. The measurements were performed in a transmission geometry that consists of a Si(Li) detector, an 241Am point source and a target. The measured results were compared with two different theoretical results. The measured results are generally consistent with the theoretical results. It is observed that the measured parameters depend on the photon energy, weighted contributions of the individual atoms within the triazoles, atom number in the triazoles, and chemical composition of triazoles. Also, the effective electron density increases linearly with increasing effective atomic number.
Embedding trees in graphs with independence number two
Authors: Hu Xiaolan , Chen Yaojun
Published: May 2018

Let [Formula: see text] be a graph of order [Formula: see text] and [Formula: see text] an integer not great than [Formula: see text]. Erdős and Sós conjectured that if [Formula: see text] has at least [Formula: see text] edges, then [Formula: see text] contains all trees of order [Formula: see text]. Loebl, Komlós and Sós conjectured that if at least [Formula: see text] vertices of [Formula: see text] have degree at least [Formula: see text], then [Formula: see text] contains all trees of order [Formula: see text]. In this paper, it is shown that both the conjectures are true for graphs with independence number two, and our results generalize some known results.
Following the Flow: China’s Approach to Global Leadership
Authors: Hodzi Obert , Yu-Wen Chen
Published: May 2018

The liberal international order has been under heavy strain in recent years. From Brexit to Trump’s presidency, its tenacity is being put to the test. The resultant commotion should be a window of opportunity for China to materially revise the existing order or establish an alternative order under its leadership. However, the puzzle that is unfolding but not yet significantly examined is that China is seemingly not taking advantage of the upheaval in the liberal international order to substantially revise the order or set up a new one. Premised on the metaphor of “following the flow,” this paper argues that there is understandable rationale as to why China is appearing to ignore the opportunity to establish a China-led global order. It then explores the approach in China’s posture as protector of globalization and the liberal international order.
Integrating Biomarkers in Social Stratification and Health Research
Authors: Harris Kathleen Mullan , Schorpp Kristen M.
Published: May 2018

This article provides an overview of the integration of biomarkers and biological mechanisms in social science models of stratification and health. The goal in reviewing this literature is to highlight research that identifies the social forces that drive inequalities over the life course and across generations. The article is structured in the following way. First, descriptive background information on biomarkers is presented, and second, the general theoretical paradigms that lend themselves to an integrative approach are reviewed. Third, the biomarkers used to capture several biological systems that are most responsive to social conditions are described. Fourth, research that explicates how social exposures “get under the skin” to affect physiological functioning and downstream health is discussed, using socioeconomic disadvantage as an illustrative social exposure. The review ends with emerging directions in the use of biomarkers in social science research. This article endeavors to encourage sociologists to embrace biosocial approaches in order to elevate the importance of social factors in biomedical processes and to intervene on the social conditions that create unjust and avoidable inequities.
Comparison of Atypical and Osteoporotic Femoral Shaft Fractures in the Elderly: A Multicenter Study
Authors: Miura Takanori , Kijima Hiroaki , Ishikawa Noriyuki , Ebina Toshihito , Tani Takayuki , Chida Shuichi , Suzuki Tetsuya , Yumto Satoshi , Tazawa Hiroshi , Miyakoshi Naohisa , Shimada Yoichi
Published: May 2018

Background. In atypical femoral fractures, owing to the high rates of complications and delayed healing that accompany the plate fixation, the most favorable treatment is intramedullary nailing. Although there is insufficient evidence, plate fixation is chosen due to anterolateral bowing of the femur. This study compared the bone healing time and rates of complications in atypical femoral shaft fractures and osteoporotic femoral shaft fractures. Methods. We searched the medical records of 3 institutions in Japan for patients with femoral shaft fractures who visited between 1 January 2010 and 31 December 2015. We identified 65 patients and excluded 37 among these due to high-energy injuries or being younger than 65 years. Among the remaining patients, we identified 17 and 11 women with atypical (AFF group) and osteoporotic femoral shaft fractures (OP group), respectively. Results. In surgical method, there were differences in intramedullary nailing (94.1% versus 27.2%) (p<0.01). The mean bone healing time was 11.1 months versus 6.7 months in 2 groups (p<0.01). Iatrogenic femoral fractures during intramedullary nail insertion were observed in both groups, and reoperation was only seen in atypical femoral fractures treated with a plate fixation, but there was no difference in the rate of complications (23.5% versus 9.1%). Conclusions. In the atypical femoral fracture group, intramedullary nailing was more chosen, but the bone healing time was delayed and plate fixation cases needed reoperation. There was no significant difference in the rate of complications between the 2 groups.
The Cross-Sectional Evaluation of the Use of Artemisinin-Based Combination Therapy for Treatment of Malaria Infection at a Tertiary Hospital in Nigeria
Authors: Okoro Roland Nnaemeka , Jamiu Muslim Olakunle
Published: May 2018

In 2005, Nigeria changed its antimalarial drug policy to Artemisinin-based Combination Therapies (ACTs) for the treatment of malaria infection, and it is imperative for prescribers to strictly comply with this guideline to harmonize malaria management practices within the country. This study aims to evaluate prescribers’ adherence with the National Antimalarial Treatment Guideline (NATG) in the treatment of malaria infections and to describe the determinants of antimalarial drugs coprescription with antibiotics at a tertiary hospital in Nigeria. A cross-sectional, retrospective study of antimalarial drug prescriptions of one-year period of 2013 was conducted. A simple method for assessing the quality of drug prescribing (DU90%) was adopted. Logistic regression was used to predict antimalarial drugs coprescription with antibiotics. Overall, 95.8% of the total prescriptions contained ACTs, out of which 80.8% were Artemether/Lumefantrine. However, adherence to NATG was 88.2% with an adjusted value of 100.0%. Age was the only predictor for antimalarial drugs coprescription with antibiotics. This study showed high concordance with NATG at the studied hospital. Age less than 5 years is a significant risk factor for antimalarial drugs coprescription with antibiotics.
Influence of Processing Parameters on Laser Direct Joining of CFRTP and Stainless Steel
Authors: Sheng Liyuan , Jiao Junke , Du Beining , Wang Feiya , Wang Qiang
Published: May 2018

The CFRTP and the stainless steel were joined by the fiber laser, and the effect of processing parameters on the joint quality was investigated in detail. The heat‐affected zone on the stainless steel and the microstructure of the joint interface were examined and analyzed. The results showed that the laser joining process refines the microstructure of the fusion and heat‐affected zones in the stainless steel. And the tensile strength of the joint was affected greatly by the laser power and scanning speed but slightly by the clamping pressure. With the PPS additive, the joint shear strength could be improved, and the optimal PPS additive thickness is 300 μm. With the best parameters, joint with a shear strength of 15–17 MPa could be obtained as the laser power is 320–350 W, the scanning speed is 4‐5 mm/s, the clamping pressure is about 0.5 Mpa, and the additive PPS thickness is about 300 μm.
In Vitro Antifungal Susceptibility ofCandidaSpecies Isolated from Iranian Patients with Denture Stomatitis
Authors: Mahdavi Omran Saeid , Rezaei Dastjerdi Maryam , Zuashkiani Maryam , Moqarabzadeh Vahid , Taghizadeh-Armaki Mojtaba
Published: May 2018

Background.Candida-associated denture stomatitis (CADS) is a common fungal infection in people who wear dentures. The main objective of this study was to make molecular identification of causative agents of CADS and in vitro antifungal susceptibility testing (AFST) in the Iranian patients with denture stomatitis.Methods. A total of 134Candidaspp. were obtained from patients with denture stomatitis. TheCandidaspp. were identified using a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) involving the universal internal transcribed spacer (ITS1 and ITS4) primers, which were subjected to digestion with MspI and BlnI restriction enzymes. The in vitro antifungal susceptibility ofCandidaspp. to fluconazole (FLC), terbinafine (TRB), itraconazole (ITC), voriconazole (VRC), posaconazole (POS), ketoconazole (KET), amphotericin B (AMB), and caspofungin (CAS) was evaluated using the Clinical and Laboratory Standards Institute M27-A3 and M27-S4 guidelines.Results. Overall,C. albicanswas the most commonly isolated species (n=84; 62.6%), followed byC. glabrata(n=23; 17.2%),C. tropicalis(n=16; 12%), andC. parapsilosis(n=11; 8.2%). Posaconazole had the lowest geometric mean minimum inhibitory concentration (MIC) (0.03 μg/ml), followed by AMB (0.05 μg/ml), ITC (0.08 μg/ml), VRC (0.11 μg/ml), CAS (0.12 μg/ml), KET (0.15 μg/ml), and FLC (0.26 μg/ml).Discussion. Our study showed thatC. albicanswas most prevalent in Iranian patients with CADS and was susceptible to both azoles and amphotericin B. In addition, POS could be an appropriate alternative to the current antifungal agents used for the treatment of CADS, as well as in the treatment of recurrent candidiasis.
Two Cases of Delayed Diagnosis of Leprosy in Mauritania
Authors: Boushab Boushab Mohamed , Fall-Malick Fatima-Zahra , Basco Leonardo K.
Published: May 2018

Leprosy is a chronic infectious disease that mainly affects the skin, mucous membranes, and peripheral nervous system. The clinical manifestations of leprosy are numerous and polymorphic with the most frequent signs involving skin and neurological damage. Some of its manifestations, such as joint pain, are unusual. Its elimination as a public health problem in many countries seems to lead to a lack of practical knowledge among health care personnel and as a consequence a risk of late diagnosis. As in other countries, leprosy has become rare in Mauritania. We report two cases of misdiagnosed leprosy in two male patients aged 17 and 65 years. Clinical manifestations included polyarthritis, bilateral plantar perforation, and severely deformed hands and feet in the first case and lichenoid lesions, hypopigmented papules, and unilateral bronchial rales in the second case. The duration of development and persistence of clinical signs before establishment of correct diagnosis was seven to ten years despite the presence of anesthetic, hypochromic maculopapular skin lesions and neurologic signs suggestive of leprosy in both cases. A multilevel chemotherapeutic regimen recommended by the World Health Organization (WHO) was effective, and the patients’ condition evolved satisfactorily. The scarcity of leprosy in our health care facilities often leads to a wrong diagnosis. It is imperative to inform physicians to increase their vigilance for appropriate screening and reporting of these cases. The prognosis depends largely on early diagnosis and appropriate treatment.
The Evolution of Radiation Therapy in Metastatic Breast Cancer: From Local Therapy to Systemic Agent
Authors: Jutzy Jessica M. S. , Lemons Jeffrey M. , Luke Jason J. , Chmura Steven J.
Published: May 2018

Radiation therapy is a mainstay of treatment in early and locally advanced breast cancer but is typically reserved for palliation of symptomatic lesions in patients with metastatic breast cancer. With new advances in the field of tumor biology and immunology, the role of radiation in the metastatic setting is evolving to harness its immune-enhancing properties. Through the release of tumor antigens, tumor DNA, and cytokines into the tumor microenvironment, radiation augments the antitumoral immune response to affect both the targeted lesion and distant sites of metastatic disease. The use of immunotherapeutics to promote antitumoral immunity has resulted in improved treatment responses in patients with metastatic disease and the combination of radiation therapy and immunotherapy has become an area of intense investigation. In this article, we will review the emerging role of radiation in the treatment of metastatic disease and discuss the current state of the science and clinical trials investigating the combination of radiation and immunotherapy.
Analysis of Rainfall Trends and Its Relationship with SST Signals in the Lake Tana Basin, Ethiopia
Authors: Weldegerima Tesfay Mekonnen , Zeleke Tadesse Terefe , Birhanu Belay Simane , Zaitchik Benjamin Frederick , Fetene Zewdu Alamineh
Published: May 2018

The impacts of climate change and climate variability on human life have led the scientific community to monitor the behavior of weather and climate variables at different spatial and temporal scales. This paper explores seasonal and annual trends of rainfall in the Lake Tana basin (LTB) and their teleconnections with global sea surface temperatures (SSTs) over the period between 1979 and 2015. The nonparametric Mann–Kendall test and Sen’s slope estimate are applied to the rainfall data collected from the National Meteorology Agency (NMA) of Ethiopia for detecting and estimating rainfall trends. Additionally, Pearson’s correlation coefficient method is used to determine the effect of SST variations on rainfall. The assessment of rainfall trends indicates that the amount of annual rainfall in the Lake Tana basin is increasing, but the rate of increase is not statistically significant. Seasonal analysis reveals that the smallest amount of rainfall occurs in the Bega season, and this season is getting drier with time. However, the analysis indicates that the other two seasons (Belg and Kiremt) are becoming wetter. The rainfall in Kiremt is increasing significantly (significant at the p=0.05 level) in Debre Tabor station with a rate of 10.20 mm/year. Besides, 78.1% of the total annual rainfall in the basin occurs during this rainy (Kiremt) season, whereas Bega and Belg contribute some 9.4% and 12.5%, respectively. Furthermore, the correlation analysis of rainfall and SSTs indicates that rainfall of the LTB is highly affected by the variations of SSTs.