bluuebunny/crossref_metadata_2025 huggingface dataset:
Does the reintroduction of large wood in a large dryland river system benefit fish assemblages at the reach scale?
Authors: Matheson Adrian , Thoms Martin , Southwell Mark , Reid Michael
Published: September 2017

Benefits of reintroduced large wood in river channels are largely based on studies at site scales in high-energy systems. By comparison, relatively little is known of the benefit of reintroduced large wood in low-energy systems at larger, reach scales. The present study assessed the effects of reintroducing large wood on fish assemblages along the Barwon–Darling River, Australia. Fish were sampled in replicated reaches subject to three treatments: six reference (wooded), six control (unwooded) and six managed (wood reintroduced) reaches. Sampling was conducted before and several months after wood addition, and then during a period following several large floods. Results demonstrate that reintroducing large wood had limited effects on fish. There were significant differences between treatments in fish length, but not in total abundance or species composition between treatments. Significant differences were detected in total abundance, species composition and fish length over time. There was an interaction recorded between treatments and time for fish length, but not total abundance or species composition. It is suggested that the lack of response by fish was because the physical character and position of the reintroduced wood pieces did not replicate ‘natural’ reference conditions. However, high variability in fish assemblages through time, likely in response to hydrological variation, reduced the power of the study to detect differences between fish over the shorter time period of the study (<5 years).
Feeding ecology of the piked spurdog Squalus megalops (Chondrichthyes: Squalidae) in the Gulf of Gabès (central Mediterranean Sea)
Authors: Marouani Sondes , Kadri Hasna , Karaa Sami , Bradai Mohamed Nejmeddine
Published: September 2017

The present study investigated the feeding ecology of the piked spurdog (Squalus megalops) in the Gulf of Gabès (Tunisia) with regard to sex, size class and season. A study of stomach contents from the 630 individuals examined showed that the species consumed teleosts (percentage index of relative importance (%IRI)=80.32), cephalopods (%IRI=11.96) and crustaceans (%IRI=7.68). A three-factor multivariate analysis of variance (MANOVA) demonstrated significant differences in diet related to size, season and sex. Trophic position analysis revealed that S. megalops is a secondary consumer throughout its life. Quantitative analysis indicated that the species is a generalist feeder with an ontogenetic change in preferred prey from crustaceans to teleosts. The niche breadths of S. megalops in both sexes were broad.
Linguistic impoliteness and religiously aggravated hate crime in England and Wales
Authors: Culpeper Jonathan , Iganski Paul , Sweiry Abe
Published: September 2017

Despite its centrality to religiously aggravated hate crime recorded in England and Wales, the nature of the language used has been neglected in research. This paper, based on a unique dataset, aims to rectify this. It takes its approach from the field of linguistic impoliteness, a field that has yet to consider hate crime. Therein lies our second aim: To consider whether impoliteness notions can be usefully extended to the language of hate crime. In our data, we examine, in particular, conventionalized impoliteness formulae, insults, threats, incitement and taboo words. Whilst we reveal some linguistic support for the way religiously aggravated hate crime is framed in the law and discussed in the legal literature, we highlight areas of neglect and potential ambiguity. Regarding impoliteness, we demonstrate its effectiveness as an approach to these data, but we also highlight areas of neglect in that literature too, notably, non-conditional threats and incitement.
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Authors: Brindle Andrew , MacMillan Corrie
Published: September 2017

This paper combines corpus linguistics and critical discourse analysis methodologies in order to investigate the discourses and cyber activism of the British right-wing nationalist party, Britain First. A study of a corpus of texts produced by elite members of the group reveals a racist, xenophobic stance which constructs Islam and Muslims as the radical, dangerous ‘Other’. This creates a discourse of fear that threatens the way of life of the indigenous in-group of the British people. An investigation of the cyber activity of the group demonstrates that Britain First is able to achieve a significant amount of following on social media by publishing populist material that veils their true nature or ideological stance.
Understanding How Angler Characteristics and Context Influence Angler Preferences for Fishing Sites
Authors: Dabrowksa Kora , Hunt Len M. , Haider Wolfgang
Published: September 2017

Understanding angler heterogeneity is critical for fisheries managers to be able to develop management approaches that minimize stress to fish and aquatic ecosystems while maximizing benefits to anglers. We used a stated-preference choice model of British Columbia, Canada, anglers to predict their behavioral intentions to fish at lakes described by catch-related and non-catch-related attributes, such as expected catch and travel distance. We investigated how different means of accounting for preference heterogeneity and decision context affected conclusions about angler preferences for fishing sites. Our preferred model of fishing site choice accounted for both observable and unobservable (to the researcher) preference heterogeneity for site attributes, angler characteristics (i.e., recreation specialization and residence), and context (i.e., trip duration and target species). On average, anglers’ preferences conformed to expectations, but preferences for different site attributes varied greatly among anglers and contexts. For example, highly specialized anglers were more influenced by catch rates, fish size, and bag limits and were less deterred by travel than were less-specialized anglers. Anglers facing multiple-day trip contexts were influenced more by fish size and bag limits than were anglers considering day fishing trips. This latter result is especially important, as researchers often estimate models of angler behaviors by excluding anglers that undertake multiple-day trips, who might be the most sensitive to changes in regulations and fishing quality characteristics.

Received June 19, 2017; accepted September 18, 2017Published online November 10, 2017
Incorporating mindfulness: questioning capitalism
Authors: Scherer Bee , Waistell Jeff
Published: September 2017

This paper engages with Buddhist critiques of capitalism and consumerism; and it challenges the capitalist appropriations of Buddhist techniques. We show how Buddhist modernism and Marxism/socialism can align, and how Engaged Buddhism spawns communalism and socially revolutionary impulses for sustainability and ecological responsibility within the framework of Buddhist thought and mindfulness traditions. Our example of the Thai Asoke community exemplifies Buddhist communal mindfulness-in-action, explores successes and idiosyncrasies, and shows how communal principles can operate in such work-based communities.
Workplace spirituality in law enforcement: a content analysis of the literature
Authors: Moran Ramon
Published: September 2017

Community protests alleging police officers excessive use of force in places like Ferguson, Missouri, the place of Michael Brown’s controversial death from a policeman’s bullet, has raised public awareness of the need to reform law enforcement culture. Identifiable challenges to policing include burnout, higher rates of depression and anxiety, a militaristic sub-culture, and the need for community policing. Workplace spirituality’s holistic model in the context of law enforcement may contribute to police officer wellness and safety, but law enforcement lacks consensus on the definition, conceptualization, and operationalization of spirituality in its workplace. A content analysis of law enforcement literature was conducted to (1) explore and distil how workplace spirituality is viewed in law enforcement and training and (2) to propose new directions in the integration of workplace spirituality in policing. Workplace spirituality was associated with meaning making, policing values and ethics, spirituality, one’s religious beliefs, and the construct of self-transcendence. Implications of the findings suggest workplace spirituality is operational as a process of coping with stressors aiming at police officer wellness, and/or as virtuous leadership for community policing. A paradigmatic model for police training was inferred from the convergence of stress management, leadership, community policing, police wellness and safety, policing effectiveness, and policing culture with workplace spirituality.
Religion and innovation. A country institutional approach
Authors: Assouad A. , Parboteeah K. Praveen
Published: September 2017

Given the importance of religion as a norm setting mechanism and the extant literature that has neglected its impact on firms, we examine the role of religion as an antecedent of firm-level innovation. We utilize a country institutional profile approach focusing on the cognitive, normative, and regulative aspects of religion and how they are related to firm-level innovation. We hypothesize that religion affects the country-level environment and impacts firm-level behavior regarding innovation. We, therefore, synthesize arguments from the economics and international business literature and test our hypothesis on a sample of firms from 30 countries. We find partial support for the hypotheses, which provide interesting insights into the relationships between a firm level construct and religion.
Headspace volatile organic compounds from bacteria implicated in ventilator-associated pneumonia analysed by TD-GC/MS
Authors: Lawal Oluwasola , Muhamadali Howbeer , Ahmed Waqar M , White Iain R , Nijsen Tamara M E , Goodacre Royston , Fowler Stephen J ,   the BreathDx consortium
Published: September 2017

Ventilator-associated pneumonia (VAP) is a healthcare-acquired infection arising from the invasion of the lower respiratory tract by opportunistic pathogens in ventilated patients. The current method of diagnosis requires the culture of an airway sample such as bronchoalveolar lavage, which is invasive to obtain and may take up to seven days to identify a causal pathogen, or indeed rule out infection. While awaiting results, patients are administered empirical antibiotics; risks of this approach include lack of effect on the causal pathogen, contribution to the development of antibiotic resistance and downstream effects such as increased length of intensive care stay, cost, morbidity and mortality. Specific biomarkers which could identify causal pathogens in a timely manner are needed as they would allow judicious use of the most appropriate antimicrobial therapy. Volatile organic compound (VOC) analysis in exhaled breath is proposed as an alternative due to its non-invasive nature and its potential to provide rapid diagnosis at the patient’s bedside. VOCs in exhaled breath originate from exogenous, endogenous, as well as microbial sources. To identify potential markers, VAP-associated pathogens Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus were cultured in both artificial sputum medium and nutrient broth, and their headspaces were sampled and analysed for VOCs. Previously reported volatile markers were identified in this study, including indole and 1-undecene, alongside compounds that are novel to this investigation, cyclopentanone and 1-hexanol. We further investigated media components (substrates) to identify those that are essential for indole and cyclopentanone production, with potential implications for understanding microbial metabolism in the lung.
Angiotensin Receptor Expression and Vascular Endothelial Dysfunction in Obstructive Sleep Apnea
Authors: Khayat Rami N , Varadharaj Saradhadevi , Porter Kyle , Sow Angela , Jarjoura David , Gavrilin Mikhail A , Zweier Jay L
Published: September 2017

BACKGROUND

Obstructive sleep apnea (OSA) is associated with vascular endothelial dysfunction (VED) in otherwise healthy patients. The role of renin–angiotensin system (RAS) in the OSA induced VED is not well understood.

METHODS

Recently diagnosed OSA patients with very low cardiovascular disease (CVD) risk (Framingham score <5%) were studied at diagnosis and after 12 weeks of verified continuous positive airway pressure (CPAP) therapy. Participants underwent biopsy of gluteal subcutaneous tissue at baseline and after CPAP. Microcirculatory endothelial expression of angiotensin receptors type-1 (AT-1) and type-2 (AT-2) was measured in the subcutaneous tissue using quantitative confocal microscopy techniques. The ex-vivo effect of AT-1 receptor blockade (ARB) on endothelial superoxide production was also measured before and after CPAP treatment.

RESULTS

In OSA patients (n = 11), microcirculatory endothelial AT1 expression decreased from 873 (200) (fluorescence units) at baseline to 393 (59) units after 12 weeks of CPAP (P = 0.02). AT2 expression did not decrease significantly in these patients (479 (75) to 329 (58) post CPAP (P = 0.08)). The ex-vivo addition of the losartan to the microcirculatory endothelium resulted in decreased superoxide expression in the vascular walls from 14.2 (2.2) units to 4.2 (0.8) P < 0.001; while it had no effect on post-CPAP patient tissue (P = 0.64).

CONCLUSIONS

In OSA patients with no to minimal CVD risk, VED is associated with upregulation of AT-1 expression that is reversible with CPAP. Endothelial oxidative stress was reversible with ARB. RAS activation may play an important role in the development of early CVD risk in OSA patients.
Canvas SPW: calling de novo copy number variants in pedigrees
Authors: Ivakhno Sergii , Roller Eric , Colombo Camilla , Tedder Philip , Cox Anthony J
Published: September 2017

Motivation

Whole genome sequencing is becoming a diagnostics of choice for the identification of rare inherited and de novo copy number variants in families with various pediatric and late-onset genetic diseases. However, joint variant calling in pedigrees is hampered by the complexity of consensus breakpoint alignment across samples within an arbitrary pedigree structure.

Results

We have developed a new tool, Canvas SPW, for the identification of inherited and de novo copy number variants from pedigree sequencing data. Canvas SPW supports a number of family structures and provides a wide range of scoring and filtering options to automate and streamline identification of de novo variants.

Availability and implementation

Canvas SPW is available for download from https://github.com/Illumina/canvas.

Supplementary information

Supplementary data are available at Bioinformatics online.
Spironolactone-induced degradation of the TFIIH core complex XPB subunit suppresses NF-κB and AP-1 signalling
Authors: Elinoff Jason M , Chen Li-Yuan , Dougherty Edward J , Awad Keytam S , Wang Shuibang , Biancotto Angelique , Siddiqui Afsheen H , Weir Nargues A , Cai Rongman , Sun Junfeng , Preston Ioana R , Solomon Michael A , Danner Robert L
Published: September 2017

Aims

Spironolactone (SPL) improves endothelial dysfunction and survival in heart failure. Immune modulation, including poorly understood mineralocorticoid receptor (MR)-independent effects of SPL might contribute to these benefits and possibly be useful in other inflammatory cardiovascular diseases such as pulmonary arterial hypertension.

Methods and results

Using human embryonic kidney cells (HEK 293) expressing specific nuclear receptors, SPL suppressed NF-κB and AP-1 reporter activity independent of MR and other recognized nuclear receptor partners. NF-κB and AP-1 DNA binding were not affected by SPL and protein synthesis blockade did not interfere with SPL-induced suppression of inflammatory signalling. In contrast, proteasome blockade to inhibit degradation of xeroderma pigmentosum group B complementing protein (XPB), a subunit of the general transcription factor TFIIH, or XPB overexpression both prevented SPL-mediated suppression of inflammation. Similar to HEK 293 cells, a proteasome inhibitor blocked XPB loss and SPL suppression of AP-1 induced target genes in human pulmonary artery endothelial cells (PAECs). Unlike SPL, eplerenone (EPL) did not cause XPB degradation and failed to similarly suppress inflammatory signalling. SPL combined with siRNA XPB knockdown further reduced XPB protein levels and had the greatest effect on PAEC inflammatory gene transcription. Using chromatin-immunoprecipitation, PAEC target gene susceptibility to SPL was associated with low basal RNA polymerase II (RNAPII) occupancy and TNFα-induced RNAPII and XPB recruitment. XP patient-derived fibroblasts carrying an N-terminal but not C-terminal XPB mutations were insensitive to both SPL-mediated XPB degradation and TNFα-induced target gene suppression. Importantly, SPL treatment decreased whole lung XPB protein levels in a monocrotaline rat model of pulmonary hypertension and reduced inflammatory markers in an observational cohort of PAH patients.

Conclusion

SPL has important anti-inflammatory effects independent of aldosterone and MR, not shared with EPL. Drug-induced, proteasome-dependent XPB degradation may be a useful therapeutic approach in cardiovascular diseases driven by inflammation.
Anomalous light curves of young tilted exorings
Authors: Sucerquia Mario , Alvarado-Montes J. A. , Ramírez Vanesa , Zuluaga Jorge I.
Published: September 2017

Despite the success of discovering transiting exoplanets, several recently observed objects (e.g. KIC-8462852, J1407 and PDS-110) exhibit unconventional transit signals, whose appropriate interpretation in terms of a spherical single body has been challenging, if not impossible. In the aforementioned examples, the presence of a ring-like structure has been proposed for explaining the unusual data. Thus, in this Letter, we delve into the dynamics of a tilted exoring disturbed by a third close companion, and the role that the Lidov–Kozai mechanism may have to explain irregular and anomalous transit signals of ringed planets, as well as the ring’s early stages. To that end, we performed numerical simulations and semi-analytical calculations to assess the ring’s dynamical and morphological properties, and their related transit observables. We found that tilted ringed structures undergo short-term changes in shape and orientation that are manifested as strong variations of transit depth and contact times, even between consecutive eclipses. Any detected anomaly in transit characteristics may lead to a miscalculation of the system’s properties (planetary radius, semimajor axis, stellar density and others). Moreover, oscillating ring-like structures may account for the strangeness of some light-curve features in already known and future discovered exoplanets.
Design strategies of highly selective nickel catalysts for H2 production via hydrous hydrazine decomposition: a review
Authors: He Lei , Liang Binglian , Huang Yanqiang , Zhang Tao
Published: September 2017

Hydrazine, a widely used liquid propellant, has the potential to be employed as a hydrogen source in certain instances and has therefore attracted considerable attention; consequently, the complete decomposition of hydrazine with 100% H2 selectivity under mild conditions has become the current research focus for catalyst design. In this review, the strategies for the design of efficient catalysts are summarized for complete hydrazine decomposition. The first part of this review introduces the mechanism of hydrazine decomposition, while the second part illustrates the key factors influencing the H2 selectivity of nickel catalysts, including the effects of alloying, alkali promoter addition and strong metal–support interactions. Finally, the critical elements of catalyst design employed in industrial applications are analyzed.
Air and Moisture Transport Properties of Low‐Oil DDGS
Authors: Bhadra Rumela , Ambrose R. P. Kingsly , Casada Mark E. , Simsek Senay , Siliveru Kaliramesh
Published: September 2017

Distillers dried grains with solubles (DDGS) are widely used as feed for cattle, dairy, and swine because of their protein, fiber, amino acids, fat, and other vital nutrients. Corn ethanol plants in the United States recently have started extracting oil from DDGS to gain additional profit, thus producing low‐oil DDGS. So far, there has been no comprehensive study reported with bulk handling and flowability properties of low‐oil DDGS. We measured the air resistance, moisture diffusivity, and air permeability properties for low‐oil DDGS at different temperature and relative humidity conditions, along with some important physical and chemical properties. Physical property comparisons between regular and low‐oil DDGS showed differences in key properties such as particle size, color, density, porosity, and angle of repose. The modified Henderson model predicted the equilibrium moisture content (EMC)–equilibrium relative humidity (ERH) relationship of low‐oil DDGS with a low standard error of regression value (0.008); it showed no pattern in the residuals and was judged the most appropriate model tested for EMC‐ERH predictions. Results of EMC‐ERH nonlinear modeling were used to define conditions for moisture diffusivity. Moisture diffusivities of low‐oil DDGS at varying drying temperatures ranged from 0.74 × 10−11 to 1.77 ×10−11m2/s. The properties are important for understanding and modeling heat and moisture transport through and flow properties of low‐oil DDGS.
How Nurse Work Environments Relate to the Presence of Parents in Neonatal Intensive Care
Authors: Hallowell Sunny G. , Rogowski Jeannette A. , Lake Eileen T.
Published: September 2017

Background:

Parental presence in the neonatal intensive care unit (NICU) is essential for families to participate in infant care and prepare them to transition from hospital to home. Nurses are the principal caregivers in the NICU. The nurse work environment may influence whether parents spend time with their hospitalized infants.

Purpose:

To examine the relationship between the NICU work environment and parental presence in the NICU using a national data set.

Methods:

We conducted a cross-sectional, observational study of a national sample of 104 NICUs, where 6060 nurses reported on 15,233 infants cared for. Secondary analysis was used to examine associations between the Practice Environment Scale of the Nursing Work Index (PES-NWI) (subscale items and with a composite measure) and the proportion of parents who were present during the nurses' shift.

Results:

Parents of 60% (SD = 9.7%) of infants were present during the nurses' shift. The PES-NWI composite score and 2 domains—Nurse Participation in Hospital Affairs and Manager Leadership and Support—were significant predictors of parental presence. A 1 SD higher score in the composite or either subscale was associated with 2.5% more parents being present.

Implications for Practice:

Parental presence in the NICU is significantly associated with better nurse work environments. NICU practices may be enhanced through enhanced leadership and professional opportunities for nurse managers and staff.

Implications for Research:

Future work may benefit from qualitative work with parents to illuminate their experiences with nursing leaders and nurse-led interventions in the NICU and design and testing of interventions to improve the NICU work environment.
The effect of plantar flexor lengthening on foot pressure in ambulatory children with cerebral palsy
Authors: Abousamra Oussama , Schwartz Joshua , Church Chris , Lennon Nancy , Henley John , Niiler Tim , Miller Freeman
Published: September 2017

This study aimed to assess the effects of plantar flexor lengthening (PFL) on dynamic foot pressures of children with cerebral palsy using pedobarographs. Of 97 enrolled, 13 children with 18 legs had PFL. Age at surgery was 4.7 (2.8–8.8) years. A significant increase in ankle dorsiflexion and heel impulse was achieved postoperatively and was maintained at 5 years. The coronal plane pressure index increased postoperatively, but reverted to preoperative levels at the 5-year follow-up. Children tend to have more valgus after PFL. In young children, there caution should be exercised to avoid over treating varus at the time of equinus correction to avoid overcorrection.
Bipedicle Flaps for Posterior Elbow Reconstruction
Authors: Chepla Kyle J. , Shue Shirley , Kafuman Bram R.
Published: September 2017

Chronic posterior elbow soft tissue defects often require soft tissue reconstruction because of exposure of the underlying triceps tendon and proximal ulna. Current options for soft tissue coverage require sacrifice of a local muscle or microsurgery. The purpose of this study is to evaluate patient and surgical outcomes after reconstruction of small-sized to medium-sized (<50 cm2) posterior elbow defects with bipedicle advancement flaps. A retrospective chart review was performed for 3 patients who underwent posterior elbow reconstruction with bipedicle flaps. The etiology of the soft tissue elbow defect was chronic infected olecranon bursitis (n=2) and exposed olecranon plate after open fracture (n=1). Patient comorbidities included: diabetes, CREST (Calcinosis, Raynaud phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasia) syndrome, and rheumatoid arthritis. The mean patient age at time of reconstruction was 44 years (39 to 51 y), and the mean area of soft tissue defect was 39.3 cm2 (24 to 54 cm2) after debridement of involved tissue. All patients had positive intraoperative cultures and were treated with culture-directed long-term intravenous antibiotics. There were no surgical complications or flap loss. All patients had reepithelialization of the donor site by postoperative week 8 and stable soft tissue coverage of the elbow after surgery at final follow-up with full preoperative elbow range of motion. This technique offers a simple, reliable solution for soft tissue coverage of the posterior elbow using excess local tissue for primary closure of posterior elbow wounds with minimal donor-site morbidity.
Evaluation of vSim for Nursing in an Adult Health Nursing Course
Authors: Wright Renée R. , Tinnon Elizabeth A. , Newton Rebecca H.
Published: September 2017

Virtual simulation technology is the next step in using simulation as an accepted teaching-learning pedagogy in nursing. The purpose of this multisite, quasi-experimental, three-group, posttest-only design was to evaluate the effectiveness and participant satisfaction of vSim for Nursing in an Adult Health Nursing course. Although the quantitative findings (examination scores and postsimulation scores) were not statistically significant, participants overwhelmingly found vSim for Nursing to be a positive experiential learning endeavor. Ninety-one percent of the participants (n = 61) indicated that vSim for Nursing helped them understand adult health concepts and that vSim for Nursing was beneficial to learning. vSim for Nursing warrants further investigation, using other methods to measure effectiveness to ascertain whether knowledge acquisition is indeed improved as indicated by participant data in this study.
Self-limiting Ibrutinib-Induced Neutrophilic Panniculitis
Authors: Stewart Jacob , Bayers Stephanie , Vandergriff Travis
Published: September 2017

Neutrophilic panniculitis is a relatively rare condition, characterized by predominantly neutrophilic inflammation in the subcutaneous fat. Rarely, neutrophilic panniculitis may be induced by chemotherapeutics or targeted molecular therapies, including the Bruton tyrosine kinase inhibitor ibrutinib. Previously reported cases of ibrutinib-induced panniculitis were suppressed with sustained low-dose steroid therapy while continuing ibrutinib therapy. To our knowledge, self-limiting panniculitis during ibrutinib therapy has not yet been described. We describe a case of self-limiting, neutrophilic panniculitis which developed during ibrutinib therapy. A 78-year-old woman presented to the dermatology clinic with a 3-week history of painful erythematous nodules on her lower extremities which occurred 1 month after initiating ibrutinib therapy for chronic lymphocytic leukemia. Physical examination revealed tender erythematous poorly demarcated subcutaneous nodules on the anterior and posterior aspects of both lower legs. A panniculitis was suspected clinically, and a punch biopsy was performed. Histological evaluation revealed a lobular panniculitis with fat necrosis and infiltrates consisting predominantly of neutrophils. A diagnosis of neutrophilic panniculitis was rendered, which the patient opted not to treat. The eruption waned before resolving spontaneously over the course of 6 months despite continued ibrutinib therapy. This case illustrates panniculitis as an emerging adverse drug reaction after treatment with ibrutinib and that not all cases will require ibrutinib dose adjustment or steroid therapy but rather may be subject to spontaneous resolution.
Psammomatous Squamous Cell Carcinoma of the Skin
Authors: Schuler Andrew , Smith Emily , Chen Stephanie , Chan May P. , Harms Paul W.
Published: September 2017

Psammoma bodies (PBs) are concentric, lamellated calcifications commonly observed in malignancies such as papillary thyroid carcinoma and serous carcinoma of the ovary in which they may serve prognostic value. PBs are rare in cutaneous squamous cell carcinoma (cSCC), with only 1 previously reported case. Here, we present 3 cases of cSCC displaying PBs. One case occurred in the setting of end-stage renal disease, whereas the other 2 cases were in patients who did not have comorbid conditions that might predispose to hypercalcemia and dystrophic calcification. All 3 tumors demonstrated classic immunophenotypic findings of cSCC. Our findings indicate that PBs are a rare but recurrent phenomenon in cSCC, with unknown prognostic significance. The potential for PB formation in cSCC should be kept in mind, as this may represent a diagnostic pitfall in tumors with limited sampling or unusual morphologies.
Potential Medication Treatment According to Pathological Mechanisms in Abdominal Aortic Aneurysm
Authors: Zhang Shi-lan , Du Xiao , Chen Yan-qiao , Tan Yuan-sheng , Liu Ling
Published: September 2017

Abdominal aortic aneurysm (AAA) is a vascular disease with high mortality. Because of the lack of effective medications to stop or reverse the progression of AAA, surgical operation has become the most predominant recommendation of treatment for patients. There are many potential mechanisms, including inflammation, smooth muscle cell apoptosis, extracellular matrix degradation, oxidative stress, and so on, involving in AAA pathogenesis. According to those mechanisms, some potential therapeutic drugs have been proposed and tested in animal models and even in clinical trials. This review focuses on recent advances in both pathogenic mechanisms and potential pharmacologic therapies of AAA.
Comparison of Dried Blood Spots Versus Conventional Plasma Collection for the Characterization of Efavirenz Pharmacokinetics in a Large-Scale Global Clinical Trial—The ENCORE1 Study
Authors: Amara Alieu B. , Else Laura J. , Carey Dianne , Khoo Saye , Back David J. , Amin Janaki , Emery Sean , Puls Rebekah L.
Published: September 2017

Background:

The aim of this study was to determine the utility of dried blood spots (DBS) compared with conventional plasma collection methods for characterization of efavirenz pharmacokinetics, in the setting of a large-scale, global clinical trial (ENCORE1).

Methods:

Six hundred thirty patients were recruited from 38 sites and had single matched whole blood DBS and plasma samples (mid-dose interval) taken at weeks 4 and 12 of treatment. In addition, a subgroup of patients underwent intensive DBS and plasma sampling (0–24 hours) to provide full-profile data for pharmacokinetic parameters. Efavirenz concentrations were determined by validated high-performance liquid chromatography–mass spectrometry methods. A DBS-predicted plasma concentration was derived and linear regression and Bland–Altman plots were used to compare DBS-predicted plasma concentrations with that of measured plasma concentrations.

Results:

Efavirenz DBS and plasma concentrations were significantly correlated (R2 = 0.904, P < 0.001; n = 1094), and DBS concentrations were, on average, 53% ± 9.5% lower than plasma. In the main study, the DBS-predicted plasma values significantly underestimated the true measured concentration of efavirenz in plasma; the mean difference (95% confidence interval) between efavirenz DBS-predicted concentrations and measured plasma concentrations was −0.451 mg/L (−0.504 to −0.398) at week 4 (n = 561). However, in the intensive study, the mean difference was only 0.086 mg/L (−0.006 to 0.178) at 12 hours after dose (n = 46) and was not statistically significant.

Conclusions:

Our data show a high correlation between measurements of efavirenz concentrations in plasma and in DBS. However, DBS concentrations significantly underestimated the true measured plasma concentrations in the sparse samples taken in this large multinational ENCORE1 trial.
Clinical trials in menopause
Authors: Marko Kathryn I. , Simon James A.
Published: September 2017

Objective:

Clinical trials in menopause have undergone much scrutiny over the years. This has led to significant shifts in the treatment of symptomatic menopause and a substantial impact on women. We aim to delineate the key studies contributing to this controversy and highlight new directions specifically related to menopausal hormone therapy (HT) and vascular disease risk.

Methods:

We performed a search of sentinel studies delineating the risks and benefits of HT in otherwise healthy postmenopausal women. Using PubMed we input the following search terms: hormone replacement therapy, cardiovascular disease, coronary artery disease, coronary atherosclerosis, myocardial infarction, angina, coronary heart calcification, carotid intimal thickness, lipids, and/or lipoproteins. We included studies of menopausal women (surgical or natural) using combined estrogen/progestogen therapy or estrogen-only therapy that looked at cardiovascular disease risk factors or outcomes. Studies were evaluated for inclusion by the authors; however, this is not intended to be a systematic or an exhaustive analysis.

Results:

In women close to the time of menopause, there is a decreased risk of subclinical and clinical coronary heart disease with menopausal HT. Additionally, HT confers a significant benefit to vasomotor symptoms of menopause, bone health, and colorectal cancer. There is an increased risk of venous thromboembolism with oral formulations that appears mitigated with transdermal estradiol. Mixed data regarding breast cancer risk are available, with some studies suggesting an increased risk of invasive breast cancer with estrogen/progestogen therapy and a null effect with estrogen-only therapy. Other more long-term epidemiologic studies identify a decreased risk.

Conclusions:

The available literature suggests that HT is a viable option for the primary prevention of cardiovascular disease in postmenopausal women. Newer trials will likely verify this assessment. If this is enough to change clinical practice, however, remains to be seen given the general fear of HT by many with prescriptive authority, and also the women in our care.
Transient Hypothyroidism and Autoimmune Thyroiditis in Children With Chronic Hepatitis C Treated With Pegylated-interferon-α-2b and Ribavirin
Authors: Serranti Daniele , Indolfi Giuseppe , Nebbia Gabriella , Cananzi Mara , D’Antiga Lorenzo , Ricci Silvia , Stagi Stefano , Azzari Chiara , Resti Massimo ,   for the Italian Study Group for Treatment of Chronic Hepatitis C in Children
Published: September 2017

Background:

Autoimmune thyroid disease and thyroid dysfunction are common in adults receiving interferon (IFN)-based treatment for chronic hepatitis C (CHC). Few data are available in children with CHC. This study is aimed to evaluate the appearance and timing of thyroid dysfunction and antithyroid autoimmunity in children with CHC treated with pegylated IFN-α-2b and ribavirin (RBV).

Methods:

Sixty-one otherwise healthy children with CHC, 3–17 years of age, infected perinatally and treatment naïve, receiving therapy with pegylated IFN-α-2b and RBV and 183 age- and sex-matched controls were included in a multicenter, prospective, case-control study. Thyroid-stimulating hormone, free thyroxine, antithyroglobulin antibodies and antithyroid peroxidase antibodies were assessed before, during and 24 weeks after the end of treatment.

Results:

From baseline to the end of treatment, subclinical hypothyroidism and autoimmune thyroiditis were diagnosed in 17 of 61 (27.94%) and in 4 of 61 (6.6%) of the children treated, respectively, and in 5 of 183 (2.7%) and in none of the controls (P < 0.0001, relative risk: 10.2, 95% confidence interval: 3.9–26.5; P = 0.03, relative risk: 26.8, 95% confidence interval: 1.5–489.1, respectively). Twenty-four weeks after the end of treatment, subclinical hypothyroidism persisted in only 4 of 61 (6.6%). Autoimmune thyroiditis persisted in 3 of 4 (75%) of the cases.

Conclusions:

Subclinical hypothyroidism is common in children with CHC receiving treatment with pegylated IFN-α-2b and RBV, but in most cases is transient. Autoimmune thyroiditis, which is less common, generally persists after treatment completion. Thyroid function should be carefully monitored in patients presenting with antithyroid autoantibodies and thyroid dysfunction during and after pegylated IFN-α–based treatment.
Brain oscillations reflecting pain-related behavior in freely moving rats
Authors: Peng Weiwei , Xia Xiaolei , Yi Ming , Huang Gan , Zhang Zhiguo , Iannetti Giandomenico , Hu Li
Published: September 2017

Recording oscillatory brain activity holds great promise in pain research. However, experimental results are variable and often difficult to reconcile. Some of these inconsistencies arise from the use of hypothesis-driven analysis approaches that (1) do not assess the consistency of the observed responses within and across individuals, and (2) do not fully exploit information sampled across the entire cortex. Here, we address these issues by recording the electrocorticogram directly from the brain surface of 12 freely moving rats. Using a hypothesis-free approach, we isolated brain oscillations induced by graded nociceptive stimuli and characterized their relation to pain-related behavior. We isolated 4 responses, one phase-locked event-related potential, 2 non–phase-locked event-related synchronizations, and one non–phase-locked event-related desynchronization (ERD), in different frequency bands (δ/θ-ERD, θ/α–event-related synchronization, and gamma-band event-related synchronization). All responses except the δ/θ-ERD correlated with pain-related behavior at within-subject level. Notably, the gamma-band event-related synchronization was the only response that reliably correlated with pain-related behavior between subjects. These results comprehensively characterize the physiological properties of the brain oscillations elicited by nociceptive stimuli in freely moving rodents and provide a foundational work to improve the translation of experimental animal findings to human physiology and pathophysiology.
Functional Outcomes in People with Transtibial Amputation Using Crossover and Energy-Storing Prosthetic Feet: A Pilot Study
Authors: Hafner Brian J. , Halsne Elizabeth G. , Morgan Sara J. , Davidson Greg
Published: September 2017

Introduction

Contemporary prosthetic feet are purposefully designed to address the many functional limitations experienced by people with transtibial amputation (TTA). Choice of materials, geometry, and fabrication techniques contribute to the overall performance of the foot, and ultimately to the functional outcomes achieved by the user. The crossover foot is a novel foot design that integrates features from traditional energy-storing feet and modern, running-specific feet in an effort to maximize performance and energy return. Although initial user feedback is promising, research is needed to determine whether the crossover foot is capable of improving user outcomes relative to other types of contemporary prosthetic feet.

Materials and Methods

A cross-sectional pilot study was conducted to evaluate mobility, endurance, perceived exertion, and walking performance attained by participants wearing prostheses with crossover and energy-storing feet. Participants with unilateral TTA were administered a short battery of performance-based tests while wearing a prosthesis with a crossover foot and a prosthesis with a traditional energy-storing foot. The order of prostheses worn was randomly assigned. Tests included the Timed Up and Go (TUG) performed at comfortable speed, the TUG performed at fast speed, and the 6-minute walk test (6MWT). Spatiotemporal measures (speed, cadence, step length, step width, and step time) were assessed during the 6MWT using a GAITRite electronic walkway. Participants were asked to report their perceived exertion following the 6MWT using the Borg rating of perceived exertion (CR100).

Results

Seven participants completed all pilot study procedures. On average, participants exhibited better mobility at comfortable and fast speeds (0.83 second and 0.63 second faster during the TUG-comfortable and TUG-fast, respectively), improved endurance (19.7 m farther in the 6MWT), reduced perceived exertion (12.9 points less on the Borg CR100), increased speed (0.05 m/s), faster cadence (2 steps/min), and longer sound side steps (3.3 cm) while wearing the crossover foot than when wearing the energy-storing foot. However, not all participants exhibited the same functional benefits from using the crossover foot.

Conclusions

The crossover foot is a promising prosthetic foot design that appears to provide modest functional benefits to transtibial prosthesis users. Given the pilot nature of this study, additional research is needed to assess benefits across a larger and more diverse range of users to inform prescription practices.
Ejection Fraction May Not Reflect Contractility: Example in Veno-Arterial Extracorporeal Membrane Oxygenation for Heart Failure
Authors: Morimont Philippe , Lambermont Bernard , Guiot Julien , Tchana Sato Vincent , Clotuche Christophe , Goffoy Jonathan , Defraigne Jean-Olivier
Published: September 2017

Precise assessment of left ventricular (LV) contractility during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support is crucial. However, changes in loading conditions may mask changes in LV function when assessed with load-dependent parameters. We compared end-systolic elastance (Ees, mm Hg/ml), the reference load-independent parameter of LV contractility, with LV ejection fraction (LVEF) in two patients. The first patient was a 54-year-old patient supported with femoro-femoral VA-ECMO for a cardiogenic shock. Afterload was calculated by using arterial elastance (Ea, mm Hg/ml). Although Ees near doubled from day 0 to day 3, no significant change was observed in LVEF. The second patient was a 61-year-old patient supported with femoro-femoral VA-ECMO for severe heart failure complicated with sepsis. We retrospectively showed that discrepancy between LVEF and Ees resulted from changes in LV-arterial coupling. We concluded that LVEF may be misleading in the assessment of LV function during VA-ECMO for heart failure.
Sofosbuvir and daclatasvir plus ribavirin treatment improve liver function parameters and clinical outcomes in Egyptian chronic hepatitis C patients
Authors: Mohamed Mohamed S. , Hanafy Amr S. , Bassiony Mohamed A.A. , Hussein Samia
Published: September 2017

Background and aims

Interferon-free direct-acting antivirals (DAA) combination therapies, including sofosbuvir (SOF) and daclatasvir (DCV) therapy, eradicate chronic hepatitis C virus (HCV) in a high percentage of patients, but its impact on improvements in liver function is unclear. The aim of this study was to investigate the changes in clinical and biochemical parameters reflecting liver function and general status in those who achieved HCV eradication by DAA.

Patients and methods

From March 2016 to October 2016, 374 chronic hepatitis C patients were enrolled for this prospective, observational study and received SOF, DCV with ribavirin, to evaluate the changes in liver function parameters, international normalized ratio, complete blood count, model for end-stage liver disease, and Child–Turcotte–Pugh scores after achieving a sustained virological response 12 weeks after treatment.

Results

In those who achieved HCV clearance, liver function parameters, serum albumin, bilirubin, platelet count, and international normalized ratio improved significantly in the majority of patients; the reduction in the model for end-stage liver disease score was (−2.36, SE 0.15, P<0.001). 44% of the patients showed an improved Child–Turcotte–Pugh score, 51% showed no change, and only 5% showed deterioration.

Conclusion

Successful HCV eradication by DAAs including SOF, DCV with ribavirin therapy improved liver function parameters and clinical outcomes in chronic hepatitis C patients.
Vitamin B12 deficiency in inflammatory bowel disease: a prospective observational pilot study
Authors: Battat Robert , Kopylov Uri , Byer Joshua , Sewitch Maida J. , Rahme Elham , Nedjar Hacene , Zelikovic Elana , Dionne Serge , Bessissow Talat , Afif Waqqas , Waters Paula J. , Seidman Ernest , Bitton Alain
Published: September 2017

Background and aim

Diagnostic and management guidelines for vitamin B12 (cobalamin, Cbl) deficiency in inflammatory bowel disease (IBD) are lacking. True deficiency is defined as Cbl concentrations below reference range combined with elevated methylmalonic acid (MMA) concentrations. Studies analyzing Cbl status in IBD use only Cbl concentrations without confirmatory MMA. This study aims to determine the proportion of IBD patients with Cbl concentrations below reference range and their predisposing clinical and genetic characteristics. We then compared this to the proportion with true deficiency.

Patients and methods

In a prospective observational pilot study of adult IBD outpatients, Cbl concentrations, MMA levels, and fucosyltransferase 2 mutations were measured at clinic visits.

Results

A total of 66 Crohn’s disease (CD) and 30 ulcerative colitis (UC) patients were recruited. Mean Cbl concentrations (pmol/l) in CD (253.7) were not significantly lower than UC (320.5, P=0.24). Serum Cbl below reference range (<148) was observed in 7.6 and 10% of CD and UC patients, respectively (P=0.70). True deficiency in CD and UC was 3 and 3.3%, respectively (P=1.0). Patients with ileal resections more than 30 cm had lower mean Cbl concentrations (177, P=0.02) and a trend toward higher proportions with Cbl levels below reference range (40%, P=0.06), but not increased deficiency rates (0%, P=1.0). Disease location, severity, and fucosyltransferase 2 mutations were not associated with altered Cbl status.

Conclusion

True Cbl deficiency was rare in IBD patients in this study. A disparity in Cbl status exists when confirmatory MMA levels are used compared with Cbl concentrations alone. Asymptomatic IBD patients with low serum Cbl require confirmatory tests to guide management and avoid unnecessary treatment.