bluuebunny/crossref_metadata_2025 huggingface dataset:
Statistical Aspects of Monitoring for Dangers in Drug Therapy)
Authors: FINNEY D. J.
Published: March 2018

A therapeutic drug has a complicated life history, and some of the important stages of this are described in the paper. Before it can even be referred to as a drug, it must be identified as a chemical compound worth investigation as possibly having useful pharmacological properties. From among large numbers in this category, a few must be selected by a screening process. Toxicity tests and clinical trials each bring their special problems for the statistician. When a new drug has had its usefulness established, standardization of its potency by biological assay may be necessary, and this also uses statistical techniques.

Most of the paper is concerned with adverse reactions to drugs when used in medical practice, and methods for detecting these. In response to recent recognition of dangers, systems for monitoring for adverse reactions to drugs that occur during normal therapeutic use have been developed in many countries. The paper outlines the logical basis of monitoring and discusses its practical implementation. New problems of statistical inference, as well as large data handling activities, arise in connexion with the interpretation of evidence that is very heterogeneous in origin. The basic statistical problem appears to be one of collecting and evaluating information that may constitute a degree of suspicion calling for intensive and more objectively planned research. This type of inference seems closer to the mode of thought of a criminal investigation department than to orthodox practice of statistical estimation or decision-making; I think it has new features that deserve further study.

National monitoring organizations are now cooperating, through the World Health Organization, in an international project for the combination of evidence.
A Retrieval System for a Library of Pathology Reports, Slides and Kodachromes
Authors: GAYNON P. , WONG R. L.
Published: March 2018

With the objective of providing easier access to pathology specimens, slides and kodachromes with linkage to x-ray and the remainder of the patient’s medical records, an automated natural language parsing routine, based on dictionary look-up, was written for Surgical Pathology document-pairs, each consisting of a Request for Examination (authored by clinicians) and its corresponding report (authored by pathologists). These documents were input to the system in free-text English without manual editing or coding.

Two types of indices were prepared. The first was an »inverted« file, available for on-line retrieval, for display of the content of the document-pairs, frequency counts of cases or listing of cases in table format. Retrievable items are patient’s and specimen’s identification data, date of operation, name of clinician and pathologist, etc. The English content of the operative procedure, clinical findings and pathologic diagnoses can be retrieved through logical combination of key words. The second type of index was a catalog. Three catalog files — »operation«, »clinical«, and »pathology« — were prepared by alphabetization of lines formed by the rotation of phrases, headed by keywords. These keywords were automatically selected and standardized by the parsing routine and the phrases were extracted from each sentence of each input document. Over 2,500 document-pairs have been entered and are currently being utilized for purpose of medical education.
Dreidimensionale Darstellung der Dosisverteilung in der Strahlentherapie
Authors: Gell G.
Published: March 2018

In der Strahlentherapie wird die berechnete Dosisverteilung gewöhnlich durch Isodosenlinien angegeben. Bei sehr inhomogenen oder regional homogenen Dosiswerten erreicht man durch die Ergänzung der Isodosenpläne durch eine dreidimensionale Darstellung eine größere Anschaulichkeit und Verständlichkeit. Dreidimensionale Darstellungen erleichtern auch die Erklärung der Funktion der Isodosenlinien und verbessern dadurch die Kommunikation zwischen Strahlentherapeut und Strahlenphysiker.
A Data Processing Support System for the Administration of a College of Dentistry’s Student Clinics
Authors: Olde G. L. , Bartlett R. C.
Published: March 2018

This report describes a data processing system which has been developed in support of the administration of the strident clinics in a college of Dentistry. By capturing data describing the work done by students on patients in the teaching clinics, a series of reporting modes have been developed which provide a capability for monitoring the progress of both patient and student. The methods used for data collection will be described along with a discussion of the various types of reports which are currently being utilized.
Multiphasic Screening as a Diagnostic Method in Preventive Medicine
Authors: Collen Morris
Published: March 2018

An automated multiphasic screening program has been described utilizing automated and semi-automated electronic and mechanical equipment to rapidly provide comprehensive, quantitative, and precise testing for a large number of diseases.

The data processing system and computer requirements of the program have been reviewed. The program incorporates a statistical method which automatically determines the likelihood of the presence or absence of selected diagnoses according to pre-determined sensitivity and specificity criteria.
Logic of the Diagnostic Process
Authors: Lusted Lee
Published: March 2018

Research on the logic of the diagnostic process is proceeding in two main areas: (a) computer diagnosis and (b) studies of the human diagnostic judgment process. These two main areas of research are complementary because discovering functional relationships between signs, symptoms and diagnosis in a computer diagnoses study may give clues to better methods of human diagnosis. Greater understanding of the human diagnostic judgment process should enable the investigator to produce these processes more exactly on a computer.
Spezielle Befunddokumentation in der Augenheilkunde
Authors: Rossmann H. , Dhaegerund J.
Published: March 2018

Für die Dokumentation einzelner, ausreichend häufiger und wichtiger Krankheitsbilder hat sich die Einführung spezieller Erhebungsbogen, die bei nur geringem Mehraufwand an Zeit und Arbeit eine gezieltere Erfassung der interessierenden Daten gestatten, gut bewährt. Die Verfasser beschreiben solche speziellen Erhebungsbogen für Amotio retinae, Strabismus und Uveitis.
The Computation of Results from Radioimmunoassays
Authors: Finney D. J.
Published: March 2018

The use of radioimmunoassay (RIA) as a routine aid to clinical diagnosis makes it important that procedures for estimating the potency of each test sample are good, ancl that the validity of assumptions implicit in the calculations is regularly monitored. The task is non-trivial: if a laboratory regularly conducts varied assays, with perhaps 50-500 test samples in each, even simple manual processes (graphical or arithmetical) are very time-consuming. Only by making RIA analysis a standard computer task, can it be handled satisfactorily. If a comprehensive program serves many centres, the costs of “writing can be relatively small and other benefits can be secured — reduction in numerical mistakes, thorough examination of the adequacy of fitted response curves, production of limits of error for potency estimates, ancl ease of managing files.

This paper is concerned with the principles that should underlie RIA software, and with requirements in respect of input, output, ancl analytical computations. Though not a detailed specification, it is a step towards producing a good program easily moved from one computer system to another and suitable for the computer facilities now becoming available in hospitals. If a proposed new program fails to supply many of the features described below, practitioners of radioimmunoassay not themselves expert hi statistics will be unwise to accept it as sufficient for their needs. Ease of input ancl clarity of output are essential but not sufficient in themselves. A user who adopts an apparently "simple" program may be safe for much of the time, but the occasional anomalous assay may lead to unsuspecting acceptance of wholly untrustworthy numerical conclusions.
The Anatomy Heresies Continued VII
Authors: Shively M. J.
Published: March 2018

This essay presents incorrect, misleading, or easily misconstructed anatomical statements from a number of sources and follows each with editorial and clinically applicable commentary. The purpose of this exercise is not to degrade the sources, but only to correct the misconceptions in an attempt to avoid their perpetuation.
Computer Aided Diagnosis – A Review of Research
Authors: Wardle Ann , Wardle L.
Published: March 2018

Computer aided diagnosis is reviewed and an assessment made of the different models used for this purpose. These are discussed under three headings:

1. Models based on physicians’ thought processes

2. Models based on the physiological relationships manifested in the disease state,

3. Statistical models.

The models are assessed in terms of their accuracy by comparison with clinical methods. Typical results show that using the computer improves diagnostic accuracy by about 10%.

It is concluded that Bayesian models are likely to give the best results since they are well suited to the probabilistic nature of medical data and can be adapted for use in many situations. Further research necessary for the improvement of Bayesian models is discussed.
Identification and Transformation of Terminal Morphemes in Medical English
Authors: Pratt A. W. , Pacak M.
Published: March 2018

The system for the identification and subsequent transformation of terminal morphemes in medical English is a part of the information system for processing pathology data which was developed at the National Institutes of Health.

The recognition and transformation of terminal morphemes is restricted to classes of adjectivals including the -ING and -ED forms, nominals and homographic adjective/noun forms.

The adjective-to-noun and noun-to-noun transforms consist basically of a set of substitutions of adjectival and certain nominal suffixes by a set of suffixes which indicate the corresponding nominal form(s).

The adjectival/nominal suffix has a polymorphosyntactic transformational function if it has the property of being transformed into more than one nominalizing suffix (e.g., the adjectival suffix -IC can be substituted by a set of nominalizing suffixes -Ø, -A, -E, -Y, -IS, -IA, -ICS): the adjectival suffix has a monomorphosyntactic transformational property if there is only one admissible transform (e.g., -CIC → -X).

The morphological segmentation and the subsequent transformations are based on the following principles:

a. The word form is segmented according to the principle of »double consonant cut,« i.e., terminal characters following the last set of double consonants are analyzed and treated as a potential suffix. For practical purposes only such terminal suffixes of a maximum length of four have been analyzed.

b. The principle that the largest segment of a word form common to both adjective and noun or to both noun stems is retained as a word base for transformational operations, and the non-identical segment is considered to be a »suffix.«

The backward right-to-left character search is initiated by the identification of the terminal grapheme of the given word form and is extended to certain admissible sequences of immediately preceding graphemes.

The nodes which represent fixed sequences of graphemes are labeled according to their recognition and/or transformation properties.

The tree nodes are divided into two groups:

a. productive or activated

b. non-productive or non-activated

The productive (activated) nodes are sequences of sets of graphemes which possess certain properties, such as the indication about part-of-speech class membership, the transformation properties, or both. The non-productive (non-activated) nodes have the function of connectors, i.e., they specify the admissible path to the productive nodes.

The computer program for the identification and transformation of the terminal morphemes is open-ended and is already operational. It will be extended to other sub-fields of medicine in the near future.
Health Information Science at UVic: The Student Perspective
Authors: Anglin C.
Published: March 2018

The graduates and students of the School of Health Information Science (HIS) at the University of Victoria (UVic) have pioneered the Canadian sphere in health informatics since 1982. After six years of growth this co-operative education program has matured and establishment of a research base and graduate school has become a recent focus. In this context an evaluation of the HIS curriculum and co-op work experience from the student perspective was undertaken. Eighty-five persons, including 50 upper level students were surveyed. Thirty-five graduates were tracked and queried regarding their present employment, job satisfaction, future goals and perception oftheir professional status. In particular, students were queried on the retrospective value and/or shortcomings of the HIS co-op program. Their perceptions on the training that they have had or that they observe as leading to successful careers is documented. The student view on the ascribed role of ´change agent´ and concerns regarding the lack of professional identity are noted. The implications ofthese findings on the future form ofthe Health Information Science curriculum and the direction of its educational model are subsequently discussed.
Iliad: Moving Medical Decision-Making into New Frontiers
Authors: Warner H. R.
Published: March 2018

If the essence of clinical practice is a process of sequential problem-solving, whereby a physician works with a patient to formulate a series of decisions about diagnostic treatment, then it would naturally follow that the essence of medical education should evolve around the training of would-be clinicians in the difficult art of diagnostic decisionmaking. Yet this is not often the case.
Visualizing the Logic of a Clinical Guideline: A Case Study in Childhood Immunization
Authors: Frawley S. J. , Powsner S. M. , Shiftman R. N. , Miller P. L. , Brandt C. A.
Published: March 2018

IMM/Graph is a visual model designed to help knowledge-base developers understand and refine the guideline logic for childhood immunization. The IMM/Graph model is domain-specific and was developed to help build a knowledge-based system that makes patient-specific immunization recommendations. A “visual vocabulary” models issues specific to the immunization domain, such as (1) the age a child is first eligible for each vaccination dose, (2) recommended, “past due” and maximum ages, (3) minimum waiting periods between doses, (4) the vaccine brand or preparation to be given, and (5) the various factors affecting the time course of vaccination. Several lessons learned in the course of developing IMM/Graph include the following: (1) The intended use of the model may influence the choice of visual presentation; (2) There is a potentially interesting interplay between the use of visual and textual information in creating the visual model; (3) Visualization may help a development team better understand a complex clinical guideline and may also help highlight areas of incompleteness.
Interpreting Open- and Closed-Loop Transfer Relations Between Cardiorespiratory Parameters: Lessons Learned from a Computer Model of Beat-to-Beat Cardiovascular Regulation
Authors: Hammer P. , Litvack D. , Saul J. P.
Published: March 2018

A computer model of cardiovascular control has been developed based on the response characteristics of cardiovascular control components derived from experiments in animals and humans. Results from the model were compared to those obtained experimentally in humans, and the similarities and differences were used to identify both the strengths and inadequacies of the concepts used to form the model. Findings were confirmatory of some concepts but contrary to some which are firmly held in the literature, indicating that understanding the complexity of cardiovascular control probably requires a combination of experiments and computer models which integrate multiple systems and allow for determination of sufficiency and necessity.
Non-parametric Classification of Esophagus Motility by Means of Neural Networks
Authors: Rasmussen C. , Rutz K. , Jakobsen E. , Kruse-Andersen S. , Thøgersen C.
Published: March 2018

Automatic long-term recording of esophageal pressures by means of intraluminal transducers is used increasingly for evaluation of esophageal function. Most automatic analysis techniques are based on detection of derived parameters from the time series by means of arbitrary rule-based criterions. The aim of the present work has been to test the ability of neural networks to identify abnormal contraction patterns in patients with nonobstructive dysphagia (NOBD).

Nineteen volunteers and 22 patients with NOBD underwent simultaneous recordings of four pressures in the esophagus for at least 23 hours. Data from 21 subjects were selected for training. The performances of two trained networks were subsequently verified on reference data from 20 subjects. The results show that non-parametric classification by means of neural networks has good potentials. Back propagation shows good performance with a sensitivity of 1.0 and a specificity of 0.8.
Simulation Study of the Interaction between Respiration and the Cardiovascular System
Authors: Bai Jing , Lu Hongli , Zhang Jupeng , Zhou Xiaoqiang
Published: March 2018

Many studies have been done on the respiratory and the cardiovascular system. Among them, only a few are on the interaction of these two physiologic systems. To explore the mechanism of the integration of these two physiological systems, computer simulation has been done; we report the preliminary results obtained in our laboratory. In this study, a mathematical model of the cardiovascular system integrated with the respiratory mechanical system has been established. The model is based on our previous work on cardiovascular modeling. The previous lumped lungi model has been replaced by a multielement model with more detail. Inter- thoracic and abdominal pressures are modeled as external pressure sources on the related cardiovascular elements. Using this model, a sequence of simulation studies have been carried out. Different respiratory modes have been simulated and the different effects are observed in the simulation results. The results indicate that by following a certain respiratory pattern, the circulation status can be improved. These results agree with clinical observations.Keywords: Mathematical Model, Respiration Mode, Cardiovascular System, Computer Simulation, Interaction
Security in Medical Information Systems
Authors: Bakker A. R.
Published: March 2018

This review article addresses security in medical information systems. First, it is discussed why special attention is necessary for security in this field. Next, the history is considered, together with the role of IMIA. Current research issues are presented. The ongoing activities in the AIM SEISMED project are briefly described, followed by a consideration of standardization. The article concludes with an appeal to pay more attention to the security aspects of information systems.
Effektivität von Nivolumab mit Mutationslast assoziiert
Authors: Krome Susanne
Published: March 2018

Im Vergleich mit einer platinbasierten Doublet-Chemotherapie verlängert der Checkpoint-Inhibitor Nivolumab in der Zweitlinientherapie das progressionsfreie Überleben (PFS) vorbehandelter Patienten mit einem metastasierten nicht kleinzelligen Bronchialkarzinom (NSCLC). In der offenen, randomisierten Phase-III-Studie CheckMate026 erhielten Patienten im fortgeschrittenen Stadium jetzt als Erstlinientherapie die Standardbehandlung oder Nivolumab. Primärer Endpunkt war das progressionsfreie Überleben (PFS) in Abhängigkeit vom PD-L1-Expressionsgrad und der Mutationslast.
Welche Marker helfen bei der Therapiewahl?
Authors: Braitmaier Helmine
Published: March 2018

Zur Behandlung des metastasierten kastrationsresistenten Prostatakarzinoms (mCRPC) haben Ärzte in Deutschland mit Docetaxel, Cabazitaxel, Abirateron, Enzalutamid und Radium-223 verschiedene Optionen zur Verfügung. Klinische Marker, die bei der Therapiewahl helfen könnten, sind bisher nicht ausreichend validiert. Mit aktuellen Erkenntnissen zu neuen Biomarkern beschäftigte sich ein Symposium auf dem DGHO 2017.
„Das Ganze ist mehr als die Summe seiner Teile“
Authors: Steiner Urs
Published: March 2018

Wie kann das Ziel Hahnemanns erreicht werden, dass die Homöopathie „den mathematischen Wissenschaften an Zuverlässigkeit nahe komme“ 7 (§ 145)? Was bedeutet das einleitende Zitat von Aristoteles mathematisch und homöopathisch?
“The art of doing nothing“ nach Milchzahntrauma
Authors: Ebeleseder Kurt
Published: March 2018

In der Behandlung von Milchzahntraumata ist das erste Ziel nicht der Erhalt der betroffenen Milchzähne, sondern der Erhalt der korrespondierenden bleibenden Zähne und der Kooperation. Dieser Umstand führt zur Frage, ob traumatisierte Milchzähne überhaupt chirurgisch anbehandelt werden sollen. Gelingt es, mittels lokaler und ggf. auch systemischer antibakterieller Therapie die lokale Infektion zu unterbinden, so kommt es häufig ohne weitere Therapie zu Spontanheilungen. So können nicht nur Schäden an bleibenden Zähnen und der Psyche des kleinen Patienten vermieden, sondern auch mehr Milchzähne erhalten werden als nach bisherigen Indikationsstellungen.
Modelling ischemia-reperfusion injury (IRI) in vitro using metabolically matured induced pluripotent stem cell-derived cardiomyocytes
Authors: Hidalgo Alejandro , Glass Nick , Ovchinnikov Dmitry , Yang Seung-Kwon , Zhang Xinli , Mazzone Stuart , Chen Chen , Wolvetang Ernst , Cooper-White Justin
Published: March 2018

Coronary intervention following ST-segment elevation myocardial infarction (STEMI) is the treatment of choice for reducing cardiomyocyte death but paradoxically leads to reperfusion injury. Pharmacological post-conditioning is an attractive approach to minimize Ischemia-Reperfusion Injury (IRI), but candidate drugs identified in IRI animal models have performed poorly in human clinical trials, highlighting the need for a human cell-based model of IRI. In this work, we show that when we imposed sequential hypoxia and reoxygenation episodes [mimicking the ischemia (I) and reperfusion (R) events] to immature human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs), they display significant hypoxia resistance and minimal cell death (∼5%). Metabolic maturation of hPSC-CMs for 8 days substantially increased their sensitivity to changes in oxygen concentration and led to up to ∼30% cell death post-hypoxia and reoxygenation. To mimic the known transient changes in the interstitial tissue microenvironment during an IRI event in vivo, we tested a new in vitro IRI model protocol that required glucose availability and lowering of media pH during the ischemic episode, resulting in a significant increase in cell death in vitro (∼60%). Finally, we confirm that in this new physiologically matched IRI in vitro model, pharmacological post-conditioning reduces reperfusion-induced hPSC-CM cell death by 50%. Our results indicate that in recapitulating key aspects of an in vivo IRI event, our in vitro model can serve as a useful method for the study of IRI and the validation and screening of human specific pharmacological post-conditioning drug candidates.
Transition between resistive ballooning mode and toroidal drift wave mode at the edge of tokamak plasmas
Authors: Peng X. D. , Xu J. Q. , Jiang H. B. , Wang G.
Published: March 2018

The transition between the resistive ballooning mode (RBM) and toroidal drift wave (DW) mode is a possible physical mechanism triggering L-H transition in tokamaks. The two-fluid model [Rafiq et al., Phys. Plasmas 17, 082511 (2010)] developed by Rafiq et al. was improved by including ion diamagnetic effects in plasma polarization drift velocity. Based on the improved fluid model, the gyrokinetic results [Bourdelle et al., Nucl. Fusion 54, 022001 (2014)] about the transition between RBM and toroidal DW were recovered. It shows good agreement under a set of real experimental conditions. Hence the fluid theory is valid to investigate the physics of edge plasmas. A transition temperature Tmin about 80 eV, which RBM is dominant for plasma temperature Te < Tmin, but DW prevails for Te > Tmin, was found in gas puffing experiments of HL-2A tokamak. Employing the improved fluid model, we have simulated this phenomenon and the experimental result has been verified exactly.
Effect of the ratio of radial gap to radius of the coils on the transmission efficiency of wireless power transfer via coupled magnetic resonances
Authors: Gao Pengfei , Tian Zijian , Wang Xuqi , Wu Jun , Gui Weifeng
Published: March 2018

Wireless power transfer (WPT) via coupled magnetic resonance is a promising technology to be applied in many fields. In general, there will be a radial gap in practical application, and some special application environments need to limit the radius of the coils. Therefore, in this paper, considering the comprehensive analysis of the radial gap and the radius of the coils, the concept of the ratio of radial gap to the radius of the coils was proposed. Based on the circuit theory, the formula between the ratio and transmission efficiency of WPT was deduced, and the effects of the ratio on the transmission efficiency were studied respectively at different axial distances. Simulation experiments were carried out and the results not only demonstrate the influence law of the ratio on transmission efficiency, but also validate the value of the ratio which the axial distance has the greatest effect on the transmission efficiency. Besides, the results shows the relationship between the effect of the ratio on the efficiency and the effect of the axial distance on the efficiency. The experimental results show that the theoretical analysis is correct, thus providing an useful theoretical reference for the design and further research on the wireless power transfer system in complicated environment.
Constructively combining languages
Authors: Quick Antje Endesfelder , Lieven Elena , Backus Ad , Tomasello Michael
Published: March 2018

Language development in bilingual children is often related to differing levels of proficiency. Objective measurements of bilingual development include for example mean length of utterance (MLU). MLU is almost always calculated for each language context (including both monolingual and code-mixed utterances). In the current study, we analyzed the MLUs of three German-English bilingual children, aged 2;3–3;11 separately for the monolingual and code-mixed utterances. Our results showed that language preference was reflected in MLU values: the more children spoke in one language the higher the MLU was in that language. However, it was the mixed utterances that had the highest MLU for all three children. We support the results with a construction type analysis and suggest a potential usage-based explanation for these results based on individual differences in each child’s developmental inventory of words and constructions.
The use of culture, pooled samples and PCR for identification of herds infected withBrachyspira hyodysenteriae
Authors: Fellström Claes , Zimmerman Ulla , Aspan Anna , Gunnarsson Anders
Published: March 2018

The sensitivity of culturingBrachyspira hyodysenteriaewas determined after sampling with swabs from porcine fecal specimens inoculated with tenfold dilutions of a field strain of these microbes. After storage of swabs,Brachyspira hyodysenteriaewas recovered throughout the first 3 weeks after inoculation from feces with more than 140 cells/g. Viable spirochetes could still be recovered after up to 83 days of storage from feces, with 1.4 × 106cells or more per gram. Culture forBrachyspiraspp. was performed on 285 rectal swabs, which were pooled in batches of five. The number of pooled samples positive forB. hyodysenteriaecorresponded with the sum results of individual analysis of the corresponding collections of five samples. A PCR system based on thetlyA gene ofB.hyodysenteriaewas developed and tested on primary cultures of pooled samples. The results of the PCR assay showed a 97% correlation with the culture results. The prevalence ofBrachyspiraspp. was determined in five swine herds and found to be highest among breeding gilts and boars aged 13–16 weeks and among 6–12-week-old weaned pigs. In contrast,Brachyspiraspp. were only rarely found in sows, which may reflect the development of immunity by adult pigs to all species of the genus.
Pathogenesis of African swine fever virus inOrnithodorosticks
Authors: Kleiboeker Steven B. , Scoles Glen A.
Published: March 2018

African swine fever virus (ASFV) is the only known DNA arbovirus and the sole member of the family Asfarviridae. It causes a lethal, hemorrhagic disease in domestic pigs. ASFV is enzootic in sub-Saharan Africa and is maintained in a sylvatic cycle by infecting both wild members of the Suidae (e.g. warthogs) and the argasid tickOrnithodoros porcinus porcinus. The pathogenesis of ASFV inO. porcinus porcinusticks is characterized by a low infectious dose, lifelong infection, efficient transmission to both pigs and ticks, and low mortality until after the first oviposition. ASFV pathogenesis in warthogs is characterized by an inapparent infection with transient, low viremic titers. ThusO. porcinus porcinusticks probably constitute the most important natural vector of ASFV, although both the mammalian and tick hosts are probably required for the maintenance of ASFV in the sylvatic cycle. The mechanism of ASFV transmission from the sylvatic cycle to domestic pigs is probably through infected ticks feeding on pigs. In addition toO. porcinus porcinus, a number of North American, Central American and Caribbean species ofOrnithodoroshave been shown to be potential vectors of ASFV.
Effects of (TiB2 + ZrB2) nanoparticles on microstructure and properties of 7055Al matrix composites
Authors: Yang Yonggang , Zhao Yutao , Kai Xizhou , Tao Ran , Wang Min , Yin Houshang , Chen Gang
Published: March 2018

The in situ (TiB2 + ZrB2)/7055Al composites were successfully fabricated from the 7055Al-K2TiF6-K2ZrF6-KBF4 system by a direct melt reaction method. Microstructural observations revealed that the nanoparticles were distributed relatively uniformly in the aluminium matrix, and that these nanoparticles exhibit various shapes such as spherical, hexagonal and cubic, with an average size of about 80 nm. Mechanical property testing showed that the strength and Young's modulus of the composites increased significantly in comparison to the 7055 matrix alloy. The maximum ultimate tensile strength was approximately 361 MPa, with a yield strength of 323 MPa and an elongation of 3.6%, which constitute increases of 31.3%, 28.7% and 44% when compared to the 7055Al alloy, respectively. The strengthening mechanisms of the fabricated composites were also discussed.
Marijuana use and Mortality following Orthopedic Surgical Procedures
Authors: Moon Andrew S. , Smith Walter , Mullen Sawyer , Ponce Brent A. , McGwin Gerald , Shah Ashish , Naranje Sameer M.
Published: March 2018

Background

The association between marijuana use and surgical procedures is a matter of increasing societal relevance that has not been well studied in the literature. The primary aim of this study is to evaluate the relationship between marijuana use and in-hospital mortality, as well as to assess associated comorbidities in patients undergoing commonly billed orthopedic surgeries.

Methods

The National Inpatient Sample (NIS) database from 2010 to 2014 was used to determine the odds ratios for the associations between marijuana use and in-hospital mortality, heart failure (HF), stroke, and cardiac disease (CD) in patients undergoing 5 common orthopedic procedures: total hip (THA), total knee (TKA), and total shoulder (TSA) arthroplasties, spinal fusion, and traumatic femur fracture fixation.

Results

Of 9,561,963 patients who underwent one of the 5 selected procedures in the 4-year period, 26,416 (0.28%) were identified with a diagnosis of marijuana use disorder. In hip and knee arthroplasty patients, marijuana use was associated with decreased odds of mortality compared with no marijuana use ( P < .0001) and increased odds of HF ( P = .018), stroke ( P = .0068), and CD ( P = .0123). Traumatic femur fixation patients had the highest prevalence of marijuana use (0.70%), which was associated with decreased odds of mortality ( P = .0483), HF ( P = .0076), and CD ( P = .0003). For spinal fusions, marijuana use was associated with increased odds of stroke ( P < .0001) and CD ( P < .0001). Marijuana use in patients undergoing total shoulder arthroplasty was associated with decreased odds of mortality ( P < .001) and stroke ( P < .001).

Conclusions

In this study, marijuana use was associated with decreased mortality in patients undergoing THA, TKA, TSA, and traumatic femur fixation, although the significance of these findings remains unclear. More research is needed to provide insight into these associations in a growing surgical population.
Nonpharmacological Management of Behavioral and Psychological Symptoms of Dementia: What Works, in What Circumstances, and Why?
Authors: Caspar Sienna , Davis Erin D , Douziech Aimee , Scott David R
Published: March 2018

Objective

Behavioral and psychological symptoms of dementia (BPSD) refer to the often distressing, noncognitive symptoms of dementia. BPSD appear in up to 90% of persons with dementia and can cause serious complications. Reducing the use of antipsychotic medications to treat BPSD is an international priority. This review addresses the following questions: What nonpharmacological interventions work to manage BPSD? And, in what circumstances do they work and why?

Method

A realist review was conducted to identify and explain the interactions among context, mechanism, and outcome. We searched electronic databases for empirical studies that reported a formal evaluation of nonpharmacological interventions to decrease BPSD.

Results

Seventy-four articles met the inclusion criteria. Three mechanisms emerged as necessary for sustained effective outcomes: the caring environment, care skill development and maintenance, and individualization of care. We offer hypotheses about how different contexts account for the success, failure, or partial success of these mechanisms within the interventions.

Discussion

Nonpharmacological interventions for BPSD should include consideration of both the physical and the social environment, ongoing education/training and support for care providers, and individualized approaches that promote self-determination and continued opportunities for meaning and purpose for persons with dementia.
Continuous Cocycle Superrigidity for the Full Shift Over a Finitely Generated Torsion Group
Authors: Cohen David Bruce
Published: March 2018

Chung and Jiang showed that if a one-ended group contains an infinite order element, then every continuous cocycle over the full shift, taking values in a discrete group, must be cohomologous to a homomorphism. We show that their conclusion holds for all one-ended groups, so that the hypothesis of admitting an infinite order element may be omitted.
How do basophils contribute to Th2 cell differentiation and allergic responses?
Authors: Karasuyama Hajime , Miyake Kensuke , Yoshikawa Soichiro , Kawano Yohei , Yamanishi Yoshinori
Published: March 2018

Basophils and mast cells share some features, including basophilic granules in the cytoplasm, cell surface expression of the high-affinity IgE receptor and release of chemical mediators such as histamine. Because of this similarity and their minority status, basophils had often been erroneously considered as minor relatives or blood-circulating precursors of tissue-resident mast cells, and therefore long been neglected or underestimated in immunological studies. Taking advantage of newly developed tools, such as basophil-depleting antibodies and engineered mice deficient for only basophils, recent studies have identified previously unappreciated roles for basophils, distinct from those played by mast cells, in allergic responses, protective immunity against parasitic infections and regulation of other immune cells. In this review, we focus on two topics that we presented and discussed in the 46th Annual Meeting of the Japanese Society for Immunology held in Sendai in December 2017. The first topic is the function of basophils as antigen-presenting cells for driving Th2 cell differentiation. We demonstrated that basophils produce few or no MHC class II (MHC-II) proteins by themselves although they can acquire peptide–MHC-II complexes from dendritic cells through trogocytosis, and present them and provide IL-4 to naive CD4 T cells, promoting Th2 cell differentiation. The second topic is the basophil-specific effector molecules involved in allergic responses. Among mouse mast cell proteases (mMCPs), mMCP-8 and mMCP-11 are expressed almost exclusively by basophils. Analyses in vitro and in vivo revealed that both proteases can induce leukocyte migration through distinct mechanisms, contributing to the development of basophil-dependent allergic inflammation.
Metastasis-related methyltransferase 1 (Merm1) represses the methyltransferase activity of Dnmt3a and facilitates RNA polymerase I transcriptional elongation
Authors: Lyu Guoliang , Zong Le , Zhang Chao , Huang Xiaoke , Xie Wenbing , Fang Junnan , Guan Yiting , Zhang Lijun , Ni Ting , Gu Jun , Tao Wei
Published: March 2018

Stimulatory regulators for DNA methyltransferase activity, such as Dnmt3L and some Dnmt3b isoforms, affect DNA methylation patterns, thereby maintaining gene body methylation and maternal methylation imprinting, as well as the methylation landscape of pluripotent cells. Here we show that metastasis-related methyltransferase 1 (Merm1), a protein deleted in individuals with Williams–Beuren syndrome, acts as a repressive regulator of Dnmt3a. Merm1 interacts with Dnmt3a and represses its methyltransferase activity with the requirement of the binding motif for S-adenosyl-L-methionine. Functional analysis of gene regulation revealed that Merm1 is capable of maintaining hypomethylated rRNA gene bodies and co-localizes with RNA polymerase I in the nucleolus. Dnmt3a recruits Merm1, and in return, Merm1 ensures the binding of Dnmt3a to hypomethylated gene bodies. Such interplay between Dnmt3a and Merm1 facilitates transcriptional elongation by RNA polymerase I. Our findings reveal a repressive factor for Dnmt3a and uncover a molecular mechanism underlying transcriptional elongation of rRNA genes.
Sliding Distal Metatarsal Minimally Invasive Osteotomy (S-DMMO) for the Treatment of Tailor’s Bunion
Authors: del Vecchio Jorge J. , Ghioldi Mauricio E. , Dalmau-Pastor Miki , Uzair Anuar E. , Chemes Lucas
Published: March 2018

Bunionette, or Tailor’s bunion, refers to a painful lateral prominence at the fifth metatarsal head. Metatarsal osteotomies have proved to be a successful treatment, and have been described at the distal, diaphyseal, and proximal levels. Distal metatarsal osteotomies have been reported as effective in bunionette correction in several clinical studies. In the last decade, there has been a growing interest in the use of percutaneous or minimally invasive surgery for the treatment of this condition. Minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) has proved to be successful when treating metatarsalgia. We present a surgical technique consisting in a distal osteotomy of the fifth metatarsal, which resembles DMMO, but requires a lateral displacement. We retrospectively investigated 38 feet from 32 patients with symptomatic bunionette deformity and showed good to excellent functional and clinical results. The S-DMMO proved to be a safe (low complication rate) and effective (adequate clinical results and powerful radiologic correction) procedure for the treatment of bunionette deformity.

Level of Evidence:Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.
Association Between Changes in Caregiver Depressive Symptoms and Child Attention-Deficit/Hyperactivity Disorder Symptoms
Authors: Walls Morgan , Cabral Howard , Feinberg Emily , Silverstein Michael
Published: March 2018

Objective:

Depression is highly prevalent among caregivers of children with attention-deficit/hyperactivity disorder (ADHD). We examined the association between caregiver depressive symptom trajectories and changes in child ADHD symptoms.

Methods:

We analyzed data from a randomized trial of 2 ADHD care management systems for children aged 6 to 12 years and their caregivers (n = 156 dyads). Child ADHD symptoms were measured using the Swanson, Nolan, and Pelham rating scale (SNAP-IV). Caregiver depressive symptoms were measured using the Quick Inventory of Depressive Symptomatology (QIDS). Measures were assessed at baseline, 6 months, and 12 months. We used multivariable models to examine associations between changes in caregiver depressive symptoms and changes in child ADHD symptoms.

Results:

From baseline to 12 months, children of caregivers with improved depressive symptoms had significantly greater reductions in SNAP-IV scores (change score: −1.43) compared with those whose depressive symptoms did not change (change score: −0.97) or worsened (change score: −0.23, p = 0.003). In adjusted models, improved caregiver depressive symptoms were associated with greater reductions in SNAP-IV scores over the 12-month period. Compared with those with worsening caregiver depressive symptoms, children whose caregivers showed no significant changes in depressive symptoms had a −0.78 point (95% confidence interval [CI]: −1.40 to −0.17) greater reduction in the SNAP-IV score, and those children whose caregiver depressive symptoms improved had a −1.31 point greater reduction in the SNAP-IV score (95% CI: −1.97 to −0.66).

Conclusion:

Given the longitudinal association between caregiver depressive symptom and child ADHD symptom trajectories, interventions that address the behavioral health needs of the family unit may offer promise for urban children with ADHD.
Lateral Branch of the Thoracodorsal Nerve (LaT Branch) Transfer for Biceps Reinnervation
Authors: Schusterman M. Asher , Jindal Rishi , Unadkat Jignesh V. , Spiess Alexander M.
Published: March 2018

In cases of significant upper extremity trauma, the thoracodorsal nerve is a reliable secondary option for the restoration of elbow flexion. In all previous descriptions, however, the entire nerve is transferred. We describe a case utilizing the lateral thoracodorsal nerve (LaT) branch for biceps reinnervation with an associated cadaver study. Transfer of the LaT branch to the biceps branch was performed on a patient who had sustained a traumatic brachial plexus injury that left him without elbow flexion. Also, 4 cadavers (8 upper extremities) were dissected to identify the bifurcation of the thoracodorsal nerve and confirm the feasibility of transferring the LaT branch to the biceps motor branch. Axon counts of the thoracodorsal proper, LaT branch, musculocutaneous proper, and the biceps branch were also obtained. A bifurcation of the thoracodorsal nerve was present in all cadaver specimens, with an average distance of 7.5 cm (range, 6.2–9.8 cm) from the insertion of the latissimus dorsi muscle. Axon counts revealed a donor-to-recipient ratio of 0.85:1. Follow-up of our patient at 1 year showed improvement of elbow flexion manual muscle testing grade from 0 to 4/5. Furthermore, electromyography at 1 year confirmed biceps reinnervation and showed normal readings of the latissimus compared with preoperative electromyography. Transfer of the LaT branch is a viable and minimally morbid option for biceps reinnervation after traumatic branchial plexus injury. Further follow-up of our patient and larger prospective studies are needed to understand the true potential of this nerve transfer.
Glaucoma Features in an East African Population: A 6-Year Cohort Study of Older Adults in Nakuru, Kenya
Authors: Bastawrous Andrew , Mathenge Wanjiku , Buchan John , Kyari Fatima , Peto Tunde , Rono Hillary , Weiss Helen A. , Macleod David , Foster Allen , Burton Matthew J. , Kuper Hannah
Published: March 2018

Purpose:

Glaucoma is a leading cause of blindness in people of African descent. Minimal data is available from African population–based cohort studies. The primary aims of this study were to describe the normative distribution of glaucoma features to enable glaucoma classification and to assess risk factors for those with glaucoma at follow-up among people aged 50 years and above in Kenya.

Materials and Methods:

Random cluster sampling with probability proportionate to size was used to select a representative cross-sectional sample of adults aged 50 years and above in 2007 to 2008 in Nakuru District, Kenya. A 6-year follow-up was undertaken in 2013 to 2014. Comprehensive ophthalmic examination included visual acuity, digital retinal photography, visual fields, intraocular pressure, optical coherence tomography, and independent grading of optic nerve images. We report glaucoma features, prevalence and predictors for glaucoma based on the International Society for Geographical & Epidemiological Ophthalmology (ISGEO) criteria. Measures were estimated using a Poisson regression model and including inverse-probability weighting for loss to follow-up.

Results:

At baseline, 4414 participants aged 50 years and above underwent examination. Anterior chamber optical coherence tomography findings: mean anterior chamber angle of 36.6 degrees, mean central corneal thickness of 508.1 μm and a mean anterior chamber depth of 2.67 mm. A total of 2171 participants were examined at follow-up. The vertical cup to disc ratio distribution was 0.7 and 0.8 at the 97.5th and 99.5th percentiles, respectively. A total of 88 (4.3%, 95% confidence interval, 3.5%-5.9%) of participants at follow-up had glaucoma consistent with ISGEO criteria. A relative afferent pupillary defect and raised intraocular pressure were associated with the diagnosis.

Conclusions:

Glaucoma is a public health challenge in low-resource settings. Research into testing and treatment modalities in Africa is needed.
Altered connectivity of the right anterior insula drives the pain connectome changes in chronic knee osteoarthritis
Authors: Cottam William J. , Iwabuchi Sarina J. , Drabek Marianne M. , Reckziegel Diane , Auer Dorothee P.
Published: March 2018

Resting-state functional connectivity (FC) has proven a powerful approach to understand the neural underpinnings of chronic pain, reporting altered connectivity in 3 main networks: the default mode network (DMN), central executive network, and the salience network (SN). The interrelation and possible mechanisms of these changes are less well understood in chronic pain. Based on emerging evidence of its role to drive switches between network states, the right anterior insula (rAI, an SN hub) may play a dominant role in network connectivity changes underpinning chronic pain. To test this hypothesis, we used seed-based resting-state FC analysis including dynamic and effective connectivity metrics in 25 people with chronic osteoarthritis (OA) pain and 19 matched healthy volunteers. Compared with controls, participants with painful knee OA presented with increased anticorrelation between the rAI (SN) and DMN regions. Also, the left dorsal prefrontal cortex (central executive network hub) showed more negative FC with the right temporal gyrus. Granger causality analysis revealed increased negative influence of the rAI on the posterior cingulate (DMN) in patients with OA in line with the observed enhanced anticorrelation. Moreover, dynamic FC was lower in the DMN of patients and thus more similar to temporal dynamics of the SN. Together, these findings evidence a widespread network disruption in patients with persistent OA pain and point toward a driving role of the rAI.