bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Hypertonic Saline and Sodium Lactate on Cortical Cerebral Microcirculation and Brain Tissue Oxygenation
Authors: Dostalova Vlasta , Schreiberova Jitka , Dostalova Vlasta , Paral Jiri , Kraus Jaroslav , Ticha Alena , Radochova Vera , Dostal Pavel
Published: March 2017

Background:

Hyperosmolar solutions have been used in neurosurgery to modify brain bulk. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of hypertonic saline (HTS) and sodium lactate (HTL) on cerebral cortical microcirculation and brain tissue oxygenation in a rabbit craniotomy model.

Methods:

Rabbits (weight, 1.5 to 2.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3.75 mL/kg intravenous infusion of either 3.2% HTS (group HTS, n=9), half-molar sodium lactate (group HTL, n=10), or normal saline (group C, n=9). Brain tissue partial pressure of oxygen (PbtO2) and microcirculation in the cerebral cortex using sidestream dark-field imaging were evaluated before, 20 and 40 minutes after 15 minutes of hyperosmolar solution infusion. Global hemodynamic data were recorded, and blood samples for laboratory analysis were obtained at the time of sidestream dark-field image recording.

Results:

No differences in the microcirculatory parameters were observed between the groups before and after the use of osmotherapy. Brain tissue oxygen deteriorated over time in groups C and HTL, this deterioration was not significant in the group HTS.

Conclusions:

Our findings suggest that equivolemic, equiosmolar HTS and HTL solutions equally preserve perfusion of cortical brain microcirculation in a rabbit craniotomy model. The use of HTS was better in preventing the worsening of brain tissue oxygen tension.
A Teachable Moment After Orthopaedic Fracture in the Smoking Patient: A Randomized, Controlled Trial
Authors: Baron Matthew D. , DeFrancesco Christopher J. , Liu Tiffany C. , Leone Frank T. , Ahn Jaimo
Published: March 2017

Objectives:

To assess whether education during hospitalization after an acute fracture changes patient attitudes toward smoking-related complications and to assess whether this change persists into the first outpatient follow-up visit.

Design:

Prospective, randomized, controlled trial.

Setting:

Level 1 trauma center.

Patients:

Inpatients with fractures who identified as smokers: 40 assessed for inclusion and randomized, 30 completed inpatient assessments, and 20 completed outpatient follow-up.

Intervention:

An educational intervention by the researcher to teach the patient about the harms of smoking regarding fracture healing.

Main Outcome Measures:

A novel questionnaire to assess the intervention via Likert scale responses, evaluating perceived risk, affective response, and self-role.

Results:

Education resulted in an increase in perceived risk and affective response within the cohort and an increase in perceived risk when compared with control subjects. No significant differences persisted into outpatient follow-up.

Conclusions:

This trial demonstrated that a teachable moment can have an early effect on certain attitudes toward smoking after an acute fracture. These changes did not persist at the first follow-up visit.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
GATA3 and MYB Expression in Cutaneous Adnexal Neoplasms
Authors: Pardal Joana , Sundram Uma , Selim M. Angelica , Hoang Mai P.
Published: March 2017

Knowledge of staining pattern of certain immunostains might be useful in the classification of cutaneous adnexal tumors that can have clinical importance. We studied GATA3 and MYB expression in archival materials of 220 adnexal tumors comprised of sebaceous carcinomas, follicular tumors, apocrine carcinoma, predominantly apocrine tumors, predominantly eccrine tumors, and others including adenoid cystic carcinomas. Nuclear GATA3 expression was seen in 70% (153/220) of cases, including sebaceous carcinoma (93%), apocrine carcinoma (93%), follicular neoplasms (100%), and predominantly apocrine neoplasms (69%), yet only 38% of predominantly eccrine neoplasms. Nuclear MYB expression was seen in 43% (81/188) of cases, including adenoid cystic carcinoma (90%), predominantly apocrine tumors (66%), follicular neoplasms (49%), apocrine carcinomas (14%), predominantly eccrine tumors (11%), and sebaceous carcinomas (4%). GATA3 and MYB expression were noted in 43% (9/21) and 24% (5/21) of cutaneous metastases, respectively. Expression of both GATA3 and MYB was noted in 33% (60/184) of primary adnexal tumors versus 19% (4/21) of cutaneous metastases. GATA3 preferentially labels tumors with follicular, sebaceous, and apocrine differentiation. MYB is potentially a helpful stain in the distinction of desmoplastic trichoepithelioma versus basal cell carcinoma. The coexpression of GATA3 and MYB might be helpful in the distinction of primary cutaneous adnexal carcinoma versus metastatic breast, salivary gland, or urothelial carcinoma.
Management of Children with Autism Spectrum Disorder in the Anesthesia and Radiographic Context
Authors: Berglund Ingalill Gimbler , Björkman Berit , Enskär Karin , Faresjö Maria , Huus Karina
Published: March 2017

Objective:

As a primary objective, this study purports to develop guidelines to better care for children with autism spectrum disorder (ASD), particularly regarding these children's preparation for anesthesia and radiologic procedures.

Methods:

Using a Delphi method with an online distribution of questionnaire, guidelines for caring for children with ASD were created. Twenty-one participants were included in the expert panel. These participants were working with children with ASD in several anesthesia and radiology departments in Sweden. A list of items was created from a previous survey and the literature. In the first round, the items with <60% agreement were discarded. Items were merged, and a new list was created. Two more similar rounds were performed. In the last 2 rounds, 21 participants responded, and 80% agreement was considered to be consensus.

Results:

The final guidelines consisted of 14 items and a checklist of 16 factors. The 5 areas covered by the items and the checklist were as follows: planning involving parents/guardians, features in the environment, and use of time, communication, and the health care professionals. The organization was important in making it possible for the health care professional to care for the individual child according to the child's needs. It was important to involve the parents/guardians to obtain knowledge about the functioning of the child.

Conclusion:

A caring encounter involving a child with ASD in the anesthesia and radiology contexts requires advance planning, catered specifically to the individual needs of each child. To accomplish this, general knowledge regarding ASD and ASD's particular manifestation in the child entrusted to their care is required from the health care workers. The organization needs to have structures in place to facilitate this process.
Transferable Training Modules
Authors: Ramírez Denise Moreno , Vea Lourdes , Field James A. , Baker Paul B. , Gandolfi A. Jay , Maier Raina M.
Published: March 2017

Community health workers (promotores de salud) have the ability to empower communities to mitigate negative health outcomes. Current training efforts in environmental topics are lacking. This project addressed this gap by developing 4 transferable training modules on environmental health. By applying a series of surveys, interviews, and trainings, we evaluated their relevance. Partners provided favorable feedback for 3 of the 4 modules. It was also learned that the development method could be improved by engaging technically trained promotores de salud in the role of co-creators. This project has implications for environmental justice communities as it can lessen information disparities.
G Protein–Coupled Receptor Signaling Through β-Arrestin–Dependent Mechanisms
Authors: Jean-Charles Pierre-Yves , Kaur Suneet , Shenoy Sudha K.
Published: March 2017

β-arrestin1 (or arrestin2) and β-arrestin2 (or arrestin3) are ubiquitously expressed cytosolic adaptor proteins that were originally discovered for their inhibitory role in G protein–coupled receptor (GPCR) signaling through heterotrimeric G proteins. However, further biochemical characterization revealed that β-arrestins do not just “block” the activated GPCRs, but trigger endocytosis and kinase activation leading to specific signaling pathways that can be localized on endosomes. The signaling pathways initiated by β-arrestins were also found to be independent of G protein activation by GPCRs. The discovery of ligands that blocked G protein activation but promoted β-arrestin binding, or vice-versa, suggested the exciting possibility of selectively activating intracellular signaling pathways. In addition, it is becoming increasingly evident that β-arrestin–dependent signaling is extremely diverse and provokes distinct cellular responses through different GPCRs even when the same effector kinase is involved. In this review, we summarize various signaling pathways mediated by β-arrestins and highlight the physiologic effects of β-arrestin–dependent signaling.
Noncanonical Roles of G Protein-coupled Receptor Kinases in Cardiovascular Signaling
Authors: Schumacher Sarah M. , Koch Walter J.
Published: March 2017

G protein-coupled receptor kinases (GRKs) are classically known for their role in regulating the activity of the largest known class of membrane receptors, which influence diverse biological processes in every cell type in the human body. As researchers have tried to uncover how this family of kinases, containing only 7 members, achieves selective and coordinated control of receptors, they have uncovered a growing number of noncanonical activities for these kinases. These activities include phosphorylation of nonreceptor targets and kinase-independent molecular interactions. In particular, GRK2, GRK3, and GRK5 are the predominant members expressed in the heart. Their canonical and noncanonical actions within cardiac and other tissues have significant implications for cardiovascular function in healthy animals and for the development and progression of disease. This review summarizes what is currently known regarding the activity of these kinases, and particularly the role of GRK2 and GRK5 in the molecular alterations that occur during heart failure. This review further highlights areas of GRK regulation that remain poorly understood and how they may represent novel targets for therapeutic development.
Is the Future of Coronary Arterial Revascularization a Hybrid Approach?
Authors: Giambruno Vincenzo , Hafiz Ahmad , Fox Stephanie A. , Jeanmart Hugues , Cook Richard C. , Khaliel Feras H. , Teefy Patrick , Sridhar Kumar , Lavi Shahar , Bagur Rodrigo , Randhawa Varinder K. , Iglesias Ivan , Jones Philip M. , Harle Christopher C. , Bainbridge Daniel , Chu Michael W. A. , Kiaii Bob B.
Published: March 2017

Objective

Hybrid coronary revascularization offers and combines the advantages of both surgical and percutaneous revascularization and eliminates at the same time the disadvantages of both procedures. The objective of this study was to assess graft and stent patency at 6 months, rate of bleeding, intensive care unit and hospital stay, rate of reintervention, and long-term clinical follow-up.

Methods

From March 2004 to November 2015, a total of 203 patients underwent robotic-assisted minimally invasive direct coronary artery bypass graft of the left internal thoracic artery to the left anterior descending artery and PCI of a non-left anterior descending vessel in a single or two stage, at three different centers. Patients underwent 6-month angiographic follow-up. The mean ± SD clinical follow-up was 77.82 ±41.4 months.

Results

Successful hybrid coronary revascularization occurred in 196 of the 203 patients. One hundred forty-six patients underwent simultaneous surgical and percutaneous intervention. Nineteen patients underwent PCI before surgery, and 38 patient underwent PCI after surgery. No in-hospital mortality occurred. The mean ± SD ICU stay was 1 ± 1 days and the mean ± SD hospital stay was 5 ± 2 days. Only 13.3% of the patients required a blood transfusion. Six-month angiographic follow-up has been performed in the 95 patients, and it demonstrated a left internal thoracic artery anastomotic patency of 97.9% and stent patency of 92.6%. A total of 77.8 ± 41.4-month clinical follow-up demonstrated 95.1% survival, 92.6% freedom from angina, and 90.7% freedom from any form of coronary revascularization.

Conclusions

Hybrid coronary revascularization seems to be a promising and safe revascularization strategy. It provides selected patients with an alternative, functionally complete revascularization with minimal surgical trauma and good long-term clinical outcomes.
Eligibility for Minimally Invasive Coronary Artery Bypass
Authors: Dillon Kate E. M. , Johnson Marjorie , Chan Ian L. , Kiaii Bob
Published: March 2017

Objective

A variable that necessitates conversion to a conventional full-sternotomy coronary artery bypass procedure from a robotic-assisted endoscopic single-vessel small thoracotomy is the inability to visualize the left anterior descending coronary artery within the surrounding epicardial adipose tissue using the endoscopic camera. The purpose of this study was to determine whether anatomical properties of the epicardial adipose tissue examined using preoperative computed tomography (CT) images are able to predict and thus reduce the need for intraoperative conversion based on effective preoperative exclusion criteria.

Methods

Retrospective analysis of patient preoperative CT angiography scans from both converted (n = 17) and successful robotic-assisted (n = 17) procedures was performed. Where possible, measurements of epicardial adipose tissue were acquired from axial slices, at the most accessible segment of the left anterior descending coronary artery.

Results

Results indicate that patients who successfully underwent the endoscopic single-vessel small thoracotomy procedure (mean ± SD depth, 4.9 ±1.9 mm) had significantly less epicardial adipose tissue (38%, P = 0.002) overlying the vessel toward the lateral chest wall than those who were converted to the full-sternotomy approach intraoperatively (mean ± SD depth, 7.9 ± 3.2 mm). Using this as a retrospective exclusion criterion reduces the conversion rate for this group by 47%, while maintaining a high specificity (94%). No significant differences exist between the two groups with respect to the remaining epicardial adipose tissue measurements or body mass index.

Conclusions

The addition of CT angiography measurements of the epicardial adipose tissue overlying the left anterior descending coronary artery may enhance preoperative surgical planning for this procedure, thereby reducing the instances of procedural changes.
Lateral Rectus Muscle Expands More Than Medial Rectus Following Maximal Deep Balanced Orbital Decompression
Authors: Gupta Adit , Nobori Alex , Wang Yi , Rootman Daniel , Goldberg Robert
Published: March 2017

Purpose:

It has been reported that extraocular muscles can enlarge following orbital decompression in thyroid eye disease. In this article, the authors studied the changes in extraocular muscles size following maximal deep lateral and medial balanced decompression in a large sample of thyroid eye disease patients.

Methods:

Imaging data were reviewed preoperatively and postoperatively. Radiologic proptosis was assessed. Maximal axial muscle width of the medial and lateral recti was measured.

Results:

Data from 48 consecutive patients (75 orbits) were included. There was a significant increase in the width of both the lateral and medial recti after decompression (p < 0.01). The mean (standard deviation [SD]) change was less for the medial rectus (0.7 mm) than for the lateral (2.7 mm). This difference was significant (p < 0.01). For the lateral rectus, 80% of all decompression surgeries were associated with an increase in width of >1 mm. Mean (SD) proptosis reduction was 8.2 mm (3.4 mm).

Conclusion:

These results suggest that the extraocular muscles enlarge in the most deep lateral wall decompressions. For decompression as performed in this article, expansion tends to be more commonly found and of a greater magnitude in the lateral rectus compared with medial.
Resting-state functional connectivity predicts longitudinal pain symptom change in urologic chronic pelvic pain syndrome: a MAPP network study
Authors: Kutch Jason J. , Labus Jennifer S. , Harris Richard E. , Martucci Katherine T. , Farmer Melissa A. , Fenske Sonja , Fling Connor , Ichesco Eric , Peltier Scott , Petre Bogdan , Guo Wensheng , Hou Xiaoling , Stephens Alisa J. , Mullins Chris , Clauw Daniel J. , Mackey Sean C. , Apkarian A. Vania , Landis J. Richard , Mayer Emeran A. ,   for the MAPP Research Network
Published: March 2017

Chronic pain symptoms often change over time, even in individuals who have had symptoms for years. Studying biological factors that predict trends in symptom change in chronic pain may uncover novel pathophysiological mechanisms and potential therapeutic targets. In this study, we investigated whether brain functional connectivity measures obtained from resting-state functional magnetic resonance imaging at baseline can predict longitudinal symptom change (3, 6, and 12 months after scan) in urologic chronic pelvic pain syndrome. We studied 52 individuals with urologic chronic pelvic pain syndrome (34 women, 18 men) who had baseline neuroimaging followed by symptom tracking every 2 weeks for 1 year as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network study. We found that brain functional connectivity can make a significant prediction of short-term (3 month) pain reduction with 73.1% accuracy (69.2% sensitivity and 75.0% precision). In addition, we found that the brain regions with greatest contribution to the classification were preferentially aligned with the left frontoparietal network. Resting-state functional magnetic resonance imaging measures seemed to be less informative about 6- or 12-month symptom change. Our study provides the first evidence that future trends in symptom change in patients in a state of chronic pain may be linked to functional connectivity within specific brain networks.
Parkinson disease and musculoskeletal pain: an 8-year population-based cohort study
Authors: Lien Wei-Hung , Lien Wei-Chih , Kuan Ta-Shen , Wu Shang-Te , Chen Yi-Ting , Chiu Ching-Ju
Published: March 2017

The aim of this study was to evaluate the incidence and clinical features of musculoskeletal pain (MSP) in patients with Parkinson disease (PD) compared with a control group without the disease. The retrospective cohort study used a subset of the Taiwan National Health Insurance Research Database (NHIRD) comprising information on 1 million beneficiaries randomly sampled from the entire population of Taiwan. A total of 490 patients aged 50 and above with newly diagnosed Parkinson disease were identified during a period from 2000 to 2005. Among them, 199 developed MSP after PD. The control group consisted of 1960 participants without PD over the study period randomly selected by matching PD cases according to the date of PD incidence, age, and sex. The study groups were then followed to the end of 2007. Musculoskeletal pain was the end point. The incidence rate ratios of MSP were higher in the PD group than in the control group, representing an adjusted hazard ratio of 1.31 (95% confidence interval 1.09 to 1.58). PD was associated with a significantly elevated risk of MSP in all sex and age stratifications, with the highest hazard ratio noted for middle-aged male patients with PD, followed by older male patients with PD. This study showed that the PD may significantly increase the risk of developing MSP. The risk of developing MSP seems to be greatest for middle-aged male patients with PD. Clinicians should be more alert for MSP in patients with PD, and early intervention should be considered.
Sustained improvements in pain, mood, function and opioid use post interdisciplinary pain rehabilitation in patients weaned from high and low dose chronic opioid therapy
Authors: Huffman Kelly L. , Rush Taylor E. , Fan Youran , Sweis Giries W. , Vij Brinder , Covington Edward C. , Scheman Judith , Mathews Manu
Published: March 2017

Increased prescribing of opioids for chronic noncancer pain is associated with significant social costs, including overdose and addiction. In this context, there is interest in interdisciplinary chronic pain rehabilitation programs focusing on self-management and minimizing opioid use. This study examined outcomes of patients weaned from opioids in an ICPRP from 2007 to 2012. Participants included 413 patients on high dose chronic opioid therapy (COT; >100 mg), 528 on low dose COT, and 516 not on opioids (NO). Outcomes were assessed at discharge, 6, and 12 months posttreatment through self-report and chart review. One thousand one hundred ninety-four participants completed treatment (81.95%); 86.74% of those on opioids were weaned. High doses were less likely to complete (78.45%) than NO participants (85.27%; P < 0.05). Results showed immediate (P < 0.01) and sustained improvements (P < 0.05) in pain severity, depression, anxiety, and functional impairment with no group differences. Effect sizes ranged from medium to large (Cohen d values 0.57-1.96). Longitudinal medication use data were available for 319 no dose and 417 weaned participants; opioid resumption rates were 10.51% and 30.70% respectively. There were no differences in resumption between the high dose and low dose groups. Logistic regression analyses determined that opioid dose predicted neither treatment completion nor opioid resumption. Anxiety predicted completion, and functional impairment predicted opioid resumption within 1 year of discharge. Results suggest that patients on COT can be successfully weaned with long-term benefits in pain, mood, and function. Targeting anxiety and functional restoration may increase success rates.
Designing an Automatic Subglottic Suction for Prevention of Ventilator-Associated Pneumonia
Authors: Elhaj Sara Hassan Ali , Khider Mohamed Omer , Hamza Alnazier Osman , Motiri Naif Ahmed Al
Published: March 2017

Ventilator-associated pneumonia is a bacterial pneumonia that develops in patients receiving mechanical ventilator support through an artificial airway (endotracheal tube). In this article, a study and analysis to the side effects of using endotracheal tube during ventilation period have been conducted; the study goal is to select 1 type of photoelectric sensors and use it to design and implement an automatic subglottic suction to prevent ventilation-associated pneumonia by immediately suctioning the area above the inflated balloon and permits aspiration of secretion in the subglottic space. So, a testing of photo detectors become a major of concern; moreover, photoelectric sensor is an equipment used to discover variety of parameters such as distance, absence or presence of an object, and wet area by using a light transmitter, often infrared, and a photoelectric receiver.

In this article, a testing of photoelectric sensors to detect the wet area above the cuff will be done to achieve the goal of designing and implementing automatic subglottic suction.
Percutaneous Single-Site Cannulation for Acute Right-Sided Support
Authors: Malik Mahim , Kilic Ahmet , Whitson Bryan A.
Published: March 2017

Right ventricular failure is a challenging problem after left ventricular assist device implantation, leading to considerable morbidity and mortality. When inotropic support is no longer adequate, a temporary right ventricular assist device is needed that often mandates reopening of the sternotomy for implant and explant. We describe our technique to percutaneously place a right internal jugular cannula for extracorporeal support.
HVAD Flow Waveform Morphologies: Theoretical Foundation and Implications for Clinical Practice
Authors: Rich Jonathan D. , Burkhoff Daniel
Published: March 2017

Continuous-flow ventricular assist device (cfVAD) performance and patient hemodynamic conditions are intimately interrelated and dynamic, changing frequently with alterations in physiologic conditions, particularly pre- and afterloading conditions. The Heartware cfVAD (HVAD) provides a unique feature among currently approved VADs of providing an estimated instantaneous flow waveform, the characteristics of which can provide significant insights into patient and device properties. Despite being readily available, HVAD waveforms are poorly understood, underutilized, and insufficiently leveraged, even by clinicians who regularly manage HVAD patients. The purpose of this review is to provide the theoretical foundation for understanding the determinants of HVAD waveform characteristics and to provide practical examples illustrating how to interpret and integrate changes of HVAD waveforms into clinical practice. Heartware cfVAD waveforms should be considered a complimentary tool for the optimization of medical therapies and device speed in HVAD patients.
Wilms Tumor Extension Into Duplex Ureter in a 10-Year-Old Girl
Authors: Karnak İbrahim , Haliloğlu Mithat , Orhan Diclehan , Kutluk Tezer
Published: March 2017

Ureteral extension of Wilms tumor (WT) is a rare occasion. The association of duplex collecting system and WT is extremely rare. Ureteral extension of WT in a duplex collecting system is an unreported entity to date. A 10-year-old girl presenting with WT extending into upper pole ureter of duplex system is reported to emphasize the importance of preoperative diagnosis to plan step by step surgery in this rare coincidental situation.
Evidence for Increased Response to Induced Endoplasmic Reticulum Stress in Myeloid Cells in Acquired Aplastic Anemia
Authors: Sidhu Alpa , Callaghan Michael U. , Gadgeel Manisha S. , Buck Steven A. , Fribley Andrew M. , Savaşan Süreyya
Published: March 2017

Autoimmune response targeting the hematopoietic stem cells highlights the current understanding of acquired aplastic anemia (AAA) pathogenesis. Upregulation of the unfolded protein response is the cell’s rejoinder to a variety of stresses, which either result in restoring homeostasis or cell death by increased expression of the transcription factor C/EBP homologous protein. We hypothesized that there is an inherent increased sensitivity to various cellular stressors, including the ones that target endoplasmic reticulum (ER) in AAA leading to a decreased proliferation and potentially contributing to susceptibility to autologous cytotoxicity. Using archived bone marrow aspirate samples, we demonstrate that the culture-expanded AAA myeloid cells have an increased response to ER stress induced by tunicamycin leading to decreased cell proliferation. Within the AAA myeloid samples, we show that the disease status, active versus response to therapy at the time of sampling does not alter the ER stress response. This is the first report, which provides evidence for an inherent defective stress control in the myeloid cells as a possible mechanism of evolution of the disease process in AAA.
Corneal Nerve Morphology, Sensitivity, and Tear Neuropeptides in Contact Lens Wear
Authors: Golebiowski Blanka , Chao Cecilia , Stapleton Fiona , Jalbert Isabelle
Published: March 2017

Purpose

To determine tear neuropeptide levels in contact lens wearers and non-wearers, and to examine relationships with indices of corneal innervation, tear function, and ocular discomfort.

Methods

A cross-sectional, single-visit, investigator-masked pilot study. Assessments included Ocular Comfort Index (OCI), central and mid-peripheral corneal nerve density and morphology (HRT-Rostock), corneal sensitivity (Cochet-Bonnet aesthesiometer), tear Substance P and calcitonin gene-related peptide (CGRP) concentration (ELISA), in situ tear osmolarity (TearLab), tear secretion (Phenol Red Thread), and noninvasive tear break-up time (NITBUT; Keeler Tearscope). Groups were compared using independent t-test or Mann–Whitney U test, and regional differences assessed using paired t-tests. Associations were analyzed using Pearson or Spearman correlation. Significance was determined at P < .05.

Results

Twenty contact lens wearers (7M:13F, 32 ± 5 years) and 20 non-wearers (7M:13F, 31 ± 5 years) completed the study. OCI score was numerically higher in lens wearers (32.27 ± 5.33) than non-wearers (27.66 ± 9.94). Tear osmolarity was higher [298.0 (IQR 291.0–309.8) vs. 288.5 (282.3–298.3) mOsmol/L; P = .01] whereas NITBUT was lower (9.8 ± 3.4 vs. 13.8 ± 5.6 s; P = .01) in lens wearers compared with non-wearers. Tear neuropeptide concentrations were not different between groups [Substance P 4.29 ng/ml (IQR 1.57–6.05), CGRP 14.89 ng/ml (5.08–59.26)], and there were no differences in nerve morphology or ocular surface sensitivity. Higher nerve density, interconnections, and tortuosity were observed in the central cornea than mid-peripherally (P < .05). OCI score was moderately associated with nerve tortuosity (r = 0.42, P = .01). CGRP was associated with central nerve density (ρ = 0.38, P = .02), as was tear secretion (r = −0.37, P = .02). Nerve interconnections were strongly associated with corneal sensitivity (ρ = 0.64, P < .001).

Conclusions

Relationships were demonstrated between nerve density, tear CGRP, and corneal sensitivity. Markers of corneal neurobiology and sensory function do not appear to be altered in contact lens wear despite worse tear function (osmolarity and stability) in lens wearers. This suggests that mechanisms other than overt changes in corneal innervation regulate tear function during lens wear. The relationship between nerve tortuosity and ocular discomfort requires elucidation.
Intimate Partner Violence
Authors: Cauchois Aurélie , Paraire François , Lorin de la Grandmaison Geoffroy
Published: March 2017

We present the case of a reciprocal homicide by stabbing that occurred within an unmarried couple without known history of spousal violence. Each partner killed the other one at the same time and at the same place using kitchen knives. They were both found dead at home lying on the floor after the neighbors heard an argument and screams coming from the couple's apartment, so they called the police and the fire department. The door was locked from the inside, and the fire department was forced to break the door. Two kitchen knives supporting blood traces were found at the scene. At autopsy, both bodies showed multiple stab wounds, and the lethal ones were due to heart injuries. Defense injuries were also found in both bodies. To our knowledge, this is the first case of reciprocal homicide described in the literature. Other manners of death are discussed, including homicide by a third party, homicide-suicide, and suicide pact.
Epigallocatechin Gallate Inhibits Macaque SEVI-Mediated Enhancement of SIV or SHIV Infection
Authors: Zhou Run-Hong , Guo Le , Liu Jin-Biao , Liu Hang , Hou Wei , Ma Tong-Cui , Wang Xu , Wu Jian-Guo , Ye Li , Ho Wen-Zhe , Li Jie-Liang
Published: March 2017

Background:

Human semen contains a factor that can enhance HIV infection up to 105-fold in cultures. This factor is termed semen-derived enhancer of virus infection (SEVI) and is composed of proteolytic fragments (PAP248-286) from prostatic acid phosphatase in semen. In this study, we examined whether macaque SEVI can facilitate simian immunodeficiency virus (SIV) or chimeric simian/human immunodeficiency virus (SHIV) infection. We also studied the effect of epigallocatechin gallate (EGCG) on macaque SEVI-mediated SIV or SHIV enhancement.

Methods:

SIV or SHIV was mixed with different concentrations of macaque SEVI in the presence or absence of EGCG. The mixture was added to cultures of TZM-bl cells or macaque PBMCs. The effect of EGCG on macaque SEVI was measured by Congo-red staining assay and thioflavin T (ThT) fluorescence assay and was visualized by a transmission electron microscope.

Results:

We identified that there is one amino acid difference at the site of 277 between human PAP248-286 and macaque PAP248-286. Macaque SEVI significantly enhanced SIV or SHIV infection of TZM-bl cells and macaque PBMCs. EGCG could block macaque SEVI-mediated enhancement of SIV or SHIV infection. Mechanistically, EGCG could degrade the formation of macaque SEVI amyloid fibrils that facilitates HIV attachment to the target cells.

Conclusions:

The finding that macaque SEVI could enhance SIV or SHIV infection indicates the possibility to use the macaque SEVI in vivo studies with the macaque models. In addition, future studies are necessary to examine whether EGCG can be used as an effective microbicide for preventing SIV or SHIV mucosal transmission.
Temporal Patterns and Drug Resistance in CSF Viral Escape Among ART-Experienced HIV-1 Infected Adults
Authors: Mukerji Shibani S. , Misra Vikas , Lorenz David , Cervantes-Arslanian Anna M. , Lyons Jennifer , Chalkias Spyridon , Wurcel Alysse , Burke Deirdre , Venna Nagagopal , Morgello Susan , Koralnik Igor J. , Gabuzda Dana
Published: March 2017

Background:

Cerebrospinal fluid (CSF) viral escape is an increasingly recognized clinical event among HIV-1-infected adults. We analyzed longitudinal data and drug-resistance mutations to characterize profiles of HIV-1-infected patients on antiretroviral therapy with discordant CSF and plasma HIV-1 RNA levels.

Methods:

Forty-one cases of CSF escape defined as detectable CSF HIV-1 RNA when plasma levels were undetectable, or HIV-1 RNA >0.5-log higher in CSF than plasma were identified from Boston Hospitals and National NeuroAIDS Tissue Consortium (NNTC) from 2005 to 2016.

Results:

Estimated prevalence of CSF escape in Boston and NNTC cohorts was 6.0% and 6.8%, respectively; median age was 50, duration of HIV-1 infection 17 years, CD4 count 329 cells/mm3 and CD4 nadir 21 cells/mm3. Neurological symptoms were present in 30 cases; 4 had repeat episodes of CSF escape. Cases were classified into subtypes based plasma HIV-1 RNA levels in the preceding 24 months: high-level viremia (1000 copies/mL), low-level viremia (LLV: 51–999 copies/mL), and plasma suppression with CSF blip or escape (CSF RNA <200 or ≥200 copies/mL). High-level viremia cases reported more substance abuse, whereas LLV or plasma suppression cases were more neurosymptomatic (81% vs. 53%); 75% of repeat CSF escape cases were classified LLV. M184V/I mutations were identified in 74% of CSF samples when plasma levels were ≤50 copies per milliliter.

Conclusions:

Characteristics frequently observed in CSF escape include HIV-1 infection >15 years, previous LLV, and M184V/I mutations in CSF. Classification based on preceding plasma HIV RNA levels provides a useful conceptual framework to identify causal factors and test therapeutics.
Injection Drug Network Characteristics Are Important Markers of HIV Risk Behavior and Lack of Viral Suppression
Authors: Cepeda Javier A. , Solomon Sunil S. , Srikrishnan Aylur K. , McFall Allison M. , Kumar Muniratnam Suresh , Vasudevan Canjeevaram K. , Anand Santhanam , Celentano David D. , Lucas Gregory M. , Mehta Shruti H.
Published: March 2017

Background:

People who inject drugs (PWID) who are highly connected within their injection drug networks may be important HIV transmission nodes if they frequently share syringes with other PWID and are not engaged in HIV care. In India, HIV transmission fueled by injection drug use is increasing; however, little is known about the associations between injection network size and syringe sharing and viral suppression.

Methods:

We recruited 14,481 PWID between October 2012 and December 2013 by respondent-driven sampling across 15 sites in India. Interviewer-administered questionnaires assessed network characteristics, substance use, HIV testing experience, and access to health services. We used multilevel logistic regression modeling to evaluate the relationship between injection drug network size and (1) syringe sharing at last injection and (2) viral suppression among HIV-positive participants (<150 copies/mL).

Findings:

The median injection network size was 3 (interquartile range: 1–5), and 7% of participants injected with >10 members in the past 30 days. PWID who had >10 members in their network were 1.65 times (95% confidence interval: 1.12 to 2.42, P = 0.0111) more likely to have shared a syringe at last injection compared with those in the 0–1 members in their drug networks. In addition, individuals with the largest injection drug networks were 31% (95% confidence interval: 0.53 to 0.90, P = 0.006) less likely to be virally suppressed compared with those in the smallest injection drug networks.

Discussion:

Individuals with larger networks may be important in HIV transmission within injection drug networks because they were the most likely to engage in recent syringe sharing and least likely to be virally suppressed.
Burkitt Lymphoma in Adult With Atypical Clinical Presentation Primarily Involving the Oral Soft Tissue
Authors: Garcia Natália Galvão , Rodrigues Moacyr Tadeu Vicente , Aleixo Rodrigo Queiroz , Oliveira Denise Tostes
Published: March 2017

Non-Hodgkin lymphoma is the second most common neoplasm of the head and neck after squamous cell carcinoma. However, it accounts for only 3.5% of all malignancies of the oral cavity. Oral lesions are often a component of disseminated disease process that may involve regional lymph nodes or may at times represent the primary extra nodal form of the disease. Although, isolated oral lymphoma in adults is extremely rare, this paper presents a patient with Burkitt lymphoma in an adult male with atypical clinical presentation primarily involving the oral soft tissue. It is believed that the prognosis of Burkitt lymphoma depends on the extent of the disease, the patient's age, and the timing of diagnosis. Therefore, the role of the dentist in the early diagnosis and prompt referral of patients with Burkitt lymphoma cannot be overemphasized.
Transient Global Amnesia: Commentary on Trip Gabriel’s First-Person Account
Authors: Kirshner Howard S.
Published: March 2017

This paper comments on a companion article, a first-person account of an episode of transient global amnesia written by New York Times reporter Trip Gabriel (Gabriel T. 2017. Cogn Behav Neurol. 30:1-4). Mr Gabriel describes having no memories of a cold, rainy day that he had spent on a sailboat competing in two races. The episode may have been triggered by his exposure to water. Afterward, the skipper recalled that Mr Gabriel had functioned fine on the boat, although after returning to shore he needed help finding his car. When he told his wife over the phone that he could not remember where he lived, she got him home and to the hospital. The staff excluded stroke and other causes of amnesia. He felt some awareness after about 9 hours, and the episode ended after about 23 hours. He has been left with a permanent memory gap of 12 hours.

The commentary on the case outlines the state of knowledge about transient global amnesia. The diagnosis is well established: a witnessed sudden-onset retrograde and anterograde amnesia lasting <24 hours in a fully conscious person who knows who he/she is and has no other cause for amnesia. Triggers include exposure to water, stress, and sexual intercourse. A normal magnetic resonance imaging scan can help with the often challenging differential diagnosis. Apart from the gap in memory, patients recover fully and only 15% to 20% have recurrences. The underlying pathophysiology has not been explained.
Relationship of Cognitive Function to Motor Symptoms and Mood Disorders in Patients With Isolated Dystonia
Authors: Foley Jennifer A. , Vinke R. Saman , Limousin Patricia , Cipolotti Lisa
Published: March 2017

Objective:

To investigate the relationship of dystonia symptoms to cognitive function by comparing cognitive performance in patients with focal (cervical) and generalized dystonia subtypes and examining the differential contributions of severity of symptoms and mood disorders to cognition.

Background:

Studies of the nonmotor syndrome in isolated dystonia have reported evidence of cognitive dysfunction, but the cause of this impairment remains unclear. Several studies have suggested that poor cognitive performance reflects the distracting effects of the motor symptoms and/or a mood disorder.

Methods:

In this retrospective study, we used an extensive battery of cognitive and mood assessments to compare 25 patients with cervical dystonia, 13 patients with generalized dystonia, and 50 healthy controls.

Results:

We found cognitive performance to be independent of all clinical and mood variables. We found no significant differences in cognition between the two dystonia groups. The combined dystonia groups had significant impairment on only one measure of cognitive function, the Trail Making Test. Two patients were also impaired on the Stroop test, and six on the Hayling Sentence Completion Test.

Conclusions:

The nonmotor features of dystonia include subtle cognitive symptoms and high rates of mood disorders, both of which occur independent of motor symptom severity and level of disability. Thus, we would argue that isolated dystonia is a tripartite disorder, with motor, affective, and subtle cognitive features.
A mechanically coupled reaction–diffusion model that incorporates intra-tumoural heterogeneity to predict
in vivo
glioma growth
Authors: Hormuth David A. , Weis Jared A. , Barnes Stephanie L. , Miga Michael I. , Rericha Erin C. , Quaranta Vito , Yankeelov Thomas E.
Published: March 2017

While gliomas have been extensively modelled with a reaction–diffusion (RD) type equation it is most likely an oversimplification. In this study, three mathematical models of glioma growth are developed and systematically investigated to establish a framework for accurate prediction of changes in tumour volume as well as intra-tumoural heterogeneity. Tumour cell movement was described by coupling movement to tissue stress, leading to a mechanically coupled (MC) RD model. Intra-tumour heterogeneity was described by including a voxel-specific carrying capacity (CC) to the RD model. The MC and CC models were also combined in a third model. To evaluate these models, rats (
n
= 14) with C6 gliomas were imaged with diffusion-weighted magnetic resonance imaging over 10 days to estimate tumour cellularity. Model parameters were estimated from the first three imaging time points and then used to predict tumour growth at the remaining time points which were then directly compared to experimental data. The results in this work demonstrate that mechanical–biological effects are a necessary component of brain tissue tumour modelling efforts. The results are suggestive that a variable tissue carrying capacity is a needed model component to capture tumour heterogeneity. Lastly, the results advocate the need for additional effort towards capturing tumour-to-tissue infiltration.
Diffusion or advection? Mass transfer and complex boundary layer landscapes of the brown algaFucus vesiculosus
Authors: Lichtenberg Mads , Nørregaard Rasmus Dyrmose , Kühl Michael
Published: March 2017

The role of hyaline hairs on the thallus of brown algae in the genusFucusis long debated and several functions have been proposed. We used a novel motorized set-up for two-dimensional and three-dimensional mapping with O2microsensors to investigate the spatial heterogeneity of the diffusive boundary layer (DBL) and O2flux around single and multiple tufts of hyaline hairs on the thallus ofFucus vesiculosus.Flow was a major determinant of DBL thickness, where higher flow decreased DBL thickness and increased O2flux between the algal thallus and the surrounding seawater. However, the topography of the DBL varied and did not directly follow the contour of the underlying thallus. Areas around single tufts of hyaline hairs exhibited a more complex mass-transfer boundary layer, showing both increased and decreased thickness when compared with areas over smooth thallus surfaces. Over thallus areas with several hyaline hair tufts, the overall effect was an apparent increase in the boundary layer thickness. We also found indications for advective O2transport driven by pressure gradients or vortex shedding downstream from dense tufts of hyaline hairs that could alleviate local mass-transfer resistances. Mass-transfer dynamics around hyaline hair tufts are thus more complex than hitherto assumed and may have important implications for algal physiology and plant–microbe interactions.
On the growth and form of shoots
Authors: Chelakkot Raghunath , Mahadevan L.
Published: March 2017

Growing plant stems and shoots exhibit a variety of shapes that embody growth in response to various stimuli. Building on experimental observations, we provide a quantitative biophysical theory for these shapes by accounting for the inherent observed passive and active effects: (i) the active controllable growth response of the shoot in response to its orientation relative to gravity, (ii) proprioception, the shoot's growth response to its own observable current shape, and (iii) the passive elastic deflection of the shoot due to its own weight, which determines the current shape of the shoot. Our theory separates the sensed and actuated variables in a growing shoot and results in a morphospace diagram in terms of two dimensionless parameters representing a scaled local active gravitropic sensitivity, and a scaled passive elastic sag. Our computational results allow us to explain the variety of observed transient and steady morphologies with effective positive, negative and even oscillatory gravitropic behaviours, without the need for ad hoc complex spatio-temporal control strategies in terms of these parameters. More broadly, our theory is applicable to the growth of soft, floppy organs where sensing and actuation are dynamically coupled through growth processes via shape.
Fundamental mechanisms of telomerase action in yeasts and mammals: understanding telomeres and telomerase in cancer cells
Authors: Armstrong Christine A. , Tomita Kazunori
Published: March 2017

Aberrant activation of telomerase occurs in 85–90% of all cancers and underpins the ability of cancer cells to bypass their proliferative limit, rendering them immortal. The activity of telomerase is tightly controlled at multiple levels, from transcriptional regulation of the telomerase components to holoenzyme biogenesis and recruitment to the telomere, and finally activation and processivity. However, studies using cancer cell lines and other model systems have begun to reveal features of telomeres and telomerase that are unique to cancer. This review summarizes our current knowledge on the mechanisms of telomerase recruitment and activation using insights from studies in mammals and budding and fission yeasts. Finally, we discuss the differences in telomere homeostasis between normal cells and cancer cells, which may provide a foundation for telomere/telomerase targeted cancer treatments.
Nonlinear growth: an origin of hub organization in complex networks
Authors: Bauer Roman , Kaiser Marcus
Published: March 2017

Many real-world networks contain highly connected nodes called hubs. Hubs are often crucial for network function and spreading dynamics. However, classical models of how hubs originate during network development unrealistically assume that new nodes attain information about the connectivity (for example the degree) of existing nodes. Here, we introduce hub formation through nonlinear growth where the number of nodes generated at each stage increases over time and new nodes form connections independent of target node features. Our model reproduces variation in number of connections, hub occurrence time, and rich-club organization of networks ranging from protein–protein, neuronal and fibre tract brain networks to airline networks. Moreover, nonlinear growth gives a more generic representation of these networks compared with previous preferential attachment or duplication–divergence models. Overall, hub creation through nonlinear network expansion can serve as a benchmark model for studying the development of many real-world networks.