bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and tolerability of inebilizumab (MEDI-551), an anti-CD19 monoclonal antibody, in patients with relapsing forms of multiple sclerosis: Results from a phase 1 randomised, placebo-controlled, escalating intravenous and subcutaneous dose study
Authors: Agius Mark A , Klodowska-Duda Gabriela , Maciejowski Maciej , Potemkowski Andrzej , Li Jing , Patra Kaushik , Wesley Jacob , Madani Soraya , Barron Gerard , Katz Eliezer , Flor Armando
Published: November 2017

Background:

B cells may be involved in the pathophysiology of multiple sclerosis (MS). Inebilizumab (formerly MEDI-551) binds to and depletes CD19+ B cells.

Objectives:

To assess safety, tolerability, pharmacokinetics, pharmacodynamics and immunogenicity of inebilizumab in adults with relapsing MS.

Methods:

This phase 1 trial randomised 28 patients 3:1 (21, inebilizumab; 7, placebo) to inebilizumab (2 intravenous (IV) doses, days 1 and 15: 30, 100 or 600 mg; or single subcutaneous (SC) dose on day 1: 60 or 300 mg) or matching placebo, with follow-up until at least week 24 or return of CD19+ B-cell count to ⩾80 cells/µL.

Results:

Complete B-cell depletion was observed across all doses. Infusion/injection (grade 1/2) reactions occurred in 6/15 patients receiving inebilizumab IV, 2/5 placebo IV and 1/6 inebilizumab SC. Serious adverse events occurred in three patients receiving inebilizumab: pyrexia, mixed-drug intoxication (unrelated to inebilizumab; resulted in death) and urinary tract infection. Mean number of cumulative new gadolinium-enhancing lesions over 24 weeks was 0.1 with inebilizumab versus 1.3 with placebo; mean numbers of new/newly enlarging T2 lesions were 0.4 and 2.4, respectively.

Conclusion:

Inebilizumab had an acceptable safety profile in relapsing MS patients and showed a trend in reductions in new/newly enlarging and gadolinium-enhancing lesions.
Pathological cut-offs of global and regional brain volume loss in multiple sclerosis
Authors: Uher Tomas , Vaneckova Manuela , Krasensky Jan , Sobisek Lukas , Tyblova Michaela , Volna Jana , Seidl Zdenek , Bergsland Niels , Dwyer Michael G , Zivadinov Robert , De Stefano Nicola , Sormani Maria Pia , Havrdova Eva Kubala , Horakova Dana
Published: November 2017

Background:

Volumetric MRI surrogate markers of disease progression are lacking.

Objective:

To establish cut-off values of brain volume loss able to discriminate between healthy controls and MS patients.

Methods:

In total, 386 patients after first demyelinating event suggestive of MS (CIS), 964 relapsing-remitting MS (RRMS) patients, 63 secondary-progressive MS (SPMS) patients and 58 healthy controls were included in this longitudinal study. A total of 11,438 MRI scans performed on the same MRI scanner with the same protocol were analysed. Annualised percentage changes of whole brain, grey matter, thalamus and corpus callosum volumes were estimated. We investigated cut-offs able to discriminate between healthy controls and MS patients.

Results:

At a predefined specificity of 90%, the annualised percentage change cut-off of corpus callosum volume (−0.57%) was able to distinguish between healthy controls and patients with the highest sensitivity (51% in CIS, 48% in RRMS and 42% in SPMS patients). Lower sensitivities (22%−49%) were found for cut-offs of whole brain, grey matter and thalamic volume loss. Among CIS and RRMS patients, cut-offs were associated with greater accumulation of disability.

Conclusion:

We identified cut-offs of annualised global and regional brain volume loss rates able to discriminate between healthy controls and MS patients.
Non-participation modestly increased with distance to the examination clinic among adults in Finnish health examination surveys
Authors: Reinikainen Jaakko , Saarsalmi Perttu , Härkänen Tommi , Jousilahti Pekka , Karvanen Juha , Männistö Satu , Tolonen Hanna
Published: November 2017

Aims: Health examination surveys (HES) provide important information about population health and health-related factors, but declining participation rates threaten the representativeness of collected data. It is hard to conduct national HESs at examination clinics near to every sampled individual. Thus, it is interesting to look into the possible association between the distance from home to the examination clinic and non-participation, and whether there is a certain distance after which the participation activity decreases considerably. Methods: Data from two national HESs conducted in Finland in 2011 and 2012 were used and a logistic regression model was fitted to investigate how distance was related to non-participation. Results: We found out that non-participation modestly increased with distance to the examination clinic. An additional analysis indicated that the option of having an examination at home may decrease the effect of distance to participation. Conclusions: Long distances from home to the examination clinic are one reason for low participation activity. Possible bias caused by these differences in participation could be decreased by providing the option of a home examination.
Surgical Management of Renal Cell Carcinoma Extending Into Venous System: A 20-Year Experience
Authors: Xiao X. , Zhang L. , Chen X. , Cui L. , Zhu H. , Pang D. , Yang Y. , Wang Q. , Wang M. , Gao C.
Published: November 2017

Background and Aims:

The purpose of this study is to report our 20-year experience with the surgical management of renal cell carcinoma extending into the inferior vena cava using a novel classification system.

Materials and Methods:

We retrospectively reviewed the data of 103 patients (69 males, 34 females, mean age: 52.9 ± 12.6 years) with renal cell carcinoma involving the venous system treated between 1993 and 2014. The inferior vena cava tumor thrombus was classified into five levels: 0 (renal vein, n = 12), 1 (infrahepatic, n = 33), 2a (low retrohepatic, n = 26), 2b (high retrohepatic, n = 19), and 3 (supradiaphragmatic, n = 13). Clinical data were summarized, and overall survival, cancer-specific survival, and disease-free survival were examined by Cox regression analysis.

Results:

All patients underwent radical surgery. Complete resections of the renal tumor and thrombus were achieved in 101 patients (98.1%). Two intraoperative and one postoperative in-hospital deaths (2.9%) occurred. In total, 19 patients (18.8%) had a total of 29 postoperative complications. Mean follow-up time was 46 months (range, 1–239 months). The 5- and 10-year overall survival rates were 62.9% and 56.0%, respectively. Metastasis, rather than thrombus level, was a significant risk factor associated with overall survival (hazard ratio = 4.89, 95% confidence interval: 2.24–10.67, p < 0.001).

Conclusion:

Our novel classification system can be used to select the optimal surgical approach and method for patients with renal cell carcinoma and venous thrombus. Its use is associated with prolonged survival and relatively few complications. Metastasis is an independent risk factor of overall survival.
What did we do when the Internet wasn’t around? Variation in free-time activities among three young-adult cohorts from 1990/1991, 2000/2001, and 2010/2011
Authors: Vilhelmson Bertil , Elldér Erik , Thulin Eva
Published: November 2017

Comparing the daily time use of three consecutive cohorts of Swedish young adults 20–29 years old, we analyse changes in free-time activity patterns over a period when private Information and Communications Technology (ICT) use was introduced, expanded, and went online. We use Swedish Time Use Survey (TUS) data from 1990/1991, 2000/2001 and 2010/2011 and apply covariate analysis, controlling for important socio-economic factors. Our theoretical approach complements a regular displacement/enhancement perspective by emphasizing the role of time elasticities, time-use priorities, and free-time availability (i.e. being time-poor vs time-rich). Results indicate that online time increased considerably, adapting to increased free time. In addition, offline time spent on social activities, activities with other people, reading books and newspapers and offline hobbies consistently declined. TV viewing increased among the time-rich, fuelling overall screen time. Time spent on outdoor physical activity, entertainment, culture, and voluntary work appear unaffected. The balance between in-home and out-of-home time remained unchanged.
Libraries as redistributive technology: From capacity to culture in Queensland’s public library network
Authors: Wyatt Danielle , Mcquire Scott , Butt Danny
Published: November 2017

Australia is currently rolling out one of the most expensive and ambitious infrastructure projects in the nation’s history. The National Broadband Network is promoted as a catalyst for far-reaching changes in Australia’s economy, governmental service provision, society and culture. However, it is evident that desired dividends, such as greater social engagement, enhanced cultural awareness and increased civic and political participation, do not flow automatically from mere technical connection to the network. This article argues that public institutions play a vital role in redistributing technological capacity to enable emerging forms of social and cultural participation. In particular, we examine public libraries as significant but often overlooked sites in the evolving dynamic between digital technology, new cultural practices and social relations. Drawing on interviews and fieldwork across the public library network of the state of Queensland, we attend to the strategies and approaches libraries are adopting in response to a digital culture.
Explaining unplanned online media behaviors: Dual system theory models of impulsive use and swearing on social networking sites
Authors: Turel Ofir , Qahri-Saremi Hamed
Published: November 2017

Unplanned (i.e. spontaneous) online behaviors such as impulsive use of social networking sites (SNS) and swearing on SNS are prevalent and can adversely affect users and society. Drawing on dual system theory, this article conceptualizes and empirically investigates the etiology of such behaviors. Results of two studies ( n1 = 295 SNS users, focuses on impulsive use; n2 = 336 SNS users, focuses on swearing) show that both of these online behaviors are driven, in part, by cognitive-emotional preoccupation with the SNS and inhibited, in part, by cognitive-behavioral control over using the SNS. The inhibition effect is both direct and indirect, through the suppression of the cognitive-emotional preoccupation effects. The findings provide a theoretical lens of analysis through which impulsive and unitneded media use behaviors can be explained.
Effects of wavelength, fluence, and dose on fragmentation pathways and photoproduct ion yield in 213 nm and 266 nm ultraviolet photodissociation experiments
Authors: Becher Simon , Spengler Bernhard , Heiles Sven
Published: November 2017

Ultraviolet photodissociation tandem mass spectrometry is a powerful tool to investigate the structure of biomolecules, due to its ability to generate rich fragmentation patterns or bond selective cleavage, as a function of used laser wavelength, laser fluence, dose (number of accumulated laser pulses), and available chromophores. Herein, we report first results obtained with a newly developed two-wavelength (266 nm and 213 nm) ultraviolet photodissociation setup coupled to a Fourier-transform ion cyclotron resonance mass spectrometer. Photoproduct yields for protonated 3-iodo-l-tyrosine were up to ∼75%. Dose and fluence dependent measurements for protonated 3-iodo-l-tyrosine, doubly charged protonated bradykinin and Fe(II) attached to 1,2-dioleoyl-sn-glycero-3-phosphocholine reveal that the ultraviolet photodissociation mechanism for photoproduct formation qualitatively differs between these model systems. Three derived photodissociation models were used to interpret the experimental results and show that while protonated 3-iodo-l-tyrosine and Fe(II) attached to 1,2-dioleoyl-sn-glycero-3-phosphocholine most likely dissociates via a single-photon process, fragmentation of doubly charged bradykinin ions was found to be most consistent with sequential two-photon dissociation (213 nm). The introduced dissociation models present an easy means to study the mechanism of ultraviolet photodissociation processes for a variety of analytes without prior knowledge of their photochemistry or to optimize experimental conditions by adjusting laser fluence or number of laser pulses.
Organizational Virtuousness and Work Engagement: Mediating Role of Happiness in India
Authors: Singh Sharda , David Rajasekhar , Mikkilineni Sitamma
Published: November 2017

The Problem

The positive psychology movement has led to an increased attention in organizational virtuousness, engagement, and happiness. Though attention has been devoted to studying the relationship between organizational virtuousness and performance, there is limited research that explores the relationship between employees’ perception of organizational virtuousness and work engagement.

The Solution

A cross-sectional survey was carried out on a sample of knowledge workers from diverse Indian industries. The findings of the study showed that the employees’ perception of organizational virtuousness predicts work engagement not only directly but also indirectly through happiness.

The Stakeholders

Managers can nurture organizational virtuousness in organizations to enhance employee happiness and promote a more engaged workforce. Considering the findings of the study, Human Resource Development (HRD) professionals should make the best use of their human capital by fostering positive psychological states such as work engagement.
Predictive Laboratory Findings of Lower Extremity Amputation in Diabetic Patients: Meta-analysis
Authors: Kim Jong-Lim , Shin Jin Yong , Roh Si-Gyun , Chang Suk Choo , Lee Nae-Ho
Published: November 2017

Lower extremity amputation is a source of morbidity and mortality among diabetic patients. This meta-analysis aimed to identify significant laboratory data in patients with diabetic foot ulcer with high rates of lower extremity amputation. We performed a systematic literature review and meta-analysis using MEDLINE, EMBASE, and Cochrane databases. We extracted and evaluated 11 variables from the included studies based on amputation rates. This study used the Newcastle-Ottawa Scale to assess the quality of the studies. The search strategy identified 101 publications from which we selected 16 articles for review. We identified HbA1c, fasting blood glucose, white blood cells, C-reactive protein, and erythrocyte sedimentation rate as predictive variables of higher major amputation rate. Although further investigation of long-term and prospective studies is needed, we identified 5 variables as predisposing factors for higher major amputation in diabetic patients through meta-analysis.
Ethics and Science in the Participatory Era: A Vignette-Based Delphi Study
Authors: Bromley Elizabeth , Mikesell Lisa , Khodyakov Dmitry
Published: November 2017

Participatory researchers rely on relationship-based ethical considerations to address ethical challenges, but little is known about how these considerations shape day-to-day decision-making. We presented vignettes describing ethical dilemmas to health researchers with varying degrees of experience in participatory research in an online modified-Delphi panel. Panelists rated potential solutions to dilemmas and provided rationales for choosing solutions in text boxes and discussion boards. Panelists agreed on a preferred solution for three of five vignettes. Panelists indicated that ethical research decision-making should be inclusive of diverse perspectives. Panelists prioritized scientific goals above participatory ones and viewed tenets of scientific validity as value-free. Panelists indicated that participatory research ethics would be difficult to codify, but that vignette-based learning could support didactic objectives.
Counselors as Leaders Who Advocate for Undocumented Students’ Education
Authors: Crawford Emily R. , Aguayo David , Valle Fernando
Published: November 2017

Research has yet to fully explore counselor advocacy for undocumented students and the leadership they use in their advocacy. This study asks the following questions: (1) What motivates counselors to pursue educational access for undocumented K-12 students? and (2) How do school counselors advocate for undocumented K-12 students? We integrate boundary spanning and border crossing leadership theories as a conceptual frame to offerholistic approach for leaders’ socially just and inclusive practices concerning undocumented students on the borderlands. This embedded case study uses data from eight K-12 counselors . School counseling-related organizations explicitly detail advocacy competencies and the knowledge base, abilities and skills, and attitudinal dispositions professionals must develop. Knowledge of counselors’ leadership advocacy efforts can help prepare preservice leaders and other educators to effectively support undocumented students.
For Better or for Worse? Outsourcing Self-Regulation and Goal Pursuit
Authors: Briskin Julia L. , Kopetz Catalina E. , Fitzsimons Gráinne M. , Slatcher Richard B.
Published: November 2017

In recent years, there has been increasing interest in how close relationships can impact personal goal pursuit. Extensive research on social support has shown that support often facilitates goal pursuit. However, Fitzsimons and Finkel found that perceived partner support may actually undermine motivation and decrease goal pursuit intentions. In this article, we report three well-powered studies ( N = 850) that investigated the conditions under which romantic partners may bolster or undermine goal pursuit. In contrast with the original Fitzsimons and Finkel’s findings, the results of these studies consistently showed that perceived partner support bolsters goal pursuit intentions by increasing goal commitment. Implications for successful goal pursuit in the context of relationships are discussed.
Free anterolateral thigh full-thickness skin flap with vascularized lateral femoral cutaneous nerve for the reconstruction of facial nerve and external auditory canal after the resection of facial nerve schwannoma
Authors: Karakawa Ryo , Narushima Mitsunaga , Ogishima Shinya , Hara Hisako , Karino Shotaro , Iida Takuya , Kakigi Akinobu , Koshima Isao
Published: November 2017

The complex reconstruction of nerves and soft tissue in the head and neck region is still challenging, especially in cases requiring external auditory canal reconstruction with facial nerve reconstruction. We report a case of left facial schwannoma extending into the external auditory canal beyond the tympanic membrane with facial paralysis in which the reconstruction of both the facial nerve and external auditory canal was successfully performed using an anterolateral thigh flap as a super-thin full-thickness skin flap, including vascularized lateral femoral cutaneous nerve. Resection of 20 mm × 46 mm facial schwannoma, including the skin of the external auditory canal, tympanic membrane, incus and malleus, was performed. The 8-cm nerve gap was repaired using a vascularized lateral femoral cutaneous nerve included in the anterolateral thigh flap. An 8 cm × 2 cm super-thin, free anterolateral thigh flap was then rolled up as a sac (diameter of 2 cm, height of 2 cm) and inset to the external auditory canal defect. The postoperative course was uneventful, and the flap survived completely. One year and nine months after the surgery, the patient’s facial movement has improved to the pre-surgery level.
Breath methane concentrations and markers of obesity in patients with functional gastrointestinal disorders
Authors: Wilder-Smith Clive H , Olesen Søren S , Materna Andrea , Drewes Asbjørn M
Published: November 2017

Background

Obesity is associated with changes in the intestinal microbiome and methane‐producing archaea may be involved in energy homeostasis.

Objective

The objective of this article is to investigate the associations between intestinal methane production, waist circumference and body mass index (BMI) as biomarkers for obesity.

Methods

Breath methane and hydrogen concentrations were measured over five hours following fructose or lactose ingestion in 1647 patients with functional gastrointestinal disorders. The relationships between gas concentrations and measures of obesity were investigated by stratifying gas concentration‐time profiles by BMI and waist circumference, and, conversely, BMI and waist circumference by peak breath hydrogen and methane concentrations.

Results

Following fructose ingestion, patients with lower BMI and lesser waist circumference had greater breath methane concentrations (all p < 0.003). Conversely, patients with increased methane concentrations had lower BMI (p < 0.001) and waist circumference (p = 0.02). After lactose ingestion, BMI and waist circumference were not associated with significant differences in methane. However, greater methane concentrations were associated with a lower BMI (p < 0.002), but not with waist circumference.

Conclusion

In this large group of patients mainly negative associations between breath methane concentrations and anthropometric biomarkers of obesity were evident. Studies investigating microbial methane production and energy homoeostasis in different populations are of substantial interest to distinguish epiphenomena from true causality.

A follow‐up study was registered at Clinical trials.gov NCT02085889.
Did anthropogeology anticipate the idea of the Anthropocene?
Authors: Häusler Hermann
Published: November 2017

The term anthropogeology was coined in 1959 by the Austrian geologist Heinrich Häusler. It was taken up by the Swiss geologist Heinrich Jäckli in 1972, and independently introduced again by the German geologist Rudolf Hohl in 1974. Their concept aimed at mitigating humankind’s geotechnical and ecological impact in the dimension of endogenic and exogenic geologic processes. In that context anthropogeology was defined as the scientific discipline of applied geology integrating sectors of geosciences, geography, juridical, political and economic sciences as well as sectors of engineering sciences. In 1979 the German geologist Werner Kasig newly defined anthropogeology as human dependency on geologic conditions, in particular focusing on building stone, aggregates, groundwater and mineral resources. The severe problems of environmental pollution since the 1980s and the political relevance of environmental protection led to the initiation of the discipline ‘environmental geosciences’, which – in contrast to anthropogeology – was and is taught at universities worldwide.
Racial and Ethnic Disparities in Prison Admissions Across Counties: An Evaluation of Racial/Ethnic Threat, Socioeconomic Inequality, and Political Climate Explanations
Authors: Durante Katherine A.
Published: November 2017

Previous macro-level studies of racial and ethnic disparities in prison admissions have focused narrowly on differences in offending and have limited their analyses to national- and state-level data. This study explores three alternative explanations for inequality in prison admissions for Blacks and Latinos compared to Whites: racial/ethnic threat, socioeconomic inequality, and the political and legal climate. I analyze data from multiple county- and state-level sources and employ hierarchical linear modeling techniques to examine the role of both county- and state-level factors in producing inequality in county-level prison admission rates. Findings indicate that Black–White disparities are lower in jurisdictions with greater shares of Black citizens; however, the reverse is true for Latino–White inequality. For both comparisons, political conservatism is associated with less inequality. Results also indicate that counties with greater parity in income and employment across race/ethnicity and that are located in the South have reduced racial/ethnic disparities in prison admissions. I argue that the presence of large shares of African Americans and of Republican voters, in addition to southern location, are likely better indicators of total prison admission rates than of racial/ethnic disparities in prison admissions.
Leveraging the Multiple Lenses of Psychological Science to Inform Clinical Decision Making: Introduction to the Special Section
Authors: Marsh Jessecae K. , De Los Reyes Andres , Lilienfeld Scott O.
Published: November 2017

Understanding how clinicians and laypeople make critical decisions related to the assessment, diagnosis, and treatment of mental health is an important step toward improving mental healthcare. This Special Section features new research that, collectively, leverages interdisciplinary approaches from basic psychological science to enhance our understanding of clinical decision making. In this “Introduction to the Special Section,” we illustrate how three tasks integral to clinical decision making (assessment, diagnosis, and treatment selection) can be reframed as specific examples of more basic cognitive processes. We conclude by highlighting challenges to conducting interdisciplinary research on clinical decision making, by providing an overview of the contributions in this Special Section, and by presenting a list of essential readings on clinical decision making.
Gaze Following Is Related to the Broader Autism Phenotype in a Sex-Specific Way: Building the Case for Distinct Male and Female Autism Phenotypes
Authors: Whyte Elisabeth M. , Scherf K. Suzanne
Published: November 2017

The search for a female autism phenotype is difficult, given the low diagnostic rates in females. Here, we studied potential sex differences in a core feature of autism, difficulty with eye gaze processing, among typically developing individuals who vary in the broad autism phenotype, which includes autistic-like traits that are common, continuously distributed, and similarly heritable in males and females. Participants viewed complex images of an actor in a naturalistic scene looking at one of many possible objects and had to identify the target gazed-at object. Among males, those high in autistic-like traits exhibited worse eye gaze following performance than did those low in these traits. Among females, eye gaze following behavior did not vary with autistic-like traits. These results suggest that deficient eye gaze following behavior is part of the broader autism phenotype for males, but may not be a part of the female autism phenotype.
Perceived comfort during minor hand surgeries with wide awake local anaesthesia no tourniquet (WALANT) versus local anaesthesia (LA)/tourniquet
Authors: Gunasagaran Jayaletchumi , Sean Ee Soon , Shivdas Sachin , Amir Shams , Ahmad Tunku Sara
Published: November 2017

Purpose:

Minor hand surgeries can be done under field sterility in procedure rooms. Surgeons are still sceptical about the usage of wide awake local anaesthesia no tourniquet (WALANT) technique. They perceive that patients can tolerate tourniquet for a brief period while they perform minor surgeries under local anaesthesia (LA). We compared the perceived comfort experienced by patients during minor hand surgeries with WALANT and LA/tourniquet. We investigated the difference in preoperative preparation time, operating time and blood loss between the two groups.

Methods:

Between July and October 2016, a total of 72 patients were diagnosed with carpal tunnel syndrome, trigger finger or ganglion, at the University Malaya Medical Centre. Forty patients consented to participate in this study and were randomized into WALANT and LA/tourniquet groups. Anaesthesia was administered accordingly and tourniquet was applied. The time taken for preoperative preparation and surgery was recorded. Each surgeon estimated the blood loss. The perceived comfort level of each patient was quantified using a visual analogue score (VAS). Data were analysed using SPSS.

Results:

The mean VAS for the WALANT group was 2.33 ± 1.94, whereas it was 4.72 ± 3.05 for the LA/tourniquet group, and the difference was statistically significant ( p < 0.05). The mean time for preoperative preparation in WALANT group was 19.17 ± 12.61 min and LA/tourniquet group was 7.05 ± 3.44 min. The difference between these groups was statistically significant ( p < 0.01). There was no significant difference in operating time and blood loss.

Conclusion:

WALANT technique was associated with better patient comfort. Tourniquet was the main reason for discomfort during surgeries. WALANT is an alternative in minor hand surgeries for a bloodless surgical field without the discomfort of tourniquet application.
Flexion Gap in the Isolated Posterior Cruciate Ligament–Injured Knee Affects Symptom Relief After Conservative Treatment: A Case-Control Study
Authors: Yonetani Yasukazu , Matsui Yoshio , Tanaka Yoshinari , Horibe Shuji
Published: November 2017

Background:

The posterior cruciate ligament (PCL) is a primary stabilizer of the knee in the posterior direction. However, PCL deficiency presents a clinical paradox because the outcome of PCL deficiency ranges from total disability to uninterrupted participation in competitive athletics.

Purpose:

To investigate whether posterior laxity (PL) and the flexion gap (FG) influence the results of the conservative treatment of isolated PCL injuries.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 27 patients (23 men, 4 women; mean age, 33 ± 14 years) with isolated PCL injuries between 2007 and 2013 were included in this study. All patients had been treated conservatively for more than 6 months. Nineteen patients achieved excellent relief of their symptoms (conservative treatment [C] group). Eight patients underwent PCL reconstruction owing to their symptoms (surgical treatment [S] group). Side-to-side differences of the FG and the PL were retrospectively measured on axial radiographs and on lateral radiographs with gravity sag views, respectively, and the degree of PCL injury was graded as I (PL, <5 mm) in 7 patients and II (PL, 5 to <10 mm) in 20 patients.

Results:

The mean PL and FG were 6.9 ± 2.5 mm and 2.0 ± 1.8 mm, respectively. A mild positive correlation between the PL and the FG was observed ( r = 0.47, P = .02). The mean PL and FG were 6.5 ± 2.9 mm and 1.2 ± 1.0 mm in the C group and 7.7 ± 1.3 mm and 3.8 ± 2.0 mm in the S group, respectively. The FG in the C group was significantly smaller than that in the S group ( P < .05), although there was no significant difference between the groups for PL. All patients with grade I injury belonged to the C group, for which the FG was less than 2 mm in all cases. Eight of the patients with grade II injury were in the S group, and their FG was more than 2 mm, except in 1 patient. The FG performed better with an area under the receiver operating characteristic curve of 0.924 (95% CI, 0.000-1.000) compared with 0.599 (95% CI, 0.388-0.809) for the PL. Discrimination between the C and S groups with a cutoff set at 2.30 mm for the FG and 7.45 mm for the PL showed a sensitivity of 75.0% and 75.0% and a specificity of 89.5% and 52.6%, respectively.

Conclusion:

Considering that the FG affects the outcome of conservative treatment, it could be a factor in the indication for the surgical treatment of isolated PCL injuries.
Early expressive and receptive language trajectories in high-risk infant siblings of children with autism spectrum disorder
Authors: Longard Julie , Brian Jessica , Zwaigenbaum Lonnie , Duku Eric , Moore Chris , Smith Isabel M , Garon Nancy , Szatmari Peter , Vaillancourt Tracy , Bryson Susan
Published: November 2017

Background & aims

In response to limited research on early language development in infants at high risk for Autism Spectrum Disorder (ASD), the current prospective study examined early expressive and receptive language trajectories in familial high-risk (HR) infants who were and were not later diagnosed with ASD (HR-ASD and HR-N, respectively), and low-risk (LR) controls with no family history of ASD.

Methods

Participants were 523 children (371 HR siblings, 56% boys; 152 LR controls, 52% boys) followed from age 6 or 12 months to 36 months. Based on independent, best-estimate clinical diagnoses at 36 months, HR participants were classified as HR-ASD (n = 94; 69% boys), or HR-N (n = 277; 52% boys); the sample also included 152 LR controls (52% boys). Expressive and receptive language trajectories were examined based on corresponding domain standard scores on the Mullen Scales of Early Learning ( MSEL) at 6, 12, 24, and 36 months. In the combined sample of HR and LR infants, semi-parametric group-based modeling was used to identify distinct trajectories in MSEL standard scores.

Results

A 3-group solution provided optimal fit to variation in both expressive and receptive language, with the following patterns of scores: (1) inclining from average to above average, (2) stable-average, and (3) declining from average to well below average. For both expressive and receptive language, membership in these trajectories was related to 3-year diagnostic outcomes.

Conclusions

Although HR-ASD, HR-N, and LR control infants were in each trajectory group, membership in the declining trajectory (expressive and/or receptive) was associated with an ASD diagnosis.

Implications

Evidence of declining trajectories in either expressive or receptive language may be a risk marker for ASD in a high-risk sample.
European Stroke Organisation (ESO) guidelines on glycaemia management in acute stroke
Authors: Fuentes Blanca , Ntaios George , Putaala Jukka , Thomas Brenda , Turc Guillaume , Díez-Tejedor Exuperio ,   for the European Stroke Organisation
Published: November 2017

Background

Hyperglycaemia is a frequent complication in acute stroke that has been shown to be independently associated with larger infarct size, haematoma growth, poor clinical outcome and mortality. This Guideline Document presents the European Stroke Organisation (ESO) Guidelines for the management of blood glucose levels in patients with acute ischemic or haemorrhagic stroke.

Methods

The working group identified related questions and developed its recommendations based on evidence from randomised controlled trials following the standard operating procedure of the ESO. This Guideline Document was reviewed and approved by the European Stroke Organisation Guidelines Committee and the European Stroke Organisation Executive Committee.

Results

We found low-quality evidence from clinical trials in ischemic or haemorrhagic stroke exploring the use of intravenous insulin aimed to achieve a tight glycaemic control with different glucose level targets and several other sources of heterogeneity. None of these trials neither the meta-analysis of them have demonstrated any significant benefit of tight glycaemic control with intravenous insulin in acute ischemic or haemorrhagic stroke patients on functional outcome or in survival and they have shown an increased risk for hypoglycaemia.

Conclusions

We suggest against the routine use of tight glycaemic control with intravenous insulin as a means to improve outcomes. The currently available data about the management of glycaemia in patients with acute stroke are limited and the strengths of the recommendations are therefore weak. Nevertheless, this does not prevent that hyperglycaemia in acute stroke patients could be treated as any other hospitalised patient.
Contributions of Function-Altering Variants in Genes Implicated in Pubertal Timing and Body Mass for Self-Limited Delayed Puberty
Authors: Howard Sasha R , Guasti Leonardo , Poliandri Ariel , David Alessia , Cabrera Claudia P , Barnes Michael R , Wehkalampi Karoliina , O’Rahilly Stephen , Aiken Catherine E , Coll Anthony P , Ma Marcella , Rimmington Debra , Yeo Giles S H , Dunkel Leo
Published: November 2017

Context

Self-limited delayed puberty (DP) is often associated with a delay in physical maturation, but although highly heritable the causal genetic factors remain elusive. Genome-wide association studies of the timing of puberty have identified multiple loci for age at menarche in females and voice break in males, particularly in pathways controlling energy balance.

Objective/Main Outcome Measures

We sought to assess the contribution of rare variants in such genes to the phenotype of familial DP.

Design/Patients

We performed whole-exome sequencing in 67 pedigrees (125 individuals with DP and 35 unaffected controls) from our unique cohort of familial self-limited DP. Using a whole-exome sequencing filtering pipeline one candidate gene [fat mass and obesity–associated gene (FTO)] was identified. In silico, in vitro, and mouse model studies were performed to investigate the pathogenicity of FTO variants and timing of puberty in FTO+/− mice.

Results

We identified potentially pathogenic, rare variants in genes in linkage disequilibrium with genome-wide association studies of age at menarche loci in 283 genes. Of these, five genes were implicated in the control of body mass. After filtering for segregation with trait, one candidate, FTO, was retained. Two FTO variants, found in 14 affected individuals from three families, were also associated with leanness in these patients with DP. One variant (p.Leu44Val) demonstrated altered demethylation activity of the mutant protein in vitro. Fto+/− mice displayed a significantly delayed timing of pubertal onset (P < 0.05).

Conclusions

Mutations in genes implicated in body mass and timing of puberty in the general population may contribute to the pathogenesis of self-limited DP.
Unadjusted Bivariate Two-Group Comparisons: When Simpler is Better
Authors: Vetter Thomas R. , Mascha Edward J.
Published: November 2017

Hypothesis testing involves posing both a null hypothesis and an alternative hypothesis. This basic statistical tutorial discusses the appropriate use, including their so-called assumptions, of the common unadjusted bivariate tests for hypothesis testing and thus comparing study sample data for a difference or association. The appropriate choice of a statistical test is predicated on the type of data being analyzed and compared. The unpaired or independent samples t test is used to test the null hypothesis that the 2 population means are equal, thereby accepting the alternative hypothesis that the 2 population means are not equal. The unpaired t test is intended for comparing dependent continuous (interval or ratio) data from 2 study groups. A common mistake is to apply several unpaired t tests when comparing data from 3 or more study groups. In this situation, an analysis of variance with post hoc (posttest) intragroup comparisons should instead be applied. Another common mistake is to apply a series of unpaired t tests when comparing sequentially collected data from 2 study groups. In this situation, a repeated-measures analysis of variance, with tests for group-by-time interaction, and post hoc comparisons, as appropriate, should instead be applied in analyzing data from sequential collection points. The paired t test is used to assess the difference in the means of 2 study groups when the sample observations have been obtained in pairs, often before and after an intervention in each study subject. The Pearson chi-square test is widely used to test the null hypothesis that 2 unpaired categorical variables, each with 2 or more nominal levels (values), are independent of each other. When the null hypothesis is rejected, 1 concludes that there is a probable association between the 2 unpaired categorical variables. When comparing 2 groups on an ordinal or nonnormally distributed continuous outcome variable, the 2-sample t test is usually not appropriate. The Wilcoxon-Mann-Whitney test is instead preferred. When making paired comparisons on data that are ordinal, or continuous but nonnormally distributed, the Wilcoxon signed-rank test can be used. In analyzing their data, researchers should consider the continued merits of these simple yet equally valid unadjusted bivariate statistical tests. However, the appropriate use of an unadjusted bivariate test still requires a solid understanding of its utility, assumptions (requirements), and limitations. This understanding will mitigate the risk of misleading findings, interpretations, and conclusions.
The Use of Liposomal Bupivacaine in Erector Spinae Plane Block to Minimize Opioid Consumption for Breast Surgery: A Case Report
Authors: Kumar Amanda , Hulsey Alina , Martinez-Wilson Hector , Kim James , Gadsden Jeff
Published: November 2017

The erector spinae plane block is a novel interfascial plane block that can provide thoracic and abdominal analgesia. We describe a patient with opioid intolerance scheduled for breast surgery who received an erector spinae plane block with liposomal bupivacaine as well as a supplemental T1 paravertebral block resulting in profound analgesia throughout her postoperative course. This case report demonstrates that use of liposomal bupivacaine in the erector spinae plane block can be successful in providing extended duration postoperative analgesia and minimizing systemic opioid requirements.
Adsorption of bacteria by soil and its epidemiological significance: monograph
Authors: Кисленко Виктор , Kislenko Viktor
Published: November 2017

This monograph discusses General regularities of adsorption of microorganisms on solid surfaces and soil. Presents modern data on the physiological and physical phenomena occurring in the process of adsorption of bacteria by soil. The regularities of adsorption of certain types of bacteria. The efficiency of the adsorbent zeolite for the correction of microbiota intestine of chickens and the epidemiological role of adsorption of pathogenic micro-organisms in soils.
The book is addressed to specialists in the field of Microbiology and to students of biological and medical faculties of the universities.
Vitamin D screening in patients with inflammatory bowel disease
Authors: Fletcher Jane , Swift Amelia
Published: November 2017

Patients with inflammatory bowel disease (IBD) are at increased risk of developing vitamin D deficiency for a variety of reasons. However, it is not routine practice to monitor vitamin D levels in these patients. In all patients, deficiency is most likely to be evident at the end of winter or early spring. This article describes a retrospective audit carried out to determine whether vitamin D serum levels had been measured in 100 randomly selected outpatients during late winter/early spring 2015, and then to identify the prevalence of deficiency in patients who had been screened. The main results showed that, overall, only 20% of patients with Crohn's disease (CD) and 8% of patients with ulcerative colitis (UC) had a vitamin D result recorded. Of these, 80% of the patients with CD and 75% of the patients with UC had insufficient levels of vitamin D (<20 ng/ml), compared with 47% of healthy controls shown in other studies. This audit shows that very few IBD patients had their vitamin-D levels measured; however. the prevalence of insufficiency was high.
Inspection: After the call has come…
Authors: David Anthony
Published: November 2017

With both of his schools having faced inspection recently, headteacher Anthony David offers his advice on preparing for inspection, handling the inspection itself, and the aftermath. In the second article in this series, he focuses on the inspection itself and what to expect after receiving the call…
Influence of major histocompatibility complex (MHC) on human mating preferences
Authors: Kulshrestha Anvita
Published: November 2017

Several studies related to vertebrates have revealed that highly polymorphic genes within the Major Histocompatibility Complex (MHC) may play a role in mate choice. Females gain direct or indirect fitness benefits by choosing between males with traits that are expressed from good genes, as females can obtain good genes for their offspring by mating with males whose genes are compatible or complementary to their own. There is a tendency for humans to prefer MHC-dissimilar mates, as it would favour the production of heterozygous offspring who would be more resistant to pathogens. This phenomenon has been reviewed on the similar concepts of the influence of MHC genes on human mating preferences, with potential but largely unknown in offspring fitness. The qualitative method can include surveying and interviewing people about their mate choices i.e. females select males with heterozygosity MHC genes over males with homozygous MHC genes. Chi-square test can be performed for statistical analysis. Mating with a MHC dissimilar individual can produce MHC heterozygous offspring that has strong immunocompetence against several parasite types. A heterozygous MHC gene combination has more capability to identify rapidly evolving parasites, which can escape recognition by immune systems containing common alleles.Plusieurs études reliées aux vertébrés ont révélé que les gènes extrêmement polymorphes au sein du complexe majeur d’histocompatibilité (MHC) peuvent jouer un rôle dans le choix d’un partenaire. Les femmes tirent des avantages directs ou indirects de valeur sélective en choisissant entre les hommes dont les traits sont exprimés avec les bons gènes, comme les femmes peuvent obtenir de bons gènes pour leur progéniture par accouplement avec des mâles dont les gènes sont compatibles ou complémentaires à leurs propres. Il y a une tendance pour les humains de préférer les camarades MHC-dissemblables, car ceci favoriserait la production de descendants hétérozygotes qui seraient plus résistants aux pathogènes. Ce phénomène était étudié sur les concepts similairesde l’influence des gènes du MHC sur les préférences d’accouplement humaines, avec un potentiel largement inconnu dans la valeur sélective de la progéniture. La méthode qualitative peut comprendre une enquête et l’interrogation des gens sur leur choix de partenaire, par ex. les femelles choisissent les mâles avec des gènes du CMH hétérozygote sur les hommes ayant des gènes du CMH homozygotes. Le test du chi carré peut être effectué pour faire l’analyse statistique. L’accouplement avec une personne avec un différent CMH peut produire la progéniture CMH hétérozygote qui a une forte immunocompétence contre plusieurs types de parasites. Une combinaison de gènes CMH hétérozygotes a plus de capacité d’identifier les parasites qui évoluent rapidement, qui peuvent échapper à la reconnaissance par le système immunitaire contenant des allèles communs.