bluuebunny/crossref_metadata_2025 huggingface dataset:
Antithrombin-III-Mangel und Thrombophilie
Authors: Thaler E.
Published: June 2018

IV. Zusammenfassende Betrachtungen

Im ersten Teil der Übersichtsarbeit wurden vier pathogenetisch unterschiedliche Formen eines vergleichbar schweren AT-III-Mangels vorgestellt.

Am besten läßt sich anhand des angeborenen, autosomal dominant vererbten AT-III-Mangels die Beziehung zwischen niedrigen Plasma-ATIII-Spiegeln und Thromboserisiko ableiten, da es sich hier um eine isolierte Störung handelt. Das Hämostasegleichgewicht ist hier einseitig durch eine geringere Gerinnungshemmung gestört. Als Ausdruck dieses Ungleichgewichts resultieren fast ausschließlich schwere venöse thromboembolische Ereignisse, jedoch gelegentlich erst nach jahrzehntelanger

Latenz. Eine weitere wichtige Erkenntnis ist, wenn AT III nicht substituiert wird, die Unwirksamkeit einer Behandlung mit Heparin bei thromboembolischen Ereignissen, jedoch eine volle prophylaktische Wirksamkeit peroraler Antikoagulantien vom Kumarintyp, offenbar durch eine Wiederherstellung des hämostatischen Gleichgewichts auf niedrigerem Niveau.

Ein hämostatisches Gleichgewicht auf niedrigerem Niveau scheint auch bei der fortgeschrittenen Leberzirrhose vorzuliegen, da trotz schwerem ATIII-Mangel das Thromboserisiko nicht erhöht ist. Dieses Gleichgewicht ist aber leichter störbar, auf relativ geringe gerinnungsfördernde Stimuli reagieren diese Patienten gehäuft mit einer VK.

Am Beispiel des schweren nephrotischen Syndroms, bei welchem das Hämostasegleichgewicht zuungunsten des AT III und zugunsten gerinnungsfördernder Faktoren verändert ist, läßt sich eine im Vergleich zum angeborenen AT-III-Mangel wesentlich höhere Thromboseneigung nachweisen.

Bei der Septikämie mit vergleichbar schwerem AT-III-Mangel ist über das Thromboserisiko zu wenig bekannt. Nach bisherigen Erkenntnissen herrscht hier die klinisch und therapeutisch nicht weniger relevante DIG mit ihren sehr komplexen Hämostaseveränderungen vor.

Im folgenden Teil der Arbeit wurde auf einige Zustände mit evidenter Thromboseneigung eingegangen, bei denen nicht sicher eine Beziehung zu einem entsprechend schweren AT-III-Mangel gefunden werden konnte, wie die Einnahme östrogenhaltiger Kontrazeptiva, größere chirurgische Eingriffe und maligne Tumoren. Interessanterweise ist bei diesen Zuständen eine Prophylaxe oder Therapie mit Heparin zumeist wirksam.
Tumorprokoagulans, Gerinnung und Fibrinolyse bei malignen Erkrankungen
Authors: Gordon Stuart
Published: June 2018

Es muß betont werden, daß das Gerinnungssystem einschließlich der Ablagerung und Auflösung von Fibrin wahrscheinlich eine bedeutende Rolle bei der Tumorkrankheit spielt. Beim Tumorprokoagulans handelt es sich um eine Zystein-Proteinase maligner Zellen, die die Gerinnung zu aktivieren vermag und somit eine Rolle bei der Hyperaktivität des Gerinnungssystems bei Tumorkranken spielen könnte.
Klinische, biochemische und zytomorphometrische Aspekte zur Thrombozytopenie und Thrombozytopathie bei Leberzirrhose
Authors: Scharf R. E. , Schneider W.
Published: June 2018

Die bei chronischen Lebererkrankungen, insbesondere bei Leberzirrhose häufig vorhandene Erniedrigung der peripheren Thrombozytenzahl scheint primär durch das Nebeneinanderbestehen einer Verteilungsstörung zwischen lienalem und zirkulierendem Plättchenpool (mit einer vermehrten Sequestration der Thrombozyten in der Milz) und einer verkürzten Thrombozytenüberlebenszeit (infolge eines gesteigerten Abbaus im Monozyten-Makrophagen-System der Milz) zustande zu kommen. Der immer wieder diskutierte Mechanismus einer schleichenden Verbrauchsko-agulopathie mit intravaskulärem Plättchenabbau und Mikrothrombosierung als Ursache der Thrombozytopenie konnte von uns für Patienten mit schwerer, aber stabiler Leberzirrhose widerlegt werden. Findet man bei schwerer Leberzirrhose trotz lienaler Plättchensequestration und verkürzter Thrombozytenüberlebenszeit normale oder nur gering erniedrigte Thrombozytenzahlen, so kann man davon ausgehen, daß bei diesen Patienten der Plättchenverbrauch durch eine gesteigerte Thrombozytenbildung im Knochenmark kompensiert wird. Mit fortschreitender Dauer und Schwere der chronischen Lebererkrankung scheint jedoch eine sekundäre Bildungsstörung im Knochenmark als eine Ursache für die zunehmende Thrombozytopenie verantwortlich zu sein. Die herabgesetzte Thrombozytopoese läßt sich durch eine unzureichende zyto-plasmatische Ausreifung von Megakaryozyten charakterisieren. Außerdem liegen Hinweise einer zirrhoseinduzierten Stoff Wechselveränderung vor, die zu einer Hemmung der Thrombozytopoese im Knochenmark bzw. zu einer Megakaryozytenreifungsstörung führen könnte. Eine metabolische Störung wie der von uns erbrachte Nachweis eines abnormen Sialinsäurebestandes der Blutplättchen läßt sich auch als eine mögliche Ursache der häufig vorhandenen Thrombozytopathie bei Leberzirrhose interpretieren.
Faktor-VII-Mangel und Varianten
Authors: Patrassi G. , Fabris F. , Vicarioto M. A. , Girolami A.
Published: June 2018

Die kongenitalen und erworbenen Faktor-VII-Mangelzustände und Varianten sind jetzt gut bekannte klinische Einheiten. Der kongenitale Faktor-VII-Mangel ist eine autosomal inkomplett rezessiv vererbte Erkrankung. Er ist charakterisiert durch den Mangel an Faktor-VII-Aktivität und Faktor-VII-Antigen (echter Mangel) oder durch den Mangel an Aktivität und verschiedene Mengen von Antigen (Variante oder abnorme Formen). Außerdem zeigen einige Patienten mit normalem Faktor-VII-Antigen eine unterschiedliche Reaktivität mit verschiedenen Gewebethrombo-plastinen. Faktor VII Padua z.B. zeigt eine normale Reaktivität mit Ochsenhirn-Thromboplastin und eine niedrige Aktivität mit Kaninchenhirn-Thromboplastin. Die Klassifizierung des kongenitalen Faktor-VII-Defektes muß daher beide Fakten berücksichtigen, nämlich das Fehlen oder die Gegenwart von Antigen (VII_, VIIred und VII+) und die Reaktivität mit Gewebethromboplastin verschiedener Herkunft. Die Blutungsmanifestationen sind variabel und nicht spezifisch. In schweren Fällen sind Hämarthro-sen beschrieben worden. Bei manchen Patienten ist die Blutungsneigung mild. Gelegentlich sind auch thrombo-embolische Manifestationen beschrieben worden, was bedeutet, daß ein Mangel an Faktor VII kein Schutz gegen thrombotische Phänomene ist. Die Diagnose des Faktor-VII-Defekts basiert auf dem Nachweis einer verlängerten Prothrombinzeit gemeinsam mit einer normalen partiellen Throm-boplastinzeit und Stypven-Cephalin-Gerinnungszeit. Der Faktor-VII-Aktivitätstest kann unterschiedlich stark vermindert sein und Gewebethrombo-plastine verschiedener Herkunft sollten in diesem Test verwendet werden. Bei Fällen mit klassischem Mangel wird keine sichere Diskrepanz bei Verwendung verschiedener Thromboplastine beobachtet. Ein immunologischer Test ist notwendig, wenn eine Diskrepanz von mehr als 15% bei einem Faktor-VII-Aktivitätsspiegel von 40-60% der Norm erhalten wird und die Patienten vollständig asymptomatisch sind. Die Substitutionstherapie beruht auf der Verabreichung von Plasma, Prothrombinkomplex-Konzentraten und Faktor-VII-Kon-zentraten. Eine große Häufigkeit von Virushepatitis scheint die Verwendung der Faktor-VII-Konzentrate einzuschränken. Erworbene Faktor-VII-Defekte sind mit dem Mangel an anderen Faktoren des Prothrombinkom-plexes verbunden.
Assessment of Individuals with Primary Progressive Aphasia
Authors: Grasso Stephanie , Henry Maya
Published: June 2018

Speech–language pathologists play a crucial role in the assessment and treatment of individuals with primary progressive aphasia (PPA). The speech–language evaluation is a critical aspect of the diagnostic and rehabilitative process, informing differential diagnosis as well as intervention planning and monitoring of cognitive-linguistic status over time. The evaluation should include a thorough case history and interview and a detailed assessment of speech–language and cognitive functions, with tasks designed to detect core and associated deficits outlined in current diagnostic criteria. In this paper, we review assessments that can be utilized to examine communication and cognition in PPA, including general aphasia batteries designed for stroke and/or progressive aphasia as well as tests of specific cognitive-linguistic functions, including naming, object/person knowledge, single-word and sentence comprehension, repetition, spontaneous speech/language production, motor speech, written language, and nonlinguistic cognitive domains. The comprehensive evaluation can inform diagnostic decision making and facilitate planning of interventions that are tailored to the patient's current status and likely progression of deficits. As such, the speech–language evaluation allows the medical team to provide individuals with PPA and their families with appropriate recommendations for the present and the future.
Treatment for Lexical Retrieval Impairments in Primary Progressive Aphasia: A Research Update with Implications for Clinical Practice
Authors: Croot Karen
Published: June 2018

Lexical retrieval impairments (also known as anomia or word-finding deficits) are an early and prominent symptom in primary progressive aphasia (PPA), causing distress and frustration to individuals with PPA and their communication partners, and prompting research on lexical retrieval treatment. This paper reviews the research on lexical retrieval treatment in PPA from the earliest reports in the 1990s to early 2018 and considers the implications of this research for clinical practice. The number of published studies has increased markedly over the past decade, consisting primarily of behavioral studies, with rapid recent growth in noninvasive brain stimulation studies. Five general treatment techniques were identified in the behavioral studies, described here as standard naming treatment, Look, Listen, Repeat treatment, cueing hierarchies, semantically focused treatments, and lexical retrieval in context. Across techniques, behavioral studies targeting difficult-to-retrieve items typically report immediate gains, and there is evidence these gains can be maintained over months to years by some participants who continue with long-term treatment. There is also evidence that prophylactic treatment supports retrieval of treated items compared with untreated items. There is limited evidence for generalization of treatment to untreated items, suggesting the primary aim of lexical retrieval treatment in this population is to maintain retrieval of a core vocabulary for as long as possible. Language and cognitive assessment and piloting of the intended treatment can inform decisions about treatment selection and participant suitability for long-term lexical retrieval treatment. The paper concludes with some questions to guide clinical decision making about whether to implement or continue with a behavioral lexical retrieval treatment.
Stress Fracture of Proximal Femur after Hip Resurfacing Treated with Cannulated Screw
Authors: Fabbri Daniele , Orsini Riccardo , Moroni Antonio
Published: June 2018

Stress fractures of the proximal femur are described in athletes and military personnel. In most cases, they are not treated surgically, except when they are at the top of the femoral neck and with cortical involvement. The return to sports is not recommended in patients with hip replacement, especially for the high rate of revision of implants in the younger patients. One of the major complications of hip resurfacing (HR) is the medial fracture of the femoral neck, which usually occurs within 9 weeks after surgery. The causes have to be attributed to a malposition of the femoral component or to an insufficient bone density. The case reported herein is unique because it describes a stress fracture on patient operated with HR, treated with screw fixation. Two years after surgery, the patient returned to his normal life, practicing sports, without progression of varus angulation of the stem.
Risk-Assessment of Esophageal Surgery: Diagnosis and Treatment of Celiac Trunk Stenosis
Authors: Lammerts Rosa , van Det Marc , Geelkerken Rob , Kouwenhoven Ewout
Published: June 2018

Anastomotic leakage of the gastric conduit following surgical treatment of esophageal cancer is a life-threatening complication. An important risk factor associated with anastomotic leakage is calcification of the supplying arteries of the gastric conduit. The patency of calcified splanchnic arteries cannot be assessed on routine computed tomography (CT) scans for esophageal cancer and, as such, in selected patients with known or assumed mesenteric artery disease, additional CT angiography of the abdominal arteries with 1 mm slices is strongly encouraged. If the mesenteric perfusion is compromised in patients with resectable esophageal cancer, angioplasty procedures with stenting of the mesenteric arteries could be performed to prevent possible ischemia of the gastric conduit.
Psychoonkologische Versorgungsangebote: Noch viel Luft nach oben
Authors: Heim Thomas
Published: June 2018

Fortschritte in der Krebstherapie haben zur Folge, dass es heute immer mehr sog. Langzeit-Überleber gibt. Die perspektivische Erhaltung von Lebensqualität jenseits der reinen Tumorbekämpfung rückt damit immer stärker in den Vordergrund. Auf dem Deutschen Krebskongress diskutierte man darüber, ob die derzeitige onkologische Versorgungslandschaft diesen Maßgaben gerecht wird. Hier liegen offenbar Licht und Schatten noch eng nebeneinander.
Lebensqualität bei Patienten mit myeloproliferativen Neoplasien
Authors: Vollmer Helga
Published: June 2018

Das 2. Studientreffen der German Study Group für Myeloproliferative Neoplasien (GSG-MPN) fand in Ulm statt. Die Teilnehmer informierten sich über das wissenschaftliche Programm der GSG-MPN, den aktuellen Stand der Studien und neue Projekte.
Roy Kühne über die kommenden vier Jahre – „Es ist richtig, von den Kassen 60 Prozent mehr zu fordern“
Authors: Kühne Roy
Published: June 2018

Seit Roy Kühne als Physiotherapeut im Bundestag sitzt, erfahren die Anliegen der Therapieberufe mehr bundespolitische Aufmerksamkeit. Er bezeichnet die Situation der niedergelassenen Therapeuten als prekär. Wenn es nach ihm ginge, müssten die Krankenkassen die therapeutischen Leistungen deutlich besser vergüten. Das zahle sich auch für die Gesellschaft aus.
The impact of individual heterogeneity on the coupled awareness-epidemic dynamics in multiplex networks
Authors: Pan Yaohui , Yan Zhijun
Published: June 2018

Awareness of disease outbreaks can trigger changes in human behavior and has a significant impact on the spread of epidemics. Previous studies usually considered the coupled awareness-epidemic dynamics to be two competing processes that interact in the information and epidemic layers. However, these studies mostly assumed that all aware individuals have the same reduced infectivity and that different neighbors have the same influence on one's perception, ignoring the heterogeneity of individuals. In this paper, we propose a coupled awareness-epidemic spreading model in multiplex networks incorporating three types of heterogeneity: (1) the heterogeneity of individual responses to disease outbreaks, (2) the influence heterogeneity in the epidemic layer, and (3) the influence heterogeneity in the information layer. The theoretical analysis shows that the influence heterogeneity in the information layer has two-stage effects on the epidemic threshold. Moreover, we find that the epidemic threshold in the higher stage depends on the heterogeneity of individual responses and the influence heterogeneity in the epidemic layer, while the epidemic threshold in the lower stage is independent of awareness spreading and individual behaviors. The results give us a better understanding of how individual heterogeneity affects epidemic spreading and provide some practical implications for the control of epidemics.
A local environment descriptor for machine-learned density functional theory at the generalized gradient approximation level
Authors: Ji Hyunjun , Jung Yousung
Published: June 2018

We propose a grid-based local representation of electronic quantities that can be used in machine learning applications for molecules, which is compact, fixed in size, and able to distinguish different chemical environments. We apply the proposed approach to represent the external potential in density functional theory with modified pseudopotentials and demonstrate its proof of concept by predicting the Perdew-Burke-Ernzerhof and local density approximation electronic density and exchange-correlation potentials by kernel ridge regression. For 16 small molecules consisting of C, H, N, and O, the mean absolute error of exchange-correlation energy was 0.78 kcal/mol when trained for individual molecules. Furthermore, the model is shown to predict the exchange-correlation energy with an accuracy of 3.68 kcal/mol when the model is trained with a small fraction (4%) of all 16 molecules of the present dataset, suggesting a promising possibility that the current machine-learned model may predict the exchange-correlation energies of an arbitrary molecule with reasonable accuracy when trained with a sufficient amount of data covering an extensive variety of chemical environments.
Thermoelectric characterization of nickel-nanowires and nanoparticles embedded in silica aerogels
Authors: Ghaderi Sherko , Hassan Khalil T. , Han Xiao , Wang Jiabin , Šiller Lidija , Olsen Sarah H.
Published: June 2018

Embedded nickel nanowires (NiNWs) and nickel nanoparticles (NiNPs) in silica aerogels at three different concentrations are characterized by scanning thermal microscopy, a Hot disk method and four probe measurements to consider them as potential thermoelectric materials. NiNW samples exhibit 9 orders of magnitude improvement in thermoelectric figure of merit while the embedded NiNPs samples show a 6 orders of magnitude improvement when the concentrations are increased from 0 to 700 ppm. The electrical resistivity is highly sensitive to the concentration of NiNWs and NiNPs in the silica aerogels, while the thermal conductivity remains largely unchanged over temperature range 300 to 420 K. The electrical conductivity σ follows a percolation scaling law of the form σ ∝ (W − Wc)t with critical weight fraction (Wc) to form a conductive network at range 0.04-0.06 Wt% and 0.08-0.1 Wt% for embedded NiNWs and NiNPs, respectively. The investigation suggest that further optimization of the concentration of nanomaterials in aerogels could yield promising thermoelectric properties.
A near-linear scaling equation of motion coupled cluster method for ionized states
Authors: Dutta Achintya Kumar , Saitow Masaaki , Riplinger Christoph , Neese Frank , Izsák Róbert
Published: June 2018

In this work, a domain-based local pair natural orbital (DLPNO) version of the equation of motion coupled cluster theory with single and double excitations for ionization potentials (IP-EOM-CCSD) equations has been formulated and implemented. The method uses ground state localized occupied and pair natural virtual orbitals and applies the DLPNO machinery to arrive at a linear scaling implementation of the IP-EOM-CCSD method. The accuracy of the method is controllable using ground state truncation parameters. Using default thresholds, the method predicts ionization potential (IP) values with good accuracy (mean absolute error of 0.08 eV). We demonstrate that our code can be used to compute IP values for systems with more than 1000 atoms and 10 000 basis functions.
Explicit screening full band quantum transport model for semiconductor nanodevices
Authors: Chu Yuanchen , Sarangapani Prasad , Charles James , Klimeck Gerhard , Kubis Tillmann
Published: June 2018

State of the art quantum transport models for semiconductor nanodevices attribute negative (positive) unit charges to states of the conduction (valence) band. Hybrid states that enable band-to-band tunneling are subject to interpolation that yields model dependent charge contributions. In any nanodevice structure, these models rely on device and physics specific input for the dielectric constants. This paper exemplifies the large variability of different charge interpretation models when applied to ultrathin body transistor performance predictions. To solve this modeling challenge, an electron-only band structure model is extended to atomistic quantum transport. Performance predictions of Metal-Oxide-Semiconductor Field-Effect Transistors (FET) and tunneling FETs confirm the generality of the new model and its independence of additional screening models.
Update: Reference Correlation for the Viscosity of Ethane [J. Phys. Chem. Ref. Data 44, 043101 (2015)]
Authors: Herrmann Sebastian , Hellmann Robert , Vogel Eckhard
Published: June 2018

An update of the reference correlation for the viscosity of ethane [E. Vogel et al., J. Phys. Chem. Ref. Data 44, 043101 (2015)] was developed because recently a new zero-density viscosity correlation based on theoretically calculated values of the dilute-gas viscosity became available. The original zero-density contribution was replaced, and the generation of the complete viscosity correlation was repeated using the residual viscosity concept and a state-of-the-art linear optimization algorithm. A term representing the critical enhancement was again included, so that a total of 18 coefficients resulted for the final formulation. The viscosity in the limit of zero density is now described with an expanded uncertainty of 0.3% (coverage factor k = 2) in the temperature range 250 ≤ T/K ≤ 700 and of 1.0% at temperatures 90 ≤ T/K < 250 and 700 < T/K ≤ 1200. The updated complete viscosity correlation is valid in the fluid region from the melting line to 675 K and 100 MPa. The uncertainty of the correlation amounts to 1.5% at temperatures 290 ≤ T/K ≤ 430 and at pressures up to 30 MPa based on very reliable data. The uncertainty of the correlated values is increased to 4.0% in the range 95 ≤ T/K ≤ 500 at pressures up to 55 MPa, for which further primary data exist. In the region where no experimental data are available, but the reference equation of state of Bücker and Wagner is valid, the uncertainty is estimated to be 6.0%. The uncertainty in the near-critical region rises with decreasing temperature up to 3.0% when taking into account the available data.
Attractor reconstruction by machine learning
Authors: Lu Zhixin , Hunt Brian R. , Ott Edward
Published: June 2018

A machine-learning approach called “reservoir computing” has been used successfully for short-term prediction and attractor reconstruction of chaotic dynamical systems from time series data. We present a theoretical framework that describes conditions under which reservoir computing can create an empirical model capable of skillful short-term forecasts and accurate long-term ergodic behavior. We illustrate this theory through numerical experiments. We also argue that the theory applies to certain other machine learning methods for time series prediction.
Aligning constructicons across languages
Authors: Lyngfelt Benjamin , Torrent Tiago Timponi , Laviola Adrieli , Bäckström Linnéa , Hannesdóttir Anna Helga , da Silva Matos Ely Edison
Published: June 2018

This chapter addresses interlingual relations between constructions. The perspective is contrastive rather than typological, with an aim towards multilingual constructicon development. Building on previous work on the alignment of frame-based multilingual lexical databases, we explore possibilities and problems for multilingual constructicography. By comparing the dataset of Berkeley’s English constructicon to Brazilian Portuguese and Swedish, we discuss the alignment of constructicons vis á vis the existence of more or less equivalent constructions or the deployment of different linguistic strategies in different languages.
Informatics can help providers incorporate context into care
Authors: Estiri Hossein , Patel Chirag J , Murphy Shawn N
Published: June 2018

Most determinants of health originate from the “contexts” in which we live, which has remained outside the confines of the U.S. healthcare system. This issue has left providers unprepared to operate with an ample understanding of the challenges patients may face beyond their purview. The recent shift to value-based care and increasing prevalence of Electronic Health Record (EHR) systems provide opportunities to incorporate upstream contextual factors into care. We discuss that incorporating context into care is hindered by a chicken-and-egg dilemma – ie, lack of evidence on the utility of contextual data at the point of care, where contextual data are missing due to the lack of an informatics infrastructure. We argue that if we build the informatics infrastructure today, EHRs can give the tomorrow’s clinicians the tools and the data they need to transform the U.S. healthcare from episodic and reactive to preventive and proactive. We also discuss system design considerations to improve efficacy of the suggested informatics infrastructure, which include systematically prioritizing contextual data domains, developing interoperability standards, and ensuring that integration of contextual data does not disrupt clinicians’ workflow.
Effects of wet/dry feeder and pen stocking density on grow-finish pig performance
Authors: Wastell Marvin E , Garbossa Cesar A P , Schinckel Allan P
Published: June 2018

Three thousand one hundred and eighty-two terminal cross pigs (barrows and gilts) PIC line 359 sires × 1,050 dams were used from three consecutive grow-finish groups (initial BW of 21.51 ± 0.42 kg, 31.61 ± 1.18 kg, 29.41 ± 0.28 kg for replicates 1–3). Pigs were randomly assigned to each pen at the start of the trial and the research period continued for 106, 94, and 100 d for the first, second, and third replicates, respectively. The experimental treatments were designed as a two by three factorial (pen space of 0.65 or 0.78 m2/pig with 10, 13, or 16 pigs per feeder space), each pen had an equal number of barrows and gilts with 20, 26, and 32 pigs per pen for the 10, 13, and 16 pigs per feeder space pens. Each pen was equipped with one double-sided wet/dry feeder, 37.5 cm wide, with one nipple drinker. All pigs had ad libitum access to feed and water supply during the trial period. Pigs for all the three replicates were fed with the same series of diets. Pigs were weighed by pen at the start of trial and at the end of the trial to calculate ADG. Feed was removed from the feeders and weighed to determine ADFI and G:F. To express floor space allowance, the k value was estimated by the equation: space per pig (m2)=k×BW (kg)0.67. No interactions (P > 0.05) of floor space allowance with pigs per feeder were observed. Pigs with less floor space allowance had reduced BW (128.8 vs. 129.5 kg, P = 0.026), ADG (1.00 vs. 1.02 kg/d, P = 0.002), and ADFI (2.52 vs. 2.61 kg/d, P < 0.001). However, G:F was improved (0.402 vs. 0.397, P = 0.039) with less floor space allowance per pig. Increased pigs per feeder space reduced final BW (129.7, 129.4, 128.4 kg, linear; P = 0.001). However, ADG had a quadratic relationship (P = 0.005) with pigs per feeder space with means of 1.03, 1.01, and 1.01 kg/d for 10, 13, and 16 pigs per feeder space. Overall, ADFI had a quadratic relationship (P < 0.0001) with number of pigs per feeder space with means of 2.62, 2.52, and 2.55 kg/d for 10, 13, and 16 pigs per feeder space. Gain efficiency had a quadratic relationship (P = 0.005) with number of pigs per feeder space with means of 0.395, 0.404, and 0.400 for 10, 13, and 16 pigs per feeder space. In conclusion, a floor space allowance of 0.65 m2/pig in the grow-finish period reduced ADFI and ADG compared with 0.78 m2/pig. Overall, with the type of wet/dry feeder used in this study, 10 pigs per feeder had the greatest ADG and ADFI, compared with 13 or 16 pigs per feeder space. However, G:F improved as the number of pigs per feeder space increased.
Carbon Source and Soil Origin Shape Soil Microbiomes and Tomato Soilborne Pathogen Populations During Anaerobic Soil Disinfestation
Authors: Testen Anna L. , Miller Sally A.
Published: June 2018

Soilborne disease complexes are an emerging constraint in protected culture tomato production systems in the Midwestern United States. Diseases in these complexes include Verticillium wilt (Verticillium dahliae), black dot root rot (Colletotrichum coccodes), corky root rot (Pyrenochaeta lycopersici), and root knot (Meloidogyne spp.). Anaerobic soil disinfestation (ASD) may be a viable, environmentally benign strategy for managing these complexes. Soils from two farms in Ohio were used to determine the impacts of ASD, using wheat bran, molasses, or ethanol as carbon sources, on soilborne diseases and soil bacterial communities. ASD with wheat bran or ethanol amendments led to significantly reduced tomato root rot severity, while nematode galling damage was significantly reduced following ASD with any carbon source compared with nontreated controls. When ethanol was used as a carbon source in ASD, the colonization of tomato roots by P. lycopersici and C. coccodes was observed less frequently than in control roots. A high throughput sequencing approach was used to characterize soil bacterial communities following ASD. Carbon source and soil origin influenced the composition of bacterial communities in soils treated with ASD. Bacterial community diversity decreased following ASD with wheat bran in all soils tested and following ASD with ethanol in soils from one farm. The abundance of bacteria in the phylum Firmicutes generally increased significantly following ASD, while the abundance of those in the phyla Acidobacteria, Actinobacteria, Chloroflexi, and Plantomycetes generally decreased following ASD. These findings provide insight into the impacts of ASD on microbial communities and soilborne diseases and will be used to optimize ASD as a tool for Midwestern vegetable growers.
Carnitine acetyltransferase (Crat) in hunger‐sensing AgRP neurons permits adaptation to calorie restriction
Authors: Reichenbach Alex , Stark Romana , Mequinion Mathieu , Lockie Sarah H. , Lemus Moyra B. , Mynatt Randall L. , Luquet Serge , Andrews Zane B.
Published: June 2018

Hunger‐sensing agouti‐related peptide (AgRP) neurons ensure survival by adapting metabolism and behavior to low caloric environments. This adaption is accomplished by consolidating food intake, suppressing energy expenditure, and maximizing fat storage (nutrient partitioning) for energy preservation. The intracellular mechanisms responsible are unknown. Here we report that AgRP carnitine acetyltransferase (Crat) knockout (KO) mice exhibited increased fatty acid utilization and greater fat loss after 9 d of calorie restriction (CR). No differences were seen in mice with ad libitum food intake. Eleven days ad libitum feeding after CR resulted in greater food intake, rebound weight gain, and adiposity in AgRP Crat KO mice compared with wild‐type controls, as KO mice act to restore pre‐CR fat mass. Collectively, this study highlights the importance of Crat in AgRP neurons to regulate nutrient partitioning and fat mass during chronically reduced caloric intake. The increased food intake, body weight gain, and adiposity in KO mice after CR also highlights the detrimental and persistent metabolic consequence of impaired substrate utilization associated with CR. This finding may have significant implications for postdieting weight management in patients with metabolic diseases.—Reichenbach, A., Stark, R., Mequinion, M., Lockie, S. H., Lemus, M. B., Mynatt, R. L., Luquet, S., Andrews, Z. B. Carnitine acetyltransferase (Crat) in hunger‐sensing AgRP neurons permits adaptation to calorie restriction. FASEB J. 32, 6923–6933 (2018). www.fasebj.org
Increased 1-Year Continuation of DMPA Among Women Randomized to Self-administration: Results From a Randomized Controlled Trial at Planned Parenthood
Authors: Kohn Julia E. , Simons Hannah R. , Badia Lisa Della , Draper Elissa , Morfesis Johanna , Talmont Elizabeth , Beasley Anitra , McDonald Melanie , Westhoff Carolyn L.
Published: June 2018

(Abstracted from Contraception 2018;97:198–204)

Consistent use of effective contraception is the most effective way to reduce unintended pregnancy. Approximately 4.5% of US contraceptive users aged 15 to 44 years, an estimated 1.5 million women, relied on injectables as their contraceptive method in 2012.
Associations Between Introduction and Withdrawal of a Financial Incentive and Timing of Attendance for Antenatal Care and Incidence of Small for Gestational Age: Natural Experimental Evaluation Using Interrupted Time Series Methods
Authors: Adams Jean , van der Waal Zelda , Rushton Steven , Rankin Judith
Published: June 2018

(Abstracted from BMJ Open 2018;8:e017697)

The Health in Pregnancy Grant (HiPG), introduced April 2009, was a one-time payment of 190£ payable to all pregnant women residing in the United Kingdom after the 25th week of gestation, contingent on them receiving routine antenatal care. The HiPG was withdrawn after a 2010 general election, and women were only able to claim the payment if they reached the 25th week of pregnancy before January 1, 2011.
Performance of Electrical Velocimetry for Noninvasive Cardiac Output Measurements in Perioperative Patients After Subarachnoid Hemorrhage
Authors: Mutoh Tatsushi , Sasaki Kazumasu , Yamamoto Shuzo , Yasui Nobuyuki , Ishikawa Tatsuya , Taki Yasuyuki
Published: June 2018

Background:

Fluid therapy guided by cardiac output measurements is of particular importance for adequate cerebral perfusion and oxygenation in neurosurgical patients. We examined the usefulness of a noninvasive electrical velocimetry (EV) device based on the thoracic bioimpedance method for perioperative hemodynamic monitoring in patients after aneurysmal subarachnoid hemorrhage.

Patients and Methods:

In total, 18 patients who underwent surgical clipping or endovascular coiling for ruptured aneurysms were examined prospectively. Simultaneous cardiac index (CI) measurements obtained with EV (CIEV) and reference transpulmonary thermodilution (CITPTD) were compared. A total of 223 pairs of data were collected.

Results:

A significant correlation was found between CIEV and CITPTD (r=0.86; P<0.001). Bland and Altman analysis revealed a bias between CIEV and CITPTD of −0.06 L/min/m2, with limits of agreement of ±1.14 L/min/m2 and a percentage error of 33%. Although the percentage error for overall data was higher than the acceptable limit of 30%, subgroup analysis during the postoperative phase showed better agreement (23% vs. 42% during the intraprocedure phase). Four-quadrant plot and polar plot analyses showed fair-to-poor trending abilities (concordance rate of 90% to 91%, angular bias of +17 degrees, radial limits of agreement between ±37 and ±40 degrees, and polar concordance rate of 72% to 75%), including the subgroup analysis.

Conclusions:

Absolute CI values obtained from EV and TPTD are not interchangeable with TPTD for perioperative use in subarachnoid hemorrhage patients. However, considering the moderate levels of agreement with marginal trending ability during the early postoperative phase, this user-friendly device can provide an attractive monitoring option during neurocritical care.
Is there a Correlation Between Degree of Radiologic Lumbar Spinal Stenosis and its Clinical Manifestation?
Authors: Andrasinova Tereza , Adamova Blanka , Buskova Jana , Kerkovsky Milos , Jarkovsky Jiri , Bednarik Josef
Published: June 2018

Study Design:

This was an observational cross-sectional study.

Objective:

The purpose of this study was to evaluate whether the degree of stenosis on magnetic resonance imaging (MRI) relates to the severity of clinical symptoms, disability, or neurological deficit in patients with symptomatic central lumbar spinal stenosis (LSS).

Summary of Background Data:

The relationship between radiologic findings and the clinical manifestations of LSS remains unclear.

Materials and Methods:

A total of 84 patients (42 men, median age 70 y) with neurogenic claudication and central degenerative LSS were included in the study. The MRI parameters describing severity (anteroposterior diameter of dural sac, cross-sectional area of the dural sac, stenosis ratio, and Schizas qualitative morphologic classification were evaluated at maximum stenotic level) and the extent of stenosis (the number of central stenotic levels) were correlated to symptoms (pain intensity, walking capacity), functional disability (measured in terms of the Oswestry Disability Index), and neurological signs of LSS (neurological status was evaluated and scored by Neurological Impairment Score in LSS).

Results:

A statistically significant correlation emerged only between the Neurological Impairment Score in LSS and Schizas morphologic classification (P=0.006). Pain intensity, walking capacity, and functional disability displayed no correlation with the MRI parameters of LSS.

Conclusions:

LSS is a clinicoradiologic syndrome with complex relationships between degree of radiologic stenosis disclosed by MRI and clinical manifestations. Neurological impairment in the lower extremities reflects the degree of morphologic LSS on MRI. This study did not identify any association between the degree of stenosis and functional disability, pain intensity, or walking capacity.

Level of Evidence:

Level II.
Cytokine Release Syndrome During Sequential Treatment With Immune Checkpoint Inhibitors and Kinase Inhibitors for Metastatic Melanoma
Authors: Dimitriou Florentia , Matter Alexandra V. , Mangana Joanna , Urosevic-Maiwald Mirjana , Micaletto Sara , Braun Ralph P. , French Lars E. , Dummer Reinhard
Published: June 2018

Switching from immunotherapy to targeted therapy in metastasized melanoma can be complicated by a cytokine release syndrome (CRS). CRS is a serious complication, which is induced by high levels of circulating cytokines, associated with T-cell engagement and proliferation, and results in a constellation of symptoms with variable organ involvement. We report 2 patients with BRAF V600 mutant melanoma who were previously treated with anti-PD-1±anti-LAG-3 antibodies and were switched to BRAF/MEK-inhibitors because of progressive disease. Both cases depict the complexity of interactions occurring during sequential treatment with immune checkpoint inhibitors and kinase inhibitors. Early identification and management of CRS is crucial to decrease its toxicity and improve safety of further drugs to be given in a therapeutic ladder.
Trichoblastic Carcinosarcoma of the Skin: A Case Report and Literature Review
Authors: Okhremchuk Ilona , Nguyen Anh Tuan , Fouet Bernard , Morand Jean-Jacques
Published: June 2018

An 83-year-old man presented to the dermatology department for an ulcerated skin lesion of the back that had been increasing in size during the past 11 years. The physical examination revealed a well-defined, fleshy, reddish plaque measuring 10 × 20 cm in diameter with erosions and black areas on the surface. The patient underwent surgical excision with margins of 10 mm followed by a skin graft. Histologic section showed a lesion composed of 2 intimately intermingled epithelial and mesenchymal components associated with a basal cell carcinoma (BCC). Immunohistochemical examination showed epithelial cells that were positive for CK AE1/AE3 and p53, whereas stromal cells were positive for vimentin, CD10, and p53. BCC was positive for CD10. On the basis of these findings, a diagnosis of trichoblastic carcinosarcoma associated with BCC was made. Given the scarcity of data available in the literature regarding this diagnosis, no standard of care exists. No adjuvant treatment was provided and after 1 year of follow-up, the patient did not experience recurrence.
Dynamic Hyperinflation Impairs Cardiac Performance During Exercise in COPD
Authors: Frazão Murillo , Silva Paulo Eugênio , Frazão Wanessa , da Silva Vinícius Zacarias Maldaner , Correia Marco Aurélio de Valois , Neto Mansueto Gomes
Published: June 2018

Purpose:

To investigate the correlation between a plateau in minute ventilation

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E during cardiopulmonary exercise tests (CPETs) and its impact on cardiac performance.

Methods:

This retrospective study analyzed 2575 CPETs of patients with chronic obstructive pulmonary disease. The study randomly selected 10 patients with a plateau in the

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E curve, suggesting dynamic hyperinflation, 10 patients with normal pattern for the

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E curve, and 10 healthy persons. Classic CPET variables, the new ventilation hyperinflation index, and the dynamic cardiac constraint index were analyzed.

Results:

The patients with dynamic hyperinflation presented with lower ventilation at 100% work rate (P < .0001), without significant differences in

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E at 50% and 100% work rate. Patients with dynamic hyperinflation also presented with a lower oxygen pulse (O2 pulse) at 100% (P < .0001), without significant difference in O2 pulse at 50% and 100% work rate. The subjects with dynamic hyperinflation had a higher ventilation hyperinflation index (P < .0001) and dynamic cardiac constraints index (P < .0001). The ventilation hyperinflation index correlated with the dynamic cardiac constraints index (r = 0.81, P < .0001); oxygen pulse variation (r =−0.63, P < .001);

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E/

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co
2 slope (r =−0.57, P < .01); work rate (r =−0.86, P < .0001);

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o
2 (r =−0.80, P < .0001), and

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E (r =−0.83, P < .0001).

Conclusion:

There is a correlation between a plateau in the

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E during CPET, suggesting hyperinflation, and it has an impact on cardiac performance.
Selenium in Graves Hyperthyroidism and Orbitopathy
Authors: Marinò Michele , Menconi Francesca , Rotondo Dottore Giovanna , Leo Marenza , Marcocci Claudio
Published: June 2018

Purpose:

To review the in vitro and in vivo studies supporting a role of selenium for the treatment of mild Graves orbitopathy.

Methods:

Review of the current literature on the role of selenium in the management of Graves orbitopathy.

Results:

Graves orbitopathy (GO) is a disfiguring and disabling disorder usually observed in patients with Graves hyperthyroidism, and more rarely in patients with hypothyroid autoimmune thyroiditis or in the absence of overt thyroid dysfunction. Noninvasive treatments include intravenous glucocorticoids and orbital radiotherapy and are generally offered to patients with moderately severe GO. In contrast, patients with mild GO are generally treated only with local measures. Thus, the benefits of intravenous glucocorticoids in mild GO are limited and do not justify the risks that the treatment carries. However, a medical treatment for mild GO is heavily wanted, as a relevant proportion of patients have a significant decrease in their quality of life, and GO can progress into more severe forms. Because of the role of oxidative stress in the pathogenesis of GO, an antioxidant approach has been proposed and the antioxidant agent selenium has been shown to be effective for GO.

Conclusion:

Studies have shown that a 6-month course of sodium selenite can improve the course of mild GO and prevent deterioration when compared with placebo.
Caring about Preemies' Safe Sleep (CaPSS)
Authors: Dowling Donna A. , Barsman Sarah Gutin , Forsythe Paula , Damato Elizabeth G.
Published: June 2018

Preterm infants born before 37 weeks' gestation die of sudden infant death syndrome (SIDS) at a rate more than double that of term infants. There is a need for SIDS prevention programs tailored to the specific needs of parents of high-risk infants. The purpose of this study was to pilot test an online educational module addressing SIDS risk-reduction recommendations (RRRs) for parents of preterm infants. This study was conducted in a 44-bed transitional care unit at a level IV NICU in the Midwest. A repeated-measures design was used. Two weeks before discharge, mothers completed a survey, addressing knowledge and plans for caring for their baby at home. Mothers then viewed the 5-section Caring about Preemies' Safe Sleep (CaPSS) education module and completed the postmodule evaluation. A discharge survey was completed 4 weeks postdischarge. Fifteen mothers, mean age 26.4 years, participated; 8 (53%) returned the postdischarge survey. Module evaluation rated clarity and completeness of information high. Mothers' ratings of SIDS knowledge were significantly higher after viewing the module (P = .000) and 4 weeks after discharge home (P = .012). Mothers found the use of a pacifier at sleep times to be new information and changed their plans for caring for their infant, with 28.6% of mothers always offering a pacifier before sleep after discharge compared with the 6.7% who had planned to do this before discharge. However, only 71% of infants slept in parents' room after discharge and only 41% were receiving at least some breast milk, which are not consistent with SIDS RRRs.
Screening of hepatitis C virus infection in adult general population in Spain
Authors: Viejo Laura Gómez-Escolar , Herola Antonio García , Lloret Isabel Sáez , Ruano Fernando Sánchez , Paulino Inmaculada Clemente , Ivorra Cristina Quílez , Saavedra Isabel Almenta , Pérez David Martínez , de la Osa Jaime Valverde
Published: June 2018

Purpose

The aim was to estimate seroprevalence and prevalence of hepatitis C virus (HCV) infection in a small health area of the Valencian Community, Spain.

Patients and methods

This is a descriptive cross-sectional study aimed at estimation of HCV infection prevalence in the whole adult population (25–70 years old), that is, a pilot study for an eventual population-based screening program.

Results

A total of 5849 participants aged 25–70 years (51% male) were invited to participate by regular mail. Overall, 143 letters were returned owing to errors in the addresses. Of 5706 participants, 2637 (46.2%) participated in the study. Rapid test of anti-HCV antibody detection was positive in 30 cases (HCV seroprevalence 1.14%, 95% confidence intervals: 0.73–1.55%). Of those, seven were not aware of their condition. Participants who had a positive result in the rapid test of anti-HCV detection were given a confirmatory test by enzyme immune assay, and all had a positive result. RNA-HCV determination by quantitative PCR in positive anti-HCV patients showed positive viremia in 13 (43.3%) cases, of which five were not aware of the disease. Of the 17 patients who had negative viremia, two were unaware of their HCV status, one was a carrier of anti-HCV and was already aware of his condition, and 14 had been previously treated with satisfactory results. Regarding fibrosis, of the seven patients who were unaware of HCV infection, none of them had significant fibrosis. Moreover, 26 (86.7%) anti-HCV positive patients were reported to have one or more risk factors for HCV infection.

Conclusion

HCV screening strategies applied to the general population are good means to diagnose and treat patients who are not aware of their infection, avoiding new transmissions as well as disease progression.