bluuebunny/crossref_metadata_2025 huggingface dataset:
Endemic Australian arboviruses of human health significance
Authors: Smith David W
Published: April 2018

Each year many thousands of cases of human arbovirus infection are notified within Australia, acquired either within Australia or when travelling overseas1. These cause diseases varying from fever and aches, to debilitating joint disease, to encephalitis and death. The arboviruses endemic to Australia are all maintained in a cycle between mosquitoes (and rarely midges) and a bird or mammalian host2. As such, the virus activity is dependent on rainfall and temperature conditions that are conducive to mosquito breeding, and to virus replication and amplification (Figure 1). Those conditions being met, there have to be suitable amplifying animal hosts nearby, and their absence is one of the factors that protects most of the larger urban populations in Australia. Then, of course, humans have to be exposed to the infected mosquitoes to get disease.
The molecular epidemiology of Murray Valley encephalitis virus in Australasia
Authors: Williams David T
Published: April 2018

Of the viruses transmitted by mosquitoes in the Australasian region, Murray Valley encephalitis (MVE) virus is the major cause of brain disease in humans. There is no vaccine to prevent MVE, nor are there effective antiviral drugs available to treat infections. Therefore, surveillance of MVE is essential to control efforts. A key element to this is understanding the virus at a genetic level, which allows the tracking and identification of known or novel genetic types and can tell us about their circulation patterns.
Comparison of sperm motility subpopulation structure among wild anadromous and farmed male Atlantic salmon (Salmo salar) parr using a CASA system
Authors: Caldeira Carina , García-Molina Almudena , Valverde Anthony , Bompart Daznia , Hassane Megan , Martin Patrick , Soler Carles
Published: April 2018

Atlantic salmon (Salmo salar) is an endangered freshwater species that needs help to recover its wild stocks. However, the priority in aquaculture is to obtain successful fertilisation and genetic variability to secure the revival of the species. The aims of the present work were to study sperm subpopulation structure and motility patterns in wild anadromous males and farmed male Atlantic salmon parr. Salmon sperm samples were collected from wild anadromous salmon (WS) and two generations of farmed parr males. Sperm samples were collected from sexually mature males and sperm motility was analysed at different times after activation (5 and 35 s). Differences among the three groups were analysed using statistical techniques based on Cluster analysis the Bayesian method. Atlantic salmon were found to have three sperm subpopulations, and the spermatozoa in ejaculates of mature farmed parr males had a higher velocity and larger size than those of WS males. This could be an adaptation to high sperm competition because salmonid species are naturally adapted to this process. Motility analysis enables us to identify sperm subpopulations, and it may be useful to correlate these sperm subpopulations with fertilisation ability to test whether faster-swimming spermatozoa have a higher probability of success.
DRUG-NEM: Optimizing drug combinations using single-cell perturbation response to account for intratumoral heterogeneity
Authors: Anchang Benedict , Davis Kara L. , Fienberg Harris G. , Williamson Brian D. , Bendall Sean C. , Karacosta Loukia G. , Tibshirani Robert , Nolan Garry P. , Plevritis Sylvia K.
Published: April 2018

Significance

Single-cell high-throughput technologies enable the ability to identify combination cancer therapies that account for intratumoral heterogeneity, a phenomenon that has been shown to influence the effectiveness of cancer treatment. We developed and applied an approach that identifies top-ranking drug combinations based on the single-cell perturbation response when an individual tumor sample is screened against a panel of single drugs. This approach optimizes drug combinations by choosing the minimum number of drugs that produce the maximal intracellular desired effects for an individual sample.
A new perspective on the Luxembourgish genitive
Authors: Döhmer Caroline
Published: April 2018

This paper deals with genitive constructions in the Luxembourgish language. It is often assumed that the Luxembourgish genitive has only survived in idioms and archaic structures (Russ 1996: 74, Schanen & Zimmer 2012: 64), but I will investigate this claim in more detail. Based on a qualitative corpus analysis of spoken and written Luxembourgish (over 62 million tokens), different constructions will be systematically compiled and analyzed. Due to the rising interest in morphosyntactic variation and the improved data situation, this descriptive analysis investigates the current status of the genitive within a single system of grammar, i.e. Luxembourgish. The paper explores six main areas that are relevant for Luxembourgish genitives: attributes, genitive complements of verbs and adjectives, prepositions, adverbials, family names, and partitives. The structures obtained from the corpus will then be discussed from a formal and a functional perspective in order to illustrate Luxembourgish case typology. As the data shows, the genitive behaves differently according to the different areas that have been selected beforehand. On the one hand, genitives can be found in lexicalized structures, i.e. adverbials. On the other hand, different genitives occasionally appear as verb or adjective complements. This phenomenon is partly caused by the expansion of the Luxembourgish language into the written domain. Another main finding is that Luxembourgish makes full use of an independent set of partitive pronouns and determiners that have been derived from former genitives.
On the motivation of genitive‑s omission in Contemporary German
Authors: Zimmer Christian
Published: April 2018

In Contemporary German strong, masculine and neuter nouns in genitive phrases either take a suffix (‑s or -es) or remain uninflected for case (e.g. Nutzung d-es Internet‑s vs. Nutzung d-es Internet-Ø, ‘use of the-gen.sg internet-gen.sg/Ø’). This paper is concerned with a corpus-based description of this variation on the basis of which an explanation of the phenomenon is given. Using data taken from synchronic and diachronic corpora (
DECOW2012
and Deutsches Textarchiv) and psycholinguistic evidence from a self-paced reading task it is shown that there is a functional motivation for the fact that a well-delimited group of nouns (i.e. peripheral nouns, such as loan words, abbreviations and proper names) tend to remain uninflected for case whilst prototypical German nouns are almost always inflected for genitive case. This variation results from the competition between two motivations: syntactic agreement on the one hand and a hitherto not very well described factor called morphological schema constancy on the other hand. The latter refers to the maintenance of word form stability e.g. through the avoidance of inflectional suffixes. However, these motivations are weighted differently depending on the nature of the noun in question: Since syntactic agreement is still important for the grammatical system, prototypical nouns are unaffected by ‑s omission. Thus, in general, the genitive singular resists the general German(ic) tendency towards a reduction of nominal case markers so far.
From genitive suffix to linking element
Authors: Kopf Kristin
Published: April 2018

Present-day German uses two formally different patterns of compounding in N+N compounds. The first combines bare stems (e.g. Tisch+decke ‘tablecloth’) while the second contains an intervening linking element (le) as in Geburt‑s-ort ‘birth-le-place’. The linked compounding type developed in Early New High German (1350–1650) from phrasal constructions by reanalyzing genitive attributes as first constituents of compounds. The present paper uses corpus data to explore three key stages in this development: In the initial stage, it shows how prenominal non-specific genitive constructions lent themselves to reanalysis due to their functional overlap and formal similarity. Additionally, compounds seem to have replaced not only prenominal genitives, but also structurally different postnominal genitives. In the second stage, the new compounding pattern increases in productivity between 1500 and 1710, especially compared to the older pattern without linking elements. The last stage pertains to changes in spelling practice. It shows that linked compounds were written separately in the beginning. Their gradual graphematic integration into directly connected words was reversed by a century of hyphenation (1650–1750). This is strikingly different from present-day spelling practice and shows that the linked pattern was still perceived as marked.
From genitive inflection to possessive marker?
Authors: Ackermann Tanja
Published: April 2018

This paper deals with the status of the s-marker with personal names in German from a diachronic perspective. On the basis of corpus data it is argued that the deflexion of personal names in genitive phrases is much more advanced than it has been claimed in the literature: only the invariant marker ‑s occurs frequently, namely in constructions of the type Hildes Wohnung ‘Hilde’s flat’. Thus, it becomes obvious that such constructions, which are less widely studied than their English or Swedish counterparts, play a special role. It will be argued that an interpretation of the ‑s in these adnominal possessive constructions as a kind of prenominal genitive use fails. Given this, a comparison with the development of possessive ‑s in the history of English reveals that there are striking similarities with the developments in German.
Genitives and proper name compounds in German
Authors: Schlücker Barbara
Published: April 2018

This paper deals with an issue related to the syntax-morphology interface, namely the comparison of proper name compounds and genitives in German. It has been claimed in the literature that proper name compounds have recently increased in use at the expense of the genitive. For this reason, proper name compounds are sometimes considered as competitors to the genitive. A prerequisite for this assumption is that both constructions are equivalent with respect to meaning and function. The paper examines the relevant properties of both constructions. It is argued that there is no true meaning equivalence between proper name compounds and genitives. However, specific subtypes of proper name compounds and genitives that exhibit a substantial amount of semantic overlap are identified. It is discussed under which circumstances they can be used interchangeably.
Mirativity and egophoricity in Kurtöp
Authors: Hyslop Gwendolyn
Published: April 2018

The terms ‘mirative’ and ‘egophoric’ have often been employed to describe various epistemic contrasts which, on the surface, appear to be quite similar. Kurtöp, a Tibeto-Burman language of Northeastern Bhutan, contrasts both mirativity and egophoricity, providing evidence that they are two separate categories. Mirativity in Kurtöp is a pervasive feature of the grammar; it occurs in imperfective and perfective aspect, in addition to being encoded in affirmative and negative forms of existential and equational copulas. In statements, the mirative is used to encode that knowledge was new or unexpected to the speaker while non-mirative forms encode old knowledge. In questions, only non-mirative forms are used. In contrast to mirative marking, egophoricity is marked in perfective aspect only. An egophoric form encodes that the speaker has intimate knowledge of an event or intention of an event; a non-egophoric form does not encode this personal knowledge. Unusually, egophoric marking in Kurtöp includes a distinction as to whether knowledge is exclusive to the speaker, or is thought to be shared. Mirative and egophoric forms have particular tendencies to co-occur with certain subjects, especially in elicitation. However, when we look within natural discourse, these categories are complex, with subtler meanings than basic elicitation would suggest.
Morphological innovations in Mangghuer and Shirongolic
Authors: Slater Keith W.
Published: April 2018

Egophoric systems with binary indexing distinctions have been described for a number of languages of Northwest China’s Amdo Sprachbund. These systems are conceptually extremely similar, though the distinctions have been disparately labeled direct vs. indirect, self person vs. other person, volitional vs. non-volitional, etc. Published descriptions of these systems generally focus on their semantic/pragmatic characteristics, and little has been said about the historical origins of the morphological markings which they employ. In this paper I trace the formal emergence of the binary opposition, which I refer to as a distinction between subjective and objective perspectives, in Mangghuer and other Shirongolic languages. Comparative Mongolic evidence, along with evidence from other Amdo Sprachbund languages, enables me to identify four historical processes in the development of the synchronic Mangghuer system. Three of these processes clearly involved reanalyses of inherited Mongolic verbal morphology, while one involved phonetic material of uncertain provenance. An important observation is that in nearly all of the historical changes described here, including those found in Mangghuer and those that we observe in other languages, the objective category is singled out as the formally more marked member of the subjective vs. objective opposition.
Egophoricity and evidentiality in Guambiano (Nam Trik)
Authors: Norcliffe Elisabeth
Published: April 2018

Egophoric verbal marking is a typological feature common to Barbacoan languages, but otherwise unknown in the Andean sphere. The verbal systems of three out of the four living Barbacoan languages, Cha’palaa, Tsafiki and Awa Pit, have previously been shown to express egophoric contrasts. The status of Guambiano has, however, remained uncertain. In this chapter, I show that there are in fact two layers of egophoric or egophoric-like marking visible in Guambiano’s grammar. Guambiano patterns with certain other (non-Barbacoan) languages in having ego-categories which function within a broader evidential system. It is additionally possible to detect what is possibly a more archaic layer of egophoric marking in Guambiano’s verbal system. This marking may be inherited from a common Barbacoan system, thus pointing to a potential genealogical basis for the egophoric patterning common to these languages. The multiple formal expressions of egophoricity apparent both within and across the four languages reveal how egophoric contrasts are susceptible to structural renewal, suggesting a pan-Barbacoan preoccupation with the linguistic encoding of self-knowledge.
Egophoric patterns in Duna verbal morphology
Authors: San Roque Lila
Published: April 2018

In the language Duna (Trans New Guinea), egophoric distributional patterns are a pervasive characteristic of verbal morphology, but do not comprise a single coherent system. Many morphemes, including evidential markers and future time inflections, show strong tendencies to co-occur with ‘informant’ subjects (the speaker in a declarative, the addressee in an interrogative), or alternatively with non-informant subjects. The person sensitivity of the Duna forms is observable in frequency, speaker judgments of sayability, and subject implicatures. Egophoric and non-egophoric distributional patterns are motivated by the individual semantics of the morphemes, their perspective-taking properties, and logical and/or conventionalised expectations of how people experience and talk about events. Distributional tendencies can also be flouted, providing a resource for speakers to convey attitudes towards their own knowledge and experiences, or the knowledge and experiences of others.
Critiquing Jung’s Ethics
Authors: Mills Jon
Published: April 2018

C. G. Jung never offered a formalized system of ethics, but his analytical psychology is teeming with ethical pronouncements. Jung’s ethical theories are introduced and explored in relation to a book written by Dan Merkur centering on the question of morality in human nature, the individuation process, and in psychotherapeutic treatment. Jung struggled to provide a dialectical account of human valuation, yet this is implied in the very process of overcoming oppositions through the negotiation and integration of differences, and in holding balances between internal and external conflicts. The psychologicalization of ethics, particularly the compensatory function of the unconscious, ensures that moral psychology is fraught with ambivalence, uncertainty, and competing dilemmas that are unique to each person, hence no formal or rational system of deontological ethics is possible.
AnoniMME: bringing anonymity to the Matchmaker Exchange platform for rare disease gene discovery
Authors: Oprisanu Bristena , De Cristofaro Emiliano
Published: April 2018

Advances in genome sequencing and genomics research are bringing us closer to a new era of personalized medicine, where healthcare can be tailored to the individual’s genetic makeup and to more effective diagnosis and treatment of rare genetic diseases. Much of this progress depends on collaborations and access to data, thus, a number of initiatives have been introduced to support seamless data sharing. Among these, the Global Alliance for Genomics and Health has developed and operates a platform, called Matchmaker Exchange (MME), which allows researchers to perform queries for rare genetic disease discovery over multiple federated databases. Queries include gene variations which are linked to rare diseases, and the ability to find other researchers that have seen or have interest in those variations is extremely valuable. Nonetheless, in some cases, researchers may be reluctant to use the platform since the queries they make (thus, what they are working on) are revealed to other researchers, and this creates concerns with respect to privacy and competitive advantage.

In this paper, we present AnoniMME, a framework geared to enable anonymous queries within the MME platform. The framework, building on a cryptographic primitive called Reverse Private Information Retrieval, let researchers anonymously query the federated platform, in a multi-server setting—specifically, they write their query, along with a public encryption key, anonymously in a public database. Responses are also supported, so that other researchers can respond to queries by providing their encrypted contact details.

Availability and implementation

https://github.com/bristena-op/AnoniMME
On the Growth of L2-Invariants of Locally Symmetric Spaces, II: Exotic Invariant Random Subgroups in Rank One
Authors: Abert Miklos , Bergeron Nicolas , Biringer Ian , Gelander Tsachik , Nikolov Nikolay , Raimbault Jean , Samet Iddo
Published: April 2018

In the 1st paper of this series we studied the asymptotic behavior of Betti numbers, twisted torsion, and other spectral invariants for sequences of lattices in Lie groups G. A key element of our work was the study of invariant random subgroups (IRSs) of G. Any sequence of lattices has a subsequence converging to an IRS, and when G has higher rank, the Nevo–Stuck–Zimmer theorem classifies all IRSs of G. Using the classification, one can deduce asymptotic statements about spectral invariants of lattices. When G has real rank one, the space of IRSs is more complicated. We construct here several uncountable families of IRSs in the groups SO(n, 1), n ≥ 2. We give dimension-specific constructions when n = 2, 3, and also describe a general gluing construction that works for every n. Part of the latter construction is inspired by Gromov and Piatetski-Shapiro’s construction of non-arithmetic lattices in SO(n, 1).
Microcatheter “First-Pass Effect” Predicts Acute Intracranial Artery Atherosclerotic Disease-Related Occlusion
Authors: Yi Ting-Yu , Chen Wen-Huo , Wu Yan-Min , Zhang Mei-Fang , Zhan A-lai , Chen Yue-Hong , Wu Zong-Zhong , Shi Yan-Chuan , Chen Bai-Ling
Published: April 2018

BACKGROUND

The differentiation between intracranial atherosclerotic stenosis (ICAS) and intracranial embolism as the immediate cause of acute ischemic stroke requiring endovascular therapy is important but challenging. In cases of ICAS, we often observe a phenomenon we call the microcatheter “first-pass effect,” which is temporary blood flow through the occluded intracranial artery when the angiographic microcatheter is initially advanced through the site of total occlusion and immediately retrieved proximally.

OBJECTIVE

To evaluate whether this microcatheter first-pass effect can be used to differentiate ICAS from intracranial embolism.

METHODS

A total of 61 patients with acute ischemic stroke resulting from large intracranial artery occlusion and in whom recanalization was achieved by endovascular treatment were included in the study. The microcatheter first-pass effect was tested in these patients. The sensitivity, specificity, positive predictive values (PPV), and accuracy of the microcatheter first-pass effect for prediction of ICAS were assessed.

RESULTS

The microcatheter first-pass effect was more frequently observed in patients with ICAS than in those with intracranial embolism (90.9% vs 12.8%, P < .001). For identifying ICAS, sensitivity, specificity, PPV, and accuracy of the microcatheter first-pass effect were 90.9%, 87.2%, 80.0%, 88.5%, respectively.

CONCLUSION

The sensitivity and PPV of the microcatheter first-pass effect are high for prediction of ICAS in patients with acute symptoms.
Four-Dimensional Flow MRI Analysis of Cerebral Blood Flow Before and After High-Flow Extracranial–Intracranial Bypass Surgery With Internal Carotid Artery Ligation
Authors: Orita Erika , Murai Yasuo , Sekine Tetsuro , Takagi Ryo , Amano Yasuo , Ando Takahiro , Iwata Kotomi , Obara Makoto , Kumita Shinichiro
Published: April 2018

BACKGROUND

The hemodynamic changes that occur after high-flow (extracranial–intracranial) EC-IC bypass surgery with internal carotid artery (ICA) ligation are not well known.

OBJECTIVE

To assess blood flow changes after high-flow EC-IC bypass with ICA ligation by time-resolved 3-dimensional phase-contrast (4D Flow) magnetic resonance imaging (MRI).

METHODS

We enrolled 11 patients who underwent high-flow EC-IC bypass. 4D Flow MRI was performed before and after surgery to quantify the blood flow volume (BFV) of the ipsilateral ICA (BFViICA), bypass artery (BFVbypass), contralateral ICA (BFVcICA), and basilar artery (BFVBA). Subsequently, we calculated the total BFV (BFVtotal = BFViICA + BFVcICA + BFVBA [before surgery], BFVcICA + BFVBA + BFVbypass [after surgery]). The BFV changes after bypass was statistically analyzed.

RESULTS

BFVbypass was slightly lower than BFViICA, but the difference was not statistically significant (3.84 ± 0.94 vs 4.42 ± 1.38 mL/s). The BFVcICA and BFVBA significantly increased after bypass surgery (BFVcICA 5.89 ± 1.44 vs 7.22 ± 1.37 mL/s [P = .0018], BFVBA 3.06 ± 0.41 vs 4.12 ± 0.38 mL/s [P < .001]). The BFVtotal significantly increased after surgery (13.37 ± 2.58 vs 15.18 ± 1.77 mL/s [P = .015]). There was no evidence of hyperperfusion syndrome in any cases.

CONCLUSION

After high-flow EC-IC bypass with permanent ICA ligation, the bypass artery could partially compensate for the loss of BFV of the sacrificed ICA. The increased flow of the contralateral ICA and BA supply collateral blood flow. Clinically irrelevant hyperperfusion was observed.
Does the Use of Electrotherapies Increase the Effectiveness of Neck Stabilization Exercises for Improving Pain, Disability, Mood, and Quality of Life in Chronic Neck Pain?
Authors: Yesil Hilal , Hepguler Simin , Dundar Umit , Taravati Sahel , Isleten Banu
Published: April 2018

Study Design.

This study was a prospective, randomized, controlled study.

Objective.

The aim of this study was to determine whether transcutaneous electrical nerve stimulation (TENS) or interferential current (IFC) increase the effectiveness of neck stabilization exercises (NSEs) on pain, disability, mood and quality of life for chronic neck pain (CNP).

Summary of Background Data.

Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Electrotherapies, such as IFC and TENS, have been applied solo or combined with exercise for management of neck pain; however, the efficacy of these combinations is unclear.

Methods.

A total of 81 patients with CNP were included in this study. Patients were randomly assigned into three groups regarding age and gender. First group had NSE, second group had TENS and NSE, and third group had IFC and NSE. Pain levels [visual analogue scale (VAS)], limits of cervical range of motion (ROM), quality of life (short form-36), mood (Beck depression inventory), levels of disability (Neck Pain and Disability Index), and the need for analgesics of all patients were evaluated before treatment, at 6th and 12th week follow-up. Physical therapy modalities were applied for 15 sessions in all groups. All participants had group exercise accompanied by a physiotherapist for 3 weeks and an additional 3 weeks of home exercise program.

Results.

According to the intragroup assessment, the study achieved its purpose of pain reduction, ROM increase, improvement of disability, quality of life, mood and reduction in drug use in all three treatment groups (P < 0.05). However, clinical outcomes at 6th and 12 th week had no significant difference among the three groups (P > 0.05).

Conclusion.

TENS and IFC therapies are effective in the treatment of CNP patients. However, they have no additional benefit or superiority over NSE.

Level of Evidence: 2
Minimum Clinically Important Difference in SF-36 Scores for Use in Degenerative Cervical Myelopathy
Authors: Badhiwala Jetan H. , Witiw Christopher D. , Nassiri Farshad , Akbar Muhammad A. , Jaja Blessing , Wilson Jefferson R. , Fehlings Michael G.
Published: April 2018

Study Design.

Post-hoc analysis of 606 patients enrolled in the AOSpine CSM-NA or CSM-I prospective, multicenter cohort studies.

Objective.

The aim of this study was to determine the minimum clinically important difference (MCID) in SF-36v2 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores in patients undergoing surgery for degenerative cervical myelopathy (DCM).

Summary of Background Data.

There has been a shift toward focus on patient-reported outcomes (PROs) in spine surgery. However, the numerical scores of PROs lack immediate clinical meaning. The MCID adds a dimension of interpretability to PRO scales; by defining the smallest change, a patient would consider meaningful.

Methods.

The MCID of the SF-36v2 PCS and MCS were determined by distribution- and anchor-based methods comparing preoperative to 12-month scores. Distribution-based approaches included calculation of the half standard deviation and standard error of measurement (SEM). Change in Neck Disability Index (NDI) served as the anchor: “worse” (ΔNDI>7.5); “unchanged” (7.5≥ΔNDI>−7.5); “slightly improved” (−7.5≥ΔNDI>−15); and “markedly improved” (ΔNDI ≤−15). Receiver operating characteristic (ROC) analysis was performed to determine the change score for the MCID with even sensitivity and specificity to distinguish patients who were “slightly improved” versus “unchanged” on the NDI.

Results.

The MCID for the SF-36v2 PCS and MCS were 4.6 and 6.8 by half standard deviation and 2.9 and 4.3 by SEM, respectively. By ROC analysis, the MCID was 3.9 for the SF-36v2 PCS score and 3.2 for the SF-36v2 MCS score. Using a cutoff of 4 points, the SF-36v2 PCS had a sensitivity of 72.2% and specificity of 68.1%, and MCS 61.9% and 64.6%, respectively, in separating patients who were “markedly improved” or “slightly improved” from those who were “unchanged” or “worse.”

Conclusion.

We found the MCID of the SF-36v2 PCS and MCS to be 4 points. This will facilitate use of the SF-36v2 as an outcome in future studies of DCM.

Level of Evidence: 3
Therapeutic strategies involving uterine stem cells in reproductive medicine
Authors: Simoni Michael , Taylor Hugh S.
Published: April 2018

Purpose of review

The current review provides an update on recent advances in stem cell biology relevant to female reproduction.

Recent findings

Stem cells are undifferentiated cells that often serve as a reservoir of cells to regenerate tissue in settings or injury or cell loss. The endometrium has progenitor stem cells that can replace all of the endometrium during each menstrual cycle. In addition, multipotent endometrial cells replace these progenitor cells when depleted. Recruitment of stem cells from outside of the uterus occurs in setting of increased demand such as ischemia or injury. Bone marrow-derived multipotent stem cells are recruited to the uterus by estrogen or injury-induced expression of the chemokine CXCL12. In the setting of overwhelming injury, especially in the setting of low estrogen levels, there may be insufficient stem cell recruitment to adequately repair the uterus resulting in conditions such as Asherman syndrome or other endometrial defects. In contrast, excessive recruitment of stem cells underlies endometriosis. Enhanced understanding of stem-cell mobilization, recruitment, and engraftment has created the possibility of improved therapy for endometrial defects and endometriosis through enhanced manipulation of stem-cell trafficking. Further, the normal endometrium is a rich source of multipotent stem cells that can be used for numerous applications in regenerative medicine beyond reproduction.

A better understanding of reproductive stem-cell biology may allow improved treatment of endometrial disease such as Asherman syndrome and other endometrial receptivity defects. Inhibiting stem-cell mobilization may also be helpful in endometriosis therapy. Finally, endometrial derived multipotent stem cells may play a crucial role in cell therapy for regenerative medicine.
Primary Repair of a Complex Panfacial Fracture by Dog Bite
Authors: Heitz Cláiton , Louzada Guilherme Pivatto , Conci Ricardo Augusto , Rodrigues Renato Luiz , Fritscher Guilherme Genehr
Published: April 2018

Facial fractures due to dog attacks have an unknown incidence rate. To date, only 41 cases of canine bite trauma in a pediatric patient, associated with facial fracture, have been reported in the literature. As major species of involving dogs are the American pitbull terrier and rottweiler. Due to the intense kinematics of this trauma, the treatment becomes complex. Thus, attention to the primary repair of such complex lesions ensures satisfactory results, which is the focus of this discussion. The purpose of this review was to analyze how different ways to approach this type of trauma in children for clarification or correct management. In addition, we address the treatment plan of a complex case of panfacial fracture by a canine bite in a 4-year-old patient. According to a review addressed, the main involved are orbit, nasal, and zygomatic. Antibiotic therapy is indicated for infected bite wounds and wounded considerations at risk of infection, with high complexity and when involving important structures such as bones, vessels, and joints. The state of tetanus immunization and the risk of rabies infection should be routinely addressed in the management of the bite wound.
Consequences of Antepartum Depression
Authors: SCHAFFIR JONATHAN
Published: April 2018

To counsel women about risks and benefits of depression treatment during pregnancy, clinicians must appreciate the potential consequences of untreated depression on the mother and her unborn child. Many studies have demonstrated associations between untreated depression during pregnancy and a range of adverse outcomes, including low birth weight, preterm delivery, preeclampsia, emergent operative delivery, postpartum depression, and both cognitive and behavioral deficits in the child. Although most of these associations are marked by low odds ratios and a host of potential confounding issues, they collectively provide considerable rationale for identifying depression in pregnancy and offering treatment for mothers at risk.
Needle-based Optical Coherence Tomography to Guide Transbronchial Lymph Node Biopsy
Authors: Shostak Eugene , Hariri Lida P. , Cheng George Z. , Adams David C. , Suter Melissa J.
Published: April 2018

Background:

Transbronchial needle aspiration (TBNA), often used to sample lymph nodes for lung cancer staging, is subject to sampling error even when performed with endobronchial ultrasound. Optical coherence tomography (OCT) is a high-resolution imaging modality that rapidly generates helical cross-sectional images. We aim to determine if needle-based OCT can provide microstructural information in lymph nodes that may be used to guide TBNA, and improve sampling error.

Methods:

We performed ex vivo needle-based OCT on thoracic lymph nodes from patients with and without known lung cancer. OCT imaging features were compared against matched histology.

Results:

OCT imaging was performed in 26 thoracic lymph nodes, including 6 lymph nodes containing metastatic carcinoma. OCT visualized lymphoid follicles, adipose tissue, pigment-laden histiocytes, and blood vessels. OCT features of metastatic carcinoma were distinct from benign lymph nodes, with microarchitectural features that reflected the morphology of the carcinoma subtype. OCT was also able to distinguish lymph node from adjacent airway wall.

Conclusions:

Our results demonstrate that OCT provides critical microstructural information that may be useful to guide TBNA lymph node sampling, as a complement to endobronchial ultrasound. In vivo studies are needed to further evaluate the clinical utility of OCT in thoracic lymph node assessment.
Anorectal complications in patients with haematological malignancies
Authors: Loureiro Rafaela V. , Borges Verónica P. , Tomé Ana L. , Bernardes Carlos F. , Silva Mário J. , Bettencourt Maria J.
Published: April 2018

Background

Anorectal complications are common in patients with haematological malignancies.

Objectives

The objectives are to characterize anorectal complications in these patients, identify risk factors and shed light on treatment, morbidity and mortality rates.

Patients and methods

A retrospective, observational study that included 83 inpatients with haematological malignancies and proctological symptoms from January 2010 to September 2015 was conducted. Clinical outcomes were obtained through a detailed review of medical records.

Results

The median age was 56 years, and 52 (62.7%) patients were men. Fifty-six (67.5%) patients had nonseptic anorectal complications and 27 (32.5%) patients had septic anorectal complications.

Risks factors

Patients with septic anorectal complications were more commonly male, older, and had lower absolute neutrophil counts, but the differences were not statistically significant (P=0.79, 0.67 and 0.89, respectively). In positive blood cultures [23/70 (32.9%)], Enterococcus faecium, Klebsiella pneumonia, and Escherichia coli were the most common isolated agents.

Treatment

In nonseptic anorectal complications, conservative treatments/minor proctological procedures were adopted, and patients with septic anorectal complications were treated with antibiotics±major proctological procedures and/or surgical drainage/debridement.

Results of treatment

Forty-eight (85.7%) patients in the nonseptic complications group improved compared with 23 (85.2%) patients in the septic complications group. The overall mortality rate was 2.4% (n=2), with one (1.2%) death related to perianal sepsis.

Conclusion

Enterococcus spp. were more commonly identified in this study and can be increasing in this specific population. In contrast to other reports, we did not identify an association between septic anorectal complications and possible risk factors such as male sex, younger age or a low absolute neutrophil count. Most patients had nonseptic anorectal complications. A major proctological procedure/surgical debridement should always be applied in septic complications, which have better prognoses now than in the past.
Maintaining Short Peripheral Catheter Patency
Authors: Roszell Sheila Serr , Rabinovich Holly Barlowe , Smith-Miller Cheryl A.
Published: April 2018

Sparse evidence exists about how short peripheral catheter (SPC) duration is affected by the presence of a saline lock versus continually infusing fluids. Often the choice to lock an SPC with saline is based on provider preference, rather than available evidence or patient-centered factors. This study compared the duration of 85 SPCs: locked with saline versus continuously running fluids. A secondary analysis considered the influence of a number of intermittent medications and flushes. Although the saline-locked group had a slightly longer duration time, it was not statistically significant. Factors such as desire to ambulate or nighttime saline flushes merit consideration in SPC care decisions and standardized nurse-driven protocols.
Schizophrenia and Criminal Responsibility
Authors: Tsimploulis Georgios , Niveau Gérard , Eytan Ariel , Giannakopoulos Panteleimon , Sentissi Othman
Published: April 2018

The significant progress of psychiatry in the 20th century provided a sophisticated theoretical framework to analyze the complex relationships between crime and mental illness. Schizophrenia has been traditionally associated with severe cognitive and affective deficits that heavily influence empathy, judgment capacities, but also control of impulsiveness. Although there is an association between psychotic disorders and absence or decrease of legal responsibility, their relationship is also determined by sociodemographic, developmental, and clinical factors. These disorders are associated not only with abolished criminal responsibility but also with diminished responsibility. We conduct a systematic literature review to examine the relation between schizophrenia and criminal responsibility. We have found that this clinical entity is often associated with diminished or abolished criminal liability. We discuss these findings, focusing on the specific deficits found in patients with schizophrenia and examining how this problem affects their behavior and eventually their accountability for their crimes.
Forearm-Based Turnover Muscle Flaps for Elbow Soft-Tissue Reconstruction: A Comparison of Regional Coverage Based on Distal Flap Perfusion
Authors: Avashia Yash J. , Shammas Ronnie L. , Poveromo Luke P. , Dekker Travis J. , Brubacher Jacob W. , Richard Marc J. , Ruch David S. , Mithani Suhail K.
Published: April 2018

Background:

Elbow wounds pose a reconstructive challenge. Prior studies have described the vascular anatomy of both the brachioradialis and flexor carpi ulnaris muscle flaps. The goal of this study was to describe the distal flap perfusion of the flexor carpi radialis, with a direct comparison of the brachioradialis, flexor carpi ulnaris, and flexor carpi radialis muscle flaps for coverage around the elbow.

Methods:

Six fresh-frozen upper extremity specimens were dissected for brachioradialis, flexor carpi radialis, and flexor carpi ulnaris flaps. Vascular data from prior studies were combined with our anatomical measurements to determine the area of perfused coverage around the elbow for the brachioradialis and flexor carpi ulnaris. The flexor carpi radialis flap distal vascular perfusion was examined separately with transverse sections at 1-cm intervals after India ink injections to determine distal flap perfusion and elbow coverage. Perfusion data were plotted on x and y axes over the posterior elbow.

Results:

The brachioradialis muscle covered an average of 56 percent of the x axis and 7.4 percent of the y axis. The flexor carpi ulnaris muscle covered an average of 90 percent of the elbow along the x axis and 23.3 percent of elbow along the y axis. The flexor carpi radialis covered an average of 34 percent of the x axis and 4.8 percent of the y axis.

Conclusion:

The flexor carpi ulnaris muscle provides the most versatile and robust coverage over the posterior elbow, followed by the brachioradialis muscle, which consistently provides coverage over the lateral epicondyle.
Effect of One-Stage versus Two-Stage Palatoplasty on Hypernasality and Fistula Formation in Children with Complete Unilateral Cleft Lip and Palate: A Randomized Controlled Trial
Authors: Reddy Rajgopal R. , Gosla Reddy Srinivas , Chilakalapudi Anusha , Kokali Swapnika , Bronkhorst Ewald M. , Kummer Ann W. , Bergé Stefaan J. , Kuijpers-Jagtman Anne Marie
Published: April 2018

Background:

Is one-stage or two-stage palatoplasty more effective for preventing fistula formation and hypernasality in patients with complete unilateral cleft lip and palate?

Methods:

This parallel blocked randomized controlled trial included 100 patients with nonsyndromic complete unilateral cleft lip and palate with a repaired cleft lip, divided into two equal groups. Group A had one-stage palatoplasty patients at age 12 to 13 months while group B had two-stage palatoplasty patients with soft palatoplasty at age 12 to 13 months and hard palatoplasty at age 24 to 25 months. Presence of a fistula was tested clinically at 3 years and speech was tested using nasometry and perceptual analyses at 6 years. Group C consisted of noncleft controls (n = 20, age 6 years) for speech using nasometry. Fistula rates, hypernasality ratings, and nasalance scores were compared between groups A and B. Nasometry recordings of groups A and B were compared with control group C.

Results:

There was no difference in fistula rates between groups A and B (p = 0.409; 95 percent CI, 0.365 to 11.9). Mean nasalance scores of group A showed higher nasalance than group B (p = 0.006; 95 percent CI, 1.16 to 6.53). Perceptual analysis showed no difference between groups A and B (p = 0.837 and p = 1.000). Group A showed higher mean nasalance than group C (p = 0.837 and p = 1.000), whereas group B showed no difference (p = 0.088; 95 percent CI, −0.14 to 2.02).

Conclusions:

There was no difference in fistula rates between groups. Nasalance was slightly higher in patients in the one-stage palatoplasty group than two-stage palatoplasty group, but the difference was not clinically significant.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, II.
Impact of the Glymphatic System on the Kinetic and Distribution of Gadodiamide in the Rat Brain
Authors: Taoka Toshiaki , Jost Gregor , Frenzel Thomas , Naganawa Shinji , Pietsch Hubertus
Published: April 2018

Objectives

The glymphatic system is a recently hypothesized waste clearance system of the brain in which perivascular space constitutes a pathway similar to the lymphatic system in other body regions. Sleep and anesthesia are reported to influence the activity of the glymphatic system. Because rats are nocturnal animals, the glymphatic system is expected to be more active during the day. We attempted to elucidate the influence of the glymphatic system for intravenously injected gadodiamide in the rat brain by 2 experiments. One was a magnetic resonance imaging (MRI) experiment to evaluate the short-term dynamics of signal intensity changes after gadodiamide administration. The other was a quantification experiment to evaluate the concentration of retained gadolinium within the rat brain after repeated intravenous administration of gadodiamide at different times of day and levels of anesthesia.

Materials and Methods

The imaging experiment was performed on 6 rats that received an intravenous injection of gadodiamide (1 mmol/kg) and dynamic MRI for 3 hours at 2.4-minute intervals. The time course of the signal intensity changes was evaluated for different brain structures. The tissue quantification experiment was performed on 24 rats divided into 4 groups by injection time (morning, late afternoon) and anesthesia (none, short, long) during administration. All animals received gadodiamide (1.8 mmol/kg, 8 times over 2 weeks). Gadolinium concentration of dissected brain tissues was quantified 5 weeks after the last administration by inductively coupled plasma mass spectrometry.

Results

In the imaging experiment, muscle and the fourth ventricle showed an instantaneous signal intensity increase immediately after gadodiamide injection. The signal curve of the cerebral cortex and deep cerebellar nuclei reached the peak signal intensity later than the fourth ventricle but earlier than that of the prepontine cistern. In the gadolinium quantification experiment, the concentration in the group with the morning injection showed a significantly lower concentration than the late afternoon injection group. The lowest tissue gadolinium concentrations were found in the groups injected in the morning during long anesthesia.

Conclusions

Instantaneous transition of gadodiamide from blood to cerebrospinal fluid was indicated by dynamic MRI. The gadodiamide distribution to the cerebral cortex and deep cerebellar nuclei seemed to depend on both blood flow and cerebrospinal fluid. This confirms previous studies indicating that the cerebrospinal fluid is one potential pathway of gadolinium-based contrast agent entry into the brain. For the distribution and clearance of the gadodiamide from brain tissue, involvement of the glymphatic system seemed to be indicated in terms of the influence of sleep and anesthesia.
Influence of hyaluronic acid transitions in tumor microenvironment on glioblastoma malignancy and invasive behavior
Authors: Chen Jee-Wei E , Pedron Sara , Shyu Peter , Hu Yuhang , Sarkaria Jann N , Harley Brendan A C
Published: April 2018

The extracellular matrix (ECM) is critical in tumor growth and invasive potential of cancer cells. In glioblastoma tumors, some components of the native brain ECM such as hyaluronic acid (HA) have been suggested as key regulators of processes associated with poor patient outlook such as invasion and therapeutic resistance. Given the importance of cell-mediated remodeling during invasion, it is likely that the molecular weight of available HA polymer may strongly influence GBM progression. Biomaterial platforms therefore provide a unique opportunity to systematically examine the influence of the molecular weight distribution of HA on GBM cell activity. Here we report the relationship between the molecular weight of matrix-bound HA within a methacrylamide-functionalized gelatin (GelMA) hydrogel, the invasive phenotype of a patient-derived xenograft GBM population that exhibits significant in vivo invasivity, and the local production of soluble HA during GBM cell invasion. Hyaluronic acid of different molecular weights spanning a range associated with cell-mediated remodeling (10, 60, and 500 kDa) was photopolymerized into GelMA hydrogels, with cell activity compared to GelMA only conditions (-HA). Polymerization conditions were tuned to create a homologous series of GelMA hydrogels with conserved poroelastic properties (i.e. shear modulus, Poisson’s ratio, and diffusivity). GBM migration was strongly influenced by HA molecular weight. While markers associated with active remodeling of the HA content, hyaluronan synthase and hyaluronidase, were found to be insensitive to matrix immobilized HA content. These results provide new information regarding the importance of local hyaluronic acid content on the invasive phenotype of GBM.