bluuebunny/crossref_metadata_2025 huggingface dataset:
Endoscopic Management of Middle Ear Paragangliomas: A Case Series
Authors: Killeen Daniel E. , Wick Cameron C. , Hunter Jacob B. , Rivas Alejandro , Wanna George B. , Nogueira João Flávio , Kutz Joe Walter , Isaacson Brandon
Published: January 2017

Objective:

To investigate the efficacy and safety of endoscopic middle ear paraganglioma (glomus tympanicum) resection.

Study Design:

Case series with chart review.

Setting:

Multi-institutional tertiary university medical centers.

Patients:

Adult patients with middle ear paragangliomas treated via a transcanal endoscopic approach from 1/2012 to 11/2015.

Intervention:

All tumors were initially approached via a transcanal endoscopic technique. An operating microscope was used only if the tumor could not be adequately visualized or resected with endoscopic techniques alone.

Main Outcome Measures:

The main outcome was completeness of tumor resection via the endoscopic technique. Secondary measures were resolution of pulsatile tinnitus, audiometric outcomes, surgical duration, and surgical complications.

Results:

Endoscopic resection was attempted on 14 middle ear paragangliomas. Thirteen patients (93%) were women with a mean age of 61.6 years. The mean tumor size was 6.2 mm (SD, 3.3). Eleven cases (79%) had complete resection via an exclusive endoscopic approach. The mean surgical duration was 108.1 minutes (SD, 55.6). One case required use of an operating microscope via a transcanal route and two cases required postauricular incisions with mastoidectomy. There were no significant postoperative complications. Two patients (14%) had tympanic membrane perforations repaired intraoperatively without residual perforation on follow-up. All patients had normal postoperative facial nerve function. Pulsatile tinnitus resolved after surgery in all 13 patients who presented with this symptom preoperatively. The mean pure-tone average improved by 5.9 dB (SD, 4.6) after surgery.

Conclusions:

Endoscopic management of middle ear paraganglioma is safe, feasible, and effective.
Clinical and Fecal Microbial Changes With Diet Therapy in Active Inflammatory Bowel Disease
Authors: Suskind David L. , Cohen Stanley A. , Brittnacher Mitchell J. , Wahbeh Ghassan , Lee Dale , Shaffer Michele L. , Braly Kimberly , Hayden Hillary S. , Klein Jani , Gold Benjamin , Giefer Matthew , Stallworth Angela , Miller Samuel I.
Published: January 2017

Goal:

To determine the effect of the specific carbohydrate diet (SCD) on active inflammatory bowel disease (IBD).

Background:

IBD is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Diet is a potential therapeutic option for IBD based on the hypothesis that changing the fecal dysbiosis could decrease intestinal inflammation.

Study:

Pediatric patients with mild to moderate IBD defined by pediatric Crohn’s disease activity index (PCDAI 10-45) or pediatric ulcerative colitis activity index (PUCAI 10-65) were enrolled into a prospective study of the SCD. Patients started SCD with follow-up evaluations at 2, 4, 8, and 12 weeks. PCDAI/PUCAI, laboratory studies were assessed.

Results:

Twelve patients, ages 10 to 17 years, were enrolled. Mean PCDAI decreased from 28.1±8.8 to 4.6±10.3 at 12 weeks. Mean PUCAI decreased from 28.3±23.1 to 6.7±11.6 at 12 weeks. Dietary therapy was ineffective for 2 patients while 2 individuals were unable to maintain the diet. Mean C-reactive protein decreased from 24.1±22.3 to 7.1±0.4 mg/L at 12 weeks in Seattle Cohort (nL<8.0 mg/L) and decreased from 20.7±10.9 to 4.8±4.5 mg/L at 12 weeks in Atlanta Cohort (nL<4.9 mg/L). Stool microbiome analysis showed a distinctive dysbiosis for each individual in most prediet microbiomes with significant changes in microbial composition after dietary change.

Conclusions:

SCD therapy in IBD is associated with clinical and laboratory improvements as well as concomitant changes in the fecal microbiome. Further prospective studies are required to fully assess the safety and efficacy of dietary therapy in patients with IBD.
Depression but Not Symptom Severity is Associated With Work and School Absenteeism in Refractory Chronic Constipation
Authors: Staller Kyle , Barshop Kenneth , Kuo Braden , Ananthakrishnan Ashwin N.
Published: January 2017

Goals:

We sought to determine the patient characteristics associated with increased absenteeism and Emergency Department (ED) utilization among patients with constipation.

Background:

Chronic constipation is associated with significant direct and indirect economic costs. There has been limited study of the predictors of direct and indirect costs in a population with refractory constipation.

Study:

We conducted a cross-sectional cohort study of patients with chronic constipation who presented to a tertiary care center for anorectal manometry. We used standardized instruments to assess disease severity, quality of life, somatization, and psychiatric comorbidities. We used multivariable logistic regression to determine the predictors of work and school absenteeism as well as ED visits for constipation.

Results:

There were 148 consecutive patients enrolled (87% female, mean age 43) of whom 32 (21.6%) had high absenteeism and 36 (24.3%) visited the ED for constipation in the past year. Patients with high absenteeism and ED visits were more likely to be depressed (56.3% vs. 18.5%, P<0.0001 for high absenteeism; 47.2% vs. 19.6%, P<0.01 for ED visits). After multivariable adjustment and sensitivity analyses, only depression (OR, 4.41; P<0.01) was associated with increased absenteeism while there was a trend toward an association between depression and ED visits (OR, 2.57; P=0.067). Symptom severity was not associated with high absenteeism or ED utilization.

Conclusions:

Among patients with chronic constipation, depression is a stronger predictor of absenteeism than symptom severity. Depression may drive a portion of the indirect costs of chronic constipation.
Endoscopic Stenting for Colorectal Cancer
Authors: Fiori Enrico , Lamazza Antonietta , Sterpetti Antonio V. , Schillaci Alberto
Published: January 2017

Goal:

The aim of our prospective study was to analyze the results of endoscopic stenting to treat obstruction due to colorectal cancer and complications after colorectal resection for cancer.

Background:

Endoscopic stenting for obstructing colorectal cancer has become a common place in clinical practice. However, there is a 2% to 5% risk of bowel perforation, and a percentage of technical failure of 2% to 10%.

Materials and Methods:

In a 15-year period (August, 1999 to December, 2013), 153 patients with colorectal cancer had endoscopic placement of a self-expandable metal stent for treatment of an obstructing colorectal cancer (133 patients) or for treatment of complications after colorectal resection for cancer (20 patients). They were prospectively evaluated in a database and they form the basis of this report.

Results:

There was no case of mortality or major morbidity. Overall technical success was 94.8%. After introducing the use of a pediatric nasogastroscope to pass the obstruction (71 patients), technical success was 100%. Complications in patients in whom the stent was left in place during the follow-up were frequent, requiring a close observation. We had 20 patients with fecal obstruction, 4 cases of stent dislodgment, and 8 cases of obstruction from ingrowth of the tumor. All patients were treated successfully endoscopically.

Conclusions:

Placement of self-expandable metal stents represents a valid technique. A proper training is required.
Acoustic radiation force impulse elastography: comparison and combination with other noninvasive tests for the diagnosis of compensated liver cirrhosis
Authors: Pfeifer Lukas , Adler Werner , Zopf Steffen , Siebler Jürgen , Wildner Dane , Goertz Ruediger S. , Schellhaas Barbara , Neurath Markus F. , Strobel Deike
Published: January 2017

Background and aims

The aim of this study was to compare acoustic radiation force impulse (ARFI) elastography with other noninvasive tests and to develop a new score for the assessment of liver fibrosis/cirrhosis.

Materials and methods

B-mode ultrasound (including high-frequency liver surface evaluation), routine blood tests, ARFI quantification, and mini-laparoscopic liver evaluation were obtained in compensated patients scheduled for mini-laparoscopic biopsy. Our new cirrhosis score (CS) for the assessment of liver cirrhosis, based on a linear combination of ARFI, platelet (PLT), liver surface, and prothrombin index (PI), was calculated by linear discriminant analysis. Its performance was compared with ARFI-elastography, APRI, FIB-4, alanine aminotransferase (ALT)/aspartate aminotransferase (AST)-ratio, PLT, and PI. For the diagnosis of cirrhosis, a combined gold standard (cirrhosis at histology and/or at macroscopic liver evaluation) was used.

Results

In total, 171 patients, of whom 38 had compensated cirrhosis, were included. The CS was significantly better for the diagnosis of cirrhosis compared with ARFI (P=0.028), APRI (P=0.012), PLTs (P=0.013), PI (P=0.025), and ALT/AST ratio (P=0.001), but not the FIB-4 score (P=0.207), with an area under the receiver operating characteristic curve of 0.92 [95% confidence interval (CI): 0.87–0.97], 0.86 (95% CI:0.79–0.93), 0.80 (95% CI: 0.72–0.87), 0.79 (95% CI: 0.7–0.87), 0.81 (95% CI: 0.73–0.89), 0.72 (95% CI:0.64–0.81), and 0.86 (95% CI: 0.8–0.93), respectively. Sensitivity, specificity, positive predictive value, and negative predictive value for CS were 87%, 86%, 63%, and 96%, respectively. The FIB-4 score was significantly superior to the APRI score (P=0.041) and the ALT/AST ratio (P=0.011), with no significant difference from ARFI elastography (P=0.88) for the diagnosis of cirrhosis.

Conclusion

Combining ARFI elastography with other noninvasive tests that are used routinely in the workup of patients with suspected liver disease can improve diagnostic accuracy for compensated liver cirrhosis as compared with ARFI elastography alone. The FIB-4 score showed an overall comparable diagnostic accuracy to ARFI-elastography for compensated cirrhosis.
ATP-citrate lyase: genetics, molecular biology and therapeutic target for dyslipidemia
Authors: Burke Amy C. , Huff Murray W.
Published: January 2017

Purpose of review

ATP-citrate lyase (ACLY) has re-emerged as a drug target for LDL cholesterol (LDL-C) lowering. We review ACLY as a therapeutic strategy, its genetics, its molecular and cellular biology, and also its inhibition.

Recent findings

ACLY is a critical enzyme linking glucose catabolism to lipogenesis by providing acetyl-CoA from mitochondrial citrate for fatty acid and cholesterol biosynthesis. Human genetic variants have been associated with enhanced growth and survival of several cancers, and with attenuated plasma triglyceride responses to dietary fish oil. In mice, liver-specific Acly deficiency protects from hepatic steatosis and dyslipidemia, whereas adipose tissue-specific Acly deletion has no phenotype, supporting therapeutic inhibition of ACLY. A lipid-regulating compound, bempedoic acid, was discovered to potently inhibit ACLY, and in animal models, it prevents dyslipidemia and attenuates atherosclerosis. Phase 2 clinical trials revealed that bempedoic acid effectively lowers LDL-C as monotherapy, combined with ezetimibe, added to statin therapy and in statin-intolerant hypercholesterolemic patients.

The efficacy of bempedoic acid as an LDL-C-lowering agent has validated ACLY inhibition as a therapeutic strategy. Positive results of phase 3 patient studies, together with long-term cardiovascular disease outcome trials, are required to establish ACLY as a major new target in cardiovascular medicine.
Emerging exposures of developmental toxicants
Authors: Wolff Mary S. , Buckley Jessie P. , Engel Stephanie M. , McConnell Rob S. , Barr Dana B.
Published: January 2017

Purpose of review

The purpose of this review is to identify emerging developmental toxicants that are understudied in children's health. Exposures may arise from new products designed to improve utility, to reduce toxicity, or to replace undesirable chemicals. Exposures to less-toxic chemicals may also be significant if they are very commonly used, thereby generating widespread exposure. Sources of exposure include the workplace, personal, home, and office products; food, water, and air.

Recent findings

We describe eight exposure categories that contain numerous potential developmental toxicants. References are discussed if reported in PubMed during the past decade at least 10 times more frequently than in 1990–2000. Examples included phthalates, phenols, sunscreens, pesticides, halogenated flame retardants, perfluoroalkyl coatings, nanoparticles, e-cigarettes, and dietary polyphenols. Replacements are often close structural homologs of their precursors. We suggest biomonitoring as preferred means of exposure assessment to emerging chemicals. Some existing analytic methods would require minimal modification to measure these exposures, but others require toxicokinetic and analytic investigation.

A deliberate strategy for biomonitoring of emerging replacement chemicals is warranted, especially in view of concerns regarding developmental toxicity. To prevent adverse health effects, it is important to characterize such exposures before they become widely disseminated.
Tobacco, e-cigarettes, and child health
Authors: Peterson Lisa A. , Hecht Stephen S.
Published: January 2017

Purpose of the review

The availability of the Children's Health Exposure Assessment Resource funded by the National Institute of Environmental Health Sciences provides new opportunities for exploring the role of tobacco smoke exposure in causing harm to children.

Recent findings

Children of smokers are exposed to nicotine and other harmful tobacco smoke chemicals in utero as well as in their environment. This passive exposure to tobacco smoke has a variety of negative effects on children. In-utero exposure to tobacco smoke causes poor birth outcomes and influences lung, cardiovascular, and brain development, placing children at increased risk of a number of adverse health outcomes later in life, such as obesity, behavioral problems, and cardiovascular disease. Furthermore, most smokers start in their adolescence, an age of increased nicotine addiction risk. Biomarkers of tobacco exposure helps clarify the role tobacco chemicals play in influencing health both in childhood and beyond. Although electronic cigarettes (e-cigarettes) appear to be a nicotine delivery device of reduced harm, it appears to be a gateway to the use of combustible cigarette smoking in adolescents.

Pediatric researchers interested in elucidating the role of tobacco smoke exposure in adverse outcomes in children should incorporate biomarkers of tobacco exposure in their studies.
Does quality improvement work in neonatology improve clinical outcomes?
Authors: Ellsbury Dan L. , Clark Reese H.
Published: January 2017

Purpose of review

Quality improvement initiatives in neonatology have been promoted as an important way of improving outcomes of newborns. The purpose of this review is to examine the effectiveness of recent quality improvement work in improving the outcomes of infants requiring neonatal intensive care.

Recent findings

Quality improvement collaboratives and single-center projects demonstrate improvement of clinical processes and outcomes in neonatology that impact both preterm and term infants. Declines in morbidities, resource use, and length of stay have been associated with reductions in healthcare costs.

Recent quality improvement work has shown evidence of improvement in clinical outcomes in neonatal intensive care patients. These improvements have important implications for the reduction of healthcare costs in this population.
Interleukin-6 and Interleukin-8 Levels Correlate With the Severity of Aplastic Anemia in Children
Authors: Gupta Vineeta , Kumar Sushil , Sonowal Rimjhim , Singh Surya K.
Published: January 2017

Aim:

The aim of this study was to evaluate the levels of interleukin (IL)-6 and IL-8 in patients with aplastic anemia and its correlation with severity of the disease.

Materials and Methods:

IL-6 and IL-8 levels were measured in 40 patients with aplastic anemia in the age group of 4 to 14 years. A total of 40 healthy children served as controls. Quantitative estimation of IL-6 and IL-8 was performed using a solid-phase sandwich ELISA kit. Results were presented as IL-6 and IL-8 concentrations in pg/mL. Patients received immunosuppressive therapy per the British Committee for Standards in Haematology Guidelines 2009.

Results:

Mean age of the patients was 9.78±2.74 years. IL-6 level of patients was elevated compared with controls (193.48±352.3 vs. 4.58±3.39; P<0.001). IL-8 levels were also significantly elevated in patients compared with controls (15.58±18.0 vs. 1.85±0.95; P<0.001). IL levels were also assessed in relation to severity of the disease. Levels were the highest in patients with very severe aplastic anemia (724.33±519.42), followed by severe aplastic anemia (80.51±66.28 pg/mL), and non–severe aplastic anemia (6.01±1.89). Differences were statistically significant. A similar trend was also observed for IL-8 levels, where the levels were 41.02±24.23, 11.34±8.0, and 1.67±0.71 for very severe aplastic anemia, severe aplastic anemia, and non–severe aplastic anemia, respectively. The differences were again statistically significant. IL levels were also correlated with the treatment outcome. Responders had lower levels compared with nonresponders, but the difference was not statistically significant (186.36±322.45 vs. 198.74±368.10). Levels of ILs decreased in responders, but were not comparable with that of controls 6 months after therapy.

Conclusions:

High levels of IL-6 and IL-8 were observed in children with aplastic anemia. Increased levels showed correlation with disease severity and therefore appear to play an important role in aplastic anemia. However, levels had no significant correlation with the treatment outcome.
Posterior Reversible Encephalopathy Syndrome and Cerebral Sinus Thrombosis in a Case of Pediatric B-Cell ALL
Authors: Fraint Ellen , Miller Robin , Walter Andrew
Published: January 2017

Posterior reversible encephalopathy syndrome (PRES) and cerebral sinus thrombosis are 2 known complications of acute lymphoblastic leukemia and its treatment. We describe a patient with acute lymphoblastic leukemia whose course was complicated by both of these conditions. This case is novel both for the fact that PRES developed before the initiation of therapy and that PRES was followed shortly by the development of cerebral sinus thrombosis. Our patient’s story raises questions about our current understanding of the pathophysiology of PRES, and it suggests that PRES may actually be a predisposing risk factor for cerebral sinus thrombosis.
Coinheritance of Hereditary Elliptocytosis and Deletional Hemoglobin H Disease
Authors: Charoenkwan Pimlak , Natesirinilkul Rungrote , Choeyprasert Worawut , Kulsumritpon Natchanon , Sangiamporn Orapan
Published: January 2017

Hereditary elliptocytosis is an inherited red blood cell membrane disorder characterized by typical peripheral blood smear findings of elliptocytes or rod-like red blood cells. Hemoglobin H disease is a form of α-thalassemia disease resulting in mild to moderate hemolytic anemia. The authors report 1 case of a girl who was diagnosed with oculo-auriculo-vertebral spectrum and a coinheritance of hereditary elliptocytosis and deletional hemoglobin H disease. She had moderate, non–transfusion-dependent anemia. The red blood cells showed marked poikilocytosis and fragmentation. The parents were α-thalassemia carriers and the father had the typical red blood cell morphology of common hereditary elliptocytosis.
Pulmonary Nodule Size <5 mm Still Warrants Investigation in Patients With Osteosarcoma and Ewing Sarcoma
Authors: Kusma Jared , Young Cody , Yin Han , Stanek Joseph R. , Yeager Nicholas , Aldrink Jennifer H.
Published: January 2017

Background:

Osteosarcoma (OS) and Ewing sarcoma (ES) have a high propensity to develop pulmonary metastases. Lung lesions with calcification, peripheral location, and size >5 mm are more likely to represent malignant metastases. We evaluated the incidence of malignancy in nodules 5 mm or less to potentially guide decisions between biopsy and observation.

Materials and Methods:

A retrospective review of patients <25 years of age with metastatic OS and ES treated at our institution between 2001 and 2014 who had undergone pulmonary nodule biopsy was performed. Computed tomographic scans were reviewed to evaluate nodule size and change over time.

Results:

Thirty-five patients (27 OS, 8 ES) met inclusion criteria. One hundred sixteen nodules were biopsied (97 OS, 19 ES). Nodule size at biopsy was not significantly different between the malignant (median, 6 mm, range, 1 to 79 mm) and benign (median, 3 mm, range, 1 to 21 mm) lesions (P=0.063). Size of pulmonary nodules <5 mm was not entirely predictive of benign status, with sensitivity estimate of 0.709 (95% confidence interval, 0.465-0.872; P=0.091) and specificity estimate of 0.776 (95% confidence interval, 0.324-0.962; P=0.219) for all nodules biopsied.

Conclusions:

Pulmonary nodules in patients with OS and ES <5 mm cannot be excluded from biopsy considerations.
Influence of the rehabilitation outcome on returning to drive after neurological impairment
Authors: Čižman Urša Š. , Vidmar Gaj , Drnovšek Petra
Published: January 2017

In traumatic brain injury (TBI) and stroke rehabilitation, the question of reintegration of the driver into traffic is faced very often. Driving is an important domain and for some patients, return to driving represents a crucial event for community inclusion. The aim of our study was to examine the utility of Glasgow Coma Scale within the first 24 h of injury and the Functional Independence Measure (FIM) at rehabilitation admission for predicting the return to driving. We included 72 patients after TBI or stroke. Driving outcome was assessed in terms of being allowed to drive without restrictions as opposed to failing the test or being allowed to drive with restrictions. We examined two samples: the TBI patients only and the entire sample including patients after stroke. The results indicate that for TBI patients, Glasgow Coma Scale and motor FIM could be predictors of driving outcome; in the entire sample, the unrestricted driving outcome was also associated with a high score on the FIM motor scale. Early prediction of return to driving after TBI and stroke is important for the patients, their families and the rehabilitation teams to set realistic goals that enable the best possible reintegration after rehabilitation.
Implementation and Evaluation of Self-Scheduling in a Hospital System
Authors: Wright Christina , McCartt Peggy , Raines Diane , Oermann Marilyn H.
Published: January 2017

Inflexible work schedules affect job satisfaction and influence nurse turnover. Job satisfaction is a significant predictor of nurse retention. Acute care hospitals report that job satisfaction is influenced by autonomy and educational opportunity. This project discusses implementation of computer-based self-scheduling in a hospital system and its impact. It is important for staff development educators to be aware that self-scheduling may play a key role in autonomy, professional development, turnover, and hospital costs.
Modified Nanoantibodies Increase Sensitivity in Avidin-Biotin Immunohistochemistry
Authors: Wong Anthony , Sykora Chelsea , Rogers Lewis , Higginbotham Jennifer , Wang Jiwu
Published: January 2017

Revealing the spatial arrangement of molecules within a tissue through immunohistochemistry (IHC) is an invaluable tool in biomedical research and clinical diagnostics. Choosing both the appropriate antibody and amplification system is paramount to the pathologic interpretation of the tissue at hand. The use of single domain VHH nanoantibodies (nAbs) promise more robust and consistent results in IHC, but are rarely used as an alternative to conventional immunoglobulin G (IgG) antibodies. nAbs are originally obtained from llamas and are the smallest antigen-binding fragments available. To determine whether the unique biophysical properties of nAbs give them an advantage in IHC, we first compared a basic fibroblast growth factor nAb to polyclonal IgG antibodies using tissue isolated from pancreatic adenocarcinoma. The nAb was extremely effective in antigen signal detection and allowed for a more streamlined and reproducible protocol. Furthermore, because nAbs are expressed in Escherichia coli from a single gene, they are quite amenable to genetic engineering. As such, we then covalently bound a highly biotinylated amplifier protein to basic fibroblast growth factor and p16 nAbs (termed nAb Plus), resulting in improved IHC sensitivity. The use of a biotinylated nAb Plus not only achieved local, covalent signal amplification, but also eliminated the need for a secondary antibody and subsequent amplification steps. These results highlight nAbs as valuable alternatives to conventional IgG antibodies, decreasing overall processing time and costs of reagents while increasing sensitivity and reproducibility across individual IHC assays.
Diabetes Complications and Depressive Symptoms: Prospective Results From the Montreal Diabetes Health and Well-Being Study
Authors: Deschênes Sonya S. , Burns Rachel J. , Pouwer Frans , Schmitz Norbert
Published: January 2017

Objective

Prospective studies testing the potential impact of diabetes complications on depression are limited. The present study examined the longitudinal associations between diabetes complications and the risk and recurrence/persistence of depressive symptoms.

Methods

Data were from a prospective community cohort telephone survey of adults with diabetes (N = 1314). Diabetes complications and depressive symptoms were assessed via self-report (Diabetes Complications Index and Patient Health Questionnaire-9, respectively) at baseline and annually for 5 years. Statistical models adjusted for sociodemographic, lifestyle, and diabetes characteristics.

Results

The number of diabetes complications at baseline was positively associated with a greater risk of elevated depressive symptoms, with the highest risk found for those with four to six complications at baseline (risk ratio = 2.73, 95% confidence interval = 1.64–4.56). Cerebrovascular disease was the complication most strongly associated with incident depressive symptoms (risk ratio = 2.22, 95% confidence interval = 1.59–3.10). Coronary artery disease, peripheral vascular disease, and neuropathy were also associated with the risk of depression, whereas foot problems and eye problems were not. In addition, a greater number of diabetes complications were associated with recurrent/persistent depression, though with a small effect size (Δr
2 = .02). A parallel process latent growth curve model indicated that increases in diabetes complications were associated with increases in depressive symptoms during the course of the follow-up period (β = .74, p < .001).

Conclusions

This study demonstrates the temporal relation between diabetes complications and depressive symptoms and underscores the psychological burden of diabetes complications by prospectively demonstrating the increased risk and recurrence of depressive symptoms associated with diabetes complications.
A Giant Tumefactive Virchow-Robin Space: A Rare Cause of a Homonymous Quadrantanopia
Authors: Rivet Alysse , Gauthier Anne-Sophie , Chatain Marion , Billon-Grand Romain , Thines Laurent , Delbosc Bernard
Published: January 2017

A 53-year-old woman was found to have a left inferior homonymous quadrantanopia. Brain MRI disclosed a giant Virchow–Robin space compressing the right optic tract. After fenestration of this cystic lesion, most of the visual field loss resolved. Giant Virchow–Robin spaces may cause homonymous field defects which, with appropriate management, may improve.
Efferent Vision Therapy
Authors: Rucker Janet C. , Phillips Paul H.
Published: January 2017

Background:

Traditional orthoptic therapy used by ophthalmologists, orthoptists, and optometrists is directed at improving visual acuity, ocular alignment, or both. For example, convergence exercises are used to treat convergence insufficiency (CI). However, other forms of “vision therapy” are directed at improving “visual processing and efficiency.” The therapeutic regimen often entails repetitive ocular motor tasks performed during multiple office visits with a behavioral optometrist. These ocular motor tasks are used to treat diverse conditions such as learning disabilities, poor reading ability, dyslexia, and attention-deficit hyperactivity disorder (ADHD). Evidence regarding the efficacy of therapy directed at ocular motility for the treatment of multiple conditions is reviewed.

Evidence Acquisition:

Review of literature.

Results:

Randomized, controlled, double-masked studies show that convergence exercises reduce symptoms and improve signs of CI in otherwise healthy patients. However, the most efficacious convergence tasks, and the optimal duration and frequency of these tasks, remain unknown. Patients with learning disabilities, poor reading ability, dyslexia, or ADHD do not consistently have unique ocular motor deficits. Patients who acquire ocular motor deficits do not develop these conditions. There are no randomized, controlled studies that show treatment consisting of repetitive ocular motor tasks improves learning disabilities, reading, dyslexia, or ADHD.

Conclusions:

Convergence exercises effectively treat CI in healthy patients. The optimal treatment regimen is unknown. There is insufficient evidence to recommend “vision therapy” for the treatment of learning disabilities, impaired reading, dyslexia, or ADHD.
Transcriptome-wide splicing quantification in single cells
Authors: Huang Yuanhua , Sanguinetti Guido
Published: January 2017

Single cell RNA-seq (scRNA-seq) has revolutionised our understanding of transcriptome variability, with profound implications both fundamental and translational. While scRNA-seq provides a comprehensive measurement of stochasticity in transcription, the limitations of the technology have prevented its application to dissect variability in RNA processing events such as splicing. Here we present BRIE (Bayesian Regression for Isoform Estimation), a Bayesian hierarchical model which resolves these problems by learning an informative prior distribution from sequence features. We show that BRIE yields reproducible estimates of exon inclusion ratios in single cells and provides an effective tool for differential isoform quantification between scRNA-seq data sets. BRIE therefore expands the scope of scRNA-seq experiments to probe the stochasticity of RNA-processing.
Nucleotide-dependent stiffness suggests role of interprotofilament bonds in microtubule assembly
Authors: Taute Katja M. , Florin Ernst-Ludwig
Published: January 2017

Many eukaryotic cell functions depend on dynamic instability, meaning the nucleotide-driven assembly and disassembly of microtubules. Assembly requires the constituent tubulin dimers to bind the nucleotide GTP, and its subsequent hydrolysis to GDP induces disassembly. The underlying structural mechanisms, however, are not well understood. Here, we determine the strength of contacts in the microtubule lattice by combining high precision measurements of the bending stiffness of analogues of GTP and GDP microtubules with a recent theoretical model. While previous structural studies have focussed on how the curvature of the tubulin dimer is affected by nucleotide binding, we present evidence of a dramatic regulation of the lateral interactions between the parallel protofilaments that dimers form in the microtubule. We conclude that the shear coupling between neighboring protofilaments is at least two orders of magnitude stronger in the GTP state than in the GDP state, and discuss the implications for the microtubule assembly.
The Effects of Sex and Diet on Physiology and Liver Gene Expression in Diversity Outbred Mice
Authors: Gatti Daniel M. , Simecek Petr , Somes Lisa , Jeffrey Clifton T. , Vincent Matthew J. , Choi Kwangbom , Chen Xingyao , Churchill Gary A. , Svenson Karen L.
Published: January 2017

Inter-individual variation in metabolic health and adiposity is driven by many factors. Diet composition and genetic background and the interactions between these two factors affect adiposity and related traits such as circulating cholesterol levels. In this study, we fed 850 Diversity Outbred mice, half females and half males, with either a standard chow diet or a high fat, high sucrose diet beginning at weaning and aged them to 26 weeks. We measured clinical chemistry and body composition at early and late time points during the study, and liver transcription at euthanasia. Males weighed more than females and mice on a high fat diet generally weighed more than those on chow. Many traits showed sex- or diet-specific changes as well as more complex sex by diet interactions. We mapped both the physiological and molecular traits and found that the genetic architecture of the physiological traits is complex, with many single locus associations potentially being driven by more than one polymorphism. For liver transcription, we find that local polymorphisms affect constitutive and sex-specific transcription, but that the response to diet is not affected by local polymorphisms. We identified two loci for circulating cholesterol levels. We performed mediation analysis by mapping the physiological traits, given liver transcript abundance and propose several genes that may be modifiers of the physiological traits. By including both physiological and molecular traits in our analyses, we have created deeper phenotypic profiles to identify additional significant contributors to complex metabolic outcomes such as polygenic obesity. We make the phenotype, liver transcript and genotype data publicly available as a resource for the research community.
Rps3/uS3 promotes mRNA binding at the 40S ribosome entry channel and stabilizes preinitiation complexes at start codons
Authors: Dong Jinsheng , Aitken Colin Echeverría , Thakur Anil , Shin Byung-Sik , Lorsch Jon R. , Hinnebusch Alan G.
Published: January 2017

The eukaryotic 43S pre-initiation complex (PIC) bearing Met-tRNAiMetin a ternary complex (TC) with eIF2-GTP scans the mRNA leader for an AUG codon in favorable “Kozak” context. AUG recognition provokes rearrangement from an open PIC conformation with TC bound in a state not fully engaged with the P site (“POUT”) to a closed, arrested conformation with TC tightly bound in the “PIN” state. Yeast ribosomal protein Rps3/uS3 resides in the mRNA entry channel of the 40S subunit and contacts mRNA via conserved residues whose functional importance was unknown. We show that substitutions of these residues reduce bulk translation initiation and diminish initiation at near-cognate UUG start codons in yeast mutants in which UUG selection is abnormally high (Sui-), conferring the Ssu-phenotype. Two such Ssu-substitutions—R116D and R117D—also increase discrimination against an AUG codon in suboptimal Kozak context. Consistently, the Arg116 and Arg117 substitutions destabilize TC binding to 48S PICs reconstituted in vitro with mRNA harboring a UUG start codon, indicating destabilization of the closed PINstate with a UUG:anticodon mismatch. Using model mRNAs lacking contacts with either the mRNA entry or exit channels of the 40S subunit, we demonstrate that Arg116/Arg117 are crucial for stabilizing PIC:mRNA contacts at the entry channel, complementing the function of eIF3 at both entry and exit channels. The corresponding residues in bacterial uS3 promote the helicase activity of the elongating ribosome, suggesting that uS3 contacts with mRNA enhance multiple phases of translation across different domains of life.
Crystal structure of (1R,3aR,7aR)-1-{(S)-1-[(2R,5S)-5-(3-hydroxypentan-3-yl)tetrahydrofuran-2-yl]ethyl}-7a-methyl-2,3,3a,4,5,6,7,7a-octahydro-1H-inden-4-one
Authors: Martínez Andrea , Santalla Hugo , Garrido Fátima , Barry Aliou Hamady , Gaye Mohamed , Fall Diop Yagamare
Published: January 2017

The title compound, C21H36O3, contains an oxolane ring, and six defined stereocentres and may serve as a useful synthon for the synthesis of calcitriol analogues. The configurations of the chiral C atoms of the side chain were unambiguously established in the refinement. In the crystal, C—H...O and extremely weak O—H...O hydrogen bonds arising from the sterically hindered alcohol group link the molecules into a three-dimensional network.
(E)-1-(1,3-Benzodioxol-5-yl)-3-(2,4,5-trimethoxyphenyl)prop-2-en-1-one
Authors: Sunitha V. M. , Naveen S. , Dileep Kumar A. , Ajay Kumar K. , Lokanath N. K. , Manivannan V. , Manjunath H. R.
Published: January 2017

The molecule of the title compound C19H18O6, adopts an E conformation about the C=C double bond and the C—C=C—C torsion angle is −179.30 (16)°. The molecule is nearly planar, as indicated by the dihedral angle of 6.99 (6)° between the benzene ring and the benzodioxalane ring. In the crystal, molecules are linked via weak C—H...O hydrogen bonds, forming zigzag chains propagating along the b axis.
(E)-3-(2,3-Dichlorophenyl)-1-(2-methoxyphenyl)prop-2-en-1-one
Authors: Sunitha V. M. , Naveen S. , Vagish C. B. , Ajay Kumar K. , Lokanath N. K. , Manjunath H. R.
Published: January 2017

In the title compound, C16H12Cl2O2, the olefinic double bond adopts an E configuration. The molecule is non-planar, as shown by the dihedral angle of 15.40 (19)° between the 2,3-dichlorophenyl ring and the 2-methoxyphenyl ring. In the crystal, molecules are linked via weak C—H...O hydrogen bonds, forming zigzag chains propagating along the c axis.
A study into the ability of SPD to restore the buckling strength and modes of rib stiffened panels with simulated stress corrosion cracks
Authors: Jones Rhys , Matthews Neil , Peng Daren , Orchowski Nicholas
Published: January 2017

Purpose

The purpose of this paper is to describe the results of a combined numerical and experimental study into the ability of supersonic particle deposition (SPD) to restore the load carrying capacity of rib stiffened wing planks with simulated stress corrosion cracking (SCC).

Design/methodology/approach

In this context the experimental results reveal that SCC can result in a dramatic reduction in the load carrying capacity of the structure and catastrophic failure via cracking that tears the length of the structure through buckling. A combined numerical and experimental study then reveals how this reduction, in the load carrying capacity can be overcome by using SPD.

Findings

This paper is the first to show that SPD can be used to restore the load carrying capacity of rib stiffened structures with SCC. It also shows that SPD repairs can be designed to have only a minimal effect on the local stiffness and hence on the load path. However, care should be taken to ensure that the design is such that premature failure of the SPD does not occur.

Originality/value

This is the first paper to show that a thin layer of SPD deposited 7,075 aluminium alloy powder on either side of the SCC-simulated stiffener has the potential to restore the load carrying capability of a rib stiffened structure. As such it represents an important first step into establishing the potential for SPD to restore the buckling strength of rib stiffened wing panels containing SCC.
Computational investigation of ballistic-impact behavior and penetration resistance of a nacre-like ceramic/polymer laminated composite
Authors: Grujicic Mica , Ramaswami S. , Snipes Jennifer
Published: January 2017

Purpose

Nacre is a biological material constituting the innermost layer of the shells of gastropods and bivalves. It consists of polygonal tablets of aragonite, tessellated to form individual layers and having the adjacent layers as well as the tablets within a layer bonded by a biopolymer. Due to its highly complex hierarchical microstructure, nacre possesses an outstanding combination of mechanical properties, the properties which are far superior to the ones that are predicted using techniques such as the rule of mixtures. Given these properties, a composite armor the structure of which mimics that of nacre may have improved performance over a monolithic armor having a similar composition and an identical areal density. The paper aims to discuss these issues.

Design/methodology/approach

In the present work, an attempt is made to model a nacre-like composite armor consisting of B4C tablets and polyurea tablet/tablet interfaces. The armor is next tested with respect to impact by a solid right circular cylindrical (SRCC) rigid projectile, using a transient non-linear dynamics finite-element analysis. The ballistic-impact response and the penetration resistance of the armor are then compared with that of the B4C monolithic armor having an identical areal density. Furthermore, the effect of various nacre microstructural features (e.g. surface profiling, micron-scale asperities, mineral bridges between the overlapping tablets lying in adjacent layers, and B4C nano-crystallinity) on the ballistic-penetration resistance of the composite armor is investigated in order to identify an optimal nacre-like composite armor architecture having the largest penetration resistance.

Findings

The results obtained clearly show that a nacre-like armor possesses a superior penetration resistance relative to its monolithic counterpart, and that the nacre microstructural features considered play a critical role in the armor-penetration resistance.

Originality/value

The present work indicates that for a given choice of armor material, penetration resistance may be improved by choosing a structure resembling that of nacre.
The use of Facebook to explore self-concept: analysing Colombian consumers
Authors: Castro Lorena , Marquez Jose
Published: January 2017

Purpose

This research aims to explore the way companies can use social network sites, in particular Facebook, to understand the elements of the actual and ideal-selves of their target market. An important issue is whether the brand’s personality should match consumers’ actual or ideal-self; this complex decision depends on specific characteristics of target markets and products.

Design/methodology/approach

Photo-elicitation and in-depth interviews were carried out and applied to 15 interviewees. This exploratory phase seeks to broaden the understanding of the phenomenon clarifying important concepts through the users’ rich descriptions and explanations. A primary exploratory qualitative research is conducted, as there is only little information available to answer the research question. Secondary data have also been used to support or contrast the findings with those made by other authors

Findings

The results indicate that Facebook users construct their virtual identity with elements from both the actual and the ideal-self, although they predominantly stress those aspects, which make them look more socially desirable. Each Facebook feature is used with different intentions, and that is why different elements of the self can be extracted from each.

Practical implications

Companies can enhance emotional connections with consumers by applying “self-congruence”, which refers to the correspondence between the consumer’s self-concept and the brand’s personality.

Originality/value

To analyse the empirical findings, the paper draws on the self-concept, brand personality and self-congruence theory. More particularly, on Facebook representations and its relationship with the way people think about them and the manner in which they are expressed.
Branding in small- and medium-sized enterprises (SMEs)
Authors: Odoom Raphael , Narteh Bedman , Boateng Richard
Published: January 2017

Purpose

Given the significant contributions of small- and medium-sized enterprises (SMEs) across several economies, calls for investigations into their branding strategies are burgeoning. However, the literature is unclear, scattered and relatively scanty. The purpose of this paper is to provide a review of the existing literature on branding with a focus on SMEs.

Design/methodology/approach

The study uses a systematic review by identifying and evaluating peer-reviewed journal publications focusing on branding within the context of SMEs. The systematic design is based on papers published within the period of 2004-2014.

Findings

The review shows that significant progress is being made in the area under discussion. With several gaps in issues and empirical evidence, as well as in theoretical and methodological approaches, the paper signals promising lines of inquiry for both empirical and theoretical research.

Research limitations/implications

By highlighting the research issues, as well as providing some pertinent research questions across various themes, the paper aims at directing future research efforts to critical areas which require immediate attention. The implications of the review are discussed in the paper.

Originality/value

The study identifies and describes the state of research issues and evidence in branding literature within the context of SMEs over a 10-year period, prompting insightful avenues to the academic and practitioner communities.
Customer loyalty in telecom service sector: the role of service quality and customer commitment
Authors: Izogo Ernest Emeka
Published: January 2017

Purpose

The purpose of this paper is to examine how firms can influence customer loyalty through customer commitment by leveraging two constructs of service quality: service assurance and service reliability.

Design/methodology/approach

The analyses are based on 138 responses retrieved from experienced users of mobile phone services in one of the big cities in the South-eastern part of Nigeria through a survey questionnaire. The validity and reliability of the measurement model as well as the proposed hypotheses were examined through the partial least squares structural equation modelling procedure.

Findings

Service reliability is a direct predictor of customer loyalty while service assurance is not. Affective commitment has a direct positive effect on customer loyalty and partially mediates the relationship between service reliability and customer loyalty. In contrast, the mediating effects of affective and continuance commitment on the relationship between service assurance and customer loyalty were positive but insignificant. Finally, affective commitment mediates the effect of continuance commitment on customer loyalty.

Research limitations/implications

The mediating role of the individual components of commitment in the links between the individual dimensions of service quality and customer loyalty is largely untested in the literature. This line of inquiry can form the basis for future research proposals. Additionally, the outcomes that emerged from this research must be interpreted with caution due to the size of the sample on which analyses were based. Future research should employ larger samples.

Practical implications

Services organisations especially telecommunication firms may benefit from customer loyalty by pursuing a combined strategy of increasing service assurance, service reliability, affective commitment and continuance commitment both independently and in tandem.

Originality/value

As far as could be established, this paper is the first to explore the mediating effects of affective and continuance commitment on the links between service quality dimensions and customer loyalty.
Effect of conjugated linoleic acid supplementation on the microbial, physical, chemical and sensory properties of yoghurt
Authors: Faihst Toni‐Jone , Myburgh Jacobus , Bothma Carina , Hugo Celia , Hugo Arno
Published: January 2017

The aim of this study was to determine the effect of synthetic conjugated linoleic acid (CLA) supplementation on the quality of yoghurt. Yoghurt was prepared by adding CLA to create yoghurt with 0%, 25%, 50% and 100% w/w of the recommended dietary allowance for CLA. CLA inclusion had no effect on the viability of the yoghurt lactic acid bacteria. Physical properties such as viscosity and pH increased with increased CLA levels. CLA inclusion had a significant effect on the fatty acid composition of the yoghurt. Yoghurts from all four treatments were found acceptable by a consumer panel.