bluuebunny/crossref_metadata_2025 huggingface dataset:
Deontic power and institutional contexts
Authors: Fairclough Isabela
Published: February 2019

In this article I study the constraints and opportunities available to decision-makers in an institutional context
(a county council), by analyzing the deliberative process that led to the rejection of an application for exploratory fracking.
Drawing on a corpus of 130,000 words, I intend to develop the theorization of argumentation in institutional contexts initiated in
pragma-dialectics (van Eemeren, 2010) by drawing on philosopher John Searle’s (2010) concept of “deontic power”. Illustrating both the restrictive and
enabling force of the institutional context, my analysis shows that, while decisions which are in keeping with institutional rules
are legitimate in the sense of being legal, the reasonableness of the institutional context itself cannot be taken for granted.
With various institutional rules in place seeming to obstruct rather than facilitate a rational decision outcome, and a local
decision, democratically arrived at, subsequently legally overturned by central government, it can be argued that bias against
local democracy was in this case built into (legal) institutional design.
“Leftie snowflakes” and other metaphtonymies in the British political discourse
Authors: Prażmo Ewelina Maria
Published: February 2019

The present paper deals with the use of deliberate metaphors in the political discourse. The potential of dehumanising metaphors to create derogatory descriptions used to disparage one’s political opponents is analysed. Also, metaphorical descriptions prove to be very productive in creating polysemy in previously monosemous items which are used in a new capacity in order to create an effect of novelty and surprise. This function appears especially useful in the language of politics in general, and the language of British politics in particular. The paper is maintained within the methodological framework of cognitive linguistics, focusing on the theories of conceptual metaphor and conceptual metonymy.
Individual moral otherness as a means to underscore sectoral otherness
Authors: Shukrun-Nagar Pnina
Published: February 2019

This study examines the news broadcasts of the Israeli TV Channel 2. It focuses on coverage of instances in whichHaredi‘Jewish ultra-Orthodox’ individuals are accused of committing immoral acts such as child abuse, hit and run accident and rape. I argue that in all of these instances, the moral otherness of these individuals is linked to theirHarediidentity, thus intensifying the negative-sectoral otherness of the entireHaredicommunity.

I discuss tagging, visual devices and especially discursive strategies used to link individual moral otherness to sectoral otherness at various levels of directness. Additionally, I analyze online comments written by viewers of the items discussed, which indicate the identification and interpretation of implications and implicatures conveyed by this rhetorical linkage.
Audiological outcome for hearing preservation surgery in acoustic neuroma
Authors: Franchella S. , Borsetto D. , Mazzocco T. , Cazzador D. , Zanoletti E.
Published: February 2019

Purpose:

Early diagnosis in acoustic neuroma (AN) has increased the prevalence of small tumors with good hearing. Otoneurological centres have increasingly aimed to preserve hearing function. The managementoptions of small ANs range from observation to active treatments (surgery, radiotherapy). No firm agreement has been made on which is the best option for audiological function preservation. Nowadays, no definitive guidelines are present in order to suggest a standard way of evaluating and comparing the hearing quality. The lack of a universally agreed hearing classification leads to the impossibility of comparing data from different centres or different therapeutic options.

Method:

The paper wantst o show, analyzing our surgical experience in hearing preservation surgery for ANs, the different results that are demonstrable by just using different hearing classification.

Results:

About the 13 patients considered ‘in protocol’ who underwent HPS, 69% are considered to have ‘good’ hearing after surgery using the Tokyo or Sanna classifications; with the AAO-HNS or the GR classifications the outcome of ‘good’ hearing preservation was 77% and in 87% with the WRS classification.

Conclusion:

A shared hearing classification is potentially the solution in order to facilitate comparison of functional outcomes across different centres or different treatment modalities.
Fibroblast Growth Factor 2 Enhances Zika Virus Infection in Human Fetal Brain
Authors: Limonta Daniel , Jovel Juan , Kumar Anil , Lu Julia , Hou Shangmei , Airo Adriana M , Lopez-Orozco Joaquin , Wong Cheung Pang , Saito Leina , Branton William , Wong Gane Ka-Shu , Mason Andrew , Power Christopher , Hobman Tom C
Published: February 2019

Zika virus (ZIKV) is an emerging pathogen that can cause microcephaly and other neurological defects in developing fetuses. The cellular response to ZIKV in the fetal brain is not well understood. Here, we show that ZIKV infection of human fetal astrocytes (HFAs), the most abundant cell type in the brain, results in elevated expression and secretion of fibroblast growth factor 2 (FGF2). This cytokine was shown to enhance replication and spread of ZIKV in HFAs and human fetal brain explants. The proviral effect of FGF2 is likely mediated in part by suppression of the interferon response, which would represent a novel mechanism by which viruses antagonize host antiviral defenses. We posit that FGF2-enhanced virus replication in the fetal brain contributes to the neurodevelopmental disorders associated with in utero ZIKV infection. As such, targeting FGF2-dependent signaling should be explored further as a strategy to limit replication of ZIKV.
Constraints on assembly bias from galaxy clustering
Authors: Zentner Andrew R , Hearin Andrew , van den Bosch Frank C , Lange Johannes U , Villarreal Antonia Sierra
Published: February 2019

We constrain the newly introduced decorated halo occupation distribution (HOD) model using SDSS DR7 measurements of projected galaxy clustering, $w$p(rp) of galaxies in r-band luminosity-threshold samples. The decorated HOD is a model for the galaxy–halo connection that augments the traditional HOD by allowing for the possibility of galaxy assembly bias: galaxy luminosity may be correlated with dark matter halo properties besides mass, Mvir. We demonstrate that it is not possible to rule out galaxy assembly bias using DR7 measurements of galaxy clustering alone. Moreover, galaxy samples with Mr < −20 and Mr < −20.5 favour central galaxy assembly bias. These samples prefer scenarios in which high-concentration haloes are more likely to host a central galaxy relative to low-concentration haloes of the same Mvir. We formally rule out zero assembly bias with high significance for these samples. In the particular case of the Mr < −20 sample, zero assembly bias is excluded at greater than the 3σ level. Satellite galaxy assembly bias is preferred for the faintest sample we study, Mr < −19. We find no evidence for assembly bias in the Mr < −21 sample. Assembly bias should be accounted for in galaxy clustering analyses or attempts to exploit galaxy clustering to constrain cosmology. In addition to presenting the first constraints on HOD models that accommodate assembly bias, our analysis includes numerous improvements over previous analyses of this data set and supersedes previously published results, even in the case of a standard HOD analysis.
Private Contracting, Law and Finance
Authors: Acheson Graeme G , Campbell Gareth , Turner John D
Published: February 2019

In the late nineteenth century Britain had almost no mandatory shareholder protections, but had very developed financial markets. We argue that private contracting between shareholders and corporations meant that the absence of statutory protections was immaterial. Using approximately 500 articles of association from before 1900, we code the protections offered to shareholders in these private contracts. We find that firms voluntarily offered shareholders many of the protections that were subsequently included in statutory corporate law. We also find that companies offering better protection to shareholders had less concentrated ownership.

Received August 19, 2016; editorial decision October 24, 2018 by Editor David Denis. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Effects of Whole Body Vibration Therapy and Classic Physiotherapy on Postural Stability in People With Back Pain
Authors: Wegener Veronika , Rarack Stephanie , Tiffe Theresa , Grill Eva , Melcher Carolin , Birkenmaier Christof , Jansson Volkmar , Wegener Bernd
Published: February 2019

Study Design:

This 2-step prospective randomized parallel trial evaluated postural stability in 65 back pain participants (61.6±7.9 y) and 50 nonback pain participants (61.2±8.6 y) in a first step using the MFT-S3-Check. In a second step, postural stability and questionnaires were evaluated in back pain participants before and after therapy with either whole body vibration therapy or classic physiotherapy.

Objective:

The first aim was to investigate whether the MFT-S3-Check is suitable to evaluate differences in postural stability in back pain and nonback pain participants. The second aim was to evaluate the effect of whole body vibration therapy and classic physiotherapy on postural stability and the influence of depressive symptoms and pain.

Summary of Background Data:

Objective bodily measurement values in chronic back pain are rare; therefore, the evaluation of effectiveness of different therapies is difficult.

Methods:

Postural stability was investigated using stability-, sensorimotor-, and symmetry indexes, in standing and seated positions with the MFT-S3-Check. The following standard questionnaires were used to investigate pain and depressive symptoms: HADS, ODI, NASS, SF-36.

Results:

No significant difference in postural stability was found between back pain participants and the nonback pain group. None of the two training concepts in back pain participants was superior, concerning postural stability and pain. Both treatments showed positive effects, with significant improvements in postural stability in the classic physiotherapy group. Depressive symptoms had a significant correlation with pain intensity in back pain participants.

Conclusions:

The MFT-S3-Check could not find a significant difference in postural stability between the back pain and nonback pain group in the study setting. Postural stability improved after treatment.
Visceral Fat Volume From Standard Preoperative CT is an Independent Predictor of Short-term Survival in Patients Undergoing Surgery for Metastatic Spine Disease
Authors: Pennington Zach , Pielkenrood Bart , Ahmed A. Karim , Goodwin C. Rory , Verlaan Jorrit-Jan , Sciubba Daniel M.
Published: February 2019

Study Design:

This is a retrospective cohort.

Objective:

Determine the relationship of body morphometry to postoperative survival in patients with vertebral metastases.

Summary of Background Data:

Most operations for vertebral metastases aim for palliation not cure, yet expected patient survival heavily influences treatment plans. We seek to demonstrate that preoperative fat and muscle volumes on standard-of-care computed tomography (CT) are independent predictors of survival after surgery for vertebral metastases.

Materials and Methods:

Included data were preoperative neurological status, adjuvant treatments, CT-assessed body composition, health comorbidities, details of oncologic disease, and Tomita and Tokuhashi scores. Body composition—visceral fat area, subcutaneous fat area, and total muscle area—were assessed on preoperative L3/4 CT slice with Image J software. Multivariable logistic regressions were used to determine independent predictors of 3-, 6-, and 12-month survival.

Results:

We included 75 patients (median age, 57, 57.3% male, 66.7% white) with the most common primary lesions being lung (17.3%), prostate (14.7%), colorectal (12.0%), breast (10.7%), and kidney (9.3%). The only independent predictor of 3-month survival was visceral fat area [95% confidence interval (CI): 1.02–1.23 per 1000 mm2; P=0.02]. Independent predictors of survival at 6 months were body mass index (95% CI: 1.04–1.35 per kg/m2; P=0.009), Karnofsky performance status (95% CI: 1.00–1.15; P<0.05), modified Charlson Comorbidity Index (95% CI: 1.11–7.91; P=0.03), and postoperative chemotherapy use (95% CI: 1.13–4.71; P=0.02). Independent predictors of 12-month survival were kidney primary pathology (95% CI: 0.00–0.00; P<0.01), body mass index (95% CI: 1.03–1.39 per kg/m2; P=0.02), and being ambulatory preoperatively (95% CI: 1.28–17.06; P=0.02).

Conclusions:

Visceral fat mass was an independent, positive predictor of short-term postoperative survival in patients treated for vertebral metastases. As a result, we believe that the prognostic accuracy of current predictors may be improved by the addition of visceral fat volume as a risk factor.
Clinical Outcome After Anterior Lumbar Interbody Fusion With a New Osteoinductive Bone Substitute Material
Authors: Rickert Marcus , Fleege Christoph , Papachristos Ioannis , Makowski Marcus R. , Rauschmann Michael , Arabmotlagh Mohammad
Published: February 2019

Study Design:

Pilot, single-center, single-blinded, parallel-group, randomized clinical study.

Objective:

The aim of this study was to pilot a randomized clinical study to evaluate whether instrumented anterior lumbar interbody fusion (ALIF) with a new nanocrystalline hydroxyapatite embedded in a silica gel matrix (NH-SiO2) leads to superior radiologic and clinical outcomes at 12-month follow-up compared with instrumented ALIF with homologous bone.

Summary of Background Data:

ALIF completed with interbody cages is an established technique for performing arthrodesis of the lumbar spine. There is ongoing discussion about which cage-filling material is most appropriate. This is the first study to assess the efficacy of NH-SiO2 in ALIF surgery.

Materials and Methods:

This randomized, clinical, pilot trial included 2 groups of 20 patients with monosegmental or multisegmental degenerative disease of the lumbar spine who were suitable to undergo monosegmental or bisegmental ALIF fusion at the level L4/L5 and L5/S1 with a carbon fiber reinforced polymer ALIF cage filled with either NH-SiO2 or homogenous bone. Primary outcome was postoperative disability as measured by the Oswestry Disability Index (ODI). Secondary outcomes were postoperative radiographic outcomes, pain, and quality of life. Patients were followed 12 months postoperatively.

Results:

Mean (±SD) 12-month ODI was 24±17 in the NH-SiO2 group and 27±19 in the homologous bone group (P=0.582). Postoperative radiography, functional outcomes, and quality-of-life indices did not differ significantly between groups at any of the regularly scheduled follow-up visits.

Conclusions:

This clinical study showed similar functional, radiologic, and clinical outcomes 12 months postoperatively for instrumented ALIF procedures with the use of NH-SiO2 or homologous bone as cage filling. In the absence of any relevant differences in outcome, we postulate that the pivotal clinical study should be designed as an equivalence trial.
Are Limb-sparing Surgical Resections Comparable to Amputation for Patients With Pelvic Chondrosarcoma? A Case-control, Propensity Score-matched Analysis of the National Cancer Database
Authors: Kim Chang-Yeon , Collier Christopher D. , Liu Raymond W. , Getty Patrick J.
Published: February 2019

Background

Chondrosarcoma is the second most frequent primary sarcoma of bone and frequently occurs in the pelvis. Surgical resection is the primary treatment with the two main operative modalities being limb-sparing resection and amputation. Contemporary management has trended toward limb-sparing procedures; however, whether this approach has an adverse effect on long-term survival is unclear.

Questions/purposes

(1) What are the 5- and 10-year survival rates after limb-sparing surgery and amputation? (2) What factors are associated with survival after contemporary surgical management of pelvic chondrosarcoma?

Methods

The 2004-2014 National Cancer Database, a nationwide registry that includes approximately 70% of all new cancers in the United States with requirement for 90% followup, was reviewed for patients diagnosed with pelvic chondrosarcoma who had undergone limb-sparing surgery or amputation. To compare survival, patient demographics, tumor attributes, and treatment characteristics were used to generate one-to-one propensity score-matched cohorts. Other factors associated with survival were determined through multivariable Cox regression. Three hundred eighty-five patients (75%) underwent limb-sparing surgery and 131 (25%) underwent amputation. Propensity score matching resulted in two balanced cohorts of 131 patients.

Results

With the numbers available, we could not demonstrate a difference in overall survival between limb-sparing procedures and amputation. The 5-year survivorship was 70% (95% confidence interval [CI], 62%-79%) for limb-sparing surgery versus 70% (95% CI, 62%-79%) for amputation. The 10-year survivorship was 60% (95% CI, 48%-75%) for limb-sparing surgery versus 59% (95% CI, 48%-72%) for amputation. Kaplan-Meier survival analysis did not demonstrate a difference in survival (p = 0.9). Older age (hazard ratio [HR] = 1.029, p < 0.001), higher Charlson/Deyo comorbidity score (HR = 3.039, p = 0.004), higher grade (HR = 2.547, p = 0.005 for Grade 2; HR = 7.269, p < 0.001 for Grade 3; HR = 10.36, p < 0.001 for Grade 4), and positive surgical margins (HR = 1.61, p = 0.039) were associated with decreased survival.

Conclusions

Our findings support the trend toward increased use of limb-sparing surgery for patients with pelvic chondrosarcoma. Orthopaedic oncologists may use our results when counseling their patients regarding treatment options. However, the choice of limb-sparing surgery versus amputation for these challenging patients should still be a highly individualized decision with careful discussion between the patient and the surgeon.

Level of Evidence

Level III, therapeutic study.
Cellular Dermatofibroma: Clinicopathologic Review of 218 Cases of Cellular Dermatofibroma to Determine the Clinical Recurrence Rate
Authors: Gaufin Meredith , Michaelis Timothy , Duffy Keith
Published: February 2019

BACKGROUND

Cellular dermatofibromas, a variant of dermatofibroma, are reported to recur at rates of 26% to 50%.

OBJECTIVE

To determine whether there are distinct clinical or histological differences between cellular dermatofibromas that recur versus those that do not. To determine recurrence rates in a real-world clinical setting.

MATERIALS AND METHODS

A retrospective analysis of the medical records and skin biopsies of cellular dermatofibroma in the University of Utah Health system between December 2011 and 2016. Clinical and dermatopathological features were evaluated to find distinct differences between the cellular dermatofibromas that recurred compared with those that did not.

RESULTS

There were no significant differences in histology between the primary lesions in recurrent and nonrecurrent cases. One factor that seemed to be associated with a greater likelihood of recurrence was an initial lesion size greater than 1 cm. The authors' data suggest that if the margins are involved on initial biopsy, there is a 10% chance of recurrence. This percentage is far less than the 26% to 50% reported in the past literature.

CONCLUSION

If a patient presents with a cellular dermatofibroma larger than 1 cm and positive margins at initial biopsy, a careful discussion should be had between the provider and patient about the low risk of local recurrence.
Ambient Air Pollution Exposure and Fecundability in Women Undergoing In Vitro Fertilization
Authors: Quraishi Sabah M. , Lin Paul C. , Richter Kevin S. , Hinckley Mary D. , Yee Bill , Neal-Perry Genevieve , Sheppard Lianne , Kaufman Joel D. , Hajat Anjum
Published: February 2019

Background:

Limited research suggests ambient air pollution impairs fecundity but groups most susceptible have not been identified. We studied whether long-term ambient air pollution exposure before an in vitro fertilization (IVF) cycle was associated with successful livebirth, and whether associations were modified by underlying infertility diagnosis.

Methods:

Data on women initiating their first autologous IVF cycle in 2012–2013 were obtained from four US clinics. Outcomes included pregnancy, pregnancy loss, and livebirth. Annual average exposure to fine particulate matter (PM2.5), PM10, and nitrogen dioxide (NO2) before IVF start were estimated at residential address using a validated national spatial model incorporating land-use regression and universal kriging. We also assessed residential distance to major roadway. We calculated risk ratios (RR) using modified Poisson regression and evaluated effect modification (EM) by infertility diagnosis on additive and multiplicative scales.

Results:

Among 7,463 eligible participants, 36% had a livebirth. There was a nonsignificant indication of an association between PM2.5 or NO2 and decreased livebirth and increased pregnancy loss. Near-roadway residence was associated with decreased livebirth (RR = 0.96, 95% CI = 0.82, 0.99). There was evidence for EM between high exposure to air pollutants and a diagnosis of diminished ovarian reserve (DOR) or male infertility and decreased livebirth.

Conclusions:

Despite suggestive but uncertain findings for the overall effect of air pollution on fecundity, we found a suggestive indication that there may be synergistic effects of air pollution and DOR or male infertility diagnosis on livebirth. This suggests two possible targets for future research and intervention.
Neighborhood Sociodemographic Effects on the Associations Between Long-term PM2.5 Exposure and Cardiovascular Outcomes and Diabetes Mellitus
Authors: Weaver Anne M. , McGuinn Laura , Neas Lucas , Mirowsky Jaime , Devlin Robert B. , Dhingra Radhika , Ward-Caviness Cavin , Cascio Wayne E. , Kraus William E. , Hauser Elizabeth R. , Di Qian , Schwartz Joel , Diaz-Sanchez David
Published: February 2019

Background:

Exposure to PM2.5 air pollution and neighborhood-level sociodemographic characteristics are associated with cardiovascular disease and possibly diabetes mellitus. However, the joint effect of sociodemographics and PM2.5 on these outcomes is uncertain.

Methods:

We examined whether clusters of sociodemographic characteristics modified effects of long-term PM2.5 exposure on coronary artery disease (CAD), myocardial infarction (MI), hypertension, and diabetes mellitus. We used medical records data from 2,192 cardiac catheterization patients residing in North Carolina and assigned to one of six previously determined clusters. For each participant, we estimated annual PM2.5 exposure at their primary residence using a hybrid model with a 1 km2 resolution. We used logistic regression models adjusted for age, sex, body mass index, and smoking status to assess cluster-specific associations with PM2.5 and to determine if there were interactions between cluster and PM2.5 on outcomes.

Results:

Compared with cluster 3 (OR = 0.93, 95% CI = 0.82, 1.07; urban, low proportion of black individuals and high socioeconomic status), we observed greater associations between PM2.5 and hypertension in clusters 1 (OR = 1.22, 95% CI = 0.99, 1.50, P
int 0.03) and 2 (OR = 1.64, 95% CI = 1.16–2.32, P
int 0.003), which were urban, high proportion of black individuals, and low socioeconomic status. PM2.5 was associated with MI (OR = 1.29, 95% CI = 1.16, 1.42) but not diabetes mellitus, regardless of cluster and was associated with CAD in cluster 3 (OR = 1.15, 95% CI = 1.00, 1.31) and overall (OR = 1.07, 95% CI = 0.98, 1.17).

Conclusion:

Areas of relative disadvantage have a stronger association between PM2.5 and hypertension compared with areas of relative advantage.
Effect of hysteroscopy before starting in-vitro fertilization for women with recurrent implantation failure
Authors: Mao Xiaoyan , Wu Ling , Chen Qiuju , Kuang Yanping , Zhang Shaozhen
Published: February 2019

Objective:

To study if hysteroscopy (HSC) before starting an in-vitro fertilization (IVF) cycle improves IVF outcomes in women with recurrent implantation failure (RIF).

Methods:

The Medline, Cochrane, EMBASE, and Google Scholar databases were searched using the following keywords until March 31, 2017: in-vitro fertilization; infertility; hysteroscopy; recurrence; embryo implantation; and pregnancy. Randomized controlled trials (RCTs), two-arm prospective studies, and retrospective studies were included.

Results:

Three RCTs, 3 nonrandomized prospective studies, and 2 retrospective cohort studies were included. The eligible studies included 3932 women with RIF: 1841 in the HSC group and 2091 in the control group. The clinical pregnancy rate and implantation rate was significantly higher in the HSC group compared with the control group (for clinical pregnancy rate, pooled odds ratio [OR] = 1.64, 95% confidence intervals [CI]: 1.30–2.07, P < 0.001; for implantation rate, pooled OR = 1.22, 95% CI: 1.02–1.45, P = 0.025). The live birth rate (pooled OR = 1.30, 95% CI: 0.90–1.88, P = 0.168) and the miscarriage rate (pooled OR = 0.94, 95% CI: 0.66–1.35, P = 0.744) of the 2 groups were not statistically significantly.

Conclusions:

HSC improved the implantation rate and clinical pregnancy rates, but failed to improve live birth rate and did not affect the miscarriage rate in women with RIF undergoing IVF. Since HSC plays a significant role in pregnancy and birth outcomes of women with RIF, further studies are warranted.
Be aware of the effects of glucocorticoids on SIADH
Authors: Li Huaqian , Huang Lijun , Wu Ge , Chen Xianmei , Zheng Qiaoan , Su Faming , Liang Maoshan , Chen Xiaoming
Published: February 2019

Rationale:

Hyponatremia is one of the most common electrolyte disorders in clinic. Due to the complicated etiology and the nonspecific clinical manifestations, the diagnosis of hyponatremia is a complicated process. A variety of clinical disorders can cause inappropriately increased antidiuretic hormone (ADH) secretion, leading to inappropriate water retention and consequent hyponatremia. The most common cause of hyponatremia in hospital inpatients is syndrome of inappropriate antidiuretic (SIADH). The action of glucocorticoid against pituitary posterior lobe can reduce the secretion of ADH. However, the effect of hormone on diuretic hormone during treatment has been less reported.

Patient concerns and diagnosis:

The patient in this case report was misdiagnosed as anterior pituitary hypofunction because of the long-term glucocorticoid therapy was effective in this patient, and the patient was finally diagnosed as SIADH after reassessment. The patient is a 76-year-old male with long-term symptomatic hyponatremia after traumatic brain injury (TBI). The patient has been consistently diagnosed as anterior pituitary hypofunction. Based on the diagnosis, glucocorticoid replacement therapy was administered. The serum sodium of the patient gradually increased to normal level after hydrocortisone intravenous injection but dropped again after switch to hydrocortisone oral administration. Through examination and analysis of the patient status during the five-time hospitalization, syndrome of inappropriate antidiuretic hormone (SIADH) was considered.

Interventions:

Water intake limitation and oral furosemide and antisterone were administered after glucocorticoid therapy was stopped.

Outcome:

The serum sodium level of the patient gradually increased and maintained within normal range based on his clinical follow-up.

Lessons:

For hyponatremia with effective glucocorticoid treatment, SIADH should still be excluded.
Targeted metabolomic analysis of plasma metabolites in patients with coronary heart disease in southern China
Authors: Zhong Zhixiong , Liu Jing , Zhang Qifeng , Zhong Wei , Li Bin , Li Cunren , Liu Zhidong , Yang Min , Zhao Pingsen
Published: February 2019

Coronary heart disease (CHD), one of the leading causes of death in the world, is a complex metabolic disorder due to genetic and environmental interactions. The potential mechanisms and diagnostic biomarkers for different types of coronary heart disease remain unclear. Metabolomics is increasingly considered to be a promising technology with the potential to identify metabolomic features in an attempt to distinguish the different stages of CHD.

We aimed to investigate serum metabolite profiling between CHD patients and normal coronary artery (NCA) subjects and identify metabolic biomarkers associated with CHD progression in an ethnic Hakka population in southern China.

Using a novel targeted metabolomics approach, we explored the metabolic characteristics of CHD patients. Blood samples from 302 patients with CHD and 59 NCA subjects were collected that analyses using targeted liquid-chromatography coupled with tandem mass spectrometry (LC-MS).

A total of 361 blood samples were determined using targeted LC-MS. Plasma concentrations for trimetlylamine oxide (TMAO), choline, creatinine, and carnitine were significantly higher in patients with CHD compared to the NCA cohort. Further, we observed that the concentration of the 4 metabolites were higher than that of the NCA group in any group of CHD, which including acute myocardial infarction (AMI), unstable angina (UA), and stable angina (SA). In addition, the diagnostic model was constructed based on the metabolites identified and the ROC curve of the NCA subjects and CHD patients were performed. For choline and creatinine, the AUCs ranged from 0.720 to 0.733. For TMAO and carnitine, the AUCs ranged from 0.568 to 0.600.

In conclusion, the current study illustrates the distribution of 4 metabolites between CHD patients and NCA subjects. Metabolomics analysis may yield novel predictive biomarkers that will potentially provide value for clinical diagnosis of CHD.
Association between PNPLA3 rs738409 polymorphism and nonalcoholic fatty liver disease (NAFLD) susceptibility and severity
Authors: Dai Guangrong , Liu Pengfei , Li Xiaomei , Zhou Xiaoyan , He Shuixiang
Published: February 2019

Objective:

This meta-analysis is to investigate the relationship between the patatin-like phospholipase domain containing 3 (PNPLA3) rs738409 polymorphism and the susceptibility and severity of nonalcoholic fatty liver disease (NAFLD).

Methods:

Chinese Journal Full-text Database, Wanfang Database, VIP Database, and PubMed Database were subjected to case-control study retrieving, from January 2008 to December 2014. Following key words were used: fatty liver, PNPLA3, and rs738409 gene or variants or polymorphism or alleles. Meta-analysis was performed based on the retrieved articles.

Results:

In total 65 studies were first retrieved according to the key words, and finally 21 studies with 14,266 subjects were included. Meta-analysis showed that PNPLA3 rs738409 polymorphism exerted strong influence not only on fatty liver but also on the histological injury. PNPLA3 rs738409 [G] allele was a risk factor for NAFLD (GG vs CC, OR = 4.01, 95% CI 2.93–5.49; GC vs CC, OR = 1.88, 95% CI 1.58–2.24). PNPLA3 gene variant was significantly associated with the increased serum alanine aminotransferase (ALT) levels (GG vs CC, standardized mean difference  = 0.47, 95% CI 0.14–0.81). In addition, nonalcoholic steatohepatitis (NASH) was more frequently observed in G allele carriers (GG vs CC, OR = 3.24, 95% CI 2.79–3.76; GC vs CC, OR = 2.14, 95% CI 1.43–3.19).

Conclusion:

PNPLA3 rs738409 polymorphism is not only a factor significantly associated with the susceptibility of NAFLD, but also related to the susceptibility of aggressive diseases.
Correlation of cervical and thoracic inlet sagittal parameters by MRI and radiography in patients with cervical spondylosis
Authors: Cheng Jie , Liu Peng , Sun Dong , Ma Zikun , Liu Jingpei , Wang Zhaolin , Mou Jianhui
Published: February 2019

To investigate the relationship between cervical and thoracic sagittal alignment parameters measured by magnetic resonance imaging (MRI) and x-ray in patients with cervical spondylosis

Data from 120 symptomatic patients who presented with cervical spondylosis between April 2015 and January 2016 were retrospectively analyzed. Patients received both a cervical MRI and a cervical radiograph during a single visit. The thoracic inlet angle (TIA), T1 slope (T1S), neck tilt (NT), C2-C7 angle (C2-C7), and C2-C7 sagittal vertical axis (C2–7 SVA) were assessed. Pearson correlation coefficient, paired t test, and linear regression models were used to analyze parameters obtained by cervical MRI and radiography.

The difference in mean thoracic inlet angle x-ray (TIAX) and thoracic inlet angle MRI (TIAM) (TIAM–TIAX) (0.72 ± 5.82°) was not significant (P > .05). There were significant differences in mean T1 slope x-ray (T1SX) and T1 slope MRI (T1SM) (T1SM-T1SX) (-2.55 ± 6.14°), mean neck tilt x-ray (NTX) and neck tilt MRI (NTM) (NTM-NTX) (3.26 ± 6.01°), mean C2-C7 angle x-ray (C2–7X) and C2-C7 angle MRI (C2–7 M) (C2–7M-C2–7X) (−3.57 ± 10.00°), and mean C2-C7 sagittal vertical axis X ray (C2–7 SVAX) and C2-C7 sagittal vertical axis MRI (C2–7 SVAM) (C2–7 SVAM-C2–7 SVAX) (-4.50 ± 1.26 mm) (all P ≤ .001). There were positive correlations between TIAM and TIAX (r = 0.807), T1SM and T1SX (r = 0.581), NTM and NTX (r = 0.759), cervical loidosis MRI and cervical loidosis x-ray (r = 0.666), and SVAM and SVAX (r = 0.226).

MRI may be useful to evaluate thoracic inlet and sagittal alignment parameters in patients with cervical spondylosis. Patients with cervical spondylosis may have a relatively low capacity for compensation in the cervical region.
Gouty spondylodiscitis with lumbar vertebral body retrolisthesis
Authors: Zou Yunlong , Li Ye , Liu Jingchen , Zhang Boyin , Gu Rui
Published: February 2019

Rationale:

Gout occurs mainly in joints, but rarely in the spine. In the spine, urate crystals can cause intervertebral space instability but rarely lead to retrolisthesis. Here, we present an extremely rare disease with gout invaded the intervertebral disc with lumbar retrolisthesis.

Patient concerns:

A 61-years male patient with gout history has suffered from severe low back pain and intermittent claudication. Physical examination showed the level of muscle strength of his left first toe was 3/5. Images illustrated a destruction of the intervertebral space, and a retrolisthesis at L4/5 interspace and the dural sac obviously compressed.

Diagnoses:

Combining with lab examinations, imaging examinations, and histopathological results, the patient was diagnosed with gouty arthritis associated with lumbar spinal stenosis, L4–5 spondylodiscitis and L4 vertebral body retrolisthesis.

Intervention:

The patient underwent posterior decompression, reduction, and interbody fusion, and then received an aggressive postoperative rehabilitation program.

Outcomes:

The patient's low back pain was significantly alleviated after the operation. Postoperative X-ray shows the internal fixation was well placed and the sequence of spine was reconstructed. 12 weeks later, the lower limb symptoms of the patients were obviously improved, his muscle strength of the left first toe was 4/5, Japanese Orthopaedic Association (JOA) score was 19 and the improvement rate was 61.5%.

Lessons:

Gouty spondylodiscitis can cause intervertebral space instability. Sagittal imbalance and degeneration of disc with decreasing of segmental disc height are considered as the main factors of retrolisthesis. The appearance may lead to misdiagnose a patient with gout history with a destruction of the intervertebral space. Surgery is a compromise method for gouty spondylodiscitis patients with urgent neurological symptoms.
Characteristics of late-onset spondyloarthritis in Japan
Authors: Endo Yushiro , Fujikawa Keita , Koga Tomohiro , Mizokami Akinari , Mine Masanobu , Tsukada Toshiaki , Uetani Masataka , Kawakami Atsushi
Published: February 2019

Spondyloarthritis may be increasingly present in older patients as life expectancy increases. We investigated clinical differences between early-onset and late-onset spondyloarthritis in Japan.

We retrospectively reviewed 114 patients consecutively diagnosed with spondyloarthritis. The clinical course of each patient was observed for ≥1 year. We defined early-onset and late-onset spondyloarthritis as <57 or ≥57 years at a median age of this study group, respectively. We compared clinical characteristics between these 2 groups.

Disease duration was significantly shorter before diagnosis in the late-onset group (P < .01). Inflammatory back pain (IBP) was significantly more common in the early-onset group (P < .01), whereas dactylitis frequency was significantly higher in the late-onset group. Significantly more patients with early-onset spondyloarthritis were human leukocyte antigen (HLA) B27-positive (P < .01). Articular synovitis, particularly of the wrist, was significantly more common on power Doppler ultrasound (PDUS) in the late-onset group (P < .01). Tenosynovitis or peritendinitis, particularly in the finger and wrist flexors were also more frequent in the late-onset group (P < .001 and P < .05, respectively). Enthesitis of the finger collateral ligament and lateral collateral ligament were significantly more common in the late-onset group (both P < .05). Multiple logistic regression analysis revealed that, comparatively, IBP was significantly and independently much more likely to occur in the early-onset group.

The patients with late-onset spondyloarthritis had a lower frequency of IBP and HLA B27 and a higher frequency of dactylitis and PDUS findings in peripheral involvement.
Determination of vascular alteration in smokers by quantitative computed tomography measurements
Authors: Yu Nan , Yuan Hui , Duan Hai-feng , Ma Jun-chao , Ma Guang-ming , Guo You-min , Wu Fei
Published: February 2019

A new method of quantitative computed tomography (CT) measurements of pulmonary vessels are applicable to morphological studies and may be helpful in defining the progression of emphysema in smokers. However, limited data are available on the relationship between the smoking status and pulmonary vessels alteration established in longitudinal observations. Therefore, we investigated the change of pulmonary vessels on CTs in a longitudinal cohort of smokers.

Chest CTs were available for 287 current smokers, 439 non-smokers, and 80 former smokers who quit smoking at least 2 years after the baseline CT. CT images obtained at the baseline and 1 year later were assessed by a new quantitative CT measurement method, computing the total number of pulmonary vessels (TNV), mean lung density (MLD), and the percentage of low-attenuation areas at a threshold of −950 (density attenuation area [LAA]%950). Analysis of variance (ANOVA) and the independent sample t test were used to estimate the influence of the baseline parameters. The t paired test was employed to evaluate the change between the baseline and follow-up results.

The current smokers related to have higher whole-lung MLD, as well as less and lower TNV values than the non-smokers (P <.05). But no significant differences in LAA%950 were found between smokers and non-smokers. After one year, the increase in LAA%950 was more rapid in the current (additional 0.3% per year, P <. 05–.01) than in the former smokers (additional 0.2% per year, P = .3). Additionally, the decline in TNV was faster in the current (additional −1.3 per year, P <.05–.01) than that in the former smokers (additional −0.2 per year, P = .6). Current smoke, pack-years, weight, and lung volume independently predicted TNV at baseline (P <.001) in multivariate analysis.

The findings of this study reveal that the decline in the pulmonary vessels in smokers can be measured and related to their smoking status.
Acupuncture for fecal incontinence
Authors: Lin Haixiong , Zhang Zhiqing , Hu Guijuan , Wang Xiaotong , Lin Chunni , Chen Yongjun
Published: February 2019

Background:

Fecal incontinence is a socially and emotionally destructive condition that has a negative impact on personal image, self-confidence, and quality of life. Acupuncture is commonly used to treat chronic conditions, including fecal incontinence. However, no relevant systematic review or meta-analysis has been designed to evaluate the effects of acupuncture on fecal incontinence.

Methods:

We will identify relevant randomized controlled trials (RCTs) from the Cochrane Library, Medline, Embase, PubMed, Springer, Web of Science, China National Knowledge Infrastructure, VIP Chinese Science and Technology Journals Database, Wanfang database, and clinical trial registration center from their inception to February 28, 2019. The primary outcome measures will be clinical effective rate, functional outcomes, and quality of life. Data that meets the inclusion criteria will be extracted and analyzed using RevMan V.5.3 software. Two reviewers will evaluate the studies using the Cochrane Collaboration risk of bias tool. Publication bias will be assessed by funnel plots, Egger test, and Begg test using the Stata software. Acupoints characteristics will be analyzed by Traditional Chinese Medicine inheritance support system.

Results:

This study will analyze the clinical effective rate, functional outcomes, quality of life, daily average number of fecal incontinence, and effective prescriptions of acupuncture for patients with fecal incontinence.

Conclusion:

Our findings will provide evidence for the effectiveness and potential treatment prescriptions of acupuncture for patients with fecal incontinence.

PROSPERO registration number:

PROSPERO CRD42019119680.
The term “floating” used in traumatic orthopedics
Authors: Mohamed Sayid Omar , Ju Weina , Qin Ying , Qi Baochang
Published: February 2019

Background:

The term “floating” is used in orthopedic literature to describe certain patterns of skeletal injuries that share one common character which is disruption and discontinuity of bones above and below a joint. The first time used in orthopedic literature being in late 1970 to describe a type of elbow injury. Later the word was used increasingly and applied to a variety of injuries affecting the knee, shoulder, hip, forearm, hand, and ankle. Currently, there are about 12 different skeletal injuries described as floating.

Objectives:

The aim of this article was to define the term “floating” used in traumatic orthopedics and to discuss its history, mechanism of injury in each region, treatment and outcomes based on the currently available literature. As there were many separate articles describing different sites of floating injuries, this review aimed to summarize all floating injuries into 1 article.
Effect of Pro-kin visual feedback balance training system on gait stability in patients with cerebral small vessel disease
Authors: Zhao WeiJing , You Hong , Jiang Shangrong , Zhang Hongxia , Yang Yanling , Zhang Min
Published: February 2019

Due to the indistinct nature of symptoms for Cerebral Small Vessel Disease (CSVD), diagnosis is often missed. With significant deterioration of movement disorder, risk of falls increases dramatically.

Comparison study was conducted to explore the association between balance function and gait instability, and the treatment effectiveness of visual feedback balance training on the gait disorder in CSVD patients.

Fifty-six patients with CSVD were studied. They were randomly divided into observation and control groups, and were given conventional gait rehabilitation training, including single-leg weight, shift of the center of gravity, step and hip extension training, stepping up and down on stairs with the affected leg, standing up with hip extension and support of the leg, lateral walking, and in situ walking. Training was performed twice a day for 20 minutes each for 4 consecutive weeks. In addition, the observation group received balance training using Pro-Kin visual feedback balance training system. Both groups were evaluated prior and post-treatment using the Tinetti Scale and the Pro-Kin Visual Feedback Balance Training System. For the Tinetti Scale, lower score indicates more serious gait balance dysfunction. For the Pro-Kin, greater length means poorer balance function. Larger area means poorer balance function. Smaller value of the 2 parameters indicates better balance function.

After training, the trajectory lengths and areas of orbital motions were significantly decreased (P < .05). However greater decrease was seen in the observation group (P < .01). The trajectory length and area for both groups were less when the eyes open than closed (P < .01). The Tinetti scores for balance and gait functions of both groups improved significantly (P < .05). However, the observation group showed even greater results than the control group (P < .01). Results from Person test showed there was a significant correlation between balance and gait functions.

Combination of visual feedback balance training with conventional rehabilitation treatment could gain a greater result than conventional rehabilitation alone. It indicates that balance training may serve as an additional method for gait stability training for CSVD patients.
Effectiveness of extracorporeal shock-wave therapy for frozen shoulder
Authors: Cao Dong-zi , Wang Cun-liang , Qing Zhong , Liu Lie-dong
Published: February 2019

Background:

This systematic review aims to explore the effectiveness and safety of extracorporeal shock-wave therapy (ESWT) for patients with frozen shoulder.

Methods:

The sources of Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and Websites of Clinical Trials Registry will be searched. All databases and other sources will be searched from inception to the date of the search will be run. Only randomized controlled trials of ESWT for frozen shoulder will be considered for inclusion in this systematic review. Two authors independently screen the studies, extract the data, and evaluate the methodology quality for included trials. If sufficient trials will be included with fair heterogeneity, the data will be pooled, and the meta-analysis will be performed by using RevMan 5.3 software.

Results:

This systematic review will assess the effectiveness and safety of ESWT for frozen shoulder. The primary outcome includes pain intensity. The secondary outcomes consist of shoulder function, quality of life, and also the adverse events.

Conclusion:

Its findings may provide latest evidence of ESWT for the treatment of frozen shoulder.

Ethics and dissemination:

No research ethics approval is required in this study, because it is a systematic review and will not use individual data. The results of this study are expected to publish at peer-reviewed journals.