bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects on Lower Extremity Neuromuscular Control Exercises on Knee Proprioception, Muscle Strength, and Functional Level in Patients with ACL Reconstruction
Authors: Kaya Defne , Guney-Deniz Hande , Sayaca Cetin , Calik Mahmut , Doral Mahmut Nedim
Published: November 2019

Objective. The purpose of this study was to determine the effects of lower extremity motor control exercises on knee proprioception, muscle strength, and functional level in patients with anterior cruciate ligament reconstruction (ACL-R). Materials and Methods. Thirty-two of the 57 patients with ACL-R using tibialis anterior allografts were divided into two groups. Group I: lower extremity motor control exercises were added to the standard rehabilitation program. Group II: standard rehabilitation program was applied. Effects of lower extremity motor control exercises on quadriceps and hamstring muscles strength, knee joint position sense, and hop test were evaluated. Results. There were no differences in muscle strength and endurance of the quadriceps and hamstring between the operative and nonoperative sides in Group I (p>0.05) while there were significant differences in strength of the quadriceps and hamstring between the operative and nonoperative sides in Group II (p<0.05). There were significant differences in the endurance of the quadriceps and hamstring and knee joint position sense at 15°, 45°, and 75° between the operative sides of the patients in both groups (p<0.05). Conclusions. The neuromuscular control exercises program was found to be more effective in reducing the difference in strength while the standard program was found to be more effective in reducing the difference in endurance between the operated knee and the other knee. This study revealed that neuromuscular control exercises should also be used to improve knee proprioception sense following ACL-R.
Experimental and Theoretical Investigations on Progressive Collapse Resistance of the Concrete‐Filled Square Steel Tubular Column and Steel Beam Frame under the Middle Column Failure Scenario
Authors: Xuan Wei , Wang Lai , Liu Changjiang , Xing Guoqi , Zhang Lili , Chen Haitao
Published: November 2019

A static loading test was carried out on a 1/3‐scale concrete‐filled square steel tubular column‐steel beam frame (CFSTSBF) specimen with 2 spans to study its progressive collapse behaviors under the middle column failure scenario using the alternate load path method and to examine the failure mode and load transfer and main resistance mechanisms of the residual structure. Then, theoretical models of the specimen, involving the whole collapse process, were developed, and the resistance and deformation relationships of each model were calculated and validated with test results. The results indicated that the specimen collapse process includes the elastoplastic stage, plastic stage, transfer stage, and catenary stage, the beam mechanism and catenary mechanism were the principal mechanisms for the structure against progressive collapse, and catenary action can significantly strengthen structural resistance. The modified theoretical models with higher practical accuracy could be used to assess structural performances against progressive collapse.
Genetic Variants in Group-Specific Component (GC) Gene Are Associated with Breast Cancer Risk among Chinese Women
Authors: Chen Fuxing , Zhu Zheng , van Duijnhoven Fränzel J. B. , Dong Meihua , Qian Yun , Yu Hao , Yang Jie , Cui Lan , Han Renqiang , Su Jian , Du Wencong , Zhou Jinyi , Wu Ming
Published: November 2019

The group-specific component (GC) gene, one of the vitamin D pathway genes, seems to play an important role in cancer development. A population-based breast cancer study including 818 cases and 935 controls in a Chinese population was carried out to evaluate the potential associations of four polymorphisms (rs16847024, rs17467825, rs2298850, and rs3755967) in the GC gene with risk of breast cancer. We detected three SNPs with statistically significant effects on breast cancer development after adjusting for age, menopausal status, body mass index (BMI), family history of breast cancer, income, waist circumference, and education (rs17467825: adjusted OR = 0.80, 95% CI = 0.65–0.99; rs2298850: adjusted OR = 0.80, 95% CI = 0.65–0.98; rs3755967: adjusted OR = 0.80, 95% CI = 0.65–0.98). Stratified analysis found that when an individual had a waist circumference <80 cm, rs17467825, rs2298850, and rs3755967 could markedly reduce the risk of breast cancer. Significant interactions between polymorphisms of rs2298850 and rs3755967 and waist circumference were also observed for breast cancer risk. Combined analysis revealed a significant association among the allele numbers of protective effects with decreased breast cancer risk (Ptrend=0.043). These results indicated that, in the GC gene, genetic mutations might be related to breast cancer susceptibility in Chinese women.
In Vitro Anti-Inflammatory and In Vivo Antiarthritic Activities of Aqueous and Ethanolic Extracts of Dissotis thollonii Cogn. (Melastomataceae) in Rats
Authors: Djuichou Nguemnang Stephanie Flore , Tsafack Eric Gonzal , Mbiantcha Marius , Gilbert Ateufack , Atsamo Albert Donatien , Yousseu Nana William , Matah Marthe Mba Vanessa , Adjouzem Carine Flore
Published: November 2019

Dissotis thollonii Cogn. (Melastomataceae) is a tropical plant widely used in traditional Cameroonian medicine to relieve and treat many pathologies. It is widespread in the western region where it is used to treat typhoid fever, gastrointestinal disorders, and inflammatory diseases. The purpose of this study is to scientifically demonstrate the anti-inflammatory and antiarthritic properties of the aqueous and ethanolic extracts of the leaves of Dissotis thollonii. The anti-inflammatory properties were evaluated in vitro by inhibition tests for cyclooxygenase, 5-lipoxygenase, protein denaturation, extracellular ROS production, and cell proliferation; while antiarthritic properties were evaluated in vivo in rats using the zymosan A-induced monoarthritis test and the CFA-induced polyarthritis model. This study shows that aqueous and ethanolic extracts at a concentration of 1000 μg/ml inhibit the activity of cyclooxygenase (47.07% and 63.36%) and 5-lipoxygenase (66.79% and 77.7%) and protein denaturation (42.51% and 44.44%). Similarly, both extracts inhibited extracellular ROS production (IC50 = 5.74 μg/ml and 2.96 μg/ml for polymorphonuclear leukocytes, 7.47 μg/ml and 3.28 μg ml for peritoneal macrophages of mouse) and cell proliferation (IC50 = 16.89 μg/ml and 3.29 μg/ml). At a dose of 500 mg/kg, aqueous and ethanolic extracts significantly reduce edema induced by zymosan A (69.30% and 81.80%) and CFA (71.85% and 79.03%). At the same dose, both extracts decreased sensitivity to mechanical hyperalgesia with 69.00% and 70.35% inhibition, respectively. Systemic and histological analyzes show that both extracts maintain the studied parameters very close to normal and greatly restored the normal architecture of the joint in animals. Dissotis thollonii would therefore be a very promising source for the treatment of inflammatory diseases.
K-mer-Based Motif Analysis in Insect Species across Anopheles, Drosophila, and Glossina Genera and Its Application to Species Classification
Authors: Cserhati Matyas , Xiao Peng , Guda Chittibabu
Published: November 2019

Short k-mer sequences from DNA are both conserved and diverged across species owing to their functional significance in speciation, which enables their use in many species classification algorithms. In the present study, we developed a methodology to analyze the DNA k-mers of whole genome, 5′ UTR, intron, and 3′ UTR regions from 58 insect species belonging to three genera of Diptera that include Anopheles, Drosophila, and Glossina. We developed an improved algorithm to predict and score k-mers based on a scheme that normalizes k-mer scores in different genomic subregions. This algorithm takes advantage of the information content of the whole genome as opposed to other algorithms or studies that analyze only a small group of genes. Our algorithm uses k-mers of lengths 7–9 bp for the whole genome, 5′ and 3′ UTR regions as well as the intronic regions. Taxonomical relationships based on the whole-genome k-mer signatures showed that species of the three genera clustered together quite visibly. We also improved the scoring and filtering of these k-mers for accurate species identification. The whole-genome k-mer content correlation algorithm showed that species within a single genus correlated tightly with each other as compared to other genera. The genomes of two Aedes and one Culex species were also analyzed to demonstrate how newly sequenced species can be classified using the algorithm. Furthermore, working with several dozen species has enabled us to assign a whole-genome k-mer signature for each of the 58 Dipteran species by making all-to-all pairwise comparison of the k-mer content. These signatures were used to compare the similarity between species and to identify clusters of species displaying similar signatures.
Dnmt3a-Mediated DNA Methylation Changes Regulate Osteogenic Differentiation of hMSCs Cultivated in the 3D Scaffolds under Oxidative Stress
Authors: Li Liangping , Ling Zemin , Dong Wenwu , Chen Xiaoying , Vater Corina , Liao Hongxing , Qi Qihua , Hu Hao , Chen Yan , Gelinsky Michael , Stiehler Maik , Zou Xuenong
Published: November 2019

Oxidative stress (OS) caused by multiple factors occurs after the implantation of bone repair materials. DNA methylation plays an important role in the regulation of osteogenic differentiation. Moreover, recent studies suggest that DNA methyltransferases (Dnmts) are involved in bone formation and resorption. However, the effect and mechanism of DNA methylation changes induced by OS on bone formation after implantation still remain unknown. Three-dimensional (3D) cell culture systems are much closer to the real situation than traditional monolayer cell culture systems in mimicking the in vivo microenvironment. We have developed porous 3D scaffolds composed of mineralized collagen type I, which mimics the composition of the extracellular matrix of human bone. Here, we first established a 3D culture model of human mesenchymal stem cells (hMSCs) seeded in the biomimetic scaffolds using 160 μM H2O2 to simulate the microenvironment of osteogenesis after implantation. Our results showed that decreased methylation levels of ALP and RUNX2 were induced by H2O2 treatment in hMSCs cultivated in the 3D scaffolds. Furthermore, we found that Dnmt3a was significantly downregulated in a porcine anterior lumbar interbody fusion model and was confirmed to be reduced by H2O2 treatment using the 3D in vitro model. The hypomethylation of ALP and RUNX2 induced by H2O2 treatment was abolished by Dnmt3a overexpression. Moreover, our findings demonstrated that the Dnmt inhibitor 5-AZA can enhance osteogenic differentiation of hMSCs under OS, evidenced by the increased expression of ALP and RUNX2 accompanied by the decreased DNA methylation of ALP and RUNX2. Taken together, these results suggest that Dnmt3a-mediated DNA methylation changes regulate osteogenic differentiation and 5-AZA can enhance osteogenic differentiation via the hypomethylation of ALP and RUNX2 under OS. The biomimetic 3D scaffolds combined with 5-AZA and antioxidants may serve as a promising novel strategy to improve osteogenesis after implantation.
Polydatin Inhibits Adipose Tissue Inflammation and Ameliorates Lipid Metabolism in High-Fat-Fed Mice
Authors: Zheng Li , Wu Jiayuan , Mo Juanfen , Guo Li , Wu Xiaoyan , Bao Yi
Published: November 2019

Polydatin (PD), an active component of Chinese herbs, is reported to have many biological functions, such as cardioprotective actions, anti-inflammatory activities, and antitumor effects. In this study, we investigated the effects of PD on body weight control, glucose and lipid metabolic regulation, and anti-inflammation in a high-fat-diet- (HFD-) induced obese mice model. After treatment of PD (100 mg/kg/d for 4 weeks), HFD mice reduced body weight, retroperitoneal fat mass, and adipose cell sizes; significantly lowered serum total cholesterol triglyceride (TG) and low-density lipoprotein (LDL) levels; and increased high-density lipoprotein (HDL) levels compared with the HFD control mice. Further studies showed that PD downregulated the mRNA and protein expressions of peroxisome proliferator-activated receptor gamma (PPARγ), a transcription factor involving in the regulation of adipocyte differentiation, in the retroperitoneal fat of HFD mice. Additionally, PD significantly upregulated the mRNA and protein expressions of leptin, an adipocyte-derived anorexic hormone that regulates food intake and energy expenditure, in the adipose tissues of HFD mice. Moreover, PD reduced the expression levels of monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-alpha (TNF-α) in the retroperitoneal and epididymal tissues of HFD mice, suggesting that PD prevented adipose tissue inflammation. In conclusion, PD may serve as a pharmaceutic candidate for obesity-related lipid metabolism, anti-inflammation, and body weight loss.
Obeticholic Acid Protects against Gestational Cholestasis-Induced Fetal Intrauterine Growth Restriction in Mice
Authors: Chen Wei , Gao Xing-Xing , Ma Li , Liu Zhi-Bing , Li Li , Wang Hua , Gao Lan , Xu De-Xiang , Chen Yuan-Hua
Published: November 2019

Gestational cholestasis is a common disease and is associated with adverse pregnancy outcomes. However, there are still no effective treatments. We investigated the effects of obeticholic acid (OCA) on fetal intrauterine growth restriction (IUGR) during 17α-ethynylestradiol- (E2-) induced gestational cholestasis in mice. All pregnant mice except controls were subcutaneously injected with E2 (0.625 mg/kg) daily from gestational day (GD) 13 to GD17. Some pregnant mice were orally administered with OCA (5 mg/kg) daily from GD12 to GD17. As expected, OCA activated placental, maternal, and fetal hepatic FXR signaling. Additionally, exposure with E2 during late pregnancy induced cholestasis, whereas OCA alleviated E2-induced cholestasis. Gestational cholestasis caused reduction of fetal weight and crown-rump length and elevated the incidence of IUGR. OCA decreased the incidence of IUGR during cholestasis. Interestingly, OCA attenuated reduction of blood sinusoid area in placental labyrinth layer and inhibited downregulation of placental sodium-coupled neutral amino acid transporter- (SNAT-) 2 during cholestasis. Additional experiment found that OCA attenuated glutathione depletion and lipid peroxidation in placenta and fetal liver and placental protein nitration during cholestasis. Moreover, OCA inhibited the upregulation of placental NADPH oxidase-4 and antioxidant genes during cholestasis. OCA activated antioxidant Nrf2 signaling during cholestasis. Overall, we demonstrated that OCA treatment protected against gestational cholestasis-induced placental dysfunction and IUGR through suppressing placental oxidative stress and maintaining bile acid homeostasis.
A Comprehensive Review of the Structure Elucidation of Tannins from Terminalia Linn.
Authors: Chang Zihao , Zhang Qiunan , Liang Wenyi , Zhou Kun , Jian Ping , She Gaimei , Zhang Lanzhen
Published: November 2019

Objectives. Tannins with complex structures are important plant resources, which are abundant in the genus Terminalia. Various Terminalia species have been playing an important role in traditional medicine system. A systematic scoping review of Terminalia Linn. research literature for tannins was conducted to summarize the structures of tannins and analysis fragmentation pathway characteristics, which could provide references for the structural analysis of tannins from Terminalia Linn. Methods. After an update of the literature search up to September 2018, the terms of Terminalia in all publications were analyzed. Electronic searches were conducted in scifinder and PubMed, and the information from 197 articles in all with regard to the tannin structure study was extracted. Results. The compounds of 82 tannins from the genus Terminalia were reviewed. According to the structural differences, they can be divided into three categories, hydrolysable tannins, condensed tannins, and complex tannins, respectively. The fragmentation pathways of 46 identified tannins were analyzed, and the fragmentation rules of tannins were speculated according to different types. Conclusion. This review has attracted attention to the active substances in this species such as the tannins summarized in further study. How to improve the extraction and purification technology of tannins from genus Terminalia is an urgent problem to be solved.
Personalized Cancer Therapy: YES1 Is the New Kid on the Block
Authors: Rai Kunal
Published: November 2019

The key bottleneck for the continued success of precision medicine in cancer lies in identifying more targetable genes and associated efficacious clinically usable inhibitors. In this issue of Cancer Research, Hamanaka and colleagues identify YES1 kinase as a targetable cancer target and generate an effective chemical inhibitor for YES1 and demonstrate its efficacy in YES1-amplified tumors.

See related article by Hamanaka et al., p. 5734
Sustained Therapeutic Efficacy of Humanized Anti-CD19 Chimeric Antigen Receptor T Cells in Relapsed/Refractory Acute Lymphoblastic Leukemia
Authors: Heng Gang , Jia Jiankun , Li Shiqi , Fu Gang , Wang Meiling , Qin Dabing , Li Yunyan , Pei Li , Tian Xiaobo , Zhang Jiasi , Wu Yi , Xiang Shali , Wan Jia , Zhu Wei , Zhang Pei , Zhang Qianzhen , Peng Xi , Wang Linling , Wang Ping , Wei Zhihao , Zhang Yingzi , Wang Guiqin , Chen Xue , Zhang Chengcheng , Sun Yanni , Zhao Wenxu , Fan Yahan , Yang Zhi , Chen Jieping , Qian Cheng
Published: November 2019

Purpose:

Immunogenicity derived from the murine scFv, a major molecular compomemt of chimeric antigen receptors (CARs), may limit the persistence of CAR T cells, resulting in tumor relapse of patients in complete remission (CR). In this study, we developed a humanized anti-CD19 scFv CAR-T (hCAR-T) to treat patients with relapsed/refractory acute lymphoblastic leukemia (r/r ALL).

Patients and Methods:

In this one-arm, open-labeled study, we infused the T cells modified with hCAR to patients with r/r ALL. Patients were evaluated with long-term follow-up for response and safety of the treatment. The study was registered at Clinicaltrials.gov (NCT02349698).

Results:

Ten patients with r/r ALL were recruited for this study. All were response evaluable and all achieved CR; eight patients remained CR, and six were in CR for over 18 months without further treatment. A long-term persistence of hCAR T cells was observed in most of the patients. Among these patients, four of them with high tumor burden and rapidly progressive disease (median, 58%) experienced grade 3–4 cytokine release syndrome (CRS) and neurotoxicity. These severe CRSs were successfully controlled by tocilizumab, glucocorticoid, and plasma exchange.

Conclusions:

T cells expressing the humanized anti-CD19 scFv CARs exhibited sustained therapeutic efficacy in the treatment of r/r ALL. Low replase rate was associated with the long-term persistence of CAR T cells.
High Incidence of Axillary Web Syndrome among Breast Cancer Survivors after Breast Reconstruction
Authors: Huang Hsiu-Chen , Liu Hui-Hua , Yin Li-Yun , Weng Chao-Hui , Fang Chien-Liang , Yang Cheng-San
Published: November 2019

Objective: The aim of this study was to identify if breast reconstruction is a surgical risk factor for axillary web syndrome (AWS) in breast cancer (BC) patients. Methods: The data of 207 patients who have been diagnosed with unilateral BC and who had mastectomy and lymph node dissection were retrospectively reviewed. Information of their clinical and pathological data, whether they had immediate ­reconstruction and intraoperative radiotherapy, surgical methods, and postoperative complications during the 3 months after their surgery (AWS, lymphedema, seroma, and myofascial adhesion) were collected, and the incidence of AWS was compared between different surgical methods. ­Results: The overall incidence of AWS was 48.8% in 207 patients. Of the 22 patients who received reconstruction, 19 developed AWS, yielding an incidence of 86%. Multivariate logistic regression modeling showed that patients who underwent reconstruction had a significantly higher incidence of AWS (odds ratio, 4.74), as did patients with postoperative complication of myofascial adhesion (odds ratio, 7.07). Conclusions: BC survivors after breast reconstruction are susceptible to AWS, and there is a significant association between myofascial adhesion and AWS. Our results can stimulate further investigation and provide an evidence base for the development of educational guidance for patients who plan to undergo breast reconstruction.
Proteomic Analyses of Endarterectomized Tissues from Patients with Chronic Thromboembolic Pulmonary Hypertension
Authors: Xi Qunying , Liu Zhihong , Song Yunhu  , Gan Huili , Huang Zhiwei , Luo Qin , Zhao Zhihui
Published: November 2019

Background: The pathogenesis of chronic thromboembolic pulmonary hypertension (CTEPH) is largely unknown. Proteomics offers an approach to overview the molecular activities and signal transduction pathways involved in specific disease processes. Objectives: In this study, the expression of proteins in endarterectomized tissues from patients with CTEPH was investigated in a novel strategy to explore the pathophysiology of this disease. Methods: We used the iTRAQ (isobaric tag for relative and absolute quantitation) approach combined with a Thermo Scientific Q Exactive MS analysis to compare the protein profiles in endarterectomized tissues from CTEPH patients and that of the control samples (mixture of cultured human pulmonary artery endothelial cells, human pulmonary artery smooth muscle cells, and human pulmonary fibroblasts). GO and KEGG analyses were performed to understand the functional classification and molecular activities of all the tissue-specific proteins, and the involved signal transduction pathways. Results: Six hundred and seventy-nine tissue-specific proteins were detected. Bioinformatic analysis showed that the major biological processes involving these proteins were: response to wounding, defense response, acute inflammatory response, immune response, complement activation, and blood coagulation. The main pathways involved were: complement and coagulation cascade, systemic lupus erythematosus, extracellular matrix-receptor interaction, cell adhesion molecules, FcεRI signaling, and leukocyte transendothelial migration. Conclusions: The present study revealed that immune and defense response might play an important role in CTEPH.
An Ecological Approach to Learning in (Not and) Development
Authors: Adolph Karen E.
Published: November 2019

The ecological approach is a framework for studying the behavior of animals in their environments. My version of an ecological approach focuses on learning in the context of development. I argue that the most important thing animals learn is behavioral flexibility. They must acquire the ability to flexibly guide their behavior from moment to moment in the midst of developmental changes in their bodies, brains, skills, and environments. They must select, modify, and create behaviors appropriate to the current situation. In essence, animals must learn how to learn. I describe the central concepts and empirical strategies for studying learning in development and use examples of infants coping with novel tasks to give a flavor of what researchers know and still must discover about the functions and processes of learning (to learn) in (not and) development.
Guilt Experience in Patients with Obsessive-Compulsive Disorder
Authors: Geissner Edgar , Knechtl Lina Marie , Baumert Anna , Rothmund Tobias , Schmitt Manfred
Published: November 2019

Background: Clinical observations suggest that many patients with obsessive-compulsive disorder (OCD) suffer from severe feelings of guilt. These observations, which are consistent with psychoanalytic assumptions (overly strict super-ego), have rarely been subjected to systematic empirical investigation. Even cognitive approaches broach the issue of guilt as a facet of OCD only indirectly. The purpose of our research was to investigate whether more patients with OCD report feelings of guilt as compared to healthy controls. Patients and Method: One hundred individuals (34 males, 66 females) participated in our study. Fifty participants were OCD patients according to IDCL criteria and in stationary treatment. An additional sample of 50 participants consisted of healthy controls matched for age, gender, and job status. All participants were interviewed via Structured Clinical Interview for DSM-IV. Two scales measured proneness to guilt: (a) Trait Guilt Scale (TGS) and (b) Test of Self-Conscious Affect (TOSCA). A new guilt-inducing scenario-based test (SIT) including two scales (SIT 1, SIT 2) served the same purpose. The SIT was developed by the authors and uses scenarios derived from interviews with patients and experts. Finally, we assessed depression (Beck Depression Inventory; BDI) and obsessive compulsiveness (Yale-Brown Obsessive Compulsive Scale; Y-BOCS) in the OCD sample only. Results: Our data confirm stronger feelings of guilt among OCD patients as compared to matched controls. Patients and controls differed mostly on the TGS and the 2 SIT scales. TOSCA guilt scores did not differ reliably between patients and controls. Finally, as a side result, OCD patients reported elevated depression scores. Discussion: The results of this study suggest that feelings of guilt should receive more attention than previously in the treatment of OCD. OCD patients suffer not only from their compulsive cognitions and actions but also from feelings of guilt. Exposure therapy of OCD should be complemented by treatment components that specifically address feelings of guilt.
Assessment of the Corticospinal Tract Profile in Pure Lower Motor Neuron Disease: A Diffusion Tensor Imaging Study
Authors: Sarica Alessia , Valentino Paola , Nisticò Rita , Barone Stefania , Pucci Franco , Quattrone Andrea , Cerasa Antonio , Quattrone Aldo
Published: November 2019

Aim: The aim of this study was to evaluate the corticospinal tract (CST) diffusion profile in pure lower motor neuron disease (pLMND) patients who at baseline did not show any clinical or electrophysiological involvement of upper motor neurons (UMN), and in amyotrophic lateral sclerosis (ALS) patients. Materials and Methods: Fifteen ALS patients with delayed central motor conduction time (CMCT) and 14 pLMND patients with normal CMCT were enrolled together with 15 healthy controls. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) maps were obtained. The tract profile of CST was reconstructed with the automated fiber quantification tool and its diffusion properties were quantified voxel-by-voxel and then compared pairwise between groups. Moreover, a random forest (RF) classifier was trained to evaluate the ability of CST diffusion metrics in distinguishing pairwise the groups from the controls. Results: ALS patients presented wide microstructural abnormalities in the entire CST as assessed by FA decrease and RD increase while pLMND patients showed focal FA decrease and a larger AD increase in the cerebral peduncle and posterior limb of the internal capsule in comparison with controls. RF revealed that diffusion tensor imaging (DTI) metrics accurately distinguished ALS patients and pLMND patients from controls (96.67 and 95.71% accuracy, respectively). Conclusions: Our study demonstrates that the CST was impaired in both ALS and pLMND patients, thus suggesting that DTI metrics are a reliable tool in detecting subtle changes of UMN in pLMND patients, also in the absence of clinical and CMCT abnormalities.
Reproductive Outcomes following Laser Surgery for Twin-Twin Transfusion Syndrome
Authors: French Ashley , Le Quoc , DeFranco Emily , Habli Mounira , Lim Foong-Yen , McKinney David , Tabbah Sammy
Published: November 2019

Background: There are limited studies describing future reproductive outcomes in women who have had selective fetoscopic laser photocoagulation (SFLP) for twin-twin transfusion syndrome (TTTS). Objective: Our study aims to compare reproductive outcomes following monochorionic multiple gestational pregnancies complicated by TTTS requiring SFLP to those not requiring SFLP. Methods: This is a retrospective cohort study that analyzed records of patients who were evaluated at the Cincinnati Fetal Center (2007–2014) for monochorionic multiple gestations. A questionnaire regarding reproductive, obstetric, gynecologic, and psychological outcomes following the index pregnancy was administered to consented participants by electronic distribution. The data was compared between pregnancies with prior SFLP versus no prior SFLP. Results: There was a higher response rate in the SFLP group (219/474, 46.2%) versus the referent group (62/187, 33.2%). The median interval between the index pregnancy and survey completion was 74 months and 46 months in the SFLP and referent groups, respectively. Approximately 38 and 37% of the women in the SFLP and referent groups attempted conception after the index pregnancy with a >90% pregnancy success rate in both groups. Use of assisted reproductive technology was highly prevalent in both the index and subsequent pregnancies, with no significant difference between the groups. Over 60% of the women in each group did not attempt future pregnancy. Of those, approximately 1 in 3 cited the outcome of the index pregnancy as the primary reason for not pursuing future conception. There were no significant differences in selected maternal-fetal complications and new-onset gynecologic problems. More than 1 in 4 women in both groups were diagnosed with a mental health disorder following the index pregnancy. Conclusion: SFLP does not appear to be associated with adverse reproductive, obstetric, or gynecologic outcomes. The data may help facilitate evidence-based counseling for this patient population.
Management of Perianal Fistulas in Crohn’s Disease
Authors: Seyfried Steffen , Herold Alexander
Published: November 2019

Background: Perianal fistulizing Crohn’s disease is associated with severe symptoms such as pain, fecal incontinence, and a significant reduction in quality of life. Results: In refractory cases, many patients face the decision of having a stoma and/or requiring proctectomy. In former years, the standard of care was a complete fistulectomy, bringing with it a high rate of continence disorders. Additionally, many patients received indefinite treatment, namely the placement of a seton to maintain surgical drainage. Conclusion: More recently, newer biologics, cell-based therapies as well as novel surgical techniques have been introduced, raising new hopes that outcomes can be improved upon.
Intracerebral Hemorrhage-Score Allows a Reliable Prediction of Mortality in Patients with Spontaneous Intracerebral Hemorrhage Managed by Fibrinolytic Therapy
Authors: Malinova Vesna , Iliev Bogdan , Mielke Dorothee , Rohde Veit
Published: November 2019

Objective: Intracerebral hemorrhage (ICH) is associated with high morbidity and mortality. Prognosis estimation would be helpful for the treatment decision making in ICH patients. The ICH-score was published in 2001 to estimate the 30-day mortality in conservatively treated patients with ICH. We evaluated the reproducibility of the ICH-score in ICH patients undergoing fibrinolytic therapy. Methods: We performed a retrospective analysis of patients with supratentorial ICH managed by fibrinolytic therapy and evaluated the 30-day mortality. The ICH-score was then applied to match the mortality in our patients with the mortality predicted by the ICH-score. The ICH-score is based on parameters available at admission: age, hematoma volume, intraventricular expansion, and clinical status according to the Glasgow Coma Scale. Results: A total of 233 patients were analyzed. The 30-day mortality rate was 30% (70/233). An age of ≥80 years was associated with a significantly higher mortality rate (OR 2.26, chi-square test p = 0.01). A hematoma volume of ≥30 mL led significantly more often to 30-day mortality (OR 3.72, chi-square test p = 0.01). The mortality was significantly higher in the patients with intraventricular hemorrhage (2.97, chi-square test p = 0.003). The ICH-score showed a significant correlation with mortality (chi-square test, p < 0.0001). The following mortality rates were estimated using the ICH-score in our cohort: 1 = 0% (0/13), 2 = 0% (0/51), 3 = 1.3% (1/82), 4 = 43% (13/31), 5 = 100% (56/56). Conclusion: The ICH-score not only allows a reliable estimation of the 30-day mortality in patients with ICH treated conservatively but also treated by clot lysis. Compared to conservative treatment, the fibrinolytic therapy reduced the 30-day mortality in the patients with ICH-scores 1–4. Patients with ICH-score 5 do not have a benefit of fibrinolytic therapy and should no longer be considered to be candidates for fibrinolytic therapy.
Polysomnography Utilization in Veterans Presenting Acutely with Ischemic Stroke or Transient Ischemic Attack
Authors: Koo Brian B. , Sico Jason J. , Myers Laura J. , Perkins Anthony J. , Levine Deborah , Miech Edward J. , Damush Teresa M. , Rattray Nicholas , Homoya Barbara , Ferguson Jared , Myers Jennifer , Zhang Ying , Bravata Dawn M.
Published: November 2019

Introduction: Obstructive sleep apnea (OSA) is an independent cerebrovascular risk factor and highly prevalent in patients with ischemic stroke and transient ischemic attack (TIA). Timely diagnosis and treatment of OSA is important as clinical data suggest that treatment of OSA in the setting of acute ischemic stroke improves functional outcomes. We aimed to assess polysomnography (PSG) utilization in US. Veterans with acute stroke or TIA over a 2-year period. Methods: Veterans with acute ischemic stroke or TIA presenting to a Veterans Administration Medical Center (VAMC) between October 1, 2015, and June 30, 2017, were included. Demographic, clinical data, and PSG within 12 months of hospital discharge were obtained from the VA Corporate Data Warehouse to determine the rate of PSG testing among those with acute ischemic stroke or TIA. Fisher’s exact test and two-sample t tests were used to compare demographic and clinical characteristics for those receiving and not receiving PSG. Mixed effect logistic regression was used to model the association of clinical and demographic characteristics with PSG receipt. Results: In fiscal years (FYs) 2016 and 2017, 9,200 Veterans were admitted to a VAMC with ischemic stroke (6,011) or TIA (3,089). Veterans were elderly (70.5 ± 11.1 years), predominantly male (95.7%), and largely Caucasian (68.0% Caucasian, 26.3% African-American). Just 6.0% of Veterans underwent PSG within 1 year of acute ischemic stroke or TIA in FY 2016, compared to 6.2% in FY 2017 (p = 0.72). Compared to Veterans ≥80 years, those <60 had adjusted OR of 6.73 (4.10–11.05), those 60–69 had OR 4.29 (2.73–6.74), and those 70–79 had OR 2.63 (1.66–4.18) of having PSG. Veterans with diabetes or heart failure had significantly higher odds, whereas those with dementia had significantly lower odds of receiving PSG. Conclusion: PSG utilization among US Veterans is low and stable over time, despite recent guidelines recommending PSG among those having stroke or TIA. Older Veterans and those with dementia were unlikely to get PSG, representing especially vulnerable populations.
Genetic Programming Hyper-Heuristics with Vehicle Collaboration for Uncertain Capacitated Arc Routing Problems
Authors: MacLachlan Jordan , Mei Yi , Branke Juergen , Zhang Mengjie
Published: November 2019

Due to its direct relevance to post-disaster operations, meter reading and civil refuse collection, the Uncertain Capacitated Arc Routing Problem (UCARP) is an important optimisation problem. Stochastic models are critical to study as they more accurately represent the real world than their deterministic counterparts. Although there have been extensive studies in solving routing problems under uncertainty, very few have considered UCARP, and none consider collaboration between vehicles to handle the negative effects of uncertainty. This article proposes a novel Solution Construction Procedure (SCP) that generates solutions to UCARP within a collaborative, multi-vehicle framework. It consists of two types of collaborative activities: one when a vehicle unexpectedly expends capacity ( route failure), and the other during the refill process. Then, we propose a Genetic Programming Hyper-Heuristic (GPHH) algorithm to evolve the routing policy used within the collaborative framework. The experimental studies show that the new heuristic with vehicle collaboration and GP-evolved routing policy significantly outperforms the compared state-of-the-art algorithms on commonly studied test problems. This is shown to be especially true on instances with larger numbers of tasks and vehicles. This clearly shows the advantage of vehicle collaboration in handling the uncertain environment, and the effectiveness of the newly proposed algorithm.
Une mission catholique en mutation
Authors: Turiano Annalaura
Published: November 2019

Les décennies 1950-1960 constituent un tournant pour les multiples sociétés missionnaires implantées en Égypte depuis le XIXe siècle. De nombreuses missions se retirent du pays pour laisser la place à des Églises qu’ elles ont elles-mêmes contribué à créer. D’ autres ordres parviennent, au prix de plusieurs réajustements, à assurer leur présence. Cet article interroge les restructurations à l’ œuvre dans une mission italienne – la mission salésienne – et la manière dont elle relève le défi de l’ arabisation. Au-delà des stratégies d’ adaptation d’ une mission catholique dans l’ Égypte nassérienne, cet article propose une réflexion sur l’ évolution des formes et des contenus de l’ action missionnaire durant deux décennies.
Sit-and-wait prey: first field observations of scorpions preying on antlions (Neuroptera)
Authors: Segev Nitzan , Gavish-Regev Efrat , Berger-Tal Oded
Published: November 2019

Antlions (Neuroptera) are a group of sit-and-wait predator insects, with some species further specializing in digging conical pit-traps in the ground in order to catch prey. Studies on antlions’ predators are scarce with only few generalist predators known to feed on them. Here we report for the first time on field observations of antlions’ predation by three scorpion genera. We suggest that scorpions may be common predators of antlions, at least in the hyper-desert environment of southern Israel. The effects of predation risk on the behavior of sit-and-wait and particularly on trap-building predators received little attention in the literature. In light of our observations, we posit that predation risk must be taken into serious consideration in future research of antlions in particular, and sit-and-wait predators in general.
Validity and Reliability of the Reflux Sign Assessment
Authors: Lechien Jérôme R. , Rodriguez Ruiz Alexandra , Dequanter Didier , Bobin Francois , Mouawad Francois , Muls Vinciane , Huet Kathy , Harmegnies Bernard , Remacle Sarah , Finck Camille , Saussez Sven
Published: November 2019

Objective:

To develop and validate the Reflux Sign Assessment (RSA), a clinical instrument evaluating the physical findings of laryngopharyngeal reflux (LPR).

Methods:

A total of 106 patients completed a 3-month treatment based on the association of diet, pantoprazole, alginate, or magaldrate with the LPR characteristics (acid, nonacid, mixed). Forty-two asymptomatic individuals completed the study (control group). The RSA results and reflux finding score (RFS) were documented for the LPR patients at baseline and after treatment. Intrarater reliability was assessed through a test-retest blinded evaluation of signs (7-day intervals). Interrater reliability was assessed by comparing the RSA evaluations of three blinded otolaryngologists through Kendall’s W. Responsiveness to change was evaluated through a comparison of the baseline and 3-month posttreatment findings. The RSA cutoffs for determining the presence and absence of LPR were examined by receiver operating characteristic (ROC) analysis.

Results:

A total of 102 LPR patients completed the study (68 females). The mean age was 53 years. The mean RSA at baseline was 25.95 ± 9.58; it significantly improved to 18.96 ± 7.58 after 3 months of therapy ( P < .001). RSA exhibited good intra- ( r = 0.813) and interrater (Kendall’s W = 0.663) reliabilities (N = 56). There was no significant association between the RSA, gastrointestinal endoscopy findings, and the types of reflux (acid, nonacid, or mixed) according to impedance-pH monitoring. An RSA >14 may be suggestive of LPR.

Conclusion:

The RSA is a complete clinical instrument evaluating both laryngeal and extralaryngeal findings associated with LPR. The RSA demonstrated high intra- and interrater reliabilities and responsiveness to change.
The application of Six Sigma to perform quality analyses of plasma proteins
Authors: Yang Fumeng , Wang Wenjun , Liu Qian , Wang Xizhen , Bian Guangrong , Teng Shijie , Liang Wei
Published: November 2019

Background

The Six Sigma theory is an important tool for laboratory quality management. It has been widely used in clinical chemistry, haematology and other disciplines. The aim of our study was to evaluate the analytical performance of plasma proteins by application of Sigma metric and to compare the differences among three different allowable total errors in evaluating the analytical performance of plasma proteins.

Methods

Three different allowable total error values were used as quality goals. Data from an external quality assessment were used as bias, and the cumulative coefficient of variation in internal quality control data was used to represent the amount of imprecision during the same period. Sigma metric of analytes was calculated using the above data. The quality goal index was calculated to provide corrected measures for continuous improvements in analytical quality.

Results

The Sigma metric was highest using the external quality assessment standards of China: it was sigma ≥6 or higher in 57.1% of plasma proteins. But Sigma metric was lower by using RiliBÄK or biological variation standards. IgG, C3 and C-reactive protein all required quality improvements in imprecision. A single-rule 13s for internal quality control was recommended for IgA, IgM, C4 and rheumatoid factor, whereas multiple rules (13s/22s/R4s) were recommended for IgG, C3 and C-reactive protein, according to the external quality assessment standards of China.

Conclusions

Different quality goals can lead to different Sigma metric for the same analyte. As the lowest acceptable standard in clinical practice, the external quality assessment standard of China can guide laboratories to formulate reasonable quality improvement programmes.
Thermo-mechanical properties of epoxy nanocomposites incorporating amino acid and acid functionalized multi-walled carbon nanotubes
Authors: Bagherzade Alireza , Jamshidi Masoud
Published: November 2019

In this study, multi-walled carbon nanotubes (MWCNTs) were functionalized by both sulfuric/nitric acids and amino acids to form COOH and NH2/COOH/OH groups on their surface, respectively. The functionalized MWCNTs were characterized by Fourier Transform Infrared Spectroscopy, titration test, thermal gravimetric analysis, and solvent stability test. The results revealed that in each method, the functional groups were successfully attached to the surface of nanotubes. Acid treatment grafted more oxygen-containing groups compared to commercial carboxylated MWCNTs. The amino acid functionalized MWCNTs indicated improved stability in different solvents compared to raw and acid treated MWCNTs. These functionalized MWCNTs were incorporated into epoxy resin and the properties of the nanocomposites were evaluated by scanning electron microscopy, tensile test, dynamic mechanical thermal analysis, differential scanning calorimetry, and thermogravimetric analysis. The morphology of the nanocomposites revealed that acid and amino acid treated samples had better interaction with the epoxy resin. Compared to epoxy sample contained raw MWCNT (control) and commercial carboxylated MWCNTs, the addition of functionalized MWCNTs to the epoxy resin improved the tensile strength by 39% and 25% (for acid treated) and 46% and 33% (for amino acid treated), respectively. The best tensile properties for acid and amino acid treated samples were reached by MWCNTs acid treated at 110℃ for 15 min and MWCNTs treated in a 50 g/L aqueous solution of amino acid, respectively. Storage modulus of the epoxy samples which contained acid and amino acid treated MWCNTs were 1560 and 1900 MPa, respectively. The glass rubber transition temperature ( Tg) of the epoxy samples containing acid and amino acid treated nanotubes were increased by 1.1℃ and 5.9℃, respectively, compared to the control sample. Therefore, based on these mechanical properties, the epoxy samples containing nanotubes functionalized by amino acid exhibited the highest performance in the epoxy nanocomposite. Incorporating acid and amino acid treated MWCNTs accelerated the curing process of epoxy where the curing temperature decreased by 9.1℃ and 13.3℃, respectively. Because of the reaction between amine groups grafted on MWCNTs in the amino acid treatment and epoxide groups of the epoxy resin, this acceleration was more significant in the case of amino acid sample. Note that addition of functionalized MWCNTs to epoxy resin did not lead to increased thermal stability.
Development and Scoring of a Survey on Public Health Accreditation Capacity
Authors: Whittington Melanie D. , Atherly Adam J. , Chen Li Wu , VanRaemdonck Lisa , Lampe Sarah
Published: November 2019

Objectives:

Public health accreditation is a 7-step process that starts with a period of preapplication during which a health department assesses its readiness for accreditation. However, no tools with established reliability and validity that quantitatively measure a local health department’s (LHD’s) capacity for accreditation are available to complete this initial step. We developed and validated a survey to measure accreditation capacity for LHDs.

Methods:

From January through April 2015, we administered a cross-sectional electronic survey instrument with 15 questions that tapped into domains of capacity for public health accreditation. We analyzed and grouped responses by using a confirmatory maximum likelihood factor analysis with oblique rotations. We assessed reliability by using Cronbach α, and we assessed validity by comparing responses with previously established instruments. We administered the survey to 174 LHD directors in Colorado, Kansas, and Nebraska, 153 (88%) of whom responded.

Results:

The factor analysis produced a 3-factor model of accreditation capacity, suggesting that accreditation capacity depends on 3 distinct latent constructs: support for accreditation, preparation, and planning and approach. The model had good scale reliability (average Cronbach α = 0.7) and validity (average factor correlation = 0.43).

Conclusions:

The survey developed and scored in this analysis can be used by LHDs to inform the feasibility of initiating the time-intensive and costly process of accreditation.
Involving Parents in Their Children’s School-based English Language Writing Using Digital Learning
Authors: Moorhouse Benjamin L. , Beaumont Andrew M.
Published: November 2019

Involving parents in their children’s school-based English language learning is beneficial to learners’ academic achievement as well as their language and literacy development. However, involving parents can be challenging. This study reports on one teacher’s use of a digital learning platform, Seesaw, with his third-grade (7 to 8 year-olds) English language writing class in Hong Kong to address the lack of parental involvement. The platform became a space for parents to be involved in their child’s school-based writing. It enabled them to view, like and comment in response to their child and other children’s English work. Although parents were seen to be involved on the platform, it was observed they mainly viewed and liked rather than commented. Future pedagogical directions will be discussed with suggestions provided on how parents can be encouraged to take a more active role on such platforms.