bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytomegalovirus Infection Presenting as Chronic Sinusitis and Nasal Polyposis: A Case Report
Authors: Yoskovitch Adi , Cantrell Harry
Published: May 2019

Cytomegalovirus (CMV) is the most common viral opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS), affecting up to 90% of patients. CMV can manifest as primary, latent or chronic persistent infection, most commonly appearing as retinitis, encephalitis or gastrointestinal disease. Other less common presentations, including otolaryngologic expression of the virus, have also been noted. Described here is the first known documented case of CMV with both chronic sinusitis and nasal polyposis in an AIDS patient.
The Role of Outfracture in Correcting Post-Rhinoplasty Nasal Obstruction
Authors: Pontell Jonathan , Slavit David H. , Kern Eugene B.
Published: May 2019

Post-rhinoplasty nasal obstruction is often related to narrowing in the region of the nasal valve. Correction of this obstruction can include inferior turbinectomy, septoplasty spreader grafts and nasal valvuloplasty. The authors have seen cases of severe valve stenosis related to infracture after osteotomy which did not respond to any of the aforementioned procedures. These patients were treated with revision osteotomy with outfracture. We discuss patient selection and surgical technique for revision osteotomy with outfracture as well as a cadaver dissection demonstrating the effects of infracture and outfracture on valve area. The clinical results, based on patient satisfaction and pre- and postoperative photographs, are presented. Revision osteotomy with outfracture should be included in the surgeon's armamentarium for the treatment of post-rhinoplasty nasal obstruction.
Sensorineural Hearing Loss Caused by NSAID-Induced Aseptic Meningitis
Authors: Davison Steven P. , Marion Mitchell S.
Published: May 2019

Aseptic meningitis is a rare complication of nonsteroidal anti-inflammatory drug (NSAID) use. Otologic symptoms may include sensorineural hearing loss and tinnitus. A 66-year-old woman sought the care of an otologist for sudden bilateral sensorineural hearing loss and a substantial increase in baseline tinnitus. The patient had previously undergone a left tympanoplasty secondary to cholesteatoma and had been treated for atypical face pain with Ibuprofen taken every six hours for three months. Magnetic resonance imaging (MRI) with gadolinium demonstrated abnormal enhancement of the dura mater and the surrounding basal cisterns, with extension of enhancing dura mater into the internal auditory canals. Cerebrospinal fluid examination revealed evidence of aseptic meningitis. An audiogram confirmed new bilateral sensorineural hearing loss. Hearing loss and tinnitus resolved and no abnormalities were observed with MRI when nonsteroidal anti-inflammatory medication was discontinued.

Otolaryngologists are well aware of the otologic sequelae in patients with meningitis. However, NSAIDs need to be considered as possible causal agents in the evaluation of meningitis with otologic symptoms.
Investigation of Endolymphatic Hydrops by Electrocochleography in Patients with Cogan's Syndrome
Authors: Benitez Jaime T. , Bojrab Dennis I. , Lubbers Donald E. , Arsenault Michael D.
Published: May 2019

We compared auditory and vestibular function between a patient with typical Cogan's syndrome and a patient with atypical Cogan's syndrome. Repeat audiograms demonstrated fluctuating sensorineural hearing loss in the affected ear. Brainstem auditory evoked response testing revealed no abnormalities. Hallpike caloric testing showed a decreased response in the affected ear in the typical case and responses within normal limits in the atypical case. Sinusoidal harmonic acceleration was normal in the typical case, and there was an abnormal phase at 0.01 Hz in the atypical case.

Endolymphatic hydrops was investigated by electrocochleography. In both patients, there was an enhancement of the summating potential, with an increased ratio of summating potential to action potential amplitude. This finding is consistent with endolymphatic hydrops.
Differential effects of anesthetics on resting state functional connectivity in the mouse
Authors: Xie Hongyu , Chung David Y , Kura Sreekanth , Sugimoto Kazutaka , Aykan Sanem A , Wu Yi , Sakadžić Sava , Yaseen Mohammad A , Boas David A , Ayata Cenk
Published: May 2019

Blood oxygen level-dependent (BOLD) functional MRI (fMRI) is a standard approach to examine resting state functional connectivity (RSFC), but fMRI in animal models is challenging. Recently, functional optical intrinsic signal imaging—which relies on the same hemodynamic signal underlying BOLD fMRI—has been developed as a complementary approach to assess RSFC in mice. Since it is difficult to ensure that an animal is in a truly resting state while awake, RSFC measurements under anesthesia remain an important approach. Therefore, we systematically examined measures of RSFC using non-invasive, widefield optical intrinsic signal imaging under five different anesthetics in male C57BL/6J mice. We find excellent seed-based, global, and interhemispheric connectivity using tribromoethanol (Avertin) and ketamine–xylazine, comparable to results in the literature including awake animals. Urethane anesthesia yielded intermediate results, while chloral hydrate and isoflurane were both associated with poor RSFC. Furthermore, we found a correspondence between the strength of RSFC and the power of low-frequency hemodynamic fluctuations. In conclusion, Avertin and ketamine–xylazine provide robust and reproducible measures of RSFC in mice, whereas chloral hydrate and isoflurane do not.
Determination of Binder Glass Transition and Crossover Temperatures using 4-mm Plates on a Dynamic Shear Rheometer
Authors: Elwardany Michael D. , Planche Jean-Pascal , Adams Jeramie J.
Published: May 2019

The accurate rheological characterization of asphalt binder properties, as a function of pavement service life, is crucial to improving asphalt binder specifications, modifications, and formulation methods. Bitumen streams from refineries have experienced significant changes since the development of SHRP Superpave specifications as a result of economic, technical, and environmental reasons. Binder rheological behavior is divided into three regions: near glassy region, terminal region, and an intermediate “transition” region between them. At a reference frequency, these regions are separated by two characteristic temperatures: (1) the glass transition temperature (Tg), which is the temperature between the near glassy region and the intermediate region, and (2) the crossover temperature (TG’=G”), which is the temperature between the intermediate region and the terminal region. In this study, Tg and TG’=G” of 50 binders were obtained from a dynamic shear rheometer (DSR) using 4-mm parallel plates. Glass transition temperatures from DSR were compared with those obtained from modulated differential scanning calorimetry (DSC). Tg and TG’=G” were also compared with continuous low-PG temperatures and ΔTc parameter. Results indicate that critical temperatures based on the creep stiffness and the relaxation rate can be determined from Tg and TG’=G”, respectively. Furthermore, ΔTc parameter correlates well with the intermediate region temperature range (TIR).
Long-term Clinical Outcomes of One-Stage Cartilage Repair in the Knee With Hyaluronic Acid–Based Scaffold Embedded With Mesenchymal Stem Cells Sourced From Bone Marrow Aspirate Concentrate
Authors: Gobbi Alberto , Whyte Graeme P.
Published: May 2019

Background:

Cell-based cartilage repair performed as a single-stage procedure is an important advancement in the treatment of full-thickness cartilage injury and has potential for widespread clinical use.

Purpose:

To investigate the long-term clinical outcomes of cartilage repair in the knee with a hyaluronic acid–based scaffold embedded with bone marrow aspirate concentrate (HA-BMAC) for the treatment of full-thickness cartilage injury.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients underwent treatment of full-thickness chondral injury in the knee with HA-BMAC and were followed prospectively for a minimum of 6 years. Clinical outcomes were examined with patient-reported scoring instruments that consisted of the Tegner Activity Scale, International Knee Documentation Committee (IKDC) subjective score, visual analog scale, and Knee injury and Osteoarthritis Outcome Score (KOOS). Comparative analysis of pre- and postoperative scores was performed, and the effects of patient age, body mass index, lesion size, number of treated lesions, and concurrent treatment with associated procedures were examined.

Results:

Twenty-three patients (mean age, 48.5 years) were followed prospectively for a mean 8 years (range, 6-10 years). Median cartilage lesion size was 6.5 cm2(range, 2-27 cm2). At final follow-up, median Tegner, visual analog scale, and IKDC subjective scores were 4, 0.3, and 85, respectively. Final median KOOS subset scores were as follows: Pain, 94; Symptoms, 89; Activities of Daily Living, 99; Sports/Recreation, 85; and Quality of Life, 85. All scores were significantly increased at final follow-up ( P < .001). Comparable median outcome scores were demonstrated after categorization of patients by age, lesion size, treatment of multiple lesions, treatment of multiple knee compartments, and treatment by associated procedures. Rank correlation analysis demonstrated a negative correlation between patient age and final outcome scores of the IKDC, Tegner, and KOOS subsets of Pain, Activities of Daily Living, and Sports/Recreation. No associations were identified between body mass index or lesion size and outcome scores.

Conclusion:

Repair of full-thickness cartilage injury in the knee with a HA-BMAC provides good to excellent clinical outcomes at long-term follow-up in the treatment of small to large lesions. Cartilage repair with HA-BMAC leads to comparatively successful long-term outcomes in the treatment of small or large lesions, single or multiple lesions, and lesions in 1 or 2 compartments, as well as in cases of associated lesion treatment. While good outcomes can be expected among treated patients >45 years of age, outcomes may be comparatively more successful in younger patients.
Constructing Sexual Harm: Prosecutorial Narratives of Children, Abuse, and the Disruption of Heterosexuality
Authors: Small Jamie L.
Published: May 2019

Sociologists have identified many factors that mitigate the progressive effects of the legal mobilization to end sexual violence. Within this body of research, however, there is little interrogation about the social construction of sexual harm. I use the case of child sexual abuse to investigate how prosecutors make sense of sexual harm. Data are qualitative interviews with 43 prosecutors. Findings reveal that prosecutors use a framework of sexual identity to construct sexual injury on the child’s body. The perceived harm centers on the anticipated loss of the child’s heterosexual potential. Girl victims are thought to grow into sexual promiscuity, and boy victims are thought to grow into sex offenders. Prosecutorial constructions of child sexual abuse cases are future-oriented, which increases their urgency, and these constructions also imagine the child as a person in formation, rather than a fully actualized person with intrinsic rights. In revealing how the state of sexual victimization is not only deeply gendered but also heteronormative, this research has theoretical implications for childhood studies, queer studies, and anti-violence advocacy.
Optimal energy management of a fuel cell-battery-supercapacitor-powered hybrid tramway using a multi-objective approach
Authors: Zhang Han , Yang Jibin , Zhang Jiye , Song Pengyun , Li Ming
Published: May 2019

Achieving an optimal operating cost is a challenge for the development of hybrid tramways. In the past few years, in addition to fuel costs, the lifespan of the power source is being increasingly considered as an important factor that influences the operating cost of a tramway. In this work, an optimal energy management strategy based on a multi-mode strategy and optimisation algorithm is described for a high-power fuel cell hybrid tramway. The objective of optimisation is to decrease the operating costs under the conditions of guaranteeing tramway performance. Besides the fuel costs, the replacement cost and initial investment of all power units are also considered in the cost model, which is expressed in economic terms. Using two optimisation algorithms, a multi-population genetic algorithm and an artificial fish swarm algorithm, the hybrid system's power targets for the energy management strategy were acquired using the multi-objective optimisation. The selected case study includes a low-floor light rail vehicle, and experimental validations were performed using a hardware-in-the-loop workbench. The results testify that an optimised energy management strategy can fulfil the operational requirements, reduce the daily operation costs and improve the efficiency of the fuel cell system for a hybrid tramway.
Lifetime prediction of high-modulus polyethylene yarns subjected to creep using the Larson–Miller methodology
Authors: Morais Gautério Jefferson , Cofferri Leonardo , da Silva Antonio Henrique Monteiro da Fonseca Thomé , Tempel Stumpf Felipe
Published: May 2019

The aim of the present work is to apply the Larson–Miller technique for the study of the mechanical behavior under creep of high-modulus polyethylene (HMPE) fibers focused on use as in offshore mooring ropes. Creep is known to be a long-term phenomenon, so in most cases, reproducing such experiments in real time is not feasible, and as the life span of anchoring systems must be in the order of decades, accelerated tests are required to verify the long-term mechanical behavior of the material. The methodology using the Larson–Miller parameter is a well-documented and powerful technique for materials’ lifetime prediction, although seldom applied to polymeric materials. It involves in performing accelerated (high temperature and/or loads) creep tests to determine the parameters that are later used to estimate the rupture time of the material under constant load. It is concluded that the Larson–Miller technique is efficient for calculating the lifetime of HMPE subjected to creep.
The Displaced Threshing Yard: Involutions of the Rural
Authors: Vasavi A. R.
Published: May 2019

In understanding contemporary rural India, it is important to go beyond rendering the rural as synonymous with villages and agriculture or focusing on the ‘agrarian question’. Given the multiple contradictions that the varied ruralities of India are exhibiting, it may be relevant to locate the rural as being constituted by the triangulated structures of reproduced caste, an economics of neglect, and a politics of rescue. The result of such triangulation is evident in the range of involutions that are manifesting across rural India. These include not only a sharpened differentiation of classes and households, but also forms of separation-integration of key rural institutions and structures, and the erosion of rural citizens. All these have implications for liveability and the nature of democracy in rural areas.
Development of a dual magnetostrictive material rods–based electro-hydrostatic actuator
Authors: Wang Zhenyu , Zhu Yuchuan , Li Renqiang , Liu Cheng , Bruno Niyomwungeri
Published: May 2019

Recently, the use of smart material–based electro-hydrostatic actuators is increasingly becoming more attractive to overcome the inherent disadvantages of conventional actuation systems and to offer new opportunities for performance improvement. A new type of a dual magnetostrictive material rods–based electro-hydrostatic actuator is presented in the current study. An active rotary rectification valve is utilized to convert small, high-frequency vibration displacements of the magnetostrictive material rods into continuous, smooth and bidirectional motion of a hydraulic cylinder by fluid rectification. Simulation and experiments were performed to confirm the feasibility of the new concept. The experimental results indicate that the dual magnetostrictive material rods–based electro-hydrostatic actuator exhibits a maximum flow rate that is approximately twice that of a single magnetostrictive material rod–based electro-hydrostatic actuator, and that the operating frequency increases from 110 to 150 Hz.
Bifid Tongue and Cleft Palate With and Without a Tessier 30 Facial Cleft: Cases of Rare Congenital Anomalies and a Review of Management and Literature
Authors: Lee Jia Yuan , Mohd Zainal Hamidah , Mat Zain Mohammad Ali Bin
Published: May 2019

Congenital bifid tongue with cleft palate is a very rare malformation with different variations. We are reporting 2 cases of rare congenital bifid tongue with cleft palate in our hospital setting and their surgical management. A multidisciplinary approach, well-planned staged operations, rehabilitation, and follow-up are needed to achieve favorable outcomes.
National and Local Trends in Serious Violence, Firearm Victimization, and Homicide
Authors: Lauritsen Janet L. , Lentz Theodore S.
Published: May 2019

The recent upturn in U.S. homicide rates may have resulted from increases in the number of serious violent incidents, growth in the percentage involving firearms, or increases in lethality. Data from the National Crime Victimization Survey (NCVS) and Supplementary Homicide Reports (SHR) suggest that the national homicide increase was not driven by increases in serious violence or the proportion of these crimes involving firearms, but may be related to a longer-term increase in lethality. In St. Louis, the increase was concentrated in communities that previously had the highest violence rates, but changes in the structural conditions and population composition were unrelated to the upsurge in homicide.
The clinical spectrum and incidence of anti-MOG-associated acquired demyelinating syndromes in children and adults
Authors: de Mol CL , Wong YYM , van Pelt ED , Wokke BHA , Siepman TAM , Neuteboom RF , Hamann D , Hintzen RQ
Published: May 2019

Objectives:

The aim of this study was to assess the Dutch nationwide incidence of myelin oligodendrocyte glycoprotein (MOG)-IgG-associated acquired demyelinating syndromes (ADS) and to describe the clinical and serological characteristics of these patients.

Methods:

All serum samples for routine diagnostics from February 2014 to December 2017 were sent to the single central reference laboratory for the full-length MOG-IgG cell-based assay (CBA) in the Netherlands. Clinical data from patients known in our National ADS centre were available.

Results:

A total of 1414 samples of 1277 patients were received; of these, 92 patients (7%) were MOG-IgG-seropositive. The mean incidence was 0.16/100,000 people, with higher seropositivity in children (0.31/100,000) than in adults (0.13/100,000). In MOG-IgG-positive patients at the National ADS centre (61/92, 66%), the most common presenting phenotype is acute disseminated encephalomyelitis (ADEM, 56%) in children and optic neuritis (ON, 44%) in adults. Relapsing disease occurred in 9/34 (26%) children and 11/27 (41%) adults during median follow-up of 27.5 months. Patients were tested MOG-IgG-positive >200 months after the initial attack, suggesting an extended time to first relapse (TTFR). Longitudinal analysis of MOG-IgG (25/61, 41%) showed that 67% of the monophasic patients remain seropositive and 60% in relapsing patients. Majority of seronegative patients had no relapses (89%).

Conclusion:

This nationwide study shows that the overall incidence of MOG-IgG-seropositive disorders is 0.16 per 100,000 people. The distribution over the clinical phenotypes differs between adults and children. Seropositivity can be maintained over years even without clinical activity, while seronegative patients generally had no relapses.
Alterations in the retinal vasculature occur in multiple sclerosis and exhibit novel correlations with disability and visual function measures
Authors: Murphy Olwen C , Kwakyi Ohemaa , Iftikhar Mustafa , Zafar Sidra , Lambe Jeffrey , Pellegrini Nicole , Sotirchos Elias S , Gonzalez-Caldito Natalia , Ogbuokiri Esther , Filippatou Angeliki , Risher Hunter , Cowley Norah , Feldman Sydney , Fioravante Nicholas , Frohman Elliot M , Frohman Teresa C , Balcer Laura J , Prince Jerry L , Channa Roomasa , Calabresi Peter A , Saidha Shiv
Published: May 2019

Background:

The retinal vasculature may be altered in multiple sclerosis (MS), potentially acting as a biomarker of disease processes.

Objective:

To compare retinal vascular plexus densities in people with MS (PwMS) and healthy controls (HCs), and examine correlations with visual function and global disability.

Methods:

In this cross-sectional study, 111 PwMS (201 eyes) and 50 HCs (97 eyes) underwent optical coherence tomography angiography (OCTA). Macular superficial vascular plexus (SVP) and deep vascular plexus (DVP) densities were quantified, and poor quality images were excluded according to an artifact-rating protocol.

Results:

Mean SVP density was 24.1% (SD = 5.5) in MS eyes (26.0% (SD = 4.7) in non-optic neuritis (ON) eyes vs. 21.7% (SD = 5.5) in ON eyes, p < 0.001), as compared to 29.2% (SD = 3.3) in HC eyes ( p < 0.001 for all MS eyes and multiple sclerosis optic neuritis (MSON) eyes vs. HC eyes, p = 0.03 for MS non-ON eyes vs. HC eyes). DVP density did not differ between groups. In PwMS, lower SVP density was associated with higher levels of disability (expanded disability status scale (EDSS): R2 = 0.26, p = 0.004; multiple sclerosis functional composite (MSFC): R2 = 0.27, p = 0.03) and lower letter acuity scores (100% contrast: R2 = 0.29; 2.5% contrast: R2 = 0.40; 1.25% contrast: R2 = 0.31; p < 0.001 for all).

Conclusions:

Retinal SVP density measured by OCTA is reduced across MS eyes, and correlates with visual function, EDSS, and MSFC scores.
The role of public health nurses in risk factor modification within a high-risk cardiovascular disease population in Ireland – a qualitative analysis
Authors: Heery Sheila , Gibson Irene , Dunne Denise , Flaherty Gerard
Published: May 2019

Background/aims:

Health promotion for cardiovascular disease risk factors management is essential to secondary prevention of cardiovascular disease events. In Ireland, post-cardiac rehabilitation patients are discharged into the care of community public health nurses, who have a health promotion role. Little is known of the public health nurses’ perceptions or knowledge surrounding their role in cardiovascular disease risk factor management. Underpinned by a constructivist viewpoint, this study aims to generate empirical evidence on the phenomenon directly from public health nurses’ encounters within the context of the current health service.

Methods:

This qualitative cross-sectional analysis involved face-to-face, semi-structured interviews with a purposeful sample of 17 public health nurses. Interviews were audio-recorded, transcribed, subjected to thematic content analysis and subsequently reported incorporating verbatim quotes.

Results:

A significant gap exists between evidence-based guidelines for cardiovascular disease prevention and current practices. Variations in public health nurses’ training, experience and knowledge result in inconsistent practices, and public health nurses feel this is specialised area for which they are not equipped. The changing public health nurse role and increasing workloads result in prioritisation of other nursing duties over health promotion. Ineffective systems for care delivery and a lack of community-based rehabilitation programmes also negatively impact on secondary prevention practices.

Conclusions:

Findings support the need to develop a community cardiovascular disease specialist role to effectively support ongoing cardiovascular disease risk factor management. Evaluation of the mechanisms of current service delivery is required to ensure a quality-assured equitable service, in line with community needs and current evidence-based guidelines for practice. A quantitative triangulation study is recommended.
Placental trophoblast transfer of opioids following exposures to individual or mixtures of opioids in vitro
Authors: Mortensen Ninell P , Caffaro Maria M , Snyder Rodney W , Yueh Yun L , Fennell Timothy R
Published: May 2019

Infants born with neonatal abstinence syndrome increased 5-fold between 2000 and 2012. Prenatal exposure to opioids has been linked to altered brain development, congenital heart defects, neural tube defects, and clubfoot. In the study presented here, placental transfer rate of six opioids; morphine, heroin, fentanyl, methadone, oxycodone, and naloxone was compared in vitro using a human trophoblast cell monolayer model, BeWo b30. The rate and concentration of opioid translocation were investigated individually and in mixtures. The opioid transfer was quantified at 5, 15, 30, 60, and 120 min, using target liquid chromatography-mass spectrometry. The transfer was lowest for heroin (<1.2% of administered dose at 120 min; the permeability across the cells [P]: 0.21 × 10−5 cm/s) and highest for oxycodone (13.2% of administered dose at 120 min; P: 2.46 × 10−5 cm/s). As oxycodone is a preferred drug for both short- and long-term pain treatment, more knowledge is needed to understand the potential adverse impact on fetal development, growth, and well-being. Opioid exposure is likely to happen as mixtures, and we therefore investigated the transfer of selected mixtures. Permeability was significantly decreased for heroin when administered together with fentanyl. This study demonstrates that the transfer rate between individual opioids varies significantly and that some mixtures may impact the transfer of some individual opioids like heroin.

Impact statement

Gaining knowledge about opioid exposure and placental transfer of opioids is an important part of providing clinicians with the necessary information for therapeutic strategies during pregnancy in the rising opioid epidemic. Opioids exposure often includes a mixture rather than an exposure to an individual opioid. We investigated placental trophoblast permeability to opioids in vitro for six individual opioids and selected mixtures. The rate and concentration of opioid translocation across placental trophoblast monolayer varied considerably between the six investigated opioids. Oxycodone had the highest level of translocation. We also found that the transfer of heroin decreased when administered together with fentanyl, while no change was observed for fentanyl transfer in the mixture. This suggests that opioid mixtures may decrease translocation of some opioids while others are unaffected.
Learning in Museums and Art Galleries in Nigeria: Exploring Arts-Based Adult Learning through Collections
Authors: Akpomuje Paul Young
Published: May 2019

The importance of arts-based adult education in today’s culturally diverse world cannot be overemphasized. Arts-based adult learning provides some of the important cultural contexts for informal learning. Other forms of adult learning—formal and nonformal—have also been immensely enriched by this form of adult education. Museums and art galleries are at the heart of arts-based learning. Whereas learning in the museum has gained attention in western climes, adult education researchers in Nigeria are yet to focus attention on this area of research. The aim of this study was to explore how collections in art galleries and museums provide important opportunities for adult learning in Nigeria. The specific objectives were to explore what adults learn when they interact with collections while visiting museums and art galleries and to highlight how they learn from these collections. Qualitative data were collected from five participants comprising visitors and curators in Natural History Museum, Obafemi Awolowo University, Ile-Ife, Nigeria, and the National Gallery of Arts, Osogbo, Nigeria, through interviews. The data were analyzed using content analysis.
Relationship Among Public Cognition, Perceived Value, and Meteorological Service Satisfaction
Authors: Wu Xianhua , Cao Yanli , Gao Ge , Zou Yi , Guo Ji
Published: May 2019

Clarifying the relationship between public cognition and satisfaction with meteorological service is an important way to adapt to and mitigate climate change. This article first proposes an innovative concept on public meteorological cognition. Also, based on the survey data from 3,029 questionnaires on public cognition of meteorological disasters in Shenzhen city of China, the relationship among public cognition, perceived value, and meteorological service satisfaction is evaluated using a structural equation model. Research results demonstrate that (a) public cognition can significantly affect service satisfaction. (b) Shenzhen residents are generally satisfied with meteorological service, particularly during the typhoon season. However, the residents are dissatisfied with the availability of information on meteorological disaster warnings. (c) Both public meteorological cognition and perceived value of meteorological service significantly affect public satisfaction. (d) The public meteorological cognition can be improved by increasing the perceived value of meteorological service, which further enhances public satisfaction.
Constitutive expression of ULBP-4 on monocytes regulates NK cell NKG2D expression
Authors: Sharma Neekun , Markiewicz Mary A.
Published: May 2019

Key Points

The NKG2D ligand ULBP-4 is expressed on healthy monocytes. Monocyte ULBP-4 expression regulates NKG2D expression by NK cells.
Differential blood pressure response to continuous positive airway pressure treatment according to the circadian pattern in hypertensive patients with obstructive sleep apnoea
Authors: Sapiña-Beltrán Esther , Torres Gerard , Benítez Iván , Santamaría-Martos Fernando , Durán-Cantolla Joaquín , Egea Carlos , Sánchez-de-la-Torre Manuel , Barbé Ferrán , Dalmases Mireia
Published: May 2019

Continuous positive airway pressure (CPAP) has a heterogeneous effect on blood pressure (BP) in hypertensive patients. However, the effect of CPAP on BP in hypertensive subjects regarding circadian BP pattern has never been explored. This study aimed to assess the effect of CPAP on BP, taking into consideration the circadian BP pattern in untreated hypertensive patients.

This study is apost hocanalysis of the Spanish Cohort for the Study of the Effect of CPAP in Hypertension (CEPECTA), a multicentre, randomised trial of CPAPversussham-CPAP in patients with new-onset systemic hypertension and an apnoea–hypopnoea index >15 events·h−1. We included patients for whom 24-h ambulatory BP monitoring (ABPM) data were available at baseline and 12 weeks after the intervention. Subjects were classified based on the dipping ratio (dipper/non-dipper). We evaluated the effect of CPAP on ABPM parameters after 12 weeks of treatment.

Overall, 272 hypertensive subjects were included in the analysis (113 dippers and 159 non-dippers). Baseline clinical and polysomnographic variables were similar between the groups. CPAP treatment in non-dipper patients was associated with reductions in 24-h ambulatory BP variables and night-time ambulatory BP measurements. However, a nonsignificant effect was reported in the dipper group. The differential effects of CPAP between the groups were −2.99 mmHg (95% CI −5.92­– −0.06 mmHg) for the mean 24-h ambulatory BP and −5.35 mmHg (95% CI −9.01– −1.69 mmHg) for the mean night-time ambulatory BP.

Our results show a differential effect of CPAP treatment on BP in hypertensive patients depending on the circadian pattern. Only non-dipper patients benefited from CPAP treatment in terms of BP reduction.
Assessing global COPD awareness with Google Trends
Authors: Boehm Anna , Pizzini Alex , Sonnweber Thomas , Loeffler-Ragg Judith , Lamina Claudia , Weiss Guenter , Tancevski Ivan
Published: May 2019

Although chronic obstructive pulmonary disease (COPD) prevalence and mortality rates rise continuously, patients often remain undiagnosed, probably due to a lack of disease-related awareness. The aim of this study was to quantify public interest in COPD by analysing the frequency of web queriesviaGoogle.

Data from 2004 to 2018 were collected using the search engine query data analysis tool Google Trends. The relative search volume of the topic “chronic obstructive pulmonary disease” was compared with the relative search volume of nine topics representing the major causes of death in high-income countries according to the World Health Organization.

Our analysis showed highest relative search volumes for the topics “diabetes mellitus”, followed by “stroke” and “breast cancer”. The topic “chronic obstructive pulmonary disease” ranked eighth and its relative search volume clearly displayed a seasonal variation, with peaks in the first and the fourth quarter of the year.

This analysis reveals that COPD is highly under-represented in the public interest, while real-world prevalence constantly rises, indicating that there is still an urgent need to raise the levels of awareness for COPD.
IL-4 subverts mycobacterial containment inMycobacterium tuberculosis-infected human macrophages
Authors: Pooran Anil , Davids Malika , Nel Andrew , Shoko Aubrey , Blackburn Jonathan , Dheda Keertan
Published: May 2019

Protective immunity againstMycobacterium tuberculosisis poorly understood. The role of interleukin (IL)-4, the archetypal T-helper type 2 (Th2) cytokine, in the immunopathogenesis of human tuberculosis remains unclear.

Blood and/or bronchoalveolar lavage fluid (BAL) were obtained from participants with pulmonary tuberculosis (TB) (n=23) and presumed latent TB infection (LTBI) (n=22). Messenger RNA expression levels of interferon (IFN)-γ, IL-4 and its splice variant IL-4δ2 were determined by real-time PCR. The effect of human recombinant (hr)IL-4 on mycobacterial survival/containment (CFU·mL−1) was evaluated inM. tuberculosis-infected macrophages co-cultured with mycobacterial antigen-primed effector T-cells. Regulatory T-cell (Treg) and Th1 cytokine levels were evaluated using flow cytometry.

In blood, but not BAL, IL-4 mRNA levels (p=0.02) and the IL-4/IFN-γ ratio (p=0.01) was higher in TBversusLTBI. hrIL-4 reduced mycobacterial containment in infected macrophages (p<0.008) in a dose-dependent manner and was associated with an increase in Tregs (p<0.001), but decreased CD4+Th1 cytokine levels (CD4+IFN-γ+p<0.001; CD4+TNFα+p=0.01). Blocking IL-4 significantly neutralised mycobacterial containment (p=0.03), CD4+IFNγ+levels (p=0.03) and Treg expression (p=0.03).

IL-4 can subvert mycobacterial containment in human macrophages, probablyviaperturbations in Treg and Th1-linked pathways. These data may have implications for the design of effective TB vaccines and host-directed therapies.
Tissue engineering a tendon-bone junction with biodegradable braided scaffolds
Authors: Ramakrishna Harshini , Li Tieshi , He Ting , Temple Joseph , King Martin W. , Spagnoli Anna
Published: May 2019

Background

Tendons play an important role in transferring stress between muscles and bones and in maintaining the stability of joints. Tendon tears are difficult to heal and are associated with high recurrence rates. So, the objective of this study was to develop a biodegradable scaffold for tendon-bone junction regeneration.

Methods

Two types of polylactic acid (PLA) yarns, having fibers with round and four deep grooved cross-sections, were braided into tubular scaffolds and cultured with murine Transforming growth factor beta type II receptor (Tgfbr2)-expressing joint progenitor cells. The scaffolds were designed to mimic the mechanical, immuno-chemical and biological properties of natural mouse tendon-bone junctions. Three different tubular scaffolds measuring 2 mm in diameter were braided on a Steeger 16-spindle braiding machine and biological and mechanical performance of the three scaffolds were evaluated.

Results

The mechanical test results indicated that three different braided scaffold structures provided a wide range of mechanical properties that mimic the components of tendon bone junction and results of the biological tests confirmed cell viability, active cell attachment and proliferation throughout all three scaffolds.

Conclusions

This study has identified that the three proposed types of braided scaffolds with some improvement in their structures have the potential to be used as scaffolds for the regeneration of a tendon bone tissue junction.
The Triggering Hypothesis of the Role of Life Events in Schizophrenia
Authors: Hirsch Steven , Cramer Philip , Bowen Jo
Published: May 2019

The idea of a triggering effect in schizophrenia emphasises the role of life events as precipitating factors which act on an individual's specific predisposition towards the illness (Wing, 1978).
Stress-Indicative Patterns of Non-Verbal Behaviour Their Role in Family Interaction
Authors: Altorfer Andreas , Goldstein Michael J. , Miklowitz David J. , Nuechterlein Keith H.
Published: May 2019

Research in the field of interpersonal behaviour is widely recognised as an important key to understanding the nature of mental illness. In schizophrenic patients especially, deviant social interaction has been proved to be associated with pathological behaviour (see Bellack et al, 1989). Numerous studies have revealed that affective attitudes expressed towards the patient by a relative during hospital admission for an episode of schizophrenia (high expressed emotion (EE)) are predictive of the short-term course of the disorder (Leff & Vaughn, 1985; Jenkins et al, 1986; Nuechterlein et al, 1986; Mintz et al, 1987).
Identifying Smoking Status and Smoking Cessation Using a Data Linkage Between the Kentucky Cancer Registry and Health Claims Data
Authors: Gallaway Michael Shayne , Huang Bin , Chen Quan , Tucker Tom , McDowell Jaclyn , Durbin Eric , Siegel David , Tai Eric
Published: May 2019

PURPOSE

Linkage of cancer registry data with complementary data sources can be an informative way to expand what is known about patients and their treatment and improve delivery of care. The purpose of this study was to explore whether patient smoking status and smoking-cessation modalities data in the Kentucky Cancer Registry (KCR) could be augmented by linkage with health claims data.

METHODS

The KCR conducted a data linkage with health claims data from Medicare, Medicaid, state employee insurance, Humana, and Anthem. Smoking status was defined as documentation of personal history of tobacco use (International Classification of Diseases, Ninth Revision [ICD-9] code V15.82) or tobacco use disorder (ICD-9 305.1) before and after a cancer diagnosis. Use of smoking-cessation treatments before and after the cancer diagnosis was defined as documentation of smoking-cessation counseling (Healthcare Common Procedure Coding System codes 99406, 99407, G0375, and G0376) or pharmacotherapy (eg, nicotine replacement therapy, bupropion, varenicline).

RESULTS

From 2007 to 2011, among 23,703 patients in the KCR, we discerned a valid prediagnosis smoking status for 78%. KCR data only (72%), claims data only (6%), and a combination of both data sources (22%) were used to determine valid smoking status. Approximately 4% of patients with cancer identified as smokers (n = 11,968) and were provided smoking-cessation counseling, and 3% were prescribed pharmacotherapy for smoking cessation.

CONCLUSION

Augmenting KCR data with medical claims data increased capture of smoking status and use of smoking-cessation modalities. Cancer registries interested in exploring smoking status to influence treatment and research activities could consider a similar approach, particularly if their registry does not capture smoking status for a majority of patients.
Oncologists’ Attitudes and Practice of Addressing Diet, Physical Activity, and Weight Management With Patients With Cancer: Findings of an ASCO Survey of the Oncology Workforce
Authors: Ligibel Jennifer A. , Jones Lee W. , Brewster Abenaa M. , Clinton Steven K. , Korde Larissa A. , Oeffinger Kevin C. , Bender Catherine M. , Tan Winston , Merrill Janette K. , Katta Sweatha , Alfano Catherine M.
Published: May 2019

PURPOSE:

Obesity and related factors have been linked to cancer risk and outcomes, but little information exists with regard to oncologists’ attention to these issues as a part of clinical care.

METHODS:

Oncology providers actively caring for patients with cancer in the United States and internationally were asked to complete an online survey about practice patterns and perceptions with regard to obesity and weight management during and after active cancer treatment.

RESULTS:

Nine hundred seventy-one practicing oncology providers completed the survey. The majority of respondents indicated a belief that the evidence linking obesity to cancer outcomes was strong and that weight and related factors should be addressed as a part of cancer treatment. The majority of respondents also reported that they frequently assessed body weight and related factors as well as counsel their patients to exercise, consume a healthy diet, and lose weight, if applicable. However, referral to providers and programs to support weight loss and increased physical activity occurred less frequently, and a number of barriers were identified for the incorporation of weight management and physical activity programs in the treatment of patients with cancer.

CONCLUSION:

In a survey of oncology providers, attention to weight management, physical activity, and diet in patients with cancer was high during and after cancer treatment but often did not result in referrals to support lifestyle change. Future work is needed to support education and training of oncology providers to facilitate referrals and overcome barriers to implementation of weight management and physical activity programs for patients with cancer.
Thyroid Hormone Action and Energy Expenditure
Authors: Yavuz Sahzene , Salgado Nunez del Prado Silvia , Celi Francesco S
Published: May 2019

Energy metabolism is one of the most recognized targets of thyroid hormone action, which indeed plays a critical role in modulating energy expenditure in all of its components. This is because thyroid hormone receptors are ubiquitous, and thyroid hormones interact and influence most metabolic pathways in virtually all systems throughout the entire life of the organism. The pleiotropic actions of thyroid hormone are the results of interaction between the local availability of T3 and the signal transduction machinery, which confer in physiologic conditions time and tissue specificity of the hormonal signal despite negligible variations in circulating levels. Historically, the measurement of energy expenditure has been used as the gold standard for the clinical assessment of the hormonal action until the advent of the immunoassays for TSH and thyroid hormone, which have since been used as proxy for measurement of thyroid hormone action. Although the clinical correlates between thyroid hormone action and energy expenditure in cases of extreme dysfunction (florid hyperthyroidism or hypothyroidism) are well recognized, there is still controversy on the effects of moderate, subclinical thyroid dysfunction on energy expenditure and, ultimately, on body weight trajectory. Moreover, little information is available on the effects of thyroid hormone replacement therapy on energy expenditure. This mini review is aimed to define the clinical relevance of thyroid hormone action in normal physiology and functional disorders, as well the effects of thyroid hormone therapy on energy expenditure and the effects of changes in energy status on the thyroid hormone axis.
Pubertal and Adult Testicular Functions in Nonclassic Lipoid Congenital Adrenal Hyperplasia: A Case Series and Review
Authors: Ishii Tomohiro , Hori Naoaki , Amano Naoko , Aya Misaki , Shibata Hirotaka , Katsumata Noriyuki , Hasegawa Tomonobu
Published: May 2019

Lipoid congenital adrenal hyperplasia (LCAH) is caused by mutations in STAR and characterized by a defect in steroidogenesis and lipid droplet accumulation in steroidogenic cells. Patients with 46,XY and classic LCAH will typically present with female-type external genitalia. However, those with nonclassic LCAH will have masculinized external genitalia. The rarity of the nonclassic form has precluded the clarification of the long-term outcomes of testicular function in nonclassic LCAH. We report the cases of three adult males with nonclassic LCAH in whom primary adrenal insufficiency had been diagnosed at 5 days, 4 years, and 5 years of age. All exhibited complete male external genitalia and had completed pubertal development without androgen replacement. The endocrinological data showed preserved gonadal function in patients 1 and 2 and hypergonadotropic hypogonadism in patient 3. Semen analyses showed normozoospermia in patient 1 and mild oligozoospermia in patient 2. Electron microscopic analysis of a testicular biopsy specimen from patient 2 at 13 years of age revealed prominent lipid accumulation in the cytosol of Leydig cells. Patients 1 and 2 shared the same compound heterozygous mutations in STAR (p.Glu258* and p.Arg272Cys). Patient 3 possessed a heterozygous dominant-negative mutation in STAR (p.Gly22_Leu59del). A functional assay of a variant STAR-Arg272Cys determined the residual activity as 35% of the wild-type STAR. The results from the present case series and a review of four previously reported adult cases indicate that testosterone synthesis can be preserved in most males with nonclassic LCAH to complete pubertal development and induce germ cell maturation despite lipid accumulation in the Leydig cells.
Lateralizing Asymmetry of Adrenal Imaging and Adrenal Vein Sampling in Patients With Primary Aldosteronism
Authors: Wada Norio , Shibayama Yui , Yoneda Takashi , Katabami Takuyuki , Kurihara Isao , Tsuiki Mika , Ichijo Takamasa , Ogawa Yoshihiro , Kawashima Junji , Sone Masakatsu , Yoshimoto Takanobu , Matsuda Yuichi , Fujita Megumi , Kobayashi Hiroki , Tamura Kouichi , Kamemura Kohei , Otsuki Michio , Okamura Shintaro , Naruse Mitsuhide ,   JPAS/JRAS Study Group
Published: May 2019

Context

In patients with primary aldosteronism (PA), it remains unclear whether aldosterone-producing adenomas are likely to develop in the left or right adrenal gland.

Objective

To investigate left-right differences of PA laterality diagnoses via CT imaging and adrenal vein sampling (AVS).

Design

Retrospective, observational study.

Patients

From the Japan Primary Aldosteronism Study, 1493 patients with PA were enrolled who underwent CT and ACTH-stimulated AVS.

Measurements

Left or right adrenal nodular lesion distribution and laterality observed on CT scans and from AVS were noted.

Results

Both on CT scans and AVS, unilateral results were observed more frequently on the left side than on the right side (25.1% vs 15.4% and 17.3% vs 13.5%, respectively; P < 0.01for both diagnostic techniques). There was no significant difference in the concordance rate for CT and AVS between patients with left and right unilateral nodular lesions observed on CT scans (44.1% and 50.9%, respectively; P = 0.15). In patients with nodules <20 mm, the concordance rate was significantly greater on the right side than the left side (45.8% vs 56.4%; P = 0.03). In patients with bilateral results of AVS, unilateral nodular lesions were detected more frequently on the left side than the right side (17.8% vs 9.4%; P < 0.01).

Conclusion

These results suggest aldosterone-producing adenomas and nonfunctioning tumors are more likely to develop on the left side in patients with PA and that misdiagnosis of CT-based lateralization may occur more frequently on the left side.