bluuebunny/crossref_metadata_2025 huggingface dataset:
Components of RNA granules affect their localization and dynamics in neuronal dendrites
Authors: Mitsumori Kazuhiko , Takei Yosuke , Hirokawa Nobutaka
Published: April 2017

In neurons, RNA transport is important for local protein synthesis. mRNAs are transported along dendrites as large RNA granules. The localization and dynamics of Puralpha and Staufen1 (Stau1), major components of RNA transport granules, were investigated in cultured hippocampal neurons. Puralpha-positive granules were localized in both the shafts and spines of dendrites. In contrast, Stau1-positive granules tended to be localized mainly in dendritic shafts. More than 90% of Puralpha-positive granules were positive for Stau1 in immature dendrites, while only half were positive in mature dendrites. Stau1-negative Puralpha granules tended to be stationary with fewer anterograde and retrograde movements than Stau1-positive Puralpha granules. After metabotropic glutamate receptor 5 activation, Stau1-positive granules remained in the dendritic shafts, while Puralpha granules translocated from the shaft to the spine. The translocation of Puralpha granules was dependent on myosin Va, an actin-based molecular motor protein. Collectively our findings suggest the possibility that the loss of Stau1 in Puralpha-positive RNA granules might promote their activity-dependent translocation into dendritic spines, which could underlie the regulation of protein synthesis in synapses.
Diffusion of lipids and GPI-anchored proteins in actin-free plasma membrane vesicles measured by STED-FCS
Authors: Schneider Falk , Waithe Dominic , Clausen Mathias P. , Galiani Silvia , Koller Thomas , Ozhan Gunes , Eggeling Christian , Sezgin Erdinc
Published: April 2017

Diffusion and interaction dynamics of molecules at the plasma membrane play an important role in cellular signaling and are suggested to be strongly associated with the actin cytoskeleton. Here we use superresolution STED microscopy combined with fluorescence correlation spectroscopy (STED-FCS) to access and compare the diffusion characteristics of fluorescent lipid analogues and GPI-anchored proteins (GPI-APs) in the live-cell plasma membrane and in actin cytoskeleton–free, cell-derived giant plasma membrane vesicles (GPMVs). Hindered diffusion of phospholipids and sphingolipids is abolished in the GPMVs, whereas transient nanodomain incorporation of ganglioside lipid GM1 is apparent in both the live-cell membrane and GPMVs. For GPI-APs, we detect two molecular pools in living cells; one pool shows high mobility with transient incorporation into nanodomains, and the other pool forms immobile clusters, both of which disappear in GPMVs. Our data underline the crucial role of the actin cortex in maintaining hindered diffusion modes of many but not all of the membrane molecules and highlight a powerful experimental approach to decipher specific influences on molecular plasma membrane dynamics.
HopLand: single-cell pseudotime recovery using continuous Hopfield network-based modeling of Waddington’s epigenetic landscape
Authors: Guo Jing , Zheng Jie
Published: April 2017

Motivation

The interpretation of transcriptional dynamics in single-cell data, especially pseudotime estimation, could help understand the transition of gene expression profiles. The recovery of pseudotime increases the temporal resolution of single-cell transcriptional data, but is challenging due to the high variability in gene expression between individual cells. Here, we introduce HopLand, a pseudotime recovery method using continuous Hopfield network to map cells to a Waddington’s epigenetic landscape. It reveals from the single-cell data the combinatorial regulatory interactions among genes that control the dynamic progression through successive cell states.

Results

We applied HopLand to different types of single-cell transcriptomic data. It achieved high accuracies of pseudotime prediction compared with existing methods. Moreover, a kinetic model can be extracted from each dataset. Through the analysis of such a model, we identified key genes and regulatory interactions driving the transition of cell states. Therefore, our method has the potential to generate fundamental insights into cell fate regulation.

Availability and implementation

The MATLAB implementation of HopLand is available at https://github.com/NetLand-NTU/HopLand.
The case for reindustrialisation in developing countries: towards the connection between the macroeconomic regime and the industrial policy in Brazil
Authors: Nassif André , Bresser-Pereira Luiz Carlos , Feijo Carmem
Published: April 2017

The majority of economic literature tends to discuss economic development issues by analysing the industrial policy and other long-term development policies separate from short-term macroeconomic policy. However, development strategies require a close coordination of the macroeconomic regime with the industrial policy. In addition to Brazil, our analytical discussion and normative implications can be addressed to other developing countries also facing premature deindustrialisation. We propose an analytical discussion of the phenomena of industrialisation, deindustrialisation and reindustrialisation, including a discussion on the connection between the macroeconomic regime and industrial policy, both oriented to reindustrialisation and catching up. The main point is that both policy regimes must be closely coordinated with each other. Concerning the macroeconomic regime, we argue that consistent monetary, fiscal, wage and exchange rate policies are those which are able to not only keep price stabilisation, but also provide average real interest rates below the average real return rates on capital, a competitive real exchange rate and real wage rates increasing in accordance with labour productivity growth. As for industrial policy, theoretical and empirical evidence suggest strategies aimed at the diversification of production, processes and products, especially within the manufacturing sector and within tradable segments of the service sector.
A dataset of images and morphological profiles of 30 000 small-molecule treatments using the Cell Painting assay
Authors: Bray Mark-Anthony , Gustafsdottir Sigrun M , Rohban Mohammad H , Singh Shantanu , Ljosa Vebjorn , Sokolnicki Katherine L , Bittker Joshua A , Bodycombe Nicole E , Dančík Vlado , Hasaka Thomas P , Hon Cindy S , Kemp Melissa M , Li Kejie , Walpita Deepika , Wawer Mathias J , Golub Todd R , Schreiber Stuart L , Clemons Paul A , Shamji Alykhan F , Carpenter Anne E
Published: April 2017

Background

Large-scale image sets acquired by automated microscopy of perturbed samples enable a detailed comparison of cell states induced by each perturbation, such as a small molecule from a diverse library. Highly multiplexed measurements of cellular morphology can be extracted from each image and subsequently mined for a number of applications.

Findings

This microscopy dataset includes 919 265 five-channel fields of view, representing 30 616 tested compounds, available at “The Cell Image Library” (CIL) repository. It also includes data files containing morphological features derived from each cell in each image, both at the single-cell level and population-averaged (i.e., per-well) level; the image analysis workflows that generated the morphological features are also provided. Quality-control metrics are provided as metadata, indicating fields of view that are out-of-focus or containing highly fluorescent material or debris. Lastly, chemical annotations are supplied for the compound treatments applied.

Conclusions

Because computational algorithms and methods for handling single-cell morphological measurements are not yet routine, the dataset serves as a useful resource for the wider scientific community applying morphological (image-based) profiling. The dataset can be mined for many purposes, including small-molecule library enrichment and chemical mechanism-of-action studies, such as target identification. Integration with genetically perturbed datasets could enable identification of small-molecule mimetics of particular disease- or gene-related phenotypes that could be useful as probes or potential starting points for development of future therapeutics.
Practical Inheritance
Authors: Sybert Virginia P.
Published: April 2017

Chapter 1 provides practical advice for evaluating a patient suspected of having a heritable skin disorder. Tips for taking an accurate medical and family history supplement a thorough review of important terms and concepts in medical genetics.
Disorders of Pigmentation
Authors: Sybert Virginia P.
Published: April 2017

Chapter 4 covers Hyperpigmentation (including Carney Complex, Dowling-Degos Disease, Dyskeratosis Congenita, Fanconi Anemia, H Syndrome, Hemochromatosis, Incontinentia Pigmenti, LEOPARD Syndrome, Linear and Whorled Nevoid Hypermelanosis, McCune-Albright Syndrome, Naegeli Syndrome, Neurofibromatosis, Nevus Phakomatosis Pigmentovascularis, Peutz-Jeghers Syndrome, and Universal Melanosis) and Hypopigmentation ( Albinisms, Albinism with Deafness, Hermansky-Pudlak Syndrome, Oculocutaneous Albinism Tyrosinase Negative, Oculocutaneous Albinism Tyrosinase Positive, Yellow Mutant Albinism, Cross Syndrome, Hypomelanosis of Ito, Piebaldism, Premature Canities, Vitiligo, and Waardenburg Syndrome Types 1, 2, 3, and 4). Each condition is discussed in detail, including dermatologic features, associated anomalies, histopathology, basic defect, treatment, mode of inheritance, prenatal diagnosis, and differential diagnosis.
Atypical presentations of Alzheimer’s disease
Authors: Jones Matthew , Thompson Jennifer
Published: April 2017

Alzheimer’s disease usually presents in older age with progressive episodic memory loss. Atypical presentations of Alzheimer’s disease occur and involve non-amnestic and early-onset forms of the disease. Posterior cortical atrophy (PCA) and logopenic progressive aphasia (lvPPA) are two well-described syndromes that are most commonly due to atypical presentations of Alzheimer’s disease. PCA is a higher-order disturbance of vision whilst lvPPA is characterized by hesitant speech with word-finding difficulties and problems with repetition of words and phrases. Early-onset Alzheimer’s disease presents before the age of 65 and typically consists of a constellation of progressive cortical deficits including language disturbance, apraxia, visuospatial deficits, and poor working memory. Alzheimer’s disease may rarely be inherited because of an autosomal dominant mutation in one of three genes (PSEN1, PSEN2, and APP). Recognition and accurate diagnosis of these atypical forms is vital to ensure patients receive the most appropriate care and treatment.
Pharmacological treatment of Alzheimer’s disease
Authors: Chinthapalli Krishna
Published: April 2017

Pharmacological treatment of Alzheimer’s disease is an important part of management of the condition. There are only four drugs available for treatment of the disease and none halt the disease process, however they have a benefit on cognition, behaviour, activities of daily living, and global function. Acetylcholinesterase inhibitors are thought to work by enhancing cholinergic transmission in the brain and are particularly effective in mild and moderate AD, with recent evidence suggesting donepezil is also effective in severe AD. Memantine is the only glutamate antagonist that is available for AD and is limited for use in moderate or severe AD. The choice of drug depends on route of administration, adverse effects, and medical comorbidities. There is intense research on alternative treatments especially those that may stop the underlying disease process.
Safety, legal issues, and driving
Authors: Jones Roy W.
Published: April 2017

This chapter describes the many practical and legal issues that are important for people with dementia and their families. A person with dementia’s autonomy must be respected together with recognition of their remaining abilities. The capacity needed for a particular decision depends on the nature and complexity of the decision. Capacity to deal with financial affairs is discussed, together with capacity to make a will, to make decisions about personal welfare, medical treatment, and consent for research including genetic testing. Whilst there are many potential safety issues for people with dementia, it is important to balance the need for protection with their continuing independence. Safety within the home includes fire, gas, and electrical safety; kitchen safety; risk of falls; risk from dangerous substances and medications; and vulnerability. Safety outside the home includes the risk of falls together with wandering, getting lost, and issues around driving.
Distinguishing but not dissociating psychiatric disorder and impairment in functioning: Bolton, Hume, and sentiment
Authors: Zachar Peter
Published: April 2017

This chapter presents a commentary on distinguishing but not dissociating psychiatric disorder and impairment in functioning. It explores Hume’s ideas about moral goodness and badness, the basis of sentiment in moral evaluations, the usefulness of distinguishing between psychiatric disorder and functional impairment, and how this relates to cultural norms.
Obsessive-compulsive and related disorders in DSM-5, ICD-11, and RDoC: Conceptual questions and practical solutions
Authors: Stein Dan J.
Published: April 2017

Key nosological questions facing the DSM-5 and ICD-11 work groups on obsessive-compulsive and related disorders (OCRDs) included whether putative OCRDs should be classified together, and whether obsessive-compulsive disorder (OCD) should retain its classification as an anxiety disorder. Given that some of the putative OCRDs were new to the official nosologies, the work groups also had to grapple with the perennial questions of how to decide whether any condition is a mental disorder, and how to draw boundaries between disorder and normality. This chapter reviews some of the conceptual questions that emerged and some of the practical solutions that were suggested. The emphasis on both diagnostic validity and clinical utility is consistent with an integrative approach which holds that nosology should be both evidence-based and values-based.
On reification of mental illness: Historical and conceptual issues from Emil Kraepelin and Eugen Bleuler to DSM-5
Authors: Hoff Paul
Published: April 2017

Reification is the assumption that mental illnesses exist independent of the observer’s conceptualization. The present debate usually addresses naturalistic reification, i.e., the definition of mental illness as an empirically detectable neurobiological dysfunction. This chapter discusses Kraepelin’s and Bleuler’s views on nosology and the position of current operationalized diagnoses (DSM-5, ICD-10), delineating recent debate on the relevance of new research technologies.There are two main conclusions: (1) “Mental illness” always refers to a concept, not to a given thing. This does not reduce the scientific value of neurobiological research: If subjective and interpersonal phenomena are acknowledged although they do not fit into a strictly naturalistic framework, sound neurobiological research will be promoted, not hampered. (2) Diagnostic and therapeutic processes in psychiatry require human interaction, so any model of mental illness must address interpersonality. Recent phenomenological concepts support this view and it seems particularly promising to reevaluate the philosophical approaches of Kant and Fichte in this respect.
Reification of mental illness: Some considerations
Authors: Stein Dan J.
Published: April 2017

This chapter presents a commentary on the reification of mental illness, as discussed in the previous chapter. It explores two key issues raised in the previous chapter: the nature of mental illness as referring to a concept, not a given thing; and the issue of subjectivity and interpersonality as indispensable elements of psychiatry.
Diagnostic epidemics and diagnostic disarray: The issue of differential diagnosis
Authors: Parnas Josef
Published: April 2017

This chapter presents a commentary on diagnostic epidemics and differential diagnosis, as discussed in the previous chapter. It explores issues around mislabeling and criteria in diagnostic categories, and calls for improvement to qualitative and descriptive aspects of psychopathology.
Epistemic iteration and natural kinds: Realism and pluralism in taxonomy
Authors: Chang Hasok
Published: April 2017

Psychiatry can benefit from methods of handling the challenge of evolving and shifting taxonomy that have been effective in other areas. Epistemic iteration creates successive stages of knowledge in order to attain certain goals. Inquiry can begin in the absence of assured foundations, using the results to correct and refine its starting point. If the iterative process converges, the pattern may be regarded as cumulative progress. But what if convergence is to a “local minimum, ” not to the best answer? I propose that all local minima should be appreciated as achievements with realist significance. A field like medicine or social care seems to require a unified taxonomic framework for the effective coordination of action, so it may be best to maintain one system as the official framework for action while fostering research in multiple systems, until another system shows itself to be clearly superior to the official one.
Introduction to “Causal pathways, random walks and tortuous paths: Moving from the descriptive to the etiological in psychiatry”
Authors: Parnas Josef
Published: April 2017

This chapter presents an introduction to the move from descriptive to etiological perspective in psychiatry. It briefly outlines the arguments discussed in the following chapter, and explores their practical implications.
Comments on “Causal pathways, random walks, and tortuous paths: moving from the descriptive to the etiological in psychiatry”
Authors: Chang Hasok
Published: April 2017

This chapter presents a commentary on the move from the descriptive to the etiological perspective in psychiatry, as discussed in the previous chapter. It also raises additional considerations, including the notion of the “cause” of non-existent things, epistemic iteration and evolving meaning, and description and latent class analysis (LCA).
What is progress in psychiatric research?
Authors: Heckers Stephan
Published: April 2017

The nosology developed by Kraepelin at the end of the nineteenth century was the first comprehensive paradigm for psychiatric research. He conjectured that clinical features, experiment, and anatomy will validate psychiatric diagnoses, that these validators converge on natural disease units, and that there is a hierarchy of validators, with course and outcome being the most important. Current psychiatric research is still shaped by Kraepelin’s paradigm, and we continue to design experiments and studies based on the dogma of the natural disease unit. To make progress, we need a new strategy for psychiatric research. We need to determine the strength of evidence for each validator, rank the strength of evidence for each diagnosis, and build consensus for the value for validators. The current debate about the scientific status of psychiatric nosology is the result of conflicting value judgments regarding validators of psychiatric diagnoses.
Facet Joint Interventions: Fluoroscopy
Authors: Jamison David , Wilkinson Indy , Cohen Steven P.
Published: April 2017

This chapter reviews the diagnosis and treatment of facet joint pain. Fluoroscopic guidance is commonly used to optimize treatment outcomes. The only reliable way to identify a painful facet joint is with image-guided blockade of either the medial branch innervating the joint or the joint itself. Although computed tomography (CT) and ultrasound have been shown to provide reliable landmarks for accurate needle placement, these modalities have limitations. The risks of CT include increased radiation exposure, cost, and an inability to perform real-time contrast injection. While ultrasound provides a convenient and inexpensive way to anesthetize the facet joints or medial branch nerves innervating them, it is unreliable in obese patients, is not as sensitive for detecting intravascular uptake as digital substraction or real-time contrast injection under fluoroscopy, and cannot be reliably used to place an electrode parallel to the course of the nerve, which has been shown to enhance lesion size.
Celiac Plexus Blockade and Neurolysis: Fluoroscopy
Authors: Lerman Imanuel R. , Hung Joseph , Souzdalnitski Dmitri , Vrooman Bruce , Kamdar Mihir
Published: April 2017

Image-guided celiac plexus neurolysis can provide substantial and long-lasting pain relief in patients suffering from malignant pain from upper abdominal viscera. When performed by experienced hands, celiac plexus neurolysis also appears to be a relatively safe procedure with a limited side effect profile. Multiple imaging modalities are available for this procedure, though no single approach has systematically been proven superior in terms of efficacy or side effect profile. Each imaging guidance modality has advantages and disadvantages. Given the ability to visualize soft-tissue structures, CT guidance is recommended over fluoroscopy when intentionally transgressing into the retroperitoneum for celiac plexus neurolysis. It is also recommended in those patients with complicated anatomy, where anatomic distortion may complicate successful celiac blockade. However, in the patient without significant tumor burden involving the celiac axis and/or pancreatic body/tail, the fluoroscopy-guided retrocrural approach has been demonstrated to be efficacious, and complications are exceedingly rare.
Piriformis Muscle, Psoas Muscle, and Quadratus Lumborum Muscle Injections: Ultrasound
Authors: Shankar Hariharan , Johar Karan
Published: April 2017

This chapter describes the anatomy, technique, available evidence, and complications of piriformis, psoas, and quadratus lumborum muscle injections. Traditionally landmark-based injections of the piriformis muscle were performed using the posterior inferior iliac spine and the greater trochanter as bony landmarks. Subsequently, fluoroscopy, electromyography, and CT were used to facilitate the injection. Activation of myofascial trigger points within the iliopsoas muscle can cause referred pain to the groin and anterior thigh. Landmark-based injections and CT-guided iliopsoas injections have been described. But they carry the risk of radiation, bowel injury, intravascular injection, and nerve injury. Ultrasound-guided injection into the psoas muscle may be performed at two different locations, the iliopsoas muscle and the iliopsoas tendon. The quadratus lumborum is a common cause of low back pain, and ultrasound-guided injection of local anesthetic into quadratus lumborum muscle may be performed.
The shortest periodic and flaring flux variability of a methanol maser emission at 6.7 GHz in G 014.23−00.50
Authors: Sugiyama Koichiro , Nagase Katsura , Yonekura Yoshinori , Momose Munetake , Yasui Yasutaka , Saito Yu , Motogi Kazuhito , Honma Mareki , Hachisuka Kazuya , Matsumoto Naoko , Uchiyama Mizuho , Fujisawa Kenta
Published: April 2017

We detected flaring flux variability that regularly occurred with a period of 23.9 d on a 6.7 GHz methanol maser emission at Vlsr = 25.30 km s−1 in G 014.23−00.50 through highly frequent monitoring using the Hitachi 32 m radio telescope. Analyzing data from 2013 January 5 to 2016 January 21, the periodic variability has persisted in at least 47 cycles, corresponding to ∼1100 d. The period of 23.9 d is the shortest one observed in masers around high-mass young stellar objects so far. The flaring component normally falls below the detection limit (3 σ) of ∼0.9 Jy. In the flaring periods, the component rises above the detection limit with a ratio of the peak flux density more than 180 in comparison with the quiescent phase, showing intermittent periodic variability. The timescale of the flux rise was typically two days or shorter, and both symmetric and asymmetric profiles of flux variability were observed through intraday monitoring. These characteristics might be explained by a change in the flux of seed photons in a colliding-wind binary (CWB) system, or a variation of the dust temperature by the extra heating source of a shock formed by a CWB system within a gap region in a circumbinary disk, in which the orbital semi-major axes of the binary are 0.26–0.34 au.
Up-regulation of Intracellular Calcium Handling Underlies the Recovery of Endotoxemic Cardiomyopathy in Mice
Authors: Morse Justin C. , Huang Joanne , Khona Natasha , Miller Edward J. , Siwik Deborah A. , Colucci Wilson S. , Hobai Ion A.
Published: April 2017

Background

In surviving patients, sepsis-induced cardiomyopathy is spontaneously reversible. In the absence of any experimental data, it is generally thought that cardiac recovery in sepsis simply follows the remission of systemic inflammation. Here the authors aimed to identify the myocardial mechanisms underlying cardiac recovery in endotoxemic mice.

Methods

Male C57BL/6 mice were challenged with lipopolysaccharide (7 μg/g, intraperitoneally) and followed for 12 days. The authors assessed survival, cardiac function by echocardiography, sarcomere shortening, and calcium transients (with fura-2-acetoxymethyl ester) in electrically paced cardiomyocytes (5 Hz, 37°C) and myocardial protein expression by immunoblotting.

Results

Left ventricular ejection fraction, cardiomyocyte sarcomere shortening, and calcium transients were depressed 12 h after lipopolysaccharide challenge, started to recover by 24 h (day 1), and were back to baseline at day 3. The recovery of calcium transients at day 3 was associated with the up-regulation of the sarcoplasmic reticulum calcium pump to 139 ± 19% (mean ± SD) of baseline and phospholamban down-regulation to 35 ± 20% of baseline. At day 6, calcium transients were increased to 123 ± 31% of baseline, associated with increased sarcoplasmic reticulum calcium load (to 126 ± 32% of baseline, as measured with caffeine) and inhibition of sodium/calcium exchange (to 48 ± 12% of baseline).

Conclusions

In mice surviving lipopolysaccharide challenge, the natural recovery of cardiac contractility was associated with the up-regulation of cardiomyocyte calcium handling above baseline levels, indicating the presence of an active myocardial recovery process, which included sarcoplasmic reticulum calcium pump activation, the down-regulation of phospholamban, and sodium/calcium exchange inhibition.
Electroencephalography Predicts Poor and Good Outcomes After Cardiac Arrest: A Two-Center Study*
Authors: Rossetti Andrea O. , Tovar Quiroga Diego F. , Juan Elsa , Novy Jan , White Roger D. , Ben-Hamouda Nawfel , Britton Jeffrey W. , Oddo Mauro , Rabinstein Alejandro A.
Published: April 2017

Objective:

The prognostic role of electroencephalography during and after targeted temperature management in postcardiac arrest patients, relatively to other predictors, is incompletely known. We assessed performances of electroencephalography during and after targeted temperature management toward good and poor outcomes, along with other recognized predictors.

Design:

Cohort study (April 2009 to March 2016).

Setting:

Two academic hospitals (Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Mayo Clinic, Rochester, MN).

Patients:

Consecutive comatose adults admitted after cardiac arrest, identified through prospective registries.

Interventions:

All patients were managed with targeted temperature management, receiving prespecified standardized clinical, neurophysiologic (particularly, electroencephalography during and after targeted temperature management), and biochemical evaluations.

Measurements and Main Results:

We assessed electroencephalography variables (reactivity, continuity, epileptiform features, and prespecified “benign” or “highly malignant” patterns based on the American Clinical Neurophysiology Society nomenclature) and other clinical, neurophysiologic (somatosensory-evoked potential), and biochemical prognosticators. Good outcome (Cerebral Performance Categories 1 and 2) and mortality predictions at 3 months were calculated. Among 357 patients, early electroencephalography reactivity and continuity and flexor or better motor reaction had greater than 70% positive predictive value for good outcome; reactivity (80.4%; 95% CI, 75.9–84.4%) and motor response (80.1%; 95% CI, 75.6–84.1%) had highest accuracy. Early benign electroencephalography heralded good outcome in 86.2% (95% CI, 79.8–91.1%). False positive rates for mortality were less than 5% for epileptiform or nonreactive early electroencephalography, nonreactive late electroencephalography, absent somatosensory-evoked potential, absent pupillary or corneal reflexes, presence of myoclonus, and neuron-specific enolase greater than 75 µg/L; accuracy was highest for early electroencephalography reactivity (86.6%; 95% CI, 82.6–90.0). Early highly malignant electroencephalography had an false positive rate of 1.5% with accuracy of 85.7% (95% CI, 81.7–89.2%).

Conclusions:

This study provides class III evidence that electroencephalography reactivity predicts both poor and good outcomes, and motor reaction good outcome after cardiac arrest. Electroencephalography reactivity seems to be the best discriminator between good and poor outcomes. Standardized electroencephalography interpretation seems to predict both conditions during and after targeted temperature management.
Pilot Feasibility Study of Therapeutic Hypothermia for Moderate to Severe Acute Respiratory Distress Syndrome*
Authors: Slack Donald F. , Corwin Douglas S. , Shah Nirav G. , Shanholtz Carl B. , Verceles Avelino C. , Netzer Giora , Jones Kevin M. , Brown Clayton H. , Terrin Michael L. , Hasday Jeffrey D.
Published: April 2017

Objectives:

Prior studies suggest hypothermia may be beneficial in acute respiratory distress syndrome, but cooling causes shivering and increases metabolism. The objective of this study was to assess the feasibility of performing a randomized clinical trial of hypothermia in patients with acute respiratory distress syndrome receiving treatment with neuromuscular blockade because they cannot shiver.

Design:

Retrospective study and pilot, prospective, open-label, feasibility study.

Setting:

Medical ICU.

Patients:

Retrospective review of 58 patients with acute respiratory distress syndrome based on Berlin criteria and Pao
2/Fio
2 less than 150 who received neuromuscular blockade. Prospective hypothermia treatment in eight acute respiratory distress syndrome patients with Pao
2/Fio
2 less than 150 receiving neuromuscular blockade.

Intervention:

Cooling to 34–36°C for 48 hours.

Measurements and Main Results:

Core temperature, hemodynamics, serum glucose and electrolytes, and P/F were sequentially measured, and medians (interquartile ranges) presented, 28-day ventilator-free days, and hospital mortality were calculated in historical controls and eight cooled patients. Average patient core temperature was 36.7°C (36–37.3°C), and fever occurred during neuromuscular blockade in 30 of 58 retrospective patients. In the prospectively cooled patients, core temperature reached target range less than or equal to 4 hours of initiating cooling, remained less than 36°C for 92% of the 48 hours cooling period without adverse events, and was lower than the controls (34.35°C [34–34.8°C]; p < 0.0001). Compared with historical controls, the cooled patients tended to have lower hospital mortality (75% vs 53.4%; p = 0.26), more ventilator-free days (9 [0–21.5] vs 0 [0–12]; p = 0.16), and higher day 3 P/F (255 [160–270] vs 171 [120–214]; p = 0.024).

Conclusions:

Neuromuscular blockade alone does not cause hypothermia but allowed acute respiratory distress syndrome patients to be effectively cooled. Results support conducting a randomized clinical trial of hypothermia in acute respiratory distress syndrome and the feasibility of studying acute respiratory distress syndrome patients receiving neuromuscular blockade.
Successful treatment with imatinib after nilotinib and ipilimumab in a c-kit-mutated advanced melanoma patient: a case report
Authors: Murer Carla , Kränzlin-Stieger Pascale , French Lars E. , Dummer Reinhard , Goldinger Simone M.
Published: April 2017

Treatment of melanoma remains a challenge in advanced disease. Recently, the molecular differentiation in BRAF-mutated, NRAS-mutated and c-kit-mutated melanomas led to new treatment strategies. Different trials show that imatinib or nilotinib lead to meaningful responses in c-kit-mutated melanoma patients. There are little published data on sequential inhibition using these two drugs in melanoma. We describe the sequential use of imatinib after nilotinib in a c-kit-mutated melanoma patient, who progressed on interferon, Allovectin, dacarbazine, nilotinib and ipilimumab, and was finally treated with the c-kit inhibitor imatinib. From July 2011 to September 2011, the patient received ipilimumab (four doses with 3 mg/kg). Clinical assessment after immunotherapy showed disease progression. Therefore, a treatment change to imatinib 800 mg daily was made from February 2012 to May 2013. Under this treatment, the patient showed a partial response as per the RECIST criteria. The present lesions continued responding (computed tomography scans: May 2012–March 2013). Unfortunately, in October 2012, new brain metastases developed. Nevertheless, the use of c-kit inhibitors in c-kit-mutated melanoma patients seems to be a promising treatment option. Furthermore, a delayed response to ipilimumab after 6 months could also have led to or supported the partial response in this case. However, when two biologically similar compounds are administered in a melanoma patient and the tumour mass shows progressive disease upon administration of the first agent, an additional progression with no effect may be expected when the second one is used. This case shows, in contrast, that the use of imatinib after progression upon nilotinib can be beneficial.
Zika virus and assisted reproduction
Authors: Cordeiro Christina N. , Bano Rashda , Washington Cross Chantel I. , Segars James H.
Published: April 2017

Purpose of review

Due to the fact that the Zika virus can be sexually transmitted, there is a potential risk for disease transmission at several stages of assisted reproduction. Such a possibility poses a serious challenge to couples pursing fertility with reproductive technologies. Here, we discuss what is known regarding Zika virus infection with respect to sexual transmission and correlate this knowledge with recent recommendations in the realm of infertility treatment.

Recent findings

Zika virus can be transmitted from infected men and women through vaginal, oral or anal intercourse. Zika virus RNA has been detected in blood, semen, cervical mucus and vaginal fluid. Currently, the Centers for Disease Control recommends that infected men wait 6 months, and infected women 8 weeks, prior to attempting pregnancy. Reproductive tissue donors should wait 6 months before giving a specimen.

Further study of Zika virus transmission in different reproductive tissues and establishment of validated testing methods for viral disease transmissibility are urgently needed. Reproductive technologists need to establish screening, testing and laboratory protocols aimed to reduce the risk of Zika virus transmission during assisted reproduction.
Ulnar Head Reconstruction with Microvascular Second Metatarsal
Authors: Cavadas Pedro C. , Thione Alessandro
Published: April 2017

Background:

The distal radioulnar joint along with the interosseous ligament of the forearm and the proximal radioulnar joint, form a functionally integrated system responsible for the pronation–supination of the hand. The distal ulna, the so-called ulnar head, is an integral part of this system. Apart from its well-known role in forearm rotation, the ulnar head is essential in transverse load transmission through the distal radioulnar joint upon resisted elbow flexion. Autologous reconstruction of ulnar head would theoretically be beneficial with respect to prostheses.

Methods:

Three cases of ulnar head reconstruction with microvascular second metatarsal are reported herein including trauma, oncological, and congenital ethiologies.

Results:

The clinical result was good without complaints of instability.

Conclusions:

The cases included in this series, although heterogeneous, indicate that this treatment may be feasible also in postoncological resections and in congenital cases.
Composite Arteriovenous Radial Conduit Flap for Lower Limb Reconstruction
Authors: Cavadas Pedro C. , Sercan Ercin Burak , Thione Alessandro
Published: April 2017

In complex lower limb trauma, the healthy recipient vessels can be far from the defect to be reconstructed due to the usually high-energy injury sustained. The use of vein grafts, either directly or in the form of arteriovenous loops, is the usual solution in these cases. In the vein graft donor–depleted patient, other options are required; the composite arteriovenous radial conduit flap may be a useful resort in these situations.
The Effect of Acupressure Applied to Point LI4 on Perceived Labor Pains
Authors: Hamlacı Yasemin , Yazici Saadet
Published: April 2017

Controlling labor pain is one of the basic goals for caregivers during the birthing process. There are many pharmacological and nonpharmacological methods that are used for controlling pain and helping the mother to cope with pain and have a favorable labor. The study was planned as a randomized, controlled experimental study to detect the effect of acupressure applied to Point LI4 on perceived labor pains. The study sample comprised 88 pregnant women (44 acupressure group, 44 control group), who complied with the study guidelines, agreed with the conditions of the study, and signed the informed consent. Acupressure was applied to the study group when cervical dilatation reached 4 to 5 cm and again when cervical dilation was 7 to 8 cm. Acupressure was applied to Point LI4 on both the hands at the same time from the beginning to the end of the contraction (16 times). Evaluation with the visual analog scale was made 6 times: when the pregnant woman was first admitted to the hospital, before and after acupressure, and within 2 hours after delivery. The control group received routine care. There were statistically significant differences between the groups in subjective labor pain scores (P < .0001). There was a significant difference between the groups in terms of total duration of labor. As shown from our study, applying acupressure to Point LI4 was found to be effective in decreasing the perception of labor pains and shortening the labor (P < .05). Mothers were pleased with this treatment, but they found it insufficient to control their pain.
Assessing the Readiness of Nursing Sectors in Low- and Middle-Income Countries to Adopt Holistic Practice
Authors: Rosa William
Published: April 2017

Over the past several years, holistic nursing education has become more readily available to nurses working in high-income nations, and holistic practice has become better defined and promoted through countless organizational and governmental initiatives. However, global nursing community members, particularly those serving in low- and middle-income countries (LMICs) within resource-constrained health care systems, may not find holistic nursing easily accessible or applicable to practice. The purpose of this article is to assess the readiness of nursing sectors within these resource-constrained settings to access, understand, and apply holistic nursing principles and practices within the context of cultural norms, diverse definitions of the nursing role, and the current status of health care in these countries. The history, current status, and projected national goals of professional nursing in Rwanda is used as an exemplar to forward the discussion regarding the readiness of nurses to adopt holistic education into practice in LMICs. A background of holistic nursing practice in the United States is provided to illustrate the multifaceted aspects of support necessary in order that such a specialty continues to evolve and thrive within health care arenas and the communities it cares for.
Investigation of the Anxiolytic and Antidepressant Effects of Curcumin, a Compound From Turmeric (Curcuma longa), in the Adult Male Sprague-Dawley Rat
Authors: Ceremuga Tomás Eduardo , Helmrick Katie , Kufahl Zachary , Kelley Jesse , Keller Brian , Philippe Fabiola , Golder James , Padrón Gina
Published: April 2017

As the use of herbal medications continues to increase in America, the potential interaction between herbal and prescription medications necessitates the discovery of their mechanisms of action. The purpose of this study was to investigate the anxiolytic and antidepressant effects of curcumin, a compound from turmeric (Curcuma longa), and its effects on the benzodiazepine site of the γ-aminobutyric acid receptor A (GABAA) receptor. Utilizing a prospective, between-subjects group design, 55 male Sprague-Dawley rats were randomly assigned to 1 of the 5 intraperitoneally injected treatment groups: vehicle, curcumin, curcumin + flumazenil, midazolam, and midazolam + curcumin. Behavioral testing was performed using the elevated plus maze, open field test, and forced swim test. A 2-tailed multivariate analysis of variance and least significant difference post hoc tests were used for data analysis. In our models, curcumin did not demonstrate anxiolytic effects or changes in behavioral despair. An interaction of curcumin at the benzodiazepine site of the GABAA receptor was also not observed. Additional studies are recommended that examine the anxiolytic and antidepressant effects of curcumin through alternate dosing regimens, modulation of other subunits on the GABAA receptor, and interactions with other central nervous system neurotransmitter systems.
Decompression Retinopathy After Goniotomy in a Child: A Case Report
Authors: Burstein Eitan S. , Netland Peter A.
Published: April 2017

Purpose:

To report a case of ocular decompression retinopathy that developed in a child after undergoing goniotomy for uncontrolled pediatric uveitic glaucoma.

Patient and Methods:

We describe an 11-year-old Hispanic boy with a history of idiopathic uveitis and elevated intraocular pressure (IOP) in both eyes. He developed marked elevation of the IOP in the right eye (44 mm Hg) despite glaucoma medical therapy.

Results:

The patient’s right eye was treated with goniotomy, with reduction of vision to 20/70 and IOP to between 4 and 7 mm Hg during the first week postoperatively. The retina developed diffuse hemorrhages, both deep and superficial. Many of these hemorrhages had white centers. The findings were consistent with decompression retinopathy. The retinal hemorrhages began to improve 2 weeks and had cleared by 6 weeks after surgery. The IOP measurements ranged between 14 and 16 mm Hg from 2 to 6 weeks after goniotomy and the vision returned to preoperative baseline of 20/20-2 in the right eye. Six weeks after the initial surgery, the left eye was treated with goniotomy with no complications.

Conclusions:

Ocular decompression retinopathy, an uncommon complication of glaucoma surgery, can occur after goniotomy.
Lacrimal Sac Pneumatocele Following Blunt Nasal Trauma
Authors: Das Sima , Ali Mohammad Javed , Bansal Smriti , Chugh Manpreet , Gupta Nishi , Janaki Vidya
Published: April 2017

Pneumatocele of the lacrimal sac is an uncommon entity and has been rarely reported in literature. The valvular function of the Hasner’s valve at the lower end of nasolacrimal duct is presumed to prevent the retrograde reflux of air into the lacrimal sac with increased intranasal pressure as in valsalva maneuver. Loss of this valvular function as noted with persistent positive airway pressure ventilation can cause retrograde air reflux into lacrimal sac. The authors report a case of lacrimal sac pneumatocele which developed following blunt nasal trauma involving the bony nasolacrimal duct.
Resistance to Narrowband Ultraviolet B Therapy Over Varicose Veins in Two Cases of Generalized Vitiligo
Authors: Roth Gretchen M. , Holcomb Zachary E. , Brown Barbara , Fine Jo-David , Powers Jennifer G.
Published: April 2017

Vitiligo is a difficult-to-control disease with a devastating impact in the lives of many patients. An association has been shown between the Koebner phenomenon and the occurrence of skin depigmentation in vitiligo. However, the medical literature contains very little information regarding the relationship between varicose veins, a common comorbidity for many patients, and vitiligo skin lesions. We present two cases of generalized vitiligo in which patients experienced delayed or absent repigmentation exclusively over varicose veins after narrowband ultraviolet B therapy, despite repigmentation over the rest of the body. In one case, repigmentation occurred after varicose vein treatment. These patients highlight potential and previously unexplored interactions between varicose veins and response to vitiligo phototherapy. The impact of varicose veins on vitiligo treatment may inform future research ideas into the pathogenesis of this skin disease. Furthermore, these cases suggest a possible mechanism of improving local treatment response in vitiligo by addressing underlying varicose veins.
Reticulated Violaceous Eruption
Authors: Vazirnia Aria , Jacob Sharon E.
Published: April 2017

Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. In this modality, there is transfer of medical information electronically (including history and visual data) on a patient in one location to a provider who is in another location (Roman & Jacob, 2015). The construct of the TeleDermViewPoint column is such that cases are presented in a standardized teledermatology reader format reflective of an actual teledermatology report. This is a case of a reticulated violaceous eruption.
Small-bowel mucosal healing assessment by capsule endoscopy as a predictor of long-term clinical remission in patients with Crohn’s disease: a systematic review and meta-analysis
Authors: Niv Yaron
Published: April 2017

Capsule endoscopy (CE) may be used for the evaluation and follow-up of patients with Crohn’s disease. CE scores correspond to the degree of mucosal inflammation, a major therapeutic target. The aim of this meta-analysis and systematic review was to determine whether mucosal healing assessment by CE may serve as a predictor of clinical remission in patients with Crohn’s disease. To identify observational or controlled English-language full-text studies assessing mucosal healing by CE in patients with Crohn’s disease up to 30 September 2016, we searched PubMed, Embase, Central, Medline, and Scopus using the key words ‘mucosal healing’ and ‘capsule endoscopy’. A meta-analysis was carried out using ‘Comprehensive meta-analysis’ software. Pooled odds ratios and 95% confidence intervals were calculated. Five observational studies including 142 patients from five countries fulfilled the inclusion criteria. No publication bias was found by funnel plot. The mucosal healing CE score was found to be significantly associated with improved outcome after a follow-up of 12 weeks to 24 months, with an odds ratio of 11.06 (95% confidence interval: 3.74–32.73, P<0.001). The degree of heterogeneity among the studies was small (Q=2.014, d.f.[Q]=3, P=0.569 and I
2=0). Endoscopy scores may play a role in the long-term prognostic evaluation of patients with Crohn’s disease. Our results may be accepted as proof of concept, but larger studies are needed to corroborate these findings.