bluuebunny/crossref_metadata_2025 huggingface dataset:
Seeking and experiencing meaning: Exploring the role of meaning in promoting mental adjustment and eudaimonic well-being in cancer patients
Authors: Scrignaro Marta , Bianchi Elisabetta , Brunelli Cinzia , Miccinesi Guido , Ripamonti Carla Ida , Magrin Maria Elena , Borreani Claudia
Published: May 2014

Objective:

The present study is the result of theory-driven research investigating the role of the search for and presence of meaning in enhancing both mental adjustment and eudaimonic well-being in cancer patients.

Method:

A cross-sectional study involved 266 cancer patients currently in the treatment and management phase of their illness. Data were collected by a written questionnaire. The search for meaning was assessed with the Seeking of Noetic Goals Test, and the presence of meaning was assessed using the Purpose in Life Test. Mental adjustment to a cancer diagnosis was assessed by two subscales of the Italian version of the Mini-Mental Adjustment to Cancer Scale, and eudaimonic well-being was assessed with the Psychological Well-Being Scale. Correlation and mediation analyses based on five thousand bootstrapping samples were performed.

Results:

The mediation analyses showed that the presence of meaning totally or partially mediated the effect of the search for meaning on both mental adjustment and eudaimonic well-being. Further correlation analyses showed a high negative correlation between eudaimonic well-being and hopelessness.

Significance of results:

Our results appear relevant from both the theoretical and clinical points of view. They support a deeper understanding of the combined contribution of the search for and presence of meaning in promoting well-being in cancer patients. Simultaneously, they are consistent with suggestions from recent studies on the clinical psychology of posttraumatic growth and emphasize the relevance of eudaimonic well-being as a protective factor for hopelessness.
Factors contributing to economic burden in lung cancer spousal caregivers
Authors: Kavanaugh Melinda , Kramer Betty J. , Walsh Matthew Cunningham , Trentham-Dietz Amy
Published: May 2014

Objective:

The determinates of economic burden in lung cancer caregivers are poorly understood. Of particular interest is the role patient symptoms play in caregiver economic burden. Guided by a stress process conceptual framework, this study examined the predictors of economic burden reported by lung cancer spousal caregivers. Our study focused on the pathway of contextual and stressor variables leading to economic burden in lung cancer caregivers.

Method:

Relying on survey data from 138 spouses, structural equation modeling was employed to examine the determinants of economic burden measured using the Family Impact Survey. Contextual variables included age, gender, education, and income; and stressor variables included patient physical and mental symptoms, as well as number of children in the home.

Results:

A significant indirect path between age and economic distress through patient symptoms (p = 0.05) indicates younger spouses providing care for patients with more symptoms and reporting greater economic burden. Direct effects between contextual variables and economic burden revealed that caregivers with less education (p = 0.02) and those with more children at home (p = 0.01) reported more adverse economic outcomes.

Significance of Results:

Numerous factors impact spousal caregivers' economic burden, including the presence of children at home, being a younger caregiver, and lower educational attainment by caregivers. Moreover, the direct effects between age and economic burden were not significant, supporting the clear role patient symptoms play in the path to economic burden in spousal caregivers. These results underscore the need for healthcare providers to address psychosocial factors when dealing with patients and families with lung cancer. Specifically, the results highlight the importance of addressing patient symptoms early before they threaten the family's economic well-being.
CBT for OCD: habituation or cognitive shift?
Authors: Morris Lottie , Nightingale Jim
Published: May 2014

Cognitive Behavioural Therapy (CBT) including Exposure and Response Prevention (ERP) is recommended by NICE as the psychological treatment of choice for obsessive compulsive disorder (OCD). Twenty-five percent of OCD patients refuse ERP, and many psychologists advocate formulation-driven cognitive therapy, including ERP, as opposed to ERP alone. However, a recent meta-analysis suggested there is insufficient evidence to suggest ERP is improved by cognitive methods. This paper proposes to contribute to this debate by providing a detailed description of the treatment of a patient with intrusive cognitions of a sexual nature, who was treated successfully using behavioural experiments designed to test cognitions, rather than ERP. This is, arguably, the way in which most cognitive behavioural therapists would work with someone with OCD. However, this approach is not reflected in the literature at present. The authors report the patient's feedback that therapeutic change was brought about through cognitive shift, as a result of the formulation-driven behavioural experiments.
Design of L-plate proximity fed base station antenna element
Authors: Bilgiç Mustafa Murat , Yeğin Korkut
Published: May 2014

Wideband microstrip antenna with L-plate capacitively coupled feed structure is designed. The antenna operates in GSM 1800/1900 (1710–1910 MHz) and UMTS I (1920–2170 MHz) frequency bands. The antenna has dual slant (±45°) polarization with high isolation (>25 dB) between the ports. Measurements of the antenna reveal good performance in terms of impedance match, gain, gain flatness, isolation, half-power beamwidth, cross-polarization level, and front-to-back ratio. The proposed antenna can be used in base station antenna arrays, pico-cell, and femto-cell small-area cellular networks.
A Q/Ku-K band MMIC double-balanced subharmonic diode ring mixer for satellite communications in GaAs pHEMT technology
Authors: Resca Davide , Cignani Rafael , Florian Corrado , Biondi Andrea , Scappaviva Francesco
Published: May 2014

A MMIC double-balanced subharmonic diode ring mixer was designed for broadband satellite communications exploiting a GaAs pHEMT process. The circuit implements the frequency conversion from Q (43.5–50 GHz) to Ku-K band (17–21.5 GHz). Besides the RF, LO, and IF baluns, the MMIC integrates a buffer amplifier for the local oscillator signal, which is designed between X and Ku bands (11–16.5 GHz), due to the subharmonic operation. The mixer measured conversion loss is between 8 and 12 dB along the bandwidth, with an LO power of 9 dBm. The input p1 dB and IP3 are 2 and 15 dBm, respectively. The balanced structure ensures an LO and 2 × LO leakages at the IF port lower than −25 and −35 dBm, respectively. Other spurious remain below −67 dBc. The chip dimensions are 2.4 × 2.4 mm2.
Miscoded Visual Processing in Degenerative Retinal Disorder?
Authors: Carozzo Simone , Martinoli Cristina , Sannita Walter G.
Published: May 2014

Standard electrophysiological procedures for visual testing were applied to record the retinal and cortical electrophysiological responses to contrast stimulation from 35 subjects with unambiguously diagnosed retinitis pigmentosa and severe impairment of visual acuity and field. Stimuli (central 9° of visual field) were sinusoidal bars with spatial frequencies of 0.6–1.2 cycle/degree and 1.3–5.0 cycle/degree for the retinal (pattern-ERG) and cortical (pattern-VEP) responses, respectively; contrast was 80%; reversal at 2.13 Hz. Structured pattern-ERG above noise level was recorded from 29 subjects at 0.6 cycle/degree and from 24 subjects at 1.2 cycle/degree; latencies were increased and amplitude reduced. Pattern-VEP responses above noise level, with increased latencies and reduced amplitude, were observed in 92% of subjects with unilateral and in all subjects with bilateral retinal response. Both responses were phase-locked to stimulus. No correlation with the residual visual acuity or field was detected. The observation is consistent with evidence of the disease sparing the neuroretina and with unconscious visual processing and suggests miscoding of visual information processing.
Regional Brain Metabolism in a Murine Systemic Lupus Erythematosus Model
Authors: Vo An , Volpe Bruce T , Tang Chris C , Schiffer Wynne K , Kowal Czeslawa , Huerta Patricio T , Ulug Aziz M , Dewey Stephen L , Eidelberg David , Diamond Betty
Published: May 2014

Systemic lupus erythematosus (SLE) is characterized by multiorgan inflammation, neuropsychiatric disorders (NPSLE), and anti-nuclear antibodies. We previously identified a subset of anti-DNA antibodies (DNRAb) cross-reactive with the N-methyl-D-aspartate receptor, present in 30% to 40% of patients, able to enhance excitatory post-synaptic potentials and trigger neuronal apoptosis. DNRAb + mice exhibit memory impairment or altered fear response, depending on whether the antibody penetrates the hippocampus or amygdala. Here, we used 18F-fluorodeoxyglucose (FDG) microPET to plot changes in brain metabolism after regional blood-brain barrier (BBB) breach. In DNRAb + mice, metabolism declined at the site of BBB breach in the first 2 weeks and increased over the next 2 weeks. In contrast, DNRAb — mice exhibited metabolic increases in these regions over the 4 weeks after the insult. Memory impairment was present in DNRAb + animals with hippocampal BBB breach and altered fear conditioning in DNRAb + mice with amygdala BBB breach. In DNRAb + mice, we observed an inverse relationship between neuron number and regional metabolism, while a positive correlation was observed in DNRAb — mice. These findings suggest that local metabolic alterations in this model take place through different mechanisms with distinct time courses, with important implications for the interpretation of imaging data in SLE subjects.
Thalamic Fractional Anisotropy Predicts Accrual of Cerebral White Matter Damage in Older Subjects with Small-Vessel Disease
Authors: Cavallari Michele , Moscufo Nicola , Meier Dominik , Skudlarski Pawel , Pearlson Godfrey D , White William B , Wolfson Leslie , Guttmann Charles RG
Published: May 2014

White matter hyperintensities (WMHs) and lacunes are magnetic resonance imaging hallmarks of cerebral small-vessel disease, which increase the risk of stroke, cognitive, and mobility impairment. Although most studies of cerebral small-vessel disease have focused on white matter abnormalities, the gray matter (GM) is also affected, as evidenced by frequently observed lacunes in subcortical GM. Diffusion tensor imaging (DTI) is sensitive to subtle neurodegenerative changes in deep GM structures. We explored the relationship between baseline DTI characteristics of the thalamus, caudate, and putamen, and the volume and subsequent accrual of WMHs over a 4-year period in 56 community-dwelling older (≤75 years) individuals. Baseline thalamic fractional anisotropy (FA) was an independent predictor of WMH accrual. WMH accrual also correlated with baseline lacune count and baseline WMH volume, the latter showing the strongest predictive power, explaining 27.3% of the variance. The addition of baseline thalamic FA in multivariate modeling increased this value by 70%, which explains 46.5% of the variance in WMH accrual rate. Thalamic FA might serve as a novel predictor of cerebral small-vessel disease progression in clinical settings and trials. Furthermore, our findings point to the possibility of a causal relationship between thalamic damage and the accrual of WMHs.
The Pharmacokinetics and Pharmacodynamics of Kollidon VA64 Dissociate its Protective Effects from Membrane Resealing after Controlled Cortical Impact in Mice
Authors: Miller Benjamin F , Keles Eyup , Tien Lee , Zhang Jimmy , Kaplan David , Lo Eng H , Whalen Michael J
Published: May 2014

Membrane-resealing agents such as poloxamer P188 improve the outcome in experimental brain injury paradigms; however, whether membrane resealing is a key mechanism for protection has not been shown in vivo. We previously reported that Kollidon VA64, a polymeric membrane-resealing agent, reduces cell membrane permeability and improves brain edema, brain tissue damage, and functional outcome after controlled cortical impact in mice, without rescuing resealed cells from death. To reconcile these disparate findings, we used a dual-pulse labeling protocol to determine membrane-resealing kinetics by VA64/P188 in vivo. Membrane resealing after controlled cortical impact in mice by intravenous or intracerebroventricular VA64 and poloxamer P188 was transient, with most cells becoming repermeabilized within 2 hours, even with multiple-dose paradigms that maintained high VA64 blood levels. Moreover, VA64 reduced cytotoxic brain edema in a water intoxication model devoid of plasmalemma permeability ( P<0.05 versus P188, VA30, mannitol, and vehicle). We conclude that VA64 reduces cytotoxic and traumatic brain edema independent of membrane resealing. The results suggest that classic membrane-resealing agents such as poloxamer P188, and the newly discovered VA64, exert protective effects in central nervous system injury paradigms by mechanisms other than or in addition to maintaining permeable cell membranes sealed.
Magnetophoretic circuits for digital control of single particles and cells
Authors: Lim Byeonghwa , Reddy Venu , Hu XingHao , Kim KunWoo , Jadhav Mital , Abedini-Nassab Roozbeh , Noh Young-Woock , Lim Yong Taik , Yellen Benjamin B. , Kim CheolGi
Published: May 2014

The ability to manipulate small fluid droplets, colloidal particles and single cells with the precision and parallelization of modern-day computer hardware has profound applications for biochemical detection, gene sequencing, chemical synthesis and highly parallel analysis of single cells. Drawing inspiration from general circuit theory and magnetic bubble technology, here we demonstrate a class of integrated circuits for executing sequential and parallel, timed operations on an ensemble of single particles and cells. The integrated circuits are constructed from lithographically defined, overlaid patterns of magnetic film and current lines. The magnetic patterns passively control particles similar to electrical conductors, diodes and capacitors. The current lines actively switch particles between different tracks similar to gated electrical transistors. When combined into arrays and driven by a rotating magnetic field clock, these integrated circuits have general multiplexing properties and enable the precise control of magnetizable objects.
Integrated Systems Pharmacology Analysis of Clinical Drug‐Induced Peripheral Neuropathy
Authors: Hur J , Guo AY , Loh WY , Feldman EL , Bai JPF
Published: May 2014

A systems pharmacology approach was undertaken to define and identify the proteins/genes significantly associated with clinical incidence and severity of drug‐induced peripheral neuropathy (DIPN). Pharmacological networks of 234 DIPN drugs, their known targets (both intended and unintended), and the intermediator proteins/genes interacting with these drugs via their known targets were examined. A permutation test identified 230 DIPN‐associated intermediators that were enriched with apoptosis and stress response genes. Neuropathy incidence and severity were curated from drug labels and literature and were used to build a predictive model of DIPN using a regression tree algorithm, based on the drug targets and their intermediators. DIPN drugs whose targets interacted with both v‐myc avian myelocytomatosis viral oncogene homolog (MYC) and proliferating cell nuclear antigen‐associated factor (PAF15) were associated with a neuropathy incidence of 38.1%, whereas drugs interacting only with MYC had an incidence of 2.9%. These results warrant further investigation in order to develop a predictive tool for the DIPN potential of a new drug.

CPT Pharmacometrics Syst. Pharmacol. (2014) 3, e114; doi:10.1038/psp.2014.11; published online 14 May 2014
Hydrothermal synthesis, hierarchical structures and properties of blue pigments SrCuSi4O10 and BaCuSi4O10
Authors: Chen Yan , Shang Mingyu , Wu Xiaofeng , Feng Shouhua
Published: May 2014

In this work, a green chemistry strategy was developed to synthesize blue pigments SrCuSi4O10 and BaCuSi4O10 with good yield and high purity. SrCuSi4O10 and BaCuSi4O10 exhibit hierarchical structures. Our study shows that hydrothermally synthesized BaCuSi2O6 exhibits interesting broad near-infrared luminescence.
Highly conductive, flexible and scalable graphene hybrid thin films with controlled domain size as transparent electrodes
Authors: Shin Keun-Young , Jang Jyongsik
Published: May 2014

A novel approach to fabricate highly conductive, flexible and large-scale graphene thin films with uniformity for use as transparent electrodes is explored using a mechanochemical process and screen printing.
Preparation and characterization of novel spica-like hierarchical vaterite calcium carbonate and a hydrophilic poly(vinylidene fluoride)/calcium carbonate composite membrane
Authors: Wang Ao-Xuan , Chu De-Qing , Wang Li-Min , Mao Bao-Guang , Sun Hong-Ming , Ma Zhong-Chao , Wang Gang , Wang Long-Xiang
Published: May 2014

Spica-like hierarchical vaterite CaCO3 and a hydrophilic PVDF/CaCO3 composite membrane were prepared.
Density functional tight binding: values of semi-empirical methods in an ab initio era
Authors: Cui Qiang , Elstner Marcus
Published: May 2014

Semi-empirical (SE) methods are derived from Hartree–Fock (HF) or Density Functional Theory (DFT) by neglect and approximation of electronic integrals.
Photo-physical properties of 2-(1-ethynylpyrene)-adenosine: influence of hydrogen bonding on excited state properties
Authors: Trojanowski P. , Plötner J. , Grünewald C. , Graupner F. F. , Slavov C. , Reuss A. J. , Braun M. , Engels J. W. , Wachtveitl J.
Published: May 2014

The photo-physical properties of 2-(1-ethynylpyrene)-adenosine (PyA), a fluorescent probe for RNA dynamics, were examined by solvation studies.
Hollow-tunneled graphitic carbon nanofibers through Ni-diffusion-induced graphitization as high-performance anode materials
Authors: Chen Yuming , Li Xiaoyan , Zhou Xiangyang , Yao Haimin , Huang Haitao , Mai Yiu-Wing , Zhou Limin
Published: May 2014

Activated N-doped hollow-tunneled graphitic carbon nanofibers with a novel architecture are excellent anode materials for lithium ion batteries, displaying a superhigh reversible specific capacity and a remarkable volumetric capacity with outstanding rate capability and good cycling stability.
Elementary mode analysis reveals that Clostridium acetobutylicum modulates its metabolic strategy under external stress
Authors: Kumar Manish , Saini Supreet , Gayen Kalyan
Published: May 2014

Clostridium acetobutylicumis a strict anaerobe which exhibits two distinct steps in its metabolic network.
Transition metal complexes with bioactive ligands: mechanisms for selective ligand release and applications for drug delivery
Authors: Renfrew Anna K.
Published: May 2014

The unique properties of transition metal complexes, such as environment-responsive ligand exchange kinetics, diverse photochemical and photophysical properties, and the ability to form specific interactions with biomolecules, make them interesting platforms for selective drug delivery.
Hydrothermal synthesis of BaZrO3 fine particles controlled in size and shape and fluorescence behavior by europium doping
Authors: Kanie Kiyoshi , Seino Yuki , Matsubara Masaki , Nakaya Masafumi , Muramatsu Atsushi
Published: May 2014

Monodispersed barium zirconate fine particles with high crystallinity were synthesized by hydrothermal reactions using barium hydroxide and a Zr–triethanolamine complex.
Tunneling spectroscopy measurements on hydrogen-bonded supramolecular polymers
Authors: Vonau François , Shokri Roozbeh , Aubel Dominique , Bouteiller Laurent , Guskova Olga , Sommer Jens-Uwe , Reiter Günter , Simon Laurent
Published: May 2014

Tunneling spectroscopy of hydrogen-bonded EHUT molecules on Au(111) showing an energy dependant LUMO peak shift depending on the position.
Design and synthesis of lipid-coupled inositol 1,2,3,4,5,6-hexakisphosphate derivatives exhibiting high-affinity binding for the HIV-1 MA domain
Authors: Tateishi Hiroshi , Anraku Kensaku , Koga Ryoko , Okamoto Yoshinari , Fujita Mikako , Otsuka Masami
Published: May 2014

Lipid-coupled inositol 1,2,3,4,5,6-hexakisphosphate binds to HIV-1 MA tightly through both electrostatic and hydrophobic interactions.
Asymmetric organocatalytic desymmetrization of 4,4-disubstituted cyclohexadienones at high pressure: a new powerful strategy for the synthesis of highly congested chiral cyclohexenones
Authors: Miyamae Naomu , Watanabe Naruhisa , Moritaka Maya , Nakano Keiji , Ichikawa Yoshiyasu , Kotsuki Hiyoshizo
Published: May 2014

A highly diastereoselective and enantioselective method for the asymmetric desymmetrization of 4,4-disubstituted cyclohexadienones at high pressure was developed.
Biostable and bioreducible polymersomes for intracellular delivery of doxorubicin
Authors: Thambi Thavasyappan , Deepagan V. G. , Ko Hyewon , Suh Yung Doug , Yi Gi-Ra , Lee Jun Young , Lee Doo Sung , Park Jae Hyung
Published: May 2014

To minimize the premature drug release of nanocarriers, we have developed chemically cross-linked bioreducible polymersomes (CLPMs) that can specifically release the drug inside cancer cells.
Electrospun carbon nanofibers surface-grown with carbon nanotubes and polyaniline for use as high-performance electrode materials of supercapacitors
Authors: Zhou Zhengping , Wu Xiang-Fa , Hou Haoqing
Published: May 2014

This paper reports the synthesis and electrochemical performance of carbon nanofibers (CNFs) surface-grown with carbon nanotubes (CNTs) and nanostructured polyaniline (PANI) films, i.e., PANI/CNT/CNF, for use as a high-performance electrode material of pseudosupercapacitors.
Thermo-sensitive zwitterionic block copolymers via ATRP
Authors: Zhang Qun , Tang Xinde , Wang Tieshi , Yu Faqi , Guo Wenjuan , Pei Meishan
Published: May 2014

Novel thermo-sensitive zwitterionic block copolymers synthesized by ATRP exhibited distinct thermo-sensitivity and excellent antifouling property.
Colloidal semiconductor nanocrystals: controlled synthesis and surface chemistry in organic media
Authors: Chang Jin , Waclawik Eric R.
Published: May 2014

State-of-the-art development of the controlled synthesis of colloidal semiconductor nanocrystals has been discussed in this review article.
One-step synthesis of nitrogen-doped microporous carbon materials as metal-free electrocatalysts for oxygen reduction reaction
Authors: Zhao Xiaojun , Zhao Huanyu , Zhang Tingting , Yan Xuecheng , Yuan Ye , Zhang Haimin , Zhao Huijun , Zhang Daming , Zhu Guangshan , Yao Xiangdong
Published: May 2014

In this work, a series of microporous nitrogen-doped carbon catalysts are reported through a convenient preparation route, and exhibit excellent performance for oxygen reduction reaction.
Codeword averaged density evolution for distributed joint source and channel coding with decoder side information
Authors: Cen Feng , Zhu Fanglai
Published: May 2014

The authors consider applying the systematic low‐density parity‐check codes with the parity based approach to the lossless (or near lossless) distributed joint source channel coding (DJSCC) with the decoder side information for the non‐uniform sources over the asymmetric memoryless transmission channel. By using an equivalent channel coding model, which consists of two parallel subchannels: a correlation and a transmission sub‐channel, respectively, they derive the codeword averaged density evolution (DE) for the DJSCC with the decoder side information for the asymmetrically correlated non‐uniform sources over the asymmetric memoryless transmission channel. A new code ensemble definition of the irregular codes is introduced to distinguish between the source and the parity variable nodes, respectively. Extensive simulations demonstrate the effectiveness of the codeword averaged DE.
Object‐oriented creation of input signals for system identification
Authors: Barker H. Anthony , Tan Ai Hui , Godfrey Keith R.
Published: May 2014

This study describes how a very large number of deterministic input signals for system identification may be created by object‐oriented methods. The concepts of aggregation and inheritance, combined with the properties of m‐sequences, are utilised to develop two new methods for the creation of pseudorandom perturbation signals with ideal spectral properties, two, three, five or seven levels and a very wide range of periods. The available signal levels ensure that the signals are suitable for both linear and non‐linear system identification and the availability of a large number of signal periods ensures that the signals are suitable for both single and multi‐input system identification. The methods are described in detail and illustrated by examples, together with their implementation in the open environment of an efficient, user‐friendly and freely available Matlab program which provides third‐party software to complement existing Matlab Identification Toolboxes.
Intelligent total sliding‐mode control with dead‐zone parameter modification for a DC motor driver
Authors: Hsu Chun‐Fei
Published: May 2014

A functional‐linked cerebellar model neural network (FCMNN) equipped with sine–cosine perturbed Gaussian basis functions to online approximate an unknown nonlinear term in the system dynamics of a DC motor driver is proposed in this study. The sine–cosine perturbation in the Gaussian basis functions possessing the ability of handling rule uncertainties is quite useful for real‐time applications. Then, an intelligent total sliding‐mode control (ITSMC) system that is composed of a computation controller and a robust compensator is proposed. The computation controller including an FCMNN approximator is the main controller and the robust compensator is designed to eliminate the effect of the approximation error introduced by the FCMNN approximator upon system stability. The online parameter adaptation laws are derived based on a Lyapunov function so that the L2 tracking performance can be guaranteed. To reduce the parameter overtraining problem, a dead‐zone parameter modification scheme is adopted so that the parameter tuning process will be stopped when a tracking index is smaller than a pre‐specified threshold. Finally, the proposed ITSMC system is implemented on a 32‐bit microcontroller for possible low‐cost and high‐performance industrial applications. The experimental results show that the ITSMC system can achieve favourable tracking performance and is robust against parameter variations in the plant.
Fast satellite selection method for multi‐constellation Global Navigation Satellite System under obstacle environments
Authors: Peng Ao , Ou Gang , Li Gengmin
Published: May 2014

Satellite selection plays an important role in a multi‐constellation Global Navigation Satellite System (GNSS) receiver. A well selected satellite combination can provide better positioning accuracy and lighter computational load. In this study, typical obstacle environments in urban areas and their effects on satellite selection are discussed. A distribution‐free satellite selecting method is proposed. The main idea of this proposed method is to expand the selected satellite subset sequentially. The performance of the proposed methods is validated and compared with four other methods by simulation in typical scenarios. Simulation results show that the proposed method is suitable for urban GNSS applications.
A Prospective Study of Correlation between Clinical Disability and Radiological Features in Degenerative Lumbar Canal Stenosis (LCS)
Authors: Kanna R. , Nanjayan K. , Shetty A. Prasad , Shanmuganathan R.
Published: May 2014

Introduction

The relationship between clinical disability and various parameters such as degree of constriction of dural sac, radiological pelvic parameters, facet joint orientation in patients with degenerative LCS has not been clearly defined.

Materials and Methods

A total of 50 patients with LCS were selected prospectively and divided into two groups (20 patients responding to conservative therapy and 30 requiring surgery) and compared with 16 controls. Patients were clinically evaluated by Oswestry disability index (ODI), SF-12, and neurogenic claudication outcome score (NCOS). All patients underwent anteroposterior, lateral dynamic radiographs of lumbar spine, and whole spine standing lateral radiograph. The spinopelvic parameters measured were spinosacral angle, thoracic kyphosis, lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt. Dural sac cross-sectional area, lateral recess angle and height, and facet joint orientation were assessed in MRI.

Results

Between conservative and operated group, the mean ODI score (55.5 vs. 62.99, p = 0.014) and NCOS (37.7 vs. 29.47, p = 0.06) were significantly different. Dural sac area significantly differed ( p < 0.001) between control (113.97 ± 57.58), conservative (47.57 ± 24.77), and operated groups (20.66 ± 14.49). NCOS had significant positive correlation with dural sac area ( r = 0.296, p = 0.037) than ODI. In patients with degenerative spondylolisthesis, there was a significant sagittal orientation of facet joints, high pelvic incidence (58.79 vs. 50.57, p = 0.047), and an increased pelvic tilt (18.99 vs. 11.25, p = 0.045).

Conclusion

Degree of dural sac stenosis corresponds to clinical disability and NCOS is a better indicator of dural sac compression than ODI score. LCS patients with sagittal facet orientation, high pelvic incidence, and high pelvic tilt develop spondylolisthesis. Disclosure of Interest None declared
Clinical Outcome after Cervical Arthroplasty Using the Novel One-Piece Viscoelastic Freedom Prosthesis
Authors: Boss O. Louis , Bäurle B. , Hausmann O. Nic
Published: May 2014

Introduction

The objective of this study was to evaluate the patients’ clinical condition after cervical arthroplasty using the Freedom Cervical Disc (AxioMed). Cervical arthroplasty is one possible treatment option for cervical degenerative disc disease (CDDD), offering an alternative to cervical decompression and fusion. As opposed to first generation ball and socket artificial disc devices, the freedom prosthesis is a one-piece viscoelastic artificial disc. This design is meant to re-establish the function of the spinal segment, mimicking the biomechanics of a healthy intervertebral disc and restoring segmental lordosis.

Materials and Methods

A total of 12 patients (women: 8; men: 4; mean age: 44.5 years, range: 37-59 years) received a prosthetic disc due to CDDD between April and September 2013. Follow-up assessment took place 6 weeks and 3 months after surgery and included clinical evaluation. The patients rated their clinical condition subjectively using the VAS for neck and arm pain, the North American Spine Society patient questionnaire for cervical pain and neurology (COSS), EuroQoL-5D, and the Neck Disability Index (NDI).

Results

All clinical indices indicated a clinically significantly improved condition of the patients after surgery. Mean VAS score for neck pain decreased from 6.36 preoperatively to 1.66 cm 3 months after surgery. Similarly, VAS score for radicular pain decreased from 6.81 to 1.33 cm. As expected, VAS for health state increased from 5.0 to 7.83 cm. Mean working capacity improved up to 75% at the 6 weeks and up to 91.66% at the 3 months follow-up. Furthermore, the COSS as well as the EuroQoL-5D and NDI showed an improvement of patients’ well-being. Mean improvement of the COSS for cervical pain and cervical neurology was 1.7 points. EuroQol-5D rose from 0.64 points preoperatively to 0.86 points 3 months after the procedure. NDI decreased from 48.6 to 16.3%.

Conclusion

At this early follow-up, our data indicate that the freedom prosthesis is a good treatment option in patients with CDDD. The clinical indices markedly improved after surgery. However, further data collection, as well as statistical analyses are needed to prove our preliminary results. Disclosure of Interest O. Boss: None declared B. Bäurle: None declared O. Hausmann: Conflict with Axiomed Spine Corporation
Thermally Triggered Injectable Hydrogel Carrier System for Mesenchymal Stem Cell Delivery to Promote Intervertebral Disc Regeneration
Authors: Boyes V. , Barthrop B. , Chiverton N. , Cole A. , Michael A. R. , Breakwell L. , Sammon C. , Le Maitre C. L.
Published: May 2014

Introduction

Instability of the motion segment as a result of intervertebral disc (IVD) degeneration is well known as a major cause of low back pain. Several tissue engineering and stem cell approaches have been investigated to attempt to regenerate the degenerate IVD. However, many of the proposed therapies would entail lengthy/risky operations to “implant” the tissue regeneration scaffold. Our vision is to develop a novel, injectable biomaterial delivery system which can deliver mesenchymal stem cells (MSCs) to the degenerate nucleus pulposus (NP) to stimulate regeneration, together with inhibitors of degeneration if required and provide mechanical support to the motion segment enabling regeneration to take place.

Materials and Methods

Here, we investigated a novel hydrogel system, which can be maintained as a liquid ex vivo and can be injected into the IVD where body temperature triggers in situ solidification. Human MSCs were incorporated into hydrogel systems and cell viability, migration characteristics, SEM, gene expression for NP markers, and matrix production investigated to determine differentiation capacity of incorporated MSCs. Mechanical properties of hydrogel systems were determined using dynamic mechanical analysis and compared with native NP tissue. Microparticles incorporation to provide delivery of inhibitors of degeneration were also investigated.

Results

Viability of MSCs was maintained within hydrogel systems for the 6 weeks investigated, where they were shown to migrate through the hydrogel system, deposit matrix within and differentiate toward NP cells with a switch in matrix gene expression from collagen type I to type II, and deposition of GAGs with immunopositivity seen for aggrecan following 4 weeks in culture. DMA analysis demonstrated hydrogel systems containing 10% hyaluronic acid displayed similar mechanical properties to native NP cells. Hydrogel systems were injected via 26-gauge needles into collagenase digested bovine caudal discs, which was maintained during loading of the bovine motion segments. In addition, microparticles were successfully incorporated into hydrogel systems in the liquid state before thermal triggered solidification.

Conclusion

Here, we have developed a hydrogel system with the potential to deliver MSCs via minimally invasive injection using small bore needles which decreases the chance of inducing damage to the annulus fibrosus. Hydrogel systems were nontoxic, support MSC growth and differentiation, and show potential to provide mechanical support to the motion segment while regeneration takes place. Such a therapy combined with inhibition of degeneration could show great promise for early and mid-stages of degeneration. Disclosure of Interest None declared
Long-Term Results of Total Lumbar Disc Replacement: A Prospective Analysis with 5 to 10 Years Follow-Up
Authors: Siepe C. J. , Heider F. , Wiechert K. , Mehren C. , Korge A. , Mayer M. H.
Published: May 2014

Introduction

The role of fusion of lumbar motion segments for the treatment of intractable low back pain (LBP) from degenerative disc disease (DDD) remains controversially debated. Total lumbar disc replacement (TDR) has been used as an alternative in a highly selected patient cohort. However, the amount of long-term follow-up (FU) data on TDR is limited.

Materials and Methods

Visual analog scale (VAS), Oswestry disability index (ODI) and patient satisfaction rates were acquired within the framework of an ongoing prospective clinical trial. The patient's professional activity/employment status, complications, and reoperations were recorded. A comparison was performed between mono- and bisegmental cases.

Results

The initial cohort consisted of 201 patients; 181 patients were available for final FU (90.0% FU rate) after a mean FU of 7.4 years (range, 5.0-10.8 years). VAS and ODI scores revealed a highly significant improvement from baseline levels at all postoperative stages ( p < 0.0001). VAS scores demonstrated a slight (VAS 2.6-3.3) but statistically significant deterioration from 48 months onward ( p < 0.05). Patient satisfaction rates remained stable throughout the entire postoperative course, with 63.6% of patients reporting a “highly satisfactory” or a “satisfactory outcome” (22.7%), while 13.7% of patients were not satisfied. The overall complication rate was 14.4% ( n = 26/181). The incidence of revision surgeries for general and/or device related complications was 7.2% ( n = 13/181). Results for two-level TDR were significantly inferior in comparison with one-level cases and were associated with higher complication (11.9 vs. 27.6%; p = 0.03) and inferior satisfaction rates ( p < 0.003).

Conclusion

Despite the fact that the current data comprise the early experiences and learning curve associated with a new surgical technique, the results demonstrate satisfactory and maintained mid- to long-term clinical results after a mean FU of 7.4 years. Patient safety was proven with acceptable complication and reoperation rates. Fear of excessive late complications or reoperations following the primary TDR procedure cannot be substantiated with the present data. In carefully selected cases, TDR can be considered a viable treatment alternative to lumbar fusion for which spine communities around the world seem to have accepted mediocre clinical results as well as obvious and significant drawbacks. Disclosure of Interest None declared
Characteristics of Stem Cells Derived from the Degenerated Human Intervertebral Disc Cartilage Endplate
Authors: Huang B. , Liu L. , Li C. , Zhuang Y. , Wang J. , Zhou Y.
Published: May 2014

Introduction

Mesenchymal stem cells (MSCs) derived from adult tissues are an important candidate for cell-based therapies and regenerative medicine due to their multipotential differentiation capability. MSCs have been identified in many adult tissues but have not reported in the human intervertebral disc cartilage endplate (CEP).

Materials and Methods

The initial purpose of this study was to determine whether MSCs exist in the degenerated human CEP. Next, the morphology, proliferation capacity, cell cycle, cell surface epitope profile, and differentiation capacity of these CEP-derived stem cells (CESCs) were compared with bone-marrow MSCs (BM-MSCs). Finally, whether CESCs are a suitable candidate for BM-MSCs was evaluated. Isolated cells from degenerated human CEP were seeded in an agarose suspension culture system to screen the proliferative cell clusters. Cell clusters were chosen and expanded in vitro and were compared with BM-MSCs derived from the same patient.

Results

The morphology, proliferation rate, cell cycle, immunophenotype, and stem cell gene expression of the CESCs were similar to BM-MSCs. In addition, the CESCs could be induced into osteoblasts, adipocytes, chondrocytes, and are superior to BM-MSCs in terms of osteogenesis and chondrogenesis. This study is first to demonstrate the presence of stem cells in the human degenerated CEP.

Conclusion

These results may improve our understanding of intervertebral disc (IVD) pathophysiology and the degeneration process, and could provide cell candidates for cell-based regenerative medicine and tissue engineering. Disclosure of Interest None declared
Assessment of the Neurocentral Synchondrosis in Pediatric Spines and the “Developmental” Etiology of Schmorl Nodes
Authors: Luk K. , Law T. , Portia-Anthony M. , Samartzis D.
Published: May 2014

Introduction

Schmorl nodes of the thoracolumbar region have been associated with the presence and severity of disc degeneration in adults. The etiology of Schmorl nodes remains precarious; however, a unique multilevel phenotype of “kissing” nodes seems to suggest a developmental origin. The neurocentral synchondrosis (NCS) are cartilaginous growth plates near the neural arch ossification centers in a growing vertebrae that may play a direct role in the development of endplate abnormalities, such as Schmorl nodes. This study assessed the NCS in pediatric spines to raise discussion of a developmental component of Schmorl nodes.

Materials and Methods

A retrospective imaging study of pediatric patients at a single institute assessed over a 5-year period (age range: 0-10 years) was performed. Patients with spinal disorders (e.g., scoliosis) were excluded. A total of 102 patients (57 males and 45 females) and a total of 113 sets of MRI images were reviewed. The thoracolumbar regions (T12-S1) were evaluated. Sagittal T1- and T2-weighted images were assessed for the presence or absence of the NCS, defined as a hypointense vertical line located between the vertebral body anteriorly and the posterior arch. The presence of Schmorl nodes was also noted.

Results

NCS was noted in 46% of the MRIs. No statistically significant difference in the disappearance of the NCS between different age groups ( p = 0.063) or gender ( p = 0.706) was found. The NCS was noted to be completely fused at the midpoint of the vertebrae. Indentation of the vertebral endplates resembling Schmorl node at many of the rostral and caudal ends of the unfused NCS were observed (Fig. 1).

Conclusion

The significance of further characterizing the nature of NCS closure may lie in potential associations with failure of complete closure with endplate abnormalities, such as Schmorl nodes. Our MRI study provides a foundation that a development etiology of Schmorl nodes exists. Disclosure of Interest None declared
MiRNA-146a and Intervertebral Disc Homeostasis: In Vitro, Ex Vivo Studies
Authors: Gu S. , Li X. , Ranjan K.C. , Sampen H. J.
Published: May 2014

Introduction

Expressions of miR-146a in chondrocytes were shown controversial effect according to different studies. This study is designed to demonstrate for the first time that MiRNA-146a is involved in intervertebral disc homeostasis, and its role in anti-inflammatory effect via both in vitro and ex vivo tests.

Materials and Methods

NP cells isolated from bovine tails in monolayer were transfected with synthetic miR-146a, and IL-1 was administered in parallel to provoke a catabolic response, using PCR and WB to confirm its effects. Then, histologic analysis using an ex vivo organ culture model of miR-146a KO mouse was used.

Results

In bovine disc NP cells in vitro experiment, PCR results showed the presence of IL-1 significantly increase the expression of all the cytokines when compared with the control group. Transfection of miR-146a antagonized IL-1 mediated increase of degrading enzymes and the inflammatory related cytokines. WB results also confirmed the miR-146a effects. Ex vivo mice whole disc organ culture model showed when challenged by IL-1, the 146KO NPs showed more serious decrease of GAG and degeneration, compared with WT NPs. And the numbers of MMP-13 and Adamts5 positive cells were significantly increased in the NPs of 146-a KO mouse than the WT.

Conclusion

The overexpression of miR-146a of bovine NP cells showed strong anti-inflammatory effects, and we thought that miR-146a might also be involved in the process of IVD degeneration, which is closely related with inflammatory factors. The relative importance of miR-146a as compared with other miRNA or proinflammatory factors in the process of IVD degeneration, however, needs further investigations. Disclosure of Interest None declared
Epidemiology of 258 Surgically Treated Cases of Lumbar Disc Prolapse
Authors: Zahoor A. , Jayachandran R. Kumar , Ashraf S. , Unnikrishnan R. , Menon K. V.
Published: May 2014

Introduction

Low back pain (LBP) is common with a lifetime prevalence of 70% and sciatic conditions in one quarter. Most of the research related to spine surgery is focused on the methods and techniques of diagnosis, therapy and rehabilitation, but hardly anything has been published on disease prevention and avoiding the need for surgery. The purpose of this study is to examine the epidemiological characters and investigate risk factors that predispose individuals to LIVDP.

Materials and Methods

This is an observational, noninterventional, descriptive study of 500 surgically treated cases of lumbar disc prolapse in a tertiary spine care center over 7 years’ time. Data were collected through questionnaires, outpatient registers, X-rays, MRI scans, and operation notes. Variables studied were age, body mass index, occupation, intensity of physical labor at work, driving, smoking, level of education, socioeconomic status, recreational activities, and family history of LIVDP. Data were analyzed and depicted in the form of various charts, tables, graphs, and histograms according to their occurrence.

Results

In our study, 26 to 45 years is the most common age group affected with LIVDP. Males were 69.8% with progressive increase in the difference as the age increases; 54.65% patients hailed from rural population, 70.54% occupations were involved in sedentary type of work with excessive bending and twisting activities, and only 28.68% were from the heavy manual group involved in lifting and other strenuous activities. Driving was a significant factor 60.47% with dominance of two wheeler drivers by 58.97%. Trauma was an event initiating back pain in 34%. Family history of back pain or spine surgeries was not significant. There was no effect of smoking or drinking. Total 84.5% were having sedentary habits with no sporting activities. Anxiety and stress were found in 61.7% people with 38.8% having it before the surgery.

Conclusion

Most common age group presenting with lumbar disc prolapse is 26 to 45 years with two-thirds predominance of males. Light manual and secretarial occupations, involving sedentary type of work with excessive bending and twisting activities form the major occupational group with LIVDP. Driving is a significant association factor. However, there is no effect of smoking or positive family history. Total 84.5% of the cases have sedentary habits with no sporting activities suggesting the protective role of sports. Emotional factors such as anxiety and stress have a possible role in the etiology of lumbar disc prolapse and its severity of symptoms to require surgery. Disclosure of Interest None declared
A New Porcine Animal Model of Cervical Disc Degeneration
Authors: Lee S. E. , Jahng T. A.
Published: May 2014

Introduction

Previous in vivo animal model for disc degeneration was predominantly smaller animals. But such small discs were inappropriate to investigate the cell transplantation therapy highlighted recently. A porcine disc degeneration model in lumbar spine was introduced; however, the lumbar spine was not influenced by the gravity. Hence, the authors performed porcine animal model of disc degeneration in cervical spine.

Materials and Methods

Three domestic minipigs (aged, 5 months; weight, 40-50 kg) were used. After anesthesia, right transverse 5 cm-sized incision was made over the three fingers above the clavicle on the anterior neck. Similar to a standard anterior cervical approach of Smith-Robinson method, anatomic dissection was performed to expose anterior surface of the cervical spine. The partial nucleotomy by a Jamshidi bone marrow biopsy needle was performed in one intervertebral disc, and the other disc spaces served as control. Radiologic study using lateral plain radiograph (X-ray) and magnetic resonance image (MRI) was evaluated at preoperation and postoperative 4 and 8 weeks.

Results

Two of three minipigs were confirmed disc degeneration at C4-5 and C6-7, respectively. The disc height was reduced by 20% at nucleotomy level. And these discs with previous Pfirrmann grade I were changed to grade IV degeneration at postoperative 4 and 8 weeks. The other disc spaces were maintained previous disc height and Pfirrmann grade I condition.

Conclusion

This was a pilot study to introduce a new disc degeneration model with relatively large animal at cervical spine. The authors will conduct a further experiment to confirm the cervical disc degeneration and plan the cell therapy for treatment of disc degeneration. Disclosure of Interest None declared