bluuebunny/crossref_metadata_2025 huggingface dataset:
Aggressive Skull Base Metastasis from Uveal Melanoma: A Clinicopathologic Study
Authors: Yonekawa Yoshihiro , Kim Ivana K. , Gragoudas Evangelos S. , Njauw Ching-Ni J. , Tsao Hensin , Jakobiec Frederick A. , Stacy Rebecca C.
Published: May 2014

Purpose

We present the clinical, pathologic, and genetic findings of the first reported case of choroidal melanoma that developed a late recurrence and aggressive metastasis to the skull base without evidence of hepatic involvement.

Methods

Retrospective chart review and clinicopathologic correlation of ocular and brain tissue, including sequencing of BAP1 for mutations.

Results

A 55-year-old woman was diagnosed with choroidal melanoma and treated with proton radiotherapy. Six years later, she developed a rapidly growing local recurrence involving the ciliary body and iris. Upon enucleation, histopathology revealed an iris and ciliary body epithelioid melanoma that was contiguous with the previously treated, regressed spindle cell choroidal melanoma. Imaging was initially negative for brain involvement. Two months later, she developed cranial neuropathies and was found to have a large skull base lesion that required surgical debulking for pain palliation. Histopathology confirmed the lesion to be metastatic melanoma. Both ocular and brain tumor specimens were wild-type for BAP1. Throughout her course, she developed no hepatic metastases.

Conclusions

Uveal melanoma may metastasize to the skull base. The present case was characterized by delayed onset and unusual aggressiveness of the metastatic disease, and lack of BAP1 mutation. The unusual course highlights a unique phenotype that may reflect an alternate molecular mechanism for metastatic disease.
Scleral Shield: Primary Results of a New Surgical Technique in Augmenting Porous Orbital Implant Protection
Authors: Gawdat Tamer I. , Ahmed Rania A.
Published: May 2014

Purpose

To evaluate the value of using an additional scleral shield in providing further protection of inserted Medpor® implants in eviscerated globes.

Methods

This was a prospective interventional case series that included 30 patients with blind and/ or disfiguring globe that warranted evisceration. Cases with intraocular masses, retained intraocular foreign bodies, as well as secondary ball implantation were excluded. All patients underwent regular evisceration with porous polyethylene ball (Medpor®) implantation. The sutured wound was further covered by scleral patch graft followed by closure of Tenon capsule and conjunctiva in separate layers. Patients were evaluated for implant exposure and all of them completed at least 4 years of follow-up.

Results

The study involved 26 male and 4 female participants with age ranging from 16 to 65 years (mean 40.74 ± 15.86 years). The Medpor sizes varied from 16 to 22 mm in diameter. It is a simple extra step with no reported exposure, infection, or granulomas during the 4 years of follow-up.

Conclusions

Scleral shield is a simple surgical technique that provides an extra layer of autogenous tissue to cover inserted orbital implant following evisceration with promising results in preventing their exposure.
Decreased Retinal Nerve Fiber Layer Thickness in Patients with Congenital Isolated Growth Hormone Deficiency
Authors: Nalcacioglu-Yuksekkaya Pinar , Sen Emine , Yilmaz Sebahat , Elgin Ufuk , Gunaydin Süleyman , Aycan Zehra
Published: May 2014

Purpose

To evaluate the optic disc topography parameters of children with congenital isolated growth hormone deficiency (GHD) using the Heidelberg retina tomograph (HRT) in a controlled study.

Methods

This prospective study included 32 eyes of 32 patients with congenital isolated GHD and 36 eyes of 36 healthy subjects. The topographic optic disc parameters (mean cup volume, rim volume, cup area, disc area, rim area, mean cup-to-disc ratio and cup depth, retinal nerve fiber layer thickness [RNFL]) were imaged in all subjects with HRT-III (software 3.01 a-M). Pearson correlation analysis was used to investigate the correlation between right and left eyes regarding the optic disc parameters. Differences between the 2 groups were evaluated by independent t test, Mann-Whitney U test, and chi-square test.

Results

The mean RNFL thickness in children with congenital isolated GHD was found to be statistically significantly thinner than in healthy subjects (p<0.05). However, no statistically significant differences were found between the mean cup volume, rim volume, cup area, disc area, rim area, mean cup-to-disc ratio and cup depth, and mean sectorial RNFL thickness (p>0.05).

Conclusions

The results suggest that congenital GHD may lead to thinner RNFL thickness when compared with healthy subjects. This indicates that GH has an important role in the development of the neural retina.
The Relationship between Intact Parathyroid Hormone Levels and Daily Physical Activity in Hemodialysis Patients
Authors: Afsar Baris
Published: May 2014

Purpose

Poor physical activity and decreased daily activities are commonly seen in hemodialysis (HD) patients. Along with the progression of chronic kidney disease (CKD), various abnormalities of mineral and bone metabolism develop, such as osteitis fibrosa and adynamic bone disease, which are related with intact parathyroid hormone (intact-PTH). Surprisingly, scarce data exists regarding the relationship between intact-PTH and daily physical activity in HD patients.

Methods

Demographics, clinical parameters, laboratory data were recorded for all patients. Depressive symtoms, quality of life and daily activities of HD patients were measured by Beck Depression Inventory, SF-36, and Nottingham Extended Activities of Daily Living Scale (NEADLS), respectively.

Results

In total 114 patients (male/female:63/51, aged: 53.0 ± 13.8 years) were enrolled. The value of intact-PTH for <25th (Group 1), <25th-50th (Group 2), 50th-75th (Group 3) and >75th (Group 4) quartiles were <132.5 pg/ml, ≥132.5 <261.0, ≥261.0 <510.4 and ≥510.4, respectively. The NEADLS scores were 25.3 ± 10.8, 35.0 ± 9.4, 27.2 ± 13.9 and 26.4 ± 12.9 as going from Group 1 to Group 4 (p = 0.009). Post-hoc analysis of these four groups revealed that only Group 1 and Group 2 (p = 0.012), and Group 2 and Group 4 (p = 0.034) were different with respect to NEADLS scores.

Conclusions

Intact-PTH levels were inversely associated with daily activities in whole group. However, the post hoc analysis demonstrated that the association between intact PTH and daily activity is not linear and daily physical activity was lower only in patients with lowest and highest quartiles of intact-PTH.
Alpinia Oxyphylla Miquel Fruit Extract Activates MAPK-mediated Signaling of PAs and MMP2/9 to Induce Schwann Cell Migration and Nerve Regeneration
Authors: Chang Yung-Ming , Ye Chi-Xin , Ho Tsung-Jung , Tsai Te-Neng , Chiu Ping-Ling , Tsai Chin-Chuan , Lin Yueh-Min , Kuo Chia-Hua , Tsai Fuu-Jen , Tsai Chang-Hai , Huang Chih-Yang
Published: May 2014

Objectives

This study investigates the molecular mechanisms by which Alpiniae oxyphyllae fructus (AOF) promotes neuron regeneration.

Methods

A piece of silicone rubber was guided across a 15 mm gap in the sciatic nerve of a rat. This nerve gap was then filled with different concentrations of AOF extract (0-200 mg/ml). We investigated the role of MAPK (ERK1/2, JNK and p38) pathways for AOF-induced matrix-degrading proteolytic enzyme (PAs and MMP2/9) production in RSC96 Schwann cells.

Results

The results showed that AOF increased the expressions of uPA, tPA, MMP-9, and MAPKs in vivo. In vitro, our results show that treatment with AOF extract induces ERK1/2, JNK, and p38 phosphorylation to activate the downstream PAs and MMPs signaling expression. AOF-stimulated ERK1/2, JNK, and p38 phosphorylation attenuated by individual pretreatment with siRNAs or inhibitors (U0126, SP600125 and SB203580), resulting in migration and uPA-related signal pathway inhibition.

Conclusions

Taken together our data suggests the MAPKs (ERK1/2, JNK and p38), PAs (uPA, tPA), MMP (MMP2, MMP9) regenerative and migration signaling pathway of Schwann cells regulated by AOF extract might play a major role in Schwann cell migration and damaged peripheral nerve regeneration.
Chronic Dialysis Discontinuation: A Systematic Narrative Review of the Literature in the New Millennium
Authors: Piccoli Giorgina Barbara , Guzzo Gabriella , Vigotti Federica Neve , Scognamiglio Stefania , Consiglio Valentina , Aroasio Emiliano , Gonella Silvana , Castelluccia Natascia , Mauro Giuseppe , Colombi Nicoletta
Published: May 2014

Introduction and aims

Renal function recovery (RFR), defined as the discontinuation of dialysis after 3 months of replacement therapy, is an uncommon occurrence. At a time when the “too early” start of dialysis is in discussion, a systematic review of the literature for cases in which patients recovered renal function after starting dialysis with chronic indications, including single cases and large series, may lead to attention being focused on this interesting issue.

Methods

The search strategy was built in Medline on Pubmed, in EMBASE and in the Cochrane Collaboration (August 2013) combining Mesh, Emtree and free terms: dialysis or hemodialysis, kidney function, renal function and recovery (publication date 2000-2013). The following tasks were performed in duplicate: titles and abstracts were manually screened, the data were extracted: title, author, objective, year, journal, period of study, multi-center, country, type of study.

Results

The systematic review retrieved 1 894 titles; 58 full papers were retrieved and the final selection included 24 papers: 11 case series or Registry data (4 from ANZdata) and 13 case reports. In spite of the high heterogeneity of the studies, overall they suggest that RFR occurs in about 1% of patients, without differences between PD and HD. RFR appears to be more frequent in elderly patients with renal vascular disease (up to 10% RFR in cholesterol emboli or scleroderma), but is reported in all types of primary and secondary kidney diseases.

Conclusions

RFR is a clinical event that should be looked for, particularly in elderly patients with vascular comorbidity.
Influence of Polysulphone-Derived Dialysis Membranes on the Interaction of Circulating Mononuclear Cells with the Endothelium
Authors: Martínez-Miguel Patricia , de Sequera Patricia , Molina Álvaro , Oviedo Victoria , Grande Jesús , Escaja Cipriano , Díaz Hugo , Abreu Elisa , Asensio Manuel , Rodríguez-Puyol Diego , López-Ongil Susana
Published: May 2014

Purpose

Cardiovascular morbidity in hemodialysis (HD) patients may be influenced by the activation of circulating mononuclear cells (MCs) with subsequently increased endothelium interaction. The use of more biocompatible membranes would reduce this monocyte activation. We compare monocyte activation after using two different high-flux polymers, polysulphone and polyethersulphone.

Methods

The first part of the study was done with 10 patients who successively received dialysis for 2 weeks with polysulphone and polyethersulphone. The second part with 30 patients dialyzed for 3 months with polysulphone or polyethersulphone. Blood samples were taken before (pre-HD) and after (post-HD) the first HD session with each membrane to evaluate the effect of a single HD session. To assess acute and chronic effects of membranes, blood samples were taken pre-HD, after 2 weeks (first part of study) and after 3 months (second part of study). MCs were isolated from blood and then incubated with cultured human endothelial cells to evaluate MC adhesion, MC-dependent endothelial toxicity, and endothelial protein expressions of nitric oxide synthase and endothelin-converting enzyme-1 (ECE-1).

Results

One single HD session did not induce any changes. Dialysis for 2 weeks (first part of study) with polyethersulphone reduced MC adhesion to endothelium, cellular toxicity, and ECE-1 protein expression compared to polysulphone or basal conditions. Dialysis for 3 months (second part of study) increased MC adhesion to endothelium, whereas cellular toxicity was decreased with both dialyzers compared to the basal situation.

Conclusions

Although polyethersulphone HD decreased the interaction of MC with the endothelium in short-term experiments, both membranes were comparable in the long-term.
5ARI and PSA: Therapeutic aspects
Authors: Sciarra Alessandro
Published: May 2014

Background

PSA modifications can be determined not only by the presence of a prostate neoplasm but also by other benign diseases such as inflammation and benign prostatic hyperplasia (BPH).

Clinical Data

In cases with progressive BPH under 5 alpha reductase inhibitors, we obtain a reduction of the risk to receive unnecessary prostate biopsies (related to an increase of PSA secondary to a progressive BPH). On the contrary, BPH patients in progression with an elevated PSA level, under monotherapy with alpha1 blockers, continue to have PSA modifications related to benign prostatic diseases, increasing the risk of other unnecessary biopsies for prostate neoplasm diagnosis.

Evidence

During 5 alpha reductase inhibitors, the reduction and the following stabilization of PSA levels to a new nadir value exclude the need of new evaluations or biopsies for the early diagnosis of prostate cancer. On the contrary, a confirmed increase of PSA levels over the nadir is associated with the risk of a clinically relevant prostate neoplasm and therefore it induces a bioptic procedure.
Impact of NK Cell Count on Bladder Cancer Recurrence
Authors: Krpina Kristian , Babarović Emina , Đorđ-ević Gordana , Markić Dean , Maričić Anton , Jonjić Nives
Published: May 2014

Purpose

The aim of the present study was to evaluate the prognostic value of the local NK cell count in patients with recurrent non-muscle-invasive bladder cancer.

Methods

The archival paraffin-embedded primary tumor specimens were derived from retrospectively-selected patients, who were treated between 1996 and 2001 for bladder cancer. The study group consisted of 46 patients who developed recurrent disease during their first two post-operative years. The control group consisted of 27 patients who did not develop recurrent disease during their first two post-operative years. Specimens were assessed immunohistochemically with standard “ABC” technique. The frequency of NK cells was expressed as total number, estimated for each tumor by counting the positive NK cells in 10 high-power representative fields. Statistical analysis was done using Kruskal-Wallis test.

Results

Patients with recurrent non-muscle invasive bladder cancer in general have significantly higher values of stromal NK cell count than the control group. Patients with single tumor and smaller tumors show a statistically significant difference in NK cell count between study and control group. There also exists a statistically significant difference in stromal NK cell count in patients with clinical stage Ta tumor.

Conclusions

Our results confirm an association of the bladder wall NK cell count in bladder cancer patients with the natural history of disease. Further well-performed, reproducible, large, prospective investigation stratified by clinical parameters, such as tumor number and diameter, is needed to display the true value of this marker in the clinical work-up of bladder cancer patients.
A Case of Sleep-Related Painful Erections with Chronic Daytime Genital Discomfort
Authors: Mellado Miguel
Published: May 2014

Sleep-related painful erections (SRPE) are an uncommon condition characterized by recurrent nocturnal penile tumescence accompanied by penile pain without penile pathology, which occurs during the rapid eye movement (REM) sleep stage. A report of a 59-year-old patient with SRPE is described. Turgid painful erections (five to seven episodes of tumescence) during the sleep hours caused pain together with burning and tingling sensations in the penis and perineal zone during the daytime hours. Swelling of the pubic and perineal area was recurrent. Sleep loss, chronic fatigue, mild anxiety, lack of concentration and decreased work occurred along with this condition. Polysomnographic findings indicated REM sleep fragmentation. Attempts to treat this condition with muscle relaxants or anxiolytics did not prompt an improvement of this disorder, but a single daily dose of gabapentin 300 mg in combination with 1 mg clonazepam at bedtime improved total sleep time and reduced full sleep erections.
Radical Prostatectomy in High-Risk Prostate Cancer: Incidence of Specimen-Confined Disease (pT2-pT3a N0R0) and Outcomes
Authors: Mearini Luigi , Nunzi Elisabetta , Bini Vittorio , Lepri Luca , Bruno Raffaella , Porena Massimo
Published: May 2014

Introduction

Radical prostatectomy (RP) in patients with high-risk prostate cancer (PC) [prostate specific antigen (PSA) ≥20 ng/mL, and/or Gleason score ≥8, and/or cT3a disease] is considered an optional therapy, usually as a part of multimodal approach. Aim of the study is to evaluate the outcome of radical prostatectomy in case of specimen-confined (SC) disease and to compare it with patients with pathological locally-advanced disease.

Materials and Methods

Data from 176 consecutive patients with high-risk prostate cancer who underwent RP as initial therapy were analyzed, identifying subjects with specimen-confined disease (i.e. negative margins and negative lymph-nodes) in which RP was considered as monotherapy, and comparing oncological outcomes to patients with pathological non-SC disease, in which RP was considered as the first step of a multimodal approach.

Results

In high-risk prostate cancer, pathological report showed the presence of specimen-confined disease in 28.3% of cases. At univariate analysis, age and PSA correlate with the presence of SC disease at radical prostatectomy, while at multivariate analysis only PSA was a significant predictor of SC disease. At 5 years, Kaplan-Meier estimation of biochemical-free and cancer-specific survival was 56.2% and 97.7% vs 40.8% and 92.8% in specimen-confined disease and non-specimen-confined disease, respectively.

Conclusions

High-risk prostate cancer presents challenges for uro-oncologists since standard treatment is still under debate. One third of patients will present with specimen-confined disease, for which radical prostatectomy represents the sole, initial curative therapy; RP as multimodal therapy in patients without SC disease permits excellent long-term oncological outcomes.
Calcium and Magnesium in Male Reproductive System and in Its Secretion. I. Level in Normal Human Semen, Seminal Plasma and Spermatozoa
Authors: Valsa James , Skandhan Kalanghot Padmanabhan , Khan Pulikkal Sahab , Avni Kalanghot Padmanabhan Skandhan , Amith Skandhan , Gondalia Meenaxi
Published: May 2014

A study was conducted to establish the level of calcium and magnesium in human semen, seminal plasma and spermatozoa. One hundred and sixteen healthy, fertile young men submitted sample for this study. Total sperm count and active motility showed a positive correlation. Both elements were found more outside spermatozoa. They maintained a positive correlation. Spermatozoa count did not show correlation with any of these two elements. There was a negative correlation in calcium inside and outside spermatozoa.
The Cancelling of Elective Surgical Operations Causes Emotional Trauma and a Lack of Confidence: Study from a Urological Department
Authors: Dell'Atti Lucio
Published: May 2014

Objectives

Cancellation of elective surgical procedures is inconvenient and stressful on patients, causing loss of working days and disruption of daily life. Furthermore, it causes significant emotional trauma to the patients and their families. The purpose of this study was to analyze the number of elective surgery cancellations, as well as to identify and compare potential emotional trauma and satisfaction between older (≥65 years) and younger (<65 years) patients.

Methods

157 patients whose surgeries were scheduled and then cancelled were divided in two groups: Group A (62 younger patients, age <65) and Group B (95 older patients, age ≥65). The Hospital Anxiety and Depression Scale (HADS) was used to assess depression and anxiety. Patient satisfaction was collected from the Healthcare Providers and Systems Survey (HCAHPS).

Results

All groups with higher HADS score demonstrated markedly reduced satisfaction scores (with a mean score of 38%, p<0.001). In fact, patient satisfaction scores varied widely across the surveyed groups. Patient overall satisfaction scores after surgery ranged from 39% to 82%, with a mean of 68.5%, and from 28% to 73%, with a mean of 47.3% in Group A and B, respectively. These results point out a significantly lower satisfaction in elderly patients with depression (p<0.001) and with anxiety than in younger patients (p<0.002).

Conclusions

The study goal was to point out the importance of satisfying patients’ expectations to offer a better assistance, in order to ensure a comforting and friendly experience, especially when the patients are weak and not young anymore.
Role of PSA-Related Variables in Improving Positive Ratio of Biopsy of Prostate Cancer within Serum PSA Gray Zone
Authors: liu Bo , pan Tie jun
Published: May 2014

Prostate neoplasms and benign prostatic hyperplasia

Objective

The aim of this study was to assess the validity of predictors of prostate biopsy outcome in order to improve their positive predictive value (PPV). The related variables of PSA such as free/total PSA ratio (F/T), complexed/total PSA ratio (C/T), density of PSA (PSAD) were studied to improve early diagnosis for early PCa within serum PSA gray zone.

Methods

Samples of venous blood were collected early in the morning from 459 patients, aged 50 to 88 years (average 70.5 years old), whose serum T-PSA was between 4 to 10 ng/mL (153 cases of Pca, 306 cases of BPH). Serum T-PSA, F-PSA and C-PSA were determined by ELISA method; prostate volume was measured by transrectal ultrasound, then prostate biopsy was taken for all patients.

Results

Out of f 459 patients, 153 cases of Pca and 306 of BPH were diagnosed by prostate biopsy, whose mean values of T-PSA were 7.2 ± 1.25 ng/mL and 6.8 ± 0.96 ng/mL, respectively (P<0.05), of F/T were 0.117 ± 0.018 and 0.196 ± 0.021 (P<0.01), and of C/T they were 0.890 ± 0.023 and 0.754 ± 0.015 (P<0.01), of PSAD were 0.197 ± 0.023 and 0.106 ± 0.019 (P<0.01). The threshold of F/T > 0.16 diagnosed 91 cases of cancer (59.5%), of C/T>0.84 88 cases (57.5%), of PSAD > 0.15 94 cases (61.4%), and especially, of F/T > 0.16 combined PSAD > 0.15 80 cases whose sensitivity, specificity, accuracy, positive predictive values were 52.3%, 76.1%, 68.2%, 52.3%, respectively (P<0.05).

Conclusion

There are some defects only in taking T-PSA as a biomarker for the diagnosis of PCa within serum PSA gray zone, and the threshold of F/T > 0.16 combined PSAD > 0.15 may be a new and significant indicator to provide a better basis for the diagnosis of early PCa.
Vesicoureteral Reflux in Pediatric Age: Where are we Today?
Authors: Altobelli Emanuela , Nappo Simona Gerocarni , Guidotti Michele , Caione Paolo
Published: May 2014

Although the diagnosis of vesicoureteral reflux and of reflux nephropathy is a well-established and shared procedure, its treatment nowadays is still very controversial. New developments on the knowledge of pathophysiology of renal damage associated to reflux opened the way towards a different diagnostic work-up and different therapeutic approaches.

Recently, the “top-down” diagnostic approach has gained wider interest, versus the “down-top” protocol. The attention has recently focused on the renal parenchyma damage and less interest has been given to the presence and the radiological degree of vesicoureteral reflux.

The review criteria were based on an in-depth search of references conducted on PubMed, using the terms “vesicoureteral reflux”, “children”, “incidence”, “etiology”, “diagnosis”, “treatment” and “outcomes”. The selection of the papers cited in this review was influenced by the content and the relevance to the points focused in the article.

Conservative approaches include no treatment option with watchful waiting, long-term antibiotic prophylaxis and bladder rehabilitation. The operative treatment consists of endoscopic, open, laparoscopic and robotic procedures to stop the refluxing ureter.

No final consensus has been achieved in literature yet, and further studies are necessary in order to better define the subset of children at risk of developing progression of renal damage.

This review aims to clarify the diagnostic management and the urological-nephrological treatment of reflux in pediatric age, on the basis of a review of the best-published evidence.
Urethral Injuries Secondary to Implantation of Penile Prosthesis. Analysis of the Causes, Prevention and Treatment
Authors: Vitarelli Antonio , Divenuto Lucia , Palminteri Enzo , Lorusso Giovanni , Pagliarulo Arcangelo
Published: May 2014

Urethral injuries due to penile prosthesis implant represent a rare complication of the intervention to position penile prosthesis, but unfortunately scientific literature about this is poor. This rare complication may occur during surgery and in the postoperative period, both early and late. It recognizes a variety of causes that may include anatomical or functional conditions, for example cavernosal fibrosis or outcomes of inflammations or previous urethral lesions and pathological sensibility due to diabetic neuropathy or other forms of neuropathy including those from spinal cord injury or myelopathy. This review evaluates the possible predisposing conditions, the clinical presentations, and the devices in the surgical procedures to use to minimize the risk of onset of this lesions and the measures to take if they occur.
Generational differences in nurses’ characteristics, job satisfaction, quality of work life, and psychological empowerment
Authors: Sparks Coburn Amy , J. Hall Samantha
Published: May 2014

Objective: Currently, there are four generations in the nursing workforce. Each generation holds a different set of values that create challenges for managing a multi-generational workforce; these values affect nurses’ perceptions of quality of work life (QWL), psychological empowerment (PE), and job satisfaction (JS). The aims of this study are to (1) identify differences in the characteristics of Baby Boomer, Generation X, and Millennial nurses, (2) identify differences in the QWL between Baby Boomer, Generation X, and Millennial nurses, (3) identify differences in JS between Baby Boomer, Generation X, and Millennial nurses, and (4) identify differences in PE between Baby Boomer, Generation X, and Millennial nurses. Methods: This descriptive, comparative design was conducted via a web-based survey among 223 registered nurses in the USA. Data was collected using Survey Monkey. Results: Baby Boomers had significantly more years of experience, higher levels of both PE and JS as compared to Generation X and Millennial nurses. Conclusions: The findings of this study indicate the prominence of RNs’ sociological value systems on their perceptions of their workplace. Based on these findings, nurse managers can work to create an environment that is supportive of multiple generations; an environment that enhances PE and, in turn, JS.
A Motion System for Social and Animated Robots
Authors: Saldien Jelle , Vanderborght Bram , Goris Kristof , Van Damme Michael , Lefeber Dirk
Published: May 2014

This paper presents an innovative motion system that is used to control the motions and animations of a social robot. The social robot Probo is used to study Human-Robot Interactions (HRI), with a special focus on Robot Assisted Therapy (RAT). When used for therapy it is important that a social robot is able to create an “illusion of life” so as to become a believable character that can communicate with humans. The design of the motion system in this paper is based on insights from the animation industry. It combines operator-controlled animations with low-level autonomous reactions such as attention and emotional state. The motion system has a Combination Engine, which combines motion commands that are triggered by a human operator with motions that originate from different units of the cognitive control architecture of the robot. This results in an interactive robot that seems alive and has a certain degree of “likeability”. The Godspeed Questionnaire Series is used to evaluate the animacy and likeability of the robot in China, Romania and Belgium.
System Design of a Cheetah Robot Toward Ultra-high Speed
Authors: Li Mantian , Wang Xin , Guo Wei , Wang Pengfei , Sun Lining
Published: May 2014

High-speed legged locomotion pushes the limits of the most challenging problems of design and development of the mechanism, also the control and the perception method. The cheetah is an existence proof of concept of what we imitate for high-speed running, and provides us lots of inspiration on design. In this paper, a new model of a cheetah-like robot is developed using anatomical analysis and design. Inspired by a biological neural mechanism, we propose a novel control method for controlling the muscles' flexion and extension, and simulations demonstrate good biological properties and leg's trajectory. Next, a cheetah robot prototype is designed and assembled with pneumatic muscles, a musculoskeletal structure, an antagonistic muscle arrangement and a J-type cushioning foot. Finally, experiments of the robot legs swing and kick ground tests demonstrate its natural manner and validate the design of the robot. In the future, we will test the bounding behaviour of a real legged system.
Balloon cell melanoma: a case report with polarized and non-polarized dermatoscopy and dermatopathology
Authors: Maher James , Cameron Alan , Wallace Sharon , Acosta-Rojas Rafael , Weedon David , Rosendahl Cliff
Published: May 2014

Balloon cell melanoma is a rare melanoma subtype, with only one previous case with dermatoscopy published. It is often non-pigmented, leading to diagnostic difficulty, and there is a tendency for lesions to be thick at diagnosis.

We report a case of balloon cell melanoma on the forearm of a 61-year-old man with both polarized and non-polarized dermatoscopy and dermatopathology. It presented as a firm pale nodule with focal eccentric pigmentation. The clinical images evoke a differential diagnosis of dermatofibroma, dermal nevus, Spitz nevus and basal cell carcinoma as well as melanoma. This melanoma was partially pigmented due to a small, pigmented superficial spreading component on the edge of the non-pigmented balloon cell nodule, prompting further evaluation. In retrospect there was the clue to malignancy of polarizing-specific white lines (chrysalis structures) and polymorphous vessels, including a pattern of dot vessels. The reticular lines exclude basal cell carcinoma, polarizing-specific white lines are inconsistent with the diagnosis of dermal nevus and their eccentric location is inconsistent with both Spitz nevus and dermatofibroma. Excision biopsy was performed, revealing a superficial spreading melanoma with two distinct invasive components, one of atypical non-mature epithelioid cells and the other an amelanotic nodular component, comprising more than 50% of the lesion, characterized by markedly distended epithelioid melanocytes showing pseudo-xanthomatous cytoplasmic balloon cell morphology. A diagnosis of balloon cell melanoma, Breslow thickness 1.9 mm, mitotic rate 3 per square millimeter was rendered. Wide local excision was performed, as was sentinel lymph node biopsy, which was negative.
Case Report: Coexistence of Non-Keratinizing Squamous Cell Carcinoma and Follicular Lymphoma in Nasopharynx
Authors: Tao Xu  , Weihong Wei  , Zeli Huang  , Weihan Hu
Published: May 2014

We report a very rare case of coexistence of non-keratinizing nasopharyngeal carcinoma and follicular lymphoma in nasopharynx. A 52-year-old woman was admitted in our hospital because of painless enlarged bilateral cervical mass. Nasopharyngoscopy revealed a nasopharyngeal mass, and biopsy showed follicular lymphoma cells infiltrating non-keratinizing squamous carcinoma. The patient underwent combined treatment which targeted two tumors and was alive without any progression in one-year follow up.
Vanadium: Possible Use in Cancer Chemoprevention and Therapy
Authors: Ladislav Novotny  , Samuel B. Kombian
Published: May 2014

Vanadium belongs among the microelements and plays a role in human nutrition. However, it is not regarded as an essential micronutrient. Vanadium affects various biochemical processes and when present in the body, it is capable of interacting with a notable number of enzymes e.g. protein kinases, phosphatases, ATPases, peroxidases, ribonucleases, oxidoreductases and others. It is documented in scientific literature that vanadium takes part in biochemical processes in mammals. Vanadium is not carcinogenic but its presence in cancer cells and its interactions with many key enzymatic processes results in modified expression of p53 and Bax and in down regulation of Bcl2 proteins and in antiproliferative activity. Anti-carcinogenic and anticancer effects of vanadium in various forms have been demonstrated using in vitro and in vivo experiments. Presently, epidemiologic and clinical studies are necessary for developing a clinically useful, vanadium-based anticancer agent/drug for chemoprevention of cancer. This review summarizes recent scientific information on the role and potential use of vanadium in cancer chemoprevention and cancer therapy.
The Overexpression of ABCG2 Reduces the Efficacy of Volasertib (BI 6727) and GSK641364 in Human S1-M1-80 Colon Carcinoma Cells
Authors: Sung-Han Hsiao  , Shi-Yu Luo  , Ching-Ya Su  , Wei-Cherng Tuo  , Cheng-Ting Chiang  , Yan-Qing Li  , Yang-Hui Huang  , Chung-Pu Wu
Published: May 2014

The polo-like kinase 1 (Plk1) is one of the key regulators in cell cycle progression. Plk1 is overexpressed in many types of cancer and promotes the proliferation of cancer cells. Inhibition of Plk1 activity induces G2/M cell cycle arrest and reduces cancer cell viability. Volasertib and GSK461364 are selective inhibitors of Plk1, active against a wide range of tumor cells at nanomolar concentrations. In this study, while examining the effectiveness of Plk1 inhibitors against multiple human colon cancer cell lines, we discovered that the overexpression of ATP-binding cassette (ABC) drug transporter ABCG2 in human S1-M1-80 colon cancer cells confers resistance to volasertib and GSK461364. Moreover, we found that ABCG2-transfected HEK293 cells were also resistant to both Plk1 inhibitors. We revealed that volasertib and GSK461364 inhibited the function of ABCG2 in a concentration dependent manner, and had no significant effect on the protein expression of ABCG2. More importantly, we showed that the G2/M cell cycle arrest induced by volasertib or GSK461364 was significantly reduced in S1-M1-80 cells, and that ABCG2-mediated drug resistance to Plk1 inhibitors can be restored by inhibition of ABCG2 function. Therefore, the development of ABCG2-mediated drug resistance to volasertib and GSK461364 in cancer clearly present a significant therapeutic challenge, and a better treatment strategy should be further investigated.
Crystalline Metabolites of the Tinder Polypore (Fomes fomentarius)
Authors: Wasko Samuel J. , Brenner Mark V. , Cartier Stephen F.
Published: May 2014

In 2005, author Paul Stamets detailed a novel fungal antimicrobial mechanism in his book “Mycelium Running.” According to Stamets' observations, microscopic octahedral crystals produced by Fomes fomentarius “stunned” surrounding E. coli bacteria. In light of the lack of published peer-reviewed evidence, the present study was conducted to evaluate Stamets' claims. Specifically, the claim that large “secondary” crystals only occur in the presence of E. coli was addressed. Fruiting bodies of F. fomentarius were collected from the Montreat Wilderness Area (Buncombe County, North Carolina) and tissue culture techniques were used to cultivate mycelia on malt-agar plates. Successful cultures were randomly assigned to two treatment groups: F. fomentarius grown in isolation (n  =  6) and F. fomentarius grown in the presence of E. coli (n  =  6). After 28 days of growth and 10 days of E. coli exposure, the periphery of each mycelium was observed using 400–1,000× Differential Interference Contrast (DIC) microscopy. None of the interspecies frontiers and one of the isolated F. fomentarius cultures contained “secondary” crystals. Samples were then selected from the center of each dish, where hyphae had been established between 28 and 58 days. High magnification microscopy (400–1,000× DIC) revealed that five out of six interspecies dishes and six out of six isolated F. fomentarius dishes contained “secondary” crystals. While these observations do confirm the presence of secondary crystals documented by Stamets, they do not support his hypothesis that they occur only in the presence of E. coli. In light of this new evidence, Stamets' proposed antibacterial mechanism is improbable. It is suggested that future chemical tests evaluate whether or not F. fomentarius crystals are composed of calcium oxalate (an unlikely antibacterial agent).
Colour Vision Revisited
Authors: Parmar Twinkle , Vanathi M. , Ghose S , Dada T , Venkatesh P
Published: May 2014

Congenital red-green colour deficiency is an X-linked inherited disorder more frequently encountered in males compared to females. Screening of coour deficiency is crucial in various occupations, at times to safeguard colour deficient individual as well as vulnerable population. Acquired colour deficiency is seen in multiple inherited retinal photopigment disorders, vascular retonopathies and optic nerve disorders. Multiple tests have been devised to detect, classify and grade colour deficiency, each having a specific purpose. Tinted spectacles and contact lenses have been tried to rehabilitate colour deficient individuals with limited success.
Suicide in US Preteens Aged 8 to 12 Years, 2001 to 2022
Authors: Ruch Donna A. , Horowitz Lisa M. , Hughes Jennifer L. , Sarkisian Katherine , Luby Joan L. , Fontanella Cynthia A. , Bridge Jeffrey A.
Published: July 2024

This cross-sectional study investigates characteristics and trends in suicide rates among US preteens using national mortality data from 2001 to 2022.
Improving criteria for dissemination in space in multiple sclerosis by including additional regions
Authors: Foster Michael A. , Pontillo Giuseppe , Davagnanam Indran , Collorone Sara , Prados Ferran , Kanber Baris , Yiannakas Marios C. , Ogunbowale Lola , Burke Ailbhe , Gandini Wheeler‐Kingshott Claudia A. M. , Ciccarelli Olga , Brownlee Wallace , Barkhof Frederik , Toosy Ahmed T.
Published: July 2024

Objective

We investigated the effects of adding regions to current dissemination in space (DIS) criteria for multiple sclerosis (MS).

Methods

Participants underwent brain, optic nerve, and spinal cord MRI. Baseline DIS was assessed by 2017 McDonald criteria and versions including optic nerve, temporal lobe, or corpus callosum as a fifth region (requiring 2/5), a version with all regions (requiring 3/7) and optic nerve variations requiring 3/5 and 4/5 regions. Performance was evaluated against MS diagnosis (2017 McDonald criteria) during follow‐up.

Results

Eighty‐four participants were recruited (53F, 32.8 ± 7.1 years). 2017 McDonald DIS criteria were 87% sensitive (95% CI: 76–94), 73% specific (50–89), and 83% accurate (74–91) in identifying MS. Modified criteria with optic nerve improved sensitivity to 98% (91–100), with specificity 33% (13–59) and accuracy 84% (74–91). Criteria including temporal lobe showed sensitivity 94% (84–98), specificity 50% (28–72), and accuracy 82% (72–90); criteria including corpus callosum showed sensitivity 90% (80–96), specificity 68% (45–86), and accuracy 85% (75–91). Criteria adding all three regions (3/7 required) had sensitivity 95% (87–99), specificity 55% (32–76), and accuracy 85% (75–91). When requiring 3/5 regions (optic nerve as the fifth), sensitivity was 82% (70–91), specificity 77% (55–92), and accuracy 81% (71–89); with 4/5 regions, sensitivity was 56% (43–69), specificity 95% (77–100), and accuracy 67% (56–77).

Interpretation

Optic nerve inclusion increased sensitivity while lowering specificity. Increasing required regions in optic nerve criteria increased specificity and decreased sensitivity. Results suggest considering the optic nerve for DIS. An option of 3/5 or 4/5 regions preserved specificity, and criteria adding all three regions had highest accuracy.
Treatment of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis With Diffuse Alveolar Hemorrhage With Avacopan
Authors: Falde Sam D. , Lal Amos , Cartin‐Ceba Rodrigo , Mertz Lester E. , Fervenza Fernando C. , Zand Ladan , Koster Matthew J. , Warrington Kenneth J. , Lee Augustine S. , Aslam Nabeel , Abril Andy , Specks Ulrich
Published: July 2024

Objective

Avacopan, an activated complement factor 5 receptor antagonist, has been approved as adjunct therapy for severe active antineutrophil cytoplasmic antibody–associated vasculitis (AAV). Current evidence supports the management of AAV presenting with diffuse alveolar hemorrhage (DAH) by administering glucocorticoids combined with either rituximab or cyclophosphamide in addition to supportive care. The role of avacopan in patients with DAH as a primary severe disease manifestation of AAV has not been well established. Furthermore, concerns remain regarding timely access to avacopan, the best glucocorticoid tapering regimen, and long‐term efficacy and safety of the drug. We sought to identify clinical features and outcomes of patients presenting with DAH secondary to AAV who received avacopan in addition to glucocorticoids and rituximab or cyclophosphamide.

Methods

We performed a retrospective cohort study of all consecutive patients presenting with DAH as part of active severe granulomatosis with polyangiitis or microscopic polyangiitis. Demographic and clinical characteristics were collected at presentation and follow‐up.

Results

Fifteen patients met inclusion criteria and were observed for a median time of 17 weeks (interquartile range [IQR] 6–37 weeks) after initiation of avacopan. Patients were predominantly female and White, had never smoked, and were a median age of 66 years (IQR 52–72 years) at diagnosis. The majority had newly diagnosed severe AAV with renal involvement. Three patients progressed to respiratory failure. The timing of avacopan introduction and patterns of glucocorticoid tapers varied widely in this cohort. Two serious adverse events related to infection were observed, including one opportunistic infection leading to the patient's death, although neither was directly attributed to avacopan administration.

Conclusion

We describe the clinical course of patients who presented with the severe AAV disease manifestation of DAH and received avacopan as adjunct therapy. Most patients achieved remission during follow‐up, and adverse events, including infection, were observed.
Efficacy and Safety of Bimekizumab in Patients With Psoriatic Arthritis With or Without Methotrexate: 52‐Week Results From Two Phase 3 Studies
Authors: McInnes Iain B. , Mease Philip J. , Tanaka Yoshiya , Gossec Laure , Husni M. Elaine , Kristensen Lars Erik , Warren Richard B. , Ink Barbara , Bajracharya Rajan , Coarse Jason , Gottlieb Alice B.
Published: July 2024

Objective

The objective of this study was to assess 52‐week efficacy and safety of bimekizumab in patients with active psoriatic arthritis (PsA) with or without concomitant methotrexate (+/−MTX) treatment at baseline.

Methods

We conducted a post hoc analysis of patients in BE OPTIMAL (NCT03895203; biologic disease‐modifying antirheumatic drug [bDMARD]‐naïve), BE COMPLETE (NCT03896581; prior inadequate response or intolerance to tumor necrosis factor inhibitors [TNFi‐IR]), and the BE VITAL open‐label extension (NCT04009499) study. Patients were randomized to one of the following treatment groups: bimekizumab 160 mg every four weeks, placebo, or a reference drug (adalimumab 40 mg every two weeks; BE OPTIMAL only). From Week 16, placebo‐randomized patients received bimekizumab. Missing data were imputed using non‐responder imputation, multiple imputation, or worst‐category imputation.

Results

Through Week 52, similar proportions of bimekizumab‐treated patients achieved American College of Rheumatology 50% (ACR50) response criteria for both +MTX and −MTX (BE OPTIMAL: 54.4% +MTX, 54.7% −MTX; BE COMPLETE: 56.3% +MTX, 48.0% −MTX). Similar proportions of bimekizumab‐treated patients achieved complete skin clearance (Psoriasis Area and Severity Index 100% [PASI100] response) and minimal disease activity in both +MTX and −MTX groups. Similar trends were seen in placebo/bimekizumab‐treated patients. Through Week 52, the proportion of bimekizumab‐treated patients with ≥1 treatment‐emergent adverse event were similar between the +MTX and −MTX groups (BE OPTIMAL 325 of 410 [79.3%] vs 230 of 292 [78.8%], BE COMPLETE 105 of 168 [62.5%] vs 138 of 220 [62.7%]). The safety profile was comparable between subgroups and consistent with the prior safety profile of bimekizumab.

Conclusion

Treatment with bimekizumab demonstrated consistent, sustained efficacy to 52 weeks in bDMARD‐naïve and TNFi‐IR patients with PsA and was well tolerated, irrespective of concomitant MTX.

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Consensus of multi‐agent system with reaction‐diffusion terms and time delays via output‐feedback adaptive boundary control
Authors: Wan Xinglong , Yan Xu , Li Zhenxing , Qiu Jianlong , Yang Chengdong
Published: July 2024

Multi‐agent systems (MASs) are widely used in many necessary fields such as cybersecurity, precision agriculture, satellites, and smart grids. In many practical processes, a proportion of states cannot be obtained directly. Therefore, it is desired to design an observer. This article explores the utilization of output‐feedback adaptive control techniques to achieve consensus in MASs based on partial differential equations (PDEs) with reaction‐diffusion terms and time delays. First, in dealing with time‐invariant delays, an observer according to the Luenberger method is proposed to assess the state of agents. Convergence conditions of the estimated states are obtained by employing Lyapunov functions and Wirtinger inequality. Using the obtained estimated states, a boundary adaptive control strategy is proposed to make the error system consensus. The merit of this control method lies in the fact that communication between agents only occurs at the spatial boundary position, not throughout the entire spatial domain, and the parameters of the system can be constantly changed. Consensus criteria of MASs with time‐invariant delays are obtained by using the output‐feedback adaptive control, and the results are further generalized to the model with time‐varying delays. Lastly, two experimental scenarios are provided to show the practicality of the proposed theories.
IRF4 Suppresses Osteogenic Differentiation of Periodontal Ligament Stem Cells by Activating IL‐18 Signaling Pathway in Periodontitis
Authors: Hu Zhenyu , Luo Yongjie , Lin Wei , Wu Xiaolian
Published: July 2024

The present study aims to investigate the role of interferon regulatory factor 4 (IRF4) in osteogenic differentiation of periodontal ligament stem cells (PDLSCs) and analyze the underlying signaling of these processes. In this study, IRF4 is upregulated in periodontitis periodontal ligament tissues, as compared to healthy periodontal ligament tissues. IRF4 knockdown increases cell proliferation, decreases levels of tumor necrosis factor‐alpha, interleukin‐6, and interleukin‐8, enhances osteogenic activity, and increases the expression of RUNX family transcription factor 2, Collagen I, and Osteocalcin in PDLSCs. The opposite results are observed in IRF4 overexpressed PDLSCs. Additionally, GSEA shows that IRF4 activates the interleukin‐18 (IL‐18) signaling pathway. The expressions of IL‐18, B‐cell translocation gene 2, interleukin‐1beta, and caspase‐3 are decreased by IRF4 knockdown, while increased by IRF4 overexpression. IL‐18 overexpression eliminates the promoting effect of IRF4 knockdown on osteogenic differentiation of PDLSCs. In conclusion, IRF4 suppresses osteogenic differentiation of PDLSCs by activating the IL‐18 signaling pathway.