bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and manometric characteristics of patients with oesophagogastric outflow obstruction: towards a new classification
Authors: Triadafilopoulos George , Clarke John O
Published: July 2018

Background

The Chicago Classification (CC) defines oesophagogastric junction outflow obstruction (EGJOO) as the presence of an elevated integrated residual pressure (IRP) together with preserved oesophageal body peristalsis but its clinical significance is evolving.

Aims

To describe the clinical and manometric characteristics in patients with EGJOO and propose a new classification.

Methods

In this retrospective cohort study, patients with functional oesophageal symptoms underwent clinical and endoscopic assessment and oesophageal high-resolution manometry (HRM). The CC V.3 was used to define and redefine abnormalities.

Results

Of 478 HRM studies performed, EGJOO, defined as median IRP >15 mm Hg, was diagnosed in 116 patients; 17 underwent a follow-up HRM. Forty-four patients had otherwise normal oesophageal motility, with the only finding being EGJOO; 14 had achalasia, 19 had EGJOO plus ineffective oesophageal motility (IEM), 28 had EGJOO plus diffuse oesophageal spasm (DES) (n=25) or jackhammer oesophagus (n=3), and 11 had EGJOO plus IEM and DES. Patients with EGJOO+IEM had lower distal contractile integral (DCI) while those with EGJOO+DES had higher DCI. All groups exhibited high percentages of incomplete bolus clearance. On repeat studies, EGJOO preceded or followed another HRM diagnosis and remained permanent in 2/17 patients. Only one patient transitioned to achalasia.

Conclusions

The new classification further defines EGJOO by considering abnormalities in the body of the oesophagus that could contribute to symptoms or require therapy. Most patients with EGJOO have a coexisting motility disorder and do not have isolated EGJOO. There is a fluidity of the HRM diagnosis that needs to be considered prior to therapy.
Managing alarm systems for quality and safety in the hospital setting
Authors: Bach Tita Alissa , Berglund Lars-Martin , Turk Eva
Published: July 2018

Objective

To provide an overview of documented studies and initiatives that demonstrate efforts to manage and improve alarm systems for quality in healthcare by human, organisational and technical factors.

Methods

A literature review, a grey literature review, interviews and a review of alarm-related standards (IEC 60601-1-8, IEC 62366-1:2015 and ANSI/Advancement of Medical Instrumentation HE 75:2009/2013) were conducted. Qualitative analysis was conducted to identify common themes of improvement elements in the literature and grey literature reviews, interviews and the review of alarm-related standards.

Results

21 articles and 7 publications on alarm quality improvement work were included in the literature and grey literature reviews, in which 10 themes of improvement elements were identified. The 10 themes were categorised into human factors (alarm training and education, multidisciplinary teamwork, alarm safety culture), organisational factors (alarm protocols and standard procedures, alarm assessment and evaluation, alarm inventory and prioritisation, and sharing and learning) and technical factors (machine learning, alarm configuration and alarm design). 26 clinicians were interviewed. 9 of the 10 themes were identified from the interview responses. The review of the standards identified 3 of the 10 themes. The study findings are also presented in a step-by-step guide to optimise implementation of the improvement elements for healthcare organisations.

Conclusions

Improving alarm safety can be achieved by incorporating human, organisational and technical factors in an integrated approach. There is still a gap between alarm-related standards and how the standards are translated into practice, especially in a clinical environment that uses multiple alarming medical devices from different manufacturers. Standardisation across devices and manufacturers and the use of machine learning in improving alarm safety should be discussed in future collaboration between alarm manufacturers, end users and regulators.
Developing and validating Parkinson’s disease subtypes and their motor and cognitive progression
Authors: Lawton Michael , Ben-Shlomo Yoav , May Margaret T , Baig Fahd , Barber Thomas R , Klein Johannes C , Swallow Diane M A , Malek Naveed , Grosset Katherine A , Bajaj Nin , Barker Roger A , Williams Nigel , Burn David J , Foltynie Thomas , Morris Huw R , Wood Nicholas W , Grosset Donald G , Hu Michele T M
Published: July 2018

Objectives

To use a data-driven approach to determine the existence and natural history of subtypes of Parkinson’s disease (PD) using two large independent cohorts of patients newly diagnosed with this condition.

Methods

1601 and 944 patients with idiopathic PD, from Tracking Parkinson’s and Discovery cohorts, respectively, were evaluated in motor, cognitive and non-motor domains at the baseline assessment. Patients were recently diagnosed at entry (within 3.5 years of diagnosis) and were followed up every 18 months. We used a factor analysis followed by a k-means cluster analysis, while prognosis was measured using random slope and intercept models.

Results

We identified four clusters: (1) ﻿fast motor progression with symmetrical motor disease, poor olfaction, cognition and postural hypotension; (2) mild motor and non-motor disease with intermediate motor progression; (3) severe motor disease, poor psychological well-being and ﻿poor sleep with an intermediate motor progression; (4) slow motor progression with tremor-dominant, unilateral disease. Clusters were moderately to substantially stable across the two cohorts (kappa 0.58). Cluster 1 had the fastest motor progression in Tracking Parkinson’s at 3.2 (95% CI 2.8 to 3.6) UPDRS III points per year while cluster 4 had the slowest at 0.6 (0.1–1.1). In Tracking Parkinson’s, cluster 2 had the largest response to levodopa 36.3% and cluster 4 the lowest 28.8%.

Conclusions

We have found four novel clusters that replicated well across two independent early PD cohorts and were associated with levodopa response and motor progression rates. This has potential implications for better understanding disease pathophysiology and the relevance of patient stratification in future clinical trials.
Excessive daytime sleepiness in Chinese patients with sporadic amyotrophic lateral sclerosis and its association with cognitive and behavioural impairments
Authors: Liu Shuangwu , Huang Yan , Tai Hongfei , Zhang Kang , Wang Zhili , Shen Dongchao , Fu Hanhui , Su Ning , Shi Jiayu , Ding Qingyun , Liu Mingsheng , Guan Yuzhou , Gao Jing , Cui Liying
Published: July 2018

Objective

To examine the frequency and clinical features of excessive daytime sleepiness (EDS) and its association with cognitive and behavioural impairments in patients with amyotrophic lateral sclerosis (ALS).

Methods

We conducted a cross-sectional investigation to explore the frequency and clinical features of EDS in a group of 121 Chinese patients with ALS compared with 121 age-matched and sex-matched healthy subjects. EDS was diagnosed using the Epworth Sleepiness Scale (ESS). Other characteristics of patients with ALS including sleep quality, REM sleep behaviour disorder (RBD), restless legs syndrome (RLS), cognition, behaviour, depression and anxiety were also evaluated.

Results

EDS was significantly more frequent in patients with ALS than in controls (26.4% vs 8.3%; p<0.05). Patients with ALS with EDS scored lower scores on the revised ALS Functional Rating Scale (ALSFRS-R), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and MMSE and MoCA delayed memory subitems and higher on the Frontal Behavioural Inventory (FBI) than patients with ALS without EDS. ESS scores correlated with global ALSFRS-R, FBI, MMSE and MoCA scores and MMSE and MoCA delayed memory scores. RLS and global ALSFRS-R scores were independently associated with EDS in patients with ALS.

Conclusions

We identified a high frequency of EDS symptoms in Chinese patients with ALS, and these patients might have more serious physical, cognitive and frontal behaviour impairment. Patients with ALS might improve quality of life from the timely recognition and optimised management of EDS symptoms. Our results further suggest that ALS is a heterogeneous disease that might exhibit abnormal sleep-wake patterns.
Military Aid to the Civil Authorities: a Defence Medical Services perspective
Authors: Millar Stuart , Lane I B F
Published: July 2018

This paper describes the policy and principles for the provision of Military Aid to the Civil Authorities (MACA). It emphasises the importance of following the proscribed process in order to avoid possible political, legal, reputational and financial pitfalls. It outlines the broader military application of MACA before focusing on where the Defence Medical Services can contribute, drawn from recent experiences and identifying other capabilities that may be of utility. It draws heavily from Joint Doctrine Publication 02 and is quoted with the agreement of the Developments, Concepts and Doctrine Centre.
Leukoaraiosis severity and outcomes after mechanical thrombectomy with stent-retriever devices in acute ischemic stroke
Authors: Guo Yongtao , Zi Wenjie , Wan Yue , Zhang Shuai , Sun Bo , Shang Xianjin , Li Shun , Bai Yongjie , Li Zibao , Zheng Dequan , Liu Xinfeng
Published: July 2018

Background and purpose

The aim of the study was to evaluate whether leukoaraiosis severity is associated with outcome in acute stroke patients undergoing mechanical thrombectomy with stent-retriever devices.

Methods

In this retrospective multicenter study, we evaluated 251 acute stroke patients (pretreatment National Institutes of Health Stroke Scale score ≥8) treated with stent-retriever devices. Leukoaraiosis severity was graded as 0–2 (absent-to-moderate) versus 3–4 (severe) according to the van Swieten scale. The main clinical outcome was the proportion of good functional outcome, defined as a modified Rankin Scale of 0–2 at 90 days.

Results

Significantly fewer patients in the severe LA group than in the absent-to-moderate LA group achieved a good functional outcome (18.4% vs 50.2%, P<0.001). In multivariable analysis, severe leukoaraiosis was a significant negative predictor of good functional outcome at 90 days (OR, 0.27; 95% CI 0.10–0.77; P=0.014).

Conclusions

The severity of leukoaraiosis is independently associated with 90-day functional outcome in acute stroke patients undergoing mechanical thrombectomy with stent-retriever devices.
The 100 most cited articles in theJournal of NeuroInterventional Surgery
Authors: Ren Yifan , Kok Hong Kuan , Zhou Kevin , Maingard Julian , Chandra Ronil V , Lee Michael J , Barras Christen D , Brooks Mark , Albuquerque Felipe C , Tarr Robert W , Hirsch Joshua A , Asadi Hamed
Published: July 2018

Background

TheJournal of NeuroInterventional Surgery(JNIS) published its first volume in 2009. Over the ensuing years,JNISflourished and has published a considerable number of high-profile articles. Citation analysis is a method of quantifying various metrics related to scholarly publications.

Objective

To apply citation analysis to the 100 most cited papers in the history ofJNIS.

Methods

The most cited articles inJNISwere identified by using the Web of Science database. The top 100 articles were ranked according to their number of citations. Further information was obtained for each article, including citations per year, year of publication, authorship, article topics, and article type and level of evidence.

Results

The total number of citations for the 100 most cited articles inJNISranged from 18 to 132 (median 26.0). Most articles (75%) were published between 2012 and 2015 and originated in the USA (79%). Eighteen authors have contributed five or more articles to the top 100 list. The most common topics are related to acute ischemic stroke and cerebral aneurysm.

Conclusions

This study highlights the influence ofJNISover its first decade by providing a comprehensive list of the 100 most cited articles and their authors as well as topics covered. This study also highlights the important factors driving the growth ofJNIS.
Seizure-like activity after gadolinium administration in an anaesthetised foal undergoing magnetic resonance imaging
Authors: Argano Martina , Hewetson Michael , Kiviranta Anna-Mariam , Larenza Menzies Maria Paula
Published: July 2018

The use of MRI has been recently increasing in veterinary patients, and this modality has been adapted for use in large animals with the concurrent use of gadolinium-based contrast media. Possible adverse reactions to its administration have been described in human and veterinary medicine, but there are no reports in foals. This case report describes the occurrence of seizure-like activity following administration of gadolinium to a 1.5-month old Finnish warmblood foal that was admitted for an MRI scan and cerebral spinal fluid collection. After the administration of contrast media, severe muscle twitching was observed. Prompt intervention, facilitated by constant patient monitoring and administration of propofol and diazepam, resulted in the control of the seizure and a favourable outcome. Since no alterations were found during the diagnostic investigation, it was suspected that the seizure-like activity might have been an adverse reaction to the contrast medium.
Political Parody and the Politics of Ambivalence
Authors: Petrović Tanja
Published: July 2018

This article offers insight into the meanings of the unprecedented political potential of humor in the early twenty-first century by discussing three parodic forms of contemporary political humor: carnivalesque politics, parodic reworkings of political discourses, and political protests and satirical activism. Revealing how political parody both produces ambiguity and hinges on it, the article proposes a shift in attention from its effects and capacity to promote or hinder a political change, and from the domination versus resistance binary, toward ambivalent political subjectivities that unfold in the production and consumption of political parody. The ambiguity of political parody, its reflexivity, and its capacity to build or reconfigure affective communities are workings of political humor that enable individuals to embrace their own involvement and vulnerability and the ambiguous and unpredictable moral consequences of their complex positioning as an authentic and potentially productive form of engaging with political reality.
The Language of Evangelism: Christian Cultures of Circulation Beyond the Missionary Prologue
Authors: Handman Courtney
Published: July 2018

This article provides an overview of recent scholarship on the language of evangelism and missionization within the anthropology of Christianity. Attention to Christian evangelism and forms of circulation was minimized as scholars worked to distinguish the study of Christianity from the study of colonialism, often treating missionaries and missionization as a prologue to a more central analysis of transformation organized through local people and local cultural change. However, issues of circulation are at the heart of many Christian experiences, especially for those within evangelical, Pentecostal, and charismatic worlds. This research is discussed here in terms of Christian cultures of circulation specifically and of models of communicative circulation more generally. Framing the language of evangelism in terms of circulation allows for the integrated discussion of a wide range of related issues, including work on translation, missionary training practices, and material formations of evangelism.
Axon Regeneration in the Central Nervous System: Facing the Challenges from the Inside
Authors: Curcio Michele , Bradke Frank
Published: July 2018

After an injury in the adult mammalian central nervous system (CNS), lesioned axons fail to regenerate. This failure to regenerate contrasts with axons’ remarkable potential to grow during embryonic development and after an injury in the peripheral nervous system (PNS). Several intracellular mechanisms—including cytoskeletal dynamics, axonal transport and trafficking, signaling and transcription of regenerative programs, and epigenetic modifications—control axon regeneration. In this review, we describe how manipulation of intrinsic mechanisms elicits a regenerative response in different organisms and how strategies are implemented to form the basis of a future regenerative treatment after CNS injury.
Plasma marinobufagenin immunoreactivity in patients with chronic kidney disease: a case control study
Authors: Piecha Grzegorz , Kujawa-Szewieczek Agata , Kuczera Piotr , Skiba Katarzyna , Sikora-Grabka Ewelina , Więcek Andrzej
Published: July 2018

Experimental data have shown increased plasma levels of marinobufagenin in kidney failure. In this case-controlled retrospective analysis, we evaluated plasma marinobufagenin immunoreactivity in hemodialysis patients compared with subjects with normal kidney function. Sixty-eight adult hemodialysis patients with chronic kidney disease (34 females and 34 males) as well as 68 age-, gender-, and blood pressure-matched subjects without chronic kidney disease were enrolled. Patients on stable hemodialysis regimen for at least 3 mo before the study were included. Exclusion criteria were: age <18 yr, severe liver or heart insufficiency, and overhydration. Subjects without chronic kidney disease must have had an estimated glomerular filtration rate ≥60 ml·min−1·1.72 m−2 according to the Modification of Diet in Renal Disease formula. Plasma marinobufagenin immunoreactivity was significantly ( P < 0.001) higher in hemodialysis patients (1.66 ± 1.13 nmol/l) compared with subjects with normal kidney function (0.46 ± 0.23). In hemodialysis patients, plasma marinobufagenin immunoreactivity was higher in men compared with women. A significant positive correlation has been found between plasma marinobufagenin immunoreactivity and serum NT-proBNP, NT-proANP, or aldosterone concentrations in all analyzed subjects. In hemodialyzed patients with plasma marinobufagenin immunoreactivity above median value 5-yr, all-cause mortality was higher compared with those with plasma marinobufagenin concentration below median. We have shown that plasma marinobufagenin immunoreactivity is increased in patients with end-stage kidney failure treated with hemodialysis parallel to the increase in serum NT-proBNP, NT-proANP, and aldosterone concentrations. Higher marinobufagenin immunoreactivity has been associated with worse survival in hemodialyzed patients.
Single-molecule labeling for studying trafficking of renal transporters
Authors: Jaykumar Ankita Bachhawat , Caceres Paulo S. , Ortiz Pablo A.
Published: July 2018

The ability to detect and track single molecules presents the advantage of visualizing the complex behavior of transmembrane proteins with a time and space resolution that would otherwise be lost with traditional labeling and biochemical techniques. Development of new imaging probes has provided a robust method to study their trafficking and surface dynamics. This mini-review focuses on the current technology available for single-molecule labeling of transmembrane proteins, their advantages, and limitations. We also discuss the application of these techniques to the study of renal transporter trafficking in light of recent research.
Figure and ground: how the visual cortex integrates local cues for global organization
Authors: von der Heydt Rüdiger , Zhang Nan R.
Published: July 2018

Inferring figure-ground organization in two-dimensional images may require different complementary strategies. For isolated objects, it has been shown that mechanisms in visual cortex exploit the overall distribution of contours, but in images of cluttered scenes where the grouping of contours is not obvious, that strategy would fail. However, natural scenes contain local features, specifically contour junctions, that may contribute to the definition of object regions. To study the role of local features in the assignment of border ownership, we recorded single-cell activity from visual cortex in awake behaving Macaca mulatta. We tested configurations perceived as two overlapping figures in which T- and L-junctions depend on the direction of overlap, whereas the overall distribution of contours provides no valid information. While recording responses to the occluding contour, we varied direction of overlap and variably masked some of the critical contour features to determine their influences and their interactions. On average, most features influenced the responses consistently, producing either enhancement or suppression depending on border ownership. Different feature types could have opposite effects even at the same location. Features far from the receptive field produced effects as strong as near features and with the same short latency. Summation was highly nonlinear: any single feature produced more than two-thirds of the effect of all features together. These findings reveal fast and highly specific organization mechanisms, supporting a previously proposed model in which “grouping cells” integrate widely distributed edge signals with specific end-stopped signals to modulate the original edge signals by feedback.

NEW & NOTEWORTHY Seeing objects seems effortless, but defining objects in a scene requires sophisticated neural mechanisms. For isolated objects, the visual cortex groups contours based on overall distribution, but this strategy does not work for cluttered scenes. Here, we demonstrate mechanisms that integrate local contour features like T- and L-junctions to resolve clutter. The process is fast, evaluates widely distributed features, and gives any single feature a decisive influence on figure-ground representation.
Differential effects of radiant and mechanically applied thermal stimuli on human C-tactile afferent firing patterns
Authors: Ackerley Rochelle , Wiklund Fernström Katarina , Backlund Wasling Helena , Watkins Roger H. , Johnson Richard D. , Vallbo Åke , Wessberg Johan
Published: July 2018

C-tactile (CT) afferents respond to gentle tactile stimulation, but only a handful of studies in humans and animals have investigated whether their firing is modified by temperature. We describe the effects of radiant thermal stimuli, and of stationary and very slowly moving mechanothermal stimuli, on CT afferent responses. We find that CT afferents are primarily mechanoreceptors, as they fired little during radiant thermal stimuli, but they exhibited different patterns of firing during combined mechano-cool stimulation compared with warming. CTs fired optimally to gentle, very slowly moving, or stationary mechanothermal stimuli delivered at neutral temperature (~32°C, normal skin temperature), but they responded with fewer spikes (median 67% decrease) and at significantly lower rates (47% decrease) during warm (~42°C) tactile stimuli. During cool tactile stimuli (~18°C), their mean instantaneous firing frequency significantly decreased by 35%, but they often fired a barrage of afterdischarge spikes at a low frequency (~5 Hz) that outlasted the mechanical stimulus. These effects were observed under a variety of stimulus conditions, including during stationary and slowly moving touch (0.1 cm/s), and we complemented these tactile approaches using a combined electrical-thermal stimulation experiment where we found a suppression of spiking during warming. Overall, CT afferents are exquisitely sensitive to tactile events, and we show that their firing is modulated with touch temperatures above and below neutral skin temperature. Warm touch consistently decreased their propensity to fire, whereas cool touch produced lower firing rates but afterdischarge spiking.

NEW & NOTEWORTHY C-tactile (CT) afferents are thought to underpin pleasant touch, and previous work has shown that they respond optimally to a slow caress delivered at typical (neutral) skin temperature. Here, we show that, although CTs are primarily mechanoreceptive afferents, they are modified by temperature: warm touch decreases their firing, whereas cool touch produces lower firing rates but long-lasting spiking, frequently seen as afterdischarges. This has implications for the encoding of affective sensory events in human skin.
Phytochemical Characterization,In VitroAntioxidant Activity, and Quantitative Analysis by Micellar Electrokinetic Chromatography of Hawthorn (Crataegus pubescens) Fruit
Authors: González-Jiménez Francisco Erik , Salazar-Montoya Juan Alfredo , Calva-Calva Graciano , Ramos-Ramírez Emma Gloria
Published: July 2018

Due to their antioxidant properties, polyphenolic compounds are considered beneficial for human health. In this work, we investigated the polyphenol profile and antioxidant activity of edible tejocote (Crataegus pubescens) fruit extracts by micellar electrokinetic chromatography (MEKC) and HPLC/UV. The major phenolic compounds in the pulp extracts were (+)-catechin (9.17 ± 0.20 mg/100 mg dry fruit), (−)-epicatechin (4.32 ± 0.11 mg/100 mg dry fruit), and chlorogenic acid (5.60 ± 0.24 mg/100 mg dry fruit). The total phenolic content was 168.6 ± 0.9 mg gallic acid equivalent/g dry fruit; the total proanthocyanidin content was 84.6 ± 1.4 mg cyanidin/100 g dry fruit; and the total flavonoid content was 55.89 ± 1.43 mg quercetin/g dry fruit. Interestingly, procyanidins (dimers, trimers, and tetramers of (−)-epicatechin and (+)-catechin) were detected in the extract. This is the first study reporting the presence of polymeric polyphenols inCrataegus pubescensfruit. Accordingly, these fruits demonstrate great potential as a natural source of antioxidant phenolic compounds and could therefore be used as a nutraceutical and functional food.
Hydrogeophysical Investigation for Groundwater Resources from Electrical Resistivity Tomography and Self-Potential Data in the Méiganga Area, Adamawa, Cameroon
Authors: Arsène Meying , Wassouo Elvis Bidichael Wahile , Daniel Gouet , Théophile Ndougsa-Mbarga , Kelian Kuiate , Daniel Ngoh Jean
Published: July 2018

Exploration and production of groundwater, a vital and precious resource, is a challenging task in hard rock, which exhibits inherent heterogeneity. A geophysical survey was conducted in Méiganga, Mbéré department, in the Adamawa region, Cameroon. High-resolution electrical resistivity tomography (ERT) and self-potential (SP) dataset were collected in a gneissic terrain to solve the groundwater problem as people are facing acute shortage of drinking water in the study area. The analysis and interpretations based on resistivity models revealed substantial resistivity contrast between the altered gneiss that might contain water and massive gneiss and delineated five deeper groundwater prospects zones located at Yelwa, Ngoa-Ekélé, Sabongari, Ngassiri, and Gbakoungué, respectively. Nevertheless shallow groundwater zones (<13 m) are located in the northern part of the study area at high elevation while best prospect and productive groundwater zones lying between 20 and 25 m depth are at low elevation in the southern part. On the other hand, analysis of SP negative peaks along with groundwater head and groundwater vector maps revealed areas of recharge and discharge across the study area. The discharge areas serve as groundwater collection center and are good groundwater potential zones. In addition these maps revealed that groundwater flow pattern shows inward flow from the flanks to center and south central parts of the study area.
Maxillary Sinus Lift Using Autologous Periosteal Micrografts: A New Regenerative Approach and a Case Report of a 3-Year Follow-Up
Authors: Lupi Saturnino Marco , Rodriguez y Baena Arianna , Todaro Claudia , Ceccarelli Gabriele , Rodriguez y Baena Ruggero
Published: July 2018

This case report discusses about an innovative bone regeneration method that involves the use of autologous periosteal micrografts, which were used for a maxillary sinus floor lift in a 52-year-old female patient. This method allows for harvesting of a graft that is to be seeded on a PLGA scaffold and involves collection of a very little amount of palatal periosteal tissue in the same surgical site after elevation of a flap and disaggregation of it by using a Rigenera® filter. Histological samples collected at the time of implant installation demonstrate a good degree of bone regeneration. The clinical and radiographic outcomes at the 3-year follow-up visit showed an adequate stability of hard and soft tissues around the implants. This report demonstrates the possibility to obtain a sufficient quality and quantity of bone with a progenitor cell-based micrograft and in turn make the site appropriate for an implant-supported rehabilitation procedure, with stable results over a period of two years.
Partial Anterior Cruciate Ligament Ruptures: Advantages by Intraligament Autologous Conditioned Plasma Injection and Healing Response Technique—Midterm Outcome Evaluation
Authors: Koch Matthias , Mayr Felix , Achenbach Leonard , Krutsch Werner , Lang Siegmund , Hilber Franz , Weber Johannes , Pfeifer Christian G. , Woehl Rebecca , Eichhorn Jürgen , Zellner Johannes , Nerlich Michael , Angele Peter
Published: July 2018

The historical treatment options for partial anterior cruciate ligament (ACL) ruptures were conservative therapy or ACL reconstruction by injured bundle or entire ACL replacement. In awareness of the regenerative potential of biologic agents such as mesenchymal stem cells or platelet rich plasma (PRP), the healing response technique was developed to preserve the injured ACL with better outcomes than the conservative therapy. Further improvement of this technique seems to be obtained by the additional application of PRP products. Thus, the aim of this study was to evaluate the midterm outcome after intraligament autologous conditioned plasma (ACP) by a clinical, scoring, and functional performance assessment. 42 patients were evaluated in this study. The failure rate was 9.5%. Outcome evaluation showed good to excellent results. The scores were IKDC subjective 83.2 (SD 14.5), Lysholm 85.5 (SD 15.5), Tegner 4.7 (SD 1.7), and Cincinnati 85.4 (SD 15.5) after a mean follow-up of 33 months. Clinical examination showed stable Lachman test, negative pivot shift phenomenon, and a significant reduction in AP-laxity compared to preoperative status (rolimeter preoperative: 1.9 (SD1.4); postoperative 0.6 (SD1.8), p=0.001) in all patients. Functional performance testing showed no significant differences between the injured and healthy side. Return to sport was achieved after a mean of 5.8 months (SD 3.6) in 71.1% of the included patients. In summary, this new treatment option revealed in midterm follow-up promising results to treat partial ACL lesions with a reduced need for conversion to ACL reconstruction and with a high percentage of return to preinjury sport activity.
Gastrodin Protects Cardiomyocytes from Anoxia/Reoxygenation Injury by 14‐3‐3η
Authors: Zhu Meifang , Deng Wei , Di Suhong , Qin Mingming , Liu Dan , Yi Bo
Published: July 2018

Gastrodin (GAS) is the major component isolated from the rhizome of the Chinese traditional medicinal herb “Tianma.” Many clinical studies have found that GAS protects cardiomyocytes in cardiovascular diseases, although the effects and underlying mechanisms on cardiovascular anoxia/reoxygenation (A/R) injury remain unknown. This study is aimed at exploring the effect of gastrodin on cardiomyocytes in A/R injury. Our results suggested that the protective effect of GAS on cardiomyocytes is associated with upregulated 14‐3‐3η levels. Pretreatment with GAS could increase the cell viability and decrease the activities of creatine phosphokinase (CPK) and lactate dehydrogenase (LDH). GAS could also reduce reactive oxygen species (ROS) production, inhibit mitochondrial permeability transition pore (mPTP) opening, alter the maintenance of the mitochondrial membrane potential (∆Ψm), decrease the activation of caspase‐3, and finally restrain cell apoptosis. Downregulating 14‐3‐3η levels by transfection with siRNA14‐3‐3η clearly attenuated the protective effect of GAS on cardiomyocytes in A/R injury.
Hepatoprotective and Anti‐Inflammatory Activities of the Cnidoscolus chayamansa (Mc Vaugh) Leaf Extract in Chronic Models
Authors: Pérez-González Mariana Z. , Siordia-Reyes A. Georgina , Damián-Nava Patricia , Hernández-Ortega Simón , Macías-Rubalcava Martha L. , Jiménez-Arellanes María A.
Published: July 2018

Previous report described that CHCl3:MeOH extract of C. chayamansa leaves and pure compounds (moretenol, moretenyl acetate, kaempferol‐3,7‐dimethyl ether, and 5‐hydroxy‐7‐3′,4′‐trimethoxyflavanone) showed important topical and systemic anti‐inflammatory activity in acute model, as well as in vitro antimycobacterial and antiprotozoal activities. In this paper, we describe the in vivo hepatoprotective and anti‐inflammatory effects of the CHCl3:MeOH extract in chronic model and the isolation of additional compounds (moretenone and lupeol acetate). The hepatoprotective activity was determined at 39 days using Balb/c mice with liver damage induced with an antitubercular drug (RIF/INH/PZA). The anti‐inflammatory activity was evaluated in a chronic model induced with CFA and in two acute models (TPA and carrageenan). In addition, moretenone and lupeol acetate were isolated and identified by spectroscopic data. Lupeol acetate is a main compound present in fractions 14‐42, and this fraction was the majority fraction from the extract; from this moretenone was obtained. In animals with liver damage, the extract at 200 and 400 mg/kg induced better body weight gain with respect to positive control (Silymarin); in addition, the mice that received the extract at 200 mg/kg and Silymarin exhibited slight steatosis; however, the animals’ livers at 400 mg/kg did not show steatosis. The extract and fractions 14‐42 showed a good anti‐inflammatory activity by TPA model (DE50 = 1.58 and 1.48 mg/ear) and by carrageenan model (DE50 = 351.53 and 50.11 mg/kg). In the chronic inflammatory test, the extract at three doses revealed a similar effect to that of phenylbutazone, although the body weight gain was better in animals that received the extract at 900 mg/kg. Conclusion. The CHCl3:MeOH extract showed significant anti‐inflammatory and good hepatoprotective effect on chronic models. The fraction containing moretenone and lupeol acetate as main compounds was more active than extract in both acute models of inflammation.
A Stacked Autoencoder-Based Deep Neural Network for Achieving Gearbox Fault Diagnosis
Authors: Liu Guifang , Bao Huaiqian , Han Baokun
Published: July 2018

Machinery fault diagnosis is pretty vital in modern manufacturing industry since an early detection can avoid some dangerous situations. Among various diagnosis methods, data-driven approaches are gaining popularity with the widespread development of data analysis techniques. In this research, an effective deep learning method known as stacked autoencoders (SAEs) is proposed to solve gearbox fault diagnosis. The proposed method can directly extract salient features from frequency-domain signals and eliminate the exhausted use of handcrafted features. Furthermore, to reduce the overfitting problem in training process and improve the performance for small training set, dropout technique and ReLU activation function are introduced into SAEs. Two gearbox datasets are employed to conform the effectiveness of the proposed method; the result indicates that the proposed method can not only achieve significant improvement but also is superior to the raw SAEs and some other traditional methods.
Frozen Section Diagnostic Pitfalls of Sertoli-Leydig Cell Tumor with Heterologous Elements
Authors: Burris Ashley , Hixson Caleb , Smith Nathaniel
Published: July 2018

A woman in her sixth decade presented with several months of abdominal cramping, decreased appetite, bloating, and increased constipation. Radiologic imaging revealed a 28 cm, multilocular, heterogeneous cystic neoplasm involving the right adnexa. An intraoperative frozen section showed mucinous glandular epithelium, with and without foci of goblet cells, embedded in apparent ovarian stroma. The findings were concerning at least borderline mucinous cystadenoma with possible invasion. Subsequent surgical management and staging were performed. Permanent sections showed a moderately to poorly differentiated Sertoli-Leydig cell tumor (SLCT) with retiform foci and heterologous elements. The discrepancy between frozen and permanent sections was attributable to solely sampling a focus of heterologous elements during intraoperative consultation. The rarity of SLCT and even rarer presence of both heterologous and retiform elements make this concerning frozen section diagnostic pitfall.
Self-Assisted First-Fix Method for A-BDS Receivers with Medium- and Long-Term Ephemeris Extension
Authors: Shen Zilong , Peng Jing , Liu Wenxiang , Wang Feixue , Zhu Shibing , Wu Zhongwang
Published: July 2018

As a sensor for standalone position and velocity determination, the BeiDou Navigation Satellite System (BDS) receiver is becoming an important part of the intelligent logistics systems under rapid development in China. The applications in the mass market urgently require the BDS receivers to improve the performance of such functions, that is, shorter Time to First Fix (TTFF) and faster navigation signal acquisition speed with Ephemeris Extension (EE) in standalone mode. As a practical way to improve such functions of the Assisted BDS (A-BDS) receivers without the need for specialized hardware support, a Self-Assisted First-Fix (SAFF) method with medium- and long-term EE is proposed in this paper. In this SAFF method, the dynamic Medium- and Long-Term Orbit Prediction (MLTOP) method, which uses the historical broadcast ephemeris data with the optimal configuration of the dynamic models and orbit fitting time interval, is utilized to generate the extended ephemeris. To demonstrate the performance of the MLTOP method used in the SAFF method, a suit of tests, which were based on the real data of broadcast ephemeris and precise ephemeris, were carried out. In terms of the positioning accuracy, the overall performance of the SAFF method is illustrated. Based on the characteristics of the medium- and long-term EE, the simulation tests for the SAFF method were conducted. Results show that, for the SAFF method with medium- and long-term EE of the BeiDou MEO/IGSO satellites, the horizontal positioning accuracy is about 12 meters, and the overall positioning accuracy is about 25 meters. The results also indicate that, for the BeiDou satellites with different orbit types, the optimal configurations of the MLTOP method are different.
HER2 Basolateral versus Circumferential IHC Expression Is Dependent on Polarity and Differentiation of Epithelial Cells in Gastric/GE Adenocarcinoma
Authors: Pervez Shahid , Arshad Sidra , Abro Brooj
Published: July 2018

Aim. Antigenic expression in epithelial cells can be heterogeneous which may pose a problem in immunohistochemical (IHC) analysis of tumor markers, in particular, predictive markers like HER2. Studies have shown that epithelial cells have distinct apical and basolateral domains which are separated by tight junctions. The cell membrane in these two domains has a different composition of macromolecules and hence can have variable antigen expression on immunohistochemistry. In our study, we aimed to investigate this phenomenon of basolateral versus circumferential IHC staining of HER2 in gastric/GE adenocarcinoma. Methods. We selected 45 cases of gastric/GE adenocarcinoma and evaluated equal number of specimens (15 each) showing well-differentiated, moderately differentiated, and poorly differentiated morphology. All cases had 3+ HER2 score as per CAP guidelines. HER2-membrane staining pattern in all specimens was analyzed. Results. Cases with well-differentiated morphology showed only basolateral or lateral membrane staining in most cases. Poorly differentiated adenocarcinoma samples showed circumferential staining (both basolateral and luminal) in all cases with highly significant p value. Mixed staining pattern was observed in moderately differentiated cases. Diffuse expression of E-cadherin in well-differentiated adenocarcinoma and loss in poorly differentiated tumors were also statistically significant. Conclusion. These findings suggest that HER2 in gastric epithelium has a polarized distribution which is maintained by the fence function of tight junctions. With progression to high grade cancer, the glandular structural differentiation in gastric mucosa is lost, along with disruption of tight junctions. This leads to loss of cell polarity and migration of antigens across the membrane.
Traditional Chinese Medicine Extract from Huaier Increases the Expression of Duffy Antigen Receptor for Chemokines and Reduces the Expression of Its Ligands
Authors: Chen Ying , Chen Qianjun , Xie Fengfeng , Peng Hui , Wu Yanlan , Zhong Shaowen , Wang Zhiyu , Li Wenxia , Xie Wanjun
Published: July 2018

Aims. The aim of the present study is to investigate whether the aqueous extract from Huaier, a traditional Chinese medicine (TCM), can affect the expression of Duffy antigen receptor for chemokines (DARC) and its ligands. Moreover, we compare the status of DARC in primary and metastatic breast cancer tissues from the same patient.Methods. Immunohistochemistry was used to detect the expression of DARC in primary and metastatic focuses in 30 patients with breast cancer. The effect of Huaier aqueous extract on the expression of DARC and its ligands was investigated by quantitative real-time polymerase chain reaction, Western blotting, and enzyme-linked immunosorbent assay.Results. The expression score of DARC in primary focuses was significantly higher than that in metastatic focuses, while changes of ER, PR, and HER2 receptors were not significantly different between primary and metastatic focuses. Huaier aqueous extract promoted the expression of DARC and reduced the secretion of CC chemokine ligand 2 (CCL-2), CXC chemokine ligand 8 (CXCL-8, IL-8), matrix metalloproteinase 2 (MMP-2), and CXC chemokine ligand 1 (CXCL-1).Conclusion. The present study demonstrates that difference in expression level of DARC between primary and metastatic focuses of breast cancer was significant, while differences in expression of ER, PR, and HER2 between primary and metastatic focuses were not significant. DARC may play a negative role in the metastasis of breast cancer. Traditional Chinese medicine extract from Huaier can increase DARC expression and reduce the expression of its ligands such as CCL-2, IL-8, MMP-2, and CXCL-1.
Deformation Measurement of a Railroad Bridge Using a Photogrammetric Board without Control Point Survey
Authors: Lee Hyoseong , Han Dongyeob
Published: July 2018

We propose a photogrammetric board to measure the deformation of a railroad bridge using close-range photogrammetry. The method can be used to compute the exterior orientation parameters and determine three-dimensional (3D) coordinates from images without measuring the control points. The bridge deformation measured using the proposed method was compared to that measured with a 3D laser tracker. The measurement error was within 1 mm, and the proposed method can measure the deformation of an I-plate girder of a railroad bridge. This method may be an alternative to precise stability inspections and bridge inspections.
UCHL1/PGP 9.5 Dynamic in Neuro-Immune-Cutaneous Milieu: Focusing on Axonal Nerve Terminals and Epidermal Keratinocytes in Psoriatic Itch
Authors: Kupczyk Piotr , Reich Adam , Gajda Mariusz , Hołysz Marcin , Wysokińska Edyta , Paprocka Maria , Nevozhay Dmitry , Chodaczek Grzegorz , Jagodziński Paweł P. , Ziółkowski Piotr , Szepietowski Jacek C.
Published: July 2018

Psoriasis is an immunogenetic skin disease manifesting as plaque lesions on the skin. Patients with psoriasis frequently suffer from itch, an unpleasant sensation causing a desire to scratch. Psoriatic itch is mainly transmitted by unmyelinated C-fibers; however, the exact molecular mechanism of psoriatic itch is still unexplained. Protein gene product 9.5 (PGP 9.5) is a panneurological marker commonly used for analysis of peripheral peptidergic and nonpeptidergic nerves and identification of cutaneous neuro-immune-endocrine cells. However, some studies suggested that nonneuronal cells, like keratinocytes, may also express PGP 9.5. This phenomenon might be linked with impaired axonal transport, keratinocyte injury, or dysfunctions of neuro-immune-cutaneous connections. The aim of this study was to analyze the expression of PGP 9.5 in psoriatic skin. We observed significantly altered density of PGP 9.5-positive axonal nerve terminals in pruritic lesional (p=0.04) and nonlesional psoriatic skin (p>0.001) compared with controls. In contrast, no significant differences were observed between psoriatic skin without itch and controls. Furthermore, PGP 9.5 expression by suprabasal keratinocytes (SBKs) was significantly increased in itchy skin lesions (p=0.007) compared to skin without itch, and a positive correlation was observed between PGP 9.5 expression and itch intensity (r=0.64; p=0.02). Our findings indicate changes in peripheral innervations and psoriatic keratinocytes, which may influence neuro-immune-cutaneous homeostasis and modulate itch transmission.
The Effect of Citalopram on Genome-Wide DNA Methylation of Human Cells
Authors: Kanherkar Riya R. , Getachew Bruk , Ben-Sheetrit Joseph , Varma Sudhir , Heinbockel Thomas , Tizabi Yousef , Csoka Antonei B.
Published: July 2018

Commonly used pharmaceutical drugs might alter the epigenetic state of cells, leading to varying degrees of long-term repercussions to human health. To test this hypothesis, we cultured HEK-293 cells in the presence of 50 μM citalopram, a common antidepressant, for 30 days and performed whole-genome DNA methylation analysis using the NimbleGen Human DNA Methylation 3x720K Promoter Plus CpG Island Array. A total of 626 gene promoters, out of a total of 25,437 queried genes on the array (2.46%), showed significant differential methylation (p<0.01); among these, 272 were hypomethylated and 354 were hypermethylated in treated versus control. Using Ingenuity Pathway Analysis, we found that the chief gene networks and signaling pathways that are differentially regulated include those involved in nervous system development and function and cellular growth and proliferation. Genes implicated in depression, as well as genetic networks involving nucleic acid metabolism, small molecule biochemistry, and cell cycle regulation were significantly modified. Involvement of upstream regulators such as BDNF, FSH, and NFκB was predicted based on differential methylation of their downstream targets. The study validates our hypothesis that pharmaceutical drugs can have off-target epigenetic effects and reveals affected networks and pathways. We view this study as a first step towards understanding the long-term epigenetic consequences of prescription drugs on human health.