bluuebunny/crossref_metadata_2025 huggingface dataset:
Heilpflanzen in der globalisierten Welt
Authors: Stange Rainer
Published: December 2018

Die Nutzung von Heilpflanzen aus anderen Kulturen erfolgte zunächst pragmatisch, da wichtige Indikationen in den heimischen traditionellen Medizinen nur unzureichend abgedeckt waren. Oft gelangten diese Therapeutika im Zuge der Kolonialzeit in westliche Industrieländer. Fragen, die über die pragmatische Verwendung hinausgingen, stellten sich erst viel später und hängen mit dem gestiegenen Bewusstsein für ökologische und politisch-soziale Aspekte sowie einem sensibleren Verständnis für kollektives materielles und geistiges Eigentum in den Herkunftsregionen zusammen. Der Fall der Kapland-Pelargonie illustriert, dass auch nach hunderten Jahren therapeutischer Nutzung juristische Differenzen auftreten können – aus westlicher Sicht greift das internationale Patentrecht, aus Sicht der Vertreter der indigenen Bevölkerung das Recht an der biologischen Spezies und dem Wissen um die traditionelle Anwendung der Heilpflanze.

Für Verschreiber wie Verbraucher traditioneller Heilmittel aus der „Weltapotheke“ erscheint die Bevorzugung von Präparaten mit anerkannten Zertifizierungen bzw. ethischen Codizes sinnvoll.
Chronisches Nierenversagen – Update 2018
Authors: Ketteler Markus , Wanner Christoph
Published: December 2018

Die CANVAS-Programm-Studie hat mit Canagliflozin die Nephroprotektion, welche mit
Empagliflozin publiziert wurde (EMPA-REG-Outcome-Studie), bestätigt. Die
Therapie mit Liraglutide in der LEADER-Studie suggeriert Nephroprotektion über
eine Reduktion der Albuminurie und geringerem eGFR-Abfall (eGFR: geschätzte
glomeruläre Filtrationsrate) in Subgruppen/Stadien der diabetischen
Nierenerkrankung. Im Juli 2017 erfolgte ein Update der KDIGO (Kidney Disease:
Improving Global Outcomes) -2009-Leitlinie zur Diagnostik und Therapie der
Störungen des Mineral- und Knochenhaushalts bei chronischen Nierenerkrankungen.
Änderungen betrafen die Knochendichtemessung, die Therapie von Hyperphosphatämie
und Hyperparathyreoidismus im Prädialysestadium und eine Warnung vor exzessiver
Kalziumexposition. Ein neues parenterales Kalzimimetikum Zwei Phase-III-Studien
zum Einsatz eines neuen parenteralen Kalzimimetikums (Etelcalcitid) wurden
publiziert.
A Bufadienolide-Enriched Fraction of Bryophyllum pinnatum
Inhibits Human Myometrial Contractility In Vitro
Authors: Santos Stefanie , Haslinger Christian , Klaic Kristian , Faleschini Maria T. , Mennet Mónica , Potterat Olivier , von Mandach Ursula , Hamburger Matthias , Simões-Wüst Ana Paula
Published: December 2018

Bryophyllum pinnatum has been used since the 1970s to prevent premature
labour, first in anthroposophic hospitals and, more recently, also in the main
Swiss perinatal centres. However, it is not known which compounds in B.
pinnatum leaves contribute to the tocolytic effect. Here we studied the
effects of a flavonoid-enriched fraction, the corresponding flavonoid aglycon
mixture, a bufadienolide-enriched fraction, and B. pinnatum leaf press
juice on human myometrial contractility in vitro. The strength (area
under the curve and amplitude) and frequency of contractions were recorded using
strips of human myometrium mounted in an organ bath system. Cell viability
assays were performed with the human myometrium hTERT-C3 and PHM1 – 41 cell
lines. Repeated addition of the flavonoid-enriched fraction, flavonoid aglycon
mixture, bufadienolide-enriched fraction, or B. pinnatum leaf press juice
led to a progressive decrease of contraction strength, without jeopardising the
vitality of myometrium strips. The bufadienolide-enriched fraction was the most
active, since 1 µg/mL of the bufadienolide-enriched fraction lowered the area
under the curve to 40.1 ± 11.8% of the initial value, whereas 150 µg/mL of the
flavonoid-enriched fraction, 6.2 µg/mL of the flavonoid aglycon mixture, and
10 mg/mL of the B. pinnatum leaf press juice were required to achieve
comparable inhibition. A progressive increase of contraction frequency was
observed, except in the case of the flavonoid aglycon mixture, which did not
affect frequency. None of the test substances decreased myometrial cell
viability, even at concentrations of 500 µg/mL of the flavonoid-enriched
fraction, 40 µg/mL of the flavonoid aglycon mixture, 3.8 µg/mL of the
bufadienolide-enriched fraction, and 75 mg/mL of the B. pinnatum leaf
press juice, i.e., higher than those used in the myometrium experiments. Given
the concentrations of flavonoids in the flavonoid-enriched fraction and B.
pinnatum leaf press juice, and of bufadienolides in the
bufadienolide-enriched fraction and B. pinnatum leaf press juice, it
appears that bufadienolides may be mainly responsible for the relaxant
effect.
Osteochondral Allograft Transplantation: Identifying the Biomechanical Impact of Using Shorter Grafts and Pulsatile Lavage on Graft Stability
Authors: Babu Jacob M. , Hodax Jonathan D. , Fadale Paul D. , Owens Brett D.
Published: December 2018

This study seeks to identify the ability of shorter osteochondral allografts (OCAs) to resist displacement/failure. Additionally, this study seeks to evaluate the effect of pulsatile lavage (PL) on the biomechanical stability of the OCA. Fifteen-millimeter diameter, human cadaveric, OCAs of 4, 7, and 10 mm in depth were harvested for comparison of resistance to compressive and tensile loads. For each group, seven specimens were subjected to tensile loads and three specimens subjected to compressive loads until failure (pullout or subsidence). An additional study group of 10 pulsatile-lavaged OCAs of 15 mm in diameter and 7 mm in depth were introduced for comparison to the original 7 mm depth OCA group. The average tensile forces for failure for the 4, 7, and 10 mm plugs were 23.74, 199.57, and 197.69 N, respectively (p = 1.5 × 10−5). After post hoc analysis of the tensile groups, significant differences in the mean tensile force to failure were appreciated between the 4 and 7 mm groups (p = 4.12 × 10−5) and the 4 and 10 mm groups (p = 1.78 × 10−5) but not between the 7 and 10 mm groups (p = 0.9601). There were no significant differences between the average tensile forces resulting in failure for the 7 mm and 7 mm PL groups (199.57 and 205.2 N, p = 0.90) or compressive forces to failure, respectively (733.6 and 656 N, p = 0.7062). For OCAs of 15 mm in diameter, a commonly used size in practice, plugs of 7 mm in depth showed comparable resistance to pull out and subsidence as 10 mm plugs and significantly better resistance to pull out than 4 mm grafts. PL of allografts prior to insertion did not take away from the structural integrity and stability of the plug.
Is There a Difference between Cemented and Uncemented Femoral Stem Extensions in Revision Knee Arthroplasty?
Authors: Lachiewicz Paul F. , O'Dell Jane Ann
Published: December 2018

A stem is usually recommended for the femoral component in revision total knee arthroplasty (TKA) for reasons of alignment, fixation, and bone loss. However, the optimal method of fixation for the femoral component stem remains controversial. We queried the prospective revision TKA database of one surgeon and performed a clinical and radiographic evaluation of 84 knee revisions in which a femoral component stem extension was implanted. There was no established protocol for fixation of the femoral stem during this time. There were 34 knees with cemented (C) fixation and 50 with uncemented (UC) fixation. There were no significant differences in age, gender, body mass index (BMI), or Anderson's Orthopaedic Research Institute (AORI) defect between the two groups. Patients were evaluated using the classic Knee Society clinical and radiographic scores and followed for a mean of 6 years (range: 2–17 years). There was no statistically significant difference in prevalence of reoperation for loosening between cemented and uncemented stems (cemented 3.3% vs. uncemented 10%; p = 0.4). Post hoc power analysis showed that 203 knees in each group would be needed for statistical significance. With the numbers available, there was no difference in aseptic component loosening and radiographic loosening combined (one revision and two radiographic loosening, 9%, in the C group vs. five revisions and three radiographic loosening, 16%, in the UC group; p = 0.51). There was no difference between the groups in the overall rate of any reoperation. There were no differences in postoperative Knee Society pain score, change in pain score, Knee Society function score, or change in function score. Due to the numbers required, a large multicenter study will be needed to determine the optimal method of fixation of the femoral stem in revision TKA.
Characterization of magnetic field lines in connection with their transport in Beltrami magnetic fields
Authors: Samanta Subha , Janaki M. S. , Ram Abhay K. , Dasgupta Brahmananda
Published: December 2018

Single and double curl Beltrami magnetic fields are studied numerically in connection with their transport properties, and the results are compared and analyzed by characterizing the magnetic field lines. In the phase space of the single curl Beltrami field, islands of regular field lines are embedded into the chaotic sea, whereas the field lines for certain solutions of the double curl Beltrami field are chaotic over the entire space. Due to the presence of regular islands in phase space, the chaotic trajectories show stickiness phenomena which are characterized by the distribution of a chaotic field line. The dynamical traps in chaotic orbits due to stickiness phenomena are also characterized by the distribution of finite distance Lyapunov exponents. Finally, the recurrence length distribution of chaotic trajectories is plotted to understand their global behaviour.
Patient out-of-pocket medical expenses over 2 years among Queenslanders with and without a major cancer
Authors: Gordon Louisa G. , Elliott Thomas M. , Olsen Catherine M. , Pandeya Nirmala , Whiteman David C. , for the QSkin study
Published: December 2018

Medical out-of-pocket costs paid by patients can be problematic when it adversely affects access to care. Survey research involving patients with out-of-pocket expenses may have selection biases, so accurate estimates are unknown. During 2010–11, 419 participants from the QSkin Sun and Health Study (n=43794) had a confirmed diagnosis of either melanoma, prostate, breast, colorectal or lung cancer. These were matched to a general population group (n=421) and a group of high users of GP services (n=419). Medical fees charged and out-of-pocket medical expenses for Medicare services were analysed. Over 2 years, three-quarters of individuals with cancer paid up-front provider fees of up to A$20551 compared with A$10995 for the high GP user group and A$6394 for the general population group. Out-of-pocket expenses were significantly higher for those with cancer (mean A$3514) compared with the high GP-user group (mean A$1837) and general population group (A$1245). Highest expenses were for therapeutic procedures (mean A$2062). Older individuals, those with poor perceived health or private health insurance had the highest costs. Regardless of private insurance status, patients with one of the main five cancers pay significantly higher out-of-pocket costs for health care compared with those without cancer.
An automated, electronic, client-centred results delivery system saves time and improves workflow
Authors: Knight Vickie , Nugent Colleen , Houghton Rebecca , O'Reilly Kelly , Scally Elizabeth , Lu Heng
Published: December 2018

Background
Traditional result notification methods, such as telephone calls, return visits and individualised emails or Short Message Service (SMS) texts, can be time consuming and may not align with client preference. We conducted a cross-sectional survey of our clients that showed that many clients prefer negative results by SMS or email, with the option to call or attend in person for positive results. Methods: We developed an innovative result-robot module in the electronic medical record that reads the electronic result and, using predefined algorithms, determines which SMS or email result template to send to the client. Results and Conclusion: Delivering automated negative results resulted in a 41% decrease in the number of clients calling for their results, demonstrating a significant efficiency gain.
Evaluating the palatability of fermented foods
Authors: Fushiki Tohru , Nakano Kumiko
Published: December 2018

The present review deal with the novel studies which present possibility of generating a novel sensory evaluation instrument for describing comprehensive food palatability. These studies suggest the palatability can be dissected into its componential subdomains and the subdomains in turn reconstitute comprehensive palatability with evaluation of the quantitative contribution of each subdomain. The studies suggest the novel instrument is useful for comprehensive evaluation of palatability of multifarious fermented foods.
Cultivating new post-secular political space
Authors: Mitchell Roger Haydon
Published: December 2018

The emergence of post-secular new political space is increasingly recognised as both urgent challenge and beckoning opportunity for innovative political intervention. The concept is framed around three defining characteristics. Firstly, it refers to socio-economic space vacated by government and demarcated by extremes of poverty and marginalisation requiring mitigation by charities, faith communities and the like. Secondly, it is evidenced in local contexts by an obvious lack of social mobility and blatant discrepancies in income, educational outcomes and life expectancy. Thirdly, it is ontological space. Arguably for the first time in a generation, the deep political structures are accessible to recognition and transformation. Fourthly, it is European space exemplified by the increasing challenge to the post-war European project and the burgeoning nationalism and xenophobia exacerbated at least in part by the influx of refugees, asylum seekers and economic migrants. This special issue of Global Discourse assembles six articles and responses emanating from a desire to cultivate and not colonise this emerging space for overall well-being.
Examining self-love, love of the ‘other’ and love of the ‘enemy’: a reply to Mitchell
Authors: Knox Andy
Published: December 2018

If Roger Haydon Mitchell's exposition of the politics of love are to provide a practical alternative to sovereign power it must have a grounding in everyday life and an applicable outworking that enables a praxis of being. In this response, three key tools mentioned in the final section of Mitchell's article, namely the ‘Enneagram’, the ‘Art of Hosting’ and the ‘Poverty Truth Commission’, are highlighted and considered as potentially helpful methodologies for exploring how a politics of love can be outworked at a personal and corporate level in practical ways. Drawing on the responder's experience as director of population health in Morecambe Bay in the North West of England the paper explores how each of the three tools are taking effect, with reference to the author's knowledge of current work building on the ideas of self-love, love of the ‘other’ and love of the ‘enemy’ within the NHS and beyond.
Inter-residue interactions in alpha-helical transmembrane proteins
Authors: Mayol Eduardo , Campillo Mercedes , Cordomí Arnau , Olivella Mireia
Published: December 2018

Motivation

The number of available membrane protein structures has markedly increased in the last years and, in parallel, the reliability of the methods to detect transmembrane (TM) segments. In the present report, we characterized inter-residue interactions in α-helical membrane proteins using a dataset of 3462 TM helices from 430 proteins. This is by far the largest analysis published to date.

Results

Our analysis of residue–residue interactions in TM segments of membrane proteins shows that almost all interactions involve aliphatic residues and Phe. There is lack of polar–polar, polar–charged and charged–charged interactions except for those between Thr or Ser sidechains and the backbone carbonyl of aliphatic and Phe residues. The results are discussed in the context of the preferences of amino acids to be in the protein core or exposed to the lipid bilayer and to occupy specific positions along the TM segment. Comparison to datasets of β-barrel membrane proteins and of α-helical globular proteins unveils the specific patterns of interactions and residue composition characteristic of α-helical membrane proteins that are the clue to understanding their structure.

Availability and implementation

Results data and datasets used are available at http://lmc.uab.cat/TMalphaDB/interactions.php.

Supplementary information

Supplementary data are available at Bioinformatics online.
Tonight’s Sleep Predicts Tomorrow’s Fatigue: A Daily Diary Study of Long-Term Care Employees With Nonwork Caregiving Roles
Authors: DePasquale Nicole , Crain Tori , Buxton Orfeu M , Zarit Steven H , Almeida David M
Published: December 2018

Background and Objectives

Long-term care employees and employees with nonwork caregiving roles are at high risk for sleep problems and fatigue. Little is known, however, about relationships between sleep and fatigue among long-term care employees who occupy nonwork caregiving roles. This study examined whether longer sleep duration and better sleep quality reduce fatigue occurrence and severity within and between long-term care employees with nonwork caregiving roles, and investigated nonwork caregiving role occupancy as a moderator of these relationships.

Research Design and Methods

The sample comprised 166 women working in U.S.-based nursing homes. All women had children aged 9–17 years and some also had nonwork caregiving responsibilities for adult relatives. Sleep (duration and quality) and fatigue (occurrence and severity) were assessed via telephone interviews for eight consecutive evenings. Multilevel modeling was used to examine within-person and between-person associations.

Results

At the within-person level, nights characterized by longer-than-usual sleep duration or better-than-usual sleep quality were followed by days with lower odds of reporting fatigue; these same sleep characteristics predicted less severe next-day fatigue. At the between-person level, employees with better average sleep quality, but not longer sleep duration, had lower odds of experiencing fatigue. Relationships between sleep and fatigue were generally similar regardless of nonwork caregiving responsibilities for children or for both children and adults.

Discussion and Implications

Findings suggest that tonight’s sleep predicts tomorrow’s fatigue. Given the serious and wide-ranging consequences of fatigue, sleep constitutes a worthwhile intervention target with potential benefits for employees, care recipients, and organizations.
Longitudinal Associations of Falls and Depressive Symptoms in Older Adults
Authors: Choi Namkee G , Marti C Nathan , DiNitto Diana M , Kunik Mark E
Published: December 2018

Background and Objectives

Fall incidents and associated medical costs are increasing among older adults. This study examined longitudinal associations between older adults’ falls status and depression at 2 time periods to further clarify bidirectional relationships.

Methods

We used the National Health and Aging Trends Study (NHATS) Waves 5 and 6 data and included sample persons (N = 6,299) who resided in the community or residential care facilities (not nursing homes) at both waves (T1 and T2). We employed multinomial logistic regression analysis to examine the association of T2 falls status with T1 depressive symptoms, and negative binomial regression and logistic regression analyses to examine the association of T2 depressive symptoms with stability/change in T1-T2 falls status.

Results

Over the study period, 46% of older adults (18 million Medicare beneficiaries) who lived in the community or residential care facilities reported a fall. T1 depressive symptoms were significantly associated with greater odds of T2 multiple falls, and increasing falls or continuing incidents of multiple falls between T1 and T2 were significantly associated with higher depressive symptoms and probable major depression at T2.

Discussion and Implications

The significant bidirectional relationships between T1 depression and T2 multiple falls point to the importance of incorporating depression treatment in fall prevention programs for older adults at high risk of increasing/multiple falls.
Not only cancer: the long non-coding RNA MALAT1 affects the repertoire of alternatively spliced transcripts and circular RNAs in multiple sclerosis
Authors: Cardamone Giulia , Paraboschi Elvezia M , Soldà Giulia , Cantoni Claudia , Supino Domenico , Piccio Laura , Duga Stefano , Asselta Rosanna
Published: December 2018

Long non-coding RNAs (lncRNAs) are post-transcriptional and epigenetic regulators, whose implication in neurodegenerative and autoimmune diseases remains poorly understood. We analyzed publicly available microarray data sets to identify dysregulated lncRNAs in multiple sclerosis (MS), a neuroinflammatory autoimmune disease. We found a consistent upregulation in MS of the lncRNA MALAT1 (2.7-fold increase; meta-analysis, P = 1.3 × 10−8; 190 cases, 182 controls), known to regulate alternative splicing (AS). We confirmed MALAT1 upregulation in two independent MS cohorts (1.5-fold increase; P < 0.01; 59 cases, 50 controls). We hence performed MALAT1 overexpression/knockdown in cell lines, demonstrating that its modulation impacts on endogenous expression of splicing factors (HNRNPF and HNRNPH1) and on AS of MS-associated genes (IL7R and SP140). Minigene-based splicing assays upon MALAT1 modulation recapitulated IL7R and SP140 isoform unbalances observed in patients. RNA-sequencing of MALAT1-knockdown Jurkat cells further highlighted MALAT1 role in splicing (approximately 1100 significantly-modulated AS events) and revealed its contribution to backsplicing (approximately 50 differentially expressed circular RNAs). Our study proposes a possible novel role for MALAT1 dysregulation and the consequent AS alteration in MS pathogenesis, based on anomalous splicing/backsplicing profiles of MS-relevant genes.
On Integral Cohomology of Certain Orbifolds
Authors: Bahri Anthony , Notbohm Dietrich , Sarkar Soumen , Song Jongbaek
Published: December 2018

The CW-complex structure of certain spaces, such as effective orbifolds, can be too complicated for computational purposes. In this paper we develop the concept of $\mathbf{q}$-CW complex structure on an orbifold, to detect torsion in its integral cohomology. The main result can be applied to well-known classes of orbifolds or algebraic varieties having orbifold singularities, such as toric orbifolds, simplicial toric varieties, torus orbifolds, and weighted Grassmannians.
Translating ‘See-and-Treat’ to primary care: opening the gates does not cause a flood
Authors: Savage Carl , Bjessmo Staffan , Borisenko Oleg , Larsson Henrik , Karlsson Jacob , Mazzocato Pamela
Published: December 2018

Objective

To explore how the See-and-Treat concept can be applied in primary care and its effect on volume and productivity.

Design

An explanatory single-case study design with a mixed methods approach and presented according to the SQUIRE 2.0 guidelines.

Setting

A publicly-funded, private primary care provider within the Stockholm County, which caters to a diverse patient population in terms of ethnicity, religion, socioeconomic status and care needs.

Participants

CEO, center manager, four physicians, two licensed practical nurses, one medical secretary and one lab assistant.

Intervention

A See-and-Treat unit was established to offer same-day service for acute unplanned visits. Standardized patient symptom forms were created that allowed patients to self-triage and then enter into a streamlined care process consisting of a quick diagnostic lab and a physician visit.

Main Outcome Measures

Volume, productivity, staff perceptions and patient satisfaction were measured through data on number and type of contacts per 1000 listed patients, visits per physician, observations, interviews and a questionnaire.

Results

A significant decrease in the acute and total number of visits, a continued trend of diminishing telephone contacts, and a non-significant increase in physician productivity. Patients were very satisfied, and staff perceived an improved quality of care.

Conclusions

See-and-Treat appears to be a viable approach for a specific primary care patient segment interested in acute same-day-service. Opening up access and standardizing care made it possible to efficiently address these needs and engage patients.
Oxidative stress levels and dynamic changes in mitochondrial gene expression in a radiation-induced lung injury model
Authors: Yin Zhongyuan , Yang Guanghai , Deng Sisi , Wang Qiong
Published: December 2018

The purpose of this study was to set up a beagle dog model, for radiation-induced lung injury, that would be able to supply fresh lung tissues in the different injury phases for research into oxidative stress levels and mitochondrial gene expression. Blood serum and tissues were collected via CT-guided core needle biopsies from dogs in the various phases of the radiation response over a 40-week period. Levels of reactive oxygen species (ROS) and manganese superoxide dismutase 2 (MnSOD) protein expression in radiation-induced lung injury were determined by in situ immunocytochemistry; malondialdehyde (MDA) content and reductase activity in the peripheral blood were also tested; in addition, the copy number of the mitochondrial DNA and the level of function of the respiratory chain in the lung tissues were assessed. ROS showed dynamic changes and peaked at 4 weeks; MnSOD was mainly expressed in the Type II alveolar epithelium at 8 weeks; the MDA content and reductase activity in the peripheral blood presented no changes; the copy numbers of most mitochondrial genes peaked at 8 weeks, similarly to the level of function of the corresponding respiratory chain complexes; the level of function of the respiratory chain complex III did not peak until 24 weeks, similarly to the level of function of the corresponding gene Cytb. Radiation-induced lung injury was found to be a dynamically changing process, mainly related to interactions between local ROS, and it was not associated with the levels of oxidative stress in the peripheral blood. Mitochondrial genes and their corresponding respiratory chain complexes were found to be involved in the overall process.
Level of Evidence for Reliability, Validity, and Responsiveness of Physical Capacity Tasks Designed to Assess Functioning in Patients With Low Back Pain: A Systematic Review Using the COSMIN Standards
Authors: Jakobsson Max , Gutke Annelie , Mokkink Lidwine B , Smeets Rob , Lundberg Mari
Published: December 2018

Background

Physical capacity tasks (ie, observer-administered outcome measures that comprise a standardized activity) are useful for assessing functioning in patients with low back pain.

Purpose

The purpose of this study was to systematically review the level of evidence for the reliability, validity, and responsiveness of physical capacity tasks.

Data Sources

MEDLINE, CINAHL, PsycINFO, Scopus, the Cochrane Library, and relevant reference lists were used as data sources.

Study Selection

Two authors independently selected articles addressing the reliability, validity, and responsiveness of physical capacity tasks, and a third author resolved discrepancies.

Data Extraction and Quality Assessment

One author performed data extraction, and a second author independently checked the data extraction for accuracy. Two authors independently assessed the methodological quality with the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) 4-point checklist, and a third author resolved discrepancies.

Data Synthesis and Analysis

Data synthesis was performed by all authors to determine the level of evidence per measurement property per physical capacity task. The 5-repetition sit-to-stand, 5-minute walk, 50-ft (∼15.3-m) walk, Progressive Isoinertial Lifting Evaluation, and Timed “Up & Go” tasks displayed moderate to strong evidence for positive ratings of both reliability and construct validity. The 1-minute stair-climbing, 5-repetition sit-to-stand, shuttle walking, and Timed “Up & Go” tasks showed limited evidence for positive ratings of responsiveness.

Limitations

The COSMIN 4-point checklist was originally developed for patient-reported outcome measures and not physical capacity tasks.

Conclusions

The 5-repetition sit-to-stand, 50-ft walk, 5-minute walk, Progressive Isoinertial Lifting Evaluation, Timed “Up & Go,” and 1-minute stair-climbing tasks are promising tests for the measurement of functioning in patients with chronic low back pain. However, more research on the measurement error and responsiveness of these tasks is needed to be able to fully recommend them as outcome measures in research and clinical practice.
Use of a Novel Tibial Traction Triangle for Intramedullary Nailing of Tibia Fractures
Authors: Sathy Ashoke K. , Prabhakar Pooja , Harirah Muhammad , Hay Michael
Published: December 2018

Malalignment after intramedullary nailing of proximal and distal tibia fractures remains a significant problem. We describe the use of a novel device to ease treatment of tibia fractures that undergo intramedullary nailing. The tibial traction triangle is simple and easy to use and allows for better reductions, leading to lower rates of malalignment. A prospective series of 11 patients is presented.
Targeting the interplay between metabolism and epigenetics in cancer
Authors: Montellier Emilie , Gaucher Jonathan
Published: December 2018

Purpose of review

Metabolic perturbation is a hallmark of cancer favoring tumor progression. It is now demonstrated that cell metabolism has an impact on gene expression through epigenetic modifications. In this review, we expose recent evidences of metabolic-driven epigenetic perturbations in cancer and subsequent therapeutic opportunities.

Recent findings

The intimate link between metabolism and epigenetics and its rewiring in carcinogenesis is a hot topic. Chromatin-modifying enzymes involved in the dynamics of methylation or acetylation require small metabolites as cofactors or substrates, thus orchestrating the integration between epigenetic and transcriptional states. Mutations in metabolic enzymes such as isocitrate dehydrogenase 1 and 2 cause the accumulation of metabolites that upset the balance of histone and DNA methylation, thus generating widespread deregulation of epigenetically controlled gene expression. Additionally, modifications of catalytic activity and subcellular localization of metabolic enzymes in cancer can impact on epigenetic modifications and gene expression programs to favor tumor progression.

The interplay between metabolism and epigenetics and its molecular characterization in cancer cells identifies potential targets for the development of new therapies.
Post-transcriptional regulations of cancer stem cell homeostasis
Authors: Berabez Nabila , Durand Sébastien , Gabut Mathieu
Published: December 2018

Purpose of review

Although extensively studied for over a decade, gene expression programs established at the epigenetic and/or transcriptional levels do not fully characterize cancer stem cells (CSC). This review will highlight the latest advances regarding the functional relevance of different key post-transcriptional regulations and how they are coordinated to control CSC homeostasis.

Recent findings

In the past 2 years, several groups have identified master post-transcriptional regulators of CSC genetic programs, including RNA modifications, RNA-binding proteins, microRNAs and long noncoding RNAs. Of particular interest, these studies reveal that different post-transcriptional mechanisms are coordinated to control key signalling pathways and transcription factors to either support or suppress CSC homeostasis.

Deciphering molecular mechanisms coordinating plasticity, survival and tumourigenic capacities of CSCs in adult and paediatric cancers is essential to design new antitumour therapies. An entire field of research focusing on post-transcriptional gene expression regulation is currently emerging and will significantly improve our understanding of the complexity of the molecular circuitries driving CSC behaviours and of druggable CSC weaknesses.
The Use of Mobile Health to Assist Self-management and Access to Services in a Rural Community
Authors: Serafica Reimund , Inouye Jillian , Lukkahatai Nada , Braginsky Nafanua , Pacheco Misty , Daub Katharyn F.
Published: December 2018

The purpose of this study was to explore the barriers to and needs for using mobile health technology to assist low-income Asian American and Pacific Islander participants living in rural Hawaii in their healthcare. Three focus groups consisting of patients, family support/significant others, and providers (N = 19) were conducted to assess the unique needs of low-income Asian American and Pacific Islander patients in rural Hawaii. The electronic health literacy scale was also used among participants in the patients and family support/significant other groups. The total electronic health literacy means were 23.57 (SD = 9.71) among participants in the patient group, 34.50 (SD = 7.78) in the family support/significant others group, and 35.67 (SD = 4.56) in the providers group. The qualitative analysis yielded categories with three main themes: value of mobile health, stumbling blocks to mobile health, and mobile health wish list and subthemes. Practice implications include uses of these findings to integrate future versions of mobile health that will promote effective communication and information specifically to diverse low-income populations.
Negative-pressure Wound Therapy for Periocular Necrotizing Fasciitis
Authors: Gillespie John W. , Pandya Jui K. , Agarwal Shilpa M. , Gassman Andrew A. , Krakauer Mark
Published: December 2018

Periocular necrotizing fasciitis is a rare, but potentially blinding, or even fatal disease. The authors report a case of a 44-year-old man who presented with quiescent bilateral periocular and facial necrotizing fasciitis. The patient was treated with antibiotics and surgical debridement, followed by negative-pressure wound therapy (NPWT), until the wound bed was thought to be healthy enough to support bilateral upper eyelid full-thickness skin grafts. NPWT appeared to decrease local edema; speed reperfusion and granulation tissue formation; and served to stabilize the skin grafts against the wound bed, while not causing any ocular complications. NPWT can be a safe and effective adjunct treatment for periocular necrotizing fasciitis.
Is Nicotine Replacement a Safe Alternative to Smoking in Plastic Surgery Patients?
Authors: Michaels Basil M. , Craft Patrick , Michaels Julian A. , Csank George A.
Published: December 2018

Background:

E-cigarettes, nicotine transdermal patches, and nicotine chewing gum are occasionally used as cigarette replacements by patients, but it is unknown if their use is a safe alternative to smoking in the perioperative period.

Methods:

All patients undergoing major surgery at a single outpatient ambulatory surgery center for a 5-year period were tested for urine cotinine, a nicotine metabolite, the day of surgery. Patients were divided into 4 groups: never smoked (group A), quit smoking with negative urine test (group B), continued to smoke (group C), and quit smoking with positive urine test (group D). Statistical significance of complications among groups was tested using right tailed chi-square test and point biserial correlation coefficient calculations. To control for confounding factors, age and BMI of each group were compared using unequal sample size and variance t tests.

Results:

Four hundred seventy patients were included in the study. Patient count in each group was group A n = 380, group B n = 48, group C n = 32, and group D n = 10. Complication frequency was as follows D > C > A > B. Statistically significant differences were observed between D + C (cotinine positive) and A + B (cotinine negative) P = 0.0001 and between D (nicotine replacement) and B (nicotine abstinence) P = 0.00026. There was neither statistical difference between groups A and B, nor C and D.

Conclusions:

Nicotine replacement carries similar risks as continued smoking and is not as safe as abstinence in the perioperative period in plastic surgery patients. Importantly, patients who stopped smoking for the surgery had equivalent risk for postoperative complications as patients who had never smoked.
A Single‐center Review of Pediatric Colonoscopy Quality Indicators
Authors: Pasquarella Christine Seif , Kaplan Barbara , Mahajan Lori , Lamparyk Katherine , Kay Marsha
Published: December 2018

Objectives:

Colonoscopy with terminal ileal (TI) intubation is an important diagnostic and therapeutic tool in the care of children with digestive diseases, especially in those with inflammatory bowel disease. Ileal intubation rate is a recognized quality indicator for pediatric colonoscopy. Our primary aim was to identify our single‐center ileal intubation rate and to secondarily identify specific factors, including bowel preparation quality, procedure duration, and cecal intubation rates which affect successful ileal intubation and by extension, complete colonoscopy.

Methods:

A retrospective chart review of all colonoscopies in 2015 was completed, identifying 458 procedures. Sixty‐seven patients were excluded, resulting in 391 colonoscopies reviewed.

Results:

We analyzed 391 colonoscopy procedures with a mean patient age of 14.4 ± 5.3 years. The most frequent primary indications for colonoscopy included abdominal pain with “red flag” symptoms (35.5%), known inflammatory bowel disease (25.1%), and isolated abdominal pain (11.5%). Ileal intubation was achieved in 91% of all colonoscopies, with a 94.4% cecal intubation rate. Failure of ileal and cecal intubations was classified into 4 categories: disease‐related conditions, bowel preparation, technical aspects, and miscellaneous issues. Potentially modifiable factors accounted for the majority of cases of failed TI intubation. The mean colonoscopy time with and without successful TI intubation were 39 and 48.1 minutes, respectively.

Conclusions:

Completion of colonoscopy to the TI is an essential part of a complete colonoscopy. TI intubation was possible in 91% of patients. This rate could potentially improve to 95% with optimization of modifiable factors such as improving bowel preparation or further refinement of endoscopic skills.
Influenza A virus and related secondary bacterial infections
Authors: Sheykhsaran Elham , Hemmat Nima , Baghi Hossein Bannazadeh
Published: December 2018

Influenza infection is considered to be a serious respiratory disease in human. Annually, epidemics or even pandemics give rise to the frequent antigenetic variations of virus surface receptors, throughout the world. Bacterial infections followed by influenza are the biggest medical concerns associated with elevated mortality rates. These high morbidity and mortality rates, have become a priority in terms of health. Likewise, economic aspects of the issue have special importance also.

In the present study, several articles have been investigated with regards to main key words including influenza A, secondary bacterial infections and pandemics. Then, attempts have been made to summarize the information in concise figures (was graphically visualized) and tables in addition to main literature. Until this date, a number of influenza pandemics have taken place with varying morbidity and mortality rates because of secondary bacterial infections followed by influenza. However, the 1918 pandemic had the highest death rate recorded. According to investigative studies,Streptococcus pneumoniaeandStaphylococcus aureusare the most common isolated bacteria in patients with secondary infections. Other bacteria, such asHaemophilus influenza,Streptococcus pyogenes, and to a lesser degreeLegionellaspp., are involved in these infections as well. Currently, it is known that various protease enzymes intensify the influenza virus infectivity. Another important aspect of influenza occurs in the Hajj pilgrimage season and many vaccines have been made to deal with its consequences. These vaccines decrement the mortality rate, however, some have minor side effects.
Diagnostic Accuracy of 18F-FDG PET/CT in Patients With Biochemical Evidence of Recurrent, Residual, or Metastatic Medullary Thyroid Carcinoma
Authors: Rodríguez-Bel Laura , Sabaté-Llobera Aida , Rossi-Seoane Susana , Reynés-Llompart Gabriel , Vercher Conejero José Luis , Cos-Domingo Mònica , Moreno-Llorente Pablo , Pérez-Maraver Manuel , Cortés-Romera Montserrat , Gámez Cenzano Cristina
Published: December 2018

Objective

Medullary thyroid carcinoma (MTC) is a rare malignancy. Location of residual, recurrent, or metastatic disease is crucial to treatment management and outcome. We aimed to evaluate the use of 18F-FDG PET/CT in localizing MTC foci in patients with biochemical relapse.

Methods

This is a retrospective cohort study. Review of 51 FDG PET/CT studies of 45 patients referred to restage MTC due to increased calcitonin (Ctn) and carcinoembryonic antigen (CEA) values at follow-up. FDG PET/CT diagnostic accuracy was determined through a patient-based analysis, using histology as criterion standard when available, or other imaging studies and clinical follow-up otherwise (mean, 4 years).

Results

There were 25 positive scans. Sensitivity, specificity, positive and negative predictive values, diagnostic accuracy, and positive likelihood ratio were 66.7%, 83.3%, 88.0%, 57.7%, 72.5%, and 4.0, respectively. Using a Ctn cutoff of 1000 pg/mL, sensitivity increased to 76.9%. There were significant differences of Ctn and CEA values between positive and negative FDG PET/CT (P < 0.05). Regarding true-positive studies, average SUVmax comparing locoregional and metastatic disease was at the limit of significance (P = 0.046).

Conclusions

PET/CT can be useful to restage patients with biochemical relapse of MTC, with a better performance in higher Ctn levels. Its high positive predictive value (88%) may impact in the therapeutic management, although its low negative predictive value (57.7%) makes strict follow-up mandatory in examinations without pathologic findings.
Fast-track Radioiodine Ablation Therapy After Thyroidectomy Reduces Sick Leave in Patients With Differentiated Thyroid Cancer (FASTHYNA Trial)
Authors: Waissi Farahnaz , Kist Jakob W. , Lodewijk Lutske , de Wit Ardine G. , van der Hage Jos A. , van Dalen Thijs , de Keizer Bart , Valk Gerlof D. , Borel Rinkes Inne H. M. , Vriens Menno R.
Published: December 2018

Background

Recombinant human thyroid stimulating hormone (RhTSH) aided radioiodine ablative therapy (RIT) is current-day practice in the treatment of differentiated thyroid cancer (DTC). It is often planned 4 to 6 weeks after surgery or sometimes even longer (standard protocol). The RhTSH-aided RIT, however, has the advantage that it can be planned shortly after thyroidectomy. The FASTHYNA trial was designed to test the hypothesis that RIT 1 week after thyroidectomy (fast-track protocol) results in a significant reduction of sick leave with lower societal costs and with a better quality of life (QOL) compared with the current standard treatment.

Methods

In a randomized, multicenter trial, we included patients with differentiated thyroid cancer, stage T1–3 N0–1 M0-x, who were treated with a total or completion thyroidectomy, with a paid job of at least 12 hours per week. The primary study end point was days of sick leave reported from time of surgery. Secondary end points were QOL and societal costs associated with absence from work.

Results

Twenty patients were eligible for inclusion between November 2013 and May 2016. Significant decreases in mean duration of sick leave in the fast-track group versus the standard care group (115 and 280 hours, respectively, P = 0.02) and in costs associated with productivity losses (€4070.77 vs €9202.90, P = 0.02) were found. There were no significant differences in QOL between both groups.

Conclusions

The trial showed a significant reduction in sick leave and in societal costs in the fast-track group without a deterioration of QOL. Therefore, fast-track ablation is desirable.

Trial Registration: Netherlands trial register: NTR 3933.
Evaluation of Vascular Parameters in Patients With Pulmonary Thromboembolic Disease Using Dual-energy Computed Tomography
Authors: Nallasamy Navi , Bullen Jennifer , Karim Wadih , Heresi Gustavo A. , Renapurkar Rahul D.
Published: December 2018

Purpose:

The purpose of this study was to evaluate patterns of vascular and lung parenchymal enhancement in patients with suspected chronic thromboembolic pulmonary hypertension (CTEPH) and in those with acute pulmonary embolism (PE) and compare those two groups.

Materials and Methods:

We retrospectively studied 186 thoracic DECT studies referred for evaluation of CTEPH or pulmonary hypertension. A total of 80 of these patients had a negative scan (control group), 13 had acute PE, and 53 had chronic thromboembolic disease (CTED)/CTEPH. Five different DECT-based parameters were evaluated that highlight patterns of vascular kinetics. Specifically, total DECT-based parenchymal attenuation in Hounsfield Unit (HU) (LungHU), percentage of perfused blood volume (PBV), peak enhancement of main pulmonary artery (PApeak in HU), maximum enhancement corresponding to 100 (PAmax), and the ratio of PApeak to LungHU were calculated.

Results:

Compared with patients with negative CT, patients with CTED/CTEPH tended to have lower LungHU (median: 27 vs. 38, P<0.001), lower PBV (median: 39 vs. 51, P=0.003), and higher PApeak/LungHU ratio (median: 17 vs. 13, P=0.003). Compared with patients with acute PE, patients with CTED/CTEPH tended to have lower LungHU (median: 27 vs. 39, P=0.006), lower PBV (median: 39 vs. 62, P=0.023), and higher PApeak/LungHU ratio (median: 17 vs. 11, P=0.023). No statistically significant differences were observed between patients with acute PE and those with negative CT.

Conclusions:

DECT-based vascular parameters offer the potential to differentiate patients with acute versus chronic PE. These various anatomic and functional vascular DECT-based parameters might be reflective of the state of the underlying vascular bed.
Errors in Interpretation of Magnetic Resonance Imaging for Thymic Lesions
Authors: Hammer Mark M. , Barile Maria , Bryson Wesley , Bhalla Sanjeev , Raptis Constantine A.
Published: December 2018

Purpose:

The objectives of this study were to evaluate the magnetic resonance imaging (MRI) features of thymic lesions and to review those features that may result in diagnostic uncertainty or error.

Materials and Methods:

This multicenter retrospective study included patients with pathologically proven thymic epithelial neoplasms (TEN) and thymic cysts who underwent preoperative MRI. Clinical reports were evaluated for the radiologist’s first-choice diagnosis, if not already known before the MRI. MR images were reviewed by thoracic radiologists to identify cystic components on T2-weighted imaging (T2WI) as well as the presence of enhancement on postcontrast series.

Results:

Through a search of electronic medical records of 3 tertiary academic medical centers, we identified 41 TEN and 13 cysts. Of 35 evaluable clinical reports, 9 (26%) gave an incorrect diagnosis. Of these, 5 cases were misdiagnosed related to contrast enhancement, and 3 cases of cysts were misdiagnosed because of lack of fluid signal on T2WI. Upon rereview of images, of the 41 TENs, 4 (10%) did not show qualitative enhancement on the first postcontrast phase (although all enhanced eventually), and 4 cysts (31%) did not show fluid signal on T2WI. In addition, 4 cases of cysts (31%) showed mural or septal enhancement.

Conclusions:

Although atypical or misleading imaging features are uncommon in TEN and thymic cysts, they do occur and may lead to diagnostic error. We suggest that lesions with a T2 signal less than simple fluid and without enhancement on postcontrast images undergo follow-up imaging to confirm a benign diagnosis.