bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary or Redo Posterior Sagittal Anorectoplasty without a Stoma: To Feed or Not to Feed?
Authors: Skerrit Clare , Dingemans Alexander , Lane Victoria , Sanchez Alejandra , Weaver Laura , Wagner Andrea , Jenkins Nicole , Wood Richard , Levitt Marc , Reck-Burneo Carlos
Published: December 2017

Introduction Repair of anorectal malformations (ARMs), primarily or with a reoperation, may be performed in certain circumstances without a diverting stoma. Postoperatively, the passage of bulky stool can cause wound dehiscence and anastomotic disruption. To avoid this, some surgeons keep patients NPO (nothing by mouth) for a prolonged period. Here, we report the results of a change to our routine from NPO for 7 days to clear fluids or breast milk.

Materials and Methods After primary or redo ARM surgery, patients given clear liquids were compared to those who were kept strictly NPO. Age, indication for surgery, incision type, use of a peripherally inserted central catheter (PICC) line, and wound complications were recorded.

Results There were 52 patients, including 15 primary and 37 redo cases. Group 1 comprised 11 female and 15 male patients. The mean age at surgery was 4.9 years (standard deviation [SD]: 2.3). There were 8 primary cases and 18 redo cases. Twelve (46.6%) received a PICC line. The average start of clear liquids was on day 5.3 (SD: 2.2) after examination of the wound, and the diet advanced as tolerated. The first stool passage was recorded on average on day 2.3 (SD: 1.3). Four minor wound complications and no major wound complications occurred.

Group 2 comprised 14 females and 12 male patients. The mean age at surgery was 3.5 (SD: 2.4) years. There were 7 primary and 19 redo cases. One (3.8%) patient required a PICC line. A clear liquid diet was started within 24 hours after surgery. A regular diet was started on average on day 5.8 (SD: 1.3). The first stool passage was recorded on an average of day 1.6 (SD: 0.9). Three minor wound complications occurred; however, there was no significant difference between the two groups (SD: 0.71). One major wound complication occurred. However, there was no significant difference in major wound complications between the groups (SD: 0.33).

Conclusion No increase in wound problems was noted in children receiving clear liquids or breast milk compared with the strict NPO group, and PICC line use was reduced. We believe this change in practice simplifies postoperative care without increasing the risk of wound complications.
Impact of Surgery on Growth, Pulmonary Functions, and Acute Pulmonary Exacerbations in Children with Non-Cystic Fibrosis Bronchiectasis
Authors: Dogru Deniz , Yalcin Songul , Tugcu Gokcen , Yalcin Ebru , Ozcelik Ugur , Ekinci Saniye , Kiper Nural , Emiralioglu Nagehan
Published: December 2017

Background Treatment decisions for the management of bronchiectasis include medical treatment, such as antibiotics, chest physiotherapy, and surgical procedures. Here, we aimed to review the effect of lung resection on longitudinal growth, clinical course of patients depending on annual exacerbation rates, and pulmonary function tests (PFTs) and compare them with the results of only medically treated children with non-cystic fibrosis (non-CF) bronchiectasis.

Methods The medical records of patients with non-CF bronchiectasis were retrospectively analyzed. Patients who underwent lobectomy/segmentectomy/pneumonectomy were categorized as “surgery group” (n = 29). Age- and gender-matched patients who were only medically treated were selected as “medical group” (n = 33). Annual data of patients were included till the end of postoperative second year in the surgery group and third year of medical treatment in the medical group.

Results Mean baseline height z-score was lower in the surgery group, and mean baseline PFT values were all lower in the surgery group than those in the medical group (p < 0.05). In the surgery group, mean values of height z-score were –1.68 ± 0.92 at the time of surgery and improved to –1.42 ± 1.22 and –1.34 ± 1.05 in the first and second postoperative years, respectively, and annual intravenous antibiotic requirements decreased significantly (p < 0.05); however, mean body mass index (BMI) z-score values and PFT parameters did not change significantly. In the medical group, height z-score mean values and PFT parameters showed nonsignificant improvement but annual exacerbation frequency, annual intravenous, and oral antibiotic requirements decreased significantly.

Conclusion Surgical management of non-CF bronchiectasis has no significant effect on BMI z-scores, annual exacerbation frequencies, oral antibiotic requirements and lung function tests; but can lead to significant improvement on height z-scores and decrease need of annual intravenous antibiotic requirements for acute severe exacerbations despite small number of patients in this study.
Meerrettich (Armoracia rusticana)
Authors: Nieber Karen
Published: December 2017

Die im Meerrettich enthaltenen Senföle wirken antibiotisch, ohne Resistenzbildung
Kunsttherapie in der Palliativversorgung. Ein narratives Review. Teil I: Forschungsstand
Authors: Kortum Ria , Koch Sabine , Gruber Harald
Published: December 2017

Kunsttherapie (Therapie mit bildnerischen Medien) wird in der Palliativversorgung seit über 30 Jahren angeboten und im Rahmen der palliativen Komplexbehandlung (OPS 9–982) neben anderen begleitenden Therapiemaßnahmen empfohlen. Entgegen einer breiten praktischen Erfahrung ist ihre Wirkung bisher jedoch wissenschaftlich kaum untersucht. Auf Basis einer systematischen Datenbankrecherche wurde der aktuelle Forschungs- und Erfahrungsstand ermittelt und in 2 Übersichtsarbeiten aufgeteilt. In dieser Publikation liegt der Schwerpunkt auf der Methodik zur Erstellung des Reviews und der Darstellung des Forschungsstands. Unter insgesamt 82 internationalen Artikeln konnten 5 an größeren Stichproben durchgeführte Studien gefunden werden, in denen sich positive Effekte von Kunsttherapie auf Depression, Traurigkeit, Ängste, Müdigkeit, Fatigue, Wohlbefinden, Krankheitsgefühl und Schmerz aufzeigen ließen. Eine Validierung dieser Befunde durch Kontrollgruppenstudien steht in der Mehrzahl der Fälle noch aus. Als erste positive Befunde sind diese Ergebnisse jedoch eine wichtige Grundlage für weitere Studien und damit zur Evidenzbasierung der Kunsttherapie in der Palliativversorgung.
Reiserückkehrer mit Denguefieber: Diagnostik und Therapieoptionen
Authors: Kroidl Inge
Published: December 2017

An eine Dengueinfektion sollte bei allen Symptomen, die 3–14 Tage nach einer Reise in die endemischen Länder auftreten, gedacht werden. Auch Symptome, die zunächst nicht an Dengue denken lassen, wie zum Beispiel ophthalmologische Beschwerden oder Enzephalopathien, kommen vor. Hingegen sind andere, im Allgemeinen als typisch geltende Zeichen für die Infektion, wie zum Beispiel das Dengueexanthem oft kaum sichtbar und auch bei anderen viralen Erkrankungen vorhanden. Die erhöhte transiente kapillare Durchlässigkeit während der kritischen Phase führt zu Organvergrößerungen und Verdickung von Schleimhäuten. Die hierbei auftretenden Symptome wie abdomineller Schmerz, Abwehrspannung, Erbrechen sowie Befunde wie Hepatomegalie, Aszites und Pleuraergüsse sind typisch für die kritische Phase der Dengueinfektion, können aber leicht an andere Krankheiten denken lassen. Die Entwicklungen einer Schocksymptomatik und weitere Komplikationen können durch die rechtzeitige Erkennung von Warnzeichen und eine adäquate Therapie verhindert beziehungsweise in der Häufigkeit reduziert werden. Die Zahl der schweren Verläufe des Denguefiebers ist bei Touristen gering, aus den Epidemieländern werden höhere Zahlen gemeldet, insbesondere bei Kindern.
Höhenanpassung und Vorhersage, an akuter Höhenkrankheit zu erkranken
Authors: Schneider Jörg
Published: December 2017

Einfache Vorhersagemöglichkeiten zum Risiko, an akuter Höhenkrankheit (acute mountain sickness, AMS) zu erkranken, fehlen bisher. Es ist zwar bekannt, dass verschiedene Menschen sich unterschiedlich schnell oder auch gar nicht an große Höhen anpassen können. Eine individuelle Vorhersage ist aber nicht möglich, auch nicht mit der viel propagierten Messung der peripheren Sauerstoffsättigung. Mit einer Ausnahme: Wer früher schon einmal an AMS gelitten hat, hat bei erneuter Höhenexposition ein erhöhtes Risiko. Fitness, Alter, Geschlecht oder Rauchen dagegen erhöhen das Risiko nicht.
Auswirkungen des altersbezogenen kornealen Elastizitätsmoduls auf die Applanationstonometrie
Authors: Sperlich Karsten , Reiß Stephan , Bohn Sebastian , Stolz Heinrich , Guthoff Rudolf , Jünemann Anselm , Stachs Oliver
Published: December 2017

Der intraokulare Druck (IOP) wird als wichtigster modifizierbarer Risikofaktor für eine Glaukomerkrankung angesehen. Die IOP-Bestimmung durch eine Applanationstonometrie wird aufgrund der individuellen Variation der zentralen Hornhautdicke (CCT) mittels entsprechender Korrekturtabellen korrigiert. Dagegen werden andere Fehler, beispielsweise hervorgerufen durch altersabhängige Veränderung des Elastizitätsmoduls (EM) der Kornea, ignoriert. Ausgehend von Formeln der experimentellen Physik wird im Rahmen dieser Arbeit ein numerisches analytisches Modell entwickelt, welches die Wirkung bekannter Einflussgrößen auf die IOP-Bestimmung insbesondere unter Einbeziehung der elastischen Eigenschaften berücksichtigt. Dabei werden die für die Modellentwicklung notwendigen erforderlichen Annahmen eingeführt und begründet sowie die für eine korrekte IOP-Bestimmung notwendigen Korrekturwerte berechnet. Unsere Korrekturwerte stimmen für CCT-Werte bis 650 µm und einem mittleren kornealen Elastizitätsmodul von 0,29 MPa gut mit der Dresdner Tabelle überein. Eine Variation des EM von 0,2 – 0,5 MPa, was einem EM vom Kindesalter bis zum Alter von 90 Jahren entspricht, verursacht eine Abweichung des IOP von bis zu 10 mmHg. Eine Variation des Krümmungsradius der Hornhaut von 7,4 – 8,0 mm entspricht dagegen einer IOP-Änderung von nur 3 mmHg und kann vernachlässigt werden. Das entwickelte Modell zeigt, dass etablierte Korrekturformeln für eine zuverlässige Bestimmung des IOP unzureichend sein können. In vielen Fällen ist die gängige Praxis der IOP-Bestimmung zuverlässig, aber die durch CCT und EM möglicherweise induzierten Messunsicherheiten liegen etwa im gleichen Größenbereich. Den IOP durch Applanationsmethoden unter Nutzung von etablierten Korrekturformeln zu bestimmen, sollte daher nicht überbewertet werden, ohne den EM der Kornea zu berücksichtigen.
5 Fachleute – 4 Behandlungsmethoden - Wundinfektionen
Authors: Dorstewitz Hartmut , Ghotbi Reza , Mansour Riad , Stör Wolfram , Lachmann Michael
Published: December 2017

Wundinfektionen
Simultaneous Determination of Rosuvastatin, Rosuvastatin-5 S-lactone, and N-desmethyl Rosuvastatin in Human Plasma by UPLC-MS/MS and Its Application to Clinical Study
Authors: Bai Xue , Wang Xi-Pei , He Guo-Dong , Zhang Bin , Huang Min , Li Jia-Li , Zhong Shi-Long
Published: December 2017

Objective A rapid and sensitive ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) assay was developed and validated for the simultaneous quantification of rosuvastatin (RST), rosuvastatin-5 S-lactone (RSTL), and N-desmethyl rosuvastatin (DM-RST) in human plasma.

Methods Sample was prepared by liquid-liquid extraction with ethyl acetate from 100 μL acidulated buffered plasma. Then analytes were chromatographically separated using an Acquity UPLC HSS T3 column (3.0 mm×100 mm, 1.8 µm) by 0.1% formic acid and gradient acetonitrile at a flow rate of 0.30 mL/min. Three analytes and internal standards (carbamazepine) were eluted in 3.5 min. Mass spectrometry detection was performed through positive ion electrospray ionization (ESI).

Results The calibration curves for three analytes were linear (R≥0.9987, n=3) within the concentration range of 0.1–50 ng/mL for RST and RSTL, and 0.2–100 ng/mL for DM-RST. Mean extraction recoveries were enhanced by means of acidulated plasma using ammonium acetate of pH 4.0, which ranged within 75.3–98.8% for three analytes. Intra- and inter precision and accuracy were 88.2–96.4%.

Conclusions This present method was lower LLOQ, less time consuming (3.5 min), less plasma consuming (100 µL) and simpler sample preparation. And it was successfully applied to determine steady state concentrations of RST, RSTL and DM-RST in a clinical study of RST for patients with coronary artery disease (CAD).
Insights from ‘policy learning’ on how to enhance the use of evidence by policymakers
Authors: Witting Antje
Published: December 2017

This article uses the policy-oriented learning literature to provide  practical insights on how to enhance the use of evidence by policymakers. After a short introduction to the field, this article presents four steps to understanding and responding to policy learning. First, all people interpret the world through the lens of their beliefs, and learn by combining heuristics and analytical processing. Second, people learn in different ways according to their roles. A novice would not be advised to learn about a specialist isue in the same way as a scientist. Instead, a modified  communication strategy would be used to ensure understanding and uptake of evidence. Third, learning is a political process: we interact with our social environment and some actors—including entrepreneurs and brokers—influence the process more than others. Therefore, to encourage learning from scientific evidence we need to move beyond communication towards entrepreneurship and brokerage roles. In other words, policy-oriented learning is as much about interaction and leadership as information.
Optimization and limit of a tilt manipulation stage based on the electrowetting-on-dielectric principle
Authors: Tan Xiao , Tao Zhi , Suzuki Kenji , Li Haiwang
Published: December 2017

This work designed a new tilt manipulation stage based on the electrowetting-on-dielectric (EWOD) principle as the actuating mechanism and investigated the performance of that stage. The stage was fabricated using a universal MEMS (Micro-Electro-Mechanical System) fabrication method. In the previously demonstrated form of this device, the tilt stage consisted of a top plate that functions as a mirror, a bottom plate that was designed for changing the shape of water droplets, and supporters that were fixed between the top and bottom plate. That device was actuated by a voltage applied to the bottom plate, resulting in a static electric force actuating the shape change in the droplets by moving the top plate in the vertical direction. Previous experimental results indicated that that device can tilt at up to ±1.8°, with a resolution of 7 μm in displacement and 0.05° in angle. By selecting the best combination of the dielectric layer, the tilt angle was maximized. The new device, fabricated using a common and straightforward fabrication method, avoids deflection of the top plate and grounding in the bottom plate. Because of the limit of Teflon and other MEMS materials, this device has a tilt angle in the range of 3.2-3.5° according to the experimental data for friction and the EWOD device limit, which is close to 1.8°. This paper also describe the investigation of the effects of various parameters, e.g., various dielectric materials, thicknesses, and droplet type and volume, on the performance of the stage. The results indicate that the apparent frictions coefficient of the solid-liquid interface may remain constant, i.e., the friction force is proportional to the normal support force and the apparent frictions coefficient.
Quantification of methane emissions from Murrah buffaloes fed different energy diets during various temperature humidity index periods in a tropical environment
Authors: Talukdar Papori , Kundu Shivlal Singh , Mondal Goutam
Published: December 2017

The objective of the present study was to quantify the enteric methane emission in Murrah buffalo heifers at high (summer) and low (winter) temperature humidity index (THI) period fed different energy level diets. Thirty-six growing Murrah buffalo heifers of average bodyweight (158.51 ± 16.5 kg) were distributed into three groups of six animals each separated based on their bodyweight and fed for the period of 120 days each during summer (high THI, 78–85) and winter (low THI, 50–61). The animals were fed on three different levels of metabolisable energy (ME) content and the Control ration (T1) having ME content according to ICAR (2013) and T2 and T3 were having 115% and 85% ME than the Control respectively, in total mixed-based ration. The SF6 tracer gas technique was used to quantify the enteric methane emission by the animals. Methane emission (g/day) of Control and the high energy (T1 and T2) group was lower (P < 0.05) than the low energy (T3) fed group in both seasons. Methane losses as percentage of gross energy intake was lower (P < 0.01) during the winter season. However, in the low energy treatment group (T3) at both seasons these values are higher than the IPCC recommended value (6.5%) for calculation of national inventory of greenhouse gas emission from enteric sources. In between season average daily gain (kg) was higher (P < 0.01) in the winter season and among the treatment groups it was higher (P < 0.01) in the high energy group (T1, T2). Higher (P < 0.01) digestibility of dry matter, organic matter, neutral detergent fibre and acid detergent fibre was reported in the Control and high energy-fed group. Whereas in the summer season digestibility of dry matter, organic matter, crude protein and acid detergent fibre was higher (P < 0.01) than in the winter season. It can be concluded that energy levels significantly (P < 0.05) affect methane emissions and was lower in the Control and high energy-fed group (T1 and T2). However, while quantifying methane emission in changing THI period at different seasons it did not show any significant variation.
Physiological response of Arundo donax L. to thallium accumulation in a simulated wetland
Authors: Pu Gaozhong , Zhang Denan , Zeng Danjuan , Xu Guangping , Huang Yuqing
Published: December 2017

A simulated wetland experiment was used to investigate the effect of thallium (Tl) accumulation on the growth of Arundo donax L., its photosynthetic characteristics and its antioxidant enzyme activities. Tl accumulated in the order of stems<leaves<roots and increased gradually with increasing Tl concentrations (from 0 to 2.5µgL–1). Moderate Tl applications (from 0.2 to 2.5µgL–1) increased the rate of both photosynthesises (Pn) and transpiration (Tr), as well as catalase and peroxidase activity. Tl significantly affected stomatal conductivity, but had no effect on the relative chlorophyll content (SPAD values) or the potential and effective photochemical efficiency of photosystem II. However, intercellular CO2 concentrations and superoxide dismutase decreased in response to increasing Tl concentrations. Although 50µgL–1 Tl significantly decreased the SPAD values, as well as the potential and effective photochemical efficiency of photosystem II, it had no effect on Pn or Tr. These results suggest that root restriction and oxidative stress are involved in the mechanism of Tl toxicity, but the photosynthetic system of A. donax was not harmed by certain concentrations of Tl, indicating the strong tolerance of this species to increased Tl pollution.
Examining trends in abundance of an overexploited elasmobranch species in a nursery area closure
Authors: McAllister Jaime D. , Barnett Adam , Lyle Jeremy M. , Stehfest Kilian M. , Semmens Jayson M.
Published: December 2017

Determining the dynamics of ecological communities following periods of anthropogenic change is critical to assessing the effectiveness of management strategies. Several coastal areas in south-eastern Australia were proclaimed shark refuge areas (SRAs) following overfishing of the school shark (Galeorhinus galeus) during the 1940s and 1950s. In conjunction with catch reduction measures, these areas provide spatial protection for juvenile G. galeus. In the present study, we compared recent (2012–14) and historic (1991–97) longline catch rates to determine whether young-of-year (YOY) and juvenile G. galeus continue to use these nursery areas (42°47′60.00″S, 147°30′0.00″E). Our data suggest that YOY abundances in the SRAs may have increased, or at least have remained stable, since the 1990s. Data from research fishing conducted from 1947 to 1956 showed that YOY abundance in the SRA correlated well with overall stock abundance in the past. If this relationship still holds, our longline data indicate that the stock may be showing signs of recovery. However, the present-day importance of the SRA to overall stock recruitment, as well as the relationship between YOY abundance in the SRA and stock health, need to be resolved before monitoring of YOY abundance in the SRA can be used as a fisheries-independent stock-assessment tool.
Human–carnivore competition for antlered ungulates: do pumas select for bulls and bucks?
Authors: Elbroch L. Mark , Feltner Jennifer , Quigley Howard
Published: December 2017

Context
Many institutions of wildlife management and their hunting constituents tend to value ungulates over large carnivores, in part due to financial incentives associated with ungulate hunting over carnivore hunting. This system benefits from mythology that presents large carnivores as competitors for antlered male ungulates most prized by the hunting community.

Aims
We explored puma (Puma concolor) foraging and prey selection in two study areas in the Rocky Mountains, USA, to test whether pumas were competing with human hunters for antlered elk (Cervus elaphus) and mule deer (Odocoileus hemionus).

Methods
We employed GPS technology to track pumas and document their prey. We measured population- and individual-level selection by comparing prey killed by pumas to two estimates of prey availability: (1) landscape-level as determined by annual agency game counts; and (2) total prey killed by marked pumas.

Key results
Pumas in both study systems killed small numbers of antlered elk and mule deer. Pumas exhibited avoidance of mature elk, instead strongly selecting for elk calves over any other age or sex class. Pumas in both systems also selected for mule deer fawns; however, they also exhibited small positive selection (Jacob’s index of 0.08 in CO and 0.11 in WY on a scale of 0.0–1.0) for antlered mule deer.

Conclusions
In terms of numbers killed, pumas were not a competitor with human hunters for either antlered species. In terms of prey selection, pumas showed that they may be greater competition for rare antlered mule deer but not for antlered elk. In both study sites, antlered elk and deer remained at levels at which they could perform their ecological functions.

Implications
Our results highlight the fact that the overhunting of large carnivores over competition for antlered ungulates is mostly unfounded; we should instead focus management, media attention and conservation science on disentangling the complex ecology driving localised declines of mule deer, elk and other important ungulate resources, many of which are anthropogenic in nature and can be addressed.
De Novo Transcriptome Study Identifies Candidate Genes Involved in Resistance to Austropuccinia psidii (Myrtle Rust) in Syzygium luehmannii (Riberry)
Authors: Tobias Peri A. , Guest David I. , Külheim Carsten , Park Robert F.
Published: December 2017

Austropuccinia psidii, causal agent of myrtle rust, was discovered in Australia in 2010 and has since become established on a wide range of species within the family Myrtaceae. Syzygium luehmannii, endemic to Australia, is an increasingly valuable berry crop. Plants were screened for responses to A. psidii inoculation, and specific resistance, in the form of localized necrosis, was determined in 29% of individuals. To understand the molecular basis underlying this response, mRNA was sequenced from leaf samples taken preinoculation, and at 24 and 48 h postinoculation, from four resistant and four susceptible plants. Analyses, based on de novo transcriptome assemblies for all plants, identified significant expression changes in resistant plants (438 transcripts) 48 h after pathogen exposure compared with susceptible plants (three transcripts). Most significantly up-regulated in resistant plants were gene homologs for transcription factors, receptor-like kinases, and enzymes involved in secondary metabolite pathways. A putative G-type lectin receptor-like kinase was exclusively expressed in resistant individuals and two transcripts incorporating toll/interleukin-1, nucleotide binding site, and leucine-rich repeat domains were up-regulated in resistant plants. The results of this study provide the first early gene expression profiles for a plant of the family Myrtaceae in response to the myrtle rust pathogen.
Bipartite Talus: Arthroscopic Resection – Case Report
Authors: de Oliveira Junior Adilson Sanches , Moreira Mendes Alberto A. , Saito Guilherme H. , Prado Marcelo P.
Published: December 2017

Background:

Bipartite talus is a rare entity. The etiology is uncertain. The definition is a large bone fragment that occupies the posterior portion of the talus and reaches the posterior subtalar joint.

Case Report:

We report a symptomatic bipartite talus in a female patient, 41 years old, treated with arthroscopic resection.

Discussion:

Posterior hindfoot arthroscopy has gained more popularity in the treatment of foot and ankle pathologies. Indeed, this is a secure and useful tool for the surgeon. In this report, we described the use of this technique for resection of a large bone fragment (bipartite talus).

Conclusions:

We present in detail the arthroscopic resection of a bipartite talus. This is an unusual pathology and a differential diagnosis for posterior impingement. We believe that arthroscopic resection of the bone fragment of the bipartite talus is a safe procedure, with less morbidity for the patient, compared with open resections.

Level of Evidence:

Level V—technique description.
Preclinical Assessment of CAR T-Cell Therapy Targeting the Tumor Antigen 5T4 in Ovarian Cancer
Authors: Owens Gemma L. , Sheard Victoria E. , Kalaitsidou Milena , Blount Daniel , Lad Yatish , Cheadle Eleanor J. , Edmondson Richard J. , Kooner Gurdeep , Gilham David E. , Harrop Richard
Published: December 2017

Chimeric antigen receptor (CAR) T cells represent a novel targeted approach to overcome both quantitative and qualitative shortfalls of the host immune system relating to the detection and subsequent destruction of tumors. The identification of antigens expressed specifically on the surface of tumor cells is a critical first step in the ability to utilize CAR T cells for the treatment of cancer. The 5T4 is a tumor-associated antigen which is expressed on the cell surface of most solid tumors including ovarian cancer. Matched blood and tumor samples were collected from 12 patients with ovarian cancer; all tumors were positive for 5T4 expression by immunohistochemistry. Patient T cells were effectively transduced with 2 different anti-5T4 CAR constructs which differed in their affinity for the target antigen. Co-culture of CAR T cells with matched autologous tumor disaggregates resulted in antigen-specific secretion of IFN-gamma. Furthermore, assessment of the efficacy of anti-5T4 CAR T cells in a mouse model resulted in therapeutic benefit against established ovarian tumors. These results demonstrate proof of principle that 5T4 is an attractive target for immune intervention in ovarian cancer and that patient T cells engineered to express a 5T4-specific CAR can recognize and respond physiologically to autologous tumor cells.
Involvement of adenosine triphosphate-sensitive potassium channels in the neuroprotective activity of hydrogen sulfide in the 6-hydroxydopamine-induced animal model of Parkinson’s disease
Authors: Sarookhani Mohammad Reza , Haghdoost-Yazdi Hashem , Sarbazi-Golezari Ali , Babayan-Tazehkand Arvin , Rastgoo Nafiseh
Published: December 2017

Studies have shown that hydrogen sulfide (H2S) exerts a neuroprotective effect and may have a therapeutic value for treating neurodegenerative diseases including Parkinsonʼs disease. However, little is known about the mechanisms underlying the neuroprotective activity of H2S in vivo. Here, we evaluated the effect of glibenclamide, an ATP-sensitive potassium channel blocker, on the neuroprotective activity of H2S in the 6-hydroxydopamine (6-OHDA) animal model of Parkinsonʼs disease. 6-OHDA was administered by stereotaxic surgery into the medial forebrain bundle. Sodium hydrosulfate (NaHS, 3 and 5.6 mg/kg), as a donor of H2S, alone or in combination with glibenclamide (5 mg/kg), was daily injected for 7 days starting 1–2 h before the stereotaxic surgery. After an apomorphine-induced rotational test, the number of tyrosine hydroxylase-positive neurons in the substantia nigra pars compacta was determined by immunofluorescence. The striatal dopamine level and oxidative stress markers were also measured in brain homogenates. Pretreatment with NaHS significantly attenuated 6-OHDA-induced motor asymmetry in the rotational test. Histological and biochemical evaluations demonstrated that NaHS, especially at high dose, increased the survival of tyrosine hydroxylase-positive neurons in the substantia nigra pars compacta and reduced the decreasing effect of 6-OHDA on striatal dopamine levels. However, co-administration of glibenclamide reversed the antiparkinsonian and neuroprotective effects of NaHS. However, glibenclamide did not change the reducing effect of NaHS on 6-OHDA-induced overproduction of malondialdehyde. Our data show that ATP-sensitive potassium channels are involved in the antiparkinsonian and neuroprotective effects of H2S in the 6-OHDA animal model of Parkinsonʼs disease.
COMPARISON AMONG DIFFERENT DIAGNOSTIC METHODS IN THE STUDY OF TYPE AND ACTIVITY OF CHOROIDAL NEOVASCULAR MEMBRANES IN AGE-RELATED MACULAR DEGENERATION
Authors: Ravera Vittoria , Giani Andrea , Pellegrini Marco , Oldani Marta , Invernizzi Alessandro , Carini Elisa , Cigada Mario , Bottoni Ferdinando , Staurenghi Giovanni
Published: December 2017

Purpose:

To determine interobserver and intraobserver agreement in classifying the subtypes of choroidal neovascularization (CNV) and the decision of retreatment in patients affected by exudative age-related macular degeneration. Different imaging techniques were evaluated individually and compared with multiimaging.

Methods:

Fifty-two patients with naive CNV in age-related macular degeneration were evaluated after 3 monthly intravitreal injections of ranibizumab. Choroidal neovascularization subtype and activity were evaluated using spectral domain optical coherence tomography, infrared light, fundus autofluorescence, fluorescein angiography (FA), and indocyanine green angiography (ICGA). The evaluation was performed independently by 10 different retina specialists, 2 for each test. Other two operators analyzed all the information available together.

Results:

The interobserver k regarding the types of CNV was 0.69 for multiimaging, 0.63 for spectral domain optical coherence tomography, 0.43 for FA, and 0.46 for ICGA. The k values for interobserver for retreatment decision were 0.77 for multiimaging, 0.88 for spectral domain optical coherence tomography, 0.61 for infrared, 0.37 for fundus autofluorescence, 0.25 for FA, and 0.23 for ICGA. Fluorescein angiography, spectral domain optical coherence tomography, ICGA, and infrared showed good association with multiimaging on defining CNV activity (P = 0.0003, P < 0.0001, P = 0.01, and P = 0.05, respectively).

Conclusion:

Optical coherence tomography and infrared evaluations of CNV activity were reproducible and strongly associated with multiimaging, whereas FA and ICGA evaluations showed poor reproducibility.
RETINAL TELANGIECTASIA IN PATIENTS WITH PATHOLOGIC MYOPIA
Authors: Lei Boya , Gu Ruiping , Jiang Chen , Xu Gezhi
Published: December 2017

Purpose:

To describe the characteristics of retinal telangiectasia in eyes with pathologic myopia.

Methods:

The study included 10 patients (18 eyes) who were diagnosed with pathologic myopia combined with retinal telangiectasia. The patients visited our retinal clinic every 3 months. Nine eyes underwent vitrectomy for vision-threatening complications after diagnosis. All eyes underwent comprehensive ophthalmologic examinations including multimodal retinal imaging at presentation and at each follow-up.

Results:

Retinal telangiectasia in pathologic myopia was characterized by saccular aneurysmal dilatation of the capillary bed without hard exudates in color fundus photographs and hyporeflective saccular structure in infrared reflectance fundus photographs, and it was filled in the early retinal arteriovenous phase with minimal dye leakage in the late phase of fundus fluorescein angiography. Spectral domain optical coherence tomography and optical coherence tomographic angiography showed that retinal telangiectasia was primarily located in the superficial retina, together with myopic traction maculopathy. In the 9 eyes that underwent vitrectomy, the retinal telangiectasia regressed within 3 months of surgery. Retinal telangiectasia remained stable in the other nine eyes, but these eyes were at risk of spontaneous bleeding.

Conclusion:

Retinal telangiectasia is a relatively quiescent and uncommon disorder in patients with pathologic myopia that might be closely related to myopic traction maculopathy.
Evaluation of the antimetastatic and antitumor activity, of antibody loaded pemetrexed nanoparticles, in DEN-HepG2 hepatocarcinoma model
Authors: Agrawal Shyam S. , Kaushik Namita
Published: December 2017

Hepatocellular carcinoma (HCC) is the sixth highest incidence of cancer worldwide, accounting for 5.7% of the overall incident cases of cancer with the third leading cause of cancer-related deaths in all age group population. Matrix metalloproteinases play an important role in cancer progression, including tumor growth, invasion, metastasis, and angiogenesis, thus the drug delivery system targeting on MMP’s would be of good significance. This study aims evaluation of the antimetastatic and antitumor activity, of antibody loaded pemetrexed nanoparticles, in di-ethylnitrosamine-HepG2 hepatocarcinoma model. An orthotopic HCC model was prepared by using di-ethylnitrosamine-CCl4 as a precursor for liver cirrhosis and as carcinogen. Study concludes that the HCC model prepared was fast and equivalent to the other models present. The targeted nanoparticles prepared, has better efficacy profile with lower side effects then the free pemetrexed available in market. Low dose and high dose (20/25 mg)/kg of pemetrexed treats HCC significantly. Our results provide a basis for further study of targeted nanoparticles.
Case Studies and Considerations for Combating the Diversion of Infusion Drugs
Authors: Block Frank E. , Azizi Jahan , Markwell Sherry
Published: December 2017

The opioid crisis in the United States has progressed to an epidemic. One avenue for obtaining controlled substances, although relatively uncommon, is diversion of infusion drugs from hospitals and other healthcare facilities. Considerable resources including device safeguards and frequent patient checks are being used in an attempt to combat this issue. In this article, we discuss how lockable infusion pumps may provide advantages to safeguarding these drugs but may also provide a false sense of security to the users. Postevent reporting of drug diversion events is important to notify others of the loss and may ultimately improve the safety or security of these devices.
Detection of Eye Melanoma Using Artificial Neural Network
Authors: Ahmed Isra O. , Ibraheem Banazier A. , Mustafa Zeinab A.
Published: December 2017

Melanoma of the eye is the most common type of cancer affecting the eye, although it is still quite rare. It occurs mainly as a secondary tumor from lung and breast cancers, which are considered the most common cancers in the world. Even though early detection increases the chances of survival, problems occur because of difficulty in diagnosis. Artificial neural network (ANN) is a software program that mimics a biological neural network. It can be programmed to help in classifying and diagnosing the type of cancer. The objective of this research was to program ANN to classify and diagnose the type of eye melanoma. Forty prediagnosed samples (20 malignant and 20 benign) were used for this research. The images obtained were processed and enhanced using median filter and histogram techniques, and the region of interest that was determined by a physician was cropped, and texture features were extracted from it using MATLAB. Finally, using ANN, the cancer was classified as either benign or malignant. Artificial neural network achieved an accuracy of 85%, a sensitivity of 80%, and a specificity of 90%. Furthermore, the system was tested using a prediagnosed malignant image, which tested positive using ANN. Artificial neural network is effective in the classification of eye melanoma and has achieved high levels of accuracy. It is recommended that physicians use ANN to enhance diagnosis, but a training course might be needed to help with the use of the program.
Heavy Metal on a Tungsten Basis With a High Radiation Absorption Capacity Is an Ecological Alternative to Toxic Lead
Authors: von Cetto Sebastian Freiherr
Published: December 2017

EU Directive 2011/65/EU (Restriction of Hazardous Substances 2) regulates the use of certain hazardous substances in electrical and electronic equipment. Lead is ranked at the top of the list, even higher than mercury and cadmium. The heavy metal used as radiation shielding or for anti-scatter grids due to its high atomic mass is highly toxic and does not break down easily, which is why a weight proportion of only 0.1 percent is permitted in new electronic and electric equipment. It also has a low melting point of just 327°C, constituting an additional hazard in case of fire. The Bavarian company Wolfram Industrie offers an innovative, more environmentally friendly alternative with Triamet, a heavy metal alloy on a tungsten basis: thanks to its specific high density and the resulting radiation absorption capacity, the dimensionally stable product that is available in both an iron-nickel and a copper-nickel binder phase even shields against gamma radiation. While tungsten is normally difficult to process, it can be shaped into blanks using a powder-metallurgical process in this form. Subsequently these blanks can be processed further with little effort.
Improvement of Smoking Abstinence Rates With Increased Varenicline Dosage
Authors: Karam-Hage Maher , Kypriotakis George , Robinson Jason D. , Green Charles E. , Mann Gurtej , Rabius Vance , Wippold Rosario , Blalock Janice A. , Mouhayar Elie , Tayar Jean , Chaftari Patrick , Cinciripini Paul M.
Published: December 2017

Purpose/Background

It is unclear whether increasing the dose of varenicline beyond the standard dose of 2 mg/d would improve smoking abstinence.

Methods

We examined the effect of 3 mg/d of varenicline on smoking abstinence among smokers who had reduced their smoking by 50% or more in response to 2 mg/d for at least 6 weeks but had not quit smoking. Of 2833 patients treated with varenicline, dosage of a subset of 73 smokers was increased to 3 mg/d after 6 weeks. We used a propensity score analysis involving multiple baseline covariates to create a comparative sample of 356 smokers who remained on 2 mg/d. All smokers received concurrent and similar smoking-cessation counseling.

Results

At 3 months, we found higher 7-day point prevalence smoking-abstinence rate in the 3-mg group (26%) than in the 2-mg group (11.5%, χ2 = 10.60, P < 0.001; risk ratio [RR], 2.3; 95% confidence interval [CI], 1.4–3.6). The difference in abstinence rates remained significant at the 6-month (P < 0.001; RR, 2.6; 95% CI, 1.6–3.9) and 9-month follow-up (P < 0.001; RR, 2.2; 95% CI, 1.4–3.3).

Conclusions

A relatively small increase in the daily dose of varenicline seems to offer a benefit for those who are not able to achieve total abstinence after approximately 6 weeks of 2 mg/d.
Results of a second examination of the right side of the colon in screening and surveillance colonoscopy: a systematic review and meta-analysis
Authors: Ai Xiuyun , Qiao Weiguang , Han Zemin , Tan Wenxin , Bai Yang , Liu Side , Zhi Fachao
Published: December 2017

Background

Screening colonoscopy is less effective in preventing proximal colon cancers than distal colon cancers. A repeat examination of the right side of the colon may increase the lesion detection. The study aimed to assess the results of a second examination of the right side of the colon with forward-view or retroflexion colonoscopy performed immediately after the initial examination.

Materials and methods

We carried out a meta-analysis of all primary studies that performed a second examination of the right side of the colon with forward-view or retroflexion colonoscopy performed immediately after the initial examination.

Results

Six cohorts of five studies with 4155 participants were included in the final study. The adenoma detection rate (ADR) was 28.8% of the combined examinations compared with 24.1% of the single examination (P<0.001), for a pooled odds ratio of 1.34 [95% confidence interval (CI): 1.13–1.59]. For retroflexion assessment, ADR was achieved in 25.4% patients in the combined group, compared with 22.3% in the single examination group (P=0.002), for a pooled odds ratio of 1.19 (95% CI: 1.06–1.33). For forward-view assessment, ADR was achieved in 46.0% patients in the combined group, compared with 33.5% in the single examination group (P<0.001), for a pooled odds ratio of 1.76 (95% CI: 1.40–2.22).

Conclusion

For ADR of the right side of the colon, a repeat examination could lead to a modest improvement in the detection of lesions in the proximal colon, irrespective of forward-view or retroflexion assessment.
Stroke severity quantification by critical care physicians in a mobile stroke unit
Authors: Hov Maren R. , Røislien Jo , Lindner Thomas , Zakariassen Erik , Bache Kristi C.G. , Solyga Volker M. , Russell David , Lund Christian G.
Published: December 2017

Background

Cerebral revascularization in acute stroke requires robust diagnostic tools close to symptom onset. The quantitative National Institute of Health Stroke Scale (NIHSS) is widely used in-hospital, whereas shorter and less specific stroke scales are used in the prehospital field. This study explored the accuracy and potential clinical benefit of using NIHSS prehospitally.

Patients and methods

Thirteen anesthesiologists trained in prehospital critical care enrolled patients with suspected acute stroke in a mobile stroke unit. NIHSS was completed twice in the acute phase: first prehospitally and then by an on-call resident neurologist at the receiving hospital. The agreement between prehospital and in-hospital NIHSS scores was assessed by a Bland–Altman plot, and inter-rater agreement for predefined clinical categories was tested using Cohen’s κ.

Results

This Norwegian Acute Stroke Prehospital Project study included 40 patients for analyses. The mean numerical difference between prehospital and in-hospital NIHSS scores was 0.85, with corresponding limits of agreement from − 5.94 to 7.64. Inter-rater agreement (κ) for the corresponding clinical categories was 0.38. A prehospital diagnostic workup (NIHSS and computed tomographic examination) was completed in median (quartiles) 10 min (range: 7–14 min). Time between the prehospital and in-hospital NIHSS scores was median (quartiles) 40 min (32–48 min).

Conclusion

Critical care physicians in a mobile stroke unit may use the NIHSS as a clinical tool in the assessment of patients experiencing acute stroke. The disagreement in NIHSS scores was mainly for very low values and would not have changed the handling of the patients.
Primary Pediatric Cutaneous T-Cell Lymphoproliferative Disorders: 3 New Cases
Authors: Guerzoni Maria E. , Pruccoli Federica , Palazzi Giovanni , Mariotti Ilaria , Cano Carmen , Cellini Monica , Cesinaro Anna M. , Mataca Ema , Iughetti Lorenzo
Published: December 2017

Primary cutaneous lymphoproliferative disorders are a composite group of diseases with considerable differences in histopathologic, immunophenotypic, and clinical features. They are exceedingly rare in children and in the literature only few cases are reported with extremely different therapeutic approaches. Because of the rarity of cutaneous lymphomas we consider crucial to increase the knowledge of these diseases providing every single case. We present 3 pediatric cases of primary cutaneous T-cell lymphomas occurred to our center with different features and therapeutic approach.
Genotype-phenotype Correlation of β-Thalassemia in Croatian Patients: A Specific HBB Gene Mutations
Authors: Vucak Jerko , Turudic Daniel , Milosevic Danko , Bilic Marko , Salek Zrinko , Rincic Martina , Bilic Ernest
Published: December 2017

An analysis of genotype-phenotype correlation was performed for 14 patients with beta-thalassemia who had been registered in Referral Centre for hematology and oncology of the University Hospital Centre, Zagreb, Croatia. HBB gene mutations were determined using a gene-specific Q5 High-Fidelity PCR analysis with direct DNA sequencing of amplified transcripts. Mahidol score index used for classification of thalassemia severity was found to be low for all the patients enrolled in the study, indicating a mild β-thalassemia phenotype with no signs of disease progression. Most of the patients have already described gene mutations: IVS-II-666 C>T (HBB:c.316-185C>T) and IVS-II-16 G>C (HBB:c.315+16G>C). Each of the aforementioned mutations was found in (11/14; 78,57%) and (10/14; 71,43%) of our patients, respectively. Recently published HBB:c.9T>C mutation was found in 8 of 14 (57,14%) in our study group. IVSII-74 T>G (HBB:c.315+74T>G) is a worldwide mutation found in 6 of 14 (42.86%) of our patients. All these mutations occur among Croatian children with no obvious Indian/Near Eastern/Iranian ancestry. We also identified 7 de novo mutations (c.316-135het_dupT, c.316-133A>G, c.93-54G>A, c.316-68_316-67het_insCGG, c.316-342delA, c.316-312delT, c.316-209delT) of mild severity phenotype according to Mahidol classification score index. We did not find children or adults with thalassemia major severity phenotype.
Paraneoplastic Cytopenia in Ovarian Germ Cell Tumor: A Novel Presentation
Authors: Mercolini Federico , Battisti Laura , Sainati Laura , Bisogno Gianni
Published: December 2017

We report on the case of a 12-year-old girl, who presented with an ovarian germ cell tumor and cytopenia (anemia and thrombocytopenia) as an associated paraneoplastic syndrome, which gradually regressed after the tumor’s removal. This report adds to the previously described paraneoplastic syndromes potentially associated with ovarian germ cell tumor.