bluuebunny/crossref_metadata_2025 huggingface dataset:
Tactile length contraction as Bayesian inference
Authors: Tong Jonathan , Ngo Vy , Goldreich Daniel
Published: May 2016

To perceive, the brain must interpret stimulus-evoked neural activity. This is challenging: The stochastic nature of the neural response renders its interpretation inherently uncertain. Perception would be optimized if the brain used Bayesian inference to interpret inputs in light of expectations derived from experience. Bayesian inference would improve perception on average but cause illusions when stimuli violate expectation. Intriguingly, tactile, auditory, and visual perception are all prone to length contraction illusions, characterized by the dramatic underestimation of the distance between punctate stimuli delivered in rapid succession; the origin of these illusions has been mysterious. We previously proposed that length contraction illusions occur because the brain interprets punctate stimulus sequences using Bayesian inference with a low-velocity expectation. A novel prediction of our Bayesian observer model is that length contraction should intensify if stimuli are made more difficult to localize. Here we report a tactile psychophysical study that tested this prediction. Twenty humans compared two distances on the forearm: a fixed reference distance defined by two taps with 1-s temporal separation and an adjustable comparison distance defined by two taps with temporal separation t ≤ 1 s. We observed significant length contraction: As t was decreased, participants perceived the two distances as equal only when the comparison distance was made progressively greater than the reference distance. Furthermore, the use of weaker taps significantly enhanced participants' length contraction. These findings confirm the model's predictions, supporting the view that the spatiotemporal percept is a best estimate resulting from a Bayesian inference process.
Elucidating the neural circuitry underlying planning of internally-guided voluntary action
Authors: Marneweck Michelle , Flamand Véronique H.
Published: May 2016

In an attempt to elucidate the neural circuitry of planning of internally guided voluntary action, Ariani et al. (2015) used a delayed-movement design and multivariate pattern analysis of functional MRI data and found areas decoding internally elicited action plans, stimulus-elicited action plans, and both types of plans. In interpreting their results in the context of a heuristic decision model of voluntary action, encompassing “what” action to perform, “when” to perform it, and “whether” to perform it at all, we highlight at least some neural dissociation of these components. More to that, we note that the exact neural circuitry of each component might vary depending on the performed action type, and finally, we underscore the importance of understanding the temporal specifics of such circuitries to further elucidate how they are involved and interact during voluntary action planning.
A biophysical model examining the role of low-voltage-activated potassium currents in shaping the responses of vestibular ganglion neurons
Authors: Hight Ariel E. , Kalluri Radha
Published: May 2016

The vestibular nerve is characterized by two broad groups of neurons that differ in the timing of their interspike intervals; some fire at highly regular intervals, whereas others fire at highly irregular intervals. Heterogeneity in ion channel properties has been proposed as shaping these firing patterns (Highstein SM, Politoff AL. Brain Res 150: 182–187, 1978; Smith CE, Goldberg JM. Biol Cybern 54: 41–51, 1986). Kalluri et al. ( J Neurophysiol 104: 2034–2051, 2010) proposed that regularity is controlled by the density of low-voltage-activated potassium currents ( IKL). To examine the impact of IKL on spike timing regularity, we implemented a single-compartment model with three conductances known to be present in the vestibular ganglion: transient sodium ( gNa), low-voltage-activated potassium ( gKL), and high-voltage-activated potassium ( gKH). Consistent with in vitro observations, removing gKL depolarized resting potential, increased input resistance and membrane time constant, and converted current step-evoked firing patterns from transient (1 spike at current onset) to sustained (many spikes). Modeled neurons were driven with a time-varying synaptic conductance that captured the random arrival times and amplitudes of glutamate-driven synaptic events. In the presence of gKL, spiking occurred only in response to large events with fast onsets. Models without gKL exhibited greater integration by responding to the superposition of rapidly arriving events. Three synaptic conductance were modeled, each with different kinetics to represent a variety of different synaptic processes. In response to all three types of synaptic conductance, models containing gKL produced spike trains with irregular interspike intervals. Only models lacking gKL when driven by rapidly arriving small excitatory postsynaptic currents were capable of generating regular spiking.
Influence of cortical synaptic input on striatal neuronal dendritic arborization and sensitivity to excitotoxicity in corticostriatal coculture
Authors: Buren Caodu , Tu Gaqi , Parsons Matthew P. , Sepers Marja D. , Raymond Lynn A.
Published: May 2016

Corticostriatal cocultures are utilized to recapitulate the cortex-striatum connection in vitro as a convenient model to investigate the development, function, and regulation of synapses formed between cortical and striatal neurons. However, optimization of this dissociated neuronal system to more closely reproduce in vivo circuits has not yet been explored. We studied the effect of varying the plating ratio of cortical to striatal neurons on striatal spiny projection neuron (SPN) characteristics in primary neuronal cocultures. Despite the large difference in cortical-striatal neuron ratio (1:1 vs. 1:3) at day of plating, by 18 days in vitro the difference became modest (∼25% lower cortical-striatal neuron ratio in 1:3 cocultures) and the neuronal density was lower in the 1:3 cocultures, indicating enhanced loss of striatal SPNs. Comparing SPNs in cocultures plated at a 1:1 vs. 1:3 ratio, we found that resting membrane potential, input resistance, current injection-induced action potential firing rates, and input-output curves were similar in the two conditions. However, SPNs in the cocultures plated at the lower cortical ratio exhibited reduced membrane capacitance along with significantly shorter total dendritic length, decreased dendritic complexity, and fewer excitatory synapses, consistent with their trend toward reduced miniature excitatory postsynaptic current frequency. Strikingly, the proportion of NMDA receptors found extrasynaptically in recordings from SPNs was significantly higher in the less cortical coculture. Consistently, SPNs in cocultures with reduced cortical input showed decreased basal pro-survival signaling through cAMP response element binding protein and enhanced sensitivity to NMDA-induced apoptosis. Altogether, our study indicates that abundance of cortical input regulates SPN dendritic arborization and survival/death signaling.
The Relationships between Anabolic Hormones and Body Composition in Middle-Aged and Elderly Men with Prediabetes: A Cross-Sectional Study
Authors: Rabijewski Michał , Papierska Lucyna , Piątkiewicz Paweł
Published: May 2016

The influence of anabolic hormones and body composition in men with prediabetes (PD) is unknown. In a cross-sectional study we investigated the relationships between total testosterone (TT), calculated free testosterone (cFT), dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF-1) and body composition assessed using dual-energy X-ray absorptiometry (DXA) method in 84 patients with PD (40–80 years) and 56 men in control group. Patients with PD had lower TT, cFT, and DHEAS levels but similar IGF-1 levels in both groups. Patients with PD presented the higher total and abdominal fat as well as the lower total and abdominal lean than control (p<0.02,p<0.01,p<0.05,andp<0.02, resp.). We observed negative relationship between TT and total fat (p=0.014) and positive with abdominal lean mass (p=0.034), while cFT was negatively associated with abdominal (p=0.02), trunk (p=0.024), and leg fat (p=0.037) and positively associated with total (p=0.022) and trunk lean (p=0.024). DHEAS were negatively associated with total fat (p=0.045), and IGF-1 were positively associated with abdominal (p=0.003) and leg lean (p=0.015). In conclusion, the lowered anabolic hormones are involved in body composition rearrangement in men with PD. Further studies are needed to establish whether the androgen replacement therapy would be beneficial in men with PD.
Solitary Myofibroma of the Bladder Trigone in a 3-Month-Old Patient: First Case Report
Authors: Pensabene Marco , Siracusa Fortunato , Rodolico Vito , Li Voti Giuseppe , Zambaiti Elisa , Cimador Marcello
Published: May 2016

Visceral solitary myofibromas are uncommon in childhood. We report a case of a solitary asymptomatic visceral myofibroma of the bladder trigone occurring in a 3-month-old boy. Once malignancies were ruled out by cystoscopy, radical excision was performed in order to avoid any potential impairment of bladder dynamic. Postoperative course was uneventful and patient was discharged on day 3 after surgery. After 36 months of follow-up, the patient is toilet-trained and remains well; bladder function is normal.
Numerical Investigations and Analysis of Cu2ZnSnS4Based Solar Cells by SCAPS-1D
Authors: Djinkwi Wanda M. , Ouédraogo S. , Tchoffo F. , Zougmoré F. , Ndjaka J. M. B.
Published: May 2016

This paper reports numerical investigation, using SCAPS-1D program, of the influence of Cu2ZnSnS4(the so-called CZTS) material features such as thickness, holes, and defects densities on the performances of ZnO:Al/i-ZnO/CdS/CZTS/Mo solar cells structure. We found that the electrical parameters are seriously affected, when the absorber thickness is lower than 600 nm, mainly due to recombination at CZTS/Molybdenum interface that causes the short-circuit current density loss of 3.6 mA/cm2. An additional source of recombination, inside the absorber layer, affects the short-circuit current density and produces a loss of about 2.1 mA/cm2above this range of absorber thickness. TheJ-Vcharacteristic shows that the performance of the device is also limited by a double diode behavior. This effect is reduced when the absorber layer is skinny. Our investigations showed that, for solar cells having a CZTS absorber layer of thin thickness and high-quality materials (defects density ~1015 cm−3), doping less than 1016 cm−3is especially beneficial. Such CZTS based solar cell devices could lead to conversion efficiencies higher than 15% and to improvement of about 100 mV on the open-circuit voltage value. Our results are in conformity with experimental reports existing in the literature.
Prior to Conception: The Role of an Acupuncture Protocol in Improving Women’s Reproductive Functioning Assessed by a Pilot Pragmatic Randomised Controlled Trial
Authors: Cochrane Suzanne , Smith Caroline A. , Possamai-Inesedy Alphia , Bensoussan Alan
Published: May 2016

The global average of couples with fertility problems is 9%. Assisted reproductive technologies are often inaccessible. Evidence points to acupuncture offering an opportunity to promote natural fertility. This study asked whether providing a multiphasic fertility acupuncture protocol to women with sub/infertility would increase their awareness of fertility and achieve normalisation of their menstrual cycle compared with a lifestyle control. In a pragmatic randomised controlled trial sub/infertile women were offered an intervention of acupuncture and lifestyle modification or lifestyle modification only. There was a statistically significant increase in fertility awareness in the acupuncture group (86.4%, 19) compared to 40% (n = 8) of the lifestyle only participants (Relative Risk (RR) 2.38, 95% confidence interval (CI) of 1.25, 4.50), with an adjusted p value of 0.011. Changes in menstrual regularity were not statistically significant. There was no statistical difference in the pregnancy rate with seven women (adjusted p = 0.992) achieving pregnancy during the course of the study intervention. Those receiving the acupuncture conceived within an average of 5.5 weeks compared to 10.67 weeks for the lifestyle only group (p = 0.422). The acupuncture protocol tested influenced women who received it compared to women who used lifestyle modification alone: their fertility awareness and wellbeing increased, and those who conceived did so in half the time.
Prediction of Load-Carrying Capacity in Steel Shear Wall with Opening Using Artificial Neural Network
Authors: Khalilzadeh Vahidi E. , Roshani M. M.
Published: May 2016

The effects of different parameters on steel plate shear wall (SPSW) are investigated. The studied parameters are thickness of plate, location of the opening, thickness of diagonal stiffeners, and thickness of circular stiffener. Load-carrying capacity of the SPSW is studied under static load using nonlinear geometrical and material analysis in ABAQUS and the obtained simulation results are verified. An artificial neural network (ANN) is proposed to model the effects of these parameters. According to the results the circular stiffener has more effect compared with the diagonal stiffeners. However, the thickness of the plate has the most significant effect on the SPSW behavior. The results show that the best place for the opening location is the center of SPSW. Multilayer perceptron (MLP) neural network was used to predict the maximum load in SPSW with opening. The predicted maximum load values using the proposed MLP model were compared with the simulated validated data. The obtained results show that the proposed ANN model has achieved good agreement with the validated simulated data, with correlation coefficient of more than 0.9975. Therefore, the proposed model is useful, reliable, fast, and cheap tools to predict the maximum load in SPSW.
Optimizing Data Access for Wind Farm Control over Hierarchical Communication Networks
Authors: Madsen Jacob , Findrik Mislav , Madsen Tatiana , Schwefel Hans-Peter
Published: May 2016

We investigate a centralized wind farm controller which runs periodically. The controller attempts to reduce the damage a wind turbine sustains during operation by estimating fatigue based on the wind turbine state. The investigation focuses on the impact of information access and communication networks on the controller performance. We start by investigating the effects of a communication network that introduces delays in the information access for the central controller. The control performance as measured by accumulated fatigue is shown to be significantly impacted by communication delays and also by the choice of the time instances at which sensor information is accessed. In order to optimize the latter, we introduce an information quality metric and a mathematical model based on Markov chains, which are compared performance-wise to a heuristic approach for finding this parameter. This information quality metric is called mismatch probability, mmPr, and is used to express quantitatively the information accuracy in a given scenario. Lastly, measurements of different communication technologies have been performed in order to carry out the analysis in a practically relevant scenario with respect to the communication network delays. These measurements are done in regard to packet loss and communication delays, and the simulations are rerun using either the traces from the measurements or scenarios constructed from the delay parameters.
Synaptic Cell Adhesion Molecules in Alzheimer’s Disease
Authors: Leshchyns’ka Iryna , Sytnyk Vladimir
Published: May 2016

Alzheimer’s disease (AD) is a neurodegenerative brain disorder associated with the loss of synapses between neurons in the brain. Synaptic cell adhesion molecules are cell surface glycoproteins which are expressed at the synaptic plasma membranes of neurons. These proteins play key roles in formation and maintenance of synapses and regulation of synaptic plasticity. Genetic studies and biochemical analysis of the human brain tissue, cerebrospinal fluid, and sera from AD patients indicate that levels and function of synaptic cell adhesion molecules are affected in AD. Synaptic cell adhesion molecules interact with Aβ, a peptide accumulating in AD brains, which affects their expression and synaptic localization. Synaptic cell adhesion molecules also regulate the production of Aβvia interaction with the key enzymes involved in Aβformation. Aβ-dependent changes in synaptic adhesion affect the function and integrity of synapses suggesting that alterations in synaptic adhesion play key roles in the disruption of neuronal networks in AD.
Vagal Reactions during Cryoballoon-Based Pulmonary Vein Isolation: A Clue for Autonomic Nervous System Modulation?
Authors: Peyrol Michaël , Barraud Jérémie , Koutbi Linda , Maille Baptiste , Trevisan Lory , Martinez Elisa , Lévy Samuel , Paganelli Franck , Franceschi Frederic
Published: May 2016

Although paroxysmal atrial fibrillation (AF) is known to be initiated by rapid firing of pulmonary veins (PV) and non-PV triggers, the crucial role of cardiac autonomic nervous system (ANS) in the initiation and maintenance of AF has long been appreciated in both experimental and clinical studies. The cardiac intrinsic ANS is composed of ganglionated plexi (GPs), located close to the left atrium-pulmonary vein junctions and a vast network of interconnecting neurons. Ablation strategies aiming for complete PV isolation (PVI) remain the cornerstone of AF ablation procedures. However, several observational studies and few randomized studies have suggested that GP ablation, as an adjunctive strategy, might achieve better clinical outcomes in patients undergoing radiofrequency-based PVI for both paroxysmal and nonparoxysmal AF. In these patients, vagal reactions (VR) such as vagally mediated bradycardia or asystole are thought to reflect intrinsic cardiac ANS modulation and/or denervation. Vagal reactions occurring during cryoballoon- (CB-) based PVI have been previously reported; however, little is known on resulting ANS modulation and/or prevalence and significance of vagal reactions during PVI with the CB technique. We conducted a review of prevalence, putative mechanisms, and significance of VR during CB-based PVI.
Assessment of the Economic Structure of Brazilian Agribusiness
Authors: Rodrigues Moreira Vilmar , Kureski Ricardo , Pereira da Veiga Claudimar
Published: May 2016

This paper presents an economic assessment of Brazilian agribusiness and its relationship with other economic sectors. It was found that, in 2011, agribusiness had a share of 18.45% (basic prices) and 19.77% (market prices) of Brazilian GDP. The tax burden of agribusiness (20.68%) was higher than that of other sectors (13.59%), despite agribusiness being a major contributor to the generation of foreign exchange, employment, and essential products, such as food. Brazilian agribusiness is a major employer, responsible for 29.39% of national employment. However, its average income is lower than in the other sectors of the Brazilian economy. Finally, agribusiness was found to be the biggest generator of foreign exchange, with a positive balance of trade. It was possible to conclude that agribusiness forms a strong link between agriculture and livestock, industry, and services in other economic sectors. For this reason, it can be said that the development of agribusiness is highly relevant to the process of Brazilian economic development and is therefore important to the progress of economic policies.
Determination of Natamycin in Turkish Yoghurt
Authors: Bilgic Alkaya Dilek , Karalomlu Ozlem
Published: May 2016

This study was aimed at developing RP-HPLC method for determination of natamycin in Turkish yoghurt. Chromatographic separation was achieved on a C8 column (150 mm × 4.6 mm × 5 µm) with a mobile phase of methanol : water : acetic acid (12 : 8 : 1 v/v/v), at 1 mL/min flow rate with a detection of 303 nm. Natamycin was spiked into handmade yoghurt samples and used for validation. The method has been fully validated according to ISO 9233-2, 2007 (IDF 140-2, 2007). It was successfully applied to determination of 28 different Turkish yoghurt products. Findings dealing with the presence of natamycin in cheese samples are presented.
Imaging Evidence for Cerebral Hyperperfusion Syndrome after Intravenous Tissue Plasminogen Activator for Acute Ischemic Stroke
Authors: Zhang Yi , Kumar Abhay , Tezel John B. , Zhou Yihua
Published: May 2016

Background. Cerebral hyperperfusion syndrome (CHS), a rare complication after cerebral revascularization, is a well-described phenomenon after carotid endarterectomy or carotid artery stenting. However, the imaging evidence of CHS after intravenous tissue plasminogen activator (iv tPA) for acute ischemic stroke (AIS) has not been reported.Case Report. Four patients were determined to have manifestations of CHS with clinical deterioration after treatment with iv tPA, including one patient who developed seizure, one patient who had a deviation of the eyes toward lesion with worsened mental status, and two patients who developed worsened hemiparesis. In all four patients, postthrombolysis head CT examinations were negative for hemorrhage; CT angiogram showed patent cervical and intracranial arterial vasculature; CT perfusion imaging revealed hyperperfusion with increased relative cerebral blood flow and relative cerebral blood volume and decreased mean transit time along with decreased time to peak in the clinically related artery territory. Vascular dilation was also noted in three of these four cases.Conclusions. CHS should be considered in patients with clinical deterioration after iv tPA and imaging negative for hemorrhage. Cerebral angiogram and perfusion studies can be useful in diagnosing CHS thereby helping with further management.
Racial Differences in Serum Adipokine and Insulin Levels in a Matched Osteoarthritis Sample: A Pilot Study
Authors: Gandhi Rajiv , Sharma Anirudh , Kapoor Mohit , Sundararajan Kala , Perruccio Anthony V.
Published: May 2016

Background. In an attempt to correlate biomarkers with disease, serum-based biomarkers often are compared between individuals with osteoarthritis (OA) and control subjects. However, variable results have been reported. Some studies have suggested an association between certain adipokines and insulin and OA. We know that there are racial differences in OA prevalence and incidence, and from general population-based studies, those of Asian race consistently demonstrate a unique adipokine/insulin serum concentration profile as compared to Caucasians. Whether similar racial differences exist within OA samples is unknown and may have implications for selecting appropriate controls in comparative studies.Methods. Serum levels of adipokines, leptin, and adiponectin, along with insulin, were determined by ELISA in patients scheduled for total hip or knee replacement surgery for OA. Fifteen Asian patients were matched 1 : 1 on age (±2 years), gender, body mass index (±1.5 kg/m2), and surgical joint with Caucasian patients. Differences in serum concentrations were tested using pairedt-tests.Results. Serum leptin and insulin levels were significantly higher in Asians compared to Caucasians (p<0.05). While serum adiponectin levels were lower among Asians, the difference did not reach statistical significance (p=0.12).Conclusion. Findings from this work suggest that when studying serum biomarker concentrations in OA versus controls, race may be an important factor to consider. Our findings warrant confirmation in larger studies.
Alternative Synthesis of 1,8-Difluoroanthracene via the Balz-Schiemann Reaction
Authors: Al-Kaysi Rabih O.
Published: May 2016

An alternative and improved method for the synthesis of 1,8-difluoroanthracene 5 is described. The precursor 1,8-difluoro-9,10-anthraquinone 4 was synthesized by precipitating the water-soluble 1,8-diazonium-9,10-anthraquinone fluoroborate 3 using isopropanol, before thermally decomposing it via the Balz-Schiemann reaction to yield 4 in the form of pure sublimed crystals. Compound 5 was later synthesized with 84% yield by reducing 4 in a Zn/NH4OH mixture. Using isopropanol to quantitatively precipitate water-soluble diazonium fluoroborate salts was also used to synthesize other fluoroanthraquinone derivatives with improved yields.
HumanPapilloma VirusInfection in Patients with Male Accessory Gland Infection: Usefulness of the Ultrasound Evaluation
Authors: Condorelli Rosita A. , Vicari Enzo , Mongioi Laura M. , Russo Giorgio I. , Morgia Giuseppe , La Vignera Sandro , Calogero Aldo E.
Published: May 2016

This study evaluated the ultrasound (US) features of 20 patients with MAGI and concomitantpapilloma virus(HPV) infection compared to 20 patients with microbial (presence ofChlamydia trachomatisalone) MAGI and 20 patients with amicrobial (inflammatory) MAGI. Patients with HPV infection showed significantly (p<0.05) higher total prostate, seminal vesicles, and epididymal US signs (18.0 ± 2.0) compared to the other 2 groups (12.0 ± 4.0 versus 10.0 ± 3.0, resp.). In addition, patients with MAGI and HPV had a higher prevalence of complicated forms of MAGI [prostatovesiculitis (PV) and prostate-vesiculo-epididymitis (PVE)] and a higher frequency of the fibrosclerotic variant compared to the other groups (70.0 ± 10.0% versus 48.0 ± 5.0% versus 15.0 ± 10.0%). Moreover, HPV infected patients had a higher number of US criteria suggestive for MAGI in the periurethral region of the prostate compared to the other groups. In particular, the patients showed a higher ratio between periurethral and lobar US criteria distribution (5.0 versus 0.5). Finally, the seminal fluid concentration ofCD45posleukocytes (2.0 ± 0.2 versus 1.3 ± 0.3 versus 1.0 ± 0.3 mil/mL) was significantly higher and sperm progressive motility was significantly lower in these patients compared to other groups.
Prevalence and Perspectives of Complementary and Alternative Medicine among University Students in Atlanta, Newcastle upon Tyne, and New Delhi
Authors: Subramanian Kritika , Midha Inuka
Published: May 2016

Objective. A cross-cultural comparative study was developed that surveyed university students in Atlanta (United States), New Delhi (India), and Newcastle upon Tyne (United Kingdom) to understand the prevalence and perspectives of CAM in three urban societies with different healthcare systems. Design. Surveys were sent to students in the three aforementioned cities. Survey distribution occurred over 6 months from May to November 2015. A total of 314 surveys were received. Results. Dietary and vitamin supplements had the highest prevalence collectively (n=203), followed by meditation, yoga, and massage. Commentary analysis showed the importance of science and evidence in justifying CAM practice. Conclusions. Matching the most prevalent practices with their designated NCCAM categories suggested that the students were attracted to biologically based, body-based, and mind-body practices as the central themes of attraction. Selected and prevalent CAM practices suggested the students’ desire to maintain physical and mental fitness. Access to healthcare may have influence on the prevalence of CAM. Indian students were more likely to view CAM as a viable alternative to conventional medicine.
The Relationship between Betatrophin Levels in Blood and T2DM: A Systematic Review and Meta-Analysis
Authors: Yue Song , Wu Jingyang , Zhang Jiahua , Liu Lei , Chen Lei
Published: May 2016

Background. In order to clarify previous ambiguous research conclusions, a meta-analysis was made to investigate the relationship between betatrophin levels in blood and type 2 diabetes mellitus (T2DM).Methods. We have searched all the English and Chinese references regarding the relationship between betatrophin and diabetes in database both manually and online. Strict criteria have been established to include and exclude articles, with Mean and Standard Deviation as statistics to evaluate strength of association. We have chosen either fixed- or random effect model according to heterogeneity inspection results and used Begg’s test and Egger’s test to analyze publication bias.Results. A total of 11 studies were included in this meta-analysis. Meta-analysis indicated a significant association between betatrophin and T2DM (Mean: 329.46; 95% confidence interval: 182.51 to 476.42,P<0.0001). However, in the subgroup analysis, there was no significant statistic between betatrophin concentration and T2DM within Caucasian population (Mean: 98.40; 95% confidence interval: −1585.08 to 1781.88,P=0.91).Conclusions. Such relationship may suggest preference for association between betatrophin and T2DM in different population.
Dual Block with Lapatinib and Trastuzumab Versus Single-Agent Trastuzumab Combined with Chemotherapy as Neoadjuvant Treatment of HER2-Positive Breast Cancer: A Meta-analysis of Randomized Trials
Authors: Clavarezza Matteo , Puntoni Matteo , Gennari Alessandra , Paleari Laura , Provinciali Nicoletta , D'Amico Mauro , DeCensi Andrea
Published: May 2016

Purpose: (Neo)adjuvant treatment with chemotherapy plus trastuzumab reduces recurrence and death risk in HER2-positive (HER2+) breast cancer. Randomized trials assessed HER2 dual block by adding lapatinib to trastuzumab and chemotherapy in the neoadjuvant setting using pathologic complete response (pCR) as the outcome measure. We conducted a meta-analysis of randomized trials testing neoadjuvant dual block with lapatinib and trastuzumab versus trastuzumab alone in HER2+ breast cancer.

Experimental Design: Trials were identified by Medline (PubMed), ISI Web of Science (Science Citation Index Expanded), Embase, Cochrane library, and reference lists of published studies, review articles, editorials, and by hand-searched reports from major cancer meeting reports.

Results: Six randomized trials including 1,155 patients were identified, of whom 483 (41.8%) were hormone receptor–negative, 672 (58.2%) hormone receptor–positive, 534 (46.2%) received taxanes alone, and 621 (53.8%) anthracyclines plus taxanes or the docetaxel–carboplatin regimen. Overall, the dual block was associated with a significant 13% absolute improvement in pCR rate compared with single-agent trastuzumab (summary risk difference, SRD 0.13; 95% CI, 0.08–0.19). The activity was greater in hormone receptor–negative patients who received chemotherapy with taxanes alone (SRD 0.25; 95% CI, 0.13–0.37), compared to hormone receptor–positive or hormone receptor–negative disease treated with anthracyclines plus taxanes or the docetaxel–carboplatin regimen (SRD 0.09; 95% CI, 0.02–0.15; Pinteraction = 0.05).

Conclusions: On the basis of ΔpCR data, the dual block with trastuzumab and lapatinib plus chemotherapy is a very active treatment only in HER2+ and hormone receptor–negative breast cancer treated with taxane monochemotherapy. Clin Cancer Res; 22(18); 4594–603. ©2016 AACR.
Changes in Bone Turnover Marker Levels and Clinical Outcomes in Patients with Advanced Cancer and Bone Metastases Treated with Bone Antiresorptive Agents
Authors: Lipton Allan , Smith Matthew R. , Fizazi Karim , Stopeck Alison T. , Henry David , Brown Janet E. , Shore Neal D. , Saad Fred , Spencer Andrew , Zhu Li , Warner Douglas J.
Published: May 2016

Purpose: Bone antiresorptive agents can significantly reduce bone turnover markers (BTM) in patients with advanced cancer. We evaluated association of changes in BTMs with overall survival (OS), disease progression (DP), and disease progression in bone (DPB) in patients with advanced cancer and bone metastases following denosumab or zoledronic acid treatment.

Experimental Design: This is an integrated analysis of patient-level data from three identically designed, blinded, phase III trials with patients randomized to subcutaneous denosumab or intravenous zoledronic acid. Levels of the BTMs urinary N-telopeptide (uNTx) and serum bone-specific alkaline phosphatase (sBSAP) measured at study entry and month 3 were analyzed. OS, DP, and DPB were compared in patients with BTMs ≥ median versus < median based on month 3 assessments.

Results: uNTx levels ≥ the median of 10.0 nmol/mmol at month 3 were associated with significantly reduced OS compared with levels < median (HR for death, 1.85; P < 0.0001). sBSAP levels ≥ median of 12.6 ng/mL were associated with significantly reduced OS compared with levels < median (HR, 2.44; P < 0.0001). uNTx and sBSAP levels ≥ median at month 3 were associated with significantly greater risk of DP (HR, 1.31; P < 0.0001 and HR, 1.71; P < 0.0001, respectively) and DPB (HR, 1.11; P = 0.0407 and HR, 1.27; P < 0.0001, respectively).

Conclusions: BTM levels ≥ median after 3 months of bone antiresorptive treatment were associated with reduced OS and increased risk of DP and DPB. Assessment of uNTx and sBSAP levels after bone antiresorptive therapy may add to identification of patients at risk for worse clinical outcomes. Clin Cancer Res; 22(23); 5713–21. ©2016 AACR.
Disease Interception: Myths, Mountains, and Mole Hills
Authors: Hait William N. , Lebowitz Peter F.
Published: May 2016

Malignant diseases develop slowly over time and are often preceded by identifiable premalignancies. As malignancy progresses, so does genomic complexity and the ability of cancers to evade most therapeutic interventions. Accordingly, with some notable exceptions, a relatively low percentage of advanced cancers are effectively treated and even fewer are cured. Despite this appreciation, much less attention has been paid to intercepting the disease process compared with that of treating well-established and refractory disease. One frequently cited reason is that the pharmaceutical industry is not interested in these pursuits. In this commentary, we attempt to define the true hurdles, the degree of difficulty inherent in each, and some important approaches to be considered. Cancer Prev Res; 9(8); 635–7. ©2016 AACR.
Thyroid-Stimulating Hormone, White Matter Hyperintensities, and Functional Outcome in Acute Ischemic Stroke Patients
Authors: Leonards Christopher O. , Schneider Harald J. , Liman Thomas G. , Fiebach Jochen B. , Endres Matthias , Ebinger Martin
Published: May 2016

Background: Thyroid-stimulating hormone (TSH) concentrations are frequently altered in acute ischemic stroke patients. It is becoming increasingly apparent that various hormones in the hypothalamus-pituitary-thyroid axis may be associated with functional stroke outcome. We have previously shown that white matter hyperintensities (WMH) of presumed vascular origin are strong indicators of functional outcome. It is unclear whether an association exists between WMH and TSH. We therefore sought to determine whether TSH levels, measured in acute ischemic stroke patients, are associated with WMH and functional outcome. Methods: We analyzed all first ischemic stroke patients who participated in the Berlin ‘Cream & Sugar' Study (NCT 01378468) and completed a 1-year follow-up assessment from January 2009 to March 2013. Patients were stratified into 3 groups: (1) low TSH (0.1-0.44 μU/ml); (2) normal TSH (0.44-2.5 μU/ml), and (3) high TSH (2.5-20 μU/ml). WMH were assessed using the Fazekas and Wahlund visual rating scales. Functional outcome was assessed using the modified Rankin Scale and was performed via telephone at 1 year by a certified rater. Results: 183 patients were included [median age 66, interquartile range (IQR) 54-75; 33% females; median National Institute of Health Stroke Scale 3, IQR 1-4, range 0-24]. Venous samples were collected a median of 4 days (IQR 3-5) following initial symptom onset between 8 and 9 a.m. following a 10-hour fast. Patients with normal TSH levels (n = 132; 72%) had significantly higher rates of prestroke diabetes than patients with high TSH levels (normal TSH 17%; high TSH 1%; p = 0.03). Additionally, patients with normal TSH levels tended to have higher estimated glomerular filtration rates than patients with high and low TSH concentrations (normal TSH median estimated glomerular filtration rates: 83 ml/min/1.73 m2; high TSH median estimated glomerular filtration rates: 76 ml/min/1.73 m2; low TSH median: 78 ml/min/1.73 m2; p = 0.068). Logistical regression analysis force-adjusted for age (quartiles), NIHSS (quartiles), prestroke diabetes status, and stroke subtype revealed significant associations between WMH and TSH [Wahlund scores: odds ratio 2.547, 95% confidence interval (CI) 1.159-5.598, p = 0.020; Fazekas scores: odds ratio 2.530, 95% CI 1.115-5.741, p = 0.003]. Functional outcome was not significantly associated with TSH levels in univariate or multivariate models. Conclusion: TSH levels are independently associated with WMH in acute ischemic stroke patients. Based on our findings, we cannot recommend assessing TSH to estimate the 1-year functional outcome following ischemic stroke.
Gastric Cancer Arising from an Upside-Down Stomach through a Paraesophageal Hiatal Hernia
Authors: Mimatsu Kenji , Kano Hisao , Oida Takatsugu , Kawasaki Atsushi , Fukino Nobutada , Kida Kazutoshi , Kuboi Youichi , Amano Sadao
Published: May 2016

We report the rare case of an elderly patient with an advanced gastric cancer arising from an upside-down stomach through a paraesophageal hiatal hernia (PEH). An 82-year-old man presented with appetite loss and anemia. Upper gastrointestinal endoscopy revealed a type 1 tumor located in the middle body of the stomach. An upper gastrointestinal series and computed tomography showed organoaxial rotation of the stomach, which was located in the mediastinum, through a PEH, indicating an upside-down stomach. The preoperative diagnosis was gastric cancer arising from an upside-down stomach through a PEH. The patient underwent total gastrectomy with lymph node dissection and closure of the hernial orifice. Although a large PEH is a chronic disorder, gastric malignancies should be considered in patients with PEH manifested as an upside-down stomach due to its anatomical characteristics, and careful preoperative diagnosis is mandatory.
A Case of Bladder Cancer after Radiation Therapy for Prostate Cancer
Authors: Kaburaki Naoto , Kosaka Takeo , Yazawa Satoshi , Oya Mototsugu
Published: May 2016

An 86-year-old male who presented with the chief complaint of clot retention and had a history of prostate cancer treated with external beam radiation therapy 11 years previously is described. Cystoscopy revealed radiation cystitis in coexistence with bladder cancer. Since bladder cancer may be present in patients with macroscopic hematuria who have a history of radiation therapy, referral to an urologist is recommended.
Psychological Correlates to Dysfunctional Eating Patterns among Morbidly Obese Patients Accepted for Bariatric Surgery
Authors: Gade Hege , Rosenvinge Jan Harald , Hjelmesæth Jøran , Friborg Oddgeir
Published: May 2016

Objective: To examine the relationships between dysfunctional eating patterns, personality, anxiety and depression in morbidly obese patients accepted for bariatric surgery. Design: The study used cross-sectional data collected by running a randomized controlled trial (http://clinicaltrials.gov/ct2/show/NCT01403558). Subjects: A total of 102 patients (69 women, 33 men) with a mean (SD) age of 42.6 (9.8) years and a mean BMI of 43.5 (4.4) kg/m2 participated. Measurements: Measurements included the NEO-PI-R (personality: neuroticism, extroversion, openness, conscientiousness and agreeableness), the TFEQ-R-21 (dysfunctional eating: emotional eating (EE), uncontrolled eating (UE) and cognitive restraint of eating (CR)) and the HADS (anxiety and depression). Results: The personality traits neuroticism and conscientiousness were more strongly correlated with dysfunctional eating than anxiety and depression. These differences were most pronounced for emotional and cognitive restraint of eating. Emotional eating occurred more often in female than in male patients, a finding that was partially mediated by neuroticism but not by anxiety and depression. Conclusion: Personality traits may be important to address in the clinical management of morbidly obese patients seeking bariatric surgery as neuroticism is particularly salient in female patients displaying an emotional eating behaviour.
Spontaneous Resolution ofLong-Standing Macular Detachment due to Optic Disc Pit with Significant Visual Improvement
Authors: Parikakis Efstratios A. , Chatziralli Irini P. , Peponis Vasileios G. , Karagiannis Dimitrios , Stratos Aimilianos , Tsiotra Vasileia A. , Mitropoulos Panagiotis G.
Published: May 2016

Purpose: To report a case of spontaneous resolution of a long-standing serous macular detachment associated with an optic disc pit, leading to significant visual improvement. Case Presentation: A 63-year-old female presented with a 6-month history of blurred vision and micropsia in her left eye. Her best-corrected visual acuity was 6/24 in the left eye, and fundoscopy revealed serous macular detachment associated with optic disc pit, which was confirmed by optical coherence tomography (OCT). The patient was offered vitrectomy as a treatment alternative, but she preferred to be reviewed conservatively. Three years after initial presentation, neither macular detachment nor subretinal fluid was evident in OCT, while the inner segment/outer segment (IS/OS) junction line was intact. Her visual acuity was improved from 6/24 to 6/12 in her left eye, remaining stable at the 6-month follow-up after resolution. Conclusion: We present a case of spontaneous resolution of a long-standing macular detachment associated with an optic disc pit with significant visual improvement, postulating that the integrity of the IS/OS junction line may be a prognostic factor for final visual acuity and suggesting OCT as an indicator of visual prognosis and the probable necessity of a surgical management.
Spontaneous Massive Necrosis of Hepatocellular Carcinoma with Narrowing and Occlusion of the Arteries and Portal Veins
Authors: Tomino Takahiro , Yamashita Yo-ichi , Iguchi Tomohiro , Itoh Shinji , Ninomiya Mizuki , Ikegami Toru , Yoshizumi Tomoharu , Soejima Yuji , Kawanaka Hirofumi , Ikeda Tetsuo , Aishima Shinichi , Shirabe Ken , Maehara Yoshihiko
Published: May 2016

We herein present the case of a 77-year-old man who had fever and right hypochondriac pain. He visited his doctor and underwent contrast computed tomography (CT), and he was suspected to have a liver abscess. He received an antibiotic treatment and his symptoms soon disappeared, but the tumor did not get smaller and its density on contrast CT image got stronger. He underwent biopsy and moderately differentiated hepatocellular carcinoma (HCC) was found. Extended left hepatic and caudate lobectomy was performed. Histological examination showed moderately differentiated HCC with narrowing and occlusion both in the arteries and portal veins associated with mild chronic inflammation. The mechanisms of spontaneous regression of HCC, such as immunological reactions and tumor hypoxia, have been proposed. In our case, histological examination showed the same findings. However, the mechanism is complex, and therefore further investigations are essential to elucidate it.
New-Onset Mediastinal and Central Nervous System Sarcoidosis in a Patient with Metastatic Melanoma Undergoing CTLA4 Monoclonal Antibody Treatment
Authors: Murphy Kevin P. , Kennedy Marcus P. , Barry Josephine E. , O'Regan Kevin N. , Power Derek G.
Published: May 2016

SummaryBackground: Ipilimumab, a cytotoxic monoclonal antibody that inhibits cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), has been established as an effective therapy in the management of advanced melanoma. Immune-mediated adverse events are a common side effect. Case Report: A 37-year-old male patient was diagnosed with nodal and osseous metastatic melanoma 15 months after the initial surgical treatment for lower limb melanoma. Therapy with the anti-CTLA-4 antibody, ipilimumab, was started. Follow-up staging imaging after treatment initiation showed symmetrical bihilar adenopathy. Transbronchial biopsy showed sarcoidosis. The patient had associated systemic symptoms of fatigue, joint pains, anorexia and weight loss. Brain magnetic resonance imaging (MRI), which was performed for the investigation of headaches, showed abnormal enhancing tissue in the sella turcica and adjacent to the pituitary infundibulum, consistent with neurosarcoidosis. The condition was successfully treated with corticosteroids. Conclusions: We report a case of immunotherapy-induced mediastinal/hilar sarcoidosis, with pituitary involvement, mimicking tumour progression. This highlights the need for awareness amongst radiologists and oncologists of the mechanism of action and potential side effects of new immunotherapies.
Online Survey of Cancer Patients on Complementary and Alternative Medicine
Authors: Huebner Jutta , Prott Franz J. , Micke Oliver , Muecke Ralf , Senf Bianca , Dennert Gabriele , Muenstedt Karsten ,   on behalf of PRIO (Working Group Prevention and Integrative Oncology - German Cancer Society)
Published: May 2016

Introduction: Complementary and alternative medicine (CAM) is often used by cancer patients, yet, communication with the oncologist is poor. The objective of our study was to gather information on patients' usage of CAM, source of information, and aims, in order to derive strategies to improve the communication between physicians and patients on this topic. Materials and Methods: An online survey was conducted by linking a standardized questionnaire to the largest internet portal for cancer patients in Germany. The questionnaire addresses CAM usage, disclosure to physicians, source of information, objectives for using CAM, and perceived reasons for cancer. Results: Of 170 participants, 77% were currently using CAM. Disclosure to a physician was rather high with 63% having informed their oncologist. Asked whether the oncologist took time to discuss CAM, 74% answered ‘no'. Most frequently used are biologically based therapies, relaxation techniques, prayer, and meditation. Most patients want to reduce side effects, boost their immune system, and get active. Almost half the participants had positive experiences with some type of CAM before they fell ill. Conclusion: Understanding patients' concepts of the etiology of cancer and accepting their goals for using CAM may help oncologists communicate with their patients and guide them to a safe use of CAM.
Spontaneous Colon Perforations Associated with a Vascular Type of Ehlers-Danlos Syndrome
Authors: Yoneda Akira , Okada Kazuya , Okubo Hitoshi , Matsuo Mitsutoshi , Kishikawa Hiroki , Naing Banyar Than , Watanabe Atsushi , Shimada Takashi
Published: May 2016

Ehlers-Danlos syndrome, vascular type (vEDS) (MIM #130050) is an autosomal dominant disorder caused by mutation in the type III collagen gene, COL3A1, leading to fragility of blood vessels, bowel and uterus that leads to spontaneous rupture. We report a previously undiagnosed vEDS patient with bowel complications. A 20-year-old female patient was referred to our hospital with abdominal pain. Computed tomography showed notable dilatation of the sigmoid colon with intraperitoneal fluid. Laparotomy revealed dilatation of the sigmoid colon, breakdown of serosa and muscularis propria of the sigmoid colon with impending perforation, and intra-abdominal hemorrhage caused by breakdown of the mesenterium. Resection of the sigmoid colon with Hartmann's pouch and an end colostomy were performed. Physical examination showed joint hypermobility, translucent skin with venous prominence and facial structure abnormalities. Genetic analysis using cDNA extracted from the patient's fibroblasts by reverse transcriptase polymerase chain reaction direct sequencing showed a missense mutation within the triple helix region of COL3A1 (c.2150 G>A; Gly717Asp).