bluuebunny/crossref_metadata_2025 huggingface dataset:
Spinal neurenteric cyst in a dog
Authors: Alder Daniela S. , Oevermann Anna , Pfister Stephan A. , Steffen Frank
Published: March 2017

CASE DESCRIPTION An 11-year-old English Cocker Spaniel was evaluated because of chronic progressive ataxia of the hind limbs.

CLINICAL FINDINGS The dog had no history of previous illness, and findings of physical examination and laboratory tests were unremarkable. Neurologic examination revealed that the dog was ambulatory with severe ataxia of the hind limbs. Proprioception was decreased in the right and left hind limbs (right affected more than left), and spinal reflexes were bilaterally unremarkable. Moderate signs of pain were detected during palpation of the lumbar portion of the vertebral column. Findings suggested a lesion within the thoracolumbar or lumbar segments of the spinal cord. Magnetic resonance imaging revealed extradural spinal cord compression attributable to an extradural space-occupying lesion originating from or infiltrating the L4 lamina on the right side.

TREATMENT AND OUTCOME Hemilaminectomy was performed to remove the extradural lesion. Histologic findings for tissue samples collected during the procedure were consistent with a neurenteric cyst. The late onset and progression of clinical signs of this rare congenital malformation were suspected to have been the result of enlargement of the neurenteric cyst through continuous production of mucus by goblet cells. The dog responded favorably to surgical decompression and was clinically normal 1 year after surgery. It was euthanized 2 years after surgery for an unrelated reason (end-stage heart disease), and no neurologic deficits were evident before that point.

CLINICAL RELEVANCE Congenital neurenteric cysts should be considered as a differential diagnosis for neoplastic disease in dogs in which results of diagnostic imaging indicate the presence of an extradural mass affecting vertebral structures.
Evaluation of the economic and clinical feasibility of introducing rigid endoscopy and laparoscopy to a small animal general practice
Authors: Jones Kelly , Case J. Brad , Evans Brian , Monnet Eric
Published: March 2017

OBJECTIVE To evaluate the economic and clinical feasibility of introducing rigid endoscopy and laparoscopy to a small animal general practice.

DESIGN Prospective study.

SAMPLE A single 2-veterinarian small animal practice in southern California.

PROCEDURES In early 2012, endoscopic equipment was purchased, and both veterinarians in the practice undertook training in rigid endoscopic and laparoscopic procedures. Subsequently, information for client-owned animals that underwent endoscopic and laparoscopic procedures during a 12-month period (2012 to 2013) was collected. Cost of equipment and training, revenue generated, specific procedures performed, surgery time, complications, and client satisfaction were evaluated.

RESULTS 78 endoscopic procedures were performed in 73 patients, including 71 dogs, 1 cat, and 1 rabbit. Cost of endoscopic and laparoscopic equipment and training in the first year was $14,809.71; most equipment was financed through a 5-year lease at a total cost of $57,507.70 ($ 10,675.20/y). Total revenue generated in the first year was $50,423.63. The most common procedures performed were ovariectomy (OVE; n = 49), prophylactic gastropexy (6), and video otoscopy (12). Mean ± SD surgery times for OVE (n = 44) and for OVE with gastropexy (5) were 63.7 ± 19.7 minutes and 73.0 ± 33.5 minutes; respectively. Twelve of 54 patients undergoing laparoscopic procedures experienced minor intraoperative complications. Conversion to laparotomy was not required in any patient. There were no major complications. All 49 clients available for follow-up were satisfied.

CONCLUSIONS AND CLINICAL RELEVANCE With appropriate training and equipment, incorporation of basic rigid endoscopy and laparoscopy may be feasible in small animal general practice. However, results of the present study are not applicable to all veterinarians and practice settings, and patient safety considerations should always be paramount.
China's State-Owned Enterprises and Canada's Foreign Direct Investment Policy
Authors: Dobson Wendy
Published: March 2017

As Canada becomes more of a destination for Chinese outward foreign direct investment (FDI), Canada's review policies should incorporate international best practice based on an accurate understanding of the evolving regimes in China governing foreign direct investment FDI and its state-owned enterprises (which account for two-thirds of China's outward investment). This article focuses primarily on Chinese state-owned enterprises (SOEs) in both an international and a Chinese context. What is driving their outward investments and those in Canada in particular? Does Canada's policy response accurately account for the evolving regimes in China? This article concludes that China's regimes governing FDI and SOEs are becoming more transparent and market oriented whereas Canada's policies, until late in 2016, have remained opaque and interventionist. However, the investment hub proposal made recently portends some warming and greater transparency.
Godly Noises—Resounding Divine Materiality in Contemporary Trailer Culture
Authors: Schirr Bertram
Published: March 2017

Addressing the phenomenon of an as of yet nameless, but ubiquitous droning sound device—often simply called BRAAAM—in contemporary teaser and trailer culture, this article explores the quasi-religious experience of encountering artfully facilitated material sounds of transcendence. BRAAAM sound phenomena are developed as Deus ex Machina devices and their significance in teasers and trailers as autonomous aestheticizations is mapped out. It will be argued that at the peak of the salvific narrative structure of trailers, they defer physical and narrative resolution. A brief genealogy of the materiality of Deus ex Machina sound devices in Western Christianity leads to a few considerations on the religious practice of teaser and trailer consumption as ritualized anticipation and deferral.
Computed tomography angiography as a confirmatory test for the diagnosis of brain death
Authors: Garrett Mark P. , Williamson Richard W. , Bohl Michael A. , Bird C. Roger , Theodore Nicholas
Published: March 2017

OBJECTIVE

For a diagnosis of brain death (BD), ancillary testing is performed if patient factors prohibit a complete clinical examination and apnea test. The American Academy of Neurology (AAN) guidelines identify cerebral angiography (CA), cerebral scintigraphy, electroencephalography, and transcranial Doppler ultrasonography as accepted ancillary tests. CA is widely considered the gold standard of these, as it provides the most reliable assessment of intracranial blood flow. CT angiography (CTA) is a noninvasive and widely available study that is also capable of identifying absent or severely diminished intracranial blood flow, but it is not included among the AAN's accepted ancillary tests because of insufficient evidence demonstrating its reliability. The objective of this study was to assess the statistical performance of CTA in diagnosing BD, using clinical criteria alone or clinical criteria plus CA as the gold-standard comparisons.

METHODS

The authors prospectively enrolled 22 adult patients undergoing workup for BD. All patients had cranial imaging and clinical examination results consistent with BD. In patients who met the AAN clinical criteria for BD, the authors performed CA and CTA so that both tests could be compared with the gold-standard clinical criteria. In cases that required ancillary testing, CA was performed as a confirmatory study, and CTA was then performed to compare against clinical criteria plus CA. Radiographic data were evaluated by an independent neuroradiologist. Test characteristics for CTA were calculated.

RESULTS

Four patients could not complete the standard BD workup and were excluded from analysis. Of the remaining 18 patients, 16 met AAN criteria for BD, 9 of whom required ancillary testing with CA. Of the 16 patients, 2 who also required CA ancillary testing were found to have persistent intracranial flow and were not declared brain dead at that time. These patients also underwent CTA; the results were concordant with the CA results. Six patients who were diagnosed with BD on the basis of clinical criteria alone also underwent CA, with 100% sensitivity. For all 18 patients included in the study, CTA had a sensitivity of 75%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 33%.

CONCLUSIONS

Clinical examination with or without CA remains the gold standard in BD testing. Studies assessing the statistical performance of CTA in BD testing should compare CTA to these gold standards. The statistical performance of CTA in BD testing is comparable to several of the nationally accepted ancillary tests. These data add to the growing medical literature supporting the use of CTA as a reliable ancillary test in BD testing.
Remote motor system metabolic profile and surgery outcome in cervical spondylotic myelopathy
Authors: Craciunas Sorin C. , Gorgan Mircea R. , Ianosi Bogdan , Lee Phil , Burris Joseph , Cirstea Carmen M.
Published: March 2017

OBJECTIVE

In patients with cervical spondylotic myelopathy (CSM), the motor system may undergo progressive functional/structural changes rostral to the lesion, and these changes may be associated with clinical disability. The extent to which these changes have a prognostic value in the clinical recovery after surgical treatment is not yet known. In this study, magnetic resonance spectroscopy (MRS) was used to test 2 primary hypotheses. 1) Based on evidence of corticospinal and spinocerebellar, rubro-, or reticulospinal tract degeneration/dysfunction during chronic spinal cord compression, the authors hypothesized that the metabolic profile of the primary motor cortices (M1s) and cerebellum, respectively, would be altered in patients with CSM, and these alterations would be associated with the extent of the neurological disabilities. 2) Considering that damage and/or plasticity in the remote motor system may contribute to clinical recovery, they hypothesized that M1 and cerebellar metabolic profiles would predict, at least in part, surgical outcome.

METHODS

The metabolic profile, consisting of N-acetylaspartate (NAA; marker of neuronal integrity), myoinositol (glial marker), choline (cell membrane synthesis and turnover), and glutamate-glutamine (glutamatergic system), of the M1 hand/arm territory in each hemisphere and the cerebellum vermis was investigated prior to surgery in 21 patients exhibiting weakness of the upper extremities and/or gait abnormalities. Age- and sex-matched controls (n = 16) were also evaluated to estimate the pre-CSM metabolic profile of these areas. Correlation and regression analyses were performed between preoperative metabolite levels and clinical status 6 months after surgery.

RESULTS

Relative to controls, patients exhibited significantly higher levels of choline but no difference in the levels of other metabolites across M1s. Cerebellar metabolite levels were indistinguishable from control levels. Certain metabolites—myo-inositol and choline across M1s, NAA and glutamate-glutamine in the left M1, and myo-inositol and glutamate-glutamine in the cerebellum—were significantly associated with postoperative clinical status. These associations were greatly improved by including preoperative clinical metrics into the models. Likewise, these models improved the predictive value of preoperative clinical metrics alone.

CONCLUSIONS

These preliminary findings demonstrate relationships between the preoperative metabolic profiles of two remote motor areas and surgical outcome in CSM patients. Including preoperative clinical metrics in the models significantly strengthened the predictive value. Although further studies are needed, this investigation provides an important starting point to understand how the changes upstream from the injury may influence the effect of spinal cord decompression.
Posterior arch C-1 screw technique: a cadaveric comparison study
Authors: Moisi Marc , Fisahn Christian , Tkachenko Lara , Jeyamohan Shiveindra , Reintjes Stephen , Grunert Peter , Norvell Daniel C. , Tubbs R. Shane , Page Jeni , Newell David W. , Nora Peter , Oskouian Rod J. , Chapman Jens
Published: March 2017

OBJECTIVE

Posterior atlantoaxial stabilization and fusion using C-1 lateral mass screw fixation has become commonly used in the treatment of instability and for reconstructive indications since its introduction by Goel and Laheri in 1994 and modification by Harms in 2001. Placement of such lateral mass screws can be challenging because of the proximity to the spinal cord, vertebral artery, an extensive venous plexus, and the C-2 nerve root, which overlies the designated starting point on the posterior center of the lateral mass. An alternative posterior access point starting on the posterior arch of C-1 could provide a C-2 nerve root–sparing starting point for screw placement, with the potential benefit of greater directional control and simpler trajectory. The authors present a cadaveric study comparing an alternative strategy (i.e., a C-1 screw with a posterior arch starting point) to the conventional strategy (i.e., using the lower lateral mass entry site), specifically assessing the safety of screw placement to preserve the C-2 nerve root.

METHODS

Five US-trained spine fellows instrumented 17 fresh human cadaveric heads using the Goel/Harms C-1 lateral mass (GHLM) technique on the left and the posterior arch lateral mass (PALM) technique on the right, under fluoroscopic guidance. After screw placement, a CT scan was obtained on each specimen to assess for radiographic screw placement accuracy. Four faculty spine surgeons, blinded to the surgeon who instrumented the cadaver, independently graded the quality of screw placement using a modified Upendra classification.

RESULTS

Of the 17 specimens, the C-2 nerve root was anatomically impinged in 13 (76.5%) of the specimens. The GHLM technique was graded Type 1 or 2, which is considered “acceptable,” in 12 specimens (70.6%), and graded Type 3 or 4 (“unacceptable”) in 5 specimens (29.4%). In contrast, the PALM technique had 17 (100%) of 17 graded Type 1 or 2 (p = 0.015). There were no vertebral artery injuries found in either technique. All screw violations occurred in the medial direction.

CONCLUSIONS

The PALM technique showed statistically fewer medial penetrations than the GHLM technique in this study. The reason for this is not clear, but may stem from a more angulated ”up-and-in” screw direction necessary with a lower starting point.
Immunoglobulin G4–related epidural inflammatory pseudotumor presenting with pulmonary complications and spinal cord compression: case report
Authors: Rumalla Kavelin , Smith Kyle A. , Arnold Paul M.
Published: March 2017

Immunoglobulin G4–related disease (IgG4-RD) is a recently defined condition characterized by inflammatory tumefactive lesions in various organ systems. IgG4-RD is a clinical and radiological diagnosis of exclusion and requires the presence of specific histopathological criteria for diagnosis.

A 50-year-old man presented to an outside hospital with a 3-month history of progressively worsening back pain and symptoms of pleurisy, nasal crusting, and hematochezia. Radiological workup revealed an epidural-paraspinal mass with displacement of the spinal cord, destruction of the T5–6 vertebrae, and extension into the right lung. Biopsy sampling and subsequent histopathological analysis revealed dense lymphoplasmacytic infiltrate with an increased number of IgG4-positive plasma cells and a storiform pattern of fibrosis. With strong histopathological evidence of IgG4-RD, the patient was started on a regimen of prednisone. Further testing ruled out malignant neoplasm, infectious etiologies, and other autoimmune diseases. Two weeks later, the patient presented with acute-onset paraplegia due to spinal cord compression. The patient underwent decompression laminectomy of T5–6, posterior instrumented fusion of T2–8, and debulking of the epidural-paraspinal mass. After the continued administration of glucocorticosteroids, the patient improved remarkably to near-normal strength in the lower extremities and sensory function 6 months after surgery.

To the authors' knowledge, this is the first case of IgG4-related epidural inflammatory pseudotumor and spinal cord compression in the United States. This case highlights the importance of early administration of glucocorticosteroids, which were essential to preventing further progression and preventing relapse. IgG4-RD evaluation is important after other diseases in the differential diagnosis are ruled out.
Comparative effectiveness of flexible versus rigid neuroendoscopy for endoscopic third ventriculostomy and choroid plexus cauterization: a propensity score–matched cohort and survival analysis
Authors: Wang Shelly , Stone Scellig , Weil Alexander G. , Fallah Aria , Warf Benjamin C. , Ragheb John , Bhatia Sanjiv , Kulkarni Abhaya V.
Published: March 2017

OBJECTIVE

Endoscopic third ventriculostomy (ETV)/choroid plexus cauterization (CPC) has become an increasingly common technique for the treatment of infant hydrocephalus. Both flexible and rigid neuroendoscopy can be used, with little empirical evidence directly comparing the two. Therefore, the authors used a propensity score–matched cohort and survival analysis to assess the comparative efficacy of flexible and rigid neuroendoscopy.

METHODS

Individual data were collected through retrospective review of infants younger than 2 years of age, treated at 1 of 2 hospitals: 1) Boston Children's Hospital, exclusively utilizing flexible neuroendoscopy, and 2) Nicklaus Children's Hospital-Jackson Memorial Hospital, exclusively utilizing rigid neuroendoscopy. Patient characteristics and postoperative outcomes were assessed. A propensity score model was developed to balance patient characteristics in the case mix.

RESULTS

A propensity score model for neuroendoscope type was developed with 5 independent variables: chronological age, sex, hydrocephalus etiology, prior CSF diversion, and prepontine scarring. Propensity score decile-adjusted and 1-to-1 nearest-neighbor matching analysis revealed that compared with flexible neuroendoscopy, rigid neuroendoscopy had an ETV/CPC failure odds ratio (OR) of 1.43 (p = 0.31) and 1.31 (p = 0.47), respectively, compared with an unadjusted OR of 2.40 (p = 0.034). Furthermore, in a Cox regression analysis controlled by propensity score, rigid neuroendoscopy had a hazard ratio (HR) of 1.10 (p = 0.70), compared with an unadjusted HR of 1.61 (p = 0.031).

CONCLUSIONS

Although unadjusted analysis suggested worse ETV/CPC outcomes for infants treated by rigid neuroendoscopy, much of the difference could be attributed to the case mix and other predictors of outcome. A larger sample observational study or randomized controlled trials are required to provide evidence-based guidelines on ETV/CPC technique.
Asymptotic approximations elucidating the Gibbs phenomenon and Fejér averaging
Authors: Fikioris George , Andrianesis Panagiotis
Published: March 2017

This paper deals with two trigonometric sums that are pervasive in the literature dealing with the Gibbs phenomenon. In particular, the two sums often serve as test cases for methods – such as the method of Fejér averaging – that aim to overcome the Gibbs phenomenon. Each of the two is the partial sum of a convergent infinite series with a discontinuous limit function. Our starting points are some recently-published results, both exact and asymptotic, for the two sums. For the case of a large number of terms, we proceed from those results to develop simple and revealing asymptotic formulas for the two sums and, also, for their Fejér averages. These formulas break down as we approach the point of discontinuity, so we further develop similar formulas that are appropriate near the discontinuity point. We repeat all these tasks for a third sum whose corresponding infinite series exhibits a logarithmic singularity. Our asymptotic results, which view the three sums from a new perspective, illuminate many aspects of the Gibbs phenomenon and the Fejér averaging method. As an illustrative example of the applicability of our formulas, we exploit their properties to develop a convergence acceleration method. We then use this method to accelerate some (more complicated) sums that exhibit logarithmic singularities, including a sum that arises in several physics applications.
Asymptotical behavior of partial integral-differential equation on nonsymmetric layered stable processes
Authors: Kang Junjun , Tang Yanbin
Published: March 2017

In this paper we consider the asymptotical behavior of the density function of one dimensional nonsymmetric layered stable processes via Lévy–Khinchin exponent. For the corresponding parabolic partial integro-differential equation [Formula: see text] generated by the Lévy operator L, the infinitesimal generator of the layered stable process, we first develop a new analytical method to instead of the usual probability method, then we give the long-time and the short-time asymptotical behavior of the solutions to the corresponding Cauchy problem of the equation [Formula: see text] respectively, and these imply the asymptotical behavior of transition density. Finally we localize the parabolic partial integro-differential equation to the bounded domains and give the error estimates due to the localization.
Monokinetic solutions to a singular Vlasov equation from a semiclassical perspective
Authors: Carles Rémi , Nouri Anne
Published: March 2017

Solutions to a singular one-dimensional Vlasov equation are obtained as the semiclassical limit of the Wigner transform associated to a logarithmic Schrödinger equation. Two frameworks are considered, regarding in particular the initial position density: Gaussian initial density, or smooth initial density away from vacuum. For Gaussian initial densities, the analysis also yields global solutions to the isothermal Euler system that do not enter the frame of regular solutions to hyperbolic systems by P.D. Lax.
On Finding the Maximum and Minimum Density Axes-parallel Regions in IRd
Authors: Basu Nilanjana G. , Majumder Subhashis , Hon Wing Kai
Published: March 2017

Finding the density of a set of n points, especially where points are in IR2 or IR3, has direct applications in thermal analysis of VLSI chips. In this paper, we consider identifying the maximum-density axes-parallel region for a set of weighted points in IR d for d ≥ 2, and show that it can be done in O( dn2) time. We also consider finding the minimum-density axes-parallel region, and show that for IR2 the problem can be solved in O( n2) time.
Triceps and Subscapular Skinfold in Men Aged 40–65 and Dementia Prevalence 36 Years Later
Authors: Ravona-Springer Ramit , Schnaider-Beeri Michal , Goldbourt Uri
Published: March 2017

Background: The relationship of obesity with risk for dementia is complex and may change with age.

Objective: To analyze the relationship between measures of obesity at age 40–65 and dementia prevalence in survivors 36 years later.

Methods: Obesity-related measures of triceps and subscapular skinfold thickness were assessed in 1963 in n = 9,760 men aged 40–65 participating in the Israel Ischemic Heart Disease study. Cognitive evaluation and assessment of dementia prevalence were performed in n = 1,643 participants of the original cohort who survived until 1999/2000 (age ≥76 years) and had anthropometric measures in 1963.

Results: Age-adjusted prevalence of dementia in survivors in 1999/2000 by baseline triceps skinfold quintile was 20.5%, 21.2%, 17.6%, 15.6%, and 14.5%, respectively, from lowest to highest ( p = 0.006 in trend test). Using logistic regression, a 6-mm increment of triceps skinfold was associated with an age and BMI-adjusted odds ratio of 0.81 (95% CI, 0.70–0.94) for dementia prevalence among survivors. Age-adjusted risk for dementia by subscapular skinfold quintile demonstrated 20.5%, 17.1%, 15.7%, 19.4%, and 18.1%, respectively, in groups of subjects by subscapular skinfold quintile from lowest to highest ( p = 0.6 in trend test).

Conclusions: Lower triceps skinfold at age 40–65, reflecting diminished peripheral fat, was associated with higher dementia prevalence in late life, potentially suggesting a protective role of peripheral fat to brain health.
Structural Anatomical Investigation of Long-Term Memory Deficit in Behavioral Frontotemporal Dementia
Authors: Bertoux Maxime , Flanagan Emma C. , Hobbs Matthew , Ruiz-Tagle Amparo , Delgado Carolina , Miranda Marcelo , Ibáñez Agustín , Slachevsky Andrea , Hornberger Michael
Published: March 2017

Although a growing body of work has shown that behavioral variant frontotemporal dementia (bvFTD) could present with severe amnesia in approximately half of cases, memory assessment is currently the clinical standard to distinguish bvFTD from Alzheimer’s disease (AD). Thus, the concept of “relatively preserved episodic memory” in bvFTD remains the basis of its clinical distinction from AD and a criterion for bvFTD’s diagnosis. This view is supported by the idea that bvFTD is not characterized by genuine amnesia and hippocampal degeneration, by contrast to AD. In this multicenter study, we aimed to investigate the neural correlates of memory performance in bvFTD as assessed by the Free and Cued Selective Reminding Test (FCSRT). Imaging explorations followed a two-step procedure, first relying on a visual rating of atrophy of 35 bvFTD and 34 AD patients’ MRI, contrasted with 29 controls; and then using voxel-based morphometry (VBM) in a subset of bvFTD patients. Results showed that 43% of bvFTD patients presented with a genuine amnesia. Data-driven analysis on visual rating data showed that, in bvFTD, memory recall & storage performances were significantly predicted by atrophy in rostral prefrontal and hippocampal/perihippocampal regions, similar to mild AD. VBM results in bvFTD (pFWE<0.05) showed similar prefrontal and hippocampal regions in addition to striatal and lateral temporal involvement. Our findings showed the involvement of prefrontal as well as medial/lateral temporal atrophy in memory deficits of bvFTD patients. This contradicts the common view that only frontal deficits explain memory impairment in this disease and plead for an updated view on memory dysfunctions in bvFTD.
Peripherally inserted central catheter in extremely preterm infants: Characteristics and influencing factors
Authors: van den Berg J. , Lööf Åström J. , Olofsson J. , Fridlund M. , Farooqi A.
Published: March 2017

OBJECTIVE: To evaluate the duration of catheter stay, incidence of non-elective removal and rates of complications associated with peripherally inserted central catheters (PICCs) in relation to different catheter positions in extremely preterm infants (EPT, <28 weeks of gestation).

METHODS: A retrospective analysis of Peripherally Inserted Central Catheters (PICCs) inserted in EPT infants over a 10-year period, from January 2004 through December 2013 (mean gestational age, 25.2 weeks; mean birth weight, 727 g).

RESULTS: Of the 379 PICCs analyzed, the majority of lines (68%) were placed in the central position, and 259 PICCs (56%) were removed electively after fulfilment of the treatment. Significantly more PICCs in the lower extremities compared to the upper extremities were in central positions (86% vs 61%, p < 0.001, respectively). Significantly more PICCs that were removed electively after fulfilment of the treatment were in a central position compared to a non-central position ( p < 0.001). Of the 166 catheters that were removed because of complications, most (71%) of them had mechanical problems, and 13% had sepsis resulting in an incidence rate of 4.4/1000 catheter days.

CONCLUSION: PICCs inserted in the lower extremity were more likely to have a centrally placed tip position compared to PICC lines inserted in the upper extremities.
Using antifibrinolytics in the peripartum period – concern for a hypercoagulable effect?
Authors: Ahmadzia H.K. , Lockhart E.L. , Thomas S.M. , Welsby I.J. , Hoffman M.R. , James A.H. , Murtha A.P. , Swamy G.K. , Grotegut C.A.
Published: March 2017

INTRODUCTION: Although antifibrinolytic agents are used to prevent and treat hemorrhage, there are concerns about a potential increased risk for peripartum venous thromboembolism. We sought to determine the impact of tranexamic acid and ɛ-aminocaproic acid on in vitro clotting properties in pregnancy.

METHODS: Blood samples were obtained from healthy pregnant, obese, and preeclamptic pregnant women ( n = 10 in each group) prior to delivery as well as from healthy non-pregnant controls ( n = 10). Maximum clot firmness (MCF) and clotting time (CT) were measured using rotation thromboelastometry in the presence of tranexamic acid (3, 30, or 300 μg/mL) or ɛ-aminocaproic acid (30, 300, or 3000 μg/mL). ANOVA and regression analyses were performed.

RESULTS: Mean whole blood MCF was significantly higher in healthy pregnant vs. non-pregnant women (66.5 vs. 57.5 mm, p < 0.001). Among healthy pregnant women, there was no significant difference between mean MCF (whole blood alone, and with increasing tranexamic acid doses = 66.5, 66.1, 66.4, 66.3 mm, respectively; p = 0.25) or mean CT (409, 412, 420, 424 sec; p = 0.30) after addition of tranexamic acid. Similar results were found using ɛ-aminocaproic acid. Preeclamptic women had a higher mean MCF after the addition of ɛ-aminocaproic acid and tranexamic acid ( p = 0.05 and p = 0.04, respectively) compared to whole blood alone.

CONCLUSIONS: Pregnancy is a hypercoagulable state, as reflected by an increased MCF compared to non-pregnant women. Addition of antifibrinolytic therapy in vitro does not appear to increase MCF or CT for non-pregnant, pregnant, and obese women. Whether antifibrinolytics are safe in preeclampsia may require further study.
Perspectives and attitudes of pediatricians concerning post-discharge care practice of premature infants
Authors: Gad A. , Parkinson E. , Khawar N. , Elmeki A. , Narula P. , Hoang D.
Published: March 2017

OBJECTIVE: Survival rates of premature infants are at a historical high and increasingly more pediatricians are caring for former premature infants. The goal of this study was to describe the perspectives and attitudes of pediatricians, as well as, the challenges of rendering post-neonatal intensive care unit (NICU) discharge care for premature infants.

METHODS: An anonymous 22-question web-based survey was emailed to pediatricians who are current members of the American Academy of Pediatrics (AAP) and practicing in Kings County, New York.

RESULTS: There were 148 completed surveys with 79% being general pediatricians. Of all respondents, 63% believed that premature infants should have a neonatal high risk follow-up visit within days after discharge and 64% were satisfied with the NICU discharge summary acquisition. While 74% of pediatricians felt comfortable following up with former extremely premature infants, 65% referred to specialists, most often to child development, neurology, and physical and/or occupational therapy. The majority (85%) were more likely to refer premature infants to early intervention. Participating pediatricians varied in their knowledge of immunization and breastfeeding guidelines. Finally, 88% of respondents acknowledged that caregivers of premature infants experience increased stress, with 53% stating that the stress should be addressed.

CONCLUSIONS: Understanding the perceptions and challenges of pediatricians who care for premature infants may help improve post NICU quality of care. Transition to the outpatient setting is a crucial step in the management of premature infants and a focus on improved hand-off procedures between hospital and physicians may prove beneficial. Also, pediatricians must stay abreast of current recommendations for breastfeeding and vaccinations. Furthermore, emphasis should be given to stress reduction and management for caregivers of former premature infants.
Early onset necrotizing enterocolitis (NEC) in premature twins
Authors: Afzal B. , Elberson V. , McLaughlin C. , Kumar V.H.S.
Published: March 2017

Twin infants born at 34 week gestation had frank blood in stools on day three of life on mixed feeds of formula and maternal breast milk. Sepsis work up was negative in these relatively well appearing infants with pneumatosis in the colon on abdominal x-ray. Blood in stools recurred on reintroduction of breast milk in Twin A. Both infants recovered from episodes of bloody stools on amino-acid based formula and were thriving at discharge. Early necrotizing enterocolitis in both twins is rare and has not been reported. Cow’s milk protein sensitivity, possibly from in-utero sensitization, could explain non-infectious colitis in these twins, precipitated by formula or breast milk after birth.
A case of infant delirium in the neonatal intensive care unit
Authors: Edwards L.E. , Hutchison L.B. , Hornik C.D. , Smith P.B. , Cotten C.M. , Bidegain M.
Published: March 2017

Infant delirium is an under-recognized clinical entity in neonatal intensive care, and earlier identification and treatment could minimize morbidities associated with this condition. We describe a case of a 6-month-old former 32 weeks gestation infant undergoing a prolonged mechanical ventilation course diagnosed with delirium related to the combination of his underlying illness and the use of multiple sedative and analgesic medications. Initiation of the atypical antipsychotic risperidone allowed for weaning from continuous infusions of benzodiazepines and opiods, and lower dosages of bolus-dosed sedation and analgesics. The patient experienced no adverse side effects from use of this neuroleptic.
Calcium chloride in neonatal parenteral nutrition: A 15 year experience
Authors: Huston R.K. , Kaempf J.W. , Wang M. , Wang L. , Grunkemeier G.L. , Cohen H.S.
Published: March 2017

OBJECTIVE: The objective of this study was to determine if outcomes at our neonatal intensive care units (NICUs) since we began using calcium chloride (CaCl2) as our preferred calcium additive in order to reduce aluminum (Al) exposure are within expected outcome ranges for NICUs in the U.S. where calcium gluconate in glass vials (CaGlu-Gl) has been the preferred additive.

STUDY DESIGN: A retrospective study of very low birth weight infants born between January 1, 2000 and December 31, 2014. Outcomes in two intensive care units (NICUs) using CaCl2 were compared to all U.S. NICUs in the Vermont Oxford Network. Primary outcomes were chronic lung disease (CLD), percent requiring supplemental oxygen at 28 days, and mortality excluding early deaths (MEED). The incidence of IV infiltrates of all admissions to the study NICUs in 2013-2014 was compared to the literature.

RESULTS: The incidence of CLD and those requiring oxygen at 28 days were 24.0% vs 28.6% and 46.2% vs 51.8% for the study NICUs compared to all U.S. NICUs, respectively (both p < 0.0001). The MEED was 8.7% vs 10.3% ( p < 0.002). All major morbidities were lower at the study NICUs. The incidence of infiltrates was lower than that in the literature.

CONCLUSION: The use of CaCl2 was not associated with any detectable adverse effects. Calcium chloride appears to be a safe alternative to the use of CaGlu-Gl based upon studies of clinical outcomes.
Retinopathy of prematurity in Indonesia: Incidence and risk factors
Authors: Edy Siswanto J. , Sauer Pieter JJ
Published: March 2017

BACKGROUND: Retinopathy of prematurity (ROP) is a vaso-proliferative disease of the eye, which mainly affects preterm newborn infants with an incompletely vascularized retina. The incidence of ROP has increased in industrialized countries due to the increased survival of extremely low birth weight (ELBW) infants. ROP is also increasing in developing countries like Indonesia, where it is most likely due to the improved survival of ELBW infants.

OBJECTIVE: To ascertain the incidence of ROP and possible risk factors associated with the development of ROP in preterm infants in Indonesia.

METHODS: We reviewed the literature on the incidence and potential risk factors for the development of ROP in Indonesia, obtained data from three referral eye clinics and added data from our institution.

RESULTS: The reported incidence of all stages of ROP in infants with a gestational age of <32 weeks ranged from 18–30%. One study showed that ROP also occurred at older gestational ages. Blindness due to ROP was seen in infants up to 35 weeks and with a birth weight of 2000 g.

CONCLUSION: Retinopathy of prematurity is an important cause of ocular morbidity and blindness in Indonesia. The overall incidence of ROP in infants born below 32 weeks in Indonesia is higher than in developed countries, and it is seen in infants with older gestational ages. This might be due to a less strict monitoring during the use of oxygen in Indonesia compared to industrialized countries.
A Survey: Potential Impact of Genetically Modified Maize Tolerant to Drought or Resistant to Stem Borers in Uganda
Authors: Wamatsembe Isaac , Asea Godfrey , Haefele Stephan
Published: March 2017

Maize production in Uganda is constrained by various factors, but especially drought and stem borers contribute to significant yield losses. Genetically modified (GM) maize with increased drought tolerance and/or Bt insect resistance (producing the Bacillus thuringiensis Cry protein) is considered as an option. For an ex ante impact analysis of these technologies, a farmer survey was carried out in nine districts of Uganda, representing the major farming systems. The results showed that farmers did rate stem borer and drought as the main constraints for maize farming. Most farmers indicated a positive attitude towards GM maize, and 86% of all farmers said they would grow GM maize. Farmer estimated yield losses to drought and stem borer damage were on average 54.7% and 23.5%, respectively, if stress occurred. Taking the stress frequency into consideration (67% for both), estimated yield losses were 36.5% and 15.6% for drought and stem borer, respectively. According to the ex-ante partial budget analysis, Bt hybrid maize could be profitable, with an average value/cost ratio of 2.1. Drought tolerant hybrid maize had lower returns and a value/cost ratio of 1.5. Negative returns occurred mainly for farmers with non-stressed grain yields below 2 t·ha−1. The regulatory framework in Uganda needs to be finalized with consideration of strengthening key institutions in the maize sector for sustainable introduction of GM maize.
Correction: Krymchantowski, A.V.; et al. Medication-Overuse Headache: Differences between Daily and Near-Daily Headache Patients; Brain Sciences 2016, 6, 30
Authors: Krymchantowski Abouch , Jevoux Carla , Valença Marcelo
Published: March 2017

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KDM2 Family Members are Regulated by HIF-1 in Hypoxia
Authors: Batie Michael , Druker Jimena , D’Ignazio Laura , Rocha Sonia
Published: March 2017

Hypoxia is not only a developmental cue but also a stress and pathological stimulus in many human diseases. The response to hypoxia at the cellular level relies on the activity of the transcription factor family, hypoxia inducible factor (HIF). HIF-1 is responsible for the acute response and transactivates a variety of genes involved in cellular metabolism, cell death, and cell growth. Here, we show that hypoxia results in increased mRNA levels for human lysine (K)-specific demethylase 2 (KDM2) family members, KDM2A and KDM2B, and also for Drosophila melanogaster KDM2, a histone and protein demethylase. In human cells, KDM2 family member’s mRNA levels are regulated by HIF-1 but not HIF-2 in hypoxia. Interestingly, only KDM2A protein levels are significantly induced in a HIF-1-dependent manner, while KDM2B protein changes in a cell type-dependent manner. Importantly, we demonstrate that in human cells, KDM2A regulation by hypoxia and HIF-1 occurs at the level of promoter, with HIF-1 binding to the KDM2A promoter being required for RNA polymerase II recruitment. Taken together, these results demonstrate that KDM2 is a novel HIF target that can help coordinate the cellular response to hypoxia. In addition, these results might explain why KDM2 levels are often deregulated in human cancers.
Friction, Free Axes of Rotation and Entropy
Authors: Kazachkov Alexander , Multanen Victor , Danchuk Viktor , Frenkel Mark , Bormashenko Edward
Published: March 2017

Friction forces acting on rotators may promote their alignment and therefore eliminate degrees of freedom in their movement. The alignment of rotators by friction force was shown by experiments performed with different spinners, demonstrating how friction generates negentropy in a system of rotators. A gas of rigid rotators influenced by friction force is considered. The orientational negentropy generated by a friction force was estimated with the Sackur-Tetrode equation. The minimal change in total entropy of a system of rotators, corresponding to their eventual alignment, decreases with temperature. The reported effect may be of primary importance for the phase equilibrium and motion of ubiquitous colloidal and granular systems.
Fractional Jensen–Shannon Analysis of the Scientific Output of Researchers in Fractional Calculus
Authors: Machado José , Mendes Lopes António
Published: March 2017

This paper analyses the citation profiles of researchers in fractional calculus. Different metrics are used to quantify the dissimilarities between the data, namely the Canberra distance, and the classical and the generalized (fractional) Jensen–Shannon divergence. The information is then visualized by means of multidimensional scaling and hierarchical clustering. The mathematical tools and metrics allow for direct comparison and visualization of researchers based on their relative positioning and on patterns displayed in two- or three-dimensional maps.
Distance-Based Lempel–Ziv Complexity for the Analysis of Electroencephalograms in Patients with Alzheimer’s Disease
Authors: Simons Samantha , Abásolo Daniel
Published: March 2017

The analysis of electroencephalograms (EEGs) of patients with Alzheimer’s disease (AD) could contribute to the diagnosis of this dementia. In this study, a new non-linear signal processing metric, distance-based Lempel–Ziv complexity (dLZC), is introduced to characterise changes between pairs of electrodes in EEGs in AD. When complexity in each signal arises from different sub-sequences, dLZC would be greater than when similar sub-sequences are present in each signal. EEGs from 11 AD patients and 11 age-matched control subjects were analysed. The dLZC values for AD patients were lower than for control subjects for most electrode pairs, with statistically significant differences (p < 0.01, Student’s t-test) in 17 electrode pairs in the distant left, local posterior left, and interhemispheric regions. Maximum diagnostic accuracies with leave-one-out cross-validation were 77.27% for subject-based classification and 78.25% for epoch-based classification. These findings suggest not only that EEGs from AD patients are less complex than those from controls, but also that the richness of the information contained in pairs of EEGs from patients is also lower than in age-matched controls. The analysis of EEGs in AD with dLZC may increase the insight into brain dysfunction, providing complementary information to that obtained with other complexity and synchrony methods.
Quantitative EEG Markers of Entropy and Auto Mutual Information in Relation to MMSE Scores of Probable Alzheimer’s Disease Patients
Authors: Coronel Carmina , Garn Heinrich , Waser Markus , Deistler Manfred , Benke Thomas , Dal-Bianco Peter , Ransmayr Gerhard , Seiler Stephan , Grossegger Dieter , Schmidt Reinhold
Published: March 2017

Analysis of nonlinear quantitative EEG (qEEG) markers describing complexity of signal in relation to severity of Alzheimer’s disease (AD) was the focal point of this study. In this study, 79 patients diagnosed with probable AD were recruited from the multi-centric Prospective Dementia Database Austria (PRODEM). EEG recordings were done with the subjects seated in an upright position in a resting state with their eyes closed. Models of linear regressions explaining disease severity, expressed in Mini Mental State Examination (MMSE) scores, were analyzed by the nonlinear qEEG markers of auto mutual information (AMI), Shannon entropy (ShE), Tsallis entropy (TsE), multiscale entropy (MsE), or spectral entropy (SpE), with age, duration of illness, and years of education as co-predictors. Linear regression models with AMI were significant for all electrode sites and clusters, where R 2 is 0.46 at the electrode site C3, 0.43 at Cz, F3, and central region, and 0.42 at the left region. MsE also had significant models at C3 with R 2 > 0.40 at scales τ = 5 and τ = 6 . ShE and TsE also have significant models at T7 and F7 with R 2 > 0.30 . Reductions in complexity, calculated by AMI, SpE, and MsE, were observed as the MMSE score decreased.
Information Submanifold Based on SPD Matrices and Its Applications to Sensor Networks
Authors: Xu Hao , Sun Huafei , Win Aung
Published: March 2017

In this paper, firstly, manifoldPD(n)consisting of alln×nsymmetric positive-definite matrices is introduced based on matrix information geometry; Secondly, the geometrical structures of information submanifold ofPD(n)are presented including metric, geodesic and geodesic distance; Thirdly, the information resolution with sensor networks is presented by three classical measurement models based on information submanifold; Finally, the bearing-only tracking by single sensor is introduced by the Fisher information matrix. The preliminary analysis results introduced in this paper indicate that information submanifold is able to offer consistent and more comprehensive means to understand and solve sensor network problems for targets resolution and tracking, which are not easily handled by some conventional analysis methods.
Smart Home Energy Management
Authors: Pau Giovanni , Collotta Mario , Ruano Antonio , Qin Jiahu
Published: March 2017

The new challenges on Information and Communication Technologies (ICT) in Automatic Home Systems (AHS) focus on the methods useful to monitor, control, and optimize the data management flow and the use of energy.[...]
Non-Destructive, Laser-Based Individual Tree Aboveground Biomass Estimation in a Tropical Rainforest
Authors: Abd Rahman Muhammad , Abu Bakar Md , Razak Khamarrul , Rasib Abd , Kanniah Kasturi , Wan Kadir Wan , Omar Hamdan , Faidi Azahari , Kassim Abd , Abd Latif Zulkiflee
Published: March 2017

Recent methods for detailed and accurate biomass and carbon stock estimation of forests have been driven by advances in remote sensing technology. The conventional approach to biomass estimation heavily relies on the tree species and site-specific allometric equations, which are based on destructive methods. This paper introduces a non-destructive, laser-based approach (terrestrial laser scanner) for individual tree aboveground biomass estimation in the Royal Belum forest reserve, Perak, Malaysia. The study area is in the state park, and it is believed to be one of the oldest rainforests in the world. The point clouds generated for 35 forest plots, using the terrestrial laser scanner, were geo-rectified and cleaned to produce separate point clouds for individual trees. The volumes of tree trunks were estimated based on a cylinder model fitted to the point clouds. The biomasses of tree trunks were calculated by multiplying the volume and the species wood density. The biomasses of branches and leaves were also estimated based on the estimated volume and density values. Branch and leaf volumes were estimated based on the fitted point clouds using an alpha-shape approach. The estimated individual biomass and the total above ground biomass were compared with the aboveground biomass (AGB) value estimated using existing allometric equations and individual tree census data collected in the field. The results show that the combination of a simple single-tree stem reconstruction and wood density can be used to estimate stem biomass comparable to the results usually obtained through existing allometric equations. However, there are several issues associated with the data and method used for branch and leaf biomass estimations, which need further improvement.