bluuebunny/crossref_metadata_2025 huggingface dataset:
Wearing Time of Ankle-Foot Orthoses with Modular Shank Supply in Cerebral Palsy: A Descriptive Analysis in a Clinically Prospective Approach
Authors: Schwarze M. , Horoba L. , Block J. , Putz C. , Alimusaj M. , Wolf S. I. , Dreher T.
Published: July 2019

Objective. To date there is only limited knowledge about the wearing time of orthoses. Ankle-foot orthoses (AFOs) have not been studied with this research question. Additional influences of the orthotic design as well as weekdays and the weekend are also unknown.Design. Monocentric, clinically prospective intervention study.Patients. Inclusion of 10 patients with bilateral spastic cerebral palsy.Methods. Equipment of all subjects with a dynamic ankle-foot orthosis (DAFO) and modular shank supply (MSS, dynamic elastic shank adaptation or ground reaction AFO). Integration of temperature sensors for recording the wearing time for a period of 3 months.Results. The actual wearing time was below the recommendations on actually worn days as well as the average of the entire study period. In addition, the actual usage in terms of days and hours was well below the recommendations. The wearing time showed differences between weekdays and weekend. Differences between DAFO and MSS were not detectable.Conclusion. The actual usage behavior of ankle-foot orthoses differs from the recommendations of the prescriber. This applies to both DAFOs and modular use with shank supplies. Environmental factors may have a significant impact on wearing times on weekdays and the weekend.
Antifungal Activity of Crude Extract from the Rhizome and Root ofSmilacina japonicaA. Gray
Authors: Liu Wei , Sun Baozheng , Yang Manman , Zhang Ziyue , Zhang Xiuxiu , Pang Tingsong , Wang Shengzheng
Published: July 2019

This study aimed to investigate the antifungal activity of hydroalcoholic extract fromSmilacina japonicaA. Gray(SJA) against different fungi. The minimum inhibitory concentration (MIC) for SJA was determined by the broth microdilution method. The antifungal effects of SJA againstCandida albicanswere further confirmed by cell growth test and time-kill curve test. The effects of SJA on the fungal morphology and ultrastructure were also evaluated. SJA has a broad-spectrum antifungal activity. The MICs of SJA against different fungi, including fluconazole-sensitive and -resistantCandida albicans, otherCandidaspecies, andCryptococcus neoformans, ranged from 208μg/ml to 1665μg/ml. Furthermore, SJA displayed fungicidal activity against varied fungi and obviously inhibited the hyphal growth of fungi. The mechanism study revealed that the antifungal activity of SJA might be associated with its effect on the cell morphology and ultrastructure.
Reactive Oxygen Species Are Involved in the Development of Gastric Cancer and Gastric Cancer-Related Depression through ABL1-Mediated Inflammation Signaling Pathway
Authors: Huang Tianhe , Zhou Fuling , Yuan Xiaohan , Yang Tian , Liang Xuan , Wang Yu , Tu Honglei , Chang Jiantong , Nan Kejun , Wei Yongchang
Published: July 2019

Background. The mechanisms of crosstalk between depression and gastric cancer (GC) remain ill defined. Given that reactive oxygen species (ROS) is involved in the pathophysiology of both GC and depression, we try to explore the activities of ROS in the development of GC and GC-related depression. Methods. 110 patients with newly diagnosed GC were recruited in our study. The clinical characteristics of these patients were recorded. Inflammation and oxidative stress markers were detected by ELISA. The depression status of patients with GC was assessed during follow-up. The association between ROS, ABL1, and inflammation factors was evaluated in H2O2-treated GC cell lines and The Cancer Genome Atlas (TCGA) database. The effect of ABL1 on inflammation was detected with Imatinib/Nilotinib-treated GC cell lines. A chronic mild stress- (CMS-) induced patient-derived xenograft (PDX) mice model was established to assess the crosstalk between depression and GC. Results. Depression was correlated with poor prognosis of patients with GC. GC patients with depression were under a high level of oxidative status as well as dysregulated inflammation. In the CMS-induced GC PDX mice model, CMS could facilitate the development of GC. Additionally, tumor bearing could induce depressive-like behaviors of mice. With the treatment of ROS, the activities of ABL1 and inflammatory signaling were enhanced both in vitro and in vivo, and blocking the activities of ABL1 inhibited inflammatory signaling. Conclusions. ROS-activated ABL1 mediates inflammation through regulating NF-κB1 and STAT3, which subsequently leads to the development of GC and GC-related depression.
Use of Cadaveric Pericardial Tissue in the Surgical Treatment of Neurogenic Bladder
Authors: Caja Madison , Lamonde Michaela , Barnard John , Zaslau Stanley , Shapiro Robert E.
Published: July 2019

The surgical treatments for neurogenic bladder are extremely variable. The lack of specific treatment guidelines makes this disease process even more challenging to treat. We present a case of a 55-year-old female with neurogenic bladder secondary to spinal cord injury (SCI). Her incontinence was conservatively managed with indwelling Foley drainage. Despite continued upsizing of the Foley catheters, the patient continued to have urinary leakage. The patient subsequently underwent a transvaginal bladder neck closure (BNC) with suprapubic bladder neck diversion (SPC). The urethra was successfully closed and uniquely supported with the use of cadaveric pericardial tissue (CPT). This surgical approach of neurogenic bladder provides durable continence with short operative times, minimal patient morbidity, decreased hospital length, and low risk of progressive renal dysfunction. BNC with SPC can provide an excellent management solution for neurogenic bladder from spinal cord injury refractory to conservative management.
Recurrent Testicular Torsion of a Fixed Testis
Authors: Alnadhari Ibrahim , Abdulmuhsin Ausama , Ali Omar , Shamsodini Ahmad , Salah Morshed , Abdeljaleel Osama
Published: July 2019

Recurrent testicular torsion after previous orchiopexy is rare and needs high index of suspension to avoid misdiagnosis and delayed management. This case showed that this diagnosis can occur even when the testis is still fixed to the scrotal wall. A 31-year-old male who had previous testicular fixation for testicular torsion with a single stitch to the lower pole before 6 years presented with recurrent testicular torsion and missed diagnosis. This case confirm that recurrent testicular torsion after previous fixation should be included in the differential diagnosis of acute scrotum and emphasis on the testicular fixation with nonabsorbable suture in at least two points to prevent recurrent torsion.
Cytotoxic Effects of Chlorophyllides in Ethanol Crude Extracts from Plant Leaves
Authors: Wang Yi-Ting , Yang Chih-Hui , Huang Ting-Yu , Tai Mi‐Hsueh , Sie Ru-Han , Shaw Jei-Fu
Published: July 2019

Chlorophyllide (chlide) is a natural catabolic product of chlorophyll (Chl), produced through the activity of chlorophyllase (chlase). The growth inhibitory and antioxidant effects of chlide from different plant leaf extracts have not been reported. The aim of this study is to demonstrate that chlide in crude extracts from leaves has the potential to exert cytotoxic effects on cancer cell lines. The potential inhibitory and antioxidant effects of chlide in crude extracts from 10 plant leaves on breast cancer cells (MCF7 and MDA-MB-231), hepatocellular carcinoma cells (Hep G2), colorectal adenocarcinoma cells (Caco2), and glioblastoma cells (U-118 MG) were studied using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) and DPPH (1,1-diphenyl-2-picrylhydrazyl) assays. The results of the MTT assay showed that chlide in crude extracts from sweet potato were the most effective against all cancer cell lines tested. U-118 MG cells were the most sensitive, while Caco2 cells were the most resistant to the tested crude extracts. The cytotoxic effects of chlide and Chl in crude extracts from sweet potato and of commercial chlorophyllin (Cu-chlin), in descending order, were as follows: chlide > Chl > Cu-chlin. Notably, the IC50 of sweet potato in U-118 MG cells was 45.65 μg/mL while those of Chl and Cu-chlin exceeded 200 μg/mL. In the DPPH assay, low concentrations (100 μg/mL) of chlide and Cu-chlin from crude extracts of sweet potato presented very similar radical scavenging activity to vitamin B2. The concentration of chlide was negatively correlated with DPPH activity. The current study was the first to demonstrate that chlide in crude extracts from leaves have potential cytotoxicity in cancer cell lines. Synergism between chlide and other compounds from leaf crude extracts may contribute to its cytotoxicity.
Excessive Methionine Supplementation Exacerbates the Development of Abdominal Aortic Aneurysm in Rats
Authors: Fan Yichuan , Li Nan , Liu Chengwei , Dong Haipeng , Hu Xinhua
Published: July 2019

Objective: The relationship between methionine (Met) and abdominal aortic aneurysm (AAA) has been previously demonstrated, but the mechanisms controlling this association remain unclear. This study investigated the potential contribution of hypermethioninemia (HMet) to the development of AAA. Methods: A model of AAA was induced by intraluminal porcine pancreatic elastase (PPE) infusion in 60 male Sprague-Dawley rats divided into 4 groups (n = 15 per group). Met was supplied by intragastric administration (1 g/kg body weight/day) from 1 week before surgery until 4 weeks after surgery. The aortic diameter was measured by ultrasound. Aortas were collected 4 weeks after surgery and subjected to biochemical analysis, histological assays, and transmission electron microscopy. Results: After 5 weeks of Met supplementation, HMet increased the dilation ratio of the HMet + PPE group, and hyperhomocysteinemia was also induced in HMet and HMet + PPE rats. Increased matrix metalloproteinase-2 (MMP-2), osteopontin, and interleukin-6 expression was detected in HMet + PPE rats. Furthermore, increased autophagy was detected in the HMet + PPE group. Conclusion: This study demonstrates that HMet may exacerbate the formation of AAA due to the increased dilation ratio partially via enhancing MMP-2 and inflammatory responses.
Acessos cirúrgicos combinados para tratamento de fraturas em assoalho orbital e lâmina papirácea
Authors: Costa Verônica Cristine Rodrigues , Streit-Junior Rosalvo , Araújo Juliana Da Luz , Queiroz Elisa Vasconcelos de , Krier Felipe Carneiro , Parreira Diderot Rodrigues , Durães Rodrigo Tamietti
Published: July 2019

A região orbitária é bastante suscetível a traumas, visto que apresenta uma posição exposta, além de ser composta por ossos frágeis. Quando indicada, é preciso intervenção cirúrgica para preservar a função visual e harmonia facial do paciente. Os acessos transconjuntival e transcaruncular são descritos na literatura como formas seguras, rápidas, funcionais e esteticamente benéficas para a abordagem ao assoalho orbitário e lâmina papirácea. Sobre os materiais biocompatíveis utilizados, a placa de titânio é inabsorvível e permite fixação interna rígida, sendo moldada às curvaturas naturais dos ossos, com baixo risco de infecção. As folhas de polietileno poroso são polímeros inertes e não absorvíveis que facilitam o crescimento de tecido e reduzem as chances de rejeição. Nesse relato de caso, evidencia-se paciente masculino, 28 anos, vítima de traumatismo facial após prática esportiva que apresentou fratura de assoalho e parede medial orbitária direita, sendo indicada reconstrução orbitária com acessos transconjuntival e transcaruncular para fixação de placa de titânio em assoalho da órbita direita e de folhas de polietileno poroso em lâmina papirácea à direita, respectivamente.
Encefalopatia por deficiência de glut-1
Authors: Simões Renato Arantes Lima , Nabhan Thaís , Delatore Lara Godela , Gazola Roberta Molinari , De Albuquerque Regina Celia Ajeje Pires , Fernandes Debora De Cassia Tomaz
Published: July 2019

Importância do problema: A síndrome da deficiência do transportador de glicose tipo 1 (GLUT1DS), descrita pela primeira vez por De Vivo em 1991, é causada por um deficitário transporte de glicose na barreira hematoencefálica e astrócitos por mutações na maioria das vezes de novo heterozigóticas no gene SLC2A1, responsável pela codificação do transportador de glicose tipo 1 (GLUT-1). Esta mutação limita a disponibilidade de glicose cerebral levando a sua deficiência energética, sendo o mecanismo gerador de suas manifestações clínicas. Os sintomas sugestivos são convulsões, atraso no desenvolvimento, microcefalia, hipotonia, espasticidade e complexas alterações no movimento consistindo de ataxia e distonia. Em pacientes GLUT1DS, substratos energéticos alternativos são de fundamental importância. Inúmeros trabalhos recomendam a utilização da dieta cetogênica de maneira imperiosa como mecanismo padrão ouro de tratamento. Esta, nos primeiros anos de vida em pacientes com GLUT1DS, garante um melhor resultado cognitivo e melhora nos aspectos psicomotores.

Comentários: A GLUT1DS por ser uma doença de recente descoberta, poucos casos descritos na literatura, características clínicas heterogêneas e falta substancial de casuística é muitas vezes subdiagnosticada. Neste sentido, critérios de suspeição e algoritmos diagnósticos se fazem necessários. Desta maneira, o objetivo deste artigo é chamar a atenção da comunidade médica brasileira a essa síndrome com vistas a incrementar seu diagnóstico e melhorar o prognóstico de epilepsias de difícil controle.
Nostalgia e demonização
Authors: Signates Luiz
Published: July 2019

Este trabalho é produto da busca por compreender os fundamentos das ideias sustentadas pelos apoiadores do intervencionismo militar no Brasil e, nesse sentido, sintetiza os resultados de uma pesquisa qualitativa realizada no 2º semestre de 2017, em Goiânia-GO, um ano antes da eleição de Bolsonaro. Os dados mostraram haver um encadeamento de fatores na base do apoio ao militarismo, tais como o medo, a adoção da ideologia fascista, a descrença seguida do desejo de destruir a democracia e erigir outro Estado, com características contraditoriamente liberais e nacionalistas, e a participação na opinião pública para angariar espaço e validade discursiva, características que, aglutinadas, compuseram um tipo de senso comum de direita, cuja rede argumentativa oscila entre a nostalgia da ditadura militar, vista como período ordeiro e seguro, e o ódio à esquerda, rejeitada ao ponto da demonização.
Decoding human screams: perception of emotional arousal from pitch and duration
Authors: Schwartz Jay W. , Gouzoules Harold
Published: July 2019

Screams are phylogenetically widespread and typically associated with emotionally intense contexts, and thus present a window into the evolution of vocal emotion expression. Screams are distinct from other vocalizations, but nonetheless exhibit acoustic variation. The purpose of this study was to assess whether humans are sensitive to this variation, specifically, whether they base perceptions of screamer arousal on the pitch and/or duration of screams. A forced choice task revealed a significant tendency to perceive longer or higher-pitched (but otherwise acoustically identical) screams as more emotionally intense than shorter or lower-pitched screams, respectively. This pattern was independent of participants’ gender, empathy score, and previous exposure to screams in the media. Furthermore, scream pairs exhibiting greater differences in duration yielded more consistent responses. Evolutionary implications relating to the acoustic correlates of arousal across mammalian species, as well as the socioecological functions of screams in other primates, are discussed.
A new species of Ilex (Aquifoliaceae) from Mexico
Authors: LOZADA-PÉREZ LUCIO
Published: July 2019

A new species of the state of Chiapas, Ilex montebellensis, is herein described and illustrated. The specimens were previously determined as I. mitis, an endemic species of Africa. This new species is morphologically akin to I. tectonica but differs for presenting larger leaves, 9.0‒22.0 × 4.0‒9 cm, petioles 1.5‒4.0 cm, masculine inflorescences in fasciculated dichasia, fruit with hard mesocarp and dorsally smooth pirenes. The checklist of species for Mexico and Mesoamerica is analysed. An identification key with Mesoamerican species that share the entire character of the leaf blade with the new species, is provided.
The Trichoptera (Insecta) of the lower Kunene River in Namibia and Angola
Authors: MEY WOLFRAM , DE MOOR FERDINAND C.
Published: July 2019

The Trichoptera of the lower Kunene River were collected at irregular intervals from 1994 to 2012 by the first author. Samples were taken mainly at several localities on the Namibian side of the border downstream of the Ruacana hydroelectric power plant. Field work concentrated on adults, which were collected by light traps. Together with results of previous investigations a total of 41 species in 16 genera covering five families are now recorded from the river. About four species were found as immatures in the past, and were identified to generic level only. The first author has collected 27 species including nine undescribed ones: Catoxyethira kunenica sp. nov., Orthotrichia epupae sp. nov., O. vadalis sp. nov., O. kunenensis sp. nov., Ecnomus magnus sp. nov., E. quadrangulatus sp. nov., E. (Psychomyiellodes) statzneri sp. nov., E. (Psychomyiellodes) angonamus sp. nov. and Ceraclea (Pseudoleptocerus) lepidopterella sp. nov. Descriptions and illustrations of the genitalia of the new species are provided. Two species were synonymized: Oecetis kunenensis Barnard, 1934 = Oectis reticulatella Kimmins, 1957, syn. nov. and Oecetis tripunctata (Fabricius, 1793) = Oecetis ovamboensis Barnard, 1934, syn. nov.
Index to key words, taxa, geographical distribution and authors

Authors: MENDEZ PATINA K.
Published: July 2019

The index contains the key words, geographical keywords, authors by last name and the complete taxonomic list for each article.
A new species of Microtityus Kjellesvig-Waering (Scorpiones: Buthidae) from northern Colombia
Authors: BOTERO-TRUJILLO RICARDO , ERAZO-MORENO MARTHA C. , PÉREZ GUSTAVO A.
Published: July 2019

Microtityus bivicentorum sp. nov. is described based on two adult specimens of both sexes from a single locality near the city of Valledupar, northern Colombia. The new species is most similar to Microtityus desuzeae González-Sponga, 2001 and Microtityus joseantonioi González-Sponga, 1981 from Venezuela, and Microtityus franckei Botero-Trujillo & Noriega, 2008 from Colombia, with which it shares the absence of trichobothrium d 2 on femur, Eb 3 and Esb on pedipalp chela, and esb on fixed finger. With this description, the number of extant species of Microtityus is raised to 25, of which eleven are present in South America and two in Colombia. A map with the known distribution of M. bivicentorum sp. nov. and similar species is presented. Some remarks about the trichobothrial arrangement of M. joseantonioi are also included.
A checklist of oligochaetes (Annelida) from Taiwan and its adjacent islands
Authors: TSAI CHU-FA , SHEN HUEI-PING , TSAI SU-CHEN , LIN KANG-JIEH , HSIEH HWEY-LIAN , YO SHAO-PIN
Published: July 2019

This checklist lists 98 species and subspecies of oligochaetes (Annelida) that have been reported so far as members of the natural fauna of Taiwan and its adjacent Lanyu (Botel Tobago), Gueishan (Turtle) and Penghu (Pescadore) Islands. Terrestrial oligochaetes have been studied for over a century since 1898, particularly intensively in the past ten years. They are represented by 72 species of which 42 (58.3%) species and subspecies are endemic to Taiwan. They belong to the families Moniligastridae, Glossoscolecidae, Lumbricidae, Octochaetidae, Ocnerodrilidae, and Megascolecidae. Megascolecidae is the most dominant family with 63 species, comprising 87.5% of the terrestrial Taiwanese earthworms reported so far. Aquatic oligochaetes have been investigated for about a decade since 1995, and are represented by 26 species. Of them, 25 are in the family Naididae (including Tubificidae) and Eiseniella tetraedra in the family Lumbricidae.
Impacts of Hydrometeor Drift on Orographic Precipitation: Two Case Studies of Landfalling Atmospheric Rivers in British Columbia, Canada
Authors: Mo Ruping , Brugman Melinda M. , Milbrandt Jason A. , Goosen James , Geng Quanzhen , Emond Christopher , Bau Jonathan , Erfani Amin
Published: July 2019

Two severe winter storms in 2016 and 2017 caused by landfalling atmospheric rivers over British Columbia (BC) are investigated in this study. Our main concern is the impact of hydrometeor drift on the orographic precipitation. It is shown that the dominant contribution to the windward orographic precipitation was from the horizontal moisture convergence. The precipitation distributions across southern BC were also influenced by the convergence/divergence of condensed water due to the wind-driven effect on hydrometeors. Observed hourly and daily precipitation amounts are used to verify the performances of three Canadian numerical weather prediction systems. Our results indicate that these operational systems were capable of predicting the general features of orographic precipitation in BC. However, the two coarse-resolution systems used a diagnostic precipitation scheme that does not fully simulate the hydrometeor drift process. The High-Resolution Deterministic Prediction System (HRDPS) with a prognostic precipitation scheme was substantially more accurate and skillful in predicting the upwind precipitation as well as the spillover of precipitation on the leeward slopes for these two storms. There was evidence suggesting that the spillover effect was overpredicted by the HRDPS due to a systematic bias originating in the model microphysics. This problem has been improved in the current HRDPS with a new microphysics scheme. Based on our atmospheric water balance analysis, we also proposed two postprocessing schemes that could be applied to improve the quantitative precipitation forecasts of the diagnostic precipitation schemes.
Complementary Impact of Carotid Intima–Media Thickness With Plaque in Associations With Noncardiac Arterial Vascular Events
Authors: Kolkenbeck-Ruh Andrea , Woodiwiss Angela J. , Monareng Talib , Sadiq Eitzaz , Mabena Philanathi , Robinson Chanel , Motau Tshegofatso H. , Stevens Belinda , Manyatsi Nomvuyo , Tiedt Scott , Dembskey Reinhard , Abdool-Carrim Talib , Veller Martin , Cassimjee Ismail , Modi Girish , Hale Martin , Norton Gavin R.
Published: July 2019

The ability of carotid intima–media thickness (IMT) to predict risk beyond plaque is controversial. In 952 participants (critical limb ischemia [CLI] or stroke, n = 473; community, n = 479), we assessed whether relationships with events for IMT complement the impact of plaque in young patients depending on the extent of thrombotic versus atherosclerotic disease. The extent of atherosclerotic versus thrombotic occlusion was determined in 54 patients with CLI requiring amputations. Thrombotic occlusion in CLI was associated with younger age ( P < .0001) and less plaque ( P = .02). Independent relations between plaque and CLI were noted in older (>50 years; P < .005 to <.0001) but not younger ( P > .38) participants, while independent relations between plaque and stroke ( P < .005 to <.0001) and between IMT and CLI ( P < .0001) were noted in younger participants. Although in performance (area under the receiver operating curve) for event detection, IMT thresholds failed to add to plaque alone in older patients (0.680 ± 0.020 vs 0.664 ± 0.017, P = .27), IMT improved performance for combined stroke and CLI detection when added to plaque in younger patients (0.719 ± 0.023 vs 0.631 ± 0.026, P < .0001). Because in younger participants the high prevalence of thrombotic occlusion in CLI is associated with less plaque, IMT adds information in associations with arterial vascular events.
Study of Caregivers Regarding Pediatric Poisoning
Authors: Crouch Barbara Insley , Malheiro Marty Christensen , Brown Kaitlyn
Published: July 2019

The overall objective was to characterize action by caregivers when a potential poison exposure occurs and identify barriers to poison control center (PCC) utilization. A prospective survey of caregivers of pediatric patients who presented to an emergency department for a potential poison exposure was completed by each study participant. A total of 371 surveys were completed between August 2016 and August 2017. The majority of patients were 3 years or younger. Caucasians were more likely to have heard of the PCC, had the toll-free number available, and had previously called compared with other races and ethnicities. Caregivers with some government insurance were more likely to think that PCCs report child poisoning calls to authorities. Education efforts of nationwide PCCs focus on awareness of the PCC as well as poison prevention strategies. Understanding barriers to utilization of PCC and populations who are more likely to underutilize the PCC can help direct education efforts.
Advancing the Sustainable Development Goals: An Analysis of the Potential Role of Philanthropy in Ghana
Authors: Kumi Emmanuel
Published: July 2019

In September 2015, the Sustainable Development Goals (SDGs) were endorsed by the United Nations General Assembly as the cardinal agenda for guiding future global development. In financing the SDGs, there has been an increasing call on stakeholder diversification by leveraging on other non-state actors and private finance including philanthropic institutions in influencing, delivering and advancing the SDGs. Drawing on insights from the Ghanaian philanthropic sector, I show that philanthropic institutions play complementary roles in service delivery, support civil society organisations to engage in active action and advocacy, and enhance paradigm shifts in development thinking around the SDGs. I argue for the need in embracing complexity thinking that recognises that the attainment of the SDGs is dependent on the creation of an enabling environment and effective multi-stakeholder consultation.
The Endocrinology of Tuberculosis
Authors: Obermer Edgar
Published: July 2019

It is suggested that the endocrines hold the key position in the mechanism of resistance to all infection. In man the glands of internal secretion are divided into two counterbalancing groups. It is the function of the “katabolic” group—or glands of emergency—to react to acute infections. It is the function of the “anabolic” group—or glands of conservation of energy—to counterbalance the prolonged over-action of the katabolic group in chronic infections. In chronic pulmonary tuberculosis improvement is dependent on the predominance of the anabolic group. Clinical and biochemical evidence to this effect is brought forward. The individual ductless glands are discussed with a view to summarizing the known tests for detecting their functional variations during life. It is suggested that present methods for the determination of basal metabolic rate are inaccurate and cumbersome. An alternative biochemical method is described and illustrated, which, it is claimed, is both more simple and more accurate. Slides of the thyroid and parathyroid are shown indicating that the histological criteria of function correlate with these biochemical findings during life. The classification of cases of pulmonary tuberculosis according to the mode of reaction rather than to the extent of lung invasion, is advocated. A terminology and the clinical, endocrine, and applied biochemical tests by which the groups can be recognized are described.

Emphasis is laid on the necessity for research into the hereditary and environmental factors which lead to injury of the ductless glands, and hence lowered resistance to disease.
Post-Encephalitis and its Problems
Authors: Parsons Allan C.
Published: July 2019

Attention to-day is chiefly focussed upon the consequences of encephalitis lethargica; the disabled victims of the disease present many problems, both medical and administrative.

The disease has a high case-mortality; though the majority of deaths occur during the primary attack, in many cases death occurs at much longer intervals after onset; the death-rate is estimated at 35 to 40 per cent. From the after-histories of some 3,000 patients in London, Glasgow, Belfast, Manchester, Bristol, Sheffield and other large towns, it appears that about 40 per cent. of notified patients become disabled. Generally speaking, severe sequels are preceded by severe symptoms in the original attack, but the Parkinsonian syndrome is a noteworthy exception to this rule.

Broadly classifying the sufferers from post-encephalitis, rather than the sequelæ observed in this condition, the author discusses (a) those who suffer mainly from physical sequels; (b) those who chiefly show origin of mental deterioration; (c) those who exhibit demoralizations.

The provision of suitable institutional accommodation for those with progressive physical disabilities (often combined with mental failing), the general re-training and education of the youngest victims and the training and control of adolescents with serious character-changes, constitute some of the problems of post-encephalitis.

While advocating further research the author considers that for the present the welfare of the passive helpless adult is best secured by ad hoc arrangements under the Poor Law Authorities or Board of Guardians. The youngest patients, with a more hopeful prognosis, need special institutional care and training on some such lines as those of the Encephalitis Unit at Winchmore Hill. It is hoped that the Mental Deficiency Act, 1927, will prove of great help for the management of moral delinquents.
Some Notes on the Origin and Prevention of Gingivitis
Authors: Pritchard G. B.
Published: July 2019

Gingivitis is a disease of local origin primarily, although in many cases a constitutional factor is concerned.—The predisposition arises during the eruptive period of the second dentition.—The developmental predisposing cause of most importance is a crowded condition of the permanent dentition.—Of acquired predisposing causes, calculus deposits on the teeth are the most important.—Others are those which either cause stagnation around the teeth, or produce definite mechanical injury to the gum margin.—They can take effect at any age.

Orthodontic treatment directed towards the arrangement of the optimum number of teeth in well functioning order is the ideal prophylactic.

Other preventive measures are to employ such methods of artificial cleansing as brushing and the use of floss silk.—These are the adjuncts to automatic cleansing best carried out by efficient mastication of a suitable diet.—This is only possible when the arrangement of the teeth is such that stagnation of any kind of food is reduced to a minimum.
Safar's Method for Treatment of Detachment of the Retina by Diathermy
Authors: Marshall J. Cole
Published: July 2019

Safar's method aims at getting discrete areas of coagulation in the choroid without any injury to the retina. Larson produces areas of coagulation by surface cauterization with a small, ball-shaped electrode. Weve uses Larson's method, and also the encircling method with a fine needle.

The advantages of Safar's method are: (a) The exact placing of the area of coagulation; (b) the possibility of using a more regular current; (c) less likelihood of the area of coagulation being too extensive; (d) the possibility of making large barrages without losing fluid and the eye becoming soft; (e) the avoidance of having to make a subsequent puncture to draw off the subretinal fluid.

Technique.—(1) Nearly the same as Guist's encircling method or the formation of barrages. (2) Instruments: Special isolated needles to avoid sparking and also to limit the depth of entry. Special ivory-headed retractors; glass retractors are also useful.

Treatment.—(1) Previous to operation: Rest in bed, with the use of Lindner's Lochbrille. (2) Subsequent to operation: Eight to fourteen days with both eyes bandaged. Wearing of the Lochbrille after the bandages have been removed.

Scars.—Ideal scars about the size of optic disc, round, and stippled with small spots of pigment; the retina lies flat over these scars as seen by tracing the retinal vessels.

Results. Up to 1932 (Safar's).—Thirty-nine unselected cases: Twenty-four reattachments, that is, more than 60% in recent cases of myopia, and after contusion more than 90%.
A Clinical Study of Delirium
Authors: Curran Desmond
Published: July 2019

The study is based upon 103 cases, which have been observed at either the Phipps Psychiatric Clinic or the Maudsley Hospital; twenty-seven different ætiological agents are represented. The following questions are raised:—

(1) Whether there is evidence that different ætiological agents produce specific or even characteristic delirious states. (2) In what ways are the ætiological agents directly related to the states they produce. (3) What other factors help to determine the clinical picture. (4) What are the characteristics which these states appear to possess in common. (5) What light may this shed upon the rôles of exogenous as opposed to endogenous factors in the production of mental disease.

The symptomatology, as recorded, is briefly sketched and some cases to illustrate particular points are given.

It is advanced, on the observations made—with a clear realization that different and more detailed study might come to quite other conclusions—that:—

(1) Nothing was found to suggest that any ætiological agent bore a truly specific relationship to the delirious state it produced.

(2) The delirious states produced appeared to be directly related to the ætiological agent, and could be considered characteristic of them, in so far as the ætiological agent tended to affect the intensity and duration and “stability” of the functional disturbance in a fairly uniform manner.

(3) The final clinical picture was also strikingly dependent upon the previous personality of the subject, and upon environmental stimuli sustained during the period of illness.

(4) The nature of the functional disturbance which all these cases had in common had two aspects: ( a) a decrease in the ability to discriminate and differentiate, “confusion,” a deficiency in just those qualities for whose proper exhibition the integrity of the cerebral cortex is generally considered to be necessary, and ( b) an increased activity of a type bearing close resemblance to the dreaming state.

(5) Finally, it is argued that it is highly improbable that in psychoses which do not show “confusion,” exogenous factors are likely to play more than a subsidiary, though in certain instances none the less an exceedingly important, rôle. Thus a study of exogenous reaction types might help to a better perspective in such debated issues as the importance of “focal sepsis” and the speculative toxæmias in the production of mental disease.
Jung's Contribution to Clinical Psychiatry
Authors: Mackenzie Murdo
Published: July 2019

This attempt to correlate Jung's work with practical psychiatry is concerned mainly with his conception of clinical types. Jung went far away from the provinces of clinical medicine and psychiatry for his evidence, and the possible cause for this is discussed.

He expands his view of introversion and extraversion, and so the suggestion is made that for practical purposes his early limitation of these terms should be maintained. The difficulties encountered in type description by comparison and contrast are emphasized. The value of his conception of basic functions is discussed and criticized.

A review is made of the personalities he describes, and a simplification of his resulting classification suggested for practical purposes. The notion is put forward that Jung describes one type in psychological adaptation much better than any others, and it is hinted that his psycho-pathological description of this type in nerve disorder constitutes his main contribution to clinical psychiatry. A review of the treatable nerve disorders suggests that this disorder has received more adequate description from Jung than any other, and reveals a unique method of investigation and therapy. This does not apply to his other descriptions. Possibly some of the vagueness attributed to Jung is because he did not give this disorder an adequate diagnosis, and an explanation for this is offered.

The correlation between the simplified classification and the classification of treatable nerve disorders is close, and it is suggested that this constitutes Jung's contribution to clinical psychiatry in general. The application of Jung's principles is of daily help to the practising psychiatrist.
An Experimental Investigation into the Association of Traumatic Occlusion with Parodontal Disease
Authors: Stones H. H.
Published: July 2019

The production of traumatic occlusion by inserting raised fillings in the teeth of monkeys is described. The fillings were inserted in three adjoining posterior teeth, one being left higher than the others. In one monkey an upper central incisor was the only tooth treated and on this was fixed a raised metal crown. Experiments were terminated after varying periods of time, from ten to forty-three weeks. The jaws containing the teeth in which raised fillings were inserted, the opposing teeth, and the controls, were sectioned. Some sections were cut mediodistally and others faciolingually. Results. These were judged from a histological examination of the sections.(a) Seven monkeys were treated. (b) In three monkeys very definite changes analogous to parodontal disease were produced. (c) In three monkeys less extreme changes were seen. (d) In one monkey there was no change. (e) in each animal the pathological changes were usually observed in only the one tooth which took the greatest stress of the three that were filled and the opposing one with which it articulated. (f) Of the 39 teeth subjected to trauma eleven showed pathological changes in the subgingival tissues. The clinical evidence in man is considered. The conclusion is reached that traumatic occlusion is an ætiological factor in the production of that variety of parodontal disease in which there is vertical pocket formation associated with one or a varying number of teeth.
Experimental Concussion
Authors: Denny-Brown D. E. , Russell W. Ritchie
Published: July 2019

The various hypotheses of the mechanism of coma resulting from cerebral trauma are discussed. Experimental evidence shows that there are two kinds of transient abolition of cerebral function by trauma—acceleration concussion, and compression concussion. The former is a passing paralysis which occurs in all brain-stem mechanisms examined and is brought about at and beyond a threshold value of change in velocity. A lesser degree of change causes momentary depression of function, a greater degree prolongs the phase of paralysis before recovery occurs. Movement of the head is necessary for the usual kind of concussion to occur, as also for contre-coup injury. Compression concussion has much more selective incidence on the respiratory centre, and appears to require an extreme crushing injury or penetration of the skull by a relatively large object. Acceleration concussion is that accompanying closed head injury and is not accompanied by any significant change in C.S.F. pressure. The cerebral blood flow is verv greatly increased in this variety owing to stimulation of the vagoglossopharyngeal nerves at the foramen magnum. With more severe blows subpial or intramedullary lesions may occur in this situation, indicating that distortion at the foramen magnum occurs. No evidence of vascular spasm or paralysis is found. An immediate brief rise of blood-pressure is due to stimulation of the vasomotor centre. Vagal effects may not appear until the traumatic paralysis of all centres begins to pass off. A delayed fall in blood-pressure lasting many minutes may follow severe vagal effects, and appears comparable to acute surgical shock as produced by intense stimulation of any other visceral nerve. Death occurs from failure of blood-pressure, an intensification of shock with shallow respiration and intense constriction of viscera.

It is concluded that sudden failure of what has been called the veno-pressor system is important in death shortly following experimental concussion. No macroscopical lesions are found, and histological examination shows no change with ordinary tissue stains. The unconsciousness of coma is believed to be related to direct traumatic paralysis of the cortical neurones and if their sensitivity to physical violence is similar to that of anæsthetics, prolonged impairment of function from this cause alone is possible. Clinical observations were related in support of these conclusions.
Isolated Oculomotor Palsy Caused by Intracranial Aneurysm
Authors: Jefferson Geoffrey
Published: July 2019

The present paper is concerned with the 55 aneurysms out of a total of 158 that caused isolated paralysis of the oculomotor nerve. The majority arose from the internal carotid artery after it had pierced the dura (supraclinoid). Rarely the aneurysm sprang from the basilar artery. In two-thirds of the cases there had been a subarachnoid hæmorrhage from leakage. Not more than 10% of patients had arteriosclerosis. Calcification of the sac is not a sign that the aneurysm has thrombosed. The only certain way of demonstrating the position and size of an intracranial aneurysm is by arteriography, which is a safe procedure.

The correct treatment is by carotid ligature. In about 8% of normals the circle of Willis is incomplete, therefore percutaneous compression must first be tried. The only fatalities from ligature were in persons in the acute stage of subarachnoid hæmorrhage, not from meningeal bleeding alone. In this type of case a clip applied to the neck of the sac is probably a better method. In the more usual cases where the hæmorrhage has been spontaneously arrested common carotid ligature in the neck is probably a little safer than intracranial clipping.
L’après 2013 des confréries soufies égyptiennes : allégeance au pouvoir, dissensions internes et « renouveau du discours religieux »
Authors: Paonessa Costantino
Published: July 2019

This article discusses the role of some Sufi orders and some of their sheikhs who are members of the Higher Council of Egyptian Sufi Brotherhoods in the project to ‘renew religious discourse’ (tajdīd khitab al-dīnī) launched by President al-Sissi in 2015. In particular, it raises the question of the extent to which contemporary Sufi ulemas reclaim concepts belonging to the Islamic mystical tradition, such as that of tajdīd (renewal), in order to adapt it to the needs of the country’s political agenda. Finally, based on the case of the al-’Azamiya brotherhood, this article aims to question the role played by Sufi identity as a factor of political mobilisation.
Peripheral Nerve Microscopic Changes Related to Study Procedures: Two Nonclinical Case Studies
Authors: Bangari Dinesh S. , Pardo Ingrid D. , Sellers Rani , Johnson Jennifer A. , Ryan Susan , Thurberg Beth L.
Published: July 2019

Peripheral nerves are routinely examined microscopically during the nonclinical safety assessment of therapeutics. In addition to test article-related on- or off-target changes, microscopic changes in peripheral nerves may also be caused by study procedures, such as parenteral test article administration and blood or tissue sampling. We present 2 nonclinical case studies in which nonstandard peripheral nerves had study procedure-related histologic changes. The first case study describes mouse trigeminal nerve changes as a result of blood sampling via retro-orbital sinus puncture. These changes included minimal-to-mild nerve fiber (axonal) degeneration associated with macrophage infiltration. The second case study presents rat brachial plexus changes associated with animal handling and blood sampling. Brachial plexus changes included minimal-to-moderate inflammation, focal hemorrhage, and nerve fiber degeneration. In both cases, the histological changes were morphologically indistinguishable from those that might be due to test article. Therefore, careful consideration of the incidence and severity across groups and a review of study procedures to rule out handling-related nerve damage are essential before identifying a test article-related effect on peripheral nerves. Study design considerations to avoid such procedure-related changes will be discussed, as well as sampling strategies to help distinguish these from test article-related effects.
Diagnostic performance of neutrophil CD64 index in patients with sepsis in the intensive care unit
Authors: Ye Zhenglong , Zou Hui , Liu Shangxiang , Mei Chengqing , Chang Xiaoliang , Hu Zhiqing , Yang Huanhuan , Wu Yong
Published: July 2019

Objective

This study was performed to evaluate the diagnostic value of the neutrophil CD64 index in patients with sepsis in the intensive care unit (ICU).

Methods

Patients with sepsis who were treated at the ICU of the authors’ institution from December 2016 to June 2018 were retrospectively reviewed. The controls comprised age- and sex-matched patients who underwent coronary bypass and had no evidence of infection. The neutrophil CD64 index, C-reactive protein (CRP) level, and procalcitonin level were compared between the two groups. The diagnostic performance of these measures, including the sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve, was examined.

Results

In total, 35 patients with sepsis and 27 control patients were included in the data analysis. The sensitivity of the neutrophil CD64 index, CRP level, and procalcitonin level was 83%, 74%, and 77%, respectively. The specificity was 88%, 86%, and 81%, respectively. The area under the ROC curve was 0.923 [95% confidence interval (CI), 0.856–0.989], 0.904 (95% CI, 0.832–0.976), and 0.863 (95% CI, 0.776–0.950), respectively.

Conclusion

The neutrophil CD64 index is a valuable biomarker for diagnosing sepsis in patients in the ICU.