bluuebunny/crossref_metadata_2025 huggingface dataset:
Are first rib fractures a marker for other life-threatening injuries in patients with major trauma? A cohort study of patients on the UK Trauma Audit and Research Network database
Authors: Sammy Ian Ayenga , Chatha Hridesh , Lecky Fiona , Bouamra Omar , Fragoso-Iñiguez Marisol , Sattout Abdo , Hickey Michael , Edwards John E
Published: January 2017

Background

First rib fractures are considered indicators of increased morbidity and mortality in major trauma. However, this has not been definitively proven. With an increased use of CT and the potential increase in detection of first rib fractures, re-evaluation of these injuries as a marker for life-threatening injuries is warranted.

Methods

Patients sustaining rib fractures between January 2012 and December 2013 were investigated using data from the UK Trauma Audit and Research Network. The prevalence of life-threatening injuries was compared in patients with first rib fractures and those with other rib fractures. Multivariate logistic regression was performed to determine the association between first rib fractures, injury severity, polytrauma and mortality.

Results

There were 1683 patients with first rib fractures and 8369 with fractures of other ribs. Life-threatening intrathoracic and extrathoracic injuries were more likely in patients with first rib fractures. The presence of first rib fractures was a significant predictor of injury severity (Injury Severity Score >15) and polytrauma, independent of mechanism of injury, age and gender with an adjusted OR of 2.64 (95% CI 2.33 to 3.00) and 2.01 (95% CI 1.80 to 2.25), respectively. Risk-adjusted mortality was the same in patients with first rib fractures and those with other rib fractures (adjusted OR 0.97, 95% CI 0.79 to 1.19).

Conclusion

First rib fractures are a marker of life-threatening injuries in major trauma, though they do not independently increase mortality. Management of patients with first rib fractures should focus on identification and treatment of associated life-threatening injuries.
Expression ofPTENand its pseudogenePTENP1, and promoter methylation ofPTENin non-tumourous thymus and thymic tumours
Authors: Masunaga Atsuko , Omatsu Mutsuko , Kunimura Toshiaki , Uematsu Shugo , Kamio Yoshito , Kitami Akihiko , Miyagi Yohei , Hiroshima Kenzo , Suzuki Takashi
Published: January 2017

Aims

Mutation or promoter methylation of the phosphatase tensin homologue deleted on chromosome 10 tumour suppressor gene (PTEN) promotes some cancers. Moreover,PTENP1(PTENpseudogene) transcript regulates PTEN expression and is thought to be associated with tumourigenesis in some cancers. Here, we investigated PTEN expression in thymic epithelium and thymic epithelial tumours.

Methods

Immunohistochemical analysis of PTEN was performed on two non-tumourous thymus (NT) samples, 33 thymomas (three type A, eight type AB, 11 type B1, six type B2, and five type B3), and four thymic carcinomas (TCs). In 16 cases (two NT, three A, five B1, two B2, one B3 and three TC), analyses of mutations, promoter methylation and comparisons ofPTENmRNA andPTENP1transcripts were undertaken using PCR-direct sequencing, methylation-specific PCR, and reverse-transcription real-time PCR after target cell collection with laser microdissection.

Results

PTEN protein was not immunohistochemically detected in NT epithelium or types B1 or B2 thymoma cells, but was expressed in type A thymoma and carcinoma cells. NeitherPTENmutations nor promoter methylation were detected in any samples. Statistical analysis revealed thatPTENmRNA expression was highest in NT epithelium and lowest in type A thymoma cells.PTENP1transcript expression did not significantly differ among NT, thymoma and TC samples.

Conclusions

We speculated that NT epithelium and types B1/B2 thymoma cells have a mechanism ofPTENtranslation repression and/or acceleration of protein degradation, whereas type A thymoma cells exhibit transcriptional repression ofPTENmRNA and accelerated translation and/or protein accumulation.
A pragmatic approach to vasculitis in the gastrointestinal tract
Authors: Chetty Runjan , Serra Stefano
Published: January 2017

Although vasculitis involving the gastrointestinal tract (GIT) is an uncommon occurrence, occasionally vasculitis can present as haemorrhagic infarction or ischaemia for which a length of bowel is removed. Invariably, the appropriate clinical history is not forthcoming, or vasculitis is not clinically suspected. The purpose of this overview is to provide the practising gastrointestinal (GI) pathologist with a framework to recognise and diagnose vasculitides within the GIT. The classification may be approached by aetiological agent or size of vessel involved; an international consensus group now favours the latter approach. The symptoms that systemic and/or localised vasculitis may cause in the GIT are protean and non-specific. As a result, pathologists examining resection specimens for unexplained haemorrhagic infarction or ischaemia should be aware that vasculitis may be a potential cause. Several well-known systemic vasculitides such as polyarteritis nodosa, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis or Churg-Strauss syndrome and granulomatosis with polyangiitis or Wegener's granulomatosis can occur in the GIT. The latter three constitute the antineutrophil cytoplasmic antibody-positive vasculitides. In addition, the so-called solitary organ vasculitis (SOV) can occur in the GIT as the harbinger of later onset systemic vasculitis, and be the cause of the GIT symptoms. In addition, SOV can occur incidentally and coexist with GIT disease such as gallstones or polyps, and there may be no manifestations of systemic vasculitis for years, or not at all.
Current management of spontaneous intracerebral haemorrhage
Authors: Dastur Cyrus K , Yu Wengui
Published: January 2017

Intracerebral haemorrhage (ICH) is the most devastating and disabling type of stroke. Uncontrolled hypertension (HTN) is the most common cause of spontaneous ICH. Recent advances in neuroimaging, organised stroke care, dedicated Neuro-ICUs, medical and surgical management have improved the management of ICH. Early airway protection, control of malignant HTN, urgent reversal of coagulopathy and surgical intervention may increase the chance of survival for patients with severe ICH. Intensive lowering of systolic blood pressure to <140 mm Hg is proven safe by two recent randomised trials. Transfusion of platelets in patients on antiplatelet therapy is not indicated unless the patient is scheduled for surgical evacuation of haematoma. In patients with small haematoma without significant mass effect, there is no indication for routine use of mannitol or hypertonic saline (HTS). However, for patients with large ICH (volume > 30 cbic centmetre) or symptomatic perihaematoma oedema, it may be beneficial to keep serum sodium level at 140–150 mEq/L for 7–10 days to minimise oedema expansion and mass effect. Mannitol and HTS can be used emergently for worsening cerebral oedema, elevated intracranial pressure (ICP) or pending herniation. HTS should be administered via central line as continuous infusion (3%) or bolus (23.4%). Ventriculostomy is indicated for patients with severe intraventricular haemorrhage, hydrocephalus or elevated ICP. Patients with large cerebellar or temporal ICH may benefit from emergent haematoma evacuation. It is important to start intermittent pneumatic compression devices at the time of admission and subcutaneous unfractionated heparin in stable patients within 48 hours of admission for prophylaxis of venous thromboembolism. There is no benefit for seizure prophylaxis or aggressive management of fever or hyperglycaemia. Early aggressive comprehensive care may improve survival and functional recovery.
Comparison of a 5‐mm and 10‐mm vessel sealing device in an open ovariectomy model in dogs
Authors: Devriendt N. , Van Goethem B. , Van Brantegem L. , De Ridder M. , Kitshoff A. , Or M. , de Rooster H.
Published: January 2017

The objectives of this study were to compare (1) the extent of thermal damage and (2) the time between the 5‐mm LigaSure V (LS5) and 10‐mm LigaSure Atlas (LS10) vessel sealing devices (VSD) when performing open ovariectomy in dogs. A prospective, randomised, clinical trial was performed in 40 client‐owned sexually entire female dogs. In each dog, one ovary was randomly assigned to be surgically removed using LS5 and the contralateral using LS10. The depth of thermal spread, measured on histopathological preparations, was significantly larger for LS10 (LS10 1.35±0.23 mm v LS5 0.82±0.10 mm; P<0.001). Mean ovariectomy time was significantly faster when using LS10 (LS5 2.58±1.32 minutes v LS10 2.07±1.27 minutes; P=0.008). Bodyweight was positively correlated with the time required for ovariectomy using LS5 (P=0.004), but no such correlation was present for LS10 (P=0.611). In conclusion, during open ovariectomy using VSD, LS10 causes significantly more thermal spread but surgical time is shorter compared with LS5. When using LS5, the ovariectomy time increases with increasing bodyweight.
Modeling the impacts of hemlock woolly adelgid infestation and presalvage harvesting on carbon stocks in northern hemlock forests
Authors: Krebs Jeffrey , Pontius Jennifer , Schaberg Paul G.
Published: January 2017

To better understand the potential impact of the invasive hemlock woolly adelgid (HWA, Adelges tsugae Annand) and presalvage activities on carbon (C) dynamics in northern stands of eastern hemlock (Tsuga canadensis (L.) Carr.), we used the Forest Vegetation Simulator and Forest Inventory and Analysis data to model C storage and successional pathways under four scenarios: presalvage harvesting; HWA-induced mortality; presalvage harvesting plus HWA-induced mortality; and no disturbance (control). Our simulation showed that all treatments differed in total C storage in the short term, with HWA-induced mortality providing the highest total C storage due to regeneration and ingrowth of replacement species combined with retention of standing and downed deadwood. At the end of the 150-year simulation, all disturbance scenarios had significantly lower total C than the control. The cumulative net C gain was lower for the two presalvage scenarios than for the HWA scenario, indicating that allowing HWA to progress naturally through a stand may result in the least impact to long-term C sequestration and net C storage. While differences were not significant on low hemlock density stands, impacts to the estimated 267 000 ha of northeastern forests where hemlock is dominant could result in conversion to red maple (Acer rubrum L.) and a net loss of over 4 million metric tons of potentially sequestered C over the next 150 years.
Lie algebras and generalized thermal coherent states
Authors: Floquet Sergio , Trindade Marco A. S. , Vianna J. David M.
Published: January 2017

In this paper, we developed an algebraic formulation for the generalized thermal coherent states with a thermofield dynamics approach for multi-modes, based on coset space of Lie groups. In particular, we applied our construction on SU(2) and SU(1,[Formula: see text]1) symmetries and we obtain their thermal coherent states and density operator. We also calculate their thermal quantum Fidelity and thermal Wigner function.
A consistent measure for lattice Yang–Mills
Authors: Vilela Mendes R.
Published: January 2017

The construction of a consistent measure for Yang–Mills is a precondition for an accurate formulation of nonperturbative approaches to QCD, both analytical and numerical. Using projective limits as subsets of Cartesian products of homomorphisms from a lattice to the structure group, a consistent interaction measure and an infinite-dimensional calculus have been constructed for a theory of non-Abelian generalized connections on a hypercubic lattice. Here, after reviewing and clarifying past work, new results are obtained for the mass gap when the structure group is compact.
Effects of temperature and pressure on the nucleation and growth of silver clusters from supersaturated vapor: A molecular dynamics analysis
Authors: Wang Qin , Xie Hui , Chen Yongshi , Liu Chao
Published: January 2017

The nucleation and growth of silver nanoparticles in the supersaturated system are investigated by molecular dynamics simulation at different temperatures and pressures. The variety of the atoms in the biggest cluster and the size of average clusters in the system versus the time are estimated to reveal the relationship between the nucleation as well as cluster growth. The nucleation rates in different situations are calculated with the threshold method. The effect of temperature and pressure on the nucleation rate is identified as obeying a linear function. Finally, the development of basal elements, such as monomers, dimers and trimmers, is revealed how the temperature and pressure affect the nucleation and growth of the silver cluster.
Bardeen–de Sitter black holes
Authors: Fernando Sharmanthie
Published: January 2017

In this paper, we present a regular black hole with a positive cosmological constant. The regular black hole considered is the well known Bardeen black hole and it is a solution to the Einstein equations coupled to nonlinear electrodynamics with a magnetic monopole. The paper discusses the properties of the Bardeen–de Sitter black hole. We have computed the gray body factors and partial absorption cross-sections for massless scalar field impinges on this black hole with the third-order WKB approximation. A detailed discussion on how the behavior of the gray body factors depend on the parameters of the theory such as the mass, charge and the cosmological constant is given. Possible extensions of the work is discussed at the end of the paper.
Exact scalar–tensor cosmological models
Authors: Belinchón J. A. , Harko T. , Mak M. K.
Published: January 2017

Scalar–tensor gravitational theories are important extensions of standard general relativity, which can explain both the initial inflationary evolution, as well as the late accelerating expansion of the universe. In the present paper, we investigate the cosmological solution of a scalar–tensor gravitational theory, in which the scalar field [Formula: see text] couples to the geometry via an arbitrary function [Formula: see text]. The kinetic energy of the scalar field as well as its self-interaction potential [Formula: see text] are also included in the gravitational action. By using a standard mathematical procedure, the Lie group approach, and Noether symmetry techniques, we obtain several exact solutions of the gravitational field equations describing the time evolutions of a flat Friedman–Robertson–Walker universe in the framework of the scalar–tensor gravity. The obtained solutions can describe both accelerating and decelerating phases during the cosmological expansion of the universe.
Thermal effects in dense matter beyond mean field theory
Authors: Constantinou Constantinos , Lalit Sudhanva , Prakash Madappa
Published: January 2017

The formalism of next-to-leading order (NLO) Fermi Liquid Theory (FLT) is employed to calculate the thermal properties of symmetric nuclear and pure neutron matter in a relativistic many-body theory beyond the mean field level which includes two-loop (TL) effects. For all thermal variables, the semi-analytical NLO corrections reproduce results of the exact numerical calculations for entropies per baryon up to 2. This corresponds to excellent agreement down to subnuclear densities for temperatures up to [Formula: see text] MeV. In addition to providing physical insights, a rapid evaluation of the equation of state (EOS) in the homogeneous phase of hot and dense matter is achieved through the use of the zero-temperature Landau effective mass function and its derivatives.
Can one measure the Cosmic Neutrino Background?
Authors: Faessler Amand , Hodák Rastislav , Kovalenko Sergey , Šimkovic Fedor
Published: January 2017

The Cosmic Microwave Background (CMB) yields information about our Universe at around 380,000 years after the Big Bang (BB). Due to the weak interaction of the neutrinos with matter, the Cosmic Neutrino Background (CNB) should give information about a much earlier time of our Universe, around one second after the BB. Probably, the most promising method to “see” the CNB is the capture of the electron neutrinos from the Background by Tritium, which then decays into 3He and an electron with the energy of the the [Formula: see text]-value [Formula: see text] 18.562[Formula: see text]keV plus the electron neutrino rest mass. The “KArlsruhe TRItium Neutrino” (KATRIN) experiment, which is in preparation, seems presently the most sensitive proposed method for measuring the electron antineutrino mass. At the same time, KATRIN can also look by the reaction [Formula: see text]. The capture of the Cosmic Background Neutrinos (CNB) should show in the electron spectrum as a peak by the electron neutrino rest mass above [Formula: see text]. Here, the possibility to see the CNB with KATRIN is studied. A detection of the CNB by KATRIN seems not to be possible at the moment. But KATRIN should be able to determine an upper limit for the local electron neutrino density of the CNB.
Spectral functions and in-medium properties of hadrons
Authors: Tripolt R.-A. , von Smekal L. , Wambach J.
Published: January 2017

The in-medium modifications of hadron properties such as masses and decay widths have been a major focus of the scientific work of Gerry Brown and the insights gained by him and his collaborators made them major drivers of this field for several decades. Their prediction of experimental signals in di-lepton pair production in relativistic heavy-ion collisions was instrumental in initiating large experimental campaigns which continue till today. In this chapter, we review recent results which elucidate the relation of hadronic spectral properties at finite temperature and density to the restoration of spontaneously broken chiral symmetry.
Gamow-Teller strength and lepton captures rates on 66−71Ni in stellar matter
Authors: Nabi Jameel-Un , Majid Muhammad
Published: January 2017

Charge-changing transitions play a significant role in stellar weak-decay processes. The fate of the massive stars is decided by these weak-decay rates including lepton (positron and electron) captures rates, which play a consequential role in the dynamics of core collapse. As per previous simulation results, weak interaction rates on nickel (Ni) isotopes have significant influence on the stellar core vis-à-vis controlling the lepton content of stellar matter throughout the silicon shell burning phases of high mass stars up to the presupernova stages. In this paper, we perform a microscopic calculation of Gamow–Teller (GT) charge-changing transitions, in the [Formula: see text]-decay and electron capture (EC) directions, for neutron-rich Ni isotopes ([Formula: see text]Ni). We further compute the associated weak-decay rates for these selected Ni isotopes in stellar environment. The computations are accomplished by employing the deformed proton–neutron quasiparticle random phase approximation (pn-QRPA) model. A recent study showed that the deformed pn-QRPA theory is well suited for the estimation of GT transitions. The astral weak-decay rates are determined over densities in the range of 10–10[Formula: see text][Formula: see text]g/cm3and temperatures in the range of 0.01[Formula: see text]–30[Formula: see text][Formula: see text]K. The calculated lepton capture rates are compared with the previous calculation of Pruet and Fuller (PF). The overall comparison demonstrates that, at low stellar densities and high temperatures, our EC rates are bigger by as much as two orders of magnitude. Our results show that, at higher temperatures, the lepton capture rates are the dominant mode for the stellar weak rates and the corresponding lepton emission rates may be neglected.
IMPACTS OF PHYLOGENETIC DILUTION AND CONCENTRATION EFFECTS ON SPECIES DIVERSITY AND DISTRIBUTION PATTERNS
Authors: CHEN YOUHUA
Published: January 2017

In theoretical ecology and community ecology, it is still unclear how phylogenetic community structure and species distributions are linked together. In this paper, a neutral model for evaluating phylogenetic constraints on species diversity and distribution patterns is developed to address these issues. To accomplish this, temporal species distribution and diversity patterns are evaluated and simulated by considering the impact of phylogenetic relatedness of species in a lattice landscape with square grids. A continuous patch for the resultant distributional range map of a species is defined as a group of grids in which the interior grids are adjacent to each other while the edge grids of the patch are isolated from other remaining grids in the range map. The adjacency or isolation of a grid with respect to another grid follows the von Neumann neighborhood criterion. The hypothesis tested is: phylogenetically closely related species tend to avoid each other (phylogenetic dilution), which produces a phylogenetic overdispersion pattern. In this case, all species have similar species abundances and distribution-patch size patterns. In contrast, if closely related species tend to associate together (phylogenetic concentration), a phylogenetic clustering pattern emerges: phylogenetically distinct species tend to have higher abundances and more large distribution patches. Using simulations, this paper presents results which demonstrate the reverse phenomenon: if it is assumed that phylogenetic relatedness of species is modeled as a dilution effect, the resultant distributional maps for evolutionarily distinct species present significantly increased numbers of continuous large patches. An evolutionarily distinct clade tends to have significantly higher relative abundance than other clades in all simulations. It was also found that if phylogenetic relatedness of species is modeled as a concentration effect, the simulated distributional map of each species would present a similar percentage of large patches for both evolutionarily unique and common clades for many cases when the community size is large enough. However, being similar to dilution effect, the resultant species relative abundance for evolutionarily unique clade is significantly higher than that for evolutionarily common clade. In conclusion, evolutionary distinct species will have more chances to survive with high populations and less fragmented distributional range in environments where the phylogenetic dilution effect is functioning. It is hoped that these results contributed to clarifying the complex associations generated by phylogenetic community structure in future ecological and evolutionary studies.
Theoretical investigation of the adsorption behaviors of CO and CO2 molecules on the nitrogen-doped TiO2 anatase nanoparticles: Insights from DFT computations
Authors: Abbasi Amirali , Sardroodi Jaber Jahanbin
Published: January 2017

Over the past years, an interest has arisen in resolving the problems of the increased carbon monoxide and carbon dioxide emissions, leading to the serious air pollution and many detrimental effects. A convenient solution would be a process that could utilize metal oxide nanoparticles such as TiO2 to control the concentration of atmospheric pollutants. The chemisorption of CO and CO2 molecules over the semiconductor titanium dioxide (TiO[Formula: see text] is such a process. In this way, density functional theory (DFT) calculations were performed to investigate CO and CO2 adsorptions on undoped and N-doped TiO2 anatase nanoparticles. The supercell approach is conducted to construct the considered nanoparticles and the adsorption of COx molecule was simulated by use of these chosen nanoparticles. By including van der Waals (vdW) interactions between COx molecule and TiO2 nanoparticle, we found that both CO and CO2 molecules can bind strongly to the N-doped nanoparticles. The adsorption on the five-fold coordinated titanium site of TiO2 nanoparticles including the bond lengths, bond angles, adsorption energies, density of states (DOSs), Mulliken population analysis and molecular orbitals has been broadly studied in this work. Based on the obtained results, it can be concluded that the adsorption on the N-doped nanoparticle is more energetically favorable than the adsorption on the pristine one, representing the higher tendency of N-doped nanoparticles for COx detention, compared to the undoped ones. Therefore, the results indicate that the N-doped TiO2 would be an ideal COx gas sensor in the environment.
Spontaneous dynamics of neural networks in deep layers of prefrontal cortex
Authors: Blaeser Andrew S. , Connors Barry W. , Nurmikko Arto V.
Published: January 2017

Cortical systems maintain and process information through the sustained activation of recurrent local networks of neurons. Layer 5 is known to have a major role in generating the recurrent activation associated with these functions, but relatively little is known about its intrinsic dynamics at the mesoscopic level of large numbers of neighboring neurons. Using calcium imaging, we measured the spontaneous activity of networks of deep-layer medial prefrontal cortical neurons in an acute slice model. Inferring the simultaneous activity of tens of neighboring neurons, we found that while the majority showed only sporadic activity, a subset of neurons engaged in sustained delta frequency rhythmic activity. Spontaneous activity under baseline conditions was weakly correlated between pairs of neurons, and rhythmic neurons showed little coherence in their oscillations. However, we consistently observed brief bouts of highly synchronous activity that must be attributed to network activity. NMDA-mediated stimulation enhanced rhythmicity, synchrony, and correlation within these local networks. These results characterize spontaneous prefrontal activity at a previously unexplored spatiotemporal scale and suggest that medial prefrontal cortex can act as an intrinsic generator of delta oscillations.

NEW & NOTEWORTHY Using calcium imaging and a novel analytic framework, we characterized the spontaneous and NMDA-evoked activity of layer 5 prefrontal cortex at a largely unexplored spatiotemporal scale. Our results suggest that the mPFC microcircuitry is capable of intrinsically generating delta oscillations and sustaining synchronized network activity that is potentially relevant for understanding its contribution to cognitive processes.
Modulation of motor cortex inhibition during motor imagery
Authors: Chong Benjamin W. X. , Stinear Cathy M.
Published: January 2017

Motor imagery (MI) is similar to overt movement, engaging common neural substrates and facilitating the corticomotor pathway; however, it does not result in excitatory descending motor output. Transcranial magnetic stimulation (TMS) can be used to assess inhibitory networks in the primary motor cortex via measures of 1-ms short-interval intracortical inhibition (SICI), long-interval intracortical inhibition (LICI), and late cortical disinhibition (LCD). These measures are thought to reflect extrasynaptic GABAA tonic inhibition, postsynaptic GABAB inhibition, and presynaptic GABAB disinhibition, respectively. The behavior of 1-ms SICI, LICI, and LCD during MI has not yet been explored. This study aimed to investigate how 1-ms SICI, LICI, and LCD are modulated during MI and voluntary relaxation (VR) of a target muscle. Twenty-five healthy young adults participated. TMS was used to assess nonconditioned motor evoked potential (MEP) amplitude, 1-ms SICI, 100- (LICI100) and 150-ms LICI, and LCD in the right abductor pollicis brevis (APB) and right abductor digiti minimi during rest, MI, and VR of the hand. Compared with rest, MEP amplitudes were facilitated in APB during MI. SICI was not affected by task or muscle. LICI100 decreased in both muscles during VR but not MI, whereas LCD was recruited in both muscles during both tasks. This indicates that VR modulates postsynaptic GABAB inhibition, whereas both tasks modulate presynaptic GABAB inhibition in a non-muscle-specific way. This study highlights further neurophysiological parallels between actual and imagined movement, which may extend to voluntary relaxation.

NEW & NOTEWORTHY This is the first study to investigate how 1-ms short-interval intracortical inhibition, long-interval intracortical inhibition, and late cortical disinhibition are modulated during motor imagery and voluntary muscle relaxation. We present novel findings of decreased 100-ms long-interval intracortical inhibition during voluntary muscle relaxation and increased late cortical disinhibition during both motor imagery and voluntary muscle relaxation.
Gut Microbiota in a Rat Oral Sensitization Model: Effect of a Cocoa‐Enriched Diet
Authors: Camps-Bossacoma Mariona , Pérez-Cano Francisco J. , Franch Àngels , Castell Margarida
Published: January 2017

Increasing evidence is emerging suggesting a relation between dietary compounds, microbiota, and the susceptibility to allergic diseases, particularly food allergy. Cocoa, a source of antioxidant polyphenols, has shown effects on gut microbiota and the ability to promote tolerance in an oral sensitization model. Taking these facts into consideration, the aim of the present study was to establish the influence of an oral sensitization model, both alone and together with a cocoa‐enriched diet, on gut microbiota. Lewis rats were orally sensitized and fed with either a standard or 10% cocoa diet. Faecal microbiota was analysed through metagenomics study. Intestinal IgA concentration was also determined. Oral sensitization produced few changes in intestinal microbiota, but in those rats fed a cocoa diet significant modifications appeared. Decreased bacteria from the Firmicutes and Proteobacteria phyla and a higher percentage of bacteria belonging to the Tenericutes and Cyanobacteria phyla were observed. In conclusion, a cocoa diet is able to modify the microbiota bacterial pattern in orally sensitized animals. As cocoa inhibits the synthesis of specific antibodies and also intestinal IgA, those changes in microbiota pattern, particularly those of the Proteobacteria phylum, might be partially responsible for the tolerogenic effect of cocoa.
Association between the Surgical Apgar Score and Perioperative Complications after Radical Prostatectomy
Authors: Orberger Matthias , Palisaar Jüri , Roghmann Florian , Mittelstädt Ludger , Bischoff Petra , Noldus Joachim , Löppenberg Björn
Published: January 2017

Objective: To evaluate whether the Surgical Apgar Score (SAS) can identify patients who are at risk for perioperative adverse events (PAE) following radical prostatectomy for prostate cancer. Patients and Methods: At a single academic institution, 994 patients undergoing radical prostatectomy between 2010 and 2013 were analyzed retrospectively. The SAS was calculated from anesthesia records, evaluated to predict PAE within a 30-day time period postoperatively; these events were classified according to standardized classification systems. Results: We observed adverse events in 45.4% (451/994) of patients with a total of 694 events. Overall, 41% (408/994) had low- and 9.9% (98/994) had high-grade events. A lower SAS was identified as an independent predictor of any (p < 0.001) and low-grade adverse events (p = 0.001) for those patients who had undergone open retropubic radical prostatectomy (ORRP). Each 1-point increment resulted in a 24% decrease in the odds of any (95% CI 0.66-0.88) and a 21% decrease in the odds of a low-grade (95% CI 0.69-0.91) event. Adverse events of robot-assisted prostatectomy were not associated with the SAS. Conclusions: Lower SAS values indicate patients at risk for adverse events after ORRP. The SAS might serve as one variable for outcome assessment, reflecting the challenge of mutual surgical and anesthesiology procedure management.
Enzymology and Ultrastructure of the in situ Pellicle in Caries-Active and Caries-Inactive Patients
Authors: Kirsch Jasmin , Hannig Christian , Pötschke Sandra , Basche Sabine , Bowen William H. , Rupf Stefan , Trautmann Simone , Umanskaya Natalia , Hannig Matthias
Published: January 2017

Aim: The present study aimed to evaluate the impact of caries activity on the key enzymes and the ultrastructure of the in situ pellicle. Methods: Pellicle formation was performed on bovine enamel slabs. Intraoral exposure (3, 30, and 120 min) was accomplished by 14 caries-active (DMFS: 22.7 ± 12.1) and 13 caries-inactive (DMFS: 1.5 ± 1.8) individuals. The enzyme activities (lysozyme, peroxidase, α-amylase, glycosyltransferase [GTF]) in the in situ pellicle and resting saliva of all participants were analyzed directly after oral exposure. In addition, a simultaneous visualization of these enzymes, extracellular glucans, and adherent bacteria was carried out. Fluorescent patterns were analyzed with fluorescence labeling and 4′,6-diamidino-2-phenylindole/concanavalin A staining. In addition, the distribution of GTF B, C, and D and the ultrastructure of the pellicle were examined by gold immunolabeling and transmission electron microscopy with selected samples. Results: Enzyme activities of amylase, peroxidase, lysozyme, and GTF were detected on all enamel slabs in an active conformation. Neither exposure time nor caries activity had an impact on the enzyme activities. Gold immunolabeling indicated that the pellicle of caries-active subjects tends to more GTF D molecules. The pellicles of caries-inactive and -active individuals revealed a similar ultrastructural pattern. Conclusion: The enzyme activities as well as the pellicle's ultrastructure are of high similarity in caries-active and -inactive subjects. Thereby, oral exposure time has no significant influence. This reflects a high uniformity during the initial phase of bioadhesion (3-120 min) concerning enzymatic functions. However, there is a tendency towards more GTF D in caries-active individuals.
Protective Effect of Phosphates and Fluoride on the Dissolution of Hydroxyapatite and Their Interactions with Saliva
Authors: Manarelli Michele M. , Pessan Juliano P. , Delbem Alberto C.B. , Amaral Jackeline G. , Paiva Mayra F. , Barbour Michele E.
Published: January 2017

This study aimed to investigate the effect of phosphates and fluoride, alone or in combination, and the influence of salivary pellicle on hydroxyapatite (HA) dissolution. The baseline dissolution rate of HA discs was measured using a pH-stat system (0.3% citric acid, pH 3.2). In the first series of experiments, HA discs (n = 8/group) were treated with: a placebo solution (PLA, deionised water); sodium trimetaphosphate (TMP), sodium tripolyphosphate (TRI) and sodium pyrophosphate (PYRO) at 1 or 8%; 500 ppm F; 1,100 ppm F; 1,100 ppm F/1% TMP; 1,100 ppm F/8% TMP; 1,100 ppm F/1% TRI; 1,100 ppm F/8% TRI. In the second phase, HA discs were immersed in pooled human saliva (37°C/2 h) and treated with PLA, 1,100 ppm F/1% TMP, 1,100 ppm F/8% TMP, 1,100 ppm F/1% TRI, and 1,100 ppm F/8% TRI. After treatments, final dissolution rates were measured from 3 consecutive 30-min assays. Statistical analyses were performed using 2-way ANOVA followed by the Fisher test (α = 0.05). The type and concentration of phosphate tested significantly influenced HA dissolution; 8% TRI showed the highest reduction (36.9%) among all treatment solutions. Fluoride alone (1,100 ppm F) significantly reduced HA dissolution by 20.7%. When fluoride and phosphates were associated, 1,100 ppm F/1% TMP, 1,100 ppm F/8% TMP, and 1,100 ppm F/8% TRI showed the highest percentage reductions of dissolution (40.3-46.1%). Salivary pellicle led to a greater and more sustained protective effect of the treatment solutions compared to their counterparts without salivary coating. It was concluded that the association of phosphate and fluoride enhanced their protective effect against HA dissolution when compared with these compounds alone, especially in the presence of salivary pellicle.
Structural Analysis of Enamel in Teeth from Head-and-Neck Cancer Patients Who Underwent Radiotherapy
Authors: Madrid Cristhian C. , de Pauli Paglioni Mariana , Line Sergio R. , Vasconcelos Karina G. , Brandão Thaís Bianca , Lopes Marcio A. , Santos-Silva Alan Roger , De Goes Mario Fernando
Published: January 2017

Objective: To analyze macroscopic, microscopic, and ultrastructural aspects of enamel from head-and-neck cancer patients submitted to radiotherapy. Materials and Methods: Twenty sound extracted permanent molars were used and divided into 2 groups. The experimental group consisted of 10 molars from head-and-neck cancer patients submitted to radiotherapy with total doses that ranged from 50 to 70 Gy. Ten molars from patients who did not receive radiotherapy were matched with experimental-group samples by anatomic tooth group and comprised the control group. To perform a macroscopic analysis, standardized photos of different enamel faces were taken with a camera. Teeth were subjected to longitudinal cuts and hand polished to a final thickness of 0.1 mm. Enamel was analyzed under polarized light microscopy, and optical retardation values of birefringence were calculated in cervical, cusp, and occlusal pit areas. Subsequently, the same enamel areas were analyzed by scanning electron microscopy. Data from optical retardation values were statistically analyzed by 2-way ANOVA and Fisher's test (α < 0.05). Results: No macroscopic differences were observed between the irradiated and control groups. Polarized light microscopy analysis revealed that cervical enamel exhibited darker areas characterized by discrete birefringence patterns compared to the control enamel. Optical retardation values were only significantly different in the cervical enamel of the irradiated and control groups (p < 0.0001). Scanning electron microscopy analysis revealed more evident interprismatic spaces in the cervical and outer cusp enamel of irradiated samples. Conclusions: Head-and-neck radiotherapy reduced optical retardation values of birefringence in cervical enamel, and the interprismatic spaces became more evident.
The Effect of Mucin in Artificial Saliva on Erosive Rehardening and Demineralization
Authors: Jordão Maisa C. , Ionta Franciny Q. , Bergantin Bianca T.P. , Oliveira Gabriela C. , Moretto Marcelo J. , Honório Heitor M. , Silva Thiago C. , Rios Daniela
Published: January 2017

The effect of mucin in artificial saliva on rehardening (RE-experiment) and inhibition (DE-experiment) of erosion was evaluated. The treatment groups were: artificial saliva with mucin, artificial saliva without mucin, human saliva, and water. For the RE-experiment, after immersion of enamel blocks in citric acid (4 min), hardness was measured and blocks were subjected to treatment for 2 h. For the DE-experiment, sound blocks were subjected to treatment for 2 h and immersed in citric acid (4 min). Percentages of hardness recovery (RE) and loss (DE) were analyzed (ANOVA/Tukey's test). The salivas promoted similar rehardening, but only the saliva with mucin was similar to human saliva with regard to enamel protection against erosion.
Comprehensive, Individualized, Person-Centered Management of Community-Residing Persons with Moderate-to-Severe Alzheimer Disease: A Randomized Controlled Trial
Authors: Reisberg Barry , Shao Yongzhao , Golomb James , Monteiro Isabel , Torossian Carol , Boksay Istvan , Shulman Melanie , Heller Sloane , Zhu Zhaoyin , Atif Ayesha , Sidhu Jaskirat , Vedvyas Alok , Kenowsky Sunnie
Published: January 2017

Background/Aims: The aim was to examine added benefits of a Comprehensive, Individualized, Person-Centered Management (CI-PCM) program to memantine treatment. Methods: This was a 28-week, clinician-blinded, randomized, controlled, parallel-group study, with a similar study population, similar eligibility criteria, and a similar design to the memantine pivotal trial of Reisberg et al. [N Engl J Med 2003;348:1333-1341]. Twenty eligible community-residing Alzheimer disease (AD) subject-caregiver dyads were randomized to the CI-PCM program (n = 10) or to usual community care (n = 10). Primary outcomes were the New York University Clinician's Interview-Based Impression of Change Plus Caregiver Input (NYU-CIBIC-Plus), assessed by one clinician set, and an activities of daily living inventory, assessed by a separate clinician set at baseline and at weeks 4, 12, and 28. Results: Primary outcomes showed significant benefits of the CI-PCM program at all post-baseline evaluations. Improvement on the NYU-CIBIC-Plus in the management group at 28 weeks was 2.9 points over the comparator group. The memantine 2003 trial showed an improvement of 0.3 points on this global measure in memantine-treated versus placebo-randomized subjects at 28 weeks. Hence, globally, the management program intervention benefits were 967% greater than memantine treatment alone. Conclusion: These results are approximately 10 times those usually observed with both nonpharmacological and pharmacological treatments and indicate substantial benefits with the management program for advanced AD persons.
Primary Prevention Strategies for Anthracycline Cardiotoxicity: A Brief Overview
Authors: Menna Pierantonio , Salvatorelli Emanuela
Published: January 2017

The clinical use of doxorubicin and other antitumor anthracyclines is limited by a dose-related risk of cardiomyopathy and heart failure which may occur “on treatment” or any time, from months to years, after completing chemotherapy. Dose reductions diminish the incidence of cardiac events attributable to anthracyclines, but heart failure still occurs in some patients exposed to low or moderate anthracycline doses. Because anthracyclines improve the life expectancy of patients with, for example, breast cancer or lymphomas, preventing or diminishing the risk of early or delayed cardiotoxicity is of obvious clinical importance. Here, we briefly review some potential strategies of primary prevention that are based on what we know about the molecular mechanisms of cardiotoxicity, and what can be done, or might be done, to interfere with the pharmacokinetic, pharmacodynamic, and genetic determinants of cardiotoxicity.
Impact of Vitamin D on the Clinical Outcome of Gastro-Entero-Pancreatic Neuroendocrine Neoplasms: Report on a Series from a Single Institute
Authors: Massironi Sara , Zilli Alessandra , Bernasconi Susanna , Fanetti Ilaria , Cavalcoli Federica , Ciafardini Clorinda , Felicetta Irene , Conte Dario
Published: January 2017

Background/Aims: Vitamin D deficiency is hypothesized to represent a risk factor in several neoplasms. The aim of this study was to determine whether serum 25-hydroxyvitamin D (25-OHvitD) deficiency represents a risk factor for neuroendocrine neoplasms (NENs) and can be associated with overall survival (OS) and progression-free survival (PFS). Methods: From 2010 to 2015, 138 patients with gastro- entero-pancreatic NENs (61 females; median age, 63 years) were included in the study. Serum 25-OHvitD levels, which were measured at baseline, were defined as deficient if ≤20 ng/mL. In such cases, 25-OHvitD supplementation was administered to the patients. The possible associations between 25-OHvitD levels and disease grading, staging, overall OS, and PFS were considered. Furthermore, the possible association between 25-OHvitD supplementation and PFS or OS was evaluated by Cox proportional hazards regression. Results: Median 25-OHvitD levels were 12.9 ng/mL (range 2-32); in detail, 94 patients (68%) had ≤20 ng/mL, with 46 cases (33%) having ≤10 ng/mL. An inverse correlation was observed between 25-OHvitD levels and OS (p = 0.03, rs = -0.18) and PFS (p = 0.01, rs = -0.22). At Cox proportional hazards regression, mortality was not related to 25-OHvitD levels; however, there was an association between 25-OHvitD supplementation and OS (p < 0.002). Conclusions: Vitamin D deficiency is highly prevalent among NEN patients. 25-OHvitD supplementation potentially plays an important role in the correction of 25-OHvitD values, and has an influence on the clinical outcome. However, further studies are needed to confirm this observation.
Impact of Heart Transplantation on the Functional Status of US Children With End-Stage Heart Failure
Authors: Peng David M. , Zhang Yulin , Rosenthal David N. , Palmon Michal , Chen Sharon , Kaufman Beth D. , Maeda Katsuhide , Hollander Seth A. , McDonald Nancy , Smoot Leslie B. , Bernstein Daniel , Almond Christopher S.
Published: January 2017

Background:

There are limited data describing the functional status (FS) of children after heart transplant (HT). We sought to describe the FS of children surviving at least 1 year after HT, to evaluate the impact of HT on FS, and to identify factors associated with abnormal FS post-HT.

Methods:

Organ Procurement and Transplantation Network data were used to identify all US children <21 years of age surviving ≥1 year post-HT from 2005 to 2014 with a functional status score (FSS) available at 3 time points (listing, transplant, ≥1 year post-HT). Logistic regression and generalized estimating equations were used to identify factors associated with abnormal FS (FSS≤8) post-HT.

Results:

A total of 1633 children met study criteria. At the 1-year assessment, 64% were “fully active/no limitations” (FSS=10), 21% had “minor limitations with strenuous activity” (FSS=9); and 15% scored ≤8. In comparison with listing FS, FS at 1 year post-HT increased in 91% and declined/remained unchanged in 9%. A stepwise regression procedure selected the following variables for association with abnormal FS at 1 year post-HT: ≥18 years of age (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.2–2.7), black race (OR, 1.5; 95% CI, 1.1–2.0), support with ≥inotropes at HT (OR, 1.7; 95% CI, 1.2–2.5), hospitalization status at HT (OR, 1.5; 95% CI, 1.0–2.19), chronic steroid use at HT (OR, 1.5; 95% CI, 1.0–2.2), and treatment for early rejection (OR, 2.0; 95% CI, 1.5–2.7).

Conclusion:

Among US children who survive at least 1 year after HT, FS is excellent for the majority of patients. HT is associated with substantial improvement in FS for most children. Early rejection, older age, black race, chronic steroid use, hemodynamic support at HT, and being hospitalized at HT are associated with abnormal FS post-HT.