bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-running and self-floating two-dimensional actuator using near-field acoustic levitation
Authors: Chen Keyu , Gao Shiming , Pan Yayue , Guo Ping
Published: September 2016

Non-contact actuators are promising technologies in metrology, machine-tools, and hovercars, but have been suffering from low energy efficiency, complex design, and low controllability. Here we report a new design of a self-running and self-floating actuator capable of two-dimensional motion with an unlimited travel range. The proposed design exploits near-field acoustic levitation for heavy object lifting, and coupled resonant vibration for generation of acoustic streaming for non-contact motion in designated directions. The device utilizes resonant vibration of the structure for high energy efficiency, and adopts a single piezo element to achieve both levitation and non-contact motion for a compact and simple design. Experiments demonstrate that the proposed actuator can reach a 1.65 cm/s or faster moving speed and is capable of transporting a total weight of 80 g under 1.2 W power consumption.
Microscopic study of stress effects around micro-crack tips using a non-contact stress-induced light scattering method
Authors: Sakata Y. , Terasaki N. , Nonaka K.
Published: September 2016

Fine-polishing techniques may cause micro-cracks under glass substrate surfaces. According to highly requirement from production field, a thermal stress-induced light scattering method (T-SILSM) was successfully developed for a non-contact inspection to detect the micro-cracks through changing in the intensity of light scattering accompanied by applying thermal stress at the responding position of the micro-cracks. In this study, in order to investigate that the origin of the measuring principle in microscopic order, a newly developed microscopic T-SILSM system with a rotation stage and a numerical simulation analysis were used to investigate the following; (1) the scattering points and surface in the micro-crack, (2) the stress concentration points in the micro-crack, and (3) the relationship between these information and the point in which intensity of the light scattering changes in the micro-crack through T-SILSM. Light scattering was observed at the responding position of the micro-crack with selectivity in the direction of laser irradiation even in the microscopic order. In addition, the position of the changes in the light scattering in was at both tips in the micro-crack, and it was consistent with the stress concentration point in the micro-crack. Therefore, it can be concluded that the intentional change in light scattering though T-SILSM is originated from light scattering at micro-crack and also from stress concentration and consecutive change in refractive index at both tips in micro-crack.
Room temperature gas-solid reaction of titanium on glass surfaces forming a very low resistivity layer
Authors: Solís Hugo , Clark Neville , Azofeifa Daniel , Avendano E.
Published: September 2016

Titanium films were deposited on quartz, glass, polyamide and PET substrates in a high vacuum system at room temperature and their electrical resistance monitored in vacuo as a function of thickness. These measurements indicate that a low electrical resistance layer is formed in a gas-solid reaction during the condensation of the initial layers of Ti on glass and quartz substrates. Layers begin to show relative low electrical resistance at around 21 nm for glass and 9nm for quartz. Samples deposited on polyamide and PET do not show this low resistance feature.
Validity of four measures in assessing school canteen menu compliance with state‐based healthy canteen policy
Authors: Reilly Kathryn , Nathan Nicole , Wolfenden Luke , Wiggers John , Sutherland Rachel , Wyse Rebecca , Yoong Sze Lin
Published: September 2016

Issue addressed

In order to assess the impact of healthy school canteen policies on food availability for students, valid methods of measuring compliance are needed that can be applied at scale. The aim of this study is to assess the validity and direct cost of four methods to assess policy compliance: 1) principal and 2) canteen manager self‐report via a computer‐assisted telephone interview; and 3) comprehensive and 4) quick menu audits by dietitians, compared with observations.

Methods

A cross‐sectional study took place in the Hunter region of NSW, Australia, in a sample of 38 primary schools that had previously participated in a randomised controlled trial to improve healthy canteen policy compliance. Policy compliance was assessed using the four methods specified above. Percentage agreement, kappa, sensitivity and specificity compared with observations was calculated together with the direct time taken and costs of each method. Indirect costs (including set‐up costs) for all measures have not been included.

Results

Agreement with observations was substantial for the quick menu audit (kappa = 0.68), and moderate for the comprehensive menu audit (kappa = 0.42). Principal and canteen manager self‐report resulted in poor agreement and low specificity with the gold standard. The self‐reported measures had the lowest cost, followed by the quick menu audit and lastly the comprehensive menu audit.

Conclusion

The quick menu audit represents a valid and potentially low‐cost method of supporting policy implementation at scale.

So what?

This study demonstrates that a quick menu audit represents a valid measure of undertaking assessment of school canteen policy compliance at a population level.
Expression of C-type lectin receptors and Toll-like receptors in decidua of patients with unexplained recurrent spontaneous abortion
Authors: Xu Liang , Qiu Tian , Wang Yudong , Chen Yan , Cheng Weiwei
Published: September 2016

In the present study, the mechanisms underlying the pathogenesis of unexplained recurrent spontaneous abortion (URSA) were explored. The protein and mRNA expression of two C-type lectin-like receptors (CLRs), namely dendritic cell-specific intercellular adhesion molecule-3-grabbing non-integrin (DC-SIGN) and mannose receptor (MR), and two Toll-like receptors (TLRs), namely TLR2 and TLR4, in the decidua and dendritic cells (DCs) was compared between URSA patients and normal controls. URSA patients had significantly lower protein and mRNA expression of DC-SIGN and significantly higher expression of TLR2 and TLR4 in decidual tissues compared with normal controls. In addition, URSA patients had significantly higher levels of the T helper (Th) 1 cytokines interleukin (IL)-2 and interferon-γ, and significantly lower levels of the Th2 cytokines IL-10 and transforming growth factor β1 in decidual tissues compared with the control group. The TLR2 agonist synthetic triacylated lipoprotein (Pam3CSK4) and the TLR4 agonist lipopolysaccharide were used to demonstrate that TLR2 and TLR4 modulate Th1/Th2 cytokine imbalance in DC–T cell cocultures. The results suggest that the balance between CLRs and TLRs was tilted towards a TLR-dominant response in URSA patients, which may disrupt maternal–fetal immune tolerance, resulting in spontaneous abortion.
Multiple orientation cues in an Australian trunk-trail-forming ant, Iridomyrmex purpureus
Authors: Card Ashley , McDermott Caitlin , Narendra Ajay
Published: September 2016

Ants use multiple cues for navigating to a food source or nest location. Directional information is derived from pheromone trails or visual landmarks or celestial objects. Some ants use the celestial compass information along with an ‘odometer’ to determine the shortest distance home, a strategy known as path integration. Some trail-following ants utilise visual landmark information whereas few of the solitary-foraging ants rely on both path integration and visual landmark information. However, it is unknown to what degree trail-following ants use path integration and we investigated this in a trunk-trail-following ant, Iridomyrmex purpureus. Trunk-trail ants connect their nests to food sites with pheromone trails that contain long-lasting orientation information. We determined the use of visual landmarks and the ability to path integrate in a trunk-trail forming ant. We found that experienced animals switch to relying on visual landmark information, and naïve individuals rely on odour trails. Ants displaced to unfamiliar locations relied on path integration, but, surprisingly, they did not travel the entire homebound distance. We found that as the homebound distance increased, the distance ants travelled relying on the path integrator reduced.
Dioxygenase-encoding
AtDAO1
gene controls IAA oxidation and homeostasis in
Arabidopsis
Authors: Porco Silvana , Pěnčík Aleš , Rashed Afaf , Voß Ute , Casanova-Sáez Rubén , Bishopp Anthony , Golebiowska Agata , Bhosale Rahul , Swarup Ranjan , Swarup Kamal , Peňáková Pavlína , Novák Ondřej , Staswick Paul , Hedden Peter , Phillips Andrew L. , Vissenberg Kris , Bennett Malcolm J. , Ljung Karin
Published: September 2016

Significance

Understanding how hormones like auxin control plant growth and development has fascinated scientists since Darwin. The past two decades have seen breakthroughs in elucidating the molecular basis of auxin transport, perception, and response, but little is known about how auxin is metabolized or its homeostasis is controlled. We report that the
DIOXYGENASE FOR AUXIN OXIDATION 1
(
AtDAO1
) enzyme represents the major pathway for auxin oxidation in
Arabidopsis
. Disrupting
AtDAO1
function elevates levels of auxin conjugates between ∼50- and 280-fold, but auxin levels remain close to the WT, helping explain why mutant phenotypes are relatively weak. We conclude that
AtDAO1
and auxin conjugation pathways play highly redundant roles and reveal a level of regulation of auxin abundance in plants.
Autonomous translational pausing is required for
XBP1u
mRNA recruitment to the ER via the SRP pathway
Authors: Kanda Satoshi , Yanagitani Kota , Yokota Yukiko , Esaki Yuta , Kohno Kenji
Published: September 2016

Significance

Unconventional splicing of unspliced X-box–binding protein 1 (
XBP1u
) mRNA on endoplasmic reticulum (ER) is an important process by which signals are transferred from the ER to the nucleus to maintain ER homeostasis. Newly synthesized XBP1u protein drags its own mRNA as a ribosome nascent chain complex to the ER; however, its precise location and molecular mechanism of ER recruitment remain unknown. We show that translational pausing of XBP1u is necessary for the recognition of the internal signal sequence of XBP1u by canonical secretory machinery. Interestingly, most XBP1u targeted to the ER was not imported into the ER lumen but was associated with the ER membrane, suggesting a noncanonical mechanism by which mRNA substrates are targeted to the ER for unconventional splicing.
DAO1 catalyzes temporal and tissue-specific oxidative inactivation of auxin in
Arabidopsis thaliana
Authors: Zhang Jun , Lin Jinshan Ella , Harris Chinchu , Campos Mastrotti Pereira Fernanda , Wu Fan , Blakeslee Joshua J. , Peer Wendy Ann
Published: September 2016

Significance

Although auxin oxidation has long been known to be the primary mechanism of auxin catabolism and
Arabidopsis
seedlings have 10–100 more 2-oxindole 3-acetic acid compared with other auxin catabolic products, the enzymes that constitutively catalyze this process remained unknown. This work fills the gap by identifying and characterizing the
Arabidopsis
proteins DIOXYGENASE FOR AUXIN OXIDATION 1 (DAO1) and DAO2, which catalyze auxin oxidation under normal growth conditions and shows that this activity has a physiological function in planta. The protein localization and phenotypes of the loss/gain of function mutants support that DAO1 is the primary constitutive mechanism of auxin catabolism in
Arabidopsis
and that the temporal- and tissue-specific oxidative inactivation of auxin by DAO adjusts indole-3-acetic acid levels throughout the life of the plant to optimize growth and development.
Convolutional networks for fast, energy-efficient neuromorphic computing
Authors: Esser Steven K. , Merolla Paul A. , Arthur John V. , Cassidy Andrew S. , Appuswamy Rathinakumar , Andreopoulos Alexander , Berg David J. , McKinstry Jeffrey L. , Melano Timothy , Barch Davis R. , di Nolfo Carmelo , Datta Pallab , Amir Arnon , Taba Brian , Flickner Myron D. , Modha Dharmendra S.
Published: September 2016

Significance

Brain-inspired computing seeks to develop new technologies that solve real-world problems while remaining grounded in the physical requirements of energy, speed, and size. Meeting these challenges requires high-performing algorithms that are capable of running on efficient hardware. Here, we adapt deep convolutional neural networks, which are today’s state-of-the-art approach for machine perception in many domains, to perform classification tasks on neuromorphic hardware, which is today’s most efficient platform for running neural networks. Using our approach, we demonstrate near state-of-the-art accuracy on eight datasets, while running at between 1,200 and 2,600 frames/s and using between 25 and 275 mW.
Modal science
Authors: Williamson Timothy
Published: September 2016

This paper explains and defends the idea that metaphysical necessity is the strongest kind of objective necessity. Plausible closure conditions on the family of objective modalities are shown to entail that the logic of metaphysical necessity is S5. Evidence is provided that some objective modalities are studied in the natural sciences. In particular, the modal assumptions implicit in physical applications of dynamical systems theory are made explicit by using such systems to define models of a modal temporal logic. Those assumptions arguably include some necessitist principles.
Updated perspectives on the cytosolic sulfotransferases (SULTs) and SULT-mediated sulfation
Authors: Suiko Masahito , Kurogi Katsuhisa , Hashiguchi Takuyu , Sakakibara Yoichi , Liu Ming-Cheh
Published: September 2016

The cytosolic sulfotransferases (SULTs) are Phase II detoxifying enzymes that mediate the sulfate conjugation of numerous xenobiotic molecules. While the research on the SULTs has lagged behind the research on Phase I cytochrome P-450 enzymes and other Phase II conjugating enzymes, it has gained more momentum in recent years. This review aims to summarize information obtained in several fronts of the research on the SULTs, including the range of the SULTs in different life forms, concerted actions of the SULTs and other Phase II enzymes, insights into the structure–function relationships of the SULTs, regulation of SULT expression and activity, developmental expression of SULTs, as well as the use of a zebrafish model for studying the developmental pharmacology/toxicology.
Weighted 𝐿² inequalities for square functions
Authors: Bañuelos Rodrigo , Osȩkowski Adam
Published: September 2016

Using the Bellman function approach, we present new proofs of weighted

L
2

L^2

inequalities for square functions, with the optimal dependence on the

A
2

A_2

characteristics of the weight and further explicit constants. We study the estimates both in the analytic and probabilistic context, and, as an application, obtain related estimates for the classical Lusin and Littlewood-Paley square functions.
Finite 2-groups with odd number of conjugacy classes
Authors: Jaikin-Zapirain Andrei , Tent Joan
Published: September 2016

In this paper we consider finite 2-groups with odd number of real conjugacy classes. On one hand we show that if

k
k

is an odd natural number less than 24, then there are only finitely many finite

2
2

-groups with exactly

k
k

real conjugacy classes. On the other hand we construct infinitely many finite

2
2

-groups with exactly 25 real conjugacy classes. Both resuls are proven using pro-

p
p

techniques, and, in particular, we use the Kneser classification of semi-simple

p
p

-adic algebraic groups.
Norharmane matrix enhances detection of endotoxin by MALDI-MS for simultaneous profiling of pathogen, host and vector systems
Authors: Scott Alison J. , Flinders Bryn , Cappell Joanna , Liang Tao , Pelc Rebecca S. , Tran Bao , Kilgour David P. A. , Heeren Ron M. A. , Goodlett David R. , Ernst Robert K.
Published: September 2016

The discovery of novel pathogenic mechanisms engaged during bacterial infections requires the evolution of advanced techniques. Here, we evaluate the dual polarity matrix norharmane (NRM) to improve detection of bacterial lipid A (endotoxin), from host and vector tissues infected withFrancisella novicida (Fn). We evaluated NRM for improved detection and characterization of a wide range of lipids in both positive and negative polarities, including lipid A and phospholipids across a range of matrix-assisted laser desorption-ionization-coupled applications. NRM matrix improved the limit of detection (LOD) for monophosphoryl lipid A (MPLA) down to picogram level representing a 10-fold improvement of LOD versus 2,5-dihydroxybenzoic acid and 100-fold improvement of LOD versus 9-aminoacridine (9-AA). Improved LOD for lipid A subsequently facilitated detection of theFn lipid A major ion (m/z 1665) from extracts of infected mouse spleen and the temperature-modifiedFn lipid A atm/z 1637 from infectedDermacentor variabilis ticks. Finally, we simultaneously mapped bacterial phospholipid signatures within anFn-infected spleen along with an exclusively host-derived inositol-based phospholipid (m/z 933) demonstrating coprofiling of the host-pathogen interaction. Expanded use of NRM matrix in other infection models and endotoxin-targeting imaging experiments will improve our understanding of the lipid interactions at the host-pathogen interface.
Critical Deficiency Ratings in Milestone Assessment: A Review and Case Study
Authors: Kinnear Benjamin , Bensman Rachel , Held Justin , O’Toole Jennifer , Schauer Daniel , Warm Eric
Published: September 2016

Purpose

The Accreditation Council for Graduate Medical Education (ACGME) requires programs to report learner progress using specialty-specific milestones. It is unclear how milestones can best identify critical deficiencies (CDs) in trainee performance. Specialties developed milestones independently of one another; not every specialty included CDs within milestones ratings. This study examined the proportion of ACGME milestone sets that include CD ratings, and describes one residency program’s experiences using CD ratings in assessment.

Method

The authors reviewed ACGME milestones for all 99 specialties in November 2015, determining which rating scales contained CDs. The authors also reviewed three years of data (July 2012–June 2015) from the University of Cincinnati Medical Center (UCMC) internal medicine residency assessment system based on observable practice activities mapped to ACGME milestones. Data were analyzed by postgraduate year, assessor type, rotation, academic year, and core competency. The Mantel–Haenszel chi-square test was used to test for changes over time.

Results

Specialties demonstrated heterogeneity in accounting for CDs in ACGME milestones, with 22% (22/99) of specialties having no language describing CDs in milestones assessment. Thirty-three percent (63/189) of UCMC internal medicine residents received at least one CD rating, with CDs accounting for 0.18% (668/364,728) of all assessment ratings. The authors identified CDs across multiple core competencies and rotations.

Conclusions

Despite some specialties not accounting for CDs in milestone assessment, UCMC’s experience demonstrates that a significant proportion of residents may be rated as having a CD during training. Identification of CDs may allow programs to develop remediation and improvement plans.
Novel Signs and Their Clinical Utility in Diagnosing Complex Regional Pain Syndrome (CRPS)
Authors: Kuttikat Anoop , Shaikh Maliha , Oomatia Amin , Parker Richard , Shenker Nicholas
Published: September 2016

Objectives:

Delays in diagnosis occur with complex regional pain syndrome (CRPS). We define and prospectively demonstrate that novel bedside tests measuring body perception disruption can identify patients with CRPS postfracture.

Methods:

The objectives of our study were to define and validate 4 bedside tests, to identify the prevalence of positive tests in patients with CRPS and other chronic pain conditions, and to assess the clinical utility (sensitivity, specificity, positive predictive value, negative predictive value) for identifying CRPS within a Fracture cohort. This was a single UK teaching hospital prospective cohort study with 313 recruits from pain-free volunteers and patients with chronic pain conditions.

Four novel tests were Finger Perception (FP), Hand Laterality identification (HL), Astereognosis (AS), and Body Scheme (BS) report. Five questionnaires (Brief Pain Inventory, Upper Extremity Functional Index, Lower Extremity Functional Index, Neglect-like Symptom Questionnaire, Hospital Anxiety and Depression Score) assessed the multidimensional pain experience.

Results:

FP and BS were the best performing tests. Prospective monitoring of fracture patients showed that out of 7 fracture patients (total n=47) who had both finger misperception and abnormal BS report at initial testing, 3 developed persistent pain with 1 having a formal diagnosis of CRPS.

Discussion:

Novel signs are reliable, easy to perform, and present in chronic pain patients. FP and BS have significant clinical utility in predicting persistent pain in a fracture group thereby allowing targeted early intervention.
Long-term Fate Mapping to Assess the Impact of Postnatal Isoflurane Exposure on Hippocampal Progenitor Cell Productivity
Authors: Jiang Yifei , Tong Dongyi , Hofacer Rylon D. , Loepke Andreas W. , Lian Qingquan , Danzer Steve C.
Published: September 2016

Background

Exposure to isoflurane increases apoptosis among postnatally generated hippocampal dentate granule cells. These neurons play important roles in cognition and behavior, so their permanent loss could explain deficits after surgical procedures.

Methods

To determine whether developmental anesthesia exposure leads to persistent deficits in granule cell numbers, a genetic fate-mapping approach to label a cohort of postnatally generated granule cells in Gli1-CreERT2::GFP bitransgenic mice was utilized. Green fluorescent protein (GFP) expression was induced on postnatal day 7 (P7) to fate map progenitor cells, and mice were exposed to 6 h of 1.5% isoflurane or room air 2 weeks later (P21). Brain structure was assessed immediately after anesthesia exposure (n = 7 controls and 8 anesthesia-treated mice) or after a 60-day recovery (n = 8 controls and 8 anesthesia-treated mice). A final group of C57BL/6 mice was exposed to isoflurane at P21 and examined using neurogenesis and cell death markers after a 14-day recovery (n = 10 controls and 16 anesthesia-treated mice).

Results

Isoflurane significantly increased apoptosis immediately after exposure, leading to cell death among 11% of GFP-labeled cells. Sixty days after isoflurane exposure, the number of GFP-expressing granule cells in treated animals was indistinguishable from control animals. Rates of neurogenesis were equivalent among groups at both 2 weeks and 2 months after treatment.

Conclusions

These findings suggest that the dentate gyrus can restore normal neuron numbers after a single, developmental exposure to isoflurane. The authors’ results do not preclude the possibility that the affected population may exhibit more subtle structural or functional deficits. Nonetheless, the dentate appears to exhibit greater resiliency relative to nonneurogenic brain regions, which exhibit permanent neuron loss after isoflurane exposure.
Infections and vasculitis
Authors: Thomas Konstantinos , Vassilopoulos Dimitrios
Published: September 2016

Purpose of review

To review recent evidence for infection rates in patients with systemic vasculitides, the role of specific infectious agents in the pathogenesis of vasculitis and recent breakthroughs in the treatment of virus-associated vasculitides.

Recent findings

In well designed recent studies, infections were found to be common during the first 6–12 months in patients with anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) and giant cell arteritis (GCA) and to contribute significantly to increased mortality during this period. New therapeutic schemes with lower cyclophosphamide doses and shorter corticosteroid courses were associated with decreased infectious rates in elderly patients with AAV whereas a prednisone dose greater than 10 mg/day at the end of the first year were associated with increased infectious-related mortality in patients with GCA. Recently, a potential role for varicella zoster virus in GCA pathogenesis has been proposed but more data are needed in order to establish a causal relationship. Finally, preliminary data show excellent short-term efficacy and safety of the new, interferon-free, oral antiviral agents in the treatment of hepatitis C virus-associated cryoglobulinemic vasculitis.

Infections continue to be one of the main causes of mortality in patients with systemic vasculitides, emphasizing the need for safer immunosuppressive therapies and appropriate prophylaxis.
High-Flow Nasal Cannula Oxygenation in Immunocompromised Patients With Acute Hypoxemic Respiratory Failure: A Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique Study
Authors: Lemiale Virginie , Resche-Rigon Matthieu , Mokart Djamel , Pène Frédéric , Argaud Laurent , Mayaux Julien , Guitton Christophe , Rabbat Antoine , Girault Christophe , Kouatchet Achille , Vincent François , Bruneel Fabrice , Nyunga Martine , Seguin Amélie , Klouche Kada , Colin Gwenahel , Kontar Loay , Perez Pierre , Meert Anne-Pascale , Benoit Dominique D. , Papazian Laurent , Demoule Alexandre , Chevret Sylvie , Azoulay Elie
Published: September 2016

Objective:

In immunocompromised patients with acute respiratory failure, invasive mechanical ventilation remains associated with high mortality. Choosing the adequate oxygenation strategy is of the utmost importance in that setting. High-flow nasal oxygen has recently shown survival benefits in unselected patients with acute respiratory failure. The objective was to assess outcomes of immunocompromised patients with hypoxemic acute respiratory failure treated with high-flow nasal oxygen.

Design:

We performed a post hoc analysis of a randomized controlled trial of noninvasive ventilation in critically ill immunocompromised patients with hypoxemic acute respiratory failure.

Setting:

Twenty-nine ICUs in France and Belgium.

Patients:

Critically ill immunocompromised patients with hypoxemic acute respiratory failure.

Intervention:

A propensity score–based approach was used to assess the impact of high-flow nasal oxygen compared with standard oxygen on day 28 mortality.

Measurements and Main Results:

Among 374 patients included in the study, 353 met inclusion criteria. Underlying disease included mostly malignancies (n = 296; 84%). Acute respiratory failure etiologies were mostly pneumonia (n = 157; 44.4%) or opportunistic infection (n = 76; 21.5%). Noninvasive ventilation was administered to 180 patients (51%). Invasive mechanical ventilation was ultimately needed in 142 patients (40.2%). Day 28 mortality was 22.6% (80 deaths). Throughout the ICU stay, 127 patients (36%) received high-flow nasal oxygen whereas 226 patients received standard oxygen. Ninety patients in each group (high-flow nasal oxygen or standard oxygen) were matched according to the propensity score, including 91 of 180 (51%) who received noninvasive ventilation. High-flow nasal oxygen was neither associated with a lower intubation rate (hazard ratio, 0.42; 95% CI, 0.11–1.61; p = 0.2) nor day 28 mortality (hazard ratio, 0.80; 95% CI, 0.45–1.42; p = 0.45).

Conclusions:

In immunocompromised patients with hypoxemic acute respiratory failure, high-flow nasal oxygen when compared with standard oxygen did not reduce intubation or survival rates. However, these results could be due to low statistical power or unknown confounders associated with the subgroup analysis. A randomized trial is needed.
Body mass index and the risk of cancer in women compared with men: a meta-analysis of prospective cohort studies
Authors: Xue Kai , Li Feng-Feng , Chen Yi-Wei , Zhou Yu-Hao , He Jia
Published: September 2016

Studies investigating the association between BMI and the risk of the common cancers in men or women have reported inconsistent results. We searched the PubMed, Embase, and Cochrane Library electronic databases for relevant articles published until April 2015. Overall, we analyzed 128 datasets (51 articles), including 154 939 incident cancer cases. The pooled relative risk ratio (RRR) (female to male) showed that the relative risk of overweight associated with colorectal [RRR: 0.91; 95% confidence interval (CI): 0.85–0.97] or rectal cancer (RRR: 0.94; 95% CI: 0.88–0.99) was significantly lower in women than in men. However, the relative risk of overweight associated with lung (RRR: 1.14; 95% CI: 1.06–1.22) or kidney cancer (RRR: 1.15; 95% CI: 1.05–1.26) was significantly higher in women than in men. Furthermore, the relative risk of obesity associated with liver (RRR: 0.71; 95% CI: 0.51–0.99), colorectal (RRR: 0.83; 95% CI: 0.75–0.93), colon (RRR: 0.73; 95% CI: 0.68–0.0.78), rectal (RRR: 0.84; 95% CI: 0.76–0.92), and kidney cancer (RRR: 1.20; 95% CI: 1.06–1.37) differed significantly between women and men. Finally, the relative risk of underweight associated with gastric (RRR: 0.83; 95% CI: 0.70–0.97), liver (RRR: 0.83; 95% CI: 0.71–0.97), and gallbladder cancer (RRR: 1.25; 95% CI: 1.04–1.49) differed significantly according to sex. In conclusion, our study showed that the association between BMI and the risk of several cancers was significantly different between the sexes. For some cancer types, the sex difference was affected by country, sample size, follow-up duration, and study quality.
CD30 Positive Lymphomatoid Angiocentric Drug Reactions: Characterization of a Series of 20 Cases
Authors: Magro Cynthia M. , Olson Luke C. , Nguyen Giang Huong , de Feraudy Sebastien M.
Published: September 2016

Introduction:

Lymphomatoid drug reactions are atypical T cell cutaneous lymphocytic infiltrates induced by pharmacological therapy. Due to phenotypic abnormalities, clonality, and their close clinical and morphologic resemblance to T cell lymphomas, these eruptions have been categorized as drug-associated reversible granulomatous T cell dyscrasias.

Design:

A total of 20 cases were encountered in which a diagnosis of CD30+ lymphomatoid drug reaction was rendered.

Results:

There were 11 women and 9 men ranging from 31 to 86 years of age presenting with a sudden onset often generalized cutaneous papular eruption. Two patients had vasculitic lesions. In all cases, a positive drug history was elicited and in most the initiation of the drug was temporally associated with the cutaneous eruption. Among the implicated drugs were statins (6 cases), immunomodulators (4 cases), ACE inhibitors (3 cases), antibiotics (3 cases), chemotherapy agents (3 cases), and antidepressants (1 case). Biopsies demonstrated a similar morphology, namely a superficial angiocentric lymphocytic infiltrate containing many immunoblasts. Tissue eosinophilia, interface dermatitis, and supervening eczematous changes in the overlying epidermis were observed in most cases. In all cases, the angiocentric infiltrate was highlighted by CD3, CD30, and CD4. Cytotoxic protein granule expression or monoclonality was not observed. In all cases, there was improvement or complete regression of the eruption upon drug modulation.

Conclusion:

The CD30 positive lymphomatoid angiocentric drug reaction poses a diagnostic challenge because of its close resemblance to type A lymphomatoid papulosis and potential confusion with a peripheral T cell lymphoma with large cell transformation.
Living on the Edge: Diagnosing Sarcomatoid Melanoma Using Histopathologic Cues at the Edge of a Dedifferentiated Tumor: A Report of 2 Cases and Review of the Literature
Authors: Erstine Emily M. , Tetzlaff Michael T. , Ko Jennifer S. , Prieto Victor G. , Cheah Alison L. , Billings Steven D.
Published: September 2016

Sarcomatoid melanoma is a rare type of melanoma lacking typical histologic features of melanoma and often lacks expression of S100 protein and melanocyte-specific markers. Given the rarity of this entity, its clinicopathologic findings are not well defined. We report 2 cases of sarcomatoid melanoma received in consultation: a 65-year-old woman with a right breast mass and a 62-year-old man with a left plantar heel mass. Both lesions were ulcerated, pedunculated, highly cellular proliferations of atypical spindle cells arranged as fascicles and/or sheets. The tumor cells of the breast mass expressed CD10 and vimentin diffusely but S100 protein only focally. The tumor cells of the heel mass lacked expression of melanocytic markers altogether, except for weak, very focal S100 protein expression. At the junctional edge of the breast mass and in the ulcer base of the heel mass, focal precursor melanoma was present and exhibited melanocytic differentiation. We report these cases to emphasize the importance of meticulous histologic inspection at the lesion's edge and/or ulcer base to correctly identify the conventional precursor melanoma in these rare lesions to ensure appropriate diagnosis and subsequent clinical management as treatment options may be significantly different from those offered for sarcomas.
An Immunohistochemical Study of Anogenital Mammary-Like Glands
Authors: Konstantinova Anastasia M. , Stewart Colin J. R. , Kyrpychova Liubov , Belousova Irena E. , Michal Michal , Kazakov Dmitry V.
Published: September 2016

Although the normal histology of anogenital mammary-like glands (AGMLG) has been studied, no systemic investigation has been performed on the immunoprofile of these structures. We studied intact AGMLG with a broad panel of antibodies. The immunoprofile of AGMLG is similar to that of a normal breast tissue, and there are similarities to eccrine glands and coils about cytokeratin expression. Our immunohistochemical data may contribute to understanding of the pathogenesis of lesions arising from AGMLG.
Inotropic Effects of Prostacyclins on the Right Ventricle Are Abolished in Isolated Rat Hearts With Right-Ventricular Hypertrophy and Failure
Authors: Holmboe Sarah , Andersen Asger , Johnsen Jacob , Nielsen Jan Møller , Nørregaard Rikke , Bøtker Hans Erik , Clapp Lucie H. , Nielsen-Kudsk Jens Erik
Published: September 2016

Background:

Prostacyclin mimetics are vasodilatory agents used in the treatment of pulmonary arterial hypertension. The direct effects of prostanoids on right-ventricular (RV) function are unknown. We aimed to investigate the direct effects of prostacyclin mimetics on RV function in hearts with and without RV hypertrophy and failure.

Methods:

Wistar rats were subjected to pulmonary trunk banding to induce compensated RV hypertrophy (n = 32) or manifest RV failure (n = 32). Rats without banding served as healthy controls (n = 30). The hearts were excised and perfused in a Langendorff system and subjected to iloprost, treprostinil, epoprostenol, or MRE-269 in increasing concentrations. The effect on RV function was evaluated using a balloon-tipped catheter inserted into the right ventricle.

Results:

In control hearts, iloprost, treprostinil, and MRE-269 improved RV function. The effect was, however, absent in hearts with RV hypertrophy and failure. Treprostinil and MRE-269 even impaired RV function in hearts with manifest RV failure.

Conclusions:

Iloprost, treprostinil, and MRE-269 improved RV function in the healthy rat heart. RV hypertrophy abolished the positive inotropic effect, and in the failing right ventricle, MRE-269 and treprostinil impaired RV function. This may be related to changes in prostanoid receptor expression and reduced coronary flow reserve in the hypertrophic and failing right ventricle.
Three-dimensional Analysis of Normal Facial Morphologies of Asians and Whites: A Novel Method of Quantitative Analysis
Authors: Kim Jamie Y. , Kau Chung H. , Christou Terpsithea , Ovsenik Maja , Guk Park Young
Published: September 2016

Background:

The purpose of this study is to compare 3-dimensional facial averages of Asians (Koreans and Chinese) and Houstonian white faces using a (3-dimensional) surface imaging system.

Methods:

Three-dimensional images of Korean adults (Seoul, Korea) with class I malocclusion captured using the 3dMDface. The images of 138 Koreans were processed to generate average male and female facial shells using Rapidform 2006 plus pack 2 software and then superimposed and compared with the average shells of Chinese adults (Xi’ An, China) and white adults (Houston, Tex.).

Results:

The average Korean male and female faces were wider with prominent malar and zygomatic areas when compared with the white faces. The average white male and female faces showed more protrusion in the glabella, nasion, rhinion, and the soft-tissue pogonion than the Korean faces. The average Korean male face was retrusive at masseteric region while having more prominent lips, nasal tip, and supraglabella than the Chinese counterpart. The average Korean female face was narrower than the average Chinese female face, but there was more protrusion in the periorbital, nasal tip, and malar region seen in the Korean female face.

Conclusions:

Although the average faces of Chinese and Korean populations in this study showed remarkable similarities, there were distinct differences seen in the facial morphology of the 2 Asian groups. Three-dimensional imaging can be effectively used to establish population facial norms and to quantify the variations seen between different ethnicities. This information may be used in the clinical environment for plastic, oral, and maxillofacial surgery and orthodontics.
Trabeculectomy Combined With Collagen Matrix Implant (Ologen)
Authors: Perez Claudio I. , Mellado Felipe , Jones Alex , Colvin Ricardo
Published: September 2016

Purpose of the Study:

The purpose of the study was to report and evaluate outcomes of trabeculectomy with use of a subconjunctival biodegradable collagen matrix implant.

Patients and Methods:

Retrospective review of trabeculectomy with Ologen implant of 65 eyes of 58 patients by the same surgeon from October, 2011 to October, 2014. Exclusion criteria were <6 months of follow-up after surgery, and uveitic or neovascular glaucoma. Demographic characteristics of the study population, visual acuity, intraocular pressure (IOP), glaucoma medications, bleb characteristics, and early and late postoperative complications were recorded. Complete and qualified IOP control success, ≤15 and ≤18 mm Hg, was calculated with the Kaplan-Meier analysis.

Results:

The mean age of the patients in the study was 65.9±15.1 years. IOP was reduced from a mean of 21.4±9.2 to 12.3±3.7 mm Hg at the last follow-up visit (P<0.0001). The number of IOP-lowering medications per eye was reduced from a mean of 1.86 preoperatively to 0.2 at the last follow-up visit (P<0.0001). The Kaplan-Meier survival curves of complete success for IOP≤15 mm Hg and ≤18 mm Hg were 47.2% and 62.9%, respectively, at 36 months. Postoperative complications occurred in 15% of the eyes, with bleb leakage (6%) and hypotony (5%), which were resolved medically. At the last postoperative visit, blebs were described as normal (86.4%), flat (9.1%), and polycystic (4.5%).

Conclusions:

Trabeculectomy surgeries with Ologen performed by the same surgeon were effective in lowering IOP with a low complication rate at mid-term follow-up.
MRI Study of the Posterior Visual Pathways in Primary Open Angle Glaucoma
Authors: Zhou Wei , Muir Eric R. , Chalfin Steven , Nagi Kundandeep S. , Duong Timothy Q.
Published: September 2016

Purpose of the Study:

The purpose of the study was to evaluate neurodegeneration along brain visual pathways in primary open angle glaucoma (POAG) using improved analysis methods of volumetric and diffusion tensor magnetic resonance imaging (MRI) data.

Methods:

Eleven POAG patients (60.0±9.2 y) with primarily mild to moderate POAG and 11 age-matched controls (55.9±7.5 y) were studied using structural and diffusion tensor MRI. Surface-based segmentation was applied to structural MRI to obtain visual cortical area and volume. Fiber tracking was applied to diffusion tensor data to obtain diffusion parameters along the optic tract and optic radiation. MRI parameters in glaucoma patients were compared with the corresponding left and right visual fields and retinal nerve fiber layer thicknesses, instead of with the left and right eye.

Results:

Area and volume of the primary visual cortex were significantly reduced in POAG patients compared with controls (P<0.05) but did not correlate with visual field loss. Fractional anisotropy was reduced at multiple locations along the optic tracts and optic radiations in POAG patients compared with controls. Axial and radial diffusivity along the fiber tracts showed trends but were not significantly different between POAG patients and controls when averaged over the whole structures. Only fractional anisotropy (P<0.05) of the optic radiations was significantly correlated with visual field loss. No MRI parameters were correlated with retinal nerve fiber layer thickness.

Conclusions:

Improved analysis techniques of MRI data improves delineation of degeneration in the brain visual pathways and further supports the notion that neurodegeneration is involved with glaucoma pathogenesis.
Attaining Proficiency in Robotic-Assisted Minimally Invasive Esophagectomy While Maximizing Safety during Procedure Development
Authors: Sarkaria Inderpal S. , Rizk Nabil P. , Grosser Rachel , Goldman Debra , Finley David J. , Ghanie Amanda , Sima Camelia S. , Bains Manjit S. , Adusumilli Prasad S. , Rusch Valerie W. , Jones David R.
Published: September 2016

Objective

Robotic-assisted minimally invasive esophagectomy (RAMIE) is an emerging complex operation with limited reports detailing morbidity, mortality, and requirements for attaining proficiency. Our objective was to develop a standardized RAMIE technique, evaluate procedure safety, and assess outcomes using a dedicated operative team and 2-surgeon approach.

Methods

We conducted a study of sequential patients undergoing RAMIE from January 25, 2011, to May 5, 2014. Intermedian demographics and perioperative data were compared between sequential halves of the experience using the Wilcoxon rank sum test and the Fischer exact test. Median operative time was tracked over successive 15-patient cohorts.

Results

One hundred of 313 esophageal resections performed at our institution underwent RAMIE during the study period. A dedicated team including 2 attending surgeons and uniform anesthesia and OR staff was established. There were no significant differences in age, sex, histology, stage, induction therapy, or risk class between the 2 halves of the study. Estimated blood loss, conversions, operative times, and overall complications significantly decreased. The median resected lymph nodes increased but was not statistically significant. Median operative time decreased to approximately 370 minutes between the 30th and the 45th cases. There were no emergent intraoperative complications, and the anastomotic leak rate was 6% (6/100). The 30-day mortality was 0% (0/100), and the 90-day mortality was 1% (1/100).

Conclusions

Excellent perioperative and short-term patient outcomes with minimal mortality can be achieved using a standardized RAMIE procedure and a dedicated team approach. The structured process described may serve as a model to maximize patients’ safety during development and assessment of complex novel procedures.
Prescribing Practice in Inpatients Versus Outpatients With Schizophrenia Initiating Treatment With Second-Generation Antipsychotics
Authors: Edlinger Monika , Rettenbacher Maria A. , Kemmler Georg , Biedermann Falko , Widschwendter Christian G. , Fleischhacker W. Wolfgang , Hofer Alex
Published: September 2016

Objective

The primary objective of this study was to investigate whether the choice and dosage of antipsychotic medication differ between patients with schizophrenia starting treatment in an inpatient or outpatient unit. In addition, we investigated whether the reason for the introduction of new antipsychotic medication had an impact on the treatment setting and whether the use of benzodiazepines differed between inpatients and outpatients.

Method

From October 1997 to September 2010, patients with a schizophrenia spectrum disorder according to the International Classification of Diseases, Tenth Revision aged between 18 and 65 years were allocated to a naturalistic drug-monitoring program when starting treatment with a second-generation antipsychotic drug. Psychopathological symptoms were rated at baseline and after 1, 2, 4, and 8 weeks of treatment using the Positive and Negative Syndrome Scale. Inpatients and outpatients were compared with regard to the use of antipsychotics and benzodiazepines. To compare different drugs, chlorpromazine and diazepam equivalents were calculated.

Results

Lack of efficacy and side effects were the main reasons for initiating new antipsychotic medication. Combined evaluation of all antipsychotic compounds by meta-analysis resulted in a significant effect of the treatment setting, with inpatients receiving higher doses than outpatients. In addition, inpatients were prescribed benzodiazepines more often and in higher doses than outpatients.

Conclusions

Both antipsychotics and benzodiazepines were prescribed at higher doses in an inpatient setting. Moreover, benzodiazepines were prescribed more frequently to inpatients. Accordingly, the treatment setting needs to be taken into consideration in treatment recommendations for schizophrenia spectrum disorders.
Prevalence of Vitamin D Deficiency in Adult Outpatients With Bipolar Disorder or Schizophrenia
Authors: Boerman Remco , Cohen Dan , Schulte Peter F. J. , Nugter Annet
Published: September 2016

Objective

Several studies show an association between schizophrenia and low levels of vitamin D. To date, there are only few studies about the prevalence of vitamin D deficiency in patients with bipolar disorder. We hypothesized that vitamin D deficiency is less common among patients with bipolar disorder than among patients with schizophrenia or schizoaffective disorder. A second hypothesis is that vitamin D deficiency is more prevalent among patients with schizophrenia, schizoaffective disorder, or bipolar disorders than among the general Dutch population.

Most studies have been conducted with hospitalized patients; in this study, we only included outpatients.

Methods

All outpatients of a center for bipolar disorders and all outpatients of 3 flexible assertive community treatment teams were asked to participate in this cross-sectional study.

Results

We included 118 patients with bipolar disorder and 202 patients with schizophrenia or schizoaffective disorder. Vitamin D levels were deficient in 30.3% (95% confidence interval, 25.5–35.6) of the cases. The type of psychiatric disorder was not a predictor of vitamin D deficiency. The absolute difference in risk of deficiency between the study population and the Dutch Caucasian population was 23.8% (95% confidence interval, 18.3%-29.3%).

Conclusions

In this study, vitamin D deficiency was 4.7 times more common among outpatients with bipolar disorder, schizophrenia, or schizoaffective disorder than among the Dutch general population.

Given the high prevalence of vitamin D deficiency, we believe that outpatients with bipolar disorder, schizophrenia, or schizoaffective disorder should be considered at risk of having low levels of vitamin D. Annual measurement of vitamin D levels in psychiatric outpatients with these disorders seems to be justified to maintain bone health, muscle strength, and to prevent osteoporosis.