bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Toxicity of Ammonia and Nitrite to Sea Bream, Sparus aurata (Linnaeus, 1758), in Relation to Salinity
Authors: Kir Mehmet , Sunar Murat C.
Published: August 2017

Sea bream, Sparus aurata, is one of the most important fish species that is commonly cultured in the Mediterranean and the eastern coasts of the Atlantic Ocean. The life cycle of sea bream in its natural habitat passes through hyposaline and hypersaline lagoons. It is important to determine the tolerance of the fish to nitrogenous compounds for aquaculture at maximum stocking densities. In the present study, a series of acute experiments were performed to evaluate the effect of salinity on ammonia and nitrite toxicity to sea bream. The fish were exposed to different ammonia and nitrite concentrations according to the static renewal methodology at three different salinities (10, 20, and 30 ppt) and at a temperature of 20 C and a pH of 8.2. The toxic effect of total ammonia nitrogen (TAN) and nitrite nitrogen (NO2‐N) decreased with increasing salinity levels (P < 0.001). Acute toxicity (96‐h lethal concentration 50 [LC50]) values of TAN were determined to be 5.93, 11.72, and 19.38 mg/L at 10, 20, and 30 ppt salinity, respectively. The 96‐h LC50 values of NO2‐N were determined to be 370.80, 619.47, and 806.33 mg/L at 10, 20, and 30 ppt salinity, respectively. Results indicate that sea bream is less tolerant to ammonia but more tolerant to nitrite compared with some other fish species.
N‐acetylcysteine and prednisolone treatment improved serum biochemistries in suspected flupirtine cases of severe idiosyncratic liver injury
Authors: Borlak Jürgen , van Bömmel Florian , Berg Thomas
Published: August 2017

Background & Aims

The analgesic flupirtine has been linked to cases of severe idiosyncratic drug‐induced liver injury (sFILI). We therefore examined whether N‐acetylcysteine (NAC) and glucocorticoid therapy is effective in the management of sFILI.

Methods

In a retrospective cohort study efficacy of NAC‐infusion and oral prednisolone treatments on liver‐function‐tests (LFTs) and clinical outcome of 21 sFILI cases was evaluated by comparing it to an external cohort of 30 sFILI cases not receiving the antidote. LFTs were also assayed in human hepatocyte cultures treated with flupirtine for 96 hours. Additionally, modulation of glutathione stores in cultures of human hepatocytes treated with 80 drugs was investigated.

Results

Upon admission, patients presented Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and bilirubin elevations of up to 90‐, 35‐ and 30‐fold of upper limits of normal (ULN) respectively. The average INR was 2.2, and 50% of patients had a high Model for end‐stage liver disease (MELD) score of ≥25 and included 5 cases of 28‐32. The combined NAC/prednisolone treatment was well tolerated and led to significant ALT, AST and INR improvements within 2 weeks. However, the hyperbilirubinaemia resolved slowly. Two patients with late start of NAC/prednisolone treatment developed hepatic encephalopathy and required liver transplantation; the remaining patients recovered without long‐term sequela. Based on serum biochemistries sFILI cases resolved more rapidly (P < .01) when compared to untreated sFILI patients and included a case with fatal outcome. Additionally, in vitro studies revealed glutathione depletion as a common culprit for drugs with liver liabilities.

Conclusions

Based on these initial findings a prospective randomized clinical trial (RCT) is needed to confirm safety and efficacy of NAC/prednisolone treatment in sFILI.
Identification of hepatitis C virus 2k/1b intergenotypic recombinants in Georgia
Authors: Zakalashvili Mamuka , Zarkua Jaba , Weizenegger Michael , Bartel Jan , Raabe Monika , Zangurashvili Lela , Kankia Nino , Jashiashvili Nino , Lomidze Maka , Telia Tengiz , Kerashvili Vakhtang , Zhamutashvili Maia , Abramishvili Nikoloz , Hedskog Charlotte , Chodavarapu Krishna , Brainard Diana M. , McHutchison John G. , Mo Hongmei , Svarovskaia Evguenia , Gish Robert G. , Rtskhiladze Irakli , Metreveli David
Published: August 2017

Background and Aims

This study aimed to evaluate the prevalence of the hepatitis C virus intergenotype recombinant strain RF1_2k/1b in Georgia, confirm viral recombination by full genome sequencing, and determine a genetic relationship with previously described recombinant hepatitis C viruses.

Methods

We retrospectively analysed data from 1421 Georgian patients with chronic hepatitis C. Genotyping was performed with the INNO‐LiPA VERSANT HCV Genotype 2.0 Assay.

Results

Virus isolates were assigned to nonspecific hepatitis C genotypes 2a/2c (n = 387) as performed by sequencing of core and NS5B genes. Subsequently, sequencing results classified the core region as genotype 2k and the NS5B region as genotype 1b for 72% (n = 280) of genotype 2 patients, corresponding to 19.7% of hepatitis C patients in Georgia. Eight samples were randomly selected for full genome sequencing which was successful in 7 of 8 samples. Analysis of the generated consensus sequences confirmed that all 7 viruses were 2k/1b recombinants, with the recombination breakpoint located within 73‐77 amino acids before the NS2‐NS3 junction, similar to the previously described RF1_2k/1b virus. Phylogenetic analysis revealed clustering of the Georgian 2k/1b viruses and RF1_2k/1b, suggesting that they are genetically related.

Conclusions

The 19.7% prevalence of RF1_2k/1b in Georgia patients is far higher than has generally been reported to date worldwide. Identification of recombinants in low income countries with a high prevalence of HCV infection might be reasonable for choosing the most cost‐effective treatment regimens.
Hepatitis C virus plays with fire and yet avoids getting burned. A review for clinicians on processing bodies and stress granules
Authors: Fernández‐Carrillo Carlos , Pérez‐Vilaró Gemma , Díez Juana , Pérez‐del‐Pulgar Sofía
Published: August 2017

Over the last few years, many reports have defined several types of RNA cell granules composed of proteins and messenger RNA (mRNA) that regulate gene expression on a post‐transcriptional level. Processing bodies (P‐bodies) and stress granules (SGs) are among the best‐known RNA granules, only detectable when they accumulate into very dynamic cytosolic foci. Recently, a tight association has been found between positive‐stranded RNA viruses, including hepatitis C virus (HCV), and these granules. The present article offers a comprehensive review on the complex and paradoxical relationship between HCV, P‐bodies and SGs from a translational perspective. Despite the fact that components of P‐bodies and SGs have assiduously controlled mRNA expression, either by sequestration or degradation, for thousands of years, HCV has learned how to dangerously exploit certain of them for its own benefit in an endless biological war. Thus, HCV has gained the ability to hack ancient host machineries inherited from prokaryotic times. While P‐bodies and SGs are crucial to the HCV cycle, in the interferon‐free era we still lack detailed knowledge of the mechanisms involved, processes that may underlie the long‐term complications of HCV infection.
Associations between social support, psychological well‐being, decision making, empowerment, infant and young child feeding, and nutritional status in Ugandan children ages 0 to 24 months
Authors: Ickes Scott B. , Wu Michael , Mandel Maia P. , Roberts Alison C.
Published: August 2017

Maternal capabilities—qualities of mothers that enable them to leverage skills and resources into child health—hold potential influence over mother's adoption of child caring practices, including infant and young child feeding. We developed a survey (n = 195) that assessed the associations of 4 dimensions of maternal capabilities (social support, psychological health, decision making, and empowerment) with mothers' infant and young child feeding practices and children's nutritional status in Uganda. Maternal responses were converted to categorical subscales and an overall index. Scale reliability coefficients were moderate to strong (α range = 0.49 to 0.80). Mothers with higher social support scores were more likely to feed children according to the minimum meal frequency (odds ratio [OR] [95% confidence interval (CI)] = 1.38 [1.10, 1.73]), dietary diversity (OR [95% CI] = 1.56 [1.15, 2.11]), iron rich foods, (OR [95% CI] = 1.47 [1.14, 1.89]), and minimally acceptable diet (OR [95% CI] = 1.55 [1.10, 2.21]) indicators. Empowerment was associated with a greater likelihood of feeding a minimally diverse and acceptable diet. The maternal capabilities index was significantly associated with feeding the minimum number of times per day (OR [95% CI] = 1.29 [1.03, 1.63]), dietary diversity (OR [95% CI] = 1.44 [1.06, 1.94]), and minimally acceptable diet (OR [95% CI] = 1.43 [1.01, 2.01]). Mothers with higher psychological satisfaction were more likely to have a stunted child (OR [95% CI] = 1.31 [1.06, 1.63]). No other associations between the capabilities scales and child growth were significant. Strengthening social support for mothers and expanding overall maternal capabilities hold potential for addressing important underlying determinants of child feeding in the Ugandan context.
Novel mutation in the SOD1 gene in a patient with early‐onset, rapidly progressive amyotrophic lateral sclerosis
Authors: Okazaki Masahiro , Suzuki Hidekazu , Takahashi Yuji , Ishiura Hiroyuki , Goto Jun , Hirano Makito , Saigoh Kazumasa , Nakamura Yusaku , Naruse Hiroya , Mitsui Jun , Tsuji Shoji , Kusunoki Susumu
Published: August 2017

Genetic mutations have been found in many familial cases of amyotrophic lateral sclerosis (ALS), and 11% of sporadic cases. The most common causative gene in Japan is the SOD1 gene, encoding Cu, Zn superoxide dismutase, a radical scavenger. We report a 25‐year‐old man who had rapidly progressive sporadic ALS with a novel mutation, Gly147Ala, in this gene. Several missense mutations at this residue have been reported in patients with sporadic and familial ALS, among whom the onset age of the present patient was youngest. He had severe weakness of four limbs, with severe respiratory and bulbar involvements within 8 months. Recently, the radical scavenger, edaravone, has been approved as a medicine to treat ALS in Japan. Accumulation of patients like the present patient might be important for immediate diagnosis and treatment of patients who have sporadic ALS with mutations in causative genes.
Adolescent nephrology: An emerging frontier for kidney care in sub‐Saharan Africa
Authors: Davidson Bianca , Okpechi Ikechi , McCulloch Mignon , Wearne Nicola
Published: August 2017

Summary at a Glance

This review focused on the complexities of adolescent nephrology in an African setting. This review will provide meaningful information in the field of the transition medicine all over the world.
Early‐life adversity, epigenetics, and visceral hypersensitivity
Authors: Liu S. , Hagiwara SI. , Bhargava A.
Published: August 2017

Abdominal pain is associated with many gastrointestinal dysfunctions, such as irritable bowel syndrome (IBS), functional dyspepsia, and inflammatory bowel disease (IBD). Visceral hypersensitivity is a key reason for development of abdominal pain that presents in these gastrointestinal disorders/diseases. The pathogenesis of visceral hypersensitivity is complex and still far from being fully understood. In animal studies, visceral hypersensitivity has been linked to several early‐life adverse (ELA) events. In humans, IBD, functional dyspepsia, and IBS can have adult onset, though the adverse events that lead to visceral hypersensitivity are largely uncharacterized. In this issue of the journal, Aguirre et al. report the interesting finding that epigenetics underlies the effects of ELA events on visceral hypersensitivity. This mini‐review examines models of ELA events leading to visceral hypersensitivity and the potential role of epigenetics, as reported by Aguirre et al. and others.
Manometric evaluation of the motilin receptor agonist camicinal (GSK962040) in humans
Authors: Deloose E. , Depoortere I. , de Hoon J. , Van Hecken A. , Dewit O. E. , Vasist Johnson L. S. , Barton M. E. , Dukes G. E. , Tack J.
Published: August 2017

Background

The gut hormone motilin stimulates gastrointestinal motility by inducing gastric phase III of the migrating motor complex (MMC) and enhancing the rate of gastric emptying. Camicinal (GSK962040), a small molecule motilin receptor agonist, has been shown to increase gastrointestinal motility.

Methods

In this proof of concept study the effects of camicinal on MMC activity, esophageal and gastric pH was evaluated in eight healthy volunteers as a secondary endpoint. Doses of 50 and 150 mg were compared to placebo for a period of 24 hours in a double‐blinded randomized crossover trial.

Key Results

The 50 mg dose (n=4) of camicinal had no significant impact on gastroduodenal manometry or pH parameters. A single dose of 150 mg (n=4) induced a gastric phase III after 0:34 h (0:25‐0:58), which was significantly faster compared to placebo (18:15 h (4:32‐22:16); P=.03). Moreover, the high dose significantly increased the occurrence of gastric phase III contractions compared to placebo (12% vs 39%; P=.0003). This increase in gastric phase III contractions during a period of 24 hour was due to an increased occurrence of gastric phases III during the daytime (5% vs 50%; P=.0001). The same dose however did not affect small bowel manometry parameters or esophageal and gastric pH.

Conclusions and Inferences

Considering its stimulating effect on the MMC and gastric emptying, camicinal is an attractive candidate for the treatment of gastroparesis and gastroesophageal reflux disease. This trial was registered at clinicaltrials.gov as NCT00562848.
Up‐regulation of transient receptor potential vanilloid (TRPV) and down‐regulation of brain‐derived neurotrophic factor (BDNF) expression in patients with functional dyspepsia (FD)
Authors: Cheung C. K. Y. , Lan L. L. , Kyaw M. , Mak A. D. P. , Chan A. , Chan Y. , Wu J. C. Y.
Published: August 2017

Background

The role of immune activation in Functional Dyspepsia (FD) patients without previous infection is unclear. We compare the gastric and circulating brain‐derived neurotropic factor (BDNF), receptor potential vanilloid type (TRPV) families and various cytokines in FD patients.

Methods

Consecutive adult FD patients (Rome III) with no recent history of gastroenteritis and asymptomatic healthy controls were recruited for upper endoscopy. Subjects with GERD and IBS as predominant symptoms, diabetes mellitus, current or previous Helicobacter pylori infection, psychiatric illness and recent use of NSAID or PPI were excluded. Corpus biopsies and serum samples were collected.

Key Results

Forty three [M:F=8:35, mean age: 35.0 (9.3)] FD patients were compared with 23 healthy controls [M:F=8:15, mean age: 36.6 (10.2)]. FD patients had postprandial distress syndrome (PDS) as predominant sub‐type (PDS: 36, EPS: 2). There was no significant difference in the median inflammation score (FD:0 (0‐1) vs Control:0 (0‐1), P=.79). However, FD patients had significantly higher mRNA expression of TRPV1 (FD:0.014±0.007, Control:0.003±0.001, 4.6 fold, P=.02) and TRPV2 (FD:0.012±0.006, Control:0.003±0.001, 4 fold, P=.02) compared to controls. The serum (FD:258.0±12.3 ng ml−1, Control:319.7±18.1 ng ml−1, P<.01) and gastric BDNF mRNA (FD:0.06±0.008, Control:0.092±0.01, 0.65 fold, P=.02)levels significantly lower in FD patients. Secretion of cytokines (IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, G‐CSF, TGF‐β2, MCP‐1)was also highly correlated with dyspeptic symptoms in patients with FD.

Conclusions & Inferences

Despite lacking gastric mucosal inflammation, up‐regulation of TRPV1 and TRPV2, down‐regulation of BDNF were observed in FD patients. These suggest that immune alteration may contribute to the pathogenesis of FD without any previous infection.
Microbiota‐derived tryptophan indoles increase after gastric bypass surgery and reduce intestinal permeability in vitro and in vivo
Authors: Jennis M. , Cavanaugh C. R. , Leo G. C. , Mabus J. R. , Lenhard J. , Hornby P. J.
Published: August 2017

Background

The diet and microbiome contribute to metabolic disease in part due to increased intestinal inflammation and permeability. Dietary tryptophan is metabolized by both mammalian and bacterial enzymes. Using in vitro, in vivo models, and clinical data, we tested whether bacterial tryptophan indole derivatives underlie the positive benefits of microbiota on inflammation that is associated with metabolic disease.

Methods

In high‐fat diet (HFD)‐fed mice intestinal permeability and plasma endotoxin levels were measured after indole‐3‐propionic acid (IPA; 20 mg kg−1 p.o. for 4 days). Tryptophan derivatives effect on permeability and gene expression were assessed in T84 intestinal cell monolayers, in the presence or absence of pro‐inflammatory cytokines. Plasma tryptophan metabolites were analyzed from lean, or obese T2D subjects undergoing Roux‐en‐Y gastric bypass surgery (RYGB).

Key Results

IPA reduced the increased intestinal permeability observed in HFD‐fed mice. Of 16 metabolites tested in vitro, only IPA, and tryptamine reduced T84 cell monolayer permeability compromised by pro‐inflammatory cytokines. In T84 cells, IPA reversed the IFN‐γ induced increase of fructose transporter SLC2A5 (GLUT5) mRNA, but not induction of inflammatory or metabolic genes. In obese subjects, IPA levels were reduced relative to lean counterparts, and these levels were increased by 3 months after RYGB.

Conclusions and Inferences

The novel findings are that obese subjects have lower levels of IPA, a solely bacterially derived tryptophan derivative, and IPA improved intestinal barrier function in vitro and DIO mice. Reduced plasma IPA levels and reversal by surgery may be a consequence of intestinal indole‐producing microbiota but underlying mechanisms warrant further investigation.
Furling the Flag: Explaining the 2015 Vote to Remove the Confederate Flag in South Carolina
Authors: Chaffin LaTasha Y. , Cooper Christopher A. , Knotts H. Gibbs
Published: August 2017

Public policy scholars have long recognized the importance of focusing events in shaping policy change. We argue that the 2015 Charleston church shooting served as a focusing event that opened a policy window, leading to the vote to remove the Confederate flag from the South Carolina Statehouse grounds. While Democrats voted unanimously to remove the flag, we employ logistic regression models to explore the determinants of the decision to remove the Confederate flag in South Carolina among Republican state representatives. There is little evidence for the effect of district racial composition or electoral threat, but our model indicates that a few factors—intraparty legislator ideology, median household income in the district, percent urban in the district, and district educational attainment—best explain Republican decisions to furl the flag. These findings have implications for how policy makers respond to focusing events and our understanding of ongoing debates over the Confederate flag.

Related Articles

Feig, Douglas G. 2004. “.” Politics & Policy 32 (): 660‐683. http://onlinelibrary.wiley.com/doi/10.1111/j.1747‐1346.2004.tb00200.x/full

Orey, Byron D'Andra,
L. Martin Overby,
Peter K. Hatemi, and
Baodong Liu. 2011. “.” Politics & Policy 39 (): 539‐558. http://onlinelibrary.wiley.com/doi/10.1111/j.1747‐1346.2011.00303.x/abstract

Woliver, Laura R.,
Angela R. Ledford, and
Chris J. Dolan. 2001. “.” Politics & Policy 29 (): 708‐730. http://onlinelibrary.wiley.com/doi/10.1111/j.1747‐1346.2001.tb00612.x/abstract

Related Media

. 2015. “Rep. Jenny Horne on Confederate Flag Debate.” https://www.youtube.com/watch?v = wZrrvirBjxE

. 2015. “South Carolina Takes Down Confederate Flag.” https://www.youtube.com/watch?v = ZgoI4‐HEvW4

. 2015. “S.C. Statehouse Fights over Confederate Flag Controversy.” https://www.youtube.com/watch?v=‐uXZ6uRyvvc
How to perform extracorporeal photopheresis via port catheter
Authors: Schwede Katharina , Nagel Stephanie , Simon Jan‐Christoph , Ziemer Mirjana
Published: August 2017

BACKGROUND

Extracorporeal photopheresis (ECP) is commonly performed via peripheral venous access catheter. If this is not possible, a tunneled central venous catheter may be considered. However, this access mode may be associated with high complication rates. Port catheters and permanent arteriovenous fistulas in principle could serve as alternative options; however, treatment opinions are limited.

STUDY DESIGN AND METHODS

We report on four adult patients with poor peripheral vein conditions in whom we performed ECP via port catheter.

RESULTS

In three of four patients, problems arising from temporarily impaired blood aspiration or reinfusion were solved by repositioning the patient, intermittent flushing of the port catheter, and, in one patient, by instillation of 2500 units of heparin into the port prior to the first ECP of the 2‐day cycle. One female patient sustained extensive central venous thrombosis.

CONCLUSION

A port catheter may, in certain circumstances, constitute a patient‐friendly alternative for venous ECP access when patients' peripheral veins are unsuitable. However, a prolonged ECP procedure duration must be taken into account for decision making.
Risk factors for blood transfusion in patients undergoing high‐order Cesarean delivery
Authors: Spiegelman Jessica , Mourad Mirella , Melka Stephanie , Gupta Simi , Lam‐Rachlin Jennifer , Rebarber Andrei , Saltzman Daniel H. , Fox Nathan S.
Published: August 2017

BACKGROUND

The objective was to identify risk factors associated with blood transfusion in patients undergoing high‐order Cesarean delivery (CD).

STUDY DESIGN AND METHODS

This was a retrospective cohort study of patients undergoing third or more CD by a single maternal‐fetal medicine practice between 2005 and 2016. We compared risk factors between women who did and did not receive a red blood cell transfusion during the operation or before discharge. Repeat analysis was performed after excluding women with placenta previa.

RESULTS

A total of 514 patients were included, 18 of whom (3.5%; 95% confidence interval [CI], 2.2%‐5.5%) received a blood transfusion. Placenta previa was the most significant risk factor for transfusion (61.1% of patients who received a transfusion vs. 1% of patients who did not; p < 0.001). Patients with a placenta previa had a 68.8% likelihood of requiring a blood transfusion. After women who had placenta previa were excluded, the incidence of blood transfusion was seven of 498 (1.4%; 95% CI, 0.7%‐2.9%). Risk factors significantly associated with blood transfusion in the absence of previa were prophylactic anticoagulation during pregnancy and having labored. The incidence of transfusion in patients with no placenta previa, no anticoagulation, and no labor was 0.7% (95% CI, 0.3%‐2.1%). Placenta previa was the most predictive risk factor for transfusion with a positive predictive value of 68.8% and a negative predictive value of 98.4%.

CONCLUSION

In patients undergoing a third or more CD, only placenta previa, prophylactic anticoagulation during pregnancy, and having labored are independently associated with requiring a blood transfusion. These data can be used to guide physician ordering of prepared blood products preoperatively.
CXCR4 antagonist delivery on decellularized skin scaffold facilitates impaired wound healing in diabetic mice by increasing expression of SDF‐1 and enhancing migration of CXCR4‐positive cells
Authors: Liu Hao , Liu Hanping , Deng Xiaoyuan , Chen Maosheng , Han Xue , Yan Wenxia , Wang Ning
Published: August 2017

C‐X‐C chemokine receptor type 4 (CXCR4) is an alpha‐chemokine receptor specific for stromal cell‐derived factor 1 (SDF‐1 also called CXCL12). The antagonist of CXCR4 can mobilize CD34+ cells and hematopoietic stem cells from bone marrow within several hours, and it has an efficacy on diabetes ulcer through acting on the SDF‐1/CXCR4 axis. In this study, we investigated for the first time whether the antagonist of CXCR4 (Plerixafor/AMD3100) delivered on acellular dermal matrix (ADM) may accelerate diabetes‐impaired wound healing. ADM scaffolds were fabricated from nondiabetic mouse skin through decellularization processing and incorporated with AMD3100 to construct ADM‐AMD3100 scaffold. Full‐thickness cutaneous wound in streptozotocin (STZ)‐induced diabetic mice were treated with ADM, AMD3100, or ADM‐AMD3100. 21 days after treatment, wound closure in ADM‐AMD3100‐treated mice was more complete than ADM group and AMD3100 group, and it was accompanied by thicker collagen formation. Correspondingly, diabetic mice treated with ADM‐AMD3100 demonstrated prominent neovascularization (higher capillary density and vascular smooth muscle actin), which were accompanied by up‐regulated mRNA levels of SDF‐1 and enhanced migration of CXCR4 in the granulation tissue. Our results demonstrate that ADM scaffold provide perfect niche for loading AMD3100 and ADM‐AMD3100 is a promising method for diabetic wound healing mainly by increasing expression of SDF‐1 and enhancing migration of CXCR4‐positive cells.
Dog ecology and its implications for rabies control in Gwagwalada, Federal Capital Territory, Abuja, Nigeria
Authors: Mshelbwala P. P. , Akinwolemiwa D. K. , Maikai B.V. , Otolorin R. G. , Maurice N. A. , Weese J. S.
Published: August 2017

The objectives of this study were to determine the characteristics of a dog population, including their accessibility to vaccination and health care, in urban and semiurban areas of Gwagwalada, Abuja, Nigeria. Direct street counts and a house‐to‐house survey of city streets were performed. A total of 451 households were surveyed comprising 43.7% urban and 53.3% semiurban areas. A total of 848 owned dogs were identified, along with 3,115 corresponding humans. With a dog‐to‐human ratio of 1:3.7, the dog population in the study area was estimated as 103,758. A total of 396 dogs were counted on the streets with the greater proportion (74%) in semiurban areas. Most dogs in semiurban areas (77.3%) had no certificate confirming vaccination against rabies, compared to 47.2% in urban areas (p = .004). The majority of dogs in the urban (60.9%) and semiurban (82.0%) were free roaming. In the multivariable model, age, presence of a collar, region, sex, use and having ever visited a veterinarian were significantly associated with rabies vaccination. The majority (125/197, 63.5%) of respondents with higher education were willing to pay more for the healthcare needs of their dogs as opposed to those with a lower level of education (93/251, 37.1%, p = .001). The study revealed a high dog population density, vaccination coverage below WHO recommendation of 70% and generally reduced healthcare‐seeking behaviour among dog owners in Gwagwalada, Abuja, Nigeria.
Detection of phasic dopamine by D1 and D2 striatal medium spiny neurons
Authors: Yapo Cedric , Nair Anu G. , Clement Lorna , Castro Liliana R. , Hellgren Kotaleski Jeanette , Vincent Pierre
Published: August 2017

Key points

Brief dopamine events are critical actors of reward‐mediated learning in the striatum; the intracellular cAMP–protein kinase A (PKA) response of striatal medium spiny neurons to such events was studied dynamically using a combination of biosensor imaging in mouse brain slices and in silico simulations.

Both D1 and D2 medium spiny neurons can sense brief dopamine transients in the sub‐micromolar range.

While dopamine transients profoundly change cAMP levels in both types of medium spiny neurons, the PKA‐dependent phosphorylation level remains unaffected in D2 neurons.

At the level of PKA‐dependent phosphorylation, D2 unresponsiveness depends on protein phosphatase‐1 (PP1) inhibition by DARPP‐32.

Simulations suggest that D2 medium spiny neurons could detect transient dips in dopamine level.

The phasic release of dopamine in the striatum determines various aspects of reward and action selection, but the dynamics of the dopamine effect on intracellular signalling remains poorly understood. We used genetically encoded FRET biosensors in striatal brain slices to quantify the effect of transient dopamine on cAMP or PKA‐dependent phosphorylation levels, and computational modelling to further explore the dynamics of this signalling pathway. Medium‐sized spiny neurons (MSNs), which express either D1 or D2 dopamine receptors, responded to dopamine by an increase or a decrease in cAMP, respectively. Transient dopamine showed similar sub‐micromolar efficacies on cAMP in both D1 and D2 MSNs, thus challenging the commonly accepted notion that dopamine efficacy is much higher on D2 than on D1 receptors. However, in D2 MSNs, the large decrease in cAMP level triggered by transient dopamine did not translate to a decrease in PKA‐dependent phosphorylation level, owing to the efficient inhibition of protein phosphatase 1 by DARPP‐32. Simulations further suggested that D2 MSNs can also operate in a ‘tone‐sensing’ mode, allowing them to detect transient dips in basal dopamine. Overall, our results show that D2 MSNs may sense much more complex patterns of dopamine than previously thought.
Fitting pole-zero micromechanical models to cochlear response measurements
Authors: Elliott Stephen J. , Ni Guangjian , Sun Luyang
Published: August 2017

An efficient way of describing the linear micromechanical response of the cochlea is in terms of its poles and zeros. Pole-zero models with local scaling symmetry are derived for both one and two degree-of-freedom micromechanical systems. These elements are then used in a model of the coupled cochlea, which is optimised to minimise the mean square difference between its frequency response and that measured on the basilar membrane inside the mouse cochlea by Lee, Raphael, Xia, Kim, Grillet, Applegate, Ellerbee Bowden, and Oghalai [(2016) J. Neurosci. 36, 8160–8173] and Oghalai Lab [(2015). https://oghalailab.stanford.edu], at different excitation levels. A model with two degree-of-freedom micromechanics generally fits the measurements better than a model with single degree-of-freedom micromechanics, particularly at low excitations where the cochlea is active, except post-mortem conditions, when the cochlea is passive. The model with the best overall fit to the data is found to be one with two degree-of-freedom micromechanics and 3D fluid coupling. Although a unique lumped parameter network cannot be inferred from such a pole-zero description, these fitted results help indicate what properties such a network should have.
Investigation of piezoelectric anisotropy of bovine cortical bone at an ultrasound frequency by coupling an experiment and a simulation
Authors: Hosokawa A.
Published: August 2017

An investigation of the piezoelectric anisotropy of bovine cortical bone at 1 MHz was attempted by coupling data obtained from an experiment and a simulation. In the experiment, a piezoelectric cell (PE-cell) was used as an ultrasound receiver. In the PE-cell, the cortical bone disk, which was cut in the direction perpendicular to the bone axis, was electrically shielded. The directivity of the PE-cell was measured at 0°–22.5° and was compared to four simulated results using the piezoelectric finite-difference time-domain method. It was shown that the piezoelectric signal in the bone could be generated by a transverse ultrasound wave.
Cocaine-related subcutaneous emphysema, pneumorrhachis and pneumomediastinum: a rare clinical finding
Authors: Kanu Obiajulu , Teleb Mohamed , Agrawal Harsh , Cashin Laura B
Published: August 2017

A young man presented with several days of dyspnoea and delirium due to cocaine use which was confirmed by urine drug screening. Imaging studies confirmed the diagnosis of subcutaneous emphysema, pneumorrhachis and pneumomediastinum. He was managed successfully with conservative therapy.

Although a rare clinical finding, cocaine-related pneumomediastinum, subcutaneous emphysema and pneumorrhachis should be recognised early on presentation. This will certainly help to effectively direct the use of healthcare resources and avoid subjecting the patient to unnecessary investigations.
An unusual case of Cushing's syndrome due to bihormonal ACTH–prolactin secreting pituitary macroadenoma with rapid response to cabergoline
Authors: Kunasegaran Shalini , Croxson Michael S , Holdaway Ian , Murphy Rinki
Published: August 2017

A 23-year-old man presenting with florid Cushing's syndrome was found to have high plasma ACTH and very high serum prolactin. Pituitary MRI showed a large invasive macroadenoma. Low-dose cabergoline promptly suppressed both ACTH and prolactin levels within 2 weeks, with unexpected clinical and biochemical hypocortisolism requiring hydrocortisone replacement. Secondary hypogonadism was reversed. Clinical and biochemical remission of his Cushing's syndrome together with significant shrinkage of his macroadenoma has been maintained for 1 year on cabergoline 0.5 mg twice weekly. Reduction in pituitary tumour volume and brisk fall in serum prolactin in response to low-dose cabergoline is regularly observed in patients with macroprolactinomas, but the concurrent fall in the plasma ACTH level and hypocortisolism was a pleasant surprise. We assume that he most likely has a single bihormonal adenoma that is enriched with dopamine-2 receptors.
Delirium as presentation of late-onset and relapsing Susac syndrome
Authors: Betend Romain , Humm Andrea M , Medlin Friedrich
Published: August 2017

A 67-year-old patient, only known for bilateral presbycusis, presented with subacute onset of delirium. Clinical examination showed multifocal neurological deficits, all together suggesting subcortical frontal dysfunction together with cerebellar and corpus callosum involvement.

Cerebral MRI demonstrated supratentorial and infratentorial subcortical and periventricular T2-hyperintense lesions with cerebellar gadolinium enhancement and multiple central lesions of the corpus callosum (snowball lesions). The diagnosis of Susac syndrome was made and the patient treated with intravenous methylprednisolone, followed by a prednisone maintenance dose over 8 weeks. After a clinical improvement, a relapse was noticed during corticosteroid tapering. The patient was again treated with intravenous methylprednisolone followed by a prednisone maintenance therapy with simultaneous introduction of mycophenolate mofetil acid and one cycle of intravenous rituximab. The patient recovered rapidly. At 11-month follow-up, only mild executive dysfunction and persistent right postural tremor was noted, MRI showed partial regression of subcortical and juxtacortical lesions.
Tracheobronchopathia osteochondroplastica: awareness is the key for diagnosis and management
Authors: Devaraja K , Sagar Prem , Chirom Amit Singh
Published: August 2017

Tracheobronchopathia osteochondroplastica is a rare airway disease of unknown aetiology. Due to overlapping symptomology and lack of awareness, the condition is often missed resulting in unnecessary medical or surgical treatment. A male patient presented with a long-standing history of hoarseness and had earlier received treatment for bronchial asthma and tuberculosis. On evaluation, he had typical submucosal calcified nodules distributed throughout the trachea sparing the posterior membranous part. Although the biopsy confirmed the diagnosis of tracheobronchopathia osteochondroplastica in our case, histopathological examination is not always needed to make this diagnosis. Our patient has been kept under conservative management and is having non-progression of disease at 1-year follow-up. After having reviewed the literature related to pathophysiology and management of tracheobronchopathia osteochondroplastica, we emphasise on the fact that the treating physicians’ awareness about this condition is the key to its diagnosis and management.
A tip from the nose: rhinocerebral mucormycosis in a patient with alcoholic liver cirrhosis and cocaine abuse, an uncommon association
Authors: Avelar Rodriguez David , Ochoa Virgen Gabriel , Miranda Ackerman Roberto Carlos
Published: August 2017

We present the case of a 28-year-old man with a long-standing history of cocaine abuse and Child-Pugh class C alcoholic liver cirrhosis who developed severe lower respiratory tract infection complicated with septic shock and multiple organ dysfunction. He was managed in the intensive care unit. On the eighth day after admission, he developed a nose discolouration, which was initially thought to be associated with high-dose vasopressors. Despite the reduction of vasopressors, the lesion progressed rapidly. It was later diagnosed as rhinocerebral mucormycosis. Amphotericin B was administered, but unfortunately the patient succumbed to the complications postinfection. The association between alcoholic liver cirrhosis and rhinocerebral mucormycosis should be known and prompt recognition warrants immediate treatment.
Locoregional recurrence of breast cancer presenting as upper limb venous thromboembolism
Authors: Sayers Anna , Hope Carla , Lingam Krishna M
Published: August 2017

Locoregional recurrence of breast cancer is a major concern for both patient and oncologist. Presentation as venous thromboembolism (VTE) carries risk of delayed diagnosis and has a poor prognosis. Here we describe, for the first time in the literature, a delayed diagnosis of local recurrence of infiltrative inflammatory breast cancer presenting as extensive deep venous thrombosis of the upper arm veins. This case demonstrates the need for a high level of vigilance for recurrence of malignancy in patients with no concurrent risk factors for VTE and atypical clinical progression in order to reach a timely diagnosis.
Aborted choroidal coloboma: fundus imaging and optical coherence tomography
Authors: Takkar Brijesh , Venkatesh Pradeep , Khokhar Sudarshan , Gagrani Meghal
Published: August 2017

Choroidal coloboma is characterised by poor embryonic development of chorioretinal structures and is of different types. We present a case of choroidal coloboma where the retinal pigment epithelium was present, clinically and on imaging, but rest of the structures were poorly formed. This observation suggests that in some cases, fusion of the fetal cleft may occur aberrantly, resulting in an aborted choroidal coloboma.
An overlooked cause of subdural effusions
Authors: Li Yan-Lin , Tsang Chi Sum
Published: August 2017

A middle-aged man presented with progressive confusion. Initial brain CT was misinterpreted to have ‘cerebral atrophy and bilateral subdural effusions’ by the emergency physician, and the patient was admitted to a medical ward for further investigation. Two days later, the patient experienced acute neurological deterioration, and burr hole drainage was performed to relieve the effusions. It was later confirmed that the effusions were caused by intracranial hypotension secondary to spinal cerebrospinal fluid leakage. The patient improved on conservative treatment with no lasting neurological sequela.
PREVENTION OF TIME-LOSS INJURIES IN THE A-LEAGUE PROFESSIONAL FOOTBALL: A 5-YEAR PROSPECTIVE STUDY
Authors: Gouttebarge Vincent , Kerkhoffs Gino
Published: August 2017

Background

Epidemiological data on the occurrence of time-loss injuries over several A-League seasons remains lacking, while the effect of the implementation of ‘Minimum Medical Standards’ as preventive measure needs evaluation.

Objective

To explore the preventive effect of the mandatory implementation of ‘Minimum Medical Standards’ in the A-League professional football on the occurrence of total time-loss injuries (and total matches missed).

Design

An observational prospective study was conducted over five A-League seasons (2008 to 2013).

Setting

A-League professional football.

Patients (or Participants)

All professional players from all clubs from the A-League were monitored over five consecutive seasons.

Interventions (or Assessment of Risk Factors)

“Minimum Medical Standards” were made mandatory in 2011 in the A-League professional football, relying on appropriate medical testing and employment of medical physicians and physiotherapists.

Main Outcome Measurements

Data were collected weekly based on official match previews, official match reviews, official media releases, official websites, and self-report by the players.

Results

The number of total time-loss injuries rose from 129 in 2008–2009 to 202 in 2010–2011, decreasing to 162 in 2012–2013 (repeated measures ANOVA not statistically significant). The number of total matches missed rose from 506 in 2008–2009 to 1110 in 2010–2011, decreasing to 542 in 2012–2013. This difference in matches missed over five seasons was found to be statistically significant (P<0.01).

Conclusions

The introduction of "Minimum Medical Standards" in the A-League had a favourable effect on the number of total, hamstring, knee and ankle injuries and on the number of matches missed due to these injuries, but not on the number of groin injuries.
A HISTORY OF CONCUSSIONS IS ASSOCIATED WITH SYMPTOMS OF COMMON MENTAL DISORDERS IN FORMER MALE PROFESSIONAL ATHLETES ACROSS A RANGE OF SPORTS
Authors: Gouttebarge Vincent , Aoki Haruhito , Lambert Mike , Stewart William , Kerkhoffs Gino
Published: August 2017

Background

Recent reports suggest that exposure to repetitive concussions in sports is associated with an increased risk of symptoms of Common Mental Disorders (CMD) and of later development of neurodegenerative diseases, in particular chronic traumatic encephalopathy (CTE).

Objective

To explore the relationship between sports career-related concussions and the subsequent occurrence of symptoms of CMD among former male professional athletes.

Design

Cross-sectional analyses performed on baseline electronic questionnaires from three prospective cohort studies.

Setting

National unions or players' associations in professional football, ice hockey and rugby.

Patients (or Participants)

A total of 576 former male professional athletes were enrolled. Mean age at recruitment was 37 years; mean duration of sports career was 10 years.

Interventions (or Assessment of Risk Factors)

The total number of confirmed concussion incidents during an athlete's career and diagnosed by a medical professional was examined.

Main Outcome Measurements

Several Patient Reported Outcome Measures (PROMs) were included and assessed with validated scales, namely symptoms of distress, anxiety/depression, sleep disturbance, adverse alcohol use.

Results

The number of sports career-related concussions was a predictor for all outcome measures (β=0.072–0.100; P≤0.035). Specifically, former professional athletes who reported a history of four or five concussions were approximately 1.5 times more likely to report symptoms of CMD, rising to a two- to four-fold increase in those reporting a history of six or more sports career-related concussions.

Conclusions

These data demonstrate a direct relationship between exposure to sports concussion and subsequent risk of symptoms of CMD in former professional athletes across a range of contact sports. Further work to explore the association between sports concussion and symptoms of CMD is required; in meantime strategies for effective risk reduction and improved management appear indicated.
RELIABILITY OF PHOTOGRAPHIC POSTURAL ASSESSMENT IN MALE ELITE JUNIOR SOCCER PLAYERS (UNDER 16, 17 & 19)
Authors: Hajduk Karen , Schmidtbleicher Dietmar
Published: August 2017

Background

Junior soccer players aged 16 to 19 years old competing on high level already present with postural deviations which are associated with an increased injury risk due to mechanical overloading of the neuro-musculoskeletal system. The application of valid postural assessments methods play an important role in terms of providing correct therapeutic consequences.

Objective

Previous research show several methodological weaknesses and inconsistent results assessing posture through photographs. Thus, the purpose of the study was to determine the more conservative inter-rater reliability assessing the static posture involving the complete kinetic chain. It was hypothesised that photographic postural assessment is a reliable method.

Design

Experimental, prospective cohort study.

Setting

Qualitative assessment in clinical practice.

Patients (or Participants)

87 male elite junior soccer players out of three different age groups: Under 16, 17, and 19.

Interventions (or Assessment of Risk Factors)

Athletes were photographed from four perspectives using professional photo equipment. An assessment protocol was completed for each player by three different highly qualified raters.

Main Outcome Measurements

37 variables describing postural characteristics, each variable graded by minimum of three, maximum of seven values.

Results

Inter-rater reliability was fair only for the type of posture on side view with Kendal's W=0.6. For all remaining 36 aspects of postural characteristics Kendal's W was zero.

Conclusions

Qualitative posture assessment is not valid and therefore not appropriate for diagnostic objectives, in particular for large scale based studies, e.g. for a single soccer team. For the purpose of meaningful postural evaluation qualitative assessments must be replaced by quantitative methods. Three-dimensional motion capture could be an appropriate alternative, avoiding radiation exposure by X-ray photography, since excellent agreement has been shown previously for different clinically-relevant kinematic parameters between these two methods.
THE EFFICACY OF A MOVEMENT CONTROL EXERCISE PROGRAMME TO PREVENT INJURIES IN YOUTH RUGBY: A CLUSTER-RANDOMISED CONTROLLED TRIAL
Authors: Hislop Michael , Stokes Keith , Williams Sean , McKay Carly , Kemp Simon , England Mike , Trewartha Grant
Published: August 2017

Background

Structured pre-activity exercise programmes have demonstrated injury prevention in a variety of settings, but their efficacy is largely unknown in contact-orientated sports.

Objective

To assess the efficacy of a pre-activity movement control exercise programme to reduce injury risk in youth rugby when compared with a standardised exercise programme.

Design

Single-blind cluster-randomised controlled trial.

Setting

Independent schools within England during the 2015/16 playing season.

Participants

Schools with onsite medical provision were eligible to participate in this trial. 31 schools (intervention, 17 schools, 1,325 players; control, 14 schools, 1,127 players) completed the trial.

Interventions

Both programmes were completed for 15–20 minutes prior to main sessions, with team coaches acting as delivery agents. The intervention programme combined progressive proprioceptive, resistance, and plyometric activities. The standardised programme combined dynamic stretching, wrestling-based and speed-based activities.

Main Outcome Measures

Trial-arm comparisons were made across summary measures of time-loss (>24 hours) injuries, with effects analysed through magnitude-based inference against thresholds for the smallest worthwhile effects (RR=0.90 & 1.11).

Results

441 time-loss injuries (intervention, 233; control, 208) were reported across 15,953 match exposure-hours (intervention, 9,083 hours; control, 6,870 hours). Intention-to-treat analyses revealed a 15% reduction in overall match injury incidence favouring the intervention (relative risk=0.85, 90% CI 0.61–1.17, unclear effect), whilst reductions were also identified in match concussion incidence (RR=0.71, 0.48–1.05, likely beneficial effect). Per-protocol analyses revealed that completing the intervention programme compared with the control programme an average of 2x/week was associated with a further reduction in overall match injury incidence (RR=0.73, 0.45–1.20, unclear effect), whilst an average use of 3x/week halved overall match injury incidence (RR=0.50, 0.22–1.13, likely beneficial effect).

Conclusions

This study presents encouraging evidence that using a preventive exercise programme 2–3x/week prior to training and matches can reduce injury risk in youth rugby when compared with a standardised programme.