bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing photoreceptor structure in patients with traumatic head injury
Authors: Braza Matthew E , Young Jonathon , Hammeke Thomas A , Robison Scott E , Han Dennis P , Warren Clinton C , Carroll Joseph , Stepien Kimberly E
Published: November 2018

Objective

Previous work using adaptive optics scanning light ophthalmoscopy (AOSLO) imaging has shown photoreceptor disruption to be a common finding in head and ocular trauma patients. Here an expanded trauma population was examined using a novel imaging technique, split-detector AOSLO, to assess remnant cone structure in areas with significant disruption on confocal AOSLO imaging and to follow photoreceptor changes longitudinally.

Methods and Analysis

Eight eyes from seven subjects with head and/or ocular trauma underwent imaging with spectral domain optical coherence tomography, confocal AOSLO and split-detector AOSLO to assess foveal and parafoveal photoreceptor structure.

Results

Confocal AOSLO imaging revealed hyporeflective foveal regions in two of eight eyes. Split-detector imaging within the hyporeflective confocal areas showed both remnant and absent inner-segment structure. Both of these eyes were imaged longitudinally and showed variation of the photoreceptor mosaic over time. Four other eyes demonstrated subclinical regions of abnormal waveguiding photoreceptors on multimodal AOSLO imagery but were otherwise normal. Two eyes demonstrated normal foveal cone packing without disruption.

Conclusion

Multimodal imaging can detect subtle photoreceptor abnormalities not necessarily detected by conventional clinical imaging. The addition of split-detector AOSLO revealed the variable condition of inner segments within confocal photoreceptor disruption, confirming the usefulness of dual-modality AOSLO imaging in assessing photoreceptor structure and integrity. Longitudinal imaging demonstrated the dynamic nature of the photoreceptor mosaic after trauma. Multimodal imaging with dual-modality AOSLO improves understanding of visual symptoms and photoreceptor structure changes in patients with head and ocular trauma.
Enteric fungal microbiota dysbiosis and ecological alterations in colorectal cancer
Authors: Coker Olabisi Oluwabukola , Nakatsu Geicho , Dai Rudin Zhenwei , Wu William Ka Kei , Wong Sunny Hei , Ng Siew Chien , Chan Francis Ka Leung , Sung Joseph Jao Yiu , Yu Jun
Published: November 2018

Objectives

Bacteriome and virome alterations are associated with colorectal cancer (CRC). Nevertheless, the gut fungal microbiota in CRC remains largely unexplored. We aimed to characterise enteric mycobiome in CRC.

Design

Faecal shotgun metagenomic sequences of 184 patients with CRC, 197 patients with adenoma and 204 control subjects from Hong Kong were analysed (discovery cohort: 73 patients with CRC and 92 control subjects; validation cohort: 111 patients with CRC, 197 patients with adenoma and 112 controls from Hong Kong). CRC-associated fungal markers and ecological changes were also validated in additional independent cohorts of 90 patients with CRC, 42 patients with adenoma and 66 control subjects of published repository sequences from Germany and France. Assignment of taxonomies was performed by exact k-mer alignment against an integrated microbial reference genome database.

Results

Principal component analysis revealed separate clusters for CRC and control (p<0.0001), with distinct mycobiomes in early-stage and late-stage CRC (p=0.0048). Basidiomycota:Ascomycota ratio was higher in CRC (p=0.0042), with increase in Malasseziomycetes (p<0.0001) and decrease in Saccharomycetes (p<0.0001) and Pneumocystidomycetes (p=0.0017). Abundances of 14 fungal biomarkers distinguished CRC from controls with an area under the receiver-operating characteristic curve (AUC) of 0.93 and validated AUCs of 0.82 and 0.74 in independent Chinese cohort V1 and European cohort V2, respectively. Further ecological analysis revealed higher numbers of co-occurring fungal intrakingdom and co-exclusive bacterial–fungal correlations in CRC (p<0.0001). Moreover, co-occurrence interactions between fungi and bacteria, mostly contributed by fungal Ascomycota and bacterial Proteobacteria in control, were reverted to co-exclusive interplay in CRC (p=0.00045).

Conclusions

This study revealed CRC-associated mycobiome dysbiosis characterised by altered fungal composition and ecology, signifying that the gut mycobiome might play a role in CRC.
Preoperative administration of the 5-HT4 receptor agonist prucalopride reduces intestinal inflammation and shortens postoperative ileus via cholinergic enteric neurons
Authors: Stakenborg Nathalie , Labeeuw Evelien , Gomez-Pinilla Pedro J , De Schepper Sebastiaan , Aerts Raymond , Goverse Gera , Farro Giovanna , Appeltans Iris , Meroni Elisa , Stakenborg Michelle , Viola Maria Francesca , Gonzalez-Dominguez Erika , Bosmans Goele , Alpizar Yeranddy A , Wolthuis Albert , D’Hoore Andre , Van Beek Kim , Verheijden Simon , Verhaegen Marleen , Derua Rita , Waelkens Etienne , Moretti Milena , Gotti Cecilia , Augustijns Patrick , Talavera Karel , Vanden Berghe Pieter , Matteoli Gianluca , Boeckxstaens Guy E
Published: November 2018

Objectives

Vagus nerve stimulation (VNS), most likely via enteric neurons, prevents postoperative ileus (POI) by reducing activation of alpha7 nicotinic receptor (α7nAChR) positivemuscularismacrophages (mMφ) and dampening surgery-induced intestinal inflammation. Here, we evaluated if 5-HT4 receptor (5-HT4R) agonist prucalopride can mimic this effect in mice and human.

Design

Using Ca2+imaging, the effect of electrical field stimulation (EFS) and prucalopride was evaluated in situ on mMφ activation evoked by ATP in jejunalmuscularistissue. Next, preoperative and postoperative administration of prucalopride (1–5 mg/kg) was compared with that of preoperative VNS in a model of POI in wild-type and α7nAChR knockout mice. Finally, in a pilot study, patients undergoing a Whipple procedure were preoperatively treated with prucalopride (n=10), abdominal VNS (n=10) or sham/placebo (n=10) to evaluate the effect on intestinal inflammation and clinical recovery of POI.

Results

EFS reduced the ATP-induced Ca2+response of mMφ, an effect that was dampened by neurotoxins tetrodotoxin and ω-conotoxin and mimicked by prucalopride. In vivo, prucalopride administered before, but not after abdominal surgery reduced intestinal inflammation and prevented POI in wild-type, but not in α7nAChR knockout mice. In humans, preoperative administration of prucalopride, but not of VNS, decreasedIl6andIl8expression in themuscularis externaand improved clinical recovery.

Conclusion

Enteric neurons dampen mMφ activation, an effect mimicked by prucalopride. Preoperative, but not postoperative treatment with prucalopride prevents intestinal inflammation and shortens POI in both mice and human, indicating that preoperative administration of 5-HT4R agonists should be further evaluated as a treatment of POI.

Trial registration number

NCT02425774.
Optimal duration and predictors of diagnostic utility of patient-activated ambulatory ECG monitoring
Authors: Tan Eugene S J , Seow Swee-Chong , Kojodjojo Pipin , Singh Devinder , Yeo Wee Tiong , Lim Toon Wei
Published: November 2018

Objective

We studied the optimal duration of ambulatory event monitors for symptomatic patients and the predictors of detected events.

Methods

Patients with palpitations or dizziness received a patient-activated handheld event monitor which records 30 s single-lead ECG strips. Patients were monitored in an ambulatory setting for a range of 1–4 weeks and ECG strips interpreted by five independent electrophysiologists. Event pick-up rates and clinical covariates were analysed.

Results

Of 335 consecutive adults (age 50±16 years, 58% female) with palpitations (94%) and dizziness (25%) monitored, 286 patients (85%) reported events, and clinically significant events were detected in 86 (26%) patients. Of these 86 patients, 26% had ≥2 significant events, and 73% had events detected in the first 3 days. No significant events were detected after 12 days. The most common ECG abnormalities detected were premature ventricular ectopy (38%), premature atrial ectopy (37%) and atrial fibrillation (AF)/atrial flutter (34%). A history of AF (adjusted OR (AOR) 4.2, 95% CI 1.1 to 15.8), previous arrhythmia (AOR 2.8, 95% CI 2.3 to 5.9) and previous abnormal ambulatory monitoring (AOR 3.4, 95% CI 1.0 to 9.4) were associated with detection of clinically significant events. Patients older than 50 years were 82% more likely to have a clinically significant event (OR 1.8, 95% CI 1.3 to 3.6).

Conclusion

Patient-activated ambulatory event monitoring for 7 days may be sufficient in the diagnosis of symptomatic patients as significant events first detected beyond 10 days were rare. Patients with a history of AF, arrhythmia or previous abnormal ambulatory monitoring may require even shorter monitoring periods.
Motorcycle taxi programme increases safe riding behaviours among its drivers in Kampala, Uganda
Authors: Muni Kennedy , Kobusingye Olive , Mock Charles , Hughes James P , Hurvitz Philip M , Guthrie Brandon
Published: November 2018

Background

SafeBodais a motorcycle taxi company that provides road safety training and helmets to its drivers in Kampala, Uganda. We sought to determine whetherSafeBodadrivers are more likely to engage in safe riding behaviours than regular drivers (motorcycle taxi drivers not part ofSafeBoda).

Methods 

We measured riding behaviours inSafeBodaand regular drivers through: (1) computer-assisted personal interview (CAPI), where 400 drivers were asked about their riding behaviours (eg, helmet and mobile phone use) and (2) roadside observation, where riding behaviours were observed in 3000 boda-boda drivers and their passengers along major roads in Kampala.

Results

Across the two cross-sectional studies, a higher proportion ofSafeBodadrivers than regular drivers engaged in safe riding behaviours. For instance, helmet use amongSafeBodacompared with regular drivers was 21% points higher (95% CI 0.15 to 0.27; p<0.001) based on the CAPI and 45% points higher (95% CI 0.43 to 0.47; p<0.001) based on roadside observation. Furthermore, compared with regular drivers,SafeBodadrivers were more likely to report having a driver’s license (66.3% vs 33.5 %; p<0.001) and a reflective jacket (99.5% vs 50.5 %; p<0.001) and were less likely to report driving towards oncoming traffic (4% vs 45.7 %; p<0.001) in the past 30 days.

Conclusion

TheSafeBodaprogramme is associated with increased safe riding behaviours among motorcycle taxi drivers in Kampala. Therefore, the promotion and expansion of such programmes may lead to a reduction in morbidity and mortality due to road injuries.
Screening of BRCA1/2 deep intronic regions by targeted gene sequencing identifies the first germline BRCA1 variant causing pseudoexon activation in a patient with breast/ovarian cancer
Authors: Montalban Gemma , Bonache Sandra , Moles-Fernández Alejandro , Gisbert-Beamud Alexandra , Tenés Anna , Bach Vanessa , Carrasco Estela , López-Fernández Adrià , Stjepanovic Neda , Balmaña Judith , Diez Orland , Gutiérrez-Enríquez Sara
Published: November 2018

Background

Genetic analysis of BRCA1 and BRCA2 for the diagnosis of hereditary breast and ovarian cancer (HBOC) is commonly restricted to coding regions and exon-intron boundaries. Although germline pathogenic variants in these regions explain about ~20% of HBOC cases, there is still an important fraction that remains undiagnosed. We have screened BRCA1/2 deep intronic regions to identify potential spliceogenic variants that could explain part of the missing HBOC susceptibility.

Methods

We analysed BRCA1/2 deep intronic regions by targeted gene sequencing in 192 high-risk HBOC families testing negative for BRCA1/2 during conventional analysis. Rare variants (MAF <0.005) predicted to create/activate splice sites were selected for further characterisation in patient RNA. The splicing outcome was analysed by RT-PCR and Sanger sequencing, and allelic imbalance was also determined when heterozygous exonic loci were present.

Results

A novel transcript was detected in BRCA1 c.4185+4105C>T variant carrier. This variant promotes the inclusion of a pseudoexon in mature mRNA, generating an aberrant transcript predicted to encode for a non-functional protein. Quantitative and allele-specific assays determined haploinsufficiency in the variant carrier, supporting a pathogenic effect for this variant. Genotyping of 1030 HBOC cases and 327 controls did not identify additional carriers in Spanish population.

Conclusion

Screening of BRCA1/2 intronic regions has identified the first BRCA1 deep intronic variant associated with HBOC by pseudoexon activation. Although the frequency of deleterious variants in these regions appears to be low, our study highlights the importance of studying non-coding regions and performing comprehensive RNA assays to complement genetic diagnosis.
How sociophenomenology of the body problematises the ‘problem-oriented approach’ to growth hormone treatment
Authors: Murano Maria Cristina , Slatman Jenny , Zeiler Kristin
Published: November 2018

This article examines how people who are shorter than average make sense of their lived experience of embodiment. It offers a sociophenomenological analysis of 10 semistructured interviews conducted in the Netherlands, focusing on if, how, and why height matters to them. It draws theoretically on phenomenological discussions of lived and objective space, intercorporeality and norms about bodies. The analysis shows that height as a lived phenomenon (1) is active engagement in space, (2) coshapes habituated ways of behaving and (3) is shaped by gendered norms and beliefs about height. Based on this analysis, the article challenges what we label as the ‘problem-oriented approach’ to discussions about growth hormone treatment for children with idiopathic short stature. In this approach, possible psychosocial disadvantages or problems of short stature and quantifiable height become central to the ethical evaluation of growth hormone treatment at the expense of first-hand lived experiences of short stature and height as a lived phenomenon. Based on our sociophenomenological analysis, this paper argues that the rationale for giving growth hormone treatment should combine medical and psychological assessments with investigations of lived experiences of the child. Such an approach would allow considerations not only of possible risks or disadvantages of short stature but also of the actual ways in which the child makes sense of her or his height.
Medina embolization device for the treatment of intracranial aneurysms: 18 months’ angiographic results
Authors: Haffaf Idriss , Clarençon Frédéric , Shotar Eimad , Rolla-Bigliani Claudia , Vande Perre Saskia , Mathon Bertrand , Drir Mehdi , Sourour Nader-Antoine
Published: November 2018

Background and purpose

The Medina embolization device (MED) is a new flow disruption device combining the design of a detachable coil with an intrasaccular flow disrupter. Safety and short-term angiographic effectiveness of this device have recently been reported. However, long-term angiographic results are lacking. We report herein the 18 months’ angiographic outcome in patients treated for a wide-neck intracranial aneurysm with the MED.

Materials and methods

Nineteen patients (17 female, mean age 50 years) with 20 wide-neck intracranial aneurysms (six ruptured; 14 unruptured) were treated by the MED between January 2015 and June 2016. Procedure-related complications were systematically recorded; discharge and 6–9 months' follow-up modified Rankin Scale scores were assessed. Angiographic mid-term and long-term follow-up were performed with a mean delay of 6.4±1.5 months (n=16 aneurysms) and 17.7±4.2 months (n=15 aneurysms), respectively. Occlusion rates were evaluated after the procedure and at the mid-term and long-term follow-up using the Roy-Raymond scale.

Results

Embolization with the MED was feasible in all except two cases (2/20, 10%). One per-procedural perforation was recorded (1/20, 5%) and one MED deployment failed because of the aneurysm’s shape (1/20, 5%). Three cases of thromboembolic complications were observed (3/20, 15%). Only one thromboembolic complication was responsible for clinical sequelae. Grade A occlusion rate was 61% (11/18) after the procedure, 75% at 6 months' follow-up (12/16), and 80% (12/15) at long-term follow-up. Two cases (2/18, 11%) of recanalization at mid-term were documented angiographically. No recanalization occurred between the mid-term and long-term follow-up.

Conclusion

MED is a hybrid embolization device, combining properties of a conventional coil with those of an intrasaccular flow disrupter. Our series focusing on long-term angiographic follow-up shows a satisfactory long-term occlusion rate. Larger series with longer angiographic follow-up times are warranted to confirm these preliminary results.
Equal performance of aspiration and stent retriever thrombectomy in daily stroke treatment
Authors: Bernsen Marie Louise Elisabeth , Goldhoorn Robert-Jan Berend , van Oostenbrugge Robert J , van Zwam Wim H , Uyttenboogaart Maarten , Roos Yvo B W E M , Hofmeijer Jeannette , Martens Jasper M
Published: November 2018

Background

Mechanical thrombectomy with stent retrievers has proved to be safe and effective in endovascular treatment of acute ischemic stroke. Direct aspiration has shown revascularization rates comparable to those of stent retrievers in the recent ASTER and COMPASS trials. However, the efficacy of aspiration in routine clinical practice has not yet been shown.

Objective

To show that aspiration has clinical and technical outcomes equal to those of stent retriever thrombectomy in daily clinical practice.

Methods

We analysed data of patients with a large vessel occlusion of the anterior circulation registered in the Dutch MR CLEAN Registry between March 2014 and June 2016. Primary outcome was functional outcome measured with the modified Rankin Scale (mRS) score. Secondary outcomes were reperfusion grade, periprocedural complication rate, and procedure duration. Association of treatment technique with functional outcome was estimated with univariable and multivariable ordinal logistic regression analysis and expressed as a common OR (cOR) for a shift towards better outcome on the mRS.

Results

As first-line treatment, 207 of 1175 patients (17.6%) were treated with direct aspiration, and 968 (82.4%) by a stent retriever. We observed no differences in functional outcome (adjusted cOR=1.020 (95% CI 0.68 to 1.52)) and periprocedural complications. Successful reperfusion (extended Thrombolysis in Cerebral Infarction ≥2b) was similar. Duration of the procedure was shorter with aspiration (57 min (IQR 35–73) vs 70 min (IQR 47–95), p<0.0001).

Conclusion

Direct aspiration shows clinical outcomes equal to those of stent retriever thrombectomy in our large multicenter real-life cohort. We found no difference in complication rates and shorter procedure times for aspiration.
Dual suction Headway27 microcatheter thrombectomy for the treatment of distal intracranial arterial occlusion strokes: initial experience with the micro-ADAPT technique
Authors: Crockett Matthew Thomas , Phillips Timothy John , Chiu Albert Ho Yuen
Published: November 2018

Background

Recent studies suggest that the proven benefits of endovascular thrombectomy (EVT) for the treatment of large vessel occlusion (LVO) strokes are transferable to more peripheral distal vessel occlusion (DVO) strokes under certain circumstances. Safely accessing and extracting these thrombi however remains challenging, particularly in more tortuous peripheral arteries. For such cases we have utilized the dual suction Headway27 microcatheter thrombectomy, or micro-ADAPT, technique with the aim of reducing potential trauma associated with negotiating stent retrievers or large bore aspiration catheters into the peripheral intracranial vasculature. We present our experience utilizing the micro-ADAPT in the treatment of DVO strokes. We describe our technique as well as present angiographic and clinical outcomes.

Methods

A retrospective review of our institution’s prospectively collected EVT registry for the 12 months spanning July 2017 to June 2018 was undertaken. Data on all cases of micro-ADAPT EVT were collected and analyzed.

Results

Micro-ADAPT EVT was performed 14 times over the study period, with a recanalization rate of 79%. DVO strokes in multiple locations were treated, including the A3, M3, P3, and superior cerebellar artery. In cases where an LVO stroke was also present, the mean duration between primary LVO recanalization and secondary DVO micro-ADAPT recanalization was 15.5 min. No complications relating to the micro-ADAPT technique were recorded. No infarcts were present in the territory of the recanalized DVO stroke on day 1 CT in successful micro-ADAPT cases

Conclusions

In the setting of challenging peripheral DVO strokes, the micro-ADAPT technique appears to be a fast and effective technique with a low complication rate.
Agatston score of the descending aorta is independently associated with coronary events in a low-risk population
Authors: Dudink Elton A M P , Peeters Frederique E C M , Altintas Sibel , Heckman Luuk I B , Haest Rutger J , Kragten Hans , Kietselaer Bas L J H , Wildberger Joachim , Luermans Justin G L M , Weijs Bob , Crijns Harry J G M
Published: November 2018

Objectives

A standard coronary artery calcium scan includes part of the aorta. This additional information is often not included in routine analyses. We aimed to determine the feasibility of assessing the Agatston score of the descending aorta calcification (DAC) on standard coronary calcium scans and the association of this score with coronary events in a low-risk study population.

Methods

Between January 2008 and March 2011, 390 consecutive patients who were referred for cardiac CT as part of work-up for pulmonary vein isolation (n=115) or assessment of presence of coronary artery disease (n=275) were included. At baseline, all patients were free of a history of cardiovascular disease. Two independent observers determined the Agatston score of the ascending aorta and descending aorta.

Results

A total of 16 patients (4.1%) developed coronary events (acute coronary syndrome (n=6) and symptomatic significant coronary artery disease requiring treatment (n=10)) during a follow-up of 67±12 months, with more events in patients with calcifications in the descending aorta than in those without (8.4% vs 3.7 %; p=0.08). Multivariable Cox regression, corrected for Framingham Risk Score (FRS) and coronary Agatston score (CAC), revealed that DAC was independently associated with coronary events (per 100 units; HR: 1.06, 95% CI 1.02 to 1.09; p=0.001). DAC furthermore increased the identification of patients that will experience a coronary event (area under the curve: 0.68 for FRS only, 0.75 for FRS+CAC and 0.78 for FRS+CAC+DAC).

Conclusions

The Agatston score of the descending aorta could be included in the standard analysis of cardiac CT scans of low-risk patients since it holds valuable information for the prediction of coronary events.
Individual variations in steps per day for meeting physical activity guidelines in young adult women
Authors: Kumahara Hideaki , Ayabe Makoto
Published: November 2018

Cross-sectional studies have found a correlation between the duration or volume of moderate-to-vigorous physical activity (MVPA) and steps per day (STEP), but there is little information on why this relationship varies among individuals. No previous research has established whether STEP can be used to estimate the duration of physical activity (PA) at or above lactate threshold (≥LT), such as for maintaining cardiorespiratory fitness. This study explored the association among STEP, MVPA indices, and ≥LT under free-living conditions. Seventy young adult women measured their PA for 7 days using a validated accelerometer. The mean LT measured by an exercise test was 5.8 ± 1.0 METs. STEP, MVPA, METs×h, and ≥LT were 9324 ± 2677 steps/day, 231.9 ± 101.5 min/week, 16.6 ± 7.4 METs×h/week and 24.0 ± 22.2 min/week, respectively. Significant correlations were found between STEP and MVPA duration and between STEP and METs×h/week (r = 0.81 and r = 0.81); however, approximately 1600 steps/day of the standard error of estimates in the regression equations were found. Multiple stepwise regression analysis revealed that the percentage of total time spent at light-intensity PA (LPA) and MVPA were significant determinants of the percent deviation of STEP from the linear relationships between STEP and MVPA indices. No significant relationship was observed between ≥LT and STEP. The association between STEP and MVPA fluctuated depending on individual daily LPA and MVPA. Thus, consideration of both STEP and the PA at specific intensities are necessary to ensure the PA guidelines are met and the health benefits gained. STEP alone would be not a sufficient indicator for assessing the ≥LT.
Delayed response of excavations in structured clays
Authors: Bertoldo Fabiano , Callisto Luigi
Published: November 2018

In this paper, the behaviour of an idealized excavation carried out in a clay sensitive to destructuration is studied through a series of finite element analyses, employing an advanced bounding surface model developed for structured clays. Several cases are examined to investigate the influence of factors including the velocity of destructuration, damage to the soil–wall contact produced by the wall construction, and width-to-height ratio of the excavation. The case of a soil deposit insensitive to microstructural damage is also studied for comparison. Results of the numerical analyses show that the progressive dissipation of excess pore-water pressures generated during the excavation stage can damage the clay microstructure severely enough to trigger an instability phenomenon. If the clay structure deteriorates rapidly, the instability is concurrent with the dissipation of excess pore-water pressures. However, for a clay less sensitive to microstructural damage, the instability can occur towards the end of the consolidation process, or even be preceded by a deceptively stable time interval, during which small redistributions of pore-water pressure can trigger an important destructuration and collapse of the excavation. In a final part of the paper, results of the numerical analyses are used to provide indications about the most appropriate quantities to monitor to provide an effective early warning of the instability phenomenon.
MALIGNANT TUMORS OF FOOT: WHAT ARE THE OUTCOMES?
Authors: Salunke Abhijeet Ashok , Shah Jaymin , Pandit Jyotindra , Amin Prakash
Published: November 2018

Introduction: We have analyzed the clinical features and outcomes of malignant tumors of foot. Methods: Between January 2010 to January 2017, 21 patients of malignant tumors of calcaneum and talus were treated. These included 14 cases of osteosarcoma, 7 cases of Ewing’s sarcoma. Talus was involved in 8 cases and calcaneum involved in 11 cases. Mean follow-up for all patients was 30 months (range 24–70 months). Results: In osteosarcoma of calcaneum and talus the presenting symptom was local pain in 63% and swelling in 37%. Patients with Ewing’s sarcoma presented with swelling in 100% cases. The mean delay in diagnosis for osteosarcoma and Ewing’s sarcoma was 8.8 months (range 6–12 months) and 9.5 months (range 6–12 months), respectively. Patients with delay in diagnoses of more than six months and less than six months had disease free survival of 11.5 months and 15 months, respectively and [Formula: see text] value 0.3. Patients with delay in diagnoses of more than six months and less than six months had metastases in 5 and 1cases, respectively. The mean disease free interval (DFI) for osteosarcoma and Ewing’s sarcoma was 16 months and 5.5 months, respectively. The correlation between osteosarcoma and Ewing’s sarcoma of calcaneum and foot with delay in diagnosis and DFI did not reach statistical significance ([Formula: see text] value 0.93 and 0.14, respectively). Conclusion: An index of suspicion, proper examination with close scrutiny of the radiographs is required in patients presenting malignant of bones of foot. Osteosarcoma of calcaneum and talus most commonly presented with local pain and Ewing’s sarcoma present with swelling. The time interval between the onset of symptoms and diagnosis (delay in diagnosis) for calcaneum and talus osteosarcoma was similar to Ewing’s sarcoma.
COMPARISON OF TWO METHODS FOR ESTIMATING THE UNLOADED STATE FOR ABDOMINAL AORTIC ANEURYSM STRESS CALCULATIONS
Authors: LEACH JOSEPH R. , ZHU CHENGCHENG , SALONER DAVID , HOPE MICHAEL D.
Published: November 2018

Biomechanical analyses can be used to better understand the rupture risk of abdominal aortic aneurysms (AAAs) on a patient-specific basis using vascular geometries obtained from medical imaging. Methodologies of varying complexity are used to estimate the unloaded state of the imaged vessel to provide a reference configuration for finite element simulations. In this work, we compare the implementation and results of two of these methods, one based on geometric scaling and the other using an iterative determination of unloaded vessel geometry. We find that the two methods result in significantly different stress predictions, and that the iterative method offers superior geometric accuracy. Our findings lend context to the variation in finite element results presented in the AAA stress analysis literature.
IMPORTANCE IN SYSTEMS WITH INTERVAL DECISIONS
Authors: KURZ SASCHA
Published: November 2018

Given a system where the real-valued states of the agents are aggregated by a function to a real-valued state of the entire system, we are interested in the influence or importance of different agents for that function. This generalizes the notion of power indices for binary voting systems to decisions over interval policy spaces and has applications in economics, engineering, security analysis, and other disciplines. Here, we study the question of importance in systems with interval decisions. Based on the classical Shapley–Shubik and Penrose–Banzhaf index, from binary voting, we motivate and analyze two importance measures. Additionally, we present some results for parametric classes of aggregation functions.
An Exploration of the Use of Facebook by Legislators in Taiwan
Authors: LIM KAH-YEW
Published: November 2018

Previous studies have found that how to win an election is always an important question for legislators. Their behavior in lawmaking and constituency service is also associated with their aspirations for re-election. In the era of booming social media, how legislators can use social media to increase their chances for election and re-election has become a compelling issue. This study argues that legislators do indeed maximize the benefits of social media to win elections. On this account, this study intends to explore two main questions: (1) What kind of messages legislators choose to convey to voters on their fan pages; and (2) Whether the political characteristics of legislators affect the types of the messages they convey there. In this study, posts were collected from the fan pages of 25 Taiwanese legislators. These text messages were then converted into numerical data that could be quantitatively analyzed with the content analysis method. It was found that legislators tend to start with soft messages in their communications with the public. They share some details of their daily schedules and everyday lives with their voters before they begin image building and posting political material. This study also found that the political characteristics of legislators, including their party membership, their status either as a district or proportional representation (PR) legislator, and their incumbency all affect the content of posts on their fan pages. For example, compared to Kuomintang (KMT) and Democratic Progressive Party (DPP) legislators who share information from their daily lives, New Power Party (NPP) legislators prefer to share only political information. PR legislators devote more attention than district legislators to criticizing the government on their fan pages. Incumbents are significantly less likely than challengers to share daily information, but more likely to share political information. This study found that the aforementioned differences have resulted from the many ways that different types of legislators use to increase their chances of winning an election.
Shuffles and Circuits (On Lower Bounds for Modern Parallel Computation)
Authors: Roughgarden Tim , Vassilvitskii Sergei , Wang Joshua R.
Published: November 2018

The goal of this article is to identify fundamental limitations on how efficiently algorithms implemented on platforms such as MapReduce and Hadoop can compute the central problems in motivating application domains, such as graph connectivity problems. We introduce an abstract model of massively parallel computation, where essentially the only restrictions are that the “fan-in” of each machine is limited to
s
bits, where
s
is smaller than the input size 
n
, and that computation proceeds in synchronized rounds, with no communication between different machines within a round. Lower bounds on the round complexity of a problem in this model apply to every computing platform that shares the most basic design principles of MapReduce-type systems. We prove that computations in our model that use few rounds can be represented as low-degree polynomials over the reals. This connection allows us to translate a lower bound on the (approximate) polynomial degree of a Boolean function to a lower bound on the round complexity of every (randomized) massively parallel computation of that function. These lower bounds apply even in the “unbounded width” version of our model, where the number of machines can be arbitrarily large. As one example of our general results, computing any nontrivial monotone graph property—such as connectivity—requires a super-constant number of rounds when every machine receives only a subpolynomial (in
n
) number of input bits 
s
. Finally, we prove that, in two senses, our lower bounds are the best one could hope for. For the unbounded-width model, we prove a matching upper bound. Restricting to a polynomial number of machines, we show that asymptotically better lower bounds would separate
P
from
NC
1
.
Reconstruction of Full Rank Algebraic Branching Programs
Authors: Kayal Neeraj , Nair Vineet , Saha Chandan , Tavenas Sébastien
Published: November 2018

An algebraic branching program (ABP) A can be modelled as a product expression
X
1
amp;middot;
X
2
…

X
d

, where
X
1
and

X
d

are 1 ×
w
and
w
× 1 matrices, respectively, and every other

X
k

is a
w
×
w
matrix; the entries of these matrices are linear forms in
m
variables over a field F (which we assume to be either Q or a field of characteristic poly(
m
)). The polynomial computed by A is the entry of the 1 × 1 matrix obtained from the product ∏

k=1

d

X
k

. We say A is a
full rank
ABP if the
w
2
(
d
− 2) + 2
w
linear forms occurring in the matrices
X
1
,
X
2
, …,

X
d

are F-linearly independent. Our main result is a randomized reconstruction algorithm for full rank ABPs: Given blackbox access to an
m
-variate polynomial
f
of degree at most
m
, the algorithm outputs a full rank ABP computing
f
if such an ABP exists, or outputs “no full rank ABP exists” (with high probability). The running time of the algorithm is polynomial in
m
and β, where β is the bit length of the coefficients of
f
. The algorithm works even if

X
k

is a

w
k−1

×

w
k

matrix (with

w
0

=

w
d

= 1), and w = (
w
1
, …,

w
d − 1

) is
unknown
. The result is obtained by designing a randomized polynomial time equivalence test for the family of iterated matrix multiplication polynomial IMM

w,
d

, the (1, 1)-th entry of a product of
d
rectangular symbolic matrices whose dimensions are according to w ∈ N

d
−1

. At its core, the algorithm exploits a connection between the
irreducible invariant subspaces
of the Lie algebra of the group of symmetries of a polynomial
f
that is equivalent to IMM

w,
d

and the “layer spaces” of a full rank ABP computing
f
. This connection also helps determine the group of symmetries of IMM

w,
d

and show that IMM

w,
d

is characterized by its group of symmetries.
The Complexity of Boolean Surjective General-Valued CSPs
Authors: Fulla Peter , Uppman Hannes , Živný Stanislav
Published: November 2018

Valued constraint satisfaction problems (VCSPs) are discrete optimisation problems with a (Q ∪ {∞ })-valued objective function given as a sum of fixed-arity functions. In Boolean surjective VCSPs, variables take on labels from
D
= {0,1}, and an optimal assignment is required to use both labels from
D
. Examples include the classical
global Min-Cut
problem in graphs and the
Minimum Distance
problem studied in coding theory.

We establish a dichotomy theorem and thus give a complete complexity classification of Boolean surjective VCSPs with respect to exact solvability. Our work generalises the dichotomy for {0, ∞}-valued constraint languages (corresponding to surjective decision CSPs) obtained by Creignou and Hébrard. For the maximisation problem of Q
≥0
-valued surjective VCSPs, we also establish a dichotomy theorem with respect to approximability.

Unlike in the case of Boolean surjective (decision) CSPs, there appears a novel tractable class of languages that is trivial in the non-surjective setting. This newly discovered tractable class has an interesting mathematical structure related to downsets and upsets. Our main contribution is identifying this class and proving that it lies on the borderline of tractability. A crucial part of our proof is a polynomial-time algorithm for enumerating all near-optimal solutions to a generalised Min-Cut problem, which might be of independent interest.
The Functional and Neurobiological Properties of Bad Taste
Authors: Schier Lindsey A. , Spector Alan C.
Published: November 2018

The gustatory system serves as a critical line of defense against ingesting harmful substances. Technological advances have fostered the characterization of peripheral receptors and have created opportunities for more selective manipulations of the nervous system, yet the neurobiological mechanisms underlying taste-based avoidance and aversion remain poorly understood. One conceptual obstacle stems from a lack of recognition that taste signals subserve several behavioral and physiological functions which likely engage partially segregated neural circuits. Moreover, although the gustatory system evolved to respond expediently to broad classes of biologically relevant chemicals, innate repertoires are often not in register with the actual consequences of a food. The mammalian brain exhibits tremendous flexibility; responses to taste can be modified in a specific manner according to bodily needs and the learned consequences of ingestion. Therefore, experimental strategies that distinguish between the functional properties of various taste-guided behaviors and link them to specific neural circuits need to be applied. Given the close relationship between the gustatory and visceroceptive systems, a full reckoning of the neural architecture of bad taste requires an understanding of how these respective sensory signals are integrated in the brain.
Wound Healing: A Cellular Perspective
Authors: Rodrigues Melanie , Kosaric Nina , Bonham Clark A. , Gurtner Geoffrey C.
Published: November 2018

Wound healing is one of the most complex processes in the human body. It involves the spatial and temporal synchronization of a variety of cell types with distinct roles in the phases of hemostasis, inflammation, growth, re-epithelialization, and remodeling. With the evolution of single cell technologies, it has been possible to uncover phenotypic and functional heterogeneity within several of these cell types. There have also been discoveries of rare, stem cell subsets within the skin, which are unipotent in the uninjured state, but become multipotent following skin injury. Unraveling the roles of each of these cell types and their interactions with each other is important in understanding the mechanisms of normal wound closure. Changes in the microenvironment including alterations in mechanical forces, oxygen levels, chemokines, extracellular matrix and growth factor synthesis directly impact cellular recruitment and activation, leading to impaired states of wound healing. Single cell technologies can be used to decipher these cellular alterations in diseased states such as in chronic wounds and hypertrophic scarring so that effective therapeutic solutions for healing wounds can be developed.
Pediatric Primary Alveolar Soft Part Sarcoma of the Bladder
Authors: Tanabe Kazuya , Nakamura Shigeru , Hyuga Taiju , Kawai Shina , Yamazaki Masahiro , Kawashima Yohei , Furukawa Rieko , Niki Toshiro , Ono Shigeru , Nakai Hideo
Published: November 2018

A 9-year-old girl was diagnosed with primary alveolar soft part sarcoma of the bladder after imaging examinations and transurethral resection (TUR) of the bladder tumor. As a positive surgical margin of the TUR indicated residual tumor cells, we performed a cystourethrectomy to remove the tumor. A continent urinary reservoir for self-catheterization was constructed using the Mainz pouch technique, and an abdominal (umbilical) continent catheterizable stoma using the appendix was performed. For 2.5 years postoperatively, the patient remained free of local recurrence and distant metastasis. The patient’s clinical course has been favorable, with good management of clean intermittent self-catheterization.
Full and Reduced-Order Unknown Input Observer Design for Linear Time-Delay Systems with Multiple Delays
Authors: Ben Warrad Seifeddine , Boubaker Olfa , Lungu Mihai , Mobayen Saleh
Published: November 2018

In this work, we consider the design problem of a full-order and also reduced-order unknown input observers for a particular class of time-delay systems. Asymptotic stability and existence conditions for the designed observers are established. The quadruple-tank process is used as a benchmark to prove the efficiency of the proposed algorithms.
Phosphatidylinositide 3‐Kinase Contributes to the Anti‐Inflammatory Effect of Abutilon crispum L. Medik Methanol Extract
Authors: Hunto Stephanie Triseptya , Shin Kon Kuk , Kim Han Gyung , Park Sang Hee , Oh Junsang , Sung Gi-Ho , Hossain Mohammad Amjad , Rho Ho Sik , Lee Jongsung , Kim Jong-Hoon , Cho Jae Youl
Published: November 2018

Abutilon crispum L. Medik, better known as bladdermallow, is used as a traditional remedy in India, for its anti‐inflammatory effect due to its high content of flavonoids. However, research about its anti‐inflammatory effect at the molecular level has not been performed. In this study, we aimed to investigate the mechanism of Abutilon crispum methanol extract (Ac‐ME) in inhibiting the inflammatory response by conducting several experiments including cellular and molecular assays. Ac‐ME inhibited the production of nitric oxide (NO) in RAW264.7 cells during treatment of LPS and Pam3CSK4 without exhibiting cytotoxicity. Ac‐ME also suppressed the mRNA expression of inducible nitric oxide (iNOS) and proinflammatory cytokines such as interleukin (IL)‐1β and IL‐6. Moreover, Ac‐ME was shown to inhibit the NF‐κB pathway, according to the luciferase reporter gene assay performed with a NF‐κB‐Luc construct containing NF‐κB‐binding promoter regions under MyD88 and TRIF overexpression conditions, and immunoblotting analysis by determining the phospho‐form levels of IκBα, IKKα/β, and p85, a regulatory domain of phosphatidylinositide 3‐kinase (PI3K). Finally, we observed that the level of phospho‐p85 induced by the overexpression of spleen tyrosine kinase (Syk) and Src was decreased by Ac‐ME at 200 μg/ml. Therefore, these results suggest that Ac‐ME has an anti‐inflammatory effect by targeting PI3K in the NF‐κB signaling pathway.
The TGF-β1 Signaling Pathway as an Attractive Target in the Fibrosis Pathogenesis of Sjögren’s Syndrome
Authors: Sisto Margherita , Lorusso Loredana , Ingravallo Giuseppe , Tamma Roberto , Ribatti Domenico , Lisi Sabrina
Published: November 2018

Transforming growth factor β1 (TGF-β1) plays a crucial role in the induction of fibrosis, often associated with chronic phases of inflammatory diseases contributing to marked fibrotic changes that compromise normal organ function. The TGF-β1 signal exerts its biological effects via the TGF-β/SMAD/Snail signaling pathway, playing an important pathogenic role in several fibrotic diseases. It has as yet been poorly investigated in the chronic autoimmune disease Sjögren’s syndrome (SS). Here, we firstly tested, by immunohistochemistry, whether the TGF-β1/SMAD/Snail signaling pathway is triggered in human pSS salivary glands (SGs). Next, healthy salivary gland epithelial cell (SGEC) cultures derived from healthy donors were exposed to TGF-β1 treatment, and the relative gene and protein levels of SMAD2/3/4, Snail, E-cadherin, vimentin, and collagen type I were compared by semiquantitative RT-PCR, quantitative real-time PCR, and Western blot analysis. We observed, both at gene and protein levels, higher expression of SMAD2, 3, and 4 and Snail in the SGEC exposed by TGF-β1 compared to untreated healthy SGEC. Additionally, in TGF-β1-treated samples, we found a significant reduction in the epithelial phenotype marker E-cadherin and an increase in the mesenchymal phenotype markers vimentin and collagen type I compared to those in untreated SGEC, indicating that TGF-β1 induces the EMT via the TGF-β1/SMAD/Snail signaling pathway. Therefore, by using the specific TGF-β receptor 1 inhibitor SB-431542 in healthy SGEC treated with TGF-β1, we showed a significant reduction of the fibrosis markers vimentin and collagen type I while the epithelial marker E-cadherin returns to levels similar to untreated healthy SGEC. These data demonstrate that TGF-β1 is an important key factor in the transition phase from SG chronic inflammation to fibrotic disease. Characteristic changes in the morphology and function of TGF-β1-treated healthy SGEC further confirm that TGF-β1 plays a significant role in EMT-dependent fibrosis.
Pros and Cons of the SeHCAT Test in Bile Acid Diarrhea: A More Appropriate Use of an Old Nuclear Medicine Technique
Authors: Fani Bernardo , Bertani Lorenzo , Paglianiti Italia , Fantechi Lorenzo , De Bortoli Nicola , Costa Francesco , Volterrani Duccio , Marchi Santino , Bellini Massimo
Published: November 2018

Bile acid malabsorption (BAM) causing chronic diarrhea may be due to organic as well as functional disorders, and some of them were included under the general label of diarrheic-type irritable bowel syndrome (IBS-D). The 75-selenium homocholic acid taurine (SeHCAT) test is a nuclear medicine investigation considered to be the gold standard for the diagnosis of bile acid malabsorption (BAM). Many studies demonstrate that it could be effective in the clinical workout of chronic diarrhea due to different conditions. The SeHCAT test provides a quantitative assessment to estimate the severity of BAM and the possible response to therapy with bile acid sequestrants (BASs). However, there is no general agreement regarding its cutoff value and the test is not widely available. The aim of this review is to discuss the advantages and disadvantages of the SeHCAT test in clinical practice.