bluuebunny/crossref_metadata_2025 huggingface dataset:
Temperature-based spawning habitat selection by capelin (Mallotus villosus) in Newfoundland
Authors: Crook Kevin A. , Maxner Emily , Davoren Gail K.
Published: February 2017

The location of reproduction is a key life history trait, as it influences the bio-physical conditions that offspring experience and, thus, fitness. Capelin Mallotus villosus is a small (< 200 mm), short-lived forage fish that spawns in two habitats in coastal Newfoundland: warm beaches and cool, deep water (15–40 m). From 2009 to 2014, we investigated temperature-dependent spawning habitat use by quantifying hourly temperature at spawning sites during July within each habitat along with population-level spawning site use. Capelin did not spawn at sites with temperatures <2 °C or consistently >12 °C, supporting the estimated suitable spawning temperature range (2–12 °C). Spawning typically occurred exclusively at beaches early in July when deep-water habitat was too cold (i.e. <2 °C), and then switched to deep-water habitat later in July when beaches became too warm (i.e. >12 °C). Spawning overlapped for 1–3 d in both habitats when temperatures were within suitable ranges (2011, 2013), but capelin also spawned exclusively in one habitat when temperatures remained suitable in the other. The latter suggests that other factors influence spawning habitat selection, such as conspecific egg densities and other environmental conditions. Overall, the flexible use of spawning habitats, along with wide tolerance ranges of capelin eggs to environmental conditions, are likely key adaptations to maximize fitness and stabilize population dynamics of this important forage fish species in an unpredictable environment.
Shifts in spawning phenology of cod linked to rising sea temperatures
Authors: McQueen Kate , Marshall C. Tara
Published: February 2017

Warming temperatures caused by climate change have the potential to impact spawning phenology of temperate marine fish as some species have temperature-dependent gonadal development. Inter-annual variation in the timing of Atlantic cod (Gadus morhua) spawning in the northern North Sea, central North Sea and Irish Sea was estimated by calculating an annual peak roe month (PRM) from records of roe landings spanning the last three decades. A trend towards earlier PRM was found in all three regions, with estimates of shifts in PRM ranging from 0.9 to 2.4 weeks per decade. Temperatures experienced by cod during early vitellogenesis correlated negatively with PRM, suggesting that rising sea temperatures have contributed to a shift in spawning phenology. A concurrent reduction in the mean size of spawning females excluded the possibility that earlier spawning was due to a shift in size structure towards larger individuals, as large cod spawn earlier than smaller-sized individuals in the North Sea. Further research into the effects of climate change on the phenology of different trophic levels within the North Sea ecosystem should be undertaken to determine whether climate change-induced shifts in spawning phenology will result in a temporal mismatch between cod larvae and their planktonic prey.
Crowdsourcing Consumer Research
Authors: Goodman Joseph K , Paolacci Gabriele
Published: February 2017

Data collection in consumer research has progressively moved away from traditional samples (e.g., university undergraduates) and toward Internet samples. In the last complete volume of the Journal of Consumer Research (June 2015–April 2016), 43% of behavioral studies were conducted on the crowdsourcing website Amazon Mechanical Turk (MTurk). The option to crowdsource empirical investigations has great efficiency benefits for both individual researchers and the field, but it also poses new challenges and questions for how research should be designed, conducted, analyzed, and evaluated. We assess the evidence on the reliability of crowdsourced populations and the conditions under which crowdsourcing is a valid strategy for data collection. Based on this evidence, we propose specific guidelines for researchers to conduct high-quality research via crowdsourcing. We hope this tutorial will strengthen the community’s scrutiny on data collection practices and move the field toward better and more valid crowdsourcing of consumer research.
Public Sector Wage Policy and Labor Market Equilibrium: A Structural Model
Authors: Bradley Jake , Postel-Vinay Fabien , Turon Hélène
Published: February 2017

We develop and estimate a structural model that incorporates a sizeable public sector in a labor market with search frictions. The wage distribution and the employment rate in the public sector are taken as exogenous policy parameters. Overall wage distribution and employment rate are determined within the model, taking into account the private sector’s endogenous response to public sector employment policies. Job turnover is sector specific and transitions between sectors depend on the worker’s decision to accept alternative employment in the same or different sector by comparing the value of employment in the current and prospective jobs. The model is estimated on British data by a method of moments. We use the model to simulate the impact of various counterfactual public sector wage and employment policies.
Estimation of whole-body radiation exposure from brachytherapy for oral cancer using a Monte Carlo simulation
Authors: Ozaki Y. , Watanabe H. , Kaida A. , Miura M. , Nakagawa K. , Toda K. , Yoshimura R. , Sumi Y. , Kurabayashi T.
Published: February 2017

Early stage oral cancer can be cured with oral brachytherapy, but whole-body radiation exposure status has not been previously studied. Recently, the International Commission on Radiological Protection Committee (ICRP) recommended the use of ICRP phantoms to estimate radiation exposure from external and internal radiation sources. In this study, we used a Monte Carlo simulation with ICRP phantoms to estimate whole-body exposure from oral brachytherapy. We used a Particle and Heavy Ion Transport code System (PHITS) to model oral brachytherapy with 192Ir hairpins and 198Au grains and to perform a Monte Carlo simulation on the ICRP adult reference computational phantoms. To confirm the simulations, we also computed local dose distributions from these small sources, and compared them with the results from Oncentra manual Low Dose Rate Treatment Planning (mLDR) software which is used in day-to-day clinical practice. We successfully obtained data on absorbed dose for each organ in males and females. Sex-averaged equivalent doses were 0.547 and 0.710 Sv with 192Ir hairpins and 198Au grains, respectively. Simulation with PHITS was reliable when compared with an alternative computational technique using mLDR software. We concluded that the absorbed dose for each organ and whole-body exposure from oral brachytherapy can be estimated with Monte Carlo simulation using PHITS on ICRP reference phantoms. Effective doses for patients with oral cancer were obtained.
Intravenous dendritic cell administration enhances suppression of lung metastasis induced by carbon-ion irradiation
Authors: Ando Ken , Fujita Hidetoshi , Hosoi Akihiro , Ma Liqiu , Wakatsuki Masaru , Seino Ken-ichiro , Kakimi Kazuhiro , Imai Takashi , Shimokawa Takashi , Nakano Takashi
Published: February 2017

Carbon-ion radiotherapy (CIRT) is an advanced radiotherapy and has achieved good local control, even in tumors that are resistant to conventional photon beam radiotherapy (PBRT). However, distant metastasis control is an important issue. Recently, the combination of radiotherapy and immunotherapy has attracted the attention. In immunotherapy, dendritic cells (DCs) play a pivotal role in the anti-tumor immune system. However, the mechanisms underlying the combination therapy of DCs and radiotherapy have been unclear. In the present study, we evaluated anti-metastatic effects of this combination therapy, focused on the irradiation type and the route of DC administration, using a mouse model. C3H/He mice bearing NR-S1 cells were treated with CIRT or PBRT, using biologically equivalent doses. Subsequently, DCs were administered intratumorally (IT) or intravenously (IV). IV and IT DC administrations combined with CIRT to the local tumor, but not alone, significantly suppressed pulmonary metastasis, whereas the combination of DCs with PBRT suppressed metastasis at a relatively higher dose. Additionally, the anti-metastatic effect was greater in IV DC administration compared with in IT DC administration in both CIRT and PBRT. The expression levels of CD40 and IL-12 in DCs were significantly increased after co-culturing with CIRT-treated NR-S1 cells. In addition, IV administration of those co-cultured DCs significantly suppressed pulmonary metastasis. Furthermore, ecto-calreticulin levels from CIRT-treated NR-S1 cells significantly increased compared with those of a PBRT-treated tumor. Taken together, these results suggest that local CIRT combined with IV DCs augments an immunogenicity of the tumor cells by ecto-calreticulin expression and the maturation of DCs to stimulate anti-tumor immunity to decrease lung metastases.
Testing Verlinde's emergent gravity with the radial acceleration relation
Authors: Lelli Federico , McGaugh Stacy S. , Schombert James M.
Published: February 2017

It has recently been proposed that space–time and gravity may emerge from an underlying microscopic theory. In a de Sitter space–time, such emergent gravity (EG) contains an additional gravitational force due to dark energy, which may explain the mass discrepancies observed in galactic systems without the need of dark matter. For a point mass, EG is equivalent to Modified Newtonian Dynamics (MOND). We show that this equivalence does not hold for finite-size galaxies: There are significant differences between EG and MOND in the inner regions of galaxies. We confront theoretical predictions with the empirical radial acceleration relation (RAR). We find that (i) EG is consistent with the observed RAR only if we substantially decrease the fiducial stellar mass-to-light ratios; the resulting values are in tension with other astronomical estimates; (ii) EG predicts that the residuals around the RAR should correlate with radius; such residual correlation is not observed.
Stabilization, Rolling, and Addition of Other Extracellular Matrix Proteins to Collagen Hydrogels Improve Regeneration in Chitosan Guides for Long Peripheral Nerve Gaps in Rats
Authors: Gonzalez-Perez Francisco , Cobianchi Stefano , Heimann Claudia , Phillips James B. , Udina Esther , Navarro Xavier
Published: February 2017

BACKGROUND: Autograft is still the gold standard technique for the repair of long peripheral nerve injuries. The addition of biologically active scaffolds into the lumen of conduits to mimic the endoneurium of peripheral nerves may increase the final outcome of artificial nerve devices. Furthermore, the control of the orientation of the collagen fibers may provide some longitudinal guidance architecture providing a higher level of mesoscale tissue structure.

OBJECTIVE: To evaluate the regenerative capabilities of chitosan conduits enriched with extracellular matrix-based scaffolds to bridge a critical gap of 15 mm in the rat sciatic nerve.

METHODS: The right sciatic nerve of female Wistar Hannover rats was repaired with chitosan tubes functionalized with extracellular matrix-based scaffolds fully hydrated or stabilized and rolled to bridge a 15 mm nerve gap. Recovery was evaluated by means of electrophysiology and algesimetry tests and histological analysis 4 months after injury.

RESULTS: Stabilized constructs enhanced the success of regeneration compared with fully hydrated scaffolds. Moreover, fibronectin-enriched scaffolds increased muscle reinnervation and number of myelinated fibers compared with laminin-enriched constructs.

CONCLUSION: A mixed combination of collagen and fibronectin may be a promising internal filler for neural conduits for the repair of peripheral nerve injuries, and their stabilization may increase the quality of regeneration over long gaps.
Controversies in Spinal Trauma and Evolution of Care
Authors: Harrop James S. , Rymarczuk George N. , Vaccaro Alexander R. , Steinmetz Michael P. , Tetreault Lindsay A. , Fehlings Michael G.
Published: February 2017

Management of spinal trauma is a complex and rapidly evolving field. To optimize patient treatment algorithms, an understanding of and appreciation for current controversies and advancing technologies in the field of spinal trauma is necessary. Therefore, members of the AOSpine Knowledge Forum Trauma initiative used a modified Delphi method to compile a list of controversial issues and emerging technologies in the field of spinal trauma, and a list of the 14 most relevant topics was generated. A total of 45 440 manuscripts covering the breadth of spine and spinal trauma were initially identified. This broad search was then refined using the 14 categories felt to be most relevant to the current field of spinal trauma. The results were further pared down using inclusion criteria to select for the most relevant topics. The 8 remaining topics were classification schemes, treatment of vertebral compression fractures, treatment of burst fractures, timing of surgery in spinal trauma, hypothermia, the importance of global sagittal balance, lumbar subarachnoid drainage, and diffusion magnetic resonance imaging. These 8 topics were felt to be the most relevant, controversial, rapidly evolving, and most deserving of inclusion in this summary. In summary, despite recent advances, the field of spinal trauma has many ongoing points of controversy. We must continue to refine our ability to care for this patient population through education, research, and development. It is anticipated that the new AOSpine fracture classification system will assist with prospective research efforts.
Measuring Cerebral Blood Flow in Moyamoya Angiopathy by Quantitative Magnetic Resonance Angiography Noninvasive Optimal Vessel Analysis
Authors: Khan Nadia , Lober Robert M , Ostergren Lauren , Petralia Jacob , Bell-Stephens Teresa , Navarro Ramon , Feroze Abdullah , Steinberg Gary K
Published: February 2017

BACKGROUND

Moyamoya disease causes progressive occlusion of the supraclinoidal internal carotid artery, and middle, anterior, and less frequently the posterior cerebral arteries, carrying the risk of stroke. Blood flow is often partially reconstituted by compensatory moyamoya collaterals and sometimes the posterior circulation. Cerebral revascularization can further augment blood flow. These changes to blood flow within the cerebral vessels, however, are not well characterized.

OBJECTIVE

To evaluate blood flow changes resulting from the disease process and revascularization surgery using quantitative magnetic resonance angiography with noninvasive optimal vessel analysis (NOVA).

METHODS

We retrospectively analyzed 190 preoperative and postoperative imaging scans in 66 moyamoya patients after revascularization surgery. Images were analyzed for blood flow using NOVA and compared with preoperative angiographic staging and postoperative blood flow. Blood flow rates within superficial temporal artery grafts were compared based on angiographic evidence of patency.

RESULTS

Diseased vessels had lower blood flow, correlating with angiographic staging. Flow in posterior cererbal and basilar arteries increased with disease severity, particularly when both the anterior and middle cerebral arteries were occluded. Basilar artery flow and ipsilateral internal carotid artery flow decreased after surgery. Flow rates were different between angiographically robust and poor direct bypass grafts, as well as between robust and patent grafts.

CONCLUSION

Preoperative changes in cerebral vessel flow as measured by NOVA correlated with angiographic disease progression. NOVA demonstrated that preoperative augmentation of the posterior circulation decreased after surgery. This report is the first to quantify the shift in collateral supply from the posterior circulation to the bypass graft.
The Survival Advantage of “Supratotal” Resection of Glioblastoma Using Selective Cortical Mapping and the Subpial Technique
Authors: Esquenazi Yoshua , Friedman Elliott , Liu Zheyu , Zhu Jay-Jiguang , Hsu Sigmund , Tandon Nitin
Published: February 2017

BACKGROUND: A substantial body of evidence suggests that cytoreductive surgery is a prerequisite to prolonging survival in patients with glioblastoma (GBM).

OBJECTIVE: To evaluate the safety and impact of “supratotal” resections beyond the zone of enhancement seen on magnetic resonance imaging scans, using a subpial technique.

METHODS: We retrospectively evaluated 86 consecutive patients with primary GBM, managed by the senior author, using a subpial resection technique with or without carmustine (BCNU) wafer implantation. Multivariate Cox proportional hazards regression was used to analyze clinical, radiological, and outcome variables. Overall impacts of extent of resection (EOR) and BCNU wafer placement were compared using Kaplan-Meier survival analysis.

RESULTS: Mean patient age was 56 years. The median OS for the group was 18.1 months. Median OS for patients undergoing gross total, near-total, and subtotal resection were 54, 16.5, and 13.2 months, respectively. Patients undergoing near-total resection (P = .05) or gross total resection (P < .01) experienced statistically significant longer survival time than patients undergoing subtotal resection as well as patients undergoing ≥95% EOR (P < .01) when compared to <95% EOR. The addition of BCNU wafers had no survival advantage.

CONCLUSIONS: The subpial technique extends the resection beyond the contrast enhancement and is associated with an overall survival beyond that seen in similar series where resection of the enhancement portion is performed. The effect of supratotal resection on survival exceeded the effects of age, Karnofsky performance score, and tumor volume. A prospective study would help to quantify the impact of the subpial technique on quality of life and survival as compared to a traditional resection limited to the enhancing tumor.
Angio-Architectural Features of High-Grade Intracranial Dural Arteriovenous Fistulas: Correlation With Aggressive Clinical Presentation and Hemorrhagic Risk
Authors: Della Pepa Giuseppe Maria , Parente Paolo , D’Argento Francesco , Pedicelli Alessandro , Sturiale Carmelo Lucio , Sabatino Giovanni , Albanese Alessio , Puca Alfredo , Fernandez Eduardo , Olivi Alessando , Marchese Enrico
Published: February 2017

BACKGROUND: High-grade dural arteriovenous fistulas (dAVFs) can present shunts with very different angio-architectural characteristics. Specific hemodynamic factors may affect clinical history and determine very different clinical courses.

OBJECTIVES: To evaluate the relationship between some venous angio-architectural features in high-grade dAVFs and clinical presentation. Specific indicators of moderate or severe venous hypertension were analyzed, such as altered configurations of the dural sinuses (by a single or a dual thrombosis), or overload of cortical vessels (restrictions of outflow, pseudophlebitic cortical vessels, and venous aneurysms).

METHODS: The institutional series was retrospectively reviewed (49 cases), and the pattern of venous drainage was analyzed in relationship with clinical presentation (benign/aggressive/hemorrhage).

RESULTS: Thirty-five of 49 cases displayed cortical reflux (high-grade dAVFs). This subgroup displayed a benign presentation in 31.42% of cases, an aggressive in 31.42%, and hemorrhage in 37.14%.

CONCLUSIONS: Our data confirm that within high-grade dAVFs, 2 distinct subpopulations exist according to severity of clinical presentation. Some indicators we examined showed correlation with aggressive nonhemorrhagic manifestations (outflow restriction and pseudophlebitic cortical vessels), while other showed a correlation with hemorrhage (dual thrombosis and venous aneurysms). Current classifications appear insufficient to identify a wide range of conditions that ultimately determine the organization of the cortical venous drainage. Intermediate degrees of venous congestion correlate better with the clinical risk than the simple definition of cortical reflux. The angiographic aspects of venous drainage presented in this study may prove useful to assess dAVF hemodynamic characteristics and identify conditions at higher clinical risk.
Academic Productivity of US Neurosurgery Residents as Measured by H-Index: Program Ranking with Correlation to Faculty Productivity
Authors: Sarkiss Christopher A. , Riley Kyle J. , Hernandez Christopher M. , Oermann Eric K. , Ladner Travis R. , Bederson Joshua B. , Shrivastava Raj K.
Published: February 2017

Engagement in research and academic productivity are crucial components in the training of a neurosurgeon. This process typically begins in residency training. In this study, we analyzed individual resident productivity as it correlated to publications across all Accreditation Council for Graduate Medical Education (ACGME)-accredited neurosurgery training programs in an attempt to identify how programs have developed and fostered a research culture and environment. We obtained a list of current neurosurgery residents in ACGME-accredited programs from the American Association of Neurological Surgeons database. An expanded PubMed and Scopus search was conducted for each resident through the present time. We tabulated all articles attributed to each resident. We then categorized the publications based on each neurosurgical subspecialty while in residency. A spreadsheet-based statistical analysis was performed. This formulated the average number of resident articles, h-indices, and most common subspecialty categories by training program. We analyzed 1352 current neurosurgery residents in 105 programs. There were a total of 10 645 publications, of which 3985 were resident first-author publications during the period of study. The most common subspecialties among all resident publications were vascular (24.9%), spine (16.9%), oncology (16.1%), pediatric (5.6%), functional (4.9%), and trauma (3.8%). The average resident published 2.9 first-author papers with average of 38.0 first-author publications by total residents at each program (range 0-241). The average h-index per resident is 2.47 ± 3.25. When comparing previously published faculty h-index program rankings against our resident h-index rankings, there is a strong correlation between the 2 datasets with a clear delineation between Top-20 productivity and that of other programs (average h-index 4.2 vs 1.7, respectively, P < .001). Increasing program size leads to a clear increase in academic productivity on both the resident and faculty level (average h-index 1.6, 1.9, 3.9 for 1, 2, and 3 resident per year programs, respectively, P < .001). Resident first-author publications correlated with recently described academic departmental productivity. Subspecialty resident publications are highest in cerebrovascular surgery. Resident research and publication is a key metric for assessing the productivity of academic neurosurgery programs and is consistent with one of the core foci of neurosurgical training.
Graft Occlusion and Graft Size Changes in Complex Internal Carotid Artery Aneurysm Treated by Extracranial to Intracranial Bypass Using High-Flow Grafts with Therapeutic Internal Carotid Artery Occlusion
Authors: Matsukawa Hidetoshi , Tanikawa Rokuya , Kamiyama Hiroyasu , Tsuboi Toshiyuki , Noda Kosumo , Ota Nakao , Miyata Shiro , Takeda Rihei , Tokuda Sadahisa
Published: February 2017

BACKGROUND

Although the extracranial-to-intracranial high-flow bypass (EC-IC HFB) continues to be indispensable for complex aneurysms, the risk factors for the graft occlusion and whether the graft size changes after the bypass have not been well established.

OBJECTIVE

To evaluate the risk factors for the graft occlusion and to confirm whether graft diameters changed over time.

METHODS

The data of 75 patients who suffered from complex internal carotid artery (ICA) aneurysms and were treated by EC-IC HFB using radial artery graft (RAG) or saphenous vein graft (SVG) with therapeutic ICA occlusion were evaluated. Clinical and radiological characteristics were compared in patients with and without the graft occlusion by the log-rank test. Graft diameters measured preoperatively, postoperatively, at 6 months, and at 1 year were compared by paired t-test.

RESULTS

During a follow-up period (median 26.2 months), graft occlusions were seen in 4 patients (5.3%), and these were the SVGs. Only SVG was related to graft occlusion (P < .001). There was a significant increase with time in RAG diameters (preoperative, 3.1 ± 0.41 mm; postoperative, 3.6 ± 0.65 mm; 6 months, 4.3 ± 1.0 mm; 1 year, 4.4 ± 1.0 mm), while there were no significant diameter changes in SVGs.

CONCLUSION

The present study showed that the SVG was related to the graft occlusion and RAGs gradually enlarged. Unless Allen test is negative, RAG may be better to be used as a graft in EC-IC HFB if therapeutic ICA occlusion is needed.
The Surgical Management of Symptomatic Benign Peripheral Nerve Sheath Tumors of the Neck and Extremities: An Experience of 442 Cases
Authors: Desai Ketan I.
Published: February 2017

BACKGROUND

The occurrence of benign peripheral nerve sheath tumors (PNSTs) is not uncommon. The surgical excision of symptomatic benign PNSTs along with preservation of the affected nerve and its function is an ideal treatment option.

OBJECTIVE

To analyze the outcome with respect to morbidity, extent of resection, and recurrence, and to review and compare our results with those reported in literature.

METHODS

A retrospective review of clinical and radiological findings of 442 patients with benign PNSTs involving the neck and extremities treated surgically from 2000 to 2014 was performed.

RESULTS

In our series, benign PNSTs involved the extremities in 290 (65.6%) patients and the brachial plexus in 146 (33%) patients, and 6 (1.4%) patients had tumors of the extracranial portion of the vagus and hypoglossal nerves in the neck. The mean age of patients was 38 yr. The presenting features were painful mass and paresthesia. Preoperative motor weakness in the extremity was noted in 15.6% of patients. The common nerves involved by the tumors were the ulnar nerve (15.8%), sciatic nerve (12.7%), and upper cervical roots (11.5%). The excision was total in 81.2%, gross total (>90%) in 17.9%, and subtotal (>50%) in 0.9% patients. In 17.6% of patients, there was severe postoperative neurogenic pain. In 28 (6.3%) patients, a new motor deficit was noted following surgery. Recurrence was seen in 2 patients in our series. The mean follow-up was 30.2 mo.

CONCLUSION

Benign PNSTs have excellent clinical outcome, and the goal for surgical treatment is total to gross total excision of the tumor with neural preservation.
Contribution of Endothelial-to-Mesenchymal Transition to the Pathogenesis of Human Cerebral and Orbital Cavernous Malformations
Authors: Takada Shigeki , Hojo Masato , Tanigaki Kenji , Miyamoto Susumu
Published: February 2017

BACKGROUND: The analysis of gene-targeted mouse mutants has demonstrated that endothelial-to-mesenchymal transition (EndMT) is crucial to the onset and progression of cerebral cavernous malformations (CMs). It has also been shown that Notch and ephrin/Eph signaling are involved in EndMT. However, their roles in the pathogenesis of human intracranial CMs remain unclear.

OBJECTIVE: To elucidate the contribution of EndMT, the Notch pathway, and ephrin-B2/EphB4 signaling to the pathogenesis of human intracranial CMs.

METHODS: Eight human intracranial CMs (5 cerebral and 3 orbital CMs) were immunohistochemically investigated.

RESULTS: CD31 (an endothelial marker) and EndMT markers, such as α-smooth muscle actin (a mesenchymal marker) and CD44 (a mesenchymal stem cell marker), were expressed in the endothelial layer of vascular sinusoids in all cases, suggesting that endothelial cells (ECs) have acquired mesenchymal and stem-cell-like characteristics and undergone EndMT in all cerebral and orbital CMs. EndMT was observed in about 70% and 35% of ECs in cerebral and orbital CMs, respectively. In all cases, Notch3 was expressed in the endothelial layer, indicating that ECs of vascular sinusoids have acquired mesenchymal features. In all cases, both ephrin-B2 and EphB4 were detected in the endothelial layer, suggesting that ECs of vascular sinusoids are immature or malformed cells and have both arterial and venous characteristics.

CONCLUSION: EndMT plays a critical role in the pathogenesis of human cerebral and orbital CMs. Modulating EndMT is expected to be a new therapeutic strategy for cerebral and orbital CMs.
Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel
Authors: Akers Amy , Al-Shahi Salman Rustam , A. Awad Issam , Dahlem Kristen , Flemming Kelly , Hart Blaine , Kim Helen , Jusue-Torres Ignacio , Kondziolka Douglas , Lee Cornelia , Morrison Leslie , Rigamonti Daniele , Rebeiz Tania , Tournier-Lasserve Elisabeth , Waggoner Darrel , Whitehead Kevin
Published: February 2017

BACKGROUND: Despite many publications about cerebral cavernous malformations (CCMs), controversy remains regarding diagnostic and management strategies.

OBJECTIVE: To develop guidelines for CCM management.

METHODS: The Angioma Alliance (www.angioma.org), the patient support group in the United States advocating on behalf of patients and research in CCM, convened a multidisciplinary writing group comprising expert CCM clinicians to help summarize the existing literature related to the clinical care of CCM, focusing on 5 topics: (1) epidemiology and natural history, (2) genetic testing and counseling, (3) diagnostic criteria and radiology standards, (4) neurosurgical considerations, and (5) neurological considerations. The group reviewed literature, rated evidence, developed recommendations, and established consensus, controversies, and knowledge gaps according to a prespecified protocol.

RESULTS: Of 1270 publications published between January 1, 1983 and September 31, 2014, we selected 98 based on methodological criteria, and identified 38 additional recent or relevant publications. Topic authors used these publications to summarize current knowledge and arrive at 23 consensus management recommendations, which we rated by class (size of effect) and level (estimate of certainty) according to the American Heart Association/American Stroke Association criteria. No recommendation was level A (because of the absence of randomized controlled trials), 11 (48%) were level B, and 12 (52%) were level C. Recommendations were class I in 8 (35%), class II in 10 (43%), and class III in 5 (22%).

CONCLUSION: Current evidence supports recommendations for the management of CCM, but their generally low levels and classes mandate further research to better inform clinical practice and update these recommendations. The complete recommendations document, including the criteria for selecting reference citations, a more detailed justification of the respective recommendations, and a summary of controversies and knowledge gaps, was similarly peer reviewed and is available on line www.angioma.org/CCMGuidelines.
Clinical trial endpoints for patients with gliomas
Authors: Taylor Jennie W , Molinaro Annette M , Butowski Nicholas , Prados Michael
Published: February 2017

Malignant glioma represents a diverse set of molecularly heterogeneous diseases. Few therapeutic agents have been approved despite decades of clinical trials research and pre-clinical investigation. Attempts to refine neuroimaging criteria and recent discovery of the genomic profiles linking tumor subsets to survival outcomes have spurred discussion on a variety of new approaches in clinical trial design and relevant endpoints. Here we focus on those endpoints in clinical trial design for patients with primary glioma and related issues still to be resolved.
Surveillance Study of Influenza Occurrence and Immunity in a Wisconsin Cohort During the 2009 Pandemic
Authors: Lo Chia-Yun , Strobl Susan L. , Dunham Kimberly , Wang Wei , Stewart Lucy , Misplon Julia A. , Garcia Mayra , Gao Jin , Ozawa Tatsuhiko , Price Graeme E. , Navidad Jose , Gradus Steve , Bhattacharyya Sanjib , Viboud Cecile , Eichelberger Maryna C. , Weiss Carol D. , Gorski Jack , Epstein Suzanne L.
Published: February 2017

Background

Antibody and T-cell immunity to conserved influenza virus antigens can protect animals against infection with diverse influenza strains. Although immunity against conserved antigens occurs in humans, whether such responses provide cross-protection in humans and could be harnessed as the basis for universal influenza vaccines is controversial. The 2009 pandemic provided an opportunity to investigate whether pre-existing cross-reactive immunity affected susceptibility to infection.

Methods

In 2009, we banked sera and peripheral blood mononuclear cells (PBMC) from blood donors, then monitored them for pandemic influenza infection (pH1N1) by polymerase chain reaction or seroconversion. Antibodies to hemagglutinin (HA), neuraminidase (NA), nucleoprotein (NP), matrix 2 (M2), and HA-pseudotypes were measured in sera. T-cell inteferon-γ enzyme-linked immunospot responses were measured in PBMC.

Results

There were 13 infections in 117 evaluable donors. Pre-existing T-cell reactivity to pH1N1 was substantial (of 153 donors tested, 146 had >100 spot-forming cells/106 cells). Antibodies reactive with pH1N1 were common: anti-NP (all donors) and anti-M2 (44% of donors). Pseudotype-neutralizing antibodies to H1 were detected, but not to highly conserved HA epitopes. Unexpectedly, donors with symptomatic pH1N1 infection had sharp rises in HA pseudotype-neutralizing antibodies, not only pH1N1 but also against multiple seasonal H1s. In addition, an exploratory study of a T-cell marker (response to NP418-426) identified probable infection missed by standard criteria.

Conclusions

Although the number of infections was inadequate for conclusions about mechanisms of protection, this study documents the wide variety of pre-existing, cross-reactive, humoral and cellular immune responses to pandemic influenza virus antigens in humans. These responses can be compared with results of other studies and explored in universal influenza vaccine studies.
eConsultations to Infectious Disease Specialists: Questions Asked and Impact on Primary Care Providers’ Behavior
Authors: Murthy Ruchi , Rose Gregory , Liddy Clare , Afkham Amir , Keely Erin
Published: February 2017

Background

Since 2010, the Champlain BASE (Building Access to Specialist Advice through eConsultation) has allowed primary care providers (PCPs) to submit clinical questions to specialists through a secure web service. The study objectives are to describe questions asked to Infectious Diseases specialists through eConsultation and assess impact on physician behaviors.

Methods

eConsults completed through the Champlain BASE service from April 15, 2013 to January 29, 2015 were characterized by the type of question asked and infectious disease content. Usage data and PCP responses to a closeout survey were analyzed to determine eConsult response time, change in referral plans, and change in planned course of action.

Results

Of the 224 infectious diseases eConsults, the most common question types were as follows: interpretation of a clinical test 18.0% (41), general management 16.5 % (37), and indications/goals of treating a particular condition 16.5% (37). The most frequently consulted infectious diseases were as follows: tuberculosis 14.3% (32), Lyme disease 14.3% (32), and parasitology 12.9% (29). Within 24 hours, 63% of cases responded to the questions, and 82% of cases took under 15 minutes to complete. In 32% of cases, a face-to-face referral was originally planned by the PCP but was no longer needed. In 8% of cases, the PCP referred the patient despite originally not planning to make a referral. In 55% of cases, the PCP either received new information or changed their course of action.

Conclusions

An eConsult service provides PCPs with timely access to infectious disease specialists’ advice that often results in a change in plans for a face-to-face referral.
Treatment Outcomes Among Older Human Immunodeficiency Virus-Infected Adults in Nigeria
Authors: Agaba Patricia A. , Meloni Seema T. , Sule Halima M. , Agbaji Oche O. , Sagay Atiene S. , Okonkwo Prosper , Idoko John A. , Kanki Phyllis J.
Published: February 2017

Background

Older age at initiation of combination antiretroviral therapy (cART) has been associated with poorer clinical outcomes. Our objectives were to compare outcomes between older and younger patients in our clinical cohort in Jos, Nigeria.

Methods

This retrospective cohort study evaluated patients enrolled on cART at the Jos University Teaching Hospital, Nigeria between 2004 and 2012. We compared baseline and treatment differences between older (≥50 years) and younger (15–49 years) patients. Kaplan-Meier analysis and Cox proportional hazard models estimated survival and loss to follow-up (LTFU) and determined factors associated with these outcomes at 24 months.

Results

Of 8352 patients, 643 (7.7%) were aged ≥50 years. The median change in CD4 count from baseline was 151 vs 132 (P = .0005) at 12 months and 185 vs 151 cells/mm3 (P = .03) at 24 months for younger and older patients, respectively. A total of 68.9% vs 71.6% (P = .13) and 69.6% vs 74.8% (P = .005) of younger and older patients achieved viral suppression at 12 and 24 months, with similar incidence of mortality and LTFU. In adjusted hazard models, factors associated with increased risk of mortality were male sex, World Health Organization (WHO) stage III/IV, and having a gap in care, whereas being fully suppressed was protective. The risk of being LTFU was lower for older patients, those fully suppressed virologically and with adherence rates >95%. Male sex, lack of education, WHO stage III/IV, body mass index <18.5 kg/m2, and having a gap in care independently predicted LTFU.

Conclusions

Older patients achieved better viral suppression, and older age was not associated with increased mortality or LTFU in this study.
Validity of Different Activity Monitors to Count Steps in an Inpatient Rehabilitation Setting
Authors: Treacy Daniel , Hassett Leanne , Schurr Karl , Chagpar Sakina , Paul Serene S. , Sherrington Catherine
Published: February 2017

Background. Commonly used activity monitors have been shown to be accurate in counting steps in active people; however, further validation is needed in slower walking populations.

Objectives. To determine the validity of activity monitors for measuring step counts in rehabilitation inpatients compared with visually observed step counts. To explore the influence of gait parameters, activity monitor position, and use of walkers on activity monitor accuracy.

Methods. One hundred and sixty-six inpatients admitted to a rehabilitation unit with an average walking speed of 0.4 m/s (SD 0.2) wore 16 activity monitors (7 different devices in different positions) simultaneously during 6-minute and 6-m walks. The number of steps taken during the tests was also counted by a physical therapist. Gait parameters were assessed using the GAITRite system. To analyze the influence of different gait parameters, the percentage accuracy for each monitor was graphed against various gait parameters for each activity monitor.

Results. The StepWatch, Fitbit One worn on the ankle and the ActivPAL showed excellent agreement with observed step count (ICC2,1 0.98; 0.92; 0.78 respectively). Other devices (Fitbit Charge, Fitbit One worn on hip, G-Sensor, Garmin Vivofit, Actigraph) showed poor agreement with the observed step count (ICC2,1 0.12–0.40). Percentage agreement with observed step count was highest for the StepWatch (mean 98%). The StepWatch and the Fitbit One worn on the ankle maintained accuracy in individuals who walked more slowly and with shorter strides but other devices were less accurate in these individuals.

Limitations. There were small numbers of participants for some gait parameters.

Conclusions. The StepWatch showed the highest accuracy and closest agreement with observed step count. This device can be confidently used by researchers for accurate measurement of step counts in inpatient rehabilitation in individuals who walk slowly. If immediate feedback is desired, the Fitbit One when worn on the ankle would be the best choice for this population.
Situational Analysis of Physical Therapist Clinical Instructors’ Facilitation of Students’ Emerging Embodiment of Movement in Practice
Authors: Covington Kyle , Barcinas Susan J.
Published: February 2017

Background. Physical therapists improve the functional ability of patients after injury and disease. A unique component of their practice is the ability to use the movement of their own bodies to effect change in their patients. This ability has been recognized as a distinctive attribute of expert physical therapists.

Objective. The purpose of this qualitative situational analysis study was to examine how physical therapist clinical instructors perceive and facilitate their students’ emerging integration of movement in practice.

Design. Data collection and analysis were guided by a theoretical framework for understanding “professional ways of being.” Data were analyzed using coding and mapping strategies consistent with situational analysis techniques.

Methods. The study included 5 physical therapist clinical instructors and their respective 5 physical therapist students. Data were collected during beginning, midterm, and final weeks of the students’ clinical internships using participant interviews, observation, and document analysis.

Results. Coded data were summarized using situational analysis mapping strategies, resulting in 11 maps. These maps were further analyzed and reduced to 5 thematic behaviors enacted by a clinical instructor as he or she helps facilitate students’ use of movement in practice. These behaviors are adapt, prepare, enhance, connect, and develop.

Limitations. The limited number of participants and the relative homogeneity of the student sample may have limited the diversity of data collected.

Conclusions. The 5 behaviors are useful when considered as a trajectory of development. To our knowledge, this study marks the first description of how physical therapist clinical instructors develop students’ use of movement in practice and how to enact behaviors important in students’ continued professional development. The findings are important for clinical instructors and academic programs considering how best to prepare students to use movement and develop their skills early in practice.
Poor Physical Performance Predicts Future Onset of Depression in Elderly People: Progetto Veneto Anziani Longitudinal Study
Authors: Veronese Nicola , Stubbs Brendon , Trevisan Caterina , Bolzetta Francesco , De Rui Marina , Solmi Marco , Sartori Leonardo , Musacchio Estella , Zambon Sabina , Perissinotto Egle , Baggio Giovannella , Crepaldi Gaetano , Manzato Enzo , Maggi Stefania , Sergi Guiseppe
Published: February 2017

Background. Reduced physical performance is predictive of deleterious outcomes in older adults. Data considering objective physical performance and incident depression are sparse.

Objective. The objective of this study was to investigate during a 4-year study whether objective physical performance can predict incident depression among older adults who do not have depression at the baseline.

Design. This was a longitudinal study.

Methods. From 3,099 older people initially enrolled in the Progetto Veneto Anziani study, 970 participants without depression at the baseline were included (mean age = 72.5 years; 54.6% women). Physical performance measures included the Short Physical Performance Battery, 4-m gait speed, Five-Times Sit-to-Stand test, leg extension and flexion, handgrip strength, and 6-minute walk test, categorized in sex-specific tertiles. Depression was classified on the basis of the Geriatric Depression Scale and a diagnosis from a geriatric psychiatrist. Area under the curve and logistic regression analyses were conducted.

Results. At the baseline, participants developing depression during the follow-up (n = 207) scored significantly worse across all physical performance measures than those who did not develop depression. The area under the curve and predictive power were similar for all of the physical performance tests assessed. In the logistic regression analysis, after adjustment for 14 potential confounders, worse physical performance across all tests increased the risk of depression. Participants in the lowest tertile of the Short Physical Performance Battery were at notable odds of developing depression (odds ratio = 1.79; 95% CI = 1.18-2.71). The association between poor physical performance and depression was typically stronger in women than in men, except for 4-m gait speed.

Limitations. No gold standard was used for a depression diagnosis; oxidative stress and inflammatory markers were not included; and there was a high rate of missing data at the follow-up.

Conclusions. Low physical performance appeared to be an independent predictor of depression over a 4-year follow-up in a sample of elderly people.
Rectracted: Anti-ribosomal-phosphoprotein autoantibodies penetrate to neuronal cells via neuronal growth associated protein, affecting neuronal cellsin vitro
Authors: Kivity Shaye , Shoenfeld Yehuda , Arango Maria-Teresa , Cahill Dolores J , O’Kane Sara Louise , Zusev Margalit , Slutsky Inna , Harel-Meir Michal , Chapman Joab , Matthias Torsten , Blank Miri
Published: February 2017

Objective

Anti-ribosomal-phosphoprotein antibodies (anti-Ribos.P Abs) are detected in 10–45% of NPSLE patients. Intracerebroventricular administration of anti-ribosomal-P Abs induces depression-like behaviour in mice. We aimed to discern the mechanism by which anti-Ribos.P Abs induce behavioural changes in mice.

Methods

Anti-Ribos.P Abs were exposed to human and rat neuronal cell cultures, as well as to human umbilical vein endothelial cell cultures for a control. The cellular localization of anti-Ribo.P Abs was found by an immunofluorescent technique using a confocal microscope. Identification of the target molecules was undertaken using a cDNA library. Immunohistochemistry and an inhibition assay were carried out to confirm the identity of the target molecules. Neuronal cell proliferation was measured by bromodeoxyuridine, and Akt and Erk expression by immunoblot.

Results

Human anti-Ribos.P Abs penetrated into human neuronal cells and rat hippocampal cell cultures in vitro, but not to endothelial cells as examined. Screening a high-content human cDNA-library with anti-Ribos.P Abs identified neuronal growth–associated protein (GAP43) as a target for anti-Ribos.P Abs. Ex vivo anti-Ribos.P Abs bind to mouse brain sections of hippocampus, dentate and amygdala. Anti-Ribos.P Abs brain-binding was prevented by GAP43 protein. Interestingly, GAP43 inhibited in a dose-dependent manner the anti-Ribos.P Abs binding to recombinant-ribosomal-P0, indicating mimicry between the ribosomal-P0 protein and GAP43. Furthermore, anti-Ribos.P Abs reduced neuronal cell proliferation activity in vitro (P < 0.001), whereas GAP43 decreased this inhibitory activity by a factor of 7.6. The last was related to Akt and Erk dephosphorylation.

Conclusion

Anti-Ribos.P Abs penetrate neuronal cells in vitro by targeting GAP43. Anti -Ribos.P Abs inhibit neuronal-cell proliferation via inhibition of Akt and Erk. Our data contribute to deciphering the mechanism for anti-Ribos.P Abs’ pathogenic activity in NPSLE.