bluuebunny/crossref_metadata_2025 huggingface dataset:
Fibrin Glue-aided, Instant Epicardial Placement Enhances the Efficacy of Mesenchymal Stromal Cell-Based Therapy for Heart Failure
Authors: Kobayashi Kazuya , Ichihara Yuki , Tano Nobuko , Fields Laura , Murugesu Nilaani , Ito Tomoya , Ikebe Chiho , Lewis Fiona , Yashiro Kenta , Shintani Yasunori , Uppal Rakesh , Suzuki Ken
Published: June 2018

Transplantation of mesenchymal stromal cells (MSCs) is a promising new therapy for heart failure. However, the current cell delivery routes result in poor donor cell engraftment. We therefore explored the role of fibrin glue (FG)-aided, instant epicardial placement to enhance the efficacy of MSC-based therapy in a rat ischemic cardiomyopathy model. We identified a feasible and reproducible method to instantly produce a FG-MSC complex directly on the heart surface. This complex exhibited prompt, firm adhesion to the heart, markedly improving initial retention of donor MSCs compared to intramyocardial injection. In addition, maintenance of retained MSCs was enhanced using this method, together contributing the increased donor cell presence. Such increased donor cell quantity using the FG-aided technique led to further improved cardiac function in association with augmented histological myocardial repair, which correlated with upregulation of tissue repair-related genes. We identified that the epicardial layer was eliminated shortly after FG-aided epicardial placement of MSCs, facilitating permeation of the donor MSC’s secretome into the myocardium enabling myocardial repair. These data indicate that FG-aided, on-site, instant epicardial placement enhances MSC engraftment, promoting the efficacy of MSC-based therapy for heart failure. Further development of this accessible, advanced MSC-therapy is justified.
Arabidopsis response to the spider mite Tetranychus urticae depends on the regulation of reactive oxygen species homeostasis
Authors: Santamaría M. Estrella , Arnaiz Ana , Velasco-Arroyo Blanca , Grbic Vojislava , Diaz Isabel , Martinez Manuel
Published: June 2018

Reactive oxygen species (ROS) are molecules that play a prominent role in plant response to numerous stresses, including plant interactions with herbivores. Previous findings indicate that Arabidopsis plants showed an increase in H2O2 accumulation after Tetranychus urticae infestation. Despite its importance, no information has been reported on the relationships between ROS-metabolizing systems and the spider mite-triggered plant-induced responses. In this work, four ROS-related genes that were differentially expressed between the resistant Bla-2 and the susceptible Kon Arabidopsis accessions were selected for the analysis. These genes encode proteins putatively involved in the generation (BBE22) and degradation (GPX7 and GSTU4) of H2O2, and in the degradation of ascorbate (AO). Overexpressing BBE22 and silencing GPX7, GSTU4 and AO resulted in higher leaf damage and better mite performance relative to the wild-type plants. Minor effects on H2O2 accumulation obscure major effects on the expression of genes related to ROS-metabolism and JA and SA signaling pathways, and on ROS-related enzymatic activities. In conclusion, the integration of ROS and ROS-related compounds and enzymes in the response of Arabidopsis to the spider mite T. urticae was confirmed. However, the complex network involved in ROS signaling makes difficult to predict the impact of a specific genetic manipulation.
Isobutane aromatization over a complete Lewis acid Zn/HZSM-5 zeolite catalyst: performance and mechanism
Authors: Liu Jiaxu , He Ning , Zhou Wei , Lin Long , Liu Guodong , Liu Chunyan , Wang Jilei , Xin Qin , Xiong Guang , Guo Hongchen
Published: June 2018

OperandoDB-FTIR and DFT results certificate that the isobutane aromatization could be exclusively catalyzed by (Zn–O–Zn)2+Lewis acid site over Zn/HZSM-5.
Purification, identification and functional characterization of an immunomodulatory protein from Pleurotus eryngii
Authors: Hu Qiuhui , Du Hengjun , Ma Gaoxing , Pei Fei , Ma Ning , Yuan Biao , Nakata Paul A. , Yang Wenjian
Published: June 2018

Pleurotus eryngii contains bioactive compounds that can activate the immune system.
Hydrogen bonding reinforcement as a strategy to improve upper critical solution temperature of poly(N-acryloylglycinamide-co-methacrylic acid)
Authors: Sun Wenhui , An Zesheng , Wu Peiyi
Published: June 2018

HB-type copolymers with suitably tunable UCST and corresponding core–shell nanogels showing UCST–LCST type behavior.
Multifunctional Ag-decorated g-C3N4 nanosheets as recyclable SERS substrates for CV and RhB detection
Authors: Ma Yunfeng , Yang Lili , Yang Yong , Peng Yusi , Wei Yuquan , Huang Zhengren
Published: June 2018

In this study, g-C3N4/Ag hybrid nanostructures were fabricated by facilely decorating silver nanoparticles on atmosphere-treated g-C3N4 and served as efficient SERS-active substrates.
Characterization of the PLP-dependent transaminase initiating azasugar biosynthesis
Authors: Arciola Jeffrey M. , Horenstein Nicole A.
Published: June 2018

Biosynthesis of the azasugar 1-deoxynojirimycin (DNJ) critically involves a transamination in the first committed step. Here, we identify the azasugar biosynthetic cluster signature in Paenibacillus polymyxa SC2 (Ppo), homologous to that reported in Bacillus amyloliquefaciens FZB42 (Bam), and report the characterization of the aminotransferase GabT1 (named from Bam). GabT1 from Ppo exhibits a specific activity of 4.9 nmol/min/mg at 30°C (pH 7.5), a somewhat promiscuous amino donor selectivity, and curvilinear steady-state kinetics that do not reflect the predicted ping-pong behavior typical of aminotransferases. Analysis of the first half reaction with l-glutamate in the absence of the acceptor fructose 6-phosphate revealed that it was capable of catalyzing multiple turnovers of glutamate. Kinetic modeling of steady-state initial velocity data was consistent with a novel hybrid branching kinetic mechanism which included dissociation of PMP after the first half reaction to generate the apoenzyme which could bind PLP for another catalytic deamination event. Based on comparative sequence analyses, we identified an uncommon His-Val dyad in the PLP-binding pocket which we hypothesized was responsible for the unusual kinetics. Restoration of the conserved PLP-binding site motif via the mutant H119F restored classic ping-pong kinetic behavior.
Rational application of hot finished rectangular hollow sections in steel structures
Authors: Kuchta Krzysztof , Tylek Izabela
Published: June 2018

Steel hollow sections are manufactured as both welded and seamless elements. The influence of manufacturing technology causes tubes made from the same carbon-manganese steel to differ significantly in terms of their mechanical properties. The cold-formed welded tubes are produced from a steel strip that is roll formed and welded; both technological processes take place at room temperature. This profile type is characterised by less favourable mechanical properties and by much higher inhomogeneity within the cross-section than the seamless tube. However, due to the lower cost of manufacturing, welded tubes are much more often used in building structures than seamless ones. After thermomechanical treatment, the welded tubes, which are referred to as “hot finished”, have almost the same mechanical properties as seamless tubes. However, hot finished sections are more expensive than welded ones; therefore if they are to be applied in the structure in a reasonable way, higher unit cost should translate into an appropriate increase of the load bearing capacity. The aim of the paper is to indicate the application areas of hot finished rectangular hollow sections in which their use is economically justified.
Composite degradation model and corresponding failure mechanism for mid-power GaN-based white LEDs
Authors: Cao Haicheng , Ma Zhanhong , Sun Baojuan , Sun Xuejiao , Yang Chao , Li Xiaodong , Wang Junxi , Zhao Lixia
Published: June 2018

The degradation mechanism of mid-power GaN-based white LEDs were investigated by using the in-situ multi-functional accelerated aging tests. The changes of the luminous flux and the chromaticity shift during the stress time show some correlations. To quantitatively analyze the degradation behavior, a composite model considering the luminous flux increasing and decreasing mechanisms was proposed and the results agree well with the experiments in the entire aging time. Furthermore, different analytical technologies have been used to understand the cause of luminous flux degradation and chromaticity shift. The results show that the chromaticity shift was mainly due to the phosphors deterioration, while the serious degradation of luminous flux was the overall effects from the package, including the phosphors deterioration and oxidation of silicone encapsulant.
Tuning the electronic and magnetic properties of graphene/h-BN hetero nanoribbon: A first-principles investigation
Authors: Das Tisita , Chakrabarty Soubhik , Kawazoe Y. , Das G. P.
Published: June 2018

Inspired by the successful synthesis of phase separated in-plane graphene/h-BN heterostructures, we have explored the design of one dimensional graphene/h-BN hetero nanoribbon (G/BNNR). Using first-principles density functional based approach, the electronic and magnetic properties of the hybrid nanoribbons with mono-hydrogenated edges have been investigated for different configurations with alternative composition of C-C and B-N units in a ribbon of fixed width. Our results suggest that the electronic as well as magnetic properties of the ribbons can be regulated by varying the number of C-C (or B-N) units present in the structure. Both the hetero nanoribbons, either with N or B terminated edges, undergo a semiconductor-to-semimetal-to-metal transition with the increase in the number of C-C units for a fixed ribbon width. The spin density distribution indicates significant localization of the magnetic moments at the edge carbon atoms, that gets manifested when the number of C-C units is greater than 2 for most of the structures.
Modeling and characterization of surface roughness effect on fluid flow in a polydimethylsiloxane microchannel using a fractal based lattice Boltzmann method
Authors: Pravinraj T. , Patrikar Rajendra
Published: June 2018

In micro and nano flows, the fluid flow pattern is sensitive to many intrinsic parameters such as surface roughness. In this letter, we have presented the capture of variations in fluid flow in polydimethylsiloxane(PDMS) microfluidic channels with respect to surface roughness. The velocity of the fluid is measured experimentally and also simulated using a mesoscopic lattice Boltzmann method (LBM). For simulations, the surface roughness is implemented using a fractal based approach. The Weierstrass-Mandelbrot(WM) mathematical function is explored for realizing various rough surfaces by tuning the fractal dimension parameter. The results show that the computational fluid dynamics model, which incorporated surface roughness, has a better agreement with the experimental results than the model without roughness.
Vortex molecules in thin films of layered superconductors
Authors: Samokhvalov A. V. , Mel'nikov A. S. , Buzdin A. I.
Published: June 2018

The seminal work of Abrikosov on the vortex lattices in type-II superconductors has triggered the creation and rapid development of the whole new field of condensed matter physics, namely, the physics of vortex matter in a large variety of superfluid and superconducting systems. Among these systems and compounds the layered superconductors are known to form a very important class which is associated with a number of fascinating new discoveries in vortex physics. The phenomenon of the vortex attraction in tilted magnetic fields provides one of the examples of such findings which affected theoretical and experimental research in the field for almost two decades. In our paper we review some recent advances in this direction focusing on the intervortex interaction and equilibrium vortex structures in thin films of layered superconductors in magnetic field tilted with respect to the layers. In such a case the magnetic field penetrates superconductor in the form of tilted vortices or a crossing array of Josephson vortices and pancake stacks. We study the interplay between two different long-range potentials: (i) attraction of tilted vortices or deformed stacks; (ii) the Pearl's repulsion. This interplay is responsible for the formation of the minimum in the total interaction energy and resulting decay of vortex chains in clusters. The number of Abrikosov vortices in these clusters (or vortex molecules) depends on field tilting angle and film thickness.
A serendipitous journey from finance to science
Authors: Broadhurst Linda
Published: June 2018

This paper describes my serendipitous journey from university to the finance sector and back to university and a significant career highlight – shifting the emphasis on collecting seed from small local populations for restoration programs in favour of collecting seed with high genetic diversity.
Evaluating cognitive ability in the domestic dog, a review of learning, memory and attention.
Authors: Provoost L. R. , Casal M. , Siracusa C.
Published: June 2018

Behavioural changes can be caused by pathology within any body system, while cognitive changes stem from alterations within the brain. A variety of cognition tests have been used to assess cognitive abilities in canines, with most research focusing on ageing processes. Learning and memory can be evaluated using such cognitive tasks that include, delayed non-match to position, sensory discrimination tasks, attention tasks and reversal learning tasks. The way in which an individual learns, stores and recalls information depends on their capacity of perception and memory. Ageing and disease can alter memory capabilities by affecting brain structures and neuronal pathways. The impact of various disease states upon cognition in dogs is unknown. The ability to understand the cognitive deficits associated with ageing and disease processes deepens our understanding of patient needs and provides new directions to evaluate treatments.
The theory and applications of CRISPR in plant and tree improvement.
Authors: Parsons J. D. , MacKay J.
Published: June 2018

Increasing global population combined with a changing climate is placing pressure on global plant production systems, and rapid leafy and woody plant improvement is required to meet the demands of the future. Conventional breeding is time-consuming, especially in woody plants, and potential new plant traits are limited by the pre-existing genetic diversity. CRISPR/Cas genome editing (GE) technology allows rapid, simple and targeted modifications of plant genomes, as well as the introduction of novel genes into the germplasm. Both agrobacterium and ribonucleoprotein (RNP)-mediated delivery of CRISPR/Cas components to plant cells can produce transgene-free edited plants, with F
1
segregation required for the former. RNP-mediated editing in protoplasts can be directly used for gene editing without transgenes, and for pyramiding of desired genes into germplasm. However, plant regeneration from protoplasts remains to be established for many woody species. In addition, high rates of SNP occurrence in outcrossing species, as well as a shortage of functional genomics knowledge, increases the complexity of designing CRISPR/Cas editing pipelines. However, despite some challenges, CRISPR/Cas GE has seen widespread application in the generation of disease-resistant plants (providing resistance to fungal, bacterial and viral pathogens), as well as improving responses to abiotic stresses and increasing yields, amongst others. With the rapid development of new computational tools for designing and targeting CRISPR/Cas systems, increasing functional genomics knowledge, progress in protoplast-RNP-based editing and favourable regulatory outlook, CRISPR/Cas GE is close to providing a new generation of future-proofed woody and leafy plants.
Adjustment Disorder
Authors: Webb Allison M. B. , Ford Shannon C. , Santiago Patcho N.
Published: June 2018

Adjustment disorder is a psychiatric diagnosis that has undergone numerous iterations within the Diagnostic and Statistical Manual of Mental Disorders and is characterized by an immediate or almost immediate maladaptive or pathologic psychological response to a stressor. When the stressor is removed, there is the expectation that the patient returns to his or her previous level of functioning. This chapter provides an overview of its historical development, diagnostic criteria, potential controversies, epidemiology, neurobiology, comorbidities, and other differential diagnostic and treatment considerations such as ruling out depression and using assessment instruments. The chapter closes with the presentation of a case illustrating application of the criteria and clinical characteristics of adjustment disorder.

The views expressed in this chapter are those of the authors and do not reflect the official policy of the Department of Army/Navy/Force, Department of Defense, or U.S. Government. The identification of specific products or scientific instrumentation is considered an integral part of the scientific endeavor and does not constitute endorsement or implied endorsement on the part of the author, DoD, or any component agency.
PTSD in Children 6 Years and Younger
Authors: De Young Alexandra C. , Scheeringa Michael S.
Published: June 2018

This chapter is an overview of the new Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM-5) subtype “posttraumatic stress disorder for children 6 years and younger” and what is known about posttraumatic stress disorder during early childhood. It outlines issues that complicate the accurate assessment of trauma-related problems in young children and reviews the new DSM-5 category, instruments currently available, and evidence for different treatment options. Young children are a high-risk population for exposure to traumatic events and are likewise at risk of developing trauma- and stressor-related disorders following trauma exposure. Early childhood is associated with unique vulnerabilities that may put young children at risk of poor outcomes and rapid maturational growth that may enhance resilience. Early and accurate assessment and treatment of posttrauma reactions in very young children can be challenging, but, because of these factors, it is critical.
Characterization, Conceptualization, and Treatment of Sleep Disturbances in PTSD
Authors: Pace-Schott Edward F. , Bottary Ryan
Published: June 2018

This chapter reviews the commonly observed sleep-related symptoms of posttraumatic stress disorder (PTSD). Sleep disturbances, such as insomnia and trauma-related recurrent nightmares, are extremely common in PTSD and have long been recognized as a core feature of the condition. They appear to play an important role in the development and maintenance of PTSD symptoms; however, first-line treatments do not specifically address sleep. The discussion in this chapter focuses on both subjective reports of sleep disturbance and objectively measured sleep abnormalities. It summarizes the contemporary theoretical pathways in which sleep disturbances and abnormalities may contribute to the development and maintenance of PTSD symptomatology. It concludes with a discussion of clinically relevant sleep-related treatment considerations for patients with PTSD.
Evidence-Based Psychotherapies for Adults with PTSD
Authors: Harik Juliette M. , Hamblen Jessica L. , Norman Sonya B. , Schnurr Paula P.
Published: June 2018

This chapter provides an overview of evidence-based psychotherapies for posttraumatic stress disorder (PTSD) in adults. It defines these psychotherapies as those that received the strongest possible recommendation in any of the current clinical practice guidelines for the treatment of PTSD. These treatments include trauma-focused cognitive-behavioral therapies (which are further categorized as primarily exposure, primarily cognitive, or mixed cognitive-exposure) and Eye Movement Desensitization and Reprocessing. For each approach, the chapter offers a review of the theoretical underpinnings, describes key techniques, and summarizes the existing empirical support. It also briefly discusses efforts to enhance existing evidence-based psychotherapies and to evaluate novel, emerging psychotherapies targeting symptoms of PTSD.
Psychosocial Interventions for Child Traumatic Stress
Authors: Saxe Glenn N. , Gartner Hannah , Brown Adam D.
Published: June 2018

This chapter reviews the array of psychosocial interventions available for the treatment of child traumatic stress and the specific qualities of these interventions for addressing the needs of traumatized children and their families. The literature supporting the efficacy or effectiveness of these interventions is reviewed in detail. Unlike other reviews of the literature on this topic—which largely focus on highlighting the interventions with the highest level of empirical evidence from clinical trials—this chapter emphasizes the information that clinicians and their agencies will need in selecting interventions for traumatized children and families and the available evidence supporting such interventions. Accordingly, this chapter also highlights the gaps in empirical knowledge that will be necessary to address in order to ensure that interventions can be effective, take root, and achieve acceptable scale in the settings where traumatized children typically receive care.
Pharmacologic Treatment of Children with Trauma- and Stressor-Related Disorders
Authors: Jani Suni , Herringa Ryan , Hursey Derek
Published: June 2018

This chapter reviews the principles of psychopharmacological treatment for trauma and stressor-related disorders in children. It will discuss emerging psychopharmacological treatments and theories of trauma- and stress-related disorders (TSRDs) common to childhood, reactive attachment disorder, and disinhibited social engagement disorder. Although there is limited literature on the role of pharmacotherapy in treating TSRDs in children, it has been recognized that α‎- and β‎-adrenergic blocking agents, novel antipsychotic agents, non-selective serotonin reuptake inhibitor antidepressants such as tricyclic antidepressants, and mood-stabilizing agents may be effective for children based on several open clinical trials. These trials, as well as existing promising clinical trials, are discussed in this chapter. It also provides an in-depth review of factors such as potential side effects, medication interactions, and black box warnings as they specifically apply to the pediatric population.
Standards and Guidelines for Perioperative Care of Bariatric Patients
Authors: Hanipah Zubaidah Nor
Published: June 2018

In order to establish a worldwide standard of care for management of bariatric patients, the American Association of Clinical Endocrinologists (AACE), The Obesity Society (TOS), and the American Society for Metabolic and Bariatric Surgery (ASMBS) published clinical practice guidelines (CPG) for perioperative management of bariatric surgery patients in 2008. The CPG, which were updated in 2013, have been endorsed by professional bariatric societies worldwide. This chapter summarizes guidelines based on the updated CPG, with a focus on prevention and management of complications of bariatric surgery. The chapter outlines the guidelines for perioperative care of bariatric patients and specific management of perioperative complications using a system- or disease-oriented approach. The guidelines are designed to assist practitioners in patient management; however, practitioners should practice bariatric surgery based on current knowledge, experience, latest literature reviews, and patients’ needs in order to achieve optimal patient care.
Operating Room Set-up and Instrumentation for Laparoscopic Bariatric Surgery
Authors: Rogula Tomasz G. , Batayyah Esam , Schauer Philip R.
Published: June 2018

This chapter discusses operating room set-up and the basic instruments required for laparoscopic bariatric surgery, including hand instruments (which come in different lengths that accommodate the large cavity of bariatric patients), retraction instruments, stabilizers, and energy sources for transection and coagulation. In addition, staplers are discussed and the articulating and power technology, along with different thicknesses of reloads, as well as buttressing materials, are described. Voice activation technology in operating theater simplifies many of the demands on the surgeon. Finally, robotics improve ergonomics for the surgeon and enhance complex maneuvers in the abdominal cavity.
Anesthesia and Recovery
Authors: Khatib Reem
Published: June 2018

As a consequence of the obesity epidemic that has developed in the United States over the past few decades, many morbidly obese patients are presenting to the operating room for a variety of procedures, including bariatric surgery. Anesthesiologists must therefore be familiar with the physiologic changes that occur as a consequence of this disease process. Changes in cardiac and respiratory physiology require special consideration as they impact anesthetic management during the perioperative period. Strategies to optimize intraoperative management of the morbidly obese patient presenting for bariatric surgery including successful airway management, fluid management, and prevention of atelectasis are discussed. Finally, common postoperative issues are examined including renal dysfunction, respiratory insufficiency, and ICU outcomes. With planning and communication the challenges these patients present can be managed effectively by the bariatric team
Readmissions after Bariatric Surgery
Authors: Khorgami Zhamak , Aminian Ali
Published: June 2018

Readmission after bariatric surgery occurs in about 5% of cases and increases the average costs up to 2.5-fold. Risk factors for readmission are dependent functional status, diabetes mellitus, steroid or immunosuppressant use, cardiac disease with intervention, bleeding disorders, longer operative time, concurrent splenectomy, high preoperative creatinine, low serum albumin, and occurrence of postoperative complications during index admission. The most common reasons for readmissions are procedure-related complications, including dehydration, abdominal pain, bleeding, anastomotic leak, gastrointestinal obstruction, and thromboembolic events. Measures that decrease readmissions after bariatric surgery include: effective preoperative education, thorough evaluation before discharge, appropriate discharge instruction with required medications, reasonable discharge disposition, 24-hour phone support, active follow-up of high-risk patients, walk-in clinic, hydration clinic, and training of other hospital teams to manage common complaints after bariatric surgery.
Gut Failure after Bariatric Surgery
Authors: Abu-Elmagd Kareem M. , Khanna Ajai , Fujiki Masato , Hashimoto Koji , Rogula Tomasz G. , Costa Guilherme
Published: June 2018

The gut plays a central role in the control of whole-body energy equilibrium, with obesity and gut failure being the two extremes of the continuum of disrupted energy homeostasis. In the last 25 years there has been a simultaneous evolution of both bariatric surgery for treatment of morbid obesity and surgical rehabilitation for management of gut failure. This chapter addresses gastrointestinal failure with the need for TPN therapy as a true concern among the bariatric surgery population. A new classification is introduced, along with novel surgical procedures, including visceral transplantation, to restore gut homeostasis and nutritional autonomy. In summary, this chapter features the enigma of patients with gut failure after bariatric surgery and underscores the successful management of these complex patients with the application of surgical ingenuity.
Complications of the Intragastric Balloon
Authors: Menon Ashok , Khwaja Haris A. , Lagardere Ariel Ortiz , Neto Manoel Galvao , Ponce Jaime
Published: June 2018

Intragastric balloons (IGB) have been used in the treatment of obesity for over 30 years. The first notable IGB device (the Garren Edwards Gastric Bubble) was withdrawn from the market due to patients’ poor weight loss and a high rate of complications. Several subsequent devices have been designed to address these shortcomings, but high-quality data are needed to compare complication rates among devices. Mortality across all IGB variants is extremely low compared to other bariatric procedures. Complications are mainly associated with visceral injury related to device insertion and retrieval, and with the presence or migration of an in-situ device, such as gastric ulceration and perforation, intolerance, gastrointestinal obstruction, and, rarely, acute pancreatitis. The incidence of postoperative venous thromboembolism (VTE) has not been extensively investigated, and it is not clear whether VTE is device-related or is due to increased VTE risk in bariatric patients.
Fetal Imaging for the Neurologist
Authors: Seligman Neil S. , Chess Mitchell
Published: June 2018

In general, ultrasonography and magnetic resonance imaging (MRI) are not associated with maternal or fetal risks and are the imaging techniques of choice for the pregnant patient. Ultrasound is the mainstay of obstetric imaging because it is safe and easily performed. However, MRI is becoming more useful as an adjunct in cases of questionable ultrasound findings or if additional information is needed to plan patient care. MRI lacks the potential risks of ionizing radiation associated with other forms of imaging and, when needed, gadolinium can be used (however, use remains uncommon in current practice). For maternal evaluation in patients with neuromuscular disorders MRI is ideal for imaging. Nevertheless, any imaging (either maternal or fetal) should be used only when needed. Furthermore, if other imaging modalities (CT, MRI with contrast, etc.) are better for assessing the mother’s or fetus’s condition and the information will influence the pregnancy care, these should be utilized.
Neurologic Infections in Pregnancy
Authors: Olson-Chen Courtney
Published: June 2018

Despite advances in prevention, diagnosis, and treatment, infectious diseases continue to be a major cause of maternal, fetal, and neonatal morbidity and mortality. Immunologic changes in pregnancy can increase both susceptibility to certain infections and the severity of infection. Infectious diseases in pregnancy contribute to the development of congenital fetal syndromes in addition to adverse outcomes including preterm birth, stillbirth, and intrauterine growth restriction. While infections of the maternal central nervous system, or CNS, are rare during pregnancy, the potential impact can be critical.1 This chapter will cover both the types of infections within the CNS and the potential organisms that cause these infections. The chapter will also provide general management recommendations for pregnancy in order to both prevent and maintain awareness about CNS infections.
Ischemic Stroke Management in Pregnancy
Authors: Dodds Jodi , Loochtan Aaron I. , Bushnell Cheryl D.
Published: June 2018

Ischemic stroke during pregnancy is relatively rare, but when it occurs, the risk is highest in the postpartum period. This is a condition that requires immediate recognition and evaluation for acute management to potentially prevent devastating neurological consequences. Determining an etiology while considering physiological changes during and after pregnancy is also important. Post-stroke care including implementing secondary stroke prevention via pharmacological and non-pharmacological methods is regular practice. Consideration of physical, occupational, and speech therapy strategies as well as lifestyle modification and evaluation and treatment of co-morbid psychiatric conditions is also paramount. Postpartum care and consideration of future pregnancies and hormonal changes that may occur is also important.
Brain Tumors in Pregnancy
Authors: Ibegbu Chinazom , Mohile Nimish A.
Published: June 2018

Approximately 79,000 people are diagnosed with a central nervous system (CNS) tumor each year, but only a few of these patients are pregnant women. There is no evidence that pregnancy confers an increased risk of developing a brain tumor and incidence during child-bearing years is estimated to be 12.24 per 100,000 women. The care and management of all patients with primary brain tumors can be challenging and requires a multidisciplinary team that includes neurologists, medical neuro-oncologists, neurosurgeons, radiation-oncologists, and palliative care physicians. In a pregnant patient, this multidisciplinary team should also include a high-risk obstetrician. This chapter provides a detailed care map for pregnant patients with brain tumors. All management decisions regarding the neoplasm must consider the health of the expectant mother, the health of the fetus, the neurological and medical complications due to the brain tumor, and the potential effect that the brain tumor has on the patient’s survival.
Movement Disorders in Pregnancy
Authors: Adams Jamie L. , Tarolli Christopher G.
Published: June 2018

Movement disorders occurring in women of childbearing age or arising during pregnancy are uncommon. However, advancing maternal age increases the likelihood for a pregnant women to have a preexisting movement disorder. Studies are limited regarding the effects of movement disorders and their treatment on pregnancy or the effects of pregnancy on preexisting movement disorders. More research is needed to provide better evidence-based guidelines. Still, there are special considerations when encountering movement disorders in this population, particularly with regard to diagnostic investigation and the safety of medications.
Seizure Medications Effects on Fetus, Neonate, and Lactation
Authors: Lynch Tara A. , Glantz J. Christopher
Published: June 2018

Medication use in pregnancy requires a careful balance between the risks of fetal teratogenicity and the maternal benefits of disease treatment. For women with epilepsy, there are many antiepileptic medications available for use in pregnancy. Each varies in their safety profile, risk for fetal anomalies, and effectiveness of seizure control. In most scenarios, the benefits of maternal treatment outweigh the risk of fetal effects, especially in cases of refractory epilepsy or severe disease. Many of the newer anti-epileptic drugs appear to have less teratogenic risk than the older medications. The ideal AED is one that is effective from the woman, is least teratogenic, and used at the lowest possible dose. Overall, a detailed understanding of antiepileptic efficacy, the pharmacologic differences in pregnancy, and the potential adverse fetal effects are required for optimal treatment of pregnant patients with epilepsy.
Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy in Pregnancy
Authors: Thaisetthawatkul Pariwat , Logigian Eric
Published: June 2018

Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) are both immune-mediated diseases of the peripheral nervous system that typically present with symmetric, progressive muscle weakness, areflexia, and sensory symptoms or signs. GBS evolves rapidly with a nadir at 2–4 weeks usually with an antecedent viral illness, while CIDP progresses more slowly over months to years. GBS is sometimes complicated by life-threatening respiratory failure or dysautonomia. Onset of GBS and relapse of CIDP can occur during pregnancy or postpartum. But with appropriate supportive care and immunotherapy, maternal and fetal outcome in both conditions is typically excellent. The exception is fetal outcome in GBS triggered by maternal CMV or Zika infection transmitted to the fetus. Full-term vaginal delivery and regional anesthesia are preferred in maternal GBS and CIDP, but if C-section and general anesthesia are indicated, non-depolarizing agents such as succinylcholine should be avoided.
ADHD brain function
Authors: Rubia Katya
Published: June 2018

ADHD patients appear to have complex multisystem impairments in several cognitive-domain dissociated inferior, dorsolateral, and medial fronto-striato-parietal and frontocerebellar neural networks during inhibition, attention, working memory, and timing functions. There is emerging evidence for abnormalities in motivation and affect control regions, most prominently in ventral striatum, but also orbital/ventromedial frontolimbic areas. Furthermore, there is an immature interrelationship between hypoengaged task-positive cognitive control networks and a poorly ‘switched off’ default mode network, both of which impact performance. Stimulant medication enhances the activation of inferior frontostriatal systems, while atomoxetine appears to have more pronounced effects on the dorsal attention network. More studies are needed to understand the neurofunctional correlates of the effects of age, gender, ADHD subtypes, and comorbidities with other psychiatric conditions. The use of pattern recognition analyses applied to imaging to make individual diagnostic or prognostic predictions are promising and will be the challenge over the next decade.
Current diagnostic criteria
Authors: Rohde Luis Augusto , Kieling Christian , Salum Giovanni Abrahão
Published: June 2018

In this chapter we describe the history of ADHD diagnosis and how it is currently conceptualized in two main classificatory manuals: the Diagnostic and Statistical Manual for the Mental Disorders (DSM) and the International Classification of Diseases (ICD). We also outline differences between DSM and ICD manuals and review discussions in the realm of the 11th edition of the ICD, in its journey to increase clinical utility. Lastly, we discuss the research domain criteria and how this initiative might affect ADHD diagnosis in the future. We conclude by offering a perspective that acknowledges both the limitations of our current classificatory systems, but also points out their paramount importance to clinical practice. ADHD, as currently defined by DSM and ICD, is a well validated clinical category and a useful diagnosis for communication among practitioners, researchers, and for selecting treatments and care for patients.
Quality of life and impairment in ADHD
Authors: Mulraney Melissa , Coghill David
Published: June 2018

The chapter ‘Quality of life and impairment in ADHD’ provides an overview of what is known about quality of life (QoL) and functional impairment in children with ADHD. The chapter begins by discussing definitions of QoL and functional impairment and how these have been measured in children with ADHD. It reviews the literature comparing how QoL in ADHD compares to QoL in other chronic health conditions, and examines factors known to influence QoL and functioning in children with ADHD. It also reviews the evidence for the impact of treatment on QoL and functioning, with specific discussion of the most common ADHD medications (i.e. methylphenidate, amphetamines, and atomoxetine). The chapter concludes with suggestions for future research.
Adult ADHD and employment
Authors: Adamou Marios
Published: June 2018

ADHD affects in a distinctive way the employment of service users. This can range from their choice of work, work performance, fitness for work, and requirements for adjustments to the workplace. Task performance, contextual performance, counterproductive work behaviour, and adaptive performance have been linked behind this impairment, and the fitness to work assessment needs to consider both the person with ADHD and the specific job the person is doing. The most evidence-based workplace intervention is treatment of ADHD with medication, although other strategies can be helpful. This, however, does not apply to every person with ADHD and many people are successfully employed.
ADHD and communication disorders
Authors: Tannock Rosemary
Published: June 2018

ADHD and communication disorders are both common neurodevelopmental disorders that often co-occur. Comorbidity (i.e. co-occurrence or two or more disorders in a person) is potentially important for the theory, the underlying aetiology, treatment, and prevention of the disorders. This chapter first reviews the extent of co-occurrence between ADHD and various subtypes of communication disorders (language disorders, speech sound disorders, social pragmatic communication disorders), along with their clinical manifestation. Next, the extant evidence to support or refute various models of comorbidity (i.e. artifactual versus non-artifactual) is reviewed and critiqued. The chapter concludes with a discussion of the implications of co-occurring communication disorders and ADHD for the clinical assessment and management of ADHD.
ADHD treatment
Authors: Zuddas Alessandro , Banaschewski Tobias , Coghill David , Stein Mark A.
Published: June 2018

Stimulants are effective medications and should be used as one of the main pharmacological options for the management of ADHD in children, adolescents, and adults. They all inhibit catecholamine uptake, but they differ for specific aspects of the mechanism of action, pharmacokinetics, as well as on efficacy for specific patients. Short-term efficacy in reducing ADHD symptoms is well established, as is the safety profile for these agents. There is increasing evidence that ADHD symptom improvement generally translates or corresponds to improved functioning and quality of life. Stimulant treatment should be based on a comprehensive assessment and diagnosis, including full medical history and physical examination, and it should always be part of a comprehensive treatment plan that includes psychological, behavioural, and educational advice and interventions. Medication treatment should be closely monitored for both common and unusual (but potentially serious) adverse events.
Ethosuximide
Authors: Cavanna Andrea E.
Published: June 2018

Ethosuximide is a first-generation antiepileptic drug characterized by few antiepileptic indications, with acceptable interaction profile in polytherapy. Ethosuximide has a good behavioural tolerability profile, but no approved indications or clinical uses in psychiatry. Behavioural adverse effects can sometimes occur following cessation of seizures and normalization of the EEG and resolve with discontinuation of Ethosuximide and seizure recurrence. Specifically, there are reports of psychosis (but no aggression-related behaviours) in adult patients treated with Ethosuximide. Since the psychotic symptoms tend to occur in clear time relation to the Ethosuximide treatment, it seems plausible that they are manifestations of alternative psychosis in the context of forced normalization.
History and Examination of the Spine
Authors: Henjum Maggie , Young Jodi
Published: June 2018

An efficient model for history-taking and physical examination of the spine using a current evidence-based approach provides the foundation for a targeted assessment and treatment plan. Taking a history and examining the cervical, thoracic, and lumbar spine may be complex, especially if the clinician does not use a systematic approach for collecting subjective and objective data. Included in this chapter are best evidence strategies for observing a patient’s posture and movement patterns, assessing active and passive range of motion, and performing neurologic testing, strength testing, special tests, and palpation. Special attention is given to test clusters and examination items with strong psychometric properties that provide efficient and accurate examination results. By incorporating these strategies into the history and examination, the examiner should be able to rule in or out particular diagnoses that will direct overall management of the patient’s symptoms.
Degenerative Conditions of the Cervical Spine
Authors: Overley Samuel C. , Leven Dante , Kumar Abhishek , Qureshi Sheeraz A.
Published: June 2018

Degenerative disease of the cervical spine, also referred to as cervical spondylosis, is one of the most common pathologies encountered by spine specialists. This degenerative condition is primarily attributed to the natural aging process. However, a subset of patients may exhibit symptoms ranging from axial neck pain to radiculopathy to florid signs of myelopathy. A sound understanding of the spinal anatomy, pathology, patient presentation and treatment options, including surgical intervention, is paramount to evaluating and treating a patient with cervical spondylosis. This chapter focuses on the disease process, its natural history, patient characteristics, and treatment options for one of the most prevalent and potentially problematic spinal pathologies: the degenerative cervical spine.
Sympathetic Blockade of the Spine
Authors: DiMuro John M. , Desai Mehul J.
Published: June 2018

This chapter focuses on the typical pain complaints and their appropriateness for sympathetic blockade and neurolysis. Anatomic considerations, block technique, associated risks, and evidence of a successful block are covered for the stellate ganglion block, T2 sympathetic block, thoracic splanchnic block, celiac plexus block, superior hypogastric plexus block, and ganglion of impar block. Sympathetic blockade is commonly used for visceral pain syndromes. Visceral pain syndromes typically are not responsive to neuraxial blocks as well as conventional rehabilitative and pharmacologic treatments. Spinal sympathetic techniques involve careful prevertebral needle placement, typically using fluoroscopic guidance. The proximity of major vessels near the target injection area is the primary risk of these techniques. In general, sympathetic blocks are non-diagnostic, but they can still help determine whether a sympathetically mediated pain condition may be present and if sympatholysis may be an effective treatment option.
Foot‐and‐mouth disease virus nonstructural protein 2B interacts with cyclophilin A, modulating virus replication
Authors: Liu Huisheng , Xue Qiao , Cao Weijun , Yang Fan , Ma Linna , Liu Wenjie , Zhang Keshan , Liu Xiangtao , Zhu Zixiang , Zheng Haixue
Published: June 2018

Foot‐and‐mouth disease (FMD) is a highly contagious virus that affects cloven‐hoofed animals. To understand better the role of nonstructural protein 2B of the causative agent FMD virus (FMDV) in the process of virus replication, we identified a porcine host protein, cyclophilin A (CypA), which interacts with FMDV 2B. The 2B‐CypA interaction was confirmed by coimmunoprecipitation and GST pull‐down assays. CypA showed antiviral functions during FMDV infection. Overexpression of CypA decreased FMDV leader protein (Lpro) and 3A at protein levels. CypA‐induced reduction of Lpro enhanced the synthesis of host proteins and increased the integrality of host eukaryotic translation initiation factor (eIF)‐4γ (eIF4G). The reduction of Lpro and 3A was dependent on the proteasome pathway. No interaction was identified between CypA and Lpro or 3A. However, CypA‐induced reduction of Lpro and 3A was suppressed by 2B, and disruption of 2B‐CypA interaction impaired this inhibitive effect induced by 2B. In summary, our findings identify the antiviral role of CypA against FMDV and provide key insights into how FMDV antagonizes host antiviral response by 2B protein.—Liu, H., Xue, Q., Cao, W., Yang, F., Ma, L., Liu, W., Zhang, K., Liu, X., Zhu, Z., Zheng, H. Foot‐and‐mouth disease virus nonstructural protein 2B interacts with cyclophilin A, modulating virus replication. FASEB J. 32, 6706–6723 (2018). www.fasebj.org