bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Synthetic Osteoconductive Bone Graft Material for Augmentation of Internally Fixed Unstable Trochanteric Fractures
Authors: Park Jin , Shin Jung Min , Lee Do Kyung , Lee Sung-Sahn , Paik Seung Ha , Lee Byung Hoon
Published: March 2019

This study aimed to evaluate whether the augmentation of CaP into the femoral head around the lag screw results in superior clinical and radiological outcomes of treatment of unstable trochanteric fractures using an intramedullary (IM) implant. Fifty-six consecutive patients with unstable trochanteric fractures who had been surgically treated with IM devices between 2014 and 2016 were prospectively reviewed and randomly divided into two groups based on the use of CaP degradable cements: 28 patients were assigned to the CaP group, while the other 28 patients were assigned to the control group (no use of CaP). Clinical evaluations and radiological analyses were conducted during a minimum of 2-year follow-up. No significant differences in the mean visual analogue scale for the hip pain scores and modified Harris Hip Scores were found between the CaP group and the controls at postoperative 2 months and 2 years. However, earlier walker ambulation was possible in the CaP group (10 ± 9 days) compared to the control group (13 ± 12 days) (P = 0.02). In radiological analysis, the CaP group showed significantly lower difference between tip-apex distance measured immediately after surgery and that measured at one-year follow-up compared to the control group (P = 0.012). No screw cut-out occurred in the CaP group, while one patient in the control group was reoperated for screw cut-out. The CaP augmentation into the femoral head around lag screw can reduce lag screw penetration, prevent screw cut-out beyond the femoral head, and facilitate early ambulation in elderly patients with unstable trochanteric fractures.
Exosomes from Human Umbilical Cord Mesenchymal Stem Cells Reduce Damage from Oxidative Stress and the Epithelial-Mesenchymal Transition in Renal Epithelial Cells Exposed to Oxalate and Calcium Oxalate Monohydrate
Authors: Li Dian , Zhang Dan , Tang Bo , Zhou Yue , Guo Wenhao , Kang Qing , Wang Zhang , Shen Lianju , Wei Guanghui , He Dawei
Published: March 2019

Objective. To investigate whether exosomes from human umbilical cord mesenchymal stem cells (hUC-MSCs) can protect against the toxic effects of oxalate and calcium oxalate monohydrate (COM) crystals in human proximal tubular epithelial (HK-2) cells. Methods. Exosomes were isolated from hUC-MSCs, purified by ultracentrifugation, and verified by examination of cell morphology using transmission electron microscopy and the presence of specific biomarkers. HK-2 cells received 1 of 4 treatments: control (cells alone), hUC-MSC exosomes, oxalate+COM, or oxalate+COM and hUC-MSC exosomes. Cell viability was determined using the MTT assay. Oxidative stress was determined by measuring LDH activity and the levels of H2O2, malondialdehyde (MDA), and reactive oxygen species (ROS). Expressions of N-cadherin, TGF-β, and ZO-1 were determined by immunofluorescence. Expressions of epithelial markers, mesenchymal markers, and related signaling pathway proteins were determined by western blotting. Results. After 48 h, cells in the oxalate+COM group lost their adhesion, appeared long, spindle-shaped, and scattered, and the number of cells had significantly decreased. The oxalate+COM treatment also upregulated TGF-β and mesenchymal markers, downregulated epithelial markers, increased the levels of LDH, H2O2, MDA, and ROS, decreased cell viability, and increased cell migration. The isolated exosomes had double-layer membranes, had hollow, circular, or elliptical shapes, had diameters mostly between 30 and 100 nm, and expressed CD9, CD63, and Alix. Treatment of HK-2 cells with hUC-MSC exosomes reversed or partly reversed all the effects of oxalate+COM. Conclusions. Exosomes from hUC-MSCs alleviate the oxidative injury and the epithelial-mesenchymal transformation of HK-2 cells that is induced by oxalate+COM.
Evaluation of Retinal Pigment Epithelial Cell Cytotoxicity of Recombinant Tissue Plasminogen Activator Using Human-Induced Pluripotent Stem Cells
Authors: Kamao Hiroyuki , Miki Atsushi , Kiryu Junichi
Published: March 2019

Purpose. The evaluation of drug-induced cytotoxicity is of great importance for the clinical application of pharmaceutical products, and human-induced pluripotent stem cells (hiPSCs) have received considerable scrutiny as a cell source for in vitro cytotoxicity testing. The aim of this study is to validate the concept of cytotoxicity testing using hiPSC-derived retinal pigment epithelium (hiPSC-RPE) by comparing the responsiveness of human fetal RPE (hfRPE) and human RPE cell line (ARPE19) to recombinant tissue plasminogen activator (rtPA). Methods. HfRPE, two types of hiPSC-RPE, and ARPE19 were cultured in media with or without rtPA. A lactate dehydrogenase release assay was performed to investigate the dose- and time-dependent effects of rtPA on cell death. RPE function was evaluated by measuring the secretion of pigment epithelium-derived factor (PEDF) and vascular endothelial growth factor (VEGF) and RPE-specific gene expression. Results. Rates of cell damage in hfRPE and both hiPS-RPE were increased by rtPA supplementation (2000 and 4000 μg/ml) for 1 hour, whereas ARPE19 cell damage was increased by supplementation with rtPA at concentrations higher than 50 μg/ml. Although 100 μg/ml rtPA for 24 hours did not affect RPE cell function, sustained rtPA exposure induced prolonged cytotoxic effects in hfRPE and two hiPSC-RPE, but not ARPE19. Conclusion. The responsiveness of hiPSC-RPE to rtPA is similar to that of hfRPE in terms of cell death and cell function. Thus, hiPSC-RPE is a valuable cell source for in vitro cytotoxicity testing.
Splenic Artery Aneurysm Case Report
Authors: Abhari Pouya , Abhari Sina , Jackson Anwar , Moustafa Ahmed S. Z. , Mercer Leo , Ashraf Mohammad
Published: March 2019

Splenic artery aneurysm rupture is a rare complication of pregnancy with very high maternal and fetal mortality rate. In this paper, a case of splenic artery aneurysm rupture at 34 weeks of gestation with both maternal and fetal survival is presented.
Target Recognition and Localization of Mobile Robot with Monocular PTZ Camera
Authors: Wang Hongxing , Li Ruifeng , Gao Yunfeng , Cao Chuqing , Ge Lianzheng , Xie Xiong
Published: March 2019

The target recognition and location based on the vision sensor is a kind of more intuitive and effective method. The paper designs a human mobile robot and the monocular PTZ camera fixed on the differential driver of the mobile robot for the target recognition and localization. The camera parameters are calibrated using the Zhang Zhengyou calibration method; target recognition is based on the combination of the color and the edge detection. First, the objects with the same color are extracted by the color recognition method (by setting an appropriate threshold value for the HSV color space of the acquired image). Then the target is further extracted by the edge detection (by Hough circle transformation); target location is based on the Similar Triangle Principle because the PTZ camera has pitch, tilt, and zoom characteristics and the monocular vision sensor of the camera with different pitching angles is used to measure the distance between the robot and the target. According to the characteristics of the monocular PTZ camera the mobile robot realizes the target localization and tracking. The simulation and experimental results demonstrate that the mobile robot shows better target recognition and localization in mobile tracking target process and proves the effectiveness of the method.
Influence of Different Chromatographic Conditions on the Level of Detection and Quantitation of Spironolactone by means of TLC-Densitometry
Authors: Dołowy Małgorzata
Published: March 2019

The aim of this study was to estimate the influence of different chromatographic conditions on the limits of detection and limits of quantitation (LODs and LOQs) of spironolactone by means of TLC-densitometry under different chromatographic conditions. A comparison of results obtained showed that the choice of appropriate chromatographic conditions for NP-TLC and RP-TLC analysis with densitometry could effectively decrease the LODs and LOQs of spironolactone. Of all chromatographic systems tested, the best was the one comprising chromatographic plates precoated with a mixture of silica gel 60, kieselguhr F254, and mobile phase A (n-hexane-ethyl acetate-glacial acetic acid, 24.5 : 24.5 : 1, v/v/v). The estimated average LOD and LOQ values were 0.034 and 0.103 μg/spot, respectively. This indicates that the described procedure is sufficiently sensitive for the identification and quantification of spironolactone alone. Thereby, the simple and cost-effective TLC-densitometric method can be utilized for the routine quality control of spironolactone in bulk drugs as well as in simple pharmaceutical formulations.
Potential Role of lncRNA H19 as a Cancer Biomarker in Human Cancers Detection and Diagnosis: A Pooled Analysis Based on 1585 Subjects
Authors: Liu Yuhan , He Anbang , Liu Baoer , Huang Zhengxian , Mei Hongbing
Published: March 2019

Long noncoding RNAs (lncRNAs) have been reported to serve as diagnostic and prognostic biomarkers of cancers, which play vital roles in tumorigenesis and tumor progression. Several studies have been performed to explore diagnostic value of lncRNA H19 in cancer detection and diagnosis. However, there are still inconsistent results in diagnostic accuracy and reliability in individual studies. Therefore, the present study was performed to summarize the overall diagnostic performance of lncRNA H19 in cancer detection and diagnosis. A total of eight studies with 770 cases and 815 controls were included in this pooled analysis. The pooled diagnostic results were as follows: sensitivity, 0.69 (95%CI=0.62-0.76), specificity, 0.79 (95% CI=0.70-0.86), positive likelihood ratio (PLR), 3.31 (95%CI=2.29-4.78), negative likelihood (NLR), 0.39 (95%CI=0.31-0.49), diagnostic odds ratio (DOR), 8.53 (95%CI=4.99-14.60), and area under the curve (AUC), 0.79 (95%CI=0.76-0.83). Deeks’ funnel plot asymmetry test (P=0.13) suggested no potential publication bias. Our results indicated that lncRNA H19 had a relatively moderate accuracy in cancer detection and diagnosis. Further comprehensive prospective studies with large sample sizes are urgently required to validate our findings.
What Do NICU Fellows Identify as Important for Achieving Competency in Neonatal Intubation?
Authors: Brady Jennifer , Kovatis Kelley , O'Dea Carol Lynn , Gray Megan , Ades Anne
Published: March 2019

Background: Tracheal intubation (TI) is one of the most important interventions for the stabilization of critically ill neonates. Competency in airway management is essential for neonatal fellows. No studies have assessed which educational models, techniques, or instructions are perceived by neonatal fellows as the most beneficial for achieving competency in TI. Objectives: This study identifies which factors are considered most helpful in achieving intubation competency. Method: This was a mixed-method study. Semi-structured phone interviews addressed training experience for neonatal intubation. Through qualitative analysis, common themes were identified. RedCap electronic surveys and procedure logs were used to assess procedural experience. Results: Forty-two fellows from 5 programs completed phone interviews. Fellows recalled 6–10 intubation attempts before fellowship. Independent statements related to achieving intubation competency were analyzed and coded into 5 main themes (Procedure, Practice, Perceptual Environment, Personnel, and Preparation). A large proportion of the statements focused on the use of video laryngoscopy. Conclusions: The themes identified by neonatal-perinatal medicine (NPM) fellows as being the most beneficial in achieving proficiency in neonatal TI are categorized as “The 5 Ps.” Careful review of these themes may be utilized to develop validated curriculums that enhance the teaching of TI and optimize the achievement of TI competency among NPM fellows.
Impact of Education on Hypothermia Delivery during Neonatal Transport
Authors: Saito-Benz Maria , Cody Sarah , Dineen Fiona , Mladenovic Jelena , Berry Mary J.
Published: March 2019

Background: Moderate therapeutic hypothermia (TH) initiated within 6 h of life reduces adverse neurodevelopmental outcomes in infants after perinatal hypoxic ischaemic insult. For infants born in non-tertiary centres, TH may be initiated manually en route to a neonatal intensive care unit (NICU). However, both over- and undercooling is reported with this strategy, precluding some infants from the benefits of TH. Objectives: To evaluate the impact of a region-wide educational programme on the safety and efficacy of manual cooling administered by the Wellington Neonatal Transport Service (NeTS). Methods: Clinical records of infants with hypoxic ischaemic encephalopathy (HIE) retrieved by the Wellington NeTS for TH between January 2012 and June 2017 were reviewed retrospectively. Temperature outcomes of infants retrieved before and after the education programme were compared. Results: A total of 101 infants were cooled manually by Wellington NeTS for TH during the study period. Education and training significantly reduced the rate of overcooling to ≤32.0°C (4/43 [9%] vs. 0/58, p = 0.02). However, there was no difference in the proportion of infants who achieved target rectal temperature within 6 h of life (29/43 [65%] vs. 35/58 [60%], p = 0.57). Conclusions: Introduction of a region-wide educational programme may have improved the safety of manual cooling during neonatal transport but it had a negligible impact on its efficacy. The use of servo-controlled cooling during transport should therefore be considered to improve access to the optimal neuroprotective benefits of TH for outborn infants with HIE.
A Practical Guide to the Role of Ancillary Techniques in the Diagnosis of Infectious Agents in Fine Needle Aspiration Samples
Authors: Glaser Laurel J. , Montone Kathleen T.
Published: March 2019

Fine needle aspiration samples and small biopsies provide a minimally invasive diagnostic modality for mass lesions. When an infectious process is suspected based on initial evaluation, ancillary techniques can assist in making a specific diagnosis. Here we review the cytopathology that should prompt additional testing and review the availability and interpretation of special stains, immunohistochemistry, and in situ hybridization. In addition, this review addresses when special cultures may be necessary and the use of newer molecular techniques for pathogen identification.
Use of a Simple in vitro Test to Assess Loss of Chemical due to Volatility during an in vitro Human Skin Absorption Study
Authors: Grégoire Sébastien , Cubberley Richard , Duplan Hélène , Eilstein Joan , Hewitt Nicola J. , Jacques-Jamin Carine , Genies Camille , Klaric Martina , Rothe Helga , Ellison Corie , Fernandez Julien , Schepky Andreas
Published: March 2019

Background: We tested the cutaneous distribution of 50 chemicals in frozen human skin. The mass balance (MB) values for 48% of the chemicals were < 90%, possibly due to evaporation. Methods: We confirmed the reduction in MB was due to evaporation for two chemicals tested in skin penetration experiments using a carbon filter above the skin to trap airborne chemical. An in vitro assay was used to predict the reduction in MB due to evaporation by comparing the recovery of chemicals after 4 h of incubation at room temperature in open and closed vials. Results: Evaporative losses in vitro correlated well with measured MBs (i.e., < 90%) in skin penetration experiments (R2 = 0.81). There was a correlation of the MB with the vapour pressure (VP) which could be used to group chemicals according to their likelihood to evaporate during the course of a skin penetration study. There was also a correlation of MB with Henry’s law constants, melting and boiling points. Conclusion: Our data support the use of a quick and simple test for volatility to account for the loss of MB in skin penetration experiment due to volatility. The best parameter to indicate the potential of a chemical to evaporate is the VP.
No Gender Differences in Long-Term Survival after Brachytherapy of 1,541 Patients with Uveal Melanoma
Authors: Stålhammar Gustav , See Thonnie Rose , Filì Maria , Seregard Stefan
Published: March 2019

Background: In several malignancies, gender-based survival differences after specific therapeutic interventions have been demonstrated. It is not known whether such differences exist after plaque brachytherapy of uveal melanoma. Methods: All patients who received brachytherapy for uveal melanoma at St. Erik Eye Hospital from November 1, 1979 through November 20, 2017 were included (n = 1,541). Retrospective data were retrieved including baseline patient and tumor characteristics, brachytherapy nuclide (ruthenium-106 or iodine-125), radiation dose, treatment duration, tumor relapses, date of metastasis, and cause of death. Results: A total of 775 men and 766 women were treated with plaque brachytherapy. There were no significant differences between the genders in baseline characteristics, treatment, or follow-up. Men and women had similar rates of tumor relapses, hazard for repeated brachytherapy (men vs. women 0.8, p = 0.47), enucleation-free survival, and survival after detection of metastasis. Five-, 10-, and 15-year melanoma-related mortality was 14, 24, and 27% for men and 15, 26, and 32% for women, respectively. There were no significant differences in hazard for melanoma-related mortality (men vs. women 0.9, p = 0.32), median Kaplan-Meier disease-specific survival (men 18.2 years, women 15.5 years, p = 0.22), or median overall survival (men 13.5 years, women 12.6 years, p = 0.60). Conclusion: There are no relevant differences between men and women in ocular or patient survival after brachytherapy for uveal melanoma.
The Study of Psychopathology from the Network Analysis Perspective: A Systematic Review
Authors: Contreras Alba , Nieto Ines , Valiente Carmen , Espinosa Regina , Vazquez Carmelo
Published: March 2019

Background: Network analysis (NA) is an analytical tool that allows one to explore the map of connections and eventual dynamic influences among symptoms and other elements of mental disorders. In recent years, the use of NA in psychopathology has rapidly grown, which calls for a systematic and critical analysis of its clinical utility. Methods: Following PRISMA guidelines, a systematic review of published empirical studies applying NA in psychopathology, between 2010 and 2017, was conducted. We included the literature published in PubMed and PsycINFO using as keywords any combination of “network analysis” with the terms “anxiety,” “affective disorders,” “depression,” “schizophrenia,” “psychosis,” “personality disorders,” “substance abuse” and “psychopathology.” Results: The review showed that NA has been applied in a plethora of mental disorders in adults (i.e., 13 studies on anxiety disorders; 19 on mood disorders; 7 on psychosis; 1 on substance abuse; 1 on borderline personality disorder; 18 on the association of symptoms between disorders), and 6 on childhood and adolescence. Conclusions: A critical examination of the results of each study suggests that NA helps to identify, in an innovative way, important aspects of psychopathology like the centrality of the symptoms in a given disorder as well as the mutual dynamics among symptoms. Yet, despite these promising results, the clinical utility of NA is still uncertain as there are important limitations on the analytic procedures (e.g., reliability of indices), the type of data included (e.g., typically restricted to secondary analysis of already published data), and ultimately, the psychometric and clinical validity of the results.
Gallbladder Metastases: A Report of Two Cases
Authors: Mouchli Mohamad , Grider Douglas J. , Yeaton Paul
Published: March 2019

Introduction: Metastasis to the gallbladder is not common and usually manifests an advanced stage of malignancy. Herein, we report a case of triple negative high grade invasive ductal carcinoma of breast with a metastatic lesion to the gallbladder. Case Presentation: The patient is a 52-year-old female diagnosed with invasive ductal carcinoma treated with mastectomy and chemotherapy. After 12 months, she presented to the emergency department with right upper quadrant pain and elevated liver chemistries. Abdominal enhanced computed tomography showed periportal and gallbladder wall edema. After cholecystectomy, the resected gallbladder was histologically considered to be a metastatic lesion arising from the primary lung cancer. The second case describes a case of a 77-year-old woman with multiple co-morbidities who presented to the hospital with sepsis secondary to biliary source. Abdominal enhanced computed tomography findings were concerning for acute cholecystitis. After cholecystectomy, the pathology of the resected gallbladder demonstrated cholecystitis and plasmacytoma. Conclusion: The atypical presentation of gallbladder metastases could mislead treating providers. The diagnosis might alter management decisions and prognosis.
Hemolytic Uremic Syndrome in an Infant with Primary Hyperoxaluria Type II: An Unreported Clinical Association
Authors: Valoti Elisabetta , Alberti Marta , Carrara Camillo , Breno Matteo , Yilmaz Keskin Ebru , Bresin Elena , Cuccarolo Paola , Açikgöz Yonca , Benigni Ariela , Noris Marina , Remuzzi Giuseppe , Mele Caterina
Published: March 2019

A 6-month-old boy presented with acute renal failure, thrombocytopenia, and severe non-immune hemolytic anemia. Infection by Shiga-like toxin-producing Escherichia coli and other causes of microangiopathic hemolysis were ruled out, leading to a diagnosis of atypical hemolytic uremic syndrome (aHUS). Neither pathogenic variants in HUS-associated genes nor anti-factor H antibodies were identified. Copy number variation analysis uncovered 4 copies of complement factor H related genes, CFHR1-CFHR4, conceivably leading to higher than normal levels of the corresponding proteins. However, this abnormality was also found in the healthy relatives, neither explaining the disease nor the excessive complement deposition on endothelial cells detected by an ex-vivo test. Whole-exome sequencing revealed a pathogenic homozygous variant in GRHPR encoding the glyoxylate and hydroxypyruvate reductase. Recessive GRHPR mutations cause primary hyperoxaluria type 2 (PH2). The presence of renal calculi in the patient and elevated oxalate levels in the urine were consistent with the genetic diagnosis of PH2. We hypothesize that, in this patient, hyperoxaluria caused by the GRHPR genetic defect triggered endothelial perturbation and complement activation, which was amplified by impaired factor H regulatory activity due to the increased ­CFHR1-CFHR4 copy numbers, resulting in aHUS.
Learning Effect of Diagnosing Depth of Invasion Using Non-Extension Sign in Early Gastric Cancer
Authors: Takeda Teruyuki , So Suketo , Sakurai Toshihiro , Nakamura Shigeo , Yoshikawa Ichiro , Yada Shinichiro , Itaba Soichi , Yamagata Hajime , Akiho Hirotada , Takatsu Noritaka , Wada Yoko , Ohtsu Kensei , Nagahama Takashi , Yao Kenshi
Published: March 2019

Background: Determining the depth of invasion is important when considering therapeutic strategies for early gastric cancer (EGC). We determined the effects of learning the non-extension sign, that is, an index of T1b2 in EGC, on identifying its depth of invasion. Methods: Endoscopic images of 40 EGC cases (20 showing positive non-extension sign on endoscopy as T1b2 and 20 showing negative non-extension sign on endoscopy as T1a-T1b1) were randomly displayed on PowerPoint. Participants read endoscopy findings (pretest) and attended a 60-min lecture on how to read the non-extension sign. Then, they read the same images using the non-extension sign as the marker (posttest). The primary endpoint was a change in accuracy rate for determining the depth of invasion before and after attending the lecture, for nonexperts (< 80%). Results: Among 35 endoscopists, 12 were nonexperts; their test results were used for analyses. Accuracy rates for pretest and posttest among nonexperts were 75.2 and 82.5%, respectively, showing a significant increase in the accuracy rate after learning to read the non-extension sign (p = 0.003). Conclusion: Nonexperts’ diagnostic ability to determine the depth of invasion of EGC improved by learning to read the non-extension sign. Thus, the non-extension sign is considered a simple and useful diagnostic marker.
How We Treat Autoimmune Small Fiber Polyneuropathy with Immunoglobulin Therapy
Authors: Schofield Jill R. , Chemali Kamal R.
Published: March 2019

Intravenous immunoglobulin therapy is FDA approved for the immune-mediated peripheral nerve disorders Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. Immunoglobulin therapy has been used increasingly with significant efficacy in the treatment of patients with disabling autoimmune forms of dysautonomia, which are most often small fiber (autonomic and/or sensory) polyneuropathies. It is recognized by most who treat these disorders, however, that patients with autonomic dysfunction treated with intravenous immunoglobulin therapy develop aseptic meningitis or severe lingering headache more frequently than other patient populations when this therapy is dosed in the traditional fashion. We discuss our combined 27 years of experience with the use of immunoglobulin and other immune modulatory therapy in patients with autoimmune small fiber polyneuropathy.
Discrete Papular Lichen Myxedematosus and Scleromyxedema with Hypothyroidism: A Report of Two Cases
Authors: Shenoy Adele , Steixner Jacklyn , Beltrani Vincent , Gottlieb Alice
Published: March 2019

Scleromyxedema and lichen myxedematosus (LM) are rare disorders that fall along the spectrum of primary cutaneous mucinoses. Scleromyxedema is a systemic form that classically presents with generalized waxy papules, sclerodermoid eruption, and monoclonal gammopathy; LM is a localized form limited to the skin that classically presents with white, firm, waxy papules and lacks monoclonal gammopathy. According to diagnostic criteria established in 2001, the diagnosis of both conditions requires absence of thyroid disease. However, atypical cases that lack monoclonal gammopathy and that present with hypothyroidism have been reported, suggesting that these criteria may require revision. First, we report a case of a 58-year-old female with a history of Hashimoto thyroiditis and biopsy-proven scleromyxedema responsive to intravenous immunoglobulin therapy with delayed presentation of monoclonal gammopathy. Next, we report a case of a 54-year-old female with a history of hypothyroidism, Hodgkin’s lymphoma in remission after radiation and chemotherapy, and concurrent rheumatoid arthritis, with biopsy-proven LM temporarily responsive to systemic steroids. Our cases demonstrate that patients with papular mucinoses can have a multitude of concurrent and prior rheumatologic and endocrine conditions, including thyroid disease, which should not preclude a diagnosis of scleromyxedema and LM.
Combined Single-Step Procedure for Correction of Silent Sinus Syndrome
Authors: Arnon Roee , Gluck Ofer , Winter Halit , Pikkel Joseph , Rubinov Avi
Published: March 2019

Silent sinus syndrome (SSS) is a rare condition characterized by enophthalmos and hypoglobus that is generally not related to trauma or surgery. We present a 30-year-old man who noticed facial asymmetry during the previous month and was referred to our oculoplastic clinic. His examination revealed right hypoglobus and a 2-mm right enophthalmos. The diagnosis of right SSS was confirmed by orbital and paranasal computed tomography scan. The patient had no otolaryngological symptoms and visual acuity was normal bilaterally. He was treated surgically in a combined approach by a team of oculoplastic and otorhinolaryngology surgeons. Functional endoscopic sinus surgery included uncinectomy, maxillary antrostomy, and orbitotomy, with insertion of an orbital implant. This case demonstrates that a single-step surgery for correction of enophthalmos secondary to SSS is a viable option, leading to quick rehabilitation and excellent aesthetic results.
Incidence, Risk factors, and Biomarkers Predicting Ischemic or Hemorrhagic Stroke Associated Acute Kidney Injury and Outcome: A Retrospective Study in a General Intensive Care Unit
Authors: Jiang Fang , Su Lianjiu , Xiang Hui , Zhang Xiaoyi , Xu Dongxue , Zhang Zhongxiang , Peng Zhiyong
Published: March 2019

Objective: We investigated the epidemiology, risk factors, and predictive parameters for ischemic or hemorrhagic stroke-associated acute kidney injury (AKI) and mortality in a general intensive care unit (ICU) in China. Methods: During 5 years, 479 stroke patients were screened, and 381 were enrolled. AKI was diagnosed within 7 days after ICU admission, based on the Kidney Disease Improving Global Outcomes criteria. Risk factors of AKI were assessed by Logistic regression analyses, and the predictive biomarkers for AKI were determined using receiver operating characteristic (ROC) curves. Also examined were factors influencing 28-day mortality, using Cox regression analyses and Kaplan-Meier curves. ­Results: Among all, 115 (30.18%) patients developed AKI. Multivariate regression analyses revealed that the following features at ICU admission significantly increased the risk of developing AKI: an increased National Institutes of Health Stroke Scale score (OR 1.136, p < 0.001) and Acute Physiology and Chronic Health Evaluation II score (OR 1.107, p = 0.042); hypertension (OR 2.346, p = 0.008); use of loop diuretics (OR 1.961, p = 0.032); and higher serum cystatin C (sCysC; OR 8.156, p = 0.001). The area under the ROC curves for predicting AKI using sCysC was 0.772, slightly better than that of other biomarkers. The sCysC ≥0.93 mg/L (hazard ratio 1.844, p = 0.004) significantly predicted 28-day mortality. Conclusions: Among stroke patients in ICU, we identified significant risk factors of stroke-associated AKI. Serum CysC level at ICU admission was an important biomarker for predicting AKI and 28-day mortality.
Prevalence of Essential Tremor in the Faroe Islands: A Population-Based Study
Authors: Eliasen Eina H. , Ferrer Monica , Gaini Shahin , Louis Elan D. , Petersen Maria Skaalum
Published: March 2019

Background: No studies of the prevalence of one of the most common movement disorders, essential tremor (ET), have been undertaken in the Faroe Islands. Given the potential for founder effects in the Islands, and the highly genetic nature of ET, the Faroe Islands provide a particularly interesting setting in which to study the prevalence of ET. Objective: To estimate the prevalence of ET and study its characteristics. Methods: We used a 2-phase, population-based design, screening 1,328 randomly selected Faroese individuals aged ≥40 years. A subsample of 282 individuals who had returned the spirals and questionnaire was selected to participate in an in-person clinical evaluation. Tremor was systematically quantified by a senior movement disorder neurologist with particular specialization in tremor using a reliable and valid clinical rating scale followed by the application of rigorous diagnostic criteria used by tremor investigators internationally. Results: The overall crude prevalence was 2.9%. The age-adjusted prevalence was 3.1%. There was an age-associated rise in prevalence; by age ≥70, prevalence reached 4.8%. Twenty six of 27 (96.2%) were previously undiagnosed. Conclusions: This is the first population-based study of the prevalence of ET in the Faroe Islands. The estimated prevalence was similar to studies using the same or comparable methodologies.
Corticosteroid Action in the Brain: The Potential of Selective Receptor Modulation
Authors: Viho Eva M.G. , Buurstede Jacobus C. , Mahfouz Ahmed , Koorneef Lisa L. , van Weert Lisa T.C.M. , Houtman René , Hunt Hazel J. , Kroon Jan , Meijer Onno C.
Published: March 2019

Glucocorticoid hormones have important effects on brain function in the context of acute and chronic stress. Many of these are mediated by the glucocorticoid receptor (GR). GR has transcriptional activity which is highly context-specific and differs between tissues and even between cell types. The outcome of GR-mediated transcription depends on the interactome of associated coregulators. Selective GR modulators (SGRMs) are a class of GR ligands that can be used to activate only a subset of GR-coregulator interactions, thereby giving the possibility to induce a unique combination of agonistic and antagonistic GR properties. We describe SGRM action in animal models of brain function and pathology, and argue for their utility as molecular filters, to characterize context-specific GR interactome and transcriptional activity that are responsible for particular glucocorticoid-driven effects in cognitive processes such as memory consolidation. The ultimate objective of this approach is to identify molecular processes that are responsible for adaptive and maladaptive effects of glucocorticoids in the brain.
Cardiovascular Effects of Treatment With the Ketone Body 3-Hydroxybutyrate in Chronic Heart Failure Patients
Authors: Nielsen Roni , Møller Niels , Gormsen Lars C. , Tolbod Lars Poulsen , Hansson Nils Henrik , Sorensen Jens , Harms Hendrik Johannes , Frøkiær Jørgen , Eiskjaer Hans , Jespersen Nichlas Riise , Mellemkjaer Søren , Lassen Thomas Ravn , Pryds Kasper , Bøtker Hans Erik , Wiggers Henrik
Published: March 2019

Background:

Myocardial utilization of 3-hydroxybutyrate (3-OHB) is increased in patients with heart failure and reduced ejection fraction (HFrEF). However, the cardiovascular effects of increased circulating plasma-3-OHB levels in these patients are unknown. Consequently, the authors’ aim was to modulate circulating 3-OHB levels in HFrEF patients and evaluate: (1) changes in cardiac output (CO); (2) a potential dose-response relationship between 3-OHB levels and CO; (3) the impact on myocardial external energy efficiency (MEE) and oxygen consumption (MVO
2
); and (4) whether the cardiovascular response differed between HFrEF patients and age-matched volunteers.

Methods:

Study 1: 16 chronic HFrEF patients (left ventricular ejection fraction: 37±3%) were randomized in a crossover design to 3-hour of 3-OHB or placebo infusion. Patients were monitored invasively with a Swan-Ganz catheter and with echocardiography. Study 2: In a dose-response study, 8 HFrEF patients were examined at increasing 3-OHB infusion rates. Study 3 to 4: 10 HFrEF patients and 10 age-matched volunteers were randomized in a crossover design to 3-hour 3-OHB or placebo infusion. MEE and MVO
2
were evaluated using 11C-acetate positron emission tomography.

Results:

3-OHB infusion increased circulating levels of plasma 3-OHB from 0.4±0.3 to 3.3±0.4 mM (
P
<0.001). CO rose by 2.0±0.2 L/min (
P
<0.001) because of an increase in stroke volume of 20±2 mL (
P
<0.001) and heart rate of 7±2 beats per minute (bpm) (
P
<0.001). Left ventricular ejection fraction increased 8±1% (
P
<0.001) numerically. There was a dose-response relationship with a significant CO increase of 0.3 L/min already at plasma-3-OHB levels of 0.7 mM (
P
<0.001). 3-OHB increased MVO
2
without altering MEE. The response to 3-OHB infusion in terms of MEE and CO did not differ between HFrEF patents and age-matched volunteers.

Conclusions:

3-OHB has beneficial hemodynamic effects in HFrEF patients without impairing MEE. These beneficial effects are detectable in the physiological concentration range of circulating 3-OHB levels. The hemodynamic effects of 3-OHB were observed in both HFrEF patients and age-matched volunteers. 3-OHB may potentially constitute a novel treatment principle in HFrEF patients.
Time‐Stratified Case Crossover Study of the Association of Outdoor Ambient Air Pollution With the Risk of Acute Myocardial Infarction in the Context of Seasonal Exposure to the Southeast Asian Haze Problem
Authors: Ho Andrew Fu Wah , Zheng Huili , Earnest Arul , Cheong Kang Hao , Pek Pin Pin , Seok Jeon Young , Liu Nan , Kwan Yu Heng , Tan Jack Wei Chieh , Wong Ting Hway , Hausenloy Derek J. , Foo Ling Li , Tan Benjamin Yong Qiang , Ong Marcus Eng Hock
Published: March 2019

Background

Prior studies have demonstrated the association of air pollution with cardiovascular deaths. Singapore experiences seasonal transboundary haze. We investigated the association between air pollution and acute myocardial infarction (
AMI
) incidence in Singapore.

Methods and Results

We performed a time‐stratified case‐crossover study on all
AMI
cases in the Singapore Myocardial Infarction Registry (2010–2015). Exposure on days where
AMI
occurred (case days) were compared with the exposure on days where
AMI
did not occur (control days). Control days were chosen on the same day of the week earlier and later in the same month and year. We fitted conditional Poisson regression models to daily
AMI
incidence to include confounders such as ambient temperature, rainfall, wind‐speed, and Pollutant Standards Index. We assessed relationships between
AMI
incidence and Pollutant Standards Index in the entire cohort and subgroups of individual‐level characteristics. There were 53 948 cases. Each 30‐unit increase in Pollutant Standards Index was association with
AMI
incidence (incidence risk ratio [
IRR
] 1.04, 95%
CI
1.03–1.06). In the subgroup of
ST
‐segment–elevation myocardial infarction the
IRR
was 1.00, 95%
CI
0.98 to 1.03, while for non–ST‐segment–elevation myocardial infarction, the
IRR
was 1.08, 95%
CI
1.05 to 1.10. Subgroup analyses showed generally significant. Moderate/unhealthy Pollutant Standards Index showed association with
AMI
occurrence with
IRR
1.08, 95%
CI
1.05 to 1.11 and
IRR
1.09, 95%
CI
1.01 to 1.18, respectively. Excess risk remained elevated through the day of exposure and for >2 years after.

Conclusions

We found an effect of short‐term air pollution on
AMI
incidence, especially non–ST‐segment–elevation myocardial infarction and inpatient
AMI
. These findings have public health implications for primary prevention and emergency health services during haze.
Statin Therapy Before Transition to End‐Stage Renal Disease With Posttransition Outcomes
Authors: Soohoo Melissa , Moradi Hamid , Obi Yoshitsugu , Rhee Connie M. , Gosmanova Elvira O. , Molnar Miklos Z. , Kashyap Moti L. , Gillen Daniel L. , Kovesdy Csaba P. , Kalantar‐Zadeh Kamyar , Streja Elani
Published: March 2019

Background

Although studies have shown that statin therapy in patients with non–dialysis‐dependent chronic kidney disease was associated with a lower risk of death, this was not observed in dialysis patients newly initiated on statins. It is unclear if statin therapy benefits administered during the predialysis period persist after transitioning to end‐stage renal disease.

Methods and Results

In 47 720 veterans who transitioned to end‐stage renal disease during 2007 to 2014, we examined the association of statin therapy use 1 year before transition with posttransition all‐cause and cardiovascular mortality and hospitalization incidence rates over the first 12 months of follow‐up. Associations were examined using multivariable adjusted Cox proportional hazard models and negative binomial regressions. Sensitivity analyses included propensity score and subgroup analyses. The cohort's mean±
SD
age was 71±11 years, and the cohort included 4% women, 23% blacks, and 66% diabetics. Over 12 months of follow‐up, there were 13 411 deaths, with an incidence rate of 35.3 (95%
CI
, 34.7–35.8) deaths per 100 person‐years. In adjusted models, statin therapy compared with no statin therapy was associated with lower risks of 12‐month all‐cause (hazard ratio [95% CI], 0.79 [0.76–0.82]) and cardiovascular (hazard ratio [95%
CI
], 0.83 [0.78–0.88]) mortality, as well as with a lower rate of hospitalizations (incidence rate ratio [95%
CI
], 0.89 [0.87–0.92]) after initiating dialysis. These lower outcome risks persisted across strata of clinical characteristics, and in propensity score analyses.

Conclusions

Among veterans with non–dialysis‐dependent chronic kidney disease, treatment with statin therapy within the 1 year before transitioning to end‐stage renal disease is associated with favorable early end‐stage renal disease outcomes.
The Effect of Local Labor Market Downturns on Postsecondary Enrollment and Program Choice
Authors: Foote Andrew , Grosz Michel
Published: March 2019

We examine how workers invest in human capital following unanticipated local labor market downturns. We find that, on average, two-year college enrollment increases by three students within three years for every one hundred workers laid off. This rise in enrollment accounts for half the observed increase in labor force nonparticipation following mass layoffs. Completions in career-technical programs also increase, especially in short-term certificates, but vary by field of study. We find the effect on completions is strongest in fields of study with larger earnings returns.
A new acotylean flatworm, Armatoplana colombiana n. sp. (Platyhelminthes: Polycladida: Stylochoplanidae) from the Caribbean coast of Colombia, South America
Authors: BOLAÑOS D. MARCELA , QUIROGA SIGMER Y. , LITVAITIS MARIAN K.
Published: March 2019

Armatoplana colombiana n. sp. (Polycladida: Stylochoplanidae), a new species of acotylean flatworm from Colombia, is described. A. colombiana is characterized by 6–8 fleshy, anterior knobs, short nuchal tentacles, tentacular and cerebral eyes. A strongly muscularized, interpolated prostatic vesicle and a penis armed with a very long stylet places the species into the genus Armatoplana. The female reproductive system is characterized by the presence of a Lang’s vesicle and a sinuous vagina with rigid walls. Type material is deposited at the Museo de Historia Natural Marina de Colombia INVEMAR under INV-PLA 0019 and INV-PLA 0020 HS.
On two new species of Halopteris Allman, 1877 (Cnidaria: Hydrozoa) from Chile
Authors: GALEA HORIA R.
Published: March 2019

Two new species of hydroids, Halopteris enersis sp.nov. and Halopteris schucherti sp.nov., from the Pacific coast of southern Chile are described and figured. Measurements and nematocyst data are provided for each species. Their morphological features are compared with those of other members of the genus, and comparative tables listing their peculiarities are presented.
The name Synallaxis whitneyi Pacheco and Gonzaga, 1995, is not a synonym of Synallaxis cinereus Wied, 1831 (Aves: Passeriformes: Furnariidae)
Authors: STOPIGLIA RENATA , RAPOSO MARCOS A.
Published: March 2019

Synallaxis whitneyi Pacheco and Gonzaga, 1995, was described from specimens collected in Bahia, Brazil. Some years later, following analysis of the specimens used by Wied (1831) to describe Synallaxis cinereus, Whitney and Pacheco (2001) considered S. whitneyi a junior synonym of S. cinereus because three of the specimens in Wied’s series were identical to those collected in Bahia by Pacheco and Gonzaga (1995). They also designated a lectotype for Synallaxis cinereus. Our analysis of the description of Synallaxis cinereus reveals that Wied was merely providing a new name for Parulus ruficeps Spix, 1824, to avoid problems of homonymy (Wied 1831). The International Code of Zoological Nomenclature is explicit in such cases, stating that if an author proposes a new species-group name as a replacement (nomen novum) for an earlier available one, then the two names are objective synonyms and have the same name-bearing type. Thus, the syntypes of S. cinereus are the specimens previously used by Spix in describing Parulus ruficeps and not those used by Wied (1831) in his description (and subsequently referred to as syntypes in the literature). The lectotype of Synallaxis cinereus proposed by Whitney and Pacheco (2001) is invalid, as it is not a former syntype. Therefore, the correct name for the Bahia Spinetail is Synallaxis whitneyi Pacheco and Gonzaga, 1995.
A review of Chinese Phyllocoptes Nalepa (Acari: Eriophyoidea: Eriophyidae: Phyllocoptinae) with descriptions of five new species
Authors: SONG ZI-WEI , XUE XIAO-FENG , HONG XIAO-YUE
Published: March 2019

Five new species of the genus Phyllocoptes Nalepa from China are described: Phyllocoptes euonymusae sp. nov. on Euonymus alatus (Thunb.) Sieb. (Celastraceae); Phyllocoptes asperatae sp. nov. and Phyllocoptes dangchangi sp. nov. on Picea asperata Mast. (Pinaceae); Phyllocoptes japonicae sp. nov. on Lonicera japonica Thunb. (Caprifoliaceae) and Phyllocoptes lyciumi sp. nov. on Lycium chinense Mill. (Solanaceae). All species described here are vagrant on the undersurface of host leaves.
Taxonomic revision of the epigean representatives of the spider subfamily Harpacteinae (Araneae: Dysderidae) on the island of Crete
Authors: CHATZAKI MARIA , ARNEDO MIQUEL A.
Published: March 2019

Here we review the taxonomy of the epigean species of the spider subfamily Harpacteinae (Araneae, Dysderidade) on Crete. Along with the endemic cave-dwelling genus Minotauria, this subfamily is represented on this island by the genera Harpactea and Stalagtia, the last of which is reported for the first time. We describe and illustrate the previously unknown females of Harpacteacressa Brignoli, 1984 and Harpactea coccifera Brignoli, 1984. Furthermore, a new species, Stalagtia thaleriana n. sp., is described and a critical appraisal and a re-delimitation of the current definition of the genus Stalagtia is provided. An identification key, some notes on the ecology (habitat preferences, activity periods) and the distribution of these species on Crete are also given.
Macrobiotus huziori, a new species of Tardigrada (Eutardigrada: Macrobiotidae) from Costa Rica (Central America)
Authors: MICHALCZYK ŁUKASZ , Kaczmarek ŁUKASZ
Published: March 2019

A new species, Macrobiotus huziori sp. nov. is described from moss samples collected in Costa Rica (Central America). The eggs of the new species have a unique, never described before, type of multi-level areolation which makes M. huziori sp. nov. easily distinguishable from all the known species. We also provide SEM pictures revealing the complex structure of the granulation on the legs (each granule consists of many smaller cones/granules).
DNA barcodes: Evaluating the potential of COI to diffentiate closely related species of Elachista (Lepidoptera: Gelechioidea: Elachistidae) from Australia
Authors: KAILA LAURI , STÅHLS GUNILLA
Published: March 2019

We compared DNA barcoding to “traditional” taxonomic tools in clarifying relationships in complexes of closely related, putative “species” of Elachistinae moths (Gelechioidea: Elachistidae) occurring in Australia. A 705 bp fragment of the 3’-end of cytochrome c oxidase subunit I gene (COI) was used. This mtDNA fragment did not differentiate between all species-level taxa that could be defined by morphological and/or ecological differences. Different evolutionary rates of COI among closely related lineages were observed. Although our findings are based on the variability of the 3’ end of the COI gene and not the 5’ end barcode fragment, we are convinced that thorough exploration of traditional morphology and ecology is a prerequisite for exploring insufficiently known taxonomies by the barcode approach. The sole use of COI barcoding, whether considering COI-5’ or COI-3’ fragment, may fail to recognize closely related species. Our results discourage this approach for delimitation of closely related species, but its use is encouraged as an additional tool for exploring little known taxonomies or as an identification tool for previously thoroughly studied species complexes.