bluuebunny/crossref_metadata_2025 huggingface dataset:
Two-loop kite master integral for a correlator of two composite vertices
Authors: Mikhailov S. V. , Volchanskiy N.
Published: January 2019

Abstract

We consider the most general two-loop massless correlator I(n
1
, n
2
, n
3
, n
4
, n
5; x, y; D) of two composite vertices with the Bjorken fractions x and y for arbitrary indices {n

i
} and space-time dimension D; this correlator is represented by a “kite” diagram. The correlator I({n

i
}; x, y; D) is the generating function for any scalar Feynman integrals related to this kind of diagrams. We calculate I({n

i
}; x, y; D) and its Mellin moments in a direct way by evaluating hypergeometric integrals in the α representation. The result for I({n

i
}; x, y; D) is given in terms of a double hypergeometric series — the Kampé de Férriet function. In some particular but still quite general cases it reduces to a sum of generalized hypergeometric functions 3
F
2. The Mellin moments can be expressed through generalized Lauricella functions, which reduce to the Kampé de Férriet functions in several physically interesting situations. A number of Feynman integrals involved and relations for them are obtained.
Multiple solutions for the non-Abelian Chern–Simons–Higgs vortex equations
Authors: Han Xiaosen , Tarantello Gabriella
Published: January 2019

In this paper we study the existence of multiple solutions for the non-Abelian Chern–Simons–Higgs

(N \times N)

-system:

\mathrm{\Delta }u_{i} = \lambda \left(\sum \limits_{j = 1}^{N}\sum \limits_{k = 1}^{N}K_{kj}K_{ji}\mathrm{e}^{u_{j}}\mathrm{e}^{u_{k}}−\sum \limits_{j = 1}^{N}K_{ji}\mathrm{e}^{u_{j}}\right) + 4\pi \sum \limits_{j = 1}^{n_{i}}\delta _{p_{ij}},\:i = 1,…,N;

over a doubly periodic domain

Ω

, with coupling matrix

K

given by the Cartan matrix of

SU(N + 1)

, (see (1.2) below). Here,

\lambda > 0

is the coupling parameter,

\delta _{p}

is the Dirac measure with pole at

p

and

n_{i} \in \mathbb{N}

, for

i = 1,…,N

. When

N = 1,2

many results are now available for the periodic solvability of such system and provide the existence of different classes of solutions known as: topological, non-topological, mixed and blow-up type. On the contrary for

N \geq 3

, only recently in [27] the authors managed to obtain the existence of one doubly periodic solution via a minimization procedure, in the spirit of [46]. Our main contribution in this paper is to show (as in [46]) that actually the given system admits a second doubly periodic solutions of “Mountain-pass” type, provided that

3 \leq N \leq 5

. Note that the existence of multiple solutions is relevant from the physical point of view. Indeed, it implies the co-existence of different non-Abelian Chern–Simons condensates sharing the same set (assigned component-wise) of vortex points, energy and fluxes. The main difficulty to overcome is to attain a “compactness” property encompassed by the so-called Palais–Smale condition for the corresponding “action” functional, whose validity remains still open for

N \geq 6

.
Parabolic equation in time and space dependent anisotropic Musielak–Orlicz spaces in absence of Lavrentiev's phenomenon
Authors: Chlebicka Iwona , Gwiazda Piotr , Zatorska–Goldstein Anna
Published: January 2019

We study a general nonlinear parabolic equation on a Lipschitz bounded domain in

\mathbb{R}^{N}

,

\begin{cases}
\partial _{t}u−\mathrm{div}A(t,x,\mathrm{∇}u) = f(t,x)\: & \text{in}\:\:\mathrm{\Omega }_{T}, \\
u(t,x) = 0\: & \text{on}\:(0,T) \times \partial \mathrm{\Omega }, \\
u(0,x) = u_{0}(x)\: & \text{in}\:\mathrm{\Omega },
\end{cases}

with

f \in L^{\infty }(\mathrm{\Omega }_{T})

and

u_{0} \in L^{\infty }(\mathrm{\Omega })

. The growth of the monotone vector field

A

is controlled by a generalized fully anisotropic

N

-function

M:[0,T) \times \mathrm{\Omega } \times \mathbb{R}^{N}\rightarrow [0,\infty)

inhomogeneous in time and space, and under no growth restrictions on the last variable. It results in the need of the integration by parts formula which has to be formulated in an advanced way. Existence and uniqueness of solutions are proven when the Musielak–Orlicz space is reflexive OR in absence of Lavrentiev's phenomenon. To ensure approximation properties of the space we impose natural assumption that the asymptotic behaviour of the modular function is sufficiently balanced. Its instances are log-Hölder continuity of variable exponent or optimal closeness condition for powers in double phase spaces.

The noticeable challenge of this paper is considering the problem in non-reflexive and inhomogeneous fully anisotropic space that changes along time.
Retrospective Application of the 2015 American Thyroid Association Guidelines for Ultrasound Classification, Biopsy Indications, and Follow-up Imaging of Thyroid Nodules: Can Improved Reporting Decrease Testing?
Authors: Mohammadi Manijeh , Betel Carrie , Burton Kirsteen Rennie , Higgins Kevin McLughlin , Ghorab Zeina , Halperin Ilana Jaye
Published: January 2019

Introduction

Thyroid ultrasound has been widely used to determine which nodules need further investigation. The goal of this study is to determine if using an ultrasonographic features checklist based on 2015 American Thyroid Association (ATA) guidelines can improve reporting and decrease unnecessary further testing.

Methods

In this retrospective study, ultrasonographic images of all nodules biopsied at our institution in 2014 and 2015 were reviewed by radiologists blinded to fine needle aspiration (FNA) biopsy result using a checklist. The checklist was prepared based on 2015 ATA guidelines. The ultrasonographic characteristics of thyroid nodules were compared with the result of biopsy to determine positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity for predicting malignancy. Radiologists also made an overall recommendation on need for FNA.

Results

A total of 425 thyroid nodule ultrasound scans were reviewed by radiologists. Biopsy results of 31 nodules were malignant and 394 were non-malignant. Malignant nodules showed higher frequency of solid composition, hypoechoechogenicity, and cervical lymph node involvement compared to benign nodules. Solid nodule composition had the highest PPV (13%) and NPV (94.7%). Extra-thyroid extension had the highest specificity (90.1%). Lesion vascularity had the highest sensitivity (83.8%), followed by hypoechogenicity (65.6%). Overall, the checklist had a positive predictive value of 9%, negative predictive value of 97.5%, sensitivity of 96.8%, and specificity of 11.14%. Radiologists determined that 10% of the nodules were very low-risk and did not require FNA.

Conclusion

Using a checklist based on 2015 ATA guideline thyroid nodule ultrasonographic features is a sensitive tool with high NPV to predict benign thyroid nodule, thereby preventing unnecessary FNAs.
The Efficacy of Computed Tomography-Guided Percutaneous Spine Biopsies in Determining a Causative Organism in Cases of Suspected Infection: A Systematic Review
Authors: Sertic Madeleine , Parkes Leighanne , Mattiassi Sabrina , Pritzker Kenneth , Gardam Michael , Murphy Kieran
Published: January 2019

Purpose

In suspected spondylodiscitis and vertebral osteomyelitis, computed tomography (CT)-guided biopsies are often performed to determine a causative organism and guide antimicrobial therapy. The aim of this study is to determine the diagnostic culture yield of CT-guided biopsies performed in cases of suspected spinal infections.

Methods

A literature search of PubMed and MEDLINE up to April 2017 was performed for keywords “CT guided vertebral biopsy infection,” “CT-guided spine biopsy infection,” “CT guided spine biopsy yield,” and “CT guided vertebral biopsy yield.” Inclusion criteria primarily consisted of studies exclusively using CT-guided biopsies in cases of suspected infectious lesions only. After study selection, published articles were analysed to determine diagnostic culture yield. Descriptive statistics were applied.

Results

220 search results were screened; 11 met our inclusion criteria and were reviewed. In total, 647 biopsies of suspected infectious spinal lesions were performed. Positive cultures were obtained in 241 cases. Upon excluding one paper's skewed results, the net pooled results culture yield was 33%. Several cultures grew multiple organisms, leading to a total of 244 species identified. Most common isolated organisms include S taphylococcus aureus (n = 83), coagulase-negative S taphylococcus (n = 45), and Mycobacteria (n = 38).

Conclusions

The diagnostic culture yield of CT-guided biopsies in cases of suspected spinal infection is 33%. In the majority of cases, a causative organism is not identified. This suggests that improvements can be made in biopsy technique and specimen transfer to optimize culture yield and increase the clinical value of the procedure.
Interobserver Variation of Colonic Polyp Measurement at Computed Tomography Colonography
Authors: Dulku Gurjeet , Hewavitharana Chandra , Halliday Tonya , Ramsay Duncan , Ho Richard , Phillips Michael , Mendelson Richard
Published: January 2019

Background

The concept of “advanced polyps” is well accepted and is defined as polyps ≥10 mm and/or those having a villous component and/or demonstrating areas of dysplasia. Of these parameters, computed tomography colonography (CTC) can only document size. The accepted management of CTC-detected “advanced polyps” is to recommend excision if feasible, whereas the management of “intermediate” (6–9 mm) polyps is more controversial, and interval surveillance may be acceptable. Therefore, distinction between 6-9 mm and ≥10 mm is important.

Methods

Datasets containing 26 polyps originally reported as between 8-12 mm in diameter were reviewed independently by 4 CTC-accredited radiologists. Observers tabulated the largest measurement for each polyp on axial, coronal, sagittal, and endoluminal views at lung-window settings. These measurements were also compared to those determined by the computer-aided detection (CAD) software.

Results

The interobserver reliability intra-class correlation coefficient (ICC) for sagittal projection was 0.80 (“excellent” category of Hosmer and Lemeshow [2004]), 0.71 for axial (“acceptable”), 0.69 for coronal, and 0.41 for endoluminal (“unacceptable”). The largest of sagittal/axial/coronal measurement gave the best reliability with the smallest variance (ICC = 0.80; 95% CI 0.67–0.89). For 8 of 26 polyps, at least one radiologist's measurement placed the polyp in a different category compared to a colleague. For the majority of the polyps, the CAD significantly overestimated the readings compared to the largest of the manual measurements with an average difference of 1.6 mm ( P < .0001 for sagittal/axial/coronal). This resulted in 33% of polyps falling into a different category—10% were lower and 23% were higher ( P < .034).

Conclusion

It is apparent that around the cutoff point of 10 mm between “advanced” and “intermediate” polyps, interobserver performance is variable.
Imaging-Based 3-Dimensional Printing for Improved Maxillofacial Presurgical Planning: A Single Center Case Series
Authors: Guest Will , Forbes Diana , Schlosser Colin , Yip Stephen , Coope Robin , Chew Jason
Published: January 2019

Purpose

3-D printing is an increasingly widespread technology that allows physical models to be constructed based on cross-sectional medical imaging data. We sought to develop a pipeline for production of 3-dimensional (3-D) models for presurgical planning and assess the value of these models for surgeons and patients.

Methods

In this institutional review board–approved, single-center case series, participating surgeons identified cases for 3-D model printing, and after obtaining patient consent, a 3-D model was produced for each of the 7 participating patients based on preoperative cross-sectional imaging. Each model was given to the surgeon to use during the surgical consent discussion and preoperative planning. Patients and surgeons completed questionnaires evaluating the quality and usefulness of the models.

Results

The 3-D models improved surgeon confidence in their operative approach, influencing the choice of operative approach in the majority of cases. Patients and surgeons reported that the model improved patient comprehension of the surgery during the consent discussion, including risks and benefits of the surgery. Model production time was as little as 4 days, and the average per-model cost was $350.

Conclusions

3-D printed models are useful presurgical tools from both surgeon and patient perspectives. Development of local hospital-based 3-D printing capabilities enables model production with rapid turnaround and modest cost, representing a value-added service for radiologists to offer their surgical colleagues.
Retrospective Analysis of Emergency Computed Tomography Imaging Utilization at an Academic Centre: An Analysis of Clinical Indications and Outcomes
Authors: Seidel Jason , Bissell Mary Beth , Vatturi Sannihita , Hartery Angus
Published: January 2019

Purpose

To explore resource utilization through evaluation of computed tomography (CT) imaging trends in the emergency department by examining common indications/outcomes for imaging in this setting.

Methods

A retrospective analysis of clinical indications/outcomes for all CT imaging in 3 emergency departments over a 1-year period was conducted. Scans were divided by body part and the most common indications for each type of scan were determined. Clinical outcomes from each study were extracted from final interpretations by the reporting radiologist.

Results

A total of 4556 CT scans were performed in the emergency department over a 1-year period. A total of 3.6% of all-comers to our emergency departments underwent CT scan as part of their investigation. There were 2107 head CTs (46%), 1296 (28%) abdominal CTs, 468 (10%) CTs of the chest, 408 (9%) CTs of the neck/spine, and 101 (2%) extremity CTs performed. The most common clinical indication for performing a CT head was focal neurological defect comprising 1534 (73%) of all CT heads. Twenty-four percent of abdominal CTs were for investigation of right lower quadrant pain, followed by flank pain (19%). Chest pain and shortness of breath were the most common indications for CTs of the chest (315 [75%]) with 10% of these examinations for this indication positive for pulmonary embolism. Trauma was the most common indication for neck CTs (296 [73%]) and extremities (70 [69%]). Nil acute was the most common final interpretation in all categories (79% CT heads, 75% neck CTs, 38% abdominal CTs, 43% chest CTs).

Conclusions

Nil acute was the most common diagnosis; however, serious clinical outcomes were identified 40% of the time. Cross-sectional imaging remains an integral tool for triage and diagnosis in this environment as the cost of missing a diagnosis in this setting has a great impact on patient care.
Computer Vision Syndrome: Darkness under the Shadow of Light
Authors: Chawla Ashish , Lim Tze Chwan , Shikhare Sumer N. , Munk Peter L. , Peh Wilfred C.G.
Published: January 2019

Radiologists typically spend long hours staring at the computer monitor. This unavoidable nature of our work can lead to detrimental effects on the eyes. Moreover, there is little awareness among radiologists with regards to such potential harm. Ocular hazards, such as computer vision syndrome, are increasingly becoming more relevant to the radiology community. In this article, we discuss the ocular occupational hazards faced by radiologists and suggestions that may help in minimizing such hazards.
Applicability of Magnetic Resonance Imaging in the Assessment of Fetal Urinary Tract Malformations
Authors: Fazecas Tatiana Mendonça , Araujo Júnior Edward , Werner Heron , Daltro Pedro , Peixoto Alberto Borges , Lima Glaucia Macedo , Barbosa Adauto Dutra
Published: January 2019

Objective

To assess the applicability of magnetic resonance imaging (MRI) to complement ultrasound in the diagnosis of fetal urinary tract anomalies.

Methods

This was a retrospective cohort study that included 41 women between 19 weeks and 37 weeks and 6 days of gestation carrying fetuses with malformations of the urinary tract which were initially diagnosed by ultrasound and then referred for MRI. In all cases, the diagnosis was confirmed after birth either through imaging or autopsy. A surface coil was positioned over the abdomen and T2-weighted sequences were obtained in the axial, coronal, and sagittal planes; T1 in at least one plane; and three-dimensional (3-D) TRUFI in fetuses with dilatation of the urinary tract.

Results

Mean gestational age at the time of MRI examination was 28.21 weeks. The rapid T2 sequences allowed all the anomalies of the fetal urinary tract to be assessed, whereas 3-D TRUFI sequencing proved very useful in evaluating anomalies involving dilatation of the urinary tract. The signs of pulmonary hypoplasia characterized by hypointense signal in the T2-weighted sequences were identified in 13 of the 41 fetuses.

Conclusion

MRI confirmed and added information to the ultrasound regarding fetal urinary tract anomalies, as well as information related to the other associated malformations, their progress in the prenatal period, and possible postnatal prognosis.
Musculoskeletal Corticosteroid Administration: Current Concepts
Authors: Shah Amit , Mak Davina , Davies A. Mark , James S.L. , Botchu Rajesh
Published: January 2019

Numerous corticosteroid preparations are available, but the type and dose administered is frequently at the discretion of the clinician. This is often based on anecdotal evidence and experience rather than formal clinical guidelines. In order to better understand current practice, we anonymously surveyed 100 members of the British Society of Skeletal Radiologists. The results of the survey demonstrated the arbitrary use of all types of steroid preparation at different anatomical locations. In this article, we review the commonly used corticosteroids and propose a guideline to help practitioners decide on the type and dose of steroid depending on the treatment location.
Trends in health service use and potentially avoidable hospitalizations before Alzheimer's disease diagnosis: A matched, retrospective study of US Medicare beneficiaries
Authors: Desai Urvi , Kirson Noam Y. , Ye Wenyu , Mehta Nori R. , Wen Jody , Andrews J. Scott
Published: January 2019

Introduction

This study evaluates rates of all‐cause emergency department visits, all‐cause hospitalizations, potentially avoidable hospitalizations, and falls in 3 years preceding Alzheimer's disease (AD) diagnosis.

Methods

Patients with AD and controls with no cognitive impairment were identified from the Medicare claims data. Patients were required to be aged ≥ 65 years and have continuous Medicare enrollment for ≥4 years before the index date (AD cohort: first AD diagnosis in 2012–2014; controls: randomly selected medical claim). Outcomes for each preindex year were compared among propensity score‐matched cohorts.

Results

Each year, before index, patients with AD were more likely to have all‐cause emergency department visits, all‐cause hospitalizations, potentially avoidable hospitalizations, and falls (P < .05 for all comparisons) than matched controls (N = 19,679 pairs). Increasing absolute and relative risks over time were observed for all outcomes.

Discussion

The study findings highlight the growing burden of illness before AD diagnosis and emphasize the need for timely recognition and management of patients with AD.
Surface‐ and voxel‐based brain morphologic study in Rett and Rett‐like syndrome with MECP2 mutation
Authors: Shiohama Tadashi , Levman Jacob , Takahashi Emi
Published: January 2019

Rett syndrome (RTT) is a rare congenital disorder which in most cases (95%) is caused by methyl‐CpG binding protein 2 (MECP2) mutations. RTT is characterized by regression in global development, epilepsy, autistic features, acquired microcephaly, habitual hand clapping, loss of purposeful hand skills, and autonomic dysfunctions. Although the literature has demonstrated decreased volumes of the cerebrum, cerebellum, and the caudate nucleus in RTT patients, surface‐based brain morphology including cortical thickness and cortical gyrification analyses are lacking in RTT. We present quantitative surface‐ and voxel‐based morphological measurements in young children with RTT and Rett‐like syndrome (RTT‐l) with MECP2 mutations. The 8 structural T1‐weighted MR images were obtained from 7 female patients with MECP2 mutations (3 classic RTT, 2 variant RTT, and 2 RTT‐l) (mean age 5.2 [standard deviation 3.3] years old). Our analyses demonstrated decreased total volumes of the cerebellum in RTT/RTT‐l compared to gender‐ and age‐matched controls (t (22)=‐2.93, p = .008, Cohen's d = 1.27). In contrast, global cerebral cortical surface areas, global/regional cortical thicknesses, the degree of global gyrification, and global/regional gray and white matter volumes were not statistically significantly different between the two groups. Our findings, as well as literature findings, suggest that early brain abnormalities associated with RTT/RTT‐l (with MECP2 mutations) can be detected as regionally decreased cerebellar volumes. Decreased cerebellar volume may be helpful for understanding the etiology of RTT/RTT‐l.
Knowledge, attitudes, and practice of healthcare workers toward influenza vaccination at Al Jalila Children's Specialty Hospital (AJCH), Dubai, UAE
Authors: Hammour Walid Abu , Al-Saleh Samar
Published: January 2019

Background

Influenza viruses usually circulate worldwide annually from the late fall through the early spring. Although most people with influenza recover without sequelae, it can cause serious illness and death, particularly among older adults, very young children, pregnant women, and those with certain chronic medical conditions.

Aim of the study

To describe the knowledge, attitudes, and practice of Al Jalila Children's Specialty Hospital healthcare workers toward influenza vaccination during 2016–2017 and understand their relative importance in promoting influenza vaccine uptake.

Method

A validated survey self-administered questionnaire was distributed to healthcare workers at AJCH. A descriptive analysis was performed, including an evaluation of associations using the chi-square test, and an alpha level of 0.05 was considered significant.

Results

The questionnaire was distributed to 350 healthcare workers, and 263 (76%) of them completed the survey. Among the responders, 63% answered that they were not vaccinated for seasonal flu in both years, 32% answered that they were vaccinated once, in either 2016 or 2017, and only 5% answered that they were vaccinated during both years.

The analysis of results by gender indicates that influenza vaccination uptake in both years (2016 and 2017) was more common in females than in males.

Despite a higher educational level, influenza vaccination remained low among physician, nurses, and postgraduate workers.

Conclusion

The healthcare workers' knowledge of influenza disease does not reflect their knowledge, attitude, and practice toward influenza vaccination. These results highlight the important predictors that must be targeted to promote hospital awareness campaigns to improve their practice and attitude, which could result in increasing seasonal influenza vaccine uptake.
Genetic screen in a large series of patients with primary progressive aphasia
Authors: Ramos Eliana Marisa , Dokuru Deepika Reddy , Van Berlo Victoria , Wojta Kevin , Wang Qing , Huang Alden Y. , Miller Zachary A. , Karydas Anna M. , Bigio Eileen H. , Rogalski Emily , Weintraub Sandra , Rader Benjamin , Miller Bruce L. , Gorno‐Tempini Maria Luisa , Mesulam Marek‐Marsel , Coppola Giovanni
Published: January 2019

Introduction

Primary progressive aphasia (PPA) is a neurological syndrome, associated with both frontotemporal dementia and Alzheimer's disease, in which progressive language impairment emerges as the most salient clinical feature during the initial stages of disease.

Methods

We screened the main genes associated with Alzheimer's disease and frontotemporal dementia for pathogenic and risk variants in a cohort of 403 PPA cases.

Results

In this case series study, 14 (3.5%) cases carried (likely) pathogenic variants: four C9orf72 expansions, nine GRN, and one TARDBP mutation. Rare risk variants, TREM2 R47H and MAPT A152T, were associated with a three‐ to seven‐fold increase in risk for PPA.

Discussion

Our results show that while pathogenic variants within the most common dementia genes were rarely associated with PPA, these were found almost exclusively in GRN and C9orf72, suggesting that PPA is more TDP43‐ than tau‐related in our series. This is consistent with the finding that PPA frequency in dominantly inherited dementias is the highest in kindreds with GRN variants.
Dual solutions for three-dimensional magnetohydrodynamic nanofluid flow with entropy generation
Authors: Mondal Hiranmoy , Almakki Mohammed , Sibanda Precious
Published: January 2019

This paper presents a formulation for simulating magnetohydrodynamic three-dimensional convective flow and heat transfer in a nanofluid by incorporating the complete viscous dissipation function in the energy equation. A novel feature of this investigation of entropy generation and dual solutions is the use of the spectral quasilinearization method to solve the conservation equations. The results are compared with exact solutions or higher order solutions and a good agreement is achieved. The accuracy is determined by calculation of residual errors and the method of solution is shown to produce smaller residual errors than those achieved by the fifth-order Runge-Kutta Fehlberg method for nonlinear differential equations. The dual solutions for different Prandtl number, and Brownian motion and thermophoresis parameters are shown graphically and discussed. It is found that the temperature profiles as well as thermal boundary layer thickness increase with the Brownian motion parameter for first and the second solutions. The temperature profiles increase with the thermophoresis parameter for the first and second solutions. The entropy generation increases with the Reynolds number.

Highlights Combined effects of entropy generation and MHD nanofluid are proposed. Spectral quasi-linearization method (SQLM) is used for computer simulations. Use axisymmetric stretching/shrinking sheet for dual solution. Validate the accuracy and convergence using residual error analysis.
Suprapubic Fat Pad Excision with Simultaneous Placement of Inflatable Penile Prosthesis
Authors: Baumgarten Adam S. , Beilan Jonathan A. , Shah Bhavik B. , Loeb Aram , Bickell Michael , Parker Justin , Henry Gerard D. , Carrion Rafael E.
Published: January 2019

Introduction

Many men suffering from erectile dysfunction are overweight with generous suprapubic fat pads, which often contribute to a decrease in visible exophytic phallic length.

Aim

To present a novel surgical concept of suprapubic fat pad excision with a concomitant placement of inflatable penile prosthesis.

Methods

A transverse incision begins slightly medial to the anterior superior iliac spine, with the superior edge crossing transversely to the contralateral anterior superior iliac spine. The inferior border is incised in a curvilinear fashion, with the medial apex being approximately 1 cm above the base of the penis. Dissection is carried down to the lower abdominal anterior fascia, which leads to excision of the suprapubic fat pad. Using this same exposure, the inflatable penile prosthesis (IPP) is placed via an infrapubic approach. The wound is reapproximated in multiple layers, and 2 drains are placed, 1 subcutaneous in the area of the fat pad excision and the other in the scrotum around the pump.

Main Outcome Measures

Primary outcomes included penile implant functionality, ability to engage in sexual activity, and cosmetic satisfaction.

Results

A total of 8 patients have undergone suprapubic fat pad excision with simultaneous placement of IPP at our institution. Average body mass index of our patient cohort was 36.6. 1 patient developed prosthetic infection after inadvertent removal of his drains in the immediate postoperative period. At last follow-up, all other patients have excellent cosmetic and functional outcomes.

Clinical Implications

This technique can lead to higher patient satisfaction with their penile implant, enhanced sexual performance, and improved quality of life for patients with concurrent erectile dysfunction and significant suprapubic fat pad.

Strengths & Limitations

This unique technique has never been previously described. It allows placement of IPP in the setting of fat pad excision without any additional incisions. Limitations include the small patient population and relatively short follow-up.

Conclusions

Suprapubic fat pad excision is a safe and reproducible technique that can be performed simultaneously with the placement of an IPP in appropriately selected patients. Patients must be counseled appropriately on the expectations of surgeries and the theoretical increased risk of postoperative complications, such as infection.
Comparative Effectiveness of Intralesional Therapy for Peyronie’s Disease in Controlled Clinical Studies: A Systematic Review and Network Meta-Analysis
Authors: Russo Giorgio Ivan , Cacciamani Giovanni , Cocci Andrea , Kessler Thomas M. , Morgia Giuseppe , Serefoglu Ege Can , Albersen Maarten , Verze Paolo
Published: January 2019

Introduction

Medical treatment of Peyronie’s disease (PD) in terms of intralesional therapy is still a matter of debate.

Aim

To compare the efficacy of different classes of intralesional therapy with a network meta-analysis (NMA) method.

Methods

The search was conducted using documents published in PubMed, Scopus, and Web of Science databases until September 30, 2017. We included randomized controlled trials comparing at least 1 intralesional therapy with a placebo therapy or with another drug for the treatment of PD. All intralesional therapies have been considered: collagenase Clostridium histolyticum (CCH), hyaluronic acid, verapamil, and interferon α-2b.

Main Outcome Measure

Outcomes of the study are the mean change in penile curvature (PC) and in erectile function (EF) assessed with the International Index of Erectile Function questionnaire.

Results

In total, 8 comparisons matched with the inclusion criteria, which includes 1,050 patients. With regard to PC (degree) improvement, hyaluronic acid and verapamil showed worse outcomes when compared with CCH (−6.66 and −2.30) and interferon α-2b (−6.75 and −2.38). When considering improvement in EF, hyaluronic acid, verapamil and interferon α-2b showed a slight increase in mean change when compared with CCH (+2.39, +1.77, and +0.65). Moreover, verapamil and interferon α-2b showed slightly worse mean change in comparison to hyaluronic acid (+0.62 and +1.74), whereas interferon α-2b was worse than verapamil (−1.12).

Clinical Implications

Based on this NMA, empirical therapy for PD should be avoided to offer the patients the best treatment in terms of level of evidence.

Strengths & Limitations

In this NMA, we have provided, for the first time, evidence of the efficacy between different intralesional therapies for the treatment of PD. We were not able to compare all specific outcomes (ie, pain, plaque size, patient satisfaction) of PD, because of the lack of homogeneity across relevant studies. Moreover, because of the few included studies, a meta-regression analysis of predictive factors of treatment response was not calculated.

Conclusion

This is the first meta-analysis comparing all available intralesional treatments for PD. CCH and interferon α-2b showed the best outcome in terms of PC, whereas hyaluronic acid was most efficient in relation to EF.
Elucidating Mechanisms of Long-Term Gasoline Vehicle Exhaust Exposure–Induced Erectile Dysfunction in a Rat Model
Authors: Zhao Shankun , Wang Jiamin , Xie Qiang , Luo Lianmin , Zhu Zhiguo , Liu Yangzhou , Deng Yihan , Kang Ran , Luo Jintai , Zhao Zhigang
Published: January 2019

Introduction

Exposure to air pollution poses a risk for morbidity in multiple diseases. However, the role of ambient air pollutant emissions in public sexual health is just beginning to be understood and remains controversial.

Aim

We have determined to elucidate the specific role of gasoline vehicle exhaust (VE), a crucial source and toxicant of air pollution, in the penile erectile function via a rat model.

Methods

40 male Sprague Dawley rats, 12 weeks of age, were used in this experiment. Except for the control group (10 rats), rats were equally exposed to VE for total 2 hours, 4 hours, and 6 hours daily for 3 months consecutively. During each VE exposure periods, particulate matter (PM) mass concentrations of PM1, PM2.5, and PM10 were 1.43 ± 0.036, 1.45 ± 0.033, and 1.47 ± 0.037 mg/m3, respectively.

Main Outcome Measure

Erectile function, pulmonary function, serum inflammatory factors, and histologic examinations of the lung and penile tissues were evaluated.

Results

Our study indicates that in vivo, 4-hour, and 6-hour daily exposure to VE causes significant reduction of erectile function, as judged by intracavernous pressure measurement. Meanwhile, we have observed that the 4-hour and 6-hour VE exposure rats exhibited remarkable increased levels of serum inflammatory factors, decreased total lung capacity and chord compliance, thickened alveoli septum, destroyed alveoli, pulmonary fibrosis, as well as down-regulation of the messenger RNA and protein expression of endothelial and neuronal nitric oxide synthase in the penile tissue when compared with normal control rats.

Clinical Implications

We speculated that the underlying mechanisms of VE inducing erectile dysfunction could be attributed to systemic inflammation, pulmonary dysfunction, and the reduction of nitric oxide synthase activity in the corpus cavernosum.

Strength & Limitations

For the first time, our study revealed the deleterious effect of VE on penile erection in vivo. However, the VE exposure model might not entirely mimic the natural condition of ambient air pollution.

Conclusion

Our results raise concerns about the potential role played by long-term exposure to gasoline VE in the development of erectile dysfunction.
A phase 1 clinical trial of the sigma‐2 receptor complex allosteric antagonist CT1812, a novel therapeutic candidate for Alzheimer's disease
Authors: Grundman Michael , Morgan Roger , Lickliter Jason D. , Schneider Lon S. , DeKosky Steven , Izzo Nicholas J. , Guttendorf Robert , Higgin Michelle , Pribyl Julie , Mozzoni Kelsie , Safferstein Hank , Catalano Susan M.
Published: January 2019

Background

Elayta (CT1812) is a novel allosteric antagonist of the sigma‐2 receptor complex that prevents and displaces binding of Aβ oligomers to neurons. By stopping a key initiating event in Alzheimer's disease, this first‐in–class drug candidate mitigates downstream synaptotoxicity and restores cognitive function in aged transgenic mouse models of Alzheimer's disease.

Methods

A phase 1, two‐part single and multiple ascending dose study was conducted in 7 and 4 cohorts of healthy human subjects, respectively. In part A, healthy, young subjects (<65 years old) received CT1812 doses ranging from 10 to 1120 mg (6:2 active to placebo [A:P] per cohort). In part B, subjects were administered 280, 560, and 840 mg once daily for 14 days (8:2 A:P per cohort). An elderly cohort, aged 65‐75 years, was dosed at 560 mg once daily for 14 days (7:2 A:P). Serum concentrations of CT1812 in part B were measured on day 3 and 14 and cerebrospinal fluid concentrations on day 7 or 9. Cognitive testing was performed in the healthy elderly cohort at baseline and at day 14 of treatment.

Results

Treatment with CT1812 was well tolerated in all cohorts. Adverse events were mild to moderate in severity and included headache and GI tract symptoms. Plasma concentrations of drug were dose proportional across two orders of magnitude with minimal accumulation over 14 days. Cognitive scores in the healthy elderly cohort were similar before and after treatment.

Conclusions

CT1812 was well tolerated with single dose administration up to 1120 mg and with multiple dose administration up to 840 mg and 560 mg in healthy young and healthy elderly subjects, respectively. CT1812 is currently being studied in early phase 2 trials in patients with Alzheimer's disease.
GROUNDING PROCEDURAL RIGHTS
Authors: Adams N. P.
Published: January 2019

It is commonly held that we wrong someone if we punish them without first determining whether they are guilty through the process of a sufficiently fair and reliable procedure. This wrong is best explained by pre-institutional moral procedural rights. Recently, Christopher Heath Wellman has argued for the skeptical conclusion that there are no such rights, challenging a widely held orthodoxy. I propose two novel grounds for pre-institutional moral procedural rights and so answer Wellman's skepticism. First, we have rights not to be subject to punitive systems that do not include specific sorts of reliable procedures because otherwise we are subject to unreasonable risks of undeserved punishment. Second, not only do we have rights that others not harm us or unreasonably risk harming us, we have rights that they control for avoiding wrongfully harming us across relevant close possible worlds.
Carboxyethyltin and transition metal co-functionalized tungstoantimonates composited with polypyrrole for enhanced electrocatalytic methanol oxidation
Authors: Wang Hai-Dan , Wang Xing-Fang , Su Fang , Li Jian-Sheng , Zhang Lan-Cui , Sang Xiao-Jing , Zhu Zai-Ming
Published: January 2019

PPy-SbW9-TM-SnR/Pt-based electrocatalysts were prepared by the electro-deposition method and showed good performance for the methanol oxidation reaction.
Current-induced restructuring in bent silver nanowires
Authors: Batra Nitin M. , Syed Ahad , Costa Pedro M. F. J.
Published: January 2019

The electrical and structural responses of suspended Ag nanowires, subjected to an increasing flow of current, relate highly to their geometric configuration.
Hyperbranched poly(ethylenimine-co-oxazoline) by thiol–yne chemistry for non-viral gene delivery: investigating the role of polymer architecture
Authors: Cook Alexander B. , Peltier Raoul , Zhang Junliang , Gurnani Pratik , Tanaka Joji , Burns James A. , Dallmann Robert , Hartlieb Matthias , Perrier Sébastien
Published: January 2019

Synthesis of long-chain hyperbranched poly(ethylenimine-co-oxazoline)s by AB2thiol–yne chemistry is reported, and their application as pDNA transfection agents studied.
Characterizing the radial oxygen abundance distribution in disk galaxies
Authors: Zinchenko I. A. , Just A. , Pilyugin L. S. , Lara-Lopez M. A.
Published: January 2019

Context. The relation between the radial oxygen abundance distribution (gradient) and other parameters of a galaxy such as mass, Hubble type, and a bar strength, remains unclear although a large amount of observational data have been obtained in the past years.

Aims. We examine the possible dependence of the radial oxygen abundance distribution on non-axisymmetrical structures (bar/spirals) and other macroscopic parameters such as the mass, the optical radius R25, the color g − r, and the surface brightness of the galaxy. A sample of disk galaxies from the third data release of the Calar Alto Legacy Integral Field Area Survey (CALIFA DR3) is considered.

Methods. We adopted the Fourier amplitude A2 of the surface brightness as a quantitative characteristic of the strength of non-axisymmetric structures in a galactic disk, in addition to the commonly used morphologic division for A, AB, and B types based on the Hubble classification. To distinguish changes in local oxygen abundance caused by the non-axisymmetrical structures, the multiparametric mass–metallicity relation was constructed as a function of parameters such as the bar/spiral pattern strength, the disk size, color index g − r in the Sloan Digital Sky Survey (SDSS) bands, and central surface brightness of the disk. The gas-phase oxygen abundance gradient is determined by using the R calibration.

Results. We find that there is no significant impact of the non-axisymmetric structures such as a bar and/or spiral patterns on the local oxygen abundance and radial oxygen abundance gradient of disk galaxies. Galaxies with higher mass, however, exhibit flatter oxygen abundance gradients in units of dex/kpc, but this effect is significantly less prominent for the oxygen abundance gradients in units of dex/R25 and almost disappears when the inner parts are avoided (R >  0.25R25). We show that the oxygen abundance in the central part of the galaxy depends neither on the optical radius R25 nor on the color g − r or the surface brightness of the galaxy. Instead, outside the central part of the galaxy, the oxygen abundance increases with g − r value and central surface brightness of the disk.
Early Postnatal IGF-1 and IGFBP-1 Blood Levels in Extremely Preterm Infants: Relationships with Indicators of Placental Insufficiency and with Systemic Inflammation
Authors: Leviton Alan , Allred Elizabeth N. , Fichorova Raina N. , VanderVeen Deborah K. , O'Shea T. Michael , Kuban Karl , Dammann Olaf ,   for the ELGAN Study Investigators
Published: January 2019

Objective To evaluate to what extent indicators of placenta insufficiency are associated with low concentrations of insulin-like growth factor 1 (IGF-1) and IGF-1–binding protein-1 (IGFBP-1) in neonatal blood, and to what extent the concentrations of these growth factors are associated with concentrations of proteins with inflammatory, neurotrophic, or angiogenic properties.

Study Design Using multiplex immunoassays, we measured the concentrations of IGF-1 and IGFBP-1, as well as 25 other proteins in blood spots collected weekly from ≥ 880 infants born before the 28th week of gestation, and sought correlates of concentrations in the top and bottom quartiles for gestational age and day the specimen was collected.

Results Medically indicated delivery and severe fetal growth restriction (sFGR) were associated with low concentrations of IGF-1 on the first postnatal day and with high concentrations of IGFBP-1 on almost all days. Elevated concentrations of IGF-1 and IGFBP-1 were accompanied by elevated concentrations of many other proteins with inflammatory, neurotrophic, or angiogenic properties.

Conclusion Disorders associated with impaired placenta implantation and sFGR appear to account for a relative paucity of IGF-1 on the first postnatal day. Elevated concentrations of IGF-1 and especially IGFBP-1 were associated with same-day elevated concentrations of inflammatory, neurotrophic, and angiogenic proteins.
Optimizing Platelet GPVI Inhibition versus Haemostatic Impairment by the Btk Inhibitors Ibrutinib, Acalabrutinib, ONO/GS-4059, BGB-3111 and Evobrutinib
Authors: Denzinger Viola , Busygina Kristina , Jamasbi Janina , Pekrul Isabell , Spannagl Michael , Weber Christian , Lorenz Reinhard , Siess Wolfgang
Published: January 2019

Ibrutinib and acalabrutinib are approved for B cell malignancies and novel Bruton's tyrosine kinase (Btk) inhibitors undergo clinical testing also in B cell-driven autoimmune disorders. Btk in platelets mediates platelet activation via glycoprotein (GP) VI, which is crucial for atherosclerotic plaque-induced platelet thrombus formation. This can be selectively inhibited by Btk inhibitors. Since patients on second-generation Btk inhibitors apparently show less bleeding than patients on ibrutinib, we compared the effects of ibrutinib and four novel irreversible Btk inhibitors on GPVI-dependent platelet aggregation in blood and in vitro bleeding time. Low concentrations of collagen which induced the same low degree of GPVI-mediated platelet aggregation as atherosclerotic plaque material were applied. IC50 values for collagen (0.2–0.5 µg/mL)-induced platelet aggregation after 15-minute pre-incubation were: ibrutinib 0.12 µM, BGB-3111 0.51 µM, acalabrutinib 1.21 µM, ONO/GS-4059 1.20 µM and evobrutinib 5.84 µM. Peak venous plasma concentrations of ibrutinib (0.5 µM), acalabrutinib (2 µM) and ONO/GS-4059 (2 µM) measured after anti-proliferative dosage inhibited collagen-induced platelet aggregation, but did not increase PFA-200 closure time on collagen/epinephrine. Closure times were moderately increased by 2- to 2.5-fold higher concentrations of these inhibitors, but not by BGB-3111 (1 µM) and evobrutinib (10 µM). Prolonging platelet drug exposure to 60 minutes lowered IC50 values of any Btk inhibitor for GPVI-mediated aggregation by several fold, and 5- to 10-fold below anti-proliferative therapeutic drug plasma levels. In conclusion, low blood concentrations of ibrutinib and the novel Btk inhibitors suffice for GPVI selective platelet inhibition relevant for atherothrombosis but do not impair primary haemostasis.
The molecular evolution of feathers with direct evidence from fossils
Authors: Pan Yanhong , Zheng Wenxia , Sawyer Roger H. , Pennington Michael W. , Zheng Xiaoting , Wang Xiaoli , Wang Min , Hu Liang , O’Connor Jingmai , Zhao Tao , Li Zhiheng , Schroeter Elena R. , Wu Feixiang , Xu Xing , Zhou Zhonghe , Schweitzer Mary H.
Published: January 2019

Significance

During the dinosaur–bird transition, feathers of bird ancestors must have been molecularly modified to become biomechanically suitable for flight. We report molecular moieties in fossil feathers that shed light on that transition. Pennaceous feathers attached to the right forelimb of the Jurassic dinosaur
Anchiornis
were composed of both feather β-keratins and α-keratins, but were dominated by α-keratins, unlike mature feathers of extant birds, which are dominated by β-keratins. Data suggest that the pennaceous feathers of
Anchiornis
had some, but not all, of the ultrastructural and molecular characteristics of extant feathers, and may not yet have attained molecular modifications required for powered flight.
Assessment of the utricular function in posterior canal benign paroxysmal positional vertigo patients before and after canalith repositioning maneuvre and its relation to residual dizziness
Authors: Dabbous Abeir Osman , El-Shennawy Amira Maged , Medhat Mariam Magdy , Kandil Mona Tarek
Published: January 2019

Background:

In benign paroxysmal positional vertigo (BPPV), the otoconia are dislodged from their usual position within the utricle and migrated into one of the semicircular canals. Utricular dysfunction in BPPV has been reported. Residual dizziness (RD) is common after the treatment.

Objective:

To assess the utricular function in patients with posterior canal BPPV after canalith repositioning maneuver (CRM) using ocular vestibular evoked myogenic potential (oVEMP) and to correlate the findings with any RD after CRM.

Methods:

Thirty adult patients with posterior canal BPPV (6 males and 24 females) were compared to well-matched controls. The oVEMP and Dizziness Handicap Inventory (DHI) Questionnaire were administrated before and after successful CRM.

Results:

Before CRM, the affected ear showed a significant delay in latency of N1 in the affected ear oVEMP and a significantly decreased in N1–P1 amplitude compared to controls and to the non-affected ears. After CRM their amplitudes were comparable. The BPPV group had a greater interaural amplitude difference percent (IAAD%) compared to controls before and after CRM. The non-affected ear showed only decrease in N1–P1 amplitude compared to controls. After CRM the affected ear amplitude increased and became comparable to the controls. The IAAD% was larger in RD group than non-RD group before and after CRM. The dizziness handicap severity decreased after CRM. But the occurrence of RD could not be predicted from DHI scores.

Conclusion:

Utricular function measured by oVEMP in the affected ear improved after CRM, and contralateral ear showed sub-clinical affection. Persistent VEMP abnormality reflecting persistent utricular dysfunction was related to residual dizziness.