bluuebunny/crossref_metadata_2025 huggingface dataset:
Familial Mediterranean fever
Authors: Padeh Shai , Berkun Yackov
Published: June 2016

Purpose of review

Familial Mediterranean fever (FMF) is the oldest and most common of the hereditary autoinflammatory diseases (AIDs). A large body of information has been accumulated over recent years on the pathophysiology, diagnosis and treatment of these diseases. The purpose of this review is to bring an up-to-date summary of the clinic manifestations, diagnostic criteria and treatment of FMF.

Recent findings

An overview of the pathophysiologic basis of FMF as part of the AID is discussed. Over the last year, attempts to establish new criteria for childhood FMF, new guidelines for treatment and follow-up of disease and novel treatment for FMF were made. A comparison of the different disease severity scores for research purposes suggests that a new score is needed. New evidence for antiinterleukin-1 blockade as a new treatment modality is described.

New diagnostic criteria, disease severity score, treatment and follow-up guidelines have been proposed, and need validation in the next several years.
Spinal Epidural Hematoma Due To Tyre-Blast Injury
Authors: Boyaci Mehmet G. , Aslan Adem , Tünay Kamil , Karademir Mustafa , Aydoğmuş Arda
Published: June 2016

Study Design.

A retrospective case report.

Objective.

The objective of this article is to report a spinal epidural hematoma (SEH) due to shock wave.

Summary of Background Data.

SEH is an infrequent condition. Most of SEH's are spontaneous. We have reported an SEH traumatic case without bone lesions due to exploding truck tire. A different category of blast injuries is the one related with exploding tyres. Shock waves are the main mechanism that is responsible for blast injuries. We are presenting the first report of acute SEH due to shock wave.

Methods.

A 33-year-old man was brought to the emergency department with complaints of weakness and numbness of the upper extremities. There was an epidural high-signal density without osseous lesion in computerized tomography from the level of C2 to C5, and there was a T2-weighted hyperintense lesion in magnetic resonance imaging from the level of C2 to C5 with compression of the spinal cord the anterior and posterior which proved to be an SEH.

Results.

The patient was discharged from the hospital with complete neurologic recovery.

Conclusion.

SEH should be considered possible in the blast injury. SEH condition carries a significant risk of morbidity and mortality without early recognition and rapid management.

Level of Evidence: 5
Targeted Prostate Biopsy Gleason Score Heterogeneity and Implications for Risk Stratification
Authors: Mesko Shane , Marks Leonard , Ragab Omar , Patel Shyamal , Margolis Daniel A. , Demanes D. Jeffrey , Kamrava Mitchell
Published: June 2016

Objectives:

To quantify Gleason score (GS) heterogeneity within multiparametric magnetic resonance imaging (MRI)-targeted prostate biopsies and to determine impact on National Comprehensive Cancer Network (NCCN) risk stratification.

Methods:

An Institutional Review Board-approved retrospective study was performed on men who underwent Artemis (MRI-transrectal–ultrasound fusion) targeted biopsy (TB) for suspected prostate cancer between 2012 and 2015. Intratarget heterogeneity was defined as a difference in GS between 2 cores within a single target in patients with ≥2 positive cores. Prostate specific antigen, maximum tumor diameter, apparent diffusion coefficient, MRI suspicion score, prostate volume, systematic biopsy (SB) GS, and T-stage were analyzed for correlation with heterogeneity. Changes in NCCN risk based on high versus low GS on TB, SB alone, and SB+TB were compared.

Results:

Fifty-three patients underwent TB of 73 suspected lesions. Seventy percent (51/73) had ≥2 positive cores, thus meeting inclusion criteria for heterogeneity analysis. Fifty-five percent (28/51) of qualifying targets showed GS heterogeneity. None of the evaluated factors showed a significant relationship with heterogeneity. NCCN low-risk, intermediate-risk, and high-risk groups were 30%, 49%, and 21%, respectively, with SB alone. Adding low GS TB to SB resulted in 17%, 55%, 28% in each risk group, while using high GS+SB resulted in 4%, 54%, and 42%. Overall, the addition of TB resulted in higher NCCN risk groups in 38% of cases.

Conclusions:

Over half of multiparametric MRI-defined targets demonstrated GS heterogeneity. The addition of high GS from TB leads to risk inflation compared with using SB alone. Further research is needed on how to integrate these findings into current risk stratification models and clinical practice.
Should Immunomodulation Therapy Alter the Surgical Management in Patients With Rectovaginal Fistula and Crohn’s Disease?
Authors: Narang Rahul , Hull Tracy , Perrins Steven , Garcia Jose Sebastian , Wexner Steven D.
Published: June 2016

BACKGROUND:

Rectovaginal fistula in Crohn’s disease is challenging for both healthcare providers and patients. The impact of immunomodulation therapy on healing after surgery is unclear.

OBJECTIVE:

The purpose of this study was to examine whether immunomodulation therapy impacts healing after surgery for rectovaginal fistula in Crohn’s disease.

DESIGN:

This was a retrospective analysis with a follow-up telephone survey.

SETTINGS:

The study was conducted at two major tertiary referral centers.

PATIENTS:

All of the patients who underwent rectovaginal fistula repair from 1997 to 2013 at our centers were included.

MAIN OUTCOME MEASURES:

A χ2 test and logistical regression analysis were used to study treatment outcomes according to type of procedure, recent use of immunosuppressives, and number of previous attempted repairs. Age, BMI, smoking, comorbidities, previous vaginal delivery/obstetric injury, use of probiotics, diverting stoma, and use of seton were also analyzed.

RESULTS:

A total of 120 (62%) patients were contacted, and 99 (51%) of them agreed to participate in the study. Mean follow-up after surgical repair was 39 months. Procedures included advancement flap (n = 59), transvaginal repair (n = 14), muscle interposition (n = 14), episioproctotomy (n = 6), sphincteroplasty (n = 3), and other (n = 3); overall, 63% of patients experienced healing. Sixty-eight patients underwent recent immunomodulation therapy but did not exhibit statistical significance in outcome after surgical repair. In the subset of patients with fistula related to obstetric injury, a 74% (n = 26) healing rate after surgical repair was observed. Age, BMI, diabetes mellitus, use of steroids, probiotics, seton before repair, fecal diversion, and number of repairs did not affect healing.

LIMITATIONS:

This was a retrospective analysis; the high volume tertiary referral inflammatory bowel disease centers studied may not be reflective of rectovaginal fistula presentation, treatment, or results in all patients, and the 3-year follow-up may not be sufficiently long.

CONCLUSIONS:

Despite a relatively low success rate (63%) in healing after surgical repair of a rectovaginal fistula, the recent use of immunomodulation therapy did not negatively impact healing. However, tissue interposition techniques had the highest success rates.
Skin Pretreatment With Conventional Non-Fractional Ablative Lasers Promote the Transdermal Delivery of Tranexamic Acid
Authors: Hsiao Chien-Yu , Sung Hsin-Ching , Hu Sindy , Huang Chun-Hsun
Published: June 2016

BACKGROUND

Laser pretreatment of skin can be used to enable drugs used in dermatology to penetrate the skin to the depth necessary for their effect to take place.

OBJECTIVE

To compare the permeation of tranexamic acid after conventional non-fractionated ablative Er:YAG and CO2 laser pretreatment in a laser-aided transdermal delivery system.

MATERIALS AND METHODS

An erbium-doped yttrium aluminium garnet (Er:YAG) and a CO2 laser were used to pretreat dorsal porcine skin. Scanning electron microscopy was used to examine disruption of the skin surface. Confocal laser scanning microscopy was used to determine the depth of penetration of a reporter molecule (fluorescein isothiocyanate) into the skin. A Franz diffusion assembly was used to examine fluency-related increases in transdermal delivery of transexamic acid.

RESULTS

Transdermal delivery of tranexamic acid increased as Er:YAG laser fluency increased. Transdermal delivery was higher when CO2 laser pretreatment was used than when Er:YAG laser pretreatment was used, but a “ceiling effect” was present and increasing the wattage did not cause a further increase in delivery. CO2 laser pretreatment also caused more extensive and deeper skin disruption than Er:YAG laser pretreatment.

CONCLUSION

For conventional, non-fractionated ablative laser pretreatment, the Er:YAG laser would be an optimal choice to enhance transdermal penetration of transexamic acid.
Surgical interventions for chronic pelvic pain
Authors: Senapati Sangeeta , Atashroo Diana , Carey Erin , Dassel Mark , Tu Frank F.
Published: June 2016

Purpose of review

The objective of this study is to review an evidence-based approach to surgical treatment of key chronic pelvic pain (CPP) contributors emphasizing the importance of preoperative evaluation and counseling.

Recent findings

CPP is a poorly understood but highly prevalent condition and there are limited, well constructed studies to guide effective, durable treatment. CPP arises from factors originating in multiple organ systems, including reproductive, urologic, gastrointestinal, and myofascial, all informing the central nervous system. For those with severe disabling conditions, who have a suboptimal response to medical management, surgical interventions can be offered for diagnostic evaluation and/or treatment. Leiomyoma, adenomyosis, adnexal disorder, pelvic adhesions, and pelvic varicosities are common considerations in the differential diagnosis of CPP amenable to surgical approach.

Surgical treatments of CPP range from conservative/fertility-sparing approaches to extirpative therapy. Consistently, successful outcomes often are predicated on correctly identifying the abnormal peripheral pain process (which often is only part of the complete picture for these patients). Further research is needed to better guide clinicians as to when to choose surgical therapy vs. targeting secondary contributors to pelvic pain.
Considerations for minimally invasive gynecologic surgery in obese patients
Authors: Louie Michelle , Toubia Tarek , Schiff Lauren D.
Published: June 2016

Purpose of review

The purpose is to review the key anatomical and physiological changes in obese patients and their effects on preoperative, intraoperative, and postoperative care and to highlight the best practices to safely extend minimally invasive approaches to obese patients and provide optimal surgical outcomes in this high-risk population.

Recent findings

Minimally invasive surgery is safe, feasible, and cost-effective for obese patients. Obesity is associated with anatomical and physiological changes in almost all organ systems, which necessitates a multimodal approach and an experienced, multidisciplinary team. Preoperative counseling, evaluation, and optimization of medical comorbidities are critical. The optimal minimally invasive approach is primarily determined by the patient's anatomy and pathology. Specific intraoperative techniques and modifications exist to maximize surgical exposure and panniculus management. Postoperatively, comprehensive medical management can help prevent common complications in obese patients, including hypoxemia, venous thromboembolism, acute kidney injury, hyperglycemia, and prolonged hospitalization.

Given significantly improved patient outcomes, minimally invasive approaches to gynecological surgery should be considered for all obese patients with particular attention given to specific perioperative considerations and appropriate referral to an experienced minimally invasive surgeon.
When and how to excise vaginal mesh
Authors: Rogo-Gupta Lisa , Castellanos Mario
Published: June 2016

Purpose of review

Since 2011, there has been increasing attention paid to the use of synthetic grafts (mesh) in pelvic reconstructive surgery. Although synthetic grafts are considered permanent implants to improve outcomes, the use of this material has created inadvertent complications such as erosion, chronic pain, and dyspareunia. Patient evaluation is complex and surgical techniques carry risks not yet completely understood. This review summarizes current opinions in synthetic graft excision for the treatment of mesh-related complications.

Recent findings

Recent studies reveal excisions are being increasingly performed and graft placement is decreasing. Patients of lower-volume surgeons have a higher risk of complication and need for excisional procedures. Pain is becoming the most common indication for vaginal mesh excision and that pain is mostly elicited with palpation of the mesh arms. Explantation is technically challenging and carries significant risks.

Vaginal synthetic graft complications are increasingly being managed by surgical excision. Careful evaluation of patient symptoms and objective findings should help guide management. Surgeons considering operative management should counsel patients regarding the risks of excision including but not limited to hemorrhage, nerve damage, muscular injury, and recurrent symptoms.
ACTINOMYCES NEUII ENDOPHTHALMITIS AFTER INTRAVITREAL ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTION
Authors: Sahni Sakshi , Watson Randee Miller , Sheth Veeral S.
Published: June 2016

Purpose:

To describe a case of acute endophthalmitis caused by Actinomyces neuii after intravitreal anti–vascular endothelial growth factor injection.

Methods:

Observational case report, review of published literature.

Results:

A 67-year-old white man with wet age-related macular degeneration developed endophthalmitis secondary to A. neuii on the 10th day after intravitreal anti–vascular endothelial growth factor injection. Both anterior chamber and vitreous cultures were positive for A. neuii. He was treated successfully with intravitreal injection of vancomycin and ceftazidime.

Conclusion:

This is the first published report of culture-positive endophthalmitis caused by A. neuii after intravitreal injection.
RHEGMATOGENOUS RETINAL DETACHMENT: A RARE OCULAR MANIFESTATION OF PROTEUS SYNDROME
Authors: Russell-Hermanns Dawn S. , Newman Douglas K.
Published: June 2016

Purpose:

To present a case report of a rare ocular manifestation of Proteus syndrome—rhegmatogenous retinal detachment.

Methods:

Retrospective review of the patient's medical record and a review of the literature.

Results:

A 16-year-old boy with Proteus syndrome who presented with a total retinal detachment because of an operculated retinal tear. This patient underwent successful surgical repair of the retinal detachment and subsequent cataract surgery.

Conclusion:

Proteus syndrome may be complicated by the development of rhegmatogenous retinal detachment, which can present in childhood.
Influence of Socioeconomic Status and Perceived Barriers on Physical Activity Among Taiwanese Middle-Aged and Older Women
Authors: Lin Chia-Huei , Chiang Shang-Lin , Yates Patsy , Tzeng Wen-Chii , Lee Meei-Shyuan , Chiang Li-Chi
Published: June 2016

Background:

Physical activity (PA) is associated with cardiovascular health in general populations, particularly in women. Middle-aged and older women are at high risk of less engagement in PA for unknown and complicated reasons.

Objectives:

The aim of this study was to investigate whether PA was positively associated with socioeconomic status and psychosocial correlates of PA (self-efficacy and perceived benefits) but inversely correlated with perceived barriers in women (age >40 years).

Methods:

A cross-sectional survey of 326 community-dwelling women was conducted. Data on socioeconomic status, PA, and its psychosocial correlates (ie, perceived benefits/barriers and self-efficacy) were collected using self-report questionnaires. Analyses were performed by multiple linear regressions.

Results:

Monthly income (β = .35, P = .015), employment status (β = .32, P < .001), and perceived barriers to PA (β = −.19, P = .008) were significantly associated with PA. More highly educated women participated in more (β = .13, P = .033) vigorous PA, women with fewer perceived barriers participated in more (β = −.14, P = .047) moderate-intensity PA, and employed women participated in more (β = .35, P < .001) walking. Significantly higher scores of perceived barriers, including “no trainer,” “feeling exhausted,” “lack of motivation,” and “lack of guidance,” were identified in women with low PA compared with those with moderate PA.

Conclusion:

Socioeconomic status and perceived barriers are associated with PA and its intensity level. Some specific barriers provide insights into the key factors that contribute to low PA in middle-aged and older women. These findings can be considered in future interventions to design PA promotion programs for this population to protect against cardiovascular diseases.
Prenatal Exposure to Folic Acid and Antidepressants and Language Development
Authors: Handal Marte , Skurtveit Svetlana , Roth Christine , Hernandez-Diaz Sonia , Selmer Randi
Published: June 2016

Objective

The aim of the study was to determine the effect of simultaneous use of folic acid supplements and selective serotonin reuptake inhibitors (SSRIs) by pregnant women on language development in their offspring at the age of 3 years.

Design

We conducted a cohort study of 45,266 women with 51,747 singleton pregnancies in the population-based Norwegian Mother and Child Cohort study (1999–2008). The association between the use of SSRIs with and without concomitant folic acid and language competence in the offspring was investigated using multinomial logistic regression. Self-reported use of folic acid supplements and SSRIs was prospectively collected in 4-week intervals during pregnancy and validated with prescription data and plasma concentrations, respectively. The children's language competence was measured by a validated language grammar rating scale and classified into 3 categories.

Results

Women reported the use of folic acid in 44,417 (85.8%) and SSRI in 372 (0.7%) of the pregnancies, 260 used the 2 simultaneously. Compared with women who used folic acid and no SSRIs, the adjusted relative risk ratio of lower language competence rose with the increased duration of simultaneous use of folic acid and SSRIs. After simultaneous use at 4 to 8 four-week intervals, the relative risk ratio reached 4.5 (95% confidence interval, 2.5–8.0) and 5.7 (2.5–13.0) for the intermediate and most delayed category, respectively, using the best language competence category as the reference. The use of SSRIs without folic acid was not significantly associated with an increased risk.

Conclusions

We detected a significant association between long-term use of SSRIs during pregnancy and delayed language competence in the offspring only when folic acid supplementation was used concomitantly. This surprising result warrants further studies.
Beaulieu–Boycott–Innes syndrome: an intellectual disability syndrome with characteristic facies
Authors: Casey Jillian , Jenkinson Allan , Magee Alex , Ennis Sean , Monavari Ahmad , Green Andrew , Lynch Sally A. , Crushell Ellen , Hughes Joanne
Published: June 2016

We report a female child from an Irish Traveller family presenting with severe intellectual disability, dysmorphic features, renal anomalies, dental caries and cyclical vomiting. Current health issues include global developmental delay, mild concentric left ventricular hypertrophy, dental malocclusion and caries and a single duplex left kidney. The proband and her mother also have multiple epiphyseal dysplasia. Whole-exome sequencing was performed to identify the underlying genetic cause. DNA from the proband was enriched with the Agilent Sure Select v5 Exon array and sequenced on an Illumina HiSeq. Rare homozygous variants were prioritized. Whole-exome sequencing identified three linked homozygous missense variants in THOC6 (c.298T>A, p.Trp100Arg; c.700G>C, p.Val234Leu; c.824G>A, p.Gly275Asp) as the likely cause of this child’s intellectual disability syndrome, resulting in a molecular diagnosis of Beaulieu–Boycott–Innes syndrome (BBIS). This is the first report of BBIS in Europe. BBIS has been reported previously in two Hutterite families and one Saudi family. A review of all patients to date shows a relatively homogenous phenotype. Core clinical features include low birth weight with subsequent growth failure, short stature, intellectual disability with language delay, characteristic facies, renal anomalies and dental malocclusion with caries. Some patients also have cardiac defects. All patients show characteristic dysmorphic facial features including a tall forehead with high anterior hairline and deep-set eyes with upslanting palpebral fissures. The coexistence of intellectual disability together with these characteristic facies should provide a diagnostic clue for BBIS during patient evaluation.
Prognostic value of C-reactive protein in cirrhosis: external validation from the CANONIC cohort
Authors: Cervoni Jean-Paul , Amorós Àlex , Bañares Rafael , Luis Montero Jose , Soriano German , Weil Delphine , Moreau Richard , Pavesi Marco , Thévenot Thierry , Di Martino Vincent
Published: June 2016

Background/aims

The variations in C-reactive protein (CRP) levels have been reported to have prognostic significance in decompensated cirrhotic patients. We aimed to provide an external validation of a prognostic model combining model for end-stage liver disease (MELD) and ‘sustained high CRP levels’ as main variables and to optimize the model to the context of liver transplantation by focusing on 3-month mortality with no consideration of severe chronic extrahepatic diseases.

Patients and methods

Data from cirrhotic patients enrolled in the CANONIC study were collected. Multivariate analyses used the competing risk model. The prognostic performance [area under receiver operating characteristic curve (AUROC)] of the model incorporating CRP variations within 15 days was compared with that of the MELD score alone.

Results

583 decompensated cirrhotic patients with Child–Pugh more than B7 and serial CRP measures available were included. Of these, 111 patients had baseline CRP at least 29 mg/l and 60 still had CRP at least 29 mg/l at day 15±6 (group A). Multivariate analysis (competing risk) identified three predictors of 3-month mortality: high MELD score [hazard ratio (HR)=1.14; 95% confidence intervals (CI): 1.11–1.17, P<0.001], age (HR=1.04; 95% CI: 1.02–1.06, P<0.001), and group A (HR=1.69; 95% CI: 1.01–2.81, P=0.046). The performance of the three variables taken together for predicting 3-month mortality was 0.796 (AUROC), which was significantly higher than that of the MELD score (AUROC=0.769; P=0.019).

Conclusion

In Child–Pugh higher than B7 cirrhotic patients with decompensation, prognostic models incorporating variations in CRP within 15 days and age predict 3-month mortality better than the MELD score alone. Such models would improve the ranking of candidates for liver transplantation by differentiating the severe patients with persistent systemic inflammation and intermediate MELD scores.
Reduction of Arachidonate Is Associated With Increase in B‐Cell Activation Marker in Infants
Authors: Miklavcic John J. , Larsen Bodil M.K. , Mazurak Vera C. , Scalabrin Deolinda M.F. , MacDonald Ian M. , Shoemaker Glen K. , Casey Linda , Van Aerde John E. , Clandinin Michael T.
Published: June 2016

Background:

Infants who are not breast‐fed benefit from formula with both docosahexaenoic acid (C22:6n3) and arachidonic acid (ARA; C20:4n6). The amount of ARA needed to support immune function is unknown. Infants who carry specific fatty acid desaturase (FADS) polymorphisms may require more dietary ARA to maintain adequate ARA status.

Objective:

The aim of the study was to determine whether ARA intake or FADS polymorphisms alter ARA levels of lymphocytes, plasma, and red blood cells in term infants fed infant formula.

Methods:

Infants (N = 89) were enrolled in this prospective, double‐blind controlled study. Infants were randomized to consume formula containing 17 mg docosahexaenoic acid and 0, 25, or 34 mg ARA/100 kcal for 10 weeks. Fatty acid composition of plasma phosphatidylcholine and phosphatidylethanolamine, total fatty acids of lymphocytes and red blood cells, activation markers of lymphocytes, and polymorphisms in FADS1 and FADS2 were determined.

Results:

Lymphocyte ARA was higher in the 25‐ARA formula group than in the 0‐ or 34‐ARA groups. In plasma, 16:0/20:4 and 18:0/20:4 species of phosphatidylcholine and phosphatidylethanolamine were highest and 16:0/18:2 and 18:0/18:2 were lowest in the 34‐ARA formula group. In minor allele carriers of FADS1 and FADS2, plasma ARA content was elevated only at the highest level of ARA consumed. B‐cell activation marker CD54 was elevated in infants who consumed formula containing no ARA.

Conclusions:

ARA level in plasma is reduced by low ARA consumption and by minor alleles in FADS. Dietary ARA may exert an immunoregulatory role on B‐cell activation by decreasing 16:0/18:2 and 18:0/18:2 species of phospholipids. ARA intake from 25 to 34 mg/100 kcal is sufficient to maintain cell ARA level in infants across genotypes.
Renal Leiomyoma and Leiomyosarcoma
Authors: Gupta Sounak , Jimenez Rafael E. , Folpe Andrew L. , Cheville John C.
Published: June 2016

Primary renal leiomyomas and leiomyosarcomas are rare, and there is a paucity of data regarding the pathologic features and outcomes of patients with these tumors. The objective of this study was to review a large series of renal smooth muscle tumors, in order to more fully elucidate their natural histories. Fifty-seven renal smooth muscle tumors were reviewed for various histopathologic features, and leiomyosarcomas were graded using the French Federation of Cancer Centers (FNCLCC) system. Tumor cores in tissue microarrays were evaluated for smooth muscle actin, desmin, h-caldesmon, calponin, myogenin, cytokeratin (OSCAR), CD117, Ki67, estrogen receptor (ER), progesterone receptor (PR), and Wilms tumor 1 (WT1). Leiomyomas were selected on the basis of preexisting diagnostic criteria, which included a lack of cytologic atypia, necrosis, and mitotic activity (0 to 1 mitoses/10 hpf). These were found to have a strong predilection for women, tended to arise from the renal capsule, were small (mean size, 4.2 cm), and had a low Ki67 proliferative rate (mean 1.4%). In addition, they uniformly expressed all smooth muscle markers and were ER/PR/WT1 positive in nearly all cases. In 10 patients with clinical follow-up, none had a tumor recurrence. In contrast, leiomyosarcomas had an equal sex distribution, were larger (mean size, 9.8 cm), had significantly higher mitotic activity (mean 8.6 mitoses/10 hpf), with most being FNCLCC grade 2. Leiomyosarcomas expressed at least 1 muscle marker, higher Ki67 proliferative activity (mean 20.4%) than leiomyomas, and most were ER/PR/WT1 negative. Tumor recurrence occurred in 65% of patients, and 35% of patients died of disease. This study therefore validates existing criteria to distinguish between leiomyomas and leiomyosarcomas.
The Role of Activin A and B and the Benefit of Follistatin Treatment in Renal Ischemia-Reperfusion Injury in Mice
Authors: Fang Doreen Y.P. , Lu Bo , Hayward Susan , de Kretser David M. , Cowan Peter J. , Dwyer Karen M.
Published: June 2016

Background

Activins, members of the TGF-β superfamily, are key drivers of inflammation and are thought to play a significant role in ischemia-reperfusion injury (IRI), a process inherent to renal transplantation that negatively impacts early and late allograft function. Follistatin (FS) is a protein that binds activin and inhibits its activity. This study examined the response of activin A and B in mice after renal IRI and the effect of exogenous FS in modulating the severity of renal injury.

Methods

Mice were treated with recombinant FS288 or vehicle before renal IRI surgery. Activin A, B, and FS levels in the serum and kidney, and renal injury parameters were measured at 3, 6, and 24 hours after reperfusion.

Results

Serum and kidney activin B levels were increased within 6 hours postrenal IRI, accompanied by renal injury—increased serum creatinine, messenger (m)RNA expression of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL); endothelial activation—increased E-selectin mRNA; and systemic inflammation—increased serum levels of IL-6, monocyte chemotactic protein-1 and TNF-α. Further injury was potentiated by an upsurge in activin A by 24 hours, with further increases in serum creatinine, KIM-1 and NGAL mRNA expression. Follistatin treatment significantly reduced the level of serum activin B and subsequently blunted the increase in activin A. Renoprotection was evident with the attenuated rise in serum creatinine, KIM-1 and NGAL expression, tubular injury score, renal cell apoptosis, and serum IL-6 and monocyte chemotactic protein-1 levels.

Conclusions

We propose that activin B initiates and activin A potentiates renal injury after IRI. Follistatin treatment, through binding and neutralizing the actions of activin B and subsequently activin A, reduced renal IRI by minimizing endothelial cell activation and dampening the systemic inflammatory response. These data support the potential clinical application of FS treatment to limit IRI during renal transplantation.
The Motor Unit Number Index of Subclinical Abnormality in Amyotrophic Lateral Sclerosis
Authors: Fukada Kei , Matsui Toyoko , Furuta Mitsuru , Hirozawa Daisuke , Matsui Misa , Kajiyama Yuta , Shimizu Mikito , Kinoshita Makoto , Mochizuki Hideki , Sawada Jin-ichi , Hazama Takanori
Published: June 2016

Purpose:

Diagnosis of amyotrophic lateral sclerosis (ALS) at an early stage is challenging, thus making the enrollment of these patients in clinical trials infeasible. In this study, we investigated the potential usability of motor unit number index (MUNIX) to detect denervation of clinically intact muscles of ALS patients.

Methods:

Thirty-two first dorsal interosseous muscles of 26 ALS patients were evaluated with both MUNIX and needle electromyography.

Results:

The mean MUNIX value of first dorsal interosseous muscles was 131 in the control group, whereas it was 48, 34, 15, and 8 for Medical Research Council scales of 5, 4, 3, and 2, respectively, in the ALS patients. The optimal cutoff point gave a sensitivity of 0.89 and a specificity of 1.0. Among 9 intact first dorsal interosseous muscles of the ALS patients, 8 showed MUNIX values below the cutoff point, whereas only 2 first dorsal interosseous muscles showed denervation on needle electromyography.

Conclusions:

MUNIX could serve as a sensitive technique to detect denervation of clinically intact muscles of ALS patients.
Tandem duplication events in the expansion of the small heat shock protein gene family inSolanum lycopersicum(cv. Heinz 1706)
Authors: Krsticevic Flavia J. , Arce Débora P. , Ezpeleta Joaquín , Tapia Elizabeth
Published: June 2016

In plants, fruit maturation and oxidative stress can induce small heat shock protein (sHSP) synthesis to maintain cellular homeostasis. Although the tomato reference genome was published in 2012, the actual number and functionality of sHSP genes remain unknown. Using a transcriptomic (RNA-seq) and evolutionary genomic approach, putative sHSP genes in theSolanum lycopersicum(cv. Heinz 1706) genome are investigated. A sHSP gene family of 33 members is established. Remarkably, roughly half of themembers of this family can be explained by nine independent tandem duplication eventsthat evolutionarily determined their functional fates. Within a mitochondrial class subfamily, only one duplicated member, Solyc08g078700, retained its ancestral chaperonefunction, while the others, Solyc08g078710 and Solyc08g078720,likely degenerated under neutrality and lack ancestral chaperone function. Functional conservation occurred within a cytosolic class I subfamily, whose four members, Solyc06g076570, Solyc06g076560, Solyc06g076540 and Solyc06g076520, support ~57% of the total sHSP RNAm in the red ripe fruit. Sub-functionalization occurred within a new subfamily, whose twomembers, Solyc04g082720 and Solyc04g082740, show heterogeneous differential expressionprofiles during fruit ripening. These findings, involving the birth/death of some genes or the preferential/plastic expression of some others during fruit ripening, highlight the importance of tandem duplication events in the expansion of the sHSP gene family in the tomato genome. Despite its evolutionary diversity, the sHSP gene family in the tomato genome seems to be endowed with a core set of four homeostasis genes: Solyc05g014280, Solyc03g082420, Solyc11g020330 and Solyc06g076560, which appear to provide abaseline protection during both fruit ripening and heat shock stress in different tomato tissues.
Intraoperative biomechanics of lumbar pedicle screw loosening following successful arthrodesis
Authors: Pearson Hope B. , Dobbs Christopher J. , Grantham Eric , Niebur Glen L. , Chappuis James L. , Boerckel Joel D.
Published: June 2016

Pedicle screw loosening has been implicated in recurrent back pain after lumbar spinal fusion, but the degree of loosening has not been systematically quantified in patients. Instrumentation removal is an option for patients with successful arthrodesis, but remains controversial. Here, we quantified pedicle screw loosening by measuring screw insertion and/or removal torque at high statistical power (β = 0.98) in N = 108 patients who experienced pain recurrence despite successful fusion after posterior instrumented lumbar fusion with anterior lumbar interbody fusion (L2-S1). Between implantation and removal, pedicle screw torque was reduced by 58%, indicating significant loosening over time. Loosening was greater in screws with evoked EMG threshold under 11 mA, indicative of screw misplacement. A theoretical stress analysis revealed increased local stresses at the screw interface in pedicles with decreased difference in pedicle thickness and screw diameter. Loosening was greatest in vertebrae at the extremities of the fused segments, but was significantly lower in segments with one level of fusion than in those with two or more.

Clinical significance

These data indicate that pedicle screws can loosen significantly in patients with recurrent back pain and warrant further research into methods to reduce the incidence of screw loosening and to understand the risks and potential benefits of instrumentation removal.
CellProfiler Analyst: interactive data exploration, analysis, and classification of large biological image sets
Authors: Dao D. , Fraser A. N. , Hung J. , Ljosa V. , Singh S. , Carpenter A. E.
Published: June 2016

CellProfiler Analyst allows the exploration and visualization of image-based data, together with the classification of complex biological phenotypes, via an interactive user interface designed for biologists and data scientists. CellProfiler Analyst 2.0, completely rewritten in Python, builds on these features and adds enhanced supervised machine learning capabilities (in Classifier), as well as visualization tools to overview an experiment (Plate Viewer and Image Gallery).

Availability

CellProfiler Analyst 2.0 is free and open source, available athttp://www.cellprofiler.org/releasesand from GitHub (https://github.com/CellProfiler/CellProfiler-Analyst) under the BSD license. It is available as a packaged application for Mac OS X and Microsoft Windows and can be compiled for Linux. We implemented an automatic build process that supports nightly updates and regular release cycles for the software.

Contact

anne@broadinstitute.org

Supplementary information

Supplementary Text 1: Manual to CellProfiler Analyst; updated versions are available atCellProfiler.org/CPA

Supplementary Data 1: Benchmarking performance of classifiers in CPA 2.0 versus CPA 1.0
Genetic Mapping by Bulk Segregant Analysis in Drosophila: Experimental Design and Simulation-Based Inference
Authors: Pool John E
Published: June 2016

Identifying the genomic regions that underlie complex phenotypic variation is a key challenge in modern biology. Many approaches to quantitative trait locus mapping in animal and plant species suffer from limited power and genomic resolution. Here, I investigate whether bulk segregant analysis (BSA), which has been successfully applied for yeast, may have utility in the genomic era for trait mapping inDrosophila(and other organisms that can be experimentally bred in similar numbers). I perform simulations to investigate the statistical signal of a quantitative trait locus (QTL) in a wide range of BSA and introgression mapping (IM) experiments. BSA consistently provides more accurate mapping signals than IM (in addition to allowing the mapping of multiple traits from the same experimental population). The performance of BSA and IM is maximized by having multiple independent crosses, more generations of interbreeding, larger numbers of breeding individuals, and greater genotyping effort, but is less affected by the proportion of individuals selected for phenotypic extreme pools. I also introduce a prototype analysis method for Simulation-based Inference for BSA Mapping (SIBSAM). This method identifies significant QTLs and estimates their genomic confidence intervals and relative effect sizes. Importantly, it also tests whether overlapping peaks should be considered as two distinct QTLs. This approach will facilitate improved trait mapping inDrosophilaand other species for which hundreds or thousands of offspring (but not millions) can be studied.
Comparison of 3.0 T PAC versus 1.5 T ERC MRI in Detecting Local Prostate Carcinoma
Authors: Ye Xin , yoyo Udochukwu , Lu Albert , Dixon Jed , Rojas Heather , Randolph Samuel , Kelly Thomas
Published: June 2016

Increased utilization of prostate-specific antigen screening and prostate imaging has led to detection of smaller indolent tumors that traditional brachytherapy and prostectomy may be too aggressive for. New targeted techniques require greater locational accuracy of tumor detection to guide treatment. Prostate MRIs can be important for initial staging and for guiding targeted biopsies and treatments. We compared the accuracy of local staging of prostate cancer using 1.5 Tesla MRI with endorectal coil (ERC) versus 3 Tesla MRI with pelvic array coil (PAC) to the gold standard of trans-rectal US guided biopsies (TRUS). ERC is uncomfortable and has many imaging artifacts that may limit detection, so we hypothesize that 3 T MRI with PAC will have improved performance. 72 patients underwent prostate MRIs and TRUS prostate biopsies from 2008-2011 (33 were excluded due to prior radiation therapy, 24 patients underwent 1.5 T ERC and 15 underwent 3.0 T PAC.) 3.0 T PAC was trending towards greater sensitivity although we lack the statistical power for significance.
Crystal structures of three 6-substituted coumarin-3-carboxamide derivatives
Authors: Gomes Lígia R. , Low John Nicolson , Fonseca André , Matos Maria João , Borges Fernanda
Published: June 2016

Three coumarin derivatives,viz.6-methyl-N-(3-methylphenyl)-2-oxo-2H-chromene-3-carboxamide, C18H15NO3(1),N-(3-methoxyphenyl)-6-methyl-2-oxo-2H-chromene-3-carboxamide, C18H15NO4(2), and 6-methoxy-N-(3-methoxyphenyl)-2-oxo-2H-chromene-3-carboxamide, C18H15NO5(3), were synthesized and structurally characterized. The molecules display intramolecular N—H...O and weak C—H...O hydrogen bonds, which probably contribute to the approximate planarity of the molecules. The supramolecular structures feature C—H...O hydrogen bonds and π–π interactions, as confirmed by Hirshfeld surface analyses.
Crystal structure of bis{4-bromo-2-[(carbamimidamidoimino)methyl]phenolato-κ3N,N′,O}cobalt(III) nitrate dimethylformamide monosolvate
Authors: Buvaylo Elena A. , Kasyanova Katerina A. , Vassilyeva Olga Yu. , Skelton Brian W.
Published: June 2016

The title compound, [Co(C8H8BrN4O)2]NO3·C3H7NO, is formed of discrete [CoL2]+cations, nitrate anions and dimethylformamide (DMF) molecules of crystallization. The cation has no crystallographically imposed symmetry. The ligand molecules are deprotonated at the phenol O atom and octahedrally coordinate the CoIIIatoms through the azomethine N and phenolate O atoms in amerconfiguration. The deprotonated ligand molecules adopt an almost planar conformation. In the crystal lattice, the cations are arranged in layers in theabplane divided by the nitrate anions and solvent molecules. No π–π stacking is observed. All of the amine H atoms are involved in hydrogen bonding to nitrate, DMF or ligand O atoms or to one of the Br atoms, forming two-dimensional networks parallel to (100).
Crystal structure of bis(isonicotinamide-κN1)bis(thiocyanato-κN)zinc
Authors: Neumann Tristan , Jess Inke , Näther Christian
Published: June 2016

The asymmetric unit of the title complex, [Zn(SCN)2(C6H6N2O)2], consists of one Zn2+cation located on a twofold rotation axis, as well as of one thiocyanate anion and one neutral isonicotinamide ligand, both occupying general positions. The Zn2+cation is tetrahedrally coordinated into a discrete complex by the N atoms of two symmetry-related thiocyanate anions and by the pyridine N atoms of two isonicotinamide ligands. The complexes are linked by intermolecular C—H...O and N—H...O, and weak intermolecular N—H...S hydrogen-bonding interactions into a three-dimensional network.
Multi-risk approach and urban resilience
Authors: Komendantova Nadejda , Scolobig Anna , Garcia-Aristizabal Alexander , Monfort Daniel , Fleming Kevin
Published: June 2016

Purpose

Urban resilience is becoming increasingly important due to increasing degree of urbanization and a combination of several factors affecting urban vulnerability. Urban resilience is also understood as a capacity of a system to prepare, respond and recover from multi-hazard threats. The purpose of multi-risk approach (MRA) is to take into consideration interdependencies between multiple risks, which can trigger a chain of natural and manmade events with different spatial and temporal scales. The purpose of this study is to understand correlation between multi-risk approach and urban resilience.

Design/methodology/approach

To increase urban resilience, MRA should also include multi-risk governance, which is based on understanding how existing institutional and governance structures, individual judgments and communication of risk assessment results shape decision-making processes.

Findings

This paper is based on extensive fieldwork in the test studies of Naples, Italy and Guadeloupe, France, the historical case study analysis and the stakeholders’ interviews, workshops and focus groups discussions.

Originality/value

Multi-risk is a relatively new field in science, only partially developed in social and geosciences. The originality of this research is in establishment of a link between MRA, including both assessment and governance, and urban resilience. In this paper, the authors take a holistic and systemic look at the MRA, including all stages of knowledge generation and decision-making. Both, knowledge generation and decision-making are reinforced by behavioural biases, different perceptions and institutional factors. Further on, the authors develop recommendations on how an MRA can contribute to urban resilience.
Critical infrastructure interdependence in New York City during Hurricane Sandy
Authors: Haraguchi Masahiko , Kim Soojun
Published: June 2016

Purpose

This study aims to investigate the impact of Hurricane Sandy from the perspective of interdependence among different sectors of critical infrastructure in New York City and to assess the interconnected nature of risks posed by such a hurricane.

Design/methodology/approach

This study uses indirect damages of each sector to estimate the degree of functional interdependence among the sectors. The study examines the impact of the hurricane on different critical infrastructures by combining hazard maps of actual inundation areas with maps of critical infrastructure. The direct damages of each sector are calculated from the inundation areas in the flood map. The indirect damages are estimated by considering the areas that were not inundated but affected by Sandy through the interconnected infrastructure.

Findings

The electricity sector was the key sector to propagate risks to other sectors. The examination of new initiatives to increase the resilience of critical infrastructures in New York City after Sandy reveals that these initiatives focus primarily on building hard infrastructures to decrease direct damages. They understate the importance of interdependent risk across sectors. Future disaster risk reduction strategies must address interdependent infrastructures to reduce indirect damages.

Originality/value

This paper focuses on estimating the direct and indirect damages caused by Hurricane Sandy in each critical infrastructure sector, using GIS mapping techniques. It also introduces a Bayesian network as a tool to analyze critical infrastructure interdependence.
Shopping for yourself versus shopping for someone else
Authors: Gillison Stephanie , Reynolds Kristy
Published: June 2016

Purpose

Shoppers often shop for and purchase products for other individuals during the course of routine shopping experiences. The purpose of this study is to investigate differences in the shopping trip based on whether the shopper is purchasing a product for him/herself, purchasing a product for someone else’s use that is not intended as a gift and gift purchases.

Design/methodology/approach

This research utilizes a survey of shoppers to test the proposed hypotheses.

Findings

The results of the study indicate differences in positive affect, flow, fantasy, satisfaction, hedonic shopping value and utilitarian shopping value across the three groups of shoppers. Individuals shopping for themselves generally have the lowest overall shopping trip outcomes, followed by those shopping for a non-gift product for another person. Those making gift purchases have highest shopping trip outcomes.

Originality/value

While existing shopping research generally assumes the shopper is making a purchase for him/herself, this study shows previous research by showing differences in the shopping trip based on who the shopper is making a purchase for, either him/herself or someone else. Additionally, this research also shows differences between shoppers making gift and non-gift purchases for another person.
Evaluation of Postmortem Cerebrospinal Fluid S100B Protein and Serotonin Levels: Comparison of Suicidal Versus Nonsuicidal Deaths in Konya, Turkey
Authors: Dogan Kamil Hakan , Unaldi Mustafa , Demirci Serafettin
Published: June 2016

Although suicide is a preventable public health problem, objective assays for suicide risk are limited. In this study, it was aimed to determine levels of S100B protein and serotonin as a marker for risk of suicide. S100B protein and serotonin levels were investigated with ELISA method in the cerebrospinal fluid (CSF) in medicolegal autopsy cases, including those of suicide cases (n = 32) and nonsuicide cases (n = 56). The CSF S100B levels were higher (9.3 ± 2.9 ng/mL vs. 5.4 ± 2.0 ng/mL), and serotonin levels were lower (10.4 ± 4.9 ng/mL vs. 19.0 ± 5.7 ng/mL) in suicide group than nonsuicide group (p < 0.05). There was no correlation between S100B protein and serotonin levels with gender, age groups, postmortem interval, and cause of death. It is concluded that both S100B protein and serotonin in CSF may be useful for determination of suicide risk.