bluuebunny/crossref_metadata_2025 huggingface dataset:
Extensor Carpi Ulnaris Tenodesis Versus No Stabilization After Wide Resection of Distal Ulna Giant Cell Tumors
Authors: Papanastassiou Ioannis D. , Savvidou Olga D. , Chloros George D. , Megaloikonomos Panayiotis D. , Kontogeorgakos Vasileios A. , Papagelopoulos Panayiotis J.
Published: November 2017

Background: The necessity of stabilizing the residual ulnar stump after distal ulna tumor resection remains controversial. The authors retrospectively compared the outcome of patients who underwent wide resection of distal ulna giant cell tumors (GCTs) and reconstruction with tenodesis of the extensor carpi ulnaris (ECU) or without reconstruction. Methods: Between 2007 and 2015, 9 patients (6 females, 3 males; mean age, 36.8 years; range, 24-65 years) who underwent distal ulna resection for GCT of bone were retrospectively reviewed. The mean resection length was 8.1 cm. Five patients had no reconstruction, whereas 4 patients had stabilization of the ulnar stump using ECU tenodesis. With a mean follow-up of 3.6 years (2-9 years), the functional outcome using the quick Disability of Arm, Shoulder and Hand (DASH) score; Musculoskeletal Tumor Society score and grip strength; as well as the oncological outcome were evaluated. Results: Musculoskeletal Tumor Society functional scores were more than 24 in 7 patients and 20 to 24 in 2 patients (mean, 27.6 or 92%). Quick DASH scores ranged from 0 to 27.3 (mean, 11.1). In both groups, similar scores were observed ( P > .5). No patient had instability or pain related to the stump. There was no ulnar translation or subluxation of the radiocarpal joint. Grip strength in the operated hand, controlled for handedness, was 11% less than in the contralateral hand, although there was no difference between groups ( P > .4). All patients were disease-free at the latest follow-up. Conclusions: The distal ulna may be widely resected with or without stabilization of the residual ulnar stump, yielding satisfactory local disease control and functional outcome.
Nutritional Assessment and Intervention to Prevent and Treat Malnutrition for Fall Risk Reduction in Elderly Populations
Authors: Esquivel Monica K.
Published: November 2017

The aging US population is increasing, and it is estimated that adults older than 65 years will make up 20% of the population by 2029 and the proportion of individuals in the United States older than 65 years will outnumber individuals younger than 18 years. In older adults, accidental falls are the leading cause of fatal and nonfatal injuries. Prevalence of chronic conditions such as sarcopenia and frailty contribute to the increased risk for fall observed in this population. Nutritional status in elderly individuals is a key predictor of both frailty and sarcopenia, thus ensuring adequacy in these populations has the potential for preventing falls. Poor nutritional status is associated with the onset of frailty. Nutrition screening, assessment and interventions can be targeted at this age group to overcome treat and prevent malnutrition to minimize fall risk.
Intermedin attenuates high-glucose exacerbated simulated hypoxia/reoxygenation injury in H9c2 cardiomyocytes via ERK1/2 signaling
Authors: Li Hong , Xiao Chuan-Shi , Bian Yun-Fei , Bai Rui , Gao Fen
Published: November 2017

Objective:

This study investigated whether and how intermedin (IMD) exerted a protective effect against simulated hypoxia/reoxygenation (H/R) injury in high-glucose-treated H9c2 cells.

Methods:

Cellular viability was assessed via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Oxidative stress was determined by malondialdehyde and superoxide dismutase content in the culture medium supernatant. Flow cytometry with Annexin V/propidium iodide staining was used to detect the cardiomyocyte apoptosis rate. The protein expression of Bax, Bcl-2, caspase-3, and ERK1/2 was determined by western blot.

Results:

IMD administration to H9c2 cells during H/R injury decreased oxidative stress product generation and inhibited apoptosis ( P < 0.05 or P < 0.01) while these effects were blocked by the ERK1/2 inhibitor ( P < 0.05 or P < 0.01). Through the application of a specific ERK1/2 inhibitor, it was demonstrated that IMD mitigates high-glucose-induced oxidative stress and apoptosis via ERK1/2 signaling.

Conclusion:

Intermedin may be a novel therapeutic agent for mitigating diabetic cardiovascular injury in the clinical setting.
Football helmet impact standards in relation to on-field impacts
Authors: Sproule David W , Campolettano Eamon T , Rowson Steven
Published: November 2017

Youth football helmets currently undergo the same impact testing and must satisfy the same criteria as varsity helmets, although youth football players differ from their adult counterparts in anthropometry, physiology, and impact exposure. This study aimed to relate football helmet standards testing to on-field head impact magnitudes for youth and varsity football helmets. Head impact data, filtered to include only impacts to locations in the current National Operating Committee on Standards for Athletic Equipment standard, were collected for 48 collegiate players (ages 18–23 years) and 25 youth players (ages 9–11 years) using helmet-mounted accelerometer arrays. These on-field data were compared to a series of National Operating Committee on Standards for Athletic Equipment standard drop tests with a youth and varsity Riddell Speed helmet. In the on-field data, the adult players had a higher frequency of impact than the youth players, and a significant difference in head acceleration magnitude only existed at the top location (p < 0.001). In the laboratory drop tests, the only significant difference between the youth and varsity helmets was at the 3.46 m/s (61 cm) impact to the front location (p = 0.0421). Drop tests generated head accelerations within the top 10% of measured on-field impacts, at all locations and drop heights, demonstrating that drop tests are representative of the most severe head impacts experienced by youth and adult football players on the field. Current standards have been very effective at eliminating skull fracture and severe brain injury in both populations. This analysis suggests that there is not currently a need for a youth-specific drop test standard. However, there may be such a need if helmet testing standards are updated to address concussion, paired with a better understanding of differences in concussion tolerance between youth and adult populations.
Freedom of Information and Data Protection Acts
Authors: Tarafdar Suhail Amin , Fay Michael
Published: November 2017

Data is frequently handled by GPs during their day-to-day work. This includes not only clinical data where patient information is handled, but also organisational data. Clinicians must be aware of the regulations that govern information handling. This article will discuss the Data Protection Act 1998, which governs personal information held on patient records. It will clarify the eight data protection principles and how they apply in practice. Thereafter, the article will discuss the Freedom of Information Act 2000, which gives the public rights to access certain data held by surgeries. The article will highlight important exemptions and grounds for refusing access to data.
Resection of unicentric interlobar Castleman disease with following adjuvant radiotherapy
Authors: Sarana Bruno , Jaal Jana , Tamm Hannes , Laisaar Tanel
Published: December 2017

A 22-year-old female patient with rare interlobar unicentric Castleman disease is presented. The tumour was discovered incidentally and thoracoscopic biopsy was planned to rule out malignancy. Due to dense adhesions to the adjacent anatomical structures and diffuse bleeding when mobilizing the tumour, a thoracoscopic approach was converted to thoracotomy. The tumour was removed without lung resection. Adjuvant radiotherapy was used to avoid possible recurrence of the disease. During the follow-up of 6 years, the patient remains free of any symptoms and evidence of recurrence.
Networked Field Studies: Comparative Inquiry and Online Communities
Authors: Lingel Jessa
Published: November 2017

In this article, I articulate a methodology for comparative qualitative analysis of online communities, which I refer to as networked field studies. I describe networked field studies as an approach that allows for looking across multiple communities and field sites to build a coherent set of analytical claims about the role of technology and everyday life, drawing on my own research investigating relationships to digital technologies among three countercultural communities. The major aim of this article is to contribute to methodological discussions on comparative qualitative analysis within Internet studies, foregrounding how research on digital technologies can both benefit from and complicate a comparative approach. After a brief summary of the communities studied in the research that has given rise to this methodological approach, I outline key methodological concepts and address the strengths and limitations of networked field studies as a method for analyzing socio-technical practices in everyday life.
Treatment With Helical Blade Cephalomedullary Nail for Two-Part Basicervical Proximal Femoral Fracture in Elderly Patients: A Retrospective Observational Study
Authors: Okano Ichiro , Sawada Takatoshi , Kushima Nobumasa , Tachibana Tetsuya , Inagaki Katsunori
Published: November 2017

Background:

Basicervical proximal femoral fracture is a known subtype of extracapsular fracture and is mechanically unstable, especially for the rotational direction, which may lead to implant failure. A cephalomedullary nail (CMN) is widely used for the fixation of unstable extracapsular fracture; however, its application for basicervical fracture remains controversial. Helical blade CMN is proven to have more rotational stability than traditional lag screw implants and potentially advantageous in the treatment of basicervical fracture. The aim of this study is to assess the effectiveness of helical blade CMN for basicervical fracture in elderly patients.

Methods:

We conducted a retrospective review of 500 consecutive extracapsular fracture patients treated surgically between January 2005 and February 2015. Patients who had trochanteric extension or multifragment fracture were excluded. Sixteen cases of 2-part basicervical proximal femoral fracture were identified. All patients were treated with the same single helical blade CMN system (DePuy Synthes PFNA-II). Implant-related complications were recorded.

Results:

Two patients dropped out during follow-up and 14 patients were included in the analysis. The average follow-up period was 21.9 months. No major complication was observed. The patients were subcategorized into 2 groups: nondisplaced (displacement <2 mm at any point of the fracture line) or displaced. Excessive telescoping was observed in 2 patients, both of whom were in the displaced fracture group. The overall implant-related complication rate was 14.2% (2/16).

Conclusion:

Internal fixation with the helical blade CMN system can be considered as a treatment option for 2-part basicervical proximal femoral fracture in elderly patients.
Game Schedules and Rate of Concussions in the National Football League
Authors: Teramoto Masaru , Cushman Daniel M. , Cross Chad L. , Curtiss Heather M. , Willick Stuart E.
Published: November 2017

Background:

Concussion prevention in the National Football League (NFL) is an important priority for player safety. The NFL now has modified game schedules, and one concern is that unconventional game schedules, such as a shortened rest period due to playing on a Thursday rather than during the weekend, may lead to an increased risk of injuries.

Hypothesis:

Unconventional game schedules in the NFL are associated with an increased rate of concussion.

Study Design:

Descriptive epidemiological study.

Methods:

This study analyzed concussions and game schedules over the NFL regular seasons from 2012 to 2015 (4 years). Documented numbers of concussions, identified by use of the online database PBS Frontline Concussion Watch, were summarized by regular-season weeks. Association of days of rest and game location (home, away, or overseas) with the rate of concussion was examined by use of the χ2 test. Logistic regression analysis was performed to examine the relationships of days of rest and home/away games to the risk of repeated concussions, with adjustment for player position.

Results:

A total of 582 concussions were analyzed in this study. A significantly greater number of concussions occurred in the second half of the season ( P < .01). No significant association was found between the rate of concussion and the days of rest, game location, or timing of the bye week by the team or the opponent ( P > .05). Game schedules were not significantly associated with the occurrence of repeat concussions ( P > .05).

Conclusion:

Unconventional game schedules in the NFL, including playing on Thursday and playing overseas, do not seem to put players at increased risk of concussions.
Do athletes alter their running mechanics after an Achilles tendon rupture?
Authors: Jandacka Daniel , Silvernail Julia Freedman , Uchytil Jaroslav , Zahradnik David , Farana Roman , Hamill Joseph
Published: November 2017

Background

Over the past thirty years, there has been dramatic increase in incidence of Achilles tendon rupture in the athletic population. The purpose of this study was to compare the lower extremity mechanics of Achilles tendon ruptured runners with healthy controls.

Methods

The participants with a past history of an Achilles tendon repair (n = 11) and healthy control (n = 11) subgroups were matched on sex, age, type of regular physical activity, mass, height, footfall pattern and lateral dominancy. Running kinetics and kinematics of the ankle, knee and hip were recorded using a high‐speed motion capture system interfaced with a force platform. Achilles tendon length was measured using ultrasonography. Main outcome measures were lower extremity joint angles and moments during stance phase of running and Achilles tendon lengths.

Results

Athletes from Achilles tendon group had an affected gastro‐soleus complex. Athletes with history of Achilles tendon rupture had reduced ankle range of motion during second half of the stance phase of running (Δ7.6°), an overextended knee during initial contact (Δ5.2°) and increased affected knee range of motion (Δ4.4°) during the first half of stance phase on their affected limb compared to the healthy control group. There was a 22% increase in the maximal hip joint moment on contralateral side of the Achilles tendon group compared to the healthy controls.

Conclusion

These results suggest a compensation mechanism, relatively extended knee at initial ground contact against the deficit in the muscle‐tendon complex of the triceps surae. Overextension during sporting activities may place the knee at risk for further injury. Avoidance of AT lengthening and plantarflexion strength deficit after surgery and during rehabilitation might help to manage AT rupture since these factors may be responsible for altered running kinematics.
Undergraduate Performance in Solving Ill-Defined Biochemistry Problems
Authors: Sensibaugh Cheryl A. , Madrid Nathaniel J. , Choi Hye-Jeong , Anderson William L. , Osgood Marcy P.
Published: November 2017

With growing interest in promoting skills related to the scientific process, we studied performance in solving ill-defined problems demonstrated by graduating biochemistry majors at a public, minority-serving university. As adoption of techniques for facilitating the attainment of higher-order learning objectives broadens, so too does the need to appropriately measure and understand student performance. We extended previous validation of the Individual Problem Solving Assessment (IPSA) and administered multiple versions of the IPSA across two semesters of biochemistry courses. A final version was taken by majors just before program exit, and student responses on that version were analyzed both quantitatively and qualitatively. This mixed-methods study quantifies student performance in scientific problem solving, while probing the qualitative nature of unsatisfactory solutions. Of the five domains measured by the IPSA, we found that average graduates were only successful in two areas: evaluating given experimental data to state results and reflecting on performance after the solution to the problem was provided. The primary difficulties in each domain were quite different. The most widespread challenge for students was to design an investigation that rationally aligned with a given hypothesis. We also extend the findings into pedagogical recommendations.
Analysis of signal to noise and directivity characteristics of DAS VSP at near and far offsets — A CO2CRC Otway Project data example
Authors: Correa Julia , Egorov Anton , Tertyshnikov Konstantin , Bona Andrej , Pevzner Roman , Dean Tim , Freifeld Barry , Marshall Steve
Published: November 2017

During the last decade, distributed acoustic sensing (DAS) has emerged as a new technology for seismic acquisition. DAS has the potential to reduce the cost of permanent monitoring operations over time as it offers long equipment survivability and requires minimum maintenance. However, broad adoption of DAS technology still faces some challenges, such as low sensitivity and high levels of noise compared to conventional seismic sensors. Recent developments in fiber-optic systems and cable designs aim to overcome these limitations. To understand how DAS can be used in monitoring applications, it is important to know how it behaves with varying offsets and incidence angles. An offset VSP survey was acquired, at the CO2CRC Otway Project, using a straight single-mode fiber, a straight “enhanced-backscatter” fiber, and a conventional three-component geophone tool. The results from this survey show that DAS has the potential to provide similar, or even superior, quality data sets as conventional geophones.
Geothermal reservoir characterization using distributed temperature sensing at Brady Geothermal Field, Nevada
Authors: Patterson Jeremy R. , Cardiff Michael , Coleman Thomas , Wang Herb , Feigl Kurt L. , Akerley John , Spielman Paul
Published: November 2017

Distributed temperature sensing (DTS) systems provide near real-time data collection that captures borehole spatiotemporal temperature dynamics. Temperature data were collected in an observation well at an active geothermal site for a period of eight days under geothermal production conditions. Collected temperature data showcase the ability of DTS systems to detect changes to the location of the steam-water interface, visualize borehole temperature recovery — following injection of a cold-water “slug” — and identify anomalously warm and/or cool zones. The high sampling rate and spatial resolution of DTS data also shows borehole temperature dynamics that are not captured by traditional pressure-temperature survey tools. Inversion of thermal recovery data using a finite-difference heat-transfer model produces a thermal-diffusivity profile that is consistent with laboratory-measured values and correlates with identified lithologic changes within the borehole. Used alone or in conjunction with complementary data sets, DTS systems are useful tools for developing a better understanding of both reservoir rock thermal properties as well as within and near borehole fluid movement.
Evidence Basis for Regional Anesthesia in Ambulatory Anterior Cruciate Ligament Reconstruction: Part III: Local Instillation Analgesia—A Systematic Review and Meta-analysis
Authors: Yung Eric M. , Brull Richard , Albrecht Eric , Joshi Girish P. , Abdallah Faraj W.
Published: December 2017

BACKGROUND:

Local infiltration analgesia offers effective postoperative analgesia after knee arthroplasty, but the role of its counterpart, local instillation analgesia (LIA), in anterior cruciate ligament reconstruction (ACLR) is unclear. This systematic review and meta-analysis evaluates the analgesic benefits of LIA for outpatient ACLR.

METHODS:

We sought randomized controlled trials investigating the analgesic effects of LIA versus control in adults having outpatient ACLR and receiving multimodal analgesia (excluding nerve blocks, which are examined in parts I and II of this project). Cumulative postoperative analgesic consumption at 24 hours was designated as a primary outcome. Analgesic consumption during postanesthesia care unit stay, proportion of patients requiring analgesic supplementation, time-to-first analgesic request, rest pain scores during the first 48 hours, hospital length of stay, and incidence of opioid-related side effects were analyzed as secondary outcomes and pooled using random effects modeling.

RESULTS:

Eleven randomized controlled trials (515 patients) were included. Analgesic consumption was selected as the primary outcome in 4 trials (36%). Compared to control, LIA reduced the 24-hour morphine consumption by a weighted mean difference (95% confidence interval) of −18.0 mg (−33.4 to −2.6) (P = .02). LIA reduced postanesthesia care unit morphine consumption by −55.9 mg (−88.4 to −23.4) (P < .05) and decreased the odds (odds ratio [95% confidence interval]) of analgesic supplementation during the first 24 hours by 0.4 (0.2–0.8) (P = .004). LIA also improved pain scores during the 0–24-hour interval, most notably at 4 hours (−1.6 [−2.2 to −1.0) (P < .00001).

CONCLUSIONS:

Administering LIA for outpatient ACLR improves postoperative analgesia by decreasing opioid consumption and improving pain control up to 24 hours, with minimal complications. These findings encourage integrating LIA into the care standard for ACLR. Questions regarding the ideal LIA components, location, and role in the setting of hamstring grafts require further research.
Large Variability in the Diversity of Physiologically Complex Surgical Procedures Exists Nationwide Among All Hospitals Including Among Large Teaching Hospitals
Authors: Dexter Franklin , Epstein Richard H. , Thenuwara Kokila , Lubarsky David A.
Published: November 2017

BACKGROUND:

Multiple previous studies have shown that having a large diversity of procedures has a substantial impact on quality management of hospital surgical suites. At hospitals with substantial diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in surgical suites will have inaccurate predictions of surgical blood usage, case durations, cost accounting and price transparency, times remaining in late running cases, and use of intraoperative equipment. What is unknown is whether large diversity is a feature of only a few very unique set of hospitals nationwide (eg, the largest hospitals in each state or province).

METHODS:

The 2013 United States Nationwide Readmissions Database was used to study heterogeneity among 1981 hospitals in their diversities of physiologically complex surgical procedures (ie, the procedure codes). The diversity of surgical procedures performed at each hospital was quantified using a summary measure, the number of different physiologically complex surgical procedures commonly performed at the hospital (ie, 1/Herfindahl).

RESULTS:

A total of 53.9% of all hospitals commonly performed <10 physiologically complex procedures (lower 99% confidence limit [CL], 51.3%). A total of 14.2% (lower 99% CL, 12.4%) of hospitals had >3-fold larger diversity (ie, >30 commonly performed physiologically complex procedures). Larger hospitals had greater diversity than the small- and medium-sized hospitals (P < .0001). Teaching hospitals had greater diversity than did the rural and urban nonteaching hospitals (P < .0001). A total of 80.0% of the 170 large teaching hospitals commonly performed >30 procedures (lower 99% CL, 71.9% of hospitals). However, there was considerable variability among the large teaching hospitals in their diversity (interquartile range of the numbers of commonly performed physiologically complex procedures = 19.3; lower 99% CL, 12.8 procedures).

CONCLUSIONS:

The diversity of procedures represents a substantive differentiator among hospitals. Thus, the usefulness of statistical methods for operating room management should be expected to be heterogeneous among hospitals. Our results also show that “large teaching hospital” alone is an insufficient description for accurate prediction of the extent to which a hospital sustains the operational and financial consequences of performing a wide diversity of surgical procedures. Future research can evaluate the extent to which hospitals with very large diversity are indispensable in their catchment area.
Design and Evaluation of a Closed-Loop Anesthesia System With Robust Control and Safety System
Authors: West Nicholas , van Heusden Klaske , Görges Matthias , Brodie Sonia , Rollinson Aryannah , Petersen Christian L. , Dumont Guy A. , Ansermino J. Mark , Merchant Richard N.
Published: November 2017

BACKGROUND:

Closed-loop control of anesthesia involves continual adjustment of drug infusion rates according to measured clinical effect. The NeuroSENSE monitor provides an electroencephalographic measure of depth of hypnosis (wavelet-based anesthetic value for central nervous system monitoring [WAVCNS]). It has previously been used as feedback for closed-loop control of propofol, in a system designed using robust control engineering principles, which implements features specifically designed to ensure patient safety. Closed-loop control of a second drug, remifentanil, may be added to improve WAVCNSstability in the presence of variable surgical stimulation. The objective of this study was to design and evaluate the feasibility of a closed-loop system for robust control of propofol and remifentanil infusions using WAVCNSfeedback, with an infusion safety system based on the known pharmacological characteristics of these 2 drugs.

METHODS:

With Health Canada authorization, research ethics board approval, and informed consent, American Society of Anesthesiologists I–III adults, requiring general anesthesia for elective surgery, were enrolled in a 2-phase study. In both phases, infusion of propofol was controlled in closed loop during induction and maintenance of anesthesia, using WAVCNSfeedback, but bounded by upper- and lower-estimated effect-site concentration limits. In phase I, remifentanil was administered using an adjustable target-controlled infusion and a controller was designed based on the collected data. In phase II, remifentanil was automatically titrated to counteract rapid increases in WAVCNS.

RESULTS:

Data were analyzed for 127 patients, of median (range) age 64 (22–86) years, undergoing surgical procedures lasting 105 (9–348) minutes, with 52 participating in phase I and 75 in phase II. The overall control performance indicator, global score, was a median (interquartile range) 18.3 (14.2–27.7) in phase I and 14.6 (11.6–20.7) in phase II (median difference, −3.25; 95% confidence interval, −6.35 to −0.52). The WAVCNSwas within ±10 of the setpoint for 84.3% (76.6–90.6) of the maintenance of anesthesia in phase I and 88.2% (83.1–93.4) in phase II (median difference, 3.7; 95% confidence interval, 0.1–6.9). The lower propofol safety bound was activated during 30 of 52 (58%) cases in phase I and 51 of 75 (68%) cases in phase II.

CONCLUSIONS:

Adding closed-loop control of remifentanil improved overall controller performance. This controller design offers a robust method to optimize the control of 2 drugs using a single sensor. The infusion safety system is an important component of a robust automated anesthesia system, but further research is required to determine the optimal constraints for these safe conditions.
Anesthetic Management of a Pacemaker With a Rate Drop Response Setting: A Case Report
Authors: Saltzman Alex K. , Fu Peter J. , Egan Brian
Published: November 2017

Permanent pacemakers are used for a variety of conditions and are commonly encountered in the perioperative period. This report describes the anesthetic management of a patient with a permanent pacemaker with a rate drop response (RDR) who presented for a laparoscopic left adrenalectomy. The RDR setting is a novel pacemaker mode often used in patients with a history of vasovagal syncope. There are no previous reports describing the anesthetic management of such a pacemaker. This case report describes the features of the RDR setting with the goal of educating clinicians who may encounter patients with this type of pacemaker. The patient described in this case report had large swings in blood pressure intraoperatively due to the natural function of his pacemaker. This report highlights the importance of understanding pacemaker modes in patients about to undergo surgery, especially because pacemaker functions are becoming increasingly sophisticated and more personalized to meet patients’ specific needs.
Successful Treatment of Idiopathic Intractable Hiccup With Cisatracurium Under Intravenous General Anesthesia: A Case Report
Authors: Wu Jian-Ping , An Jian-Xiong , Qian Xiao-Yan , Wang Yong
Published: November 2017

We report the successful treatment of idiopathic intractable hiccups with cisatracurium under intravenous general anesthesia. The patient had a history of hiccups for 19 years that were refractory to a variety of treatments. When his hiccups were accompanied by vomiting, insomnia, shortness of breath, and poor oral intake for 9 days, he sought relief. We administered a nondepolarizing muscle relaxant, cisatracurium, during total intravenous anesthesia, to stop the hiccups. The duration of the anesthetic was determined by the time it took for the patient to recover from the neuromuscular blockade without reversal the cisatracurium. On emergence he had no hiccups. When the hiccups recurred 2 weeks later after a big meal, we repeated the procedure with success. He has now been hiccup free for at least 6 months.
Massive Macroglossia After Posterior Cranial Fossa Surgery: A Case Report
Authors: Ha Jennifer F. , Vitale Lisa N. , Pfarr Marie A. , Kawai Yu , Zopf David A.
Published: November 2017

A 16-year-old boy with Chiari 1 malformation presented for an elective suboccipital craniectomy and C1 laminectomy. His intraoperative course was uneventful. At the conclusion of the procedure, he met extubation criteria and followed commands. After extubation, he developed progressive upper airway obstruction and became obtunded. He was reintubated via videolaryngoscopy, which showed edema not only to the tongue, but also to the posterior pharynx and blisters over the vocal folds and epiglottis. The patient was transferred to the pediatric intensive care unit intubated and sedated. This report describes the clinical course of his massive macroglossia and discusses short- and long-term management.
The primary role of zebrafish nanog is in extra-embryonic tissue
Authors: Gagnon James A. , Obbad Kamal , Schier Alexander F.
Published: November 2017

The role of the zebrafish transcription factor Nanog has been controversial. It has been suggested that Nanog is primarily required for the proper formation of the extra-embryonic yolk syncytial layer (YSL) and only indirectly regulates gene expression in embryonic cells. In an alternative scenario, Nanog has been proposed to directly regulate transcription in embryonic cells during zygotic genome activation. To clarify the roles of Nanog, we performed a detailed analysis of zebrafish nanog mutants. Whereas zygotic nanog mutants survive to adulthood, maternal-zygotic (MZnanog) and maternal mutants exhibit developmental arrest at the blastula stage. In the absence of Nanog, YSL formation and epiboly are abnormal, embryonic tissue detaches from the yolk, and the expression of dozens of YSL and embryonic genes is reduced. Epiboly defects can be rescued by generating chimeric embryos of MZnanog embryonic tissue with wild-type vegetal tissue that includes the YSL and yolk cell. Notably, cells lacking Nanog readily respond to Nodal signals and when transplanted into wild-type hosts proliferate and contribute to embryonic tissues and adult organs from all germ layers. These results indicate that zebrafish Nanog is necessary for proper YSL development but is not directly required for embryonic cell differentiation.
On genes and form
Authors: Coen Enrico , Kennaway Richard , Whitewoods Christopher
Published: November 2017

The mechanisms by which organisms acquire their sizes and shapes through growth was a major focus of D'Arcy Thompson's book On Growth and Form. By applying mathematical and physical principles to a range of biological forms, Thompson achieved fresh insights, such as the notion that diverse biological shapes could be related through simple deformations of a coordinate system. However, Thompson considered genetics to lie outside the scope of his work, even though genetics was a growing discipline at the time the book was published. Here, we review how recent advances in cell, developmental, evolutionary and computational biology allow Thompson's ideas to be integrated with genes and the processes they influence to provide a deeper understanding of growth and morphogenesis. We consider how genes interact with subcellular-, cellular- and tissue-level processes in plants to yield patterns of growth that underlie the developmental and evolutionary shape transformations Thompson so eloquently described.
The skeletal phenotype of achondrogenesis type 1A is caused exclusively by cartilage defects
Authors: Bird Ian M. , Kim Susie H. , Schweppe Devin K. , Caetano-Lopes Joana , Robling Alexander G. , Charles Julia F. , Gygi Steven P. , Warman Matthew L. , Smits Patrick J.
Published: November 2017

Inactivating mutations in the ubiquitously expressed membrane trafficking component GMAP-210 (encoded by Trip11) cause achondrogenesis type 1A (ACG1A). ACG1A is surprisingly tissue specific, mainly affecting cartilage development. Bone development is also abnormal, but as chondrogenesis and osteogenesis are closely coupled, this could be a secondary consequence of the cartilage defect. A possible explanation for the tissue specificity of ACG1A is that cartilage and bone are highly secretory tissues with a high use of the membrane trafficking machinery. The perinatal lethality of ACG1A prevents investigating this hypothesis. We therefore generated mice with conditional Trip11 knockout alleles and inactivated Trip11 in chondrocytes, osteoblasts, osteoclasts and pancreas acinar cells, all highly secretory cell types. We discovered that the ACG1A skeletal phenotype is solely due to absence of GMAP-210 in chondrocytes. Mice lacking GMAP-210 in osteoblasts, osteoclasts and acinar cells were normal. When we inactivated Trip11 in primary chondrocyte cultures, GMAP-210 deficiency affected trafficking of a subset of chondrocyte-expressed proteins rather than globally impairing membrane trafficking. Thus, GMAP-210 is essential for trafficking specific cargoes in chondrocytes but is dispensable in other highly secretory cells.
Morphogenesis one century afterOn Growth and Form
Authors: Lecuit Thomas , Mahadevan L.
Published: November 2017

Summary: This Editorial introduces the special issue – providing a perspective on the influence of D'Arcy Thompson's work and an overview of the articles in this issue.
FYCO1 regulates accumulation of post-mitotic midbodies by mediating LC3-dependent midbody degradation
Authors: Dionne Lai Kuan , Peterman Eric , Schiel John , Gibieža Paulius , Skeberdis Vytenis Arvydas , Jimeno Antonio , Wang Xiao-Jing , Prekeris Rytis
Published: December 2017

The post-mitotic midbody (MB) is a remnant of cytokinesis that can be asymmetrically inherited by one of the daughter cells following cytokinesis. Until recently, the MB was thought to be degraded immediately following cytokinesis. However, recent evidence suggests that the MB is a protein-rich organelle that accumulates in stem cell and cancer cell populations, indicating that it may have post-mitotic functions. Here, we investigate the role of FYCO1, an LC3-binding protein (herein, LC3 refers to MAP1LC3B), and its function in regulating the degradation of post-mitotic MBs. We show that FYCO1 is responsible for formation of LC3-containing membrane around the post-mitotic MB and that FYCO1 knockdown increases MB accumulation. Although MBs accumulate in the stem-cell-like population of squamous cell carcinomas, FYCO1 depletion does not affect the clonogenicity of these cells. Instead, MB accumulation leads to an increase in anchorage-independent growth and invadopodia formation in HeLa cells and squamous carcinoma cells. Collectively, our data suggest that FYCO1 regulates MB degradation, and we present the first evidence that cancer invasiveness is a feature that can be modulated by the accumulation of MBs in cancer stem cells.

This article has an associated First Person interview with the first author of the paper.
Recall and Unemployment
Authors: Fujita Shigeru , Moscarini Giuseppe
Published: November 2017

We document in the Survey of Income and Program Participation covering the period 1990–2013 that a surprisingly large share of workers return to their previous employer after a jobless spell, and experience very different unemployment and employment outcomes than job switchers. The probability of recall is much less procyclical and volatile than the probability of finding a new employer. We add to a quantitative, and otherwise canonical, search-and-matching model of the labor market a recall option, which can be activated freely following aggregate and job-specific productivity shocks. Recall and search effort significantly amplify the cyclical volatility of new job-finding and separation probabilities. (JEL E24, E32, J63, J64)
Valuing Alternative Work Arrangements
Authors: Mas Alexandre , Pallais Amanda
Published: November 2017

We employ a discrete choice experiment in the employment process for a national call center to estimate the willingness to pay distribution for alternative work arrangements relative to traditional office positions. Most workers are not willing to pay for scheduling flexibility, though a tail of workers with high valuations allows for sizable compensating differentials. The average worker is willing to give up 20 percent of wages to avoid a schedule set by an employer on short notice, and 8 percent for the option to work from home. We also document that many job-seekers are inattentive, and we account for this in estimation. (JEL J22, J31, J80, L84)
Texture analysis of 18F-FDG PET/CT for grading thymic epithelial tumours: usefulness of combining SUV and texture parameters
Authors: Nakajo Masatoyo , Jinguji Megumi , Shinaji Tetsuya , Nakajo Masayuki , Aoki Masaya , Tani Atsushi , Sato Masami , Yoshiura Takashi
Published: November 2017

Objective:

To retrospectively investigate the standardized uptake value (SUV)-related and heterogeneous texture parameters individually and in combination for differentiating between low- and high-risk 18Fluorone-fludeoxyglucose (18F-FDG)-avid thymic epithelial tumours (TETs) with positron emission tomography (PET)/CT.

Methods:

SUV-related and 6 texture parameters (entropy, homogeneity, dissimilarity, intensity variability, size-zone variability and zone percentage) were compared between 11 low-risk and 23 high-risk TETs (metabolic tumour volume >10.0 cm3 and SUV ≥2.5). Diagnostic performance was evaluated by receiver operating characteristic analysis. The diagnostic value of combining SUV and texture parameters was examined by a scoring system.

Results:

High-risk TETs were significantly higher in SUVmax (p = 0.022), entropy (p = 0.038), intensity variability (p = 0.041) and size-zone variability (p = 0.045) than low-risk TETs. Diagnostic accuracies of these 4 parameters, dissimilarity and zone percentage which also showed significance in receiver operating characteristic analysis ranged between 64.7 and 73.5% without significant differences in AUC (range; 0.71 to 0.75) (p ≥ 0.05 each). Each parameter was scored as 0 (negative for high-risk) or 1 (positive for high-risk) according to each threshold criterion, then scores were summed [0 or 1 for low-risk TETs (median; 1); ≥2 for high-risk TETs (median; 4)]. The sensitivity, specificity and accuracy of detecting high-risk TETs were 100, 81.8 and 94.1%, respectively, with an AUC of 0.99.

Conclusion:

The diagnostic performances of individual SUVmax and texture parameters were relatively low. However, combining these parameters can significantly increase diagnostic performance when differentiating between relatively large low- and high-risk 18F-FDG-avid TETs.

Advances in knowledge:

Combined use of SUVmax and texture parameters can significantly increase the diagnostic performance when differentiating between low- and high-risk TETs.
Πολιτικά κόμματα και καταπολέμηση του ρατσισμού και της ξενοφοβίας
Authors: Παπαδημητρίου Γιώργος
Published: November 2017

Δεν διατίθεται περίληψη.
Keith R. Legg - John Μ. Roberts, Modern Greece: A Civilization on the Periphery, Boulder, Colorado, Westview Press, 1997,235 σελ.
Authors: Τσακρακλίδου Σοφία Π.
Published: November 2017

Δεν διατίθεται περίληψη.
Innocent Gentillet: ένας πρώιμος «εθνικιστής» στον 16ο αιώνα
Authors: Νικολαΐδης Θεοδόσης
Published: November 2017

Το άρθρο επιχειρεί να ερμηνεύσει την πραγματεία του Innocent Gentillet, Discours contre Machiavel (1576) όχι ως προϊόν της ηθικής εξέγερσης ενός ευσεβούς χριστιανού, αλλά ως ένα κείμενο πολιτικής προπαγάνδας που πρέπει να τοποθετηθεί στο πλαίσιο των γαλλικών θρησκευτικών πολέμων. Η πραγματεία έχει έντονες εθνικιστικές αποχρώσεις. Ο εθνικισμός -η ιδέα, όπως λέει ο Gentillet, ότι οι υπήκοοι του βασιλιά ήταν ενωμένοι από την κοινή γλώσσα και τα κοινά ήθη- ήταν, το 1576, μια πολιτική πλατφόρμα που προήγαν οι προτεστά- ντες προκειμένου να επιτύχουν το νομικό καθεστώς μιας αυτόνομης, μειοψηφούσας θρησκευτικής ομάδας εντός του βασιλείου. Ο προτε- σταντικός εθνικισμός, επιθετικός εναντίον των «ξένων» συμβούλων της Αικατερίνης των Μεδίκων, εισήγαγε έτσι την ιδέα της ανεξιθρη- σκείας. Η πλατφόρμα αυτή έγινε αντικείμενο επιθέσεων από τους ακραίους καθολικούς τη δεκαετία του 1580 και στις αρχές εκείνης του 1590, αλλά τελικά επικράτησε με την ανάρρηση του Ερρίκου του 4ου στον γαλλικό θρόνο και χρησιμέυσε ως ιδεολογική βάση για το Διάταγμα της Νάντης (1598).
Interhospital Transfer and Receipt of Specialty Procedures
Authors: Mueller Stephanie K. , Zheng Jie , Orav E. John , Schnipper Jeffrey L.
Published: November 2017

The practice of transferring patients between acute care hospitals is variable and largely nonstandardized. Although often‐cited reasons for transfer include providing patients access to specialty services only available at the receiving institution, little is known about whether and when patients receive such specialty care during the transfer continuum. We performed a retrospective analysis using 2013 100% Master Beneficiary Summary and Inpatient claims files from Centers for Medicare and Medicaid Services. Beneficiaries were included if they were aged ≥65 years, continuously enrolled in Medicare A and B, with an acute care hospitalization claim, and transferred to another acute care hospital with a primary diagnosis of acute myocardial infarction, gastrointestinal bleed, renal failure, or hip fracture/dislocation. Associated specialty procedure codes (International Classification of Diseases, 9th Revision, Clinical Modification) were identified for each diagnosis. We performed descriptive analyses to compare receipt of specialty procedural services between transferring and receiving hospitals, stratified by diagnosis. Across the 19,613 included beneficiaries, receipt of associated specialty procedures was more common at the receiving than the transferring hospital, with the exception of patients with a diagnosis of gastrointestinal bleed. Depending on primary diagnosis, between 32.4% and 89.1% of patients did not receive any associated specialty procedure at the receiving hospital. Our results demonstrate variable receipt of specialty procedural care across the transfer continuum, implying the likelihood of alternate drivers of interhospital transfer other than solely receipt of specialty procedural care.
Choledochal cyst of the proximal cystic duct: a taxonomical and therapeutic conundrum
Authors: Kilambi R , Singh AN , Madhusudhan KS , Das P , Pal S
Published: November 2017

Isolated choledochal cysts involving the cystic duct are rare. We present a case of a choledochal cyst involving only the proximal cystic duct, and discuss the taxonomic and therapeutic challenges. There is a need for a clearly defined classification system for these cysts as they may be categorised as either type II or type VI cysts. The optimal treatment remains debatable, with some authors recommending a bilioenteric reconstruction owing to the wide cystic duct–bile duct junction. However, we suggest that a cholecystectomy should be performed with examination of the specimen and frozen section in case of any abnormality rather than upfront bile duct excision. In addition, given the rarity of this condition and the paucity of long-term data, we recommend meticulous follow-up for development of any malignancy.
The effect of Bifidobacterium animalis lactis HNO19 supplementation among pregnant and lactating women on interleukin-8 level in breast milk and infant’s gut mucosal integrity
Authors: Dewanto Naomi E.F. , Firmansyah Agus , Sungkar Ali , Dharmasetiawani Nani , Sastroasmoro Sudigdo , Kresno Siti B. , Suradi Rulina , Bardosono Saptawati , Prasetyo Dwi
Published: November 2017

Background: Newborn’s gut mucosal is not fully developed, therefore infants are prone to diarrhea. Probiotic supplementation is known to induce the gut mucosal maturity. This study aimed to identify whether probiotics supplementation among pregnant women since the third trimester would increase the infant’s gut mucosal integrity.Methods: A double-blind, randomized clinical trial was conducted to understand the potential effect of probiotic supplementation on the level of probiotics and IL-8 in breastmilk, urine IFABP, faecal α-1-antytripsin (AAT) and calprotectin in infant’s at birth (V0) and three-months old (V3). A single strain of Bifidobacterium lactis animalis HNO19 (known as DR10) was used since it was not the resident bacteria. The study was held at Budi Kemuliaan Hospital and its satellite clinics from December 2014 to December 2015.Results: About 14% (5/35) and 20% (7/35) of the subjects had DR10 in the breastmilk’s colostrum and at the age of 3-months. The median values of IL-8 in the probiotic group vs the placebo group at V0 and V3 were 2810,1 pg/mL vs 1516.4 pg/mL (p=0.327) and 173.2 pg/mL vs 132.7 pg/mL (p=0.211) respectively. IFABP level 211.7 ng/mL vs 842.5 ng/mL (p=0.243) and 25.3 ng/mL vs 25.1 ng/mL (p=0.466); AAT 136.2 mg/dL vs 148.1 mg/dL (p=0.466) and 24 mg/mL vs 29.72 mg/mL (p=0.545); Calprotectin 746.8 ng/mL vs 4645.2 ng/mL (p=0.233) and 378.6 ng/mL vs 391.3 ng/mL (p=0.888).Conclusion: Probiotic DR10 given to pregnant women since the 3rd trimester can be found in colostrum and 3-months breastmilk. However, it did not affect the level of other probiotics or IL-8 and the gut mucosal integrity.