bluuebunny/crossref_metadata_2025 huggingface dataset:
The functional movement test 9+ is a poor screening test for lower extremity injuries in professional male football players: a 2-year prospective cohort study
Authors: Bakken Arnhild , Targett Stephen , Bere Tone , Eirale Cristiano , Farooq Abdulaziz , Tol Johannes L , Whiteley Rod , Khan Karim M , Bahr Roald
Published: May 2017

Background

The 9+ screening battery test consists of 11 tests to assess limitations in functional movement.

Aim

To examine the association of the 9+ with lower extremity injuries and to identify a cut-off point to predict injury risk.

Methods

Professional male football players in Qatar from 14 teams completed the 9+ at the beginning of the 2013/2014 and 2014/2015 seasons. Time-loss injuries and exposure in training and matches were registered prospectively by club medical staff during these seasons. Univariate and multivariate Cox regression analyses were used to calculate HR and 95% CI. Receiver operating characteristic (ROC) curves were calculated to determine sensitivity and specificity and identify the optimal cut-off point for risk assessment.

Results

362 players completed the 9+ and had injury and exposure registration. There were 526 injuries among 203 players (56.1%) during the two seasons; injuries to the thigh were the most frequent. There was no association between 9+ total score and the risk of lower extremity injuries (HR 1.02, 95% CI 0.99 to 1.05, p=0.13), even after adjusting for other risk factors in a multivariate analysis (HR 1.01, 95% CI 0.98 to 1.04, p=0.37). ROC curve analysis revealed an area under the curve of 0.48, and there was no cut-off point that distinguished injured from non-injured players.

Conclusion

The 9+ was not associated with lower extremity injury, and it was no better than chance for distinguishing between injured and uninjured players. Therefore, the 9+ test cannot be recommended as an injury prediction tool in this population.
A specialty-specific, multimodality educational quality improvement initiative to deimplement rarely appropriate myocardial perfusion imaging
Authors: Winchester David E , Schmalfuss Carsten , Helfrich Christian D , Beyth Rebecca J
Published: May 2017

Objective

Investigations of Appropriate Use Criteria (AUC) education have shown a mixed effect on changing provider behaviour. At our facility, rarely appropriate myocardial perfusion imaging (MPI) differs by specialty; awareness of AUC is low. Our objective is to investigate if specialty-specific, multimodality education could reduce rarely appropriate MPI.

Methods

We designed education focused on the rarely appropriate MPI ordered most often by each specialty. We tracked appropriateness of MPI in three cohorts: pre, post (immediately after) and late-post (4 months after) intervention.

Results

A total of 889 MPI were evaluated (n=287 pre, n=313 post, n=289 late-post), 95.3% were men. Chest pain was the most common symptom (n=530, 59.6%), while 14.1% (n=125) had no symptoms. Rarely appropriate testing decreased from 4.9% to 1.3% and remained at 1.4% in the late-post cohort (p<0.0001). In logistic regression, lack of symptoms (OR 31.3, 95% CI 10.3 to 94.8, p≤0.0001) and being in the post or late-post cohorts (OR 0.27, 95% CI 0.11 to 0.68, p=0.006) were associated with rarely appropriate MPI. Preoperative MPI in patients with good exercise capacity was a common rarely appropriate indication. Ischaemia was not observed among patients with rarely appropriate indication for MPI.

Conclusions

In certain clinical settings, education may be an effective approach for deimplementing rarely appropriate MPI. The effect of education may be enhanced when focused on improving patient care, delivered by a peer, and needs assessment indicates low awareness of guidelines. Lack of symptoms and preoperative MPI continue to be the predominant rarely appropriate MPI ordered.
Rifaximin induces and maintains clinical remission in a dachshund with chronic enteropathy: antibiotic‐responsive diarrhoea or inflammatory bowel disease?
Authors: Menozzi Alessandro , Dall'Aglio Manuel , Quintavalla Fausto , Meucci Valentina , Bertini Simone
Published: May 2017

A two‐year‐old male dachshund was presented with a long‐term history of chronic small intestine diarrhoea. The dog had been previously treated with several antibiotics, with temporary remission of clinical signs, relapsing each time the therapy was discontinued. On the basis of clinical signs, history and on the investigations performed which failed to detect any other cause of disease, a diagnosis of antibiotic‐responsive diarrhoea (ARD) or small intestine bacterial overgrowth secondary to inflammatory bowel disease was made. A three‐week antibiotic treatment with rifaximin by oral route was prescribed, achieving a prompt clinical remission but diarrhoea relapsed shortly after the end of drug administration. A continuous therapy with rifaximin was therefore established, allowing to maintain the dog in complete remission, without any side effect. The efficacy shown by rifaximin in this report suggests, for the first time, that this drug could be a good choice for long‐term treatment of ARD.
Unsuccessful resuscitation with epinephrine in a dog with suspected severe perioperative anaphylaxis
Authors: Sasaki Kazumasu , Mutoh Tatsushi , Shiga Takuya , Gómez de Segura Ignacio Álvarez
Published: May 2017

An 11‐month‐old ASA 1 male miniature dachshund was anaesthetised for neutering. Butorphanol and midazolam were administered as preanaesthetic medication along with cefazolin. Anaesthesia was induced with propofol and maintained with isoflurane. Latex products (surgical gloves and a breathing bag) were used intraoperatively. Intraoperative vital signs were within normal ranges. Approximately 5 min after extubation, the dog developed intense urticarial erythema, hypotension and pulmonary oedema. First‐line treatment with repeated intramuscular epinephrine, oxygenation, fluid loading, corticosteroids and antihistamines to address severe hypotension was unsuccessful. Additional vasopressin, continuous epinephrine infusion, mechanical ventilation and cardiopulmonary resuscitation proved unsuccessful and the owners opted for euthanasia. The causative agent remains unclear; serological or skin tests were not performed. This is the first report of severe perioperative anaphylactic shock in a dog unresponsive to current therapeutic recommendations based on epinephrine administration. Further research is warranted to advance clinical guidelines for managing anaphylaxis in dogs.
Transversus abdominis plane block in two calves undergoing umbilical herniorrhaphy
Authors: Zoff Aurora , Dugdale Alex , Coates A N , Rioja Eva
Published: May 2017

A transversus abdominis plane (TAP) block was performed in two calves undergoing umbilical hernia repair. Both calves were in good health and body condition and were anaesthetised using standard anaesthesia protocols. After placement in dorsal recumbency, the abdomen was scanned with an 11‐MHz linear array probe from the last rib to the iliac crest to identify the abdominal musculature comprising the external and internal abdominal oblique muscles and the transversus abdominis (TA). The needle (SonoTAP cannula 22G×50 mm; Pajunk) was advanced using an in‐plane technique, and a volume of 0.3 ml/kg was injected after a test dose. No obvious reduction of isoflurane requirements was apparent and one of the calves required rescue analgesia. The calves recovered uneventfully from anaesthesia.

This case report discusses the advantages of the TAP block over the paravertebral block, discusses the risks associated with TAP blocks and highlights the importance of training in ultrasound‐guided techniques.
Investigation of amorphous to crystalline phase transition of sodium titanate by X-ray absorption spectroscopy and scanning transmission X-ray microscopy
Authors: Liu Jian , Wang Biqiong , Banis Mohammad N. , Wang Zhiqiang , Li Ruying , Wang Jian , Hu Yongfeng , Sham Tsun-Kong , Sun Xueliang
Published: May 2017

Nanostructured sodium titanate has great potential for various applications such as sodium-ion batteries, photocatalysts, and waste treatment. Understanding the phase-transition mechanism in sodium titanate after annealing is fundamentally important to tune the structure, morphology, and property for targeted applications. In this work, we adopted amorphous sodium titanate grown on carbon nanotubes by an atomic layer deposition technique as a reference and used X-ray absorption spectroscopy (XAS) and scanning transmission X-ray microscopy (STXM), as well as a high-temperature in situ X-ray diffraction (XRD) technique, to elucidate the phase-transition mechanism of sodium titanate from amorphous to crystalline upon annealing from 25 °C to 900 °C. XAS and XRD analysis disclosed that anatase TiO2 first formed in the matrix of amorphous sodium titanate at 500 °C and then recrystallized into Na0.23TiO2 at 700 °C and 900 °C. XAS studies also revealed that the Ti atoms in sodium titanate were oxidized during the annealing process and reached an oxidation state about 3.8+ for Na0.23TiO2. The elevated annealing temperature increased the coordination number of Ti atoms and the crystallinity of sodium titanate. STXM chemical map provided spatial information and visualized evidence on the phase transition among amorphous sodium titanate, anatase TiO2, and Na0.23TiO2 in the samples annealed at intermediate temperatures (500 °C and 700 °C). This work provides a comprehensive understanding on the evolution of sodium titanate, in terms of crystal structure, electronic structure, chemical environment, and morphology, under different post annealing conditions.
Radioprotection guidelines for the safe use and decommissioning of a medical cyclotron
Authors: Calandrino Riccardo
Published: May 2017

The general principles for the safe management of a medical cyclotron dedicated to [Formula: see text] emitter isotope production, energy range 10–18 MeV for proton beams, are presented.
Effects of laser power on the microstructure and mechanical properties of 316L stainless steel prepared by selective laser melting
Authors: Zheng Zeng , Wang Lianfeng , Yan Biao
Published: May 2017

Selective laser melting (SLM) was used to prepare 316L stainless steel parts and the effects of laser power on the microstructure and mechanical properties of the final products were studied. With increasing applied laser power, the defects of as-built parts were reduced greatly and the as-built parts presented a highest relative density of 99.1%. The tensile strength of samples was significantly improved from 321 ± 10 MPa to 722 ± 10 MPa. The microhardness was homogeneous; the residual stresses in the samples were tensile, which were higher in the section perpendicular to the laser scanning strategy. The probable reasons for this phenomenon were proposed.
Elements loss analysis based on spectral diagnosis in laser-arc hybrid welding of aluminum alloy
Authors: Chen Yong , Chen Hui , Zhu Minhao , Yang Tao , Shen Lin
Published: May 2017

Aluminum alloy has been widely used in automobiles, high-speed trains, aerospace and many other fields. The loss of elements during welding process causes welding defects and affects the microstructure and properties of the joints. This paper discusses the correlation between welding process, spectral intensity and loss of elements in laser-arc hybrid welding of Al alloys. The results show that laser power and arc current have a significant impact on the spectral intensity and loss of elements. Compared with the base metal, the contents of alloying elements in the weld area are lower. The burning losses of alloy elements increase with the welding heat input.
Effects of W on microstructure and high-temperature oxidation behavior of ferritic stainless steel weldment
Authors: Ji Yijie , Xie Yuye , Zhu Shuangchun , Yan Biao
Published: May 2017

With the promotion of fuel economy policy and automobile lightweight concept, ferritic stainless steels applied in vehicles’ exhaust hot end systems have been developed. This paper simulated the high-temperature environment at which the automobile exhaust system serviced in for high-temperature corrosion. Kinetic curves were conducted in isothermal environments at 1000[Formula: see text]C. X-ray diffraction, scanning electron microscope and energy dispersive spectrometer were used to study the oxidation behavior of ferritic stainless steels and the effects of tungsten (W) addition. The results show that, with increasing oxidation time, the rate of weight gains increase and the main failure is spalling of surface oxide layer. The addition of W has a complicated effect on the oxidation behavior of ferritic stainless steel weldment.
Construction and surface/interface behavior of bio-functional surface layer by microwave-excited Ar/H2O plasma-induced polyethylene glycol polymerization
Authors: Shao Z. , Ogino A. , Nagatsu M.
Published: May 2017

Ar/H2O microwave-excited surface-wave plasma-induced grafting-polymerization and crosslinking technique was presented to construct a bio-functional surface layer. Optical emission spectroscopy was used to diagnose Ar/H[Formula: see text]O plasma. The surface/interface behavior especially the aging effect of hydroxyl groups over the grafted PEG spacer layer was investigated by measuring water contact angle and X-ray photoelectron spectroscopy. The results demonstrate that the addition of water vapor into Ar plasma can optimize the concentration of hydroxyl functional groups on surface; grafted PEG spacer layer can provide a long-term hydrophilicity of PU films, and alleviate the aging effect of hydroxyl functional groups.
Formal analysis and evaluation of the back-off procedure in IEEE802.11P VANET
Authors: Jin Li , Zhang Guoan , Zhu Xiaojun
Published: May 2017

The back-off procedure is one of the media access control technologies in 802.11P communication protocol. It plays an important role in avoiding message collisions and allocating channel resources. Formal methods are effective approaches for studying the performances of communication systems. In this paper, we establish a discrete time model for the back-off procedure. We use Markov Decision Processes (MDPs) to model the non-deterministic and probabilistic behaviors of the procedure, and use the probabilistic computation tree logic (PCTL) language to express different properties, which ensure that the discrete time model performs their basic functionality. Based on the model and PCTL specifications, we study the effect of contention window length on the number of senders in the neighborhood of given receivers, and that on the station’s expected cost required by the back-off procedure to successfully send packets. The variation of the window length may increase or decrease the maximum probability of correct transmissions within a time contention unit. We propose to use PRISM model checker to describe our proposed back-off procedure for IEEE802.11P protocol in vehicle network, and define different probability properties formulas to automatically verify the model and derive numerical results. The obtained results are helpful for justifying the values of the time contention unit.
A cognitive gateway-based spectrum sharing method in downlink round robin scheduling of LTE system
Authors: Deng Hongyu , Wu Cheng , Wang Yiming
Published: May 2017

A key technique of LTE is how to allocate efficiently the resource of radio spectrum. Traditional Round Robin (RR) scheduling scheme may lead to too many resource residues when allocating resources. When the number of users in the current transmission time interval (TTI) is not the greatest common divisor of resource block groups (RBGs), and such a phenomenon lasts for a long time, the spectrum utilization would be greatly decreased. In this paper, a novel spectrum allocation scheme of cognitive gateway (CG) was proposed, in which the LTE spectrum utilization and CG’s throughput were greatly increased by allocating idle resource blocks in the shared TTI in LTE system to CG. Our simulation results show that the spectrum resource sharing method can improve LTE spectral utilization and increase the CG’s throughput as well as network use time.
Estimation of symmetrical components and their orthogonal components under unknown frequencies and unknown biases
Authors: Chu Zhaobi , Zhang Rui , Chen Bo , Li Hua
Published: May 2017

An algorithm to estimate symmetrical components, orthogonal components and amplitudes of each sinusoidal component in three-phase power system signal under unknown frequencies and unknown biases is presented. The algorithm consists of a signal transformation, a biased adaptive orthogonal decomposition (BAOD) and a symmetrical component estimation. The BAOD can be regarded as a combination of a low pass filter and a number of three-phase frequency estimators in parallel. The symmetrical component estimation employs addition and multiplication rather than operations of trigonometry, division and phase shift. The decomposition property and the convergence property were investigated by Lyapunov theorem, integral manifold of slow adaptation and average method. Two design parameters, bandwidth parameter and frequency adaptive gains, give different effects on the convergence property of frequency adaptation and amplitude estimation independently. Simulation results demonstrate the performance of the method.
Bit-Error-Rate Evaluation of High-Efficiency Differential-Chaos-Shift-Keying System Over Wireless Channels
Authors: Quyen Nguyen Xuan
Published: May 2017

A high-efficiency differential-chaos-shift-keying (HE-DCSK) system has been proposed previously for the improvement of both bit-rate and bit-error-rate (BER) performance in comparison with the conventional DCSK system. This improvement made HE-DCSK be a promising solution for chaos-based communications. However, the performance of this system was just investigated under an additive white Gaussian noise (AWGN) channel. This is main motivation for our work to evaluate the performance of HE-DCSK over a typical wireless channel which is simultaneously affected by white noise, fading, multipath, and delay spread. The operation of the transmitter and receiver over the wireless channel is modeled and described. The BER performance is evaluated by theoretical analysis using Gaussian approximation and discrete integration. The numerical results obtained by Monte Carlo simulations are presented to verify the analyzed performance. Obtained results point out that the HE-DCSK system not only performs better than other DCSK-based ones under wireless channels but also can exploit the multipath characteristic to improve the performance.
Existence of approximate current-vortex sheets near the onset of instability
Authors: Morando Alessandro , Secchi Paolo , Trebeschi Paola
Published: May 2017

We study the free boundary problem for two-dimensional current-vortex sheets in ideal incompressible magneto-hydrodynamics near the transition point between the linearized stability and instability. In order to study the dynamics of the discontinuity near the onset of the instability, Hunter and Thoo have introduced an asymptotic quadratically nonlinear integro-differential equation for the amplitude of small perturbations of the planar discontinuity. For this amplitude equation, a local-in-time existence theory for smooth solutions to the Cauchy problem was established earlier by the authors under a suitable stability condition. However, the solution found therein enjoyed a loss of regularity (of order two) in comparison to the regularity of the initial data. In this work, we are able to prove an existence result with optimal regularity, in the sense that the regularity of the initial data is preserved in the evolution for positive times.
Some local questions for hyperbolic systems with non-regular time dependent coefficients
Authors: Fanelli Francesco
Published: May 2017

We investigate local properties for microlocally symmetrizable hyperbolic systems with just time dependent coefficients. Thanks to Paley–Wiener theorem, we establish finite propagation speed by showing precise estimates on the evolution of the support of the solution in terms of suitable norms of the coefficients of the operator and of the symmetrizer. From this result, local existence and uniqueness follow by quite standard methods. Our argument relies on the use of Fourier transform, and it cannot be extended to operators whose coefficients depend also on the space variables. On the other hand, it works under very mild regularity assumptions on the coefficients of the operator and of the symmetrizer.
Changing Trend of Population Migration in China and Its Spatial Pattern
Authors: WANG Ning
Published: May 2017

Based on the data from the sixth national census of the population at the county level, this paper comprehensively analyzes the changing trend of the migration of the population in China and its spatial pattern at national, large regional and urban levels. The results show that: (1) the overall scale of the migration of the population in China presents a constantly increasing trend, and the pattern that the Eastern regions are still the primary destination does not change; however, migration to the Central and Western regions shows a rapid growth; (2) the generational change of the migrant population has obvious characteristics, and a great number of the new generation of migrant workers call for higher demands regarding the quality of future urbanization; (3) the aggregates of the migrant population in cities at the prefecture level and above, especially in metropolises and megacities, are obvious, and small towns play an active role in absorbing the migrant population nearby; (4) the activity of the migration of the population in cities is closely related to their economic development, administrative level, etc. In the future, we should attach importance to the new requirements of urban development proposed by the structural change in the migration of the population, weaken the impact of the urban administrative level on migration, and promote a balanced development of the urban scale system.
Advances in Automation and Cost Reduction in Spark Plugs Pressing System
Authors: Campos Luiz Fernando R. , da Luz Gabriel Augusto , Rivabem Marcos , Mocelin Matheus
Published: May 2017

This study deals with the gain in quality and cost reduction in the pressing of the spark plug wires from the need to ensure a standard, eliminate quality defects such as poor contact of the cables generating low power failures and unexpected problems. The main objective is to study the best practices in the automotive market, to ensure a standard for fixing the spark plug wires, comparing them with the current method, pointing out potential gains from the analysis of deployment costs by reducing the time of labor and applying the results in the production line to ensure that the spark plug wires come out correctly set. To understand this work some key points were studied and addressed such as the system World Class Manufacturing (WCM), quality tools like FMEA, PDCA cycle and Kaizen. These were applied in the process of pressing the plug wires, highlighting their advantages and disadvantages, seeking the best way to use. The results show the implementation of automation to press the spark plug wires in a positive manner towards the operation performed by the operator. Automation was accepted and used to run the company in 2014. Referring to the layout of the production area, there was a reduction in the cycle time of the post. Moreover, reducing the cycle time of the operator with consequent cost savings for the company and improved ergonomic operation was observed. It is concluded that the main goal, which was to ensure a standard for pressing the plug wires and eliminating quality defects, was achieved as evidenced by cost analyses, beyond the desaturation of the job, thus receiving new activities.
Circadian Modulation of GABA Function in the Rat Suprachiasmatic Nucleus: Excitatory Effects During the Night Phase
Authors: De Jeu Marcel , Pennartz Cyriel
Published: May 2017

Gramicidin-perforated patch-clamp recordings were made from slices of the suprachiasmatic nucleus (SCN) of adult rats to characterize the role of γ-amino butyric acid (GABA) in the circadian timing system. During the day, activation of GABAA receptors hyperpolarized the membrane of SCN neurons. During the night, however, activation of GABAA receptors either hyperpolarized or depolarized the membrane. These night-restricted depolarizations in a large subset of SCN neurons were capable of triggering spikes and thus appeared to be excitatory. The GABAA reversal potentials of SCN neurons revealed a significant day-night difference with more depolarized GABAA reversal potentials during the night than during the day. The emergence of depolarizing GABAA-mediated responses in a subset of SCN neurons at night can be ascribed to a depolarizing shift in GABAA reversal potential. The GABAA receptor antagonist bicuculline (12.5 μM) increased the spontaneous firing rate of all SCN neurons during the day, indicating that spontaneous GABAA-mediated inputs inhibited the SCN neurons during this period. The effect of bicuculline (12.5 μM) on the spontaneous firing rate of SCN neurons during the night was heterogeneous due to the mixture of depolarizing and hyperpolarizing GABAA-mediated inputs during this period. We conclude that GABA uniformly acts as an inhibitory transmitter during the day but excites a large subset of SCN neurons at night. This day-night modulation of GABAergic neurotransmission provides the SCN with a time-dependent gating mechanism that may counteract propagation of excitatory signals throughout the biological clock at day but promotes it at night.
Immediate Changes in Tuning of Inferior Colliculus Neurons Following Acute Lesions of Cat Spiral Ganglion
Authors: Snyder Russell L. , Sinex Donal G.
Published: May 2017

In previous studies, we demonstrated that acute lesions the spiral ganglion (SG), the cells of origin of the auditory nerve (AN), change the frequency organization of the inferior colliculus central nucleus (ICC) and primary auditory cortex (AI). In those studies, we used a map/re-map approach and recorded the tonotopic organization of neurons before and after restricted SG lesions. In the present study, response areas (RAs) of ICC multi-neuronal clusters were recorded to contralateral and ipsilateral tones after inserting and fixing-in-place tungsten microelectrodes. RAs were recorded from most electrodes before, immediately (within 33–78 min) after, and long(several hours) after restricted mechanical lesions of the ganglion. Each SG lesion produced a “notch” in the tone-evoked compound action potential (CAP) audiogram corresponding to a narrow range of lesion frequencies with elevated thresholds. Responses of contralateral IC neurons, which responded to these lesion frequencies, underwent an elevation in threshold to the lesion frequencies with either no change in sensitivity to other frequencies or with dramatic decreases in threshold to lesion-edge frequencies. These changes in sensitivity produced shifts in characteristic frequency (CF) that could be more than an octave. Thresholds at these new CFs matched the prelesion thresholds of neurons tuned to the lesion-edge frequencies. Responses evoked by ipsilateral tones delivered to the intact ear often underwent complementary changes, i.e., decreased thresholds to lesion frequency tones with little or no change in sensitivity to other frequencies. These results indicate that responses of IC neurons are produced by convergence of auditory information across a wide range of AN fibers and that the acute “plastic” changes reported in our previous studies occur within 1 h of an SG lesion.
Invasive Mucormycosis Induced Pneumopericardium: A Rare Cause of Pneumopericardium in an Immunocompromised Patient
Authors: Khan Sana , Waqar Elahi Muhammad , Ullah Waqas , Abdullah Hafez Mohammad Ammar , Ahmad Ejaz , Al Mohajer Mayar , Majeed Aneela
Published: May 2017

Mucor and Rhizopus cause life-threatening infections primarily involving the lungs and sinuses, which disseminate very rapidly by necrosis and infarction of the contiguous tissues. We present a case of a 64-year-old African American posttransplant patient who presented with a productive cough and weight loss. He had a past surgical history of renal transplant for renal cell carcinoma and was on dual immunosuppressive therapy, that is, mycophenolate and tacrolimus. During his hospital stay, he developed a pneumopericardium due to the direct extension of a lung lesion. The diagnosis was made by radiological imaging and PCR result which was consistent with Mucor species. He was treated with antifungal therapy. The purpose of this report is to highlight the unusual association of mucormycosis with pneumopericardium.
On the Convergence of the Uniform Attractor for the 2D Leray-α Model
Authors: Deugoué Gabriel
Published: May 2017

We consider a nonautonomous 2D Leray-α model of fluid turbulence. We prove the existence of the uniform attractor Aα. We also study the convergence of Aα as α goes to zero. More precisely, we prove that the uniform attractor Aα converges to the uniform attractor of the 2D Navier-Stokes system as α tends to zero.
High Doses of Halotolerant Gut-IndigenousLactobacillus plantarumReduce Cultivable Lactobacilli in Newborn Calves without Increasing Its Species Abundance
Authors: Rodriguez-Palacios Alexander , Staempfli Henry R. , Weese J. Scott
Published: May 2017

To elucidate the ecological effect of high oral doses of halotolerant (resistant to table salt) indigenous-gut bacteria on other commensals early in life, we conducted a culture-based study to quantify the effect of intestinalLactobacillus plantarumstrain of bovine origin (with remarkable aerobic growth capabilities and inhibitory activity againstEscherichia coliO157:H7 and F5) on clinical health and gut lactobacilli/coliforms in newborn calves. In a double-blind placebo-randomized trial twelve colostrum-fed calves, consecutively born at a farm, were fedL. plantarumwithin 12 hours from birth at low (107-8 CFU/day) or high concentrations (1010-11) or placebo (q24 h, 5 d; 10 d follow-up). We developed a 2.5% NaCl-selective culture strategy to facilitate the enumeration ofL. plantarum-strain-B80, and tested 384 samples (>1,152 cultures).L. plantarum-B80-like colonies were detected in a large proportion of calves (58%) even before their first 24 hours of life indicating endemic presence of the strain in the farm. In contrast to studies where human-derivedLactobacillusLGG orrhamnosushad notoriously high, but short-lived, colonization, we found thatL. plantarumcolonized stably with fecal shedding of6±1 log10·g−1(irrespective of dose,P>0.2). High doses significantly reduced other fecal lactic acid bacteria (e.g., lactobacilli,P<0.01) and slightly reduced body weight gain in calves after treatment. For the first time, a halotolerant strain ofL. plantarumwith inhibitory activity against a human pathogen has the ability to inhibit other lactobacilliin vivowithout changing its species abundance, causing transintestinal translocation, or inducing clinical disease. The future selection of probiotics based on halotolerance may expand therapeutic product applicability.
Patient Factors Predicting Weight Loss after Roux-en-Y Gastric Bypass
Authors: Sillén Linda , Andersson Ellen
Published: May 2017

Objective. The purpose of this study was to identify preoperative factors predicting weight loss following Roux-en-Y gastric bypass (RYGB) surgery. Material and Methods. 281 patients subjected to RYGB between January 2006 and June 2012 were included. Demographic, physical, and socioeconomic factors were assessed with regression analysis. Dependent variable was percent of excess weight loss (% EWL) at follow-up. Results. Follow-up data at one year was available in 96%, at two years in 88%, and at three years in 65% of the patients. Mean EWL was 72.5%. The success rate (defined as ≥60% EWL) at 1 year was 73% and at 2 years 74% and was 71% after 3 years. An earlier onset of obesity and high preoperative BMI were independently associated with unsuccessful weight loss at 1-year follow-up. At 2-year follow-up, an association between unsuccessful weight loss and psychiatric disorder, diabetes, hypertension, and preoperative BMI was seen. At 3-year follow-up no statistically significant associations were detected. Conclusions. RYGB provides successful weight loss for most patients. The results from this study indicate that an earlier age of onset of obesity, high preoperative BMI, psychiatric disorder, diabetes, and hypertension are associated with unsuccessful weight loss.
Clinical Usefulness of the VS Classification System Using Magnifying Endoscopy with Blue Laser Imaging for Early Gastric Cancer
Authors: Yoshifuku Yoshikazu , Sanomura Yoji , Oka Shiro , Kuroki Kazutaka , Kurihara Mio , Mizumoto Takeshi , Urabe Yuji , Hiyama Toru , Tanaka Shinji , Chayama Kazuaki
Published: May 2017

Background. Blue laser imaging (BLI) enables the acquisition of more information from tumors’ surfaces compared with white light imaging. Few reports confirm the validity of magnifying endoscopy (ME) with BLI (ME-BLI) for early gastric cancer (EGC). We aimed to assess the detailed endoscopic findings from EGCs using ME-BLI. Methods. We enrolled 386 consecutive patients with 417 EGCs that were diagnosed using ME-BLI and resected by endoscopic submucosal dissection. Using the VS classification system, three highly experienced endoscopists (HEEs) and three less experienced endoscopists (LEEs) evaluated the demarcation line (DL), microsurface pattern (MSP), and microvascular pattern (MVP) within the endoscopic images of EGCs obtained using ME-BLI, assigning high-confidence (HC) or low-confidence (LC) levels. We investigated the clinicopathological features associated with each confidence level. Results. The HEEs’ evaluations determined the presence of DL in 99%, irregular MSP in 96%, and irregular MVP in 96%, and the LEEs’ evaluations determined the presence of DL in 98%, irregular MSP in 95%, and irregular MVP in 95% of the EGCs. When DL was present, HC levels in the Helicobacter pylori- (H. pylori-) eradicated group and noneradicated group were evident in 65% and 89%, a difference that was significant (p<0.001). Conclusions. In the diagnosis of EGC with ME-BLI, the VS classification system with ME-NBI can be applied, but identifying the DL after H. pylori was difficult.
Prevalence of Malnutrition and Associated Factors among Children in Rural Ethiopia
Authors: Endris Neima , Asefa Henok , Dube Lamessa
Published: May 2017

Background. Child malnutrition continues to be the leading public health problem in developing countries. In Ethiopia, malnutrition is a leading cause of child illness and death. Recently the composite index of anthropometric failure (CIAF) has been implemented to measure the prevalence of malnutrition. This index presents a more complete picture compared with the previous conventional indices. In this study, CIAF was used to determine the prevalence of malnutrition among children aged 0–59 months in rural Ethiopia. Methods. Data was extracted from the 2014 Ethiopian Mini Demographic and Health Survey (EMDHS) for this study. A total of 3095 children were included in the analysis. The composite index of anthropometric failure (CIAF) was used to measure the nutritional status of the children. Logistic regression was fitted, to identify factors associated with malnutrition among children in rural Ethiopia, using STATA 13. Result. The prevalence of malnutrition among rural children in Ethiopia was 48.5%. Age of the children, preceding birth interval, educated status of mother, wealth status, and region were factors independently associated with nutritional status of children in rural Ethiopia. Conclusion. The prevalence of malnutrition among children in rural Ethiopia was high. A child older than 12 months, having uneducated mother, living in a household with poor wealth status, born with short birth interval, and living in some region of the country are associated with increased odds of being malnourished.
Can Microsatellite Status of Colorectal Cancer Be Reliably Assessed after Neoadjuvant Therapy?
Authors: Goldstein Jennifer B. , Wu William , Borras Ester , Masand Gita , Cuddy Amanda , Mork Maureen E. , Bannon Sarah A. , Lynch Patrick M. , Rodriguez-Bigas Miguel , Taggart Melissa W. , Wu Ji , Scheet Paul , Kopetz Scott , You Y. Nancy , Vilar Eduardo
Published: May 2017

Purpose: Determination of microsatellite instability (MSI) by PCR is the gold standard; however, IHC of mismatch repair (MMR) proteins is frequently performed instead. The reliability of these methods on postneoadjuvant therapy specimens is unknown. We examined the effect of neoadjuvant therapy on MSI results by PCR and IHC.

Experimental design: A total of 239 colorectal cancers resected after neoadjuvant therapy were assessed for MSI with PCR and IHC. PCR and IHC results for matched paired pre- and posttreatment specimens were compared. In parallel, 2 isogenic cell lines conditioned for MMR functioning and 2 different patient-derived xenografts (PDXs) were exposed to chemotherapy, radiation, or both. We also examined whether establishment of PDXs induced MSI changes in 5 tumors. IHC and MSI were tested after treatment to assess for changes.

Results: We identified paired pre- and posttreatment specimens for 37 patients: 2 with PCR only, 34 with IHC only, and 1 with both. All 3 patients with PCR had microsatellite stable pre- and posttreatment specimens. Of the 35 patients with IHC, 30 had intact MMR proteins in pre- and posttreatment specimens, 1 had equivocal MLH1 staining in the pretreatment and loss in the posttreatment specimen, and 4 had intact pretreatment MSH6 but variable posttreatment staining. In the experimental setting, no changes in MSI status were detected after treatment or tumor implantation in animals.

Conclusions: Our findings show that the expression of MMR proteins, commonly MSH6, can change after neoadjuvant therapy and confirm PCR as the gold-standard test for MSI after neoadjuvant therapy. Clin Cancer Res; 23(17); 5246–54. ©2017 AACR.
Clinical Utility of Risk Models to Refer Patients with Adnexal Masses to Specialized Oncology Care: Multicenter External Validation Using Decision Curve Analysis
Authors: Wynants Laure , Timmerman Dirk , Verbakel Jan Y. , Testa Antonia , Savelli Luca , Fischerova Daniela , Franchi Dorella , Van Holsbeke Caroline , Epstein Elisabeth , Froyman Wouter , Guerriero Stefano , Rossi Alberto , Fruscio Robert , Leone Francesco PG , Bourne Tom , Valentin Lil , Van Calster Ben
Published: May 2017

Purpose: To evaluate the utility of preoperative diagnostic models for ovarian cancer based on ultrasound and/or biomarkers for referring patients to specialized oncology care. The investigated models were RMI, ROMA, and 3 models from the International Ovarian Tumor Analysis (IOTA) group [LR2, ADNEX, and the Simple Rules risk score (SRRisk)].

Experimental Design: A secondary analysis of prospectively collected data from 2 cross-sectional cohort studies was performed to externally validate diagnostic models. A total of 2,763 patients (2,403 in dataset 1 and 360 in dataset 2) from 18 centers (11 oncology centers and 7 nononcology hospitals) in 6 countries participated. Excised tissue was histologically classified as benign or malignant. The clinical utility of the preoperative diagnostic models was assessed with net benefit (NB) at a range of risk thresholds (5%–50% risk of malignancy) to refer patients to specialized oncology care. We visualized results with decision curves and generated bootstrap confidence intervals.

Results: The prevalence of malignancy was 41% in dataset 1 and 40% in dataset 2. For thresholds up to 10% to 15%, RMI and ROMA had a lower NB than referring all patients. SRRisks and ADNEX demonstrated the highest NB. At a threshold of 20%, the NBs of ADNEX, SRrisks, and RMI were 0.348, 0.350, and 0.270, respectively. Results by menopausal status and type of center (oncology vs. nononcology) were similar.

Conclusions: All tested IOTA methods, especially ADNEX and SRRisks, are clinically more useful than RMI and ROMA to select patients with adnexal masses for specialized oncology care. Clin Cancer Res; 23(17); 5082–90. ©2017 AACR.
Herpes Simplex Virus Glycoprotein D Targets a Specific Dendritic Cell Subset and Improves the Performance of Vaccines to Human Papillomavirus-Associated Tumors
Authors: Porchia Bruna F.M.M. , Moreno Ana Carolina R. , Ramos Rodrigo N. , Diniz Mariana O. , de Andrade Laís Helena T.M. , Rosa Daniela S. , Barbuto José Alexandre M. , Boscardin Silvia B. , Ferreira Luís Carlos S.
Published: May 2017

Cervical cancer is a major public health problem and one of the leading causes of cancer deaths in women. Virtually all cases of cervical cancer, as well as a growing share of anal and head/neck tumors, are associated with human papillomavirus (HPV) infection. Despite the effectiveness, the available prophylactic vaccines do not benefit women with cervical lesions or cancer. Therefore, the search of new immunotherapeutic approaches to treat HPV-induced tumors is still a priority. The present study characterizes a therapeutic antitumor vaccine based on the genetic fusion of the Herpes simplex virus-1 (HSV-1) glycoprotein D (gD) with the E7 oncoprotein from HPV-16 (gDE7). Two subcutaneous doses of gDE7, admixed with poly (I:C), conferred complete and long-lasting therapeutic antitumor protection on mice previously challenged with tumor cells expressing the HPV-16 oncoproteins. The vaccine induced multifunctional E7-specific CD8+ T cells with cytotoxic activity and effector memory phenotype (CD44+ CD62Llow). In addition, gDE7 admixed with poly (I:C) vaccination controlled the expansion of tumor-induced regulatory T cells and myeloid-derived suppressor cells. More importantly, gDE7 activated mouse CD11c+ CD8α+ and human BDCA3+ dendritic cells (DC), specialized in antigen cross-presentation to CD8+ T cells, under in vitro conditions. These results indicated that the activation of a specific DC population, mediated by gD, improved the antigen-specific immune responses and the therapeutic performance induced by antitumor vaccines. These results open perspectives for the clinical testing of gDE7-based vaccines under the concept of active immunization as a tool for the therapeutic control of cancer. Mol Cancer Ther; 16(9); 1922–33. ©2017 AACR.
Theorie-Praxis-Netzwerke in verhaltenstherapeutischer Ausbildung: Schulung, Selbsterfahrung und Einsatz in der Therapie am Beispiel von Achtsamkeit
Authors: Mander Johannes , Kröger Paula , Blanck Paul , Call Manuela , Bents Hinrich , Heidenreich Thomas
Published: May 2017

Hintergrund: Die Bausteine der theoretischen und praktischen verhaltenstherapeutischen Ausbildung finden selten direkt aufeinander bezogen statt. Die stärkere Vernetzung von Schulung, Übungsintervall und Einsatz in der Therapie von relevanten therapeutischen Interventionen ist wünschenswert. Am Beispiel einer Untersuchung von Achtsamkeitsinterventionen wurde im vorliegenden Manuskript der Versuch unternommen, dieses Thema zu adressieren. Methodik: 27 Ausbildungstherapeuten führten Achtsamkeits-Workshops mit Selbsterfahrungsintervallen durch. Darauf aufbauend wurden bei 36 Patienten standardisierte sitzungseinleitende Übungen mit Achtsamkeitselementen direkt in die Ausbildungstherapien integriert. Das Programm wurde auf Akzeptanz, Durchführbarkeit und Effektivität überprüft. Die Symptomreduktion (Beck Depression Inventory (BDI-II), Brief Symptom Inventory (BSI)) von Probatorik zur 15. Therapiesitzung wurde varianzanalytisch mit Patienten der Routineversorgung als Kontrollgruppe verglichen. Ergebnisse: In qualitativen Interviews zeigten sich positive Achtsamkeitserfahrungen. Generell waren Akzeptanz und Durchführbarkeit des Theorie-Praxis-Netzwerks hoch. Laut Aussagen der Ausbildungstherapeuten wurden hier sinnvolle Schnittstellen zwischen theoretischer und praktischer Ausbildung realisiert. Bezüglich der Symptomreduktion zeigten sich für Patienten der Achtsamkeitsgruppe und Routineversorgung ähnliche Effektstärken, hier bestanden keine signifikanten Unterschiede. Schlussfolgerung: Die Kombination aus Achtsamkeits-Workshops und darauf aufbauenden sitzungseinleitenden Übungen wurde als sinnvoll erlebt, zeigte allerdings keine stärkeren klinischen Effekte als die Routineversorgung. Zukünftige Forschung sollte Theorie-Praxis-Netzwerke in anderen Bereichen (z.B. Progressive Muskelrelaxation, Compassion) untersuchen. Zusätzlich zu positiven Durchführbarkeits- und Akzeptanzbefunden könnten dort auch klinisch relevante Effekte identifizierbar sein.
Sociocultural Influence on Obesity and Lifestyle in Children: A Study of Daily Activities, Leisure Time Behavior, Motor Skills, and Weight Status
Authors: Hilpert Martin , Brockmeier Konrad , Dordel Sigrid , Koch Benjamin , Weiß Verena , Ferrari Nina , Tokarski Walter , Graf Christine
Published: May 2017

Background: Juvenile overweight is increasing, and effective preventive measures are needed. After years of arbitrarily assigning these measures disregarding socioeconomic and/or cultural differences, it has become necessary to tailor interventions more specific to these target groups. Providing data for such an intervention is the objective of this study. Methods: Influencing variables on children's weight status, motor skills and lifestyle have been analyzed among 997 first graders (53.2% male) involved in the Children's Health InterventionaL Trial (CHILT). Results: Median age was 6.9 years; 7.3% were obese, 8.8% were overweight. Children with low socioeconomic status (SES) were more likely to be obese (p = 0.029). Low SES (p ˂ 0.001), migration background (p = 0.001) and low sports activity levels (p = 0.007) contributed most to an increased consumption of television. Migration background (p = 0.003) and male gender (p < 0.001) were the strongest factors in predicting a greater consumption of computer/video games. Children with higher SES (p = 0.02), lower BMI (p = 0.035), and males (p = 0.001) performed better in motor tests. Conclusion: Children with a low SES and migration background were more likely to exhibit unfavorable health behavior patterns, higher BMI scores, and poorer motor skills. Interventions should integrate motivational and targeting strategies and consider cultural and educational differences to address these vulnerable groups.
Risk of Onset of Hematological Malignancies in Patients Infected with the Hepatitis B Virus: Results from a Large-Scale Retrospective Cohort Study in China
Authors: Li Xiaoyang , Zheng Yu , Zhu Hongming , Lin Xiaojing , Zhang Yunxiang , Zhao Yubing , Hu Jiong , Li Junmin
Published: May 2017

The hepatitis B virus (HBV) is a major global issue, because an increased risk of hepatocellular carcinoma among patients infected with HBV is well established. Recently, it has been suggested that HBV is associated with other human cancers. However, the association between HBV and the risk of onset of hematological malignancies remains controversial. The aim of this large-scale retrospective cohort study was to evaluate the association between HBV infection and hematological malignancies. A retrospective analysis of 86,115 newly admitted patients at Shanghai Ruijin Hospital was performed. A cohort of patients previously exposed to HBV (n = 1,874) and a cohort of individuals without a positive test for anti-hepatitis B core antigen (anti-HBc; n = 45,118) were compared to assess the risk of hematological malignancies. Anti-HBc was positive in 61.2% cases and 54.3% controls (p = 0.0001). The risk of B cell non-Hodgkin's lymphoma, acute lymphoblastic leukemia, and multiple myeloma was higher in the HBV-infected cohort than in the non-HBV-infected cohort. In conclusion, patients infected with HBV have a substantially increased risk of hematological malignancies.