bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptive learning in smart cities – The cases of Catania and Helsinki
Authors: Laitinen Ilpo , Piazza Roberta , Stenvall Jari
Published: February 2017

Our research is a comparative qualitative study. The material has been gathered from the cities of Helsinki and Catania. The target cities showcase varied successes and models of smart cities. In the cities, key people involved in the smart city concept – with different kinds of professional backgrounds – were interviewed, both individually and in teams. All interviewees had at least a basic knowledge of information technology and of organizational learning processes. On the basis of these interviews it has been possible to create an overall picture of learning processes occurring in the organizations involved (universities and local government) and within the smart city programmes produced or still to be developed. We explore how the expertise has been challenged: how the key players of the smart city uphold the concept and promote it.
Culture of human cells in experimental units for spaceflight impacts on their behavior
Authors: Cazzaniga Alessandra , Moscheni Claudia , Maier Jeanette AM , Castiglioni Sara
Published: February 2017

Because space missions produce pathophysiological alterations such as cardiovascular disorders and bone demineralization which are very common on Earth, biomedical research in space is a frontier that holds important promises not only to counterbalance space-associated disorders in astronauts but also to ameliorate the health of Earth-bound population. Experiments in space are complex to design. Cells must be cultured in closed cell culture systems (from now defined experimental units (EUs)), which are biocompatible, functional, safe to minimize any potential hazard to the crew, and with a high degree of automation. Therefore, to perform experiments in orbit, it is relevant to know how closely culture in the EUs reflects cellular behavior under normal growth conditions. We compared the performances in these units of three different human cell types, which were recently space flown, i.e. bone mesenchymal stem cells, micro- and macrovascular endothelial cells. Endothelial cells are only slightly and transiently affected by culture in the EUs, whereas these devices accelerate mesenchymal stem cell reprogramming toward osteogenic differentiation, in part by increasing the amounts of reactive oxygen species. We conclude that cell culture conditions in the EUs do not exactly mimic what happens in a culture dish and that more efforts are necessary to optimize these devices for biomedical experiments in space.

Impact statement

Cell cultures represent valuable preclinical models to decipher pathogenic circuitries. This is true also for biomedical research in space. A lot has been learnt about cell adaptation and reaction from the experiments performed on many different cell types flown to space. Obviously, cell culture in space has to meet specific requirements for the safety of the crew and to comply with the unique environmental challenges. For these reasons, specific devices for cell culture in space have been developed. It is important to clarify whether these alternative culture systems impact on cell performances to allow a correct interpretation of the data.
Targeted High Performance Liquid Chromatography Tandem Mass Spectrometry-based Metabolomics differentiates metabolic syndrome from obesity
Authors: Zhong Fanyi , Xu Mengyang , Bruno Richard S , Ballard Kevin D , Zhu Jiangjiang
Published: February 2017

Both obesity and the metabolic syndrome are risk factors for type 2 diabetes and cardiovascular disease. Identification of novel biomarkers are needed to distinguish metabolic syndrome from equally obese individuals in order to direct them to early interventions that reduce their risk of developing further health problems. We utilized mass spectrometry-based targeted metabolic profiling of 221 metabolites to evaluate the associations between metabolite profiles and established metabolic syndrome criteria (i.e. elevated waist circumference, hypertension, elevated fasting glucose, elevated triglycerides, and low high-density lipoprotein cholesterol) in plasma samples from obese men ( n = 29; BMI = 35.5 ± 5.2 kg/m2) and women ( n = 40; 34.9 ± 6.7 kg/m2), of which 26 met the criteria for metabolic syndrome (17 men and 9 women). Compared to obese individuals without metabolic syndrome, univariate statistical analysis and partial least squares discriminant analysis showed that a specific group of metabolites from multiple metabolic pathways (i.e. purine metabolism, valine, leucine and isoleucine degradation, and tryptophan metabolism) were associated with the presence of metabolic syndrome. Receiver operating characteristic curves generated based on the PLS–DA models showed excellent areas under the curve (0.85 and 0.96, for metabolites only model and enhanced metabolites model, respectively), high specificities (0.86 and 0.93), and good sensitivities (0.71 and 0.91). Moreover, principal component analysis revealed that metabolic profiles can be used to further differentiate metabolic syndrome with 3 versus 4–5 metabolic syndrome criteria. Collectively, these findings support targeted metabolomics approaches to distinguish metabolic syndrome from obesity alone, and to stratify metabolic syndrome status based on the number of criteria met.

Impact statement

We utilized mass spectrometry-based targeted metabolic profiling of 221 metabolites to evaluate the associations between metabolite profiles and established MetS criteria. To our best knowledge, the findings of this study provide the first evidence that metabolic profiles can be used to differentiate participants with MetS from similarly obese individuals who do not meet established criteria of MetS. Furthermore, the study demonstrated that within MetS participants, their unique metabolic profiles correlated to the number of criteria used for MetS determination. Taken together, this metabolic profiling approach can potentially serve as a novel tool for MetS detection and monitoring, and provide useful metabolic information for future interventions targeting obesity and MetS.
Nuclear factor E2-related factor 2 knockdown enhances glucose uptake and alters glucose metabolism in AML12 hepatocytes
Authors: Yuan Xiaoyang , Huang Huijing , Huang Yi , Wang Jinli , Yan Jinhua , Ding Ling , Zhang Cuntai , Zhang Le
Published: February 2017

Nuclear factor E2-related factor 2 (Nrf2) is a transcription factor known to induce the expression of a variety of antioxidant and detoxification genes. Recently, increasing evidence has revealed roles for Nrf2 in glucose, lipid, and energy metabolism; however, the exact functions of Nrf2 in hepatocyte biology are largely unclear. In the current study, the transient knockdown of Nrf2 via siRNA transfection enhanced the glucose uptake of fasting AML12 hepatocytes to 325.3 ± 11.1% ( P < 0.05) of that of untransfected control cells. The impacts of Nrf2 knockdown (NK) on the antioxidant system, inflammatory response, and glucose metabolism were then examined in AML12 cells under both high-glucose (33 mmol/L) and low-glucose (4.5 mmol/L) conditions. NK lowered the gene and protein expression of the anti-oxidases heme oxygenase-1 and NAD(P)H: quinone oxidoreductase 1 and increased p-eukaryotic initiation factor-2αS51, p-nuclear factor-κB p65S276, and its downstream proinflammatory factors, including interleukin-1 beta, tumor necrosis factor-α, matrix metalloproteinase 2, and matrix metalloproteinase 9, at the protein level. NK also altered the protein expression of fibroblast growth factor 21, glucose transporter type 4, insulin-like growth factor 1, forkhead box protein O1, p-AKTS473, and p-GSK3α/βY279/Y216, which are involved in glucose uptake, glycogenesis, and gluconeogenesis in AML12 cells. Our results provide a comprehensive understanding of the central role of Nrf2 in the regulation of glucose metabolism in AML12 hepatocytes, in addition to its classical roles in the regulation of redox signaling, endoplasmic reticulum stress and proinflammatory responses, and support the potential of Nrf2 as a therapeutic target for the prevention and treatment of obesity and other associated metabolic syndromes.

Impact statement

Increasing evidence supports the complexity of Nrf2 functions beyond the antioxidant and detoxification response. Previous in vivo studies employing either Nrf2-knockout or Nrf2-activated mice have achieved a similar endpoint: protection against an obese and insulin-resistant phenotype that includes impaired lipogenesis and gluconeogenesis in the liver. These apparently paradoxical observations led us to evaluate the impact of Nrf2 in liver cells in the absence of any influence from the systemic environment, including changes in the secretion of adipokines and proinflammatory cytokines by adipose tissues. In the present study, Nrf2 knockdown was sufficient to induce fundamental changes in the glucose metabolism of AML12 hepatocytes in addition to its classical cytoprotective functions. We also discuss similarities and differences between our in vitro study and previous in vivo studies, which may be helpful to dissect and better understand in vivo data that represents the culmination of both local and systemic alterations.
Increasing Community Research Capacity to Address Health Disparities
Authors: Komaie Goldie , Ekenga Christine C. , Sanders Thompson Vetta L. , Goodman Melody S.
Published: February 2017

The Community Research Fellows Training program is designed to enhance capacity for community-based participatory research; program participants completed a 15-week, Master of Public Health curriculum. We conducted qualitative, semistructured interviews with 81 participants from two cohorts to evaluate the learning environment and how the program improved participants’ knowledge of public health research. Key areas that provided a conducive learning environment included the once-a-week schedule, faculty and participant diversity, and community-focused homework assignments. Participants discussed how the program enhanced their understanding of the research process and raised awareness of public health–related issues for application in their personal lives, professional occupations, and in their communities. These findings highlight key programmatic elements of a successful public health training program for community residents.
Ethical Issues Surrounding the Use of Modern Human Remains for Research in South Africa
Authors: Briers N. , Dempers J. J.
Published: February 2017

Chapter 8 of the South African National Health Act 61 of 2003 (NHA) that deals with the donation of human tissue was promulgated in 2012. The new Act is perceived to impose restrictions on low-risk research involving human remains. This study aimed to identify the issues raised by a research ethics committee (REC) when reviewing protocols where human remains are used as data source. REC minutes from 2009 to 2014 were reviewed, and issues raised by the committee were categorized. In total, 127 protocols submitted to the committee over 6 years involved human remains. Queries relating to science (22.2%) and administration (18.9%) were the most common, whereas queries relating to legal issues constituted only 10.2%. Ethical issues centered on informed consent regarding sensitive topics such as HIV, DNA, and deceased children. The change in legislation did not change the number or type of legal issues identified by the REC.
Exercise and mental health of people living with HIV: A systematic review
Authors: Nosrat Sanaz , Whitworth James W. , Ciccolo Joseph T.
Published: February 2017

Objective

Mental illness is highly prevalent among people living with HIV. Poor mental health is linked to HIV disease progression, making the treatment of mental illness alongside HIV essential. While the benefits of exercise on the physical health of people living with HIV are well established, the effect of exercise on mental health in this population is less examined. Therefore, this study aimed to conduct a systematic literature review of the effects of exercise on mental health in people living with HIV.

Methods

A search of electronic databases (PubMed, Web of Science, PsycINFO) through 30 November 2016 was completed. The methodological framework for scoping studies was used to conduct the review process. RISMA guidelines were used to report the results.

Results

The search resulted in 2273 articles and 52 were determined to be relevant. After review of the full text of potentially relevant studies, 24 studies were included for the analysis.

Discussion

Both aerobic and resistance exercise have independent and combined positive effects on various indicators of mental health in people living with HIV. Major limitations include high attrition rate, small sample size, and poor study designs. Higher quality studies with more diverse populations such as women, older adults, and transgender individuals are required.
Lessons for psychology laboratories from industrial laboratories
Authors: Gomez Pablo , Anderson Autumn R , Baciero Ana
Published: February 2017

In the past decade there has been a lot of attention to the quality of the evidence in experimental psychology and in other social and medical sciences. Some have described the current climate as a ‘crisis of confidence’. We focus on a specific question: how can we increase the quality of the data in psychology and cognitive neuroscience laboratories. Again, the challenges of the field are related to many different issues, but we believe that increasing the quality of the data collection process and the quality of the data per se will be a significant step in the right direction. We suggest that the adoption of quality control systems which parallel the methods used in industrial laboratories might be a way to improve the quality of data. We recommend that administrators incentivize the use of quality systems in academic laboratories.
Management of post-traumatic stiffness of the shoulder following upper limb trauma with manipulation under anaesthetic
Authors: Lancaster Sarah T. , Grove Thomas N. , Woods David A.
Published: February 2017

Background

A proportion of patients who sustain upper limb fractures develop post-traumatic stiffness (PTS), which may progress in a similar way to primary frozen shoulder (PFS). We have had success in treating PFS with manipulation under anaesthetic (MUA) and therefore treated PTS using MUA. Oxford Shoulder Scores (OSS), range of motion (ROM) data pre- and post-MUA, and the need for repeat procedure were compared.

Methods

Sixty-four patients with PTS following an upper limb fracture, unresponsive to conservative measures, were seen between 1 January 1999 and 1 November 2015. Thirty-two patients had sustained a proximal humeral fracture, six of whom had a concurrent shoulder dislocation. MUA was performed using a standard technique. The results were compared with 487 PFS patients undergoing the same procedure.

Results

There was no significant difference in ROM change between the groups. Improvement in OSS was slightly greater in the PFS group (17 versus 14, p = 0.005) but, upon subgroup analysis of the PTS group, no significant difference was found for patients presenting with humeral fractures alone.

Conclusions

MUA results for PTS following upper limb fracture are comparable to MUA for PFS. We therefore recommend MUA in PTS cases where conservative methods have failed.
Combination of metformin and curcumin targets breast cancer in mice by angiogenesis inhibition, immune system modulation and induction of p53 independent apoptosis
Authors: Falah Rabah Rashad , Talib Wamidh H. , Shbailat Seba Jamal
Published: February 2017

Background:

The effects of metformin (MET) and curcumin (CUR) single treatments have been tested against breast cancer; however, their combination has not been explored. Here, we evaluated the antitumor activity of MET and CUR combination against breast cancer in mice.

Materials and methods:

The antiproliferative activity of single and combined treatments against breast cancer cell lines was determined. Vascular endothelial growth factor (VEGF) and Trp53 expression was examined in EMT6/P cells. In vivo studies were carried out by inoculating BALB/c mice with EMT6/P cells and examining tumor growth and apoptosis induction in tumor sections. Furthermore, serum levels of different cytokines and transaminases and creatinine were measured to detect the immune response and toxicity, respectively.

Results:

The combination treatment exhibited the highest effects against tumor proliferation and growth. It significantly reduced VEGF expression, induced Trp53 independent apoptosis, triggered Th2 immune response and showed no toxicity.

Conclusion:

The combination can be a potential therapeutic option to treat breast cancer. However, further testing is needed to measure the exact serum levels of MET and CUR and to further explain the obtained results.
Massive Extraction of the Orchid Laelia speciosa (HBK) Schltr. for Trading in Local Markets Affect Its Population Genetic Structure in a Fragmented Landscape in Central Mexico
Authors: Rojas-Méndez Karla Joanna , Peñaloza-Ramírez Juan Manuel , Rocha-Ramírez Víctor , Cortés-Palomec Aurea , McCauley Ross A. , Oyama Ken
Published: February 2017

Laelia speciosa is an orchid species listed as threatened of extinction in the Mexican standard NOM-059. Wild populations of L. speciosa have been declining due to fragmentation of its habitat and massive extraction for trading in local markets in Mexico. In this study, we aimed to evaluate the evolutionary potential of L. speciosa within a fragmented landscape of ca. 4000 km2 in the Cuitzeo basin, State of Michoacán. We sampled 15 populations throughout the Cuitzeo basin and amplified eight nuclear microsatellite markers to assess genetic diversity, structure, and connectivity and to test for evidence of recent bottlenecks. Surprisingly, L. speciosa populations showed high genetic diversity, with values ranging from moderate to high compared with those reported for other orchid species. Also, the analysis of molecular variance and R ST results indicated the existence of low genetic differentiation, favored by its cross pollination habit which facilitates the maintenance of gene flow and that have been observed in other orchid species. Wright's within-population inbreeding ( F IS) was positive in all cases, denoting a heterozygosity deficit, with moderate-to-high values. Fragmentation may also lead to inbreeding due to either increased self-fertilization or mating between related individuals within remnant fragments. The L. speciosa populations examined showed evidence suggesting that some populations had recently gone through a bottleneck. We also observed that all the L. speciosa populations had a moderate effective population size. The history of L. speciosa in the Cuitzeo basin suggests that both fragmented and non-fragmented populations may have been recently subject to moderate reductions in effective population size, large enough to affect their allelic diversity, F IS, but not their H E. Such reductions may have been caused by episodic environmental fluctuations or resulted from the recent founding of some of the populations. The effective population size can be used as an indicator of habitat quality, and this was confirmed for the L. speciosa populations, which have undergone a drastic decline due to environmental changes, habitat destruction, and illegal collection. The ultimate goals of conservation are to ensure the continuous survival of populations and maintain their evolutionary potential by preserving natural levels of genetic diversity. Great efforts should be made to preserve this species' extant populations and their habitats to prevent further population reductions and preserve its overall genetic basis. Collection of this orchid should be banned and robust legal protection measures should be enforced through local authorities.
Priming radioimmunotherapy with external beam radiation in patients with relapsed low grade non-Hodgkin lymphoma
Authors: Abuodeh Yazan , Ahmed Kamran , Echevarria Michelle , Naghavi Arash , Grass G. Daniel , Robinson Timothy J. , Tomblyn Michael , Shah Bijal , Chavez Julio , Bello Celeste , El-Haddad Ghassan , Harrison Louis , Kim Sungjune
Published: February 2017

Background:

The aim of this study was to evaluate the outcomes of priming salvage radioimmunotherapy (RIT) with a low dose of external beam radiotherapy (EBRT) in patients with relapsed low grade non-Hodgkin lymphoma (LG-NHL).

Methods:

Patients who received salvage RIT with or without 2 × 2 Gy EBRT between March 2009 and February 2013 were retrospectively reviewed at a single institution. Planning target volume (PTV) for EBRT was created by adding a 1–2 cm expansion to the gross tumor volume depending on the anatomical location. Kaplan−Meier method via log-rank was employed to analyze the endpoints freedom from progression (FFP) and overall survival (OS).

Results:

We identified 22 patients who received salvage RIT without chemotherapy with a median follow up of 34 months. Of these, 9 (41%) patients were treated with EBRT immediately prior to RIT, and 13 (59%) received salvage RIT alone. Median FFP was not reached in patients who underwent combination treatment, while it was 9 months for patients treated with RIT alone ( p = 0.02). OS for all patients at 36 months was 80.3% with no significant difference between the two groups ( p = 0.88). On univariate analysis, the addition of EBRT was associated with improved FFP [hazard ratio (HR) = 4.17; 95% confidence interval (CI), 1.24–19.1; p = 0.02)]. No long term toxicities were reported in both groups.

Conclusions:

RIT outcomes and effects were improved with addition of low-dose EBRT immediately prior to it, in the treatment of relapsed LG-NHL with no additional toxicity. This study is hypothesis-generating and the findings should be validated in prospective studies.
Gastric heterotopia in rectum: A literature review and its diagnostic pitfall
Authors: Dinarvand Peyman , Vareedayah Ashley A. , Phillips Nancy J , Hachem Christine , Lai Jinping
Published: February 2017

Objectives:

The term heterotopia, in pathology, refers to the presence of normal tissues at foreign sites. Gastric heterotopia has been reported anywhere in the gastrointestinal tract. However, the presence of gastric heterotopia in the rectum is very rare.

Methods:

We, here, report a rare case of a localized 2-cm area of cratered mucosa with heaped-up borders in the rectum of a 51-year-old, asymptomatic woman who underwent screening colonoscopy.

Results:

Histologic examination of the biopsy from the lesional tissue in rectum demonstrated fragments of rectal mucosa co-mingling with oxyntic- and antral-type gastric mucosa. No intestinal metaplasia or Helicobacter pylori is identified.

Conclusion:

Patients with gastric heterotopia in rectum usually present with bleeding and/or abdominal pain. Definite treatment of choice is surgical or endoscopic resection, although the lesions also respond to histamine-2 receptor blockers. In this article, most recent literature about gastric heterotopia in rectum is reviewed, following a case presentation about it.
Ocimum gratissimum Ameliorates Gentamicin-Induced Kidney Injury but Decreases Creatinine Clearance Following Sub-Chronic Administration in Rats
Authors: Ogundipe Dare J. , Akomolafe Rufus O. , Sanusi Abubakar A. , Imafidon Christian E. , Olukiran Olaoluwa S. , Oladele Ayowole A.
Published: February 2017

The effects of aqueous extract of Ocimum gratissimum leaf (AOGL) on the renal function of rats with gentamicin-induced nephrotoxicity were investigated. This study involved the use of forty five (45) adult male Wistar rats (housed in separate metabolic cages) such that graded doses of OAGL were administered to the experimental groups (p.o.) for 28 days after exposure to gentamicin toxicity (100 mg/kg i.p.) for 1 week. At the end of the study, comparisons of some indices of renal function as well as antioxidant status (GSH and TBARS) were made between the control, toxic and AOGL-treated groups at P < 0.05. The result showed that gentamicin treatment caused significant increase ( P < .05) in urine output, urea, creatinine, total protein, relative kidney weight, and TBARS, as well as significant decrease ( P < .05) in urine creatinine and GSH levels. Post-treatment with graded doses of AOGL caused significant increase in food consumption, GSH, urine, and plasma creatinine, as well as significant decrease ( P < .05) in relative kidney weight, TBARS, and urine total protein. There was an appreciable difference in the kidney histology of the AOGL-treated groups when compared with the toxic control. Hence, the extract has therapeutic potential in the management of gentamicin-induced kidney injury, although a risk profile of renal dysfunction is not unlikely from 28 days of administration as evident by the decrease in creatinine clearance.
Attenuation of Oxidative Stress and Inflammation by Portulaca oleracea in Streptozotocin-Induced Diabetic Rats
Authors: Samarghandian Saeed , Borji Abasalt , Farkhondeh Tahereh
Published: February 2017

The present study was designed to investigate the protective effect of the aqueous extract of Portulaca oleracea against hyperglycemic, oxidative damage and inflammation in the serum of streptozotocin (STZ)-induced diabetic rats. In the present study, the rats were divided into the following groups of 8 animals each: control, untreated diabetic, 3 Portulaca oleracea (100, 200, 400 mg/kg/d)–treated diabetic groups. At the end of the 4-week period, glucose, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA), glutathione (GSH), and total antioxidant status (TAS) levels were measured. STZ caused an elevation in the serum levels of glucose, MDA, IL-6, and TNF-α with reduction in the levels of GSH and TAS ( P < .01). Portulaca oleracea ameliorated glucose, MDA, IL-6, TNF-α, GSH, and TAS levels in diabetic groups versus to the untreated groups ( P < .05). Taken together, Portulaca oleracea prevented hyperglycemia by preventing the oxidative stress and inflammation.
“Another Kind of Swede”
Authors: Gyberg Fanny , Frisén Ann , Syed Moin , Wängqvist Maria , Svensson Ylva
Published: February 2017

The purpose of this study was to use a narrative approach to investigate the types of ethnicity-related experiences (i.e., ethnic identity content) that were prevalent in the lives of young people in Sweden and to examine if these types of experiences differed due to immigrant status, self-identified ethnicity, or age-groups. Ninety-five participants (87% women, 66% immigrants; 57% emerging adults, 43% adolescents; Mage = 19.62) shared their ethnicity-related experiences. Results indicated that youth from immigrant backgrounds more often wrote about ethnicity-related experiences. Thematic analysis revealed six types of stories: feelings of prejudice or racism, general differences, not fitting in, being “another kind of Swede,” being in between cultures or ethnicities, and cultural ideologies. These themes showed little variation by participant immigrant background, ethnicity, or age. The themes found in this study reflect complex and multicultural identities that may play an important part in young people’s identity formation.
Extra-articular diffuse-type tenosynovial giant cell tumor with benign histological features resulting in fatal pulmonary metastases
Authors: Osanai Toshihisa , Suzuki Hiroaki , Hiraga Hiroaki , Soma Tamotsu , Nojima Takayuki
Published: February 2017

Diffuse-type tenosynovial giant cell tumor (TS-GCT) is categorized as a locally aggressive but non-metastasizing neoplasm according to the WHO classification. Herein, we report an extremely rare case of a 41-year-old woman who developed multiple metastases from diffuse TS-GCT with benign histological features. The patient complained of a painful buttock mass and imaging studies revealed a soft tissue tumor of the buttock and multiple pulmonary nodules. The buttock tumor was excised and the final diagnosis was extra-articular diffuse-type TS-GCT. By video-assisted thoracic surgery, pulmonary nodules were pathologically identical to the primary tumor. Residual pulmonary nodules progressively grew, and she developed a muscle metastasis and a subcutis metastasis. She died of respiratory dysfunction due to multiple pulmonary metastases 1 year after primary surgery. Very few reports on histologically benign metastases from TS-GCT have been published, and the natural course of this rare condition remains unclarified. This rare case could provide important information for further clinical evaluation of this tumor.
Comparative evaluation of posterior cruciate ligament in total knee arthroplasty
Authors: Ma Yuan , Chen Wei-Jia , Nagamine Ryuji
Published: February 2017

Introduction:

It has been realized that for osteoarthritis (OA) knee with varus deformity, posterior cruciate ligament (PCL) release resulted in the increase of the flexion gap without significant effect on the extension gap. While the effect of release on gap angle is still obscure. On the other hand, gap distance and varus angle measured under different distraction forces suggest different patterns.

Objectives:

In the current study, mechanical gap balance in displacement and angular alternation of extension and flexion gaps will be evaluated, with PCL fully retained or resected under different distracting forces in varus knees.

Methods:

Fifty cases with medial OA undergoing posterior-stabilized (PS) total knee arthroplasty (TKA) were included in the study. PCL of all the cases were identified intact before resection. After distal femoral and proximal tibial cuts were initially performed and anterior cruciate ligament was excised, joint gap angle and distance in full extension and at 90° flexion were obtained by means of a tensioning device with 10, 20 and 30 inch-pounds (in-lbf) of distraction force. The gap angle and distance were measured three times at each step. After the excision of PCL, the same measurement was performed.

Results:

Both the distance and the varus angles of the knee gap enlarged accordingly with the augment of distraction forces at both extension and flexion with or without PCL resection. As to the gap distance, it remained the same after PCL resection at extension; while at flexion, the gap distance significantly ( p < 0.001) enlarged – 1.2, 1.6 and 1.9 mm – under 10, 20 and 30 in-lbf, respectively, after PCL resection. As to the varus angles, it significantly ( p < .050) decreased 0.6°, 0.3° and 0.4° at extension; while at flexion, the varus angles decreased 0° (not significant), 0.6° ( p < 0.050) and 1.1° ( p < 0.001) with 10, 20 and 30 in-lbf, respectively, after PCL resection.

Conclusion:

Our study indicated that the sacrifice of PCL will decrease the varus deformity at both extension and flexion, but with the exception under low distraction force at flexion. A proper distraction tension is of great importance in gap balancing during TKA. Sufficient attention of varus differences should be paid to the gap balance technique when choosing from different techniques, PCL-retained TKA or PCL-sacrificed TKA, as well as and an appropriate distract tension during measurement.
Injury of the infrapatellar branch of the saphenous nerve due to hamstring graft harvest
Authors: Sipahioglu Serkan , Zehir Sinan , Sarikaya Baran , Levent Ali
Published: February 2017

Purpose:

Sensory disturbance around the surgical incision due to injury of the infrapatellar branch of the saphenous nerve can be seen in the anterior cruciate ligament reconstruction. In this research, we aimed to compare the incidence, extent of sensory loss, its clinical effect, and natural course caused by two different skin incisions used for hamstring graft harvest.

Methods:

Vertical incision for 36 patients and oblique incision for 42 patients used for graft harvest were included in this study. Sensory loss areas were documented at 6th week, 3rd month and 6th month. Pin prick examination is used to detect the change in sensation. Digital photographs of hypaesthesia were taken and analysed by computer for area detection. The length of incision and subjective complain of sensory loss were also noted.

Results:

At 6th month, 77% (28/36) of the vertical incisions were associated with persistent sensory loss when compared to the oblique incision (45%, 19/42). The measured area of hypaesthesia was significantly higher in vertical incision (42.4 ± 22.3 cm2) than that in oblique incision (9.3 ± 15.3 cm2) at 6th month. The area of hypaesthesia gradually shrunk in size from distal to proximal in direction. Also, subjective cutaneous anaesthesia was higher in vertical incision (15/36, 41%) than oblique incision (6/41, 14%) at 6th month.

Conclusion:

Oblique incision with less risk of nerve damage is better for graft harvesting. Area of hypaesthesia gradually reduces with time and even recover totally. As a possible complication, nerve injury and its benign prognosis should be explained to the patient before surgery.
Lunatum excision and scaphocapitate arthrodesis in Kienböck’s disease
Authors: Özdemir Güzelali , Akgül Turgut , Çiçekli Özgür , Yılmaz Barış , Atbinici Hasan , Yücel Ferit
Published: February 2017

Purpose:

The aim of this study was to compare functional results before and after lunatum excision and scaphocapitate arthrodesis (SCA) using an angular stable circular plate in patients with Lichtman’s stage IIIB Kienböck’s disease.

Methods:

The study included nine patients (six females and three males) with a mean age of 33.2 ± 11 years (range: 18–54 years). Clinical and radiological assessment before and after surgery included wrist extension and flexion, range of motion and grip strength, visual analogue scale (VAS) score to assess pain, modified Mayo wrist scores, and measurements of the scapholunate (SL) angle and modified carpal height ratio.

Results:

The mean follow-up period was 17.33 ± 4.69 months (range: 12–24 months), mean operation time was 56.67 ± 12.5 min (range: 45–75 min) and mean hospitalization time was 3.44 ± 1.13 days (range: 2–6 days). Preoperative mean wrist extension was 23.89° ± 4.17°, mean wrist flexion was 32.22° ± 5.07°, mean grip strength compared to the healthy side was 34% (range: 28–37%) and mean VAS score was 7.6 (range: 7–8). Modified Mayo wrist scores were poor in all of the nine patients. Post-operative mean wrist extension was 27.78° ± 4.41°, mean wrist flexion was 40.56° ± 4.64°, mean grip strength compared to the healthy side was 71% (range: 63–81%) and mean VAS score was recorded as 1.4 (range: 1–2). Modified Mayo wrist scores were good in five and moderate in four patients. No patients had non-union or additional surgery.

Conclusion:

Lunatum excision and SCA using angular stable circular plate fixation provide pain relief with acceptable preservation of the range of motion.
Infection after fracture osteosynthesis – Part II
Authors: Fang Christian , Wong Tak-Man , To Kelvin KW , Wong Samson SY , Lau Tak-Wing , Leung Frankie
Published: February 2017

In the first part of this article, we have discussed the pathogenesis, clinical presentation, diagnosis and classification of infection after fracture osteosynthesis with implants, termed here as osteosynthesis-associated infection (OAI). Prolonged antibiotic treatment is usually necessary. Implant retention and maintenance of fracture stability to allow for fracture healing in spite of infection are allowed for OAI. Depending on the severity of infection, status of fracture healing and host status, the treatment follows five common pathways. These are non-operative treatment, debridement with implant retention, conversion of fixation, implant removal and suppression therapy. The decision-making process leading to each treatment pathway and challenging scenarios is discussed in detail.
Cell-Based Meniscus Repair and Regeneration: At the Brink of Clinical Translation?
Authors: Korpershoek Jasmijn V. , de Windt Tommy S. , Hagmeijer Michella H. , Vonk Lucienne A. , Saris Daniel B. F.
Published: February 2017

Background:

Meniscus damage can be caused by trauma or degeneration and is therefore common among patients of all ages. Repair or regeneration of the menisci could be of great importance not only for pain relief or regaining function but also to prevent degenerative disease and osteoarthritis. Current treatment does not offer consistent long-term improvement. Although preclinical research focusing on augmentation of meniscal tear repair and regeneration after meniscectomy is encouraging, clinical translation remains difficult.

Purpose:

To systematically evaluate the literature on in vivo meniscus regeneration and explore the optimal cell sources and conditions for clinical translation. We aimed at thorough evaluation of current evidence as well as clarifying the challenges for future preclinical and clinical studies.

Study Design:

Systematic review.

Methods:

A search was conducted using the electronic databases of MEDLINE, Embase, and the Cochrane Collaboration. Search terms included meniscus, regeneration, and cell-based.

Results:

After screening 81 articles based on title and abstract, 51 articles on in vivo meniscus regeneration could be included; 2 additional articles were identified from the references. Repair and regeneration of the meniscus has been described by intra-articular injection of multipotent mesenchymal stromal (stem) cells from adipose tissue, bone marrow, synovium, or meniscus or the use of these cell types in combination with implantable or injectable scaffolds. The use of fibrochondrocytes, chondrocytes, and transfected myoblasts for meniscus repair and regeneration is limited to the combination with different scaffolds. The comparative in vitro and in vivo studies mentioned in this review indicate that the use of allogeneic cells is as successful as the use of autologous cells. In addition, the implantation or injection of cell-seeded scaffolds increased tissue regeneration and led to better structural organization compared with scaffold implantation or injection of a scaffold alone. None of the studies mentioned in this review compare the effectiveness of different (cell-seeded) scaffolds.

Conclusion:

There is heterogeneity in animal models, cell types, and scaffolds used, and limited comparative studies are available. The comparative in vivo research that is currently available is insufficient to draw strong conclusions as to which cell type is the most promising. However, there is a vast amount of in vivo research on the use of different types of multipotent mesenchymal stromal (stem) cells in different experimental settings, and good results are reported in terms of tissue formation. None of these studies compare the effectiveness of different cell-scaffold combinations, making it hard to conclude which scaffold has the greatest potential.
Meta-analysis of single-case treatment effects on self-injurious behavior for individuals with autism and intellectual disabilities
Authors: Morano Stephanie , Ruiz Salvador , Hwang Jiwon , Wertalik Jennifer L. , Moeller Jeremy , Karal Muhammed Akif , Mulloy Austin
Published: February 2017

Background and aim

Research has demonstrated that a variety of treatments can reduce or eliminate self-injurious behavior (SIB) in individuals with autism and/or intellectual disabilities but evidence suggests that not all treatments are equally effective.

Methods

We used multi-level meta-analysis to synthesize the results of 137 single-case design studies on SIB treatment for 245 individuals with autism and/or intellectual disabilities. Analyses compare the effects of various behavioral and medical treatments for SIB and assess associations between treatment effects and participant- and study-level variables.

Results

Findings suggest differential reinforcement, punishment, and treatment packages with reinforcement and punishment components resulted in the largest SIB reductions.

Conclusions

Results indicate that overall, treatment for SIB is highly effective and that participant and study characteristics do not moderate treatment effects.

Implications

Based on results and in line with current practice recommendations, we encourage use of reinforcement-based procedures in all cases of SIB. In the event that reinforcement-only treatments have failed or if SIB poses a serious, immediate threat to the health and well-being of an individual, our results suggest that overcorrection paired with reinforcement may be the most effective as well as less invasive alternative.
Long-Term Follow-Up of a Vascularized Metacarpal Bone Graft in the Treatment of Idiopathic Avascular Necrosis of the Capitate
Authors: Moriya Koji , Yoshizu Takae , Makino Masaharu , Maki Yutaka
Published: February 2017

Idiopathic avascular necrosis of the capitate was treated with a vascularized bone graft from the base of the second metacarpus. The good clinical results and prevention of significant collapse maintained over the long term favour the use of this technique for the treatment of avascular necrosis of the capitate.
Congenital Absence of Abductor Pollicis Brevis
Authors: Ho Trung Q , Santiago Jose M , Parker Wendy L
Published: February 2017

Congenital thenar hypoplasia is a rare anomaly, and even more perplexing when it is isolated to a specific muscle with associated nerve and vascular anomalies. In the present article, the authors report a case involving a 14-year-old female with unilateral absence of the abductor pollicis brevis muscle, a bifid median nerve and persistent median artery presenting with wrist pain. Comprehensive assessment, including radiographic, electromyographic and magnetic resonance imaging studies, were used to evaluate and document this anomaly.
Intravascular Pyogenic Granuloma in a Child
Authors: Beserminji Miroslav , Bade Stuart A , Zuker Ronald M
Published: February 2017

Intravascular pyogenic granuloma is a rare tumour, with approximately 30 cases presented previously in the literature. It most commonly occurs in the veins of the head and neck and upper extremity in middle-age patients. There is a paucity of reports detailing this lesion the pediatric literature. A case involving a 14-year-old boy with an intravenous pyogenic granuloma is presented.
Hemipelvis Reconstruction in Trauma: A Case Report and Literature Review
Authors: Roumeliotis Grayson A , Ignatiuk Ashley , Liew Allan SL , Allen Murray W , Boyd Kirsty U
Published: February 2017

Composite reconstruction of the pelvis in the setting of trauma is challenging. In addition to coverage and containment of the abdominal viscera, recreating a robust sitting surface is critical. However, there is a paucity of literature to guide the reconstructive surgeon. The authors present a case of traumatic hemipelvectomy, and describe their application of the ‘spare-parts’ concept to successfully reconstruct the bony pelvis and provide soft tissue coverage.
Late Seroma Formation During Pregnancy: Case Report and Review of the Literature
Authors: Steen Kalila , Gauvin Gabrielle , Meathrel Kimberley
Published: February 2017

Breast augmentation surgery is the most common cosmetic surgery in the United States, and seroma is a known complication of breast augmentation. However, late seroma is a rare event and is most associated with textured implants. A 29-year-old woman with a remote history of breast implantation presented to the plastic surgery clinic for evaluation of a swollen breast, which began 24 h postpartum. Magnetic resonance imaging revealed peri-implant fluid maintained within the fibrous capsule. The patient was managed conservatively and the swelling self-resolved without recurrence. The authors report the first known case of a late seroma associated with pregnancy, occurring nine years postoperatively.
Rupture of a Breast Tissue Expander Due to Chest Wall Exostosis: Case Report and Literature Review
Authors: Degeorge Brent R , Mericli Alexander F , Lin Kant Y
Published: February 2017

The incidence of device failure or rupture during tissue expansion is rare, and the etiology of device rupture is most commonly idiopathic; however, a multitude of potential etiologies have been reported including direct trauma, device over-expansion beyond manufacturer recommendations, capsular contracture, compressive forces during medical imaging studies, iatrogenic device damage during operative placement of the device or iatrogenic rupture during the process of filling the device. The authors report a case of device failure of the posterior wall of a tissue expander used for routine implant-based breast reconstruction that was attributed to bony exostosis of the anterior chest wall. They explore the relative incidence of bony exostosis-related and all-cause tissue expander rupture in peer-reviewed published literature. The present report illustrates the importance of evaluating the tissue quality of the periprosthetic capsule and pocket following a device failure to ensure that chest wall exostosis, a potential cause of further device failure, is not present.
Pachydermodactyly: A Case Report
Authors: Al-Qattan Mohammad M , Arafah Maha M , Alkattan Wael M
Published: February 2017

Pachydermodactyly is a rare form of fibromatosis of the hand related to repeated mechanical trauma to the skin. The recommended management is nonsurgical. Most of the literature regarding the topic appears in the nonsurgical literature and, hence, the condition is not familiar to hand surgeons. In the authors’ hand centre, one patient with pachydermodactyly was misdiagnosed with a fibrous tumour and underwent surgical excision. The correct diagnosis was made retrospectively from the histology and on asking the patient about habitual manipulation of the finger. The authors present the case and review the literature to increase the awareness of hand surgeons to this condition.
Jeopardized Digital Circulation From a Closed Phalangeal Fracture
Authors: Lim Jin-Soo , Han Ki-Taik , Ko Jun-Gul , Kim Min-Cheol
Published: February 2017

Closed phalangeal fractures that accompany concomitant vascular injuries are not common. The mechanism of such vessel injuries vary, from direct vascular trauma by fractured bone segment, increased compartmental pressure or unintentional vascular traction during reduction procedures. Acute digital ischemia requires appropriate surgical intervention(s) to minimize complications. The authors present a case of a closed phalangeal fracture with concomitant digital artery injury, and a brief review of the related literature.
Unilateral Compartment Syndrome Secondary to Eosinophilic Fasciitis
Authors: Nassar Mark , Jalil Waqqas , Islur Avinash
Published: February 2017

The authors describe a case involving a 40-year-old Caucasian man with acute onset of unilateral painful swelling, erythema and parasthesias of the left upper extremity after physical activity. A diagnosis of acute compartment syndrome was made and the patient was treated effectively with surgical intervention. Postoperative histology revealed the underlying cause of the compartment syndrome to be eosinophilic fasciitis (EF). Although EF is uncommon, surgeons should consider EF as an underlying cause of compartment syndrome in patients presenting without a history of trauma.
Optimizing electromagnetic sensors for unexploded ordnance detection
Authors: Billings Stephen , Beran Laurens
Published: February 2017

Time-domain electromagnetic (TEM) instruments are the predominant geophysical sensor for detection of buried unexploded ordnance (UXO). Detection surveys commonly use towed TEM sensor arrays to acquire a digital map for target detection. We use a dipolar model to predict a detection threshold for a UXO at a specified clearance depth, given an arbitrary sensor geometry. In general, the minimum target response is obtained for a horizontally oriented target. We find that for multistatic sensors, the minimum response can also depend on the azimuth of the target. By considering the statistics of the target response, we find that the detection threshold can be raised slightly while still ensuring a high probability of detection of UXO at depth. This increase in the detection threshold can have a significant effect on the number of false alarms that need to be interrogated or investigated and hence on the cost of clearance. We also use Monte Carlo simulation to investigate how array geometry and height affect clutter rejection.