bluuebunny/crossref_metadata_2025 huggingface dataset:
Inflammation and Liver Cancer: Molecular Mechanisms and Therapeutic Targets
Authors: Yang Yoon , Kim So , Seki Ekihiro
Published: January 2019

Hepatocellular carcinoma (HCC) is associated with chronic inflammation and fibrosis arising from different etiologies, including hepatitis B and C and alcoholic and nonalcoholic fatty liver diseases. The inflammatory cytokines tumor necrosis factor-α and interleukin-6 and their downstream targets nuclear factor kappa B (NF-κB), c-Jun N-terminal kinase (JNK), and signal transducer and activator of transcription 3 drive inflammation-associated HCC. Further, while adaptive immunity promotes immune surveillance to eradicate early HCC, adaptive immune cells, such as CD8+ T cells, Th17 cells, and B cells, can also stimulate HCC development. Thus, the role of the hepatic immune system in HCC development is a highly complex topic. This review highlights the role of cytokine signals, NF-κB, JNK, innate and adaptive immunity, and hepatic stellate cells in HCC and discusses whether these pathways could be therapeutic targets. The authors will also discuss cholangiocarcinoma and liver metastasis because biliary inflammation and tumor-associated stroma are essential for cholangiocarcinoma development and because primary tumor-derived inflammatory mediators promote the formation of a “premetastasis niche” in the liver.
Reliability of the Hirschsprung-Associated Enterocolitis Score in Clinical Practice
Authors: Vilanova Sanchez Alejandra , Triana Junco Paloma , Barrena S. , De Ceano-Vivas María , Jimenez Gomez Javier , Andres Moreno Ane , Lopez Santamaria Manuel , Martinez Leopoldo , Dore Mariela
Published: January 2019

Introduction There is a lack of an agreed Hirschsprung-associated enterocolitis (HAEC) definition. In 2009, a HAEC score was proposed for the diagnosis of HAEC episodes. Our aim was to apply the HAEC score on HAEC episodes to determine its diagnostic efficiency and whether it correlated to its severity.

Methods Retrospective study of patients with HAEC admitted between 2000 and 2016. Episodes of HAEC were identified and the HAEC score was calculated. A cut-off of ≥ 10 according to Pastor et al and ≥ 4 according to Frykman et al were used. A Pearson's correlation coefficient was performed for outcome variable: length-of-stay (LOS).

Results Note that 21/93 (22.6%) patients with Hirschsprung's disease presented 50 HAEC episodes with a median of 2 (1–5) episodes during an 8.3-year (2–15.6) follow-up. The most common symptoms were foul-smelling (86% [43/50]) and explosive (60% [30/50]) diarrhea. Physical findings showed a distended abdomen (76% [38/50]) and fever (60% [30/50]) with dilated bowel (82% [41/50]) and rectosigmoid cut-off (80% [40/50]) identified on X-rays. Only 34% (17/50) showed abnormal laboratory findings. Patients were admitted with a median LOS of 7 days (1–28). A HAEC score of 9 (2–16) was found, and only 50% (25/50) of patients met the initial criteria (score of 10 points). However, the use of a 4-point cut-off would have allowed the diagnosis of 98% (49/50) of the patients. A positive linear correlation was found for LOS and HAEC score (r = 0.3, p = 0.014).

Conclusion There is no standardized definition for HAEC. The initial HAEC score cut-off is restrictive and might fail to identify milder episodes. The positive correlation with LOS and thus HAEC severity might aid in patient information and anticipation of treatment.
The Effect of Minocycline on Fat Graft Survival and Apoptotic Pathway
Authors: Güney Kırdar , Özel Bora , Seymen Cemile , Elmas Çiğdem , Tuncer Serhan , Çenetoğlu Seyhan , Tatar Sedat
Published: January 2019

Variable absorption rate is one of the biggest problems of fat grafting and one of the most important causes of fat graft volume loss is apoptosis. Minocycline is a tetracycline derivative and besides its antibacterial capacity, it has been widely using for anti-apoptotic effects. This study was designed to investigate the effect of minocycline on fat graft survival and adipocyte apoptosis. A total of two main and eight subgroups were designed and a total of 48 experimental animals, 6 in each group, were used. Fat grafts are obtained from Wistar albino rats and implanted to dorsal area of rats. Local and systemic minocycline was applied in the study groups. On the 9th day, apoptotic cells were detected by the terminal deoxynucleotidyl transferase dUTP nick end labeling method and on the 90th day morphologic characteristics and viability of adipocytes were evaluated using histologic and immunohistochemical methods and statistically compared. This study revealed that the fat grafts were bigger, and they kept their structures better and they were more vascular in the minocycline groups and apoptosis was significantly lower in the minocycline groups. The authors demonstrated that minocycline increases fat graft survival and statistical improvement in apoptosis inhibition via using minocycline therapy has been shown.
Impact of Rolandic Epilepsy on Language, Cognitive, and Behavioral Functioning in Children: A Review
Authors: Premchand Angie , Tops Wim
Published: January 2019

The objective of this narrative review was to investigate how the clinical aspects, such as age-at-onset, epilepsy duration, centrotemporal spikes, spike location, and seizure frequency, affect various domains of language, cognition, and behavior in children with benign childhood epilepsy. Data were collected using various research databases, including Wiley Online Library, PubMed Central, Elsevier ClinicalKey, and Springer Complete Journals. Keywords such as “Benign Childhood Epilepsy” or “BECTS and language impairment” were used among other terms. Case reports, meta-analyses, and reviews were excluded. Children with benign childhood epilepsy are mainly impaired in semantic processing (receptive language), working memory, attention/inhibitory control, complex visuospatial skills, and social skills. Functional magnetic resonance imaging reveals not only structural abnormalities, but also alterations in language, sensorimotor, attentional, and social networks, suggesting long-term consequences. It so seems that the occurrence of centrotemporal spikes (with or without seizures), especially at a young age (below 6 years) and for an extended period of time, is the most meaningful contributor to the language, cognitive, and behavioral deficits in benign childhood epilepsy with centrotemporal spikes (BECTS), while the distribution of centrotemporal spikes (left, right, bilateral) seems of only little significance.
Exact solitary wavelike solutions in a nonlinear microtubule RLC transmission line
Authors: Ndzana Fabien II , Mohamadou Alidou
Published: January 2019

Analytically, we study the dynamics of ionic waves in a microtubule modeled by a nonlinear resistor, inductor, and capacitor (RLC) transmission line. We show through the application of a reductive perturbation technique that the network can be reduced in the continuum limit to the dissipative nonlinear Schrödinger equation. The processes of the modulational instability are studied and, motivated with a solitary wave type of solution to the nonlinear Schrödinger (NLS) equation, we use the direct method and the Weierstrass’s elliptic function method to present classes of solitary wavelike solutions to the dissipative NLS equation of the network. The results suggest that microtubules are the biological structures where short-duration nonlinear waves called electrical envelope solitons can be created and propagated. This work presents a good analytical approach of investigating the propagation of solitary waves through a microtubule modeled by a nonlinear RLC transmission line.
Geminal perturbation theory based on the unrestricted Hartree–Fock wavefunction
Authors: Földvári D. , Tóth Zs. , Surján P. R. , Szabados Á.
Published: January 2019

A perturbative correction exploiting natural orbitals and the pair function structure of the unrestricted Hartree-Fock (UHF) wavefunction is devised. The method offers a simple framework for describing multireference systems where static correlation is captured by UHF. The UHF wavefunction is built of two-electron fragments (geminals), involving both singlet and triplet (ms = 0) parts. At order zero of the perturbative treatment, configuration interaction coefficients of UHF geminals are relaxed. The zero order Hamiltonian is of the Dyall-type, including explicit two-electron interaction within geminals and leading to a formal 6th power scaling. Adopting an effective one-electron zero order Hamiltonian term for the subset of virtual orbitals reduces scaling of the correction step to 4th power. Formal properties of the proposed schemes are discussed. Energetic data and natural occupation numbers of illustrative test systems are used to assess the new approach. The cases where the wavefunction becomes essentially spin pure at the level of reference show good performance. Spin contamination remaining at order zero is found to undermine the perturbative correction.
Synthesis of bismuth selenide nanoplates by solvothermal methods and its stacking optical properties
Authors: Liu Yanping , Cao Lingkai , Zhong Jiahong , Yu Juan , He Jun , Liu Zongwen
Published: January 2019

Bismuth selenide (Bi2Se3) is a novel topological insulator that is promising for broad optical absorption materials on the basis of its large bulk band and well-defined single Dirac cone. Herein, few-layer Bi2Se3 nanoplates of different sizes have been successfully synthesized via the solvothermal method. We present our discovery of optical properties on homojunction Bi2Se3 nanoplates with FTIR measurements. The interface of homojunction Bi2Se3 nanoplates demonstrates an interesting optical modulation in the near-infrared region in contrast to individual bulk Bi2Se3 and other reported 2D hetero-structure materials. It was validated that the unexpected behavior was attributed to the interface between variously stacked nanoplates and its unique zero-wave anti-reflection properties. Our experimental results provide evidence of the Bi2Se3 nanoplate possess high optical absorption in the near-infrared range, promising for photothermal and optical diagnostic therapy application.
Control of transverse wakefields via phase-matched laser modes in parabolic plasma channels
Authors: Djordjević B. Z. , Benedetti C. , Schroeder C. B. , Esarey E. , Leemans W. P.
Published: January 2019

The use of higher-order modes is proposed to control the transverse wakefield structure generated by a laser pulse propagating through a plasma channel. This can be done in the quasilinear regime in both the Laguerre-Gaussian and Hermite-Gaussian bases for appropriate laser-plasma parameters, independent of the longitudinal field. Control of the wake can be achieved by using modes of different mode numbers but with matched phase velocities to generate tunable, matched laser propagation. The wake can be tuned by modifying the initial phase and amplitude of each mode. In addition, it is shown that two different higher order modes can propagate at the same group velocity by appropriately tuning the frequencies. Geometric and frequency tuning of the laser driver allows for greater control of the transverse phase-space of the accelerated electron bunch.
Nonlinear interaction of thermogravitational waves and thermomagnetic rolls in a vertical layer of ferrofluid placed in a normal magnetic field
Authors: Dey Pinkee , Suslov Sergey A.
Published: January 2019

The interacting thermogravitational and thermomagnetic instabilities arising in a vertical layer of non-isothermal ferrofluid placed in a horizontal magnetic field are investigated by means of a weakly nonlinear analysis. An expansion in disturbance amplitude leads to the reduction of a full problem to a system of coupled cubic Landau amplitude equations. Their solutions are analyzed and interpreted from a physical point of view. The details of an intricate competition between gravitational and magnetic buoyancy mechanisms are highlighted. The spatial structure of the resulting flow patterns is discussed. It is shown that the parametric existence regions determined for finite amplitude disturbances differ drastically from those predicted based on the analysis of infinitesimal perturbations. Subsequently, the cross-layer heat flux characteristics are discussed. It is shown that the co-existence of two physical mechanisms of convection can lead to a suppression of heat transfer rather than to its enhancement.
New numerical surfaces to the mathematical model of cancer chemotherapy effect in Caputo fractional derivatives
Authors: Veeresha P. , Prakasha D. G. , Baskonus Haci Mehmet
Published: January 2019

In this paper, we apply the q-homotopy analysis transform method to the mathematical model of the cancer chemotherapy effect in the sense of Caputo fractional. We find some new approximate numerical results for different values of parameters of alpha. Then, we present novel simulations for all cases of results conducted by considering the values of parameters of alpha in terms of two- and three-dimensional figures along with tables including critical numerical values.
Broadband dynamic spectrum characterization based on gating-assisted electro-optic time lens
Authors: Wei Yuan , Li Bowen , Feng Pingping , Kang Jiqiang , Wong Kenneth K. Y.
Published: January 2019

A broadband real-time optical spectrum characterization technique is proposed based on a gating-assisted electro-optic time lens. Operating at the repetition rate of 10-MHz, a 10-dB spectral measurement range of more than 70-nm is achieved with a resolution of up to 42.5-pm in the near-infrared regime. To demonstrate its performance in applications, real-time spectral observation of broadband wavelength sweeping of a Fourier domain mode-locked laser and a 32.4-GHz optical frequency comb is presented. Furthermore, a detailed comparison between dispersive Fourier transform and the time lens based spectral analysis technique for frequency comb measurements is made from both simulation and experiment. With its broadband performance, this technique can provide widespread applications requiring real-time spectral analysis.
Magnetocaloric effect in cubically anisotropic magnets
Authors: Hu Yong , Hu Tianyi , Chi Xiaodan , Wang Yuying , Lu Qiang , Yu Le , Li Ruijun , Liu Yan , Du An , Li Zongbin , Shi Feng
Published: January 2019

Magnetocaloric response in anisotropic single-crystals with cubic crystal symmetry is studied. As compared to isotropic magnets where only paramagnetic-to-ferromagnetic phase transition occurs at Curie temperature (TC=185 K) and magnetization increases monotonously with increasing field and/or decreasing temperature, the spin reorientation phase transitions may occur at lower temperatures (∼115 K) as the magnetic field gets oriented along one of the cubic anisotropy easy axes and induces nonmonotonic increases in magnetization with increasing field and temperature, leading to a spike-like entropy change (−ΔSM) and positive ΔSM at TC, or move the −ΔSM peak towards higher temperatures. Finally, the power laws of maximum −ΔSM and relative cooling power with the field and the double-shifted loop results evidence that only second-order phase transition occurs and the abnormal magnetization behavior completely comes from the spin order evolution due to energy competition. Therefore, the Maxwell relation is applicable. The results are also suitable for multiple anisotropy or polycrystalline materials with well-defined domains.
Feeding state sculpts a circuit for sensory valence in
Caenorhabditis elegans
Authors: Rengarajan Sophie , Yankura Kristen A. , Guillermin Manon L. , Fung Wendy , Hallem Elissa A.
Published: January 2019

Significance

Hunger regulates many animal behaviors. In particular, some chemosensory stimuli can be attractive or repulsive depending on the feeding state of an animal. The neural basis for hunger-dependent changes in chemosensory valence is poorly understood. Here, we show that the response of
Caenorhabditis elegans
to CO
2
depends on hunger. CO
2
shifts from repulsive to attractive during starvation. This valence change results from modulation of the CO
2
circuit by opposing biogenic amine signals. Dopamine promotes repulsion in well-fed animals, whereas octopamine promotes attraction in starved animals. Biogenic amine signaling alters the CO
2
-evoked activity of interneurons in the CO
2
circuit, resulting in hunger-dependent changes in CO
2
response valence. Our results illustrate a role for biogenic amine signaling in determining chemosensory valence.
α-Synuclein O-GlcNAcylation alters aggregation and toxicity, revealing certain residues as potential inhibitors of Parkinson’s disease
Authors: Levine Paul M. , Galesic Ana , Balana Aaron T. , Mahul-Mellier Anne-Laure , Navarro Mariana X. , De Leon Cesar A. , Lashuel Hilal A. , Pratt Matthew R.
Published: January 2019

Significance

Preventing the aggregation of toxic proteins in neurodegenerative diseases is both an important biological function and a potential therapeutic strategy. Here, we examine the consequences of O-GlcNAcylation on the aggregation and toxicity of α-synuclein, the aggregating protein in Parkinson’s disease. α-Synuclein is modified by O-GlcNAc at at least nine different positions in vivo, but the consequences of most of these modifications are unknown. Here, we use synthetic protein chemistry to prepare six different O-GlcNAcylated forms of α-synuclein and show that they have largely inhibitory, but site-specific, effects on the aggregation and cellular toxicity of this protein. These results suggest that O-GlcNAc may be a cellular strategy to prevent protein aggregation, which could potentially be exploited for treatment.
A folding switch regulates interleukin 27 biogenesis and secretion of its α-subunit as a cytokine
Authors: Müller Stephanie I. , Friedl Antonie , Aschenbrenner Isabel , Esser-von Bieren Julia , Zacharias Martin , Devergne Odile , Feige Matthias J.
Published: January 2019

Significance

Interleukins are small secreted proteins that drive immune cell communication. Understanding how cells produce interleukins is thus key for decoding and modulating immune responses. Our study elucidates the molecular mechanisms of interleukin 27 (IL-27) biosynthesis, a key cytokine in control of autoimmunity and infections. IL-27 is composed of two subunits, α and β. In humans, these have to assemble to form bioactive IL-27, whereas in mice, IL-27α can be secreted alone, modulating immune reactions and reducing sepsis-related mortality. Strikingly, differences in a single amino acid regulate IL-27α secretion. Using our molecular insights, we engineer a more human-like IL-27 system in mice and design a secretion-competent and functional human IL-27α subunit. This may provide an approach toward treating inflammatory diseases.
LncRNA17A regulates autophagy and apoptosis of SH-SY5Y cell line as anin vitromodel for Alzheimer’s disease
Authors: Wang Xinhua , Zhang Min , Liu Hengfang
Published: January 2019

Considerable evidence suggest that a variety of Long-non-coding RNAs (LncRNAs) are widely implicated in several neurodegenerative disorders. The present study aims to investigate the regulatory effect of LncRNA 17A in an in vitro model of Alzheimer’s disease (AD). AD cell model was established by treating the SH-SY5Y cells with amyloid β peptide 1-42, and then the cells were transfected with 17A shRNA and pcDNA-17A. Apoptosis, migration, invasion and ELISA assays were performed to investigate the effect of differentiated 17A expression level on AD cell line. It was determined that 17A-overexpressing promotes autophagy, induces neurodegenration and deactivates GABAB signaling. In conclusion, our results demonstrated that the dysregulation of LncRNA 17A was involved in cellular functions and biological processes of neuroblastoma cells in an AD cell model, shedding light on the diagnostic value and therapeutic potential of LncRNA 17A for AD intervention.
Xiaochen Wang: Building up our understanding of breaking down
Authors: Infarinato Nicole
Published: January 2019

Wang studies lysosomal degradation pathways using C. elegans as a model system.
Quiver varieties and symmetric pairs
Authors: Li Yiqiang
Published: January 2019

We study fixed-point loci of Nakajima varieties under symplectomorphisms and their antisymplectic cousins, which are compositions of a diagram isomorphism, a reflection functor, and a transpose defined by certain bilinear forms. These subvarieties provide a natural home for geometric representation theory of symmetric pairs. In particular, the cohomology of a Steinberg-type variety of the symplectic fixed-point subvarieties is conjecturally related to the universal enveloping algebra of the subalgebra in a symmetric pair. The latter symplectic subvarieties are further used to geometrically construct an action of a twisted Yangian on a torus equivariant cohomology of Nakajima varieties. In the typeAAcase, these subvarieties provide a quiver model for partial Springer resolutions of nilpotent Slodowy slices of classical groups and associated symmetric spaces, which leads to a rectangular symmetry and a refinement of Kraft–Procesi row/column removal reductions.
Compliance Technology and Self-enforcing Agreements
Authors: Harstad Bård , Lancia Francesco , Russo Alessia
Published: January 2019

This paper analyzes a game in which countries repeatedly make emission and technology investment decisions. We derive the best equilibrium, that is, the Pareto-optimal subgame-perfect equilibrium, when countries are insufficiently patient for folk theorems to be relevant. Relative to the first best, the best equilibrium requires countries to overinvest in technologies that are green, that is, strategic substitutes for polluting, but to underinvest in adaptation and brown technologies, that is, strategic complements to polluting. Technological transfers and spillovers might discourage investments but can be necessary to motivate compliance with emissions when countries are heterogeneous.
Neutrophil-to-Monocyte-Plus-Lymphocyte Ratio as a Potential Marker for Discriminating Pulmonary Tuberculosis from Nontuberculosis Infectious Lung Diseases
Authors: Jeon You La , Lee Woo-In , Kang So Young , Kim Myeong Hee
Published: January 2019

Objective

To determine whether NMLR has more statistical strength than NLR in discriminating TB from non-TB infectious lung diseases.

Methods

Among patients who underwent 3 or more TB culture tests with molecular study between January 2016 and December 2017, 110 patients with TB, and 159 patients diagnosed with non-TB infectious lung diseases were enrolled. The original complete blood count (CBC) parameters and modified CBC indices, including NLR and NMLR, were analyzed.

Results

The NLR and NMLR were significantly lower in TB patients than in patients with other infectious lung diseases. However, the area under the curve (AUC) for NMLR (0.90; 95% confidence interval [CI], 0.86–0.93) was significantly greater than that for NLR (0.88 [0.84–0.92]).

Conclusions

The neutrophil-to-monocyte-plus-lymphocyte ratio (NMLR) can be used as a new index that is more powerful than neutrophil-to-lymphocyte ratio (NLR) in discriminating tuberculosis (TB) from non-TB infectious lung diseases.

NMLR had more statistical strength than NLR in discriminating TB from non-TB infectious lung diseases.
Neurotrauma
Authors: Wang Kevin K. W.
Published: January 2019

This new book volume, simply titled Neurotrauma, aims to bring together the latest clinical practice and research in the field of two forms of trauma to the central nervous system: namely, traumatic brain injury (TBI) and spinal cord injury (SCI). Nationally, more 1.9 million Americans sustain a TBI annually. In parallel, there are an estimated 12,000 new cases of SCI in the United States annually. In addition, approximately 1.2 million people live with paralysis due to SCI. In recent years, dramatic advancements in the field have resulted in much improved outcomes for patients and higher standards of care. This volume brings together the latest research and clinical practice in the treatment of neurotrauma in a comprehensive but easy-to-follow format. Our target readership is intentionally broad. It includes clinicians who are involved in caring for TBI in the emergency room, hospital, or neurointensive care unit or during patient rehabilitation; clinical research professionals; research nurses; and nonclinical academic researchers, such as research professors, research scientists, medical students, graduate students, and nurse specialists, as well as biomedical industry R&D scientists and clinical associates. As editor of this volume, I want all readers to find a chapter or section on almost all aspects related to TBI or SCI. I also hope that they will encounter some areas they might be already familiar with. Yet, at the same time, I hope that they will also discover or rediscover other less familiar areas in neurotrauma that they have always wanted to learn more about. Last, I want to make this volume as layman-like and as easy to follow as possible so that it can also serve as a resource book for TBI or SCI patients or caregivers who want to better educate themselves about these conditions.
History, Overview, and Human Anatomical Pathology of Traumatic Brain Injury
Authors: Shimoda Kentaro , Yokobori Shoji , Bullock Ross
Published: January 2019

Traumatic brain injury (TBI) is one of the oldest and commonest causes of medical distress in humans. However, despite much research effort, the prognosis for severe TBI patients remains poor. Worldwide, TBI is recognized as the leading cause of mortality and morbidity in young adults. TBI is a major worldwide health and socioeconomic problem. The most important factor in the prognosis of TBI patients is the severity of the "primary" brain injury. Additional delayed "secondary" brain damage continues from the time of traumatic impact in TBI patients, and the two combine to determine outcome. This chapter discusses the incidence of TBI, trends in morbidity and mortality, shifts in causes of TBI, its economic burden on society, and the pathophysiology of primary and secondary brain injuries. The authors discuss indications for surgical and intensive care treatment for intracranial hypertension and mass lesion management in TBI patients.
Severe TBI in Military: Medical and Surgical Interventions
Authors: Ling Geoffrey S. F. , Ecklund James M.
Published: January 2019

Traumatic brain injury (TBI) is a common casualty of war. In Operation Iraqi Freedom and Operation Enduring Freedom in Afghanistan, TBI was described as the “signature injury of these wars.” As in civilian practice, severe TBI is a serious life-threatening medical condition requiring treatment by expert medical providers. Military providers adapt existing civilian clinical practice guidelines (CPG) to manage these patients. Where civilian CPG are nonexistent or inadequate for war theater use, the DoD creates new ones. These CPG are published to enable critique and improvement. Two CPG for TBI to come from the war are the “Guidelines for the Field Management of Combat-Related Head Trauma” and the “VA/DoD Clinical Practice Guidelines for Management of Concussion/Mild TBI.” From these efforts, a new type of TBI, explosive blast TBI, was elucidated. Intracranial vasospasm was identified as a sequelae to this TBI. Treatments used by military healthcare providers include hemicraniectomy and endovascular techniques.
Abusive Head Trauma
Authors: Berger Rachel Pardes , Clarke Jennifer , Leeper Christine
Published: January 2019

Abusive head trauma (AHT) is a leading cause of morbidity and mortality from traumatic brain injury (TBI) in infants and young children. The epidemiology of, risk factors for, and pathophysiology of AHT are unique. As a result, there are differences in the clinical management of AHT compared with other types of pediatric TBI. Evaluation of cases of suspected AHT includes multiorgan system evaluation for both acute and healing injuries. The assessment of children with suspected AHT extends beyond the field of medicine: collaboration with child protective services and/or police during the investigative phase and/or involvement in the legal system may be needed to ensure child safety and prevent a recurrence of abuse. This chapter discusses the epidemiology of and risk factors for AHT, provides guidance as it relates to accurate diagnosis, and reviews pathophysiology and clinical management.
Traumatic Cerebral Vascular Injury
Authors: Kenney Kimbra , Haber Margalit , Diaz-Arrastia Ramon
Published: January 2019

Traumatic cerebral vascular injury (TCVI) is a frequent, if not universal, feature after traumatic brain injury (TBI). Because multiple pharmacologic and nonpharmacologic therapies promote vascular health, TCVI is an attractive target for therapeutic intervention after TBI. The cerebral microvasculature is a component of the neurovascular unit (NVU) coupling neuronal metabolism with local cerebral blood flow. The NVU participates in the pathogenesis of TBI, either directly from physical trauma or as part of the cascade of secondary injury that occurs after TBI. Pathologically, there is extensive microvascular injury in humans and experimental animals, identified with either conventional light microscopy or ultrastructural examination. Noninvasive, physiologic measures of cerebral microvascular function show dysfunction after TBI in humans and experimental animal models of TBI. These include imaging sequences, transcranial Doppler, and near infrared spectroscopy. Understanding the pathophysiology of TCVI, a relatively understudied component of TBI, has promise for the development of novel therapies for TBI.
Acute Assessment of Mild Traumatic Brain Injury
Authors: Papa Linda
Published: January 2019

Most patients with mild TBI (mTBI) are discharged from the emergency department (ED) after a normal clinical examination and a reasonable period of observation and/or following a negative head computed tomography (CT) scan. Studies indicate that about 30% of mTBI patients discharged from the ED will have symptoms at 3 months and up to 15% will be symptomatic at 1 year post-injury. Serum markers have the potential to better manage patients with mTBI. Unlike clinical variables, serum biomarkers offer a more objective measure of injury and could complement clinical decision-making. In 2018, the US Food and Drug Administration approved the use of a blood test combining UCH-L1 and GFAP for detecting lesions on CT scan in adults with mTBI within 12 hours of injury. Introducing biomarkers into clinical practice requires well-designed studies with adequate sample sizes, proper sample timing, stringent reporting of outcome measures, and well-described assay performance characteristics.
Chemosensory Impairment After Traumatic Brain Injury
Authors: Williams Shanna , Zasler Nathan
Published: January 2019

Posttraumatic olfactory and gustatory impairments following traumatic brain injury (TBI) are more common than many clinicians appreciate and have a variety of different causes. It is important to fully assess this class of posttraumatic impairments due to the implications of such sensory loss on daily life functions that we otherwise take for granted. Additionally, smell loss in and of itself may be an indicator of dysexecutive impairments and/or a risk marker for anterior parenchymal contusional injury. This chapter provides an overview of chemosensory impairments following traumatic brain injury (TBI) and examines the incidence, etiology, clinical assessment, and management strategies of these disorders, including neurorehabilitative interventions as well as neuroprognosis. Issues regarding the functional impact of chemosensory impairments will be discussed, including quality of life ramifications, vocational implications, and medicolegal perspectives, with the latter focusing on impairment rating of chemosensory impairment.
The Potential of Brain-Specific Blood Biomarkers for TBI Patient Management, Diagnosis, and Clinical Research
Authors: Glushakova Olena Y. , Valadka Alex B. , Hayes Ronald L. , Glushakov Alexander V.
Published: January 2019

Rapid and continuous monitoring and analysis of biomarkers present in blood after TBI could serve as a reliable and useful tool to distinguish type of injury, predict secondary insults, and evaluate the efficacy of therapeutic interventions. The use of biomarkers in combination with current disease monitoring and management tools could improve management of TBI patients and improve clinical trials for TBI drug development. In this chapter, the authors discuss current clinical studies on brain-specific neuronal and glial biomarkers of TBI and their association with short- and long-term TBI outcome and secondary insults, as well the ability of biomarkers to distinguish type of injury and correlation with treatment.
Serum Markers of Subclinical Brain Damage in Low-Grade Chronic Concussion and Asymptomatic Cerebral Small Vessel Disease
Authors: González-García Sergio , González-Quevedo Alina , Hernández-Díaz Zenaida , Betancourt-Loza Melany , Cordero-Eiriz Anay
Published: January 2019

The early detection of subclinical brain damage (SBD) remains challenging, and its frequency is widely underestimated. Specifically, the identification of subjects who sustain multiple asymptomatic concussions and subjects with asymptomatic cerebral small vessel disease is an urgent task in order to evaluate the cumulative effects of both on the brain—the first induced by low-grade chronic brain trauma and the second by sustained vascular load over the course of decades. Serum markers could be useful in the early detection of subclinical brain damage in order to filter individuals at high risk of developing neurodegenerative and vascular diseases.
Proteomics-Based Strategies to Define Brain Tissue Biomarkers of Closed Head, Mild Traumatic Brain Injury in Translational Rodent Models
Authors: Boutté Angela M. , Guingab-Cagmat Joy , Moghieb Ahmed , Caruso Joseph A. , Stemmer Paul M. , Ahlers Stephen T. , Wang Kevin K. W.
Published: January 2019

Closed head, mild traumatic brain injury (mTBI) is associated with increased risk of chronic neurodegenerative disease and psychological disorder diagnoses, specifically chronic traumatic encephalopathy (CTE). However, discrete knowledge of the molecular events that occur immediately after injury and throughout its progression prior to diagnosis or postmortem pathological evidence remains unknown. The application of proteomics strategies to translational rodent models of mTBI provides a means to define proteins, pathways, and mechanisms of injury progression. Understanding the proteins involved in this “invisible wound” may lead to robust therapeutic strategies that prevent or mitigate neurodegenerative disease and disability caused by mTBI.
Neuroregenerative Medicine in TBI
Authors: Chen Jinhui , Wang Xiaoting , Gao Xiang
Published: January 2019

Traumatic brain injury (TBI) is affecting a large population with permanent physical disabilities and neurobehavioral abnormalities worldwide. Cell death in multiple brain regions is one of the most common pathological changes seen after TBI. Neuronal replacement then represents an urgent need for functional recovery. Neural stem cells (NSC) to mediate endogenous neurogenesis in the adult brain holds great promise for neural repair by replacing dead neurons and rebuilding damaged connections. It has been shown that TBI promotes NSC proliferation, detected in both the forebrain and the hippocampus, displaying an intrinsic neuroplasticity in response to injury. Thus, endogenous neurogenesis is an appropriate target for clinical interference aimed at neural repair post-trauma.
Stem Cell Studies in Traumatic Brain Injury
Authors: Sun Dong
Published: January 2019

Traumatic brain injury (TBI) is a global public health concern, with limited treatment options available. Despite improving survival rates after TBI, there is no effective treatment to improve the neural structural repair and functional recovery of patients. Neural regeneration through neural stem cells, either by stimulating endogenous neural stem cells or by stem cell transplantation, has gained increasing attention as a potential strategy to repair and regenerate the injured brain. This chapter summarizes strategies that have been explored to enhance endogenous neural stem cells-mediated regeneration and recent developments in cell transplantation studies for post-TBI brain repair with varying types of cell sources.
Spinal Cord Injury: Neurointensive Care and Surgical Intervention
Authors: Kolcun John Paul G. , Chang Peng-Yuan , Wang Michael Y.
Published: January 2019

Spinal cord injury (SCI) is a major trauma, with profound effects on health, productivity, and social status. As new victims suffer SCI each year, hospital staff must be prepared to recognize and respond to these patients on arrival. While surgical intervention is often necessary, the major theater of SCI treatment remains the intensive care unit (ICU). This chapter describes the process of caring for SCI victims in an ICU setting, beginning with evaluation on arrival and proceeding through treatment and eventual discharge. Emphasis will be placed on well-established techniques used in approaching SCI victims, both diagnostically and therapeutically, with mention given to promising avenues of future clinical research.
Animal Models of Spinal Cord Injury
Authors: Floyd Candace L.
Published: January 2019

The annual incidence of spinal cord injury (SCI) is approximately 17,000 new cases per year, with an estimated 282,000 persons living with SCI in the United States. Animal models of SCI remain instrumental in elucidating pathological mechanisms and in the discovery of novel therapeutic interventions. Indeed, 50% of the most cited SCI research utilizes animal models. Classification of SCI based on pathological features serves as a primary framework for the development of animal models. Additionally, the spinal location of the SCI in the animal model is a critical consideration. Both large and small animal models are critical to advancing discovery.
Therapeutic Hypothermia and Targeted Temperature Management in the Treatment of Traumatic Brain and Spinal Cord Injury
Authors: Dietrich W. Dalton , Bramlett Helen M.
Published: January 2019

Traumatic brain and spinal cord injury are devastating conditions that affect thousands of people each year within the United States. Despite significant research efforts, few successful treatments are available, reflecting the highly complex pathophysiology of neurotrauma. Treatment modalities that target multiple injury pathways may be required to provide robust and long-term improvements in functional recovery. The successful use of therapeutic hypothermia in various patient populations has a rich history, either applied selectively to the nervous tissues or administered systemically. Some recent clinical trials in brain and spinal cord injury have reported benefits with therapeutic hypothermia and targeted temperature management, whereas others have not shown dramatic improvements. This field remains controversial in terms of how and when to use temperature-related therapeutic interventions to maximize protection and repair. This chapter summarizes current knowledge on this evolving field and discusses future directions for research and clinical care.
Functional MRI in Neurosurgery and Neurology
Authors: Bandt S. Kathleen , Spencer Dennis D.
Published: January 2019

The relationship between neuroimaging and the care of patients with neurosurgical and neurological disorders has long been a close one. The integration of these fields dates back to neuroimaging’s earliest days in the 20th century. However, no single imaging technique has had the enduring impact on clinical medicine that magnetic resonance imaging (MRI) has. The impact of MRI has resulted not only from an enhanced understanding of structural abnormalities but also the functional implications of those abnormalities. Beyond this, advances in functional neuroimaging have improved our understanding not only of the functional correlates of lesion disorders but also of non-lesion conditions including developmental, degenerative and movement disorders as well as predicting rehabilitation potential following stroke or traumatic brain injury. The advent of functional MRI (fMRI), which capitalizes on the relationship between cerebral blood flow and neuronal activity, combines all of these advantages together with the ability to define regions of brain activity, or function, and has further revolutionized the clinical care of patients with neurosurgical and neurological disorders. Here, we discuss current fMRI techniques as well as their clinical application to the care of patients with neurosurgical and neurological disorders. We also briefly review other functional imaging modalities beyond fMRI.
Functional MRI Approaches to Studying Cognition
Authors: John John P. , Parekh Pravesh
Published: January 2019

Functional magnetic resonance imaging (fMRI) is a widely used technique for studying brain substrates of cognition. The objective of this chapter is to provide an overview of the basics of fMRI including fundamentals of MR physics and the blood oxygen level dependent (BOLD) contrast, paradigm design, data storage, image quality analysis, data pre-processing and data analytic strategies. We have discussed three illustrative examples from our published research works in schizophrenia, a neurodevelopmental disorder characterized by cognitive dysfunction and abnormalities of thought, perception and conation. We attempt to provide a broad understanding of the basic principles of fMRI research for clinicians and budding cognitive neuroscience researchers alike, without aiming to be exhaustive or in-depth in our coverage. We hope this primer in fMRI methods and applications would motivate the reader to peruse the additional resources cited at the end of the chapter while getting started in this exciting area of research.
Functional MRI in Psychiatric Disorders
Authors: Ji Jie Lisa , Anticevic Alan
Published: January 2019

sSince its introduction to clinical research, functional magnetic resonance imaging (fMRI) has had a pivotal role in understanding the systems-level neural substrates of psychiatric disorders. fMRI is a powerful tool for the field of psychiatry because it is well suited to studying large-scale neural systems and distributed neuropathology, which are thought to underlie many of the behavioral symptoms in psychiatric conditions. This chapter highlights key fMRI findings in four major types of psychiatric disorders: schizophrenia, mood disorders (including major depressive disorder and bipolar disorder), obsessive-compulsive disorder, and posttraumatic stress disorder.
Neuroma
Authors: Blackburn John , Bautista Alexander
Published: January 2019

Neuroma is a benign condition that is associated with growth or tumor of the nerve tissue. This pain generator can be a cause of debilitating neuropathic pain if not properly addressed. The clinical hallmarks of neuroma include the presence of a scar in close proximity that causes substantial pain in the distribution of the involved nerve. This chapter discusses the definition, epidemiology, diagnosis, and treatment of neuroma. It also reviews common neuromas encountered in clinical practice. A treatment algorithm is presented to guide clinicians as a plausible approach to managing this complex pain syndrome. Painful neuroma following a peripheral nerve injury maybe refractory to treatment. Hence, prevention is the key to neuroma management.
HIV Polyneuropathy
Authors: Basi Hersimren
Published: January 2019

HIV polyneuropathy has become increasingly common as a neurological disorder associated with AIDS over the recent years. Patients frequently experience paresthesias, pain, numbness, and dysesthesias. Direct and indirect neurotoxicity associated with the HIV virus may lead to painful neuropathy. There are six main types of HIV-associated polyneuropathies: distal symmetrical neuropathy, inflammatory demyelinating polyneuropathy, progressive polyradiculopathy, mononeuropathy multilplex, autonomic neuropathy and diffuse infiltrative lymphocytosis syndrome. This chapter discusses all six types, including their assessment, diagnosis, pathophysiology, and treatment.
Immune-Related Neuropathy
Authors: Braddy Whit
Published: January 2019

There are many causes of neuropathic pain, as this book illustrates in great detail. The closer we look into these causes, the more researchers are discovering how the immune system contributes to chronic pain. This chapter reviews the most commonly accepted immune-related causes of painful peripheral neuropathy. These fall into four main categories: viral, vasculitis, autoimmune, and paraneoplastic. The review borrows from the texts, journals, and wisdom of colleagues in internal medicine, neurology, and oncology. Despite the fact that these are uncommon subjects for most pain clinicians, they do present in pain clinics. The mechanisms of these related conditions, such as Guillain-Barré syndrome, hepatitis, Sjogren syndrome, and multiple sclerosis, and their treatments have bearing on understanding immune-related causes of painful peripheral neuropathy.
Spinal Cord Infarction
Authors: Brewer Randall P. , Munjampalli Sai , Kumpinsky Aliza
Published: January 2019

This chapter discusses spinal cord infarctions, which are rare but with devastating consequences. It is associated with surgical procedures that compromise oxygen supply to the spinal cord, arteriosclerosis, embolism of the spinal cord circulation, or compression of blood vessels of the spinal cord. The most common of spinal neurovascular syndromes is the anterior spinal artery syndrome, caused by infarction in the anterior two-thirds of the cord. This syndrome spares the dorsal columns as the posterior one-third of the spinal cord is supplied by a pair of posterior spinal arteries. It is characterized by complete motor paralysis below the level of the lesion; loss of pain and temperature sensation with sparing of proprioception and vibratory sensation; and autonomic dysfunction, such as hypotension, sexual, and bowel and bladder dysfunction. MRI imaging, biochemical and immunological studies from cerebrospinal fluid and blood, and spinal angiography can be considered to confirm the diagnosis and delineate the cause. Treatments are directed at managing motor paralysis and spasticity, sensory dysfunction and pain, and autonomic dysfunction that includes neurogenic bladder and autonomic dysreflexia. Cervical and thoracic spinal cord injury affects respiratory muscles, causing pneumonia, in addition to autonomic dysreflexia. Preventive measures during abdominal aorta aneurysm surgery include neuromonitoring of the spinal cord, spinal fluid drainage, induced hypothermia, and use of pharmacological adjuncts such as intrathecal papaverine. Precautions in using particulate steroids for transforaminal epidural injection in pain management may help reduce the risk of articular embolism in the spinal cord or brainstem.
Glossopharyngeal Neuralgia
Authors: Chang Chien George C. , Trescot Andrea M. , Stogicza Agnes R.
Published: January 2019

Glossopharyngeal neuralgia (GPN) is both an uncommon and poorly recognized cause of face and neck pain. Because of its potential underdiagnosis, this condition may be more common than reported in the literature. GPN presents with symptoms similar to tic douloureux (trigeminal neuralgia); however, the pathology is not from the trigeminal nerve but rather from the glossopharyngeal nerve. GPN is characterized by unilateral paroxysmal pain in the oropharynx, nasopharynx, larynx, base of the tongue, tonsillar region, and lower jaw, as well as the ipsilateral ear. There are several causes, including tumors, elongated styloid process (Eagle’s syndrome), and vascular compression; however, most cases are considered idiopathic. Treatment for GPN includes treatment of the secondary causes, while medical treatment is similar to that for trigeminal neuralgia. Techniques for cervical, extraoral, intraoral, fluoroscopic, or ultrasound-assisted glossopharyngeal nerve block have been described, and neurolytic techniques such as cryoneuroablation and radiofrequency denervation are available. Because of the location, complications from injections can be serious, and so the injections must be performed with care and knowledge of the anatomy.