bluuebunny/crossref_metadata_2025 huggingface dataset:
Muscular tendinous junction rupture of the posterior tibial tendon after closed bimalleolar ankle fracture
Authors: Jasqui-Remba Salomon , Rodriguez-Corlay Ruy Ernesto
Published: February 2016

In this case report, we present an acute rupture in the muscular tendinous junction of a posterior tibialis muscle in a bimalleolar closed ankle fracture after a high-energy trauma in a 30-year-old patient with no significant medical history. Fracture was confirmed by simple X-rays, and was treated with an open reduction in which both of the fractures were treated with osteosynthesis material and reparation of the syndesmosis. If left untreated, this uncommon finding can result in a bad postsurgical outcome; we believe this injury is more common but under-reported in the literature. The surgeon should be aware and look specifically for this type of lesion during the procedure. Finding and treating this injury requires special postoperative care, non-weight-bearing instructions and balanced physiotherapy.
Cross-sectional study on parental pro-drinking practices and adolescent alcohol drinking in Hong Kong
Authors: Au Wing Man , Ho Sai Yin , Wang Man Ping , Lo Wing Sze , Tin Sze Pui Pamela , Huang Rong , Lam Tai Hing
Published: February 2016

Objectives

To investigate the association between parental pro-drinking practices (PPDPs) and alcohol drinking in Hong Kong Chinese adolescents.

Design

A cross-sectional study.

Setting

4 randomly selected secondary schools in Hong Kong.

Participants

1738 students (mean age 14.6 years ±2.0, boys 67.8%).

Main outcome measures

Drinking status, drinking intention and exposure to 9 PPDPs (eg, seeing parents drunk, helping parents buy alcohol, encouraged to drink by parents) were reported by students. Logistic regression was used to compute adjusted ORs (AORs) of drinking and intention to drink by each PPDP and the number of PPDPs (0, 1–2, 3–4, 5 or above), adjusting for sociodemographic characteristics, parental drinking and school clustering.

Results

Nearly half (48.6%) of the students were ever-drinkers, 16.2% drank monthly (at least once per month) and 40.3% intended to drink in the next 12 months. Most PPDPs were significantly associated with ever drinking (AORs 1.40–6.20), monthly drinking (AORs 1.12–8.20) and intention to drink (AORs 1.40–5.02). Both ever and monthly drinking were most strongly associated with parental training of drinking capacity (ability to drink more without getting drunk) with AORs of 6.20 and 8.20 (both p<0.001), respectively. Adolescent drinking intention was most strongly associated with parental encouragement of drinking and training of drinking capacity with AORs of 3.19 and 5.02 (both p<0.001), respectively.

Conclusions

Exposure to PPDPs was associated with ever drinking, monthly drinking and drinking intention in Hong Kong Chinese adolescents. More studies, especially prospective studies, should be conducted to confirm these results, followed by interventional studies.
Experiences and reflections of patients with motor neuron disease on breaking the news in a two-tiered appointment: a qualitative study
Authors: Seeber Antje A , Pols A Jeannette , Hijdra Albert , Grupstra Hepke F , Willems Dick L , de Visser Marianne
Published: February 2016

Background

Breaking bad news should be fine-tuned to the individual patient, contain intelligible information, include emotional support and offer a tailor-made treatment plan. To achieve this goal in motor neuron disease (MND), neurologists of the amyotrophic lateral sclerosis (ALS) centre Amsterdam deliver the message on 2 separate visits within 14 days.

Aim

To evaluate how patients with MND react to and view disclosure of the diagnosis, in this 2-tiered approach.

Methods

Non-participating observations and in-depth interviews with patients were conducted in 1 tertiary ALS referral centre. Qualitative analysis consisted of inductive analysis of observation reports and verbatim typed out interviews.

Results

10 2-tiered appointments were observed and 21 Dutch patients with MND interviewed. They experienced the straightforward message to be suffering from a fatal disease as devastating, yet unavoidable. The prospect of a short-term second appointment offered structure for the period immediately following the diagnosis. The time between appointments provided the opportunity for a first reorientation on their changed perspective on their life. The second appointment allowed for detailed discussions about various aspects of MND and a tailor-made treatment plan.

Conclusions

The 2-tiered approach fits well with the way in which Dutch patients with MND process the disclosure of their diagnosis, gather information and handle the changed perspective on their life. It may serve as a model for other life-limiting diseases.
Changing established protocols
Authors: Stabursvik Hanne
Published: February 2016

THIS series gives readers the opportunity to consider and contribute to discussion of some of the ethical dilemmas that can arise in veterinary practice. Each month, a case scenario is presented, followed by discussion of some of the issues involved.

In addition, a possible way forward is suggested; however, there is rarely a cut‐and‐dried answer in such cases, and readers may wish to suggest an alternative approach. This month's dilemma, ‘Changing established protocols’, was submitted and is discussed by Hanne Stabursvik. Readers with comments to contribute are invited to send them as soon as possible, so that they can be considered for publication in the next issue. Discussion of the dilemma ‘When in Rome. . . ’, which was published in the January issue of In Practice, appears on page 95.

The series is being coordinated by Steven McCulloch, a practising vet with a PhD in the ethics of veterinary policy. It is hoped it will provide a framework that will help practitioners find solutions when facing similar dilemmas.
Undertaking COSHH assessments – a five‐point plan
Authors: Noyce Steve
Published: February 2016

The Control of Substances Hazardous to Health (COSHH) regulations require employers to assess risks associated with substances that are hazardous to health and implement appropriate controls. Steve Noyce explains the assessments that employers must carry out to assess the risk to their employees.
Comparative effects of long-acting and short-acting loop diuretics on cardiac sympathetic nerve activity in patients with chronic heart failure
Authors: Matsuo Yae , Kasama Shu , Toyama Takuji , Funada Ryuichi , Takama Noriaki , Koitabashi Norimichi , Ichikawa Shuichi , Suzuki Yasuyuki , Matsumoto Naoya , Sato Yuichi , Kurabayashi Masahiko
Published: February 2016

Objective

Short-acting loop diuretics are known to enhance cardiac sympathetic nerve activity (CSNA) in patients with chronic heart failure (CHF). The effects of two loop diuretics—long-acting azosemide and short-acting furosemide—on CSNA were evaluated using123I-metaiodobenzylguanidine (MIBG) scintigraphy in patients with CHF.

Methods

The present study was a subanalysis of our previously published study, which had reported that serial123I-MIBG studies were the most useful prognostic indicator in patients with CHF. Patients with CHF (n=208, left ventricular ejection fraction <45%) but no history of cardiac events for at least 5 months prior to the study were identified according to their histories of acute decompensated heart failure requiring hospitalisation. Patients underwent123I-MIBG scintigraphy immediately before hospital discharge and at a 6-month follow-up. The delayed % denervation, delayed heart/mediastinum count (H/M) ratio and washout rate (WR) were determined using123I-MIBG scintigraphy. A total of 108 patients were selected, and propensity score matching was used to compare patients treated with either oral azosemide (n=54) or furosemide (n=54).

Results

After treatment,123I-MIBG scintigraphic parameters improved in both groups. However, the degree of change in % denervation was −13.8±10.5 in the azosemide group and −5.7±12.7 in the furosemide group (p<0.01), the change in H/M ratio was 0.20±0.16 in the azosemide group and 0.06±0.19 in the furosemide group (p<0.01), and the change in WR was −11.3±9.2% in the azosemide group and −3.0±12.7% in the furosemide group (p<0.01). Moreover, multivariate analysis showed an independent and significant positive relationship between furosemide and δ-WR from hospital discharge to 6 months after treatment in patients with CHF (p=0.001).

Conclusions

These findings indicate that azosemide suppresses CSNA compared with furosemide in patients with CHF.

Trial registration number

UMIN000000626 (UMIN-CTR Clinical Trial).
Difficult orotracheal intubation in a rabbit resulting from the presence of faecal pellets in the oropharynx
Authors: Engbers Sarah , Larkin Amy , Jonnalagadda Mahesh , Prebble Melanie , Rousset Nicolas , Knight Cameron G , Pang Daniel S J
Published: February 2016

Rabbits have a high rate of anaesthesia‐related death compared with other companion animal species. This is influenced by a variety of factors, one of which is difficulty in obtaining a secure airway. The rabbit in this report was enrolled in a larger non‐survival study that required orotracheal intubation to be performed. Orotracheal intubation was difficult, taking 306 seconds, compared with a median of 134 seconds (range 29–171 seconds) in the four preceding rabbits. Necropsy examination revealed a faecal pellet lodged in the caudal oropharynx abutting compacted faecal material, ventral to the epiglottis. Two structures of mixed gas and soft tissue attenuation were seen on CT scans obtained pre‐ and post‐intubation, at a location consistent with the faecal material, thus confirming the presence of the pellets at the time of sedation and during intubation. Oral prehension of faecal pellets before anaesthesia represents a previously unreported obstacle to orotracheal intubation in rabbits.
Skeletal site-specific effects of endurance running on structure and strength of tibia, lumbar vertebrae, and mandible in male Sprague–Dawley rats
Authors: Bott Kirsten N. , Sacco Sandra M. , Turnbull Patrick C. , Longo Amanda B. , Ward Wendy E. , Peters Sandra J.
Published: February 2016

Bone microarchitecture, bone mineral density (BMD), and bone strength are affected positively by impact activities such as running; however, there are discrepancies in the magnitude of these effects. These inconsistencies are mainly a result of varying training protocols, analysis techniques, and whether or not the skeletal sites measured are weight bearing. This study’s purpose was to determine the effects of endurance running on sites that experience different weight bearing and load. Eight-week-old male Sprague–Dawley rats (n = 20) were randomly assigned to either a group with a progressive treadmill running protocol (25 m/min for 1 h, incline of 10%) or a nontrained control group for 8 weeks. The trabecular structure of the tibia, lumbar vertebra (L3), and mandible and the cortical structure at the tibia midpoint were measured using microcomputed tomography to quantify bone volume fraction (i.e., bone volume divided by total volume (BV/TV)), trabecular number (Tb.N), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), and cortical thickness. BMD at the proximal tibia, lumbar vertebrae (L1–L3), and mandible was measured using dual energy X-ray absorptiometry. The tibia midpoint strength was measured by 3-point bending using a materials testing system. Endurance running resulted in superior bone structure at the proximal tibia (12% greater BV/TV (p = 0.03), 14% greater Tb.N (p = 0.01), and 19% lower Tb.Sp (p = 0.05)) but not at other sites. Contrary to our hypothesis, mandible bone structure was altered after endurance training (8% lower BV/TV (p < 0.01) and 15% lower Tb.Th (p < 0.01)), which may be explained by a lower food intake, resulting in less mechanical loading from chewing. These results highlight the site-specific effects of loading on the skeleton.
Comparative study of the effects of the structurally similar flavonoids quercetin and taxifolin on the therapeutic behavior of alprazolam
Authors: Mohseni-Shahri Fatemeh S. , Housaindokht Mohammad R. , Bozorgmehr Mohammad R. , Moosavi-Movahedi Ali A.
Published: February 2016

After a meal rich in plant products, dietary flavonoids can be detected in plasma as serum albumin bound conjugates. Flavonoid–albumin binding is expected to control the bioavailability of drugs. In this study, the binding of alprazolam (ALP) and human serum albumin (HSA) has been investigated in the absence and presence of two flavonoids with similar structures, quercetin (QUER) and taxifolin (TAX), by means of fluorescence spectroscopy, chemometrics, and molecular dynamics simulation. Our results show that ALP has the ability to quench the intrinsic fluorescence of HSA. This quenching is affected by flavonoids. The presence of QUER and TAX decreased the quenching constants, binding constants, and equilibrium constants associated with ALP binding to HSA. The effect of ALP and both flavonoids on the conformation of HSA was analyzed using synchronous fluorescence spectroscopy. Our results indicate a conformational change of HSA with the addition of ligands. The molecular dynamics study makes an important contribution to understanding the effect of the binding of ALP, QUER, and TAX on conformational changes of HSA and modification of its tertiary structure in the absence and presence of flavonoids. All of these results may have relevant consequences in rationalizing the interferences of common food and drugs.
Correction of air freezing index for pavement frost protection design to consider future climate changes
Authors: Bilodeau Jean-Pascal , Doré Guy , Drolet François Perron , Chaumont Diane
Published: February 2016

In cold regions, climate affects flexible pavement performance, such as frost heave. In the context of a changing climate, air freezing index can no longer be considered as fixed for pavement design. Climate simulations were performed for Quebec conditions to determine the evolution of the air freezing index over the coming decades. Using a relationship between average frost heave and the yearly roughness deterioration rate and a proposed method to consider decreasing air freezing index, the effect of climate change was quantified with respect to the 1971–2000 conditions. Thinner pavement structures are obtained with the calculation approach, and its effect was quantified in terms of materials and pavement life. It was shown that a reduction of 100 mm could be considered for pavements built on frost sensitive soils. In addition, the proposed method showed an increase of pavement life, quantified with roughness, for most of the cases considered.
Immune responses to Mycoplasma bovis proteins formulated with different adjuvants
Authors: Prysliak Tracy , Perez-Casal Jose
Published: February 2016

Most vaccines for protection against Mycoplasma bovis disease are made of bacterins, and they offer varying degrees of protection. Our focus is on the development of a subunit-based protective vaccine, and to that end, we have identified 10 novel vaccine candidates. After formulation of these candidates with TriAdj, an experimental tri-component novel vaccine adjuvant developed at VIDO–InterVac, we measured humoral and cell-mediated immune responses in vaccinated animals. In addition, we compared the immune responses after formulation with TriAdj with the responses measured in animals vaccinated with a mix of a commercial adjuvant (Emulsigen™) and 2 of the components of the TriAdj, namely polyinosinic:polycytidylic acid (poly I:C) and the cationic innate defense regulator (IDR) peptide 1002 (VQRWLIVWRIRK). In this latter trial, we detected significant IgG1 humoral immune responses to 8 out of 10 M. bovis proteins, and IgG2 responses to 7 out of 10 proteins. Thus, we concluded that the commercial adjuvant formulated with poly I:C and the IDR peptide 1002 is the best formulation for the experimental vaccine.
Enhancing Reliability of Workflow Execution Using Task Replication and Spot Instances
Authors: Poola Deepak , Ramamohanarao Kotagiri , Buyya Rajkumar
Published: February 2016

Cloud environments offer low-cost computing resources as a subscription-based service. These resources are elastically scalable and dynamically provisioned. Furthermore, cloud providers have also pioneered new pricing models like spot instances that are cost-effective. As a result, scientific workflows are increasingly adopting cloud computing. However, spot instances are terminated when the market price exceeds the users bid price. Likewise, cloud is not a utopian environment. Failures are inevitable in such large complex distributed systems. It is also well studied that cloud resources experience fluctuations in the delivered performance. These challenges make fault tolerance an important criterion in workflow scheduling. This article presents an adaptive, just-in-time scheduling algorithm for scientific workflows. This algorithm judiciously uses both spot and on-demand instances to reduce cost and provide fault tolerance. The proposed scheduling algorithm also consolidates resources to further minimize execution time and cost. Extensive simulations show that the proposed heuristics are fault tolerant and are effective, especially under short deadlines, providing robust schedules with minimal makespan and cost.
Paracrine regulation of glucagon secretion: the β/α/δ model
Authors: Watts Margaret , Ha Joon , Kimchi Ofer , Sherman Arthur
Published: February 2016

The regulation of glucagon secretion in the pancreatic α-cell is not well understood. It has been proposed that glucose suppresses glucagon secretion either directly through an intrinsic mechanism within the α-cell or indirectly through an extrinsic mechanism. Previously, we described a mathematical model for isolated pancreatic α-cells and used it to investigate possible intrinsic mechanisms of regulating glucagon secretion. We demonstrated that glucose can suppress glucagon secretion through both ATP-dependent potassium channels (KATP) and a store-operated current (SOC). We have now developed an islet model that combines previously published mathematical models of α- and β-cells with a new model of δ-cells and use it to explore the effects of insulin and somatostatin on glucagon secretion. We show that the model can reproduce experimental observations that the inhibitory effect of glucose remains even when paracrine modulators are no longer acting on the α-cell. We demonstrate how paracrine interactions can either synchronize α- and δ-cells to produce pulsatile oscillations in glucagon and somatostatin secretion or fail to do so. The model can also account for the paradoxical observation that glucagon can be out of phase with insulin, whereas α-cell calcium is in phase with insulin. We conclude that both paracrine interactions and the α-cell's intrinsic mechanisms are needed to explain the response of glucagon secretion to glucose.
Electrical stimulation of the aortic depressor nerve in conscious rats overcomes the attenuation of the baroreflex in chronic heart failure
Authors: Pinto Tomás O. C. Teixeira , Lataro Renata M. , Castania Jaci A. , Durand Marina T. , Silva Carlos A. A. , Patel Kaushik P. , Fazan Rubens , Salgado Helio C.
Published: February 2016

Chronic heart failure (CHF) is characterized by autonomic dysfunction combined with baroreflex attenuation. The hypotensive and bradycardic responses produced by electrical stimulation of the aortic depressor nerve (ADN) were examined in conscious CHF and control male Wistar rats (12–13 wk old). Furthermore, the role of parasympathetic and sympathetic nervous system in mediating the cardiovascular responses to baroreflex activation was evaluated by selective β1-adrenergic and muscarinic receptor antagonists. CHF was induced by myocardial infarction. After 6 wk, the subjects were implanted with electrodes for ADN stimulation. Twenty-four hours later, electrical stimulation of the ADN was applied for 20 s using five different frequencies (5, 15, 30, 60, and 90 Hz), while the arterial pressure was recorded by a catheter implanted into the femoral artery. Electrical stimulation of the ADN elicited progressive and similar hypotensive and bradycardic responses in control ( n = 12) and CHF ( n = 11) rats, while the hypotensive response was not affected by methylatropine. Nevertheless, the reflex bradycardia was attenuated by methylatropine in control, but not in CHF rats. Atenolol did not affect the hypotensive or bradycardic response in either group. The ADN function was examined under anesthesia through electroneurographic recordings. The arterial pressure-ADN activity relationship was attenuated in CHF rats. In conclusion, despite the attenuation of baroreceptor function in CHF rats, the electrical stimulation of the ADN elicited a stimulus-dependent hypotension and bradycardia of similar magnitude as observed in control rats. Therefore, electrical activation of the aortic baroreflex overcomes both the attenuation of parasympathetic function and the sympathetic overdrive.
Prevalence of Low Back Pain among Undergraduate Physiotherapy Students in Nigeria
Authors: Vincent-Onabajo Grace O. , Nweze Ejiofor , Kachalla Gujba Fatima , Ali Masta Mamman , Usman Ali Mohammad , Alhaji Modu Ali , Umeonwuka Chuka
Published: February 2016

Background. Low back pain (LBP) is a major cause of disability and the most common work-related musculoskeletal disorder among physiotherapists. This study examined the prevalence of low back pain among students undergoing training to become physiotherapists. Methods. Participants were 207 undergraduate clinical physiotherapy students at three universities in Nigeria. A modified version of a questionnaire used in a previous study was utilized to obtain demographic, educational activities, and LBP data. Prevalence of LBP was examined with descriptive statistics while factors associated with prevalence were explored using chi-square statistics. Results. More male students (53.1%) and those in the penultimate year of study (53.1%) participated in the study. Lifetime, 12-month, 1-month, and 7-day prevalence of LBP were 45.5%, 32.5%, 17.7%, and 11.5%, respectively. Prevalence of LBP was not significantly associated with any of the demographic variables. Educational activities, namely, “having techniques practiced on self for ≤10 hours” and “treating patients for ≥30 hours,” a month prior to the study were significantly (P<0.05) associated with higher 1-month and 7-day LBP prevalence, respectively. Conclusions. Although the prevalence of LBP was comparatively low, its association with educational activities emphasizes the need to incorporate effective LBP preventive strategies in the training of physiotherapy students.
Existence Results for Some Equilibrium Problems Involvingα-Monotone Bifunction
Authors: Hashoosh Ayed E. , Alimohammady Mohsen , Kalleji M. K.
Published: February 2016

This paper deals with some existence results of equilibrium problems(EPΨ)on convex and closed sets (either bounded or unbounded) in Banach spaces. Moreover, an application to the existence of solution for a differential inclusion is given.
De Novo Interstitial Microdeletion at 1q32.1 in a 10-Year-Old Boy with Developmental Delay and Dysmorphism
Authors: Carter Jennifer , Zombor Melinda , Máté Adrienn , Sztriha László , Waters Jonathan J.
Published: February 2016

A 10-year-old boy was referred with developmental delay and dysmorphism. Genomewide aCGH microarray analysis detected a de novo 3.7 Mb deletion at 1q32.1: arr 1q32.1(199,985,888-203,690,832)x1 dn [build HG19]. This first report of a deletion in this region implies a critical role for dosage-sensitive genes within 1q32.1 in neurological development. This is consistent with previously reported duplications of this region in patients with a similar phenotype.
Colchicum autumnale in Patients with Goitre with Euthyroidism or Mild Hyperthyroidism: Indications for a Therapeutic Regulative Effect—Results of an Observational Study
Authors: Scheffer Christian , Debus Marion , Heckmann Christian , Cysarz Dirk , Girke Matthias
Published: February 2016

Introduction. Goitre with euthyroid function or with subclinical or mild hyperthyroidism due to thyroid autonomy is common. In anthroposophic medicine various thyroid disorders are treated with Colchicum autumnale (CAU). We examined the effects of CAU in patients with goitre of both functional states. Patients and methods. In an observational study, 24 patients with goitre having suppressed thyroid stimulating hormone (TSH) levels with normal or slightly elevated free thyroxine (fT4) and free triiodothyronine (fT3) (group 1, n = 12) or normal TSH, fT3, and fT4 (group 2, n = 12) were included. After 3 months and after 6 to 12 months of CAU treatment, we investigated clinical pathology using the Hyperthyroid Symptom Scale (HSS), hormone status (TSH, fT4, and fT3), and thyroidal volume (tV). Results. After treatment with CAU, in group 1 the median HSS decreased from 4.5 (2.3–11.8) to 2 (1.3–3) (p < 0.01) and fT3 decreased from 3.85 (3.5–4.78) to 3.45 (3.3–3.78) pg/mL (p < 0.05). In group 2 tV (13.9% (18.5%–6.1%)) and TSH (p < 0.01) were reduced. Linear regression for TSH and fT3 in both groups indicated a regulative therapeutic effect of CAU. Conclusions. CAU positively changed the clinical pathology of subclinical hyperthyroidism and thyroidal volume in patients with euthyroid goitre by normalization of the regulation of thyroidal hormones.
Blowup Phenomenon of Solutions for the IBVP of the Compressible Euler Equations in Spherical Symmetry
Authors: Cheung Ka Luen , Wong Sen
Published: February 2016

The blowup phenomenon of solutions is investigated for the initial-boundary value problem (IBVP) of theN-dimensional Euler equations with spherical symmetry. We first show that there are only trivial solutions when the velocity is of the formc(t)xα-1x+b(t)(x/x)for any value ofα≠1or any positive integerN≠1. Then, we show that blowup phenomenon occurs whenα=N=1andc2(0)+c˙(0)<0. As a corollary, the blowup properties of solutions with velocity of the form(a˙t/at)x+b(t)(x/x)are obtained. Our analysis includes both the isentropic case(γ>1)and the isothermal case(γ=1).
Second Hankel Determinants for the Class of Typically Real Functions
Authors: Zaprawa Paweł
Published: February 2016

We discuss the Hankel determinantsH2(n)=anan+2-an+12for typically real functions, that is, analytic functions which satisfy the conditionIm ⁡z Im⁡f(z)≥0in the unit disk Δ. Main results are concerned withH2(2)andH2(3). The sharp upper and lower bounds are given. In general case, forn≥4, the results are not sharp. Moreover, we present some remarks connected with typically real odd functions.
Increased Fracture Collapse after Intertrochanteric Fractures Treated by the Dynamic Hip Screw Adversely Affects Walking Ability but Not Survival
Authors: Fang Christian , Gudushauri Paata , Wong Tak-Man , Lau Tak-Wing , Pun Terence , Leung Frankie
Published: February 2016

In osteoporotic hip fractures, fracture collapse is deliberately allowed by commonly used implants to improve dynamic contact and healing. The muscle lever arm is, however, compromised by shortening. We evaluated a cohort of 361 patients with AO/OTA 31.A1 or 31.A2 intertrochanteric fracture treated by the dynamic hip screw (DHS) who had a minimal follow-up of 3 months and an average follow-up of 14.6 months and long term survival data. The amount of fracture collapse and shortening due to sliding of the DHS was determined at the latest follow-up and graded as minimal (<1 cm), moderate (1-2 cm), or severe (>2 cm). With increased severity of collapse, more patients were unable to maintain their premorbid walking function (minimal collapse = 34.2%, moderate = 33.3%, severe = 62.8%, andp=0.028). Based on ordinal regression of risk factors, increased fracture collapse was significantly and independently related to increasing age (p=0.037), female sex (p=0.024), A2 fracture class (p=0.010), increased operative duration (p=0.011), poor reduction quality (p=0.000), and suboptimal tip-apex distance of >25 mm (p=0.050). Patients who had better outcome in terms of walking function were independently predicted by younger age (p=0.036), higher MMSE marks (p=0.000), higher MBI marks (p=0.010), better premorbid walking status (p=0.000), less fracture collapse (p=0.011), and optimal lag screw position in centre-centre or centre-inferior position (p=0.020). According to Kaplan-Meier analysis, fracture collapse had no association with mortality from 2.4 to 7.6 years after surgery. In conclusion, increased fracture collapse after fixation of geriatric intertrochanteric fractures adversely affected walking but not survival.
Comparing Single and Dual Console Systems in the Robotic Surgical Training of Graduating OB/GYN Residents in the United States
Authors: Mikhail Emad , Salemi Jason L. , Hart Stuart , Imudia Anthony N.
Published: February 2016

Objective. To assess the impact of a single versus dual console robotic system on the perceptions of program directors (PD) and residents (RES) towards robotic surgical training among graduating obstetrics and gynecology residents.Design. An anonymous survey was developed usingQualtrics, a web-based survey development and administration system, and sent to obstetrics and gynecology program directors and graduating residents.Participants. 39 program directors and 32 graduating residents (PGY4).Results. According to residents perception, dual console is utilized in about 70% of the respondents’ programs. Dual console system programs were more likely to provide a robotics training certificate compared to single console programs (43.5% versus 0%,p=0.03). A greater proportion of residents graduating from a dual console program perform more than 20 robotic-assisted total laparoscopic hysterectomies, 30% versus 0% (p=0.15).Conclusions. Utilization of dual console system increased the likelihood of obtaining robotic training certification without significantly increasing the case volume of robotic-assisted total laparoscopic hysterectomy.
A Simple HPLC-ELSD Method for Sugar Analysis in Goji Berry
Authors: Montesano D. , Cossignani L. , Giua L. , Urbani E. , Simonetti M. S. , Blasi F.
Published: February 2016

Fructose, glucose, and sucrose were identified and quantified in commercial samples ofLycium barbarumL. fruits (goji berries) by high performance liquid chromatography-evaporative light scattering detector (HPLC-ELSD) method. This study described a rapid, simple, sensitive, selective, and reliable HPLC method suitable for the profiling of major sugars in berries, the evaluation of the nutritional/energetic properties, and assessment of the maturation stage. The proposed analytical method was validated and the results showed good precision, accuracy, and linearity. In all analyzed goji fruits, glucose and fructose were the predominant sugars, while sucrose content was about ten times lower than each monose. It was observed that glucose and fructose were detected in comparable quantities in all considered samples. Quantitative analysis showed that fructose, glucose, and sucrose content ranged from 154.20 to 259.13 mg g−1, from 152.92 to 284.60 mg g−1, and from 13.75 to 36.43 mg g−1, respectively.
Steady Flow of Couple-Stress Fluid in Constricted Tapered Artery: Effects of Transverse Magnetic Field, Moving Catheter, and Slip Velocity
Authors: Bakhti Hamzah , Azrar Lahcen
Published: February 2016

Steady flow of a couple-stress fluid in constricted tapered artery has been studied under the effects of transverse magnetic field, moving catheter, and slip velocity. With the help of Bessel’s functions, analytic expressions for axial velocity, flow rate, impedance, and wall shear stress have been obtained. It is of interest to note that these solutions can be used for different types of fluid flow in tubes and not only the case of blood. The effects of various geometric parameters, the parameters arising out of the fluid considered and the magnetic field, are discussed by considering the slip velocity, the catheter velocity, and tapering angle. The study of the above model is very important as it has direct applications in the treatment of cardiovascular diseases.
Human Breathing Rate Estimation from Radar Returns Using Harmonically Related Filters
Authors: Mabrouk Mohamed , Rajan Sreeraman , Bolic Miodrag , Forouzanfar Mohamad , Dajani Hilmi R. , Batkin Izmail
Published: February 2016

Radar-based noncontact sensing of life sign signals is often used in safety and rescue missions during disasters such as earthquakes and avalanches and for home care applications. The radar returns obtained from a human target contain the breathing frequency along with its strong higher harmonics depending on the target’s posture. As a consequence, well understood, computationally efficient, and the most popular traditional FFT-based estimators that rely only on the strongest peak for estimates of breathing rates may be inaccurate. The paper proposes a solution for correcting the estimation errors of such single peak-based algorithms. The proposed method is based on using harmonically related comb filters over a set of all possible breathing frequencies. The method is tested on three subjects for different postures, for different distances between the radar and the subject, and for two different radar platforms: PN-UWB and phase modulated-CW (PM-CW) radars. Simplified algorithms more suitable for real-time implementation have also been proposed and compared using accuracy and computational complexity. The proposed breathing rate estimation algorithms provide a reduction of about 81% and 80% in the mean absolute error of breathing rates in comparison to the traditional FFT-based methods using strongest peak detection, for PN-UWB and PM-CW radars, respectively.
ILK Induction in Lymphoid Organs by a TNFα–NF-κB–Regulated Pathway Promotes the Development of Chronic Lymphocytic Leukemia
Authors: Krenn Peter W. , Hofbauer Sebastian W. , Pucher Susanne , Hutterer Evelyn , Hinterseer Elisabeth , Denk Ursula , Asslaber Daniela , Ganghammer Sylvia , Sternberg Christina , Neureiter Daniel , Aberger Fritz , Wickström Sara A. , Egle Alexander , Greil Richard , Hartmann Tanja N.
Published: February 2016

The proliferation of chronic lymphocytic leukemia (CLL) cells requires communication with the lymphoid organ microenvironment. Integrin-linked kinase (ILK) is a multifunctional intracellular adaptor protein that transmits extracellular signals to regulate malignant cell motility, metastasis, and cell-cycle progression, but is poorly characterized in hematologic malignancies. In this study, we investigated the role of ILK in the context of CLL and observed high ILK expression in patient samples, particularly in tumor cells harboring prognostic high-risk markers such as unmutated IGHV genes, high Zap70, or CD38 expression, or a signature of recent proliferation. We also found increased numbers of Ki67 (MKI67)-positive cells in regions of enhanced ILK expression in lymph nodes from CLL patients. Using coculture conditions mimicking the proliferative lymph node microenvironment, we detected a parallel induction of ILK and cyclin D1 (CCND1) expression in CLL cells that was dependent on the activation of NF-κB signaling by soluble TNFα. The newly synthesized ILK protein colocalized to centrosomal structures and was required for correct centrosome clustering and mitotic spindle organization. Furthermore, we established a mouse model of CLL in which B-cell–specific genetic ablation of ILK resulted in decelerated leukemia development due to reduced organ infiltration and proliferation of CLL cells. Collectively, our findings describe a TNFα–NF-κB–mediated mechanism by which ILK expression is induced in the lymph node microenvironment and propose that ILK promotes leukemogenesis by enabling CLL cells to cope with centrosomal defects acquired during malignant transformation. Cancer Res; 76(8); 2186–96. ©2016 AACR.
Prognostic Impact of IL6 Genetic Variants in Patients with Metastatic Colorectal Cancer Treated with Bevacizumab-Based Chemotherapy
Authors: Matsusaka Satoshi , Hanna Diana L. , Cao Shu , Zhang Wu , Yang Dongyun , Ning Yan , Sunakawa Yu , Okazaki Satoshi , Berger Martin D. , Miyamato Yuji , Parekh Anish , Stintzing Sebastian , Loupakis Fotios , Lenz Heinz-Josef
Published: February 2016

Purpose: The IL6/STAT3 axis promotes inflammation, angiogenesis, and cancer. The effect of genetic variants within this pathway on benefit from antiangiogenic cancer therapy is unknown. We tested whether SNPs in genes involved in IL6/STAT3 signaling can predict efficacy of bevacizumab-based chemotherapy in metastatic colorectal cancer (mCRC) patients.

Experimental Design: Associations between potentially functional IL6 (rs2069837 and rs1800795) and STAT3 (rs744166 and rs4796793) SNPs and clinical outcomes [progression-free survival (PFS), overall survival, and tumor response rate] were evaluated in mCRC patients receiving first-line FOLFIRI plus bevacizumab in two randomized phase III trials: TRIBE (n = 223, training cohort) and FIRE-3 (n = 288, validation cohort). Patients receiving FOLFIRI plus cetuximab in FIRE-3 (n = 264) served as a control cohort. The interaction between genotype and primary tumor location with clinical outcomes was examined. Genomic DNA isolated from whole blood or tumor tissue was analyzed by PCR-based direct sequencing.

Results: Patients with an IL6 rs2069837 G allele treated with FOLFIRI plus bevacizumab had an inferior PFS than those with the A/A genotype in TRIBE [9.4 vs. 11.1 months; HR = 1.53; 95% confidence interval (CI), 1.12–2.10; P = 0.004] and FIRE-3 (8.8 vs. 10.9 months; HR = 1.40; 95% CI, 1.06–1.85; P = 0.015). These associations were confirmed in multivariable analyses and were not seen in the control cohort. In subgroup analysis, the effect of IL6 rs2069837 on PFS was present only in patients with left-sided cancers, but the test for interaction was not significant.

Conclusions: IL6 rs2069837 genotype is a clinically relevant prognostic factor in mCRC patients treated with first-line bevacizumab-based chemotherapy. Clin Cancer Res; 22(13); 3218–26. ©2016 AACR.
Combined Effects of Suberoylanilide Hydroxamic Acid and Cisplatin on Radiation Sensitivity and Cancer Cell Invasion in Non–Small Cell Lung Cancer
Authors: Feng Jianguo , Zhang Shirong , Wu Kan , Wang Bing , Wong Jeffrey Y.C. , Jiang Hong , Xu Rujun , Ying Lisha , Huang Haixiu , Zheng Xiaoliang , Chen Xufeng , Ma Shenglin
Published: February 2016

Lung cancer is a leading cause of cancer-related mortality worldwide, and concurrent chemoradiotherapy has been explored as a therapeutic option. However, the chemotherapeutic agents cannot be administered for most patients at full doses safely with radical doses of thoracic radiation, and further optimizations of the chemotherapy regimen to be given with radiation are needed. In this study, we examined the effects of suberoylanilide hydroxamic acid (SAHA) and cisplatin on DNA damage repairs, and determined the combination effects of SAHA and cisplatin on human non–small cell lung cancer (NSCLC) cells in response to treatment of ionizing radiation (IR), and on tumor growth of lung cancer H460 xenografts receiving radiotherapy. We also investigated the potential differentiation effect of SAHA and its consequences on cancer cell invasion. Our results showed that SAHA and cisplatin compromise distinct DNA damage repair pathways, and treatment with SAHA enhanced synergistic radiosensitization effects of cisplatin in established NSCLC cell lines in a p53-independent manner, and decreased the DNA damage repair capability in cisplatin-treated primary NSCLC tumor tissues in response to IR. SAHA combined with cisplatin also significantly increased inhibitory effect of radiotherapy on tumor growth in the mouse xenograft model. In addition, SAHA can induce differentiation in stem cell–like cancer cell population, reduce tumorigenicity, and decrease invasiveness of human lung cancer cells. In conclusion, our data suggest a potential clinical impact for SAHA as a radiosensitizer and as a part of a chemoradiotherapy regimen for NSCLC. Mol Cancer Ther; 15(5); 842–53. ©2016 AACR.
Identification of Genes and Pathways Associated with Kidney Ischemia-Reperfusion Injury by Bioinformatics Analyses
Authors: Feng Wei , Tang Rongwei , Ye Xudong , Xue Chao , Liao Yunhua
Published: February 2016

Background/Aims: Ischemia-reperfusion (IR) injury in the kidney is a major cause of acute kidney injury in humans. However, the molecular mechanisms responsible for the progression of kidney IR injury still need to be explored. In this study, we aimed to explore the underlying genes and pathways associated with kidney IR injury. Methods: Gene microarray of GSE27274 was downloaded from the Gene Expression Omnibus database. The differentially expressed genes (DEGs) between kidney IR injury and kidney IR rat samples were analyzed. Gene Ontology biological process (BP) and pathway enrichment analyses of DEGs were performed, followed by protein-protein interaction (PPI) network construction. Results: A total of 88 up-regulated and 102 down-regulated DEGs were identified. The up-regulated DEGs including FK506 binding protein 1A (Fkb1a) were mainly enriched in biological processes (BPs) related to protein ubiquitination. The down-regulated DEGs including complement component 5 (C5) were enriched in complement and coagulation cascades pathway. Choline phosphotransferase 1 (Chpt1) was enriched in glycerophospholipid metabolism pathway. In the PPI network, heme oxygenase (decycling) 1 (Hmox1) was as a hub gene that interacted with the maximum nodes. Conclusions: DEGs of Fkb1a, C5, Chpt1, and Hmox1, as well as complement and coagulation cascades pathway, glycerophospholipid metabolism pathway, and BP terms related to protein ubiquitinatione may be the potential targets for diagnosis and treatment of kidney IR injury.
Relationship between Histological and Clinical Course of Psoriasis: A Pilot Investigation by Reflectance Confocal Microscopy during Goeckerman Treatment
Authors: Archid Rami , Duerr Hans Peter , Patzelt Alexa , Philipp Sandra , Röwert-Huber Hans-Joachim , Ulrich Martina , Meinke Martina Claudia , Knorr Fanny , Lademann Jürgen
Published: February 2016

Alterations of the skin microvasculature are known to play an important role in the development and maintenance of psoriatic skin lesions. In this study, we investigated lesional skin in 11 psoriatic patients during a modified Goeckerman treatment using reflectance confocal microscopy (RCM) to study the relationship between clinical clearance and histological normalization of psoriatic skin and the significance of histological abnormalities on the course of disease. The treatment regimen resulted in a significant reduction of the Psoriasis Area and Severity Index (PASI) as well as capillary and papillary diameters (p < 0.0001). The capillary and papillary diameters were still enlarged when compared to those in normal skin (p < 0.001). Capillary and papillary diameters correlated with each other prior to and after treatment (correlation coefficient = 0.63 and 0.64, p = 0.01 and 0.002, respectively) but not with the PASI. Capillary and papillary diameters after treatment and percentage reduction of the PASI during treatment seemed to be better predictors for the clinical course of relapse than the PASI after treatment. These findings make the subclinical changes of psoriatic skin vessels and dermal papillae a legitimate target for treatment. Further investigations of a large group of patients are needed to evaluate the potential of RCM findings as successor of the PASI in the monitoring of psoriasis.
Beneficial Effect of a Resorbable Biliary Stent in Living Donor Liver Transplantation
Authors: Sánchez-Cabús Santiago , Calatayud David , Ferrer Joana , Molina Víctor , Pavel Mihai-Calin , Sampson Jaime , Saavedra David , Fondevila Constantino , Fuster Josep , García-Valdecasas Juan Carlos
Published: February 2016

Background: Living donor liver transplantation (LDLT) entails a significant number of bile duct complications. We aimed to diminish the biliary complication rate with the use of a resorbable biliary stent (RBS) during LDLT. The objective of this study is to describe the surgical techniques and the associated outcomes, especially in terms of safety, of RBS use in LDLT. Methods: From 2011 to 2014, 12 LDLT recipients were enrolled in a clinical trial with the use of a specifically designed RBS. These patients were followed according to the clinical protocol. Specific complications derived from RBS as well as biliary complications were recorded. Results: One patient underwent early retransplantation due to a small-for-size syndrome. None of the patients had a complication attributable to the placement, remaining in place, or degradation of the stent. Four of the remaining patients presented with a biliary complication: 1 (9.1%) with a biliary leak alone, 1 (9.1%) with a biliary stenosis alone, and 2 (18.2%) with both. However, none of the leaks could be directly attributed to the RBS. Patient and graft 1-year survival was 100 and 91.7%, respectively. Conclusion: The use of an RBS in LDLT is not associated with complications, and initial results regarding efficacy and safety are encouraging. The need for a larger and prospective study is warranted.
Posterior Reversible Encephalopathy Syndrome Associated with Sorafenib and Successful Retreatment
Authors: Laruelle Marie , Filleul Bertrand , Duprez Thierry , Machiels Jean-Pascal
Published: February 2016

Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological syndrome characterized by acute hypertension, headache, decreased level of consciousness, visual disturbances and seizures associated with characteristic neuroimaging changes indicative of vasogenic edema of the posterior cerebral white matter. Several medical conditions have been associated with PRES including hypertensive encephalopathy and eclampsia. The use of cytotoxic and immunosuppressant drugs, such as those which target vascular endothelial growth factor (VEGF), have also been implicated. We report here the case of a 71-year-old woman with metastatic clear cell renal carcinoma who developed PRES 3 months after commencing sorafenib. Elevated blood pressure (BP) was recorded, and MRI of the brain) of the brain showed asymmetric areas of increased signal intensity within the supratentorial white matter suggestive of PRES. Clinical and radiological features rapidly improved with BP control and discontinuation of sorafenib. Sorafenib was resumed with no sign of PRES recurrence. The present case report supports the hypothesis that, in selected patients, the re-introduction of anti-VEGF therapies after PRES is feasible.
Ideas Production Function and Growth in Brazil
Authors: Nogueira Leilyanne Viana , Arraes Ronaldo De Albuquerque e
Published: February 2016

Propõe-se estimar funções de produção de ideias e testar a importância de spillovers regionais, baseado em proposições teóricas divergentes. Formula-se tal função e aplicam-se métodos de estimação com correções de erro para contornar heterogeneidades comuns em painéis. Observouse que estoque de conhecimento contribui positivamente para produção de ideias e rejeitou-se a hipótese de fortes spillovers intertemporais. Ademais, a elasticidade da produção de conhecimento com respeito ao capital humano foi significante, positiva e menor que um. A hipótese de retornos de escala constantes ou crescentes também foi rejeitada. O efeito do estoque de conhecimento da vizinhança sobre o desempenho tecnológico foi significante e positivo na função de produção do Brasil. Entretanto, não houve resultado convergente nas funções regionais.