bluuebunny/crossref_metadata_2025 huggingface dataset:
A Nomogram to Predict Distant Metastasis for Patients with Esophageal Cancer
Authors: Zhu Chao , You Yunhong , Liu Shichao , Ji Youxin , Yu Jinming
Published: November 2019

Background: Distant metastasis of esophageal cancer (EC) is prone to be neglected, so it is necessary to screen out the high-risk population for more sensitive and rigorous pretreatment imaging evaluations. Objective: The aim of this study was to evaluate the risk factors for distant metastasis in patients with EC and to construct a clinical nomogram. Methods: Eligible patients diagnosed from 2010 to 2015 were selected from the Surveillance, Epidemiology and End Results (SEER) database. Multivariable logistic regression analysis was applied to establish a prediction nomogram. Discrimination, calibration, clinical usefulness, and reproducibility were assessed by C-index, receiver-operating characteristic curve/the area under the curve (AUC), calibration plot, decision curve analysis (DCA), and bootstrapping validation. DCA was also used to compare the novel model with the conventional predictive methods. Results: A total of 9,026 patients were included for analysis. The nomogram incorporated the predictors: age, sex, race, grade, T stage, N stage, histology, tumor location, and pathological grading. The prediction model presented good discrimination with an AUC of 0.738 and a concordance index of 0.747 (95% confidence interval: 0.734–0.760), which was confirmed to be 0.745 through bootstrapping validation. Calibration plot and DCA showed satisfactory calibration and good net benefit, respectively. Comparing with the conventional prediction methods, the nomogram yielded superior net benefit. Conclusions: We constructed and validated a novel nomogram to help clinicians access the risk of distant metastasis in patients with EC.
Left Ventricular Strain and Rotation in Patients with Dilated Cardiomyopathy and Severe Systolic Dysfunction
Authors: Kinova Elena , Somleva-Todorova Desislava , Goudev Assen
Published: November 2019

Introduction: In dilated cardiomyopathy (DCM) left ventricular (LV) strain and twist are significantly decreased. However, the rate of attenuation has not been investigated well in patients with varying degrees of systolic dysfunction. Aim: The present study aimed to investigate the relationship between LV deformational and rotational mechanics and conventional and tissue Doppler imaging (TDI) parameters, and to search for a constellation of findings distinguishing patients with severe systolic dysfunction (SSD) in DCM. Methods: Fifty-two patients with heart failure NYHA class III–IV and ejection fraction (EF) ≤45% were prospectively enrolled (mean age 61.8 ± 13.4 years; 36 males, 69%). Severe systolic LV dysfunction was considered as EF <30%. Echocardiography with 2D-speckle tracking analysis was performed. Results: The relationships of global longitudinal strain (GLS) with EF, circumferential strain at mid-level (CSmid), and systolic medial mitral annulus velocity were strong (r = –0.53, 0.67, and –0.56, respectively, p < 0.0001 for all). A good correlation was found between CSmid and EF (r = –0.50, p < 0.0001). There were weak correlations between basal endocardial rotation (BRendo) and EF and CSmid. Multiple regression analysis found GLS (p < 0.0001) and BRendo (p = 0.04) to be predictors of the change of EF. In ROC curve analysis, the cut-off values of GLS –7.2% (AUC 0.81, p < 0.0001), CSmid –7.5% (AUC 0.76, p = 0.002), and BRendo –2.43° (AUC 0.68, p = 0.03) identified SSD. Conclusions: Parameters of LV mechanics were related to conventional and TDI systolic parameters in patients with DCM. The degree of alterations of LV longitudinal and circumferential deformation and basal rotation may identify patients with SSD and a higher risk, and may help in therapeutic decision making.
A Novel Long-Term ex vivo Model for Studying Vascular Calcification Pathogenesis: The Rat Isolated-Perfused Aorta
Authors: Schuchardt Mirjam , Siegel Nathalie Vanessa , Babic Milen , Reshetnik Alexander , Lützenberg Ronald , Zidek Walter , van der Giet Markus , Tölle Markus
Published: November 2019

The investigation of vascular calcification and its underlying cellular and molecular pathways is of great interest in current research efforts. Therefore, suitable assays are needed to allow examination of the complex calcification process under controlled conditions. The current study describes a new ex vivo model of isolated-perfused rat aortic tissue with subsequent quantification and vessel staining to analyze the calcium content of the aortic wall. A rat aorta was perfused ex vivo with control and calcification media for 14 days, respectively. The calcification medium was luminally perfused and induced a significant increase in calcium deposition within the media of the vessel wall detected alongside the elastic laminae. Perfusion with control medium induced no calcification. In addition, the mRNA expression of the osteogenic marker bone morphogenetic protein 2 (BMP-2) increased in aortic tissue after perfusion, while SM22α as smooth muscle marker decreased. This newly developed ex vivo model of isolated-perfused rat aorta is suitable for vascular calcification studies testing inducers and inhibitors of vessel calcification and studying signaling pathways within calcification progression.
Lovastatin Prevents Depressive Behaviors and Increased Hippocampal Neurogenesis in Streptozotocin-Induced Diabetic Mice
Authors: Tang Cong-Rong , Yu Xu-Ben , Zhang Hai-Na , Cao Yan-Cheng , Yang Fan , Xu Lei-Mei , Sun Ruo-Lan , Ye Zi , Wang Ye-Xuan , Liang Jin
Published: November 2019

Depression is a progressive and chronic syndrome and commonly related to several neuropsychiatric comorbidities, of which depression is the most studied. Population-based studies have suggested a positive role of statins in ameliorating depression risk. However, the role of statins in the treatment of diabetes-related depression has not been well examined. Herein, we investigated the effects of lovastatin (LOV) on depressive phenotypes in streptozotocin-induced diabetic mice. The data suggested that the treatment of LOV at 10 or 20 mg/kg for 3 weeks markedly prevented diabetes-associated depressive behaviors reflected by better performance in the sucrose preference test, tail suspension test, and novelty-suppressed feeding test. The study further showed that these treatments improved the hippocampal neurogenesis as evidenced by increased bromodeoxyuridine-positive cells in the dentate gyrus with higher expression of mature brain-derived neurotrophic factor and increased phosphorylation of cAMP-response element-binding protein. As expected, diabetic mice treated with LOV showed significant improvement of hyperlipidemia rather than hyperglycemia. These results suggest that LOV may be employed as a drug for the treatment of diabetes-related depression.
Psychotherapeutische Fernbegleitung von Expositionstherapie bei Angststörungen mittels Smart Glass: Praktikabilitäts- und Akzeptanzevaluation
Authors: Noack René , Eckelt Tobias , Scharoba Janine , Hoferichter Esther , Jacobi Frank , Weidner Kerstin , Hoyer Jürgen
Published: November 2019

Hintergrund: Trotz vielfach belegter Wirksamkeit expositionsbasierter Methoden bei Angststörungen werden diese in verhaltenstherapeutischen Praxen häufig nicht oder nicht vertieft genug umgesetzt. Planungs- und Zeitaufwand sind häufige Hinderungsgründe. In dieser Studie wurden Usability (Gebrauchstauglichkeit), User Experience (Nutzererleben) und Nutzerakzeptanz eines Systems zur Fernbegleitung von Expositionstherapie mittels Smart Glass evaluiert. Methoden: In einer standardisierten Laboruntersuchung bewerteten 39 Probanden mit Spinnenangst sowie 16 Therapeuten Usability, User Experience und Nutzerakzeptanz mittels etablierter Fragebögen. Vergleiche mit Normstichproben wurden vorgenommen und Adjective Rankings vergeben. Ergebnisse:92% der Probanden konnten sich selbstständig in das technische System einarbeiten und die Anweisungen des Therapeuten wahrnehmen und umsetzen. Die Usability wurde von den Probanden als “OK” bewertet. Bei der User Experience wurden bei konservativster Berechnung für die aufgabenbezogenen Faktoren Durchschaubarkeit, Effizienz und Steuerbarkeit “unterdurchschnittliche” und für die hedonischen Merkmale Stimulation und Originalität “gute” bis “exzellente” Bewertungen abgegeben. Die Nutzerakzeptanz war “durchschnittlich”. Die informiert rekrutierten Therapeuten zeigten in allen Variablen höhere Bewertungen. Schlussfolgerungen:Es besteht eine ausreichende Usability, eine in Bezug auf unterschiedliche Qualitäten heterogene User Experience und eine zufriedenstellende Akzeptanz. Insofern kann eine Expositionsfernbegleitung eine vielversprechende Alternative für die begleitete Exposition in vivo bieten. Verbesserungswürdige technische Probleme sowie medizinproduktebezogene und datenschutzrechtliche Fragen werden benannt.
Association between Depression and Renal Hyperfiltration in a General Chinese Population
Authors: Lin Miao , Huang Huibin , Yao Jin , Liang Jixing , Li Liantao , Lin Wei , Lin Lixiang , Hong Fuyuan , Lu Jieli , Bi Yufang , Wang Weiqing , Wen Junping , Chen Gang
Published: November 2019

Background: Depression is prevalent in patients with all stages of CKD and is associated with adverse outcome. Abnormally elevated GFR, or hyperfiltration, may play a crucial role in the initiation and progression of CKD. However, the association between depression and hyperfiltration is not known. The aim of this study is to investigate the relationship between depression and hyperfiltration. Methods: This was an observational cross-sectional study. A total of 3,716 volunteers (1,303 males and 2,413 females) aged 40–75 years without CKD from a community in China were included for the study. Depressive symptoms and the presence of a minor or major depressive episode were assessed with the 9-item Patient Health Questionnaire (PHQ-9) and Diagnostic and Statistical Manual of Mental Disorders (4th edition)-based structured interview, respectively. Results: The mean age of the participants in the present study was 53.8 ± 9.0 years. 115 participants had clinically relevant depression, and 122 participants had a minor or major depressive episode. In a multivariable logistic regression analysis adjusted for potential confounders, the association between clinically relevant depression and renal hyperfiltration remained significant in men but not in women. As compared with men without depression (PHQ <5) or depressive episodes, those with clinically relevant depression (PHQ ≥10) had a significantly higher risk of renal hyperfiltration. The fully adjusted OR (95% CI) was 4.81 (1.62–14.30, p = 0.005), those with a major depressive episode had a higher risk of renal hyperfiltration (OR 7.45; 95% CI 2.04–27.21, p = 0.002). Conclusion: Depressive symptoms and major depressive episodes are associated with renal hyperfiltration in middle-aged and elderly Chinese men without CKD. Future studies are needed to verify and clarify the role of depression in the development of abnormally high eGFR and CKD.
Interleukin-27 Ameliorates Renal Ischemia-Reperfusion Injury through Signal Transducers and Activators of Transcription 3 Signaling Pathway
Authors: Zhou Peihui , Deng Bo , Wu Ming , Ding Feng , Wang Li
Published: November 2019

Background: Acute kidney injury (AKI) is a clinical syndrome characterized by significant morbidity and a high death rate. Interleukin (IL)-27 is a newly described member of the IL-6/IL-12 heterodimeric cytokine family and displays anti-inflammatory and antiapoptotic properties. Objectives: To determine the effect and mechanism of IL-27 in AKI. Method: We used a mouse model of renal ischemia/reperfusion (I/R) injury to investigate whether IL-27 has a therapeutic potential for the treatment of AKI. For the IL-27 administration group, IL-27 protein was injected 1 h before ischemia. Human proximal tubular epithelial cells were exposed to ischemia for 2 h and followed by 2 h of reperfusion (I2h+R2h treatment) used as an in vitro model to investigate the effect of IL-27. Results: Two IL-27 subunits, Epstein-Barr virus gene 3 and p28, were upregulated in kidneys 24 h after I/R. Renal expression of IL-27 receptor subunits (gp130 and WSX-1) was also increased. Treatment with IL-27 reduced structural/functional damages, ameliorated renal inflammation, inhibited the cleaved caspase-3 expression, upregulated antiapoptotic protein Bcl-2 and downregulated proapoptotic protein Bax in the kidneys of mice subjected to I/R. Meanwhile, the level of IL-27 receptor on renal tubular epithelial cells was increased after I2h+R2h treatment, and IL-27 administration suppressed I2h+R2h-induced epithelial cell apoptosis. Furthermore, IL-27 treatment led to activation of signal transducer and activator of transcription 3 (STAT3) both in vivo and in vitro, and IL-27-mediated protection against I2h+R2h injury was abolished by STAT3 inhibition. Conclusions: IL-27 protects against renal I/R injury by activating STAT3, suggesting that IL-27 may represent a novel strategy for the treatment of AKI.
The Possibility of Urinary Liver-Type Fatty Acid-Binding Protein as a Biomarker of Renal Hypoxia in Spontaneously Diabetic Torii Fatty Rats
Authors: Tanabe Jun , Ogura Yuji , Nakabayashi Mikie , Nagai Yoshio , Watanabe Shiika , Sugaya Takeshi , Ohata Keiichi , Ichikawa Daisuke , Inoue Kazuho , Hoshino Seiko , Kimura Kenjiro , Shibagaki Yugo , Ono Yumie , Kamijo-Ikemori Atsuko
Published: November 2019

Background: Renal hypoxia is an aggravating factor for tubulointerstitial damage, which is strongly associated with renal prognosis in diabetic kidney disease (DKD). Therefore, urinary markers that can detect renal hypoxia are useful for monitoring DKD. Objective: To determine the correlation between urinary liver-type fatty acid-binding protein (L-FABP) and renal hypoxia using a novel animal model of type 2 diabetes. Methods: Male spontaneously diabetic Torii (SDT) fatty rats (n = 6) were used as an animal model of type 2 diabetes. Age- and sex-matched Sprague-Dawley (SD) rats (n = 8) were used as controls. Body weight, systolic blood pressure, and blood glucose levels were measured at 8, 12, 16, and 24 weeks of age. Urine samples and serum and kidney tissues were collected at 24 weeks of age. Microvascular blood flow index (BFI) was measured using diffuse correlation spectroscopy before sampling both the serum and kidneys for the evaluation of renal microcirculation at the corticomedullary junction. Results: Obesity, hyperglycemia, and hypertension were observed in the SDT fatty rats. Focal glomerular sclerosis, moderate interstitial inflammation, and fibrosis were significantly more frequent in SDT fatty rats than in SD rats. While the frequency of peritubular endothelial cells and phosphoendothelial nitric oxide synthase levels were similar in both types of rats, the degree of renal hypoxia-inducible factor-1α (HIF-1α) expression was significantly higher (and with no change in renal vascular endothelial growth factor expression levels) in the SDT fatty rats. Urinary L-FABP levels were significantly higher and renal microvascular BFI was significantly lower in the SDT fatty rats than in the SD rats. Urinary L-FABP levels exhibited a significant positive correlation with renal HIF-1α expression and a significant negative correlation with renal microvascular BFI. Conclusions: Urinary L-FABP levels reflect the degree of renal hypoxia in DKD in a type 2 diabetic animal model. Urinary L-FABP may thus prove useful as a renal hypoxia marker for monitoring DKD in patients with type 2 diabetes in clinical practice.
Yam-Containing Serum Promotes Proliferation and Chondrogenic Differentiation of Rabbit Bone Marrow Mesenchymal Stem Cells and Synthesis of Glycosaminoglycan
Authors: Yang Ruize , Zhang Rui , Deng Hongli , Wang Gang , Zhao Jingjing , Yang Hao , Ning Ning , Ma Jie , Zhou Jinsong
Published: November 2019

The chondrogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) is affected by a variety of factors, including environmental, physical, and chemical factors and growth factors, and traditional Chinese medicine (TCM) preparations can further influence this process. In this study, the effects of different concentrations of Yam-containing serum of rabbits on BMSC proliferation and chondrogenic differentiation were investigated, as were the underlying molecular mechanisms. The growth and proliferation of BMSCs were significantly enhanced upon treatment with Yam-containing serum. Under both monolayer and micromass culture conditions, Yam-containing serum promoted the differentiation of BMSCs into chondrocytes. Toluidine blue staining results revealed that chondrocyte differentiation in the group treated by Yam-containing serum was significantly more pronounced than in the control group. Glycosaminoglycan levels, as measured by 1,2-dimethylmethylene blue (DMMB) detection, were significantly higher in cells of the Yam-containing group relative to the control group. This is the first study to our knowledge that demonstrates that Yam-containing serum can promote BMSC proliferation and chondrogenic differentiation. This study therefore lays an experimental groundwork for further application of TCM as a means of treating degenerative cartilage diseases and provides an experimental and theoretical basis for the combination of TCM and stem cells for the treatment of such diseases.
The Color Difference between Differentiated Early Gastric Cancer and Suspicious Mucosal Areas on Linked Color Imaging
Authors: Kanzaki Hiromitsu , Kawahara Yoshiro , Okada Hiroyuki
Published: November 2019

Background: Image enhanced endoscopy (IEE) contributes to the early detection of gastrointestinal cancer. IEE enhances the color between a lesion and the background mucosa. Linked color imaging (LCI), a novel form of IEE, is a unique system for enhancing color and some studies have demonstrated the efficacy of LCI in the diagnosis of early gastric cancer (EGC) based on the color difference between cancer and the background mucosa. However, the effect may increase the area in which cancer is suspected and lead to an increase in false-positive results. Summary: We conducted a retrospective study of linked color images of differentiated EGC and suspicious mucosal areas to compare the colors between each lesion. Images of 38 EGCs and 23 suspicious areas were analyzed. The mean color values of EGC were as follows; L*(lightness), 61.7; a*(green to red), 41.2; and b*(blue to yellow), 27.1. Those of suspicious mucosal areas were as follows; L*, 56.1; a*, 44.2; and b*, 21.3. EGC had significantly higher L*, b* values and lower a* values in comparison to suspicious mucosal areas. EGC and suspicious mucosal areas had significantly higher a* values in comparison to the background mucosa. Key Messages: EGC had higher b* values in comparison to suspicious mucosal areas, and was not only reddish but also mixed with yellow, with an orange-like color.
Completion Rates and Clinical Changes of Patients Seeking Non-Invasive Treatment for Low Back Pain in 13 Centres of a Sports Medicine Institute in India
Authors: Rajamani Priyadarshini , Shewade Hemant Deepak , Kundu Debashish , Sekaran Kishore Kumar , Amalan Santhanam Daniel , Pugazhendi Sujatha , Pugazhendi Kannan
Published: November 2019

Background/Aim: Low back pain (LBP) is the major cause of disability worldwide. The existing treatments are expensive and associated with complications. The present study aimed to determine the proportion of patients completing therapy and rehabilitation phases and describe the changes in self-reported symptoms and functional disability among LBP patients enrolled in a private sports medicine institute. Methods: This is a cohort study involving review of case records. We studied 2 phases out of 3 of non-invasive treatment of LBP: therapy of around 10 days (myofascial trigger point release therapy, cryotherapy, aqua therapy and acupuncture) and rehabilitation of around 3 weeks (muscle strengthening exercises). Results: A total of 443 patients were enrolled; their mean (SD) age was 46 (15) years, 46% were male, and 193 (44%) presented with chronic (>6 months) pain. The numbers of patients who completed the therapy and rehabilitation phases were 327 (74%) and 115 (26%), respectively. The median (IQR) visual analogue scale pain scores were 7 (6–9) at entry, 2 (1–3) at completion of therapy and 1 (0–2) at completion of rehabilitation (p < 0.001). The median (IQR) functional disability scores were 32 (22–53) at entry, 15 (6–26) at completion of therapy and 4 (0–14) at completion of rehabilitation (p < 0.001). Conclusion: Low completion rates were observed. Patients who completed therapy reported reduction in pain and improved functionalities.
The Immune Microenvironment in Breast Carcinoma: Predictive and Prognostic Role in the Neoadjuvant Setting
Authors: Badr Nahla M. , Berditchevski Fedor , Shaaban Abeer M.
Published: November 2019

The prognostic value of the immune cell infiltrate in the breast carcinoma microenvironment is still uncertain. We reviewed published articles analysing the infiltration of inflammatorycells in the microenvironment of breast carcinoma. Data revealed the importance of infiltration of these immune cells in the prognosis of breast carcinoma, particularly the triple-negative and HER2-positive phenotypes. Tumour-infiltrating lymphocytes and their subtypes play a fundamental role in predicting the pathological complete response (pCR) to neoadjuvant chemotherapy. More research aiming to dissect a complex network of communication between cancer cells and other cellular components of the tumour microenvironment is necessary to develop more effective therapeutic approaches.
The Clinicopathological Features of Papillary Thyroid Carcinoma Patients with Positive Hepatitis B Surface Antigen
Authors: Zhong Zhenwei , Yuan Jiru , Chen Xiaohang , Chen Zhengbo , Du Jialin , Chen Zhijian , Kuang Jian , Cong Shuzhen , Li Jinghua , Wu Zeyu
Published: November 2019

Background: Hepatitis B virus infection has been reported to be associated with some kinds of cancer. The aim of this study was to investigate clinicopathological features of papillary thyroid carcinoma (PTC) patients with positive hepatitis B surface antigen (HBsAg). Materials and Methods: A total of 569 PTC patients were analyzed retrospectively in this study. The relationships of HBsAg with clinicopathologic features of PTC were analyzed by univariate analysis. The relationships of central lymph node metastasis (CLNM) with clinicopathological features of PTC were analyzed by univariate and multivariate logistic regression analysis. Results: The incidence of CLNM in PTC with positive HBsAg was higher than that in PTC with negative HBsAg (71.4 vs. 60.0%, p = 0.047). Univariate analysis showed that positive HBsAg was significantly associated with bilateral tumors (p = 0.043) and lymph node metastasis (LNM) (p = 0.047) in PTC patients. In addition, the incidence of CLNM in patients with PTC was 61.7% (351 of 569 cases). Univariate analysis showed that CLNM of patients with PTC was significantly associated with positive HBsAg (p = 0.047). Multivariate logistic regression analysis revealed that positive HBsAg (p = 0.038) was an independent predictor of CLNM in patients with PTC. Conclusions: The incidence of CLNM in PTC patients with positive HBsAg was significantly higher than that of patients with negative HBsAg. Positive HBsAg was correlated with LNM and bilateral tumors. In addition to gender, age <45 years, tumor size >2 cm, and lateral LNM, positive HBsAg was also an independent predictor of CLNM in PTC patients.
Structured Data Acquisition in Oncology
Authors: Henkel Maurice , Stieltjes Bram
Published: November 2019

Background: Demographic changes and improvement in therapy have shifted the focus of treatment towards chronic diseases and multiple health conditions. This has caused a tremendous increase in data per patient that needs to be integrated longitudinally and across departmental silos. The general increase in the volume of data per diagnostic examination and the number of diagnostic procedures per diagnostic pathway additionally accentuate this data integration challenge. Summary: Subspecialization in medicine has led to largely autonomously organized departments with in­dependent IT ecosystems. This patchwork of IT infrastructure is not prepared to meet the data integration challenge. The resulting lack of integrated information makes the treatment of chronically ill patients increasingly difficult and error prone. Key Message: A sustainable method for data ac­quisition is needed to aid multimodal treatment and improve efficiency in healthcare.
Defining the Anatomy of the Vagus Nerve and Its Clinical Relevance for the Neurosurgical Treatment of Glossopharyngeal Neuralgia
Authors: Krüger Marie T. , Dong Charles C.J. , Honey Christopher R.
Published: November 2019

The neurosurgical treatment of glossopharyngeal neuralgia includes microvascular decompression or rhizotomy of the nerve. When considering open section of the glossopharyngeal nerve, numerous authors have recommended additional sectioning of the ‘upper rootlets’ of the vagus nerve because these fibers can occasionally carry the pain fibers causing the patient’s symptoms. Sacrifice of vagus nerve rootlets, however, carries the potential risk of dysphagia and dysphonia. In this study, the anatomy and physiology of the vagus nerve rootlets are characterized to provide guidance for surgical decision-making. Twelve patients who underwent posterior fossa craniotomy with intraoperative electrophysiological monitoring of the vagus nerve rootlets were included in this study. In the 7 patients with glossopharyngeal neuralgia, the clinical outcomes and complications were further analyzed. In half of the patients, electrophysiological data demonstrated pure sensory function in the rostral rootlet(s) of the vagus nerve and motor responses in its caudal rootlets. This orientation of the vagus nerve, with some pure sensory function in its most rostral rootlet(s), was defined as Type A. In the other half of patients, all vagus nerve rootlets (including the most rostral) had motor responses. This was defined as Type B. The surgical strategy was guided by whether the patient had a Type A or Type B vagus nerve. For those with Type B, no vagus nerve rootlets were sacrificed. None of the patients with glossopharyngeal neuralgia developed any permanent neurological deficits. We recommend intraoperative electrophysiological testing of the vagus nerve rootlets. If the testing reveals motor innervation in the rostral vagal rootlet (Type B), that rootlet may be decompressed but should not be sectioned to avoid a motor complication. Patients with pure sensory innervation of the rostral rootlet(s) (Type A) can have decompression or section of those rootlets without complication.
Increased Alkaline Phosphatase in Cord Blood of Obese Diabetic Mothers Is Associated to Polyunstaurated Fatty Acid Levels
Authors: Prieto-Sánchez María T. , Blanco-Carnero José E. , Ruiz-Palacios María , Pagán Ana , Ruiz-Alcaraz Antonio J. , Larqué Elvira
Published: November 2019

Introduction: Recent studies indicate that alkaline phosphatase (ALP) may affect expression and activity of fatty acid (FA) transport proteins in placenta and other tissues. Objective: To evaluate if disturbed FA profile in offspring of gestational diabetes mellitus (GDM) with different maternal pregestational weight could be related to maternal or neonatal ALP. Methods: Prospective observational study of pregnant women recruited in the third trimester (25 controls, 23 lean-GDM, 20 obese-GDM). Fetal ultrasound was performed. At delivery, FAs were analyzed in placenta, maternal, and venous cord blood. Western blotting analysis of lipid carriers was performed in placenta. Results: Newborns from obese-GDM tended to higher birthweight (p = 0.059) than those from both lean-GDM and controls. ALP in maternal blood tended to be lower in GDM (p = 0.170) while increased significantly in cord blood of obese-GDM with respect to controls (p = 0.039). Saturated FA percentages in cord blood were significantly higher (p < 0.000), while polyunsaturated FA (PUFA) percentages were lower (p = 0.003) in both GDM, which could be due to a lower expression of major family domain 2a receptor (MFSD2a) in the placenta. Plasma ALP in the offspring of obese-GDM was inversely associated to cord essential PUFAs (β = –6.18, p = 0.005) and to placental MFSD2a (β = –38.46, p = 0.014). Conclusions: Cord PUFA and placental MFSD2a are decreased in both lean and obese-GDM pregnancies. Higher ALP in cord blood of obese-GDM could play a role in the FA levels in these pregnancies
Evaluation of the Site and Frequency of Lymph Node Metastasis with Non-Functioning Pancreatic Neuroendocrine Tumor
Authors: Izumo Wataru , Higuchi Ryota , Furukawa Toru , Yazawa Takehisa , Uemura Shuichiro , Shiihara Masahiro , Yamamoto Masakazu
Published: November 2019

Backgrounds: The optimal lymph node dissection range in patients with non-functioning pancreatic neuroendocrine tumors is not yet clear. In this study, we investigated the site and frequency of lymph node metastasis and the significance of lymph node dissection in patients with non-functioning pancreatic neuroendocrine tumors. Methods: This retrospective study analyzed 74 patients who underwent a curative pancreatectomy for non-functioning pancreatic neuroendocrine tumors between 2000 and 2016. The site and frequency of lymph node metastasis and clinicopathological factors were evaluated. Results: The rate of synchronous lymph node metastasis was 17.6%, with 11.1 and 29.4% for tumors with diameters of 10–19 mm and ≥20 mm, respectively. Lymph node metastasis was not observed for tumors with a diameter <10 mm. Lymph node metastasis was observed along the anterior (17a: 13.3%, 17b: 12.5%) and posterior (13a: 5.9%, 13b: 26.7%) surfaces of the pancreatic head and the superior mesenteric artery (14p: 12.5%, 14d: 7.7%) in patients with non-functioning pancreatic head neuroendocrine tumors, in the common hepatic (8a: 5.3%), splenic (10: 14.3%, 11p: 17.6%, 11d: 12.5%), and super mesenteric artery (14d: 14.3%) in patients with non-functioning pancreatic body neuroendocrine tumors, and only in the splenic artery (11p: 8.3%, 11d: 7.7%) in patients with non-functioning pancreatic tail neuroendocrine tumors. Grade 2 (HR = 6.21) and synchronous lymph node metastasis (HR = 10.4) were significant risk factors for disease-free survival. The 5-year disease-free survival was 95.7, 72.6, and 0% in patients with 0, 1, and 2 prognostic factors, respectively. Conclusions: This study clarified the site and frequency of lymph node metastasis and the optimal range of lymph node dissection in patients with non-functioning pancreatic neuroendocrine tumors.
Hyponatremia in Acute Stroke Patients: Pathophysiology, Clinical Significance, and Management Options
Authors: Liamis George , Barkas Fotios , Megapanou Efstathia , Christopoulou Eliza , Makri Andromachi , Makaritsis Konstantinos , Ntaios George , Elisaf Moses , Milionis Haralampos
Published: November 2019

Background: Hyponatremia is frequent in acute stroke patients, and it is associated with worse outcomes and increased mortality. Summary: Nonstroke-related causes of hyponatremia include patients’ comorbidities and concomitant medications, such as diabetes mellitus, chronic kidney disease, heart failure, and thiazides. During hospitalization, “inappropriate” administration of hypotonic solutions, poor solute intake, infections, and other drugs, such as mannitol, could also lower sodium levels in patients with acute stroke. On the other hand, secondary adrenal insufficiency due to pituitary ischemia or hemorrhage, syndrome of inappropriate antidiuretic hormone secretion, and cerebral salt wasting are additional stroke-related causes of hyponatremia. Although it is yet unclear whether the appropriate restoration of sodium level improves outcomes in patients with acute stroke, the restoration of the volume depletion remains the cornerstone of treatment in hypovolemic hyponatremia. In case of hyper- and euvolemic hyponatremia, apart from the correction of the underlying cause (e.g., withdrawal of an offending drug), fluid restriction, administration of hypertonic solution, loop diuretics, and vasopressin-receptor antagonists (vaptans) are among the therapeutic options. Key Messages: Hyponatremia is frequent in patients with acute stroke. The plethora of underlying etiologies warrants a careful differential diagnosis which should take into consideration comorbidities, concurrent medication, findings from the clinical examination, and laboratory measurements, which in turn will guide management decisions. However, it is yet unclear whether the appropriate restoration of sodium level improves outcomes in patients with acute stroke.
Synthetic ablations in the C. elegans nervous system
Authors: Towlson Emma K. , Barabási Albert-László
Published: November 2019

Synthetic lethality, the finding that the simultaneous knockout of two or more individually nonessential genes leads to cell or organism death, has offered a systematic framework to explore cellular function, and also offered therapeutic applications. Yet the concept lacks its parallel in neuroscience—a systematic knowledge base on the role of double or higher order ablations in the functioning of a neural system. Here, we use the framework of network control to systematically predict the effects of ablating neuron pairs and triplets on the gentle touch response. We find that surprisingly small sets of 58 pairs and 46 triplets can reduce muscle controllability in this context, and that these sets are localized in the nervous system in distinct groups. Further, they lead to highly specific experimentally testable predictions about mechanisms of loss of control, and which muscle cells are expected to experience this loss.
Scholars, Spice Traders, and Sultans: Arguing over the Alms-Tax in the Mamluk Era
Authors: Blecher Joel
Published: November 2019

Amidst the politics of the Mamluk-era spice route, why did the standard-bearers of Islamic law routinely oppose the sultanate’s imposition of an alms-tax on merchandise (zakāt al-tijāra), despite the abundance of support for such a tax within the classical tradition of Islamic law? Rather than contending – as some modern scholars have – that prominent jurists developed loopholes that circumvented the original intent of the law to protect the wealthy and the ruling class, I argue that it was precisely the jurists’ careful defense of exemptions and exclusions that allowed them to define the essence of zakāt against forms of taxation they considered unlawful. By narrowing the scope of zakāt, jurists attempted to achieve a moral aim that went beyond the ritual purification of wealth: a limit on the sultanate’s otherwise arbitrary power to tax Muslims as it wished. In doing so, they alleviated some of the tax burden for spice merchants and camel herders alike.
Morphological and molecular characterisation of Aporcelinus zapotitlanensis sp. n. (Dorylaimida: Aporcelaimidae) from central Mexico
Authors: Mejía-Madrid Hugo H. , Peña-Santiago Reyes
Published: November 2019

A new species of Aporcelinus, collected in a natural habitat of central Mexico, is described and illustrated, including molecular (D2-D3 28S-rRNA) data. Aporcelinus zapotitlanensis sp. n. is characterised by its 1.19-1.43 mm long body, lip region offset by a deep constriction and 16.5-18.5 μm broad, odontostyle 19.5-22 long, neck 325-368 μm long, pharyngeal expansion 150-201 μm long or 46-55% of the total neck length, uterus 130-167 μm long and tripartite, V = 54-56, tail conical with finely rounded tip (30-37 μm, c = 34-43, c′ = 1.2-1.4) lacking a distinct dorsal concavity, spicules 48-51 μm long, and 11-12 spaced ventromedian supplements with one or two of them located within the range of the spicules. Molecular analyses confirm the monophyly of Aporcelinus and places the new species within a clade shared with A. infundibulicaudatus and A. amazonicus.
Une interprétation politique de la représentation pontificale en Syrie et au Liban
Authors: Coquet Édouard
Published: November 2019

Au début du mandat français en Syrie et au Liban, le Saint-Siège renouvelle ses objectifs et ses moyens d’ action dans la région. Nous avons étudié ce mouvement à travers les lettres adressées à Rome par Mgr Frediano Giannini, vicaire apostolique d’ Alep et délégué apostolique en Syrie de 1905 à 1936. Les rapports de Giannini constituent un bon exemple de la manière dont les missionnaires participent à la production de connaissances sur les communautés chrétiennes orientales. En rendant compte des épreuves et des migrations qui leur sont imposées, Giannini participe au développement d’ une nouvelle perception de ces communautés, vues comme des minorités persécutées. Giannini sollicite les autorités françaises pour défendre les intérêts des chrétiens (à la fois les catholiques et les orthodoxes). Sa position est ambiguë : alors qu’ il exprime sa nostalgie au sujet du fonctionnement traditionnel du protectorat français, Giannini s’ implique lui-même dans le domaine politique et prend en charge une partie de l’ ancien rôle des Français. Cette ambivalence révèle l’ émergence d’ une nouvelle politique pontificale, fondée sur un double mouvement d’ autonomisation et de centralisation.
A Causality-Based View of the Interaction between Synoptic- and Planetary-Scale Atmospheric Disturbances
Authors: Samarasinghe Savini M. , Deng Yi , Ebert-Uphoff Imme
Published: November 2019

This paper reports preliminary yet encouraging findings on the use of causal discovery methods to understand the interaction between atmospheric planetary- and synoptic-scale disturbances in the Northern Hemisphere. Specifically, constraint-based structure learning of probabilistic graphical models is applied to the spherical harmonics decomposition of the daily 500-hPa geopotential height field in boreal winter for the period 1948–2015. Active causal pathways among different spherical harmonics components are identified and documented in the form of a temporal probabilistic graphical model. Since, by definition, the structure learning algorithm used here only robustly identifies linear causal effects, we report only causal pathways between two groups of disturbances with sufficiently large differences in temporal and/or spatial scales, that is, planetary-scale (mainly zonal wavenumbers 1–3) and synoptic-scale disturbances (mainly zonal wavenumbers 6–8). Daily reconstruction of geopotential heights using only interacting scales suggest that the modulation of synoptic-scale disturbances by planetary-scale disturbances is best characterized by the flow of information from a zonal wavenumber-1 disturbance to a synoptic-scale circumglobal wave train whose amplitude peaks at the North Pacific and North Atlantic storm-track region. The feedback of synoptic-scale to planetary-scale disturbances manifests itself as a zonal wavenumber-2 structure driven by synoptic-eddy momentum fluxes. This wavenumber-2 structure locally enhances the East Asian trough and western Europe ridge of the wavenumber-1 planetary-scale disturbance that actively modulates the activity of synoptic-scale disturbances. The winter-mean amplitude of the actively interacting disturbances are characterized by pronounced fluctuations across interannual to decadal time scales.
The increase in non-marital childbearing and its link to educational expansion
Authors: Schnor Christine , Jalovaara Marika
Published: November 2019

The increase in non-marital childbearing has coincided with educational expansion, although non-marital childbirths are more common among the low-educated population. This article quantifies the contribution of changes in education-specific rates of non-marital childbearing and educational distribution of parents to increases in non-marital childbearing among Finnish first-time parents over the period 1970–2009. Using Finnish register data on first-time mothers ( N = 112,730) and fathers ( N = 108,812), the study decomposes changes in the proportion of non-marital first childbearing in pairwise comparisons of successive decades for four educational segments: low educated (International Standard Classification of Education (ISCED) 0–2), medium educated (ISCED 3–4), lower tertiary educated (ISCED 5–6) and upper tertiary educated (ISCED 7–8). The findings show that the increase in non-marital first-time births was mainly attributable to the large population of medium-educated women and men and the growing segment of lower tertiary-educated women. The highest proportion of non-marital first-time childbearing remained among the low-educated population, but diminishing group size meant their overall contribution was small. The growing upper tertiary-educated population increased its contribution to non-marital childbearing but still exhibited the lowest non-marital childbearing rates. We conclude that the medium-educated population merits increased scholarly attention for its important contribution to population-level changes.
Ketamine for suicidal ideation in adults with psychiatric disorders: A systematic review and meta-analysis of treatment trials
Authors: Witt Katrina , Potts Jennifer , Hubers Anna , Grunebaum Michael F , Murrough James W , Loo Colleen , Cipriani Andrea , Hawton Keith
Published: November 2019

Objective:

Ketamine may reduce suicidal ideation in treatment-resistant depression. But it is not known how quickly this occurs and how long it persists. We undertook a systematic review and meta-analysis to determine the short- and long-term effectiveness of ketamine for suicidality.

Method:

CENTRAL, EMBASE, Medline, and PsycINFO were searched until 12 December 2018. Randomised controlled trials of ketamine or esketamine reporting data on suicidal ideation, self-harm, attempted or completed suicide in adults diagnosed with any psychiatric disorder were included. Two reviewers independently extracted data, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. Standardised mean difference was used for continuous outcomes.

Results:

Twenty-five reports from 15 independent trials, with a total of 572 participants diagnosed with predominately affective disorders, were included. The evidence was rated moderate to low. In most trials, ketamine was administered at 0.5 mg/kg via a single intravenous infusion over a 30- to 45-minute period. Only a single trial of intranasal esketamine was identified. At 4 hours post-infusion, treatment with ketamine was associated with a significant reduction in suicidal ideation scores (standardised mean difference = −0.51, 95% confidence interval = [−1.00, −0.03]), which persisted until 72 hours post-infusion (time points between 12 and 24 hours: standardised mean difference = −0.63, 95% confidence interval = [−0.99, −0.26]; between 24 and 72 hours: standardised mean difference = −0.57, 95% confidence interval = [−0.99, −0.14]), but not thereafter. However, there was marked heterogeneity of results. In a single trial of esketamine, marginal effects on suicidal ideation were observed. In terms of actual suicidal behaviour, there were virtually no data on effects of ketamine or esketamine.

Conclusion:

A single infusion of ketamine may have a short-term (up to 72 hours) beneficial impact on suicidal thoughts. While confirmation of these results in further trials is needed, they suggest possible use of ketamine to treat acute suicidality. Means of sustaining any anti-suicidal effect need to be found.
Dream Adjusters: High School Counselors in a Low-Income School District
Authors: Monaghan David B. , Hawkins Jamie , Hernandez Anthony
Published: November 2019

Prior research has discussed high school counselors’ role in students’ experience, but counselors’ understandings of their work and of students has received little commentary. We interviewed counselors in a high-poverty, low-performing urban school district in which two structural elements shape how counselors make sense of their work. First, counselor “success” is contingent on convincing students to act in (what schools see as) students’ own best interest, and many students do not do so. Second, resource constraints severely limit planned one-on-one counseling. We find that counselors see students as both victims of crushing circumstances and as agents actively undermining their own opportunities, as holding ambitions misaligned with performance and as vulnerable to despair. Counselors’ strategies follow from these conceptions: building self-efficacy, emphasizing the importance of goals, and nudging plans toward realizability while maintaining hope. We discuss how counselors cope with the rarity with which they experience professional “success,” given student outcomes.
A Theories-in-Use Approach to Building Marketing Theory
Authors: Zeithaml Valarie A. , Jaworski Bernard J. , Kohli Ajay K. , Tuli Kapil R. , Ulaga Wolfgang , Zaltman Gerald
Published: November 2019

This article’s objective is to inspire and provide guidance on the development of marketing knowledge based on the theories-in-use (TIU) approach. The authors begin with a description of the TIU approach and compare it with other inductive and deductive research approaches. The benefits of engaging in TIU-based research are discussed, including the development of novel organic marketing theories and the opportunity to cocreate relevant marketing knowledge with practitioners. Next, they review criteria for selecting research questions that are particularly well-suited for examination with TIU-based research. This is followed by detailed suggestions for TIU research: focusing on developing new constructs, theoretical propositions (involving antecedents, moderators, and consequences), and arguments for justifying theoretical propositions. A discussion of TIU tradecraft skills, validity checks, and limitations follows. The authors close with a discussion of future theory-building opportunities using the TIU approach.
Criminal Records, Positive Employment Credentials, and Race
Authors: DeWitt Samuel E. , Denver Megan
Published: November 2019

Objectives:

To assess the impact of positive credentials on perceptions of individuals with criminal records and whether the effects of credentials differ by the type of conviction or the criminal record holder’s race.

Methods:

We present fictional job applicant details to a nationwide survey of American adults ( n = 5,822) using a factorial design. We manipulate whether the job applicant is Black or White and has a criminal record or not. Among those randomly assigned to have a criminal record, we also vary the type of felony (violent or drug), whether they report a positive credential, and the type of credential (if applicable).

Results:

Among those with criminal records, respondents viewed applicants with positive credentials more favorably than those without credentials. In fact, a supportive reference letter from a former employer mitigates most of the stigma from a criminal record. The results are consistent by applicant race as well as criminal record type, and our employer respondents react similarly to experimental conditions as compared to the overall sample.

Conclusions:

Our results suggest that the inclusion of positive credentials can help reduce criminal record stigma and aid in the normification process.