bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of Deescalation Failure in Critically Ill Patients with Sepsis: A Prospective Cohort Study
Authors: Salahuddin Nawal , Amer Lama , Joseph Mini , El Hazmi Alya , Hawa Hassan , Maghrabi Khalid
Published: July 2016

Introduction.Deescalationrefers to either discontinuation or a step-down of antimicrobials. Despite strong recommendations in the Surviving Sepsis Guidelines (2012) to deescalate, actual practices can vary. Our objective was to identify variables that are associated with deescalation failure.Methods. In this prospective study of patients with sepsis/septic shock, patients were categorized into 4 groups based on antibiotic administration:no changein antibiotics,deescalation,escalation(where antibiotics were changed to those with a broader spectrum of antimicrobial coverage), ormixed changes(where both escalation to a broader spectrum of coverage and discontinuation of antibiotics were carried out).Results. 395 patients were studied; mean APACHE II score was24±7.8. Antimicrobial deescalation occurred in 189 (48%) patients; no changes were made in 156 (39%) patients. On multivariate regression analysis, failure to deescalate was significantly predicted by hematologic malignancy OR 3.3 (95% CI 1.4–7.4)p<0.004, fungal sepsis OR 2.7 (95% CI 1.2–5.8)p=0.011, multidrug resistance OR 2.9 (95% CI 1.4–6.0)p=0.003, baseline serum procalcitonin OR 1.01 (95% CI 1.003–1.016)p=0.002, and SAPS II scores OR 1.01 (95% CI 1.004–1.02)p=0.006.Conclusions. Current deescalation practices reflect physician reluctance when dealing with complicated, sicker patients or with drug-resistance or fungal sepsis. Integrating an antibiotic stewardship program may increase physician confidence and provide support towards increasing deescalation rates.
Berberine Protects Human Umbilical Vein Endothelial Cells against LPS‐Induced Apoptosis by Blocking JNK‐Mediated Signaling
Authors: Guo Junping , Wang Lijun , Wang Linyao , Qian Senmi , Zhang Dayong , Fang Jie , Pan Jianping
Published: July 2016

Endothelial dysfunction is a critical factor during the initiation of atherosclerosis. Berberine has a beneficial effect on endothelial function; however, the underlying mechanisms remain unclear. In this study, we investigated the effects of berberine on lipopolysaccharide‐ (LPS‐) induced apoptosis in human umbilical vein endothelial cells (HUVECs) and the molecular mechanisms mediating the effect. The effects of berberine on LPS‐induced cell apoptosis and viability were measured with 5‐ethynyl‐2′‐deoxyuridine staining, flow cytometry, and Cell Counting Kit‐8 assays. The expression and/or activation of proapoptotic and antiapoptotic proteins or signaling pathways, including caspase‐3, poly(ADP‐ribose) polymerase, myeloid cell leukemia‐1 (MCL‐1), p38 mitogen‐activated protein kinase, C‐Jun N‐terminal kinase (JNK), and extracellular signal‐regulated kinase, were determined with western blotting. The malondialdehyde levels, superoxide dismutase (SOD) activity, and production of proinflammatory cytokines were measured with enzyme‐linked immunosorbent assays. The results demonstrated that berberine pretreatment protected HUVECs from LPS‐induced apoptosis, attenuated LPS‐induced injury, inhibited LPS‐induced JNK phosphorylation, increased MCL‐1 expression and SOD activity, and decreased proinflammatory cytokine production. The effects of berberine on LPS‐treated HUVECs were prevented by SP600125, a JNK‐specific inhibitor. Thus, berberine might be a potential candidate in the treatment of endothelial cell injury‐related vascular diseases.
Molding Properties of Inconel 718 Feedstocks Used in Low-Pressure Powder Injection Molding
Authors: Fareh Fouad , Demers Vincent , Demarquette Nicole R. , Turenne Sylvain , Scalzo Orlando
Published: July 2016

The impact of binders and temperature on the rheological properties of feedstocks used in low-pressure powder injection molding was investigated. Experiments were conducted on different feedstock formulations obtained by mixing Inconel 718 powder with wax-based binder systems. The shear rate sensitivity index and the activation energy were used to study the degree of dependence of shear rate and temperature on the viscosity of the feedstocks. The injection performance of feedstocks was then evaluated using an analytical moldability model. The results indicated that the viscosity profiles of feedstocks depend significantly on the binder constituents, and the secondary binder constituents play an important role in the rheological behavior (pseudoplastic or near-Newtonian) exhibited by the feedstock formulations. Viscosity values as low as 0.06 to 2.9 Pa·s were measured at high shear rates and high temperatures. The results indicate that a feedstock containing a surfactant agent exhibits the best moldability characteristics.
An Effective and Feasible Method, “Hammering Technique,” for Percutaneous Fixation of Anterior Column Acetabular Fracture
Authors: Zhang Lihai , Yin Peng , Zhang Wei , Li Tongtong , Li Jiantao , Chen Hua , Yao Qi , Tang Peifu
Published: July 2016

Objective. The objective of this study was to evaluate the effectiveness and advantages of percutaneous fixation of anterior column acetabular fracture with “hammering technique.”Materials and Methods. We retrospectively reviewed 16 patients with percutaneous fixation of anterior column acetabular fracture with “hammering technique.” There were 11 males and 5 females with an average age of 38.88 years (range: 24–54 years) in our study. Our study included 7 nondisplaced fractures, 6 mild displaced fractures (<2 mm), and 5 displaced fractures (>2 mm). The mean time from injury to surgery was 4.5 days (range: 2–7 days).Results. The average of operation time was 27.56 minutes (range: 15–45 minutes), and the mean blood loss was 55.28 mL (range: 15–100 mL). The mean fluoroscopic time was 54.78 seconds (range: 40–77 seconds). The first pass of the guide wire was acceptable without cortical perforation or intra-articular perforation in 88.89% (16/18) of the procedures, and the second attempt was in 11.11% (2/18).Conclusion. Our study suggested that percutaneous fixation of anterior column acetabular fracture with “hammering technique” acquired satisfying surgical and clinical outcomes. It may be an alternative satisfying treatment for percutaneous fixation of anterior column acetabular fracture by 2D fluoroscopy using a C-arm with less fluoroscopic time.
Generalized Anxiety Disorder and Hypoglycemia Symptoms Improved with Diet Modification
Authors: Aucoin Monique , Bhardwaj Sukriti
Published: July 2016

Observational evidence suggests that a relationship may exist between high glycemic index diets and the development of anxiety and depression symptoms; however, as no interventional studies assessing this relationship in a psychiatric population have been completed, the possibility of a causal link is unclear. AB is a 15-year-old female who presented with concerns of generalized anxiety disorder and hypoglycemia symptoms. Her diet consisted primarily of refined carbohydrates. The addition of protein, fat, and fiber to her diet resulted in a substantial decrease in anxiety symptoms as well as a decrease in the frequency and severity of hypoglycemia symptoms. A brief return to her previous diet caused a return of her anxiety symptoms, followed by improvement when she restarted the prescribed diet. This case strengthens the hypothesis that dietary glycemic index may play a role in the pathogenesis or progression of mental illnesses such as generalized anxiety disorder and subsequently that dietary modification as a therapeutic intervention in the treatment of mental illness warrants further study.
Comparison of Perioperative Ranibizumab Injections for Diabetic Macular Edema in Patients Undergoing Cataract Surgery
Authors: Yumuşak Erhan , Örnek Kemal
Published: July 2016

Purpose. To compare the efficacy of perioperative ranibizumab injections on diabetic macular edema (DME) in patients undergoing cataract surgery.Methods. This study included 59 eyes of 59 patients. All patients had advanced cataract with DME and underwent an uneventful phacoemulsification surgery. There were 3 subgroups. The first group received intravitreal ranibizumab injection 2 weeks preoperatively, the second group received intraoperatively, and the third group received 2 weeks postoperatively. Follow-up examinations were performed at 1 week as well as at 1 and 3 months.Results. Baseline visual acuity showed a significant increase in all groups at 1 month. In group 1, compared to baseline value, foveal thickness (FT) increased significantly at 1 month and showed a significant decrease up to month 3. In group 2, FT increased at month 1 and this continued up to month 3. In group 3, FT increased at month 1 and was almost stable up to month 3. There were not any significant differences for visual acuity and FT between the groups.Conclusions. Although intrapostoperative ranibizumab injection for DME seems to be more effective than preoperative injections in patients undergoing cataract surgery, the treatment still needs to be continued following surgery.
Structural Analysis and Magnetic Properties of FeCo Alloys Obtained by Mechanical Alloying
Authors: Sánchez-De Jesús F. , Bolarín-Miró A. M. , Cortés Escobedo C. A. , Torres-Villaseñor G. , Vera-Serna P.
Published: July 2016

A systematic study on the structural and magnetic properties of Fe100-xCox alloys (10<x<90, Δx=10 in wt. percent) obtained by mechanical alloying is presented. Elemental powders of Fe and Co mixed in an adequate weight ratio were milled at room temperature in a shaker mixer mill using vials and balls of hardened steel as milling media with a ball : powder weight ratio of 12 : 1. The mixtures were milled for 3 h. The results show that, after milling, for almost all the composition (up to x=60), solid solutions based on bcc structures were obtained. For Co-rich alloys (x≥70), different phases were found, revealing the formation of a metastable intermetallic phase (FeCo, wairauite) together with fcc-Co and hcp-Co phases. The specific saturation magnetization increases by increasing Co content, reaching a maximum value of 225 emu/g for hcp-Fe70Co30, and then it shows a diminution up to 154 emu/g for bcc-Fe30Co70. All studied alloys (Fe100-xCox) present low coercivity, in the range from 0 to 65 Oe, which is lower than reported. The coercivity increases with the increment in Co, reaching a maximum of 64.1 Oe for Fe40Co60. After that, the coercivity falls up to 24.5 Oe for Co-rich alloys, which make them a very low coercive material.
An Update on Inflamm-Aging: Mechanisms, Prevention, and Treatment
Authors: Xia Shijin , Zhang Xinyan , Zheng Songbai , Khanabdali Ramin , Kalionis Bill , Wu Junzhen , Wan Wenbin , Tai Xiantao
Published: July 2016

Inflamm-aging is a challenging and promising new branch of aging-related research fields that includes areas such as immunosenescence. Increasing evidence indicates that inflamm-aging is intensively associated with many aging diseases, such as Alzheimer’s disease, atherosclerosis, heart disease, type II diabetes, and cancer. Mounting studies have focused on the role of inflamm-aging in disease progression and many advances have been made in the last decade. However, the underlying mechanisms by which inflamm-aging affects pathological changes and disease development are still unclear. Here, we review studies of inflamm-aging that explore the concept, pathological features, mechanisms, intervention, and the therapeutic strategies of inflamm-aging in disease progression.
In VitroBioactivity Study of RGD-Coated Titanium Alloy Prothesis for Revision Total Hip Arthroplasty
Authors: Man Zhentao , Sha Dan , Sun Shui , Li Tao , Li Bin , Yang Guang , Zhang Laibo , Wu Changshun , Jiang Peng , Han Xiaojuan , Li Wei
Published: July 2016

Total hip arthroplasty (THA) is a common procedure for the treatment of end-stage hip joint disease, and the demand for revision THA will double by 2026. Ti6Al4V (Titanium, 6% Aluminum, and 4% Vanadium) is a kind of alloy commonly used to make hip prothesis. To promote the osseointegration between the prothesis and host bone is very important for the revision THA. The peptide Arg-Gly-Asp (RGD) could increase cell attachment and has been used in the vascular tissue engineering. In this study, we combined the RGD with Ti6Al4V alloy using the covalent cross-linking method to fabricate the functional Ti6Al4V alloy (FTA). The distribution of RGD oligopeptide on the FTA was even and homogeneous. The FTA scaffolds could promote mouse osteoblasts adhesion and spreading. Furthermore, the result of RT-qPCR indicated that the FTA scaffolds were more beneficial to osteogenesis, which may be due to the improvement of osteoblast adhesion by the RGD oligopeptide coated on FTA. Overall, the FTA scaffolds developed herein pave the road for designing and building more efficient prothesis for osseointegration between the host bone and prothesis in revision THA.
Resuscitating the Baby after Shoulder Dystocia
Authors: Menticoglou Savas , Schneider Carol
Published: July 2016

Background. To propose hypovolemic shock as a possible explanation for the failure to resuscitate some babies after shoulder dystocia and to suggest a change in clinical practice.Case Presentation. Two cases are presented in which severe shoulder dystocia was resolved within five minutes. Both babies were born without a heartbeat. Despite standard resuscitation by expert neonatologists, no heartbeat was obtained until volume resuscitation was started, at 25 minutes in the first case and 11 minutes in the second. After volume resuscitation circulation was restored, there was profound brain damage and the babies died.Conclusion.Unsuspected hypovolemic shock may explain some cases of failed resuscitation after shoulder dystocia. This may require a change in clinical practice. Rather than immediately clamping the cord after the baby is delivered, it is proposed that (1) the obstetrician delay cord clamping to allow autotransfusion of the baby from the placenta and (2) the neonatal resuscitators give volume much sooner.
Morel-Lavallée Lesion of the Knee in a Recreational Frisbee Player
Authors: Shmerling Alison , Bravman Jonathan T. , Khodaee Morteza
Published: July 2016

Traumatic swelling/effusion in the knee region is a relatively common presenting complaint among athletes and nonathletes. Due to its broad differential diagnosis, a comprehensive evaluation beginning with history and physical examination are recommended. Knee joint effusion can be differentiated from other types of swelling by careful physical examination. Imaging, including plain radiography, ultrasound, and magnetic resonance imaging (MRI), is preferred modality. Aspiration of a local fluctuating mass may help with the diagnosis and management of some of these conditions. We present a case of a 26-year-old gentleman with superomedial Morel-Lavallée lesion (MLL) of the knee with history of a fall during a Frisbee game. His MLL was successfully treated with therapeutic aspiration and compression wrap without further sequelae. MLL is a rare condition consisting of a closed degloving injury caused by pressure and shear stress between the subcutaneous tissue and the superficial fascia or bone. Most commonly, MLL is found over the greater trochanter and sacrum but in rare cases can occur in other regions of the body. In most cases, concurrent severe injury mechanisms and concomitant fractures are present. MLL due to sports injuries are very rare. Therapeutic strategies may vary from compression wraps and aspiration to surgical evacuation.
Structural Analysis and Reactivity of Tetramethylcopper(III) Complex towards Nitrogen Donor Ligands by Density Functional Theory
Authors: Balu Perumal , Kannappan Venu , Kumar Rathinavelu
Published: July 2016

DFT studies are carried out on some ligand substitution reactions of tetramethylcuprate(III) (TMC) complex with five different nitrogen donor ligands as probe ligands. The geometry optimization of the possible nine model systems and the frequency calculations are carried out at DFT level using LANL2DZ basis set. The selected structural parameters of optimized model systems of Cu(III) complexes are reported and discussed. The change in the M-C bond distance in TMC due to substitution by probe ligands is explained. Natural population analysis (NPA) has been carried out for these complexes to establish the charge of copper in these complexes. A detailed population analysis of valence orbitals of copper complexes supports the existence of d8 configuration for metal in complexes and there is evidence for the transmission of electrons from the nitrogen donor atom to dxy, dx2-y2, and 4s orbitals. Bond order calculations have been performed for all the complexes to probe the interaction between Cu(III) and the ligand. The stability of the complexes is ascertained from the computed chemical hardness. In order to understand the nature of Cu(III)-L (L = N donors) and Cu(III)-Me bonds in different complexes, Energy Decomposition Analysis (EDA) has been carried out for all the complexes chosen in the theoretical study. Thermodynamic feasibility of these reactions is investigated in terms of free energy changes of these reactions.
A Best Proximity Point Theorem for Generalized Non-Self-Kannan-Type and Chatterjea-Type Mappings and Lipschitzian Mappings in Complete Metric Spaces
Authors: Ungchittrakool Kasamsuk
Published: July 2016

The purpose of this paper is to provide and study a best proximity point theorem for generalized non-self-Kannan-type and Chatterjea-type mappings and Lipschitzian mappings in complete metric spaces. The significant mapping in a unified form which related to contractive mappings, Kannan-type mappings, and Chatterjea-type mappings is established. We also provide some examples to illustrate the situation corresponding to the main theorem. The main result of this paper can be viewed as a general and unified form of several previously existing results.
INFIX/EXFIX: Massive Open Pelvic Injuries and Review of the Literature
Authors: Vaidya Rahul , Nasr Kerellos , Feria-Arias Enrique , Fisher Rebecca , Kajy Marvin , Diebel Lawrence N.
Published: July 2016

Introduction. Open pelvic fractures make up 2–5% of all pelvic ring injuries. Their mortality has been reported to be as high as 50%. During Operation Enduring Freedom protocols for massive open pelvic injuries lead to the survival of injuries once thought to be fatal. The INFIX is a subcutaneous anterior fixator for pelvic stabilization which is stronger than external fixation. The purpose of this paper is to describe the use of INFIX and modern algorithms for massive open pelvic injuries.Methods. An IRB approved retrospective review describes 4 cases in civilian practice with massive open pelvic injuries. We also review the modern literature on open pelvic injures.Discussion. Key components in the care of massive open pelvic injuries include hemorrhage control by clamping of the aorta or REBOA when necessary and fecal/urinary diversion. The INFIX can be used internally, as a partial INFIX partial EXFIX, or as an EXFIX. Its low profile allows for easy application of wound vacs and wound care and when subcutaneous avoids pin tract infections.Conclusion. Massive open pelvic injuries are a difficult problem. Following modern protocols can help prevent mortality.
Morphology and Functional Anatomy of the Recurrent Laryngeal Nerve with Extralaryngeal Terminal Bifurcation
Authors: Cetin Fuat , Gürleyik Emin , Dogan Sami
Published: July 2016

Anatomical variations of the recurrent laryngeal nerve (RLN), such as an extralaryngeal terminal bifurcation (ETB), threaten the safety of thyroid surgery. Besides the morphology of the nerve branches, intraoperative evaluation of their functional anatomy may be useful to preserve motor activity. We exposed 67 RLNs in 36 patients. The main trunk, bifurcation point, and terminal branches of bifid nerves were macroscopically determined and exposed during thyroid surgery. The functional anatomy of the nerve branches was evaluated by intraoperative nerve monitoring (IONM). Forty-six RLNs with an ETB were intraoperatively exposed. The bifurcation point was located along the prearterial, arterial, and postarterial segments in 11%, 39%, and 50% of bifid RLNs, respectively. Motor activity was determined in all anterior branches. The functional anatomy of terminal branches detected motor activity in 4 (8.7%) posterior branches of 46 bifid RLNs. The motor activity in posterior branches created a wave amplitude at 25–69% of that in the corresponding anterior branches. The functional anatomy of bifid RLNs demonstrated that anterior branches always contained motor fibres while posterior branches seldom contained motor fibres. The motor activity of the posterior branch was weaker than that of the anterior branch. IONM may help to differentiate between motor and sensory functions of nerve branches. The morphology and functional anatomy of all nerve branches must be preserved to ensure a safer surgery.
ATM Mutations in Cancer: Therapeutic Implications
Authors: Choi Michael , Kipps Thomas , Kurzrock Razelle
Published: July 2016

Activation of checkpoint arrest and homologous DNA repair are necessary for maintenance of genomic integrity during DNA replication. Germ-line mutations of the ataxia telangiectasia mutated (ATM) gene result in the well-characterized ataxia telangiectasia syndrome, which manifests with an increased cancer predisposition, including a 20% to 30% lifetime risk of lymphoid, gastric, breast, central nervous system, skin, and other cancers. Somatic ATM mutations or deletions are commonly found in lymphoid malignancies, as well as a variety of solid tumors. Such mutations may result in chemotherapy resistance and adverse prognosis, but may also be exploited by existing or emerging targeted therapies that produce synthetic lethal states. Mol Cancer Ther; 15(8); 1781–91. ©2016 AACR.
Co-inhibition of Angiotensin II Receptor and Endothelin-1 Attenuates Renal Injury in Unilateral Ureteral Obstructed Mice
Authors: Chang Yoon-Kyung , Choi Hyunsu , Jeong Jin Young , Na Ki-Ryang , Lee Kang Wook , Choi Dae Eun
Published: July 2016

Background/Aims: Both endothelin-1 (ET-1) and the renin-angiotensin system (RAS) may play important roles in renal fibrosis in the obstructed kidney. However, there have been few clear demonstrations of a relationship between their activation and additive or synergistic roles in renal fibrosis. We investigated the protective roles and relationship between renal RAS and ET-1 in unilateral ureteral obstruction (UUO) mice. Methods: 8-week-old male C57BL/6 mice were divided into seven groups: sham, bosentan+sham, valsartan+sham, vehicle+UUO, bosentan+UUO, valsartan+UUO, and valsartan+bosentan+UUO. Valsartan and bosentan were administered orally using an NG tube (valsartan 10 mg/kg/day, bosentan 100 mg/kg/day for 8 days, after which the molecular and structural kidney parameters were evaluated. Bosentan treatment elevated plasma renin activity, renal renin, and AT1R expression in UUO mice. Results: Although valsartan decreased plasma ET-1 in these mice, it did not affect ET(A) or ET(B) in their kidneys. Co-treatment with valsartan and bosentan decreased ET-1 in these mice compared to the single treatments. Bosentan, but not valsartan, elevated eNOS expression in their kidneys. Co-treatment with valsartan and bosentan reduced TGF-β, α-SMA, and collagen IV expression, and the Masson's trichrome stained area in their kidneys. Conclusions: Bosentan and valsartan acted complementarily, and co-treatment with both drugs had an additive protective effect against renal fibrosis.
Evaluation of Vitamin C Supplementation on Kidney Function and Vascular Reactivity Following Renal Ischemic Injury in Mice
Authors: Zhu Yao-Bin , Zhang Ya-Ping , Zhang Jing , Zhang Yan-Bo
Published: July 2016

Background/Aims: Renal ischemia/reperfusion injury (IRI) is a very common clinical event and usually leads to ischemic acute renal failure (ARF). In the present study, we investigated the protective role of vitamin C in renal function and renal arterial relaxation following ischemic injury. Methods: IRI model in mice was used. Various biochemical parameters including nitric oxide (NO), reduced glutathione (GSH), total reactive oxygen species (ROS) level and superoxide dismutase (SOD) were examined. Doppler was used to investigate renal arterial resistance. The isolated renal arterial rings served for hypoxia/reoxygenation analysis. Acetylcholine (ACh) and sodium nitroprusside (SNP)-induced relaxations of isolated renal arterial rings were exerted. Results: Vitamin C supplementation preserved kidney morphology and renal function following IRI. It was shown that pretreatment with vitamin C for mice subjected to IRI significantly elevated renal NO and GSH levels after reperfusion. Meanwhile, vitamin C administration decreased resistance index of renal artery and ameliorated oxidative stress secondary to IRI. The total ROS level in renal artery was decreased whereas the renal arterial SOD expression was increased by vitamin C supplementation following IRI. Pretreatment with vitamin C significantly potentiated the ACh and SNP-induced relaxations in both control and hypoxic renal arterial rings. Conclusion: Vitamin C protects kidney function and renal arterial reactivity against IRI. The protective role of vitamin C is linked to ROS, SOD, GSH and NO levels in renal ischemic injury.
Intraocular Pressure Spikes after Aflibercept Intravitreal Injections
Authors: El Chehab Hussam , Agard Emilie , Russo Aurélie , Boujnah Ygal , Dot Corinne
Published: July 2016

The objective of this study was to assess the intraocular pressure (IOP) as well as the anatomical modifications of the anterior segment following an aflibercept injection. Patients underwent an aflibercept intravitreal injection (IVI) (0.05 ml) with a 30.5-gauge needle and an antireflux system. IOP was assessed before injection (T0), immediately after (T1), and 5 min (T5), 15 min (T15), and 45 min (T45) after the IVI. Before the IVI and immediately after the T1 measurement, a PENTACAM® acquisition was used to evaluate the anterior chamber parameters (anterior chamber volume, depth and measure of the iridocorneal angle). At T0, IOP was 12.9 ± 1.3 mm Hg. IOP significantly increased after IVI (42.7 ± 3 mm Hg, p < 0.001). IOP returned to baseline at T45 (13.0 ± 1.2 mm Hg, p = 0.877). Anterior chamber volume decreased after IVI (160.6 vs. 168.3 mm3, p = 0.002). No significant changes were found for iridocorneal angle and anterior chamber depth. Aflibercept IVI causes an acute increase in IOP over a short period without iridocorneal angle closure.
A Structurally and Functionally Common Unit in Testes and Ovaries of Medaka (Oryzias latipes), a Teleost Fish
Authors: Nishimura Toshiya , Nakamura Shuhei , Tanaka Minoru
Published: July 2016

Testes and ovaries are structurally and functionally different organs, but they originate from the same gonadal primordium. Here, we propose how a tissue composed of germ cells and sox9b-expressing cells underlain by a basement membrane develops a functionally common unit that reserves sexually indifferent or unfixed germline stem cells in both the ovaries and testes of adult medaka. During testicular development, the unit expands and gives rise to lobules where germline stem cells continuously produce a tremendous amount of sperm, while the unit in the female becomes germinal cradles that represent niche areas for neo-oogenesis. A recent finding in female foxl3 mutants demonstrates that the unit can also serve as the niche for germline stem cells continuously producing sperm in the ovary. We hypothesize that this unit in medaka might correspond to the medullary cords of the gonadal primordium in amniotes and that fragmentation of the medullary cords during ovarian development may be related to the absence of germline stem cells.
Resilience Factors in Women with Severe Early-Life Maltreatment
Authors: Hillmann Karen , Neukel Corinne , Hagemann Dirk , Herpertz Sabine C. , Bertsch Katja
Published: July 2016

Introduction: Early-life maltreatment (ELM) has long-lasting negative consequences and is the most important general risk factor for mental disorders. Nevertheless, a number of maltreated children grow up to become healthy adults and have therefore been called ‘resilient'. The aim of the current study is to investigate ‘resilience factors' in the context of severe ELM. Method: The study was part of the large multicenter project Understanding and Breaking the Intergenerational Cycle of Abuse (UBICA). A total of 89 women were examined, 33 with ELM and at least one lifetime mental disorder (nonresilient), 19 with ELM but without lifetime mental disorders (resilient), and 37 without ELM and without lifetime mental disorders (controls). ELM and other circumstances before the age of 18 years were assessed with the Childhood Experience of Care and Abuse (CECA) Interview. Additional relevant person and situation factors were measured with the Structured Clinical Interview for Mental Disorders (SCID-I), International Personality Disorder Examination (IPDE), Difficulties in Emotion Regulation Scale (DERS), Vulnerable Attachment Style Questionnaire (VASQ), Barratt Impulsiveness Scale (BIS), NEO Five-Factor Inventory (NEO-FFI), and Multiple-Choice Vocabulary Intelligence Test (MWT-B). Factor analyses and paired t tests were performed to identify those variables which differentiate best between the three groups. In addition, a discriminant analysis was conducted to detect the accuracy of assigning women to their specific group. Results: The factor analyses revealed 10 resilience factors based on which we could correctly assign 80% of the women to their group in the discriminant analysis. t tests of factor scores showed that resilient and nonresilient maltreated women mainly differed in current individual attributes (e.g. impulsivity, attachment style), while resilient and nonresilient maltreated women differed from controls in both their current individual attributes and their view of their situation as a child. Conclusion: The 4 variables neuroticism, extraversion, vulnerable attachment, and perceived loneliness during childhood were identified as most important in differentiating all three examined groups. Therefore, prevention and intervention programs focusing on the individual's development of secure attachment and social competence may be of particular importance in the context of ELM.
Functional Independence following Endovascular Treatment for Basilar Artery Occlusion despite Extensive Bilateral Pontine Infarcts on Diffusion-Weighted Imaging: Refuting a Self-Fulfilling Prophecy
Authors: Haussen Diogo C. , Oliveira Renato A.C. , Patel Vikas , Nogueira Raul G.
Published: July 2016

Background and Purpose: Extensive brainstem diffusion-weighted imaging (DWI) hyperintensity has been associated with poor outcomes. We aim at documenting a series of patients with extensive DWI pontine lesions who achieved independence following endovascular therapy and aggressive medical therapy in the setting of posterior circulation basilar artery occlusion (BAO). Methods: This is a retrospective endovascular database review of a single-operator experience over a 9-year period for patients with (1) complete BAO, (2) extensive bilateral pontine DWI changes and (3) 90-day modified Rankin scale 0-2. Results: Three out of a total of 40 patients met the inclusion criteria. Case 1 was an 18-year-old male with National Institutes of Health Stroke Scale (NIHSS) 32 on admission, treated 25 h after symptom onset. Case 2 was a 56-year-old male with NIHSS 19, treated 10 h after onset. Case 3 was a 73-year-old male with NIHSS 29, treated 6 h after onset. Full endovascular reperfusion was achieved in all 3 patients. A literature review identified 9 additional cases of extensive pontine DWI changes and good outcome. These patients were young (32 ± 22 years), mostly males (69%), presented with a relatively low posterior circulation Acute Stroke Prognosis Early CT Score (6 ± 1), were treated relatively late from last known normal (13 ± 10 h) and were mostly (84%) treated with endovascular intervention. Conclusion: Extensive bilateral pontine DWI lesions among patients with BAO are not an unequivocal indicator of poor prognosis. We advise strong caution when considering these findings in the treatment decision algorithm.
Microparticles reveal cell activation during IVF – a possible early marker of a prothrombotic state during the first trimester
Authors: Mobarrez Fariborz , Wallen Håkan , Westerlund Eli , Hovatta Outi , Henriksson Peter , Olausson Nina
Published: July 2016

Cell-derived microparticles (MPs) are known to be elevated in a number of diseases related to arterial and venous thromboembolism (VTE), such as acute myocardial infarction, VTE (deep-vein thrombosis and pulmonary embolism) and peripheral arterial disease. IVF-associated pregnancies have previously been shown to be associated with an increased incidence of VTE, mechanisms behind being unknown and sparsely studied. Our objective was to assess cell activation during IVF through analysis of MP levels and phenotype following ovarian stimulation. Thirty-one women undergoing IVF were included and blood samples were collected at down regulation of oestrogen and at high level stimulation with 10- to 100-fold increased endogenous oestrogen levels. MPs were analysed by flow cytometry and phenotyped according to size and protein expression. We found that overall phosphatidylserine positive platelet-, endothelial- and monocyte-derived MPs significantly increased following ovarian stimulation with increased levels of platelet activation markers CD40 ligand and P-selectin. Furthermore, there was an increase in endothelial-derived MPs exposing activation marker E-selectin and monocyte-derived MPs, while neutrophil-derived MPs decreased slightly. In conclusion we found a major increase in MPs and markers indicating cell activation in parallel with the profound oestrogen boost during IVF. To assess whether these changes in MPs are associated with thromboembolic events requires extended longitudinal studies.
Reduced Myocardial Flow in Heart Failure Patients With Preserved Ejection Fraction
Authors: Srivaratharajah Kajenny , Coutinho Thais , deKemp Robert , Liu Peter , Haddad Haissam , Stadnick Ellamae , Davies Ross A. , Chih Sharon , Dwivedi Girish , Guo Ann , Wells George A. , Bernick Jordan , Beanlands Robert , Mielniczuk Lisa M.
Published: July 2016

Background—

There remains limited insight into the pathophysiology and therapeutic advances directed at improving prognosis for patients with heart failure with preserved ejection fraction (HFpEF). Recent studies have suggested a role for coronary microvascular dysfunction in HFpEF. Rb-82 cardiac positron emission tomography imaging is a noninvasive, quantitative approach to measuring myocardial flow reserve (MFR), a surrogate marker for coronary vascular health. The aim of this study was to determine whether abnormalities exist in MFR in patients with HFpEF without epicardial coronary artery disease.

Methods and Results—

A total of 376 patients with ejection fraction ≥50%, no known history of obstructive coronary artery disease, and a confirmed diagnosis of heart failure (n=78) were compared with patients with no evidence of heart failure (n=298), further stratified into those with (n=186) and without (n=112) hypertension. Global and regional left ventricular MFR was calculated as stress/rest myocardial blood flow using Rb-82 positron emission tomography. Patients with HFpEF were more likely to be older, female, and have comorbid hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, anemia, and renal dysfunction. HFpEF was associated with a significant reduction in global MFR (2.16±0.69 in HFpEF versus 2.54±0.80 in hypertensive controls;
P
<0.02 and 2.89±0.70 in normotensive controls;
P
<0.001). A diagnosis of HFpEF was associated with 2.62 times greater unadjusted odds of having low global MFR (defined as <2.0) and remained a significant predictor of reduced global MFR after adjusting for comorbidities.

Conclusions—

HFpEF, in the absence of known history for obstructive epicardial coronary artery disease, is associated with reduced MFR independent of other risk factors.
Extent of Myocardium at Risk for Left Anterior Descending Artery, Right Coronary Artery, and Left Circumflex Artery Occlusion Depicted by Contrast-Enhanced Steady State Free Precession and T2-Weighted Short Tau Inversion Recovery Magnetic Resonance Imaging
Authors: Nordlund David , Heiberg Einar , Carlsson Marcus , Fründ Ernst-Torben , Hoffmann Pavel , Koul Sasha , Atar Dan , Aletras Anthony H. , Erlinge David , Engblom Henrik , Arheden Håkan
Published: July 2016

Background—

Contrast-enhanced steady state free precession (CE-SSFP) and T2-weighted short tau inversion recovery (T2-STIR) have been clinically validated to estimate myocardium at risk (MaR) by cardiovascular magnetic resonance while using myocardial perfusion single-photon emission computed tomography as reference standard. Myocardial perfusion single-photon emission computed tomography has been used to describe the coronary perfusion territories during myocardial ischemia. Compared with myocardial perfusion single-photon emission computed tomography, cardiovascular magnetic resonance offers superior image quality and practical advantages. Therefore, the aim was to describe the main coronary perfusion territories using CE-SSFP and T2-STIR cardiovascular magnetic resonance data in patients after acute ST-segment–elevation myocardial infarction.

Methods and Results—

CE-SSFP and T2-STIR data from 2 recent multicenter trials, CHILL-MI and MITOCARE (n=215), were used to assess MaR. Angiography was used to determine culprit vessel. Of 215 patients, 39% had left anterior descending artery occlusion, 49% had right coronary artery occlusion, and 12% had left circumflex artery occlusion. Mean extent of MaR using CE-SSFP was 44±10% for left anterior descending artery, 31±7% for right coronary artery, and 30±9% for left circumflex artery. Using T2-STIR, MaR was 44±9% for left anterior descending artery, 30±8% for right coronary artery, and 30±12% for left circumflex artery. MaR was visualized in polar plots, and expected overlap was found between right coronary artery and left circumflex artery. Detailed regional data are presented for use in software algorithms as a priori information on the extent of MaR.

Conclusions—

For the first time, cardiovascular magnetic resonance has been used to show the main coronary perfusion territories using CE-SSFP and T2-STIR. The good agreement between CE-SSFP and T2-STIR from this study and myocardial perfusion single-photon emission computed tomography from previous studies indicates that these 3 methods depict MaR accurately in individual patients and at a group level.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifiers: NCT01379261 and NCT01374321.
Alpheid shrimps (Decapoda: Caridea) of the Trindade & Martin Vaz Archipelago, off Brazil, with new records, description of a new species of Synalpheus and remarks on zoogeographical patterns in the oceanic islands of the tropical southern Atlantic
Authors: ANKER ARTHUR , TAVARES MARCOS
Published: July 2016

The present study deals with shrimps of the family Alpheidae collected in the shallow waters around the remote Trindade & Martin Vaz Archipelago, situated 1200 km off the coast of Espírito Santo, Brazil. A few additional samples came from dredges on top of the seamounts of the Vitória-Trindade Seamount Chain. A total of 23 species in eight genera are reported, the vast majority representing new records for the area. One species is described as new, Synalpheus trinitatis sp. nov., based on the type material from Trindade Island. The new species clearly belongs to the Synalpheus brooksi Coutière, 1909 species complex, differing from all its other members by at least two morphological features. Four species represent new records for Brazil and the southwestern Atlantic: Alpheopsis aequalis Coutière, 1897 sensu lato, Alpheopsis chalciope de Man, 1910 sensu lato, Alpheus crockeri (Armstrong, 1941) and Prionalpheus gomezi Martínez-Iglesias & Carvacho, 1991; the two species of Alpheopsis are recorded from the Atlantic Ocean for the first time. The colour pattern of the recently described Alpheus rudolphi Almeida & Anker, 2011, a species endemic to Brazil, is shown for the first time and compared to the colour patterns of the four closely related species of the A. armatus Rathbun, 1901 complex from the Caribbean–Florida region. A brief zoogeographical analysis of the alpheid fauna of the oceanic islands of the tropical southern Atlantic (Trindade & Martin Vaz, Fernando de Noronha, Atol das Rocas, São Pedro & São Paulo, Ascension, Saint Helena, Cape Verde, São Tomé & Príncipe) is also provided.
Two newly introduced tropical bark and ambrosia beetles (Coleoptera: Curculionidae, Scolytinae) damaging figs (Ficus carica) in southern Italy
Authors: FACCOLI MASSIMO , CAMPO GIUSEPPE , PERROTTA GIANCARLO , RASSATI DAVIDE
Published: July 2016

In summer 2014, the bark beetle Hypocryphalus scabricollis (Eichhoff) and the ambrosia beetle Xyleborus bispinatus Eichhoff, species new to Italy and Europe, respectively, were found for the first time in south-eastern Sicily (Italy). Large infestations of the two species were recorded in many plantations of common fig (Ficus carica L.) both in 2014 and 2015. Data concerning insect characteristics, taxonomy, and distribution are briefly reported.
A new species of Neoephemera McDunnough, 1925 (Ephemeroptera: Neoephemeridae) from North Carolina and Virginia
Authors: HOLLAND VICTOR B. , BEATY STEVEN R. , JACOBUS LUKE M.
Published: July 2016

Neoephemera eatoni sp. nov. is described based on nymphs, imagos, and eggs from North Carolina and Virginia, USA. Nymphs of the new species are associated only with hornleaf riverweed (Podostemum ceratophyllum) growing on the surfaces of cobbles and boulders in moderate to swift flows, at a depth of up to one meter. Life stages were associated by laboratory rearing. Nymphs of the new species are distinguished from other Nearctic Neoephemera by the following combination of characters: all legs are short and stout, with overall lengths subequal to each other; tibial and tarsal lengths are subequal on all legs; tarsal claws are sharply curved; anterolateral projections on the pronotum and mesonotum are reduced; and anterosubmedian tubercles are absent from the pronotum. Male and female imagos exhibit unique abdominal maculations; the anterior protuberance of the mesonotum is obovate; and distinct leg banding patterns are absent. Male imagos have the fore tibia at least 2× the length of mid and hind tibiae, and female imagos have all legs subequal in length. Our new species may be most closely related to N. youngi based on imagos of the two species each having a small spine posteromedially on abdominal tergum II and having annulated terminal filaments. An updated key to North American species is provided.
Sea Spray Generation in Very High Winds
Authors: Ortiz-Suslow David G. , Haus Brian K. , Mehta Sanchit , Laxague Nathan J. M.
Published: July 2016

Quantifying the amount and rate of sea spray production at the ocean surface is critical to understanding the effect spray has on atmospheric boundary layer processes (e.g., tropical cyclones). Currently, only limited observational data exist that can be used to validate available droplet production models. To help fill this gap, a laboratory experiment was conducted that directly observed the vertical distribution of spume droplets above actively breaking waves. The experiments were carried out in hurricane-force conditions (10-m equivalent wind speed of 36–54 m s−1), and the observed particles ranged in radius r from 80 to nearly 1400 μm. High-resolution profiles (3 mm) were reconstructed from optical imagery taken within the boundary layer, ranging from 2 to 6 times the local significant wave height. Number concentrations were observed to have a radius dependence proportional to r−3 leading to spume production estimates that diverge from typical source models, which tend to exhibit a radius falloff closer to r−8. This was particularly significant for droplets with radii circa 1 mm whose modeled production rates were several orders of magnitude less than the rates expected from the observed concentrations. The vertical dependence of the number concentrations was observed to follow a logarithmic profile, which does not confirm the power-law relationship expected by a conventional spume generation parameterization. These observations bear significant implications for efforts to characterize the role these large droplets play in boundary layer processes under high-wind conditions.
Comparison of Videostroboscopy and High-speed Videoendoscopy in Evaluation of Supraglottic Phonation
Authors: Zacharias Stephanie R. C. , Myer Charles M. , Meinzen-Derr Jareen , Kelchner Lisa , Deliyski Dimitar D. , de Alarcón Alessandro
Published: July 2016

Objectives:

To compare clinicians’ ratings of videolaryngoscopy (VLS) and high-speed videoendoscopy (HSV) and assess confidence of ratings with VLS and HSV in patients with supraglottic phonation.

Methods:

The VLS and HSV video samples were taken from 11 adolescents post airway reconstruction who use supraglottic tissues for voice. The 22 recordings were randomized and presented to 4 clinicians: 2 speech-language pathologists and 2 pediatric otolaryngologists. Additionally, a 5-point Likert scale was used to rate level of confidence of ratings.

Results:

Clinicians were more likely to rate regularity on HSV versus VLS videos ( P = .003). Presence of mucosal wave was rated similarly on both imaging modalities; however, HSV was more likely to identify location ( P = .002). Supraglottic phase symmetry ( P = .014) and number of vibratory tissues used for phonation were rated more often with HSV versus VLS. Clinicians were more confident with HSV ratings compared to VLS ratings for determining vibration source, vibration pattern, and ability to make treatment decisions ( P < .0001).

Conclusions:

The HSV improves the ability to rate tissue vibratory characteristics when compared with VLS in children with supraglottic phonation. This information may allow better understanding of the underlying mechanisms of voice production in these individuals, leading to improved therapeutic and surgical recommendations.
Local Ethnic Geography, Expectations of Favoritism, and Voting in Urban Ghana
Authors: Nathan Noah L.
Published: July 2016

African democracies are increasingly urban. While ethnicity is generally correlated with vote choice, recent research suggests there may be less ethnic voting in cities. But I show that voting for ethnically affiliated parties is as common in some neighborhoods in urban Ghana as in rural areas, while virtually non-existent in other neighborhoods elsewhere within the same city. This intra-urban variation is not explained by differences in the salience of ethnic identities or other individual-level characteristics of voters themselves. Instead, it is influenced by the diversity and wealth of the local neighborhoods in which parties and voters interact. These neighborhood characteristics change otherwise similar voters’ expectations of the benefits they will receive from an ethnically affiliated party when living in different places, producing intra-urban differences in the importance of ethnicity for vote choice.