bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysing bilingual talk
Authors: Musk Nigel , Cromdal Jakob
Published: October 2018

Shifting focus from monolingual to multilingual talk within conversation analysis has offered new, radically social and post-cognitivist understandings of bilingualism, especially through the empirical study of language alternation. This chapter presents some central ideas in the literature on language alternation and traces the emergence and development of the organisational approach. This prioritises a participant perspective, whereby bilinguals mobilise their linguistic resources to organise their actions in mundane and institutional settings. While languaging rather than the linguistic concept of “language” is advocated to capture the nature of bilingual talk, extending the analysis to include multimodal aspects of social interaction is put forward as a promising direction for future inquiry.
Case marking of predicative possession in Vedic
Authors: Danesi Serena , Barðdal Jóhanna
Published: October 2018

Possession is an abstract domain of human conceptualization whose expression may be based on different cognitive structures. Heine (1997) identifies a small set of basic conceptual patterns that express predicative possession across the languages of the world. Vedic has three of these patterns exemplified by (i) a genitive construction (with a genitive possessor), (ii) a dative construction (with a dative possessor, a nominative possessee, and a form of ‘be’), and (iii) a locative construction (with a locative possessor and a form of ‘be’). In later stages of the language, the three constructions reduce to one and the structure with the genitive becomes the conventional expression for possession. Despite the importance of the Vedic data for shedding light on the Indo-European linguistic expression of possession, the situation in Vedic has not received proper attention. In this article, we describe and analyze the three early Vedic constructions, their syntactic, semantic, and pragmatic properties, showing that the locative construction is the most marginal of the three, the genitive construction conveys a possessee-oriented relation and is the canonical expression for possession, while the dative construction, expressing a possessor-oriented relation, is a multifunctional construction of which possession is only one of its possible meanings. We further show that claims in the literature that the dative experiencer construction developed from the dative possessive construction are not confirmed by the situation in Vedic.
The history of the mixed inflection of German masculine and neuter nouns
Authors: Ronneberger-Sibold Elke
Published: October 2018

This paper provides an investigation of the dialectal spread of the “mixed” inflection (i.e. the combination of a “strong” singular with a “weak” plural) to non-feminine German nouns from the 14th to the 19th century, thereby revealing three different lines of development: Mixed inflection is well attested in Upper German, but poorly so in Low German and East Central German, whereas the standard language combined both traditions in the 18th century, depending on the sound shape of the respective nouns. It is only at the transition from the 19th to the 20th century that “mixed” inflection was almost lost entirely with non-feminine nouns, thus becoming a signal of feminine gender. A typological explanation relying on syntactic framing in German is proposed.
Ablaut reorganisation
Authors: Nowak Jessica
Published: October 2018

The present paper argues for the existence of an 8th Ablaut Class in German which, comparable to the analogical emergence of Class VII in West-Germanic, evolved analogically in the course of ablaut reorganisation processes in Early New High German. Class VIII is characterised by the pattern x-o-o with a uniform exponent o in the past tense and present perfect as opposed to a relatively variable vowel in the infinitive stem (e.g. melken ‘to milk’, klimmen ‘to climb’, schwören ‘to swear’). The analogical extension of the pattern x-o-o (originally stemming from Class II) is highly functional in that it presents a partial regularisation strategy for low-frequency strong verbs (e.g. melken – malk – gemolken → molk – gemolken).
Manner of motion and semantic transitivity
Authors: Gillmann Melitta
Published: October 2018

Based on a corpus of the major Old High German texts and a corpus of contemporary German newspapers, the paper shows that the German auxiliary system is characterised by both continuity and change. While transitivity proves to be a stable predictor of haben selection throughout German language history, auxiliary selection of intransitive verbs has been partly reorganised. At the expense of telicity, the sein perfect became productive within the intransitive group of manner of motion verbs. This reorganisation of the distributional contexts will be explained in terms of entrenchment. Based on several highly frequent motion verbs such as gehen ‘go’, an abstract schema has evolved which systematically connects manner of motion semantics and sein selection. However, semantic transitivity proves to be an antagonist to this recently entrenched manner of motion schema. Highly transitive manner of motion verbs disallow sein selection. The incidence of the haben perfect rises with increasing transitivity. Here, the patienthood of the direct object turns out to be crucial, with individuation being particularly important.
Cross-sectional Whole-genome Sequencing and Epidemiological Study of Multidrug-resistant Mycobacterium tuberculosis in China
Authors: Huang Hairong , Ding Nan , Yang Tingting , Li Cuidan , Jia Xinmiao , Wang Guirong , Zhong Jun , Zhang Ju , Jiang Guanglu , Wang Shuqi , Zong Zhaojing , Jing Wei , Zhao Yongliang , Xu Shaofa , Chen Fei
Published: October 2018

Background

The increase in multidrug-resistant tuberculosis (MDR-TB) severely hampers tuberculosis prevention and control in China, a country with the second highest MDR-TB burden globally. The first nationwide drug-resistant tuberculosis surveillance program provides an opportunity to comprehensively investigate the epidemiological/drug-resistance characteristics, potential drug-resistance mutations, and effective population changes of Chinese MDR-TB.

Methods

We sequenced 357 MDR strains from 4600 representative tuberculosis-positive sputum samples collected during the survey (70 counties in 31 provinces). Drug-susceptibility testing was performed using 18 anti-tuberculosis drugs, representing the most comprehensive drug-resistance profile to date. We used 3 statistical and 1 machine-learning methods to identify drug-resistance genes/single-nucleotide polymorphisms (SNPs). We used Bayesian skyline analysis to investigate changes in effective population size.

Results

Epidemiological/drug-resistance characteristics showed different MDR profiles, co-resistance patterns, preferred drug combination/use, and recommended regimens among 7 Chinese administrative regions. These factors not only reflected the serious multidrug co-resistance and drug misuse but they were also potentially significant in facilitating the development of appropriate regimens for MDR-TB treatment in China. Further investigation identified 86 drug-resistance genes/intergenic regions/SNPs (58 new), providing potential targets for MDR-TB diagnosis and treatment. In addition, the effective population of Chinese MDR-TB displayed a strong expansion during 1993–2000, reflecting socioeconomic transition within the country. The phenomenon of expansion was restrained after 2000, likely attributable to the advances in diagnosis/treatment technologies and government support.

Conclusions

Our findings provide an important reference and improved understanding of MDR-TB in China, which are potentially significant in achieving the goal of precision medicine with respect to MDR-TB prevention and treatment.
Inhibition of GSK-3 to induce cardiomyocyte proliferation: a recipe for in situ cardiac regeneration
Authors: Singh Anand Prakash , Umbarkar Prachi , Guo Yuanjun , Force Thomas , Gupte Manisha , Lal Hind
Published: October 2018

With an estimated 38 million current patients, heart failure (HF) is a leading cause of morbidity and mortality worldwide. Although the aetiology differs, HF is largely a disease of cardiomyocyte (CM) death or dysfunction. Due to the famously limited amount of regenerative capacity of the myocardium, the only viable option for advanced HF patients is cardiac transplantation; however, donor’s hearts are in very short supply. Thus, novel regenerative strategies are urgently needed to reconstitute the injured hearts. Emerging data from our lab and others have elucidated that CM-specific deletion of glycogen synthase kinase (GSK)-3 family of kinases induces CM proliferation, and the degree of proliferation is amplified in the setting of cardiac stress. If this proliferation is sufficiently robust, one could induce meaningful regeneration without the need for delivering exogenous cells to the injured myocardium (i.e. cardiac regeneration in situ). Herein, we will discuss the emerging role of the GSK-3s in CM proliferation and differentiation, including their potential implications in cardiac regeneration. The underlying molecular interactions and cross-talk among signalling pathways will be discussed. We will also review the specificity and limitations of the available small molecule inhibitors targeting GSK-3 and their potential applications to stimulate the endogenous cardiac regenerative responses to repair the injured heart.
Non-Kähler Mirror Symmetry of the Iwasawa Manifold
Authors: Popovici Dan
Published: October 2018

We propose a new approach to the mirror symmetry conjecture in a form suitable to possibly non-Kähler compact complex manifolds whose canonical bundle is trivial. We apply our methods by proving that the Iwasawa manifold $X$, a well-known non-Kähler compact complex manifold of dimension $3$, is its own mirror dual to the extent that its Gauduchon cone, replacing the classical Kähler cone that is empty in this case, corresponds to what we call the local universal family of essential deformations of $X$. These are obtained by removing from the Kuranishi family the two “superfluous” dimensions of complex parallelisable deformations that have a similar geometry to that of the Iwasawa manifold. The remaining four dimensions are shown to have a clear geometric meaning including in terms of the degeneration at $E_2$ of the Frölicher spectral sequence. On the local moduli space of “essential” complex structures, we obtain a canonical Hodge decomposition of weight $3$ and a variation of Hodge structures, construct coordinates and Yukawa couplings while implicitly proving a local Torelli theorem. On the metric side of the mirror, we construct a variation of Hodge structures parametrised by a subset of the complexified Gauduchon cone of the Iwasawa manifold using the sGG property (which means that all the Gauduchon metrics are strongly Gauduchon) of all the small deformations of this manifold proved in earlier joint work of the author with L. Ugarte. Finally, we define a mirror map linking the two variations of Hodge structures and we highlight its properties.
Experiments on Belief Formation in Networks
Authors: Grimm Veronika , Mengel Friederike
Published: October 2018

We study belief formation in social networks using a laboratory experiment. Participants in our experiment observe an imperfect private signal on the state of the world and then simultaneously and repeatedly guess the state, observing the guesses of their network neighbors in each period. Across treatments we vary the network structure and the amount of information participants have about the network. Our first result shows that information about the network structure matters and in particular affects the share of correct guesses in the network. This is inconsistent with the widely used naive (deGroot) model. The naive model is, however, consistent with a larger share of individual decisions than the competing Bayesian model, whereas both models correctly predict only about 25%–30% of consensus beliefs. We then estimate a larger class of models and find that participants do indeed take network structure into account when updating beliefs. In particular they discount information from neighbors if it is correlated, but in a more rudimentary way than a Bayesian learner would.
Giant cometary H ii regions and molecular bow shocks in spiral arms of galaxies: M 83
Authors: Sofue Yoshiaki
Published: October 2018

A number of giant cometary H ii regions (GCHs) sheathed inside molecular bow shocks (MBSs) are found along spiral arms of the barred galaxy M 83. The open cone structure is explained by a model of an expanded H ii front in a gaseous arm with a steep density gradient, and the bow shock is shown to be formed by the encounter of an H ii region with the supersonic gas flow across the arm. It is suggested that dual-side compression of molecular gas at the bow head between the MBS and the GCH enhances star formation along the spiral arms.
Laughter in Stories of Crime and Tragedy: The Importance of Humor for Marginalized Populations
Authors: Sandberg Sveinung , Tutenges Sébastien
Published: October 2018

Humor is essential to social life, but it is often overlooked in the study of crime and other social problems. We introduce and make use of humor theory, emphasizing the theories of superiority and relief. Based on interviews with incarcerated men, we demonstrate how humor is used to criticize authorities, for self-aggrandizement, and to alleviate the pain of tragic experiences. Funny remarks and stories are often ambiguous and evade simple categorization, which may explain why humor is neglected in the study of social problems. We argue that researchers should pay more attention to humor to achieve a fuller understanding of marginalized individuals and their social worlds.
Early Resumption of β Blockers Is Associated with Decreased Atrial Fibrillation after Noncardiothoracic and Nonvascular Surgery
Authors: Khanna Ashish K. , Naylor Douglas F. , Naylor Amanda J. , Mascha Edward J. , You Jing , Reville Eric M. , Riter Quinton M. , Diwan Murtaza , Kurz Andrea , Sessler Daniel I.
Published: October 2018

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Beta (β) blockers reduce the risk of postoperative atrial fibrillation and should be restarted after surgery, but it remains unclear when best to resume β blockers postoperatively. The authors thus evaluated the relationship between timing of resumption of β blockers and atrial fibrillation in patients recovering from noncardiothoracic and nonvascular surgery.

Methods

The authors evaluated 8,201 adult β-blocker users with no previous history of atrial fibrillation who stayed at least two nights after noncardiothoracic and nonvascular surgery as a retrospective observational cohort. After propensity score matching on baseline and intraoperative variables, 1,924 patients who did resume β blockers by the end of postoperative day 1 were compared with 973 patients who had not resumed by that time on postoperative atrial fibrillation using logistic regression. A secondary matched analysis compared 3,198 patients who resumed β blockers on the day of surgery with 3,198 who resumed thereafter.

Results

Of propensity score–matched patients who resumed β blockers by end of postoperative day 1, 4.9% (94 of 1,924) developed atrial fibrillation, compared with 7.0% (68 of 973) of those who resumed thereafter (adjusted odds ratio, 0.69; 95% CI, 0.50–0.95; P = 0.026). Patients who resumed β blockers on day of surgery had an atrial fibrillation incidence of 4.9% versus 5.8% for those who started thereafter (odds ratio, 0.84; 95% CI, 0.67–1.04; P = 0.104).

Conclusions

Resuming β blockers in chronic users by the end of the first postoperative day may be associated with lower odds of in-hospital atrial fibrillation. However, there seems to be little advantage to restarting on the day of surgery itself.
Treatment With Tumor-infiltrating Lymphocytes in Advanced Melanoma: Evaluation of Early Clinical Implementation of an Advanced Therapy Medicinal Product
Authors: Lindenberg Melanie A. , Retèl Valesca P. , van den Berg Joost H. , Geukes Foppen Marnix H. , Haanen John B. , van Harten Wim H.
Published: October 2018

Tumor-infiltrating lymphocytes (TIL)-therapy in advanced melanoma is an advanced therapy medicinal product (ATMP) which, despite promising results, has not been implemented widely. In a European setting, TIL-therapy has been in use since 2011 and is currently being evaluated in a randomized controlled trial. As clinical implementation of ATMPs is challenging, this study aims to evaluate early application of TIL-therapy, through the application of a constructive technology assessment (CTA). First the literature on ATMP barriers and facilitators in clinical translation was summarized. Subsequently, application of TIL-therapy was evaluated through semistructured interviews with 26 stakeholders according to 6 CTA domains: clinical, economic, patient-related, organizational, technical, and future. In addition, treatment costs were estimated. A number of barriers to clinical translation were identified in the literature, including: inadequate financial support, lack of regulatory knowledge, risks in using live tissues, and the complex path to market approval. Innovative reimbursement procedures could particularly facilitate translation. The CTA survey of TIL-therapy acknowledged these barriers, and revealed the following facilitators: the expected effectiveness resulting in institutional support for an internal pilot, the results of which led to the inclusion of TIL-therapy in a national coverage with evidence development program, the availability of an in-house pharmacist, quality assurance expertise and a TIL-skilled technician. Institutional and national implementation of TIL-therapy remains complex. The promising clinical effectiveness is expected to facilitate the adoption of TIL-therapy, especially when validated through a randomized controlled trial. Innovative and conditional reimbursement procedures, together with the organization of knowledge transfer, could support and improve clinical translation of TIL and ATMPs.
Factors Affecting Racial Disparities in End-of-Life Care Costs Among Lung Cancer Patients
Authors: Karanth Siddharth , Rajan Suja S. , Revere Frances L. , Sharma Gulshan
Published: October 2018

Objectives:

Racial disparities exist in end-of-life lung cancer care, which could potentially lead to considerable racial differences in end-of-life care costs. This study for the first time estimates the racial differences in end-of-life care costs among lung cancer patients, and identifies and quantifies factors that contribute the most to these differences using a statistical decomposition method.

Methods:

This is a retrospective analysis of patients 66 years and older, diagnosed with stage I-IV lung cancer, who died on or before December 31, 2013, using the Surveillance Epidemiology and End Result-Medicare data from 1991 to 2013. Ordinary least square regression of logarithmically transformed cost was used to estimate racial differences in end-of-life care costs among lung cancer patients. Blinder-Oaxaca decomposition was used to identify and quantify factors that contributed the most to these differences.

Results:

Non-Hispanic blacks had 10% to 13% higher end-of-life care costs as compared with non-Hispanic whites. Geographic variations, baseline comorbidity indices and stage at diagnosis contributed the most to explaining the racial differences in costs, with geographic variation explaining most of the differences. However, the observed factors could only explain 25% to 32% of the racial differences in end-of-life care costs.

Conclusions:

Geographic differences in access to timely and appropriate care, and provider practice patterns, should be examined to understand the reasons behind geographic variations in racial disparity. Provider-level educational interventions to reduce small area practice variations and differential management of patients by race, as well as racially sensitive patient-level educational and navigational interventions might be critical in improving quality of care and reducing costs during end-of-life.
The mysteries of menopause and urogynecologic health: clinical and scientific gaps
Authors: Alperin Marianna , Burnett Lindsey , Lukacz Emily , Brubaker Linda
Published: October 2018

Objectives:

A significant body of knowledge implicates menopausal estrogen levels in the pathogenesis of the common pelvic floor disorders (PFDs). These health conditions substantially decrease quality of life, increase depression, social isolation, caregiver burden, and economic costs to the individuals and society.

Methods:

This review summarizes the epidemiology of the individual PFDs with particular attention to the understanding of the relationship between each PFD and menopausal estrogen levels, and the gaps in science and clinical care that affect menopausal women. In addition, we review the epidemiology of recurrent urinary tract infection (rUTI)—a condition experienced frequently and disproportionately by menopausal women and hypothesized to be potentiated by menopausal estrogen levels.

Results:

The abundance of estrogen receptors in the urogenital tract explains why the natural reduction of endogenous estrogen, the hallmark of menopause, can cause or potentiate PFDs and rUTIs. A substantial body of epidemiological literature suggests an association between menopause, and PFDs and rUTIs; however, the ability to separate this association from age and other comorbid conditions makes it difficult to draw definitive conclusions on the role of menopause alone in the development and/or progression of PFDs. Similarly, the causative link between the decline in endogenous estrogen levels and the pathogenesis of PFDs and rUTIs has not been well-established.

Conclusions:

Innovative human studies, focused on the independent effects of menopausal estrogen levels, uncoupled from tissue and cellular senescence, are needed.
Clinical application and mid-term results of modified vaginal closure: pelvic symptoms, quality of life, satisfaction, and regret rate
Authors: Jia Ningyi , Zhao Weihong , Yang Baojun , Xu Yun , Li Jinghua , Feng Limin
Published: October 2018

Objective:

To evaluate the safety and efficacy of a modified vaginal closure in older women with severe pelvic organ prolapse (POP) with respect to symptoms, quality of life, postoperative satisfaction, regret rate, and complications

Methods:

From March, 2014 to December, 2016, in all, 32 women were enrolled in the study. All the participants underwent a modified vaginal closure. Records were reviewed to collect demographic characteristics and perioperative parameters. The Pelvic Floor Distress Inventory—short form 20 (PFDI-20) and the Short Form 36 Health Survey Profile (SF-36) were used to evaluate pelvic symptoms and self-perceived quality of life, respectively, 6 months postoperatively and at the latest follow-up. The Patient Global Impression of Change (PGI-C) was used to estimate the satisfaction. The satisfaction and regret rates were assessed at the latest follow-up.

Results:

After an average follow-up period of 23 months (range 8-41 months), none of the 32 women experienced recurrence of prolapse that required reoperation. During follow-up, significant improvements were observed in the Pelvic Organ Prolapse Distress Inventory (POPDI-6), Urinary Distress Inventory (UDI-6), and SF-36 results (P < 0.001). However, the Colorectal-Anal Distress Inventory (CRADI-8) results did not improve significantly (P = 0.074). None of the participants regretted undergoing this procedure, and the PGI-C indicated a satisfaction rate of 93.8%.

Conclusions:

The modified vaginal closure showed a positive impact on POP and urinary symptoms, and consequently improved quality of life of the 32 participants. This procedure achieved a relatively high satisfaction rate and a low regret rate.
Age at natural menopause and life expectancy with and without type 2 diabetes
Authors: Asllanaj Eralda , Bano Arjola , Glisic Marija , Jaspers Loes , Ikram Mohammad Arfan , Laven Joop S.E. , Vőlzke Henry , Muka Taulant , Franco Oscar H.
Published: October 2018

Objective:

Effective interventions of future health care require a better understanding of the health risks associated with early onset of menopause and diabetes, but the necessary data are scarce. Little quantitative information is available about the combined association of early menopause and diabetes on life expectancy and the number of years lived with and without diabetes.

Methods:

We included 3,650 postmenopausal women aged 45+ years from the Rotterdam Study, a prospective population-based cohort study. Age at menopause categories were defined as follows: early (≤44 y old), normal (45-54 y old), and late (≥55 y old). For life table calculations, we used prevalence, incidence rates, and hazard ratios for three transitions (free of diabetes to diabetes, free of diabetes to death, and diabetes to death) stratifying by age at menopause categories and adjusting for confounders.

Results:

Compared with late menopause, the difference in life expectancy for women who experienced early menopause was −3.5 (95% CI, −6.6 to −0.8) years overall and −4.6 (95% CI, −8.9 to −0.9) years without diabetes. Compared with age at normal menopause, the difference in life expectancy for women who experienced early menopause was −3.1 (95% CI, −5.1 to −1.1) years overall and −3.3 (95% CI, −6.0 to −0.6) years without diabetes.

Conclusions:

Women who experienced early menopause lived less long and spent fewer years without diabetes than women who experienced normal or late menopause.
ADULT-ONSET VITELLIFORM MACULAR DYSTROPHY SECONDARY TO A NOVEL IMPG2 GENE VARIANT
Authors: Shah Saumya M. , Schimmenti Lisa A. , Marmorstein Alan D. , Bakri Sophie J.
Published: October 2018

Purpose:

To report a case of adult-onset vitelliform macular dystrophy in a patient who was found to have a previously unreported variant of the IMPG2 gene.

Methods:

Case report.

Results:

A 65-year-old white woman with no significant medical or ocular history presented with a complaint of persistent wavy vision for 10 months. On funduscopic examination, bilateral vitelliform lesions of approximately 1 mm in the right eye and 0.5 mm in the left eye were evident, with no choroidal neovascularization in either eye. The patient was diagnosed with adult-onset vitelliform macular dystrophy. Genetic testing revealed a single likely pathogenic variant of the IMPG2 gene that may explain the examination findings.

Conclusion:

Adult-onset vitelliform macular dystrophy is a common and relatively benign condition occurring in approximately 1 in 8,000 individuals. Although vitelliform lesions can be a manifestation of systemic diseases or be idiopathic, in a minority of patients, genetic predisposition may play a role. Mutations in four particular genes BEST1, PRPH2, IMPG1, and IMPG2 have been associated with some cases of adult-onset vitelliform macular dystrophy, with this particular gene variant of IMPG2 being previously unreported.
BEARING DOWN ON TREPONEMES: AN ATYPICAL PRESENTATION OF SYPHILITIC UVEITIS
Authors: Cherfan Daniel G. , Browne Andrew W. , Deasy Ryan , Lapinski James , Srivastava Sunil K.
Published: October 2018

Purpose:

To present an atypical case of syphilis that presented with findings concerning for endocarditis and valsalva retinopathy.

Methods:

History and clinical examination of 42-year-old white man who presented to the emergency department with acute onset vision changes associated with gastrointestinal symptoms, otalgia, and constitutional symptoms.

Results:

The review of this case highlights the atypical nature in which syphilis can present and can remain undiagnosed even in the face of extensive workups for other systemic conditions.

Conclusion:

We present a case of syphilis in a patient with multiorgan involvement in whom the diagnosis was made based on atypical ocular examination findings.
NEUROTROPHIC KERATOPATHY AFTER RETINAL DETACHMENT SURGERY COMBINED WITH ENDOLASER PHOTOCOAGULATION
Authors: Kurt Rengin Aslıhan , Sonmez Baris , Kapran Ziya
Published: October 2018

Purpose:

To report neurotrophic keratopathy after vitreoretinal surgery combined with aggressive photocoagulation.

Methods:

We report a series of three cases with neurotrophic keratopathy after pars plana vitrectomy combined with endolaser photocoagulation.

Results:

Three patients who had pars plana vitrectomy with different indications were identified. On follow-up, all patients were diagnosed with neurotrophic keratopathy. Two of the patients underwent amniotic membrane transplantation for the treatment of resistant neurotrophic corneal ulcers.

Conclusion:

Neurotrophic keratopathy may occur after pars plana vitrectomy. The possible mechanism is long ciliary nerve damage related to the extensive endolaser photocoagulation.
The Relationship Between Binocular Visual Field Loss and Various Stages of Monocular Visual Field Damage in Glaucoma Patients
Authors: Xu Jianan , Lu Peng , Dai Miaomiao , Huang Wenmin , Lin Jialiu , Huang Jingjing
Published: October 2018

Purpose:

To investigate the effects of monocular visual field loss severity on binocular visual field (BVF) loss in primary angle-closure glaucoma, primary open-angle glaucoma, and normal tension glaucoma patients.

Materials and Methods:

In this observational cross-sectional study, 250 glaucoma patients and 31 healthy participants were assigned to groups according to the stage of monocular visual field loss in both eyes; normal, early, moderate, or severe. BVF assessments were determined via integrated visual field and Esterman binocular visual evaluations. Monocular and BVF parameters were compared within and among groups.

Results:

In patients with one eye at normal or early stage and the other at severe stage, the average integrated mean deviations (MDs) were [mean (SD)], −1.67 (1.39), and −3.27 (2.05) dB, respectively, and the average Esterman scores were >95% [99.17% (1.89%), 96.08% (3.99%), respectively]. Where both eyes had progressed to moderate or severe damage (moderate/moderate, moderate/severe, or severe/severe), the average integrated MDs were worse than −6 dB, and the mean Esterman scores in the moderate/moderate and the moderate/severe damage groups were still >90% [94.20% (5.96%), 94.32% (4.95%), respectively], but it dropped rapidly from >90% to 68.44% (26.27%) when both eyes were at severe stage.

Conclusions:

The BVF can remain relatively intact provided one eye is at the normal or early stage. Significant BVF defects measured by integrated MD were evident when both eyes had progressed to moderate or severe stage, and significant Esterman BVF defects were only detected when both eyes had advanced to a severe stage.
Prognosis of patients with gastric variceal bleeding after endoscopic variceal obturation according to the type of varices
Authors: Lee Han A. , Chang Jung M. , Goh Hyun G. , Kim Tae H. , Lee Young-Sun , Suh Sang J. , Jung Young K. , Choi Hyuk S. , Kim Eun S. , Kim Ji H. , An Hyunggin , Seo Yeon S. , Yim Hyung J. , Jeen Yoon T. , Yeon Jong E. , Chun Hoon J. , Byun Kwan S. , Um Soon H. , Kim Chang D.
Published: October 2018

Background and aims

This study was performed to evaluate the treatment efficacy of endoscopic variceal obturation (EVO) in patients with gastric variceal bleeding (GVB) according to the type of varices.

Patients and methods

All patients who were treated with EVO for bleeding from gastric varices (GVs) were included. Patients with a previous history of endoscopic treatment for GVB and those with accompanying portal vein invasion by hepatocellular carcinoma or other malignancy were excluded.

Results

Ninety-one patients with GVB were included. Mean age was 59.4±12.4 years and 72 (79.1%) patients were men. The types of varices were gastroesophageal varices (GOV) type 1 (GOV1), GOV2, and isolated gastric varices type 1 (IGV1) in 30 (33.3%), 35 (38.5%), and 26 (28.6%) patients, respectively. Hemostasis and GV obliteration were achieved in 88 (96.7%) and 81 (89.0%) patients, respectively. Among 81 patients with GV obliteration, GV recurred in 26 (32.1%) patients. The GV recurrence rate was significantly lower in patients with GOV1 than in those with GOV2 (P=0.007), while it was comparable between patients with GOV1 and IGV1 (P=0.111) and between patients with GOV2 and IGV1 (P=0.278). Variceal rebleeding occurred in 11 (13.6%) patients. GVB recurrence rate was significantly higher in patients with GOV2 than in those with GOV1 (P=0.034) and IGV1 (P=0.018), while it was comparable between patients with GOV1 and IGV1 (P=0.623). Mortality rate was comparable among the three groups.

Conclusions

EVO was very effective in patients with GVB. GV recurrence and GV rebleeding were significantly lower in patients with GOV1 than in those with GOV2.
Recurrent laryngeal nerve reinnervation: is this the standard of care for pediatric unilateral vocal cord paralysis?
Authors: Espinosa Maria Catalina , Ongkasuwan Julina
Published: October 2018

Purpose of review

Ansa to recurrent laryngeal nerve reinnervation, otherwise known as a nonselective laryngeal reinnervation (NSLR), is growing in popularity for the management of pediatric unilateral neuronal vocal fold movement impairment (VFMI). In this chapter, we will review the current treatment options for neuronal VFMI and role that NSLR plays in the treatment algorithm.

Recent findings

In 2018, Bouhabel and Hartnick published a survey of fellowship trained pediatric otolaryngologists and found an increasing comfort level with NSLR. Respondents felt that NSLR resulted in favorable subjective and objective postsurgical voice outcomes. Furthermore, NSLR may decrease the risk of aspiration in children with neuronal VFMI. Although NSLR appears to work, the voice results are not perfect for all children. Further work is being done to understand which preoperative variables, such as age, time from injury, and preop laryngeal electromyography, may predict a better voice outcome.

A variety of treatment options exist for unilateral neuronal VFMI. Recent data and developments demonstrate the effectiveness of reinnervation as a potential first-line surgical intervention in children with unilateral neuronal VFMI.
Mesenchymal stromal cell therapy in intestinal diseases
Authors: Ciccocioppo Rachele , Fioravante Marzia , Frulloni Luca
Published: October 2018

Purpose of review

The advent of cell therapies, mainly based on the use of mesenchymal stromal cells (MSCs), represents a great step forward in the treatment of immune-mediated conditions. Here, we focus on those intestinal disorders wherein MSCs have been applied for immunotherapeutic purposes and whose results are available.

Recent findings

By virtue of their ability to favour both tissue regeneration and immune tolerance, together with a substantial lack of immunogenicity, MSCs have gained huge attention in the last decade. Following abundant positive experimental data, a sizable number of clinical trials using MSCs as a new treatment in chronic inflammatory intestinal diseases were carried out with promising results and several are still ongoing. The main indication was refractory Crohn's disease wherein both feasibility and safety clearly emerged when treating the luminal phenotype with intravenous infusion/s, albeit no definitive conclusion on efficacy may be drawn. By contrast, the availability of robust demonstration also on the efficacy when treating the fistulizing phenotype through local injection/s of MSCs has led to approval of the marketing of an industrial preparation (darvadstrocel).

Successful clinical implementation of this attractive option is hampered by a number of obstacles arising from methodology and regulation issues, which require the institution of interdisciplinary task forces before this cell therapy becomes a bedside reality.
Physiotherapy in Postinfection Injury to Cranial Nerves III, IV, and VI
Authors: Rongies Witold , Bojakowski Jacek , Koktysz Lidia , Dolecki Włodzimierz , Lewińska Agnieszka Olga , Krzeski Antoni
Published: October 2018

The patient with bacterial infection sequelae in the form of damage to cranial nerves III, IV, and VI was followed up. He had exhibited clinical and radiographic signs of paranasal sinusitis. Before his physiotherapy, the patient received standard treatment with natural and synthetic antibiotics and steroids. After acute signs of infection resolved without any functional improvement, the patient was referred to a rehabilitation unit to undergo neuromuscular re-education of the paralyzed extraocular muscles. Periorbital hydrocortisone iontophoresis and visuomotor exercises with intense ideomotor stimulation led to complete and rapid resolution of extraocular muscle paralysis and diplopia. Physiotherapy can be an effective treatment of choice after failed pharmacological treatment in patients with damage to cranial nerves III and VI. It has many theoretical advantages, including noninvasiveness and avoidance of first-pass metabolism of drugs administered systemically.
Bereavement, Self-Reported Sleep Disturbances, and Inflammation: Results From Project HEART
Authors: Chirinos Diana A. , Ong Jason C. , Garcini Luz M. , Alvarado Daisy , Fagundes Christopher
Published: October 2018

Objective

Spousal bereavement is linked to increased mortality and morbidity from inflammatory conditions. It also has a significant impact on sleep disturbances. Evidence from experimental studies indicates that chronic stress may prime individuals to have an exaggerated inflammatory response to acute stress. In this study, we examined the association between self-reported sleep disturbances and inflammation after adjusting for depressive symptoms and determined whether this association varies by bereavement status (bereaved individuals versus controls).

Methods

Participants included 54 bereaved individuals and 47 controls with a M (SD) age of 67.12 (12.11) years. Inflammation was measured using C-reactive protein. Self-reported sleep disturbances were measured using the Pittsburgh Sleep Quality Index. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale.

Results

Sleep disturbances were not associated with elevated levels of C-reactive protein in the overall group (B = 0.030, standardized β = 0.122, 95% confidence interval [CI] = −0.027 to 0.087, p = .299) after adjusting for depressive symptoms. Results indicated, however, that bereavement moderated the association between inflammation and sleep disturbances (B = 0.104, β = 0.517, 95% CI = 0.009 to 0.198, p = .032). Stratified analyses demonstrated that these associations differed across groups. Associations were significant among bereaved individuals (B = 0.104, β = 0.406, 95% CI = 0.013 to 0.196, p = .026) and not controls (B = −0.016, β = −0.066, 95% CI = −0.096 to 0.065, p = .690).

Conclusions

These findings provide preliminary evidence that bereavement moderates the association between self-reported sleep disturbances and inflammation. Future studies should examine the course of sleep disturbances after bereavement and establish whether objective sleep has differential associations with inflammation among bereaved adults.
18F-Choline and 18F-FDG PET/CT in a Patient With Diffuse Large B-Cell Lymphoma and Recurrent Prostate Cancer
Authors: De Leiris Nicolas , Riou Laurent , Leenhardt Julien , Vuillez Jean-Philippe , Djaileb Loïc
Published: October 2018

We report herein the case of an 80-year-old man who was referred for a biochemical recurrence of a high-risk prostate cancer. In addition to prostate cancer recurrence, 18F-choline allowed partial initial staging of an incidental diffuse large B-cell lymphoma which was further confirmed and staged using 18F-FDG and a biopsy. Two types of metabolic behavior were therefore identified using 18F-choline and 18F-FDG which corresponded to 2 different uptake patterns, that is, those of the prostate and lymphoma tumoral cell contingents.
18F-DCFPyL PET/CT in Oncocytoma
Authors: Li Jeremy , Xu Richard , Kim Chun K. , Bénard François , Kapoor Anil , Bauman Glenn , Zukotynski Katherine A.
Published: October 2018

A 76-year-old man with biochemical failure after primary radiotherapy for prostate cancer had no malignant disease detected on 99mTc-MDP bone scan and diagnostic CT. Prostate-specific membrane antigen (PSMA), a type II transmembrane glycoprotein, is overexpressed in prostate cancer cells. The PSMA-targeted 18F-DCFPyL PET/CT demonstrated lymph node disease and photopenic defects in the left kidney associated with a cyst and biopsy-proven oncocytoma. Prostate-specific membrane antigen is expressed in the neovasculature of several solid tumors. It has been reported that PSMA expression is seen in approximately 50% of oncocytoma versus 76% of clear cell renal carcinomas. Biopsy confirmation is needed regardless of 18F-DCFPyL avidity.
Unexpected Bone Metastases in 99mTc-Pertechnetate Scan of Recurrent Goiter
Authors: Hoberück Sebastian , Michler Enrico , Seppelt Danilo , Kotzerke Jörg , Brogsitter Claudia
Published: October 2018

A 68-year-old woman who underwent a thyroidectomy for bilateral goiter 20 years ago was referred to our department. The examination revealed a newly occurred thyroid nodule in the right central lobe. Unexpectedly the 99mTc-pertechnetate scan revealed several extrathyroidal foci right-sided supraclavicular, beside a cold thyroid nodule in the right lower lobe. Consecutive surgery and histology confirmed the suspected diagnosis of follicular thyroid cancer with multiple bone metastases. Whole-body scintigraphy performed after the following radioiodine therapy indicated disseminated osseous metastases.
Hyperechoic Abdominal Fat
Authors: Chakraborty Amit K. , Olcott Eric W. , Jeffrey Brooke R.
Published: October 2018

One of the most useful sonographic signs of acute abdominal inflammation is the identification of increased echogenicity of the surrounding fat. Hyperechoic fat results from vasodilation and edema extending from an adjacent source of infection or inflammation. These changes are mediated by such factors such as bradykinin, histamine, and various cytokines. The recognition of hyperechoic fat on sonography may be an important indicator of the primary source of pathology. In addition, it often reflects a more advanced degree of transmural pathology, such as “walled-off” perforation of a hollow viscus. This pictorial essay will present a variety of examples of hyperechoic inflamed fat involving different abdominal organs and will illustrate the diagnostic value of this finding.
Quantitative Assessment of Palatine Tonsils in Healthy Children and Adolescents With Shear-Wave Elastography
Authors: Öztürk Mehmet , Çalişkan Emine , Bayramoğlu Zuhal , Adaletli İbrahim
Published: October 2018

The normal elasticity and velocity values for palatine tonsils (PTs) in healthy children and adolescents were defined using shear wave elastography, and the relationship with potential factors affecting these values was assessed. This prospective study included a total of 80 cases with ages ranging from 3 to 17 years. Sex, age, and body mass index (BMI) were recorded. Elasticity and velocity measurements of both PTs and the relationship with basic descriptive data were investigated. For statistical analyses, independent-samples t tests and Spearman ρ (r) correlation coefficient were used. Quantitative variables are shown as the mean ± SD, and categorical variables are shown as n (%). The mean age was 10.6 ± 6.4 years, and the mean BMI was 17.40 ± 4 kg/m2. The mean elasticity and velocity values were 9.38 ± 1.27 kPa and 1.76 ± 0.11 m/s for the right PT and 9.57 ± 1.43 kPa and 1.79 ± 1.04 m/s for the left PT, respectively. The mean tonsil volume was 2.44 mL for the right PT and 2.36 mL for the left PT. There were no significant differences in elasticity, velocity, and volumes when comparing location, age, or sex groups. No significant correlations were observed between the elasticity and velocity values and BMI. In conclusion, this preliminary work can be used as a reference for the diagnosis of PT diseases. Future comprehensive studies are necessary to establish the role of elastography in the diagnosis of pathologic tissue differentiation confirmed by clinical, laboratory, or pathology analyses.
Ultrasound Assessment of Acute Kidney Injury
Authors: Kelahan Linda C. , Desser Terry S. , Troxell Megan L. , Kamaya Aya
Published: October 2018

Ultrasound assessment of the kidneys in patients with renal impairment has been described in various ways in the critical care, nephrology, and radiology literature, resulting in a somewhat heterogeneous picture of the gray-scale and Doppler ultrasound manifestation of acute kidney injury (AKI). Given that ultrasound assessment can potentially identify reversible causes of AKI or identify underlying chronic kidney disease, it is important for radiologists to be aware of the common etiologies of AKI and the spectrum of ultrasound findings. We review the definition and etiologies of renal injury and introduce the ultrasound SERVeillance framework—assessment of renal size, echogenicity, renal hilum, and vascularity—for the imaging assessment of AKI.
Difference in Detection Rate of Portal Venous Gas via Computed Tomography and Ultrasonography in Pediatric Patients
Authors: Hosokawa Takahiro , Yamada Yoshitake , Tanami Yutaka , Sato Yumiko , Hosokawa Mayumi , Oguma Eiji
Published: October 2018

This study was performed to compare computed tomography (CT)– and ultrasonography (US)–derived detection rates of portal venous gas (PVG) in pediatric patients and investigate whether discrepancies between these modalities were influenced by patient age and interval between examinations. We included 25 children who underwent both CT and US within 2 days for evaluation of intestinal ischemia. McNemar test was used to compare the detection of PVG between the 2 modalities. The cohort was retrospectively divided into 2 groups based on whether comparable results were obtained via both modalities; the Mann-Whitney U test was used to compare patient age and interval between CT and US between these 2 groups. Among 25 children, CT and US yielded similar results in 17 patients regarding the presence or absence of PVG (median age/interval, 2 years [range, 0–17 years]/51 minutes [range, 2–1196 minutes]; 3/14 detected via both/not both modalities) and different results in 8 (median age/interval, 0 years [range, 0–15 years]/171.5 minutes [range, 64–1486 minutes]; 7/1 detected via US only/via CT only). There was a significant difference in PVG detection rate between US and CT (P = 0.034). Patient age did not differ significantly between the 2 groups (P = 0.206), but the interval between CT and US did (P = 0.025). In conclusion, the detection rate of PVG was higher with US, compared with CT, although the timings of the examinations could have influenced this finding. Ultrasonography could be useful for PVG detection in pediatric patients because it can be performed repeatedly at the bedside without radiation exposure.