bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation into tensile strength of noncrimp three-dimensional orthogonal woven structure
Authors: Minapoor Shohreh , Ajeli Saeed , Salmani Tehrani Mahdi
Published: May 2018

Noncrimp three-dimensional orthogonal carbon weave is a specific type of three-dimensional woven fabric which is expected to have high performance as composite reinforcement. In this paper, two different orthogonal weaves in terms of carbon fiber tow type and binder yarns insertion density are produced, and a comprehensive study on the tensile strength of carbon composite reinforcements is conducted. The fiber volume fraction and mechanical performance are found to be affected by these two weave parameters. The fabric architecture changes due to different binder yarns’ insertion densities, influencing the stress wave propagation by preventing crack growth, thus leading to improve tensile strength of three-dimensional orthogonal reinforcement. Based on experimental weave parameters, a set of numerical compression tests are simulated by using a meso-scale finite element model. The results show that the model can predict the tensile strength of noncrimp three-dimensional orthogonal carbon composite reinforcements.
Trends in polymeric electrospun fibers and their use as oral biomaterials
Authors: Meireles Agnes B , Corrêa Daniella K , da Silveira João VW , Millás Ana LG , Bittencourt Edison , de Brito-Melo Gustavo EA , González-Torres Libardo A
Published: May 2018

Electrospinning is one of the techniques to produce structured polymeric fibers in the micro or nano scale and to generate novel materials for biomedical proposes. Electrospinning versatility provides fibers that could support different surgical and rehabilitation treatments. However, its diversity in equipment assembly, polymeric materials, and functional molecules to be incorporated in fibers result in profusion of recent biomaterials that are not fully explored, even though the recognized relevance of the technique. The present article describes the main electrospun polymeric materials used in oral applications, and the main aspects and parameters of the technique. Natural and synthetic polymers, blends, and composites were identified from the available literature and recent developments. Main applications of electrospun fibers were focused on drug delivery systems, tissue regeneration, and material reinforcement or modification, although studies require further investigation in order to enable direct use in human. Current and potential usages as biomaterials for oral applications must motivate the development in the use of electrospinning as an efficient method to produce highly innovative biomaterials, over the next few years.

Impact statement

Nanotechnology is a challenge for many researchers that look for obtaining different materials behaviors by modifying characteristics at a very low scale. Thus, the production of nanostructured materials represents a very important field in bioengineering, in which the electrospinning technique appears as a suitable alternative. This review discusses and provides further explanation on this versatile technique to produce novel polymeric biomaterials for oral applications. The use of electrospun fibers is incipient in oral areas, mainly because of the unfamiliarity with the technique. Provided disclosure, possibilities and state of the art are aimed at supporting interested researchers to better choose proper materials, understand, and design new experiments. This work seeks to encourage many other researchers–Dentists, Biologists, Engineers, Pharmacists–to develop innovative materials from different polymers. We highlight synthetic and natural polymers as trends in treatments to motivate an advance in the worldwide discussion and exploration of this interdisciplinary field.
Featured Article: The loss of copper is associated with the increase in copper metabolism MURR domain 1 in ischemic hearts of mice
Authors: Li Kui , Li Chen , Xiao Ying , Wang Tao , James Kang Y
Published: May 2018

The distribution of copper (Cu) in the biological system is regulated by Cu transporters and chaperones. It has been known for a long time that myocardial ischemia is accompanied by the loss of Cu from the heart, but the mechanism by which this occurs remains unknown. The present study was undertaken to understand the relationship between Cu loss and alterations in Cu transporters during the pathogenesis of myocardial ischemia. Male mice (C57 BL/6J) were subjected to left anterior descending (LAD) coronary artery ligation to induce myocardial ischemia. Changes in Cu concentrations in serum and hearts were determined from blood and tissue samples harvested at different time points for a total of 28 days after the operation. Cu concentrations in the ischemic myocardium were continuously decreased starting at the fourth day after LAD artery ligation, gradually depleted by more than 80% of the normal level at the 10th day, and remained at the lowest level (about 20% of normal levels) thereafter. Serum Cu concentrations were correspondingly increased starting at the fourth day, reached to the highest level between day 7 and 10, and gradually recovered to the normal level until 21st day after the operation. Along with the same time course, the intracellular Cu exporter copper metabolism MURR domain 1 (COMMD1) was significantly and sustainably increased, but ATP7A and ATP7B were not significantly changed in the ischemic myocardium. These results suggest that during the pathogenesis of myocardial ischemia, COMMD1 would play a critical role in exporting Cu from the ischemic myocardium to the blood.

Impact statement

In this work, we found that copper efflux from the ischemic heart leads to the elevation of serum copper concentrations, addressing a long-term question related to serum copper elevation in myocardial ischemia patients. The efflux of copper from the ischemic heart results at least in part from the upregulation of copper metabolism MURR domain 1 (COMMD1) in the heart upon ischemic insult. This work provides a novel insight into copper homeostasis and alteration in cardiovascular system.
Narrating Mother Identities From Prison
Authors: Easterling Beth A. , Feldmeyer Ben , Presser Lois
Published: May 2018

Incarcerated mothers face challenges to mothering in prison, including restricted opportunities to perform parenting tasks, ambiguous loss, and a compromised parenting identity. This study uses interviews with incarcerated mothers in the United States to explore how such women negotiate motherhood. All of the women grappled with how to care for their children from prison and projected futures that they hoped to experience as mothers. They varied in their active involvement as decision makers and in their intimacy with their children, but all were seen as renegotiating narrative identities. The study underscores the fact that social actors can be creative with self-narrative when they can be creative in few other ways.
Effects of object size and distance on reaching kinematics in patients with schizophrenia
Authors: Wang Shu-Mei , Kuo Li-Chieh , Ouyang Wen-Chen , Hsu Hsiao-Man , Ma Hui-Ing
Published: May 2018

Background/Objective

Patients with schizophrenia not only have psychiatric symptoms, but also have movement problems, which might also be associated with their reduced quality of life. Little is known about how to improve their movement performance for patients. Manipulating object size and distance is common in occupational therapy practice to evaluate and optimize reaching performance in patients with physical disabilities, but effects of the manipulation in patients with schizophrenia remain unclear. The purpose of this study was to examine whether object size and distance could change performance of reaching kinematics in patients with mild schizophrenia.

Methods

Twenty-nine patients with mild schizophrenia and 15 age- and gender-matched healthy controls were required to reach for, as quickly as possible, a small or large object that was placed at a near or far distance. We measured movement time, peak velocity, path length ratio, percentage of time to peak velocity, and movement units to infer movement speed, forcefulness, spatial efficiency (directness), control strategies, and smoothness.

Results

Patients’ reaching movements were slower ( p = .017) and less direct ( p = .007) than those of controls. A larger object induced faster ( p = .016), more preprogrammed ( p = .018), and more forceful ( p = .010) movements in patients. A farther object induced slower, more feedback dependent, but more forceful and more direct movements (all p < .001).

Conclusion

The results of kinematic deficiencies suggest the need of movement training for patients with mild schizophrenia. Occupational therapists may grade or adapt reaching activities by changing object size and distance to enhance movement performance in patients with schizophrenia.
Development of the Japanese version of the Westmead Home Safety Assessment for the elderly in Japan
Authors: Hasegawa Aya , Kamimura Tomoko
Published: May 2018

Objective

Home safety assessment and intervention is a key component in the management of fall risk in elderly people. However, a standardised assessment for home safety has not yet been established in Japan. We developed a Japanese version of the Westmead Home Safety Assessment by partially modifying the original version according to house structures and lifestyles in Japan and examined its inter-rater reliability and content validity.

Methods

Japanese elderly in the community who had fear of falls were recruited to investigate the reliability of the Japanese version of the Westmead Home Safety Assessment. Two occupational therapists simultaneously visited a participant’s home to perform the Japanese version of the Westmead Home Safety Assessment independently. Further, an expert panel of 18 occupational therapists evaluated the relevance of each item of the Japanese version of the Westmead Home Safety Assessment.

Results

Fifty elderly people (aged 78.2 ± 7.1 years) participated in this reliability study. The most frequent hazards were identified as internal steps/stairs, seating, bathroom, bath, and external steps/stairs. Forty-nine items (69%) in the Japanese version of the Westmead Home Safety Assessment were rated to have fair to good (0.40 < κ < 0.75) or excellent (κ ≥ 0.75) reliability as well as excellent validity (item content validity ≥0.78). These items were concerned with basic activities of daily living and some simple instrumental activities of daily living. The scale content validity was 0.78 ± 0.16 but was not excellent (scale content validity index <0.90).

Conclusions

This study suggested that 49 items in the Japanese version of the Westmead Home Safety Assessment were appropriate for home safety assessment for Japanese elderly. Further research is necessary to improve the reliability and validity of the present version of the Japanese version of the Westmead Home Safety Assessment for this population.
Orthotic management of fixed flexion deformity of the proximal interphalangeal joint following traumatic injury: A systematic review
Authors: Young Nicole , Terrington Nichola , Francis Diana , Robinson Luke S
Published: May 2018

Background/objective

Fixed flexion deformity of the proximal interphalangeal joint can commonly occur following a traumatic injury impacting on hand function and occupational performance. Numerous interventions have been proposed for fixed flexion deformity resolution. This paper investigates the efficacy of static or dynamic orthoses in reducing fixed flexion deformity contracture following traumatic proximal interphalangeal joint injury.

Methods

A multi-database search of three databases (CINAHL, EMBASE, MEDLINE) was conducted. Data extracted for each study were design, patient descriptions, degree of fixed flexion deformity pre- and post-orthoses, and prescribed interventions and exercise programmes.

Results

The search yielded 643 studies, of which eight met the inclusion criteria. Studies used heterogeneous methodologies investigating various orthotic interventions. Meta-analysis or pooling of results was not possible. Dissimilar orthotic wear regimes were noted in all studies and an alternative clinical significance outcome was found.

Conclusion

More research is required to support clinical reasoning in orthotic choice for fixed flexion deformity of the proximal interphalangeal joint post-traumatic injury.
Multiphysics modelling of manufacturing processes: A review
Authors: Jabbari Masoud , Baran Ismet , Mohanty Sankhya , Comminal Raphaël , Sonne Mads Rostgaard , Nielsen Michael Wenani , Spangenberg Jon , Hattel Jesper Henri
Published: May 2018

Numerical modelling is increasingly supporting the analysis and optimization of manufacturing processes in the production industry. Even if being mostly applied to multistep processes, single process steps may be so complex by nature that the needed models to describe them must include multiphysics. On the other hand, processes which inherently may seem multiphysical by nature might sometimes be modelled by considerably simpler models if the problem at hand can be somehow adequately simplified. In the present article, examples of this will be presented. The cases are chosen with the aim of showing the diversity in the field of modelling of manufacturing processes as regards process, materials, generic disciplines as well as length scales: (1) modelling of tape casting for thin ceramic layers, (2) modelling the flow of polymers in extrusion, (3) modelling the deformation process of flexible stamps for nanoimprint lithography, (4) modelling manufacturing of composite parts and (5) modelling the selective laser melting process. For all five examples, the emphasis is on modelling results as well as describing the models in brief mathematical details. Alongside with relevant references to the original work, proper comparison with experiments is given in some examples for model validation.
Fatigue life analysis of dropper used in pantograph-catenary system of high-speed railway
Authors: Chen Liming , Peng Peihuo , He Fan
Published: May 2018

Dropper is an important component of pantograph-catenary system employed in high-speed railway. The cyclic stress in dropper can lead to the fatigue failure during operation. The study of the fatigue life of dropper is the premise to ensure the safe exploitation of the train. The analytic vibration equation of dropper is proposed. Based on the finite difference method and MATLAB numerical calculation program, the vibration process and stress variation of the dropper are simulated. The influence of excitation frequency, vibration amplitude, and applied force on fatigue life of dropper is studied, according to the stress history of the dropper, the Basquin equation, and the Palmgren–Miner linear fatigue cumulative damage criterion. The numerical results show that the logarithm of the fatigue life of dropper shows a linear decreasing trend with the increase in the excitation frequency, vibration amplitude, or applied force.
Common femoral artery endarterectomy in the age of endovascular therapy
Authors: Elsherif Mohamed , Tawfick Wael , Elsharkawi Mohamed , Campell Ruth , Hynes Niamh , Sultan Sherif
Published: May 2018

Objectives

Common femoral artery endarterectomy (CFE) is the standard treatment for common femoral artery occlusive disease. We aim to assess the medium term outcomes of CFE with or without further concomitant procedures.

Design

A retrospective observational study.

Methods

All patients who underwent either isolated CFE (ICFE), CFE with angioplasty for occlusive arterial disease (CFEA) or concomitant CFE with endovascular aortic aneurysm repair (CFEE) were included. Patient demographics follow up, clinical improvement, types of CFE closure, patency rates, and survival-free amputation were noted.

Results

From 2002 to 2015, 1512 patients were referred with a diagnosis of critical limb ischemia. Of those, 1134 required revascularization. Sixty-one patients underwent 66 CFE. Ten limbs underwent an ICFE, 35 had CFEA, and 21 underwent CFEE. Demographics were comparable in all groups. Twenty-seven were closed primarily, while 39 required patch closure (12 venous, 8 Dacron, 19 biological). Technical success was 100% in ICFEs, 94% in CFEA, and 100% for CFEE ( p = 0.274). Immediate clinical success was 100% in both CFE and CFEE, but was 85.7% in CFEA ( p = 0.035). Immediate hemodynamic success was similar in all three groups ( p = 0.73). Sustained hemodynamic success was 30% in ICFE, 54.3% in CFEA, and 23.8% in CFEE ( p = 0.056). At two years, the primary patency was 90% in ICFE, 74.3% in CFEA, and 100% in CFEE ( p = 0.049). Primary-assisted patency was 90% in ICFE, 82.9% in CFEA, and 100% in CFEE ( p = 0.17). Secondary patency was 90% in ICFE, 94.3% in CFEA, and 100% in CFEE ( p = 0.409). Re-intervention was required in 26.9% of primary closures, versus 12.8% with patch closures ( p = 0.279). Amputation-free survival was 100% in ICFE, 80% in CFEA, and 100% in CFEE ( p = 0.056).

Conclusion

CFE is a reliable and dependable procedure, even in the absence of good distal runoff.
New approach of sliding mode control for nonlinear uncertain pneumatic artificial muscle manipulator enhanced with adaptive fuzzy estimator
Authors: Anh Ho Pham Huy , Kien Cao Van , Son Nguyen Ngoc , Nam Nguyen Thanh
Published: May 2018

A new enhanced adaptive fuzzy sliding mode control approach is proposed in this article with its good availability for application in control of a highly uncertain nonlinear two-link pneumatic artificial muscle manipulator. Stability demonstration of the robust convergence of the closed-loop pneumatic artificial muscle manipulator system based on a novel enhanced adaptive fuzzy sliding mode control is experimentally proved using Lyapunov stability theorem. Obtained result confirms that the new enhanced adaptive fuzzy sliding mode control method, applied to the two-link uncertain nonlinear pneumatic artificial muscle manipulator system, is fully investigated with better robustness and precision than the standard sliding mode control and fuzzy sliding mode control techniques.
Influence of pipe geometric deviation on bristled in-pipe mobile robot locomotion
Authors: Galajdová Alena , Virgala Ivan , Kelemen Michal , Miková Lubica , Lipták Tomás , Kelemenová Tatiana
Published: May 2018

This article deals with the analysis of geometric deviations influence on in-pipe robot locomotion, which uses the principle of friction difference principle. Bristles are as carrying elements. They are mounted as cantilever beams at angle to robot body. The robot should locomote inside industrial pipelines. All pipes have geometric deviations, which come from production process otherwise from operation process. It is necessary to know about the influence of these geometric deviations on the robot locomotion.
Vasa praevia: Should we routinely screen high-risk women for this rare but serious condition?
Authors: McQueen Victoria , Speed Michelle , Rutter Susan , Gray Thomas
Published: May 2018

Vasa praevia is described as the unprotected fetal vessels traversing through the placental membranes over the cervical os, below the fetal presenting part and unprotected by placental tissue or the umbilical cord. It is often not detected antenatally and presents with painless bleeding and rapid fetal compromise after spontaneous or artificial rupture of the membranes, which causes trauma to these vessels. It is a rare condition affecting one in 2500 pregnancies and has a reported perinatal mortality rate of up to 60%. More than 80% of cases of vasa praevia have at least one risk factor for the condition and it has been shown that identification of vasa praevia antenatally results in fetal survival rates of up to 97%. Risk factors include placenta praevia, velamentous cord insertion, bi-lobed placenta, succenturiate lobe, assisted reproduction and multiple pregnancy. Screening for vasa praevia with transvaginal ultrasound has been shown to be sensitive and cost effective when used in a targeted population where risk factors are present. Here, we present the antenatal assessment and management of a case of vasa praevia detected during the routine 20-week anatomy scan of a healthy primigravida, which resulted in elective caesarean section delivery of a healthy baby at 36 weeks' gestation. The pathophysiology of vasa praevia is discussed and the methods and role of screening for this rare but serious condition are appraised.
Association between comorbid cancer and outcomes among admissions for acute ischemic stroke receiving systemic thrombolysis
Authors: Weeda Erin R , Bohm Nicole
Published: May 2018

Background

The impact of cancer on outcomes was not assessed in major trials of systemic thrombolysis in acute ischemic stroke.

Aims

To evaluate the association between comorbid cancer and hospital outcomes among patients receiving systemic thrombolysis for the treatment of acute ischemic stroke.

Methods

The 2013 and 2014 United States National Inpatient Sample was used to identify adult patients hospitalized for acute ischemic stroke who received systemic thrombolysis. Identified admissions were stratified into two cohorts based on the presence or absence of comorbid cancer. Multivariable logistic regression was performed to determine the association between comorbid cancer and the odds of in-hospital mortality and intracerebral hemorrhage after adjustment for age ≥75 years and comorbid atrial fibrillation.

Results

A total of 13,993 acute ischemic stroke admissions were treated with systemic thrombolysis. Of these, 3.0% ( n = 416) had comorbid cancer. The overall incidence of in-hospital mortality was 7.0% and intracerebral hemorrhage occurred in 7.6% of patients. Upon multivariable adjustment, comorbid cancer was not associated with an increased odds of in-hospital mortality (odds ratio = 1.24; 95% confidence interval = 0.88–1.76). However, the adjusted odds of intracerebral hemorrhage were higher among those with comorbid cancer (odds ratio = 1.60; 95% confidence interval = 1.17–2.17).

Conclusions

In this retrospective study of admissions for acute ischemic stroke receiving thrombolysis, comorbid cancer was not associated with a higher odds of in-hospital mortality but was associated with an increased odds of intracerebral hemorrhage. Factors driving this observed association should be explored in data sets containing clinical variables.
Upper limb congenital muscular hypertrophy and aberrant muscle syndrome in children
Authors: Dahan Emmanuel , Chaves Camilo , Bachy Manon , Fitoussi Frank
Published: May 2018

Congenital muscle hypertrophy of the upper limb is a very rare condition with unknown aetiology. This descriptive observational and retrospective series included eight children followed by a multidisciplinary team from 2005 to 2017. The diagnosis was based on a cluster of clinical and radiological characteristics after elimination of differential diagnoses. Patients were categorized according to: anomalies of the wrist, anomalies of long fingers of intrinsic or extrinsic origin; and anomalies of the thumb with or without first web space contracture. Treatment begins in young children with hand orthoses to limit muscle contraction and joint malposition. The purpose of surgical treatment was to release contractures and to restore muscle balance through, in the main, finger intrinsic releases and first web releases. At the 2-year follow-up, we found that limited surgical procedures improved finger, thumb and wrist positions. We conclude that muscle hypertrophy is the main cause of deformity and that selective releases of contracted musculo-tendinous units and skin lengthening are effective.

Level of evidence: IV
Development of a Core Outcome Set for research on critically ill obstetric patients: A study protocol
Authors: Viau-Lapointe Julien , D’Souza Rohan , Rose Louise , Lapinsky Stephen E
Published: May 2018

Background

Current data on critical illness during pregnancy are insufficient for evidence-based decision making. Core outcome sets are promoted to improve reporting of outcomes important to decision makers. We aim to develop a Core Outcome Set for research on critically ill obstetric patients (COSCO study).

Methods

We will perform a systematic review of studies on critical illness in pregnancy and focus groups or interviews with women who were critically ill while being pregnant. These data will inform an international Delphi survey where stakeholders will rank proposed outcomes. Selected outcomes will be brought forward to a consensus meeting where core outcomes will be defined. We will then complete a second consensus process to define measures for each core outcome.

Conclusion

The Core Outcome Set on Critically ill Obstetric patients study aims to develop a set of core outcomes to be part of all studies on critically ill obstetric patients. Implementation of this core outcome set will help improve future research efforts. Trial registration: This study is registered on the COMET-initiative website (COS #916). This systematic review is registered on PROSPERO (CRD #42017071944).
Direct and indirect costs associated with nonoperative treatment for shoulder instability: an observational study in 132 patients
Authors: van der Linde Just A , Bosmans Judith E , ter Meulen Dirk P , van Kampen Derk A , van Deurzen Derek FP , Haverlag Robert , Saris Daniel BF , van den Bekerom Michel PJ
Published: May 2018

Background

Shoulder instability is associated with decreased functioning. The associated costs could be substantial and interesting to clinicians, researchers, and policy makers. This prospective observational study aims to (1) estimate productivity losses and healthcare expenses following the nonoperative treatment of shoulder instability and (2) identify patient characteristics that influence societal costs.

Methods

One hundred and thirty-two patients completed a questionnaire regarding production losses and healthcare utilization following consecutive episodes of shoulder instability. Productivity losses were calculated using the friction cost approach. Healthcare utilization was evaluated using standard costs. analysis of variance test was used to assess which patient characteristics are related to productivity losses and healthcare expenses. Societal costs were assessed using multilevel analyses. Bootstrapping was used to estimate statistical uncertainty.

Results

Mean productivity losses are €1469, €881, and €728 and mean healthcare expenses are €3759, €3267, and €2424 per patient per dislocation for the first, second, and third dislocation. Productivity losses decrease significantly after the second (mean difference €−1969, 95%CI= −3680 to −939) and third (mean difference €−2298, 95%CI= −4092 to −1288) compared to the first dislocation.

Conclusions

Nonoperative treatment of shoulder instability has substantial societal costs.

Level of Evidence

III, economic analysis.
Social Media as a Sphere for “Risky” Political Expression: A Twenty-Country Multilevel Comparative Analysis
Authors: Barnidge Matthew , Huber Brigitte , de Zúñiga Homero Gil , Liu James H.
Published: May 2018

In the context of the United States, research shows a positive relationship between network heterogeneity and political expression on social media at the individual level. This study builds on that research, relying on multilevel analysis that (1) leverages a twenty-country comparative survey and (2) includes country-level data on freedom of expression. Results show a positive relationship between network heterogeneity and political expression on social media across countries, but that relationship is stronger where freedom of expression is more limited.
Tackling transnational crime
Authors: Wolffe QC W. James
Published: May 2018

In this speech, given in Brussels on 29 January 2018, the Lord Advocate, James Wolffe QC, the head of Scotland’s systems of prosecution and investigation of deaths, discusses, from a Scottish perspective, the challenge of transnational crime and the benefits of current European Union (EU) cooperation regimes in the prosecution of cross-border crime, in the context of the United Kingdom’s intention to withdraw from the EU.
Interplay between hypercholesterolaemia and inflammation in atherosclerosis: Translating experimental targets into clinical practice
Authors: Tuñón José , Bäck Magnus , Badimón Lina , Bochaton-Piallat Marie-Luce , Cariou Bertrand , Daemen Mat J , Egido Jesus , Evans Paul C , Francis Sheila E , Ketelhuth Daniel FJ , Lutgens Esther , Matter Christian M , Monaco Claudia , Steffens Sabine , Stroes Erik , Vindis Cécile , Weber Christian , Hoefer Imo E
Published: May 2018

Dyslipidaemia and inflammation are closely interconnected in their contribution to atherosclerosis. In fact, low-density lipoprotein (LDL)-lowering drugs have anti-inflammatory effects. The Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS) has shown that interleukin (IL)-1β blockade reduces the incidence of cardiovascular events in patients with previous myocardial infarction and C-reactive protein levels >2 mg/L. These data confirm the connection between lipids and inflammation, as lipids activate the Nod-like receptor protein 3 inflammasome that leads to IL-1β activation. LDL-lowering drugs are the foundation of cardiovascular prevention. Now, the CANTOS trial demonstrates that combining them with IL-1β blockade further decreases the incidence of cardiovascular events. However, both therapies are not at the same level, given the large evidence showing that LDL-lowering drugs reduce cardiovascular risk as opposed to only one randomized trial of IL-1β blockade. In addition, IL-1β blockade has only been studied in patients with C-reactive protein >2 mg/L, while the benefit of LDL-lowering is not restricted to these patients. Also, lipid-lowering drugs are not harmful even at very low ranges of LDL, while anti-inflammatory therapies may confer a higher risk of developing fatal infections and sepsis. In the future, more clinical trials are needed to explore whether targeting other inflammatory molecules, both related and unrelated to the IL-1β pathway, reduces the cardiovascular risk. In this regard, the ongoing trials with methotrexate and colchicine may clarify whether the cardiovascular benefit of IL-1β blockade extends to other anti-inflammatory mechanisms. A positive result would represent a major change in the future treatment of atherosclerosis.
A pilot study investigating whether quantitative sensory testing alters after treatment in patients with fibromyalgia
Authors: Wodehouse Theresa , Poply Kavita , Ramaswamy Shankar , Snidvongs Saowarat , Bourke Julius , Tahir Hasan , Ullrich Kristin , Mehta Vivek
Published: May 2018

Background:

Fibromyalgia is a chronic musculoskeletal pain condition that is often associated with sleep disturbances and fatigue. The pathophysiology of fibromyalgia is not understood, but indirect evidence suggests a central dysfunction of the nociceptive modulating system. The aim of this study was to evaluate whether quantitative sensory testing detects a change in pain thresholds in fibromyalgia patient receiving pregabalin treatment.

Methods:

A total of 25 patients were recruited for the study and received routine pregabalin, but only 14 patients completed the treatment. Assessment of pressure pain thresholds and changes in conditioned pain modulation using ischaemic pain as a conditioning stimulus were measured at baseline and every 4 weeks for 12 weeks. Fibromyalgia impact questionnaire, PainDETECT and SF-12 were also completed.

Results:

Patients with fibromyalgia demonstrated a less-efficient conditioned pain modulation at baseline. An efficient conditioned pain modulation was observed at 1 month and this was maintained until the final visit. Pressure pain thresholds (PPTs) showed a significant improvement from baseline. Patients also reported a similar magnitude of improvements in PainDETECT, fibromyalgia impact questionnaire (FIQ) and its impact on daily life and change in outcome for SF-12.

Conclusion:

This pilot study reports an increase in PPTs and improved conditioned pain modulation response after commencing pregabalin, which was maintained at 12 weeks, and this was supported by positive pain scores. Pregabalin is a licenced treatment for fibromyalgia in Europe, and its response to central sensitisation, particularly ‘dynamic responses’, has not been reported. We conclude that pregabalin has the potential to reduce peripheral and central sensitisation in patients with fibromyalgia, as measured using quantitative sensory testing.
Differentiating overlapping symptoms of vulvodynia and pudendal neuralgia
Authors: Ghizzani Anna , Carta Serafino , Casoni Annalisa , Ferrata Paolo , Luisi Stefano , Fortina Mattia
Published: May 2018

Context:

Vulvodynia is defined as a chronic vulvar pain non-associated with infectious, inflammatory, neoplastic or hormonal disorders.

Objectives:

To present a case demonstrating the difficulty in assessing concomitant disease in vulvodynia.

Methods:

A 26-year-old woman, presented with persistent vulvodynia. She received oral and topical medications and behavioural interventions to lessen sexual pain and restore sexuality. As sexual pain decreased, the patient reported symptoms previously not mentioned: continuous, intense periclitoral pain and numbness at the perineum when sitting for a long time. These new symptoms suggest the involvement of the peripheral neural system. The physical evaluation confirmed right-side pelvic distortion, and pathological increase in lumbar lordosis, which caused neuralgia radiating to the external genitalia and perineum, and overlapping with sexual pain. After diagnosing pudendal neuralgia according to the Nantes criteria, physical treatment and relaxation exercises to de-contract the spine were added to the vulvodynia regimen.

Results:

During treatment, vulvodynia was sometimes present but never unbearable, allowing satisfactory sex. With physical therapy, the symptoms of pudendal neuralgia decreased.

Conclusion:

Differentiating the presence of two conditions with overlapping symptoms is difficult because the vestibular pain had shadowed pudendal neuralgia symptoms at initial assessment. Syndromes of chronic pain tend to associate with each other and one syndrome may shadow symptoms of the concomitant condition affecting adjacent anatomical areas. Only the accurate identification of all the syndromes involved allows adopting the correct treatment.
Entrepreneurial Teams, Gender, and New Venture Survival: Contexts and Institutions
Authors: Box Marcus , Larsson Segerlind Tommy
Published: May 2018

The link between new venture survival and the presence of founding teams is investigated, in particular the effect of the gender composition of teams. Furthermore, we study venture survival, gender, and institutional change. A unique longitudinal database is employed, covering a large number of Swedish ventures established during 6 specific years, 1930-2005. These data capture the initial gender diversity of start-ups. The contextualization of entrepreneurship involves situational and temporal boundaries, and we elaborate on contextual factors at different levels of analysis. Our results show that ventures founded by teams have a higher probability of surviving, but show no overall team gender homogeneity/heterogeneity effect. However, we find some support for the fact that ventures founded by all-female teams have lower survival chances. Nevertheless, the clearest negative effect is found for female solo start-ups. Furthermore, our results support the fact that institutional transformation may gradually have increased the likelihood of ventures founded by females to survive.
Shewanella putrefaciens: An Emerging Cause of Nosocomial Pneumonia
Authors: Ullah Saad , Mehmood Hassan , Pervin Najwa , Zeb Hassan , Kamal Khushbakht Ramsha , Liaqat Sadaquat
Published: May 2018

Gram-negative infections are a rising concern faced by the medical community. Approximately 30% of nosocomial bloodstream infections in intensive care units in the United States are caused by these gram-negative species. Emergence of multidrug-resistant organisms further complicate this issue. In this article, we report a case of an 84-year-old Caucasian male who was diagnosed with Shewanella pneumonia treated with cefepime with minimal to no improvement in his symptoms. To the best of our knowledge, this is the third reported case of Shewanella putrefaciens nosocomial pneumonia and first case of bacteremia secondary to pneumonia by Shewanella putrefaciens.
Patient-Related Risk Factors for Infection Following Ulnar Nerve Release at the Cubital Tunnel: An Analysis of 15,188 Cases
Authors: Camp Christopher L. , Tebo Collin C. , Degen Ryan M. , Dines Joshua S. , Altchek David W. , Werner Brian C.
Published: May 2018

Background:

Although cubital tunnel release is a commonly performed orthopaedic procedure, the overall incidence of and independent risk factors for infection largely remain undefined in the current literature.

Purpose:

To establish the rate of postoperative infection after isolated cubital tunnel release and define relevant patient-related risk factors.

Study Design:

Case-control study; Level 3.

Methods:

All Medicare-insured patients undergoing ulnar nerve decompression at the cubital tunnel from 2010 through 2012 were identified. A multivariate binomial logistic regression analysis was utilized to evaluate the impact of patient-related risk factors for postoperative infection.

Results:

A total of 330 (2.17%) postoperative infections were identified in 15,188 cases. The majority (87%) were managed nonoperatively, while 13% required surgical debridement. The most significant risk factors for infection included hemodialysis use (odds ratio [OR], 2.47), chronic anemia (OR, 2.24), age <65 years (OR, 2.08), tobacco use (OR, 1.65), morbid obesity (OR, 1.53), inflammatory arthritis (OR, 1.43), depression (OR, 1.36), hyperlipidemia (OR, 1.33), male sex (OR, 1.32), and chronic lung disease (OR, 1.29).

Conclusion:

The present study was adequately powered to determine numerous patient-related risk factors for infection following cubital tunnel release.
Pyronaridine–artesunate and artemether–lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in Kenyan children: a randomized controlled non-inferiority trial
Authors: Roth Johanna M. , Sawa Patrick , Makio Nicodemus , Omweri George , Osoti Victor , Okach Selpha , Choy Felix , Schallig Henk D. F. H. , Mens Pètra
Published: May 2018

Background

Pyronaridine–artesunate is a novel artemisinin-based combination therapy. The efficacy and safety of pyronaridine–artesunate were compared with artemether–lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in children.

Methods

This phase III open-label randomized controlled non-inferiority trial was conducted in Western Kenya. Children aged 6 months to ≤ 12 years with a bodyweight > 5 kg and microscopically confirmed P. falciparum malaria were randomly assigned in a 1:1 ratio to orally receive pyronaridine–artesunate or artemether–lumefantrine, dosed according to bodyweight, for 3 days.

Results

Of 197 participants, 101 received pyronaridine–artesunate and 96 received artemether–lumefantrine. The day-28 adequate clinical and parasitological response in the per-protocol population, PCR-corrected for reinfections, was 98.9% (93/94, 95% CI 94.2–99.8) for pyronaridine–artesunate and 96.4% (81/84, 95% CI 90.0–98.8) for artemether–lumefantrine. Pyronaridine–artesunate was found to be non-inferior to artemether–lumefantrine: the treatment difference was 2.5% (95% CI − 2.8 to 9.0). Adverse events occurred in 41.6% (42/101) and 34.4% (33/96) of patients in the pyronaridine–artesunate group and the artemether–lumefantrine group, respectively. No participants were found to have alanine or aspartate aminotransferase levels > 3 times the upper limit of normal.

Conclusions

Pyronaridine–artesunate was well tolerated, efficacious and non-inferior to artemether–lumefantrine for the treatment of uncomplicated P. falciparum malaria in Kenyan children. Results are in line with previous reports and inclusion of pyronaridine–artesunate in paediatric malaria treatment programmes should be considered.

This study is registered at clinicaltrials.gov under NCT02411994. Registration date: 8 April 2015. https://clinicaltrials.gov/ct2/show/NCT02411994?term=pyronaridine–artesunate&cond=Malaria&cntry=KE&rank=1
Medical Transition without Social Transition
Authors: Rachlin Katherine
Published: May 2018

People who want gender-affirming surgery without a change in social role represent a range of unique perspectives and use a range of self-descriptive terms, including transgender, transsexual, genderqueer, gender nonconforming, TGNC, nonbinary, and cross-dresser. They may seek surgery to reduce gender dysphoria or to enhance gender euphoria. Professional literature and medical protocols such as the World Professional Association for Transgender Health's (WPATH) Standards of Care, version 7 (SOC-7), have been developed to reflect the needs of people who want to change their social role as well as their body. Medical protocols including SOC-7 recommend a period of “real-life experience” as a criterion for some surgeries, which is not appropriate for people who want medical without social transition, who may want a private expression of gender, and who are at high risk for self-treatment and self-injury. This article describes the many factors that may affect transition and surgical choices. A composite case example is presented to illustrate how surgery without social transition might enhance the life of a female-identified person who lives socially as a man. Medical and mental health providers do provide treatment for people who want medical transition without social transition, but the practice has yet to be well documented.
Lineage-guided Notch-dependent gliogenesis byDrosophilamulti-potent progenitors
Authors: Ren Qingzhong , Awasaki Takeshi , Wang Yu-Chun , Huang Yu-Fen , Lee Tzumin
Published: May 2018

Macroglial cells in the central nervous system exhibit regional specialization and carry out region-specific functions. Diverse glial cells arise from specific progenitors in specific spatiotemporal patterns. This raises an interesting possibility that there exist glial precursors with distinct developmental fates, which govern region-specific gliogenesis. Here we mapped the glial progeny produced by the Drosophila type II neuroblasts, which, like vertebrate radial glia cells, yield both neurons and glia via intermediate neural progenitors (INPs). Distinct type II neuroblasts produce different characteristic sets of glia. A single INP can make both astrocyte-like and ensheathing glia, which co-occupy a relatively restrictive subdomain. Blocking apoptosis uncovers further lineage distinctions in the specification, proliferation, and survival of glial precursors. Both the switch from neurogenesis to gliogenesis and the subsequent glial expansion depend on Notch signaling. Taken together, lineage origins preconfigure the development of individual glial precursors with involvement of serial Notch actions in promoting gliogenesis.
Distinct regulation of Snail in two muscle lineages of the ascidian embryo achieves temporal coordination of muscle development
Authors: Tokuoka Miki , Kobayashi Kenji , Satou Yutaka
Published: May 2018

The transcriptional repressor Snail is required for proper differentiation of the tail muscle of ascidian tadpole larvae. Two muscle lineages (B5.1 and B6.4) contribute to the anterior tail muscle cells, and are consecutively separated from a transcriptionally quiescent germ cell lineage at the 16- and 32-cell stages. Concomitantly, cells of these lineages begin to express Tbx6.b at the 16- and 32-cell stages, respectively. Meanwhile, Snail expression begins in these two lineages simultaneously at the 32-cell stage. Here, we showed that Snail expression is regulated differently between these two lineages. In the B5.1 lineage, Snail was activated through Tbx6.b, which is activated by maternal factors, including Zic-r.a. In the B6.4 lineage, the MAPK pathway was cell-autonomously activated by a constitutively active form of Raf, and it enabled Zic-r.a to activate Snail independently of Tbx6.b. As a result, Snail begins to be expressed at the 32-cell stage simultaneously in these two lineages. Such shortcuts may be required for coordinating developmental programs in embryos in which cells become separated progressively from stem cells including germ line cells.
Refinement of a mouse cardiovascular model: Development, application and dissemination
Authors: Taylor Kirk A. , Emerson Michael
Published: May 2018

European and UK legislation requires all animal procedures to be conducted with consideration to reduction, refinement and replacement. In this review, 3Rs developments are discussed in the field of platelet biology and thromboembolism. Platelet research requires the use of animal models, and mice are widely used in the field. When working in vitro, conventional light transmission techniques have been scaled down allowing reduction in animal numbers. In vivo, vascular injury models are widely used and work is ongoing to develop ex vivo approaches that use fewer animals. Thromboembolic mortality models, which inflict considerable pain and suffering, have also been used widely. A published and characterised refinement of this mortality model allows real-time monitoring of radiolabelled platelets under general anaesthesia and reduces both the severity level and the numbers of mice used in a typical experiment. This technique is more sensitive than the mortality approach and has opened up new avenues of research, which would not have been feasible by using death as an end-point. To drive uptake of real-time monitoring, a more simplistic approach has been developed involving micro-sampling and cell counting. Thromboembolic mortality models should therefore be considered obsolete due to the emergence of 3Rs models with improved scientific outcomes and that can be implemented relatively easily.
Preparation of organotypic brain slice cultures for the study of Alzheimer’s disease
Authors: Croft Cara L. , Noble Wendy
Published: May 2018

Alzheimer's disease, the most common cause of dementia, is a progressive neurodegenerative disorder characterised by amyloid-beta deposits in extracellular plaques, intracellular neurofibrillary tangles of aggregated tau, synaptic dysfunction and neuronal death. There are no cures for AD and current medications only alleviate some disease symptoms.

Transgenic rodent models to study Alzheimer’s mimic features of human disease such as age-dependent accumulation of abnormal beta-amyloid and tau, synaptic dysfunction, cognitive deficits and neurodegeneration. These models have proven vital for improving our understanding of the molecular mechanisms underlying AD and for identifying promising therapeutic approaches. However, modelling neurodegenerative disease in animals commonly involves aging animals until they develop harmful phenotypes, often coupled with invasive procedures.In vivo studies are also resource, labour, time and cost intensive.

We have developed a novel organotypic brain slice culture model to study Alzheimer’ disease which brings the potential of substantially reducing the number of rodents used in dementia research from an estimated 20,000 per year. We obtain 36 brain slices from each mouse pup, considerably reducing the numbers of animals required to investigate multiple stages of disease. This tractable model also allows the opportunity to modulate multiple pathways in tissues from a single animal. We believe that this model will most benefit dementia researchers in the academic and drug discovery sectors.

We validated the slice culture model against aged mice, showing that the molecular phenotype closely mimics that displayedin vivo, albeit in an accelerated timescale. We showed beneficial outcomes following treatment of slices with agents previously shown to have therapeutic effectsin vivo,and we also identified new mechanisms of action of other compounds. Thus, organotypic brain slice cultures from transgenic mouse models expressing Alzheimer’s disease-related genes may provide a valid and sensitive replacement forin vivostudies that do not involve behavioural analysis.