bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinically Available Assessment Measures for Lingual and Labial Somatosensation in Healthy Adults: Normative Data and Test Reliability
Authors: Etter Nicole M. , Miller Olivia M. , Ballard Kirrie J.
Published: June 2017

Purpose

High-quality orofacial somatosensory inputs are essential for achieving rapid and accurate motor outputs. Little somatosensory testing is currently being completed in clinical settings. The purpose of this study is to assess the feasibility and test–retest reliability of clinical assessment tools for orofacial somatosensory testing in healthy young adults.

Method

A total of 45 healthy young adults (ages 20–41 years) was recruited. Participants reported basic health information, completed pure-tone hearing thresholds, and were assessed using two-point discrimination discs and Von Frey hair detection and discrimination thresholds for bilateral lip and tongue. A subsample of participants (
n
= 18; 40%) returned to complete reliability testing.

Results

Descriptive results are presented for the normative group as well as the reliability group. Difference scores between Tests 1 and 2 for each testing measure and location show high agreement.

Conclusion

Two-point discrimination and Von Frey hair monofilament assessment for both detection- and discrimination-threshold estimates have high test–retest reliability in a healthy young population. These testing measures could be a way to easily complete objective somatosensory testing of the orofacial region in a clinical context.
The Effect of Stimulus Valence on Lexical Retrieval in Younger and Older Adults
Authors: Blackett Deena Schwen , Harnish Stacy M. , Lundine Jennifer P. , Zezinka Alexandra , Healy Eric W.
Published: June 2017

Purpose

Although there is evidence that emotional valence of stimuli impacts lexical processes, there is limited work investigating its specific impact on lexical retrieval. The current study aimed to determine the degree to which emotional valence of pictured stimuli impacts naming latencies in healthy younger and older adults.

Method

Eighteen healthy younger adults and 18 healthy older adults named positive, negative, and neutral images, and reaction time was measured.

Results

Reaction times for positive and negative images were significantly longer than reaction times for neutral images. Reaction times for positive and negative images were not significantly different. Whereas older adults demonstrated significantly longer naming latencies overall than younger adults, the discrepancy in latency with age was far greater when naming emotional pictures.

Conclusions

Emotional arousal of pictures appears to impact naming latency in younger and older adults. We hypothesize that the increase in naming latency for emotional stimuli is the result of a necessary disengagement of attentional resources from the emotional images prior to completion of the naming task. We propose that this process may affect older adults disproportionately due to a decline in attentional resources as part of normal aging, combined with a greater attentional preference for emotional stimuli.
Convergent Total Synthesis of (±)-Apomorphine via Benzyne Chemistry: Insights into the Mechanisms Involved in the Key Step
Authors: Raminelli Cristiano , Muraca Ana , Perecim Givago , Rodrigues Alessandro
Published: June 2017

Convergent total synthesis of (±)-apomorphine hydrochloride was accomplished by an approach that employs in the key step a sequence of transformations involving a [4+2]-cycloaddition reaction followed by a hydrogen migration. Through this sequence of transformations, the desired aporphine core was obtained regioselectively in 75% isolated yield. Since only one regioisomer was produced in the key step of the synthesis, a polar [4+2]-cycloaddition mechanism was proposed. Furthermore, NMR experiments and theoretical calculations were carried out to elucidate the hydrogen migration mechanism. (±)-Apomorphine hydrochloride was achieved after 9 steps in an overall yield of 8% involving benzyne chemistry.
Joint Space Width and Osteoarthritis in Patients Undergoing Hip Arthroscopy
Authors: Pidgeon Tyler , Schiller Jonathan , Evangelista Peter , Machan Jason , Tabaddor Ramin , Gil Joseph
Published: June 2017

Preoperative hip joint space width (JSW) of ≤2 mm on plain radiography has been shown to be predictive of intraoperative findings of osteoarthritis, worse functional outcomes, and failure to total hip arthroplasty following hip arthroscopy. However, there is no evidence to suggest that hip joint space greater than 2 mm can definitively rule out the presence of osteoarthritis. We hypothesize that a preoperative JSW of 2 mm or greater does not reliably rule out the presence of high-grade arthritis on hip arthroscopy. Retrospective review of 50 patients who underwent hip arthroscopy between January 11, 2010, and January 3, 2015, at a single institution was performed. Preoperative, standing anteroposterior hip radiographs were reviewed to determine the minimum hip JSW of each operative hip. Operative notes and images were reviewed to determine the Outerbridge classification of cartilage changes on both the acetabulum and femoral head for each patient. High-grade arthritis was defined as a minimum of grade 3 changes on either the femoral head or the acetabulum, which was required for inclusion in the study. The sensitivity of a JSW of 2 mm or less on preoperative radiographs to diagnose a patient with grade 3, grade 4, and grade 3 or 4 arthritis was calculated. Linear regression was used to test for an association between Outerbridge grading and the radiographic minimum JSW. The mean JSW for all patients was 3.5 ± 1.2 mm (range: 0–5.5 mm). Regression found an inverse relationship between joint space and the arthroscopic grading of the articular surfaces (p = 0.0031). However, a preoperative JSW of ≤ 2 mm was only 14.3% sensitive (95% confidence interval [CI] 2.6–51.3%) for predicting Outerbridge grade 3 changes, 7.3% sensitive (95% CI: 2.5–19.4%) for predicting Outerbridge grade 4 changes, and 8.3% sensitive (95% CI: 3.3–20.6%) for predicting Outerbridge grade 3 or 4 changes. The threshold of ≤2 mm of hip JSW on plain radiographs has poor sensitivity for predicting the existence of high-grade arthritis.
Effekte einer proteinoptimierten Ernährung in Kombination mit moderatem Krafttraining auf den postoperativen Verlauf bei älteren Patienten mit Hüftfraktur
Authors: Hermanky Maria , Korninger Christian , Fuchs Dietmar , Strasser Barbara
Published: June 2017

Hintergrund Die Sarkopenie ist ein signifikanter Prädiktor für Stürze und Brüche, die in Verlust der Selbstständigkeit resultieren können. Das primäre Ziel der vorliegenden Studie war es, die Effekte einer proteinoptimierten Ernährung auf den postoperativen Verlauf bei älteren Patienten mit Hüftfraktur zu untersuchen.

Material und Methodik Es wurden 40 ältere Patienten (Durchschnittsalter: 79,5 Jahre) mit einer hüftnahen Fraktur in die Studie inkludiert und durch Randomisierung entweder der Interventionsgruppe (n = 20) oder der Kontrollgruppe (n = 20) zugewiesen. Patienten in der Interventionsgruppe erhielten im Vergleich zur Kontrolle mit Standardkost eine eiweißoptimierte Kost und absolvierten ein moderates Krafttraining. Das Mini Nutritional Assessment diente zur Erkennung einer Mangelernährung. Albumin und Präalbumin, anthropometrische und Funktionsparameter wurden zum Zeitpunkt der Aufnahme, der Entlassung und zum 1-Monat-Follow-up bestimmt.

Ergebnisse Zum Aufnahmezeitpunkt wurden 10,5 % der Probanden als mangelernährt eingestuft; bei weiteren 26,3 % lag ein erhöhtes Risiko für Mangelernährung vor. Zum Zeitpunkt der Entlassung zeigte sich ein signifikanter Unterschied (Intervention/Kontrolle) in der täglichen Energieaufnahme (1438/1219 kcal; p = 0,016) und Proteinzufuhr (70,5/52,3 g; p < 0,001). Der Präalbuminspiegel verbesserte sich in beiden Gruppen mit dem Aufenthalt, der Albuminspiegel blieb im Zeitverlauf konstant. Zum 1-Monat-Follow-up war die Interventionsgruppe stabiler gegenüber Veränderungen der fettfreien Masse als die Kontrollgruppe (– 0,3/– 1,3 kg). Signifikante Effekte auf die Muskelfunktion wurden nicht festgestellt.

Schlussfolgerung Eine erhöhte Energie- und Proteinversorgung begünstigt den postoperativen Verlauf bei älteren Patienten mit Hüftfraktur. Durch eine verstärkte Zusammenarbeit der verschiedenen betreuenden Berufsgruppen könnte die Patientenversorgung in der frühen postoperativen Phase optimiert werden.
Neuraltherapie bei nicht vertebragenen Schulterbeschwerden
Authors: Günter Uwe
Published: June 2017

Die Neuraltherapie bildet eine gute Option die Beschwerden einer Omalgie zu lindern. Sie setzt sich aus lokaler bzw. Segmenttherapie, der erweiterten Segmenttherapie der Facettenregionen C¾, C⅘ und kaudaler sowie Injektionen an das Ganglion stellatum, ggf. in Kombination mit nervalen Strukturen und perivaskulärem Sympathikus, zusammen.

Bei anamnestischem Hinweis auf Phrenicusreizung sind der Plexus coeliacus in Verbindung mit Akupunktur und Homöosiniatrie je nach Organdiagnostik sowie die Störfeldtherapie je nach Blockierungsmuster und Nackenreflexpunkten nach Adler und Langer durchzuführen.

Bei Persistenz der o.g. Punkte stehen die stomatologische Diagnostik sowie Sanierungstherapie unter Nutzung von Ozon im Vordergrund.

Als Begleittherapie fungieren Manualtherapie, Antiphlogose, Homöopathie, autologes konditioniertes Plasma extraartikulär, Ozon intraartikulär, Procain-Basen-Infusionen bzw. intravenöse Oxygenierung sowie orthomolekulare Medizin.
Sauna bei muskuloskelettalen Erkrankungen
Authors: Brenke Rainer
Published: June 2017

Beschwerden am Bewegungsapparat sind eine sehr häufige Indikation zur Anwendung der Sauna und von Wärme im Rahmen der Selbsthilfe. Bei einer früheren Befragung durch den Deutschen Sauna-Bund gaben 23 % der befragten Saunagäste Beschwerden des Bewegungsapparats an. Durch den Saunabesuch konnten die Beschwerden in 92 % gebessert werden.

Inzwischen konnten erfahrungsheilkundlich vermutete Wirkmechanismen wissenschaftlich bestätigt werden. Der Beitrag gibt einen Überblick zur Studienlage und den daraus ableitbaren Indikationen sowie Empfehlungen für die Praxis.
Aktuelle Systemtherapie des Urothelkarzinoms
Authors: Niegisch Günter
Published: June 2017

Eine perioperative Chemotherapie verbessert wahrscheinlich sowohl in einem neoadjuvanten als auch in einem adjuvanten Konzept das Überleben des Patienten. Damit ist sie ein integraler Teil der modernen Therapie von Patienten mit einem muskelinvasiven Harnblasenkarzinom. Jeder Patient, der für eine Cisplatin-basierte Chemotherapie geeignet ist, sollte in ein entsprechendes Konzept eingebunden werden.

Standard sowohl in der perioperativen als auch in der palliativen Systemtherapie des Urothelkarzinoms sind Cisplatin-basierte Kombinationstherapien. Carboplatin stellt nur bei „unfitten“ Patienten in der palliativen Therapiesituation einen möglichen Ersatz dar, in der perioperativen Systemtherapie besitz es keinen Stellenwert. Im Falle eines Rezidivs nach einer palliativen Erstlinientherapie oder bei einem schnellen Progress nach perioperativer Therapie kann eine Zweitlinientherapie mit Vinflunin durchgeführt werden. Alternativ dazu können auch Taxane oder Taxan-basierte Kombinationen zum Einsatz kommen.

Neue Therapiemöglichkeiten sind der Einsatz von Immuncheckpoint-Inhibitoren, welche in ersten Studien vielversprechende Ergebnisse zeigten. Erste Zulassungen durch die FDA sind für die Therapie des metastasierten/fortgeschrittenen Urothelkarzinoms bereits erfolgt. Andere zukünftige Optionen sind „maßgeschneiderte“ Therapiekonzepte, die auf der Molekularpathogenese des individuellen Patienten beruhen. Hier sind jedoch noch weitreichende präklinische Arbeiten erforderlich.
Akupunktur bei Heberden-, Bouchard- und Rhizarthrose
Authors: Stör Wolfram
Published: June 2017

Arthrotische Veränderungen der Fingergelenke können nicht nur kosmetisch störende Schwellungen, sondern auch Schmerzen verursachen und die Feinmotorik behindern. Die konventionellen Therapieansätze sind rar und unbefriedigend. Mit speziellen Akupunkturtechniken können die Beschwerden durch degenerative Veränderungen der Fingergelenke erfolgreich behandelt werden. Bereits nach wenigen Behandlungen lassen die Schmerzen nach, Schwellungen gehen zurück, die Selbstständigkeit im Alter kann länger erhalten werden.

Dieser Artikel beschreibt die Akupunkturtechniken, zwei Fälle aus der Praxis des Autors zeigen die möglichen Behandlungserfolge.
Unklare Synkope: ein Fall für die Anamnese
Authors: Israel Carsten
Published: June 2017

Die Abklärung unklarer Synkopen stellt eine häufige und vielfach problematische Aufgabe im klinischen Alltag dar, da die Ursache (z. B. Herzrhythmusstörungen, vasovagal induzierter Blutdruckabfall) meist nur sporadisch auftritt und zum Zeitpunkt der Abklärung nicht nachweisbar ist. Daher ist es in den meisten Fällen erforderlich, mittels einer durchdachten Anamnese die Synkopenursache zumindest sehr wahrscheinlich zu machen und gefährliche Ursachen weitestgehend auszuschließen. Die Anamnese muss zunächst klarstellen, ob es sich um eine Synkope oder einen nicht synkopalen Anfall (syncope mimic) handelt, wobei vor allem Epilepsie (Beginn der Zuckungen, postiktaler Dämmer), psychogene Pseudosynkope (Augen geschlossen, Emotionalität nach dem Anfall), Schlaganfall (neurologisches Defizit nach Wiedererlangen des Bewusstseins) und Drop Attacks (Sturz auf die Knie ohne Bewusstseinsverlust) ausgeschlossen werden sollten. Typisch für die neurokardiale Synkope sind das Fehlen kardiovaskulärer Erkrankungen, Auftreten im Stehen/Sitzen, typische Auslöser und Prodromi. Eine Orthostase tritt meist stereotyp innerhalb von 3 min nach dem Aufstehen auf, oft sind Medikamente mit auslösend. Rhythmogene Synkopen haben häufig keine Prodromi und führen zum Sturz, insbesondere Gesichtsverletzungen sind ein Warnsignal. Besonders bei Synkopen unter Belastung und im Liegen sollte an Arrhythmien gedacht werden. Die Familienanamnese ist zur Erkennung von Kanalerkrankungen und Kardiomyopathien essenziell. Strukturelle Herzerkrankungen können Synkopen über Arrhythmien oder Vorwärtsversagen (z. B. Aortenstenose) auslösen, hinweisend sind auch hier ein Auftreten unter Belastung oder im Liegen sowie weitere Symptome wie Thoraxschmerz und Dyspnoe und die Anamnese einer kardiovaskulären Erkrankung.
Blutegel helfen Gelenken auf die Beine
Authors: Liebscher Daniela , Hohmann Christoph-Daniel
Published: June 2017

Der Einsatz von Blutegeln kann im Bereich muskuloskelettaler Erkrankungen erstaunlich gute Erfolge bringen. Im Fall des vorgestellten 68-jährigen Patienten mit aktivierter Knie- und Fußwurzelarthrose wurden im Rahmen einer naturheilkundlich-physikalischen Komplextherapie mit Heilfasten, Ganzkörperkryotherapie, Ergo- und Physiotherapie die Knie- und Tarsometatarsalgelenke mit Blutegeln behandelt. Der Patient sprach sehr gut auf die Behandlung an, die Schmerzen gingen zurück und die Schmerzmitteldosis konnte deutlich reduziert werden.

Nicht alle Patienten profitieren von der Blutegelbehandlung in so ausgeprägtem Maße wie im vorgestellten Fall. Die klinische Erfahrung der Autoren mit ca. 500 Blutegelbehandlungen pro Jahr zeigt jedoch insgesamt eine deutliche Wirksamkeit der Therapie. Vor dem Hintergrund der klinischen Erfahrungen bildet die Blutegeltherapie bei sachgemäßer Anwendung eine effektive und gut verträgliche Therapieoption insbesondere für muskuloskelettale Erkrankungen.
Wassergefilterte Infrarot-Hyperthermie – Lassen sich muskuloskelettale Schmerzen wegschmelzen?
Authors: Stange Rainer
Published: June 2017

Wassergefilterte Infrarot-Hyperthermie wird außerhalb der Onkologie auch für weichteilrheumatische Beschwerden und Arthrosen genutzt. Erste Studien zur seriellen Anwendung der Ganzkörperhyperthermie mit Fibromyalgiepatienten sowie bei ankolysierender Spondylitis liefern vielversprechende Ergebnisse hinsichtlich Schmerzreduktion sowie der Auslösung adaptiver Prozesse.

Der Beitrag gibt einen Überblick zur bisherigen Studienlage bei muskuloskelettalen Schmerzen, den Applikationsformen, der Anwendung in der Praxis, Verträglichkeit und Sicherheit sowie den Möglichkeiten der Kostenerstattung.
Adverbial clauses and speaker and interlocutor gender in Shakespeare’s plays
Authors: McGarry Theresa , Kiser Kelsey
Published: June 2017

This study draws on previous findings regarding adverbial clauses in relation to speaker and interlocutor gender in a corpus of current actual speaker data. Our aim is to examine those same relations in a corpus of Shakespeare’s comedies and histories. Mondorf (2004) investigated four types of adverbial clauses in a corpus of modern speech and found that the women used more causal, conditional and purpose clauses than the men, while the men used more concessive clauses. Mondorf’s explanation for this difference is that women use the three clause types that mitigate the speaker’s commitment to the truth of the proposition, while men tend to use more concessives, which strengthen the commitment. She also found that in mixed-gender conversations these trends were generally intensified. However, other analyses have indicated that these patterns do not hold across contexts. Much more research is called for to understand the localized relations among adverbial clause usage, speaker gender and context in particular settings. One question to pursue is whether we can see gendered patterns of adverbial usage in historical varieties of English. Accordingly, in this study we analyse dialogue in Shakespeare’s plays to ascertain whether Mondorf’s findings can be extrapolated to the language of these fictional speakers. The results indicate that Shakespeare generally does not use the adverbial clauses to portray the gender of the characters in ways similar to those of actual, modern speakers. Only small differences are found, regarding purpose clauses in the histories and conditional clauses in the comedies. The analysis indicates that female and male characters speak very similarly with regard to syntax, and adverbial clauses contribute to the construction of characters in very localized contexts.
Manipulative uses of pragmatic markers in political discourse
Authors: Furko Peter
Published: June 2017

Pragmatic markers comprise a functional class of linguistic items that do not typically change the propositional meaning of an utterance but are essential for the organization and structuring of discourse, for marking the speaker’s attitudes to the proposition being expressed as well as for facilitating processes of pragmatic inferences. Pragmatic marker research has been characterised by descriptive approaches: even case studies that take their data from political discourse tend to focus on linguistic patterns of co-occurrence and sequentiality rather than social-institutional norms or broader societal concerns. The novelty of this article is, therefore, in linking pragmatic marker research, a primarily discourse analytical, language-oriented field to the broader field of Discourse Studies with a focus on manipulative social practices and their manifestations in discursive strategies. This article analyses evidential markers, general extenders, quotation markers and markers of (un)certainty1 in political interviews broadcasted by the BBC, CNN and Hungarian ATV. After a short overview of the formal and functional characteristics of pragmatic markers and their relevance to Discourse Studies in general and Critical Discourse Analysis (CDA) research in particular, characteristics of the political interview as political discourse, institutional discourse and media(tised) discourse are discussed. In the second part, the results of previous (primarily descriptive and genre analytical) research are reconsidered from the perspective of CDA and particular pragmatic markers are associated with manifestations of manipulative intent, such as suppression, polarization, recontextualising, conversationalisation and intended ambiguity. An important finding of this study is that a single pragmatic marker can serve several manipulative functions, while a given manipulative strategy is potentially realized by a variety of pragmatic items. Potential manipulative uses are exemplified with a view to applying the heuristic to the analysis of representations of particular political events and happenings, which is a direction for further research.
Minimal sufficient statistical experiments on von Neumann algebras
Authors: Kuramochi Yui
Published: June 2017

A statistical experiment on a von Neumann algebra is a parametrized family of normal states on the algebra. This paper introduces the concept of minimal sufficiency for statistical experiments in such operator algebraic situations. We define equivalence relations of statistical experiments indexed by a common parameter set by completely positive or Schwarz coarse-graining and show that any statistical experiment is equivalent to a minimal sufficient statistical experiment unique up to normal isomorphism of outcome algebras. We also establish the relationship between the minimal sufficiency condition for a statistical experiment in this paper and those for subalgebra. These concepts and results are applied to the concatenation relation for completely positive channels with general input and outcome von Neumann algebras. In the case of the quantum-classical channel corresponding to the positive-operator valued measure (POVM), we prove the equivalence of the minimal sufficient condition previously proposed by the author and that in this paper. We also give a characterization of the discreteness of a POVM up to postprocessing equivalence in terms of the corresponding quantum-classical channel.
Effects of phosphorus supplementation in high-grain diets on blood, chemical and physical parameters of bones of feedlot Nellore bulls
Authors: Souza Vinícius C. , Malafaia Pedro , Granja-Salcedo Yury T. , Vieira Bruno R. , Gomes Raphael S. , Costa Diogo F. A. , Negrão João Alberto , Shimano Antônio C. , Berchielli Telma T.
Published: June 2017

The study was conducted to evaluate the effects of phosphorus supplementation (PS) on blood, chemical and physical parameters from bones of feedlot Nellore bulls. Forty-two animals were distributed in a completely randomised design consisting of three treatments and 14 replicates. The treatments consisted of no supplementary phosphorus (P; T1; 2.4 g P/kg DM), a commercial mineral supplement formulated according to recommendations from the main Brazilian industries of mineral supplements for feedlot beef cattle (T2; 4.2 g P/kg DM) and dicalcium phosphate (T3; 5.0 g P/kg DM) in high-grain diets. The animals submitted or not to PS had similar calcium (Ca) and P values, Ca : P ratio, specific gravity, cortical thickness and bone mineral density in the 12th rib. However, a decrease in magnesium (Mg) concentration was observed in the 12th rib in T1 and T3 treatments throughout the study (P < 0.05). The animals in T1 had lower cortical thickness of the metacarpus (P < 0.05), without compromising its resistance and stiffness (P > 0.05). To evaluate the P status in the animals, we performed the needle test, which allowed an assessment of differences in bone strength on the basis of the resistance to needle penetration on the transverse process (TP) of the lumbar vertebrae. Throughout the trial period, no animals were positive for the needle test conducted in the transverse processes of the lumbar vertebrae. The PS significantly changed parathyroid hormone and alkaline phosphatase concentrations (P < 0.05) and the animals in T1 had lower concentrations of these hormones. However, there was no effect of PS on the concentration of Ca and P in the serum of animals (P > 0.05). The inclusion of a mineral mix supplement in T2 resulted in higher Mg concentrations in the serum of animals (P > 0.05). P supplementation for Nellore bulls, fed high proportions of concentrate during the feedlot period, resulted in no benefits in neither chemical nor physical properties of their bones and the level in the control diet appeared adequate in these circumstances.
Discourse and identity formation
Authors: Alkooheji Lamya , Sinha Chitra
Published: June 2017

The book explores eleven debates held at the Bahraini Council of Representatives (or the Parliament) over 2007-2010 to comprehend how parliamentary discourse contributes towards identity formation within Bahraini society. Within the framework of critical discourse studies, the book traces the ideological struggle over power in the linguistic content of legislative discourse through a range of discursive strategies and devices.
The authors contend that the discursive choices across the political spectrum in the legislative debates reflected strong sectarian characteristics which contained in it the seeds of political unrest of 2011, the so-called ‘Arab Spring’ of Bahrain. Parliamentary rhetoric and its resonance in the public sphere, the authors argue, revealed the underlying contradictions in Bahraini society. The book highlights the significance of legislative discourse as a platform of social cohesion, and its instability being symptomatic of contradictions within society.
Intentional preparation of auditory attention-switches: Explicit cueing and sequential switch-predictability
Authors: Seibold Julia C , Nolden Sophie , Oberem Josefa , Fels Janina , Koch Iring
Published: June 2017

In an auditory attention-switching paradigm, participants heard two simultaneously spoken number-words, each presented to one ear, and decided whether the target number was smaller or larger than 5 by pressing a left or right key. An instructional cue in each trial indicated which feature had to be used to identify the target number (e.g., female voice). Auditory attention-switch costs were found when this feature changed compared to when it repeated in two consecutive trials. Earlier studies employing this paradigm showed mixed results when they examined whether such cued auditory attention-switches can be prepared actively during the cue–stimulus interval. This study systematically assessed which preconditions are necessary for the advance preparation of auditory attention-switches. Three experiments were conducted that controlled for cue-repetition benefits, modality switches between cue and stimuli, as well as for predictability of the switch-sequence. Only in the third experiment, in which predictability for an attention-switch was maximal due to a pre-instructed switch-sequence and predictable stimulus onsets, active switch-specific preparation was found. These results suggest that the cognitive system can prepare auditory attention-switches, and this preparation seems to be triggered primarily by the memorised switching-sequence and valid expectations about the time of target onset.
ER stress causes widespread protein aggregation and prion formation
Authors: Hamdan Norfadilah , Kritsiligkou Paraskevi , Grant Chris M.
Published: June 2017

Disturbances in endoplasmic reticulum (ER) homeostasis create a condition termed ER stress. This activates the unfolded protein response (UPR), which alters the expression of many genes involved in ER quality control. We show here that ER stress causes the aggregation of proteins, most of which are not ER or secretory pathway proteins. Proteomic analysis of the aggregated proteins revealed enrichment for intrinsically aggregation-prone proteins rather than proteins which are affected in a stress-specific manner. Aggregation does not arise because of overwhelming proteasome-mediated degradation but because of a general disruption of cellular protein homeostasis. We further show that overexpression of certain chaperones abrogates protein aggregation and protects a UPR mutant against ER stress conditions. The onset of ER stress is known to correlate with various disease processes, and our data indicate that widespread amorphous and amyloid protein aggregation is an unanticipated outcome of such stress.
Regional comparison of absolute gravimeters SIM.M.G-K1 key comparison
Authors: Newell D B , Westrum D van , Francis O , Kanney J , Liard J , Ramirez A E , Lucero B , Ellis B , Greco F , Pistorio A , Reudink R , Iacovone D , Baccaro F , Silliker J , Wheeler R D , Falk R , Ruelke A
Published: June 2017

Twelve absolute gravimeters were compared during the regional Key Comparison SIM.M.G-K1 of absolute gravimeters. The four gravimeters were from different NMIs and DIs. The comparison was linked to the CCM.G-K2 through EURAMET.M.G-K2 via the DI gravimeter FG5X-216. Overall, the results and uncertainties indicate an excellent agreement among the gravimeters, with a standard deviation of the gravimeters' DoEs better than 1.3 μGal. In the case of the official solution, all the gravimeters are in equivalence well within the declared uncertainties.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
Final report of the key comparison of APMP.AUV.V-K2
Authors: Usuda Takashi , Ota Akihiro , Nozato Hideaki , Ishigami Tamio , Kokuyama Wataru , Plangsangmas Virat , Rattanangkul Pairoj , Tsuei Kuang Yih , Huang Yu-Chung , Keong Chan Chee , Shan Cui
Published: June 2017

A key comparison of vibration acceleration APMP.AUV.V-K2, which is an upgrade from APMP.AUV.V-K1.1, has been made within the Asia Pacific Metrology Programme (APMP) to include three national laboratories; the CMS-ITRI (Chinese Taipei), the NIMT (Thailand) and the A*Star (Singapore). One pilot laboratory, the NMIJ (Japan), participated to link the RMO APMP results to the CIPM CC key comparison (CCAUV.V-K2), according to the decision of the CCAUV10/D7 during the 10th CCAUV meeting. The admissible acceleration amplitude ranges from 10 m/s2 to 200 m/s2 over the frequency range from 40 Hz to 5 kHz. The RMO APMP results demonstrate the agreement with the key comparison reference value of CCAUV.V-K2 within the expanded uncertainties considering the armature effect of vibration exciter in a high-frequency range.

Main text

To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.

The final report has been peer-reviewed and approved for publication by the CCAUV, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).
The Use of Semitranslucent Rubber Pledgets During Microsurgical Dissection of Cerebellopontine Angle Tumors: Technical Note
Authors: Mazur Marcus D , Gurgel Richard , MacDonald Joel D
Published: June 2017

BACKGROUND AND IMPORTANCE

Dissection of cerebellopontine angle (CPA) tumors that abut or adhere to the brainstem or cranial nerves can be a challenging surgical endeavor. We describe the use of semitranslucent latex rubber pledgets in the tumor–brain interface as a method to improve visualization and protection of vital tissue during microsurgical dissection of CPA masses. The rubber pledgets are fashioned by cutting circular discs out of the cuff portion of talc-free, partially opaque latex gloves. These pledgets provide a semitranslucent, nonadherent membrane that can be placed between vital neural tissues and a tumor capsule to minimize trauma during dissection. The semitranslucent latex enables visualization of the underlying anatomical structures while also providing a protective surface onto which a suction device can be rested to facilitate clearance of the surgical field.

CLINICAL PRESENTATION

A 56-yr-old woman with left ear tinnitus presented with a 3-cm CPA meningioma. During microsurgical dissection, rubber pledgets were used to preserve the interface between the brain stem, cranial nerves, and tumor capsule. The use of the rubber pledgets appeared to secure the interface between to tumor and the brain while at the same time protecting the cranial nerves, brainstem, and cerebellum.

CONCLUSION

Semitranslucent rubber pledgets may facilitate microsurgical dissection of CPA tumors.
Pediatric oncologic endosurgery
Authors: Boo Yoon Jung , Goedecke Jan , Muensterer Oliver J.
Published: June 2017

Despite increasing popularity of minimal-invasive techniques in the pediatric population, their use in diagnosis and management of pediatric malignancy is still debated. Moreover, there is limited evidence to clarify this controversy due to low incidence of each individual type of pediatric tumor, huge diversity of the disease entity, heterogeneity of surgical technique, and lack of well-designed studies on pediatric oncologic minimal-invasive surgery. However, a rapid development of medical instruments and technologies accelerated the current trend toward less invasive surgery, including oncologic endosurgery. The aim of this article is to review current literatures about the application of the minimal-invasive approach for pediatric tumors and to give an overview of the current status, indications, individual techniques, and future perspectives.
Evaluation of an Automated Express Care Triage Model to Identify Clinically Relevant Cases in a Sexually Transmitted Disease Clinic
Authors: Chambers Laura C. , Manhart Lisa E. , Katz David A. , Golden Matthew R. , Barbee Lindley A. , Dombrowski Julia C.
Published: June 2017

Background

Many sexually transmitted disease (STD) clinics offer testing-only “express” visits. We evaluated the express care triage algorithm that is based on a computer-assisted self-interview (CASI) used in the Public Health—Seattle and King County STD Clinic.

Methods

During the analysis period, patients received a clinician evaluation irrespective of triage status. In this cross-sectional study, we compared the algorithm triage status to a disease-focused outcome determined by medical record review. We defined a patient as “needing a standard visit” if they reported key symptoms, received empiric treatment, or were diagnosed with an infection or syndrome at the same visit. We estimated the sensitivity of the algorithm for identifying patients who needed a standard visit and identified the characteristics of patients who could have received express care but were excluded from it by the algorithm.

Results

Between October 2010 and June 2015, patients completed a CASI at 32,113 visits; 23% were triaged by the algorithm to express care. The triage status was appropriate for 21,337 (87%) men and 6259 (82%) women. The algorithm had 95% and 98% sensitivity for identifying men and women, respectively, needing standard visits. The most common reason for mistriage to express care was patient report of symptoms to clinicians that they did not disclose to the CASI. Of women who could have received express care, only 33% were triaged to it by the algorithm; the remainder was triaged to standard visits, primarily for health service indications.

Conclusions

The CASI-based algorithm accurately identified patients who were eligible for express care based on a disease-focused outcome.
Using Multiple Outcomes of Sexual Behavior to Provide Insights Into Chlamydia Transmission and the Effectiveness of Prevention Interventions in Adolescents
Authors: Enns Eva Andrea , Kao Szu-Yu , Kozhimannil Katy Backes , Kahn Judith , Farris Jill , Kulasingam Shalini L.
Published: June 2017

Background

Mathematical models are important tools for assessing prevention and management strategies for sexually transmitted infections. These models are usually developed for a single infection and require calibration to observed epidemiological trends in the infection of interest. Incorporating other outcomes of sexual behavior into the model, such as pregnancy, may better inform the calibration process.

Methods

We developed a mathematical model of chlamydia transmission and pregnancy in Minnesota adolescents aged 15 to 19 years. We calibrated the model to statewide rates of reported chlamydia cases alone (chlamydia calibration) and in combination with pregnancy rates (dual calibration). We evaluated the impact of calibrating to different outcomes of sexual behavior on estimated input parameter values, predicted epidemiological outcomes, and predicted impact of chlamydia prevention interventions.

Results

The two calibration scenarios produced different estimates of the probability of condom use, the probability of chlamydia transmission per sex act, the proportion of asymptomatic infections, and the screening rate among men. These differences resulted in the dual calibration scenario predicting lower prevalence and incidence of chlamydia compared with calibrating to chlamydia cases alone. When evaluating the impact of a 10% increase in condom use, the dual calibration scenario predicted fewer infections averted over 5 years compared with chlamydia calibration alone [111 (6.8%) vs 158 (8.5%)].

Conclusions

While pregnancy and chlamydia in adolescents are often considered separately, both are outcomes of unprotected sexual activity. Incorporating both as calibration targets in a model of chlamydia transmission resulted in different parameter estimates, potentially impacting the intervention effectiveness predicted by the model.
Outcome of Pediatric Forearm Fracture Reductions Performed by Pediatric Emergency Medicine Providers Compared With Reductions Performed by Orthopedic Surgeons
Authors: Milner Donna , Krause Ernest , Hamre Karen , Flood Andrew
Published: June 2017

Objective

The aim of this study was to describe the outcome differences between board-certified orthopedists and pediatric emergency medicine (PEM) physicians conducting forearm fracture reductions.

Methods

We performed an analysis of patients between 1 and 14 years of age who presented to the emergency department (ED) with a forearm fracture requiring reduction. Data collected included reducing provider (PEM or orthopedist) and prereduction, postreduction, and follow-up fracture angles and displacements of both radius and ulna. We collected costs of care, both in the ED and at follow-up, as well as length-of-stay data. χ2 Tests and Fisher exact test compared associations between categorical variables; 2-sample t tests compared the PEM and orthopedic groups. Regression models were used to control for injury severity confounders.

Results

Of the 222 fractures, orthopedists reduced 135, and PEM doctors reduced 87. Based on fracture angle and displacement, the orthopedic group tended to have slightly more complicated cases. After adjusting for age and time to follow-up, fractures reduced by orthopedists were less likely to require remanipulation (adjusted odds ratio, 0.30; P = 0.020). The PEM group had a significantly lower length of stay (59.4 minutes shorter; P < 0.001) and a small overall saving in charges ($273.90; P = 0.47).

Conclusions

Orthopedists performed better in maintaining fracture reductions compared with PEM physicians but lengthened the ED stay for our patients. There was no significant difference in cost.
Tibialis Posterior Tenosynovitis
Authors: Shupper Peter , Stitik Todd P.
Published: June 2017

Extra-articular manifestations of gout can present in several ways, including tenosynovitis. We present a rare case of acute tibialis posterior gouty tenosynovitis. An 82-year-old man with a history of well-controlled gout presented with acute onset of left ankle pain, occurring without inciting event. The medial ankle was slightly erythematous with moderate dorsal-medial swelling and mild dorsal-lateral swelling, with severe tenderness to palpation over the medial retro-malleolar region. Range of motion and manual muscle testing were pain limited throughout. Ultrasound examination revealed a left posterior tibialis tendon sheath tenosynovitis with effusion and overlying soft tissue edema. Tendon sheath aspirate revealed sodium urate crystals and a white blood cell count of 6400/μL. Tendon sheath injection with a mixture of 1% lidocaine and dexamethasone 4 mg resulted in symptom resolution. Repeat ultrasound examination demonstrated no evidence of tibialis posterior tendon sheath effusion. This case is unique not only because acute gouty posterior tibialis tenosynovitis is very rare, particularly in a normouricemic individual, but also because the sonographic evidence of gouty infiltration into the posterior tibialis tendon and overlying subcutaneous tissue considerably aided in arriving at the correct diagnosis in a timely manner.
Zika virus: a cause of concern in transplantation?
Authors: Levi Marilyn E.
Published: June 2017

Purpose of review

Worldwide, the number of countries reporting Zika virus (ZKV) infection continues to increase. Although 80% of cases are asymptomatic, ZKV has been identified as a neurotropic virus associated with congenital microcephaly, Guillain-Barre’ syndrome, and meningoencephalitis. Until recently, infection in transplant recipients has not been identified. This study will review the existing literature on ZKV infection, laboratory testing, and management in transplant recipients.

Recent findings

Donor-derived transfusion of contaminated blood products and naturally occurring ZKV infections have been recently reported in solid organ and stem cell transplant recipients, ranging from asymptomatic infections to meningoencephalitis. Interpretation of diagnostic testing of ZKV is evolving, with prolonged viral shedding identified in blood, semen, and urine of unclear significance. Serologic testing may be associated with cross-reactivity with other flaviviridae, requiring plaque reduction neutralization testing for confirmation. Thus far, donor screening guidelines for transplantation have not been established.

The study reviews the limited existing literature in transplant recipients infected with ZKV, available laboratory testing and management. Ultimately, guidelines are needed for donor screening from high-risk areas, interpretation of studies and management of infected patients to ensure safe transplantation.
High-Quality 3-Dimensional 1H Magnetic Resonance Spectroscopic Imaging of the Prostate Without Endorectal Receive Coil Using A Semi-LASER Sequence
Authors: Tayari Nassim , Steinseifer Isabell K. , Selnæs Kirsten M. , Bathen Tone F. , Maas Marnix C. , Heerschap Arend
Published: June 2017

Objectives

Inclusion of 3-dimensional 1H magnetic resonance spectroscopic imaging (3D-1H-MRSI) in routine multiparametric MRI of the prostate requires good quality spectra and easy interpretable metabolite maps of the whole organ obtained without endorectal coil in clinically feasible acquisition times. We evaluated if a semi-LASER pulse sequence with gradient offset independent adiabaticity refocusing pulses (GOIA-sLASER) for volume selection can meet these requirements.

Materials and Methods

Thirteen patients with suspicion of prostate cancer and 1 patient known to have prostate cancer were examined at 3 T with a multichannel body-receive coil. A 3D-1H-MRSI sequence with GOIA-sLASER volume selection (echo time, 88 milliseconds) was added to a routine clinical multiparametric MRI examination of these patients. Repetition times from 630 to 1000 milliseconds and effective voxel sizes of approximately 0.9 and 0.6 cm3 were tested. Spectral components were quantified by LCModel software for quality assessment and to construct choline and citrate maps.

Results

Three-dimensional MRSI of the prostate was successfully performed in all patients in measurement times of 5 to 10 minutes. Analysis of the multiparametric MRI examination or of biopsies did not reveal malignant tissue in the prostate of the 13 patients. In 1404 evaluated voxels acquired from 13 patients, the citrate resonance could be fitted with a high reliability (Cramér-Rao lower bound <30%), 100% for 7 × 7 × 7-mm3 voxels and 96 ± 7 in 6 × 6 × 6-mm3 voxels. The percentage of 7 × 7 × 7-mm3 voxels in which the choline signal was fitted with Cramér-Rao lower bound of less than 30% was approximately 50% at a TR of 630 milliseconds and increased to more than 80% for TRs of 800 milliseconds and above. In the patient with prostate cancer, choline was detectable throughout the prostate in spectra recorded at a TR of 700 milliseconds. The homogeneous B1
- field over the prostate of the receive coil enabled the generation of whole organ metabolite maps, revealing choline and citrate variations between areas with normal prostate tissue, seminal vesicles, proliferative benign prostatic hyperplasia, and tumor.

Conclusions

The good signal-to-noise ratio and low chemical shift artifacts of GOIA-sLASER at an echo time of 88 milliseconds enable acquisition of high-quality 3D-1H-MRSI of the prostate without endorectal coil in less than 10 minutes. This facilitates reconstruction of easy interpretable, quantitative metabolite maps for routine clinical applications of prostate MRSI.
Relationship of Reaction Time to Perception of a Stimulus and Volitionally Delayed Response
Authors: Meador Kimford J. , Boyd Alan , Loring David W.
Published: June 2017

Background and Objective:

Initiation of response in a simple reaction time (RT) task may precede conscious perception of the stimulus. Since volitionally delayed responses may require conscious perception of the stimulus before response initiation, it has been hypothesized that volitionally delayed responses will markedly delay RT.

Methods:

We conducted two experiments with separate groups of healthy volunteers (n=16; n=13) who performed computerized simple and choice RT tasks. In the standard condition, we instructed the participants to respond to a visual stimulus by pushing a button as quickly as possible. In the second condition, we instructed the participants to respond after a slight volitional delay. The second experiment had an additional volitional delay condition in which we asked participants to delay their responses by an estimated 50% above their usual standard response.

Results:

We found marked delays and increased variability when participants volitionally delayed their responses, averaging 322 ms for standard and 861 ms for delayed simple RTs (267% increase), and 650 ms for standard and 1018 ms for delayed choice RTs (157% increase). Effects did not differ across age, sex, or handedness. However, a minority of participants did not meaningfully delay their RT during the volitional delay conditions.

Conclusions:

On average, participants had marked delays when they tried to delay their responses slightly, but a subset of participants exhibited essentially no delay despite trying to delay. We suggest some potential mechanisms that future investigations might delineate.