bluuebunny/crossref_metadata_2025 huggingface dataset:
MRI diagnosis and follow‐up of chest wall and breast desmoid tumours in patients with a history of oncologic breast surgery and silicone implants: A pictorial report
Authors: Grubstein Ahuva , Rapson Yael , Zer Alona , Gadiel Itay , Atar Eli , Morgenstern Sara , Gutman Haim
Published: November 2018

Introduction

Breast and chest wall desmoid tumours can cause debilitating symptoms and deformity. The mutilating effects of surgical treatment have prompted a shift to medical treatments and even to a wait‐and‐see approach. This study sought to highlight specific characteristics of breast and chest wall desmoid tumours on long‐term follow‐up by sequential MRI scans.

Methods

Thirty‐two breast MRI scans from six patients with chest wall or breast desmoid tumours followed up for up to 6 years were retrospectively reviewed.

Results

All patients underwent breast surgery prior to the development of the desmoid tumour. Five of the patients had reconstruction or augmentation using silicone implants. Two desmoids were treated primarily with surgery, three with medical means and one is under wait‐and‐see approach. On MRI, tumours appeared either oval and lobulated (chest wall) or spiculated with architectural distortion (breast). Chest wall desmoids demonstrated both an enhancing high‐T2‐signal component and a non‐enhancing low‐T2‐ signal component. The histologically defined phases during the course of desmoid tumours (progression, regression, residual disease) could be demonstrated by corresponding MRI changes in each of the components.

Conclusions

Magnetic resonance imaging delineates the complex infiltrative features of chest wall and breast desmoid tumours. In tumours with a bright cellular enhancing and dark collagenous non‐enhancing component, treatment response may be predicted by changes on serial T2‐weighted sequences, beyond the tumour‐dimension‐based RECIST assessment alone.
Medical emergencies in rural North Queensland: Doctors perceptions of the training needs
Authors: Pandit Tarsh , Sabesan Sabe , Ray Robin A.
Published: November 2018

Objective

This study aimed to explore doctors’ perceptions of the training needs of rural doctors in the context of managing emergencies in rural North Queensland.

Design

Using a qualitative approach, 20 semistructured interviews were conducted via telephone, video conference and in‐person. Using an interview guide, areas such as preparedness of junior doctors for rural practice, areas for further training and confidence with managing emergencies were discussed. Interviews were analysed using the principles of grounded theory. Participant recruitment continued until data saturation was achieved.

Setting

Multiple health facilities across three hospital and health services in North Queensland.

Participants

(i) Doctors with current or recent work in rural North Queensland; (ii) doctors involved with rural medical training; and (iii) emergency medicine specialists working in a tertiary referral centre.

Main outcome measure

Perspectives of doctors on the training needs of rural doctors in North Queensland.

Results

Rural doctors were found to be as prepared as they could be to take up rural practice; however, they still had training needs. Region‐specific emergencies, access to regular in‐house simulations and non‐medical challenges, including understanding local team dynamics and taking on a team leader role, were seen as key training needs. Senior doctors indicated that further formal and informal on‐the‐job training were required for provisional fellows with limited experience in the emergency department.

Conclusion

Certain training needs of rural doctors still remain unmet. Further access to in‐house simulations and tele‐training could be useful strategies to meet these training needs to further support rural doctors.
Neural signatures of the risk for bipolar disorder: A meta‐analysis of structural and functional neuroimaging studies
Authors: Cattarinussi Giulia , Di Giorgio Annabella , Wolf Robert Christian , Balestrieri Matteo , Sambataro Fabio
Published: November 2018

Objective

Widespread functional and structural alterations in the brain have been extensively reported in unaffected relatives (RELs) of patients with bipolar disorder (BD) who are at genetic risk for BD. A sufficiently powered meta‐analysis of structural (sMRI) and functional magnetic resonance imaging (fMRI) alterations in RELs is still lacking.

Methods

Functional and structural magnetic resonance imaging studies investigating RELs and healthy controls (HCs) published by July 2017 were included in the meta‐analyses. Study procedures were conducted in accordance with the Meta‐analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Random‐effects coordinate‐based meta‐analyses were performed across all the studies per imaging modality using Seed‐based d Mapping (SDM). For fMRI studies, meta‐analyses were calculated for each task type. For sMRI studies, regional volumetric changes‐analyses were estimated using R. Finally, multimodal meta‐analyses of structural and functional abnormalities were performed.

Results

Sixty‐nine imaging studies (2195 RELs and 3169 HCs) were included in the meta‐analyses. RELs showed hyperactivation in the fronto‐striatal regions as well as parietal hypoactivation during cognition. Also, activation was increased in the amygdala during emotional processing and in the orbitofrontal cortex during reward, respectively. Frontal and superior temporal cortex were hypertrophic in RELs. The right inferior frontal gyrus (rIFG) showed both increased activation during cognitive tasks and greater volume in RELs.

Conclusions

Our findings demonstrate that increased brain volume and activation are present in RELs and may represent intermediate phenotypes for the disorder. Furthermore, some neural changes including increased rIFG volume may be associated with the resilience to BD.
Venous thromboembolism in multiple myeloma – choice of prophylaxis, role of direct oral anticoagulants and special considerations
Authors: Swan Dawn , Rocci Alberto , Bradbury Charlotte , Thachil Jecko
Published: November 2018

Multiple myeloma is associated with a significant risk of venous thromboembolism (VTE), causing substantial levels of morbidity and mortality. The thrombogenicity of myeloma is multifactorial, with disease‐ and treatment‐related factors playing important roles. Immunomodulatory drugs (IMiDs) and high‐dose dexamethasone, in particular, are known to enhance the thrombotic potential of myeloma. For this reason, assessment of the VTE risk has long been advocated prior to treatment initiation in patients with myeloma requiring IMiD‐based regimens. However, despite routine use of thromboprophylaxis, these patients can still develop VTE and its sequelae. The optimum choice and dose of thromboprophylactic drug is not entirely clear, and with this, there is growing interest regarding use of the direct oral anticoagulants in this setting. In this review we discuss the pathogenesis of thrombosis in multiple myeloma, its relation to some of the commonly used chemotherapeutic regimens, current risk stratification and the evidence supporting the different anticoagulants used as thromboprophylaxis. We propose an amended risk stratification, and consider management of challenging patients, including those with renal impairment and recurrent thrombosis.
CLARITY reveals a more protracted temporal course of axon swelling and disconnection than previously described following traumatic brain injury
Authors: Weber Maura T. , Arena John D. , Xiao Rui , Wolf John A. , Johnson Victoria E.
Published: November 2018

Diffuse axonal injury (DAI) is an important consequence of traumatic brain injury (TBI). At the moment of trauma, axons rarely disconnect, but undergo cytoskeletal disruption and transport interruption leading to protein accumulation within swellings. The amyloid precursor protein (APP) accumulates rapidly and the standard histological evaluation of axonal pathology relies upon its detection. APP+ swellings first appear as varicosities along intact axons, which can ultimately undergo secondary disconnection to leave a terminal “axon bulb” at the disconnected, proximal end. However, sites of disconnection are difficult to determine with certainty using standard, thin tissue sections, thus limiting the comprehensive evaluation of axon degeneration. The tissue‐clearing technique, CLARITY, permits three‐dimensional visualization of axons that would otherwise be out of plane in standard tissue sections. Here, we examined the morphology and connection status of APP+ swellings using CLARITY at 6 h, 24 h, 1 week and 1 month following the controlled cortical impact (CCI) model of TBI in mice. Remarkably, many APP+ swellings that appeared as terminal bulbs when viewed in standard 8‐µm‐thick regions of tissue were instead revealed to be varicose swellings along intact axons when three dimensions were fully visible. Moreover, the percentage of these potentially viable axon swellings differed with survival from injury and may represent the delayed onset of distinct mechanisms of degeneration. Even at 1‐month post‐CCI, ~10% of apparently terminal bulbs were revealed as connected by CLARITY and are thus potentially salvageable. Intriguingly, the diameter of swellings decreased with survival, including varicosities along intact axons, and may reflect reversal of, or reduced, axonal transport interruption in the chronic setting. These data indicate that APP immunohistochemistry on standard thickness tissue sections overestimates axon disconnection, particularly acutely post‐injury. Evaluating cleared tissue demonstrates a surprisingly delayed process of axon disconnection and thus longer window of therapeutic opportunity than previously appreciated. Intriguingly, a subset of axon swellings may also be capable of recovery.
Oligodendroglial α‐synucleinopathy‐driven neuroinflammation in multiple system atrophy
Authors: Hoffmann Alana , Ettle Benjamin , Battis Kristina , Reiprich Simone , Schlachetzki Johannes C. M. , Masliah Eliezer , Wegner Michael , Kuhlmann Tanja , Riemenschneider Markus J. , Winkler Jürgen
Published: November 2018

Neuroinflammation and oligodendroglial cytoplasmic α‐synuclein (α‐syn) inclusions (GCIs) are important neuropathological characteristics of multiple system atrophy (MSA). GCIs are known to interfere with oligodendroglial maturation and consequently result in myelin loss. The neuroinflammatory phenotype in the context of MSA, however, remains poorly understood. Here, we demonstrate MSA‐associated neuroinflammation being restricted to myeloid cells and tightly linked to oligodendroglial α‐syncleinopathy. In human putaminal post‐mortem tissue of MSA patients, neuroinflammation was observed in white matter regions only. This locally restricted neuroinflammation coincided with elevated numbers of α‐syn inclusions, while gray matter with less α‐synucleinopathy remained unaffected. In order to analyze the temporal pattern of neuroinflammation, a transgenic mouse model overexpressing human α‐syn under the control of an oligodendrocyte‐specific myelin basic protein (MBP) promoter (MBP29‐hα‐syn mice) was assessed in a pre‐symptomatic and symptomatic disease stage. Strikingly, we detected an increased neuroinflammation in regions with a high α‐syn load, the corpus callosum and the striatum, of MBP29‐hα‐syn mice, already at a pre‐symptomatic stage. Furthermore, this inflammatory response was restricted to myeloid cells being highly proliferative and showing an activated, phagocytic phenotype. In contrast, severe astrogliosis was observed only in gray matter regions of MSA patients as well as MBP29‐hα‐syn mice. To further characterize the influence of oligodendrocytes on initiation of the myeloid immune response, we performed RNA sequencing analysis of α‐syn overexpressing primary oligodendrocytes. A distinct gene expression profile including upregulation of cytokines important for myeloid cell attraction and proliferation was detected in α‐syn overexpressing oligodendrocytes. Additionally, microdissected tissue of MBP29‐hα‐syn mice exhibited a similar cellular gene expression profile in white matter regions even pre‐symptomatically. Collectively, these results imply an early crosstalk between neuroinflammation and oligodendrocytes containing α‐syn inclusions leading to an immune response locally restricted to white matter regions in MSA.
Ileal pouch revision vs excision: short‐term (30‐day) outcomes from the National Surgical Quality Improvement Program
Authors: Holubar S. D. , Neary P. , Aiello A. , Shawki S. , Delaney C. P. , Steele S. R. , Hull T. , Stocchi L.
Published: November 2018

Aim

Ileal pouch–anal anastomosis (IPAA) failure occurs in approximately 5%–10% of patients. We aimed to compare short‐term (30‐day) postoperative outcomes associated with pouch revision and pouch excision using a large international database. Our null hypothesis was that there is no statistically significant difference in overall postoperative complications between patients selected for pouch revision vs pouch excision.

Methods

Using the American College of Surgeons National Surgical Quality Improvement Program Participant User File from 2005 to 2016 we identified patients who underwent either IPAA revision via the combined abdominoperineal approach [Current Procedural Terminology (CPT) 46712] or IPAA excision (CPT 45136). Differences in baseline characteristics and short‐term outcomes between groups were assessed with univariate and matched analyses.

Results

We identified 593 reoperative IPAA procedures: revision group 78 (13%) and excision group 515 (86%). The groups had similar age and body mass index (kg/m2), but the revision group had more women (65.4% vs 51.8%, P = 0.02) and fewer were on chronic steroids (3.9% vs 17.9%, P = 0.0008) relative to the excision group. Revision IPAA patients were more likely to have received a preoperative transfusion (5.1% vs 0.97%, P = 0.02). Revision and excision were associated with similar postoperative length of stay (9.3 vs 8.6 days, 0.44), mortality (nil vs 0.58%, respectively; P = 0.99) and short‐term morbidity (34.6% vs 40.2%, respectively; P = 0.88) at 30 days.

Conclusions

Pouch revision and excision have comparable short‐term postoperative outcomes, but pouch excision appears to be more commonly utilized. Increased awareness of the indications for pouch revision or referral to specialized centres may improve pouch revision rates.
Endoscopic ultrasound‐guided choledochoduodenostomy using a thin stent delivery system in patients with unresectable malignant distal biliary obstruction: A prospective multicenter study
Authors: Itonaga Masahiro , Kitano Masayuki , Hatamaru Keiichi , Tamura Takashi , Nuta Junya , Kawaji Yuki , Takenaka Mamoru , Minaga Kosuke , Kudo Masatoshi , Ogura Takeshi , Higuchi Kazuhide , Chiba Yasutaka
Published: November 2018

Background and Aim

When endoscopic retrograde cholangiopancreatography (ERCP) fails in patients with malignant distal biliary obstruction, endoscopic ultrasound‐guided choledochoduodenostomy (EUS‐CDS) is an alternative. It has high technical and clinical success rates, but also has high adverse event rates. This prospective cohort study was aimed to evaluate the clinical efficacy and safety of EUS‐CDS with our newly developed partially covered self‐expandable metal stent with a thin delivery system.

Methods

Patients consisted of all consecutive patients in three tertiary referral centers with unresectable malignant distal obstruction in whom ERCP failed and in whom EUS‐CDS with the thin delivery system was selected as the second‐line approach. Rates of clinical success, technical success, technical success in cases not requiring fistulous tract dilation, adverse events, and stent dysfunction were determined.

Results

In the 20 patients, technical and clinical success rates were 95.0% (19/20) and 100% (19/19), respectively. In 31.6% (6/19), the delivery system was successfully inserted into the bile duct without requiring a fistulous‐tract dilatation device. These patients had significantly shorter procedure times than patients requiring fistulous‐tract dilatation (12.7 ± 3.1 vs 23.2 ± 2.1 min; P < 0.01). One patient (5.0%) who required fistulous dilation had an adverse event, which was managed conservatively. There were no procedure‐related deaths. During follow up, four patients (21.1%) developed stent dysfunction. Reintervention was successful in all cases.

Conclusions

The EUS‐CDS approach had 95% technical and 100% clinical success rates, with adverse events reported in 5% of cases. EUS‐CDS may become safer if efforts are made to avoid the dilation step (UMIN 000023938).
Cryptic temporal changes in stock composition explain the decline of a flounder (Platichthys spp.) assemblage
Authors: Momigliano Paolo , Jokinen Henri , Calboli Federico , Aro Eero , Merilä Juha
Published: November 2018

Unobserved diversity, such as undetected genetic structure or the presence of cryptic species, is of concern for the conservation and management of global biodiversity in the face of threatening anthropogenic processes. For instance, unobserved diversity can lead to overestimation of maximum sustainable yields and therefore to overharvesting of the more vulnerable stock components within unrecognized mixed‐stock fisheries. We used DNA from archival (otolith) samples to reconstruct the temporal (1976–2011) genetic makeup of two mixed‐stock flounder fisheries in the Åland Sea (AS) and the Gulf of Finland (GoF). Both fisheries have hitherto been managed as a single stock of European flounders (Platichthys flesus), but were recently revealed to target two closely related species: the pelagic‐spawning P. flesus and the newly described, demersal‐spawning P. solemdali. While the AS and GoF fisheries were assumed to consist exclusively of P. solemdali, P. flesus dominated the GoF flounder assemblage (87% of total) in 1983, had disappeared (0%) by 1993, and remained in low proportions (10%–11%) thereafter. In the AS, P. solemdali dominated throughout the sampling period (>70%), and P. flesus remained in very low proportions after 1983. The disappearance of P. flesus from the GoF coincides in time with a dramatic (~60%) decline in commercial landings and worsening environmental conditions in P. flesus’ northernmost spawning ground, the Eastern Gotland Basin, in the preceding 4–6 years. These results are compatible with the hypothesis that P. flesus in the GoF is a sink population relying on larval subsidies from southern spawning grounds and the cause of their disappearance is a cessation of larval supply. Our results highlight the importance of uncovering unobserved genetic diversity and studying spatiotemporal changes in the relative contribution of different stock components, as well as the underlying environmental causes, to manage marine resources in the age of rapid anthropogenic change.
Obtaining Accurate Isotopic Compositions with the Double Spike Technique: Practical Considerations
Authors: Klaver Martijn , Coath Christopher D.
Published: November 2018

Ever‐increasing precision in isotope ratio measurements requires a concomitant small bias within and between laboratories. The double spike technique is the most suitable method to obtain reliable isotope composition data that are accurately corrected for instrumental mass fractionation. Compared with other methods, such as sample‐calibrator bracketing (SCB), only the double spike technique can correct for all sources of fractionation after equilibration of the sample with the double spike, such as that incurred during chemical separation and measurement. In addition, it is not dependent on a priori assumptions of perfect matrix matching of samples to reference materials or quantitative recovery of the sample through the chemical separation procedure to yield accurate results. In this review article, we present a detailed discussion of the merits of the double spike technique, how to design and calibrate a suitable double spike and analytical strategies. Our objective is to offer a step‐by‐step introduction to the use of the double spike technique in order to lower potential barriers that researchers new to the subject might face, such that double spiking will replace SCB as the measurement method of choice.
Transcriptional control of natural killer cell differentiation
Authors: Brillantes Marc , Beaulieu Aimee M.
Published: November 2018

Natural killer (NK) cells are highly specialized cytotoxic lymphocytes that provide protection against pathogens and malignant cells. They develop from common lymphoid progenitors via a multi‐stage lineage commitment and differentiation process that gives rise to mature NK cells with potent cytotoxic functionality. Although generally considered cells of the innate immune system, recent studies have demonstrated that NK cells have the capacity to mount immune responses with features of adaptive immunity, including robust antigen‐specific clonal‐like expansion and the generation of long‐lived memory cells that mediate enhanced recall responses. Here, we discuss specific transcription factors that have been shown to commonly and uniquely regulate NK cell development and effector and memory responses in experimental mouse models.
Combination of procalcitonin and C‐reactive protein levels in the early diagnosis of bacterial co‐infections in children with H1N1 influenza
Authors: Li Zhihao , He Liya , Li Shuhua , He Waner , Zha Caihui , Ou Wanxing , Hou Qiaozhen , Wang Weiying , Sun Xin , Liang Huiying
Published: November 2018

Objective

This study evaluated the diagnostic value of measuring the levels of procalcitonin (PCT) and C‐reactive protein (CRP) to differentiate children co‐infected with H1N1 influenza and bacteria from children infected with H1N1 influenza alone.

Methods

Consecutive patients (children aged < 5 years) with laboratory‐confirmed H1N1 influenza who were hospitalized or received outpatient care from a tertiary‐care hospital in Canton, China, between January 1, 2012, and September 1, 2017, were included in the present study. Laboratory results, including serum PCT and CRP levels, white blood cell (WBC) counts, and bacterial cultures, were analyzed. The predictive value of the combination of biomarkers versus any of the biomarkers alone for diagnosing bacterial co‐infections was evaluated using logistic regression analyses.

Results

Significantly higher PCT (1.46 vs 0.21 ng/mL, P < 0.001) and CRP (19.20 vs 5.10 mg/dL, P < 0.001) levels were detected in the bacterial co‐infection group than in the H1N1 infection‐alone group. Using PCT or CRP levels alone, the areas under the curves (AUCs) for predicting bacterial co‐infections were 0.801 (95% CI, 0.772‐0.855) and 0.762 (95% CI, 0.722‐0.803), respectively. Using a combination of PCT and CRP, the logistic regression‐based model, Logit(P) = −1.912 + 0.546 PCT + 0.087 CRP, showed significantly greater accuracy (AUC: 0.893, 95% CI: 0.842‐0.934) than did the other three biomarkers.

Conclusions

The combination of PCT and CRP levels could provide a useful method of distinguishing bacterial co‐infections from an H1N1 influenza infection alone in children during the early disease phase. After further validation, the flexible model derived here could assist clinicians in decision‐making processes.
Use of platelet‐rich plasma to facilitate wound healing
Authors: Menchisheva Yuliya , Mirzakulova Ulmeken , Yui Rudolf
Published: November 2018

Platelet‐rich plasma (PRP) is widely used nowadays in different fields of medicine, affecting physiological processes including tissue regeneration. The use of PRP in maxillofacial surgical interventions and its efficiency in the improvement of postoperative wound healing were analysed. Patients undergoing plastic and reconstructive surgeries in the maxillofacial region were recruited: 50 patients were enrolled into a control group (received no PPRP injection) and 50 patients were enrolled into a treatment group, where PRP was applied during the surgical procedure. Evaluation of treatment outcomes was carried out by determination of IL‐1β, TNFα, and IL‐6 cytokines levels in the wound‐drain fluid. The stages of wound healing were assessed by cytological analyses and ultrasound within a month period. The use of the PRP has substantially positive effects, contributing to the improvement of the healing process. In the treatment group, fibroblasts, macrophages, and collagen fibres appeared and their quantities increased earlier than when compared with control group patients. The concentration of IL‐1β and TNFα in wound fluid on day 1 and day 5 after operation was higher for the treatment group as opposed to the control group, which was linked to the influence of PRP on inflammatory and granulation phases of the healing process. An ultrasound examination showed less oedema and infiltration in the tissues around the wound of the treatment group.
Conductivity of iron‐doped strontium titanate in the quenched and degraded states
Authors: Long Daniel M. , Cai Biya , Baker Jonathon N. , Bowes Preston C. , Bayer Thorsten J.M. , Wang Jian‐Jun , Wang Rui , Chen Long‐Qing , Randall Clive A. , Irving Douglas L. , Dickey Elizabeth C.
Published: November 2018

The electrical behavior of iron‐doped strontium titanate (Fe:SrTiO3) single crystals equilibrated at 900°C and quenched below 400°C at various oxygen partial pressures () was investigated via impedance spectroscopy and compared to defect chemistry models. Fe:SrTiO3 annealed and quenched between 1.2 × 10−14 and 2.0 × 10−4 Pa exhibits a conduction activation energy (EA) around 0.6 eV, consistent with ionic conduction of oxygen vacancies. However, sudden changes in EA are found to either side of this range; a transition from 0.6 to 1 eV is found in more oxidizing conditions, while a sudden transition to 1.1 and then 0.23 eV is found in reducing These transitions, not described by the widely used canonical model, are consistent with predictions of transitions from ionic to electronic conductivity, based on first principles point defect chemistry simulations. These models demonstrate that activation energies in mixed conductors may not correlate to specific conduction mechanisms, but are determined by the cumulative response of all operative conduction processes and are very sensitive to impurities. A comparison to electrically degraded Fe:SrTiO3 provides insight into the origins of the conductivity activation energies observed in those samples.
Structural and physical characteristics of Au2O3‐doped sodium antimonate glasses – Part II electrical characteristics
Authors: Ashok Jujjavarapu , Kostrzewa Marek , Ingram Adam , Nalluri Purnachand , Venkatramaiah Nutalapati , Srinivasa Reddy Maddireddy , Ravi Kumar Vandana , Veeraiah Nalluri
Published: November 2018

In continuation of our earlier investigations on structural and physical characteristics of Au2O3‐doped sodium antimonate glass‐ceramics (Part‐1), in this part we have investigated the influence of gold ions on electrical characteristics of the Na2O–Sb2O3: Au2O3 glass‐ceramics. The study contains the results of quantitate investigations on dielectric properties, impedance spectra and A.C. conductivity in larger ranges of continuous frequencies (4 Hz‐8 MHz) and temperatures (300‐630 K). The variations exhibited by dielectric parameters with temperature and also with frequency were discussed in terms of various polarization mechanisms. The observed dielectric relaxation effects were analyzed using pseudo Cole‐Cole plot method and the analysis indicated spreading of relaxation times for dipoles. A.c. conductivity and also d.c. conductivity were found to decrease (to three orders of magnitude) with increase in Au2O3 concentration upto 0.1 mol%. The decrement is ascribed to the increasing concentration of Sb5+ ions that were predicted to participate in the glass network forming with SbO4 units. Even though, both ionic and polaronic contributions are possible for conduction in the studied material, quantitative analysis of these results indicated that the polaronic conduction (due to intervalence transfer between Sb3+ ↔ Sb5+ and Au0 ↔ Au3+) is prevalent. The results have also suggested that there is a gradual decrement in the ionic component with increase in Au2O3 concentration. Variation in σac in the low‐temperature region could satisfactorily be explained using quantum mechanical tunneling (QMT) model. Analysis of the results of d.c. conductivity indicated that the small polaron hoping (SPH) model is valid, especially in a high‐temperature region while the low temperature part of d.c. conductivity is analyzed based on variable range hopping (VRH) model. Overall, the increase in Au2O3 dopant concentration in the studied glass‐ceramics caused a decrement in the magnitude of the conductivity or increase in the insulating strength of the material.
Home blood pressure control status in 2017‐2018 for hypertension specialist centers in Asia: Results of the Asia BP@Home study
Authors: Kario Kazuomi , Tomitani Naoko , Buranakitjaroen Peera , Chia Yook‐Chin , Park Sungha , Chen Chen‐Huan , Divinagracia Romeo , Shin Jinho , Siddique Saulat , Sison Jorge , Ann Soenarta Arieska , Sogunuru Guru Prasad , Tay Jam Chin , Turana Yuda , Zhang Yuqing , Nailes Jennifer , Wanthong Sirisawat , Hoshide Satoshi , Matsushita Noriko , Kanegae Hiroshi , Wang Ji‐Guang ,   HOPE Asia Network
Published: November 2018

A self‐measured home blood pressure (BP)‐guided strategy is an effective practical approach to hypertension management. The Asia BP@Home study is the first designed to investigate current home BP control status in different Asian countries/regions using standardized home BP measurements taken with the same validated home BP monitoring device with data memory. We enrolled 1443 medicated hypertensive patients from 15 Asian specialist centers in 11 countries/regions between April 2017 and March 2018. BP was relatively well controlled in 68.2% of patients using a morning home systolic BP (SBP) cutoff of <135 mm Hg, and in 55.1% of patients using a clinic SBP cutoff of <140 mm Hg. When cutoff values were changed to the 2017 AHA/ACC threshold (SBP <130 mm Hg), 53.6% of patients were well controlled for morning home SBP. Using clinic 140 mm Hg and morning home 135 mm Hg SBP thresholds, the proportion of patients with well‐controlled hypertension (46%) was higher than for uncontrolled sustained (22%), white‐coat (23%), and masked uncontrolled (9%) hypertension, with significant country/regional differences. Home BP variability in Asian countries was high, and varied by country/region. In conclusion, the Asia BP@Home study demonstrated that home BP is relatively well controlled at hypertension specialist centers in Asia. However, almost half of patients remain uncontrolled for morning BP according to new guidelines, with significant country/regional differences. Strict home BP control should be beneficial in Asian populations. The findings of this study are important to facilitate development of health policies focused on reducing cardiovascular complications in Asia.
Molecular basis for Poria cocos mushroom polysaccharide used as an antitumour drug in China
Authors: Li Xiulian , He Yanli , Zeng Pengjiao , Liu Yong , Zhang Meng , Hao Cui , Wang Hua , Lv Zhihua , Zhang Lijuan
Published: November 2018

Poria cocos is an edible medicinal fungus known as “Fuling” in Chinese and has been used as a Chinese traditional medicine for more than two thousand years. Pharmacological studies reveal that polysaccharide is the most abundant substance in Poria cocos and has a wide range of biological activities including antitumour, immunomodulation, anti‐inflammation, antioxidation, anti‐ageing, antihepatitis, antidiabetics and anti‐haemorrhagic fever effects. As a result, “Poria cocos polysaccharide oral solution” was developed and sold as an over‐the‐counter health supplement since 1970s. In 2015, “Polysaccharidum of Poria cocos oral solution” was approved as a drug by Chinese Food and Drug Administration for treating multiple types of cancers, hepatitis and other diseases alone or during chemo‐ or radiation therapy for patients with cancer. In this article, biochemical, preclinical and clinical studies of Poria cocos polysaccharide from 72 independent studies during the past 46 years (1970‐2016) based on PubMed, VIP (Chongqing VIP Chinese Scientific Journals Database), CNKI (China National Knowledge Infrastructure) and Wanfang database searches are summarized. The structure, pharmacological effects, clinical efficacy, immunobalancing molecular mechanism and toxicity of Poria cocos polysaccharide are deliberated to provide a general picture of Poria cocos polysaccharide as a clinically used antitumour drug.
MiR‐130b promotes the progression of oesophageal squamous cell carcinoma by targeting SASH1
Authors: Zhu Yuxing , Ma Yanni , Peng Honghua , Gong Lian , Xiao Mengqin , Xiang Liang , He Dong , Cao Ke
Published: November 2018

MiR‐130b and SAM and SH3 domain containing 1 (SASH1) play an important role in many types of human cancers. The aim of our research was to study their interactions in the process of the proliferation and aggressiveness of oesophageal squamous cell carcinoma (ESCC) cells. Microarray analysis was done to screen the differentially expressed genes in the ESCC tissues. miR‐130b and SASH1 mRNA levels in the ESCC tissues and cells were detected by qRT‐PCR. Dual luciferase reporter system was used to verify the target relationship between miR‐130b and SASH1. The effects of miR‐130b on SASH1 expression were explored by western blot in KYSE30 and TE1 cell lines. CCK‐8 assay, flow cytometry, Transwell, and wound healing assays were conducted to explore the effects of miR‐130b and SASH1 in vitro. In addition, in vivo experiments were conducted to study the roles of miR‐130b and SASH1. miR‐130b was highly expressed, while SASH1 was the opposite in both the ESCC tissues and cells. The expression of SASH1 was inhibited by the direct binding of miR‐130b. The inhibition of miR‐130b reduced the proliferation and aggressiveness of ESCC cells, while it also induced apoptosis and cell cycle arrest in the ESCC cells by suppressing SASH1. The in vivo assay suggested that the overexpression of miR‐130b promoted the growth of ESCC tumours. MiR‐130b was up‐regulated in the ESCC tumour tissues and cells, acting as a tumour promoter. A stimulating effect was demonstrated on ESCC cell growth and aggressiveness by suppressing SASH1, which is an anti‐oncogene.
Vildagliptin improves high glucose‐induced endothelial mitochondrial dysfunction via inhibiting mitochondrial fission
Authors: Liu Hengdao , Xiang Hong , Zhao Shaoli , Sang Haiqiang , Lv Fenghua , Chen Ruifang , Shu Zhihao , Chen Alex F. , Chen Shuhua , Lu Hongwei
Published: November 2018

The dipeptidyl peptidase 4 inhibitor vildagliptin (VLD), a widely used anti‐diabetic drug, exerts favourable effects on vascular endothelium in diabetes. We determined for the first time the improving effects of VLD on mitochondrial dysfunction in diabetic mice and human umbilical vein endothelial cells (HUVECs) cultured under hyperglycaemic conditions, and further explored the mechanism behind the anti‐diabetic activity. Mitochondrial ROS (mtROS) production was detected by fluorescent microscope and flow cytometry. Mitochondrial DNA damage and ATP synthesis were analysed by real time PCR and ATPlite assay, respectively. Mitochondrial network stained with MitoTracker Red to identify mitochondrial fragmentation was visualized under confocal microscopy. The expression levels of dynamin‐related proteins (Drp1 and Fis1) were determined by immunoblotting. We found that VLD significantly reduced mtROS production and mitochondrial DNA damage, but enhanced ATP synthesis in endothelium under diabetic conditions. Moreover, VLD reduced the expression of Drp1 and Fis1, blocked Drp1 translocation into mitochondria, and blunted mitochondrial fragmentation induced by hyperglycaemia. As a result, mitochondrial dysfunction was alleviated and mitochondrial morphology was restored by VLD. Additionally, VLD promoted the phosphorylation of AMPK and its target acetyl‐CoA carboxylase in the setting of high glucose, and AMPK activation led to a decreased expression and activation of Drp1. In conclusion, VLD improves endothelial mitochondrial dysfunction in diabetes, possibly through inhibiting Drp1‐mediated mitochondrial fission in an AMPK‐dependent manner.
Advances in evidence‐based medicine for immunotherapy of non‐small cell lung cancer
Authors: Dong Jingsi , Li Bingjie , Zhou Qinghua , Huang Depei
Published: November 2018

Tumor immunotherapy is praised as “green therapy,” which can attack tumor by mobilizing immune system. By removing the inhibition of immune cells, checkpoint inhibitors help T cells to identify and kill tumor cells. In recent years, more and more attention has been paid to its effectiveness as a tumor therapy with a large number of clinical data. Currently, inhibitors of 2 checkpoints, CTLA‐4 and PD‐1/PD‐L1, have been approved to be listed. In particular, the latter has achieved breakthrough progress in non‐small cell lung cancer in recent years, bringing about changes in the therapeutic strategy of lung cancer, as well as challenges to the evaluation criteria. This article focuses on the latest immunotherapy methods for lung cancer. The purpose of this article is to summarize the development of evidence‐based medicine for lung cancer immunotherapy and to provide help for further understanding of lung cancer immunotherapy.
Lipoid pneumonia in an orangutan (Pongo abelii) with chronic respiratory problems
Authors: Novacco Marilisa , Hofmann‐Lehmann Regina , Hetzel Udo , Hatt Jean‐Michel , Ohlerth Stefanie , Stirn Martina
Published: November 2018

An orangutan (Pongo abelii) presented with chronic respiratory problems. Cytological evaluation of the bronchoalveolar lavage fluids revealed macrophages with well‐circumscribed intracytoplasmic clear vacuoles and lipid droplets in the background, confirmed by Oil Red O staining. The findings were indicative of lipoid pneumonia. This is the first report of lipoid pneumonia in an orangutan.
High carbon storage in carbon‐limited trees
Authors: Weber Raphael , Gessler Arthur , Hoch Günter
Published: November 2018

The concentrations of nonstructural carbohydrates (NSCs) in plant tissues are commonly used as an indicator of total plant carbon (C) supply; but some evidence suggests the possibility for high NSC concentrations during periods of C limitation. Despite this uncertainty, NSC dynamics have not been investigated experimentally under long‐term C limitation.

We exposed saplings of 10 temperate tree species differing in shade tolerance to 6% of ambient sunlight for 3 yr to induce C limitation, and also defoliated one species, Carpinus betulus, in the third season. Growth and NSC concentrations were monitored to determine C allocation.

Shade strongly reduced growth, but after an initial two‐fold decrease, NSC concentrations of shaded saplings recovered to the level of unshaded saplings by the third season. NSC concentrations were generally more depleted under shade after leaf flush, and following herbivore attacks. Only under shade did artificial defoliation lead to mortality and depleted NSC concentrations in surviving individuals.

We conclude that, irrespective of shade tolerance, C storage is maintained under prolonged shading, and thus high NSC concentrations can occur during C limitation. Yet, our results also suggest that decreased NSC concentrations are indicative of C limitation, and that additional leaf loss can lead to lethal C shortage in deep shade.
Differential modulations of reward expectation on implicit facial emotion processing: ERP evidence
Authors: Wu Lulu , Müller Hermann J. , Zhou Xiaolin , Wei Ping
Published: November 2018

Implicit emotional processing refers to the preferential processing of emotional content even if it is task irrelevant. Given that motivation enhances executive control by biasing attentional resources toward target stimuli, here we investigated the effects of reward expectation on implicit facial emotional processing in two experiments using ERPs. A precue signaling additional monetary reward for fast and accurate response for the upcoming trial (incentive condition; relative to a cue indicating no such additional reward, i.e., nonincentive condition) was followed by the presentation of a happy, angry, or neutral face. Participants had to determine the gender of the face in Experiment 1 and decide whether a number superimposed on the face was even or odd in Experiment 2. In both experiments, incentive cues elicited larger P3 and contingent negative variation responses, and the targets following incentive cues elicited more positive‐going ERPs (200–700 ms), compared with the nonincentive condition. Importantly, the N2 responses (200–280 ms) to the target exhibited differential patterns of Reward × Emotion interaction: relative to the nonincentive condition, the N2 amplitude differences between emotional (i.e., happy and/or angry) and neutral faces increased in the incentive condition in Experiment 1, but diminished in Experiment 2. These results indicate that reward expectation can differentially modulate implicit processing of facial expressions, with increased sensitivity to emotions when the processing of whole faces is required, but with reduced sensitivity when the processing of faces is distractive. This study enriches the evidence for interactions between reward‐related executive control and implicit emotional processing.
Effect of CPAP on airway reactivity and airway inflammation in children with moderate–severe asthma
Authors: Praca Eduardo , Jalou Hasnaa , Krupp Nadia , Delecaris Angela , Hatch Joseph , Slaven James , Gunst Susan J. , Tepper Robert S.
Published: November 2018

Background and objective

Asthma is characterized by airway hyperreactivity and airway inflammation. We previously demonstrated that adults with mild well‐controlled asthma exhibited a marked decrease in airway reactivity (PC20 increased >2‐fold) after using nocturnal continuous positive airway pressure (CPAP) for 1 week. If CPAP produces a similar suppression of airway reactivity in children with moderate–severe asthma, who require chronic use of corticosteroids, then this non‐pharmacological therapy might provide a beneficial alternative or supplemental therapy in these subjects.

Methods

Children aged 8–17 years with moderate–severe asthma were treated with 4 weeks of nocturnal CPAP (8–10 cm H2O) or sham CPAP (<2 cm H2O). Adherence was monitored with a modem installed in the equipment or by memory cards. Airway reactivity, assessed by methacholine bronchial challenge, was measured prior to and following treatment.

Results

The percentage of subjects adherent to treatment was similar in both groups (19/27 CPAP vs 19/28 sham, ~70%). There was a tendency for PC20 to increase with treatment in both groups (3.0–5.3 mg/mL CPAP vs 3.2 to 4.3 mg/mL sham, P = 0.083); however, the change did not differ significantly between groups (P = 0.569).

Conclusion

We found that the 4‐week treatment with nocturnal CPAP did not produce a twofold suppression of airway reactivity in children with moderate–severe asthma.
Construction of Row–Column Factorial Designs
Authors: Godolphin J. D.
Published: November 2018

The arrangement of 2n-factorials in row–column designs to estimate main effects and two-factor interactions is investigated. Single-replicate constructions are given which enable estimation of all main effects and maximize the number of estimable two-factor interactions. Constructions and guidance are given for multireplicate designs in single arrays and in multiple arrays. Consideration is given to constructions for 2n − t fractional factorials.
Systematic review of factors associated with the development of Guillain–Barré syndrome 2007–2017: what has changed?
Authors: Wachira Virginia Kagure , Peixoto Henry Maia , de Oliveira Maria Regina Fernandes
Published: November 2018

Objective

The objective of this study was to describe the factors associated with the development of Guillain–Barré syndrome, both infectious and non‐infectious, during and after the A(H1N1) influenza pandemic in 2009 and the recent Zika virus epidemic in the Americas.

Method

Systematic review of literature on factors associated with the development of the Guillain–Barré syndrome published between 2007 and 2017 listed in EBSCO, MEDLINE and LILACS databases. The quality of the studies was evaluated using the Newcastle Ottawa Scale.

Results

Thirty‐four articles met inclusion criteria and were selected for analysis. Their quality was considered good in relation to most of the items evaluated. Many aetiological agents had the results of association with Guillain–Barré syndrome, among them Campylobacter jejuni, influenza vaccine – both pandemic and seasonal vaccines, respiratory infection, gastrointestinal infection among others. The aetiological agents found are, in most part, the same reported prior to the study period. The association with surgeries, chikungunya virus (CHIKV), Zika virus and quadrivalent human papillomavirus vaccine stand out as new aetiological agents in the list of the various possible agents that trigger Guillain–Barré syndrome reported in the study period. There were no Brazilian studies identified during this period.

Conclusions

The results of the review reaffirmed C. jejuni as the major trigger of GBS, whereas the association of influenza vaccines and GBS is less clear; Zika virus infection in association with GBS was found in only one study.
Minimally invasive percutaneous medial plate‐rod osteosynthesis for treatment of humeral shaft fractures in dog and cats: Surgical technique and prospective evaluation
Authors: Guiot Laurent P. , Guillou Reunan P. , Déjardin Loïc M.
Published: November 2018

Objective

To describe and prospectively report outcomes associated with a novel minimally invasive percutaneous osteosynthesis (MIPO) technique for the treatment of humeral fractures in dogs and cats.

Study design

Prospective clinical case series.

Animals

Eleven dogs and 4 cats with traumatic nonarticular humeral fractures.

Methods

Dogs and cats that presented with traumatic humeral fractures were enrolled in the study. After closed reduction, the fracture was stabilized by using a plate‐rod combination applied via remote medial incisions. Postoperative alignment in the frontal and sagittal planes was statistically compared with the contralateral limbs. Time to clinical union and complications were also recorded.

Results

Eleven dogs and 4 cats were included in this study. Body weight ranged from 4.5 to 33.6 kg in dogs and from 2.2 to 3.6 kg in cats. A veterinary cuttable plate (6/11 dogs and 3/4 cats) or locking compression plate was used in a plate‐rod configuration (11/11 dogs and 2/4 cats) or alone (2/4 cats). Rod‐to‐medullary‐cavity ratio was 30%. Plate‐span ratio was 5.8 (range, 2‐13.5). No significant differences were found in frontal or sagittal plane alignment. Healing time in cases that completed on‐time follow‐up (12/15) was 36 ± 14 days (range, 20‐69). No major complications were recorded.

Conclusion

The reported technique was associated with good outcomes in a large variety of fracture configurations and animal sizes, with no complications.

Clinical significance

This report provides evidence that MIPO is a compelling alternative to open reduction and internal fixation in the treatment of various humeral fractures.