bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Silane Treatment of All-Ceramic Surfaces (e-Max) on the Cementation with Tooth Dentine
Authors: Gkogkas Evangelos , Dalla Panagiota T. , Matikas Theodore E. , Agathopoulos Simeon
Published: November 2017

The influence of the treatment of the surface of IPS Empress II (e-max) glass-ceramic dental material with different silane agents on the surface roughness of this glass-ceramic was evaluated. IPS Empress II (e-max) cores were treated with five different commercial silane agents used in dentistry nowadays, for several periods of time and were finally air dried. After silanization, the surfaces of the glass-ceramic cores were observed with a light profilometer, a scanning electron microscope (SEM), and an atomic force microscope (AFM). The values of surface roughness (Ra) were also measured with the light profilometer. The results showed an important effect of silane treatment applied for different periods of time, especially for prolonged treatment for 24 hours, on the surface roughness of IPS Empress II (e-max). These results can have an important impact on the deep understanding of the cementation protocols applied in modern dentistry.
Hardness Evaluation of Carbonate Apatite Cement Based on Various Ratio of Precursor
Authors: Djustiana Nina , Amaranila Mitha , Greviana Nadia , Zakaria Myrna Nurlatifah , Sunarso  , Cahyanto Arief
Published: November 2017

Carbonate Apatite (CO3Ap) cement is considered as an ideal bone substitute due to its biocompatibility and osteoconductivity. Also, CO3Ap cement has the chemical composition that closes to natural bone. During cement preparation, precursors play an important role that affects the properties of CO3Ap cement. Cement hardness is one of the important properties that need to be evaluated before the obtained cement can be applied as a bone substitute. Therefore, the purpose of this study is to determine the effect of precursor ratio of CaCO3 and CaHPO4 on the hardness level of CO3Ap cement. In the present study, the CO3Ap cement was prepared from CaCO3 and CaHPO4. Both Commercial and synthesized CaCO3 were used. The CO3Ap cement obtained from commercial CaCO3 was used as a control group. Synthesized CaCO3 was obtained from Indonesian natural limestone. Three different CaCO3:CaHPO4 ratios, 40:60, 30:70 and 20:80 were mixed with 1 mol/L Na2HPO4. Samples were kept at 37°C with 100% relative humidity for 24 hours then tested using micro Vickers hardness testing machine. The micro Vickers hardness of the control group with CaCO3:CaHPO4 ratio of 40:60, 30:70 and 20:80 were 5.09 VHN, 6.34 VHN, and 6.73 VHN, respectively. Meanwhile, the micro Vickers hardness of the CO3Ap cement obtained from synthesized CaCO3 were 6.22 VHN, 7.50 VHN, and 10.37 VHN for the CaCO3:CaHPO4 ratio of 40:60, 30:70 and 20:80, respectively. The micro Vickers hardness level of CO3Ap cement precursor ratio from the lowest to the highest was 40:60 < 30:70 < 20:80. In conclusion, the precursor ratio significantly affects the hardness level of the CO3Ap cement. The hardness level of CO3Ap cement obtained from synthesized CaCO3 was higher compared with that obtained from commercial CaCO3.
Mechanical Strength Properties of Injectable Carbonate Apatite Cement with Various Concentration of Sodium Carboxymethyl Cellulose
Authors: Cahyanto Arief , Imaniyyah Atina Ghina , Zakaria Myrna Nurlatifah , Hasratiningsih Zulia
Published: November 2017

Mechanical strength is one of the key factors for clinical application of injectable carbonate apatite (CO3Ap) cement. Incorporation of polymeric additives into the mixing liquid of injectable bone cement has been known to improve cement injectability. The aim of this study is to determine whether incorporation of sodium carboxymethyl cellulose (Na CMC) into the mixing liquid would affect the diametral tensile strength (DTS) of injectable CO3Ap cement. In the present study, Na CMC, a polymeric additive and a cellulose derivative, was used to promote the injectability of CO3Ap cement. Three groups of CO3Ap cement samples consist of CaCO3 and CaHPO4 powder in each group were mixed with 0.5 %, 1%, and 2% Na CMC solution incorporated to 0.2 mol/L Na2HPO4 solution. As a control, powder mixed with 0.2 mol/L Na2HPO4 solution was used. Samples were kept in an incubator (37°C, 100% relative humidity, 24 hours). The mechanical strength properties were evaluated by diametral tensile strength (DTS). The average DTS of samples containing 0.5%, 1%, and 2% Na CMC were 3.19 MPa, 3.57 MPa, and 3.06 MPa, respectively. While the average DTS of the control group was 3.29 MPa. The groups containing Na CMC in all concentrations showed no statistical difference (p>0.05) on DTS compared to the control group. The injectability improved as the concentration of Na CMC increased. In conclusion, revealed that Na CMC does not affect the mechanical strength of CO3Ap cement. Therefore, it may be considered as an effective material to promote cement injectability. Further study of additives that can be used to promote the injectability of CO3Ap cement and enhance the mechanical strength awaits based on this initial finding.
Apatite Formation Ability of Bioactive Bearing Grade Polyetheretherketone Fabricated by Incorporation of Apatite Nuclei
Authors: Hiruta Tomoko , Yabutsuka Takeshi , Watanabe Shin , Fukushima Keito , Takai Shigeomi , Yao Takeshi
Published: November 2017

The fabrication process of bioactive bearing grade PEEK was consisted of three steps. First, micropores were formed on the bearing grade PEEK plates by sulfuric acid treatment. Second, plates were exposed to O2 plasma by glow discharge. Finally, the plates were immediately immersed in SBF controlled at pH 8.4 at 25.0 °C and held at 70 °C for 24 hours. By this final treatment, Apatite Nuclei were precipitated inside of the pores. In order to investigate which step has the most influence on enriching bioactivity, four types of samples were obtained by changing the combinations of each process and evaluated the bioactivity by using SBF.
Evaluation of Protein Adsorption Capacity of TiO2-Supported Spherical Porous Hydroxyapatite
Authors: Katayama Max , Tamazawa Kengo , Kodaira Ayu , Nonami Toru
Published: November 2017

In this study, a novel titania-supported spherical porous hydroxyapatite (sHAp + TiO2) was prepared by compounding minute, uniquely shaped spherical porous hydroxyapatites (sHAp) with TiO2. Adsorption of the representative protein bovine serum albumin (BSA) was evaluated and simulated body fluid immersion experiments were carried out. Minimal adsorption of BSA to TiO2 was observed, and 33% and 25% adsorption to sHAp + TiO2 and sHAp were observed, respectively. The reduction in BSA concentration observed in the sHAp and sHAp + TiO2 solutions is presumably due to adsorption to HAp. It is highly likely that adsorption of the acidic protein BSA occurred at the sHAp Ca2+ site. In the simulated body fluid immersion experiments, there was greater expression of hydroxyapatite (HAp) on the surface of sHAp than there was on the surface of sHAp + TiO2. In the case of TiO2 alone, no HAp was produced, even after immersion for 3 days. These results suggest a relationship between BSA adsorption and the osteoconductivity of materials.
Eight-Color Multiplex Immunohistochemistry for Simultaneous Detection of Multiple Immune Checkpoint Molecules within the Tumor Microenvironment
Authors: Gorris Mark A. J. , Halilovic Altuna , Rabold Katrin , van Duffelen Anne , Wickramasinghe Iresha N. , Verweij Dagmar , Wortel Inge M. N. , Textor Johannes C. , de Vries I. Jolanda M. , Figdor Carl G.
Published: November 2017

Therapies targeting immune checkpoint molecules CTLA-4 and PD-1/PD-L1 have advanced the field of cancer immunotherapy. New mAbs targeting different immune checkpoint molecules, such as TIM3, CD27, and OX40, are being developed and tested in clinical trials. To make educated decisions and design new combination treatment strategies, it is vital to learn more about coexpression of both inhibitory and stimulatory immune checkpoints on individual cells within the tumor microenvironment. Recent advances in multiple immunolabeling and multispectral imaging have enabled simultaneous analysis of more than three markers within a single formalin-fixed paraffin-embedded tissue section, with accurate cell discrimination and spatial information. However, multiplex immunohistochemistry with a maximized number of markers presents multiple difficulties. These include the primary Ab concentrations and order within the multiplex panel, which are of major importance for the staining result. In this article, we report on the development, optimization, and application of an eight-color multiplex immunohistochemistry panel, consisting of PD-1, PD-L1, OX40, CD27, TIM3, CD3, a tumor marker, and DAPI. This multiplex panel allows for simultaneous quantification of five different immune checkpoint molecules on individual cells within different tumor types. This analysis revealed major differences in the immune checkpoint expression patterns across tumor types and individual tumor samples. This method could ultimately, by characterizing the tumor microenvironment of patients who have been treated with different immune checkpoint modulators, form the rationale for the design of immune checkpoint-based immunotherapy in the future.
Lower Extremity Musculoskeletal Injury Risk After Concussion Recovery in High School Athletes
Authors: Lynall Robert C. , Mauntel Timothy C. , Pohlig Ryan T. , Kerr Zachary Y. , Dompier Thomas P. , Hall Eric E. , Buckley Thomas A.
Published: November 2017

Context: 

Although an association between concussion and musculoskeletal injury has been described in collegiate and professional athletes, no researchers have investigated an association in younger athletes.

Objective: 

To determine if concussion in high school athletes increased the risk for lower extremity musculoskeletal injury after return to activity.

Design: 

Observational cohort study.

Setting: 

One hundred ninety-six high schools across 26 states.

Patients or Other Participants: 

We used data from the National Athletic Treatment, Injury and Outcomes Network surveillance system. Athletic trainers provided information about sport-related concussions and musculoskeletal injuries in athletes in 27 sports, along with missed activity time due to these injuries.

Main Outcome Measure(s): 

Three general estimating equations were modeled to predict the odds of sustaining (1) any lower extremity injury, (2) a time-loss lower extremity injury, or (3) a non–time-loss lower extremity injury after concussion. Predictors were the total number of previous injuries, number of previous concussions, number of previous lower extremity injuries, number of previous upper extremity injuries, and sport contact classification.

Results: 

The initial dataset contained data from 18 216 athletes (females = 39%, n = 6887) and 46 217 injuries. Lower extremity injuries accounted for most injuries (56.3%), and concussions for 4.3% of total injuries. For every previous concussion, the odds of sustaining a subsequent time-loss lower extremity injury increased 34% (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.13, 1.60). The number of previous concussions had no effect on the odds of sustaining any subsequent lower extremity injury (OR = 0.97; 95% CI = 0.89, 1.05) or a non–time-loss injury (OR = 1.01; 95% CI = 0.92, 1.10).

Conclusions: 

Among high school athletes, concussion increased the odds of sustaining subsequent time-loss lower extremity injuries but not non–time-loss injuries. By definition, time-loss injuries may be considered more severe than non–time-loss injuries. The exact mechanism underlying the increased risk of lower extremity injury after concussion remains elusive and should be further explored in future research.
A Family Study of Consanguinity in Children with Intellectual Disabilities in Barwani, India
Authors: Lakhan Ram , Bipeta Rajshekhar , Yerramilli Srinivasa S. R. R. , Nahar Vinayak K.
Published: November 2017

Background: Intellectual disability (ID) can be inherited in families through consanguineous marriage. The ID in an individual can be associated with the ID, epilepsy, and mental illness in their parents. Such connections can be seen more closely among consanguineous marriages in tribal and nontribal population in India. Objective: This study shows a few common patterns of the consanguineous relationship in the parents of children with ID in India. Materials and Methods: This is a case series research design. Extreme or deviant case sampling was applied. Data were collected in homes, camps, and clinical settings in the Barwani district of Madhya Pradesh, India. The patterns of consanguineous marriages and the relationship between children with ID and their relatives with ID, epilepsy, and mental illness were analyzed and reported with pedigree charts. Results: Multiple patterns of consanguineous marriages in tribal and nontribal populations were observed. ID was found to be associated in children with their relatives of the first, second, and third generations. Conclusion: ID may inherit in individuals from their relatives of the first, second, and third generations who have ID, epilepsy, or mental illness and married in the relationship. Appropriate knowledge, guidance, and counseling may be provided to potential couples before planning a consanguineous marriage.
Clinical Profile of Cognitive Decline in Patients with Parkinson's Disease, Progressive Supranuclear Palsy, and Multiple System Atrophy
Authors: Gupta Dipti , Sharma Anjani Kumar , Kumar Naveen ,   Sulena
Published: November 2017

Background: There are very less data on the comparison between the cognitive profile in Parkinson's disease (PD) and Parkinson's-plus groups, especially in India. Aims: The aim of this study is to compare the cognitive profile across PD, progressive supranuclear palsy (PSP), and multiple system atrophy (MSA) groups and compare them using Mini–Mental State Examination (MMSE), frontal assessment battery (FAB), and verbal fluency tests. Settings and Design: This was a cross-sectional study. Materials and Methods: MMSE, FAB, and verbal fluency tests were administered in a total of 73 patients constituting 22 patients in MSA, 26 patients in PD, and 25 patients in PSP group, respectively. Twenty-six participants both age- and gender-matched were enrolled in control group. Statistical Analysis: Statistical analysis was done using SPSS Version 20.0. Descriptive statistics were done to find out the mean and standard deviation of different variables. ANOVA was done for followed by post hoc Bonferroni test to assess the cognitive function in three groups. Results: ANOVA showed that there is a significant difference for MMSE scores (P = 0.038) being worse scores for PSP and maximum for MSA. A significant difference was found for FAB scores within three groups. There is a significant difference for FAB scores (P = 0.00003) being worse scores for PSP and highest scores obtained for PD. All the subtests of FAB test differed significantly except motor programming across MSA, PSP, and PD groups. Conclusions: Our data suggest that global cognitive impairment and executive dysfunction are worst in PSP among the three groups. Patients with MSA had significant cognitive decline as opposed to previous experience. FAB scores and verbal fluency tests are good tests to assess cognitive impairment in these diseases. Subsets of FAB score have significant differences but cannot help differentiating conclusively between these three diseases.
A Simplified Overview of World Health Organization Classification Update of Central Nervous System Tumors 2016
Authors: Gupta Anshu , Dwivedi Tanima
Published: November 2017

After 8 years, an update of central nervous system (CNS) tumors was published in 2016 after 2007. First time ever, molecular markers along with histology have been used in classification of any tumor. Major changes are seen in glioma and medulloblastoma groups. Few entities have been added such as diffuse midline glioma, H3 K27M-mutant, RELA fusion-positive ependymoma, embryonal tumor with multilayered rosettes, C19MC-altered, and hybrid nerve sheath tumors. Few variants and patterns that no longer have diagnostic and/or biological relevance and have been deleted such as glioblastoma cerebri, protoplasmic and fibrillary astrocytoma, and cellular ependymoma. Other changes include deletion of term “primitive neuroectodermal tumor,” addition of criterion of brain invasion in atypical meningioma, separation of melanotic schwannoma from other schwannoma, and combination of solitary fibrous tumors and hemangiopericytoma as one entity. There is also expansion of entities in nerve sheath tumors and hematopoietic/lymphoid tumors of the CNS. In this review article, we tried to review CNS tumors 2016 classification update in a simplified manner; comparing the differences between 2016 and 2007 CNS tumors classifications with brief description of important molecular markers and finally utility as well as challenges of this classification.
Knowledge, Attitude, and Practice among Practitioners Regarding Epilepsy in Bhutan: A Rural and a Remote Country
Authors: Bhalla Devender
Published: November 2017

Purpose: Epilepsy is a major neurological disorder with many countries as scientifically silent and little-to-nothing known on various aspects of epilepsy. Methods: Taking background of a first multinational seminar on epilepsy in Bhutan and a short valid questionnaire pertaining to various aspects of epilepsy, before participation. Results: Large participation was achieved (76 out of 87 approached, 87.3%; 53.0% males). Based on the responses of 76.0% lecturers and clinician and medical administration, 21.0% nurses, and 3.0% traditional practitioners, important derivations were obtained: positively, (a) event provided at least an opportunity to bring service providers at a common platform toward initiating particular epilepsy goals, (b) none regarded epilepsy as contagious or due to past sins, (c) all responded favorably to that “they found this event useful' and 'this event added something meaningful to them personally or professionally,” (d) large participation indicated acceptance, need, and common interest among a number of stakeholders. Negatively, significant knowledge-deficit was noted: for 38.4% electroencephalogram is essential for diagnosis, 48.0% responded with incorrect definition of epilepsy, etc. Conclusions: Events, such as this, provides, for scientifically silent countries, basis for not only bringing service providers to a common platform but also to discuss to initiate particular epilepsy goals, to provide additional professional knowledge for strengthening service development, and to determine need and social acceptance around epilepsy. Important knowledge deficit was identified which cannot be fully explained through lack of time or limited training. There might be a need to reappraise the approach to teaching medical professionals about epilepsy.
Flow-diverting Stent-assisted Coil Embolization of a Ruptured Internal Carotid Artery Blister Aneurysm with the Pipeline Flex Embolization Device
Authors: Ding Dale , Starke Robert M. , Hope Ayton , Brew Stefan
Published: November 2017

Internal carotid artery (ICA) blister aneurysms are rare and challenging to successfully treat, using contemporary surgical or endovascular approaches, without partial or complete compromise of the parent vessel. We describe the use of a resheathable flow diverter, the Pipeline Flex Embolization Device (PFED) to perform stent-assisted coiling of a ruptured supraclinoid ICA blister aneurysm in a 56-year-old female who presented with a high-grade subarachnoid hemorrhage (SAH). The first PFED was deployed across the aneurysm neck to jail a microcatheter within the aneurysm dome, and then, two small coils were delivered into the aneurysm. After removing the coiling microcatheter, the second PFED was telescoped into the first PFED. There were no postprocedural complications, and follow-up magnetic resonance angiography 15 months after embolization showed complete aneurysm obliteration. Flow-diverting stent-assisted coiling should be considered as a reconstructive, vessel-preserving, endovascular treatment option for appropriately selected patients with ruptured ICA blister aneurysms. However, future studies are necessary to assess the periprocedural safety in the setting of acute SAH.
Use of Preoperative Ependymal Enhancement on Magnetic Resonance Imaging Brain as a Marker of Grade of Glioma
Authors: Sharma Sumit , Jain Shashi Kant , Sinha Virendra Deo
Published: November 2017

Objectives: Neural stem cells within the subventricular zone (SVZ) are thought to be responsible for the origin and the heterogeneous nature of the gliomas. The relationship of the gliomas to the SVZ can be appreciated as ependymal enhancement on contrast magnetic resonance imaging (MRI). This study evaluates the rate of ependymal enhancement and its association with the histopathological grade of gliomas. Patients and Methods: Seventy-five patients with radiological features of glioma were recruited. Preoperative MRI was evaluated for the presence of ependymal enhancement and fluid-attenuated inversion recovery (FLAIR) signal proximity of tumor to ependyma, and the association to grade was investigated. Results: Seventy-five patients studied showed a male predominance (62.66%) with a mean age of 44.91 ± 13.64 years. Evidence of ependymal enhancement was positive in 24% (n =; 18), 46.67% (n =; 35) showed no evidence, and in 29.33% (n =; 22), assessment was inconclusive. According to WHO grading, 76% (n =; 57) were high-grade gliomas (HGGs) including Grade III (n =; 17) and Grade IV (n =; 40) and 24% (n =; 18) were low-grade gliomas (LGGs) Grade II. HGGs were significantly associated with ependymal enhancement (P< 0.01) and FLAIR signal proximity to the ependyma (P< 0.001). Among HGGs, rate of ependymal enhancement and FLAIR signal proximity was more in Grade IV than Grade III but was not statistically significant (P > 0.05). Conclusion: SVZ is associated with HGGs. These MRI features can be helpful in predicting the tumor grade preoperatively and by including LGGs, the role of SVZ in the heterogeneous disease process of glioma can be studied as a whole, not only in the glioblastoma (GBM).
The Knowledge and Attitudes of University Students concerning HPV Vaccine and Cervical Screening
Authors: Elit L , Trim K , Mohan R , Nastos S , Harnish D
Published: November 2017

Background

Cervical cancer is preventable with regular PAP tests and the human papillomavirus (HPV) vaccine.

Objective

Identify factors influencing initiation into regular sexual health examinations within a group of undergraduate health science students who have high parental SES.

Methods

After reviewing the literature, a survey of knowledge, attitudes and behaviors about HPV exposure and cervical cancer prevention through vaccination and cervical cancer screening was developed. The survey was circulated using a web-based survey tool to undergraduate Faculty of Health Sciences student.

Results

Two hundred and three students at McMaster University completed the survey. The sample included 72% women and 28% men. The mean age was 19.4 years. This sample represents a population of young adults who the previous literature would suggest are most likely to have regular health care since they are affluent (FAS greater than 6.7 ∓ 1.4). This group is also motivated in health education as 83.3% knew about the HPV vaccine and 76.4% could define the purpose of a PAP smear. Both male and female students were more likely to consult their family doctor about sexual health than their family. More than half of sexually active females have a family doctor, 82.1% of which visit them regularly. Sexually active women visit more regularly than sexually inactive women (p ≤ 0.01). The majority (66%) are comfortable discussing sexual health with their family doctor, yet only 62.5% of women have had this discussion. 57% of sexually active women and less that 1% of non-sexually active women had had a PAP smear or a pelvic exam.

Conclusion

These affluent and well educated students do not appear to be able to apply their knowledge of HPV and PAP smears to their own sexual health. Thus they require access to tools that help motivate university students to personalize information and make important health decisions.
Obesity and Time to Conception
Authors: Richman Susan
Published: November 2017

Objective

To examine the association between body mass index and time to conception.

Methods

Secondary data analysis of The Asthma in Pregnancy Study, a Prospective cohort of 2205 women assembled from April 1997-June 2000.

Results

Time to conception in women not on contraception, by BMI category, did not show a significant difference among the groups, p = 0.81 for test of equality over the strata.

Conclusions

No association between time to conception and BMI was demonstrated in these data.
Endometrial Thickness- a Practical Prospective Marker for the Risk of Surgical Intervention after RU486 Induced Abortion
Authors: Blumenfeld Zeev , Abdallah William , Kaplan Dalia , Nevo Ori
Published: November 2017

Background

Medical termination of pregnancy [TOP] during the early first trimester is commonly used. However, treatment failure which warrants surgical intervention occurs in small proportion of patients. Our objective was to examine the effectiveness and predictive value of sonographic measurement of endometrial thickness during a follow up visit after medical abortion as an accurate predictor of the necessity of curettage for completion of pregnancy termination.

Methods

Women who opted for medical TOP where treated by single dose of RU486 followed by a single dose of misoprostol. Endometrial thickness was evaluated by transvaginal U.S. at 14 days after misoprostol tretament. The data was collected prospectively for this cohort study which includes all the women undergoing medical abortion in the first seven weeks of gestation.

Results

In 34.7% of the patients the endometrial width was > 11 mm on the follow-up visit. Surgical intervention was performed in 18% of these patients, for a failure rate of the medical termination of pregnancy [TOP] of 6.25%, as compared with no failure rate in those with endometrium < 11 mm, P < 0.001. In the patients where the endometrium was 11-12 mm on follow-up, the failure rate was 5%, and if > 12 mm the failure was 5.9%. In cases where the endometrium was 12-13 mm the failure rate was 27.3%, and if >13 mm the failure was 18.9%. When the endometrium was 13-14 mm the failure rate was 10%, and when >14 mm the failure was 23.7%. Half of the 18 patients who had undergone dilatation and curettage [D&C] for completion of the TOP, had endometrium > 14 mm, one to two weeks after the medical abortion.

Conclusion

Measurement of endometrial width after medical TOP is beneficial in segregating patient to low or high risk for surgical treatment of retained product of conception [POC]. Using a cutoff of 11 mm during the follow-up visit after medical TOP, 18% of the patients may need dilatation and curettage to complete the pregnancy termination, and if it is >14 mm, half of them may need surgical intervention. There is no difference between 11 and 14 mm regarding the risk of surgical intervention after medical TOP.
Expression of Placental Neurotrophin-3 (NT-3) in Physiological Pregnancy, preeclampsia and chorioamnionitis
Authors: Casciaro Alessandra , Arcuri Felice , Occhini Rossella , Toti M. Stefania , De Felice Claudio , Toti Paolo
Published: November 2017

Neurotrophic factors are a group of proteins that act as paracrine and autocrine growth factors. They are involved in the regulation of morphogenesis and development of several tissues. The present study aims to evaluate, for the first time, the expression of Neurotrophin-3 in the human placenta during normal pregnancy and in preeclampsia and chorioamnionitis. Neurotrophin-3 mRNA, assessed by RT-PCR analysis in six term placentas, were observed in all the specimens examined. Neurotrophin-3 protein expression and tissue distribution was evaluated by immunohistochemistry in placenta samples from uncomplicated first trimester (n = 5) and term (n = 5) pregnancies as well as in specimens from preeclampsia (n = 5) and chorioamnionitis (n = 5). In first trimester specimens, strong immunoreactivity was present in villous stromal cells, in the cyto- and syncytiotrophoblast, in decidua cells and in endometrial glands. Third trimester specimens showed prominent immunostaining in cyto- and syncytiotrophoblast cells, in decidua cells and in the amniotic membranes. Villous stromal cells were weakly stained. Similar protein localization was observed in placentas with preeclampsia and chorioamnionitis. In the latter, however, positive villous stromal cells increased in number and in staining intensity when compared with controls and preeclampsia (p < 0.001). The roles of Neurotrophin-3 in pregnancy are presently unknown. A regulatory function on placenta and foetal brain development and maternal inflammatory response may be hypothesized.
First-ever Ischemic Stroke after a Flight in a Patient with Prior Poliomyelitis
Authors: Chang Cheng-Chiang , Chang Shin-Tsu , Ku Chih-Hung , Chiang Shang-Lin , Chang Hsiao-Ying , Lai Min-Hsin , Tsai Kao-Chung , Chen Liang-Cheng
Published: November 2017

Survivors of poliomyelitis sometimes travel by air with mobility assistance. However, prolonged seating during long-haul flights may also possibly produce stroke events on polio-inflicted patients. A 48-year-old polio-inflicted male suffered a stroke after an extended flight. A two-dimensional echocardiography was normal without detected patent foramen ovale or dyskinetic segment. The venodynamic variables were all within normal limits. MR Imaging studies revealed acute cerebral infarction in the distribution of the right middle cerebral artery and posterior watershed area. Hematological examination revealed positive anti-cardiolipin IgG antibody which might contribute to the risk of thrombosis as an underlying condition in addition to immobilization. This is the first presentation of ischemic stroke after a flight in a patient with prior poliomyelitis. In addition to decompression sickness, economy class stroke syndrome and postpoliomyelitis syndrome, the physician should also take other coagulation disorders into consideration during the investigation.
P16 and Ki67 Immunostains Decrease Intra- and Interobserver Variability in the Diagnosis and Grading of Anal Intraepithelial Neoplasia (AIN)
Authors: Walts Ann E. , Lechago* Juan , Hu Bing , Shwayder MaryBeth , Sandweiss Lynn , Bose Shikha
Published: November 2017

Background

Significant variation is reported in the diagnosis of HPV-associated AIN. We previously observed that band-like positivity for p16 in >90% of contiguous cells coupled with Ki67 positivity in >50% of lesional cells is strongly associated with high grade AIN. This study was undertaken to determine if addition of p16 and Ki67 immunostaining would reduce inter- and intraobserver variability in diagnosis and grading of AIN.

Design

H&E stained slides of 60 anal biopsies were reviewed by three pathologists and consensus diagnoses were achieved: 25 negative, 12 low (condyloma and/or AIN I) and 23 high (9 AIN II and 14 AIN III) grade lesions. The H&E stained slides were diagnosed independently by three additional (“participant”) pathologists. Several weeks later they re-examined these slides in conjunction with corresponding p16 and Ki67 immunostains.

Results

Addition of p16 and Ki67 immunostains reduced intra- and interobserver variability, improved concurrence with consensus diagnoses and reduced two-step differences in diagnosis. Negative and high grade AIN diagnoses showed the most improvement in concurrence levels.

Conclusion

Addition of p16 and Ki67 immunostains is helpful in the diagnosis and grading of AIN.
Histological Changes on Liver Glycogen Storage in Mice (Mus musculus) Caused by Unbalanced Diets
Authors: Ulusoy Esma , Eren Banu
Published: November 2017

Weight-losing diets have appealed to people who want to lose weight in the short-term. They usually apply high-protein (HP) diets (like Atkin's, Stillman's, Scarsdale) which they practice for 2 weeks or so. Unfortunately, these people who have rapid weight loss return to their old habits and quickly regain the weight lost. We have shown in previous work that actually these weight losses have been associated with body fluids, protein and glycogen storage. In our study, we examined the effect of unbalanced diet–-related to an HP diet- on liver glycogen storage.

For this study 40 Swiss albino mice consisting of two groups were used. The first group (HPSD) was fed with 25% HP for fifteen days and then were fed standard meals for the remaining 15 days; the other group was fed with standard meals throughout. The two groups were fed their respective diets for 30 days. At the end of 15th, 20th, 25th and 30th days 5 from each group were killed with cervical dislocation. The livers were removed perfused and then fixated.

There were major differences in weight between the first and the fifteenth days. We detected remarkable increase in the weight gain of mice in the remaining 15 days. Glycogen storage was significantly reduced in HPSD (15) stained with PAS. In the others 20th, 25th and 30th days abnormally dense glycogen deposits were observed. Vacuoles in the hepatocyte cytoplasm, brownish deposits within hepatocytes, wide sinusoids, macrovesiculler steatosis structures and hydropic degeneration were observed in PAS and H&E stained HPSD group.

As a result for the HPSD group a significant decrement in glycogen storage at the 15th day and also an accumulation of excessive amounts of glycogen deposits in mice liver was observed in the normal feeding phase.
Mutation Detection in the Menkes Gene ATP7A Using the Protein Truncation Test
Authors: Møller Lisbeth Birk , Horn Nina
Published: November 2017

Menkes disease (MD) is a rare recessively inherited lethal disorder of copper metabolism. The gene ATP7A defective in MD consists of 23 exons and the coding region encompasses 4500 bp. About 300 distinct mutations, representing all types, have been identified in ATP7A. However all mutations identified so far in the exon 2 to exon 7, corresponding to 1869 bp of the coding sequence, result in truncated protein products. No missense mutations have been identified in this region. As about 30% of the total number of mutations identified are located in exon 2 to exon 7, we have designed a protein truncation test (PTT) for rapid detecting of mutations in this part of the gene. In order to determine the applicability of the test, we analysed RNA obtained from eleven MD patients with known mutations in this region. As a truncated product could be identified in all the included samples, PTT proves to be a useful technique for rapid detection of mutations in the N-terminal part of the ATP7A gene. Furthermore as MD is a X-linked disease, normally only affecting boys, the risk of false negative results, due to nonsense mediated RNA decay, leading to allelic exclusion, can be left out of account.
Squamous Differentiation and Cytokeratin Expression in an Osteosarcoma: A Case Report and Review of the Literature
Authors: Layfield Lester J. , Emerson Lyska , Crim Julia R. , Randall Lor
Published: November 2017

Cytokeratin expression has been documented in a variety of sarcomas including synovial sarcomas, epithelioid sarcomas, Ewing's sarcomas and, rarely, osteosarcomas. In osteosarcomas immunohistochemically shown to expression cytokeratins, a component of epithelioid cells is generally present. These epithelioid cytokeratin positive cells raise the possibility of metastatic disease with prognostic and therapeutic implications differing from primary osteosarcoma. The cytokeratin-expressing cells of the cases reported in the literature have not shown definitive squamous differentiation with keratin pearl formation. We report a case of osteosarcoma in which islands of malignant squamous cells were present showing keratin pearl formation and expression of cytokeratins.
L-Tryptophan: Basic Metabolic Functions, Behavioral Research and Therapeutic Indications
Authors: Richard Dawn M , Dawes Michael A , Mathias Charles W , Acheson Ashley , Hill-Kapturczak Nathalie , Dougherty Donald M
Published: November 2017

An essential component of the human diet, L-tryptophan is critical in a number of metabolic functions and has been widely used in numerous research and clinical trials. This review provides a brief overview of the role of L-tryptophan in protein synthesis and a number of other metabolic functions. With emphasis on L-tryptophan's role in synthesis of brain serotonin, details are provided on the research uses of L-tryptophan, particularly L-tryptophan depletion, and on clinical trials that have been conducted using L-tryptophan supplementation. The ability to change the rates of serotonin synthesis in the brain by manipulating concentrations of serum tryptophan is the foundation of much research. As the sole precursor of serotonin, experimental research has shown that L-tryptophan's role in brain serotonin synthesis is an important factor involved in mood, behavior, and cognition. Furthermore, clinical trials have provided some initial evidence of L-tryptophan's efficacy for treatment of psychiatric disorders, particularly when used in combination with other therapeutic agents.
Effects of Kynurenine Pathway Metabolites on Intracellular NAD+ Synthesis and Cell Death in Human Primary Astrocytes and Neurons
Authors: Braidy Nady , Grant Ross , Brew Bruce J , Adams Seray , Jayasena Tharusha , Guillemin Gilles J.
Published: November 2017

The kynurenine pathway (KP) is a major route of L-tryptophan catabolism resulting in the production of the essential pyridine nucleotide nicotinamide adenine dinucleotide, (NAD+). Up-regulation of the KP during inflammation leads to the release of a number of biologically active metabolites into the brain. We hypothesised that while some of the extracellular KP metabolites may be beneficial for intracellular NAD+ synthesis and cell survival at physiological concentrations, they may contribute to neuronal and astroglial dysfunction and cell death at pathophysiological concentrations. In this study, we found that treatment of human primary neurons and astrocytes with 3-hydroxyanthranilic acid (3-HAA), 3-hydroxykynurenine (3-HK), quinolinic acid (QUIN), and picolinic acid (PIC) at concentrations below 100 nM significantly increased intracellular NAD+ levels compared to non-treated cells. However, a dose dependent decrease in intracellular NAD+ levels and increased extracellular LDH activity was observed in human astrocytes and neurons treated with 3-HAA, 3-HK, QUIN and PIC at concentrations >100 nM and kynurenine (KYN), at concentrations above 1 μM. Intracellular NAD+ levels were unchanged in the presence of the neuroprotectant, kynurenic acid (KYNA), and a dose dependent increase in intracellular NAD+ levels was observed for TRP up to 1 mM. While anthranilic acid (AA) increased intracellular NAD+ levels at concentration below 10 μM in astrocytes. NAD+ depletion and cell death was observed in AA treated neurons at concentrations above 500 nM. Therefore, the differing responses of astrocytes and neurons to an increase in KP metabolites should be considered when assessing KP toxicity during neuroinflammation.
Revisiting the Use of Percutaneous Endoscopic Gastrostomy Tubes in Patients with Advanced Dementia
Authors: Shaikh Ayesha K. , Hamilton Eric L. , Bharadwaj Parag , Ward Katherine T.
Published: November 2017

Mr. Smith is an 85-year-old nursing home patient who has suffered from dementia for the past eight years. He has been bed bound and uncommunicative for the last six months. He was admitted with aspiration pneumonia three times in the past year. Over the last few months he has lost weight due to poor dietary intake and has developed a decubitus ulcer. Mr. Smith's family inquires about the advantages and disadvantages of the placement of a percutaneous endoscopic gastrostomy (PEG) tube to help improve his weight loss.
Knowledge toward Cancer Pain and the Use of Opioid Analgesics among Medical Students in their Integrated Clinical Clerkship
Authors: Manalo Maria Fidelis C.
Published: November 2017

Introduction

Among the focal issues of barriers to pain management include the physicians’ lack of knowledge about cancer pain and negative attitudes towards opioids. Many physicians and educators attribute this, at least in part, to limited exposure to pain and palliative care education during medical school.

Aim

The researcher investigated the medical students’ knowledge about cancer pain and the use of opioid analgesics.

Methods

The subjects were a sample of 50 students of the University of the Philippines College of Medicine in their integrated clinical clerkship year. Descriptive statistics (frequencies, means, standard deviation, rating scales) were used to determine mean knowledge score and level of confidence with opioid use. The study also identified specific areas where students exhibited good or poor knowledge of opioids.

Results

Approximately sixty-nine (69%) of the study respondents mentioned that pain management was given to them during their Anesthesiology lectures while a few recalled that they had these lectures during their Family Medicine rotation in Supportive, Palliative and Hospice Care. More than a third (35%) of the respondents admitted to not being confident with morphine use at present. The top three reasons cited as limitations in choice of opioids for cancer pain include fear of addiction, lack of adequate knowledge and experience and fear of side effects and complications. Out of a maximum of 13 correct answers, the mean knowledge score of the medical students was 6.6 ± 2.9. Less than 16% of the respondents had adequate knowledge on cancer pain and opioid use.

Conclusions

The results show that basic knowledge of the role of opioids in cancer pain management among medical students in their integrated clinical clerkship year at the University of the Philippines is poor. The findings imply a need to look into making revisions in the medical curriculum to include a training program that will enable all students to graduate with basic competency in pain management and palliative care.
On the regularity of the roots of a polynomial depending on one real parameter
Authors: Colombini Ferruccio , Orrù Nicola , Pernazza Ludovico
Published: November 2017

We investigate the regularity of functions

\tau

of one variable such that

P(t,\tau(t))=0

, where

P(t,x)

is a given polynomial of degree

m

in

x

whose coefficients are functions of class

C^{m^2!}

of one real parameter. We show that if a root is chosen with a continuous dependence on the parameter, this function is indeed absolutely continuous. From this and a theorem of Kato one deduces that such polynomials have complete systems of roots that are absolutely continuous functions.
On some geometric properties of currents and Frobenius theorem
Authors: Alberti Giovanni , Massaccesi Annalisa
Published: November 2017

In this note we announce some results, due to appear in [2], [3], on the structure of integral and normal currents, and their relation to Frobenius theorem. In particular we show that an integral current cannot be tangent to a distribution of planes which is nowhere involutive (Theorem 3.6), and that a normal current which is tangent to an involutive distribution of planes can be locally foliated in terms of integral currents (Theorem 4.3). This statement gives a partial answer to a question raised by Frank Morgan in [1].
Dispositivo Robótico Multifuncional para la Rehabilitación de las Extremidades Superiores
Authors: Mancisidor Aitziber , Zubizarreta Asier , Cabanes Itziar , Bengoa Pablo , Hyung Jung Je
Published: November 2017

En este trabajo se presenta un dispositivo de rehabilitación innovador por su flexibilidad y eficiencia denominado Universal Haptic Pantograph (UHP). Este robot, gracias a su estructura multi-configurable permite la rehabilitación del miembro superior con un único dispositivo. Además, se ha diseñado con la habilidad de realizar diferentes tareas asistivas y resistivas, pudiendo así adaptarse al estado de recuperación del paciente. Finalmente, el software Telereha genera un entorno de realidad virtual que facilita la ejecución del ejercicio y aumenta la motivación del paciente. El sistema de control del robot se ha implementado entiempo real con el fin de garantizar la correcta ejecución de las tareas de rehabilitación. Usando este sistema, se han realizado diferentes ensayos experimentales.  Los resultados demuestran que el robot de rehabilitación UHP funciona  correctamente  con diferentes tareas de rehabilitación, realizando movimientos suaves y seguros que garantizan la seguridad del usuario.
Modelado Dinámico y Control de un Dispositivo Sumergido Provisto de Actuadores Hidrostáticos
Authors: Pérez de la Portilla Marina , López Piñeiro Amable , Somolinos Sánchez José Andrés , Morales Herrera Rafael
Published: November 2017

Las corrientes marinas, fuente de energía renovable más predecible, localizan la mayor parte de su energía en altas profundidades. Para aprovechar esta energía se están desarrollando dispositivos flotantes, de tipo fondeado. La viabilidad económica de estos dispositivos requiere el abaratamiento de costos. El desarrollo de sistemas de control que permitan el cambio automático de orientación y profundidad del generador, con el fin de abaratar las maniobras de mantenimiento y aprovechar el recurso energético de forma óptima, resulta imprescindible. En este trabajo se presenta un actuador hidrostático y se realiza un modelo dinámico simple para control, de un dispositivo de dos grados de libertad, con un sistema de control de lastre. A partir de este modelo se ha desarrollado una ley de control multivariable, basada en una matriz de desacoplamiento no lineal y en la compensación de los términos de fricción y compresibilidad. Finalmente, la bondad del controlador ha sido validada mediante simulación.
Estimación Eficiente de Parámetros y Control en Base a un Sistema de Guía LOS Modificado de un Vehículo Subacuático
Authors: Revestido Herrero Elías , Velasco Francisco J. , Vega Luis M. , Lastra Francisco J.
Published: November 2017

En este trabajo, se propone una metodología para la mejora de la eficiencia en la estimación de parámetros de un modelo de maniobra no lineal de un vehículo subacuático no tripulado con forma de torpedo. Para este cometido, se dispone de datos de diferentes ensayos, llevados a cabo con el citado vehículo en las instalaciones del Canal de Experiencias Hidrodinámicas del Pardo, Madrid. En la metodología propuesta, se tiene en cuenta los siguientes aspectos para mejorar la eficiencia en la estimación de los parámetros: selección del periodo de muestreo, suavizado de los datos adquiridos en los ensayos considerando un compromiso entre varianza y sesgo del filtro suavizador a aplicar, análisis del modelo de regresión lineal clásico planteado en cada ensayo, desde el punto de vista estadístico para la estimación de los parámetros. Las mejora de la eficiencia se verifica mediante métodos gráficos y estadísticos. Además, se propone una modificación del método line-of-sight (LOS) convencional que proporciona resultados satisfactorios en presencia de corrientes oceánicas mediante la realización de un procedimiento sencillo.