bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic B-Type Natriuretic Peptide Therapy Prevents Atrial Electrical Remodeling in a Rabbit Model of Atrial Fibrillation
Authors: Zhao Hongyan , Li Tiankai , Liu Guangzhong , Zhang Li , Li Guangnan , Yu Jia , Lou Qi , He Rui , Zhan Chengchuang , Li Luyifei , Yang Wen , Zang Yanxiang , Cheng Cheping , Li Weimin
Published: June 2019

Background:

Atrial fibrillation (AF) is an important and growing clinical problem. Current pharmacological treatments are unsatisfactory. Electrical remodeling has been identified as one of the principal pathophysiological mechanisms that promote AF, but there are no effective therapies to prevent or correct electrical remodeling in patients with AF. In AF, cardiac production and circulating levels of B-type natriuretic peptide (BNP) are increased. However, its functional significance in AF remains to be determined. We assessed the hypotheses that chronic BNP treatment may prevent the altered electrophysiology in AF, and preventing AF-induced activation of Ca2+/calmodulin-dependent protein kinase II (CaMKII) may play a role.

Methods and Results:

Forty-four rabbits were randomly divided into sham, rapid atrial pacing (RAP at 600 beats/min for 3 weeks), RAP/BNP, and sham/BNP groups. Rabbits in the RAP/BNP and sham/BNP groups received subcutaneous BNP (20 μg/kg twice daily) during the 3-week study period. HL-1 cells were subjected to rapid field stimulation for 24 hours in the presence or absence of BNP, KN-93 (a CaMKII inhibitor), or KN-92 (a nonactive analog of KN-93). We compared atrial electrical remodeling-related alterations in the ion channel/function/expression of these animals. We found that only in the RAP group, AF inducibility was significantly increased, atrial effective refractory periods and action potential duration were reduced, and the density of I Ca, L and I to decreased, while I K1 increased. The changes in the expressions of Cav1.2, Kv4.3, and Kir2.1 and currents showed a similar trend. In addition, in the RAP group, the activation of CaMKIIδ and phosphorylation of ryanodine receptor 2 and phospholamban significantly increased. Importantly, these changes were prevented in the RAP/BNP group, which were further validated by in vitro studies.

Conclusions:

Chronic BNP therapy prevents atrial electrical remodeling in AF. Inhibition of CaMKII activation plays an important role to its anti-AF efficacy in this model.
Assessment of compounded transdermal mirtazapine as an appetite stimulant in cats with chronic kidney disease
Authors: Quimby Jessica M , Benson Kellyi K , Summers Stacie C , Saffire Ashlie , Herndon Andrea K , Bai Shasha , Gustafson Daniel L
Published: June 2019

Objectives

The aim of this study was to assess the appetite stimulation properties of compounded transdermal mirtazapine (CTM) in cats with chronic kidney disease (CKD).

Methods

Two sequential double-blind placebo-controlled crossover prospective studies were performed in client-owned cats with stable stage 2 or 3 CKD and a history of decreased appetite. In the first study nine CKD cats were randomized to receive 3.75 mg/0.1 ml CTM gel or placebo on the inner pinna every other day for 3 weeks, then, after a 4 day washout period, the cats were crossed over to the alternate 3 week treatment. In a second study, 10 CKD cats were randomized to receive 1.88 mg/0.1 ml CTM or placebo on the same schedule. Physical examination and serum biochemistry were performed before and after each treatment period, and owners kept daily logs of appetite, activity and eating behaviors. Mirtazapine concentrations in CTM gels and steady-state mirtazapine serum concentrations were measured using liquid chromatography/tandem mass spectrometry.

Results

Administration of both 3.75 mg and 1.88 mg CTM resulted in a statistically significant increase in weight ( P = 0.002 for both), increase in appetite ( P = 0.01 and P = 0.005, respectively), and increase in rate of food consumption ( P = 0.03 and P = 0.008, respectively). No significant difference in activity or vocalization was seen at either dose; however, individual cats experienced excessive meowing. Median weight increase for the 3.75 mg arm was 0.22 kg (range 0.04–0.44 kg), while median weight increase for the 1.88 mg arm was 0.26 kg (range –0.25 to 0.5 kg). Improvement in body condition score was seen in 5/9 cats in the 3.75 mg arm (P = 0.04) and 6/10 cats in the 1.88 mg arm (P = 0.004).

Conclusions and relevance

CTM increased appetite and resulted in weight gain in CKD cats despite significant inconsistencies in compounding, and may benefit cats in countries where an approved product is not available.
Dynamic deflection analysis induced by blast load in viscoelastic sandwich plates with nanocomposite facesheets
Authors: Mahjoobi Mahdi , Bidgoli Mahmood Rabani
Published: June 2019

The current work suggests a mathematical model for the dynamic response of sandwich concrete foundation with nano-fiber reinforced polymer (NFRP) layers at the top and bottom face sheets subjected to a blast load. The facesheets are reinforced by carbon nano-fibers where the equivalent material properties of the nanocomposite layers are obtained using Mori-Tanaka model considering agglomeration effects. The Kelvin-Voigt model is employed to consider the viscoelastic properties of the structure. The sandwich structure is rested on a soil foundation which is modeled by spring element. Based on refined zigzag theory, energy method and Hamilton’s principle, the motion equations are derived. The differential quadrature method in conjunction with Newmark method is utilized for obtaining the dynamic deflection of the structure for different boundary conditions. The effects of various parameters such as blast load, soil foundation, structural damping, volume fraction of carbon nano-fibers, NFRP layer, geometrical parameters of the structure are considered on the dynamic deflection of the structure. The results show that the NFRP layer can improve the resistance of the concrete foundation with respect to blast load.
Developing a crosswalk between the RAND-12 and the health utilities index for multiple sclerosis
Authors: Marrie Ruth Ann , Dufault Brenden , Tyry Tuula , Cutter Gary R , Fox Robert J , Salter Amber
Published: June 2019

Background:

Researchers studying health-related quality of life (HRQOL) in multiple sclerosis (MS) can choose from many instruments, but findings from studies which use different instruments cannot be easily combined. We aimed to develop a crosswalk that associates scores from the RAND-12 to scores on the Health Utilities Index—Mark III (HUI3) in persons with MS.

Methods:

In 2018, participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry completed the RAND-12 and the HUI3 to assess HRQOL. We used item-response theory (IRT) and equipercentile linking approaches to develop a crosswalk between instruments. We compared predicted scores for the HUI3 from each crosswalk to observed scores using Pearson correlations, intraclass correlation coefficients (ICCs), and Bland–Altman plots.

Results:

Of 11,389 invited participants, 7129 (62.6%) responded. Predicted and observed values of the HUI3 from the IRT-linking method were moderately correlated (Pearson r = 0.76) with good concordance (ICC = 0.72). However, the Bland–Altman plots suggested biased prediction. Predicted and observed values from the equipercentile linking method were also moderately correlated (Pearson r = 0.78, ICC = 0.78). The Bland–Altman plots suggested no bias.

Conclusion:

We developed a crosswalk between the RAND-12 and the HUI3 in the MS population which will facilitate data harmonization efforts.
Gender and Technology Culture: Points of Contact in Tech Cities
Authors: Hardey Mariann
Published: June 2019

This article considers several features of tech cities and masculine technology culture and their impact on the conditions of work and interactions of professionals working within them. It uses interdisciplinary perspectives of gender, technology culture, and professional identity and status to understand work in tech cities. Using focus groups involving 60 women and men across different professional backgrounds at three tech city sites in the UK and USA, the article examines the extent of change in work roles and status norms in a highly male-dominated sector and physical space. Professional life in tech cities is shaped by ‘points of contact’, characterised by heightened knowledge and awareness of masculine culture that restricts women’s progression. Three such points of contact are identified. As increased scholarly and policy attention is paid to the lack of diversity in tech, this study contributes to a much-needed shift in tech culture. Attitudes and professional identities built around work and social networking in tech cities reveal the importance of professional communities and networks in supporting women to manage rejection and career barriers.
Infant and young child feeding practice, dietary diversity, associated predictors, and child health outcomes in Bangladesh
Authors: Sheikh Nurnabi , Akram Raisul , Ali Nausad , Haque SM Raysul , Tisha Shabareen , Mahumud Rashidul Alam , Sarker Abdur Razzaque , Sultana Marufa
Published: June 2019

The aim of this study was to explore the association of Infant and Young Child Feeding (IYCF) practices with health and nutritional status among children aged 0–23 months and to investigate the predictors of minimum acceptable diets (MADs) using Bangladesh Demographic and Health Survey (BDHS) data. Binary logistic regression models were performed to assess the association between IYCF and child health and to determine the influential predictors for MAD. About 55% mothers reported exclusive breastfeeding; 65% introduced solid, semisolid, or soft foods for their child; and 27% maintained minimum dietary diversity (MDD). About 64% children received recommended minimum meal frequency (MMF) and 23% received recommended MAD. The likelihood of having wasting was .22 times lower for the child who received MDD and MMF, respectively. MDD and MAD were associated with lower probability of experiencing underweight among children (Adjusted odds ratio [AOR] = .73 and AOR= .81, respectively). Early initiation and continuation of breastfeeding were significantly associated with reduction in diarrhea prevalence among young children. The findings of the study generated imperative evidence related to dietary diversity, associated factors, and child health outcomes. Policy should focus on the improvement of IYCF practices and complimentary food diversity by taking initiatives for designing and implementing effective interventions to tackle childhood morbidity.
Thermal comfort in high altitude Himalayan residential houses in Darjeeling, India – An adaptive approach
Authors: Thapa Samar
Published: June 2019

The study of thermal comfort in buildings is required to maintain a stable and comfortable condition of the indoor environment. The climate chamber study used to determine thermal comfort is mathematically reproducible and robust, but exaggerative and hence is energy inefficient, whereas the adaptive model-based field survey method is exhaustive and bioclimatic specific. Although, several field survey-based thermal comfort studies have been reported from India, these studies were conducted mostly either in hot and humid or composite climatic condition, and very few research has been reported from cold climatic region, which lies mostly along the high altitudinal Himalayan region. In this paper, the results of field survey-based thermal comfort studies in residential houses of highly altitudinal Darjeeling Himalayan region in eastern India are presented. The study found that female subjects showed a lesser clothing cover but portrayed a higher discomfort with lower thermal sensation and higher comfort temperature. The comfort temperature as determined in this study did not comply with the ASHRAE standard 55 graphical method, and hence new comfort zone for regions with similar cold climate is proposed.
Nigeria’s Flare Gas (Prevention of Waste & Pollution) Regulations 2018
Authors: Aye Israel , Wingate Emmanuel Onyedi
Published: June 2019

Nigeria has recently issued the Flare Gas (Prevention of Waste & Pollution) Regulations 2018. Its objective is to completely phase out gas flaring which has persisted notwithstanding several efforts to encourage associated gas utilisation and discourage the process. This work assesses the Regulations in light of enabling legislation, particularly the Petroleum Act 1969 and the Associated Gas (Reinjection) Act 1979 to address questions that arise regarding some of its innovative aspects such as the taking of all flare gas by the Federal Government of Nigeria and a new permits regime to enable third-party investors access to petroleum lease areas to effect the taking of the flare gas. It argues that public interest is at the heart of the Regulations and considering enabling legislation and previous case law, justifies its provisions given the pollution and economic waste ill-effects of gas flaring.
Sensitivity in the law of nuisance: Should people in glass houses expect voyeurs? Fearn v Tate Gallery [2019] EWHC 246 (Ch)
Authors: Hilson Chris
Published: June 2019

The case Fearn v Tate Gallery involved claims brought by luxury London flat owners for breach of privacy in relation to the Tate Modern’s nearby viewing platform. One of the key issues in the case, heard by Mann J in the High Court, was whether the floor-to-ceiling glass windows of the flats – through which members of the public on the viewing platform could easily gaze – meant the residents were unduly sensitive users of the land for the purposes of the tort of nuisance. This case note considers this question along with the principle in nuisance that it is normally no defence to say that the claimant came to the nuisance. Both sensitivity and the coming to the nuisance (non-) defence are important elements of nuisance as an environmental tort and hence the case is worthy of note for environmental lawyers.
Species conservation – The chosen few
Authors: Warren Lynda M.
Published: June 2019

Species conservation in the UK is covered by several different pieces of legislation. Not all species enjoy the same level of protection. Birds are the best protected; under a reverse listing system they are protected unless expressly excluded. All plants are also protected to some extent. Non-avian fauna fares less well. For most species, there is no protection unless they are listed in schedules to the Wildlife & Countryside Act 1981 or in Annexes to the EU Habitats Directive. Most invertebrates have no protection at all. Overall, species legislation is restricted to large well known and much loved groups, such as birds, and species that are known to be rare. While more than 150 years of species protection legislation has left us with a reasonable framework for protection, there are inconsistencies in the way it is applied to different taxa. The Law Commission has recommended consolidation, and the introduction of more flexibility in the system so that changes to listing could be made quickly where necessary – but has not addressed the biases towards vertebrates, especially birds, and higher plants. If the legislation is to be changed, it is suggested that more thought should be given to why we wish to conserve certain species and not others.
Comprehensive Analysis of lncRNA–miRNA– mRNA Network Ascertains Prognostic Factors in Patients with Colon Cancer
Authors: Gao Zhenzhen , Fu Peng , Yu Zhengyi , Zhen Fuxi , Gu Yanhong
Published: June 2019

Background:

Non-coding RNAs are competing endogenous RNAs in the occurrence and development of tumorigenesis; numerous microRNAs are aberrantly expressed in colon cancer tissues and play significant roles in oncogenesis development and metastasis. However, large clinical and RNA data are lacking to further confirm the exact role of these RNAs in tumors. This study aimed to ascertain differential RNA expression between colon cancer and normal colon tissues.

Materials and Methods:

RNA sequencing and clinical data of patients with colon cancer were procured from The Cancer Genome Atlas database; differentially expressed long non-coding RNA, differentially expressed messenger RNAs, and differentially expressed microRNAs were achieved using the limma package in edgeR to generate competing endogenous RNAs networks. Then, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were conducted with ggplot2 package, the Kaplan-Meier survival method was used to predict survival in patients with colon cancer.

Results:

In total, 1174 differentially expressed long non-coding RNAs, 2068 differentially expressed messenger RNAs, and 239 differentially expressed microRNAs were generated between 480 colon cancer and 41 normal colon tissue samples. Three competing endogenous RNA networks were established. Gene Ontology analysis indicated that the genes of the up-regulated microRNA network were involved in negative regulation of transcription, DNA-template, and those of down-regulated microRNA network were involved in transforming growth factor β receptor signaling pathways, response to hypoxia, cell migration, while Kyoto Encyclopedia of Genes and Genomes analyses of these networks turned out to be negative. Three long non-coding RNAs (AP004609.1, ARHGEF26-AS1, and LINC00491), 3 microRNAs (miRNA-141, miRNA-216a, and miRNA-193b) and 3 RNAs (ULBP2, PHLPP2, and TPM2) were detected to be associated with prognosis by the Kaplan-Meier survival analysis. Additionally, univariate and multivariate Cox regression analyses showed that the microRNA-216a of the competing endogenous RNA might be an independent prognostic factor in colon cancer.

Conclusions:

This study constructed the non-coding RNA-related competing endogenous RNA networks in colon cancer and sheds lights on underlying biomarkers for colon cancer cohorts.
Arteriovenous Fistula—A Rare Complication of IVC Filter Retrieval
Authors: DeSai Charisma , Lamus Daniel , Kumar Girish
Published: June 2019

Inferior vena cava (IVC) filters are important devices for patients who are at high risk for developing thrombi and pulmonary embolism but have conditions that preclude the use of pharmacologic anticoagulants. IVC filter retrieval has become an important quality initiative backed by Food and Drug Administration guidelines for prompt removal after the filter is no longer indicated. Filter retrieval is a common procedure that usually has very few complications. However, when the filter is tilted or embedded in the caval wall, advanced techniques of retrieval may be necessary. These techniques have a higher rate of success but also a higher risk of complications such as injury to the IVC. Here, we describe a case of IVC filter retrieval resulting in formation of an arteriovenous fistula between the right renal artery and IVC and subsequent successful repair of this fistula using a vascular plug.
Effectiveness of Transition Readiness Interventions by School-Based Occupational Therapy Personnel
Authors: Pierce Doris , Sakemiller Lisa , Spence Amy , LoBianco Tony
Published: June 2019

Despite federal mandates to transition students with disabilities to successful adulthood, outcomes have been poor. Although areas of occupational therapy expertise, such as life and work skills, are effective in improving transition outcomes, occupational therapy personnel rarely provide transition services. The purpose of this study was to examine the effectiveness of occupational therapy transition readiness services for students with disabilities, 14 to 16 years of age, over two academic years of intervention. Forty-two students and 14 occupational therapy personnel from 10 school districts participated. Assessments were provided to transition teams. Peer groups explored work and life skills and completed long-term student-led projects. Pre–post scores of functional behavior were analyzed using a proportional change index. Students receiving occupational therapy transition readiness services demonstrated statistically significant gains. Occupational therapy holds potential to increase the functional readiness of students with disabilities for transition to a successful and productive adult life.
Recurrence of an internal carotid artery aneurysm after complete exclusion by a Willis covered stent
Authors: Tian Zhongbin , Mu Shiqing , Li Wenqiang , Zhu Wei , Zhang Ying , Yang Xinjian , Liu Jian
Published: June 2019

Treatment of selective intracranial aneurysms treated with a Willis covered stent is safe and effective. We describe a previously unreported case of a large, irregular, carotid-ophthalmic aneurysm that was treated with a Willis covered stent. An immediate angiogram after the procedure showed complete occlusion of the aneurysm. However, a six-month follow-up angiogram demonstrated contrast media filling of the aneurysm neck. To the best of our knowledge, this is the first report of a recurrent aneurysm treated with a Willis covered stent because of a membrane partially isolated with the stent. This case suggests that an aneurysm that is treated with a Willis covered stent might recanalise, and the risk of aneurysm rupture persists when the membrane of the stent is isolated with the stent. Therefore, follow-up angiography is necessary, even if an immediate angiogram shows complete aneurysm occlusion. Long-term follow-up is required, and the final outcome of such a case is still unknown.
Framing overseas Chinese students: A comparative analysis of newspaper coverage in mainland China, U.S., and Hong Kong
Authors: Su Yan , Borah Porismita
Published: June 2019

Within the theoretical framework of framing, this study comparatively content analyzed the portrayals of overseas Chinese students in five newspapers of mainland China, U.S., and Hong Kong. The primary findings reveal that mainland Chinese media favored to frame overseas Chinese students as victims and patriots, while the U.S. and Hong Kong medias framed them as of liberalists and education seekers. Findings also revealed nuances among different media within the same society. This study enriched the extant framing literature through the utilization of consistent versus unique frames, using episodic versus thematic frames as its typological model, and the comparisons of media in different societies as well as different media organizations within a given society.
Pattern recognition neural classifier for fall detection in rock climbing
Authors: Bonfitto Angelo , Tonoli Andrea , Feraco Stefano , Zenerino Enrico Cesare , Galluzzi Renato
Published: June 2019

From an athlete’s perspective, the identification of falls during rock climbing is of major importance. It constitutes a solid performance indicator, but more importantly, it could be used to trigger an instantaneous alarm to rescue teams, thus reducing the negative health consequences for the climber. In this context, an artificial neural network–based technique for fall detection during rock climbing is presented in this study. The output of this tool could be used for safety and performance monitoring purposes. The proposed method exploits a neural network for binary pattern recognition. This network is fed with a set of features extracted in real time from the acceleration and altitude signals acquired by means of a wearable device. The classifier is trained and validated with experimental datasets recorded during real climbing sessions of eight athletes through different route grades and conditions. This article illustrates the architecture of the proposed algorithm, feature extraction process, and evaluation of its accuracy. In addition, an analysis of the severity level of the detected falls is conducted. The method is able to identify real fall events with a high success rate, while yielding very few false positive indications of a fall.
Species Distribution Modeling in Latin America: A 25-Year Retrospective Review
Authors: Urbina-Cardona Nicolás , Blair Mary E. , Londoño Maria C. , Loyola Rafael , Velásquez-Tibatá Jorge , Morales-Devia Hernan
Published: June 2019

Species distribution modeling (SDM) is a booming area of research that has had an exponential increase in use and development in recent years. We performed a search of scientific literature and found 5,533 documents published from 1993 to 2018 using SDM, representing a global network of 4,329 collaborating institutions from 155 countries, with Brazil and Mexico being in the top 10 of the most prolific countries globally. National Autonomous University of Mexico, Chinese Academy of Sciences, University of Kansas, and U.S. Geological Survey are the most prolific institutions worldwide. Latin American institutions ( n = 556) participated in 1,000 (18% of global productivity) documents published in collaboration with 591 institutions outside Latin American countries, from which the National Autonomous University of Mexico, Federal University of Goiás, Institute of Ecology A.C., National Scientific and Technical Research Council in Argentina, University of São Paulo, and University of Brasilia were the most productive. From this body of literature, the most frequently modeled taxonomic groups were Chordata and Insecta, and the most common realms of application were conservation planning and management, climate change, species conservation, epidemiology, evolutionary biology, and biological invasions. From the 36 modeling methods identified to generate SDMs, MaxEnt is used in 73.5% of the papers, followed by Genetic Algorithm for Rule-Set Prediction (GARP) with 18.7%, and just 7.4% of the papers compared between 3 and 10 modeling methods. In Latin American countries, productivity in SDM research could be improved as the network of collaborations diversifies and connects with other productive countries (such as United Kingdom, China, Spain, Germany, Australia, and France). The scientific collaboration between Latin American countries should be increased, as the most prolific countries (Brazil, Mexico, Argentina, and Colombia) share less than 10% of its productivity. Some of the main challenges for SDM development in Latin America include bridging the gaps from (a) software use to research productivity and (b) translation to decision-making. To address these challenges, we propose to strengthen communities of practice where modelers, species experts, and decision-makers come together to discuss and develop SDM to shift and enhance current paradigms on how science and decision-making are linked.
Atopy and Quality of Life in Pediatric Chronic Rhinosinusitis
Authors: Anamika Anamika , Chakravarti Arunabha , Kumar Raj
Published: June 2019

Background

Atopy has been suggested in the development of chronic rhinosinusitis (CRS), as allergic rhinitis (AR) is common coexisting disease in pediatric and adult patients with CRS. The contribution of AR to CRS is less clear till date.

Objectives

The objectives of this study were to determine atopic profile of children with CRS and impact of atopic status on disease severity and quality of life.

Methods

One hundred ten patients, aged between 7 and 18 years of age, diagnosed with CRS based on history, detailed clinical examination including nasal endoscopic examination were included in this cross-sectional study. Scoring of CRS was done according to Lund Mackay Endoscopic Appearance Score. Patients underwent skin prick test against 65 common aeroallergens (1:10 w/v, 50% glycerinated) for evidence of atopy. SN-5 Sinus and Nasal Quality of Life Survey was used to assess the quality of life in the study subjects.

Results

Positive skin prick test to at least one of the common aeroallergens was present in 58 (52.7%) patients. Most common aeroallergen sensitivity was seen with insects in 48 (43.6%) patients. Patients of CRS with atopy had higher mean Lund Mackay endoscopic score and SN-5 score than nonatopic patients which was statistically significant.

Conclusion

In conclusion, we recommend that testing for aeroallergen sensitivity and assessment of quality of life should be included in the protocol for diagnosis and management of pediatric patients with CRS. Early diagnosis and treatment of allergy may halt the progression of CRS and also the development of asthma and other allergic multimorbid disorders.
Preoperative Grades of Osteoarthritis and Meniscus Volume Correlate with Clinical Outcomes of Osteochondral Graft Treatment for Cartilage Defects in the Knee
Authors: Wang Dean , Marom Niv , Coxe Francesca R. , Kalia Vivek , Burge Alissa J. , Jones Kristofer J. , Rodeo Scott A. , Williams Riley J.
Published: June 2019

Objective

To identify preoperative imaging-based indicators of knee degeneration that correlate with graft failure risk and postoperative clinical outcome scores after osteochondral graft treatment for chondral defects of the knee.

Design

Prospectively collected data from 113 patients (mean age, 34 years; 65% male) treated with mosaicplasty or osteochondral allograft transplantation (OCA) was reviewed. Four different aspects of knee degeneration were examined based on preoperative radiographs or magnetic resonance imaging: (1) Osteoarthritis using the Kellgren-Lawrence (KL) grading system, (2) meniscus volume, (3) meniscus quality, and (4) synovitis. Primary outcomes included graft failure, defined by removal/revision of the graft or conversion to arthroplasty, and patient responses to clinical outcome scores.

Results

Forty-one knees (36%) underwent mosaicplasty, and 72 knees (64%) underwent OCA. Mean duration of follow-up was 4.5 years (range, 2-14 years). A preoperative KL grade of ≥3 was correlated with increased failure rates ( P = 0.01), lower postoperative International Knee Documentation Committee form (IKDC), Activities of Daily Living of the Knee Outcome Survey (KOS-ADL), and Overall Condition scores ( P < 0.01), and decreased improvement in Overall Condition scores ( P = 0.01). Within an individual tibiofemoral compartment, a preoperative meniscus volume grade of ≥3 (indicating <50% meniscus volume remaining) was correlated with increased condylar graft failure rates ( P < 0.01). Preoperative meniscus quality and synovitis grades were not associated with graft failure rates or clinically meaningful differences in postoperative outcome scores.

Conclusions

Greater preoperative osteoarthritis and meniscus volume loss were correlated with increased graft failure rates after osteochondral graft treatment for chondral defects of the knee.
Identification of the cerebral effects of paracetamol in healthy subjects: an fMRI study
Authors: De Coster Olivier , Forget Patrice , De Mey Johan , Van Schuerbeek Peter , Poelaert Jan
Published: June 2019

Introduction:

Paracetamol is commonly used for its antipyretic properties and analgesic effects, but the central mechanism remains elusive. We designed a study in healthy volunteers to detect the central functional working mechanism of paracetamol.

Subjects, material and methods:

A total of 20 subjects had a baseline functional magnetic resonance imaging (fMRI) before the intake of 1000 mg paracetamol orally; 60 minutes later, a second fMRI was made aiming detection of regional blood flow differences.

Results:

A decreased connectivity was observed in the ventral volume of interest (VOI), with the posterior cingulate (with both the left anterior cingulate cortex (ACC) and right ACC: respectively, Ke = 576; t = −6.8894 and Ke = 185; t = −4.8178) and the inferior temporal left (Ke = 103; t = −5.0993); in the combined ventral and dorsal VOIs, the posterior cingulate (with the left ACC; Ke = 149; t = −4.5658) and, both with the right ACC, the inferior temporal left (Ke = 88; t = −3.8456) and the inferior frontal gyrus (Ke = 86; t = −4.3937) had a decrease in connectivity. An increase was seen in other regions, including, among others, the middle frontal and temporal gyri (respectively, Ke = 85; t = 4.4256 and Ke = 85; t = 5.6851), the inferior frontal (with the left ACC: Ke = 165; t = 4.4998) and the superior frontal gyrus (with the right ACC; Ke = 281; t = 4.5992), and the post/precentral gyrus (with the right ACC, respectively, Ke = 102; t = 6.0582 and Ke = 105; t = 4.0776).

Conclusions:

On fMRIs in healthy volunteers, the ingestion of paracetamol affects connections with the ACC. This suggests a central effect of paracetamol in cerebral areas known to be associated with pain. Further studies are needed to demonstrate the same effects in acute and chronic pain states.
Sweet’s syndrome and fistulizing Crohn’s disease: A case report
Authors: Siedlikowski Stefan T , Lacroix Julie D
Published: June 2019

Sweet’s syndrome is a rare, acute febrile neutrophilic dermatosis sometimes associated with inflammatory diseases, infections, malignancies or the administration of pharmacotherapeutics. Very seldom, it occurs as an extraintestinal manifestation of Crohn’s disease. We present a unique combined diagnosis of recurrent Sweet’s syndrome associated with colovaginal fistulization, subsequently diagnosed as Crohn’s disease.
Carcinosarcoma of the breast: A case of breast conservation surgery and breast reconstruction
Authors: Kanaizumi Hirofumi , Higashi Chihiro , Tanaka Yumiko , Hamada Mika , Shinzaki Wataru , Hashimoto Yukihiko , Komoike Yoshifumi
Published: June 2019

Breast carcinosarcoma is an extremely rare, clinically aggressive tumor, and no standard treatment has been established. We report about a 34-year-old woman presenting with a 2.5-cm-sized carcinosarcoma in her right breast. She presented to our hospital for examination of this mass. Ultrasonography showed a hypoechoic mass with partially irregular margins. Fine-needle aspiration cytology indicated malignancy. No enlarged lymph nodes or distant metastases were detected. We diagnosed right breast cancer and performed partial mastectomy, sentinel lymph node biopsy, and latissimus dorsi muscle flap transfer. Histological findings revealed that the tumor consisted of a mixture of an epithelial component and a mesenchymal component. The final diagnosis was carcinosarcoma. After undergoing adjuvant chemotherapy and radiotherapy, the patient has had no recurrence, and her cosmesis is maintained. Clinical data of carcinosarcoma are insufficient. Breast conservation and reconstruction for carcinosarcoma may be suitable as local treatments; however, the most appropriate treatment method has not been established.
Growth and glycemic control in children with type 1 diabetes and asymptomatic celiac disease treated with a gluten -free diet for 1 year
Authors: Berioli Maria Giulia , Mancini Giulia , Principi Nicola , Santi Elisa , Ascenzi Martina , Rogari Francesco , Ceccarini Giulia , Grohmann Ursula , Esposito Susanna
Published: June 2019

To compare growth and glycemic control in children with type 1 diabetes and silent celiac disease treated with a gluten-free diet for 1 year with those of similar age and gender with type 1 diabetes but without celiac disease, 16 type 1 diabetes patients with silent celiac disease were enrolled and each celiac disease-positive case was matched for age, sex, and duration of diabetes with two type 1 diabetes controls with negative serologic markers of celiac disease. All 16 children with positive celiac disease serology had histologic features consistent with celiac disease despite the absence of symptoms. The mean growth and metabolic control values were similar between children with type 1 diabetes and celiac disease and those with type 1 diabetes but without celiac disease. This study seems to suggest that the early diagnosis of celiac disease and initiation of a gluten-free diet may prevent further deterioration in the nutritional status of children with type 1 diabetes and celiac disease and may reduce the prospect of celiac disease complications without any impact on type 1 diabetes control.
Ray-based modeling and imaging in viscoelastic media using graphics processing units
Authors: Sarajaervi Martin , Keers Henk
Published: June 2019

In seismic data processing, the amplitude loss caused by attenuation should be taken into account. The basis for this is provided by a 3D attenuation model described by the quality factor [Formula: see text], which is used in viscoelastic modeling and imaging. We have accomplished viscoelastic modeling and imaging using ray theory and the ray-Born approximation. This makes it possible to take [Formula: see text] into account using complex-valued and frequency-dependent traveltimes. We have developed a unified parallel implementation for modeling and imaging in the frequency domain and carried out the numerical integration on a graphics processing unit. A central part of the implementation is an efficient technique for computing large integrals. We applied the integration method to the 3D SEG/EAGE overthrust model to generate synthetic seismograms and imaging results. The attenuation effects are accurately modeled in the seismograms and compensated for in the imaging algorithm. The results indicate a significant improvement in computational efficiency compared to a parallel central processing unit baseline.
Against the Stream: The teenage brain is not unique
Authors: Graham Philip
Published: June 2019

Increasingly, claims are being made by developmental neuroscientists that adolescence is characterised by unique changes to the brain. These changes are said to underlie what are claimed to be unique behavioural features of the teenage years. In this paper, it is argued that the brain changes described begin before the teen years and continue long after them. This is not surprising, as there are no behavioural features that are specific to adolescence.
Standard smoking cessation services in sites participating in the SCIMITAR+ trial for people with severe mental ill health
Authors: Heron Paul , McCloud Tayla , Arundel Catherine , Bailey Della , Ker Suzy , Li Jinshuo , Mishu Masuma , Osborn David , Parrott Steve , Peckham Emily , Stribling Alison , Gilbody Simon
Published: June 2019

Aims and method

The SCIMITAR+ trial was commissioned to evaluate the effectiveness of a bespoke smoking cessation intervention for people with severe mental ill health compared with usual services. It is difficult to define what constitutes usual care in smoking cessation services. We aimed to define what this was during the trial. Twenty-two National Health Service healthcare providers participated in a bespoke survey asking about usual care in their area.

Results

All sites offered smoking cessation support; however, service provider and service type varied substantially. In some cases services were not streamlined, meaning that people received smoking cessation counselling from one organisation and smoking cessation medication from another.

Clinical implications

To better implement the National Institute for Health and Care Excellence guideline PH48, clearer referral pathways need to be implemented and communicated to patients, staff and carers. People with severe mental ill health need to be able to access services that combine nicotine replacement therapy and behavioural support in a streamlined manner.
External Beam, Brachytherapy, or Chemotherapy? Defining Adjuvant Therapy for Early-Stage and High- and High–Intermediate-Risk Endometrial Cancer
Authors: Jang Joanne Wei-un , Lee Larissa Janeen
Published: June 2019

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.

A 54-year-old postmenopausal female with a history of stroke and carotid endarterectomy presented with 3 weeks of vaginal bleeding with passage of clots. Gynecologic exam revealed a 3-cm barrel-shaped cervix with friability at the os and no appreciable parametrial involvement. Cervical biopsy showed high-grade endometrioid adenocarcinoma. Pelvic magnetic resonance imaging demonstrated a 9.9-cm × 4.5-cm × 6.2-cm mass extending from the uterus to the cervix with greater than 50% myometrial invasion (MMI; Fig 1 ). Total laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy revealed International Federation of Gynecology and Obstetrics (FIGO) stage II endometrial cancer: a 12-cm grade 3 endometrioid adenocarcinoma with 80% MMI and lymphovascular invasion (LVI) involving the outer half of the cervical stroma ( Fig 1 ), and without pelvic lymph node involvement.
Evaluation of the Quality of Dying and Death Questionnaire in Kenya
Authors: Mah Kenneth , Powell Richard A. , Malfitano Carmine , Gikaara Nancy , Chalklin Lesley , Hales Sarah , Rydall Anne , Zimmermann Camilla , Mwangi-Powell Faith N. , Rodin Gary
Published: June 2019

PURPOSE

A culturally appropriate, patient-centered measure of the quality of dying and death is needed to advance palliative care in Africa. We therefore evaluated the Quality of Dying and Death Questionnaire (QODD) in a Kenyan hospice sample and compared item ratings with those from a Canadian advanced-cancer sample.

METHODS

Caregivers of deceased patients from three Kenyan hospices completed the QODD. Their QODD item ratings were compared with those from 602 caregivers of deceased patients with advanced cancer in Ontario, Canada, and were correlated with overall quality of dying and death ratings.

RESULTS

Compared with the Ontario sample, outcomes in the Kenyan sample (N = 127; mean age, 48.21 years; standard deviation, 13.57 years) were worse on 14 QODD concerns and on overall quality of dying and death ( P values ≤ .001) but better on five concerns, including interpersonal and religious/spiritual concerns ( P values ≤ .005). Overall quality of dying was associated with better patient experiences with Symptoms and Personal Care, interpersonal, and religious/spiritual concerns ( P values < .01). Preparation for Death, Treatment Preferences, and Moment of Death items showed the most omitted ratings.

CONCLUSION

The quality of dying and death in Kenya is worse than in a setting with greater PC access, except in interpersonal and religious/spiritual domains. Cultural differences in perceptions of a good death and the acceptability of death-related discussions may affect ratings on the QODD. This measure requires revision and validation for use in African settings, but evidence from such patient-centered assessment tools can advance palliative care in this region.
Comutation of PIK3CA and TP53 in Residual Disease After Preoperative Anti-HER2 Therapy in ERBB2 (HER2)-Amplified Early Breast Cancer
Authors: Holmes Frankie Ann , Levin Maren K. , Cao Ying , Balasubramanian Sohail , Ross Jeffrey S. , Krekow Lea , McIntyre Kristi , Osborne Cynthia , Espina Virginia , Liotta Lance , O’Shaughnessy Joyce
Published: June 2019

PURPOSE

To identify proteomic and genomic alterations in residual disease (RD) for human epidermal growth factor receptor 2 (HER2)-positive (HER2+) breast cancer (BC) after preoperative trastuzumab (H), lapatinib (L), or both (H+L) in combination with chemotherapy.

PATIENTS AND METHODS

Patients with stage II/III HER2+ BC (n = 100) were randomly assigned to preoperative treatment with H versus L 1,250mg versus H+L (L: 750 to 1,000 mg) plus 5-fluorouracil, epirubicin, and cyclophosphamide, followed by weekly paclitaxel. After receiving institutional review board–approved informed consent, targeted next-generation sequencing was performed on 20 patients’ formalin-fixed paraffin embedded tumors to characterize genomic alterations across 287 cancer-related genes. Reverse phase protein array (RPPA) analysis was performed on both the baseline biopsy and RD specimens, when available.

RESULTS

Two of 20 RD tissues were HER2 negative per next-generation sequencing; one sample had insufficient tissue. Of six pretreatment biopsy specimens, four were comutated with TP53 and PIK3CA. Of 17 HER2+ RD, seven specimens (41%) had PIK3CA mutations always comutated with TP53, and four (24%) also had concurrent CDK12 amplification. Overall, CDK12 amplification was observed in eight of the 17 (47%) HER2+ RD specimens. A total of 12 RD specimens (71%) had TP53 mutations. Although prevalence of individual TP53 and PIK3CA mutations was only modestly higher than published estimates for those in HER2+ primary BCs (55% and 32% for TP53 and PIK3CA, respectively), prevalence of these as comutations appeared higher (41%), compared with less than 10% in several series. On RPPA analysis of the RD tissue with comutations, the strongest Spearman ρ correlations were limited to EGFR and phospho-AKT (ρ, 0.999; P = .019) and phospho-mTOR and phospho-S6 ribosomal protein (ρ, 0.994; P = .048).

CONCLUSION

HER2-amplified RD tissue after preoperative H, L, or H+L plus chemotherapy was enriched for PIK3CA and TP53 comutations, and the RD tissue demonstrated activation of EGFR/AKT/mTOR signaling on RPPA.
Association of Galectin-3 With Diabetes Mellitus in the Dallas Heart Study
Authors: Vora Amy , de Lemos James A , Ayers Colby , Grodin Justin L , Lingvay Ildiko
Published: June 2019

Context

Galectin-3 is a biomarker associated with inflammation and fibrosis in cardiac, liver, and renal disease. Galectin-3 is higher in overweight and obese individuals; whether an association with diabetes exists independent of weight is unknown.

Objective

To evaluate if galectin-3 is associated with diabetes mellitus.

Design

We performed measurements of galectin-3 among participants in the Dallas Heart Study (DHS) Phases 1 and 2 (DHS-1 and DHS-2; n = 3392, and n = 3194, respectively). Of these, 1989 participants were evaluated longitudinally in both studies. Associations of galectin-3 with prevalent and incident type 2 diabetes were determined using logistic regression models. Associations of galectin-3 with relevant biomarkers and fat compartments were evaluated using Spearman correlation coefficients and multivariable linear regression models, respectively.

Setting and Participants

DHS is a population-based, single-site, multiethnic study conducted in Dallas County, Texas, with oversampling to comprise 50% blacks.

Results

Galectin-3 levels were associated with diabetes prevalence in DHS-1 [OR 1.56 per SD change in log-galectin (95% CI 1.41 to 1.73)] and DHS-2 [OR 1.86 (95% CI 1.67 to 2.06)]. Galectin-3 levels in DHS-1 also associated with incident diabetes mellitus over the 7.1 (interquartile range 6.6 to 7.6)-year follow-up period [OR 1.34 (95% CI 1.14 to 1.58)]. These associations maintained significance in models adjusted for traditional metabolic risk factors (age, sex, race, body mass index, and hypertension) and renal function. Galectin-3 levels correlated with levels of biomarkers implicated in inflammation (high-sensitivity C-reactive peptide, IL-18, monocyte chemoattractant protein 1, soluble TNF receptor 1A, myeloperoxidase), insulin secretion (C-peptide and C-peptide/homeostatic model assessment for insulin resistance), and subcutaneous adiposity.

Conclusions

Galectin-3 is associated with diabetes prevalence and incidence, possibly through the inflammatory pathway contributing to β-cell fibrosis and impaired insulin secretion.