bluuebunny/crossref_metadata_2025 huggingface dataset:
DIEAP Flap Patients Equally as Satisfied with the Abdomen as Abdominoplasty Patients
Authors: Ingvaldsen Christoffer Aam , Tindholdt Tyge Tind , Tønseth Kim Alexander
Published: August 2018

Background:

The dermolipectomy of the deep inferior epigastric artery perforator (DIEAP) flap procedure is designed to give an end result as seen with abdominoplasty (AP). Several steps of an AP are, however, not routinely performed. This study compared the patient-reported outcomes between these 2 procedures with an emphasis on the abdomen.

Methods:

Thirty-four patients reconstructed with a DIEAP flap (DIEAP group), and 30 patients with an AP (AP group) were asked to complete 2 study-specific questionnaires. The first questionnaire covered abdominal outcomes, whereas the second was concerned with general outcomes.

Results:

The DIEAP group was significantly older compared with the AP group. Eighty-five percentage of the DIEAP group and 66 % of the AP group answered the questionnaires. Postoperatively, the DIEAP group was significantly more satisfied with their bodies when dressed (P = 0.009), and there was a trend of DIEAP patients being more satisfied with the appearance of the abdomen (P = 0.085). No significant difference was found comparing outcomes concerning umbilicus, muscle function, pain, scarring, and contour. The DIEAP group was more worried about their health than the AP group postoperatively (P = 0.044). AP patients had a significantly more altered body image (P = 0.016) and increased sexual desire (P = 0.003) than DIEAP patients. There was no significant difference regarding changes in self-image, social relationships, being naked with partner, and overall satisfaction.

Conclusion:

DIEAP flap patients were equally as satisfied with the abdomen as AP patients.
Viability of Descemet Membrane Endothelial Keratoplasty Grafts Folded in the Eye Bank
Authors: Lohmeier John , Christy Jason , Chiang Eric , Barnes Kali , Cai Stephanie , Chen Conan , Subramanya Anshul , Chaurasia Akash , Rosen Allison , Vora Parth , Durr Nicholas J. , Allen Robert , Eghrari Allen Omid
Published: August 2018

Purpose:

Preloaded, trifolded grafts in Descemet membrane endothelial keratoplasty require transfer of the trifolding process from the corneal transplant surgeon to the eye bank technician. We sought to assess whether trifolding may be safely conducted by an eye bank technician with cell loss comparable to standard peeling and lifting.

Methods:

A total of 10 grafts were stained, peeled, and transferred directly onto a bed of Calcein-AM and Amvisc Plus by an eye bank technician. Five grafts were removed and stained as a scroll, and 5 grafts were trifolded with the endothelium in before transfer. Photographs were acquired with an inverted fluorescence microscope, and image segmentation was performed. A t test was conducted to compare differences in endothelial cell loss across groups.

Results:

Mean cell loss in the scroll group was 18.5% [95% confidence interval (CI): 15.2%–21.9%] compared with 7.6% of the trifolded group (95% CI: 1.7%–13.5%). A 2-tailed t test indicated decreased cell loss in the trifolded group (P = 0.013).

Conclusions:

Despite additional manipulation of the graft, trifolding of Descemet membrane and endothelium may be performed by an eye bank technician without significantly increased cell loss relative to graft preparation as a scroll.
Childhood Head and Neck Lymphadenopathy: A Report by a Single Institution (2003-2017)
Authors: Indolfi Paolo , Perrotta Silverio , Rossi Francesca , Di Martino Martina , Pota Elvira , Di Pinto Daniela , Gualdiero Giovanna , Boccieri Emilia , Indolfi Cristiana , Casale Fiorina
Published: August 2018

Actually, there is still no consensus related to diagnostic and management algorithms in case of head and neck lymphadenopathy in children. The aim of our study was to analyze the causes of head and neck lymphadenopathy in children to determine a systematic diagnostic approach. We enrolled all cases of head and neck lymphadenopathy in children under the age of 18 diagnosed at the Unit of Hemato-Oncology, Pediatric Department of University “Luigi Vanvitelli,” Naples, over a 15-year period (January 2003-December 2017). In total, 405 patients (271 males) were enrolled in the study. Thirteen cases due to other causes, were left off the study. Therefore, the study was performed on 392 cases. A total of 220 patients (56.1%) had a history of infection, 66 cases (16.8%) a diagnosis of neoplasia, and 101 (24.9%) cases a diagnosis of reactive inflammatory changes of nonspecific origin. We have observed the following from our study: (1) the acute infections are the most common causes of head and neck lymphadenopathy in the pediatric population; (2) in about a quarter of patients, the lymphadenopathy resulted by nonspecific origin; (3) the supraclavicular nodes should be regarded with a high index of suspicion of malignancy.
Cisplatin-induced Ototoxicity in Children With Solid Tumor
Authors: Wei Meng , Yuan Xiaojun
Published: August 2018

Cisplatin is the principal chemotherapeutic agent and also tremendously increases the survival for pediatric patients with neuroblastoma or hepatoblastoma. With the extended overall survival period, clinical medical workers and parents gradually attach more attention to the late effect of chemotherapy of these children. The purpose of this study is to analyze the incidence and risk factors of cisplatin-based hearing loss. We retrospectively collected the archives of cisplatin-based chemotherapy and audiometric evaluation from 2005 through 2017 at Xinhua Hospital. From 384 patients treated with cisplatin, full data of 59 patients were available, and 14 cases (23.7%) were identified as significant hearing loss. The median time from usage of platinum compounds to the most recent audio test was 406 days. Cumulative and single maximum cisplatin dose was 622.6±283.2 and 137.6±51.6 mg/m2/cycle, respectively. Accumulated cisplatin dose (95% confidence interval, 1.001-1.006; P=0.012) and single maximum cisplatin dose (95% confidence interval, 1.000-1.029; P=0.049) were independently important predictors for moderate to severe hearing loss in children treated with cisplatin. Cisplatin can cause ototoxicity which profoundly handicap language development and social communication for children. Regular audiological management and long-term follow-up are strongly recommended for this vulnerable group.
Paraffin Immunofluorescence: A Role Beyond Kidney Biopsies
Authors: Singh Geetika , Pradeep Immanuel , Agarwal Shipra , Barwad Adarsh , Dinda Amit
Published: August 2018

Paraffin immunofluorescence is a well established “salvage” technique in renal pathology when representative glomeruli are not found in the fresh frozen tissue sent for routine direct immunofluorescence studies. A step of enzymatic digestion of the formalin-fixed paraffin-embedded biopsy exposes the antigenic immune complexes and allows staining with fluorochrome-tagged antibodies. We explored the utility of the technique of paraffin immunofluorescence outside the kidney in certain specific scenarios including extra renal amyloid and duodenal macroglobulinemia.
Evaluation of Cyclin D1 as a Discriminatory Immunohistochemical Biomarker for Idiopathic Pulmonary Fibrosis
Authors: Wei Christina H. , Baratelli Felicita E. , Xiao Guang-Qian , Koss Michael N. , Elatre Wafaa
Published: August 2018

Background:

Distinction of idiopathic pulmonary fibrosis (IPF) from other chronic fibrosing interstitial pneumonitides, such as hypersensitivity pneumonitis (HP) and connective tissue diseases, is critical due to varied biological and clinical outcomes. However, their histologic overlaps often pose diagnostic challenges. A recent study suggested an association of herpesvirus saimiri infection with IPF. Productive viral infection is associated with coexpression of pirated mammalian protein cyclin D1, shown to be overexpressed by immunohistochemistry (IHC) in the regenerating alveolar epithelium in IPF but not in normal lungs. We evaluated the diagnostic utility of cyclin D1 to discriminate between IPF and other fibrosing interstitial lung diseases.

Materials and Methods:

A retrospective study of cyclin D1 IHC expression in 27 consecutive cases of chronic fibrosing interstitial lung diseases from 2011 to 2017: 12 usual interstitial pneumonia (UIP) pattern; 5 nonspecific interstitial pneumonia pattern; 3 HP pattern; 7 unclassifiable was performed. Five cases of normal lung obtained from lobectomy specimen for malignancy are included as control. Immunoreactivity was graded semiquantitatively on a scale of 0 to 3.

Results:

Cyclin D1 staining was uniformly strongly positive in all cases evaluated in the study, particularly in proliferating type II pneumocytes in the region of fibrosing areas. There was no statistical difference in the extent of cyclin D1 expression between UIP and non-UIP groups (2.7 vs. 2.5) and IPF versus non-IPF groups (2.7 vs. 2.4). Cyclin D1 expression is lower in control group compared with UIP groups (1.2 vs. 2.7).

Conclusions:

Cyclin D1 is not a specific marker of UIP pattern/IPF. The high expression of cyclin D1 in lung tissue of fibrosing interstitial pneumonitides regardless of etiology most likely correlates with proliferation in type II pneumocytes.
APOBEC3B High Expression in Gastroenteropancreatic Neuroendocrine Neoplasms and Association With Lymph Metastasis
Authors: Feng Changyin , Zheng Qiaoling , Yang Yinghong , Xu Meifang , Lian Yuane , Huang Jianping , Jiang Yiting
Published: August 2018

Purpose:

Apolipoprotein B mRNA editing enzyme catalytic polypeptide-like 3B (APOBEC3B) is known as a source of mutations in multiple cancers. Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are a group of heterogeneous tumors. However, the expression and significance of APOBEC3B in GEP-NENs remains unclear.

Materials and Methods:

A total of 158 cases of GEP-NENs, including 78 cases of biopsy or endoscopic submucosal dissection resection specimens and 83 cases of surgical resection specimens were collected in this study. The cases were grouped according to tumor classification grade, including 42 cases of neuroendocrine tumors G1 (NET G1), 36 cases of NET G2, 36 cases of NET G3, 44 cases of neuroendocrine carcinoma (NEC). All of the 158 tumors were immunohistochemically studied using a polyclonal antibody against APOBEC3B. We evaluated APOBEC3B expression in GEP-NENs and investigated the relationships among the immunoreactivity of APOBEC3B, clinical and pathologic features, such as age, sex, tumor site, Ki67 cell proliferation index, and lymph metastasis.

Results:

A total of 33 cases (78.6%) of NET G1 showed high expression of APOBEC3B. A total of 28 cases (77.8%) of NET G2 demonstrated high expression of APOBEC3B. In NET G3 and NEC cases, the positive rates were 52.8% and 2.3%, respectively. The expression of APOBEC3B in NETs was significantly higher than that in NECs, NET G1 and NET G2 were higher than NET G3, and the difference was statistically significant. APOBEC3B high expression cases have lower lymph node metastasis rate, lower Ki67 cell proliferation index.

Conclusions:

In this study, APOBEC3B is highly expressed in GEP-NETs and is a predictor of lymph node metastasis in NET G3 and NEC cases. These findings might provide new insights into the biological mechanisms of GEP-NENs tumorigenesis and progression.
High Fidelity of Breast Biomarker Metrics: A 10-Year Experience in a Single, Large Academic Institution
Authors: Zhang Huina , Han Min , Varma Kavita R. , Clark Beth Z. , Bhargava Rohit , Dabbs David J.
Published: August 2018

Purpose:

Recommendations for standardization of breast biomarkers including estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) led to the creation of American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines to provide continuous guidance. Included in these recommendations is the “ongoing assay assessment procedures.” We report these biomarker metrics as there is a dearth of published information on this topic.

Materials and Methods:

ER, PR, and HER2 positivity rates of all newly diagnosed, recurrent, and metastatic invasive breast cancers on core biopsies, and repeated testing on resection specimen by immunohistochemistry (IHC) and/or fluorescence in situ hybridization (FISH) were collected from April 1, 2008 to December 31, 2017.

Results:

The positivity rates of ER, PR, and HER2 over almost 10 years of monitoring showed high fidelity. Total ER-positive rate was 83.6% (81.4% to 86.8%), ER+/PR+ was 71.7% (68.6% to 75.5%), ER+/PR− was 17.6% (11.0% to 15.0%), ER−/PR− was 16.0% (13.5% to 18.2%), and ER−/PR+ was 0.6% (0.2% to 1.0%). The HER2-positive rate was 13.7% (10.2% to 17.4%) including 9.9% (7.3% to 11.9%) by IHC and 3.8% (1.9% to 5.9%) by FISH reflexed from IHC 2+ results. FISH amplification rate of HER2 IHC 2+ cases was 11.0% (5.8% to 19.2%). Annual quality-assurance check for HER2 IHC/FISH percent positive and percent negative agreement (as defined by Food and Drug Administration) was 96% to 100%.

Conclusions:

This longitudinal active assessment of 9564 breast biomarker cases shows the achievement of high fidelity of breast biomarker results when following the ASCO/CAP guidelines. Continuous monitoring of breast biomarkers may minimize assay analytical drift and assure quality clinically relevant results.
Small Biopsies Misclassify up to 35% of PD-L1 Assessments in Advanced Lung Non–Small Cell Lung Carcinomas
Authors: Bigras Gilbert , Mairs Simon , Swanson Paul E. , Morel Didier , Lai Raymond , Izevbaye Iyare
Published: August 2018

Pembrolizumab is an FDA-approved immune-checkpoint (IC) inhibitor that targets programmed cell death protein PD-1, and recent phase III trials have demonstrated its superiority over chemotherapy in the treatment of patients with advanced non–small cell lung cancer (NSCLC). Eligibility for treatment with Pembrolizumab is based on demonstration of PD-L1 expression on tumoral cells using the approved companion test 22C3 PharmDx (Dako). Access to the drug depends on a tumor proportion score (TPS) expressing the PD-L1 protein above predetermined cutoffs. The scoring interpretation guide requires a minimum of 100 viable cells to be considered adequate for evaluation. Recent studies have questioned the adequacy of the sampling process when small biopsies are utilized. To further explore this concern, the viable tumor area of 426 consecutive NSCLC biopsies and surgical excisions submitted for PD-L1 assessment was measured and recorded with corresponding PD-L1 expression. About 14.6% of all biopsies measured <2 mm2creating 2 groups (<2 mm2and ≥2 mm2) whose PD-L1 categories distribution [negative (<1%), low expressor (≥1% and <50%), and positive (≥50%)] were compared. Results were significantly different between both groups (χ2test;P=0.0012). To help understand this difference, 1,407,000 in silico simulated biopsies of various sizes were performed on 201 numerical tumors created from digitalized full sections and analyzed. Not only the same results shown in actual biopsies were reproduced, but the model calculated that up to 35% of very small biopsies were misclassified including a mixture of false negative and false positive results. The percentage decreased to 10% with a threshold of 5 mm2. In era of precision medicine, appropriate sampling is more than ever critical to achieve accurate assessment of the NSCLC PD-L1. Ignored in most clinical trials, recording of biopsy size would permit refining data analysis and increase predictive accuracy of current and future biomarkers.
Energy Intake and Expenditure in Children With Heart Failure
Authors: Hoover John D. , Wong William W. , Adachi Iki , Brandt Paige , Jeewa Aamir
Published: August 2018

Objectives:

Up to one third of children with heart failure exhibit growth failure. Limited data exists reporting energy requirements in this population. A study was designed to characterize the energy intake and total daily energy expenditure of children with heart failure using the doubly labeled water method.

Design:

Prospective study using doubly labeled water to measure total daily energy expenditure in children with heart failure. Doubly labeled water was administered orally and daily urine samples collected for 10 days. Total daily energy expenditure was compared with historic data from age- and gender-matched healthy population. Anthropometrics and 3-day calorie count were also done.

Setting:

The Cardiovascular Intensive Care Unit and Cardiology ward at Texas Children's Hospital.

Patients:

Children with new presentation of heart failure as defined by an ejection fraction less than 35% and requiring inotrope(s) at the time of enrollment.

Measurements and Main Results:

A total of five children with heart failure were enrolled from 2015 to 2016. All children showed weight-for-length less than mean-for-age. All had depressed myocardial function at enrollment, and all but one demonstrated improvement in ejection fraction at follow-up. Three had energy intake that met or surpassed their total daily energy expenditure, with total daily energy expenditure that measured below historic controls. One infant, despite supplementation, had an energy intake substantially below that of measured total daily energy expenditure and required cardiac transplantation.

Conclusions:

Growth failure in heart failure is likely multifactorial and may be related to suboptimal energy intake secondary to exercise intolerance, malabsorption, and/or end-organ dysfunction due to impaired cardiac output. Doubly labeled water is a feasible method to assess total daily energy expenditure in children with heart failure.
Three-Dimensional High-Resolution Black-Blood Magnetic Resonance Imaging for Detection of Arteritic Anterior Ischemic Optic Neuropathy in Patients With Giant Cell Arteritis
Authors: Sommer Nora N. , Treitl Karla M. , Coppenrath Eva , Kooijman Hendrik , Dechant Claudia , Czihal Michael , Kolben Theresa M. , Beyer Sebastian E. , Sommer Wieland H. , Saam Tobias
Published: August 2018

Objectives

Arteritic anterior ischemic optic neuropathy (A-AION) caused by inflammatory occlusion of the posterior ciliary arteries is the most common reason for irreversible vision loss in patients with giant cell arteritis. Atypical clinical presentation and negative funduscopy can delay systemic high-dose corticosteroid therapy to prevent impending permanent blindness and involvement of the contralateral eye.

The purpose of this study was to assess the diagnostic accuracy of 3-dimensional (3D) high-resolution T1-weighted black-blood magnetic resonance imaging (T1-BB-MRI) for the detection of posterior ciliary artery involvement in patients with giant cell arteritis and funduscopic A-AION.

Materials and Methods

After institutional review board approval and informed consent, 27 patients with suspected giant cell arteritis and vision disturbances were included in this monocentric prospective cohort study. Giant cell arteritis was diagnosed in 18 patients according to the diagnostic reference standard (6 men, 73.8 [69.0–78.0] years); 14 of those were positive for A-AION. Precontrast and postcontrast 3D T1-BB-MRI was performed in all 27 patients. Two radiologists separately assessed image quality and local fat suppression (4-point scale), visual contrast enhancement (3-point scale), and diagnostic confidence (5-point scale) regarding arteritic posterior ciliary artery involvement. Magnetic resonance imaging findings were assessed in comparison to funduscopy. Statistical analysis included accuracy parameters and interrater agreement.

Results

Sensitivity of 3D T1-BB-MRI was 92.9% (95% confidence interval, 66.1%–99.8%) and specificity was 92.3% (95% confidence interval, 64.0%–99.8%) for detection of A-AION–positive patients. Image quality and local fat suppression were assessed with 3.2 ± 0.8 (median 3) and 3.8 ± 0.5 (median 4). Visual contrast enhancement with 2.3 ± 0.8 (median 3) and diagnostic confidence was rated at 4.7 ± 0.5 (median 5). Interrater agreement was high (κ = 0.85,P< 0.001). Three-dimensional T1-BB-MRI displayed bilateral findings in 50% of the cases, whereas only unilateral A-AION was detected in funduscopy as a possible indication for the contralateral eye at risk.

Conclusions

Three-dimensional T1-BB-MRI allows accurate detection of arteritic posterior ciliary artery involvement in patients with A-AION. Further, 3D T1-BB-MRI seems to display arteritic involvement of the posterior ciliary arteries earlier than funduscopy and might, therefore, display “vision-at-risk” in patients with visual impairment and suspected giant cell arteritis but unremarkable funduscopy.
Neurokinin-1 Receptor Deficiency Improves Survival in Murine Polymicrobial Sepsis Through Multiple Mechanisms in Aged Mice
Authors: Mella Juan R. , Stucchi Arthur F. , Duffy Elizabeth R. , Remick Daniel G.
Published: August 2018

Objective:

Substance P (SP) is a neuropeptide that contributes to a proinflammatory state by binding to the neurokinin 1 receptor (NK-1R). Limiting this interaction has been shown to attenuate the acute inflammation. Our hypothesis was that NK-1R activation would contribute to the morbidity and mortality of sepsis in a model using mice genetically deficient in the NK-1R.

Methods:

To investigate the role of the SP/NK-1R axis in a murine model of sepsis, cecal ligation and puncture (CLP) in NK-1R deficient and wild type (WT) aged mice was performed. Acute inflammation was assessed by measuring circulating cytokines and clinical parameters.

Results:

Deletion of the NK-1R results in improved survival following CLP (NK-1R knockout mice survival = 100% vs. WT = 14%). A reduction in the inflammatory cytokines interleukin (IL) 6, macrophage inflammatory peptide 2, and IL-1 receptor antagonist, improved hemodynamic parameters, and increased neutrophilia were present in the NK-1R-deficient mice after CLP compared with WT mice.

Conclusions:

These data confirm the hypothesis that eliminating the SP/NK-1R interaction in a highly lethal murine model of sepsis leads to decreased morbidity and mortality through multiple mechanisms.
Pilot Study to Evaluate the Safety, Feasibility, and Financial Implications of a Postoperative Telemedicine Program
Authors: Nikolian Vahagn C. , Williams Aaron M. , Jacobs Benjamin N. , Kemp Michael T. , Wilson Jesse K. , Mulholland Michael W. , Alam Hasan B.
Published: August 2018

Background:

Telemedicine in surgery holds promise for improving access and decreasing costs, but its role remains ill-defined. This pilot study was performed to investigate the safety, feasibility, and financial implications of providing postoperative care using an electronic clinic (eClinic) at a university hospital.

Methods:

An easy-to-use and secure eClinic platform was constructed in Epic (Epic Systems Corporation, Verona, WA). Patients undergoing laparoscopic cholecystectomy, appendectomy, and hernia repairs on an adult acute care surgery service were enrolled in this program over an 11-month period (March 2017 to January 2018). Patients with prolonged hospitalizations (greater than 4 nights), perioperative complications, drains, and open wounds were excluded. Demographics, clinical outcomes, encounter time, patient satisfaction survey results, and cost analysis were compared with the traditional clinic (tClinic) patient population.

Results:

Two hundred thirty-three eligible patients (61% female; mean age 41 ± 16 years) were enrolled in this program. Their demographics were no different than the tClinic. Frequencies of readmission, reoperation, and emergency department visits (2.7%, 0%, and 4.2%, respectively) in the eClinic group were also similar to the tClinic group. However, total visit time was significantly shorter in the eClinic group (14 vs 145 minutes, P < 0.01). Anonymous surveys demonstrated a high degree of satisfaction, with 85% of patients expressing desire to utilize the eClinic again. This program enhanced the capacity for new visits to tClinic, with a resultant projected increase in additional operative cases and revenue for the health care system.

Conclusions:

A safe and efficient postoperative telemedicine program can be constructed utilizing a widely available electronic medical record system, which can improve patient satisfaction, optimize throughput, and increase gross charges for the healthcare system.
Visual Snow: Visual Misperception
Authors: White Owen B. , Clough Meaghan , McKendrick Allison M. , Fielding Joanne
Published: August 2018

Background:

Visual snow (VS) is a constant visual disturbance described as flickering dots occupying the entire visual field. Recently, it was characterized as the defining feature of a VS syndrome (VSS), which includes palinopsia, photophobia, photopsias, entoptic phenomena, nyctalopia, and tinnitus. Sixty percent of patients with VSS also experience migraine, with or without aura. This entity often is considered psychogenic in nature, to the detriment of the patient's best interests, but the high frequency of similar visual symptoms argues for an organic deficit. The purpose of this review is to clarify VSS as a true entity and elaborate the nature of individual symptoms and their relationship to each other.

Evidence Acquisition:

The literature was reviewed with specific regard to the clinical presentation and psychophysical, neurophysiological, and functional imaging studies in patients with defined visual disturbances that comprise VSS.

Results:

Consideration of the individual symptoms suggests that multiple factors are potentially involved in the development of VSS, including subcortical network malfunction and cortical hyperexcitation. Although there is substantial overlap between VSS and migraine syndromes in terms of co-occurring symptoms, both neurophysiological and neuroimaging studies provide substantial evidence of separate abnormalities of processing, supporting these as separate syndromes.

Conclusions:

VSS is likely associated with either hyperactive visual cortices or, alternatively, impaired processing of simultaneous afferent information projecting to cortex. VSS likely results from widespread disturbance of sensory processing resulting in sensory misperception. There may be a number of syndromes associated with impaired sensory processing resulting in sensory misperception, including migraine, persistent perceptual postural dizziness, and tinnitus, which overlap with VSS. Elucidation of abnormality in one defined syndrome may provide a path forward for investigating all.
Effectiveness and Predictors of Response to 1-Hz Repetitive Transcranial Magnetic Stimulation in Patients With Obsessive-Compulsive Disorder
Authors: Singh Swarndeep , Kumar Saurabh , Gupta Ankit , Verma Rohit , Kumar Nand
Published: August 2018

Objective

The present study aimed to assess the effectiveness of repetitive transcranial magnetic stimulation (rTMS) treatment targeting either supplementary motor area (SMA) or orbitofrontal cortex (OFC) among patients with OCD in real-world clinical practice settings. Also, the present study explored for potential predictors of response to rTMS treatment.

Methods

Retrospective review and analysis of records of 79 patients with medication-refractory OCD, all of whom had received 20 sessions of 1-Hz rTMS as part of routine clinical care. Of 79 patients, 46 received rTMS over the bilateral SMA and 33 over the left OFC. A reduction of 25% and 35% in Yale-Brown Obsessive Compulsive Scale (YBOCS) scores was used to classify outcome as partial and complete response, respectively. Statistical analysis was done using SPSS version 23.0.

Results

There was a significant decrease in mean YBOCS score from baseline to end of treatment (7.68 ± 5.62; t = 12.14, P < 0.001). Forty-five patients (57%) met criteria for partial response, of which 32 patients (40.5%) showed complete response. There was no significant difference in outcomes between patients receiving rTMS over SMA or OFC. Binary logistic regression analysis revealed presence of comorbid depression and higher baseline YBOCS score to be associated with lesser likelihood of response to rTMS.

Conclusions

This study provided evidence for overall effectiveness of adjunctive 1-Hz rTMS treatment over either SMA or OFC in patients with medication-refractory OCD, and reported comorbid depression and higher pretreatment YBOCS scores as potential predictors of poor response to rTMS.
Cognitive Effects of Transcranial Direct Current Stimulation in Healthy and Clinical Populations
Authors: Berryhill Marian E. , Martin Donel
Published: August 2018

Transcranial direct current stimulation (tDCS) is a neuromodulatory approach that is affordable, safe, and well tolerated. This review article summarizes the research and clinically relevant findings from meta-analyses and studies investigating the cognitive effects of tDCS in healthy and clinical populations. We recapitulate findings from recent studies where cognitive performance paired with tDCS was compared with performance under placebo (sham stimulation) in single sessions and longitudinal designs where cognitive effects were evaluated following repeated sessions. In summary, the tDCS literature currently indicates that the effects of tDCS on cognitive measures are less robust and less predictable compared with the more consistent effects on motor outcomes. There is also a notable difference in the consistency of single-session and longitudinal designs. In single-session tDCS designs, there are small effects amid high variability confounded by individual differences and potential sham stimulation effects. In contrast, longitudinal studies provide more consistent benefits in healthy and clinical populations, particularly when tDCS is paired with a concurrent task. Yet, these studies are few in number, thereby impeding design optimization. While there is good evidence that tDCS can modulate cognitive functioning and potentially produce longer-term benefits, a major challenge to widespread translation of tDCS is the absence of a complete mechanistic account for observed effects. Significant future work is needed to identify a priori responders from nonresponders for every cognitive task and tDCS protocol.
Transcranial Direct Current Stimulation in Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, and Anxiety Disorders
Authors: D'Urso Giordano , Mantovani Antonio , Patti Sara , Toscano Elena , de Bartolomeis Andrea
Published: August 2018

Obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and anxiety disorders share the basic clinical feature of anxiety, which probably explains their common response to similar pharmacological and psychological interventions. Transcranial direct current stimulation (tDCS) is a neuromodulation technique that has proved effective in reducing the symptoms of a number of neuropsychiatric disorders. It was also used in healthy subjects to modulate neuropsychological processes that are involved in the pathophysiology of anxiety. We review the published studies in which tDCS was administered to patients with OCD, PTSD, or anxiety disorders. Our systematic search in the major electronic databases resulted in 14 articles for OCD, 1 for an OCD-related disorder (ie, hoarding disorder), 2 for PTSD, and 2 for anxiety disorders. In the studies involving OCD patients, tDCS was targeted to either the dorsolateral prefrontal cortex or the orbitofrontal cortex or the pre–supplementary motor area and induced a clear reduction of obsessive-compulsive symptoms. However, the lack of sham control groups and the great diversity in sample selection and tDCS protocols among studies prevent us from generalizing these results. In the studies involving PTSD and anxiety disorders patients, tDCS was applied over the dorsolateral prefrontal cortex and reduced symptoms, but the number of treated patients is too little to draw any conclusion on efficacy. However, these reports highlighted the importance of combining tDCS with different procedures, including computerized tasks and behavioral paradigms. In conclusion, even in its infancy, the use of tDCS for the treatment of OCD, PTSD, and anxiety disorders does show promise and deserves extensive research effort.
Cows are highly motivated to access a grooming substrate
Authors: McConnachie Emilie , Smid Anne Marieke C. , Thompson Alexander J. , Weary Daniel M. , Gaworski Marek A. , von Keyserlingk Marina A. G.
Published: August 2018

In natural environments, cattle use trees and other abrasive surfaces to scratch and groom themselves. Modern indoor dairy cattle housing systems often lack appropriate grooming substrates, restricting the animals' ability to groom. We assessed the motivation of dairy cows to access an automated mechanical brush, a grooming resource that can be implemented in indoor cattle housing systems. Cows were trained to push a weighted gate to access either fresh feed (positive control), a mechanical brush or the same space without a brush (negative control). Weight on the gate was gradually increased until all cows failed to open it. The weight each cow was willing to push to access each resource was assessed using the Kaplan–Meier survival analysis. Despite differences in methodology used to obtain data on motivation to access feed and the brush, the outcomes were very similar; cows worked as hard for access to fresh feed and the brush (p= 0.94) and less hard for access to the empty space (compared with fresh feed:p< 0.01; brush:p< 0.02). These results indicate that cows are highly motivated to access a mechanical brush and that it is an important resource for cows.
Three-dimensional kinematics and the origin of the hominin walking stride
Authors: O'Neill Matthew C. , Demes Brigitte , Thompson Nathan E. , Umberger Brian R.
Published: August 2018

Humans are unique among apes and other primates in the musculoskeletal design of their lower back and pelvis. While the last common ancestor of thePan–Homolineages has long been thought to be ‘African ape-like’, including in its lower back and ilia design, recent descriptions of early hominin and Miocene ape fossils have led to the proposal that its lower back and ilia were more similar to those of some Old World monkeys, such as macaques. Here, we compared three-dimensional kinematics of the pelvis and hind/lower limbs of bipedal macaques, chimpanzees and humans walking at similar dimensionless speeds to test the effects of lower back and ilia design on gait. Our results indicate that locomotor kinematics of bipedal macaques and chimpanzees are remarkably similar, with both species exhibiting greater pelvis motion and more flexed, abducted hind limbs than humans during walking. Some differences between macaques and chimpanzees in pelvis tilt and hip abduction were noted, but they were small in magnitude; larger differences were observed in ankle flexion. Our results suggest that ifPanandHomodiverged from a common ancestor whose lower back and ilia were either ‘African ape-like’ or more ‘Old World monkey-like’, at its origin, the hominin walking stride likely involved distinct (i.e. non-human-like) pelvis motion on flexed, abducted hind limbs.
Conserved temporal ordering of promoter activation implicates common mechanisms governing the immediate early response across cell types and stimuli
Authors: Vacca Annalaura , Itoh Masayoshi , Kawaji Hideya , Arner Erik , Lassmann Timo , Daub Carsten O. , Carninci Piero , Forrest Alistair R. R. , Hayashizaki Yoshihide ,   the FANTOM Consortium, Aitken Stuart , Semple Colin A.
Published: August 2018

The promoters of immediate early genes (IEGs) are rapidly activated in response to an external stimulus. These genes, also known as primary response genes, have been identified in a range of cell types, under diverse extracellular signals and using varying experimental protocols. Whereas genomic dissection on a case-by-case basis has not resulted in a comprehensive catalogue of IEGs, a rigorous meta-analysis of eight genome-wide FANTOM5 CAGE (cap analysis of gene expression) time course datasets reveals successive waves of promoter activation in IEGs, recapitulating known relationships between cell types and stimuli: we obtain a set of 57 (42 protein-coding) candidate IEGs possessing promoters that consistently drive a rapid but transient increase in expression over time. These genes show significant enrichment for known IEGs reported previously, pathways associated with the immediate early response, and include a number of non-coding RNAs with roles in proliferation and differentiation. Surprisingly, we also find strong conservation of the ordering of activation for these genes, such that 77 pairwise promoter activation orderings are conserved. Using the leverage of comprehensive CAGE time series data across cell types, we also document the extensive alternative promoter usage by such genes, which is likely to have been a barrier to their discovery until now. The common activation ordering of the core set of early-responding genes we identify may indicate conserved underlying regulatory mechanisms. By contrast, the considerably larger number of transiently activated genes that are specific to each cell type and stimulus illustrates the breadth of the primary response.
A mathematical understanding of how cytoplasmic dynein walks on microtubules
Authors: Trott L. , Hafezparast M. , Madzvamuse A.
Published: August 2018

Cytoplasmic dynein 1 (hereafter referred to simply as dynein) is a dimeric motor protein that walks and transports intracellular cargos towards the minus end of microtubules. In this article, we formulate, based on physical principles, a mechanical model to describe the stepping behaviour of cytoplasmic dynein walking on microtubules from the cell membrane towards the nucleus. Unlike previous studies on physical models of this nature, we base our formulation on the whole structure of dynein to include the temporal dynamics of the individual subunits such as the cargo (for example, an endosome, vesicle or bead), two rings of six ATPase domains associated with diverse cellular activities (AAA+ rings) and the microtubule-binding domains which allow dynein to bind to microtubules. This mathematical framework allows us to examine experimental observations on dynein across a wide range of different species, as well as being able to make predictions on the temporal behaviour of the individual components of dynein not currently experimentally measured. Furthermore, we extend the model framework to include backward stepping, variable step size and dwelling. The power of our model is in its predictive nature; first it reflects recent experimental observations that dynein walks on microtubules using a weakly coordinated stepping pattern with predominantly not passing steps. Second, the model predicts that interhead coordination in the ATP cycle of cytoplasmic dynein is important in order to obtain the alternating stepping patterns and long run lengths seen in experiments.
The contribution of nano-zinc to alleviate salinity stress on cotton plants
Authors: Hussein M. M. , Abou-Baker N. H.
Published: August 2018

To investigate the effect of nano-zinc fertilizer on growth, yield and mineral status of cotton plants grown under salt stress, a pot experiment was set up in the greenhouse of the National Research Centre. The treatments were as follows: (I) diluted seawater: 10% (S1), 20% (S2) and tap water as a control (S0), (II) 100 ppm (NZn1), 200 ppm (NZn2) nano-zinc and distilled water as a control (NZn0). Irrigation with 10 and 20% seawater decreased dry weight (DW) of leaves by 11.53 and 43.22%, while decreases in bolls were 15.50 and 71.65%, respectively. Except for root DW and top/root ratio, the measured growth parameters were increased as nano-zinc concentration increased. As for the interaction between treatments, the highest DW of stem, leaves and bolls resulted from the addition of NZn2 under normal condition, followed by NZn2 x S1 and the next was NZn2 x S2. The foliar application of 200 ppm nano-Zn led to mitigating the adverse effect of salinity and confirmed that diluted seawater could be used in the irrigation of cotton plant. However, phosphorus fertilizer should be added with nano-Zn application to avoid P/Zn imbalance. Some elements’ status and their ratios were recorded.
Assessment of tea garden soils at An'xi County in southeast China reveals a mild threat from contamination of potentially harmful elements
Authors: Cao Hai-Lei , Cai Feng-Ying , Jiao Wen-Bin , Liu Cheng , Zhang Ning , Qiu Hai-Yuan , Rensing Christopher , Lü Jian
Published: August 2018

An extensive study of the spatial distribution characteristics of potentially harmful elements (PHEs) in tea (
Camellia sinensis
(L.) O. Kuntze) garden soils and ecological risk assessment at An'xi County, the birthplace of oolong tea in China, was implemented. A total of 78 soil samples were examined to determine the concentration of five PHEs (As, Cd, Cr, Hg and Pb), soil organic matter and pH by using geostatistical approaches combined with geographical information system analysis. All PHEs presented in the study area were slightly higher than their background values for provincial and national standards except Cr. Moreover, ecological risk assessment of PHEs in the tea garden soils at An'xi County was performed by means of the Håkanson method. The average ecological potential risk index (
E
r
) of the five PHEs followed a descending order of Cd > Hg > Pb > As > Cr, and suggested a moderate ecological risk in the study area.
Vertical stress and stability of interburden over an abandoned pillar working before upward mining: a case study
Authors: Bai Jinwen , Feng Guorui , Wang Shanyong , Qi Tingye , Yang Jian , Guo Jun , Li Zhen , Du Xianjie , Wang Zehua , Du Yunlou , Zhang Yujiang
Published: August 2018

Upward mining of the residual coal seam over an abandoned pillar working is one of the effective measures to alleviate the contradiction between limited resources and increased consumption. Interburden stability over an abandoned pillar working plays a significant role in guaranteeing the safety of upward mining; however, it has not yet been extensively studied and understood. In this study, the vertical stress of the interburden over an abandoned pillar working was first investigated. The mechanical model of the interburden was established and the damage conditions were analysed. Then, the stability of the interburden over 38502 abandoned workings in Baijiazhuang coal mine was determined by mechanical analysis and field monitoring. The results show that: (i) Vertical stress of the interburden over abandoned mining zones is clearly lower than the initial stress, indicating the existence of a de-stressed effect. Moreover, vertical stress of the interburden over residual coal pillars is greater than the initial stress, which is the evidence of a stress concentration effect. (ii) The interburden over an abandoned pillar working should be regarded as an elastic rectangular plate supported by generalized Kelvin bodies in mechanical modelling. (iii) The interburden over abandoned mining zones may experience two damage stages. In the first stage, initial plastic damage appears at the central region of interburden. In the second stage, the plastic damage evolves from the central point to the surrounding areas. (iv) The mechanical analysis and field monitoring both indicate the initial damage occurred at the central region over 38502 abandoned workings in Baijiazhuang coal mine before upward mining. Related rock control measures should be implemented in that region to guarantee the safe mining of the residual coal seam.
Proof of Kernel Work: a democratic low-energy consensus for distributed access-control protocols
Authors: Lundbæk Leif-Nissen , Janes Beutel Daniel , Huth Michael , Jackson Stephen , Kirk Laurence , Steiner Robert
Published: August 2018

We adjust the Proof of Work (PoW) consensus mechanism used in Bitcoin and Ethereum so that we can build on its strength while also addressing, in part, some of its perceived weaknesses. Notably, our work is motivated by the high energy consumption for mining PoW, and we want to restrict the use of PoW to a configurable, expected size of nodes, as a function of the local blockchain state. The approach we develop for this rests on three pillars: (i)
Proof of Kernel Work
(PoKW), a means of dynamically reducing the set of nodes that can participate in the solving of PoW puzzles such that an adversary cannot increase his attack surface because of such a reduction; (ii)
Practical Adaptation of Existing Technology
, a realization of this PoW reduction through an adaptation of existing blockchain and enterprise technology stacks; and (iii)
Machine Learning for Adaptive System Resiliency
, the use of techniques from artificial intelligence to make our approach adaptive to system, network and attack dynamics. We develop here, in detail, the first pillar and illustrate the second pillar through a real use case, a pilot project done with Porsche on controlling permissions to vehicle and data log accesses. We also discuss pertinent attack vectors for PoKW consensus and their mitigation. Moreover, we sketch how our approach may lead to more democratic PoKW-based blockchain systems for public networks that may inherit the resilience of blockchains based on PoW.
A dwarf walrus from the Miocene of Baja California Sur, Mexico
Authors: Velez-Juarbe Jorge , Salinas-Márquez Fernando M.
Published: August 2018

Here, we describe the odobenid
Nanodobenus arandai
gen. et sp. nov., based on a nearly complete left mandible from the mid to late Miocene Tortugas Formation in Baja California Sur.
Nanodobenus
is distinguished among odobenids by displaying a unique combination of plesiomorphic and derived characters, such as narrow mandibular symphysis, well-developed genial tuberosity, bilobed canine and p2 roots, bulbous post-canine teeth with the paraconid, protoconid and hypoconid, and smooth lingual cingula. Moreover, it is characterized by its small adult body length, which is estimated at about 1.65 m. Throughout the Miocene–Pliocene odobenids are characterized by an increase in body size, especially after the extinction of desmatophocids in the late Miocene. The small size of
Nanodobenus
departs from this trend, demonstrating that there was greater size disparity among odobenids in the mid–late Miocene than previously thought. It is hypothesized that
Nanodobenus
occupied a niche that was later on occupied by similar-sized otariids, such as
Thalassoleon mexicanus,
which occurs sympatrically with large odobenids in the overlying Almejas Formation.