bluuebunny/crossref_metadata_2025 huggingface dataset:
An Enhancing Effect of Poly-Lysine on the Activation of Plasminogen
Authors: Allen R A
Published: July 2018

This study demonstrates that poly-lysine mimics the cofactor (enhancing) function of fibrin that is seen in tissue activator-induced plasminogen activation. Additionally, and in contrast to fibrin, poly-lysine exhibited an enhancing effect on low molecular weight (and not high molecular weight) urokinase-induced plasminogen activation.

A mechanism is proposed for this enhancement that involves the rendezvous and local concentration of plasminogen and plasminogen activator molecules on the lysine polymer. All components were able to bind to immobilized poly-lysine making the proposed machanism feasible. It was possible to elute the activators and mini-plasminogen by high salt (1 M NaCl), in contrast to Glu-plasminogen and plasmin which required 1 M lysine for elution, suggesting specific binding involving lysine binding sites.

The enhancing effect was specific for poly-D- and L-lysine and poly-L-ornithine, which has a similar structure. The use of poly-lysine can lead to a better standardization and increased sensitivity of indirect two-step assays for plasminogen activators employing synthetic chromogenic substrates.
Synthesis of Thromboplastin Protein by a Murine Macrophage-Like Cell Line
Authors: Lyberg T , Hetland Ø , Prydz H
Published: July 2018

The established murine macrophage cell line J-774.1 responds to endotoxin with synthesis of thromboplastin apoprotein. The response develops in the absence of added lymphocytes and there is no increased responsiveness in cocultures of J-774.1 cells and BALB/c lymphocytes. J-774.1 cells therefore do not depend on lymphocyte cooperation for their response to endotoxin.
The Amidolytic Activity of the SK-Plasminogen Complex Is Enhanced by a Potentiator which Is Generated in the Presence of Vascular Plasminogen Activator - Role of Fibrin Degradation Products
Authors: Soria J , Soria C , Bertrand O , Dunn F , Samama M , Bachmann F
Published: July 2018

In the presence of an excess of streptokinase (SK) the amidolytic activity of the plasminogen-SK complex on chromogenic substrates is 12% lower in serum than in the corresponding plasma. However, in subjects in whom venous stasis lead to a shortening of the euglobulin lysis time to less than 60 min (high responders), the amidolytic activity of the plasminogen-SK complex in serum was 60% higher than in the corresponding plasma. Attempts to find alterations of the plasminogen molecule itself which would account for the enhanced activity in high responder serum were negative. No free plasmin was present and the plasminogens isolated from plasma and serum before and after venous stasis had the same amidolytic activity as glu-plasminogen in the presence of an excess of SK. N-terminal analysis of these four plasminogens revealed in each instance glutamic acid.

The enhancement of the amidolytic activity of the SK-plasminogen complex in serum of high responders (potentiator activity) could be reproduced by adding purified tissue plasminogen activator (TA) to native blood before clotting, but not if TA was added to plasma or to prestasis serum. Removal of fibrin degradation products from poststasis serum resulted in the disappearance of potentiator activity. These experiments suggest that fibrin degradation products, generated during clotting in the presence of vascular or tissular plasminogen activator act as a potentiator of the amidolytic activity of the plasminogen SK-complex.
Predicting the Dose of Warfarin for Therapeutic Anticoagulation
Authors: Sharma N K , Routledge P A , Rawlins M D , Davies D M
Published: July 2018

The validity of a previously described technique for predicting warfarin requirements based on the anticoagulant response to a fixed loading dose was assessed prospectively in 57 patients. There was a close relationship between the predicted and initially observed daily warfarin dose required to maintain the patient within the therapeutic range for anticoagulation. The significant relationship between predicted and observed maintenance dose persisted at 4 and 12 weeks although it decreased with increasing time.

The relationship between observed and predicted maintenance requirement of warfarin was not affected by the concomitant use of intermittent intravenous injections of heparin when 9 hr was allowed to elapse between the previous dose of heparin and the thrombotest estimation on which the prediction was based.

It is concluded that the method is valuable in predicting an individual’s warfarin requirement, although it does not obviate the need for regular monitoring of anticoagulant control.
Effects of Heparin Oligosaccharides with High Affinity for Antithrombin III in Experimental Venous Thrombosis
Authors: Thomas D P , Merton Rosemary E , Barrowcliffe T W , Thunberg L , Lindahl U
Published: July 2018

The in vitro and in vivo characteristics of two oligosaccharide heparin fragments have been compared to those of unfractionated mucosal heparin. A decasaccharide fragment had essentially no activity by APTT or calcium thrombin time assays in vitro, but possessed very high specific activity by anti-Factor Xa assays. When injected into rabbits at doses of up to 80 ¼g/kg, this fragment was relatively ineffective in impairing stasis thrombosis despite producing high blood levels by anti-Xa assays. A 16-18 monosaccharide fragment had even higher specific activity (almost 2000 iu/mg) by chromogenic substrate anti-Xa assay, with minimal activity by APTT. When injected in vivo, this fragment gave low blood levels by APTT, very high anti-Xa levels, and was more effective in preventing thrombosis than the decasaccharide fragment. However, in comparison with unfractionated heparin, the 16-18 monosaccharide fragment was only partially effective in preventing thrombosis, despite producing much higher blood levels by anti-Xa assays.

It is concluded that the high-affinity binding of a heparin fragment to antithrombin III does not by itself impair venous thrombogenesis, and that the anti-Factor Xa activity of heparin is only a partial expression of its therapeutic potential.
Acyl-Enzymes as Thrombolytic Agents in a Rabbit Model of Venous Thrombosis
Authors: Smith R A G , Dupe R J , English P D , Green J
Published: July 2018

A derivative of human lys-plasmin in which the active site has been reversibly acylated (BRL 26920; p-anisoyl human lys-plasmin) has been examined as a fibrinolytic agent in a previously described rabbit model of venous thrombosis and shown to be significantly more active and less fibrinogenolytic than free plasmin. A p-anisoylated derivative of a streptokinase (SK)-activated plasmin preparation was significantly less fibrinogenolytic in vivo than the non-acylated enzyme. Acylation increased the fibrinolytic activity of preparations of SK-plasmin activator complexes. BRL 26921, the active site anisoylated derivative of the primary 2-chain SK-plasminogen complex was the most potent fibrinolytic agent studied. SK-Val442-plasminogen complexes, free or acylated, were biologically inactive in this model and confirm the essential nature of fibrin binding processes for effective thrombolysis in vivo.
The Effect of Bovine Lung Heparin on Normal Human Platelets as Measured by Electronic Particle Size Analysis
Authors: McLean Margaret R , Hause Lawrence L
Published: July 2018

The response of normal human platelets to treatment with bovine lung heparin was evaluated using electronic particle size analysis and aggregometry. Samples for electronic particle size analysis were obtained both before and after the addition of heparin to platelet-rich plasma (PRP). The number of single platelets decreased significantly after the addition of heparin to PRP obtained from 22 individuals. This decrease averaged 18% in 19 samples which did not show a significant increase in transmittance and was at least 70% in 3 samples which showed a significant increase in transmittance. The size distribution of single platelets was not significantly altered. In addition, electron microscopic examination revealed that platelets treated with heparin are activated.
A Possible Method to Control Prolongations of Bleeding Time under Antiplatelet Therapy with Ticlopidine
Authors: Thébault J , Blatrix C , Blanchard J , Panak E
Published: July 2018

The interactions of oral and i.v. administrations of corticosteroids with the effects of ticlopidine were studied, in a search for an antidote for possible excessive prolongations of bleeding time induced by antiaggregating agents. Indeed, the results show that an i.v. injection of methylprednisolone or an oral treatment with prednisolone counteract the prolongation of bleeding time but do not interfere with the inhibition of platelet aggregation brought about by ticlopidine. This could be ascribed to a vasoconstrictive effect of corticosteroids, possibly through reduction of vascular prostacyclin release. If this mode of action was confirmed, this useful finding would essentially apply to ticlopidine, but not to cyclooxygenase inhibitors such as aspirin which, by themselves, abolish prostacyclin production.
The Intrinsic Fluorescence of Human Fibrinogen and Its Fragments D and E
Authors: Kowalska M A , Cierniewski C S
Published: July 2018

The tryptophan fluorescence of fibrinogen and its final degradation products - fragment D and E - were compared. Fibrinogen and its derivatives exhibit identical emission and excitation spectra. Their fluorescence intensity is influenced to a different extent by pH titration and temperature.

Our studies showed that tryptophan residues of core fragments D and E are much more exposed to quenching effects of acrylamide and ions than intact fibrinogen, which may be caused by conformational changes occurring over the domains during plasmin digestion of fibrinogen molecule.
Kinetics of the Reaction Between Urokinase and an Inhibitor of Fibrinolysis from Placental Tissue
Authors: Christensen Ulla , Holmberg L , Bladh B , Åstedt B
Published: July 2018

The interaction of urokinase (EC 3.4.21.31) and a protein proteinase inhibitor of fibrinolysis partially purified from placental tissue, which inhibits urokinase but not plasmin, was investigated. The preparations of the inhibitor contained no other known proteinase inhibitors. It was found that a 1:1 complex is formed and that the reaction proceeds as a second order, one step process, the association rate constant of which is 4.5 106 M−1 S−1 at pH 8.4, 37° C and 3.0 106 M−1 S−1 at pH 7.3, 37° C. The binding is very tight, the dissociation constant of the inhibitor-urokinase complex was estimated to be Ki≦10−11 M.
Homo- and Heterogeneous Forms of Human Factor VIII
Authors: Vukovich Th Chr
Published: July 2018

In order to determine the molecular size of human F VIII as found in fresh plasma and as found in fresh-frozen plasma and in cryoprecipitate and to study the relationship of the factor-related properties, namely F VIII:C, F VIIIR:Rcof and F VIIIR:Ag to F VIII, the factor’s elution pattern on Sephacryl 1000 was investigated. When fresh plasma was chromatographed on this gel, F VIII eluted in a single sharp peak with all three F VIII-related activities appearing in the separation range of the gel column. The molecular weight of F VIII was calculated to be higher than 8 × 105. When fresh-frozen plasma was chromatographed on this gel, the elution pattern was identical to that of fresh plasma with the single exception that in several samples F VIII eluted in a broader peak tailing to higher molecular forms. When cryoglobulin fraction of fresh-frozen plasma was chromatographed, F VIII showed distinct heterogenicity in the elution pattern with respect to molecular size and relationship to the F VIII-related properties. Chelation of the endogenous plasma Ca-ions by citrate was found to have no influence on the factor’s elution pattern.
A Kinetic Method for Characterization of Heterogenous Fibrinogen and Its Application to Fibrinogen Grand Rapids, a Congenital Dysfibrinogenemia
Authors: Higgins D L , Lewis S D , Penner J A , Shafer J A
Published: July 2018

A kinetic analysis was developed to determine the steady state kinetic parameter kcat/KM for the thrombin-catalyzed release of FPA from abnormal and normal fibrinogen in mixtures of the two. Such mixtures are likely to comprise the fibrinogen of individuals with congenital dysfibrinogenemia. The analysis was used to characterize fibrinogen Grand Rapids, a new congenital dysfibrinogenemia. It indicated that fibrinogen from affected individuals was composed of normal and abnormal fibrinogen in roughly equal amounts, and that the value of kcat/KM for the thrombin-catalyzed release of FPA from the fibrinogen variant was 77fold lower than that for the release of FPA from the normal fibrinogen. In separate studies, fibrinogen Grand Rapids was found to exhibit a reduced clottability. Additionally, affected individuals appeared to have plasma fibrinogen concentrations which were about one-third the normal value.
Rheo-Optical Shape Analysis of Human Blood Platelets
Authors: Affolter Hubert , Pletscher Alfred
Published: July 2018

Alterations in rheo-optical signals obtained from suspensions of human blood platelets treated in various ways (drugs, storage in the cold, stirring, etc.) were monitored. A self-normalizing instrument measuring scattered light and relative amplitude of rapid oscillation of light intensity (noise level) at different angles was used. The following results have been obtained: 1. The light scattered at an angle of 40° was decreased with considerable selectivity by pseudopod formation, if aggregation was inhibited. 2. The noise levels at 0° and 40° were selectively diminished by the transition from the discoid to the spheroid shape of the platelets. 3. At 40°, but not at 0°, the noise level responded without delay and was not influenced by aggregate formation. Using this method alterations in platelet form, i.e. spheroid transformation and pseudopod formation, can be specifically and continuously monitored. In addition, the noise level at 40° is a definite quantitative measure of the discoid state. This allows the determination of platelet activation without manipulations such as changes in stirring rates or addition of drugs.
The Effect of Oral Contraceptives on Coagulation and Fibrinolytic Parameters in the Chinese – A Prospective Study
Authors: Wong Vivian , Chan T K , Chan Vivian , Tso S C , Todd D , Ma H K
Published: July 2018

Thirty-two Chinese and 7 Caucasians were studied prospectively for 12 months for the effects of oral contraceptives (OC) on certain coagulation and fibrinolytic parameters. In both ethnic groups there was an increase in α1 antitrypsin level. There was no significant change in antithrombin III concentration measured either by radioimmunoassay (At-III-RIA) or chromogenic assay (anti Xa-chromogenic) in the Chinese, but a significant decrease in anti Xa-chromogenic at 7 months and At-III-RIA at 12 months in the Caucasians. Also, α2 plasmin inhibitor (α2PI) levels were unchanged in the Chinese but a significant increase occurred in the Caucasians at 12 months. Enhanced fibrinolytic response to venous occlusion was demonstrated in the Chinese at 12 months but not in the Caucasians.
Common Units for Clotting Factors Assayed Against Different Standards
Authors: North W R S , Stirling Y , Meade T W
Published: July 2018

There are no generally accepted units for clotting factors except factor VIII. Results are usually expressed as percentages of the standards used in the assays and standards vary in their potency. Over a six year period, factors V, VII and VIII were measured in over 3000 participants in the Northwick Park Heart Study. Six different standards had to be used. For comparative purposes, all results were expressed in terms of the first standard (71/11). This paper describes how appropriate conversion values were derived. Three different methods were compared. One consisted of the assay of each standard against its replacement. Another was based on the use of a reference plasma spanning the use of two successive standards. The third was a population-based, or epidemiological method using the data from all the participants in the study. This method is based on the assumption that results would be the same in comparable groups of study participants. In order to ensure comparability, personal characteristics which affect clotting factor levels, such as age and degree of obesity, were taken into account. The three methods gave similar results but the population method was, in general, the most satisfactory for factor VIII as well as factors V and VII, and has been adopted for routine use.
Alteration of Platelet Aggregation by Cigarette Smoke and Carbon Monoxide
Authors: Mansouri Ali , Perry Carol A
Published: July 2018

Platelet aggregation with epinephrine, adenosine diphosphate and arachidonic acid was studied in the presence of cigarette smoke and carbon monoxide. It is shown that cigarette smoke inhibits the arachidonic acid induced platelet aggregation as well as the second phase of epinephrine induced aggregation. The adenosine diphosphate induced platelet aggregation is not significantly affected by cigarette smoke. Carbon monoxide causes similar alterations in platelet aggregation. These results suggest that cigarette smoke inhibits platelet aggregation. This aggregation inhibition is due to the presence of carbon monoxide.
The Effect of a Medicinal Chinese Herb on Platelet Function
Authors: Wang Z , Roberts J M , Grant P G , Colman R W , Schreiber A D
Published: July 2018

We investigated the effect of the Chinese herb Injectio Salvia Miltiorrhizae (ISM) on human platelet function in vitro. ISM inhibited platelet aggregation and serotonin release induced by either ADP or epinephrine in a dose dependent manner. This effect of ISM was observed with both gel-filtered platelets (ID50 = 8–30 μg ISM/ml gel-filtered platelets) and platelets in plasma (ID50 = 400–900 μg ISM/ml of platelet-rich plasma). The active molecule(s) in ISM was heat stable, resistant to acid, base and proteolysis and fractionated on Sephadex 6-25 at MW ~ 280. ISM did not interact with the platelet α-adrenergic receptor, but increased cAMP in intact platelets. The results are consistent with the concept that ISM inhibition of platelet aggregation and release is mediated by an increase in platelet cAMP. The exact mechanism whereby ISM increases platelet cAMP appears to be that of inhibition of cyclic AMP phosphodiesterase. The effect of ISM on platelet function is one mechanism which might explain the therapeutic effect of ISM in experimental and clinical coronary artery disease.
Pharmacokinetics and Effects on Fibrinolytic and Coagulation Parameters of Two Doses of Recombinant Tissue-Type Plasminogen Activator in Healthy Volunteers
Authors: Verstraete M , Su C A P F , Tanswell P , Feuerer W , Collen D
Published: July 2018

Pharmacokinetics and pharmacological effects of two intravenous doses of recombinant tissue-type plasminogen activator (rt-PA) (40 and 60 mg over 90 min) were determined in healthy volunteers. Mean maximum plasma concentrations were 1080 and 1560 ng/ml respectively. The steady state level during subsequent maintenance infusion of 30 mg over 6 h was 250 ng/ml. The pharmacokinetics of rt-PA showed a bi-exponential disappearance from plasma consistent with a 2-compartment model of t½α = 5.7 min, a t½β = 1.3 h and a total clearance of 380 ml/min.

Mean fibrinogen levels at the end of the infusions of 40 mg or 60 mg rt-PA over 90 min, measured in thawed plasma samples collected on citrate/aprotinin, decreased to 74% and 57% of the preinfusion values respectively. Plasminogen fell to 55% and 48%, and α2-antiplasmin to 28% and 18% of initial values. No further decrease of these parameters was observed during the infusion of 30 mg rt-PA over 6 h. Only 2% of the preinfusion fibrinogen levels could be recovered as fibrinogen-fibrin degradation products. This moderate extent of systemic fibrinogenolysis is much less than that reported for therapeutic i.v. infusions of streptokinase.
Effect of Indomethacin and Dazoxiben on Intravascular Platelet Aggregation in the Anaesthetized Rabbit
Authors: Honey A C , Lad N , Tuffin D P
Published: July 2018

Collagen (10-40 μg kg−1), thrombin (1-10 units kg−1), adenosine diphosphate (ADP; 3-300 pμ kg−1), 1-0-hexadecyl Paf-acether and 1-0-octadecyl Paf-acether (1-300 ng kg−1) administered by bolus intravenous injection each caused dose-dependent thrombocytopoenia accompanied by marked hypotension in anaesthetized rabbits. Responses to ADP and the Paf-acether derivatives were transient in nature (3-8 min) whereas those induced by collagen and thrombin were always of longer duration (5-20 min) and frequently fatal at high doses. Responses to collagen, thrombin, and the Paf-acether derivatives were invariably accompanied by substantial, dose-related increases in plasma levels of thromboxane B2 in samples obtained 30 s after agonist administration, whereas following ADP, no change in plasma thromboxane B2 was detected at any dose level. Indomethacin (3.0 mg kg−1 by infusion) had no effect on responses to thrombin or Paf-acether, partially inhibited collagen-induced thrombocytopenia, and potentiated responses to ADP. In contrast, dazoxiben (10 mg kg−1 by infusion) partially but significantly inhibited responses to thrombin, whereas those induced by collagen, Paf-acether or ADP were unchanged. These results indicate that in this model of intravascular aggregation, whilst platelet responses to collagen and thrombin appear partially dependent on intact cyclic endoperoxide and thromboxane A2 synthetic capacity respectively, responses to ADP and Paf-acether are independent of arachidonate metabolism via cyclo-oxygenase despite measurably increased TXB2 formation in the latter case.
Early Life Epilepsy and Episodic Apnea Revealing an ATP1A3 Mutation: Report of a Pediatric Case and Literature Review
Authors: Benrhouma Hanene , Klaa Hedia , Rouissi Aida , Chaabouni Myriam , Kraoua Ichraf , Youssef-Turki Ilhem , Younes Thouraya
Published: July 2018

ATP1A3 mutations have now been recognized in infants, children, and adults presenting with a diverse group of neurological phenotypes, including rapid-onset dystonia-parkinsonism, alternating hemiplegia of childhood, and most recently, cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss syndrome. The phenotypic spectrum of ATP1A3-related neurological disorders continues to expand. In this case study, we report on early life epilepsy with episodic apnea potentially secondary to ATP1A3 mutation in a Tunisian child.
Einflussfaktoren auf die Rückkehr zur Arbeit bei chronischen Rückenschmerzen
Authors: Allgeier Linda , Bengel Jürgen
Published: July 2018

Theorie Die Mehrzahl der Menschen erlebt mind. eine Rückenschmerzepisode in ihrem Leben. Patienten mit chronischen Schmerzen verursachen durch Arbeitsunfähigkeit und Inanspruchnahme von Gesundheitsdienstleistungen hohe Kosten. Die Rückkehr an den Arbeitsplatz stellt daher ein zentrales Rehabilitationsziel dar.

Methode Die Literaturrecherche erfolgte in den Datenbanken PSYNDEX, PsycINFO, MEDLINE und ScienceDirect und ergab 27 Artikel.

Ergebnisse Die untersuchten Einflussfaktoren ließen sich in 3 Gruppen einteilen: (1) psychische und psychosoziale, (2) arbeits- und arbeitsplatzbezogene und (3) (gesundheits-)systembezogene Einflussfaktoren. Geringe Genesungserwartungen, Rezidivangst, Fear-avoidance-beliefs und ein Mangel an sozialer Unterstützung am Arbeitsplatz stellen Hindernisse für Return to work dar. Hohe Selbstwirksamkeitserwartungen, Anpassungen des Arbeitsplatzes an die Bedürfnisse des Patienten, sowie Informationen durch Gesundheitsdienstleister wirken sich positiv aus.
Überblick über aktuelle Erkenntnisse berufsbedingter muskuloskeletaler Beschwerden am Bildschirmarbeitsplatz hinsichtlich der Anwendung des Oberflächen-EMGs zur Beanspruchungsmessung
Authors: Nisser Maria , Derlien Steffen , Best Norman
Published: July 2018

Fragestellung Muskuloskeletale Erkrankungen zählen zu den häufigsten berufsbedingten Erkrankungen. Mittels Oberflächen-Elektromyografie (OEMG) lässt sich der muskuläre Beanspruchungsgrad messen, der die beruflichen Tätigkeiten am Bildschirmarbeitsplatz widerspiegelt. In Untersuchungen konnte eine Korrelation zwischen statischer Haltung mit wiederkehrend gleichen Bewegungen und berufsbedingten muskuloskeletalen Erkrankungen nachgewiesen werden. Vor diesem Hintergrund stellt sich die Frage, ob das OEMG hinreichende Daten zur Analyse körperlicher Beanspruchung am Bildschirmarbeitsplatz liefert.

Material und Methoden Eine systematische Literaturrecherche zu Electromyografy AND Work-Related Disorders innerhalb der Datenbank Web of Science Core Collection wurde durchgeführt.

Ergebnisse Von 124 Abstracts wurden 19 in die Volltextanalyse einbezogen.

Diskussion Die OEMG ist eine effektive Methode muskuläre Beanspruchungen zu erfassen, jedoch fehlen einheitliche Datenpools, um eine Klassifikation der Daten vorzunehmen.

Schlussfolgerung Einheitliche Studiendesigns sind zwingend notwendig, um gesundheitsförderliche Ableitungen treffen zu können.
Physiotherapie bei Chemotherapie-assoziierter peripherer Neuropathie in der pädiatrischen Onkologie – Eine Literaturrecherche
Authors: Jung M. , Rein N. , Fuchs B.
Published: July 2018

Hintergrund Die Chemotherapie-induzierte periphere Neuropathie (CIPN) ist eine häufige Nebenwirkung von Medikamenten, die zur Behandlung von Krebs eingesetzt werden. Betroffene können unter motorischen, sensorischen und autonomen Nervenschäden leiden. Zur Behandlung der CIPN werden häufig weitere Medikamente verabreicht, die wiederum Nebenwirkungen hervorrufen können. Den Patienten können aber ebenso physiotherapeutische Behandlungen zuteilwerden, um die Symptome zu lindern.

Ziel Das Ziel dieser Arbeit ist es, eine Übersicht über vorhandene Literatur, die sich mit Physiotherapie bei CIPN in der pädiatrischen Onkologie beschäftigt, zu geben.

Methodik Es wurde eine systematische Literaturrecherche in den Datenbanken CINAHL, The Cochrane Library, ERIC, MEDPILOT, PEDro, PsycARTICLES, PsycINFO, PubMed und DIMDI durchgeführt. Weiterhin wird die methodische Qualität der identifizierten Literatur überprüft.

Ergebnis Geeignete Publikationen aus dem Bereich pädiatrische Onkologie wurden nicht gefunden. Allerdings konnten mehrere Publikationen im Bereich Erwachsener identifiziert werden, von denen ein möglicher Transfer auf Kindern hergestellt wurde.

Schlussfolgerung Die Akupunktur erwies sich als effektive Behandlungsmethode zur Schmerzreduktion bei Erwachsenen mit CIPN. Auch Sensomotorisches Training, Balancetraining, Elektrotherapie und alternative Therapieverfahren wie Reiki und Yoga konnten die Symptome der Teilnehmer reduzieren. In dieser Arbeit wird ein Ausblick darauf gegeben, wie CIPN auch bei Kindern mit diesen Maßnahmen erfolgreich behandelt werden könnte. Wirksamkeitsstudien zu diesen Interventionen an Kindern stehen noch aus.
Overview Tumour Disease and Oncologic Therapy During Pregnancy
Authors: Findeklee Sebastian
Published: July 2018

Newly diagnosed cancer in pregnancy is an issue with increasing importance, because fulfilling the wish to have a child is shifted later in life. Tumour disease is diagnosed in around 0.1% of all pregnancies in Germany. Most common tumour entities involve the breast, the cervix and the hematopoietic system. As tumour prognosis is not negatively affected by pregnancy and gestation does not disclude oncologic therapy it is important to plan treatment immediately. Oncologic surgery preserving the uterus is not at all limited. Chemotherapy with anthracyclines, taxanes or platinum derivates is possible from the second trimenon on. Only radiotherapy should be avoided during pregnancy. Before initiating therapy, fertility preserving methods like cryopreservation of oocytes and/or ovarian tissue should be offered to the patient. Preterm birth is more common in women with a first diagnosis of cancer during pregnancy. Other negative effects on the child’s future are not yet known. Treatment of pregnant cancer patients should be handled by experienced centres with a multi-professional team.
CTG-Analyse und Sectiorate – Ergebnisse einer deutschlandweiten Umfrage
Authors: Schiermeier Sven , Frisenda Sandra , Reinhard Joscha , Dagres Timoleon , Noé Karl-Günter , Lobmaier Silvia , Schneider Karl , Daumer Martin
Published: July 2018

Einleitung Die Rate der Sectiones in Deutschland ist in den letzten Jahrzehnten stark angestiegen. Bei der Entscheidung für oder gegen eine Sectio sollen Mikroblutuntersuchungen und computerunterstützte Kardiotokografien helfen.Im Wesentlichen befasst sich diese Studie mit der Frage, wie diese Untersuchungen die Sectiorate möglicherweise beeinflussen.

Methodik Um diese Fragestellung zu untersuchen, stand ein Datensatz über Krankenhäuser in Deutschland zur Verfügung, der durch Crowd Sourcing Fragebogen erhoben wurde. Alle Variablen wurden kategorisiert erhoben. Anhand dieses Datensatzes wurden Zusammenhangsmaße berechnet. Die Zusammenhänge wurden zusätzlich durch Mosaikplots visuell untersucht.

Ergebnisse 97 Fragebogen konnten analysiert werden. Im Datensatz ließen sich deutliche Zusammenhänge zwischen Variablen erkennen. Insbesondere hatten Krankenhäuser, die leitliniengerecht eine fetale Herzfrequenz im Bereich 110–160 bpm als ungefährlich einstuften, im Datensatz eine geringere Sectiorate. Auch Krankenhäuser, die leitliniengerecht die Kardiotokografie nach dem Auswertungsschema des FIGO durchführten, hatten im Datensatz eine vergleichsweise geringere Sectiorate.

Schlussfolgerung Computerunterstützte Analysen der fetalen Herzfrequenz auf Grundlage der FIGO-Richtlinien korrelieren mit einer niedrigeren Sectiorate. Die Durchführung und Weiterentwicklung der computergestützten CTG-Analyse sollte fortgesetzt werden.
Delineating the role of cooperativity in the design of potent PROTACs for BTK
Authors: Zorba Adelajda , Nguyen Chuong , Xu Yingrong , Starr Jeremy , Borzilleri Kris , Smith James , Zhu Hongyao , Farley Kathleen A. , Ding WeiDong , Schiemer James , Feng Xidong , Chang Jeanne S. , Uccello Daniel P. , Young Jennifer A. , Garcia-Irrizary Carmen N. , Czabaniuk Lara , Schuff Brandon , Oliver Robert , Montgomery Justin , Hayward Matthew M. , Coe Jotham , Chen Jinshan , Niosi Mark , Luthra Suman , Shah Jaymin C. , El-Kattan Ayman , Qiu Xiayang , West Graham M. , Noe Mark C. , Shanmugasundaram Veerabahu , Gilbert Adam M. , Brown Matthew F. , Calabrese Matthew F.
Published: July 2018

Significance

Proteolysis targeting chimera (PROTAC)-based protein degradation is an emerging field that holds significant promise for targeting the “undruggable” proteome: the vast majority of the proteins that do not exhibit enzymatic activity and are thereby not amenable to classical inhibition. Despite significant progress, a thorough mechanistic characterization of biochemical determinants that underpin efficient PROTAC activity is lacking. Here we address one such question: Is positive cooperativity necessary for potent protein degradation? Through a collection of independent techniques, we show that within a Bruton’s tyrosine kinase/cereblon PROTAC system, potent knockdown correlates with alleviation of steric clashes in the absence of thermodynamic cooperativity. This result broadens the scope of PROTAC applications and affects fundamental design criteria across the field.
Billy's Drum: Feet and Rhythm in Sesame Therapeutic Practice
Authors: Butler Catherine
Published: July 2018

Billy Lindkvist's demonstration at a Sesame Seasonal School of foot and rhythm work for connection, sense of self, and grounding, was an inspiration for me to train as a Sesame practitioner. In this paper, I will explore the origins of this work in Billy's experience and how she developed it, how it has continued in Sesame training, and lastly show how I have used this associated aspect of a basic strand of the Sesame Approach, Movement with Touch and Sound, from RCSSD placements through to current client work, describing its application and adaptation for different client groups including people with dementia, ASD, Parkinson's, and physical and learning difficulties.
Measuring 30 years of improvements to aquatic connectivity in the Greater Toronto Area
Authors: Choy M. , Lawrie D. , Edge C. B.
Published: July 2018

Instream barriers (e.g. dams, weirs and road crossings) fragment aquatic habitat and prevent the upstream movement of fish, impairing the ability of fishes to complete critical life stages, access critical habitat and for dispersal among local populations. Mitigation efforts have improved aquatic connectivity to some degree, but it has been challenging to quantify the overall improvement in connectivity without long-term and costly field assessments. The development of spatially explicit habitat connectivity indices make it possible to evaluate current stream connectivity, and quantify the improvement prior mitigation projects have had on connectivity. We combined a list of instream barrier mitigation projects completed in five watersheds in the Toronto (Ontario, Canada) area from 1987–2016 (mitigated barriers) and a previously established inventory of all known instream barriers in 2016 (current barriers). The cumulative improvement to connectivity was measured for potadromous (remain in tributaries) and diadromous (move between tributaries and lake) fish species using the dendritic connectivity index. Aquatic connectivity improved for diadromous species between 0 and 14.5% and for potadromous species between 0.1 and 4.4% in the five studied watersheds. Some variation in improvement among the watersheds can likely be attributed to differences in mitigation strategies among the watersheds and a historical emphasis on mitigating instream barriers to benefit migratory salmonid species.
Idealization and Galileo’s Proto-Inertial Principle
Authors: Van Dyck Maarten
Published: July 2018

Galileo proposed what has been called a proto-inertial principle, according to which a body in horizontal motion will conserve its motion. This statement is only true in counterfactual circumstances where no impediments are present. This article analyzes how Galileo could have been justified in ascribing definite properties to this idealized motion. This analysis is then used to better understand the relation of Galileo’s proto-inertial principle to the classical inertial principle.
The Dark Galaxy Hypothesis
Authors: Weisberg Michael , Jacquart Melissa , Madore Barry , Seidel Marja
Published: July 2018

Gravitational interactions allowed astronomers to conclude that dark matter rings all luminous galaxies in gigantic halos, but this only accounts for a fraction of the total mass of dark matter believed to exist. Where is the rest? We hypothesize that some of it resides in dark galaxies, pure dark matter halos that either never possessed or have totally lost their baryonic matter. This article explores methodological challenges that arise because of the nature of observation in astrophysics and examines how the blend of observation, simulation, and theory we call the Observing the Invisible approach might make detecting such dark objects possible.
Food and nutrition literacy (FNLIT) and its predictors in primary schoolchildren in Iran
Authors: Doustmohammadian Aazam , Keshavarz Mohammadi Nastaran , Omidvar Nasrin , Amini Maryam , Abdollahi Morteza , Eini-Zinab Hassan , Amirhamidi Zeinab , Esfandiari Saeed , Nutbeam Don
Published: July 2018

This study used a locally designed and validated questionnaire to describe the distribution of food and nutrition literacy (FNLIT) in a cross-sectional sample of 803 students aged 10–12 years from elementary schools in Tehran city, Iran. Logistic regression was used to assess the extent to which various independent covariates were associated with low FNLIT. The data were used to identify significant differences using a range of social and cultural variables relevant to the context of school students in Iran. The results of the study showed that although the total FNLIT level was good, this headline finding masked important differences in the sub-domains. More than half of the children (69%) had high levels of FNLIT in the cognitive domain, but in the skills domain, very few (3%) scored highly. The study also identified some associations between the total FNLIT and its subscales and sociodemographic variables including gender, parent’s education and age, birth order. These results highlighted groups within the school population who were at higher risk of having lower FNLIT levels. They also indicate that girls feel more able to exert choice and control over food and nutrition decisions than boys are but may be less able to do so in practice. Overall, these results are a general reminder to schools of the different learning needs of children from different family backgrounds. The article highlights the need for continuous improvement in the health education curriculum of schools in Iran, particularly highlighting the importance of giving greater attention to the development of practical food and nutrition skills alongside more traditional food and nutrition knowledge. Additional studies (with long-term follow-up) are needed to more fully assess and understand the predictors of FNLIT.
Depression in Children and Adolescents
Authors: Dougherty Lea R. , Klein Daniel N. , Olino Thomas M.
Published: July 2018

Abstract: The diagnoses of the depressive disorders have a moderate degree of clinical utility and construct validity in children and adolescents. This chapter focuses on the assessment of depression in children and adolescents. An assessment strategy should be driven by the available data on the clinical features, associated characteristics, course, and treatment of depression, as well as what is known about the processes involved in the maintenance and recurrence of episodes. This chapter begins with a review of the nature of the disorder, which is followed by a review of clinical assessment instruments designed for the assessment purposes of (a) diagnosis, (b) case conceptualization and treatment planning, and (c) treatment monitoring and evaluation. Recommendations are included for instruments with the greatest scientific support and for assessing depression in a clinically sensitive manner.
Right Retrosigmoid Approach for In Situ Occlusion of Brainstem Arteriovenous Malformation Surrounding the Trigeminal Nerve: 3-Dimensional Operative Video
Authors: Rubio Roberto Rodriguez , Vigo Vera , Bonaventura Rina Di , Abla Adib A
Published: July 2018

Arteriovenous malformations (AVMs) of the trigeminal root entry zone are rare and can be associated with neurovascular compression syndromes as well as intracranial hemorrhage.
1
They generally have a small nidus located on and around the pial surface of the brainstem; thus, they are feasible for surgery. Nevertheless, they represent a challenge given the vicinity and involvement of cranial nerves and brainstem perforators.
2–4

This video demonstrates the case of a 57-yr-old man with new onset of a severe headache without neurological deficit associated with MRI evidence of a vascular malformation around the cisternal right trigeminal nerve. The nerve showed an altered signal on the MRI. Angiography revealed a Spetzler–Martin grade II AVM with a 16-mm nidus supplied by basilar artery perforators, right anterior inferior cerebellar artery, and the superior cerebellar artery (SCA), with drainage into the superior petrosal vein and sigmoid sinus. After an unsuccessful attempted embolization, the patient was referred for and elected microsurgical treatment. With the patient in a lateral position, a right retrosigmoid approach was performed. After cisternal dissection and identification of the nidus, the feeders were occluded by alternating cauterization and clipping to avoid damage to the critical surrounding structures. The AVM in-situ occlusion was carried on without resection, given the involvement of the trigeminal nerve. The intraoperative indocyanine green angiography allowed recognition of the venous drainage and helped to localize and differentiate the feeders from normal perforators. In the immediate postoperative course, the patient suffered from mild numbness with a V2-V3 distribution that progressively improved. Angiography showed no residual AVM.
Photometric investigation of the contact binary GU Orionis with high metallicity
Authors: Zhou Xiao , Qian Shengbang , Boonrucksar Soonthornthum , Poshyachinda Saran , Zhu Li-Ying , Liu Nian-Ping , Sarotsakulchai Thawicharat , Fang Xiao-Hui
Published: July 2018

GU Ori was observed with the 1 m telescope at Yunnan Observatories in 2005. To determine its physical properties, the Wilson–Devinney program was used. The results reveal that GU Ori is a W-subtype shallow contact binary with a more massive but cooler second star. The masses of its two component stars are estimated to be M1 = 0.45 M⊙, M2 = 1.05 M⊙. The O’Connell effect was reported to be negative on the light curves observed in 2005. However, it changed to a positive one on the light curves observed from 2011 to 2012. The mean surface temperatures of star 2 (T2) determined by the two sets of light curves were different, which may result from stellar activity. The O − C diagram shows that the period of GU Ori is decreasing at a rate of dP/dt = −6.24 × 10−8d yr−1, which may be caused by mass transfer from star 2 to star 1 with a rate of ${dM_{2}}/{dt}= - 2.98\times {10^{-8}}\, M_{\odot }$ yr−1. GU Ori is a contact binary with quite high metallicity.
Physical Therapy Services for People With Intellectual and Developmental Disabilities: The Role of Medicaid Home- and Community-Based Service Waivers
Authors: Friedman Carli , Feldner Heather A
Published: July 2018

Background

Care and support for people with intellectual and developmental disabilities (IDD) in natural community contexts are increasing. Many people with IDD use physical therapy services to support their community participation. Medicaid Home- and Community-Based Services (HCBS) 1915(c) waivers are the largest providers of long-term services and supports for people with IDD. However, little is known about physical therapy provision under this program.

Objective

The aim of this study was to compare the operational definitions of physical therapy service under the HCBS 1915(c) waiver system and to describe projected physical therapy service utilization, spending, and reimbursement for people with IDD across states.

Design

This was a cross-sectional, descriptive study.

Methods

This study analyzed fiscal year 2015 HCBS IDD waivers from across the nation (N = 111), focusing on physical therapy utilization (total projected spending, total participants, reimbursement rates, and average annual service provision per participant). Service definitions were also analyzed to determine trends across waivers.

Results

Fifty-one waivers (45.9%) provided 61 different types of physical therapy services in fiscal year 2015. States utilized waivers to provide long-term remedial care rather than the acute short-term physical therapy. HCBS waiver physical therapy services were often provided in participants’ homes and communities to expand physical therapy access and secure the benefits of providing physical therapy services in natural environments. Although most states have adopted similar definitions of physical therapy service, procedures and services vary.

Limitations

Medicaid HCBS waivers are state projections made to the federal government rather than actual utilization data.

Conclusions

Physical therapy service definitions, projected service utilization, spending, and reimbursement for people with IDD who use Medicaid HCBS waivers vary greatly between states. Physical therapy may be utilized less than expected given the reported benefits for people with IDD.
Comparative Analysis of Utilization of Epidural Procedures in Managing Chronic Pain in the Medicare Population
Authors: Manchikanti Laxmaiah , Soin Amol , Mann Dharam P. , Bakshi Sanjay , Pampati Vidyasagar , Hirsch Joshua A.
Published: July 2018

Study Design.

A retrospective cohort study of utilization patterns of epidural injections.

Objective.

The aim of this study was to assess patterns of utilization and variables of in chronic spinal pain in the fee-for-service (FFS) Medicare population, with a comparative analysis of pre- and post-Affordable Care Act (ACA) data from 2000 to 2009 and 2009 to 2016.

Summary of Background Data.

Over the years, utilization of interventional pain management techniques, specifically epidural injections have increased creating concern over costs and public health policy.

Methods.

The master data from the Centers for Medicare & Medicaid Services (CMS) physician/supplier procedure summary from 2000 to 2016 was utilized to assess utilization patterns. The descriptive analysis of the database analysis was performed using guidance from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Multiple variables were analyzed based on the procedures, specialties, and geography.

Results.

Caudal and lumbar interlaminar epidural injections decreased 25% from 2009 to 2016 with an annual decrease of 4% in contrast to lumbosacral transforaminal epidural injection episodes, increasing at an annual rate of 0.3%. In contrast, lumbar interlaminar epidural injections increased 2.4% annually, while transforaminal episodes increased 23% from 2000 to 2009. The ratio of interlaminar epidural injections to transforaminal epidural injection episodes has changed from 7 in 2000 to 1 in 2016, whereas ratio of services changed from 5 to 0.7. From 2009 to 2016, cervical/thoracic interlaminar epidural injections episodes increased at an annual rate of 0.5%, with a decrease of 2.3% for transforaminal epidural injections.

Conclusion.

Comparative analysis of the utilization of epidural injections from 2000 to 2009 and 2009 to 2016 showed vast differences with overall significant decreases in utilization, specifically for lumbar interlaminar and caudal epidural injections, with a continued, though greatly slowed increase of lumbosacral transforaminal epidural injections.

Level of Evidence: 3
Risk Factors for Positive Cultures in Presumed Aseptic Revision Spine Surgery
Authors: Steinhaus Michael E. , Salzmann Stephan N. , Lovecchio Francis , Shifflett Grant D. , Yang Jingyan , Kueper Janina , Sama Andrew A. , Girardi Federico P. , Cammisa Frank P. , Hughes Alexander P.
Published: July 2018

Study Design.

Retrospective case-control study.

Objective.

To report culturing patterns and results in the setting of presumed aseptic revision spinal surgery.

Summary of Background Data.

The indications for obtaining cultures in revision spinal surgery remain unclear in the absence of a definitive diagnosis of infection. Culture results and risk factors for having positive cultures in this setting have not been previously studied.

Methods.

We retrospectively reviewed 595 consecutive revision spine surgeries performed by four senior spine surgeons between 2008 and 2013. Preoperative workup revealed the diagnosis of infection in 17 cases which were excluded from review. The remaining 578 presumed aseptic cases were included. Univariate and multivariate analyses were performed to identify variables associated with obtaining cultures and risk factors for positive cultures.

Results.

Cultures were obtained in 112 (19.4%) cases and were positive in 40.2%. Pseudarthrosis was the most common revision diagnosis when cultures were obtained (49.1%) and Propionibacterium acnes was the most common organism isolated from positive cultures (48.8%). Regarding culture results, multivariate analysis demonstrated that male sex (odds ratio [OR] = 3.4) and pseudarthrosis (OR = 4.1) were significantly associated with having positive cultures while fusion procedures (OR = 0.3) were negatively correlated, with area under the curve (AUC) 0.71.

Conclusion.

Unexpected positive cultures occurred commonly and P. acnes was the predominant isolated organism. Male sex, pseudarthrosis, and non-fusion cases predicted positive cultures. Considering these results, we recommend cultures be obtained in revision cases for pseudarthrosis, even in the setting of negative infectious work-up preoperatively.

Level of Evidence: 4