bluuebunny/crossref_metadata_2025 huggingface dataset:
Can We Train Military Surgeons in a Civilian Trauma Center?
Authors: Uchino H. , Kong V. Y. , Oosthuizen G. V. , Bruce J. L. , Bekker W. , Laing G. L. , Clarke D. L.
Published: July 2017

Introduction

The objective of this study was to review the trauma workload and operative exposure in a major South African trauma center and provide a comparison with contemporary experience from major military conflict.

Materials and methods

All patients admitted to the PMTS following trauma were identified from the HEMR. Basic demographic data including mechanism of injury and body region injured were reviewed. All operative procedures were categorized. The total operative volume was compared with those available from contemporary literature documenting experience from military conflict in Afghanistan. Operative volume was converted to number of cases per year for comparison.

Results

During the 4‐year study period, 11,548 patients were admitted to our trauma center. Eighty‐four percent were male and the mean age was 29 years. There were 4974 cases of penetrating trauma, of which 3820 (77%) were stab wounds (SWs), 1006 (20%) gunshot wounds (GSWs) and the remaining 148 (3%) were animal injuries. There were 6574 cases of blunt trauma. The mechanism of injuries was as follows: assaults 2956, road traffic accidents 2674, falls 664, hangings 67, animal injuries 42, sports injury 29 and other injuries 142. A total of 4207 operations were performed. The volumes per year were equivalent to those reported from the military surgical literature.

Conclusion

South Africa has sufficient burden of trauma to train combat surgeons. Each index case as identified from the military surgery literature has a sufficient volume in our center. Based on our work load, a 6‐month rotation should be sufficient to provide exposure to almost all the major traumatic conditions likely to be encountered on the modern battlefield.
Risk Factors for Early Postoperative Small Bowel Obstruction After Anterior Resection for Rectal Cancer
Authors: Suwa Katsuhito , Ushigome Takuro , Ohtsu Masamichi , Narihiro Satoshi , Ryu Shunjin , Shimoyama Yuya , Okamoto Tomoyoshi , Yanaga Katsuhiko
Published: July 2017

Purpose

The aim of the study was to evaluate risk factors for small bowel obstruction (SBO) in early postoperative period after anterior resection for rectal cancer.

Methods

Patients who underwent anterior resection (AR) [high AR (HAR) or low AR (LAR)] for rectal cancer between January 2009 and April 2016 were enrolled into the study after fulfilling selection criteria. In included patients, risk factors for early postoperative SBO (EPSBO) were analyzed by means of univariate and multivariate analysis. Cases with perioperative major complications other than intestinal obstruction and with simultaneous resection of other organs were excluded. The same analyses were also performed for cases of redo surgery due to EPSBO. EPSBO was defined as clinically and radiologically confirmed SBO that developed after resuming oral intake within 30 days following surgery. The logistic regression method was used for statistical analyses.

Results

In enrolled 180 patients, EPSBO occurred in 23 (12.8%). In univariate analysis, male sex [odds ratio (OR) = 2.17, 95% CI = 0.82–6.84, p < 0.0001], previous abdominal surgery (OR = 0.20, 95% CI = 0.03–0.73, p = 0.0117), low tumor (OR = 3.26, 95% CI = 1.28–8.13, p = 0.0140), LAR (OR = 17.25, 95% CI = 3.49–312.55, p < 0.0001), D3 node dissection (OR = 13.61, 95% CI = 2.75–246.69, p = 0.0002), defunctioning ileostomy (DI) formation (OR = 9.88, 95% = 3.80–29.14, p < 0.0001), and prolonged operation time (OR = 1.01, 95% CI = 1.00–1.01, p = 0.0122) were significantly related to EPSBO. Multivariate analysis demonstrated that D3 node dissection (OR = 10.93, 95% CI = 1.94–208.23, p = 0.0038) and DI formation (OR = 5.82, 95% CI = 1.55–25.31, p = 0.0083) were independent risk factors for EPSBO. Four cases (17.4%) with EPSBO required re‐operation because conservative therapies failed; all were laparoscopic DI formation cases. In three of those four cases, stenosis of stoma at the level of the posterior sheath of rectus abdominis muscle was the reason of SBO, and in one case it was kinking of the stomal limb.

Conclusions

D3 lymph node dissection and DI formation are independent risk factors for EPSBO in AR.
Intracorporeal Traction of the Rectum with a Beaded Plastic Urinary Drainage Bag Hanger: Comparison with Conventional Laparoscopic Rectal Cancer Surgery
Authors: Lim Sang Woo , Kim Hyeong Rok , Kim Young Jin
Published: July 2017

Background

Laparoscopic rectal cancer surgery with proper total mesorectal excision is a challenge for colorectal surgeons during trouble shooting. We used a beaded plastic urinary drainage bag hanger to encircle the rectum and clamp laparoscopic rectal transaction in this study.

Methods

Sixty‐three patients with rectal cancer underwent laparoscopic radical rectal resection with curative intent between February 2015 and December 2015. Plastic beaded form urinary Foley catheter bag hanger was inserted intracorporeally via right lower 12‐mm trocar, encircling the rectal tube distal to the rectal lesion followed by fastening. Thirty patients in the rectal resection group (28 laparoscopic, 2 robotic‐assisted) using the commercial beaded plastic hanger for Foley catheter drainage were compared to 33 patients who underwent conventional laparoscopic rectal resection.

Results

Low anterior resection was performed for both groups. The Foley bag hanger group had less operation time (162.6 min vs. 187.3 min, p = 0.006) and fewer numbers of stapler cartilage (1.6 vs. 2.1, p = 0.001).

Conclusions

Intracorporeal ligation of the rectum with a beaded plastic Foley catheter bag hanger could be used as a valuable method for rectal handling and transaction in laparoscopic rectal cancer surgery.
Therapeutic Effects of Topical Tranexamic Acid in Comparison with Hydroquinone in Treatment of Women with Melasma
Authors: Atefi Najmolsadat , Dalvand Behzad , Ghassemi Mahammadreza , Mehran Golnaz , Heydarian Amir
Published: July 2017

Introduction

Few studies have focused on therapeutic as well as side effects of tranexamic acid (TXA) as a topical drug compared to other topical drugs in treating melasma. The present study aimed to assess and compare the beneficial therapeutic effects and also side effects of local TXA in comparison with hydroquinone in treating women with melasma.

Methods

This randomized double-blinded clinical trial was performed on 60 women who suffered from melasma and were referred to the skin disorders clinic at the Rasoul-e-Akram hospital in Tehran in 2015. The patients were then randomly assigned via computerized randomization to two groups: group A received TXA%5 (topically twice a day for 12 weeks in the location of the melasma) and group B (received hydroquinone 2% with the same treatment order). Prior to intervention and at 12 weeks after intervention, the intensity and extension of melasma were assessed based on the Melasma Area and Severity Index (MASI) scoring method.

Results

The mean MASI score in both treatment groups decreased considerably after completion of treatment and was not significant between the two groups. No side effects were detected in group A, but 10% of those in group B complained of drug-related side effects including erythema and skin irritation (p = 0.131). Regarding the level of patient satisfaction, the patients in group A had a significantly higher level of satisfaction level of 33.3% compared with 6.7% in group B (p = 0.015) (Fig. 9). Multivariate linear regression modeling with the presence of age, history of systemic disorder, drug history, and family history of melasma demonstrated no difference in the mean MASI between the two groups.

Conclusion

Topical use of TXA significantly reduced both melanin level and MASI score. Given its high efficiency and low drug side effects, this regimen results in high patient satisfaction compared with topical hydroquinone. IRCT code: IRCT2016040627220N2.
Prevalence and characteristics of chronic pain: Experience of Niger
Authors: Assadeck Hamid , Daouda Moussa Toudou , Djibo Fatimata Hassane , Maiga Djibo Douma , Omar Eric Adehossi
Published: July 2017

Introduction

Chronic pain is a major health problem, considered as a disease in its own right. The prevalence of chronic pain is estimated to be between 2% and 40% in adult populations. In Niger, there are no data on chronic pain.

Aims

This study was designed to provide the demographic, clinical and etiological profile of chronic pain in patients from Niger in order to create a database on chronic pain in Niger.

Patients and methods

Our study is prospectively conducted at the department of external consultation of the Hôpital National de Niamey over a period of 10 months from 31 May 2016 to 30 January 2017 collecting all cases of chronic pain. The demographic, clinical and etiological characteristics of all patients were collected and analyzed.

Results

During the period of the study, 1927 patients consulted at the department of external consultation of the Hôpital National de Niamey, among which 411 patients had chronic pain (21.33% [95% CI: 19.53% and 23.13%]). The average age was 48.28 years (±12.84) with 51.6% of patients aged over 50 years. The male sex was predominant (61.8%). The most common sites of chronic pain were legs (25.5%), back (14.4%), neck (13.6%), knees (13.4%) and feet (13.1%). Osteoarthritis was the most common cause of chronic pain (35.5%), followed by herniated disc (22.2%), spondylodiscitis (14.6%) and migraine (4.1%). Significantly patients aged 50-59 years suffered from neck and legs pain (p value < 0.001). Significantly chronic headaches and rheumatoid arthritis were more common in women while osteoarthritis, herniated disc and spondylodiscite were more common in men (p value = 0.001). Significantly osteoarthritis and herniated disc were more common in patients older than 40 years (p value < 0.001).

Conclusion

Our study provides demographic, clinical and etiological data of chronic pain in patients from Niger, and shows that chronic pain is a common reason for consultation in Niger concerning 1 in 5 patients with a high prevalence among men and patients aged over 40 years.
Prolonged Coagulopathy, Ecchymoses, and Microangiopathic Hemolytic Anemia Following Hump-Nosed Pit Viper (Hypnale hypnale) Bite in Sri Lanka
Authors: Namal Rathnayaka Rathnayaka Mudiyanselage M.K. , Kularatne Senanayake A.M. , Ranathunga Anusha Nishanthi , Kumarasinghe Mahinda , Rajapakse Jayantha , Ranasinghe Shirani
Published: July 2017

A 74-year-old previously healthy woman was bitten by a hump-nosed pit viper ( Hypnale hypnale) at dusk causing incoagulable blood lasting for 6 days. Further, she developed ecchymoses over her forearms, upper arms, hands, and lower back on day 4 after the snakebite, and microangiopathic hemolytic anemia (MAHA). Features of this nature are rare after hump-nosed pit viper bite.
A History of the African American Novel
Authors: Babb Valerie
Published: July 2017

A History of the African American Novel offers an in-depth overview of the development of the novel and its major genres. In the first part of this book, Valerie Babb examines the evolution of the novel from the 1850s to the present, showing how the concept of black identity has transformed along with the art form. The second part of this History explores the prominent genres of African American novels, such as neoslave narratives, detective fiction, and speculative fiction, and considers how each one reflects changing understandings of blackness. This book builds on other literary histories by including early black print culture, African American graphic novels, pulp fiction, and the history of adaptation of black novels to film. By placing novels in conversation with other documents - early black newspapers and magazines, film, and authorial correspondence - A History of the African American Novel brings many voices to the table to broaden interpretations of the novel's development.
Life beyond Grades
Authors: Covington Martin V. , Hoene Linda M. von , Voge Dominic J.
Published: July 2017

This book raises the question of whether or not educators can promote intrinsic motivation among college students when they seem overwhelmingly focused on grades. Indeed, can there be life beyond grades? The answer is 'Yes'. A love of learning can coexist, even thrive, in the face of competing pressures from grades. Drawing on recent, ground-breaking classroom research, the authors articulate a new understanding of the causes of the stalemate between intrinsic and external motivation, so that a reconciliation between them can be achieved. Then the authors apply a powerful set of motivational and pedagogical principles to lay out a step-by-step blueprint for designing and teaching college courses that promote intrinsic motivation as a primary educational goal in its own right, above and beyond knowledge and skill acquisition. This practical blueprint draws on authentic case study examples from a variety of subject-matter disciplines.
Teaching diagnostic reasoning: using simulation and mixed practice to build competence
Authors: Murray Heather , Savage Tyson , Rang Louise , Messenger David
Published: July 2017

The acquisition of competence in diagnostic reasoning is essential for medical trainees. Exposure to a variety of patient presentations helps develop the skills of diagnostic reasoning, but reliance on ad hoc clinical encounters is inefficient and does not guarantee timely exposure for all trainees. We present a novel teaching series led by emergency physicians that builds upon the existing medical education literature to teach diagnostic reasoning to preclinical (2nd year) medical students. The series used emergency department simulations involving patient actors and simulated vital signs to provide students with exposure to three acute care presentations: chest pain, abdominal pain, and headache. Emergency physicians coached and provided immediate feedback to the students as they actively worked through diagnostic reasoning. The participating medical students reported benefit from these sessions immediately following the sessions and in an 18-month follow-up survey where the students could consider the impact of the sessions on their clinical clerkship. Students felt that the sessions had assisted them in recognizing the key features of relevant diagnoses during clerkship as well as providing a helpful adjunct to their in-class learning.
Rank monotonicity in centrality measures
Authors: BOLDI PAOLO , LUONGO ALESSANDRO , VIGNA SEBASTIANO
Published: July 2017

A measure of centrality isrank monotoneif after adding an arcx→y, all nodes with a score smaller than (or equal to)yhave still a score smaller than (or equal to)y. If, in particular, all nodes with a score smaller than or equal toyget a score smaller thany(i.e., all ties withyare broken in favor ofy), the measure is calledstrictly rank monotone. We prove that harmonic centrality is strictly rank monotone, whereas closeness is just rank monotone on strongly connected graphs, and that some other measures, including betweenness, are not rank monotone at all (sometimes not even on strongly connected graphs). Among spectral measures,dampedscores such as Katz's index and PageRank are strictly rank monotone on all graphs, whereas the dominant eigenvector is strictly monotone on strongly connected graphs only.
Holocene environmental change inferred from multiple proxies in the mouth of Gomso Bay on the west coast of South Korea
Authors: Song Bing , Yi Sangheon , Chang Tae-Soo , Kim Jin-Cheul , Mao Limi , Nahm Wook-Hyun , Jia Hongjuan
Published: July 2017

A sediment core (14DH-C01) obtained from the mouth of Gomso Bay, on the west coast of South Korea, was used to obtain high-resolution palynomorph, grain-size, and14C age data to investigate the Holocene sedimentary environment. The results indicated a transgressive depositional process with four stages controlled by sea-level change, as follows: river-dominated fluvial deposition from the early Holocene to 8.48 cal ka BP; tide-dominated tidal channel fill transgression from 8.48 to 8.08 cal ka BP; tide- to wave-dominated tidal channel fill transgression from 8.08 to 6.98 cal ka BP; and wave-dominated marine transgression from 6.98 cal ka BP to the present. Tidal channel filling was the primary mid-Holocene depositional process, accounting for the high sedimentation rate observed. The different hydrodynamics of the river-dominated, tide-dominated, tide- to wave-dominated, and wave-dominated processes following the changes in sea level may have controlled the transgressive depositional process. This transgressive sedimentary model differs from those of other large river mouth areas (e.g., the Changjiang River) since the mid-Holocene, perhaps resulting from the limited sediment supply in the study area.
EDITORIAL FOREWORD
Authors: Khater Akram , Culang Jeffrey
Published: July 2017

It is with deep sorrow that we open this issue with the announcement that IJMES editorial board member Barbara Harlow has passed away. We mourn the unexpected loss of our dear colleague, one of the most brilliant and accomplished scholars in Middle East studies. In addition to her influential work, Barbara was known for her keen mind, generous spirit, and gentle sense of humor, coupled with an unabiding sense of justice. She will be sorely missed by the IJMES and Middle East and North Africa studies families. We encourage you to read Tarek al-Ariss's moving tribute to Barbara published at the end of this issue.
Delocalization of Fieldwork and (Re)Construction of Place: Doing Ethnography in Wartime Yemen
Authors: Brandt Marieke
Published: July 2017

The period I have spent exploring tribal societies in Yemen's northernmost Saʿdah area spans—with interruptions—around fifteen years, and I can hardly imagine a more profound set of changes converging on and in one place. For an anthropologist, these changes are of a political, spatial, technological, and methodological nature, all of which are deeply intertwined.
Researching Hizbullah in Lebanon
Authors: Lob Eric
Published: July 2017

As one of the Middle East's more open countries, Lebanon is fairly congenial to foreign researchers. Classified as “partly free” by Freedom House, it ranks ahead of all the region's countries, except Israel, Tunisia, and Turkey. However, when it comes to researching Hizbullah, this openness and congeniality subsides. While Hizbullah contains political and social branches, it is first and foremost a military and guerilla organization—the self-proclaimed Islamic Resistance in Lebanon (al-Muqawama al-Islamiyya fi Lubnan). Like any military and guerrilla organization—especially one that is subjected to Western terrorist designations and economic sanctions—Hizbullah is innately and justifiably secretive, vigilant, and suspicious of foreigners and outsiders, including academics, scholars, and researchers. Based on my personal experiences researching Hizbullah in Lebanon, these characteristics have ebbed and flowed with its organizational evolution and situational context. At the international, regional, and local levels, the complexities and dynamics of the politics surrounding Hizbullah have shaped my experiences as a researcher in Lebanon and have demonstrated the importance of being aware of these politics and adapting to them. These convoluted and shifting politics have also revealed the inherent merits and challenges of ethnography—a rigorous, informal, and improvisational endeavor and process that necessitates, above all else, flexibility.
THINKING IN FOUR DIMENSIONS: NEW DIRECTIONS IN SPATIAL ANALYSIS OF THE MIDDLE EAST
Authors: El-Kazaz Sarah
Published: July 2017

The study of the Middle East is experiencing an explosion in the dimensions through which scholars study space. The five new books reviewed in this essay stand out for pushing the boundaries of how we conceptualize the production of space and mobilize it as a methodological intervention. Through remarkably sensitive ethnography, creative use of sources, and an array of vibrant theoretical and methodological tools, they expand upon an earlier pioneering literature that centered spatial analysis in the study of the Middle East. In this essay, I focus on three dimensions they have opened up: analyzing space intime; drawingconnectivitiesacross spaces; and reframing theagencyof spatial tactics and the nonhuman.
VIE HÉROÏQUE: IN MEMORY OF BARBARA HARLOW (1948–2017)
Authors: El-Ariss Tarek
Published: July 2017

On 28 January 2017, the field of Middle East studies lost one of its strongest and most vocal advocates—Barbara Harlow. Barbara led a heroic life: writing, resisting, drinking, and smoking, to the end! With the heart of a warrior, she practiced muqāwama at every level and in every possible way. Her power of the “No” confronted structures of power, normativity of all kind, and fluff. She was solid, engaged, wise, and infinitely supportive of her students, colleagues, and causes. She was the first to arrive at every demonstration and the last to leave, making sure that the pro-bono lawyers were ready at police stations to work on releasing those arrested. Barbara was real, genuine, and fun to be around. She loved to hear the latest news—and gossip—from Cairo and Beirut as we sat at her kitchen table, sipping white wine and smoking. She read everything, from mystery novels set in Cairo or London to the most recent study on Arabic literature and culture. Browsing her library one finds graphic novels from the Ghassan Kanafani Foundation that she used to learn Arabic; all of Lacan, Blanchot, Artaud, and Derrida from her poststructuralist days; legal and political theory books dealing with South Africa and Palestine; and complete series of journals such as al-Hadaf and al-Karmel.
The People's Rôle in Allocating Provincial Commands in the Middle Roman Republic
Authors: Day Simon
Published: July 2017

Mommsen — followed more recently by Brennan and Ferrary — proposed that laws were passed in around 228 and in 198 that constitutionally ‘fixed’ Sicily and Sardinia, and later Hispania Citerior and Hispania Ulterior, as praetorianprouinciae. This paper challenges that theory. It first examines the ancient evidence, comprising two ambiguous passages from Livy'sAb Vrbe Condita. It then offers a counter-hypothesis that elucidates the people's rôle in forestalling and/or resolving political disputes over the allocation of provincial commands. It will show that this rôle was crucial for mitigating the harmful effects of élite competition and, in turn, maintaining political stability in Rome.
Spotted Fever Group Rickettsioses (SFGR): weather and incidence in Illinois
Authors: KERINS J. L. , DOREVITCH S. , DWORKIN M. S.
Published: July 2017

The purpose of this study was to identify predictors of increasing incidence of Spotted Fever Group rickettsioses (SFGR) in Illinois, with a specific focus on weather variables. We analysed cases of SFGR reported to the Illinois Department of Public Health from 2004 to 2013. Surveillance definitions changed in 2008 and 2010, but those changes alone did not account for observed spikes in incidence in 2008, 2012 and 2013. A total of 590 cases of SFGR occurred, with the majority in the southernmost portion of the state. Only 3·4% of the reported cases were considered confirmed under the case definition. Increased mean winter temperature (IRR 1·32, CI 1·25–1·40) and increased precipitation (IRR 1·08, CI 1·04–1·11) were each associated with increased incidence of SFGR. Our findings show that weather appears to play a significant role in explaining the increasing annual incidence of SFGR in Illinois.
Pedagogy and State: An Archaeological Inquiry into Classic Maya Educational Practice
Authors: Rossi Franco D.
Published: July 2017

Education is notoriously difficult to identify archaeologically, but crucial for understanding the inner workings of any society. Strikingly, in Mesoamerican archaeology, more seems to be known about the transmission of crafting skills than about practices of statecraft. Elsewhere in the ancient world, much evidence speaks to various social and institutional contexts in which specialized knowledge of histories, literacies, civics, and sciences was generated and taught as vital to state-making projects. Yet these same contexts among the Classic Period Maya (ad 200–900) remain poorly understood and under-theorized. Pulling from comparative research alongside recent work at the site of Xultun, Guatemala, this article explores how educational systems may have worked in Classic-era Maya polities—assessing evidence for educational loci, the different forms that education might assume, and the varied curricula that likely existed across different cities and particular demographics. Through this discussion, I seek to shed some light on the actors, gendered exclusions and diverse arrangements of pedagogy in Maya society, and grant further insight into how specialized bodies of knowledge (transmitted within formal educational institutions) were built into the very fabric of the Classic Maya states of which they were part.
Food advertising on Argentinean television: are ultra-processed foods in the lead?
Authors: Allemandi Lorena , Castronuovo Luciana , Tiscornia M Victoria , Ponce Miguel , Schoj Veronica
Published: July 2017

Objective

To describe the number of processed and ultra-processed food (PUPF) advertisements (ads) targeted to children on Argentinean television (TV), to analyse the advertising techniques used and the nutritional quality of the foods advertised, and to determine the potential exposure of children to unhealthy food advertising in our country.

Design

Five free-to-air channels and the three most popular children’s cable networks were recorded from 07.00 to 22.00 hours for 6 weeks. Ads were classified by target audience, type of product, advertised food categories and advertising strategies used. The NOVA system was used to classify food products according to industrial food processing level. Nutritional quality was analysed using the Pan American Health Organization’s nutrient profile model.

Setting

Buenos Aires, Argentina. Results are considered applicable to most of the country.

Subjects

The study did not involve human subjects.

Results

Of the sample of food ads, PUPF products were more frequently advertised during children’s programmes (98·9 %)v. programmes targeted to the general audience (93·7 %,χ2=45·92,P<0·01). The top five food categories were desserts, dairy products, non-alcoholic sugary beverages, fast-food restaurants, and salty snacks. Special promotions and the appearance of cartoon characters were much more frequent in ads targeting children. Argentinean children are estimated to be exposed to sixty-one ads for unhealthy PUPF products per week.

Conclusions

Our study showed that Argentinean children are exposed to a high number of unhealthy PUPF ads on TV. The Argentinean Government should build on this information to design and implement a comprehensive policy to reduce exposure to unhealthy food marketing that includes TV and other communication channels and places.
Low Doses of Simvastatin Potentiate the Effect of Sodium Alendronate in Inhibiting Bone Resorption and Restore Microstructural and Mechanical Bone Properties in Glucocorticoid-Induced Osteoporosis
Authors: Sequetto Priscila L. , Gonçalves Reggiani V. , Pinto Aloísio S. , Oliveira Maria G. A. , Maldonado Izabel R. S. C. , Oliveira Tânia T. , Novaes Rômulo D.
Published: July 2017

By using an experimental model of dexamethasone-induced osteoporosis we investigated the effects of different therapeutic schemes combining sodium alendronate (SA) and simvastatin on bone mineral and protein composition, microstructural and mechanical remodeling. Wistar rats were randomized into eight groups: G1: non-osteoporotic; G2: osteoporotic; G3, G4, and G5: osteoporotic+SA (0.2, 0.4, and 0.8 mg/kg, respectively); G6, G7, and G8: osteoporotic+SA (0.2, 0.4, and 0.8 mg/kg, respectively)+simvastatin (0.4, 0.6, and 1 mg/kg, respectively). Osteoporosis was induced by dexamethasone (7 mg/kg, i.m.) once a week for 5 weeks. All treatments were administered for 8 weeks. Dexamethasone increased serum levels of alkaline phosphatase, calcium, phosphorus, and urea, especially in non-treated animals, which showed severe osteoporosis. Dexamethasone also induced bone microstructural fragility and reduced mechanical resistance, which were associated with a marked depletion in mineral mass, collagenous and non-collagenous protein levels in cortical and cancellous bone. Although SA has attenuated osteoporosis severity, the effectiveness of drug therapy was enhanced combining alendronate and simvastatin. The restoration in serum parameters, organic and inorganic bone mass, and mechanical behavior showed a dose-dependent effect that was potentially related to the complementary mechanisms by which each drug acts to induce bone anabolism, accelerating tissue repair.
Atomic Force Microscopy Study of the Anti-inflammatory Effects of Triptolide on Rheumatoid Arthritis Fibroblast-like Synoviocytes
Authors: Su Zhanhui , Sun Han , Ao Man , Zhao Chunying
Published: July 2017

High-resolution atomic force microscopy (AFM) was used for the in situ evaluation of the anti-inflammatory effects of triptolide on rheumatoid arthritis (RA) fibroblast-like synoviocytes (FLS) to understand the anti-RA effects of triptolide, based on the morphological and biophysical changes observed in RA-FLS. RA-FLS have been reported to play a primary role in inflammatory bone destruction during the development of RA and thus are regarded as an important target for RA treatment. Triptolide pretreatment significantly inhibited tumor necrosis factor-α-induced expression of the interleukin (IL)-1β, IL-6, and IL-8 genes in MH7A cells. Using AFM, we showed that triptolide-induced morphological damage in MH7A cells by inducing significant ultrastructure changes in the membrane, which were closely related to triptolide-induced apoptosis in MH7A cells. Using force measurements determined with AFM, triptolide was shown to increase the stiffness of MH7A cells. These findings not only revealed the strong anti-inflammatory effects of triptolide on RA-FLS, highlighting triptolide as a potential anti-RA agent, but also revealed the possible use of AFM for studying anti-inflammatory responses in RA-FLS, which we expect to be developed into a potential tool for anti-RA drug studies in RA-FLS.
Die Versorgung von Schwerstverletzten: von der Unfallstelle bis zur Notaufnahme
Authors: Koppenberg Joachim , Button Daniel , Albrecht Roland
Published: July 2017

Zusammenfassung. Zusammenfassung: Schwere Unfälle zählen weiterhin zu den häufigsten Todesursachen bei jungen Erwachsenen. Die Notfallmedizin hat im Bereich der Traumaversorgung in den vergangenen Jahren grosse Fortschritte erzielen können. In diesem Artikel werden die strukturelle Entwicklung der Notfallmedizin in der Schweiz und die medizinischen Behandlungsstrategien bei Schwerstverletzten dargestellt.
Akute Beinschmerzen mit fulminantem Verlauf bei einem 69-Jährigen
Authors: Brönnimann Alain , Piso Rein Jan , Paganoni Reto , Studhalter Michael
Published: July 2017

Zusammenfassung. Zusammenfassung: Wir berichten über einen 69-jährigen Patienten, bei dem eine mikrochirurgische Dekompression und Diskektomie durchgeführt wurde. Im Verlauf entwickelte er stärkste Beinschmerzen ohne Ansprechen auf eine Schmerztherapie. Die durchgeführte Computertomografie zeigte grosse Lufteinschlüsse im retroperitonealen Raum von subdiaphragmal bis ins kleine Becken. Trotz sofortiger und radikaler chirurgischer Sanierung sowie antibiotischer Therapie starb der Patient noch im Operationssaal. Die vielzähligen intraoperativen Biopsien sowie alle Blutkulturen waren postmortem positiv für Clostridium perfringens.
Hole-phonon coupling effect on the band dispersion of organic molecular semiconductors
Authors: Bussolotti F. , Yang J. , Yamaguchi T. , Yonezawa K. , Sato K. , Matsunami M. , Tanaka K. , Nakayama Y. , Ishii H. , Ueno N. , Kera S.
Published: July 2017

The dynamic interaction between the traveling charges and the molecular vibrations is critical for the charge transport in organic semiconductors. However, a direct evidence of the expected impact of the charge-phonon coupling on the band dispersion of organic semiconductors is yet to be provided. Here, we report on the electronic properties of rubrene single crystal as investigated by angle resolved ultraviolet photoelectron spectroscopy. A gap opening and kink-like features in the rubrene electronic band dispersion are observed. In particular, the latter results in a large enhancement of the hole effective mass (> 1.4), well above the limit of the theoretical estimations. The results are consistent with the expected modifications of the band structures in organic semiconductors as introduced by hole-phonon coupling effects and represent an important experimental step toward the understanding of the charge localization phenomena in organic materials.
Efficient increase of ɣ-aminobutyric acid (GABA) content in tomato fruits by targeted mutagenesis
Authors: Nonaka Satoko , Arai Chikako , Takayama Mariko , Matsukura Chiaki , Ezura Hiroshi
Published: July 2017

γ-Aminobutyric acid (GABA) is a non-proteinogenic amino acid that has hypotensive effects. Tomato (Solanum lycopersicum L.) is among the most widely cultivated and consumed vegetables in the world and contains higher levels of GABA than other major crops. Increasing these levels can further enhance the blood pressure-lowering function of tomato fruit. Glutamate decarboxylase (GAD) is a key enzyme in GABA biosynthesis; it has a C-terminal autoinhibitory domain that regulates enzymatic function, and deleting this domain increases GAD activity. The tomato genome has five GAD genes (SlGAD1–5), of which two (SlGAD2 and SlGAD3) are expressed during tomato fruit development. To increase GABA content in tomato, we deleted the autoinhibitory domain of SlGAD2 and SlGAD3 using clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein (Cas)9 technology. Introducing a stop codon immediately before the autoinhibitory domain increased GABA accumulation by 7 to 15 fold while having variable effects on plant and fruit size and yield. This is the first study describing the application of the CRISPR/Cas9 system to increase GABA content in tomato fruits. Our findings provide a basis for the improvement of other types of crop by CRISPR/Cas9-based genetic modification.
Multi-color single-molecule tracking and subtrajectory analysis for quantification of spatiotemporal dynamics and kinetics upon T cell activation
Authors: Ito Yuma , Sakata-Sogawa Kumiko , Tokunaga Makio
Published: July 2017

The dynamic properties of molecules in living cells are attracting increasing interest. We propose a new method, moving subtrajectory analysis using single-molecule tracking, and demonstrate its utility in the spatiotemporal quantification of not only dynamics but also the kinetics of interactions using single-color images. Combining this technique with three-color simultaneous single-molecule imaging, we quantified the dynamics and kinetics of molecules in spatial relation to T cell receptor (TCR) microclusters, which trigger TCR signaling. CD3ε, a component of the TCR/CD3 complex, and CD45, a phosphatase positively and negatively regulating signaling, were each found in two mobility states: faster (associated) and slower (dissociated) states. Dynamics analysis suggests that the microclusters are loosely composed of heterogeneous nanoregions, possibly surrounded by a weak barrier. Kinetics analysis quantified the association and dissociation rates of interactions with the microclusters. The associations of both CD3ε and CD45 were single-step processes. In contrast, their dissociations were each composed of two components, indicating transient and stable associated states. Inside the microclusters, the association was accelerated, and the stable association was increased. Only CD45 showed acceleration of association at the microcluster boundary, suggesting specific affinity on the boundary. Thus, this method is an innovative and versatile tool for spatiotemporal quantification.
The prospect of rising in rank is key to long-term stability in Tibetan macaque society
Authors: Sun Lixing , Xia Dong-Po , Sun Shine , Sheeran Lori K. , Li Jin-Hua
Published: July 2017

One of the most fundamental questions in behavioural biology is why societies can persist for a long period of time. While researchers in animal behaviour have been hindered by a lack of an aggregate measure (such as social mobility) to quantify the dynamics of animal societies, researchers in social sciences have been challenged by the complexity and diversity of human societies. As a result, direct empirical evidence is still lacking for the hypothesized causal relationship between social mobility and social stability. Here we attempt to fill the void by examining a much simpler society in the Tibetan macaque (Macaca thibetana), which we have tracked for 30 consecutive years. By testing two group-level hypotheses based on benefit-cost analysis and social stratification, we show the first quantitative evidence that an annual 2-to-1 stay/change ratio in the hierarchy with a 3-to-1 upward/downward ratio in intragenerational social mobility provides a substantive expected benefit for adult members to stay in the group and wait for their chances to advance. Furthermore, using a Markov transition matrix constructed from empirical data, we demonstrate that the 3-to-1 upward/downward ratio could lead to long-term structural stability in Tibetan macaque society.
A Study of the Dynamic Relation between Physiological Changes and Spontaneous Expressions
Authors: Yang Fenglei , Hu Sijung , Li Baomin , Dwyer Vincent M. , Hassan Harnani , Wei Dong-Qing , Shi Ping
Published: July 2017

Recent progress in Affective Computing (AC) has enabled integration of physiological cues and spontaneous expressions to reveal a subject’s emotional state. Due to the lack of an effective technique for evaluating multimodal correlations, experience and intuition play a main role in present AC studies when fusing affective cues or modalities, resulting in unexpected outcomes. This study seeks to demonstrate a dynamic correlation between two such affective cues, physiological changes and spontaneous expressions, which were obtained by a combination of stereo vision based tracking and imaging photoplethysmography (iPPG), with a designed protocol involving 20 healthy subjects. The two cues obtained were sampled into a Statistical Association Space (SAS) to evaluate their dynamic correlation. It is found that the probability densities in the SAS increase as the peaks in two cues are approached. Also the complex form of the high probability density region in the SAS suggests a nonlinear correlation between two cues. Finally the cumulative distribution on the zero time-difference surface is found to be small (<0.047) demonstrating a lack of simultaneity. These results show that the two cues have a close interrelation, that is both asynchronous and nonlinear, in which a peak of one cue heralds a peak in the other.
Predictions of Backbone Dynamics in Intrinsically Disordered Proteins Using De Novo Fragment-Based Protein Structure Predictions
Authors: Kosciolek Tomasz , Buchan Daniel W. A. , Jones David T.
Published: July 2017

Intrinsically disordaered proteins (IDPs) are a prevalent phenomenon with over 30% of human proteins estimated to have long disordered regions. Computational methods are widely used to study IDPs, however, nearly all treat disorder in a binary fashion, not accounting for the structural heterogeneity present in disordered regions. Here, we present a new de novo method, FRAGFOLD-IDP, which addresses this problem. Using 200 protein structural ensembles derived from NMR, we show that FRAGFOLD-IDP achieves superior results compared to methods which can predict related data (NMR order parameter, or crystallographic B-factor). FRAGFOLD-IDP produces very good predictions for 33.5% of cases and helps to get a better insight into the dynamics of the disordered ensembles. The results also show it is not necessary to predict the correct fold of the protein to reliably predict per-residue fluctuations. It implies that disorder is a local property and it does not depend on the fold. Our results are orthogonal to DynaMine, the only other method significantly better than the naïve prediction. We therefore combine these two using a neural network. FRAGFOLD-IDP enables better insight into backbone dynamics in IDPs and opens exciting possibilities for the design of disordered ensembles, disorder-to-order transitions, or design for protein dynamics.
Integration of miRNA and mRNA expression profiles reveals microRNA-regulated networks during muscle wasting in cardiac cachexia
Authors: Moraes Leonardo N. , Fernandez Geysson J. , Vechetti-Júnior Ivan J. , Freire Paula P. , Souza Rodrigo W. A. , Villacis Rolando A. R. , Rogatto Silvia R. , Reis Patricia P. , Dal-Pai-Silva Maeli , Carvalho Robson F.
Published: July 2017

Cardiac cachexia (CC) is a common complication of heart failure (HF) associated with muscle wasting and poor patient prognosis. Although different mechanisms have been proposed to explain muscle wasting during CC, its pathogenesis is still not understood. Here, we described an integrative analysis between miRNA and mRNA expression profiles of muscle wasting during CC. Global gene expression profiling identified 1,281 genes and 19 miRNAs differentially expressed in muscle wasting during CC. Several of these deregulated genes are known or putative targets of the altered miRNAs, including miR-29a-3p, miR-29b-3p, miR-210-5p, miR-214, and miR-489. Gene ontology analysis on integrative mRNA/miRNA expression profiling data revealed miRNA interactions affecting genes that regulate extra-cellular matrix (ECM) organization, proteasome protein degradation, citric acid cycle and respiratory electron transport. We further identified 11 miRNAs, including miR-29a-3p and miR-29b-3p, which target 21 transcripts encoding the collagen proteins related to ECM organization. Integrative miRNA and mRNA global expression data allowed us to identify miRNA target genes involved in skeletal muscle wasting in CC. Our functional experiments in C2C12 cells confirmed that miR-29b down-regulates collagen genes and contributes to muscle cell atrophy. Collectively, our results suggest that key ECM-associated miRNAs and their target genes may contribute to CC in HF.
Body mass index, waist-to-hip ratio and late outcomes: a report from the Shanghai Breast Cancer Survival Study
Authors: Zhang Minlu , Cai Hui , Bao Pingping , Xu Wanghong , Qin Guoyou , Shu Xiao Ou , Zheng Ying
Published: July 2017

Obesity has been well studied in relation to breast cancer survival. However, the associations of post-diagnosis obesity and late outcomes (≥5 years after diagnosis) have been much less studied. A total of 4062 5-year disease-free patients were recruited from the Shanghai Breast Cancer Survival Study, a longitudinal study of patients diagnosed during 2002-2006. Cox proportional hazard model with restricted cubic spline were used to evaluate the potential non-linear associations of post-diagnosis body mass index (BMI) and waist-to-hip ratio (WHR) with late all-cause mortality and late recurrence. While no significant association was observed for post-diagnosis BMI or WHR with late recurrence; a U-shaped association was observed for the two measures with late all-cause death. Women with BMI of 25.0 kg/m2 or WHR of 0.83 were at the lowest risk of late all-cause mortality, whereas those with BMI beyond the range of 22.1–28.7 kg/m2 or WHR beyond the range of 0.81–0.86 had a higher risk. ER, stage or menopausal status did not modify the effect of post-diagnosis BMI or WHR on the outcomes. In conclusion, post-diagnosis BMI and WHR, as indicators of overall and central obesity respectively, were associated with late all-cause mortality in U-shaped pattern among long-term breast cancer survivors.
Reference gene selection to determine differences in mitochondrial gene expressions in phosphine-susceptible and phosphine-resistant strains of Cryptolestes ferrugineus, using qRT-PCR
Authors: Tang Pei-An , Duan Jin-Yan , Wu Hai-Jing , Ju Xing-Rong , Yuan Ming-Long
Published: July 2017

Cryptolestes ferrugineusis a serious pest of stored grain and has developed high levels of resistance to phosphine fumigants in many countries. Measuring differences in expression levels of certain ‘resistant’ genes by quantitative real-time PCR (qRT-PCR) may provide insights into molecular mechanisms underlying resistance to phosphine inC. ferrugineus, but reliable qRT-PCR results depend on suitable reference genes (RGs). We evaluated the stability of nine candidate RGs across different developmental stages and phosphine strains ofC. ferrugineus, using four softwares. The results showed thatRPS13andEF1αwere the most stable RGs, whereasα-TUBwas the least under developmental stages. Across the different strains,RPS13andγ-TUBwere the most stable RGs, whereasCycAandGAPDHwere the least. We confirmed the reliability of the selected RGs by qRT-PCR analyses of the mitochondrialcox1gene. Expression ofcox1was not significantly different in the phosphine-resistant strain compared with the phosphine-susceptible strain, but three mitochondrial genes (nad3, atp6andcob) were significantly down-regulated. These results suggest that alterations in the expressions of these three genes may be associated with phosphine resistance inC. ferrugineus. The findings will facilitate future functional genomics studies on the development and phosphine resistance inC. ferrugineus.
Harvesting more grain zinc of wheat for human health
Authors: Chen Xin-Ping , Zhang Yue-Qiang , Tong Yi-Ping , Xue Yan-Fang , Liu Dun-Yi , Zhang Wei , Deng Yan , Meng Qing-Feng , Yue Shan-Chao , Yan Peng , Cui Zhen-Ling , Shi Xiao-Jun , Guo Shi-Wei , Sun Yi-Xiang , Ye You-Liang , Wang Zhao-Hui , Jia Liang-Liang , Ma Wen-Qi , He Ming-Rong , Zhang Xi-Ying , Kou Chang-Lin , Li Yan-Ting , Tan De-Shui , Cakmak Ismail , Zhang Fu-Suo , Zou Chun-Qin
Published: July 2017

Increasing grain zinc (Zn) concentration of cereals for minimizing Zn malnutrition in two billion people represents an important global humanitarian challenge. Grain Zn in field-grown wheat at the global scale ranges from 20.4 to 30.5 mg kg−1, showing a solid gap to the biofortification target for human health (40 mg kg−1). Through a group of field experiments, we found that the low grain Zn was not closely linked to historical replacements of varieties during the Green Revolution, but greatly aggravated by phosphorus (P) overuse or insufficient nitrogen (N) application. We also conducted a total of 320-pair plots field experiments and found an average increase of 10.5 mg kg−1 by foliar Zn application. We conclude that an integrated strategy, including not only Zn-responsive genotypes, but of a similar importance, Zn application and field N and P management, are required to harvest more grain Zn and meanwhile ensure better yield in wheat-dominant areas.