bluuebunny/crossref_metadata_2025 huggingface dataset:
Resveratrol Attenuates Cardiomyocyte Apoptosis in Rats Induced by Coronary Microembolization Through SIRT1-Mediated Deacetylation of p53
Authors: Mao Qing , Liang Xiulin , Wu Yufu , Lu Yongxiang
Published: May 2019

Objective:

Coronary microembolization (CME)-induced cardiomyocyte apoptosis is the primary factor in causing cardiac dysfunction. Resveratrol (RES) is known to play a protective role in a variety of cardiovascular diseases, yet it is not known whether RES has a protective role in CME. Therefore, the effect of RES on cardiomyocyte apoptosis and cardiac function damage which are induced by CME in rats was investigated in this study.

Methods:

Fifty Sprague-Dawley rats were separated into 5 groups randomly (10 rats were included in each): sham group, CME group, RES+CME group, RES+CME+Sirtuin-1 (SIRT-1) inhibitor EX527 (RES+CME+EX) group, and CME+EX group. Cardiac function, serum c-troponin I (cTnI) level, apoptotic index, and microinfarct were measured by cardiac ultrasound, myocardial enzyme assessment, TdT-mediated dUTP Nick-end labeling and hematoxylin-basic fuchsin-picric acid staining. The levels of p53, p53 acetylation, SIRT-1, Bax, Bcl-2, and cleaved caspase-3 were detected by Western blot.

Results:

Myocardial dysfunction, enhanced apoptotic index as well as cTnI were caused after the operation of CME. Coronary microembolization induced increased expression of p53 acetylation and cleaved caspase-3, while the SIRT-1 and Bcl-2/Bax ratio was reduced. The CME effect was reversed by RES while EX527 attenuated this protective effect.

Conclusions:

Resveratrol can improve cardiac function, in the sense that it attenuates CME-induced cardiomyocyte apoptosis, which is perhaps associated with its inhibition pro-apoptotic pathway of p53 which is transcription-independent.
Ultrasonic pulse propagation simulation using OpenCL for environment mapping and discovery
Authors: Al-Shorman Mohammad Y , Al-Kofahi Majd M
Published: May 2019

A fast, highly parallelized, simulation of unidirectional ultrasonic pulse propagating in a two-dimensional environment is presented. The pulse intensity versus time is recorded using an array of unidirectional ultrasonic receivers located at known locations and arranged in a small circle around the transmitter. To speed up the simulation process, OpenCL 2.0 heterogeneous compute language on a graphics processing unit is used. The simulation result is then compared with experimental data to validate its accuracy. By comparing both simulated and experimental data, the collected intensity–time profiles can be used to map an environment. Environments can be mapped using not only direct reflections but also higher order reflections from objects that are not directly seen by the transmitter. With the help of this simulation, subtle characteristics in an environment, such as a slight tilt or curvature, can be measured. The front end of the simulation is written using C#, while the back end is written using C\C++ and OpenCL.
SOX10 Is a Sensitive Marker for Breast and Salivary Gland Adenoid Cystic Carcinoma: Immunohistochemical Characterization of Adenoid Cystic Carcinomas
Authors: Yang Chen , Zhang Lingxin , Sanati Souzan
Published: May 2019

Breast adenoid cystic carcinomas (AdCCs) can pose diagnostic difficulty due to their rarity, particularly on limited biopsy material. Given that these tumors are triple-negative breast cancers with favorable prognosis, accurate diagnosis is critical for clinical management. A total of 12 cases of breast AdCCs were studied; 17 age-matched salivary gland AdCCs and 5 metastatic AdCCs (1 breast and 4 salivary gland primaries) were also examined. Immunohistochemical stains for SOX10, Ki-67, c-KIT, β-catenin, epithelial membrane antigen (EMA), p63, cytokeratin 7 (CK7), cytokeratin 5/6 (CK5/6), and androgen receptor (AR) were performed. All breast (100%) and metastatic (100%) AdCCs and all but 2 salivary gland AdCCs showed diffuse nuclear staining (>50% of cells) for SOX10. Epithelial membrane antigen showed lowest expression in breast AdCCs and the highest expression in metastatic AdCCs ( P < .01). Except one case of salivary gland AdCC that showed loss of β-catenin expression and developed subsequent metastasis, all AdCCs showed strong and diffuse membranous β-catenin expression. There were no significant differences in expression of CK7, p63, CK5/6, AR, Ki-67, and c-KIT ( P > .05) among breast, salivary gland, and metastatic AdCCs. We investigated the immunophenotypic features of breast AdCCs in comparison with salivary gland and metastatic AdCCs. Despite the contrast in prognosis, these tumors are immunophenotypically similar. SOX10 is a sensitive diagnostic marker in all AdCCs, which could potentially aid in diagnosis of these tumors on limited material.
Crack propagation in elastomers subjected to cyclic loading
Authors: Hamdi Adel , Boulenouar Abdelkader , Benseddiq Noureddine , Guessasma Sofiane
Published: May 2019

This work tackles crack propagation mechanisms of styrene butadiene and natural rubbers, both subject to cyclic loading under a positive load ratio. The experimental evidence is based on pure shear loading of notched specimens supported by SEM analysis of fracture surfaces. Relationship between crack growth rate and tearing energy is revisited. The experimental results show that the fatigue behaviour of studied vulcanisates can be clearly separated in the power-law regime. Furthermore, the reported results from the literature extend this statement to any load condition. Fracture surface observations reveal also differences in energy dissipation mechanisms inferred to structural mutations in the case of natural rubber. Alternation of rough and smooth fracture surfaces associated with change in crack growth rate is more likely to occur for styrene butadiene rubber. All observations suggest that crack branching is a secondary ranked dissipation mechanism for the studied materials compared to crack deviation.
Fusion leadership: A transcultural interpretation and application
Authors: Vu Mai Chi , Gill Roger
Published: May 2019

This article introduces a new perspective that challenges well-known leadership styles that have flourished in hitherto stable environments. ‘Fusion leadership’ integrates Eastern and Western values and mindsets to establish an approach that may more effectively respond to the challenges and dilemmas of leadership and organizational issues in contemporary situations in the context of globalization. Our approach contributes to the literature on leadership by providing skills, techniques and practical wisdom for leaders to consider and develop their leadership values, styles and practices to respond to cross-cultural challenges.
Learning to communicate with people with dementia: Exploring the impact of a simulation session for medical students (Innovative practice)
Authors: Winter Rebecca , Al-Jawad Muna , Harris Richard , Wright Juliet
Published: May 2019

There is a recognised need to improve undergraduate education within dementia care. UK medical schools provide dementia-specific teaching, but this has previously been found to focus more on student knowledge and skills rather than behaviours and attitudes and does not often involve the wider multidisciplinary team. A simulation day was established, based on communicating with a person with dementia in a number of scenarios. This article aims to identify if this method of teaching within dementia care is successful. It is a qualitative study and draws on data from postcourse questionnaire responses and field notes of the simulation day. The data offered rich insights into how the session allowed participants to be challenged and taken to their perceived thresholds of capability. It highlights that behaviours and skills can be learnt via simulation and leads to a transformative change in the language learners used, suggesting that learning may happen through threshold concepts.
Development Distribution? EU Aid for Formal Audiovisual Distribution and the Case of Africa’s First Video-on-Demand Platform
Authors: Pearson Benjamin A. J.
Published: May 2019

This article examines the European Union’s support for formal distribution initiatives abroad, focusing on ACPCultures+, an economic development program that aims to grow the audiovisual industries of developing countries through the expansion and adaptation of the logics and mechanisms of intra-European media policies. While these distribution initiatives aim to challenge Hollywood’s reach in developing countries, their activities nevertheless foster the integration of audiovisual industries in developing countries into global media industries. At the same time, the program’s pairing of formal distribution and development aid is at times at odds with audience and industry expectations. Using data from policy documents, fieldwork in Brussels, and interviews with recipients of ACPCultures+ distribution project awards—including a detailed case study of Africa’s first VOD platform—I explore how these initiatives attempt to shape formal distribution in countries on the peripheries of large audiovisual industries.
Potential Interactions of Biologically Based Complementary Medicine in Gynecological Oncology
Authors: Drozdoff Loisa , Klein Evelyn , Kalder Matthias , Brambs Christine , Kiechle Marion , Paepke Daniela
Published: May 2019

Objective. The aim of this study was to assess the potential risks of interactions between biologically based complementary and alternative medication (BB-CAM) and conventional drugs during systemic therapy in breast and gynecological cancer patients by analyzing the actual CAM-drug combinations from individual patients’ records. Methods. From September 2014 to December 2014 and from February 2017 to May 2017, all patients (n = 717) undergoing systemic therapy at the Gynecologic Oncology Day Care Unit in the Gynecology and Obstetrics Department of the Technical University of Munich, Germany, were asked to participate in a questionnaire about all their medications. To assess the potential risk of CAM-drug interactions (CDIs), we initially utilized the Lexicomp drug interaction database. This assessment was then expanded with a systematic search of other digital databases, such as the National Center for Complementary and Integrative Health, Memorial Sloan Kettering Cancer Center, PubMed, and MEDLINE as well as the Cochrane Library. Results. Among 448 respondents, 74.1% reported using BB-CAM simultaneously with their systemic therapy. The assessment showed 1 patient with a potentially clinically relevant CDI, where the interaction was based on a self-medicated combination of Echinacea and cyclophosphamide. Furthermore, 81 patients (18.1%) were thought to have interactions because of a combination of BB-CAMs and cytochrome P450 3A4–metabolized anticancer drugs. Conclusions. Our data demonstrated high overall use of BB-CAMs by cancer patients undergoing systemic therapy. The analyses showed only 1 clinically relevant CDI.
Retrieval of Inferior Vena Cava Filters Temporarily Placed in a Suprarenal Position: A Review of 13 Patients
Authors: Mandel Jacob E. , Fisher Jason A. , Cedillo Mario A. , Shukla Pratik A. , Bishay Vivian , Ranade Mona , Patel Rahul S. , Kim Edward , Nowakowski Scott F. , Lookstein Robert A. , Fischman Aaron M.
Published: May 2019

Purpose:

To evaluate the safety and efficacy of retrieval of inferior vena cava filters (IVCF) temporarily placed in a suprarenal position.

Methods:

Retrieval of IVCF placed in a suprarenal position was performed in 13 patients (5 men and 8 women; mean age: 45.1 ± 13.8 years) between July 2006 and May 2018 using either a loop snare technique or endobronchial forceps. Electronic medical records were reviewed for patient demographics and procedural information.

Results:

Inferior vena cava filters retrieved included Option Elite (n = 9, 69%) and Günther Tulip (n = 4, 31%). Caval thrombosis was not detected in any patients on pre- or postretrieval cavogram. Eleven suprarenal IVCF (84%) were retrieved during the first retrieval attempt after a median indwelling time of 1.8 months (range, 0.03-12.10 months). Retrieval was initially unsuccessful in 2 (16%) patients with Option Elite filters, but both were successfully removed on second attempt using endobronchial forceps. Thirteen suprarenal IVCF (100%) were ultimately retrieved.

Conclusion:

Endovascular retrieval of IVCF temporarily placed in a suprarenal position is safe and efficacious.
Worlds at Our Fingertips: Reading (in) What Remains of Edith Finch
Authors: Bozdog Mona , Galloway Dayna
Published: May 2019

Video games are works of written code that portray worlds and characters in action and facilitate an aesthetic and interpretive experience. Beyond this similarity to literary works, some video games deploy various design strategies that blend gameplay and literary elements to explicitly foreground a hybrid literary/ludic experience. We identify three such strategies: engaging with literary structures, forms, and techniques; deploying text in an aesthetic rather than a functional way; and intertextuality. This article aims to analyze how these design strategies are deployed in What Remains of Edith Finch to support a hybrid readerly/playerly experience. We argue that this type of design is particularly suited for walking simulators (or walking sims) because they support interpretive play through slowness, ambiguity, narrative, and aesthetic aspirations. Understanding walking sims as literary games can shift the emphasis from their lack of “traditional” gameplay complexity and focus instead on the opportunities that they afford for hybrid storytelling and for weaving literature and gameplay in innovative and playful ways.
The Role of Educational Leaders: A Case for Inclusion in Institutions of Higher Education
Authors: Joseph Brianna , Kearney Kelly B. , Wilson Cynthia L.
Published: May 2019

Over the last decade, an increasing number of postsecondary education (PSE) programs have been developed for students with intellectual disability (ID). This case discusses one such program. Along with the courses designed to meet the specific needs of students with ID, the program also permits these students to take courses in the various departments of the university. Faculty were informed that their course(s) might include students from the PSE program for students with ID. One faculty member likes the idea of the program but is not comfortable with students with ID registering for his courses. This case uses discussion prompts and activities to prepare instructors and professors in higher education to foster inclusive practices and ideology throughout the collective university community.
Parents’ Perspectives on Decisions to Participate in Pediatric Clinical Research: Results From a Focus Group Study With Laypeople
Authors: Tromp Krista , van de Vathorst Suzanne
Published: May 2019

Knowing why parents decide to consent or dissent to participation of their child in pediatric clinical research is essential to further the ethical debate concerning pediatric research. We performed this qualitative focus group study with 16 parents from the Dutch general public to explore their perspectives on decisions to participate in pediatric clinical research. Group discussion revealed the following: Parents conflate clinical research and clinical care, they do not grasp the trajectory of pediatric drug development, their protectiveness matches current research guidelines, and benefit for their child is the most important factor in their decision. Research professionals should be aware of the knowledge gap of parents, the pitfalls of jargon, and unintended false expectations.
The Impacts of Ramadan Intermittent Fasting on Oxidant/Antioxidant Stress Biomarkers of Stable Chronic Obstructive Pulmonary Disease Male Patients
Authors: Mrad Sawssan , Rejeb Hadhemi , Ben Abdallah Jihene , Graiet Hajer , Ben Khelifa Mouna , Abed Amel , Ferchichi Salima , Limem Khelifa , Ben Saad Helmi
Published: May 2019

No prior study has evaluated the impacts of Ramadan intermittent fasting (RIF) on oxidant/antioxidant stress (OS/AOS) biomarkers in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to assess the impacts of RIF on some OS/AOS biomarkers measured in male patients with stable COPD. Fifteen COPD patients (mean age: 71 ± 6 years) fasting Ramadan in 2017 volunteered to take part in the study. Three sessions (before Ramadan [BR], end Ramadan [ER], after Ramadan [AR]) were selected. Blood samples of OS (homocysteine [μmol/L], thiobarbituric acid reactive substances [TBARS, μmol/L]) and AOS (catalase [U/ml], ceruloplasmin [g/L], superoxide dismutase [SOD, ng/ml], zinc [µmol/L], albumin [g/L]) biomarkers were consistently taken 4.5 to 2.5 hr before the iftar. Findings were analyzed by applying Friedman or Kruskal–Wallis ANOVA. Comparisons of the number of patients with high OS [high homocysteine and/or TBARS] and low AOS (low catalase and/or ceruloplasmin and/or SOD and/or zinc and/or albumin) blood values between the three sessions were performed using the Cochran test. The median ± interquartile of homocysteine (BR: 21.48 [18.98–24.49], ER: 23.15 [21.77–26.45], AR: 24.87 [21.91–37.12]), ceruloplasmin (BR: 0.27 [0.24–0.30], ER: 0.28 [0.26–0.33], AR: 0.28 [0.25–0.32]), SOD (BR: 288.00 [112.00–400.00], ER: 182.00 [152.00–386.00], AR: 234.00 [190.00–420.00]) and the mean ± SD of TBARS (BR: 5.66 ± 1.26, ER: 4.59 ± 0.78, AR: 5.29 ± 1.69), catalase (BR: 120.97 ± 54.62, ER: 106.73 ± 50.92, AR: 137.39 ± 40.88), zinc (BR: 11.85 ± 2.01, ER: 12.47 ± 2.34, AR: 12.21 ± 2.58) and albumin (BR: 39.78 ± 3.19, ER: 40.74 ± 2.26, AR: 40.56 ± 2.38) were not significantly affected by RIF. The number of patients with high OS (BR [ n = 13], ER [ n = 15], AR [ n = 14]) or low AOS (BR [ n = 12], ER [ n = 13], AR [ n = 13]) statuses were not significantly influenced by RIF. In conclusion, RIF did not induce any significant statistical or clinical changes in OS/AOS biomarkers or statuses in COPD patients.
Sterility of Ethyl Chloride Spray After Use in the Clinic
Authors: Sandrowski Kristin , Graham Jack , Knott Samantha , Hickok Noreen , Fitzgerald Keith , Beredjiklian Pedro K. , Rivlin Michael
Published: May 2019

Background: Ethyl chloride spray is used frequently in the outpatient setting as a local anesthetic for injections and aspirations with varying consensus about the sterility of the spray. We hypothesize that ethyl chloride spray remains sterile and would show no bacterial growth during routine clinical use. Methods: Thirteen ethyl chloride bottles were collected for testing. Two unopened bottles were used as controls. Eleven unopened bottles were placed in orthopedic clinics and recollected after varying duration of use. The final volume and duration of use were recorded. Each bottle was sprayed in a separate test tube and allowed to evaporate. Trypticase soy broth was added to each tube and incubated for 48 hours. Control test tubes with broth alone were prepared and incubated under the same conditions. Cultures were evaluated at 24 and 48 hours. Results: The mean duration of ethyl chloride bottle use prior to culturing was 26 days. The average volume used per day was 1.9 mL. Each ethyl chloride bottle had an initial volume of 103.5 mL. Using the average daily volume usage, an extrapolated lifespan of each bottle was estimated at 7.7 weeks. None of the samples showed bacterial or fungal growth at 24 or 48 hours. Conclusion: Ethyl chloride bottles used in the clinical settings showed no bacterial or fungal contamination through their shelf life and routine use. The duration and amount of use did not affect sterility. Although the antimicrobial activity of ethyl chloride spray on skin is debated, ethyl chloride itself remains sterile through clinical use.
Effect of residual shaft bow on the dynamic analysis of a double-stage geared rotor-bearing system with translational motion due to shaft deformation
Authors: Chen Ying-Chung
Published: May 2019

In this study, the dynamic responses of a double-stage geared rotor-bearing system with translational motion due to the effects of rotating shaft deformation were examined, which was lacking in past research. Residual shaft bow has been neglected in most geared rotor-bearing system models. In this study, the dynamic response of a double-stage geared rotor-bearing system whose gear set underwent translational motion was examined when the shaft was deformed (residual shaft bow). The proposed model considers contact ratio and pressure angle of gear pair as time-dependent variables, whereas in other models, they are constants. A finite element model of a double-stage geared rotor-bearing system with residual shaft bow was developed, and equations of motion were obtained by applying the Lagrange’s equation. System equations of motion are solved by Runge–Kutta numerical method. The dynamic response was investigated, including lateral response, contact ratio and pressure angle of gear pair with different residual shaft bow magnitudes and gear positions. The results show that residual shaft bow raises the amplitudes of lateral displacement, contact ratio and phase angle of gear pairs in the system. This study demonstrated that the residual shaft bow effect is too considerable to ignore when it becomes sufficiently large.
Evolution of game-play characteristics within-season for the National Basketball Association
Authors: Zhang Shaoliang , Lorenzo Alberto , Woods Carl T , Leicht Anthony S , Gómez Miguel-Angel
Published: May 2019

The aim of this study was to explore the (dis)similarity of game-play characteristics throughout an in-season period within the National Basketball Association. Thirteen performance-related indicators of all 1230 games of the regular 2016–2017 season in the National Basketball Association were analysed. Non-metric multidimensional scaling was used to examine (dis)similarity of team profiles. The two-dimensional multivariate matrix showed that team profiles generally presented similarity, while the beginning and ending of the season (October and April) showed relative dissimilarity. Although each team presented unique paths throughout the in-season period, the dominant teams in the National Basketball Association presented similar game styles. In addition, the game-play of the teams evolved into effective interactions in terms of offence and defence as the competition progressed while presenting an increased trend in the number of three-point field-goals made (p < 0.000, small effect size (η2) = 0.011) throughout the in-season period. The analytics performed in this study could be used practically to evaluate temporal changes of game-play characteristics in basketball as well as inform strategic periodization plans within season periods.
Leukocyte nucleus segmentation method based on enhancing the saliency of saturation component
Authors: Wang Yapin , Cao Yiping
Published: May 2019

The accuracy of the leukocyte nucleus segmentation is an important preprocessing step in the leukocyte automatic analysis. However, different dyeing conditions or different illumination conditions may cause capturing different color leukocyte images in microscopic imaging system, which will result in the over-segmentation or under-segmentation of the leukocyte nucleus. A leukocyte nucleus segmentation method based on enhancing the saliency of the saturation component is proposed. While applying the set of calibration offset values [Formula: see text], [Formula: see text], and [Formula: see text] of the red (R), green (G), and blue (B) chrominance value on the blood smear microscopic images, it can enhance the saliency of the saturation component and the saliency of the leukocyte nucleus region increases the most obviously. The leukocyte nuclei are then segmented using Otsu’s histogram thresholding method. The experimental results show that the proposed algorithm outperforms the related algorithms in segmentation accuracy, over-segmentation rate, error rate, and relative distance error. It improves the accuracy, robustness, and universality further.
A new technique to determine the tension in extensor pollicis longus reconstruction
Authors: Kamoi Fumiki , Kondo Makoto , Hayashi Masanori , Uchiyama Shigeharu , Kato Hiroyuki
Published: May 2019

We present an original technique for determining the tension of the extensor pollicis longus tendon after reconstruction. We treated 20 patients using this technique for an extensor pollicis longus tendon graft or extensor indicis tendon transfer and reviewed the results. The tension of the reconstructed extensor pollicis longus was adjusted so that the centre of the distal edge of the thumbnail was elevated 2 cm above the operation table. The mean retropositional distance of the treated thumbs was 1.2 cm less than the contralateral thumbs. The mean total active motion of the thumb was 90%. This technique resulted in satisfactory thumb function.

Level of evidence: IV
Validity of inertial measurement unit–based knee flexion strength-power test
Authors: Nagahara Ryu , Kameda Mai , Neville Jonathon
Published: May 2019

This study aimed to examine the concurrent validity of inertial measurement unit–based knee flexion strength-power test variables. Ten physically active males performed a knee flexion strength-power test, consisting of serial right knee flexion-extension motions. Two trials were performed, each at 50%, 75% and 100% effort. Lower-extremity motion during the trial was recorded using a motion capture system and an inertial measurement unit. For inertial measurement unit data, the measured length of each lower-extremity segment was used to estimate segment endpoint coordinates. Knee flexion kinetic variables were then computed using inverse dynamics analysis for both systems. The inertial measurement unit provided comparable values with the motion capture system for angular impulse, mean moment, positive work and mean power (−0.8%, 1.0%, −0.9%, and 1.5%, respectively). Moreover, intraclass correlation coefficients and correlation coefficients for angular impulse, mean moment, positive work and mean power of knee flexion were acceptably high (ICC or r = 0.903–0.970). For positive mean power, however, a Bland–Altman plot showed heteroscedasticity. For knee flexion negative work and mean power, the inertial measurement unit clearly showed an overestimation of the values (32.5% and 23.5%, respectively). Moreover, the intraclass correlation coefficients and correlation coefficients were not acceptably high for knee flexion negative work and mean power (ICC or r = 0.541–0.899). These results indicate that the angular impulse, mean moment and positive work can be measured accurately and validly using an inertial measurement unit for knee flexion strength-power test variables. Given its simplicity, the suggested inertial measurement unit–based knee flexion strength-power test would improve on-the-field physical fitness evaluation.
Illicit drug use
Authors: Mylan Sophie , Moore Robert
Published: May 2019

Illicit drug use is not uncommon in the UK. In 2016, it was estimated that 2 700 000 people between the ages of 16 and 59 years and living in England or Wales had used at least one illicit drug in the last year. Patients may present to primary care with issues relating directly to their drug use, or with physical, social or mental health conditions that cannot be managed without considering concurrent drug use. Treatment options can be discussed and ongoing plans made in primary care. Primary care is increasingly an important setting for the specialist management of such patients, given the relevant focus on holistic care. This article describes commonly used illicit drugs, and the consequences of such use. It also outlines how to approach a consultation involving drug use and discusses key management principles in such patients.
Human induced pluripotent stem cell models for the study and treatment of Duchenne and Becker muscular dystrophies
Authors: Piga Daniela , Salani Sabrina , Magri Francesca , Brusa Roberta , Mauri Eleonora , Comi Giacomo P. , Bresolin Nereo , Corti Stefania
Published: May 2019

Duchenne and Becker muscular dystrophies are the most common muscle diseases and are both currently incurable. They are caused by mutations in the dystrophin gene, which lead to the absence or reduction/truncation of the encoded protein, with progressive muscle degeneration that clinically manifests in muscle weakness, cardiac and respiratory involvement and early death. The limits of animal models to exactly reproduce human muscle disease and to predict clinically relevant treatment effects has prompted the development of more accurate in vitro skeletal muscle models. However, the challenge of effectively obtaining mature skeletal muscle cells or satellite stem cells as primary cultures has hampered the development of in vitro models. Here, we discuss the recently developed technologies that enable the differentiation of skeletal muscle from human induced pluripotent stem cells (iPSCs) of Duchenne and Becker patients. These systems recapitulate key disease features including inflammation and scarce regenerative myogenic capacity that are partially rescued by genetic and pharmacological therapies and can provide a useful platform to study and realize future therapeutic treatments. Implementation of this model also takes advantage of the developing genome editing field, which is a promising approach not only for correcting dystrophin, but also for modulating the underlying mechanisms of skeletal muscle development, regeneration and disease. These data prove the possibility of creating an accurate Duchenne and Becker in vitro model starting from iPSCs, to be used for pathogenetic studies and for drug screening to identify strategies capable of stopping or reversing muscular dystrophinopathies and other muscle diseases.
Advances in cerebral amyloid angiopathy imaging
Authors: Chen Szu-Ju , Tsai Hsin-Hsi , Tsai Li-Kai , Tang Sung-Chun , Lee Bo-Chin , Liu Hon-Man , Yen Ruoh-Fang , Jeng Jiann-Shing
Published: May 2019

Cerebral amyloid angiopathy (CAA) is a cerebral small vessel disease caused by β -amyloid (Aβ) deposition at the leptomeningeal vessel walls. It is a common cause of spontaneous intracerebral hemorrhage and a frequent comorbidity in Alzheimer’s disease. The high recurrent hemorrhage rate in CAA makes it very important to recognize this disease to avoid potential harmful medication. Imaging studies play an important role in diagnosis and research of CAA. Conventional computed tomography and magnetic resonance imaging (MRI) methods reveal anatomical alterations, and remains as the most reliable tool in identifying CAA according to modified Boston criteria. The vascular injuries of CAA result in both hemorrhagic and ischemic manifestations and related structural changes on MRI, including cerebral microbleeds, cortical superficial siderosis, white matter hyperintensity, MRI-visible perivascular spaces, and cortical microinfarcts. As imaging techniques advance, not only does the resolution of conventional imaging improve, but novel skills in functional and molecular imaging studies also enable in vivo analysis of vessel physiological changes and underlying pathology. These modern tools help in early detection of CAA and may potentially serve as sensitive outcome markers in future clinical trials. In this article, we reviewed past studies of CAA focusing on utilization of various conventional and novel imaging techniques in both research and clinical aspects.
Utilisation of hospital information systems for medical research in Saudi Arabia: A mixed-method exploration of the views of healthcare and IT professionals involved in hospital database management systems
Authors: Samra Halima , Li Alice , Soh Ben , Zain Mohammed Al
Published: May 2019

Background:

Although in recent times the Saudi government has paid much attention to the adaptation of hospital information systems (HIS) and electronic medical records (EMR), the importance of utilising HIS to enhance medical research has been neglected.

Objective:

We aimed to (i) investigate the current state of medical research in Saudi Arabia, (ii) identify possible issues that hinder improvement of medical research and (iii) identify possible solutions to enhance the role of HIS in medical research in Saudi Arabia.

Method:

We used a questionnaire and structured interview approach. Questionnaires were distributed to Saudi healthcare professionals. One hundred responses to our questionnaire were captured by the online Google Form designed specifically for our survey. Structured interviews with two IT professionals were conducted regarding technical aspects of their hospital data management systems.

Results:

Six themes contributing to the inefficacy of HIS in medical research in Saudi Arabia emerged from the data: incorrect datasets, difficult data collection and storage, poor data analytics, a lack of system interoperability across different HIS for universal access and negative perception of the usefulness of HIS for medical research.

Conclusion and implications:

Our findings suggest (i) cloud-based HIS would support efficient, reliable and integrated data collection and storage across all hospitals in Saudi Arabia; (ii) EMR data sources should be seamlessly linked to avoid incomplete, fragmented or erroneous EMR in Saudi Arabia; and (iii) collaboration between all hospitals in Saudi Arabia to adopt a uniform standard to support interoperability and improve data exchange and integration is necessary.
Lack of choline elevation on proton magnetic resonance spectroscopy in grade I–III gliomas
Authors: Chawla Sanjeev , Lee Seung-Cheol , Mohan Suyash , Wang Sumei , Nasrallah MacLean , Vossough Arastoo , Krejza Jaroslaw , Melhem Elias R , Ali Nabavizadeh S
Published: May 2019

Elevated levels of choline are generally emphasized as marker of increased cellularity and cell membrane turnover in gliomas. In this study, we investigated the incidence rate of lack of choline/creatine and choline/water elevation in a population of grade I–III gliomas. A cohort of 41 patients with histopathologically confirmed gliomas underwent multi-voxel proton magnetic resonance spectroscopy on a 3 T magnetic resonance system prior to treatment. Peak areas for choline and myoinositol were measured from all voxels that exhibited hyperintensity on fluid-attenuated inversion recovery images and were normalized to creatine and unsuppressed water from each voxel. The average metabolite/creatine and metabolite/water ratios from these voxels were then computed. Similarly, average metabolite ratios were computed from normal brain parenchyma. Gliomas were considered for lack of choline elevation when choline/creatine and choline/water ratios from neoplastic regions were less than those from normal brain parenchyma regions. Six of 41 (14.6%) grade I–III gliomas showed lack of elevation for choline/creatine and choline/water ratios compared to normal brain parenchyma. Four of these six gliomas also demonstrated elevated levels of myoinositol/creatine ratio. All other gliomas ( n = 35) had elevated choline levels from neoplastic regions relative to normal parenchyma. The sensitivity of choline/creatine or choline/water in determining a grade I–III glioma was 85.4%. These findings suggest that a lack of choline/creatine or choline/water elevation may be seen in some gliomas and low choline levels should not prevent us from considering the possibility of a grade I–III glioma.
Dynamic strength training intensity in cardiovascular rehabilitation: is it time to reconsider clinical practice? A systematic review
Authors: Hansen Dominique , Abreu Ana , Doherty Patrick , Völler Heinz
Published: May 2019

When added to endurance training, dynamic strength training leads to significantly greater improvements in peripheral muscle strength and power output in patients with cardiovascular disease, which may be relevant to enhance the patient’s prognosis. As a result, dynamic strength training is recommended in the rehabilitative treatment of many different cardiovascular diseases. However, what strength training intensity should be selected remains under intense debate. Evidence is nonetheless emerging that high-intensity strength training (≥70% of one-repetition maximum) is more effective to increase acutely myofibrillar protein synthesis, cause neural adaptations and, in the long term, increase muscle strength, when compared to low-intensity strength training. Moreover, multiple studies report that high-intensity strength training causes fewer increments in (intra-)arterial blood pressure and cardiac output, as opposed to low-intensity strength training, thus potentially pointing towards sufficient medical safety for the cardiovascular system. The aim of this systematic review is therefore to discuss this line of evidence, which is in contrast to current clinical practice, and to re-open the debate as to what dynamic strength training intensities should actually be applied.
Beyond the East/West Dichotomy—The Course Yoga: Theory and Practice Conveys the Benefits of an Ayurvedic Lens for Global Health
Authors: Klatt Maryanna , Moore Katherine
Published: May 2019

The course Yoga: Theory and Practice (YTP) evolved from the realization that graduate and undergraduate academic offerings of “yoga courses” were filled beyond capacity, while students were not being exposed to the depth and breadth of what yoga has to offer as a holistic, integrative practice, nor how it grew up alongside Ayurveda. Students experientially understood the contribution that yoga practice made in their lives and sensed the health benefits it afforded. Yet, they were hungry for an understanding of the lens through which yoga emerged. YTP is an elective course within an academic minor of study, “Integrative Approaches to Health and Wellness” that provides nonwestern ways of understanding global medicine and health. The focus of YTP is to offer college students an in-depth, academic study of yoga, incorporating both scientific (reductionist), and an Ayurveda health perspective. This course is an educational innovation, translating the benefits of Ayurvedic and yogic lifestyle to a Western audience.
The Advantaged Cause: Affect Control Theory and Social Movements
Authors: Bergstrand Kelly
Published: May 2019

The role of grievances in drawing public concern and activist support is a surprisingly understudied topic in modern social movement literature. This research is the first to parse issues into core components to understand whether some grievances are more successful than others in evoking reactions that can benefit social movements. Specifically, I use concepts and measures developed by affect control theory scholars that tap into cultural perceptions of the goodness or badness of behaviors and identities to investigate how people react to different configurations of good or bad perpetrators, behaviors, and victims in mobilizing events. I find strong support, across outcomes, that evaluations of goodness and badness in grievances affect people’s willingness to care about an issue or support a campaign. This provides insights into both the types of movements more likely to be successful as well as the types of social problems less likely to draw public support.
Relocating the “inmate”: Tracing the geographies of social reproduction in correctional supervision
Authors: Massaro Vanessa A
Published: May 2019

Neoliberal governance spurs the contradictory drives of securitization and austerity in the US carceral system. Correctional and parole offices cut costs by relocating care, relying upon the work of Black women, their families, and communities to provide myriad services to their incarcerated and paroled loved ones. Yet while their labor is vital to the reproduction and growth of this system, these same neoliberal processes work systematically to erase it. In doing so, they allow new kinds of unwarranted state surveillance through the private space of the home. In this article, I critically analyze the austerity measures implemented by Pennsylvania’s Department of Corrections, an institution that has undergone extensive reforms since 2012. To do so, I bridge feminist political and economic geographies, examining state processes via an analysis of unpaid reproductive labor, everyday practices, and emotion. Through a three-year ethnographic study with the loved ones of incarcerated people, I show how the state externalizes the cost of supervision onto prisoners’ support networks, relying in varied ways on families for the care and surveillance of prisoners. I show that this covert strategy enables the state to claim reductions in prison populations while, in fact, maintaining containment of formerly incarcerated people. These findings urge increased attention to the state’s dependence on incarcerated people’s support networks, demonstrating the vital insights a feminist geographic perspective offers in this age of austerity.
Singularity cities
Authors: Li Yunfei , Rybski Diego , Kropp Jürgen P.
Published: May 2019

We propose an upgraded gravitational model which provides population counts beyond the binary (urban/non-urban) city simulations. Numerically studying the model output, we find that the radial population density gradients follow power-laws where the exponent is related to the preset gravity exponent γ. Similarly, the urban fraction decays exponentially, again determined by γ. The population density gradient can be related to radial fractality and it turns out that the typical exponents imply that cities are basically zero-dimensional. Increasing the gravity exponent leads to extreme compactness and the loss of radial symmetry. We study the shape of the major central cluster by means of another three fractal dimensions and find that overall its fractality is dominated by the size and the influence of γ is minor. The fundamental allometry, between population and area of the major central cluster, is related to the gravity exponent but restricted to the case of higher densities in large cities. We argue that cities are shaped by power-law proximity. We complement the numerical analysis by economics arguments employing travel costs as well as housing rent determined by supply and demand. Our work contributes to the understanding of gravitational effects, radial gradients, and urban morphology. The model allows to generate and investigate city structures under laboratory conditions.
GRFS and CRFS in alternative donor hematopoietic cell transplantation for pediatric patients with acute leukemia
Authors: Mehta Rohtesh S. , Holtan Shernan G. , Wang Tao , Hemmer Michael T. , Spellman Stephen R. , Arora Mukta , Couriel Daniel R. , Alousi Amin M. , Pidala Joseph , Abdel-Azim Hisham , Ahmed Ibrahim , Aljurf Mahmoud , Askar Medhat , Auletta Jeffery J. , Bhatt Vijaya , Bredeson Christopher , Chhabra Saurabh , Gadalla Shahinaz , Gajewski James , Gale Robert Peter , Gergis Usama , Hematti Peiman , Hildebrandt Gerhard C. , Inamoto Yoshihiro , Kitko Carrie , Khandelwal Pooja , MacMillan Margaret L. , Majhail Navneet , Marks David I. , Mehta Parinda , Nishihori Taiga , Olsson Richard F. , Pawarode Attaphol , Diaz Miguel Angel , Prestidge Tim , Qayed Muna , Rangarajan Hemalatha , Ringden Olle , Saad Ayman , Savani Bipin N. , Seo Sachiko , Shah Ami , Shah Niketa , Schultz Kirk R. , Solh Melhem , Spitzer Thomas , Szer Jeffrey , Teshima Takanori , Verdonck Leo F. , Williams Kirsten M. , Wirk Baldeep , Wagner John , Yared Jean A. , Weisdorf Daniel J.
Published: May 2019

We report graft-versus-host disease (GVHD)-free relapse-free survival (GRFS) (a composite end point of survival without grade III-IV acute GVHD [aGVHD], systemic therapy–requiring chronic GVHD [cGVHD], or relapse) and cGVHD-free relapse-free survival (CRFS) among pediatric patients with acute leukemia (n = 1613) who underwent transplantation with 1 antigen–mismatched (7/8) bone marrow (BM; n = 172) or umbilical cord blood (UCB; n = 1441). Multivariate analysis was performed using Cox proportional hazards models. To account for multiple testing, P < .01 for the donor/graft variable was considered statistically significant. Clinical characteristics were similar between UCB and 7/8 BM recipients, because most had acute lymphoblastic leukemia (62%), 64% received total body irradiation–based conditioning, and 60% received anti-thymocyte globulin or alemtuzumab. Methotrexate-based GVHD prophylaxis was more common with 7/8 BM (79%) than with UCB (15%), in which mycophenolate mofetil was commonly used. The univariate estimates of GRFS and CRFS were 22% (95% confidence interval [CI], 16-29) and 27% (95% CI, 20-34), respectively, with 7/8 BM and 33% (95% CI, 31-36) and 38% (95% CI, 35-40), respectively, with UCB (P < .001). In multivariate analysis, 7/8 BM vs UCB had similar GRFS (hazard ratio [HR], 1.12; 95% CI, 0.87-1.45; P = .39), CRFS (HR, 1.06; 95% CI, 0.82-1.38; P = .66), overall survival (HR, 1.07; 95% CI, 0.80-1.44; P = .66), and relapse (HR, 1.44; 95% CI, 1.03-2.02; P = .03). However, the 7/8 BM group had a significantly higher risk for grade III-IV aGVHD (HR, 1.70; 95% CI, 1.16-2.48; P = .006) compared with the UCB group. UCB and 7/8 BM groups had similar outcomes, as measured by GRFS and CRFS. However, given the higher risk for grade III-IV aGVHD, UCB might be preferred for patients lacking matched donors.
Peptides identified on monocyte-derived dendritic cells: a marker for clinical immunogenicity to FVIII products
Authors: Jankowski Wojciech , Park Yara , McGill Joseph , Maraskovsky Eugene , Hofmann Marco , Diego Vincent P. , Luu Bernadette W. , Howard Tom E. , Kellerman Roberta , Key Nigel S. , Sauna Zuben E.
Published: May 2019

The immunogenicity of protein therapeutics is an important safety and efficacy concern during drug development and regulation. Strategies to identify individuals and subpopulations at risk for an undesirable immune response represent an important unmet need. The major histocompatibility complex (MHC)–associated peptide proteomics (MAPPs) assay directly identifies the presence of peptides derived from a specific protein therapeutic on a donor’s MHC class II (MHC-II) proteins. We applied this technique to address several questions related to the use of factor VIII (FVIII) replacement therapy in the treatment of hemophilia A (HA). Although >12 FVIII therapeutics are marketed, most fall into 3 categories: (i) human plasma-derived FVIII (pdFVIII), (ii) full-length (FL)–recombinant FVIII (rFVIII; FL-rFVIII), and (iii) B-domain–deleted rFVIII. Here, we investigated whether there are differences between the FVIII peptides found on the MHC-II proteins of the same individual when incubated with these 3 classes. Based on several observational studies and a prospective, randomized, clinical trial showing that the originally approved rFVIII products may be more immunogenic than the pdFVIII products containing von Willebrand factor (VWF) in molar excess, it has been hypothesized that the pdFVIII molecules yield/present fewer peptides (ie, potential T-cell epitopes). We have experimentally tested this hypothesis and found that dendritic cells from HA patients and healthy donors present fewer FVIII peptides when administered pdFVIII vs FL-rFVIII, despite both containing the same molar VWF excess. Our results support the hypothesis that synthesis of pdFVIII under physiological conditions could result in reduced heterogeneity and/or subtle differences in structure/conformation which, in turn, may result in reduced FVIII proteolytic processing relative to FL-rFVIII.