bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of Hepple Stage V Osteochondral Lesion of the Talus with a Platelet-Rich Plasma Scaffold
Authors: Shi Zhongmin
Published: September 2018

Category:

Ankle

Introduction/Purpose:

There has been no consensus on the treatment or prognosis of Hepple stage V osteochondral lesions of the talus (OLTs), especially for lesions greater than 1.5 cm2 in size. The objective of this study was to investigate the clinical outcomes achieved upon application of a platelet-rich plasma (PRP) scaffold with a cancellous bone autograft for Hepple stage V OLTs.

Methods:

Fourteen patients (mean age, 39 years) were treated with a cancellous bone graft and a PRP scaffold between 2013 and 2015. The mean time to surgical treatment was 23.5 months. Ankle X-ray and magnetic resonance imaging were performed at the final follow-up. Functional outcomes were evaluated according to the Visual Analog Scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Short Form36 (SF-36) score.The range of motion (ROM) of the ankle joint and complications also were recorded.

Results:

Thirteen patients completed the full follow-up, with a mean follow-up duration of 18 months. MRI demonstrated the complete regeneration of subchondral bone and cartilage in all patients.The postoperative VAS, AOFAS ankle and hindfoot, and SF-36 scores were improved significantly (all 𝑃 < 0.001) without obvious complications.

Conclusion:

We suggest that, for the Hepple stage V OLTs, management with cancellous bone graft and PRP scaffold may be a safe and effective treatment.
Combined Anterior and Dual Posterolateral Approaches for Ankle Arthroscopy for Posterior and Anterior Ankle Impingement Syndrome
Authors: Song Bin , Zhou Yunfeng
Published: September 2018

Category:

Arthroscopy

Introduction/Purpose:

We introduce a novel method of combining the standard anteromedial and anterolateral approaches and dual posterolateral approaches in the arthroscopic treatment of posterior and anterior ankle impingement syndrome and compare the postoperative outcomes with conventional anteromedial/anterolateral and posteromedial/posterolateral

Methods:

From January 2015 to January 2017, we treated 28 patients with posterior and anterior ankle impingement syndrome by arthroscopy. The patients were divided into the conventional group (n = 13) and the modified group (n = 15) according to the surgical approaches used in the operation. Preoperative and postoperative American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analog scale (VAS) score, range of ankle motion, and operation time were recorded. The average follow-up was 16 months (range 6-24 months).

Results:

Posterior and anterior ankle impingement syndrome was confirmed arthroscopically in all patients. After the operation, the range of ankle motion in all patients was restored. There was no significant difference in postoperative AOFAS score, VAS score, dorsiflexion, and plantarflexion between the conventional group and the modified group. Moreover, the operation time was significantly reduced in the modified group compared with the conventional group. There was no recurrence of osteophyte and no complications such as infection, neurovascular injury, or delayed healing of surgical incision in the modified group.

Conclusion:

Dual posterolateral approaches combined with standard anteromedial and anterolateral approaches was a novel method for arthroscopic treatment of posterior and anterior ankle impingement syndrome. It proved to be safe and effective, and significantly reduced the operation time. Reposition, repeated prep and drape, and limb distraction were avoided.
Minimally invasive calcaneal osteotomy
Authors: Teoh Kar , Hariharan Kartik
Published: September 2018

Category:

Hindfoot

Introduction/Purpose:

A calcaneal osteotomy can be used to treat a variety of pathologic entities in which the hindfoot needs realignment. Minimally invasive calcaneal osteotomy (MICO) is becoming increasingly popular due to being soft tissue friendly, its ability to place other incisions nearby and high union rate. Previous studies have look specifically at medialising MICO or comparing open calcaneal osteotomy versus MICO. The purpose of our study was to compare 3 different types of commonly used MICO in our centre.

Methods:

Sixty-two MICO which fit the criteria were included in this study. They were performed in our unit from 2010 and 2016 and all patients had at least one year follow up data. The type of osteotomies was as follows: Medialising, n = 34, Lateralising, n =15 and Zadek (Dorsal closing wedge), n =13. Clinical and radiographic data were recorded. The diagnosis for 31/34 of the medialising MICO was Stage 2 PTTD, the diagnosis for 12/15 of the lateralising MICO was cavus foot, while the diagnosis for all Zadek MICO was for insertional Achilles tendinopathy. Apart from the Zadek MICO, the other MICO were all associated with other procedures. The average age (years) were as follows: Medialising, 58 (30 – 74); Lateralising, 33 (14 – 67) and Zadek, 47 (42-62).

Results:

The average calcaneal displacement was 10.2 (range: 8 – 12) mm for medialising MICO, and 6.6 (4 – 8) mm for lateralising MICO(p=0.021). Average time to union was 7.8 (5.4 – 11.6) weeks for medialising MICO, 6.2 (4.6 to 7.9) weeks for lateralising MICO, and 6.1 (4.1 – 7.6) weeks for Zadek MICO. All the MICO healed radiologically and clinically. Five (8%) patients (Medialising, n = 2; Lateralising n =2; Zadek, n =1) reported transient sural nerve paraesthesia following surgery. Wound problems developed in 5 patients (Lateralising, n =3; Zadek, n =2). The number of total complications were as follow: Medialising, n = 5, Lateralising, n = 7 and Zadek, n =5. Average length of stay was as follows: Medialising, 2(0-8) days; Lateralising, 1(0-3) day and Zadek, 1(0-3) day.

Conclusion:

Minimally invasive calcaneal osteotomy was safe with a high union rate and low complication rates and length of stay across all 3 common osteotomies. The average calcaneal displacement was significantly less for lateralising than medialising which is similar to reported figures for open osteotomy. Wound problems were more likely for lateralising and Zadek MICO compared to medialising and this could be because of how the osteotomies are shifted.
Computer Foot
Authors: Griend Robert Vander
Published: September 2018

Category:

Midfoot/Forefoot

Introduction/Purpose:

Metatarsalgia can result from both intrinsic and extrinsic causes of increased plantar pressure. The index patient in this study was a college professor with bilateral metarsalgia (and failed Morton’s neuroma surgeries). In clinic he was noted to be sitting with both feet positioned under his chair (Figure shows example of this position). He indicated that he sat in this position while using his computer for several hours at a time. He was counseled to sit with his feet flat and subsequently noted much improvement in his symptoms. Other patients were then noted to have metatarsalgia and similar computer use foot positions prompting this evaluation of forefoot plantar pressures in this sitting position.

Methods:

Fifteen patients (eight with computer foot and seven without) were seated in a chair that they could adjust to their normal sitting position. The patients wore socks of their choice but not shoes to avoid loading differences resulting from different types foot wear. A plexiglass plate portable pressure sensor was placed ln the floor. The pressure and contact area was measured for each foot with the foot flat and then the foot positioned with the foot directly under the edge of the chair.

Results:

The plantar pressures in the seated foot flat position ranged from 8-18 kg (some correlation with leg size/weight and self selected chair height). This pressure was fairly evenly distributed across the entire plantar foot. There were no right-left foot differences. The plantar pressures in the computer foot position (foot directly under the edge of the chair) increased by 40-60% while the contact area decreased by 50% or more. Positioning the foot as far under the chair as possible increased the pressures by an additional 10+%.

Conclusion:

Foot position while seated can result in increased loads on the plantar forefoot. Maintaining this position for long periods of time-as when working on a computer-can contribute to metatarsalgia . While rarely the only cause of metatarsalgia we have found that about 1/4 of patients with forefoot symptoms do acknowledge that they sit for periods of time in the computer foot position. Change in foot position commonly improves their foot symptoms
Patient Perceptions of Achilles Tendon Rupture
Authors: Vosseller J. Turner , Greisberg Justin
Published: September 2018

Category:

Sports

Introduction/Purpose:

The optimal treatment of Achilles tendon ruptures (ATRs) is a subject of some debate amongst orthopaedic surgeons. However, patient perceptions of ATRs are unclear. Many patients understanding of Achilles injuries is limited and may be more informed by popular culture than anything objective. Many patients may assume that an ATR necessitates surgical treatment or that surgical treatment is “better” because that is how professional athletes are often treated. These ideas may be related to a patient’s health literacy. We sought to assess patient perceptions of ATRs using a proprietary questionnaire and correlate that with health literacy and the education level of the patient.

Methods:

Patients presenting to an academic orthopaedic foot and ankle clinic with a complaint of Achilles tendon injury were asked to fill out a demographic form, the LiMP (Literacy in Musculoskeletal Problems) survey to assess musculoskeletal health literacy, and a 22 question survey on ATRs designed to assess patients knowledge and perception of ATRs that was modelled after a similar survey done for meniscal injuries.

Results:

Twenty-nine patients were surveyed with a mean age of 45 years. 62% of respondents noted that they had little knowledge of the Achilles, with the remaining 38% saying that their knowledge of the Achilles was moderate to considerable. 14% of those surveyed were employed in healthcare. The mean LiMP score was 4.91 (out of 9, mean in general population in another study was 4.68). 70% of patients replied that surgery alone or in combination with physical therapy was the most appropriate treatment for an ATR. Only 11% of patients responded that physical therapy with some immobilization was sufficient.

Conclusion:

Patient perception of ATR treatment appears to be biased to some degree towards surgery. In an educated patient group that scored well in terms of health literacy, a majority of patients felt that surgical treatment was most appropriate. In a setting in which the optimal treatment has not been fully worked out by surgeons, it is difficult to tell what influence patient perceptions may have on treatment, although it is possible these patient perceptions may cause surgeons to be more surgically aggressive.
Safety and Effectiveness of Talus Subchondroplasty® and Bone Marrow Aspirate Concentrate for Treatment of Osteochondral Defects of the Talus
Authors: Vulcano Ettore , Chan Jimmy
Published: September 2018

Category:

Arthroscopy

Introduction/Purpose:

Subchondroplasty® is a relatively new technique used to treat multiple conditions associated with bone marrow edema. Asymptomatic talus osteochondral defects (OCD) typically present with no bone marrow edema on MRI. Therefore the aim of this retrospective study is to assess the safety and effectiveness of an arthroscopic-percutaneous procedure for the treatment of painful OCDs using subchondral highly porous injectable calcium phosphate – to address the marrow edema - and intra-articular bone marrow aspirate concentrate (BMAC) – to address joint inflammation.

Methods:

From September 2016 to November 2016 9 consecutive patients with an isolated symptomatic osteochondral defect were included in the study. The Foot and Ankle Orthopaedic Score (FAOS) and the visual analogue scale (VAS) for pain were administered preoperatively and at the 1 year postoperative mark. At 52 weeks patients were asked if they would have the procedure again. The procedure was performed by debriding only unstable cartilage and joint synovitic tissue. No microfracture was performed to prevent spilling of calcium paste into the joint. At the end of the procedure 8 cc of BMAC were injected into the joint. Patients were allowed to weight bear as tolerated in a sneaker postoperatively. Return to sports was also indicated as tolerated.

Results:

Mean OCD size as measured on preoperative MRI was 1.3 x 1.4 cm (range, 1 x 0.8 cm to 2 x 2.3 cm). Mean 1.7 cc (range, 1.5 to 2 cc) of calcium paste were injected in the subchondral bone at the level of the OCD, under arthroscopic visualization to debride any calcium paste leakage. All outcome measures demonstrated marked improvement from baseline to final follow-up: The mean weight bearing VAS pain score improved from mean 7.8 (range 6 to 9) to 0.5 (range, 0 to 1); the mean total FAOS improved from mean 67.1 (range, 55 to 79) to mean 90.6 (range, 87 to 95). At the 1-year postoperative visit all patients declared that they would have the procedure again.

Conclusion:

Despite the short follow up and the limited number of patients, subchondroplasty and BMAC injection offered good pain relief in all patients. The procedure is not technically challenging, it allows for immediate postoperative weight bearing, and does not compromise future treatments in case of recurrence of symptoms. Further high-quality studies are needed to confirm these results and to assess the long-term outcomes of the procedure.
A new arthroscopic BrostrÖm procedure for chronic lateral ankle instability
Authors: Xu Hailin
Published: September 2018

Category:

Arthroscopy

Introduction/Purpose:

Chronic lateral ankle instability is usually progressed from previous lateral ankle sprain which is not treated properly. Although patients with acute lateral ankle ligament injury are often managed successfully with conservative treatment, approximately 20%-40% will go on developing symptomatic chronic recurrent lateral ankle instability. Several procedures have been introduced to address these patients including open or arthroscopic techniques, the most common of which is the BrostrÖm procedure. The aim of this study was to describe a new outside-in arthroscopic BrostrÖm procedure and its results for treating patients with chronic lateral ankle instability.

Methods:

Of the 32 patients that were treated, 18 males and 14 females, and aged from 15~57 years (mean 27.8 years). All patients were symptomatic with a combination of recurrent ankle sprains, giving way and avoidance of sports, as well as presented positive anterior drawer test in the physical examination. The history of all patients was over 6 months and conservative treatments were not enough to relieve the symptoms. Standard anteromedial and anterolateral portal was established. Using a suture anchor (2.9 mm Lupine BR, preloaded with double orthocord sutures, DePuy Synthes) and a cannulated needle as a suture passer, anterior talofibular ligament repair was achieved with an outside-in technique. Follow-up was 6~14 months (mean 8.7).

Results:

Subjective instability and mechanical instability were all significantly improved. No recurrences of ankle instability were reported. The mean AOFAS Ankle-Hindfoot score increased from 74 preoperatively to 95 at final follow-up. 2 patients reported superficial peroneal nerve (SPN) irritation symptom postoperatively but only 1 persisted. 2 patients complained mild pain anteroinferior to the lateral ankle.

Conclusion:

The arthroscopic outside-in BrostrÖm procedure with a single suture anchor was a safe, effective and reproducible technique for chronic lateral ankle instability. The ankle stability resumed with high clinical success rate. The main complication of this procedure was injury to SPN, which crossed the area of repair. The transient neurologic symptom may be related to stretch injury when establishing the anterolateral portal, while the persistent one may be due to nerve entrapment.
Classification and operative management of malunion after midfoot injury
Authors: Zhang Ming-Zhu , Yu Guang-rong
Published: September 2018

Category:

Midfoot/Forefoot

Introduction/Purpose:

To characterize clinical treatment of the malunion after midfoot injury.

Methods:

22 cases of malunion following complex midfoot injury from 2004 to 2012. They were 19 men and 3 women with mean age of 37.8. The foot deformity was categorized into 3 types and 3 subtypes, with type? indicating normal foot arch (type ?a forefoot abduction, ?b forefoot adduction and Ic forefoot normal), type? Cavus deformity (subtype is same as?), and type ? flatfoot deformity (subtype is same as?) . There were 2 cases of type?a, 4 cases of type?c, 9 cases of type?a, 4 cases of type ?a, 3 cases of type ?c in our cohort. According to the malunion typing, osteotomy, joint arthrodesis, or realignment was used to correct deformity. Clinical outcomes were evaluated by AOFAS score and VAS.

Results:

All the patients were followed up for average 34.7 months.The mean VAS score was 2.0 points (0-6) and mean AOFAS score was 83.9±2.3 points (73-94) at the last follow-up, giving an excellent to good rate of 81.8%. All cases obtained favorable functional outcomes without bone nonunion, except one patient who still suffered from midfoot walking discomfort 3 years after operation.

Conclusion:

Operative management of malunion following midfoot injury is effective and good results can only be obtained by stabilizing injured joint, realignment and recover foot arch.Our typing of the midfoot malunion is helpful in the operative treatment.
The endothelial glycocalyx anchors von Willebrand factor fibers to the vascular endothelium
Authors: Kalagara Thejaswi , Moutsis Tracy , Yang Yi , Pappelbaum Karin I. , Farken Anne , Cladder-Micus Lucia , Vidal-y-Sy Sabine , John Axel , Bauer Alexander T. , Moerschbacher Bruno M. , Schneider Stefan W. , Gorzelanny Christian
Published: September 2018

The dynamic change from a globular conformation to an elongated fiber determines the ability of von Willebrand factor (VWF) to trap platelets. Fiber formation is favored by the anchorage of VWF to the endothelial cell surface, and VWF-platelet aggregates on the endothelium contribute to inflammation, infection, and tumor progression. Although P-selectin and ανβ3-integrins may bind VWF, their precise role is unclear, and additional binding partners have been proposed. In the present study, we evaluated whether the endothelial glycocalyx anchors VWF fibers to the endothelium. Using microfluidic experiments, we showed that stabilization of the endothelial glycocalyx by chitosan oligosaccharides or overexpression of syndecan-1 (SDC-1) significantly supports the binding of VWF fibers to endothelial cells. Heparinase-mediated degradation or impaired synthesis of heparan sulfate (HS), a major component of the endothelial glycocalyx, reduces VWF fiber–dependent platelet recruitment. Molecular interaction studies using flow cytometry and live-cell fluorescence microscopy provided further evidence that VWF binds to HS linked to SDC-1. In a murine melanoma model, we found that protection of the endothelial glycocalyx through the silencing of heparanase increases the number of VWF fibers attached to the wall of tumor blood vessels. In conclusion, we identified HS chains as a relevant binding factor for VWF fibers at the endothelial cell surface in vitro and in vivo.
Migrant and refugee populations: a public health and policy perspective on a continuing global crisis
Authors: Abbas Mohamed , Aloudat Tammam , Bartolomei Javier , Carballo Manuel , Durieux-Paillard Sophie , Gabus Laure , Jablonka Alexandra , Jackson Yves , Kaojaroen Kanokporn , Koch Daniel , Martinez Esperanza , Mendelson Marc , Petrova-Benedict Roumyana , Tsiodras Sotirios , Christie Derek , Saam Mirko , Hargreaves Sally , Pittet Didier
Published: September 2018

The 2015–2017 global migratory crisis saw unprecedented numbers of people on the move and tremendous diversity in terms of age, gender and medical requirements. This article focuses on key emerging public health issues around migrant populations and their interactions with host populations. Basic needs and rights of migrants and refugees are not always respected in regard to article 25 of the Universal Declaration of Human Rights and article 23 of the Refugee Convention. These are populations with varying degrees of vulnerability and needs in terms of protection, security, rights, and access to healthcare. Their health status, initially conditioned by the situation at the point of origin, is often jeopardised by adverse conditions along migratory paths and in intermediate and final destination countries. Due to their condition, forcibly displaced migrants and refugees face a triple burden of non-communicable diseases, infectious diseases, and mental health issues. There are specific challenges regarding chronic infectious and neglected tropical diseases, for which awareness in host countries is imperative. Health risks in terms of susceptibility to, and dissemination of, infectious diseases are not unidirectional. The response, including the humanitarian effort, whose aim is to guarantee access to basic needs (food, water and sanitation, healthcare), is gripped with numerous challenges. Evaluation of current policy shows insufficiency regarding the provision of basic needs to migrant populations, even in the countries that do the most. Governments around the world need to rise to the occasion and adopt policies that guarantee universal health coverage, for migrants and refugees, as well as host populations, in accordance with the UN Sustainable Development Goals. An expert consultation was carried out in the form of a pre-conference workshop during the 4th International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland, on 20 June 2017, the United Nations World Refugee Day.
Seismic Performance of Ductile Steel Moment-Resisting Frames Subjected to Multiple Strong Ground Motions
Authors: Tenderan Randy , Ishida Takanori , Jiao Yu , Yamada Satoshi
Published: September 2018

This study evaluates the seismic performance of steel moment-resisting frames (SMRFs) under multiple strong ground motions. The cumulative damage of beam members is used as the main damage index. A cumulative damage formula is generated based on the experimental results of the steel beam-to-column connection test considering the ductile fracture. Local buckling of members is not considered in this study. Six SMRF models with two parameters (the number of stories and the strength of the column base) are analyzed by conducting an inelastic response analysis. Three different ground motion intensities (peak ground velocity = 0.5 m/s (design level), 0.75 m/s, and 1.0 m/s), each with five repeated excitations are used in the inelastic response analysis to simulate the occurrence of multiple strong ground motions. Stable behavior with a linear increment in cumulative damage is found in most cases, especially when the ground motion intensity is equal to the design level. However, when the intensity is greater than the design level, both ductile fracture and weak story collapse are observed in several cases.
Seismic Collapse Fragility Analysis of Reinforced Concrete Shear Wall Buildings
Authors: Dabaghi Mayssa , Saad George , Allhassania Naser
Published: September 2018

This paper examines the behavior of reinforced concrete shear wall buildings subjected to strong earthquake ground motions, with a focus on collapse performance. The effect of varying the number of stories, shear wall and boundary element dimensions, and reinforcement detailing on the seismic collapse fragility is investigated. The buildings are seismically designed based on the ASCE 7-10 and ACI 318-14 codes with additional provisions for capacity design and dynamic amplification. The shear walls are modeled using the shear-flexure interaction multiple vertical line element model with nonlinear hysteretic material models. Incremental dynamic analysis is performed to simulate the structural collapse of the two-dimensional building models subjected to the FEMA-P695 set of far field recorded ground motions scaled to increasing intensity values. For each building, a lognormal collapse fragility curve is fitted to the results. A collapse assessment of the studied buildings shows how the seismic performance is significantly affected by the varied parameters.
High Pregnancy, Cord Blood, and Infant Vitamin D Concentrations May Predict Slower Infant Growth
Authors: Hauta-alus Helena H , Kajantie Eero , Holmlund-Suila Elisa M , Rosendahl Jenni , Valkama Saara M , Enlund-Cerullo Maria , Helve Otto M , Hytinantti Timo K , Viljakainen Heli , Andersson Sture , Mäkitie Outi
Published: September 2018

Context

The relationship of maternal and infant 25-hydroxyvitamin D concentration [25(OH)D] with infant growth is unclear.

Objective

Our objective was to explore whether 25(OH)D in pregnancy, umbilical cord blood (UCB), or in infancy was associated with infant growth.

Design

This study involved 798 healthy infants and their mothers in Finland. We assessed 25(OH)D during pregnancy, from UCB at birth, and from the infant at the age of 12 months.

Main Outcome Measures

Infant length, weight, length-adjusted weight, and head circumference at 6 and 12 months and midupper-arm circumference at 12 months.

Results

Of the mothers and infants, 96% and 99% were vitamin D sufficient [25(OH)D ≥50 nmol/L], respectively. Mothers with pregnancy 25(OH)D >125 nmol/L had the shortest, lightest (in weight), and thinnest (in length-adjusted weight) infants at 6 months (P for all < 0.05). For each 10 nmol/L higher UCB 25(OH)D, the infants were 0.03 SD score (SDS) shorter at 6 months (95% CI −0.05 to −0.01), adjusted for birth size, infant 25(OH)D, and parental height. Higher UCB 25(OH)D associated with smaller head circumference at 6 and 12 months (P for all <0.05) but attenuated after adjustments. Mothers with pregnancy 25(OH)D >125 nmol/L had the thinnest infants at 12 months (P = 0.021). For each 10 nmol/L higher infant 25(OH)D, the infants were 0.03 SDS lighter (−0.05 to −0.01) and 0.03 SDS thinner (−0.05 to 0.00) at 12 months.

Conclusions

Our results suggest that high pregnancy, cord blood, and infant vitamin D concentration may have disadvantageous effects on infant growth.
Pharmacokinetics of Glucocorticoid Replacement Before and After Bariatric Surgery in Patients With Adrenal Insufficiency
Authors: de Heide Loek J M , de Boer Hannah H R , van Borren Marcel , Emous Marloes , Aarts Edo , de Boer Hans
Published: September 2018

Adequate glucocorticoid replacement in patients with primary or secondary adrenal insufficiency is essential to maintain general well-being. Little is known about the effects of bariatric surgery on glucocorticoid absorption. This study evaluates glucocorticoid absorption before and after bariatric surgery, with assessment of plasma cortisol profiles in five patients receiving glucocorticoid replacement therapy for primary (n = 1) or secondary (n = 4) adrenal insufficiency. One patient underwent sleeve gastrectomy (SG), one a one-anastomosis gastric bypass (mini-GB), and three a Roux-en-Y gastric bypass (RYGB). Pharmacokinetic calculations were based on plasma cortisol measurements performed during the first 6 hours after ingestion of the morning dose. Plasma cortisol profiles were very similar before and after surgery; only minor differences were observed. After SG, plasma peak cortisol concentration and cortisol area under the curve (AUC) were higher by 23% and 24%, respectively, and time to peak cortisol was 10 minutes shorter. The mini-GB had no marked effect on pharmacokinetic parameters. In the three patients who underwent RYGB, AUC changes ranged from −12% to 20%. In conclusion, in this small number of patients with adrenal insufficiency, plasma cortisol profiles were similar before and after bariatric surgery. However, in view of individual differences in response to different types of surgery, we recommend postoperative cortisol profiling to guide appropriate glucocorticoid dose adjustment.
Axial morphology and 3D neurocranial kinematics in suction-feeding fishes
Authors: Jimenez Yordano E. , Camp Ariel L. , Grindall Jonathan D. , Brainerd Elizabeth L.
Published: September 2018

Many suction-feeding fish use neurocranial elevation to expand the buccal cavity for suction feeding, a motion necessarily accompanied by the dorsal flexion of joints in the axial skeleton. How much dorsal flexion the axial skeleton accommodates and where that dorsal flexion occurs may vary with axial skeletal morphology, body shape and the kinematics of neurocranial elevation. We measured three-dimensional neurocranial kinematics in three species with distinct body forms: laterally compressed Embiotoca lateralis, fusiform Micropterus salmoides, and dorsoventrally compressed Leptocottus armatus. The area just caudal to the neurocranium occupied by bone was 42±1.5%, 36±1.8% and 22±5.5% (mean±s.e.m.; N=3, 6, 4) in the three species, respectively, and the epaxial depth also decreased from E. lateralis to L. armatus. Maximum neurocranial elevation for each species was 11, 24 and 37°, respectively, consistent with a hypothesis that aspects of axial morphology and body shape may constrain neurocranial elevation. Mean axis of rotation position for neurocranial elevation in E. lateralis, M. salmoides and L. armatus was near the first, third and fifth intervertebral joints, respectively, leading to the hypothesis of a similar relationship with the number of intervertebral joints that flex. Although future work must test these hypotheses, our results suggest the relationships merit further inquiry.
Characterisation of maturation of photoreceptor cell subtypes during zebrafish retinal development
Authors: Crespo Cátia , Knust Elisabeth
Published: September 2018

Photoreceptor cells (PRCs) mature from simple epithelial cells, a process characterised by growth and compartmentalisation of the apical membrane into an inner and an outer segment. So far, a PRC subtype-specific description of morphological and cellular changes in the developing zebrafish retina is missing. Here, we performed an in-depth characterisation of four of the five PRC subtypes of the zebrafish retina between 51 and 120 hours post fertilisation, including quantification of the size of different compartments, localisation of polarity proteins and positioning of organelles. One of the major findings was the anisotropic and subtype-specific growth of the different PRC compartments. In addition, a transient accumulation of endoplasmic reticulum in rod PRCs, changes in chromatin organisation in UV sensitive cones and differential expression of polarity proteins during the initial stages of PRC maturation were observed. The results obtained provide a developmental timeline that can be used as a platform for future studies on PRC maturation and function. This platform was applied to document that increased exposure to light leads to smaller apical domains of PRCs.
Mice doubly deficient in Six4 and Six5 show ventral body wall defects reproducing human omphalocele
Authors: Takahashi Masanori , Tamura Masaru , Sato Shigeru , Kawakami Kiyoshi
Published: September 2018

Omphalocele is a human congenital anomaly in ventral body wall closure and may be caused by impaired formation of the primary abdominal wall (PAW) and/or defects in abdominal muscle development. Here, we report that mice doubly deficient in homeobox genes Six4 and Six5 showed the same ventral body wall closure defects as those seen in human omphalocele. SIX4 and SIX5 were localized in surface ectodermal cells and somatic mesoderm-derived mesenchymal and coelomic epithelial cells (CECs) in the PAW. Six4−/−;Six5−/− fetuses exhibited a large omphalocele with protrusion of both the liver and intestine, or a small omphalocele with protrusion of the intestine, with complete penetrance. The umbilical ring of Six4−/−;Six5−/− embryos was shifted anteriorly and its lateral size was larger than that of normal embryos at the E11.5 stage, before the onset of myoblast migration into the PAW. The proliferation rates of surface ectodermal cells in the left and right PAW and somatic mesoderm-derived cells in the right PAW were lower in Six4−/−;Six5−/− embryos than those of wild-type embryos at E10.5. The transition from CECs of the PAW to rounded mesothelial progenitor cells was impaired and the inner coelomic surface of the PAW was relatively smooth in Six4−/−;Six5−/− embryos at E11.25. Furthermore, Six4 overexpression in CECs of the PAW promoted ingression of CECs. Taken together, our results suggest that Six4 and Six5 are required for growth and morphological change of the PAW, and the impairment of these processes is linked to the abnormal positioning and expansion of the umbilical ring, which results in omphalocele.
Regulated reconstitution of spindle checkpoint arrest and silencing through chemically induced dimerisation in vivo
Authors: Amin Priya , Soper Ní Chafraidh Sadhbh , Leontiou Ioanna , Hardwick Kevin G.
Published: September 2018

Chemically induced dimerisation (CID) uses small molecules to control specific protein–protein interactions. We employed CID dependent on the plant hormone abscisic acid (ABA) to reconstitute spindle checkpoint signalling in fission yeast. The spindle checkpoint signal usually originates at unattached or inappropriately attached kinetochores. These are complex, multiprotein structures with several important functions. To bypass kinetochore complexity, we took a reductionist approach to studying checkpoint signalling. We generated a synthetic checkpoint arrest ectopically by inducing heterodimerisation of the checkpoint proteins Mph1 (the fission yeast homologue of Mps1) and Spc7 (the fission yeast homologue of KNL1). These proteins were engineered such that they cannot localise to kinetochores, and only form a complex in the presence of ABA. Using this novel assay we were able to checkpoint arrest a synchronous population of cells within 30 min of ABA addition. This assay allows detailed genetic dissection of checkpoint activation and, importantly, also provides a valuable tool for studying checkpoint silencing. To analyse silencing of the checkpoint and the ensuing mitotic exit, we simply washed out the ABA from arrested fission yeast cells. We show here that silencing is critically dependent on protein phosphatase 1 (PP1) recruitment to Mph1-Spc7 signalling platforms.
Frog muscle fibers bear a larger fraction of passive muscle tension than mouse fibers
Authors: Meyer Gretchen , Lieber Richard L.
Published: September 2018

Differences in passive muscle mechanical properties between amphibians and mammals have led to differing hypotheses on the functional role of titin in skeletal muscle. Early studies of frog muscle clearly demonstrated intracellular load-bearing by titin, but more recent structural and biological studies in mice have shown that titin may serve other functions. Here we present biomechanical studies of isolated frog and mouse fibers and fiber bundles to compare the relative importance of intracellular vs. extracellular load bearing in these species. Mouse bundles exhibited increased modulus compared with fibers on the descending limb of the length-tension curve, reaching a 2.4-fold elevation at the longest sarcomere lengths. By contrast, frog fibers and bundles had approximately the same modulus at all sarcomere lengths tested. These findings suggest that, in contrast to frog muscle, titin does not bear a significant amount of the whole muscle passive tension in mammals.
Autoimmune epilepsy: findings on MRI and FDG-PET
Authors: Guerin Julie , Watson Robert E , Carr Carrie M. , Liebo Greta B , Kotsenas Amy L
Published: September 2018

Autoimmune epilepsy (AE) is becoming increasingly recognized as a potentially reversible cause of frequent or medically intractable seizures and cognitive deterioration. We describe various presentations of autoimmune encephalopathy which have specifically presented with seizure and describe reported imaging findings. This is organized as a review of the more common autoantibodies which can specifically precipitate seizure according to the intracellular or extracellular location of the targeted antigen. For each antibody, we illustrate their pathophysiology, characteristic clinical presentations with typical effective treatments and prognoses and imaging findings on MRI and PET/CT exams. Parenchymal involvement is variable with the limbic structures typically affected; however, non-limbic cortex, cerebellum, brainstem and basal ganglia can also be involved. In the acute setting, affected regions typically demonstrate T  2 hyperintensity with mild mass effect from edema and increased 18F-fludeoxyglucose uptake. Chronically involved parenchyma will often undergo atrophy and demonstrate decreased metabolism; mesial temporal sclerosis is often the end result when the limbic system is involved. Without treatment, long-term effects from AE range from ongoing cognitive dysfunction and refractory seizures to death. Familiarity with AE may prompt appropriate antibody screening, particularly in cases of refractory seizure disorders. Early investigation and proper management of AE cases may help to prevent parenchymal and neurologic deterioration in these patients.
Feature selection with the R package MXM
Authors: Tsagris Michail , Tsamardinos Ioannis
Published: September 2018

Feature (or variable) selection is the process of identifying the minimal set of features with the highest predictive performance on the target variable of interest. Numerous feature selection algorithms have been developed over the years, but only few have been implemented in R as a package. The R package MXM is such an example, which not only offers a variety of feature selection algorithms, but has unique features that make it advantageous over its competitors: a) it contains feature selection algorithms that can treat numerous types of target variables, including continuous, percentages, time to event (survival), binary, nominal, ordinal, clustered, counts, left censored, etc; b) it contains a variety of regression models to plug into the feature selection algorithms; c) it includes an algorithm for detecting multiple solutions (many sets of equivalent features); and d) it includes memory efficient algorithms for high volume data, data that cannot be loaded into R. In this paper we qualitatively compare MXM with other relevant packages and discuss its advantages and disadvantages. We also provide a demonstration of its algorithms using real high-dimensional data from various applications.
Dialectic of Violence and Nonviolence
Authors: Таусинова О. , Tausinova O.
Published: September 2018

The article attempts to consider the dialectical interconnection between violence and nonviolence. Practical applications include a better understanding of the boundaries of violence and non-violence, which may further help to clarify the classification of types of violence.
Phenomenon of Autism in the Prospect of Cultural Anthropology
Authors: Викторук Елена , Viktoruk Elena , Гох А. , Goh A. , Минеев В. , Mineev V.
Published: September 2018

The entity of people with special health needs (SHN), in particular with disorders of the autistic spectrum becomes an important socio-cultural subsystem. This subsystem covers not only persons with SHN, but also their environment. The implementation of the correctional system is a disadvantage, in comparison with the inclusive model in which people with SHN are integrated into society. The problem for the solution of which the authors’ efforts are made is that, for the present, the considerable part of the world population is not ready to accept the autistic community as a real agent of the social planning, which fulfills its own management strategies. Researchers of autism quite often ignore a position of the most autistic community on this or that question. The purpose of this article consists in search of approaches to creation of a conceptual model of autism and autistic community, which could form the reliable basis for development of the social technologies promoting a full integration of the people with special health needs into society. Mainly theoretical methods of research are used: logical analysis, elements of the structural-functional analysis, comparative analysis, and also axiological approach. At the same time, an attempt to generalize a primary data obtained by empirical methods, such as observation, participant observation, questioning, the content analysis, interview is made. It is shown that for the stated goal to be achieved it is fruitful to consider a phenomenon of autism in the prospect of cultural anthropology. The concept of autistic culture is clarified and its relevance for study of autism and autistic community is substantiated. Some features of autistic culture are revealed. The discussion showed that many criteria of autism can be fully understood from the cultural-anthropological standpoint. The proposed approach meets the principles of post-non-classical rationality and allows to mitigate the social-biological dilemma. The results obtained can form a methodological-and-world-outlook basis for investigations in the fields of pedagogics, psychology, culturology.
Designing an education programme to improve quality of life for cancer survivors: a systematic review
Authors: Aubin Mel , Egan Dominic
Published: September 2018

Health and wellbeing education programmes, as part of the recovery package, are now recommended for all cancer patients on completion of treatment. There is limited evidence to determine whether such programmes improve the quality of life (QoL) for cancer survivors. The purpose of the systematic review was to synthesise the available research and provide recommendations for practice and education programme delivery. A critical appraisal and narrative synthesis of eligible randomised controlled trials showed that there was a small mean percentage difference in reported QoL for cancer survivors who participated in an education programme (8%) over those who received usual care alone (7%). Cancer-site specific programmes are recommended over generic programmes. The optimum time frame for programme delivery is between 3 and 12 months following treatment. Various methods of programme delivery are effective, including face-to-face group sessions and self-directed web-based programmes.
APPLYING ANP TO ANALYZE THE ROLE OF DESIGN IN THE FURNITURE INDUSTRY
Authors: Azizi Majid , Mehdikhanloo Gholamreza
Published: September 2018

This study was carried out due to the severe dearth of research on the role of design in furniture production and the furniture market in Iran. Accordingly, this research proposes a decision making model to select the best solution for the role of design in this industry. The four possibilities that can be considered as potential solutions include using fashion design in furniture production (S1), using engineering design in furniture production (S2), using a combination of fashion and engineering designs in furniture production (S3), and applying the leading country’s design capability with an outsourcing approach in furniture production (S4). The Analytic Network Process and Super Decision software were used to synthesize and analyze the model. It was found that all of the calculated decisions were influenced by the strategic criteria. A value-weighted competency model was calculated in the first stage with the influence of strategic criteria on the model. Hierarchical design decisions were made for each of the competencies and their subsets (298 sub-criteria and 31 middle indices). Paired comparison matrices associated with the degree of importance of each of the competencies were achieved in the second stage. In the final stage, subsets of the competency’s weights and their sub-options were identified with the combination of the competencies and the best solution was obtained.
Prospects for Nordic intensive forest management solutions in the Republic of Karelia
Authors: Senko Sergei , Kurttila Mikko , Karjalainen Timo
Published: September 2018

In this study, the prospects for future forest management in Republic of Karelia, Russia were analyzed. Forestry has an important role in the economy of Karelia. However, productivity and profitability in the forestry sector are extremely low, forest stand structure and quality are weak, the commercial forest land of coniferous species has declined and the wood processing industry struggles with a deficit of raw materials. The situation is typical to many forest regions in Russia with extensive forest management cited as one reason for the current situation. In contrast, the Nordic countries have significant experience in intensive and sustainable forest management and the results have been to a large extent positive. The transfer of Nordic intensive forest management solutions (NIFMS) could improve forestry in Karelia. SWOT analysis, combined with the multi-criteria decision support (MCDS) method was used to identify local operational environments and to assign priorities. Major threats included unprepared regulations, poor road infrastructure, insecure investments, low forestry productivity, forest degradation, high investment costs and a negative attitude to intensive forestry. The main opportunities are high forest resource potential in Karelia, favorable authority development programs, proven Nordic expertise, wood-based energy development and availability of new technology. Results also showed that the main weaknesses that might influence the NIFMS in Karelia are slow return on investments, low market demand for energy wood, high costs associated with young forest thinnings, high demand for skilled specialists and a lack of investment in research and development.
Existence and non-existence results for Kirchhoff-type problems with convolution nonlinearity
Authors: Chen Sitong , Zhang Binlin , Tang Xianhua
Published: September 2018

This paper is concerned with the following Kirchhoff-type problem with convolution nonlinearity:

-(a+b∫ℝ3|∇u|2dx)Δu+V(x)u=(Iα*F(u))f(u),x∈ℝ3,u∈H1(ℝ3),-\bigg{(}a+b\int_{\mathbb{R}^{3}}\lvert\nabla u|^{2}\,\mathrm{d}x\bigg{)}% \Delta u+V(x)u=(I_{\alpha}*F(u))f(u),\quad x\in{\mathbb{R}}^{3},\,u\in H^{1}(% \mathbb{R}^{3}),

wherea,b>0{a,b>0},Iα:ℝ3→ℝ{I_{\alpha}\colon\mathbb{R}^{3}\rightarrow\mathbb{R}}, withα∈(0,3){\alpha\in(0,3)}, is the Riesz potential,V∈𝒞⁢(ℝ3,[0,∞)){V\in\mathcal{C}(\mathbb{R}^{3},[0,\infty))},f∈𝒞⁢(ℝ,ℝ){f\in\mathcal{C}(\mathbb{R},\mathbb{R})}andF⁢(t)=∫0tf⁢(s)⁢ds{F(t)\kern-1.0pt=\kern-1.0pt\int_{0}^{t}f(s)\,\mathrm{d}s}. By using variational and some new analytical techniques, we prove that the above problem admits ground state solutions under mild assumptions onVandf. Moreover, we give a non-existence result. In particular, our results extend and improve the existing ones, and fill a gap in the case wheref⁢(u)=|u|q-2⁢u{f(u)=|u|^{q-2}u}, withq∈(1+α/3,2]{q\in(1+\alpha/3,2]}.
Pharaoh’s Sorcerers Revisited: A Sahidic Exodus Apocryphon (P.Lips. Inv. 2299) and the Legend of Jannes and Jambres the Magicians Between Judaism, Christianity, and Native Egyptian Tradition
Authors: Krueger Frederic
Published: September 2018

This article presents an edition of a 4th century Coptic fragment of a hitherto unknown Old Testament apocryphon that gives a non-canonical version of the events of Exodus. It offers a specifically Egyptian literary history of the legendary magicians Jannes and Jambres, which highlights the so far unappreciated dependence of their own Apocryphon on pagan Egyptian tales about magicians.
The Physical Activity Leader and Comprehensive School Physical Activity Program Effectiveness
Authors: Brusseau Timothy A. , Burns Ryan D.
Published: September 2018

Study aim: Two thirds of children are not meeting recommended levels of physical activity. A solution to physical inactivity is Comprehensive School Physical Activity Programming (CSPAP). Little is known regarding the impact of a school’s physical activity leader on CSPAP effectiveness. Therefore, this study explored changes in physical activity accumulated during school hours in CSPAP schools being led by the physical education teacher compared to a stand-alone physical activity leader.