bluuebunny/crossref_metadata_2025 huggingface dataset:
SPECT/CT With the PSMA Ligand 99mTc-MIP-1404 for Whole-Body Primary Staging of Patients With Prostate Cancer
Authors: Schmidkonz Christian , Cordes Michael , Beck Michael , Goetz Theresa Ida , Schmidt Daniela , Prante Olaf , Bäuerle Tobias , Uder Michael , Wullich Bernd , Goebell Peter , Kuwert Torsten , Ritt Philipp
Published: February 2018

Background

99mTc-MIP-1404 (Progenics Pharmaceuticals, Inc, New York, NY) is a novel ligand binding to prostate-specific membrane antigen suitable for SPECT. There are, as yet, no data concerning its use in whole-body primary staging and its interobserver variability in patients with prostate cancer (PC) prior to therapy.

Methods

A search of our clinical database from April 2013 to May 2017 yielded 93 patients with histologically confirmed cancer in whom 99mTc-MIP-1404 SPECT/CT had been performed for primary whole-body staging before therapy. Whole-body planar and SPECT/CT images of the lower abdomen and thorax had been obtained 3 to 4 hours postinjection of 706 ± 72 MBq 99mTc-MIP-1404. Images were visually analyzed for extent and location of abnormal uptake by 2 experienced nuclear physicians. Interobserver agreement for detection of primary tumor and metastatic lesions was assessed. In addition, SUVs of prostate-specific membrane antigen–positive regions of the prostate were determined in all patients, and from these, a variable reflecting total tumor load in the prostate gland was calculated (TUprostate). Follow-up reports of subsequent therapeutic interventions were available in 52 (56%) of all patients with a median follow-up of 18 months.

Results

In 90 (97%) of 93 patients, prostate uptake above background was detected as correlate of the histologically diagnosed PC. Forty-eight lymph node and 29 bone metastases were detected in 16 and 9 patients, respectively. In addition, 3 patients had disseminated bone metastases. No distant organ metastases were found. Interobserver agreement was high for the overall scan result (97%), as well as for the detection of the primary tumor (97%), of lymph node metastases (97%), and of bone metastases (99%). Recurrence of PC occurred in 5 patients in whom follow-up was available (10%). TUprostate was significantly higher in patients with Gleason scores of 8 or greater compared with patients with Gleason scores of 7 or less and at prostate-specific antigen (PSA) serum levels of 10 ng/mL or greater compared with PSA serum levels of 10 ng/mL or less. TUprostate of greater than 26 in the primary tumor predicted the occurrence of lymph node or bone metastases with a sensitivity of 82% and specificity of 76%.

Conclusions

MIP-1404 SPECT/CT has a high accuracy and low interobserver variability in the diagnosis of PC and allows detection of lymph node and bone metastases in a significant proportion of as yet untreated PC patients. TUprostate is correlated with Gleason score and PSA serum concentration and allows prediction of the occurrence of lymph node and bone metastases with moderate accuracy at primary staging.
Incidental Detection of Synchronous Lung Melanoma on 18F-FDG PET/CT in a Patient With Parotid Gland Myoepithelial Carcinoma
Authors: Parihar Ashwin Singh , GA Abhiram , Sood Karan , Seam Rajeev Kumar , Kaushal Vijay , Sood Ashwani , Kakkar Nandita , Mittal Bhagwant Rai
Published: February 2018

The detection of synchronous or metachronous malignancies is on the rise with the advent of whole-body 18F-FDG PET/CT. It has shown its utility in detecting second primary carcinoma in patients undergoing imaging for evaluation of primary carcinoma, influencing the management and overall survival. Primary malignant melanoma of the lung is an extremely rare entity, accounting for 0.01% of all lung tumors. It is an even rare occurrence as a synchronous malignancy. We present the case of a 33-year-old woman with primary parotid myoepithelial carcinoma and incidental detection of second primary malignant melanoma of lung during 18F-FDG PET/CT imaging.
False-Positive 18F-FDG PET/CT Due to Filgrastim That Induced Extramedullary Liver Hematopoiesis in a Burkitt Lymphoma
Authors: Maffione Anna Margherita , Rampin Lucia , Rossella Paolini , Pecori Sara , Colletti Patrick M. , Rubello Domenico
Published: February 2018

We report a case of Burkitt lymphoma with largely extranodal disease localizations at staging. Chemotherapy was given, thus obtaining a complete metabolic response in all previous disease sites as shown at a control PET, however associated to the appearance of new focal uptake areas in the liver; these findings were confirmed at US and MRI. Chemotherapy determined also neutropenia that was treated by filgrastim, followed by a prompt and important medullary response. Liver biopsy revealed extramedullary hematopoiesis, probably filgrastim induced. Filgrastim administration may cause false-positive findings in the liver at FDG PET.
Cognitive Aids Do Not Prompt Initiation of Cardiopulmonary Resuscitation in Simulated Pediatric Cardiopulmonary Arrests
Authors: Nelson McMillan Kristen , Rosen Michael A. , Shilkofski Nicole A. , Bradshaw Jamie Haggerty , Saliski Mary , Hunt Elizabeth A.
Published: February 2018

Introduction

Although American Heart Association guidelines exist for proper management of cardiopulmonary arrest (CPA), in-hospital cardiopulmonary resuscitation (CPR) may be of poor quality and is not performed in all indicated situations. Cognitive aids have been created to assist in rapid, accurate recall of guidelines for pediatric CPA management.

Methods

Pediatric residents participated in individual mock codes for two years. Using a high-fidelity simulator, each resident participated in a standardized scenario that required management of both pulseless ventricular tachycardia and pulseless electrical activity. The primary study objective was to calculate the proportion of residents (a) who were not performing CPR on a simulated “pulseless” patient when cognitive aid use was first initiated and (b) who subsequently initiated CPR after cognitive aid use.

Results

One hundred thirty-two (83.5%) of 158 pediatric residents participated, and of 125 videos available for review, 107 residents (85.6%) used a cognitive aid. Mean (SD) time to cognitive aid use was 106 (100) seconds after the mannequin became pulseless. Most common immediate actions prompted by cognitive aid use were the following: defibrillation, 43 (40%) of 107; and adrenaline (epinephrine) administration, 28 (26%) of 107. Most alarmingly, 58 (54%) of 107 were not performing CPR on the pulseless patient when cognitive aid use was initiated and only two (3.4%) of 58 were subsequently prompted to initiate chest compressions.

Discussion

Cognitive aids in use during this study did not prompt timely initiation of CPR, potentially contributing to delays and errors in CPA management. Failure of these aids to prompt CPR initiation represents a “missed opportunity” to enhance performance of this vital skill.
CSF Beta-amyloid 1–42 Concentration Predicts Delirium Following Elective Arthroplasty Surgery in an Observational Cohort Study
Authors: Cunningham Emma L. , McGuinness Bernadette , McAuley Daniel F. , Toombs Jamie , Mawhinney Tim , O’Brien Seamus , Beverland David , Schott Jonathan M. , Lunn Michael P. , Zetterberg Henrik , Passmore Anthony P.
Published: February 2018

Objective:

To test the hypothesis that APOE ε4 status and cerebrospinal fluid (CSF) Aβ42, T-tau and P-tau would independently predict the risk of postoperative delirium.

Background:

Delirium following surgery is common and associated with adverse outcomes. Age and cognitive impairment are consistent risk factors for postoperative delirium.

Methods:

This observational cohort study recruited 282 participants aged 65 years or older, without a diagnosis of dementia, admitted for primary elective hip or knee arthroplasty. Cognitive tests were undertaken preoperatively, blood and CSF were sampled at the time of spinal anesthesia, and participants were assessed daily postoperatively for delirium.

Results:

Increasing age (P = 0.04), preoperative comorbidity (P = 0.03), type of surgery (P = 0.05), intravenous opioid usage (P = 0.04), and low CSF Aβ42 (P < 0.01) were independent predictors of postoperative delirium.

Conclusions:

This study is the first to show an independent association between CSF Aβ42 and delirium incidence in an elective surgical population, suggesting that postoperative delirium may indicate incipient Alzheimer disease.
Immunomodulatory effects of plasma products on monocyte function in vitro
Authors: Shah Sanjna , Coppolino Katirina , Menocha Somaang , Beceiro Susana , Nateri Jyotsna , Spinella Philip C. , Nicol Kathleen , Hall Mark W. , Muszynski Jennifer A.
Published: February 2018

BACKGROUND

Restoration of a balanced innate immune response is paramount to recovery from critical injury. Plasma transfusion may modulate innate immune responses; however, little is known about the immunomodulatory potential of various plasma products. We conducted in vitro experiments to determine the effects of fresh frozen plasma, thawed plasma, solvent/detergent plasma, and an investigational spray-dried solvent/detergent plasma product on monocyte function.

METHODS

Monocytes were isolated from healthy adult volunteers and cocultured with aliquots of autologous plasma (control), fresh frozen plasma, thawed plasma, solvent/detergent treated plasma, or spray-dried solvent/detergent plasma. Monocyte function was assessed by cytokine production with and without lipopolysaccharide (LPS) stimulation, and flow cytometric assessment of HLA-DR cell surface expression.

RESULTS

Monocyte cytokine production was not significantly altered after exposure to fresh frozen plasma or thawed plasma. In the absence of LPS, spray-dried solvent/detergent plasma exposure resulted in markedly increased IL-8 production compared to other plasma groups and controls (p = 0.01, analysis of variance [ANOVA]). Likewise, spray-dried SD plasma exposure resulted in higher LPS-induced IL-8, TNFα, and IL-1β production compared with autologous plasma controls (p < 0.0001; p < 0.0001, p = 0.002, respectively; ANOVA). LPS-induced IL-8 and TNFα production was lowest after exposure to solvent/detergent plasma (p < 0.0001, ANOVA).

CONCLUSION

Exposure to spray-dried solvent/detergent plasma resulted in marked augmentation of monocyte inflammatory cytokine production. Solvent/detergent plasma exposure resulted in the lowest cytokine production, suggesting lower immunomodulatory potential. Further work is needed to determine how these in vitro findings may translate to the bedside.
Prophylactic use of resuscitative endovascular balloon occlusion of the aorta in women with abnormal placentation: A systematic review, meta-analysis, and case series
Authors: Ordoñez Carlos A. , Manzano-Nunez Ramiro , Parra Michael W. , Rasmussen Todd E. , Nieto Albaro J. , Herrera-Escobar Juan P. , Fernandez Paula , Naranjo Maria P. , García Alberto F. , Carvajal Javier A. , Burgos Juan M. , Rodriguez Fernando , Escobar-Vidarte Maria F.
Published: February 2018

BACKGROUND

We describe intraoperative and postdischarge outcomes of a case series after the prophylactic use of resuscitative endovascular balloon occlusion of the aorta (REBOA) during elective cesarean delivery in pregnant women with morbidly adherent placenta (MAP). We furthermore performed a systematic review and meta-analysis to investigate the safety and effectiveness of the use of REBOA during elective cesarean delivery in pregnant women with MAP.

METHODS

Descriptive case series of REBOA (December 2015 to June 2017) used during elective cesarean delivery in pregnant women with MAP. The systematic review was conducted following PRISMA guidelines. We included studies involving pregnant women with a diagnosis of MAP who underwent an elective cesarean delivery with prophylactic REBOA placement. A meta-analysis was performed to assess the overall amount of transfusions and intraoperative hemorrhage of REBOA compared to NO-REBOA cases.

RESULTS

A total of 12 patients with MAP underwent elective cesarean delivery with REBOA deployment. The median (interquartile range) of packed red blood cells transfused during the first 24 hours following surgery was two units (0–3.5). The median (interquartile range) of intraoperative blood loss was 1,500 mL (900–2,750). At 28 days, all patients were alive, and no adverse outcomes were observed. Four articles were included in the systematic review and meta-analysis. These articles included a total of 441 patients. Quantitative synthesis (meta-analysis) found that the use of REBOA as prophylaxis for the prevention of major hemorrhage was associated with a lower amount of intraoperative hemorrhage (in milliliters) (weighted mean difference, −1,384.66; 95% confidence interval, −2,141.74 to −627.58) and lower requirements of blood products transfusions (in units) (weighted mean difference, −2.42; 95% confidence interval, −3.90 to −0.94).

CONCLUSION

We provide clinical data supporting the use of REBOA in the management of pregnant women with MAP undergoing elective cesarean delivery. Our findings demonstrate the feasibility of REBOA as a prophylactic intervention to improve outcomes in women at risk of catastrophic postpartum hemorrhage.

LEVEL OF EVIDENCE

Therapeutic study, level V; Systematic Review, level IV.
Histone deacetylase inhibitors: Isoform selectivity improves survival in a hemorrhagic shock model
Authors: Chang Panpan , Weykamp Michael , Dennahy Isabel S. , Williams Aaron M. , Bhatti Umar F. , Liu Baoling , Nikolian Vahagn C. , Li Yongqing , Alam Hasan B.
Published: February 2018

BACKGROUND

Hemorrhage is a leading preventable cause of death. Nonselective histone deacetylase inhibitors (HDACIs), such as valproic acid (VPA), have been shown to improve outcomes in hemorrhagic shock (HS). The HDACs can be divided into four functional classes (I, IIa/IIb, III, and IV). Classes I, IIa/IIb, and III have previously been implicated in the pathophysiology of HS. This study aimed to determine which HDAC class, or classes, are responsible for the survival benefit observed with nonselective HDACIs.

METHODS

Survival study: Sprague-Dawley rats were subjected to lethal HS (50% hemorrhage) and randomized to the following groups (n = 8): (1) no treatment, (2) normal saline vehicle, (3) cyclodextrin vehicle, (4) MS275 (class I HDACI), (5) VPA (class I/IIa HDACI), (6) MC1568 (class IIa HDACI), (7) ACY1083 (class IIb HDACI), and (8) EX527 (class III HDACI). Survival was monitored for 24 hours. Mechanistic study: Sprague-Dawley rats were subjected to sublethal HS (40% hemorrhage) and randomized to the same groups (n = 3), excluding EX527, based on results of the survival study. Tissues were harvested at 3 hours posttreatment, and expression of phosphorylated-AKT, β-catenin, acetylated histones H3 and H4, and acetylated α-tubulin were analyzed in myocardial tissue.

RESULTS

Survival rate was 12.5% in the untreated group, and did not improve with vehicle or MS275 treatment. EX527 improved survival to 50%, although this did not achieve statistical significance (p = 0.082). However, treatment with VPA, MC1568, and ACY1083 improved survival rates to 87.5%, 75%, and 75%, respectively (p < 0.05). The VPA-induced acetylation of both histones H3 and H4, while MC1568 and ACY1083 increased acetylation of histone H4. ACY1083 also induced acetylation of α-tubulin. All treatment groups, except MS275, increased phosphorylated-AKT, and β-catenin.

CONCLUSION

Inhibition of HDAC classes IIa or IIb, but not class I, activates prosurvival pathways, which may be responsible for the improved outcomes in rodent models of HS.
Hospital variation in mortality after emergent bowel resections: The role of failure-to-rescue
Authors: Mehta Ambar , Efron David T. , Stevens Kent , Manukyan Mariuxi C. , Joseph Bellal , Sakran Joseph V.
Published: February 2018

BACKGROUND

Hospital variation in failure-to-rescue (FTR) rates has partially explained nationwide differences in mortality after elective surgeries. To examine the role of FTR among emergency general surgery, we compared nationwide risk-adjusted mortality, complications, and FTR rates after emergent bowel resections.

METHODS

We identified patients who underwent emergent small or large bowel resections in the 2010 to 2011 Nationwide Inpatient Sample using the American Association for the Surgery of Trauma criteria. We then calculated risk-adjusted mortality rates for each hospital using multivariable logistic regressions and postestimation, which adjusted for patient age, sex, race and ethnicity, payer status, comorbidities, and hospital clustering. After excluding hospitals with fewer than 10 resections per year, we ranked the remaining hospitals by their risk-adjusted mortality rates and divided them into five quintiles. We compared both risk-adjusted complication rates and FTR rates between the top (lowest mortality) and bottom (highest mortality) quintiles.

RESULTS

We identified 21,564 emergent bowel resections, weighted to 105,925 procedures nationwide. The bottom quintile of hospitals had an overall risk-adjusted mortality rate that was 10.9 times higher than that of the top quintile of hospitals (15.3% vs. 1.4%). While risk-adjusted complication rates were similarly high for both the bottom and the top quintiles of hospitals (22.5% vs. 15.7%), the risk-adjusted FTR rates were 10.8 times higher in the bottom quintile of hospitals relative to the top quintile of hospitals (33.4% vs. 3.1%). Using larger hospital volume thresholds yielded similar findings. Furthermore, large variations existed in complication-specific FTR rates (surgical site infection [6.6%] to myocardial infarction [29.4%]).

CONCLUSION

Nationwide hospital variation in risk-adjusted mortality rates exist after emergent bowel resections. As complication rates were similar across hospitals, the significantly higher FTR rates at higher-mortality hospitals may drive this variation in mortality. System-level initiatives addressing the management of postoperative complications may improve patient care and reduce variation in outcomes.

LEVEL OF EVIDENCE

Prognostic and epidemiological study, level IV.
Transplantation of a Liver Allograft From a Hepatitis C Virus Seropositive Donor With Previous Sustained Virologic Response to an Uninfected Recipient Suffering Steroid Refractory Acute Graft Rejection With No Evidence of HCV Transmission
Authors: Mitchell Robert A. , Hussaini Trana , Yau Alan H. , Krajden Mel , Wright Alissa J. , Scudamore Charles H. , Marquez Azalgara Vladimir , Erb Siegfried R. , Yoshida Eric M.
Published: February 2018

Background

The goal of treating chronic hepatitis C virus (HCV) infection is sustained virologic response (SVR). There is concern that despite achieving SVR, replication-competent HCV may be sequestered at low levels within the liver and could theoretically reactivate with immunosuppression. We report transplantation of a HCV-seropositive liver donor, who achieved SVR, into a seronegative patient without HCV reactivation despite profound immunosuppression.

Method

Retrospective chart review.

Results

We present a 21-year-old male who was HCV seronegative and received a liver transplant from a donor who had been treated for HCV and achieved SVR. The liver recipient, despite developing severe acute graft rejection and undergoing intense immunosuppression with T cell–depleting antibodies, did not become HCV RNA-positive with a follow up period of 8 months. The recipient was HCV seronegative before transplant, but became HCV seropositive immediately posttransplant. The antibodies were undetectable after 97 days, in keeping with a passive antibody transmission or B lymphocyte transmission with the graft.

Conclusions

To the best of our knowledge, this is the first reported case of an HCV seropositive liver allograft transplanted into an HCV-negative recipient who subsequently received intense immunosuppression. This case, therefore, is an encouraging and novel step in liver transplantation, and demonstrates that SVR may be closer to a true “cure” of HCV in the donor population and that, even in circumstances of very potent immunosuppression in the recipient, this SVR is sustained.
Camptocormia Induced by a Dopaminergic Agonist
Authors: Mano Tomoo
Published: February 2018

Camptocormia, a condition that involves the abnormal flexion of the trunk and results in a forward-bending posture, is relatively common during the course of Parkinson disease (PD). Despite this, there is ongoing controversy concerning its mechanisms and no consensus regarding the underlying etiology. This report demonstrates a case in which a dopaminergic agonist (DA) was implicated in the onset of camptocormia episodes in a non-PD patient who developed camptocormia after the start of DA treatment. Over a course of 8 years, the patient experienced intermittent camptocormia, which resulted in multiple falls. After cessation of the DA, the patient showed decreased camptocormia symptoms. This case report suggests that clinicians should consider the possibility of DA-induced camptocormia in patients with PD and non-PD patients receiving DA treatments, and serves to caution clinicians regarding the administration of DAs.
Bismuth (III) sulfide as additive: towards better lubricity without toxicity
Authors: Müller Camila , Redondo Franco Leonardo , Dennehy Mariana , Ciolino Andrés Eduardo , Tuckart Walter Roberto
Published: February 2018

Purpose

The purpose of this study is to design a fluid formulation with good lubricant properties by using an environmentally friendly additive for: high and low contact pressure conditions and steel/steel and polymer/steel systems.

Design/methodology/approach

Bismuth (III) sulfide (Bi2S3, “green chemistry” synthesis) is added to a commercial vinyl-terminated silicone fluid (PDMS-Vi) to obtain different weight-per cent mixtures. Tribological performance of formulations is studied from Reichert’s tests (steel/steel system) and block on ring tests (polymer/steel). The results are compared with formulations prepared with commercial bismuth (III) sulfide (Bi2S3), molybdenum (IV) sulfide (MoS2) and graphite.

Findings

An orthorhombic crystal lattice (XRD ) and a high-purity product (XRF) are evidenced for synthesized Bi2S3. Lubricant properties increase when the weight-per cent of the synthesized Bi2S3 increases in formulations. The wear area decreases up to 90 per cent according to Reichert’s tests. The synthesized Bi2S3 shows a better tribological behavior when compared to commercial Bi2S3, MoS2 and graphite.

Originality/value

Replacement of lead derivatives by an environmentally friendly lubricant in extreme pressure (EP) formulations and excellent performance compared to commercially used additives are achieved.
Tribological characterization of Fe-Cu-Sn alloy with graphite as solid lubricant
Authors: Mushtaq Shuhaib , Wani Mohd Farooq
Published: February 2018

Purpose

This paper aims to investigate the effect of varying Wt.% (0-3 per cent) of graphite as a solid lubricant on the tribological properties of Fe-Cu-Sn alloy.

Design/methodology/approach

Powder metallurgy technique is used for the fabrication of Fe-Cu-Sn alloy with varying Wt.% of graphite. The tribological tests were conducted on a ball-on-disc universal tribometer under different testing conditions.

Findings

The friction coefficient decreases with sliding distance and load, but the wear rate increases with the increase in load. The G3 composition showed the best tribological properties under dry conditions. The wear mechanism of G0 composition shows adhesive wear and abrasive wear, while G1, G2 and G3 compositions show mildly abrasive wear.

Originality/value

This paper reported a new, cheap and wear-resistant self-lubricating Fe matrix material for gears and bearings.
Aging affects the in vivo regenerative potential of human mesoangioblasts
Authors: Rotini Alessio , Martínez‐Sarrà Ester , Duelen Robin , Costamagna Domiziana , Di Filippo Ester Sara , Giacomazzi Giorgia , Grosemans Hanne , Fulle Stefania , Sampaolesi Maurilio
Published: February 2018

Sarcopenia is the age‐related loss of muscle mass, strength, and function. Although the role of human satellite cells (SCs) as adult skeletal muscle stem cells has been deeply investigated, little is known about the impact of aging on muscle interstitial stem cells. Here, we isolated the non‐SC CD56– fraction from human muscle biopsies of young and elderly subjects. The elderly interstitial cell population contained a higher number of CD15+ and PDGFRα+ cells when compared to young samples. In addition, we found that the CD56–/ALP+ cells were well represented as a multipotent stem cell population inside the CD56– fraction. CD56–/ALP+/CD15– cells were clonogenic, and since they were myogenic and expressed NG2, α‐SMA and PDGFRβ can be considered mesoangioblasts (MABs). Interestingly, elderly MABs displayed a dramatic impairment in the myogenic differentiation ability in vitro and when transplanted in dystrophic immunodeficient Sgcb‐null Rag2‐null γc‐null mice. In addition, elderly MABs proliferated less, but yet retained other multilineage capabilities. Overall, our results indicate that aging negatively impacted on the regenerative potential of MABs and this should be carefully considered for potential therapeutic applications of MABs.
α‐Motor neurons are spared from aging while their synaptic inputs degenerate in monkeys and mice
Authors: Maxwell Nicholas , Castro Ryan W. , Sutherland Natalia M. , Vaughan Kelli L. , Szarowicz Mark D. , de Cabo Rafael , Mattison Julie A. , Valdez Gregorio
Published: February 2018

Motor function deteriorates with advancing age, increasing the risk of adverse health outcomes. While it is well established that skeletal muscles and neuromuscular junctions (NMJs) degenerate with increasing age, the effect of aging on α‐motor neurons and their innervating synaptic inputs remains largely unknown. In this study, we examined the soma of α‐motor neurons and innervating synaptic inputs in the spinal cord of aged rhesus monkeys and mice, two species with vastly different lifespans. We found that, in both species, α‐motor neurons retain their soma size despite an accumulation of large amounts of cellular waste or lipofuscin. Interestingly, the lipofuscin profile varied considerably, indicating that α‐motor neurons age at different rates. Although the rate of aging varies, α‐motor neurons do not atrophy in old age. In fact, there is no difference in the number of motor axons populating ventral roots in old mice compared to adult mice. Moreover, the transcripts and proteins associated with α‐motor neurons do not decrease in the spinal cord of old mice. However, in aged rhesus monkeys and mice, there were fewer cholinergic and glutamatergic synaptic inputs directly abutting α‐motor neurons, evidence that aging causes α‐motor neurons to shed synaptic inputs. Thus, the loss of synaptic inputs may contribute to age‐related dysfunction of α‐motor neurons. These findings broaden our understanding of the degeneration of the somatic motor system that precipitates motor dysfunction with advancing age.
Short‐term and long‐term measures of cortisol in saliva and hair in atypical and non‐atypical depression
Authors: Herane‐Vives A. , de Angel V. , Papadopoulos A. , Wise T. , Chua K.‐C. , Strawbridge R. , Castillo D. , Arnone D. , Young A. H. , Cleare A. J.
Published: February 2018

Background

Atypical depression may show lowered rather than raised short‐term cortisol levels. Atypical major depressive episodes (A‐MDE) may also be more closely linked to environmental factors and show overlap with somatic symptom disorders. Hair specimens allow measuring long‐term cortisol levels.

Methods

Twenty‐seven A‐MDE and 44 NA‐MDE patients and 40 matched controls were tested. Measures of hair cortisol concentration [HCC] covering the previous 3 months and short‐term cortisol parameters (six saliva specimens to assess the cortisol awakening response [CAR] and total daily cortisol output calculated as the area under the curve [AUCg]) were taken alongside measures of environmental factors and clinical variables.

Results

There were no differences in HCC between the three groups (P = 0.8), and no difference in the CAR (P = 0.95). However, A‐MDE showed lowered short‐term cortisol output (AUCg) compared to controls (P = 0.04). A‐MDE patients also reported a higher number of daily hassles, and higher levels of fatigue and impaired concentration than NA‐MDE.

Conclusions

Normal long‐term (HCC) and reduced short‐term (AUCg) cortisol levels in A‐MDE could suggest a disrupted long‐term cortisol rhythm, perhaps affected by environmental factors or by certain symptoms, such as mid‐nocturnal insomnia. However, other underlying explanations for these findings should also be investigated in the future.
THE POLITICS OF FDI EXPROPRIATION
Authors: Azzimonti Marina
Published: February 2018

I examine the role of political instability and fractionalization as potential explanations for the lack of capital flows from rich countries to poor countries (i.e., the Lucas Paradox). Using panel data from 1984 to 2014, I document that (i) developed countries exhibit larger inflows of foreign direct investment (FDI), (ii) countries subject to high investment risk (IR) receive low FDI inflows, and (iii) IR is higher in fractionalized and politically unstable economies. These findings suggest a negative relationship between political instability and FDI through the IR channel. I inspect the theoretical mechanism using a dynamic political economy model of redistribution, wherein policymakers can expropriate resources from foreign investors. The proceeds are used to finance group‐specific transfers to domestic workers but hinder economic growth by discouraging FDI. I show that the political equilibrium exhibits overexpropriation and underinvestment.
LEARNING MATTERS: REAPPRAISING OBJECT ALLOCATION RULES WHEN AGENTS STRATEGICALLY INVESTIGATE
Authors: Harless Patrick , Manjunath Vikram
Published: February 2018

Individuals form preferences through search, interviews, discussion, and investigation. In a stylized object allocation model, we characterize the equilibrium learning strategies induced by different allocation rules and trace their welfare consequences. Our analysis reveals that top trading cycles rules dominate serial priority rules under inequality‐averse measures of social welfare.
BANKRUPTCY AND DELINQUENCY IN A MODEL OF UNSECURED DEBT
Authors: Athreya Kartik , Sánchez Juan M. , Tam Xuan S. , Young Eric R.
Published: February 2018

This article documents and interprets a fact central to the dynamics of informal consumer debt default. We observe that for individuals 60– 90 days late on payments, (i) 85% make payments during the next quarter, and (ii) 40% reduce their debt. To understand these facts, we develop a quantitative model of debt delinquency and bankruptcy. Our model reproduces the dynamics of delinquency and suggests an interpretation of the data in which lenders frequently reset loan terms for delinquent borrowers, typically offering partial debt forgiveness, instead of a blanket imposition of the “penalty rates” most unsecured credit contracts specify.
WHAT DO VARS TELL US ABOUT THE IMPACT OF A CREDIT SUPPLY SHOCK?
Authors: Mumtaz Haroon , Pinter Gabor , Theodoridis Konstantinos
Published: February 2018

In the aftermath of the recent financial crisis, a variety of structural vector autoregression (VAR) models have been proposed to identify credit supply shocks. Using a Monte Carlo experiment, we show that the performance of these models can vary substantially, with some identification schemes producing particularly misleading results. When applied to U.S. data, the estimates from the best performing VAR models indicate, on average, that credit supply shocks that raise spreads by 10 basis points reduce GDP growth and inflation by 1% after one year. These shocks were important during the Great Recession, accounting for about half the decline in GDP growth.
AN OVER‐THE‐COUNTER APPROACH TO THE FOREX MARKET
Authors: Geromichalos Athanasios , Jung Kuk Mo
Published: February 2018

The foreign exchange (FOREX) market is an over‐the‐counter market characterized by intermediation and significant bid–ask spreads. However, most of the existing international macroeconomics literature models the FOREX as a standard Walrasian market. This article constructs a dynamic general equilibrium model of intermediation in the FOREX market. We use our framework to compute standard measures of FOREX liquidity, such as bid–ask spreads and trade volume, and study how they are affected by macroeconomic fundamentals and market microstructure. We also study how FOREX market microstructure affects the volume of international trade and, consequently, welfare. Our empirical exercise offers support to the models' main predictions.
CREDIT RATING AND DEBT CRISES
Authors: Holden Steinar , Natvik Gisle James , Vigier Adrien
Published: February 2018

We develop an equilibrium theory of credit rating in the presence of rollover risk. By influencing rational creditors, ratings affect sovereigns' probability of default, which in turn affects ratings. Our analysis reveals a pro‐cyclical impact of credit rating: In equilibrium the presence of a rating agency increases default risk when it is high and decreases default risk when it is low.
Robot‐assisted laparoscopic partial nephrectomy versus laparoscopic partial nephrectomy: A propensity score‐matched comparative analysis of surgical outcomes and preserved renal parenchymal volume
Authors: Tachibana Hidekazu , Takagi Toshio , Kondo Tsunenori , Ishida Hideki , Tanabe Kazunari
Published: February 2018

Objectives

To compare surgical outcomes, including renal function and the preserved renal parenchymal volume, between robot‐assisted laparoscopic partial nephrectomy and laparoscopic partial nephrectomy using propensity score‐matched analyses.

Methods

In total, 253 patients, with a normal contralateral kidney, who underwent laparoscopic partial nephrectomy (n = 131) or robot‐assisted laparoscopic partial nephrectomy (n = 122) with renal arterial clamping between 2010 and 2015, were included. Patients’ background and tumor factors were adjusted by propensity score matching. Surgical outcomes, including postoperative renal function, complications, warm ischemia time and preserved renal parenchymal volume, evaluated by volumetric analysis, were compared between the surgical procedures.

Results

After matching, 64 patients were assigned to each group. The mean age was 56–57 years, and the mean tumor size was 22 mm. Approximately 50% of patients had low complexity tumors (RENAL nephrometry score 4–7). The incidence rate of acute kidney failure was significantly lower in the robot‐assisted laparoscopic partial nephrectomy (11%) than laparoscopic partial nephrectomy (23%) group (P = 0.049), and warm ischemia time shorter in the robot‐assisted laparoscopic partial nephrectomy (17 min) than laparoscopic partial nephrectomy (25 min) group (P < 0.0001). The preservation rate of renal function, measured by the estimated glomerular filtration rate, at 6 months post‐surgery was 96% for robot‐assisted laparoscopic partial nephrectomy and 90% for laparoscopic partial nephrectomy (P < 0.0001). The preserved renal parenchymal volume was higher for robot‐assisted laparoscopic partial nephrectomy (89%) than laparoscopic partial nephrectomy (77%; P < 0.0001). The rate of perioperative complications, surgical margin status and length of hospital stay were equivalent for both techniques.

Conclusions

Robot‐assisted laparoscopic partial nephrectomy allows to achieve better preservation of renal function and parenchymal volume than laparoscopic partial nephrectomy.
Impact of age on quality of life in patients with localized prostate cancer treated with high‐dose rate brachytherapy combined with external beam radiotherapy
Authors: Kikkawa Kazuro , Iba Akinori , Kohjimoto Yasuo , Noda Yasutaka , Sonomura Tetsuo , Hara Isao
Published: February 2018

Objectives

To evaluate age‐related quality of life changes in patients with localized prostate cancer treated by high‐dose rate brachytherapy combined with external beam radiation therapy.

Methods

A total of 172 patients with clinically localized prostate cancer were categorized to age groups <75 years and ≥75 years. Changes in their quality of life were evaluated using the Japanese version of Medical Outcome Study 8‐Items Short Form Health Survey, Expanded Prostate Cancer Index Composite and International Index of Erectile Function‐5 at baseline, and followed up to 24 months after treatment.

Results

There were no significant differences in Medical Outcome Study 8‐Items Short Form Health Survey scores, and urinary and bowel scores of the Expanded Prostate Cancer Index Composite for older men after treatment. International Index of Erectile Function‐5 summary scores were significantly decreased in both groups. Although sexual function and sexual bother scores were decreased in patients aged <75 years, these scores were maintained in patients aged ≥75 years.

Conclusions

Quality of life of prostate cancer patients undergoing high‐dose rate brachytherapy combined with external beam radiation therapy does not seem to be significantly affected by age.
Use of strategies to improve antihypertensive medication adherence within United States outpatient health care practices, DocStyles 2015‐2016
Authors: Chang Tiffany E. , Ritchey Matthew D. , Ayala Carma , Durthaler Jeffrey M. , Loustalot Fleetwood
Published: February 2018

Patients’ adherence to antihypertensive medications is key to controlling high blood pressure. Evidence‐based strategies to improve adherence exist, but their use, individually and in combination, has not been described. 2015‐2016 DocStyles data were analyzed to describe health care professionals’ and their practices’ use of 10 strategies to improve antihypertensive medication adherence across 3 categories: prescribing, education, and tracking/encouragement. Among 1590 respondents, a mean of using 5 strategies was reported, with individual strategy use ranging from 17.2% (providing patients adherence‐related rewards) to 69.4% (prescribing once‐daily regimens). Those with higher odds of using ≥7 strategies and strategies across all 3 categories included: (1) nurse practitioners compared to family practitioners/internists and (2) health care professionals in practices with standardized hypertension treatment protocols who routinely recommend home blood pressure monitor use compared to respondents without those characteristics. Despite using an array of evidence‐based adherence‐promoting strategies, additional opportunities exist for health care professionals to provide adherence support among hypertensive patients.
Impact of different antihypertensives on carotid arterial wall thickness
Authors: Kim Ki‐Hong , Song In Geol , Kwon Taek‐Geun , Park Jeong Bae , Kim Kee‐Sik , Kim Wuon‐Shik , Bae Jang‐Ho
Published: February 2018

Hypertension has been associated with atherosclerosis and cardiovascular disease. Carotid intima media thickness is increased in hypertensive patients. But, the correlation between carotid intima media thickness and antihypertensive agents is still uncertain. Therefore, we investigated carotid intima media thickness based on types of antihypertensive agents. 1809 patients were enrolled in this study and it showed that 1079 hypertensive patients had thicker carotid intima media thickness than non‐hypertensive patients, with carotid intima media thicknesses of (0.72 ± 17 mm vs 0.64 ± 15 mm, P < .001), (0.31 ± 0.07 mm vs 0.30 ± 0.06 mm, P < .001), and (0.41 ± 0.13 mm vs 0.35 ± 0.12 mm, P < .001). Additionally, hypertensive patients on beta‐blockers also had thicker carotid intima media thickness than the non‐beta‐blocker group, with carotid intima media thicknesses of (0.74 ± 0.18 mm vs 0.71 ± 0.16 mm, P = .018), (0.33 ± 0.09 mm vs 0.31 ± 0.07 mm, P = .029), and (0.43 ± 0.13 mm vs 0.40 ± 0.13 mm, P = .035). Multivariate analysis showed that carotid intima thickness was only correlated with beta‐blockers (odds ratio = 2.489, confidence interval = 1.183‐5.239, P = .016); however, this study showed that beta‐blocker could be associated with increased carotid wall thickness as well.
Post‐stroke hypertension control and receipt of health care services among veterans
Authors: Kohok Dhanashri D. , Sico Jason J. , Baye Fitsum , Myers Laura , Coffing Jessica , Kamalesh Masoor , Bravata Dawn M.
Published: February 2018

Many ischemic stroke patients do not achieve goal blood pressure (BP < 140/90 mm Hg). To identify barriers to post‐stroke hypertension management, we examined healthcare utilization and BP control in the year after index ischemic stroke admission. This retrospective cohort study included patients admitted for acute ischemic stroke to a VA hospital in fiscal year 2011 and who were discharged with a BP ≥ 140/90 mm Hg. One‐year post‐discharge, BP trajectories, utilization of primary care, specialty and ancillary services were studied. Among 265 patients, 246 (92.8%) were seen by primary care (PC) during the 1‐year post‐discharge; a median time to the first PC visit was 32 days (interquartile range: 53). Among N = 245 patients with post‐discharge BP data, 103 (42.0%) achieved a mean BP < 140/90 mm Hg in the year post‐discharge. Provider follow‐ups were: neurology (51.7%), cardiology (14.0%), nephrology (7.2%), endocrinology (3.8%), and geriatrics (2.6%) and ancillary services (BP monitor [30.6%], pharmacy [20.0%], nutrition [8.3%], and telehealth [8%]). Non‐adherence to medications was documented in 21.9% of patients and was observed more commonly among patients with uncontrolled compared with controlled BP (28.7% vs 15.5%; P = .02). The recurrent stroke rate did not differ among patients with uncontrolled (4.2%) compared with controlled BP (3.8%; P = .89). Few patients achieved goal BP in the year post‐stroke. Visits to primary care were not timely. Underuse of specialty as well as ancillary services and provider perception of medication non‐adherence were common. Future intervention studies seeking to improve post‐stroke hypertension management should address these observed gaps in care.
Elevated mitochondrial activity distinguishes fibrogenic hepatic stellate cells and sensitizes for selective inhibition by mitotropic doxorubicin
Authors: Gajendiran Priya , Vega Leonel Iglesias , Itoh Kie , Sesaki Hiromi , Vakili Mohammad Reza , Lavasanifar Afsaneh , Hong Kelvin , Mezey Esteban , Ganapathy‐Kanniappan Shanmugasundaram
Published: February 2018

Activation of hepatic stellate cells (HSCs) is an integral component of the wound‐healing process in liver injury/inflammation. However, uncontrolled activation of HSCs leads to constant secretion of collagen‐rich extracellular matrix (ECM) proteins, resulting in liver fibrosis. The enhanced ECM synthesis/secretion demands an uninterrupted supply of intracellular energy; however, there is a paucity of data on the bioenergetics, particularly the mitochondrial (mito) metabolism of fibrogenic HSCs. Here, using human and rat HSCs in vitro, we show that the mito‐respiration, mito‐membrane potential (Δψm) and cellular ‘bioenergetic signature’ distinguish fibrogenic HSCs from normal, less‐active HSCs. Ex vivo, HSCs from mouse and rat models of liver fibrosis further confirmed the altered ‘bioenergetic signature’ of fibrogenic HSCs. Importantly, the distinctive elevation in mito‐Δψm sensitized fibrogenic HSCs for selective inhibition by mitotropic doxorubicin while normal, less‐active HSCs and healthy human primary hepatocytes remained minimally affected if not, unaffected. Thus, the increased mito‐Δψm may provide an opportunity to selectively target fibrogenic HSCs in liver fibrosis.
GDF‐15 is a better complimentary marker for risk stratification of arrhythmic death in non‐ischaemic, dilated cardiomyopathy than soluble ST2
Authors: Stojkovic Stefan , Kaider Alexandra , Koller Lorenz , Brekalo Mira , Wojta Johann , Diedrich Andre , Demyanets Svitlana , Pezawas Thomas
Published: February 2018

Growth differentiation factor (GDF)‐15 and soluble ST2 (sST2) are established prognostic markers in acute and chronic heart failure. Assessment of these biomarkers might improve arrhythmic risk stratification of patients with non‐ischaemic, dilated cardiomyopathy (DCM) based on left ventricular ejection fraction (LVEF). We studied the prognostic value of GDF‐15 and sST2 for prediction of arrhythmic death (AD) and all‐cause mortality in patients with DCM. We prospectively enrolled 52 patients with DCM and LVEF ≤ 50%. Primary end‐points were time to AD or resuscitated cardiac arrest (RCA), and secondary end‐point was all‐cause mortality. The median follow‐up time was 7 years. A cardiac death was observed in 20 patients, where 10 patients had an AD and 2 patients had a RCA. One patient died a non‐cardiac death. GDF‐15, but not sST2, was associated with increased risk of the AD/RCA with a hazard ratio (HR) of 2.1 (95% CI = 1.1‐4.3; P = .031). GDF‐15 remained an independent predictor of AD/RCA after adjustment for LVEF with adjusted HR of 2.2 (95% CI = 1.1‐4.5; P = .028). Both GDF‐15 and sST2 were independent predictors of all‐cause mortality (adjusted HR = 2.4; 95% CI = 1.4‐4.2; P = .003 vs HR = 1.6; 95% CI = 1.05‐2.7; P = .030). In a model including GDF‐15, sST2, LVEF and NYHA functional class, only GDF‐15 was significantly associated with the secondary end‐point (adjusted HR = 2.2; 95% CI = 1.05‐5.2; P = .038). GDF‐15 is superior to sST2 in prediction of fatal arrhythmic events and all‐cause mortality in DCM. Assessment of GDF‐15 could provide additional information on top of LVEF and help identifying patients at risk of arrhythmic death.
The Suicidal Narrative and Its Relationship to the Suicide Crisis Syndrome and Recent Suicidal Behavior
Authors: Cohen Lisa Janet , Gorman Bernard , Briggs Jessica , Jeon Min Eun , Ginsburg Tal , Galynker Igor
Published: February 2018

In this study, we introduce the construct of the suicidal narrative, a hypothetical personal narrative linked to imminent suicide, and explore its relationship to near‐term suicidal risk and the suicide crisis syndrome (SCS). Psychiatric outpatients (N = 289) were administered the Columbia Suicide‐Severity Rating Scale (C‐SSRS), Suicide Crisis Inventory (SCI), and Suicide Narrative Inventory (SNI), a novel instrument combining the documented risk factors of Thwarted Belongingness, Perceived Burdensomeness, Humiliation, Social Defeat, Goal Disengagement, and Goal Reengagement. Dimensional measures of past month, lifetime, and past suicidal phenomena, incorporating ideation and behavior, were calculated from the C‐SSRS. Structural equation modeling was used to explore the interaction among variables. Factor analysis of the SNI yielded two orthogonal factors, termed Interpersonal and Goal Orientation. The former factor was comprised of Perceived Burdensomeness, Social Defeat, Humiliation, and Thwarted Belongingness, the latter of Goal Disengagement and Goal Reengagement. The Interpersonal factor correlated with both SCS severity and suicidal phenomena in each time frame and the Goal Orientation factor with no other variable. As hypothesized, the proposed model was significant for the past month only. Our findings support the construct of the suicidal narrative and its function as a near‐term suicidal risk factor.
OPTIMIZATION STUDIES OF OIL PALM EMPTY FRUIT BUNCH LIQUEFACTION FOR CARBON CRYOGEL PRODUCTION AS CATALYST IN LEVULINIC ACID ESTERIFICATION
Authors: Mohammad Zainol Muzakkir , Saidina Amin Nor Aishah , Asmadi Mohd
Published: February 2018

Liquefaction of oil palm empty fruit bunch (EFB) using 1-butyl-3-methylimidazolium chloride was investigated in this study. The experiments were designed based on central composite by response surface methodology (RSM). The optimum conditions for the predicted liquefied EFB yield of 80.97 wt% was obtained at the temperature of 151.9 °C, a reaction time of 112.78 min and a ratio (Ionic liquid to EFB) of 4.27. The Regression coefficient (R2) for the model was 0.90 indicating a high correlation between observed and predicted values. The liquefied EFB mixture was used in the preparation of carbon cryogel via a sol-gel poly-condensation reaction and calcination process. The presence of sulfuric acid during the gel synthesis promoted an active site on the gel linkage and surface. The carbon cryogel prepared was tested as catalyst in an esterification reaction. The conversion of levulinic acid and yield of ethyl levulinate were reported as 58.7% ansd 57.2 mol%, respectively.