bluuebunny/crossref_metadata_2025_split huggingface dataset:
Small amounts of involuntary muscle activity reduce passive joint range of motion
Authors: Diong Joanna , Gandevia Simon C. , Nguyen David , Foo Yanni , Kastre Cecilia , Andersson Katarina , Butler Jane E. , Héroux Martin E. 
Published: May 2019

When assessing passive joint range of motion in neurological conditions, concomitant involuntary muscle activity is generally regarded small enough to ignore. This assumption is untested. If false, many clinical and laboratory studies that rely on these assessments may be in error. We determined to what extent small amounts of involuntary muscle activity limit passive range of motion in 30 able-bodied adults. Subjects were seated with the knee flexed 90° and the ankle in neutral, and predicted maximal plantarflexion torque was determined using twitch interpolation. Next, with the knee flexed 90° or fully extended, the soleus muscle was continuously electrically stimulated to generate 1, 2.5, 5, 7.5, and 10% of predicted maximal torque, in random order, while the ankle was passively dorsiflexed to a torque of 9 N·m by a blinded investigator. A trial without stimulation was also performed. Ankle dorsiflexion torque-angle curves were obtained at each percent of predicted maximal torque. On average (mean, 95% confidence interval), each 1% increase in plantarflexion torque decreases ankle range of motion by 2.4° (2.0 to 2.7°; knee flexed 90°) and 2.3° (2.0 to 2.5°; knee fully extended). Thus 5% of involuntary plantarflexion torque, the amount usually considered small enough to ignore, decreases dorsiflexion range of motion by ~12°. Our results indicate that even small amounts of involuntary muscle activity will bias measures of passive range and hinder the differential diagnosis and treatment of neural and nonneural mechanisms of contracture. NEW & NOTEWORTHY The soleus muscle in able-bodied adults was tetanically stimulated while the ankle was passively dorsiflexed. Each 1% increase in involuntary plantarflexion torque at the ankle decreases the range of passive movement into dorsiflexion by >2°. Thus the range of ankle dorsiflexion decreases by ~12° when involuntary plantarflexion torque is 5% of maximum, a torque that is usually ignored. Thus very small amounts of involuntary muscle activity substantially limit passive joint range of motion.
The influence of direct and indirect fibroblast cell contact on human myogenic cell behavior and gene expression in vitro
Authors: Bechshøft Cecilie J. L. , Schjerling Peter , Kjaer Michael , Mackey Abigail L. 
Published: May 2019

Underpinning skeletal muscle plasticity is the interplay between many cell types, of which fibroblasts are emerging as potent players, both negatively in the development of fibrosis but also positively in stimulating muscle repair through enhancing myogenesis. The mechanisms behind this interaction however remain unknown. To investigate this, waste hamstring muscle tissue was obtained from eight healthy young men undergoing reconstructive anterior cruciate ligament surgery and primary myoblasts and fibroblasts were isolated. Myoblasts were cultured alone or with fibroblasts, either in direct or indirect contact (separated by an insert with a permeable membrane). The myogenesis parameters proliferation, differentiation, and fusion were determined from immunostained cells, while, in replicate samples, gene expression levels of GAPDH, Ki67, Pax7, MyoD, myogenin, myomaker, MHC-Iβ, TCF7L2, COL1A1, and p16 were determined by RT-PCR. We found only trends for an influence of skeletal muscle fibroblasts on myogenic cell proliferation and differentiation. While greater mRNA levels of GAPDH, Pax7, MyoD, myogenin, and MHC-Iβ were observed in myogenic cells in indirect contact with fibroblasts (insert) when compared with cells cultured alone, a similar effect of an empty insert was also observed. In conclusion we find very little influence of skeletal muscle fibroblasts on myoblasts derived from the same tissue, although it cannot be excluded that a different outcome would be seen under less optimal myogenic growth conditions. NEW & NOTEWORTHY Using passage one primary myoblasts and fibroblasts isolated from human skeletal muscle, we found only a trend for an effect of skeletal muscle fibroblasts on myogenic cell proliferation and differentiation. This is contrary to previous reports and raises the possibility that fibroblasts of different tissue origins exert distinct roles.
Benefit of Pelvic Floor Physical Therapy in Pediatric Patients with Dyssynergic Defecation Constipation
Authors: Zar-Kessler Claire , Kuo Braden , Cole Elizabeth , Benedix Anna , Belkind-Gerson Jaime 
Published: May 2019

Objectives: Chronic constipation is a common childhood problem and often caused or worsened by abnormal dynamics of defecation. The aim of this study was to assess the benefit of pelvic floor physical therapy (PFPT), a novel treatment in pediatrics for the treatment of chronic constipation with dyssynergic defecation. Methods: This was a retrospective study of 69 children seen at a pediatric neurogastroenterology program of a large tertiary referral center for chronic constipation and dyssynergic defecation, determined by anorectal manometry and balloon expulsion testing. We compared the clinical outcome of patients who underwent PFPT (n = 49) to control patients (n = 20) whom received only medical treatment (laxatives/stool softeners). Additionally, characteristics of the treatment group were analyzed in relation to therapeutic response. Results: Thirty-seven (76%) of the patients who received physical therapy had improvement in constipation symptoms, compared to 5 (25%) of the patients on conservative treatment (p < 0.01). Additionally, patients who received pelvic physical therapy had fewer hospitalizations for cleanouts (4 vs. 25%, p = 0.01) and ­colonic surgery than those that were treated with medical therapy exclusively (0 vs. 10%, p = 0.03). Among the patients who received physical therapy, those that suffered from anxiety and/or low muscle tone had a higher response rate (100%). There were no adverse effects from the intervention. Conclusion: The new field of pediatric PFPT is a safe and effective intervention for children with dyssynergic defecation causing or contributing to chronic constipation, particularly in children whose comorbidities include anxiety and low ­muscle tone.
Diagonal Acceleration for Covariance Matrix Adaptation Evolution Strategies
Authors: Akimoto Y. , Hansen N. 
Published: May 2019

We introduce an acceleration for covariance matrix adaptation evolution strategies (CMA-ES) by means of adaptive diagonal decoding (dd-CMA). This diagonal acceleration endows the default CMA-ES with the advantages of separable CMA-ES without inheriting its drawbacks. Technically, we introduce a diagonal matrix [Formula: see text] that expresses coordinate-wise variances of the sampling distribution in DCD form. The diagonal matrix can learn a rescaling of the problem in the coordinates within a linear number of function evaluations. Diagonal decoding can also exploit separability of the problem, but, crucially, does not compromise the performance on nonseparable problems. The latter is accomplished by modulating the learning rate for the diagonal matrix based on the condition number of the underlying correlation matrix. dd-CMA-ES not only combines the advantages of default and separable CMA-ES, but may achieve overadditive speedup: it improves the performance, and even the scaling, of the better of default and separable CMA-ES on classes of nonseparable test functions that reflect, arguably, a landscape feature commonly observed in practice. The article makes two further secondary contributions: we introduce two different approaches to guarantee positive definiteness of the covariance matrix with active CMA, which is valuable in particular with large population size; we revise the default parameter setting in CMA-ES, proposing accelerated settings in particular for large dimension. All our contributions can be viewed as independent improvements of CMA-ES, yet they are also complementary and can be seamlessly combined. In numerical experiments with dd-CMA-ES up to dimension 5120, we observe remarkable improvements over the original covariance matrix adaptation on functions with coordinate-wise ill-conditioning. The improvement is observed also for large population sizes up to about dimension squared.
Laryngomalacia and Swallow Dysfunction
Authors: Scott Brian L. , Lam Derek , MacArthur Carol 
Published: May 2019

Objectives: Laryngomalacia is an established cause of stridor and sleep-disordered breathing in children. However, the relationship between laryngomalacia and dysphagia has not been well characterized. The objectives of this study were to (1) describe the patient characteristics, symptoms, and prevalence of dysphagia in children with laryngomalacia and (2) examine the effectiveness of supraglottoplasty in improving feeding. Methods: This was a retrospective study of patients with laryngomalacia who underwent a modified barium swallow study (MBSS) at a tertiary academic pediatric medical center between March 1, 2014, and March 1, 2018. Patients were excluded if they did not undergo a MBSS. Comorbidities, airway and feedings symptoms, MBSS results, and surgical history were recorded from each patient’s electronic medical record. Results: Forty-four children met inclusion/exclusion criteria. The median age at presentation was 96 days. There was a male predominance (66%). About one-third had a genetic or neuromuscular comorbidity. Most children had stridor (93%) and feeding difficulty (86%), while 50% had parent-reported poor weight gain. Fifty-seven percent of patients had evidence of penetration or aspiration on MBSS. All patients with a positive MBSS had dysphagia symptoms. Fifty-seven percent of patients underwent supraglottoplasty. Postoperatively, 92% reported improvement in dysphagia symptoms. Conclusion: Dysphagia is prevalent among a subset of children with laryngomalacia. Symptomatic children may benefit from a swallow evaluation to help determine the need for further intervention. Children who undergo supraglottoplasty for laryngomalacia have improved dysphagia at follow-up, though the amount of improvement directly attributable to surgery is unclear and warrants further investigation.
An average three-dimensional virtual human skull for a template-assisted maxillofacial surgery
Authors: Badiali Giovanni , Marcelli Emanuela , Bortolani Barbara , Marchetti Claudio , Cercenelli Laura 
Published: May 2019

Introduction: Although many advances have been made in three-dimensional virtual planning in maxillofacial surgery, facial harmony is still difficult to achieve and is heavily dependent on the surgeon’s experience. The aim of the study is to present a method to build up an average three-dimensional virtual human skull to be used as a reference template for bone repositioning and reconstruction during maxillofacial surgical interventions. Methods: A total of 20 patients (10 females and 10 males) were selected for the optimal outcome after orthognathic surgery. Postoperative cone-beam computed tomography scans were collected and processed in order to obtain three-dimensional digital models of each skull. For male and female subgroups, the three-dimensional skull models were registered and an average three-dimensional virtual skull model was computed. Deviation color maps were calculated to show differences between each postoperative skull model in the population and the obtained average three-dimensional skull. A clinical use case of genioplasty treatment assisted by the provided average three-dimensional skull template was presented. Results: The overall mean deviation from the average three-dimensional skull model was 1.3 ± 0.6 and 1.6 ± 0.5 mm in male and female subgroups, respectively. For both groups, the greatest deviations were at the area of the mandible, while almost no deviation was found at the zygomatic and orbital areas. In the presented use case, the female average three-dimensional skull model was effectively used for guiding surgical planning. Conclusion: The presented method of obtaining an average three-dimensional virtual human skull may offer the interesting perspective of performing an innovative template-assisted maxillofacial surgery.
Cellular mesoblastic nephroma in infants and children: Report of four cases and review of the literature
Authors: Geramizadeh Bita , Kashkooe Ali , Keshavarz Pedram , Zareifar Soheila , Foroutan Hamidreza 
Published: May 2019

Background: Cellular mesoblastic nephroma is rare after infancy, and there are many controversial reports about its clinical presentation and treatment as well as outcome in infants, young children, and adolescents. Objectives: In this report, we will discuss our experience with four cases of cellular mesoblastic nephroma presented from infancy to childhood (from 18 months of age to 11 years of age). Cases: During 10 years, we had the experience of 4 cases of pediatric renal tumor with the diagnosis of cellular mesoblastic nephroma, which have been followed between 1 year and 6 years. There were three male and one female patients with the age of 1.5, 2, 2, and 11 years. These tumors showed variable characteristics according to the number of mitosis, proliferative rate, necrosis, immunohistochemical markers, and metastatic potential; however, despite of all of these variabilities, all of these patients have done well and all have been well at the end of study. Conclusion: Pediatric renal tumors with the histologic diagnosis of cellular mesoblastic nephroma have good outcome even with metastasis, mitosis, and high proliferative rate.
Adolescent Tobacco and Betel Nut Use in the US-Affiliated Pacific Islands: Evidence From Guam
Authors: Pokhrel Pallav , Dalisay Francis , Pagano Ian , Buente Wayne , Guerrero Elizabeth , Herzog Thaddeus A. 
Published: May 2019

Purpose: To determine the prevalence of, and the risk and protective factors associated with, tobacco product use among adolescents in Guam, a US-Affiliated Pacific Island (USAPI) territory. To examine disparities in risk and protective factors across indigenous and nonindigenous groups. Design: Quantitative; cross-sectional. Setting: Middle and high schools in Guam. Sample: The Global Youth Tobacco Survey sample included a representative sample of 2449 6th to 12th graders (71% response rate). Sample for the supplemental study included 670 middle school students (76% response rate across randomly selected classrooms). Measures: Self-reported measures of lifetime and past 30-day tobacco and betel nut use, social competence, resistance self-efficacy, risk perceptions, friend and family tobacco product use, and ease of access to tobacco products. Analysis: Multilevel logistic regression and analysis of covariance. Results: The prevalence rates of current cigarette, smokeless tobacco, and e-cigarette use among middle school students were 8%, 8%, and 25%, respectively. Ability to resist social pressure to use tobacco/betel nut use was strongly associated with lower likelihood of tobacco (odds ratio [OR] = 0.76; 95% confidence interval [CI]: 0.68-0.84) and betel nut use (OR = 0.74; 95% CI: 0.67-0.82). Indigenous Pacific Islanders scored significantly lower on protective and higher on risk factors. Conclusion: Tobacco product use rates among Guam middle school students appear to be 4 to 5 times higher than the US national average rates. There is an urgent need for developing tobacco and betel nut use prevention programs for USAPI youth that are tailored to the needs of indigenous Pacific Islanders.
Tobacco Advertising and ID Checks in Columbus, Ohio, in Advance of Tobacco 21
Authors: Muralidharan Nirupama , Ferketich Amy K. , Keller-Hamilton Brittney , Roberts Megan E. 
Published: May 2019

Purpose: In autumn 2017, Columbus, Ohio, joined numerous other US locations in raising their legal sales age for purchasing tobacco to 21 (ie, becoming “T21”). The present study sought to establish a baseline for ID checks in Columbus prior to T21 enforcement and to examine whether store type and marketing were associated with better rates of ID checks. Design: Fieldworkers aged 20 to 21 years visited a random sample of 110 tobacco retailers during summer 2017 (drawn from >10 000 licensed retailers in the county). After collecting store-related information, they attempted to purchase cigarettes and recorded whether their ID was checked (federal law requires ID checks for anyone who looks younger than 27 years). Setting: Columbus, Ohio. Measures: Store type, external tobacco advertising, and ID check outcome. Analysis: Descriptive and inferential statistics. Results: Among stores where cigarettes were purchased, 61.1% did not conduct ID checks. Absent ID checks were associated with the store being a convenience store or tobacco shop, χ2(2) = 4.45, P = .035, and having a greater amount of external advertising, t(93) = 2.00, P = .049. Conclusion: Overall, the low rate of ID checks for young adults purchasing tobacco in Columbus is concerning. Continued monitoring of retailer compliance will be important as retailers adjust to the arrival of T21. Targeted enforcement and additional outreach with tobacco shops, convenience stores, and stores with a high amount of external advertising may be particularly needed.
Lupus is associated with poorer outcomes after primary total hip arthroplasty
Authors: Singh J A , Cleveland J D 
Published: May 2019

Objective The aim of this study was to assess whether lupus is associated with poorer outcomes after primary total hip arthroplasty (THA). Methods We used the 1998–2014 US National Inpatient Sample data. Multivariable-adjusted separate logistic regression models assessed the association of lupus with post-operative complications (implant infection, transfusion, THA revision and mortality) and health care utilization outcomes (total hospital charges, discharge to an inpatient facility and length of hospital stay >3 days) post-THA, adjusting for demographics, underlying diagnosis, comorbidity, insurance payer and hospital characteristics, using odds ratios (OR) and 95% confidence intervals (CI). Results Among 4,116,485 primary THA hospitalizations, 22,557 (0.5%) were in patients with lupus. Patients with lupus were younger and more likely to be female, African-American or Hispanic, living in the South, or to have Medicaid insurance, and had higher comorbidity or lower income. In multivariable-adjusted analyses, the presence of lupus was associated with significantly higher risk of implant infection, transfusion, discharge to an inpatient facility and higher hospital charges above the median, with respective ORs of 1.95 (95% CI, 1.28, 2.97), 1.34 (95% CI, 1.25, 1.43), 1.21 (95% CI, 1.01, 1.44) and 1.38 (95% CI, 1.30, 1.47). Lupus was not significantly associated with the risk of revision, mortality or hospital stay >3 days; the ORs were 1.10 (95% CI, 0.68, 1.78), 0.95 (95% CI, 0.61, 1.47) and 1.06 (95% CI, 0.99, 1.13), respectively. Conclusions Lupus was associated with a higher risk of implant infection, transfusion, discharge to an inpatient facility and higher hospital charges post-primary THA. Insight into modifiable factors associated with these outcomes may improve outcomes in patients with lupus undergoing THA.
Is visual imagery ability higher for orthodontic students than those in other disciplines? A cross-sectional questionnaire-based study
Authors: Smyth Robert SD , Acharya Priti , Hunt Nigel P 
Published: May 2019

Objective: To investigate the effect visual imagery may have on career choice among current university students across a range of subjects and disciplines. Setting: University College London (UCL), UK. Design: Cross-sectional questionnaire-based study. Participants: The study compared four main groups of UCL students: current students at the Slade School of Fine Art; UCL Eastman Dental Institute; UCL Bartlett School of Architecture; and the Faculty of Laws. Method: A questionnaire based on the Vividness of Visual Imagery Questionnaire (VVIQ) was distributed along with questions regarding demographic information. Results: There were no significant differences between the VVIQ scores across the four included Schools/Faculty: The Slade School of Fine Art; UCL Bartlett School of Architecture; Faculty of Laws; and UCL Eastman Dental Institute, F(3,219) = 2.160, P = 0.094. There were also no significant differences in the scores for the Eastman ( M = 60.21, SD = 13.58) and the three other Schools/Faculty ( M = 62.87, SD = 10.96); t(–1.317) = 221, P = 0.189, and no significant difference in the scores for the Orthodontic students ( M = 60.80, SD = 13.39) and the remaining other included students ( M = 61.44, SD = 9.68); t(–0.232) = 221, P = 0.817. Aphantasia was uncommon in this sample, with a prevalence of 0.9%. A positive correlation was found between age group and total VVIQ score, with older participants scoring higher on the VVIQ. Women were significantly more likely to say that their ability to visualise had affected their career choice than male respondents. Conclusions: There were no significant differences between the VVIQ scores across the four included Schools/Faculty. Visual imagery ability did not differ in dental or orthodontic students in comparison to other student groups. Further work is needed to replicate these findings in more diverse samples.
The p53/miR-193a/EGFR feedback loop function as a driving force for non-small cell lung carcinoma tumorigenesis
Authors: Wang Wei , Shen Xia-Bo , Jia Wei , Huang Da-Bing , Wang Yong , Pan Yue-Yin 
Published: May 2019

Background: Non-small cell lung carcinoma (NSCLC) is a major worldwide health threat due to its low cure rate and high lethality. Emerging evidence suggests that epidermal growth factor receptor (EGFR) plays vital roles in cancer initiation and progression, and is considered an important cancer-driving protein. However, how EGFR expression is regulated during NSCLC development remains to be fully elucidated. Methods: In NSCLC clinical samples, EGFR protein levels were measured by western blotting and qRT-PCR, respectively. Combining microRNA (miRNA) target prediction software and the pulldown assay, we predicted microRNAs (miRNAs) that targeted EGFR. Next, three NSCLC cell lines, A549 (p53 WT), H322 (p53 mutant), and H1299 (p53 null), were used to demonstrate the direct targeting of EGFR by miR-193a. In addition, we investigated the biological effects of EGFR inhibition by miR-193a in vitro using Cell Counting Kit-8, 5-Ethynyl-2′-deoxyuridine (EdU), transwell, and apoptosis assays. Then, using ChIP and luciferase assays, we demonstrated that miR-193a was directly activated by p53 at the transcriptional level and that p53-induced-miR-193a and EGFR form a double-negative feedback loop. Results: We found that EGFR mRNA and protein were upregulated in NSCLC. We predicted that EGFR was a target of miR-193a and validated that miR-193a bound directly to the 3′-UTR of the EGFR mRNA. Moreover, miR-193a inhibited NSCLC proliferation and invasion, and promotes NSCLC apoptosis by directly downregulating EGFR. Then, we demonstrated that p53 directly activated miR-193a transcription, whereas EGFR functioned as a transcriptional repressor to negatively control miR-193a expression, forming a feedback loop. The loop promoted NSCLC cell proliferation and migration and accelerated tumor growth in xenograft mice. Conclusions: This study highlights a double-negative feedback loop in NSCLC. The feedback loop is crucial because overexpressing EGFR strongly accelerated tumor growth, while miR-193a restoration blocked tumor growth in vivo. Our findings are in line with the emerging opinion that miRNAs and protein regulators form regulatory networks in critical biological processes and that their dysregulation can lead to cellular dysfunction. In conclusion, this study provides important insights into the molecular mechanisms of NSCLC progression and may help inform the development of new therapeutics for managing NSCLC.