bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex differences in wheelchair propulsion biomechanics and mechanical efficiency in novice young able‐bodied adults
Authors: Chaikhot Dhissanuvach , Taylor Matthew J. D. , Hettinga Florentina J. 
Published: March 2018

AbstractAn awareness of sex differences in gait can be beneficial for detecting the early stages of gait abnormalities that may lead to pathology. The same may be true for wheelchair propulsion. The aim of this study was to determine the effect of sex on wheelchair biomechanics and mechanical efficiency in novice young able‐bodied wheelchair propulsion. Thirty men and 30 women received 12  min of familiarisation training. Subsequently, they performed two 10‐m propulsion tests to evaluate comfortable speed (CS). Additionally, they performed a 4‐min submaximal propulsion test on a treadmill at CS, 125% and 145% of CS. Propulsion kinetics (via Smartwheel) and oxygen uptake were continuously measured in all tests and were used to determine gross mechanical efficiency (GE), net efficiency (NE) and fraction of effective force (FEF). Ratings of perceived exertion (RPE) were assessed directly after each trial. Results indicated that CS for men was faster (0.98 ± 0.24 m/s) compared to women (0.71 ± 0.18 m/s). A lower GE was found in women compared to men. Push percentage, push angle and local RPE were different across the three speeds and between men and women. NE and FEF were not different between groups. Thus, even though their CS was lower, women demonstrated a higher locally perceived exertion than men. The results suggest sex differences in propulsion characteristics and GE. These insights may aid in optimising wheelchair propulsion through proper training and advice to prevent injuries and improve performance. This is relevant in stimulating an active lifestyle for those with a disability.
Differential effects of attentional focus strategies during long‐term resistance training
Authors: Schoenfeld Brad Jon , Vigotsky Andrew , Contreras Bret , Golden Sheona , Alto Andrew , Larson Rachel , Winkelman Nick , Paoli Antonio 
Published: March 2018

AbstractThe purpose of this study was to investigate the effects of using an internal versus external focus of attention during resistance training on muscular adaptations. Thirty untrained college‐aged men were randomly assigned to an internal focus group (INTERNAL) that focused on contracting the target muscle during training (n = 15) or an external focus group (EXTERNAL) that focused on the outcome of the lift (n = 15). Training for both routines consisted of 3 weekly sessions performed on non‐consecutive days for 8 weeks. Subjects performed 4 sets of 8–12 repetitions per exercise. Changes in strength were assessed by six repetition maximum in the biceps curl and isometric maximal voluntary contraction in knee extension and elbow flexion. Changes in muscle thickness for the elbow flexors and quadriceps were assessed by ultrasound. Results show significantly greater increases in elbow flexor thickness in INTERNAL versus EXTERNAL (12.4% vs. 6.9%, respectively); similar changes were noted in quadriceps thickness. Isometric elbow flexion strength was greater for INTERNAL while isometric knee extension strength was greater for EXTERNAL, although neither reached statistical significance. The findings lend support to the use of a mind–muscle connection to enhance muscle hypertrophy.
Equine feed contamination and toxicology
Authors: Bischoff Karyn , Moiseff Jennifer 
Published: March 2018

AbstractFeed as a cause of poisoning in horses can occur on small or large scales. It is challenging to work up cases of suspected feed contamination, but there are resources available to veterinarians and owners. Feed contamination can be chemical or biological. This article focuses on and provides examples of chemical feed contamination including misformulation, adulteration, and natural contaminants. Additionally, recommendations for feed sampling and diagnostic submission, including legal documentation, are included.
Three-phase Bone Scintigraphy Can Predict the Analgesic Efficacy of Ketamine Therapy in CRPS
Authors: Sorel Marc , Beatrix Jacques-Christian , Locko Blanche , Armessen Catherine , Domec Anne-Marie , Lecompte Otilia , Boucheneb Sofiane , Harache Benoit , Robert Jacques , Lefaucheur Jean-Pascal 
Published: March 2018

Objectives:
The efficacy of ketamine in relieving complex regional pain syndrome (CRPS) lacks predictive factors. The value of three-phase bone scintigraphy (TPBS) was assessed for this purpose.

Materials and Methods:
TPBS was performed in 105 patients with unilateral, focal CRPS of type 1 before 5 days of ketamine infusions. Tracer uptake was measured in the region of interest concerned by CRPS and the contralateral homologous region. For the 3 scintigraphic phases (vascular, tissular, and bone phases), an asymmetry ratio of fixation was calculated between the affected and the unaffected sides (vascular phase [VPr], tissular phase [TPr], and bone phase [BPr]). Ketamine efficacy was assessed on pain intensity scores.

Results:
Ketamine-induced pain relief did not correlate with VPr, TPr, and BPr, but with the ratios of these ratios: BPr/TPr (r=0.32, P=0.009), BPr/VPr (r=0.34, P=0.005), and TPr/VPr (r=0.23, P=0.02). The optimum cut-off value for predicting the response to ketamine therapy was >1.125 for BPr/TPr, >1.075 for BPr/VPr, and >0.935 for TPr/VPr. The combination of increased values of BPr/TPr, BPr/VPr, and TPr/VPr was highly significantly associated with ketamine therapy outcome.

Conclusions:
The relative hyperfixation of the radioactive tracer in the limb region concerned by CRPS in phases 2 and 3 versus phase 1 of TPBS correlated positively to the analgesic efficacy of ketamine. This study shows for the first time the potential predictive value of TPBS regarding ketamine therapy outcome. In addition, these results suggest that the analgesic action of ketamine is not restricted to “central” mechanisms, but may also involve “peripheral” mechanisms related to tissue inflammation and bone remodeling.
Sarcopenia Is Predictive of 1-Year Mortality After Acetabular Fractures in Elderly Patients
Authors: Mitchell Phillip M. , Collinge Cory A. , O'Neill David E. , Bible Jesse E. , Mir Hassan R. 
Published: March 2018

Objectives:
To determine whether sarcopenia is an independent predictor of mortality in geriatric acetabular fractures.

Design:
Retrospective cohort.

Setting:
American College of Surgeons Level I trauma center.

Patients/Participants:
One hundred and forty-six patients over the age 60 with acetabular fractures treated at our institution over a 12-year period.

Main Outcome Measurements:
The primary outcome was 1-year mortality, collected using the Social Security Death Index. We used the psoas:lumbar vertebral index (PLVI), calculated using the cross-sectional area of the L4 vertebral body and the left and right psoas muscles, to assess for sarcopenia.

Results:
Using a multivariate logistic regression model, we found that low PLVI was associated with increased 1-year mortality (P = 0.046) when controlling for age, gender, Charlson Comorbidity Index, Injury Severity Score (ISS), smoking status, and associated pelvic ring injury. Increasing age and ISS also showed a relationship with 1-year mortality in this cohort (P < 0.001, P < 0.001, respectively). We defined sarcopenia as those patients in the lowest quartile of PLVI. The mortality rate of this cohort was 32.4%, compared with 11.0% in patients without sarcopenia (odds ratio 4.04; 95% confidence interval 1.62–10.1). Age >75 years, ISS >14, and sarcopenia had 1-year mortality rates of 37.1%, 30.9%, and 32.4%, respectively. In patients with all 3 factors, the mortality rate was 90%.

Conclusion:
Sarcopenia is an independent risk factor for 1-year mortality in elderly patients with acetabular fractures. This study highlights the importance of objective measures to assess frailty in elderly patients who have sustained fractures about the hip and pelvis.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Tobacco and alcohol-induced epigenetic changes in oral carcinoma
Authors: Ghantous Yasmine , Schussel Juliana L. , Brait Mariana 
Published: March 2018

Purpose of review
The present review aims to describe the epigenetic alterations observed in oral cancer linked to the exposure to alcohol and/or tobacco.

Recent findings
Recent findings emphasize the importance of epigenetics in oral cancer progression and in how risk factors (as tobacco and alcohol) affect the basal epigenetic profiles. Deeper techniques and detailed approaches allowed the perception that individual CG changes and even subtle changes may represent important epigenetic alterations resulting in expression changes and other carcinogenic consequences. New classes of epigenetic alterations including noncoding RNAs have been gaining attention.

Summary
Many epigenetic alterations have been described in oral carcinoma progression induced by tobacco and/or alcohol, including: promoter hypermethylation in genes with tumor suppressive activity, global (genome-wide) hypomethylation, change in methylation patterns throughout the genes, alteration in noncoding RNAs, and histones modifications. These changes represent progress in the knowledge of how these risk factors act in a molecular level. There is an urgent need for large independent studies to move these potential makers further and validate them to identify risk assessment, early diagnostic markers, and therapeutic targets, as well as to be the base for prevention and intervention strategies.
Managing seminomatous and nonseminomatous germ cell tumors
Authors: Chahoud Jad , Zhang Miao , Shah Amishi , Lin Sue-Hwa , Pisters Louis L. , Tu Shi-Ming 
Published: March 2018

Purpose of review
In the present review, we summarize the recent developments in the management of germ cell tumors (GCTs).

Recent findings
Treatment-related acute and late-onset toxicity remains a key challenge in the management of GCTs, with recent evidence showing that the adverse health outcomes of etoposide and cisplatin for four cycles in comparison to bleomycin, etoposide, and cisplatin for three cycles appear to be similar. Recent data showed that multidisciplinary clinic approach and management in experienced academic centers were associated with improved overall survival in GCT patients. There are currently multiple conventional-dose chemotherapy options for salvage therapy in patients with refractory or recurrent disease. In addition, more efficacious high-dose chemotherapy regimens continue to be developed. The role of salvage conventional-dose chemotherapy versus high-dose chemotherapy is currently being investigated prospectively. Recent reports suggested that brentuximab vedotin could be a potential salvage option for cluster of differentiation 30 positive refractory GCTs. On the other hand the results of the first phase II clinical trial investigating pembrolizumab in refractory GCTs were disappointing showing no clinical activity.
Finally, deep exploration of the immune profile of GCTs using immunohistochemistry and gene expression profiling has identified that advanced GCT stage was associated with decreased T-cell and Natural killer-cell signatures, whereas T regulatory, neutrophil, mast cell, and macrophage signatures increased with advanced stage. Even though these results indicated that activated T-cell infiltration correlated with seminoma histology and good prognosis, and could be used in the future as a biomarker, this approach needs to be validated in a large cohort.

Summary
Remaining challenges to be addressed include minimizing therapeutic toxicity, and improving outcomes in patients with refractory/recurrent GCTs.
The evolving genomic landscape in urothelial cancer
Authors: Kujtan Lara , Hussain Arif , Subramanian Janakiraman , Masood Ashiq 
Published: March 2018

Purpose of review
Recent advances in next-generation sequencing have allowed for detailed molecular analysis of urothelial carcinomas, with potentially significant clinical implications for personalized treatment. Our objective in this review is to highlight studies from the past year that have furthered the understanding of urothelial cancer genomics.

Recent findings
Recent studies by The Cancer Genome Atlas consortium further characterized urothelial carcinomas via molecular subtyping, and a schema was proposed to match each subtype with potential therapeutic implications. Molecular subtyping was also utilized in a separate analysis to determine which tumours benefit from neoadjuvant chemotherapy. Tumour characteristics were also explored pre and postneoadjuvant chemotherapy and a mutational signature associated with postcisplatin treatment was described. We also review a comprehensive analysis of upper tract urinary carcinomas published this past year.

Summary
Recent genomic analyses have revealed that the classification of urothelial carcinoma is much more complex than the traditional dichotomy of nonmuscle-invasive and muscle-invasive bladder cancers. Molecular subtyping has provided additional insights into prognoses and treatment options for these patients. Although molecular subtyping is not yet ready for implementation into clinical practice, these latest efforts offer an exciting opportunity to integrate such information into prospective clinical studies that may ultimately lead to improved treatment outcomes.
Polymorphous Sweat Gland Carcinoma: An Immunohistochemical and Molecular Study
Authors: Ronen Shira , Aguilera-Barrantes Irene , Giorgadze Tamara , Šteiner Petr , Grossmann Petr , Suster Saul 
Published: March 2018

Abstract:
Polymorphous sweat gland carcinoma is an uncommon low-grade malignant adnexal tumor with a marked predilection for the distal extremities. Histologically, the lesions are characterized by a cellular proliferation showing a combination of growth patterns, including trabecular, solid, tubular, cribriform, or adenoid cystic and pseudopapillary. The immunohistochemical and molecular profile of these tumors has not yet been properly addressed. We have studied 3 cases of polymorphous sweat gland carcinoma using a broad panel of immunohistochemical markers including cytokeratin AE1/AE3, CK5/6, MOC31, p40, p63, p16, chromogranin, synaptophysin, CD56, MIB-1, estrogen receptor, progesterone receptor, androgen receptor, BER-EP4, smooth muscle actin, epithelial membrane antigen, carcinoembryonic antigen, CD117, S100 protein, HBME-1, DOG1, vimentin, and mammaglobin. We also examined for the MYB-NFIB fusion by fluorescent in situ hybridization (ISH) and for human papilloma virus by ISH. Our studies show that cytokeratin AE1/AE3, CK5/6, p40, p63, p16, chromogranin, and CD56 stains were positive in all 3 cases. All 3 cases were negative for MYB-NFIB fusion by fluorescent ISH which rules out adenoid cystic carcinoma. DNA ISH studies for high-risk human papilloma virus were negative in all cases. MIB-1 proliferation index was very high (30%–70% nuclear positivity), supporting a malignant phenotype. The positivity for chromogranin and CD56 suggests partial neuroendocrine differentiation. The differential diagnosis includes metastases from internal malignancies, basal cell carcinoma, and other benign and malignant adnexal neoplasms such as adenoid cystic carcinoma, ductal eccrine carcinoma, and microcystic carcinoma. Positivity for p16 in combination with chromogranin and CD56 may be potentially good markers for differentiating this tumor from other adnexal tumors.
Rare Variant of Agminated Spitz Nevi on a Hypopigmented Background and Segmental Distribution: Case Report and Review of Literature
Authors: Nevares-Pomales Oscar W. , Carrasquillo Osward Y. , Santiago-Vazquez Marely , Colon-Fontanez Francisco 
Published: March 2018

Abstract:
Spitz nevus is a type of melanocytic nevus that can arise as a solitary lesion or as multiple lesions either disseminated or agminated (grouped) in different skin backgrounds (eg, grossly normal, hyperpigmented, or hypopigmented). Agminated Spitz nevi have been rarely reported and are even rarer in a background of hypopigmented skin. We present the case of a 2-month-old girl with multiple, grouped, dome-shaped, red papules arising on a hypopigmented patch with a segmental distribution. Biopsy of 2 lesions showed findings characteristic of Spitz nevus, confirming the diagnosis. We also review 4 other cases of agminated Spitz nevi arising on hypopigmented skin reported in the literature.
Neurokinin 3 receptor antagonism rapidly improves vasomotor symptoms with sustained duration of action
Authors: Prague Julia K. , Roberts Rachel E. , Comninos Alexander N. , Clarke Sophie , Jayasena Channa N. , Mohideen Pharis , Lin Vivian H. , Stern Theresa P. , Panay Nicholas , Hunter Myra S. , Webber Lorraine C. , Dhillo Waljit S. 
Published: March 2018

Abstract

Objective:
Seventy percent of postmenopausal women experience vasomotor symptoms, which can be highly disruptive and persist for years. Hormone therapy and other treatments have variable efficacy and/or side effects. Neurokinin B signaling increases in response to estrogen deficiency and has been implicated in hot flash (HF) etiology. We recently reported that a neurokinin 3 receptor (NK3R) antagonist reduces HF in postmenopausal women after 4 weeks of treatment. In this article we report novel data from that study, which shows the detailed time course of this effect.

Methods:
Randomized, double-blind, placebo-controlled, single-center, crossover trial of an oral NK3R antagonist (MLE4901) for vasomotor symptoms in women aged 40 to 62 years, experiencing ≥7 HF/24 hours some of which were reported as bothersome or severe (Clinicaltrials.gov NCT02668185). Thirty-seven women were randomized and included in an intention-to-treat analysis. To ascertain the therapeutic profile of MLE4901, a post hoc time course analysis was completed.

Results:
By day 3 of treatment with MLE4901, HF frequency reduced by 72% (95% CI, −81.3 to −63.3%) compared with baseline (51 percentage point reduction compared with placebo, P < 0.0001); this effect size persisted throughout the 4-week dosing period. HF severity reduced by 38% compared with baseline by day 3 (95% CI, −46.1 to −29.1%) (P < 0.0001 compared with placebo), bother by 39% (95% CI, −47.5 to −30.1%) (P < 0.0001 compared with placebo), and interference by 61% (95% CI, −79.1 to −43.0%) (P = 0.0006 compared with placebo); all continued to improve throughout the 4-week dosing period (to −44%, −50%, and −70%, respectively by day 28, all P < 0.0001 compared with placebo).

Conclusions:
NK3R antagonism rapidly relieves vasomotor symptoms without the need for estrogen exposure.
Virtual Incision Pattern Planning using Three-Dimensional Images for Optimization of Syndactyly Surgery
Authors: Hoevenaren Inge A. , Vreeken Rinaldo D. , Verhulst Arico C. , Ulrich Dietmar J. O. , Maal Thomas J. J. , Wagner Till 
Published: March 2018

Summary:
Syndactyly is a congenital condition characterized by fusion of the fingers. If not treated correctly during infancy, syndactyly may hinder the normal development of hand function. Many surgical techniques have been developed, with the main goal to create a functional hand with the smallest number of operative corrections. Therefore, exact preoperative planning of the reconstructive procedure is essential. An imaging method commonly used for preoperative planning is 3-dimensional (3D) surface imaging. The goal of this study was to implement the use of this technique in hand surgery, by designing a virtual planning tool for a desyndactylization procedure based on 3D hand images. A 3D image of a silicon syndactyly model was made on which the incision pattern was virtually designed. A surgical template of this pattern was printed, placed onto the silicon model and delineated. The accuracy of the transfer from the virtual delineation toward the real delineation was calculated, resulting in a mean difference of 0.82 mm. This first step indicates that by using 3D images, a virtual incision pattern can be created and transferred back onto the patient successfully in an easy and accurate way by using a template. Thereafter, 3D hand images of 3 syndactyly patients were made, and individual virtual incision patterns were created. Each pattern was transferred onto the patient by using a 3D printed template. The resulting incision pattern needed minor modifications by the surgeon before the surgery was performed. Further research and validation are necessary to develop the virtual planning of desyndactylization procedures.
The stress regulator FKBP51: a novel and promising druggable target for the treatment of persistent pain states across sexes
Authors: Maiarù Maria , Morgan Oakley B. , Mao Tianqi , Breitsamer Michaela , Bamber Harry , Pöhlmann Max , Schmidt Mathias V. , Winter Gerhard , Hausch Felix , Géranton Sandrine M. 
Published: March 2018

Abstract
It is well established that FKBP51 regulates the stress system by modulating the sensitivity of the glucocorticoid receptor to stress hormones. Recently, we have demonstrated that FKBP51 also drives long-term inflammatory pain states in male mice by modulating glucocorticoid signalling at spinal cord level. Here, we explored the potential of FKBP51 as a new pharmacological target for the treatment of persistent pain across the sexes. First, we demonstrated that FKBP51 regulates long-term pain states of different aetiologies independently of sex. Deletion of FKBP51 reduced the mechanical hypersensitivity seen in joint inflammatory and neuropathic pain states in female and male mice. Furthermore, FKBP51 deletion also reduced the hypersensitivity seen in a translational model of chemotherapy-induced pain. Interestingly, these 3 pain states were associated with changes in glucocorticoid signalling, as indicated by the increased expression, at spinal cord level, of the glucocorticoid receptor isoform associated with glucocorticoid resistance, GRβ, and increased levels of plasma corticosterone. These pain states were also accompanied by an upregulation of interleukin-6 in the spinal cord. Crucially, we were able to pharmacologically reduce the severity of the mechanical hypersensitivity seen in these 3 models of persistent pain with the unique FKBP51 ligand SAFit2. When SAFit2 was combined with a state-of-the-art vesicular phospholipid gel formulation for slow release, a single injection of SAFit2 offered pain relief for at least 7 days. We therefore propose the pharmacological blockade of FKBP51 as a new approach for the treatment of persistent pain across sexes, likely in humans as well as rodents.