bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and control of a robotic arm for percutaneous surgery
Authors: Zhou Chunlin , Wu Huifeng , Xu Xiang , Liu Yong , Zhu Qi , Pan Shuwen 
Published: September 2017

Purpose
The purpose of this paper is to propose a robotic system for percutaneous surgery. The key component in the system, a robotic arm that can manipulate a puncture needle is presented. The mechanical design, the motion control and the force control method of the robotic arm are discussed in the paper.

Design/methodology/approach
The arm with an arc mechanism placed on a 3D Cartesian stage is developed as a puncture needle manipulator to locate the position of the needle tip, tune the needle’s posture and actuate the puncture motion under the visual guidance of two orthogonal X-ray images of a patient by a surgeon. A focusing method by using two laser spots is proposed to automatically move the needle tip to a surgery entry point on the skin. A dynamics model is developed to control the position of the needle mechanism and an explicit force control strategy is utilized to perform the needle insertion.

Findings
With the surgical system, a surgeon can easily perform puncture operation by taking two orthogonal real-time X-ray images as a visual feedback and accurately navigating the needle insertion. The laser-guided focusing method is efficient in placement of the needle tip. The explicit force control strategy is proved to be effective for holding constant and stable puncture force in experiments.

Originality/value
The robotic arm has an advantage in easy redirection of the needle because the rotation and the translation are decoupled in the mechanism. By adopting simple laser pens and a well-developed kinematics model, the system can handle the entry point, locating task automatically. The focusing method and the force control method proposed in the paper are useful for the present system and could be intuitive for similar surgical robots.
Indices of anti‐dengue immunoglobulin G subclasses in adult Mexican patients with febrile and hemorrhagic dengue in the acute phase
Authors: Posadas‐Mondragón Araceli , Aguilar‐Faisal José Leopoldo , Chávez‐Negrete Adolfo , Guillén‐Salomón Edith , Alcántara‐Farfán Verónica , Luna‐Rojas Lucero , Ávila‐Trejo Amanda Marineth , del Carmen Pacheco‐Yépez Judith 
Published: September 2017

ABSTRACTHeterologous secondary infections are at increased risk of developing dengue hemorrhagic fever (DHF) because of antibody‐dependent enhancement (ADE). IgG subclasses can fix and activate complement and bind to Fcɣ receptors. These factors may also play an important role in the development of ADE and thus in the pathogenesis of DHF. The aim of this study was to analyze the indices of anti‐dengue IgG subclasses in adult patients with febrile and hemorrhagic dengue in the acute phase. In 2013, 129 patients with dengue fever (DF) and 57 with DHF in Veracruz, Mexico were recruited for this study and anti‐dengue IgM and IgG determined by capture ELISA. Anti‐dengue IgG subclasses were detected by indirect ELISA. Anti‐dengue IgG2 and IgG3 subclasses were detected in patients with dengue. IgG1 increased significantly in the sera of patients with both primary and secondary infections and DHF, but was higher in patients with secondary infections. The IgG4 subclass index was significantly higher in the sera of patients with DHF than in that of those with DF, who were in the early and late acute phase of both primary and secondary infection. In conclusion, indices of subclasses IgG1 and IgG4 were higher in patients with DHF.
The expression of Spodoptera exigua P450 and UGT genes: tissue specificity and response to insecticides
Authors: Hu Bo , Zhang Shu‐Heng , Ren Miao‐Miao , Tian Xiang‐Rui , Wei Qi , Mburu David Kibe , Su Jian‐Ya 
Published: September 2017

AbstractCytochrome P450 and UDP‐glucosyltransferase (UGT) as phase I and phase II metabolism enzymes, respectively, play vital roles in the breakdown of endobiotics and xenobiotics. Insects can increase the expression of detoxification enzymes to cope with the stress from xenobiotics including insecticides. However, the molecular mechanisms for insecticide detoxification in Spodoptera exigua remain elusive, and the genes conferring insecticide metabolisms in this species are less well reported. In this study, 68 P450 and 32 UGT genes were identified. Phylogenetic analysis showed gene expansions in CYP3 and CYP4 clans of P450 genes and UGT33 family of this pest. P450 and UGT genes exhibited specific tissue expression patterns. Insecticide treatments in fat body cells of S. exigua revealed that the expression levels of P450 and UGT genes were significantly influenced by challenges of abamectin, lambda‐cyhalothrin, chlorantraniliprole, metaflumizone and indoxacarb. Multiple genes for detoxification were affected in expression levels after insecticide exposures. The results demonstrated that lambda‐cyhalothrin, chlorantraniliprole, metaflumizone and indoxacarb induced similar responses in the expression of P450 and UGT genes in fat body cells; eight P450 genes and four UGT genes were co‐up‐regulated significantly, and no or only a few CYP/UGT genes were down‐regulated significantly by these four insecticides. However, abamectin triggered a distinct response for P450 and UGT gene expression; more P450 and UGT genes were down‐regulated by abamectin than by the other four compounds. In conclusion, P450 and UGT genes from S. exigua were identified, and different responses to abamectin suggest a different mechanism for insecticide detoxification.
Reduced risk of decompensation and death associated with use of statins in patients with alcoholic cirrhosis. A nationwide case‐cohort study
Authors: Bang U. C. , Benfield T. , Bendtsen F. 
Published: September 2017

SummaryBackgroundReports have indicated that the use of statins may ameliorate the course of cirrhosis.AimTo determine the relationship between use of statins and mortality rate in patients with cirrhosis.MethodsWe did a retrospective case‐cohort analysis based on data from the Danish registers from the period 1995 through 2014. Index date was time of diagnosis of cirrhosis (ICD‐10: K703) and cohort entry depended on whether the patient was statin user or not. We used propensity score matching with a statin:non‐statin ratio of 1:2. We included the exposure to statins (ATC classification C10AA) from the index date until death or end of follow‐up based on prescription claims. Use of statins based on at least two statin claims as well as the longitudinal pattern over time of statin claims was tested against mortality. The main outcome was mortality rate.ResultsA total of 24 748 patients with alcoholic cirrhosis were identified and 5417 were eligible for matching. The mean age was 56 (SD 10) years and 36% were females. The prevalence of use of statins was 15%. We included 744 in the matched cohort. Mortality rates were 88 (95% CI 73‐105) per 1000 years for patients using statin and 127 (95% CI 114‐141) for non‐statin patients with a HR of 0.57 (95% CI 0.45‐0.71). A more regular pattern of statin claims was related to a lower risk of death.ConclusionsOur results showed an association between regular use of statins and reduced mortality in patients with alcoholic cirrhosis.
Editorial: subgroups in irritable bowel syndrome—more than just diarrhoea and constipation? Authors' reply
Authors: Polster A. , Van Oudenhove L. , Jones M. , Öhman L. , Törnblom H. , Simrén M. 
Published: September 2017

Linked ContentThis article is linked to Black and Ford, and Patel et al papers. To view these articles visit https://doi.org/10.1111/apt.14238 and https://doi.org/10.1111/apt.13074.
Ribavirin steady‐state plasma level is a predictor of sustained virological response in hepatitis C–infected patients treated with direct‐acting antivirals
Authors: van Tilborg M. , Lieveld F. I. , Smolders E. J. , van Erpecum K. J. , de Kanter C. T. M. M. , Maan R. , van der Valk M. , Arends J. E. , Dofferhoff A. S. M. , Blokzijl H. , Bijmolen M. , Drenth J. P. H. , de Knegt R. J. , Burger D. M. ,   the HepNed Study Group
Published: September 2017

SummaryBackgroundIn the era of highly effective direct‐acting antivirals (DAAs) for treatment of patients with chronic hepatitis C virus (HCV) infection, ribavirin (RBV) is still considered beneficial in certain patients.AimTo assess the association between RBV steady‐state plasma levels and sustained virological response (SVR).MethodsConsecutive HCV‐infected patients treated with DAAs plus RBV from four Dutch academic medical centres were enrolled. RBV steady‐state plasma levels were prospectively measured at treatment week 8 using validated assays. Logistic regression analyses were performed to assess the influence of RBV steady‐state plasma level on SVR, and RBV therapeutic range was explored using area under the ROC curve analyses.ResultsA total of 183 patients were included, of whom 85% had one or more difficult‐to‐cure characteristics (ie treatment experienced, HCV genotype 3, cirrhosis). The majority was treated with a sofosbuvir‐based regimen and 163 (89%) patients achieved SVR. Median RBV dose was 12.9 (interquartile range 11.2‐14.7) mg/kg/d, and median RBV steady‐state plasma level was 2.66 (1.95‐3.60) mg/L. In multivariable analyses, higher RBV steady‐state plasma level (adjusted odds ratio 1.79 [95% CI 1.09‐2.93]) was an independent predictor of SVR. With regard to the optimal RBV therapeutic range, 2.28 mg/L was the optimal lower cut‐off for achieving SVR and 3.61 mg/L was the upper cut‐off for preventing significant anaemia (Haemoglobin < 10 g/dL).ConclusionIn this cohort of mainly difficult‐to‐cure patients treated with DAAs plus RBV, higher RBV steady‐state plasma level was an independent predictor of SVR.
The body composition profile is associated with response to anti‐TNF therapy in Crohn's disease and may offer an alternative dosing paradigm
Authors: Ding N. S. , Malietzis G. , Lung P. F. C. , Penez L. , Yip W. M. , Gabe S. , Jenkins J. T. , Hart A. 
Published: September 2017

SummaryBackgroundAnti‐tumour necrosis factor (TNF)s form a major part of therapy in Crohn's disease and have a primary nonresponse rate of 10%‐30% and a secondary loss of response rate of 5% per year. Myopenia is prevalent in Crohn's disease and is measured using body composition analysis tools.AimTo test the hypothesis that body composition can predict outcomes of anti‐TNF primary nonresponse and secondary loss of response.MethodsBetween January 2007 and June 2012, 106 anti‐TNF naïve patients underwent anti‐TNF therapy for Crohn's disease with body composition parameters analysed using CT scans to estimate body fat‐free mass. The outcome measures were primary nonresponse and secondary loss of response. COX‐regression analysis was used with 3 year follow‐up data.ResultsA total of 106 patients were included for analysis with 26 (24.5%) primary nonresponders and 29 (27.4%) with secondary loss of response to anti‐TNF therapy. Sex‐specific cut‐offs for muscle and fat were ascertained by stratification analysis. On univariate analysis, primary nonresponse was associated with low albumin (OR 0.94; 0.88‐0.99, P = .04) and presence of myopenia (OR 4.69; 1.83‐12.01, P = .001) when taking into account patient's medical therapy, severity of disease and body composition. On multivariate analysis, presence of myopenia was associated with primary nonresponse (OR 2.93; 1.28‐6.71, P = .01). Immunomodulator therapy was associated with decreased secondary loss of response (OR 0.48; 0.23‐0.98, P = .04). BMI was poorly correlated with lean body mass (r2 = 0.15, P = .54).ConclusionsIn this cohort study, body composition profiles did not correlate well with BMI. Myopenia was associated with primary nonresponse with potential implications for dosing and serves as an explanation for pharmacokinetic failure.
Saddle nose deformity and septal perforation in granulomatosis with polyangiitis
Authors: Coordes A. , Loose S.M. , Hofmann V.M. , Hamilton G.S. , Riedel F. , Menger D.J. , Albers A.E. 
Published: September 2017

BackgroundPatients who have granulomatosis with polyangiitis (GPA, syn. M. Wegener) often develop an external nose deformity which may have devastating psychological effects. Therefore, reconstruction of nasal deformities by rhinoplasty may become necessary to achieve a normal appearance.Objective of reviewThe aim of this systematic review was to investigate the efficacy and safety of surgical reconstruction in external nasal deformities and septal perforation in GPA patients.Search strategyA systematic literature search with defined search terms was performed for scientific articles archived in the MEDLINE‐Database up to 10 June 2016 (PubMed Advanced MEDLINE Search), describing management of cases or case series in GPA patients with saddle nose deformity and/or septal perforation.ResultsEleven of 614 publications met the criteria for this analysis including 41 GPA patients undergoing external nasal reconstruction and/or septal reconstruction with a median follow‐up of 2.6 years. Overall, saddle nose reconstruction in GPA patients is safe even if an increased rate of revision surgery has to be expected compared with individuals without GPA undergoing septorhinoplasty. Most implanted grafts were autografts of calvarial bone or costal cartilage. For septal perforation reconstruction, few studies were available. Therefore, based on the available data for surgical outcomes, it is impossible to make evidence‐based recommendations. All included GPA patients had minimal or no local disease at the time of reconstructive surgery. Therefore, the relationship between disease activity and its impact on surgical outcomes remains unanswered. The potential impact of immune‐modulating medications on increased complication rates and the impact of prophylactic antibiotics are unknown.ConclusionsThis study systematically reviews the efficacy and safety of surgical reconstruction of external nasal deformities in GPA patients for the first time. Saddle nose reconstruction in GPA patients with minimal or no local disease is a safe procedure despite an increased rate of revision surgery. Further research is required regarding the impact of antibiotic prophylaxis, immune‐modulating therapy, long‐term outcomes and functional outcomes measured with subjective and objective parameters.
Active site geometry of a novel aminopropyltransferase for biosynthesis of hyperthermophile‐specific branched‐chain polyamine
Authors: Hidese Ryota , Tse Ka Man , Kimura Seigo , Mizohata Eiichi , Fujita Junso , Horai Yuhei , Umezawa Naoki , Higuchi Tsunehiko , Niitsu Masaru , Oshima Tairo , Imanaka Tadayuki , Inoue Tsuyoshi , Fujiwara Shinsuke 
Published: September 2017

Branched‐chain polyamines are found exclusively in thermophilic bacteria and Euryarchaeota and play essential roles in survival at high temperatures. In the present study, kinetic analyses of a branched‐chain polyamine synthase from the hyperthermophilic archaeon Thermococcus kodakarensis (Tk‐BpsA) were conducted, showing that N4‐bis(aminopropyl)spermidine was produced by sequential additions of decarboxylated S‐adenosylmethionine (dcSAM) aminopropyl groups to spermidine, through bifunctional catalytic action. Tk‐BpsA catalyzed the aminopropylation of the linear‐chain polyamines spermidine, spermine, norspermidine, and the tertiary‐branched polyamines N4‐aminopropylspermidine and N4‐aminopropylnorspermidine, but not of short‐chain diamines, putrescine, and cadaverine, suggesting that Tk‐BpsA does not catalyze the aminopropylation of primary amino groups of diamines. X‐ray structural analyses of Tk‐BpsA in the presence or absence of the substrates spermidine and dcSAM revealed that a large, negatively charged cavity is responsible for the binding of branched‐chain substrates. The binding is different from that in the active site of linear polyamine spermidine/spermine synthases, and loop‐closures occur upon the binding of spermidine. Based on structural analyses, further kinetic studies were carried out for various mutants, revealing that Asp159, positioned between the reactive secondary amino group of the substrate polyamine and a sulfur atom of the product 5ʹ‐methylthioadenosine and in a Gly‐Asp‐Asp‐Asp motif, functions as a catalytic center, with reactions proceeding via a ping‐pong mechanism. Our study provides a novel aminopropyltransfer reaction mechanism, distinct from the SN2 displacement mechanism found in other known linear spermidine/spermine synthases.DatabaseAtomic coordinates and structure factors have been deposited in the Protein Data Bank with PDB codes 5XNF for apo‐Tk‐BpsA, 5XNH for the binary complex, and 5XNC for the ternary complex.
Automated cell counts on CSF samples: A multicenter performance evaluation of the GloCyte system
Authors: Hod E. A. , Brugnara C. , Pilichowska M. , Sandhaus L. M. , Luu H. S. , Forest S. K. , Netterwald J. C. , Reynafarje G. M. , Kratz A. 
Published: September 2017

AbstractObjectivesAutomated cell counters have replaced manual enumeration of cells in blood and most body fluids. However, due to the unreliability of automated methods at very low cell counts, most laboratories continue to perform labor‐intensive manual counts on many or all cerebrospinal fluid (CSF) samples. This multicenter clinical trial investigated if the GloCyte System (Advanced Instruments, Norwood, MA), a recently FDA‐approved automated cell counter, which concentrates and enumerates red blood cells (RBCs) and total nucleated cells (TNCs), is sufficiently accurate and precise at very low cell counts to replace all manual CSF counts.MethodsThe GloCyte System concentrates CSF and stains RBCs with fluorochrome‐labeled antibodies and TNCs with nucleic acid dyes. RBCs and TNCs are then counted by digital image analysis. Residual adult and pediatric CSF samples obtained for clinical analysis at five different medical centers were used for the study. Cell counts were performed by the manual hemocytometer method and with the GloCyte System following the same protocol at all sites. The limits of the blank, detection, and quantitation, as well as precision and accuracy of the GloCyte, were determined.ResultsThe GloCyte detected as few as 1 TNC/μL and 1 RBC/μL, and reliably counted as low as 3 TNCs/μL and 2 RBCs/μL. The total coefficient of variation was less than 20%. Comparison with cell counts obtained with a hemocytometer showed good correlation (>97%) between the GloCyte and the hemocytometer, including at very low cell counts.ConclusionsThe GloCyte instrument is a precise, accurate, and stable system to obtain red cell and nucleated cell counts in CSF samples. It allows for the automated enumeration of even very low cell numbers, which is crucial for CSF analysis. These results suggest that GloCyte is an acceptable alternative to the manual method for all CSF samples, including those with normal cell counts.
Globalism vs culture(s): a critique of transculturalism and the one world, one culture globalist narrative in Africa
Authors: Petrus Theodore 
Published: September 2017

AbstractThere can be little doubt that with the advances in mass communication and technologies, the phenomenon of transculturalism is well and truly underway. However, this global phenomenon did not originate with technological advances in mass communication. Although the internet and the spread of popular culture have been the most obvious examples of transculturalism, the phenomenon itself has a long history. The current global(ist) world emerged, at least as far as modern history is concerned, with colonialism, where the seed of transculturalism was planted. Arguably, we are now experiencing the fruits of that seed, which has germinated and become this giant tree with branches and roots permeating almost every level of human society. The resultant interconnectedness brought about by globalism and its process, globalisation, has, among other things, created transculturalism. Both cultural globalisation and transculturalism share the ideological position of the world moving towards a “one world culture”. This contribution seeks to critique this perspective by interrogating whether (a) such a global move towards “oneness” is in fact possible, and (b) if it is, whether such a one world culture would be beneficial. The discussion is presented with specific reference to the working of transculturalism in the African context.
Femtosecond assisted intracorneal segments implantation for mild to moderate keratoconus: long term results
Authors: Kontadakis G. , Parikakis E. , Kaprinis K. , Stoupaki M. , Nikas S. , Konstantinidou V. , Peponis V. 
Published: September 2017

PurposeTo describe the 2 year results of femtosecond assisted intracorneal segments implantation for the treatment of mild to moderate keratoconus with the use of a femtosecond laser.MethodsProspective case series including 4 eyes of 4 consecutive patients with keratoconus. Patients where implanted with KC Solutions intrastromal segments (IS). Patients’ assessment included visual acuity measurement, manifest refraction, clinical examination and corneal topography and tomography. IS implantation was scheduled in patients with unsatisfying corrected visual acuity (CDVA) and contact lens intolerance. Planning of the operation was done based on the topography and refraction based on nomogram provided by the IS manufacturer. IS were implanted in intracorneal pocket created with the FS200 femtosecond laser. Comparisons were made between pre‐ to postoperative values with the Wilcoxon signed‐rank test.ResultsPreoperative average steep keratometry was 48.45D (range 45.6 to 51.6), whereas at 2 years postoperatively it was 46.73 (44.8 to 48.7), (p<0.05). Preoperatively corneal astigmatism on average was 4.95D (2 to 9.1) and refractive astigmatism was 3.94D (2 to 9), whereas postoperatively average corneal and refractive astigmatism was 2.75 (1.2 to 6) and 1.87 (range 0,5 to 5) (p<0.05 in both comparisons). CDVA improved in all cases by 1 to 2 lines of Snellen visual acuity. Average spherical equivalent refraction was ‐3.22 (‐1.87 to ‐4.5) preoperatively, and postoperatively it was reduced to ‐1,81 (‐0.50 to ‐3,5) (p<0.05). No statistically significant differences were found between the last and 6th month follow up results.ConclusionsAccording to our pilot long term study, Implantation of KC Solutions intrastromal segments with the aid of a femtosecond laser improved all patients’ topographic and refractive astigmatism, visual acuity and refraction.