bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the OSC‐TV iterative reconstruction algorithm for cone‐beam optical CT
Authors: Matenine Dmitri , Mascolo‐Fortin Julia , Goussard Yves , Després Philippe 
Published: October 2015

Purpose:The present work evaluates an iterative reconstruction approach, namely, the ordered subsets convex (OSC) algorithm with regularization via total variation (TV) minimization in the field of cone‐beam optical computed tomography (optical CT). One of the uses of optical CT is gel‐based 3D dosimetry for radiation therapy, where it is employed to map dose distributions in radiosensitive gels. Model‐based iterative reconstruction may improve optical CT image quality and contribute to a wider use of optical CT in clinical gel dosimetry.Methods:This algorithm was evaluated using experimental data acquired by a cone‐beam optical CT system, as well as complementary numerical simulations. A fast GPU implementation of OSC‐TV was used to achieve reconstruction times comparable to those of conventional filtered backprojection. Images obtained via OSC‐TV were compared with the corresponding filtered backprojections. Spatial resolution and uniformity phantoms were scanned and respective reconstructions were subject to evaluation of the modulation transfer function, image uniformity, and accuracy. The artifacts due to refraction and total signal loss from opaque objects were also studied.Results:The cone‐beam optical CT data reconstructions showed that OSC‐TV outperforms filtered backprojection in terms of image quality, thanks to a model‐based simulation of the photon attenuation process. It was shown to significantly improve the image spatial resolution and reduce image noise. The accuracy of the estimation of linear attenuation coefficients remained similar to that obtained via filtered backprojection. Certain image artifacts due to opaque objects were reduced. Nevertheless, the common artifact due to the gel container walls could not be eliminated.Conclusions:The use of iterative reconstruction improves cone‐beam optical CT image quality in many ways. The comparisons between OSC‐TV and filtered backprojection presented in this paper demonstrate that OSC‐TV can potentially improve the rendering of spatial features and reduce cone‐beam optical CT artifacts.
Spatially Distinct Neutrophil Responses within the Inflammatory Lesions of Pneumonic Plague
Authors: Stasulli Nikolas M. , Eichelberger Kara R. , Price Paul A. , Pechous Roger D. , Montgomery Stephanie A. , Parker Joel S. , Goldman William E. 
Published: October 2015

ABSTRACT

During pneumonic plague, the bacterium
Yersinia pestis
elicits the development of inflammatory lung lesions that continue to expand throughout infection. This lesion development and persistence are poorly understood. Here, we examine spatially distinct regions of lung lesions using laser capture microdissection and transcriptome sequencing (RNA-seq) analysis to identify transcriptional differences between lesion microenvironments. We show that cellular pathways involved in leukocyte migration and apoptosis are downregulated in the center of lung lesions compared to the periphery. Probing for the bacterial factor(s) important for the alteration in neutrophil survival, we show both
in vitro
and
in vivo
that
Y. pestis
increases neutrophil survival in a manner that is dependent on the type III secretion system effector YopM. This research explores the complexity of spatially distinct host-microbe interactions and emphasizes the importance of cell relevance in assays in order to fully understand
Y. pestis
virulence.

IMPORTANCE
Yersinia pestis
is a high-priority pathogen and continues to cause outbreaks worldwide. The ability of
Y. pestis
to be transmitted via respiratory droplets and its history of weaponization has led to its classification as a select agent most likely to be used as a biological weapon. Unrestricted bacterial growth during the initial preinflammatory phase primes patients to be infectious once disease symptoms begin in the proinflammatory phase, and the rapid disease progression can lead to death before
Y. pestis
infection can be diagnosed and treated. Using
in vivo
analyses and focusing on relevant cell types during pneumonic plague infection, we can identify host pathways that may be manipulated to extend the treatment window for pneumonic plague patients.
Predictors of the antibody response to influenza vaccination in older adults with type 2 diabetes
Authors: McElhaney Janet E , Garneau Hugo , Camous Xavier , Dupuis Gilles , Pawelec Graham , Baehl Sarra , Tessier Daniel , Frost Eric H , Frasca Daniela , Larbi Anis , Fulop Tamas 
Published: October 2015

ObjectiveType 2 diabetes mellitus (T2DM) is one of the most prevalent chronic inflammatory diseases of the elderly. Its development is related to the alteration of the immune system with aging characterized by immunosenescence and inflamm-aging. In turn, T2DM also alters the immune response. As a consequence, older people with T2DM are more susceptible to influenza and to its complications as compared with healthy controls. Vaccination against influenza has shown poor efficacy in the older population and even less efficacy in patients with diabetes. We studied here the antibody response to vaccination in healthy and diabetic elderly participants.Research design and methodsIn 2 groups of elderly participants (healthy N=119 and T2DM N=102), we measured the immunogenicity of influenza vaccine by hemagglutination inhibition assays. We assessed several blood and functional parameters as potential predictors of the vaccine efficacy.ResultsWe found no difference between antibody responses in diabetic elderly compared with healthy elderly. Among the biological and functional determinants, the cytomegalovirus (CMV) serostatus played a more prominent role in determining the magnitude of response. We concluded that in addition to age and diabetic status, immunological history such as CMV status should be taken into account. None of the other biological or functional parameters studied could be reliably linked to the vaccine antibody response in older adults who are not frail including those with well-controlled diabetes.ConclusionsOur data strongly suggest that influenza vaccine should be administered to elderly patients with T2DM; however, the immune determinants of the antibody response to influenza vaccination should be further investigated.
Association between alcohol consumption and Korean young women's bone health: a cross sectional study from the 2008 to 2011 Korea National Health and Nutrition Examination Survey
Authors: Seo Seonwha , Chun Sungsoo , Newell Maxine Andrea , Yun Mieun 
Published: October 2015

ObjectivesTo assess the association between alcohol consumption and healthy Korean young women bone by Alcohol Use Disorders Identification Test (AUDIT) scores and drinking consumption; frequency and amount.DesignCross-sectional study composed of three parts: health interview, health examination, nutrition survey.Setting2008–2011 Korea National Health and Nutrition Examination Survey.ParticipantsOf the 21 303 participants whose bone mineral density (BMD) was assessed, 1176 healthy women aged 19–30 years were selected.Primary and secondary outcome measuresMean BMD T-scores of the total femur (TF), femur neck (FN) and lumbar spine (LB) by drinking consumption and AUDIT scores, and the odds of having a low BMD (T-score <−1) at the sites by AUDIT scores.ResultsAfter adjustment, lower BMD was found at three sites in those who drank more and had higher AUDIT scores. These associations were significant by AUDIT scores at TF (p=0.002) and FN (p=0.004) and by drinking frequency and amount at FN (p=0.029 and 0.039, respectively). The adjusted OR of having low BMD increased significantly, particularly at FN, in those who had higher AUDIT scores such as 16–17 harmful drinking (OR 4.31; 95% CI 1.16 to 16.06) and 20–40 alcohol dependence (OR 5.99; 95% CI 1.69 to 21.21), compared with young women who scored 0–7 low-risk drinking or abstinence. No beneficial effect of moderate drinking was observed at any of the sites and the association between alcohol consumption and bone health was most evident at FN.ConclusionsIt is crucial to promote the awareness of alcohol harm on Korean young women's bone health. At the same time, since alcohol's effect on the bone is complex with cumulative effects of various factors over the years and there is an absence of studies with young women in their twenties, more studies, in particular for FN, are needed with more precise and appropriate design to confirm our findings.
THE PROFILE OF MULTIPLE SCLEROSIS IN GENERAL PRACTICE
Authors: Binks Sophie , Green Liz 
Published: October 2015

IntroductionMultiple sclerosis (MS) is a long-term neurological condition requiring a multi-disciplinary team approach. Recently, NICE highlighted the role of primary care professionals in MS management through an updated clinical guideline. This quality improvement project investigated aspects of MS patient care in a large Brighton GP practice.MethodElectronic GP records were searched to identify all currently registered patients with a diagnosis of MS. Details of initial presentation, epidemiology and care received over a one-year period were examined.ResultsThere were 19 patients, representing a prevalence of 186 per 100,000. Most patients first presented in GP with sensory disturbance, optic neuritis or motor symptoms. The mean number of primary care contacts per patient per year was 4.3, compared to 0.4 contacts per person per year with a neurologist and 0.5 with the MS nurse. 46% of GP consultations were wholly or partially related to the patient's MS. Around half of patients took up proactive interventions such as flu vaccination (47%) and Vitamin D monitoring (50%).ConclusionsPrimary care professionals are significant contributors to the care of people with MS with frequent patient contact. During this project, patients were reminded of preventive care opportunities and this will be re-audited in 2015.
SUSAC'S SYNDROME: A CASE SERIES FROM A REGIONAL NEUROSCIENCES UNIT
Authors: King Dominic , Appleton Jason Philip , Jacob Saiju 
Published: October 2015

The clinical triad of branch retinal artery occlusions, hearing loss and encephalopathy constitutes Susac's Syndrome. This rare, immune mediated, microangiopathic disorder shows a variable course with a preponderance of 3 to 1 for women, mainly in their 2nd to 4th decade. The condition relies on diagnosis and early aggressive immunosuppressive therapy to avoid severe sequale. Unfortunately, due to the paucity of experience, and a variable disease course, often lacking all elements of the triad concurrently, diagnosis continues to be delayed.We present five cases (Age 34–45, M:F–1:4) seen at our regional neurosciences centre, which highlight the diagnostic differences and challenges and the variety of management techniques adopted. Three patients had a monophasic illness and two had a relapsing remitting course. In addition, we provide an up-to-date literature review on the pathophysiology, diagnosis and management of this rare and fascinating condition.Susac's disease, otherwise described as retinocochleocerebral vasculopathy, RED-M (retinopathy, encephalopathy, deafness associated microangiopathy) and SICRET (small infarcts of cochlear, retinal and encephalic tissues), is a syndromic pathology requiring the recognition of a triad of deficits to make a diagnosis. The relevance of this and the difficulty in diagnosis is exemplified in the cases presented here.
RARE PARANEOPLASTIC POLYNEUROPATHY SECONDARY TO SKIN MELANOMA
Authors: Kioulachidis Konstantinos , Ailenei Elena , Afshari Fardad , Mockova Martina 
Published: October 2015

Paraneoplastic diseases of peripheral and central nervous systems are rare manifestations of malignancies. Here we report a rare case of 51 year old male who presented with symmetrical progressive sensory and motor deficit over the course of one year. His past medical history included a malignant melanoma excised 5 years ago from the skin of interscapular region.His nerve conduction studies showed evidence of severe, symmetrical, predominantly sensory, axonal peripheral neuropathy. He under-went CT chest-abdomen-pelvis which showed large right axillary lymph nodes. Axillary Lymph node biopsy contained metastatic melanoma cells positive with MelanA and HMB 45. Analysis of the BRAF gene from biopsy sample cells revealed the presence of a mutation within codon 600 of the BRAF gene. All further investigations did not show evidence of any other type of tumour.Paraneoplastic syndromes can affect the motor, sensory and autonomic nervous systems and are associated with lung cancer, especially small-cell lung cancer, lymphoma and gynecological tumors. To our knowledge our case is the first report of paraneoplastic polyneuropathy secondary to malignant melanoma.The presence of paraneoplastic neuropathy should be considered in all patients with malignancy and can happen at any point in the disease prior or after induction of any treatment. We report rare case of malignant melanoma presenting with paraneoplastic polyneuropathy.
BING-NEEL SYNDROME: A RARE CAUSE OF PROGRESSIVE GAIT DISTURBANCE AND DEMENTIA
Authors: Doshi Anisha , Haque Anis , Chowdhury Muhammad , Boyd Kevin 
Published: October 2015

A 69 year old retired lady presented with a 3 year history of progressive gait disturbance with unsteadiness and falls. Over the preceding year she had become recluse, failing to attend social gatherings and becoming anxious. She complained of lethargy and poor appetite and had lost weight. A witnessed generalised seizure led to admission. Examination revealed mixed pyramidal and extrapyramidal signs in the limbs with global hyperreflexia and upgoing plantars. There was upper limb ataxia with bilateral intention tremor and myoclonus. She was only obeying one stage commands.Investigations revealed elevated ESR and monoclonal IgM kappa band with paraprotein concentration 9.4 g/L. MRI whole axis revealed periventricular diffuse T2 and FLAIR signal change and prominence of the leptomeninges along the distal spinal cord, conus medullaris and cauda equina. Bone scan showed prominent uptake within both humeri. Bone marrow trephine biopsy indicated a low-grade B-cell lymphoproliferative disorder; lymphoplasmacytic lymphoma. Serial CSF analysis revealed lymphocytic pleocytosis with elevated protein of 4.47–6.25 g/L. CSF protein electrophoresis demonstrated the presence of an IgM paraprotein with monoclonal IgM kappa band on immunonofixation. CSF immunophenotyping confirmed the presence of clonal B–cells.We therefore present a rare case of Bing-Neel Syndrome, CNS manifestation of Wäldenstroms Macroglobulinaemia.
CO-MORBIDITY BURDEN IN PARKINSON'S DISEASE AND MATCHED CONTROLS
Authors: Goddard Hannah , Macleod Angus , Counsell Carl 
Published: October 2015

BackgroundIdiopathic Parkinson's disease (PD) is a common, disabling, neurodegenerative disorder. The overall co-morbidity burden associated with PD is unclear, but may be important to adjust for when predicting prognosis or comparing cases and controls.Aims
▸ To determine how best to assess overall co-morbidity in PD▸ To compare PD co-morbidity burden to that of age- and sex-matched controlsMethodsData from an incident, community-based cohort of 205 patients with PD and 148 age-, sex- and GP-matched controls (the PINE study) were used. The intra- and inter-rater reliability and mortality predictive ability of three co-morbidity scales (the Charlson Co-Morbidity Index, the Cumulative Illness Rating Scale and a disease count) were evaluated. The co-morbidity burden of cases and controls was compared at baseline and over 5 years of follow-up.Results and conclusionsThe Charlson Co-Morbidity Index was more reliable for use in PD and was the only scale that was independently predictive of mortality (hazard ratio=1.20, [95% CI 1.07–1.34]). There was no significant difference between cases and controls at baseline (p=0.20). Charlson Co-Morbidity Index scores increased over time. This increase was greater in patients with PD than controls and greater in patients and controls who died earlier.
SLEEP AND CIRCADIAN RHYTHM REGULATION IN EARLY PARKINSON'S DISEASE
Authors: Breen David , Vuono Romina , Nawarathna Upekshani , Fisher Kate , Shneerson John , Reddy Akhilesh , Barker Roger 
Published: October 2015

AimSleep disturbances are recognised as a common non-motor complaint in Parkinson's disease but their aetiology is poorly understood. We set out to define the sleep and circadian phenotype of early-stage Parkinson's disease patients.MethodsWe began by assessing the sleep characteristics of a large population-representative incident Parkinson's disease cohort (n=239) at the University of Cambridge. We went on to carry out more comprehensive case-control sleep assessments in a subgroup of these patients (n=30) and matched controls (n=15). Outcome measures were sleep diagnoses and sleep architecture based on polysomnography studies; actigraphy assessment; and 24-hour analyses of serum cortisol, melatonin and peripheral clock gene expression (Bmal1, Per2, and Rev-Erbα).ResultsSubjective sleep complaints were present in almost half of newly-diagnosed patients and correlated significantly with poorer quality of life. Parkinson's disease patients exhibited increased sleep latency, reduced sleep efficiency and reduced REM sleep. In addition, there was a sustained elevation of serum cortisol levels, reduced circulating melatonin levels, and altered Bmal1 expression in Parkinson's disease patients compared to controls.ConclusionsThe sleep dysfunction seen in early Parkinson's disease may reflect a more fundamental pathology in the molecular clock underlying circadian rhythms.
ELEVATED SALIVARY DJ-1 IN PARKINSON'S DISEASE IS ASSOCIATED WITH ALTERED SALIVARY SECRETION
Authors: Masters Joseph , Noyce Alaistair , Giovannoni Gavin , Warner Tom , Proctor Gordon 
Published: October 2015

AimTo investigate the composition of saliva in patients with Parkinson's disease (PD).MethodsSaliva was collected from 16 patients with PD and 22 age-matched controls. Salivary DJ-1 concentrations were measured with quantitative immunoblotting; total protein concentration with a BCA assay; amylase with an amylase activity assay; and mucin concentrations with periodic-acid Schiff stained SDS gels.ResultsSalivary flow rate was not significantly different between patients and controls. Patient saliva showed increases in DJ-1 concentration (0.84 vs 0.42 µg/ml, p=0.001) and total protein concentration (8.4 vs 5.0 mg/ml, p=0.001). In patients, adjusted DJ-1 levels correlated with disease severity measured with the Unified Parkinson's Disease Rating Scale (p=0.019). Concentrations of amylase, but not mucins, were elevated in the saliva of patients (0.127 vs 0.061 units/ml, p<0.001) and correlated positively with both total protein (p<0.001) and DJ-1 concentration (p<0.013).ConclusionsThis preliminary study suggests that the saliva of patients with PD is different in composition to that of controls, which supports the notion that saliva may be a good candidate for biomarker discovery in PD. Altered protein secretion may be a manifestation of autonomic dysfunction in PD.
BED PARTNER ‘GAS-LIGHTING’ AS A CAUSE OF FICTITIOUS SLEEP-TALKING
Authors: Bashford James , Leschziner Guy 
Published: October 2015

We report a rare and striking, but under-recognised, cause of reported sleep-talking to a specialist sleep clinic. A 67 year-old right-handed bus driver was referred with one year's history of sleep-talking reported by his bed-partner of eighteen months. The somniloquy occurred on most nights, beginning within ten minutes of sleep and lasting several minutes to hours. The speech was elaborate relating to ex-girlfriends, often describing explicit sexual activities.Nocturnal polysomnography demonstrated clinically significant obstructive sleep apnoea and the working diagnosis was that obstructive events were triggering a non-REM parasomnia.On review two months later his partner reported on-going nocturnal speech. However, the patient's mounting curiosity had led to the implementation of surreptitious night-time electronic recordings. It soon became apparent that his partner's account was fictitious. Full psychiatric evaluation of his partner excluded morbid jealousy and psychotic illness.We highlight the psychological phenomenon of gas-lighting, coined from the 1938 play Gas Light, in which a husband systematically torments his unsuspecting wife in order to provoke admission to a mental health unit. This phenomenon should be considered amongst the differential diagnoses of unusual presentations to sleep clinic, especially pertinent in this setting as the clinical assessment relies heavily on the bed-partner account.
ANALYSIS OF CONVULSIVE SEIZURES AT A DGH EMERGENCY DEPARTMENT
Authors: Edwards Amy , Percival Kevin , Zouita Louisa , Arevalo Jan , O'Dwyer John Philip 
Published: October 2015

IntroductionSeizures represent 3% of all emergency department attendances.MethodsA list of all possible seizure mimics was generated from ED computerized triage systems from 1/1/12 to 31/12/13. Data was extracted manually from review of ED notes and analyzed.Results905 seizure attendances by 636 patients were examined over 2 years. 340 men and 296 women accounted for them, with average age 33±28 years. 245 patients had a history of epilepsy and were taking at least one AED. >2 AEDs were used by 32 patients. 22 had known Non-Epileptic Attacks (NEAD). Convulsive seizures occurred in 429 and Status Epilepticus in 13. The mode for the number of convulsive events in ED was 2 for NEAD patients and 1 for others. Lactate and neutrophils in NEAD were 1.3±0.3 mM and 4.4±1.2×10^9/L respectively. In other patients with convulsive seizures, they were 3.2 ±3.2 mM (median 2.1) and 6.6±3.1×10^9/L (median 6.1). 73 had neuroimaging acutely. Few patients with NEAD were admitted. 1/3 of convulsive seizures were admitted.ConclusionThis retrospective service audit indicates the burden of epilepsy attendance in a busy hospital. There is a potential role for more acute neurology input to prevent unnecessary admissions, and a pathway for non-epileptic attack sufferers.
WHY NEUROLOGY? THE CAREER CHOICES OF CURRENT UK NEUROLOGY TRAINEES
Authors: Thomas Rhys , Devine Helen , Donnelly Ann , Foulkes Alexander , Galtrey Clare , Khaleeli Zhaleh , Lawrence Joanne , Novak Marianne , Redgrave Jessica , Tallantyre Emma 
Published: October 2015

IntroductionIt is important that we attract high-calibre medics to neurology. There are few studies of what motivated neurologists to choose their speciality, when they chose, or what else they might have become.MethodsAll UK neurology trainees were invited to complete an online survey.Results160 trainees responded (53% female; 17% less-than-fulltime). 54% decided on neurology before graduating (6% before medical school), whilst 29% decided after foundation training. Common reasons to choose neurology included: academically interesting (72%); clinical exposure as a student or junior (67%); personality fit (53%); influential role-model (37%). Less common motivations included lifestyle, family friendliness, prestige, and family members with neurological conditions. Two trainees chose neurology because they personally have a neurological condition. When asked what their second choice of medical career would have been the answers were diverse and 31 different specialties were named, but only one might have been a neurosurgeon.ConclusionsCareers advice should begin early in medical school and continue through medical training with direct exposure to clinical neurology. Traditional neurology values such as the intellectual challenge should be emphasised. Neurologists have a broad interest in medical and psychiatric specialties underlining the importance of core medical training to developing neurologists of the future.