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1
Rouse, Robert W. "SEC/the audit engagement—project or process?" Journal of Corporate Accounting & Finance 7, no. 2 (1995): 103–5. http://dx.doi.org/10.1002/jcaf.3970070213.
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Howard, Marla. "Flex or Break? Extensions in XBRL Disclosures to the SEC." CFA Digest 42, no. 3 (August 2012): 82–84. http://dx.doi.org/10.2469/dig.v42.n3.7.
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Debreceny, Roger S., Stephanie M. Farewell, Maciej Piechocki, Carsten Felden, Andre Gräning, and Alessandro d'Eri. "Flex or Break? Extensions in XBRL Disclosures to the SEC." Accounting Horizons 25, no. 4 (December 1, 2011): 631–57. http://dx.doi.org/10.2308/acch-50068.
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SYNOPSIS The Securities and Exchange Commission (SEC) has adopted the eXtensible Business Reporting Language (XBRL) in a multi-year program to enhance the functionality of the Commission's EDGAR database. Filers tag their financial statements with elements from a taxonomy that defines the reporting concepts so that the XBRL files can be understood by information consumers. The U.S. GAAP taxonomy was designed to represent common reporting practices and support the disclosure requirements of U.S. GAAP. If taxonomy elements for each disclosure concept are not present, the filer creates an extension element. Extensions, when used appropriately, provide decision-relevant information. When used inappropriately, particularly when a semantically equivalent element already exists in the foundation taxonomy, extensions add no information content. This research analyzes extensions made in a subset of XBRL filings made to the SEC between April 2009 and June 2010. Forty percent of these extensions were unnecessary, as semantically equivalent elements were already in the U.S. GAAP taxonomy. Extensions that aggregated or disaggregated existing elements comprised 21 percent of the extensions. New concepts accounted for 30 percent of the extensions, although many were variants of existing elements, rather than significantly new concepts.
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DeLeve, Laurie D., Xiangdong Wang, Liping Hu, Margaret K. McCuskey, and Robert S. McCuskey. "Rat liver sinusoidal endothelial cell phenotype is maintained by paracrine and autocrine regulation." American Journal of Physiology-Gastrointestinal and Liver Physiology 287, no. 4 (October 2004): G757—G763. http://dx.doi.org/10.1152/ajpgi.00017.2004.
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The phenotypic features of liver sinusoidal endothelial cells (SEC), open fenestrae in sieve plates and lack of a basement membrane, are lost with capillarization. The current study examines localization of CD31 as a marker for the dedifferentiated, nonfenestrated SEC and examines regulation of SEC phenotype in vitro. CD31 localization in SEC was examined by confocal microscopy and immunogold-scanning electron microscopy. SEC cultured for 1 day express CD31 in the cytoplasm, whereas after 3 days, CD31 is also expressed on cell-cell junctions. Immunogold-scanning electron microscopy confirmed the absence of CD31 surface expression on fenestrated SEC 1 day after isolation and demonstrated the appearance of CD31 surface expression on SEC that had lost fenestration after 3 days in culture. SEC isolated from fibrotic liver do show increased expression of CD31 on the cell surface. Coculture with either hepatocytes or stellate cells prevents CD31 surface expression, and this effect does not require heterotypic contact. The paracrine effect of hepatocytes or stellate cells on SEC phenotype is abolished with anti-VEGF antibody and is reproduced by addition of VEGF to SEC cultured alone. VEGF stimulates SEC production of nitric oxide. NG-nitro-l-arginine methyl ester blocked the paracrine effect of hepatocytes or stellate cells on SEC phenotype and blocked the ability of VEGF to preserve the phenotype of SEC cultured alone. In conclusion, surface expression of CD31 is a marker of a dedifferentiated, nonfenestrated SEC. The VEGF-mediated paracrine effect of hepatocytes or stellate cells on maintenance of SEC phenotype requires autocrine production of nitric oxide by SEC.
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Schacht, Kurt. "SEC Rules on Wall Street Pay: Major Intrusion or Minor Annoyance?" CFA Institute Magazine 22, no. 3 (May 2011): 22. http://dx.doi.org/10.2469/cfm.v22.n3.9.
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Vettor, Giulia, Gaetano Fassini, Stefania Riva, Fabrizio Tundo, Massimo Moltrasio, Sergio Conti, Mauro Pepi, Claudio Tondo, and Anna Maltagliati. "138-01: Spontaneous echo contrast (SEC) or Sludge in LAA Occlusion." EP Europace 18, suppl_1 (June 2016): i178. http://dx.doi.org/10.1093/europace/18.suppl_1.i178a.
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Etnyre, Bruce R., Eva J. Lee, and Hally B. W. Poindexter. "Variability of Positioning Accuracy following a Maximum Isometric Contraction." Perceptual and Motor Skills 64, no. 3 (June 1987): 759–64. http://dx.doi.org/10.2466/pms.1987.64.3.759.
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The purpose of this study was to examine the effects of different contraction times and delay times prior to a positioning task. While blindfolded, each of 25 subjects learned to produce elbow-extension movements to a short and a long target using a kinesthesiometer. The subject then produced 30 trials without feedback to each target. These control trials were preceded by a foreperiod of 0-, 3-, or 6-sec. delay. The 60 experimental trials were identical to control trials except the subject isometrically contracted elbow extensor muscles for 3 or 6 sec. prior to each trial. Following each isometric contraction the subject delayed movement for 0, 3, or 6 sec. The 3-sec. and 6-sec. prepositioning contractions produced greater undershooting and variability than no prepositioning contractions, and the 0-sec. delay produced less constant error than either the 3- or 6-sec. delay. It was concluded that following isometric contraction, undershooting a target occurred and this effect did not dissipate within a 6-sec. period.
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Nuttli, Otto W., David S. Bowling, J. E. Lawson, and Randall Wheeler. "Some Aspects of the Seismic Scaling and the Strong Ground Motion of the Eastern Missouri Earthquake of January 12, 1984." Seismological Research Letters 58, no. 2 (April 1, 1987): 53–58. http://dx.doi.org/10.1785/gssrl.58.2.53.
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Abstract Strong-motion records from a velocity meter were recorded at an epicentral distance of 4.5 km from the January 12, 1984 eastern Missouri earthquake of mb = 3.0. Peak values of ground velocity, associated with only one or two wave cycles, are: transverse component, 0.18 cm/sec; radial component, 0.16 cm/sec; vertical component, 0.12 cm/sec. The levels of the sustained motion, which extends from the onset of S to about 0.4 sec later, are: transverse component, 0.064 cm/sec; radial component, 0.061 cm/sec; vertical component, 0.061 cm/sec. The data are consistent with a spectral scaling relation assuming either a 3.5 or 4.0 slope of the logarithm of the seismic moment versus the logarithm of the corner frequency, but cannot be used to choose between the two relations.
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Patel, Hena, Stephen Boateng, Gurpreet Singh, and Steven Feinstein. "Spontaneous right-sided microcavitations in a healthy adult." Echo Research and Practice 2, no. 3 (August 2015): K33—K36. http://dx.doi.org/10.1530/erp-15-0021.
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SummarySpontaneous echo contrast (SEC) is frequently observed in patients with structural and functional cardiovascular abnormalities. Literature describes cases of SEC either from agglutination of red blood cells and plasma proteins or from microcavitations. SEC secondary to the former is an independent predictor of future thromboembolic events and is most commonly observed in the left atrium or left atrial appendage. Thus, many authors reason that left atrial SEC is an indication for initiating anticoagulant therapy. We report a rare case of right atrial SEC that was incidentally found during echocardiographic evaluation of isolated peripheral edema in a healthy adult with a structurally normal heart. At present, there are no studies to offer guidance for management of right atrial SEC. This case emphasizes a necessary area of future research.Learning pointsCardiovascular implications of SEC.Diagnostic evaluation and management of SEC.
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Komaria, Komaria, Abdul Halim R, Ali Nafiah Nst, and Harris Hasan. "Predictor of Left Atrial Spontaneous Echocardiographic Contrast in Rheumatic Mitral Stenosis Patients." Indonesian Journal of Cardiology 38, no. 3 (September 29, 2017): 168–78. http://dx.doi.org/10.30701/ijc.v38i3.780.
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Background: Previously conducted researches showed that presence of SEC in the left atrium can constitute a risk factor for thrombus formation. Some previous studies have also reported that in addition to atrial fibrillation and blood stasis in the left atrium, the pathophysiology of left atrial thrombus and SEC occurring in patients with rheumatic mitral stenosis exhibits some other mechanisms, such as autoimmunity, inflammation and increased thrombotic activity.
Methods: Cross sectional study was conducted between July 2015 to July 2017 in patient who admitted to Haji Adam Malik Hospital due to rheumatic mitral stenosis. They were divided into two groups according to presence of left atrial SEC.
Result: From 104 patients, 52 (mean age 40 ± 11 years; 71,2% women) were in the left atrial SEC-negative group and 52 patients (mean age 40 ± 10 years; 73,1% women) were in the left atrial SEC-positive group. There were no significant differences in the leucocyte, 8,06±1,54 were in the left atrial SEC-negative group and 7,37±1,76 were in the left atrial SEC-positive group. In multivariate analysis, atrial fibrillation (OR = 51,311, 95% CI 3,723 – 707,100, p = 0,003) neutrophil/lymphocyte ratio (OR = 21,641, 95% CI 5,174 – 90,528, p < 0,001), mitral valve area (OR = 14,423, 95% CI 1,665 – 124,908, p = 0,015), and RDW (OR = 5,743, 95% CI 1,349 – 24,445, p = 0,018), These study show that neutrophil/lymphocyte ratio with cut off point of >3,2 had sensitivity, spesificity, positive predictive value, and negative predictive value to predict left atrial SEC is the same 81%, respectively.
Conclusion: Atrial fibrillation, neutrophil/lymphocyte ratio, RDW and mitral valve area can predict left atrial spontaneous echocardiographic contrast in rheumatic mitral stenosis patients.
Abstrak
Latar Belakang: Penelitian sebelumnya menunjukkan adanya SEC di atrium kiri menjadi faktor risiko untuk pembentukan trombus. Pada pasien stenosis mitral rematik, risiko trombosis dan perkembangan SEC di atrium kiri tinggi. Beberapa penelitian sebelumnya melaporkan bahwa patofisiologi trombus dan SEC di atrium kiri selain fibrilasi atrium dan stasis aliran darah di atrium kiri juga adanya beberapa mekanisme lain seperti respon imun, inflamasi dan peningkatan aktifitas trombotik.
Metode: Ini adalah penelitian observasional yang bersifat cross sectional, dilakukan dari Juli 2015 sampai Juli 2017 terhadap pasien stenosis mitral rematik yang datang ke rumah sakit Haji Adam Malik. Pasien dibagi 2 kelompok berdasarkan kehadiran SEC di atrium kiri menurut hasil pemeriksaan ekokardiografi.
Hasil: Didapatkan 104 pasien, dimana 52 pasien (usia rata-rata 40 ± 11 tahun, 71% wanita) merupakan kelompok tanpa SEC, dan 52 pasien (usia rata-rata 40 ± 10 tahun, 73% wanita) merupakan kelompok dengan SEC. Tidak ada perbedaan bermakna pada lekosit, dimana kelompok tanpa SEC (8,06±1,54) dan kelompok dengan SEC (7,37±1,76). Dari analisis multivariat regresi logistik, didapatkan fibrilasi atrium (OR = 51,311, nilai IK 95% antara 3,723 – 707,100, p = 0,003) rasio netrofil/limfosit (OR = 21,641, nilai IK 95% antara 5,174 – 90,528, nilai p < 0,001), area katup mitral (OR = 14,423, nilai IK 95% antara 1,665 – 124,908, nilai p = 0,015), dan RDW (OR = 5,743, nilai IK 95% antara 1,349 – 24,445, nilai p = 0,018), merupakan prediktor independen untuk terjadinya SEC. Titik potong untuk nilai rasio N/L > 3,2 memiliki angka sensitivitas, sensitifitas, nilai prediktif positif dan nilai prediktif negatif yang sama yaitu masing-masing 81% untuk memprediksi kejadian SEC di atrium kiri pada pasien stenosis mitral rematik.
Kesimpulan: Fibrilasi atrium, rasio netrofil/limfosit, RDW dan area katup mitral dapat menjadi prediktor SEC di atrium kiri pada pasien stenosis mitral rematik.
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Peng, Kun, Fuxin Chen, Xuegong She, Chunhui Yang, Yuxin Cui, and Xinfu Pan. "Selective oxidation of benzylic or allylic hydroxyl group of sec-1,2-diols." Tetrahedron Letters 46, no. 7 (February 2005): 1217–20. http://dx.doi.org/10.1016/j.tetlet.2004.12.073.
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Eldridge, Stacie L., Albert K. Korir, Sarah M. Gutierrez, Fernando Campos, John F. K. Limtiaco, and Cynthia K. Larive. "Heterogeneity of depolymerized heparin SEC fractions: to pool or not to pool?" Carbohydrate Research 343, no. 17 (November 2008): 2963–70. http://dx.doi.org/10.1016/j.carres.2008.08.027.
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Kawano, Osamu, Takeshi Maeda, Eiji Mori, Itaru Yugue, Takayoshi Ueta, and Keiichiro Shiba. "A Safe Surgical Procedure for Old Distractive Flexion Injuries of the Subaxial Cervical Spine." Asian Spine Journal 11, no. 6 (December 31, 2017): 935–42. http://dx.doi.org/10.4184/asj.2017.11.6.935.
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<sec><title>Study Design</title><p>Retrospective review.</p></sec><sec><title>Purpose</title><p>To describe a safe and effective surgical procedure for old distractive flexion (DF) injuries of the subaxial cervical spine.</p></sec><sec><title>Overview of Literature</title><p>Surgical treatment is required in old cases when a progression of the kyphotic deformity and/or persistent neck pain and/or the appearance of new neurological symptoms are observed. Since surgical treatment is more complicated and dangerous in old cases than in acute distractive-flexion cases, the indications for surgery and the selection of the surgical procedure must be carefully conducted.</p></sec><sec><title>Methods</title><p>To identify a safe and effective surgical procedure, the procedure selected, reason(s) for its selection, and associated neurological complications were investigated in 13 patients with old cervical DF injuries.</p></sec><sec><title>Results</title><p>No neurological complications were observed in nine patients (DF stage 2 or 3) who underwent the anterior-posterior-anterior (A-P-A) method and two patients (DF stage 1) who underwent the posterior method. It was initially planned that two patients (DF stage 2) who underwent the P-A method would be treated using the Posterior method alone; however, anterior discectomy was added to the procedure after the development of a severe spinal cord disorder.</p></sec><sec><title>Conclusions</title><p>The A-P-A method (anterior discectomy, posterior release and/or partial facetectomy, reduction and instrumentation, anterior bone grafting) is considered to be a suitable surgical procedure for old cervical DF injuries.</p></sec>
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Hartweck, Lynn M., Cheryl L. Scott, and Neil E. Olszewski. "Two O-Linked N-Acetylglucosamine Transferase Genes of Arabidopsis thaliana L. Heynh. Have Overlapping Functions Necessary for Gamete and Seed Development." Genetics 161, no. 3 (July 1, 2002): 1279–91. http://dx.doi.org/10.1093/genetics/161.3.1279.
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Abstract The Arabidopsis SECRET AGENT (SEC) and SPINDLY (SPY) proteins are similar to animal O-linked N-acetylglucosamine transferases (OGTs). OGTs catalyze the transfer of N-acetylglucosamine (GlcNAc) from UDP-GlcNAc to Ser/Thr residues of proteins. In animals, O-GlcNAcylation has been shown to affect protein activity, stability, and/or localization. SEC protein expressed in Escherichia coli had autocatalytic OGT activity. To determine the function of SEC in plants, two tDNA insertional mutants were identified and analyzed. Although sec mutant plants did not exhibit obvious phenotypes, sec and spy mutations had a synthetic lethal interaction. This lethality was incompletely penetrant in gametes and completely penetrant postfertilization. The rate of both female and male sec spy gamete transmission was higher in plants heterozygous for both mutations than in plants heterozygous for sec and homozygous for spy. Double-mutant embryos aborted at various stages of development and no double-mutant seedlings were obtained. These results indicate that OGT activity is required during gametogenesis and embryogenesis with lethality occurring when parentally derived SEC, SPY, and/or O-GlcNAcylated proteins become limiting.
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Khan, Sohail Ahmed, Amjad Sattar, Usman Khanzada, Hatem Adel, Syed Omair Adil, and Munawar Hussain. "Facture of the Pars Interarticularis with or without Spondylolisthesis in an Adult Population in a Developing Country: Evaluation by Multidetector Computed Tomography." Asian Spine Journal 11, no. 3 (June 30, 2017): 437–43. http://dx.doi.org/10.4184/asj.2017.11.3.437.
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<sec><title>Study Design</title><p>Descriptive cross-sectional study.</p></sec><sec><title>Purpose</title><p>To determine the prevalence of lumbar spondylolysis and spondylolisthesis in a general adult population unrelated to lower back pain as evaluated by multidetector computed tomography.</p></sec><sec><title>Overview of Literature</title><p>There is a significant paucity of information related to the prevalence of spondylolysis and spondylolisthesis and its degenerative changes in a general adult population unrelated to lower back pain in developing countries.</p></sec><sec><title>Methods</title><p>A retrospective study was conducted on abdominopelvic computed tomography (CT) scans performed between January 1st 2015 and December 31st 2015 for various clinical indications. Patients with lower back pain, with a history of trauma or road traffic accident, or referred from orthopedic or neurosurgery departments were excluded to avoid any bias. CT scans were reviewed in axial, sagittal, and coronal planes using bone window settings for evaluating spondylolysis and spondylolisthesis.</p></sec><sec><title>Results</title><p>Of 4,348 patients recruited, spondylolysis and spondylolisthesis were identified in 266 (6.1%) and 142 (3.3%) patients, respectively. Age was significantly higher in both spondylolysis and spondylolisthesis patients than in those without spondylolysis and spondylolisthesis (47.19±15.45 vs. 42.5±15.96, <italic>p</italic><0.001 and 53.01±15.31 vs. 42.44±15.88, <italic>p</italic><0.001, respectively). Gender was significantly associated with spondylolisthesis (<italic>p</italic>=0.029) but not spondylolysis. Of patients who were >60 years old, both spondylolysis (<italic>p</italic>=0.018) and spondylolisthesis (<italic>p</italic>=0.025) were significantly more prevalent in females.</p></sec><sec><title>Conclusions</title><p>The prevalence of pars interarticularis fracture observed higher with gradual increase in the prevalence with advancing age. In particular, preponderance was significantly higher among older females.</p></sec>
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Moshe, Marcia, Helen Doan, and Fredric Weizmann. "Intertrial Intervals and Visual Habituation in Neonates." Perceptual and Motor Skills 64, no. 2 (April 1987): 619–27. http://dx.doi.org/10.2466/pms.1987.64.2.619.
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Eighteen 3-day-old human neonates were shown a 12 by 12 black-white checkerboard target for 45-sec. trials with either a 10-, 20-, or 30-sec. intertrial interval until their visual fixation time decreased to a set criterion for habituation. On subsequent recovery trials, a 2 by 2 black-white checkerboard target received significantly longer fixations from boys in the 10-sec. and girls in the 20-sec. conditions. 30-sec. intervals, however, produced little habituation and recovery. The implications of these findings are discussed.
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Divi, Srikanth Naga, and Mark M. Mikhael. "Use of Allogenic Mesenchymal Cellular Bone Matrix in Anterior and Posterior Cervical Spinal Fusion: A Case Series of 21 Patients." Asian Spine Journal 11, no. 3 (June 30, 2017): 454–62. http://dx.doi.org/10.4184/asj.2017.11.3.454.
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<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>To report our early experience using allogenic mesenchymal cellular bone matrix (CBM) products in cervical spine fusion.</p></sec><sec><title>Overview of Literature</title><p>Multi-level cervical fusions have historically yielded lower fusion rates than single level fusions, especially in patients with high risk medical comorbidities. At this time, significant literature in cervical fusion outcomes with this cellular allograft technology is lacking.</p></sec><sec><title>Methods</title><p>Twenty-one patients underwent either multilevel (3 or 4 level) anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, or posterior cervical fusion. ViviGen (DePuy Synthes Spine, Raynham, MA, USA), an allogenic bone matrix product, was used in addition to standard instrumentation. Radiographic evaluation was performed at 2 weeks, 12 weeks, 24 weeks and 1 year postoperative. Visual analog scale (VAS) and neck disability index (NDI) scores along with return to work and leisure activity were recorded.</p></sec><sec><title>Results</title><p>At 6 months postoperative, all patients had radiographic evidence of bone fusion regardless of age or medical comorbidities. All patients reported subjective improvement with a mean decrease in VAS from 8.3 to 1.5 and a mean decrease in NDI from 40.3% to 6.0% at 1 year. All patients also returned to work and/or regular leisure activity within 3 months.</p></sec><sec><title>Conclusions</title><p>Twenty-one patients undergoing high-risk anterior and posterior cervical spine fusion, with the use of a commercially available mesenchymal CBM product, went on to radiographic fusion and all had improvement in subjective outcomes. While further effort and research is needed to validate its widespread use, this study shows favorable use of CBM in cervical fusion for high-risk cases.</p></sec>
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Takigawa, Tomoyuki, Masato Tanaka, Yoshihisa Sugimoto, Tomoko Tetsunaga, Keiichiro Nishida, and Toshifumi Ozaki. "Discrimination between Malignant and Benign Vertebral Fractures Using Magnetic Resonance Imaging." Asian Spine Journal 11, no. 3 (June 30, 2017): 478–83. http://dx.doi.org/10.4184/asj.2017.11.3.478.
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<sec><title>Study Design</title><p>Retrospective analysis using magnetic resonance imaging (MRI).</p></sec><sec><title>Purpose</title><p>To identify MRI features that could discriminate benign from malignant vertebral fractures.</p></sec><sec><title>Overview of Literature</title><p>Discrimination between benign and malignant vertebral fractures remains challenging, particularly in patients with osteoporosis and cancer. Presently, the most sensitive means of detecting and assessing fracture etiology is MRI. However, published reports have focused on only one or a few discriminators.</p></sec><sec><title>Methods</title><p>Totally, 106 patients were assessed by MRI within six weeks of sustaining 114 thoracic and/or lumbar vertebral fractures (benign, n=65; malignant, n=49). The fractures were pathologically confirmed if malignant or clinically diagnosed if benign and were followed up for a minimum of six months. Seventeen features were analyzed in all fractures' magnetic resonance images. Single parameters were analyzed using the chi-square test; a logit model was established using multivariate logistic regression analysis.</p></sec><sec><title>Results</title><p>The chi-square test revealed 11 malignant and 4 benign parameters. Multivariate logistic regression analysis selected (i) posterior wall diffuse protrusion (odds ratio [OR], 48; 95% confidence interval [CI], 4.2–548; <italic>p</italic>=0.002), (ii) pedicle involvement (OR, 21; 95% CI, 2.0–229; <italic>p</italic>=0.01), (iii) posterior involvement (OR, 21; 95% CI, 1.5–21; <italic>p</italic>=0.02), and (iv) band pattern (OR, 0.047; 95% CI, 0.0005–4.7; <italic>p</italic>=0.19). The logit model was expressed as P=1/[1+exp (x)], x=−3.88×(i)−3.05×(ii)−3.02×(iii)+3.05×(iv)+5.00, where P is the probability of malignancy. The total predictive value was 97.3%. The only exception was multiple myeloma with features of a benign fracture.</p></sec><sec><title>Conclusions</title><p>Although each MRI feature had a different meaning with a variable differentiation power, combining them led to an accurate diagnosis. This study identified the most relevant MRI features that would be helpful in discriminating benign from malignant vertebral fractures.</p></sec>
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van Eck, Carola Francisca, Mitchell Stephen Fourman, Amir Mohamad Abtahi, Louis Alarcon, William Fielding Donaldson, and Joon Yung Lee. "Risk Factors for Failure of Nonoperative Treatment for Unilateral Cervical Facet Fractures." Asian Spine Journal 11, no. 3 (June 30, 2017): 356–64. http://dx.doi.org/10.4184/asj.2017.11.3.356.
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<sec><title>Study Design</title><p>Retrospective clinical study.</p></sec><sec><title>Purpose</title><p>The purpose of this study was to determine what percentage of patients who underwent nonoperative management of unilateral non-displaced or minimally displaced facet fractures progressed radiographically and to determine what percentage of patients required surgical intervention and to identify risk factors for failure of conservative management.</p></sec><sec><title>Overview of Literature</title><p>According to most commonly used classification systems, unilateral, non-and minimally displaced facet fractures are be amendable to nonoperative management.</p></sec><sec><title>Methods</title><p>A retrospective review of the Trauma Registry of a Level I trauma center was performed to identify all patients diagnosed with a non- or minimally displaced unilateral facet fracture which was managed nonoperatively. Several demographic variables and clinical outcomes were recorded. Using computed tomography scanning and plain radiographs, fracture pattern, listhesis, displacement, angle and percentage of the facet that included the fracture were determined. Radiographic progression was defined as the occurrence of listhesis of more than 10% of the anterior-posterior dimensions of the inferior vertebral body during radiographic follow-up. Failure of conservative management was defined as a patient requiring surgical intervention after initially being managed nonoperatively.</p></sec><sec><title>Results</title><p>Seventy-four patients were included. Fifteen patients (20%) progressed radiographically. However, only 2 developed radicular symptoms and none developed myelopathy or other catastrophic cord related symptoms. Seven patients (9%) underwent surgery. Indications for surgery included significant radiographic progression and/or radicular symptoms. Risk factors for failure of conservative management included presence of radiculopathy at the time of presentation, a higher body mass index, increased Injury Severity Score, greater initial fracture displacement and more than 2 mm of listhesis.</p></sec><sec><title>Conclusions</title><p>Patients with non-displaced or minimally displaced facet fractures who do not have neurological symptoms at the time of presentation can safely be managed conservatively with careful observation and follow-up.</p></sec>
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Aoude, Ahmed, Sultan Aldebeyan, Maryse Fortin, Anas Nooh, Peter Jarzem, Jean A. Ouellet, and Michael H. Weber. "Prevalence and Complications of Postoperative Transfusion for Cervical Fusion Procedures in Spine Surgery: An Analysis of 11,588 Patients from the American College of Surgeons National Surgical Quality Improvement Program Database." Asian Spine Journal 11, no. 6 (December 31, 2017): 880–91. http://dx.doi.org/10.4184/asj.2017.11.6.880.
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<sec><title>Study Design</title><p>Retrospective cohort study.</p></sec><sec><title>Purpose</title><p>The purpose of this study was to assess the rate of blood transfusion after cervical fusion surgery, and its effect on complication rates.</p></sec><sec><title>Overview of Literature</title><p>Cervical spine fusions have gained interest in the literature since these procedures are now ever more frequently being performed in an outpatient setting with few complications.</p></sec><sec><title>Methods</title><p>The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients that underwent cervical fusion from 2010 to 2013. Multivariate regression analysis was used to determine postoperative complications associated with transfusion and cervical fusion.</p></sec><sec><title>Results</title><p>We identified 11,588 patients who had cervical fusion between 2010 and 2013. The rate of blood transfusion following cervical fusion found to be 1.47%. All transfused patients were found to have increased risk of venous thromboembolism (TBE) (odds ratio [OR], 3.19; 95% confidence interval [95% CI], 1.16–8.77), myocardial infarction (MI) (OR, 9.12; 95% CI, 2.53–32.8), increased length of stay (LOS) (OR, 28.03; 95% CI, 14.28–55.01) and mortality (OR, 4.14; 95% CI, 1.44–11.93). Single level fusion had increased risk of TBE (OR, 3.37; 95% CI, 1.01–11.33), MI (OR, 10.5; 95% CI, 1.88–59.89), and LOS (OR, 14.79; 95% CI, 8.2–26.67). Multilevel fusion had increased risk of TBE (OR, 5.64; 95% CI, 1.15–27.6), surgical site infection (OR, 16.29; 95% CI, 3.34–79.49), MI (OR, 10.84; 95% CI, 2.01–58.55), LOS (OR, 26.56; 95% CI, 11.8–59.78), and mortality (OR, 10.24; 95% CI, 2.45–42.71). Patients who had anterior cervical discectomy and fusion surgery and received a transfusion had an increased risk of TBE (OR, 4.87; 95% CI, 1.04–22.82), surgical site infection (OR, 9.73; 95% CI, 2.14–44.1), MI (OR, 9.88; 95% CI, 1.87–52.2), increased LOS of more than 2 days (OR, 28.34; 95% CI, 13.79–58.21) and increase in mortality (OR, 6.3; 95% CI, 1.76–22.48). While, transfused patients who had posterior fusion surgery had increased risk of MI (OR, 10.45; 95% CI, 1.42–77.12) and increased LOS of more than 6 days (OR, 4.42; 95% CI, 2.68–7.29).</p></sec><sec><title>Conclusions</title><p>Our results demonstrate that although cervical fusions can be done as outpatient procedures special precautions and investigations should be done for patients who receive transfusion after cervical fusion. These patients are demonstrated to have higher rate of MI, TBE, wound infection and mortality when compared to those who do not receive transfusion.</p></sec>
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Iizuka, Yoichi, Haku Iizuka, Tokue Mieda, Daisuke Tsunoda, Tsuyoshi Sasaki, Tsuyoshi Tajika, Atsushi Yamamoto, and Kenji Takagishi. "Prevalence of Chronic Nonspecific Low Back Pain and Its Associated Factors among Middle-Aged and Elderly People: An Analysis Based on Data from a Musculoskeletal Examination in Japan." Asian Spine Journal 11, no. 6 (December 31, 2017): 989–97. http://dx.doi.org/10.4184/asj.2017.11.6.989.
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<sec><title>Study Design</title><p>A cross-sectional study.</p></sec><sec><title>Purpose</title><p>To clarify the prevalence of chronic nonspecific low back pain (CNSLBP) and its associated factors among middle-aged and elderly Japanese individuals using data from a musculoskeletal examination conducted in general Japanese populations.</p></sec><sec><title>Overview of Literature</title><p>Most studies evaluating low back pain-associated factors have been conducted in Western countries, but they have not always evaluated CNSLBP.</p></sec><sec><title>Methods</title><p>We obtained data on 213 subjects aged >50 years who responded to a survey regarding age, gender, body mass index, lifestyle-related diseases (diabetes mellitus, hypertension, and hyperlipidemia), glucocorticoid use, smoking and alcohol-drinking habits, labor intensity, and chronic low back pain (CLBP) and underwent screening for lumbar spinal stenosis, evaluation for quality of life (QOL), and evaluation for specific spinal pathology via thoracolumbar spine X-rays. We investigated the prevalence of CNSLBP and association between CNSLBP and measured variables.</p></sec><sec><title>Results</title><p>The prevalence of CNSLBP and chronic specific low back pain (CSLBP) was 15.4% and 9.3%, respectively. Among the subjects with CLBP, 62.2% had CNSLBP. In age-adjusted logistic models, smoking habits (<italic>p</italic>=0.049, odds ratio [OR]=2.594), low back pain (<italic>p</italic><0.001, OR=0.974), lumbar function (<italic>p</italic>=0.001, OR=0.967), and social function (<italic>p</italic>=0.023, OR=0.976) in the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were significantly associated with CNSLBP, whereas EQ-5D utility score (<italic>p</italic>=0.024, OR=0.068), low back pain (<italic>p</italic>=0.007, OR=0.981), lumbar function (<italic>p</italic>=0.001, OR=0.963), walking ability (<italic>p</italic>=0.001, OR=0.968), and social function (<italic>p</italic>=0.002, OR=0.966) in JOABPEQ were significantly associated with CSLBP.</p></sec><sec><title>Conclusions</title><p>CNSLBP among middle-aged and elderly individuals was associated with smoking habits and decreased QOL; however, CSLBP was considered to be more multilaterally associated decreased QOL.</p></sec>
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Hawkins, Benjamin, and Stefanie Ettelt. "The strategic uses of evidence in UK e-cigarettes policy debates." Evidence & Policy: A Journal of Research, Debate and Practice 15, no. 4 (November 1, 2019): 579–96. http://dx.doi.org/10.1332/174426418x15212872451438.
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<sec id="st1"> Background Current debates on e-cigarette policy in the UK are highly acrimonious and are framed in terms of evidence-based policymaking.</sec> <sec id="st2"> Aims and objectives The article aims to understand the use of evidence in policymaking in the context of both political controversy and limited policy-relevant evidence via a case study of UK e-cigarette debates.</sec> <sec id="st3"> Methods The study draws on a series of semi-structured interviews with policy actors to examine their positions on e-cigarette policy process and their use of evidence to support this.</sec> <sec id="st4"> Findings Policy actors articulate a strong commitment to evidence-based policymaking and claim that their positions are evidence-based. Some actors also claim emerging consensus around their positon as a rhetorical tool in the debate. Respondents argued that actors adopting opposing policy positions fail to follow the evidence base. This is attributed to a lack of understanding or disregard for the relevant evidence for political or ideological reasons.</sec> <sec id="st5"> Discussion Respondents adhere to a rationalist understanding of policymaking in which policy disputes can be settled by recourse to ‘the evidence’. Interpretative policy analysis suggests that multiple legitimate framings of policy issues, supported by different bodies of evidence, are possible. Policy differences are thus not due to bad faith but to policy actors framing the issue at stake in different terms and thus advocating different policy responses.</sec> <sec id="st6"> Conclusions Process of ‘frame reflection’ may help to overcome the acrimony of current policy leading to more effective engagement by public health actors in the e-cigarettes policy debates.</sec>
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Marks, Natalie, Anil Hingorani, and Enrico Ascher. "Duplex-Guided Angioplasty of Failing or Nonmaturing Arteriovenous Access." Journal for Vascular Ultrasound 33, no. 1 (March 2009): 9–12. http://dx.doi.org/10.1177/154431670903300101.
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Objective Patients not yet on dialysis with nonmaturing arterio-venous (AV) accesses present a therapeutic problem. Because the standard treatment with balloon angioplasty requires nephrotoxic contrast use for diagnosis and treatment, we have sought an alternative therapy. Methods Five consecutive patients with chronic renal insufficiency and failing arteriovenous (AV) access underwent duplex-guided balloon angioplasties at our institution. These were 3 women and 2 men with age ranging from 70 to 85 years (mean 77 ± 7 years). All patients were hypertensive, 4 (80%) were diabetics, and 3 (60%) had coronary artery disease. Three patients (60%) had target AV access used for dialysis. Preoperative volume flows (VF) measured by duplex ranged from 200 mL/min to 1160 mL/min (mean 755 ± 358 mL/min). Peal systolic velocity obtained at the most significant stenosis preoperatively ranged from 428 cm/sec to 656 cm/sec (mean 555 ± 87 cm/sec). Technique All procedures were performed via short sheath inserted under duplex guidance. Wire and balloon passage and inflation were performed under duplex surveillance as well. Results None of these procedures required use of fluoroscopy or contrast material. One patient had a stent placed for recoiling lesion. Postoperative VF ranged from 520 mL/min to 1750 mL/min (mean 1272 ± 486 mL/min). Peal systolic velocity obtained at the most significant stenosis postoperatively ranged from 142 cm/sec to 321 cm/sec (mean 233 ± 64 cm/sec). Conclusions Angioplasty of failing AV access can be performed under duplex guidance alone. Duplex guidance offers advantages of hemodynamic evaluation for recoiling lesions and need for stenting.
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Na, Hee Young, Jeong Hwan Park, Sun Ah Shin, Sejoon Lee, Heonyi Lee, Heejoon Chae, HoKyung Choung, Namju Kim, Jin-Haeng Chung, and Ji Eun Kim. "Targeted Sequencing Revealed Distinct Mutational Profiles of Ocular and Extraocular Sebaceous Carcinomas." Cancers 13, no. 19 (September 26, 2021): 4810. http://dx.doi.org/10.3390/cancers13194810.
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The biological behavior of sebaceous carcinoma (SeC) is relatively indolent; however, local invasion or distant metastasis is sometimes reported. Nevertheless, a lack of understanding of the genetic background of SeC makes it difficult to apply effective systemic therapy. This study was designed to investigate major genetic alterations in SeCs in Korean patients. A total of 29 samples, including 20 ocular SeCs (SeC-Os) and 9 extraocular SeCs (SeC-EOs), were examined. Targeted next-generation sequencing tests including 171 cancer-related genes were performed. TP53 and PIK3CA genes were frequently mutated in both SeC-Os and SeC-EOs with slight predominance in SeC-Os, whereas the NOTCH1 gene was more commonly mutated in SeC-EOs. In clinical correlation, mutations in RUNX1 and ATM were associated with development of distant metastases, and alterations in MSH6 and BRCA1 were associated with inferior progression-free survival (all p < 0.05). In conclusion, our study revealed distinct genetic alterations between SeC-Os and SeC-EOs and some important prognostic molecular markers. Mutations in potentially actionable genes, including EGFR, ERBB2, and mismatch repair genes, were noted, suggesting consideration of a clinical trial in intractable cases.
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Sell, Yvonne, and Theresa J. B. Kline. "Age, Cooperative vs Lecture Training, and Group Composition: Some Preliminary Findings of Effects on Performance." Psychological Reports 77, no. 1 (August 1995): 267–74. http://dx.doi.org/10.2466/pr0.1995.77.1.267.
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18 younger (under 25 years) and 18 older (over 39 years) undergraduate women were trained in problem-solving by either a cooperative or traditional lecture technique and in age-consistent, i.e., younger or older participants only, or mixed age, i.e., younger and older participants, groups. Analysis indicated that older subjects did not score as well on the problem-solving task (48.9 vs 43.9) where lower scores indicate better performance, particularly in mixed-age groups (58.2 vs 44.3); older subjects completed the task more quickly (349 sec. vs 466 sec), age-consistent groups completed the task equally quickly regardless of training; and age-inconsistent groups completed the task more quickly when cooperatively trained (183 sec. vs 390 sec).
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Hasegawa, Tomomi, Yoshihiro Oshima, Shinji Yokoyama, Asuka Akimoto, Yusuke Misaka, and Shota Akiyama. "Clinical application of a new ternary polymer, SEC-1 coat™, for pediatric cardiopulmonary bypass circuits: a prospective randomized pilot study." Perfusion 35, no. 8 (April 20, 2020): 826–32. http://dx.doi.org/10.1177/0267659120915387.
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Objective: The use of biocompatible materials to reduce the systemic activation of inflammation and coagulation pathways is expanding rapidly. However, there have been few clinical studies of biocompatible circuits for pediatric cardiopulmonary bypass. This pilot study aimed to preliminarily evaluate the biocompatibility of SEC-1 coat™ (SEC) for cardiopulmonary bypass circuits in pediatric cardiac surgery. Methods: Twenty infants undergoing cardiac surgery for isolated ventricular septal defects at Kobe Children’s Hospital were assigned randomly to an SEC-coated (SEC group, n = 10) or heparin-coated (control group, n = 10) circuit. Perioperative data and the following markers were prospectively analyzed: platelet counts and interleukin-6, interleukin-8, C3a, β-thromboglobulin, and thrombin–antithrombin complex levels. Results: Neither patient characteristics nor postoperative clinical outcomes differed significantly between the SEC and control groups. Platelet counts markedly decreased during cardiopulmonary bypass in both groups, but were significantly better preserved in the SEC group. Fewer patients needed postoperative platelet transfusions in the SEC group. After cardiopulmonary bypass termination, serum levels of β-thromboglobulin and thrombin–antithrombin complex were significantly lower in the SEC than in the control group. Although the differences were not statistically significant, serum levels of interleukin-6, interleukin-8, and C3a had a tendency toward being lower in the SEC group, with good preservation of leukocyte counts, fibrinogen, and antithrombin III. Conclusion: SEC-1 coat™ for cardiopulmonary bypass circuits have good biocompatibility with regard to platelet preservation and in terms of attenuating inflammatory reaction or coagulation activation during pediatric cardiac surgery. It can be beneficial in pediatric as well as adult cardiac surgery.
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Moustafa, Mohamed E., Bradley A. Carlson, Muhammad A. El-Saadani, Gregory V. Kryukov, Qi-An Sun, John W. Harney, Kristina E. Hill, et al. "Selective Inhibition of Selenocysteine tRNA Maturation and Selenoprotein Synthesis in Transgenic Mice Expressing Isopentenyladenosine-Deficient Selenocysteine tRNA." Molecular and Cellular Biology 21, no. 11 (June 1, 2001): 3840–52. http://dx.doi.org/10.1128/mcb.21.11.3840-3852.2001.
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ABSTRACT Selenocysteine (Sec) tRNA (tRNA[Ser]Sec) serves as both the site of Sec biosynthesis and the adapter molecule for donation of this amino acid to protein. The consequences on selenoprotein biosynthesis of overexpressing either the wild type or a mutant tRNA[Ser]Sec lacking the modified base, isopentenyladenosine, in its anticodon loop were examined by introducing multiple copies of the corresponding tRNA[Ser]Sec genes into the mouse genome. Overexpression of wild-type tRNA[Ser]Sec did not affect selenoprotein synthesis. In contrast, the levels of numerous selenoproteins decreased in mice expressing isopentenyladenosine-deficient (i6A−) tRNA[Ser]Sec in a protein- and tissue-specific manner. Cytosolic glutathione peroxidase and mitochondrial thioredoxin reductase 3 were the most and least affected selenoproteins, while selenoprotein expression was most and least affected in the liver and testes, respectively. The defect in selenoprotein expression occurred at translation, since selenoprotein mRNA levels were largely unaffected. Analysis of the tRNA[Ser]Sec population showed that expression of i6A− tRNA[Ser]Sec altered the distribution of the two major isoforms, whereby the maturation of tRNA[Ser]Sec by methylation of the nucleoside in the wobble position was repressed. The data suggest that the levels of i6A− tRNA[Ser]Sec and wild-type tRNA[Ser]Sec are regulated independently and that the amount of wild-type tRNA[Ser]Sec is determined, at least in part, by a feedback mechanism governed by the level of the tRNA[Ser]Sec population. This study marks the first example of transgenic mice engineered to contain functional tRNA transgenes and suggests that i6A−tRNA[Ser]Sec transgenic mice will be useful in assessing the biological roles of selenoproteins.
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BERCU, GABRIEL, CLAUDIU CORCODEL, and MIHAI POSTOLACHE. "ITERATIVE GEOMETRIC STRUCTURES." International Journal of Geometric Methods in Modern Physics 07, no. 07 (November 2010): 1103–14. http://dx.doi.org/10.1142/s0219887810004749.
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In this work, we propose a study of geometric structures (connections, pseudo-Riemannian metrics) adapted to some fundamental problems of Differential Geometry. Then we find geometrical characteristics of some ODE or PDE of Mathematical Physics. While Sec. 1 contains the general setting, Secs. 2–5 contain our results. In Sec. 2, we introduce a Hessian structure having the same connection as the initial metric. In Sec. 3, we initiate a study on iterative 2D Hessian structures. In Sec. 4, we find pairs (metric, connection) generated by special functions. In Sec. 5, we find geometric characteristics of a PDE.
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Kiyak, Gorkem, Tevfik Balikci, Ahmed Majid Heydar, and Murat Bezer. "Comparison of the Pullout Strength of Different Pedicle Screw Designs and Augmentation Techniques in an Osteoporotic Bone Model." Asian Spine Journal 12, no. 1 (February 28, 2018): 3–11. http://dx.doi.org/10.4184/asj.2018.12.1.3.
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<sec><title>Study Design</title><p>Mechanical study.</p></sec><sec><title>Purpose</title><p>To compare the pullout strength of different screw designs and augmentation techniques in an osteoporotic bone model.</p></sec><sec><title>Overview of Literature</title><p>Adequate bone screw pullout strength is a common problem among osteoporotic patients. Various screw designs and augmentation techniques have been developed to improve the biomechanical characteristics of the bone–screw interface.</p></sec><sec><title>Methods</title><p>Polyurethane blocks were used to mimic human osteoporotic cancellous bone, and six different screw designs were tested. Five standard and expandable screws without augmentation, eight expandable screws with polymethylmethacrylate (PMMA) or calcium phosphate augmentation, and distal cannulated screws with PMMA and calcium phosphate augmentation were tested. Mechanical tests were performed on 10 unused new screws of each group. Screws with or without augmentation were inserted in a block that was held in a fixture frame, and a longitudinal extraction force was applied to the screw head at a loading rate of 5 mm/min. Maximum load was recorded in a load displacement curve.</p></sec><sec><title>Results</title><p>The peak pullout force of all tested screws with or without augmentation was significantly greater than that of the standard pedicle screw. The greatest pullout force was observed with 40-mm expandable pedicle screws with four fins and PMMA augmentation. Augmented distal cannulated screws did not have a greater peak pullout force than nonaugmented expandable screws. PMMA augmentation provided a greater peak pullout force than calcium phosphate augmentation.</p></sec><sec><title>Conclusions</title><p>Expandable pedicle screws had greater peak pullout forces than standard pedicle screws and had the advantage of augmentation with either PMMA or calcium phosphate cement. Although calcium phosphate cement is biodegradable, osteoconductive, and nonexothermic, PMMA provided a significantly greater peak pullout force. PMMA-augmented expandable 40-mm four-fin pedicle screws had the greatest peak pullout force.</p></sec>
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Keshava, Shiva, Jagan Sundaram, Anuradha Rajulapati, Charles T. Esmon, Usha R. Pendurthi, and L. Vijaya Mohan Rao. "Factor VIIa Interaction with Endothelial Cell Protein C Receptor: Its Role in Hemostatic Effect of rFVIIa in Treating Hemophilia." Blood 128, no. 22 (December 2, 2016): 562. http://dx.doi.org/10.1182/blood.v128.22.562.562.
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Abstract Recent studies from our laboratory and others established that clotting factor FVII/FVIIa, which binds tissue factor and triggers the coagulation cascade, also binds endothelial cell protein C receptor (EPCR), a receptor that plays a critical role in protein C/activated protein C (APC)-mediated anticoagulation pathway. We postulated that FVIIa binding to EPCR might augment the hemostatic effect of rFVIIa in therapeutic conditions by down-regulating the EPCR-mediated anticoagulation pathway. Our recent studies showing the blockade of endogenous protein C binding to EPCR by administration of EPCR blocking antibodies augmented the hemostatic effect of rFVIIa in a mouse hemophilia model provided an indirect support to this hypothesis. However, studies from other investigators raised a possibility that FVIIa interaction with EPCR may influence the hemostatic effect of rFVIIa in vivo through EPCR-FVIIa directly activating FX or EPCR tethering FVIIa to provide an extended locale of procoagulant reactions on the endothelium. The present study is carried out to investigate the mechanism by which FVIIa interaction with EPCR contributes to the hemostatic effect of FVIIa in hemophilia therapy. The study employed wild-type, transgenic mice expressing no EPCR (EPCR-/-) or overexpressing EPCR (Tie2-EPCR). FVIII mAb (1 mg/kg) were given to mice to induce hemophilia. The saphenous vein incision bleeding model was used to evaluate the hemostatic effect of human rFVIIa. In this model, bleeding is induced by a sharp incision to the saphenous vein and the bleeding from the cut was monitored for 30 min. After each hemostasis incident, the clot was disrupted gently to reinitiate a new bleeding episode and average time to achieve hemostasis (ATH) was calculated. First, we investigated the role of EPCR in hemostasis by comparing the bleeding episodes in unchallenged wild-type, EPCR-/- and Tie2-EPCR mice following the saphenous vein incision. In this model, control wild-type mice had a median ATH of 55 sec (mean 63 ± 7 sec; n=9) and EPCR-/- mice had a median ATH of 67 sec (mean 74 ± 6 sec; n =12). The difference between them is not statistically significant. Surprisingly, the median ATH in EPCR overexpressing Tie2-EPCR mice was significantly lower (a median ATH of 43 sec; mean 46 ± 2 sec; n=10) compared to the ATH in wild-type or EPCR-/- mice. The reason for a shorter ATH observed in EPCR overexpressing mice is unknown at present. Analysis of blood count showed no significant differences among wild-type, EPCR-/- and Tie2-EPCR in their platelet count, RBC, and other blood cell count. Next, we induced acquired hemophilia condition in wild-type, EPCR-/- and Tie2-EPCR by injecting FVIII mAb (1 mg/kg) i.v. 2 h before inducing the bleeding. Administration of FVIII mAb markedly prolonged the bleeding time in wild-type and Tie2-EPCR mice (between 300 to 1800 sec) with a median ATH of 600 sec (mean 730 ± 277 sec) in wild-type mice and 750 sec (mean 939 ± 200 sec) in Tie2-EPCR mice. Interestingly, EPCR-/- mice were protected from the antibody-induced acquired hemophilia. Administration of FVIII mAb prolonged the bleeding time only marginally in this group of mice to a median ATH of 120 sec (mean 163 ± 38 sec). Administration of a low dose of rFVIIa (0.25 mg/kg) fully corrected the mild bleeding defect in EPCR-/- acquired hemophilia mice (median ATH of 67 sec; mean 86 ± 17 sec). Administration of 0.25 mg/kg rFVIIa is corrected the bleeding disorder only partially in wild-type acquired hemophilia mice (median ATH 164 sec; mean 303 ± 94 sec; n=5). Administration of either 1 or 4 mg/kg of rFVIIa was required to correct the bleeding in these mice (1 mg/kg dose: median ATH of 75 sec, mean 74 ± 1 sec; 4 mg/kg dose: median ATH of 37 sec; mean 40 ± 2 sec, n=5). In Tie2-EPCR hemophilia mice, administration of 1 mg/kg rFVIIa was not sufficient to fully achieve the hemostatic effect (median ATH 164 sec; mean 521 ± 237 sec; n=6). Administration of 4 mg/kg rFVIIa was required to restore the hemostasis in these mice (median ATH of 90 sec; mean 94 ± 7 sec, n= 6). In summary, the present data indicate that EPCR levels influence the hemostatic effect of rFVIIa in treating antibody-induced hemophilia. The present study rules out the possibility of direct activation of FX by FVIIa-EPCR complexes or EPCR tethering of FVIIa as probable mechanisms by which EPCR-FVIIa influences the hemostatic effect of rFVIIa. Disclosures No relevant conflicts of interest to declare.
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Clark, Lucy V., Roberta Fida, Jane Skinner, Jamie Murdoch, Nigel Rees, Julia Williams, Theresa Foster, and Kristy Sanderson. "Mental health, well-being and support interventions for UK ambulance services staff: an evidence map, 2000 to 2020." British Paramedic Journal 5, no. 4 (March 1, 2021): 25–39. http://dx.doi.org/10.29045/14784726.2021.3.5.4.25.
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<sec id="s1"> Background: Prior to COVID-19 there had been a renewed policy focus in the National Health Service on the health and well-being of the healthcare workforce, with the ambulance sector identified as a priority area. This focus is more important than ever as the sector deals with the acute and longer-term consequences of a pandemic. </sec> <sec id="s2"> Aim: To systematically identify, summarise and map the evidence regarding mental health, well-being and support interventions for United Kingdom ambulance services staff and to identify evidence gaps. </sec> <sec id="s3"> Method: Evidence mapping methodology of published and grey original research published in English from 1 January 2000 to 23 May 2020 describing the health risk, mental health and/or well-being of UK ambulance services staff including retired staff, volunteers and students. MEDLINE, EMBASE, PsychINFO, CINAHL and AMED databases, plus EThOS, Zetoc, OpenGrey and Google, were searched, alongside hand-searching of grey literature and bibliographies. Information was extracted on study aims, sample, design and methodology, funding source, country and key findings. Included studies were categorised into seven a priori theme areas. </sec> <sec id="s4"> Results: Of 1862 identified articles, 45 peer-reviewed studies are included as well as 24 grey literature documents. Peer-reviewed research was largely observational and focused on prevalence studies, post-traumatic stress disorder or organisational and individual social factors related to health and well-being. Most grey literature reported the development and testing of interventions. Across all study types, underpinning theory was often not cited. </sec> <sec id="s5"> Conclusion: To date, intervention research has largely been funded by charities and published in the grey literature. Few studies were identified on self-harm, bullying, sleep and fatigue or alcohol and substance use. Theoretically informed intervention development and testing, including adaptation of innovations from other countries and 24-hour workforces, is needed. This evidence map provides important context for planning of staff well-being provision and research as the sector responds to and recovers from the pandemic. </sec> <sec id="s6"> PROSPERO registration number: CRD42018104659. </sec>
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Dobran, Mauro, Davide Nasi, Domenico Paolo Esposito, Maurizio Gladi, Massimo Scerrati, and Maurizio Iacoangeli. "The Incidence of Adjacent Segment Degeneration after the Use of a Versatile Dynamic Hybrid Stabilization Device in Lumbar Stenosis: Results of a 5–8-Year Follow-up." Asian Spine Journal 12, no. 2 (April 30, 2018): 263–71. http://dx.doi.org/10.4184/asj.2018.12.2.263.
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<sec><title>Study Design</title><p>Retrospective study with long-term follow-up.</p></sec><sec><title>Purpose</title><p>To evaluate the long-term incidence of adjacent segment degeneration (ASD) and clinical outcomes in a consecutive series of patients who underwent spinal decompression associated with dynamic or hybrid stabilization with a Flex+TM stabilization system (SpineVision, Antony, France) for lumbar spinal stenosis.</p></sec><sec><title>Overview of Literature</title><p>The incidence of ASD and clinical outcomes following dynamic or hybrid stabilization with the Flex+TM system used for lumbar spinal stenosis have not been well investigated.</p></sec><sec><title>Methods</title><p>Twenty-one patients with lumbar stenosis and probable post-decompressive spinal instability underwent decompressive laminectomy followed by spinal stabilization using the Flex+TM stabilization system. The indication for a mono-level dynamic stabilization was a preoperative magnetic resonance imaging (MRI) demonstrating evidence of severe disc disease associated with severe spinal stenosis. The hybrid stabilization (rigid-dynamic) system was used for multilevel laminectomies with associated initial degenerative scoliosis, first-grade spondylolisthesis, or rostral pathology.</p></sec><sec><title>Results</title><p>The improvement in Visual Analog Scale and Oswestry Disability Index scores at follow-up were statistically significant (<italic>p</italic><0.0001 and <italic>p</italic><0.0001, respectively). At the 5–8-year follow-up, clinical examination, MRI, and X-ray findings showed an ASD complication with pain and disability in one of 21 patients. The clinical outcomes were similar in patients treated with dynamic or hybrid fixation.</p></sec><sec><title>Conclusions</title><p>Patients treated with laminectomy and Flex+TM stabilization presented a satisfactory clinical outcome after 5–8 years of follow-up, and ASD incidence in our series was 4.76% (one patient out of 21). We are aware that this is a small series, but our long-term follow-up may be sufficient to contribute to the expanding body of literature on the development of symptomatic ASD associated with dynamic or hybrid fixation.</p></sec>
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Goulet, Sonia, Franç Y. Doré, and Rachel Lehotkay. "Activation of Locations in Working Memory in Cats." Quarterly Journal of Experimental Psychology Section B 49, no. 1b (February 1996): 81–92. http://dx.doi.org/10.1080/713932612.
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Cats saw an object appear and disappear at two successive locations; the movement of the object from one location to the other was not perceived but was indicated by indirect cues and the two disappearances were separated by a 0-sec or a 20-sec interval. Performance was poorer with the 0-sec than with the 20-sec interval. With the 0-sec interval, the percentages of search attempts made at the object's initial and final hiding locations did not differ whereas with the 20-sec interval, more search attempts were made at the final than at the initial location. These results provide additional support to Goulet, Dore and Rousseau's (1994) interpretation of cats’ search behaviour in terms of activation of spatial locations in working memory.
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White, Thomas W. "SEC enforcement actions under exchange act rule 21F-17." Journal of Investment Compliance 18, no. 3 (September 4, 2017): 1–10. http://dx.doi.org/10.1108/joic-06-2017-0034.
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Purpose To review recent enforcement actions in which the Securities and Exchange Commission (“SEC”) enforced Rule 21F-17(a) under the Securities Exchange Act, which prohibits actions to impede whistleblower communications with the SEC, and to identify changes that entities subject to SEC regulation (including public companies, broker-dealers and investment managers) may wish to consider in their employee separation agreements and other documents that may include confidentiality provisions. Design/methodology/approach Examines settled cases since 2015, in which the SEC found that contractual provisions in employee separation agreements and other documents impeded employees from communicating with the SEC staff about possible violations of the securities laws, to identify the types of language that the SEC found to be problematic and the types of provisions that the SEC believes are desirable, if not legally mandated, to protect employee whistleblower rights and avoid impeding communications under Rule 21F-17(a). Findings Beginning in 2015, the SEC has actively enforced Rule 21F-17(a), focusing on provisions in separation agreements and other employee-related documents that potentially prevent employees from reporting legal violations to the SEC. The SEC’s efforts have resulted in settled orders involving alleged violations of the rule. The cases generally allege that provisions in employee separation agreements or other documents violated the rule because they prohibited or chilled employee communications with the SEC about possible legal violations. Practical implications Entities subject to SEC regulation (including public companies, broker-dealers and investment managers) should review their confidentiality agreements with employees and consider whether changes are warranted to address the SEC’s concerns as identified in the Rule 21F-17(a) cases. Originality/value Practical guidance regarding important whistleblower developments from experienced securities lawyer.
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Wu, J., and P. F. James. "Mullite formation from gels derived from tetraethoxysilane or tetramethoxysilane with aluminium sec-butoxide." Journal of Non-Crystalline Solids 221, no. 2-3 (December 1997): 297–301. http://dx.doi.org/10.1016/s0022-3093(97)00412-2.
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Chaves, Bernardo José Moreira, Luis Eduardo Carelli Teixeira da Silva, Luis Antonio Medeiros Moliterno, and Renato Tavares. "Interobserver evaluation of TLICS system to treat thoracolumbar fractures." Coluna/Columna 14, no. 2 (June 2015): 125–28. http://dx.doi.org/10.1590/s1808-185120151402114422.
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<sec><title>OBJECTIVE:</title><p> To evaluate the interobserver agreement regarding the TLICS Classification (Thoracolumbar Injury Classification and Severity Score). Furthermore, evaluate the reliability, analyzing the correlation between the treatment indicated by TLICS system (surgical or conservative) and the treatment indicated by each evaluator surgeon.</p></sec><sec><title>METHODS:</title><p> Imaging tests and clinical data of 22 patients with thoracolumbar fractures were analyzed by eight spine surgeons, and two main analyzes were performed: the first compared the interobserver agreement related to TLICS and the second compared the agreement between the treatment indicated by TLICS classification (surgical or conservative) and treatment indicated by each surgeon - based on his personal experience and the preferred classification.</p></sec><sec><title>RESULTS:</title><p> Using the parameters of Landis and Koch for interpretation of Kappa value, the interobserver agreement of TLICS classification was considered moderate in our study (K=0.6). The agreement between the indications of treatment (surgical or conservative) dictated by the classification and the indication of each surgeon was considered excellent, with kappa value of 0.89.</p></sec><sec><title>CONCLUSION:</title><p> We believe that the classification is a good tool for the evaluation and the treatment indication in thoracolumbar fractures.</p></sec>
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Akazawa, Tsutomu, Toshiaki Kotani, Tsuyoshi Sakuma, Takehide Katogi, Shohei Minami, Hisateru Niki, Yoshiaki Torii, et al. "Bone Mineral Density and Physical Performance of Female Patients 27 Years or Longer after Surgery for Adolescent Idiopathic Scoliosis." Asian Spine Journal 11, no. 5 (October 31, 2017): 780–86. http://dx.doi.org/10.4184/asj.2017.11.5.780.
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<sec><title>Study Design</title><p>Retrospective cohort study.</p></sec><sec><title>Purpose</title><p>To assess bone mineral density (BMD) and bone metabolism ≥27 years after surgery in female patients who underwent spinal fusion for adolescent idiopathic scoliosis (AIS) during adolescence and to determine their associations with physical performance. </p></sec><sec><title>Overview of Literature</title><p>There are no studies investigating postsurgical BMD in middle-aged AIS patients.</p></sec><sec><title>Methods</title><p>This study included 23 patients who provided informed consent among 229 female patients with AIS who underwent spinal fusion from 1968 until 1988. Average age at the time of observation was 48.8 years. BMD was measured at the left femoral neck, and the levels of two bone metabolism markers–procollagen type 1 N-terminal propeptide (P1NP) and tartrate-resistant acid phosphatase 5b (TRACP-5b)–were measured from blood samples. Physical performance was measured using grip strength, sit-ups, sit-and-reach, side step, and standing long jump.</p></sec><sec><title>Results</title><p>Mean BMD was 0.784 g/cm<sup>2</sup>. According to the World Health Organization diagnostic criteria, one subject (4.3%) had osteoporosis, whereas nine subjects (39.1%) had osteopenia. In patients with osteoporosis or osteopenia, P1NP and TRACP-5b levels were high, and BMD loss was because of high metabolic turnover. All calculated standard scores for physical performance were lower in the study cohort than in healthy individuals. There was a positive correlation between BMD and the standard score for grip strength, whereas there were weak positive correlations between BMD and the standard scores for side step and standing long jump.</p></sec><sec><title>Conclusions</title><p>In female AIS patients who underwent spinal fusion in adolescence, 4.3% and 39.1% had osteoporosis and osteopenia, respectively, ≥27 years after surgery. Exercise performance of these patients was poor compared with the national standards. In these patients, increased physical activity should be encouraged to prevent BMD loss in middle age.</p></sec>
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Choonara, Esme, and Julia Williams. "What factors affect paramedics’ involvement of people with dementia in decisions about their care? A qualitative study." British Paramedic Journal 5, no. 4 (March 1, 2021): 1–8. http://dx.doi.org/10.29045/14784726.2021.3.5.4.1.
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<sec id="s1">Background: Paramedics are frequently called to people with dementia, but decision making can be challenging due to lack of information or difficulties in assessment. Best-practice dementia care should be holistic and involve people with dementia in decisions as far as possible. </sec> <sec id="s2">Aims: To explore how paramedics make decisions when attending people with dementia, with a particular focus on factors that impact on how, and to what degree, paramedics involve people with dementia in these decisions. </sec> <sec id="s3">Methods: A generic qualitative research approach was used. Data were collected through semi-structured individual interviews with seven paramedics. The interviews were recorded and transcribed verbatim and subsequently analysed using thematic analysis. </sec> <sec id="s4">Results: Four themes were identified that all touched on challenges to delivering person-centred care. Themes identified were: 1) paramedics’ differing approaches to assessing capacity and making best interest decisions; 2) communication and developing a rapport; 3) interconnections with others important to the person with dementia; and 4) the impact of paramedics’ values and attitudes. </sec> <sec id="s5">Conclusion: The involvement of people with dementia is sometimes limited by medical, social or clinician-dependent factors. This study highlights how paramedics’ values and communication skills influence their interactions with people with dementia. As the paramedic role evolves, there is an opportunity to embed person-centred care in practice and to ensure that education equips paramedics with the skills and ethical frameworks needed to deliver high quality dementia care. </sec>
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Barutta, Federica, Shunsuke Kimura, Koji Hase, Stefania Bellini, Beatrice Corbetta, Alessandro Corbelli, Fabio Fiordaliso, et al. "Protective Role of the M-Sec–Tunneling Nanotube System in Podocytes." Journal of the American Society of Nephrology 32, no. 5 (March 15, 2021): 1114–30. http://dx.doi.org/10.1681/asn.2020071076.
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BackgroundPodocyte dysfunction and loss are major determinants in the development of proteinuria. FSGS is one of the most common causes of proteinuria, but the mechanisms leading to podocyte injury or conferring protection against FSGS remain poorly understood. The cytosolic protein M-Sec has been involved in the formation of tunneling nanotubes (TNTs), membrane channels that transiently connect cells and allow intercellular organelle transfer. Whether podocytes express M-Sec is unknown and the potential relevance of the M-Sec–TNT system in FSGS has not been explored.MethodsWe studied the role of the M-Sec–TNT system in cultured podocytes exposed to Adriamycin and in BALB/c M-Sec knockout mice. We also assessed M-Sec expression in both kidney biopsies from patients with FSGS and in experimental FSGS (Adriamycin-induced nephropathy).ResultsPodocytes can form TNTs in a M-Sec–dependent manner. Consistent with the notion that the M-Sec–TNT system is cytoprotective, podocytes overexpressed M-Sec in both human and experimental FSGS. Moreover, M-Sec deletion resulted in podocyte injury, with mitochondrial abnormalities and development of progressive FSGS. In vitro, M-Sec deletion abolished TNT-mediated mitochondria transfer between podocytes and altered mitochondrial bioenergetics. Re-expression of M-Sec reestablishes TNT formation and mitochondria exchange, rescued mitochondrial function, and partially reverted podocyte injury.ConclusionsThese findings indicate that the M-Sec–TNT system plays an important protective role in the glomeruli by rescuing podocytes via mitochondrial horizontal transfer. M-Sec may represent a promising therapeutic target in FSGS, and evidence that podocytes can be rescued via TNT-mediated horizontal transfer may open new avenues of research.
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Santos, Alaneir de Fátima dos, Antônio Thomaz Gonzaga da Matta Machado, Clarice Magalhães Rodrigues dos Reis, Daisy Maria Xavier Abreu, Lucas Henrique Lobato de Araújo, Simone Cristina Rodrigues, Ângela Maria de Lourdes Dayrell de Lima, Alzira de Oliveira Jorge, and Délcio Fonseca Sobrinho. "Institutional and matrix support and its relationship with primary healthcare." Revista de Saúde Pública 49 (2015): 1–7. http://dx.doi.org/10.1590/s0034-8910.2015049005519.
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<sec><title>OBJECTIVE</title><p> To analyze whether the level of institutional and matrix support is associated with better certification of primary healthcare teams.</p></sec><sec><title>METHODS</title><p> In this cross-sectional study, we evaluated two kinds of primary healthcare support – 14,489 teams received institutional support and 14,306 teams received matrix support. Logistic regression models were applied. In the institutional support model, the independent variable was “level of support” (as calculated by the sum of supporting activities for both modalities). In the matrix support model, in turn, the independent variables were the supporting activities. The multivariate analysis has considered variables with p < 0.20. The model was adjusted by the Hosmer-Lemeshow test.</p></sec><sec><title>RESULTS</title><p> The teams had institutional and matrix supporting activities (84.0% and 85.0%), respectively, with 55.0% of them performing between six and eight activities. For the institutional support, we have observed 1.96 and 3.77 chances for teams who had medium and high levels of support to have very good or good certification, respectively. For the matrix support, the chances of their having very good or good certification were 1.79 and 3.29, respectively. Regarding to the association between institutional support activities and the certification, the very good or good certification was positively associated with self-assessment (OR = 1.95), permanent education (OR = 1.43), shared evaluation (OR = 1.40), and supervision and evaluation of indicators (OR = 1.37). In regards to the matrix support, the very good or good certification was positively associated with permanent education (OR = 1.50), interventions in the territory (OR = 1.30), and discussion in the work processes (OR = 1.23).</p></sec><sec><title>CONCLUSIONS</title><p> In Brazil, supporting activities are being incorporated in primary healthcare, and there is an association between the level of support, both matrix and institutional, and the certification result.</p></sec>
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Huang, Jun, Hong-tao Liao, Hong-wen Fei, Yu-mei Xue, Li Zhang, Qiong-wen Lin, Si-qi Ren, et al. "Association of Thromboembolic Risk Score with Left Atrial Thrombus and Spontaneous Echocardiographic Contrast in Non-Anticoagulated Nonvalvular Atrial Fibrillation Patients." Cardiology 140, no. 2 (2018): 87–95. http://dx.doi.org/10.1159/000489390.
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Objectives: The aim of the study was to examine the association of CHADS2/CHA2DS2-VASc scores with left atrial thrombus (LAT) and spontaneous echocardiographic contrast (SEC) in non-anticoagulated nonvalvular atrial fibrillation (NVAF) spontaneous patients, and to develop a new scoring system for LAT/SEC prediction. Methods: Consecutive non-anticoagulated NVAF patients with or without LAT/SEC by transesophageal echocardiography were identified in the Guangdong General Hospital. Results: Among 2,173 patients, the prevalence of LAT/SEC was 4.9%. Both predictive values of CHADS2 and CHA2DS2-VASc scores for the presence of LAT/SEC were low-to-moderate (receiver operating characteristic [ROC] = 0.591 and 0.608, respectively, p = 0.90). By multivariate analysis, non-paroxysmal AF, decreased left ventricular ejection fraction, and left atrial enlargement were positively associated with LAT/SEC, while CHADS2/CHA2DS2VASc scores were not. A new scoring system based on these 3 factors above significantly improved the discrimination for LAT/SEC (ROC = 0.792). Conclusions: CHADS2/CHA2DS2-VASc scores had limited value in predicting LAT/SEC; a new scoring system that combines AF type and echocardiographic parameters may better predict LAT/SEC as a surrogate for cardioembolic risk in NVAF patients.
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Roszak, Kinga, and Andrzej Katrusiak. "High-pressure and environment effects in selenourea and its labile crystal field around molecules." Acta Crystallographica Section B Structural Science, Crystal Engineering and Materials 77, no. 3 (May 27, 2021): 449–55. http://dx.doi.org/10.1107/s205252062100398x.
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Ambient-pressure trigonal phase α of selenourea SeC(NH2)2 is noncentrosymmetric, with high Z′ = 9. Under high pressure it undergoes several intriguing transformations, depending on the pressure-transmitting medium and the compression or recrystallization process. In glycerine or oil, α-SeC(NH2)2 transforms into phase β at 0.21 GPa; however in water, phase α initially increases its volume and can be compressed to 0.30 GPa due to the formation of α-SeC(NH2)2·xH2O. The single crystals of α-SeC(NH2)2 and of its partial hydrate α-SeC(NH2)2·xH2O are shattered by pressure-induced transitions. Single crystals of phase β-SeC(NH2)2 were in situ grown in a diamond-anvil cell and studied by X-ray diffraction. The monoclinic phase β is centrosymmetric, with Z′ = 2. It is stable to 3.20 GPa at least, but it cannot be recovered at ambient conditions due to strongly strained NH...Se hydrogen bonds. No hydrogen-bonding motifs present in the urea structures have been found in selenourea phases α and β.
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Dillon, Kate, Chris Hook, Zoe Coupland, Pascale Avery, Hazel Taylor, and Andy Lockyer. "Pre-hospital lowest recorded oxygen saturation independently predicts death in patients with COVID-19." British Paramedic Journal 5, no. 3 (December 1, 2020): 59–65. http://dx.doi.org/10.29045/14784726.2020.09.5.3.59.
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<sec id="s1">Background: The coronavirus disease 2019 (COVID-19) results in hypoxia in around a fifth of adult patients. Severe hypoxia in the absence of visible respiratory distress (‘silent hypoxia’) is increasingly recognised in these patients. There are no published data evaluating lowest recorded pre-hospital oxygen saturation or pre-hospital National Early Warning Score 2 (NEWS2) as a predictor of outcome in patients with COVID-19. </sec> <sec id="s2">Methods: In this retrospective service evaluation, we included adult inpatients with laboratory confirmed COVID-19 who were discharged from hospital or who died in hospital between 12 March and 28 April 2020 (n = 143). Pre-hospital and in-hospital data were extracted and analysed to explore risk factors associated with in-hospital mortality to inform local triage and emergency management. </sec> <sec id="s3">Results: The lowest recorded pre-hospital oxygen saturation was an independent predictor of mortality when controlling for age, gender and history of COPD. A 1% reduction in pre-hospital oxygen saturation increased the odds of death by 13% (OR 1.13, p < 0.001). Lower pre-hospital oxygen saturation predicted mortality after adjusting for the pre-hospital NEWS2 (OR for a 1% reduction in pre-hospital oxygen saturation 1.09, p = 0.02). The pre-hospital NEWS2 was higher in those who died (Median 9; IQR 7-10; n = 24) than in those who survived to discharge (Median 6; IQR 5-8; n = 63). </sec> <sec id="s4">Conclusion: This service evaluation suggests that the lowest recorded pre-hospital oxygen saturation may be an independent predictor of mortality in COVID-19 patients. Lowest pre-hospital oxygen saturation should be recorded and used in the assessment of patients with suspected COVID-19 in pre-hospital and emergency department triage settings. </sec>
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Feitosa, Fernanda Alves, Mateus Guimarães Lage Reggiani, and Rodrigo Máximo de Araújo. "Removable partial or complete dentures exposed to beverages and mouthwashes: evaluation of microhardness and roughness." Revista de Odontologia da UNESP 44, no. 4 (August 2015): 189–94. http://dx.doi.org/10.1590/1807-2577.0049.
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<title>Abstract</title><sec><title>Purpose</title><p>To evaluate microhardness and roughness of denture base polymethylmethacrylate resinn exposed to acid beverages and mouthwashes.</p></sec><sec><title>Material and method</title><p>Rectangular samples (n=80) were prepared from poly (methyl methacrylate) (PMMA). They were divided into 8 groups and had the initial microhardness and Knoop roughness measured. Samples of each group were immersed for 10 min into a test solution (coffee, lemon juice, chlorhexidine gluconate, red wine, cola-based soft drink, vinegar or antiseptic with and without alcohol) and after stored in artificial saliva for 23 h and 50 min, completing a period of 24 h. This procedure was performed for 14 consecutive days and after this period the microhardness and surface roughness measurements were made again. Data were statistically analyzed using ANOVA non parametric, Kruskal-Walis and the Dunn´s test for microhardness and the t-Student and ANOVA for roughness.</p></sec><sec><title>Result</title><p>For microhardness there were found statistically significant differences among the chlorhexidine gluconate solution, antiseptic without alcohol and cola-based soft drink. For roughness was observed that the mean values between the initial period and after immersion in the test products differed statistically in all groups, without difference among groups.</p></sec><sec><title>Conclusion</title><p>The microhardness of poly(methyl methacrylate) was affected by continue exposition to chlorhexidine gluconate, antiseptic without alcohol and cola-based soft drink. The roughness of poly(methyl methacrylate) is negatively influenced by the exposure to all tested products. It may be concluded that both, microhardness and roughness, were affected by the treatments.</p></sec>
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Ilkovitch, Dan, and Diana M. Lopez. "Urokinase-mediated recruitment of myeloid-derived suppressor cells and their suppressive mechanisms are blocked by MUC1/sec." Blood 113, no. 19 (May 7, 2009): 4729–39. http://dx.doi.org/10.1182/blood-2008-08-176438.
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Abstract The transmembrane isoform of mucin 1 (MUC1/TM) is a well-recognized tumor antigen, contributing to tumorigenesis and immune evasion. Although MUC1/TM has been correlated with malignancy, we have previously reported on antitumor properties and prevention of tumor development by a secreted splice variant of MUC1 (MUC1/sec). Because myeloid-derived suppressor cells (MDSCs) play a critical role in tumor-induced immunosuppression, we investigated their recruitment by tumor cells expressing either MUC1/TM or MUC1/sec. DA-3 tumor cells expressing MUC1/sec recruit dramatically lower levels of MDSCs, relative to MUC1/TM-expressing DA-3 cells. Because MUC1/sec was previously shown to down-regulate tumor expression of urokinase plasminogen activator (uPA), a protease linked to tumor aggressiveness and metastasis, the potential role of uPA in MDSC recruitment was investigated. Tumor-derived uPA is capable of recruiting MDSCs, and correlates with tumor development. In addition to diminishing recruitment of MDSCs, the effect of MUC1/sec on MDSC-suppressive mechanisms was investigated. MUC1/sec, or its unique immunoenhancing peptide, is capable of blocking expression of arginase 1 and production of reactive oxygen species in MDSCs, implicated in the suppression of T cells. These findings demonstrate a new mechanism of MDSC recruitment, and provide evidence that MUC1/sec has antitumor properties affecting MDSCs.
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Guo, Chenghao, Zhuanzhuan Che, Junjie Yue, Peng Xie, Shaohua Hao, Wei Xie, Zhuojuan Luo, and Chengqi Lin. "ENL initiates multivalent phase separation of the super elongation complex (SEC) in controlling rapid transcriptional activation." Science Advances 6, no. 14 (April 2020): eaay4858. http://dx.doi.org/10.1126/sciadv.aay4858.
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Release of paused RNA polymerase II (Pol II) requires incorporation of the positive transcription elongation factor b (P-TEFb) into the super elongation complex (SEC), thus resulting in rapid yet synchronous transcriptional activation. However, the mechanism underlying dynamic transition of P-TEFb from inactive to active state remains unclear. Here, we found that the SEC components are able to compartmentalize and concentrate P-TEFb via liquid-liquid phase separation from the soluble inactive HEXIM1 containing the P-TEFb complex. Specifically, ENL or its intrinsically disordered region is sufficient to initiate the liquid droplet formation of SEC. AFF4 functions together with ENL in fluidizing SEC droplets. SEC droplets are fast and dynamically formed upon serum exposure and required for rapid transcriptional induction. We also found that the fusion of ENL with MLL can boost SEC phase separation. In summary, our results suggest a critical role of multivalent phase separation of SEC in controlling transcriptional pause release.
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Buckland, Aaron J., Bryan M. Beaubrun, Evan Isaacs, John Moon, Peter Zhou, Sam Horn, Gregory Poorman, et al. "Psoas Morphology Differs between Supine and Sitting Magnetic Resonance Imaging Lumbar Spine: Implications for Lateral Lumbar Interbody Fusion." Asian Spine Journal 12, no. 1 (February 28, 2018): 29–36. http://dx.doi.org/10.4184/asj.2018.12.1.29.
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<sec><title>Study Design</title><p>Retrospective radiological review.</p></sec><sec><title>Purpose</title><p>To quantify the effect of sitting vs supine lumbar spine magnetic resonance imaging (MRI) and change in anterior displacement of the psoas muscle from L1–L2 to L4–L5 discs.</p></sec><sec><title>Overview of Literature</title><p>Controversy exists in determining patient suitability for lateral lumbar interbody fusion (LLIF) based on psoas morphology. The effect of posture on psoas morphology has not previously been studied; however, lumbar MRI may be performed in sitting or supine positions.</p></sec><sec><title>Methods</title><p>A retrospective review of a single-spine practice over 6 months was performed, identifying patients aged between 18–90 years with degenerative spinal pathologies and lumbar MRIs were evaluated. Previous lumbar fusion, scoliosis, neuromuscular disease, skeletal immaturity, or intrinsic abnormalities of the psoas muscle were excluded. The anteroposterior (AP) dimension of the psoas muscle and intervertebral disc were measured at each intervertebral disc from L1–L2 to L4–L5, and the AP psoas:disc ratio calculated. The morphology was compared between patients undergoing sitting and/or supine MRI.</p></sec><sec><title>Results</title><p>Two hundred and nine patients were identified with supine-, and 60 patients with sitting-MRIs, of which 13 patients had undergone both sitting and supine MRIs (BOTH group). A propensity score match (PSM) was performed for patients undergoing either supine or sitting MRI to match for age, BMI, and gender to produce two groups of 43 patients. In the BOTH and PSM group, sitting MRI displayed significantly higher AP psoas:disc ratio compared with supine MRI at all intervertebral levels except L1–L2. The largest difference observed was a mean 32%–37% increase in sitting AP psoas:disc ratio at the L4–L5 disc in sitting compared to supine in the BOTH group (range, 0%–137%).</p></sec><sec><title>Conclusions</title><p>The psoas muscle and the lumbar plexus become anteriorly displaced in sitting MRIs, with a greater effect noted at caudal intervertebral discs. This may have implications in selecting suitability for LLIF, and intra-operative patient positioning.</p></sec>
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Lee, Dong-Yeong, Young-Jin Park, Sang-Youn Song, Soon-Taek Jeong, and Dong-Hee Kim. "Risk Factors for Posterior Cage Migration after Lumbar Interbody Fusion Surgery." Asian Spine Journal 12, no. 1 (February 28, 2018): 59–68. http://dx.doi.org/10.4184/asj.2018.12.1.59.
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<sec><title>Study Design</title><p>A retrospective clinical case series.</p></sec><sec><title>Purpose</title><p>To determine the strength of association between cage retropulsion and its related factors.</p></sec><sec><title>Overview of Literature</title><p>Lumbar interbody fusion with cage can obtain a firm union and can restore the disc height with normal sagittal and coronal alignment. Although lumbar interbody fusion procedures have satisfactory clinical outcomes, peri- and postoperative complications regarding the cage remain challenging.</p></sec><sec><title>Methods</title><p>From January 2006 to June 2016, 1,047 patients with lumbar degenerative disc disease who underwent posterior lumbar interbody fusion or transforaminal interbody fusion at Gyeongsang National University Hospital were enrolled. Medical records and pre- and postoperative radiographs were reviewed to identify significant cage retropulsion-related factors. The associations between cage retropulsion with various risk factors were evaluated by calculating odds ratios (ORs) and 95% confidence intervals (CIs) using multiple logistic regression analysis.</p></sec><sec><title>Results</title><p>Of 1,229 disc levels, 16 cases (1.3%, 10 men and 6 women) had cage retropulsion. Univariate analysis revealed no significant differences between the cage retropulsion group and the no cage retropulsion group with regard to demographic data such as age, sex, weight, height, body mass index (BMI), smoking habits, presence of osteoporosis, and duration of follow-up. Multivariate analysis revealed that low BMI (OR, 0.875; 95% CI, 0.771–0.994; <italic>p</italic>=0.040), presence of screw loosening (OR, 27.400; 95% CI, 7.818–96.033; <italic>p</italic><0.001), and pear-shaped disc (OR, 9.158; 95% CI, 2.455–34.160; <italic>p</italic>=0.001) were significantly associated with cage retropulsion.</p></sec><sec><title>Conclusions</title><p>This study demonstrated that low BMI, loosening of posterior instrumentation, and pear-shaped disc were associated with cage retropulsion after lumbar interbody fusion. Therefore, when performing lumbar interbody fusion with a cage, surgeons should have skillful surgical techniques for firm fixation to prevent cage retropulsion, particularly in non-obese patients.</p></sec>
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Popovich, Michael, Andrew Sas, Andrea Ana Almeida, Jeremiah Freeman, Bara Alsalaheen, Matthew Lorincz, and James T. Eckner. "Symptom Provocation During Aerobic and Dynamic Supervised Exercise Challenges in Adolescents With Sport-Related Concussion." Journal of Athletic Training 56, no. 2 (January 11, 2021): 148–56. http://dx.doi.org/10.4085/1062-6050-0072.20.
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Context Supervised exercise challenges (SECs) have been shown to be safe and beneficial in the early symptomatic period after concussion. Thus far, most in-clinic SECs studied have included a form of basic aerobic exercise only. An SEC that also includes dynamic forms of exercise mimics all steps of a standard return-to-play progression and may enhance the detection of concussion symptoms to guide in-clinic management decisions. Objective To determine whether an SEC that includes a dynamic SEC (DSEC) uncovered symptoms that would not have been identified by an SEC involving an aerobic SEC (ASEC) alone in adolescent patients with sport-related concussion. Design Retrospective case series. Setting Multidisciplinary sport concussion clinic at a tertiary care center. Patients or Other Participants A total of 65 adolescent athletes (mean age = 14.9 ± 2.0 years, 72.3% males) who underwent an in-clinic SEC within 30 days of concussion. Main Outcome Measure(s) Presence of pre-exercise symptoms and symptom provocation during the SEC were recorded, with exercise-provoked symptoms categorized as occurring during ASEC or DSEC. Results Of the total patient sample, 69.2% (n = 45/65) experienced symptom provocation at some point during the SEC. Symptoms were provoked in 20 patients during the ASEC, whereas 25 completed the ASEC without symptom provocation before becoming symptomatic during the subsequent DSEC and 20 completed the SEC without any symptom provocation. Of the 65 patients in the total sample, 46 were asymptomatic immediately before the SEC. Of these previously asymptomatic patients, 23.9% (n = 11/46) experienced symptom provocation during the ASEC, and an additional 37.0% (n = 17/46) remained asymptomatic during the ASEC but then developed symptoms during the DSEC. Conclusions The ASEC alone may not detect symptom provocation in a significant proportion of concussion patients who otherwise would develop symptoms during a DSEC.
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Dohzono, Sho, Hiromitsu Toyoda, Akira Matsumura, Hidetomi Terai, Akinobu Suzuki, and Hiroaki Nakamura. "Clinical and Radiological Outcomes after Microscopic Bilateral Decompression via a Unilateral Approach for Degenerative Lumbar Disease: Minimum 5-Year Follow-Up." Asian Spine Journal 11, no. 2 (April 30, 2017): 285–93. http://dx.doi.org/10.4184/asj.2017.11.2.285.
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<sec><title>Study Design</title><p>A retrospective study.</p></sec><sec><title>Purpose</title><p>To assess postoperative bone regrowth at surgical sites after lumbar decompression with >5 years of follow-up. Postoperative preservation of facet joints and segmental spinal instability following surgery were also evaluated.</p></sec><sec><title>Overview of Literature</title><p>Previous reports have documented bone regrowth after conventional laminectomy or laminotomy and several factors associated with new bone formation.</p></sec><sec><title>Methods</title><p>Forty-nine patients who underwent microscopic bilateral decompression via a unilateral approach at L4–5 were reviewed. Primary outcomes included correlations among postoperative bone regrowth, preservation of facet joints, radiographic parameters, and clinical outcomes. Secondary outcomes included comparative analyses of radiographic parameters and clinical outcomes among preoperative diagnoses (lumbar spinal stenosis, degenerative spondylolisthesis, and degenerative lumbar scoliosis).</p></sec><sec><title>Results</title><p>The average value of bone regrowth at the latest follow-up was significantly higher on the dorsal side of the facet joint (3.4 mm) than on the ventral side (1.3 mm). Percent facet joint preservation was significantly smaller on the approach side (79.2%) than on the contralateral side (95.2%). Bone regrowth showed a significant inverse correlation with age, but no significant correlation was observed with facet joint preservation, gender, postoperative segmental spinal motion, or clinical outcomes. Subanalysis of these data revealed that bone regrowth at the latest follow-up was significantly greater in patients with degenerative lumbar scoliosis than in those with lumbar spinal stenosis. Postoperative segmental spinal motion at L4–L5 did not progress significantly in patients with degenerative spondylolisthesis or degenerative lumbar scoliosis compared with those with lumbar spinal stenosis.</p></sec><sec><title>Conclusions</title><p>Microscopic bilateral decompression via a unilateral approach prevents postoperative spinal instability because of satisfactory preservation of facet joints, which may be the primary reason for inadequate bone regrowth. Postoperative bone regrowth was not related to clinical outcomes and postoperative segmental spinal instability.</p></sec>