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Spinal serotonin enables neuro‐motor recovery (i.e., plasticity) in patients with debilitating paralysis. While there exists time of day fluctuations in serotonin‐dependent spinal plasticity, it is unknown, in humans, whether this is due to dynamic changes in spinal serotonin levels or downstream signaling processes. The primary objective of this study was to determine if time of day variations in spinal serotonin levels exists in humans. To assess this, intrathecal drains were placed in seven adults with cerebrospinal fluid (CSF) collected at diurnal (05:00 to 07:00) and nocturnal (17:00 to 19:00) intervals. High performance liquid chromatography with mass spectrometry was used to quantify CSF serotonin levels with comparisons being made using univariate analysis. From the 7 adult patients, 21 distinct CSF samples were collected: 9 during the diurnal interval and 12 during nocturnal. Diurnal CSF samples demonstrated an average serotonin level of 216.6 ±$ \pm $ 67.7 nM. Nocturnal CSF samples demonstrated an average serotonin level of 206.7 ±$ \pm $ 75.8 nM. There was no significant difference between diurnal and nocturnal CSF serotonin levels (p =.762). Within this small cohort of spine healthy adults, there were no differences in diurnal versus nocturnal spinal serotonin levels. These observations exclude spinal serotonin levels as the etiology for time of day fluctuations in serotonin‐dependent spinal plasticity expression. [ABSTRACT FROM AUTHOR]

Background: Large right adrenal tumours may invade the liver and mimic primary hepatic malignancy, presenting diagnostic and management challenges. The 'anterior approach hepatectomy' (AAH) using hanging manoeuvre may be safe for resection of such tumours. Methods: Prospectively maintained database was analysed to identify the large tumours of adreno‐hepatic region subjected to hepatectomy. Clinico‐biochemical, radiological and surgical details were reviewed. AAH and hanging manoeuvre was adopted for the patients requiring right hepatectomy. Results: Out of the eight patients with adreno‐hepatic tumour, four had indeterminate origin of the mass, two had complex cysts, and two were diagnosed as hepatocellular carcinoma on the pre‐operative imaging. The median age was 38 years (23–66); male:female ratio was 5:3. AAH was performed in four patients, while others underwent non‐anatomical resection of involved segment(s). This accounted for 1.01% of 789 hepatectomies performed during the study period. The median intra‐operative blood loss was 525 mL (150–2200 mL) and the median tumour size was 9 cm (6–17 cm). All patients underwent R0 resection. The final histopathological diagnoses were: three phaeochromocytomas (two malignant and one benign), two adrenocortical carcinomas, one malignant paraganglionomas and two adrenal cysts. Major complication (grade IVa) was experienced in one patient. On median follow‐up of 67.5 months (7–84), all were alive and one patient had tumour recurrence. Conclusion: Adrenal tumours mimicking primary hepatic malignancy are rare but pose diagnostic challenges. The AAH is a safe approach with acceptable R0 resection, blood loss, surgical complications and overall outcome for the patients requiring right hepatectomy. [ABSTRACT FROM AUTHOR]

Creating realistic styled spaces is a complex task, which involves design know‐how for what furniture pieces go well together. Interior style follows abstract rules involving color, geometry and other visual elements. Following such rules, users manually select similar‐style items from large repositories of 3D furniture models, a process which is both laborious and time‐consuming. We propose a method for fast‐tracking style‐similarity tasks, by learning a furniture's style‐compatibility from interior scene images. Such images contain more style information than images depicting single furniture. To understand style, we train a deep learning network on a classification task. Based on image embeddings extracted from our network, we measure stylistic compatibility of furniture. We demonstrate our method with several 3D model style‐compatibility results, and with an interactive system for modeling style‐consistent scenes. [ABSTRACT FROM AUTHOR]

Background: Parenteral nutrition (PN) via a central venous catheter is routinely used for surgical patients without a functioning gastrointestinal tract. Complications of PN can be metabolic and thrombotic. Blindness is a rare and unexpected complication.Case: A young female patient with postcorrosive pyloric stenosis was started on PN through an indwelling central venous catheter. On the sixth day of PN, the patient reported sudden painless bilateral complete loss of vision. Examination revealed bilateral normal-sized pupils with normal pupillary reaction. There was complete bilateral absence of visual acuity with no perception of light. Fundus examination was normal. Magnetic resonance imaging revealed an acute infarct in the left occipital lobe, left corpus callosum, and posteromedial aspect of the left thalamus. No cardiac source of the thrombus could be identified. After supportive treatment, the vision started improving after 3 days; recovery was 95% after 10 days. A feeding jejunostomy was performed urgently under local anesthesia, and 1 month of enteral nutrition was administered. One month after the event, the patient's vision returned to normal. Definitive surgery in the form of antrectomy with Billroth II reconstruction was performed 8 weeks later.Conclusion: Blindness secondary to central venous catheterization is very rare; possible mechanisms are venous thrombosis with paradoxical emboli, air emboli, or accidental arterial puncture. Clinicians must exercise caution while using PN. A high index of suspicion is required to diagnose and treat unexpected complications. [ABSTRACT FROM AUTHOR]

ABSTRACT Glycosylation often plays a key role in the safety and efficacy of therapeutic proteins to patients, thus underlying the need for consistent control of this important post-translational modification during biologics production. In this study, we profiled the site-specific evolution of N-glycans on a CTLA4-Fc-fusion protein, from the intracellular secretory pathway to the conditioned medium (CM) in fed-batch cell culture. For this, we developed an approach that combined sub-cellular fractionation with liquid chromatography-tandem mass spectrometry (LC-MS/MS) analyses. The study revealed that there was a significant amount of heterogeneity in the glycans displayed amongst the three distinct N-glycosylation sites. Furthermore, 54-60% of the intracellular protein was characterized by Man8 and Man9 glycans on day 10, when the cell density peaks, indicative of a significant bottleneck between the endoplasmic reticulum (ER) and the cis-Golgi. At longer culture duration, the accumulation of intracellular protein with bi-antennary-fucosylated GlcNAc-terminated residues identified the formation of another bottleneck in the medial and trans-Golgi compartments, which subsequently led to a decrease in sialylated species in the secreted protein. Glucose deprivation caused a reduction in the Man8 and Man9 glycans in favor of Man5 glycans and bi-antennary-fucosylated GlcNAc-terminated residues in the organellar pool of the Fc-fusion protein. However, transient deprivation of glucose did not lead to major differences in the glycan profile of proteins secreted into the CM. The approach developed here allows us to probe the secretory pathway and sheds light on the site-specific intracellular processing of glycans during fed-batch cell culture, thus serving as an initial step towards their rational control. Biotechnol. Bioeng. 2017;114: 1550-1560. © 2017 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis Patients are increasingly using the Internet as a source of information on medical conditions. Because the average American adult reads at a 7th- to 8th-grade level, the National Institutes of Health recommend that patient education material be written between a 4th- and 6th-grade level. In this study, we assess and compare the readability of patient education materials on major surgical subspecialty Web sites relative to otolaryngology. Study Design Descriptive and correlational design. Methods Patient education materials from 14 major surgical subspecialty Web sites (American Society of Colon and Rectal Surgeons, American Association of Endocrine Surgeons, American Society of General Surgeons, American Society for Metabolic and Bariatric Surgery, American Association of Neurological Surgeons, American Congress of Obstetricians and Gynecologists, American Academy of Ophthalmology, American Academy of Orthopedic Surgeons, American Academy of Otolaryngology-Head and Neck Surgery, American Pediatric Surgical Association, American Society of Plastic Surgeons, Society for Thoracic Surgeons, and American Urological Association) were downloaded and assessed for their level of readability using 10 widely accepted readability scales. Results The readability level of patient education material from all surgical subspecialties was uniformly too high. Average readability levels across all subspecialties ranged from the 10th- to 15th-grade level. Conclusions Otolaryngology and other surgical subspecialties Web sites have patient education material written at an education level that the average American may not be able to understand. To reach a broader population of patients, it might be necessary to rewrite patient education material at a more appropriate level. Level of Evidence N/A. Laryngoscope, 124:405-412, 2014 [ABSTRACT FROM AUTHOR]

Contemporary research indicates promising anticonvulsant effect of curcumin. However, its poor oral bioavailability is a major hindrance toward its pharmacological action. Thus, this study was carried out to evaluate the acute effect of liposome-entrapped curcumin on increasing current electroshock seizures (ICES) test, pentylenetetrazole (PTZ)-induced seizures, and status epilepticus in mice. Liposome-entrapped curcumin in doses 25 and 50 mg/kg demonstrated significant increase in seizure threshold current and latency to myoclonic and generalized seizures in ICES test and PTZ-induced seizures, respectively. Similarly, liposomal-entrapped curcumin also increased the latency to the onset and decreased the duration of seizures during status epilepticus in mice. To conclude, liposomal-entrapped curcumin possesses anticonvulsant activity against status epilepticus in mice. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis The h-index, a bibliometric indicator that objectively characterizes the impact of an author's scholarship, is an effective tool that may be considered by academic departments for decisions related to hiring and faculty advancement. Our objective was to characterize the scholarly productivity of academic surgeons from different specialties relative to otolaryngologists. Study Design Analysis of a bibliometric database. Methods The h-indices of 2,429 faculty members within surgical specialties at 20 randomly selected academic institutions were calculated using the Scopus database and were examined to determine relationship with academic rank and comparison among surgical subspecialties. Results The h-index statistically increased with academic rank. Mean h-indices were as follows: assistant professor, 4.37 (range, 2.73-6.69); associate professor, 8.70 (6.53-11.02); professor, 16.44 (13.39-20.45); and chairperson, 20.79 (14.81-27.89). Mean increase between academic rank was 5.47, with the largest increase between the levels of associate professor and professor. Further examination demonstrated statistically significant increases through all academic ranks for most, but not all, individual specialties. Urologists, general surgeons, and neurosurgeons had the highest mean h-indices. Conclusions h-indices among the different surgical specialties vary and are potentially impacted by the number of practitioners as well as research emphasis within a field. The mean h-index of academic otolaryngologists falls in the lower values for academic surgeons. Because this metric varies among different fields, it is most relevant for comparison when examining values within a field. H-indices reliably increase with increasing academic rank through professor and offer a quantifiable and objective alternative to other metrics when evaluating faculty members for academic advancement. [ABSTRACT FROM AUTHOR]

Given its practicality, the internet is a primary resource for patients afflicted with diseases like peripheral neuropathy. Therefore, it is important that the readily available online resources on peripheral neuropathy are tailored to the general public, particularly concerning readability. Patient education resources were downloaded from the US National Library of Medicine, Mayo Clinic, National Institute of Neurological Disorders and Stroke, Neuropathy.org, GBS/ CIDP Foundation International, Hereditary Neuropathy Foundation, Charcot-Marie-Tooth Association, Foundation for Peripheral Neuropathy, and Neuropathy Action Foundation websites. All patient education material related to peripheral neuropathy was evaluated for its level of readability using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level. The FRE scores averaged 43.4 with only the US National Library of Medicine scoring above 60 (76.5). The Flesch-Kincaid Grade Level scores averaged 11.0. All scores were above a seventh-grade level except the US National Library of Medicine, which had a score of a fifth-grade reading level. Most Americans may not fully benefit from patient education resources concerning peripheral neuropathy education on many of the websites. Only the US National Library of Medicine, which is written at a fifth-grade level, is likely to benefit the average American. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Deficient health literacy remains a widespread public issue. As such, the National Institutes of Health (NIH) recommends that all patient resources should be written around a sixth-grade level. The authors evaluate healthcare-oriented resources specified for patient use on the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) Web site in order to identify potential areas of improvement and highlight those sections that may serve as paradigms for future revisions. Study Design: Descriptive and correlational design. Methods: Seventeen healthcare-oriented resources specifically for patients were downloaded in February 2012 from the American Academy of Facial Plastic and Reconstructive Surgery Web site. Readability assessments of each article were performed using Readability Studio Professional Edition Version 2012.1. These tests included the Flesch Reading Ease, Flesch-Kincaid Grade Level, SMOG Grading, Coleman-Liau Index, Gunning-Fog Index, the New Fog Count, the New Dale-Chall Readability Formula, FORCAST formula, Raygor Readability Estimate, and the Fry Graph. Results: Patient health education material found on the AAFPRS Web site has been found to be written at an average grade level of 12th grade using 10 different readability scales. Conclusions: Modifications of the patient education section of the AAFPRS Web site can increase the readability of the literature, and allow greater comprehension among a wider audience. Laryngoscope, 2013 [ABSTRACT FROM AUTHOR]

The article reports on assessment of readability of otolaryngology related Internet-based patient education material (IPEM) from otolaryngology associations in the U.S. It mentions the use of analysis of variance and post hoc Turkey's honestly significant difference (HSD) analysis to identify if IPEM adopt recommended reading level of American Medical Association (AMA) and National Institutes of Health (NIH). It concludes that IPEM were found out to exceed the recommended reading level.

J. Neurochem. (2010) 112, 625–635. Blood–brain barrier (BBB) membrane proteins play crucial roles in the proper functioning of the BBB as well as in disease progression. Previously, we developed a novel approach for identifying membrane proteins expressed at the BBB, which we referred to as multiplex expression cloning. In this study, the proteome coverage of the multiplex expression cloning approach was expanded to allow the identification of a total of 30 BBB membrane proteins that are diverse in function and abundance. To unveil those membrane proteins that are enriched at the BBB and hence partially responsible for some of its unique characteristics, the transcript abundance levels for all 30 BBB membrane proteins were compared with those found in microvessels derived from lung, liver, heart, and kidney. Such quantitative PCR profiling of RNA samples from laser capture microdissected microvessels revealed that the transcripts for five membrane proteins, namely Lutheran glycoprotein, carbonic anhydrase IV, uncoupling protein 2, podocalyxin, and solute carrier family 38, member 5, were BBB selective, in that expression was elevated in brain microvessels when compared with all of the vascular beds tested. Many other membrane protein transcripts, whereas not as BBB-restricted, showed selective expression within subsets of tissues indicating other potential parallels and contrasts between vascular beds in the body. The identification of BBB membrane proteins could help better understand the molecular mechanisms responsible for BBB function and those with selective expression may have utility for BBB-targeted therapies. [ABSTRACT FROM AUTHOR]

The ultrasonic degradation of poly(bisphenol A carbonate), poly(ε-caprolactone), and poly(vinyl acetate) was investigated with various solvents such as benzene, monochlorobenzene, and dichlorobenzene. The time evolution of molecular weight was determined using gel permeation chromatography. A limiting molecular weight was observed for all the systems and was a function of solvent properties. The degradation rates increased with increase in viscosity and decrease in vapor pressure. The polydispersity reached a maximum before reaching a constant value at longer times. The experimental data indicate that the breakage of the polymer is around midpoint, with a distribution rather than an ideal midpoint scission. A continuous distribution model with a stoichiometric kernel based on Lorentzian probability distribution function was developed to satisfactorily model the experimental data. [ABSTRACT FROM AUTHOR]

Glycation, the nonenzymatic reaction between the reducing sugar glucose and the primary amine residues on amino acid side chains, commonly occurs in the cell culture supernatant during production of therapeutic monoclonal antibodies (mAbs). While glycation has the potential to impact efficacy and pharmacokinetic properties for mAbs, the most common undesirable impact of glycation is on the distribution of charged species, often a release specification for commercial processes. Existing empirical approaches are usually insufficient to rationalize the effects of cell line and process changes on glycation. To address this gap, we developed a kinetic model for estimating mAb glycation levels during the cell culture process. The rate constant for glycation, including temperature and pH dependence, was estimated by fitting the kinetic model to time‐course glycation data from bioreactors operated at different process settings that yielded a wide range of glycation values. The parameter values were further validated by independently estimating glycation rate constants using cell‐free incubation studies at various temperatures. The model was applied to another mAb, by re‐estimating the activation energy to account for effect of a glycation "hotspot". The model was further utilized to study the role of temperature shift as an approach to reduce glycation levels in the manufacturing process for mAb2. While a downshift in temperature resulted in lowering of glycation levels for mAb2, the model helped elucidate that this effect was caused due to contribution from changes in glucose consumption, mAb secretion and temperature, instead of a direct impact of temperature alone on the kinetic rate of glycation. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which reports a lyme disease and atypical cases of neuroborreliosis in children.