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Background: Pisa syndrome (PS) and camptocormia (CC) are postural abnormalities frequently associated with Parkinson's disease (PD). Their pathophysiology remains unclear, but the role of cognitive deficits has been postulated. Objectives: To identify differences in the neuropsychological functioning of patients with PD with PS or CC compared with matched patients with PD without postural abnormalities. Methods: We performed a case-control study including 57 patients with PD with PS (PS+) or CC (CC+) and 57 PD controls without postural abnormalities matched for sex, age, PD duration, phenotype, and stage. Patients were divided into four groups: PS+ (n = 32), PS+ controls (PS-, n = 32), CC+ (n = 25), and CC+ controls (CC-, n = 25). We compared PS+ versus PS- and CC+ versus CC-using a neuropsychological battery assessing memory, attention, executive functions, visuospatial abilities, and language. Subjective visual vertical (SVV) perception was assessed by the Bucket test as a sign of vestibular function; the misperception of trunk position, defined as a mismatch between the objective versus subjective evaluation of the trunk bending angle >5°, was evaluated in PS+ and CC+. Results: PS+ showed significantly worse visuospatial performances (P = 0.025) and SVV perception (P = 0.038) than their controls, whereas CC+ did not show significant differences compared with their control group. Reduced awareness of postural abnormality was observed in >60% of patients with PS or CC. Conclusions: Low visuospatial performances and vestibular tone imbalance are significantly associated with PS but not with CC. These findings suggest different pathophysiology for the two main postural abnormalities associated with PD and can foster adequate therapeutic and prevention strategies. [ABSTRACT FROM AUTHOR]

The study of the La(1‐x)BixMnO3 system is conducted using X‐ray diffraction (XRD) and electrical measurements. A continuous solid solution is evidenced for the LaMnO3 rich part of this system (x ≤ 0.6). According to the analyses of XRD results, a rhombohedral symmetry (R3¯c) is observed for x ≤ 0.4 and a cubic structure for x = 0.5. The structural study allows to determine an increase in the mean perovskite lattice parameter, together with a decrease in the rhombohedral angle up to a cubic symmetry for x = 0.5. For x > 0.6, the system is no more single‐phased. Impedance measurements are conducted for ceramics in a wide‐frequency range (100 Hz–1 MHz), between room temperature and 800 °C. The exponential decrease in the alternative current (AC) conductivities (σAC) and the room temperature values correspond to a semiconducting behavior. Direct current (DC) conductivity measurements (σDC) are also performed below room temperature (25 K < T < 300 K). The results evidence for a metal–insulator phase transition. For the exponential part of the σDC curves, the gap energy is between 0.1 and 0.2 eV, confirming the semiconductor behavior of these materials. [ABSTRACT FROM AUTHOR]

Here we report on a singleton patient affected by a complicated congenital syndrome characterized by growth delay, retinal dystrophy, sensorineural deafness, myopathy, ataxia, combined pituitary hormone deficiency, associated with mitochondrial impairment. Targeted clinical exome sequencing led to the identification of a homozygous missense variant in OTX2. Since only dominant mutations within OTX2 have been associated with cases of syndromic microphthalmia, retinal dystrophy with or without pituitary dysfunctions, this represents the first report of an OTX2 recessive mutation. Part of the phenotype, including ataxia, myopathy and multiple mitochondrial respiratory chain defects, seemed not related to OTX2. Further analysis of next generation sequencing (NGS) data revealed additional candidate variants: a homozygous variant in LETM1, and heterozygous rare variants in AFG3L2 and POLG. All three genes encode mitochondrial proteins and the last two are known to be associated with ataxia, a neurological sign present also in the father of the proband. With our study, we aim to encourage the integration of NGS data with a detailed analysis of clinical description and family history in order to unravel composite genotypes sometimes associated with complicated phenotypes. [ABSTRACT FROM AUTHOR]

ABSTRACT: This work aims to investigate the dielectric potential of microcrystalline cellulose, a green biosourced material, as a third constituent in the three‐phase composites based on ethylene vinyl acetate‐vinyl ester of versatic acid (EVA‐VeoVa) terpolymer and BaTiO3. For that, new green three‐phase composites were prepared using an economic and green process, with simple implementation at room temperature and using water as a solvent. Compared with the binary composite EVA‐VeoVa/BaTiO3, the three‐phase composite EVA‐VeoVa/BaTiO3/microcrystalline cellulose showed an improvement of the BaTiO3 particles dispersion, enhanced relative permittivity, and reduced dielectric loss, which explains the significance of this study. © 2017 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2018, 135, 46147. [ABSTRACT FROM AUTHOR]

ABSTRACT An economic and environment friendly process was adapted to synthesize new dielectric composite materials. Using ethylene vinyl acetate (EVA)/vinyl ester of versatic acid (VeoVa) terpolymer as an aqueous emulsion provides a homogenous dispersion of BaTiO3 (BT) particles, due to the high viscosity and polarity of the vinyl resin (VR). Composites films were obtained from these dispersions by water evaporation. The evolution of the dielectric properties as a function of the BaTiO3 content, was correctly fitted by a Maxwell-Garnett model. This fitting of the experimental curve shows a good dispersion of filler in the vinyl resin and the particles separation by a layer of resin as expected for the preparation method used in this study. The VR/BT composites show good synergy between the dielectric properties of the different phases of the composites due to the formation of macrodipoles and to the strong interactions between polar EVA/VeoVa groups and the BaTiO3 particles surface. © 2016 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2016, 133, 44333. [ABSTRACT FROM AUTHOR]

The use of sentinel node biopsy (SNB) after neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer is debated. Our aim was to quantitatively review the available evidence on the performance of SNB after NAC in patients with locally advanced breast cancer. We performed a systematic review (by searching the PubMed, Cochrane and Scopus databases) and random effects meta-analysis to investigate on the feasibility and accuracy of SNB in these patients. The two outcomes of interest were the sentinel node identification rate (SIR) and the false negative rate (FNR). Sensitivity analysis and meta-regression were used to investigate the potential sources of between-study heterogeneity. We retrieved 72 eligible studies enrolling 7,451 patients. Upon meta-analysis, summary SIR resulted 89.6% [95% confidence interval (CI): 87.8-91.2; heterogeneity I²: 76.9%], which poorly compares with the 95% SIR observed in some recent series of early breast cancer. The summary FNR resulted 14.2% (CI: 12.5-16.0; heterogeneity I²: 29.1%), which was significantly higher than the 8-10% reference value. Considering an average post-NAC lymph node positivity rate of 50%, the downstaging due to false negative SNB would occur in 7/100 patients (with an excess error rate of 2-3/100 as compared to the early-stage setting). No plausible source of between-study heterogeneity was found. Based on the largest series of studies ever meta-analyzed, our findings highlight the limits of SNB performance in this population, where the impact of SNB on patient survival is still to be defined. [ABSTRACT FROM AUTHOR]

Background and Purpose Leptin, an adipokine synthesized by the placenta during pregnancy, has been proposed for the management of preterm labour ( PTL), as it is able to prevent in vitro uterine contractility and remodelling associated with labour onset. Another common feature of labour onset is the phenotypic switch of myometrial smooth muscle cells from a proliferative to a hypertrophic state. As proliferative effects have been demonstrated for leptin in other tissues, we aimed to investigate its ability to induce myometrial proliferation and thus to maintain uterine quiescence. Experimental Approach We stimulated human primary myometrial smooth muscle cells with leptin in the presence or absence of receptor antagonists or signalling pathway inhibitors. Key Results Leptin induced myometrial cell proliferation in a biphasic manner. At 6.25 ng·mL−1, leptin-induced proliferation was mediated by the leptin receptor and required the early activation of ERK1/2. At a concentration above 25 ng·mL−1, leptin induced direct non-specific stimulation of the IL-6 receptor, leading to NF-κB activation, and exerted anti-proliferative effects. However, at 50 ng·mL−1, leptin re-induces proliferation via IL-6 receptor stimulation that requires STAT3 and delayed ERK1/2 activation. Conclusions and Implications These data bring new insights into leptin signalling-induced myometrial proliferation and its interrelationship with the IL-6/ IL-6 receptor axis. In the light of our previous work, the present study emphasizes the potential value of leptin in the pharmacological management of PTL and it also strengthens the hypothesis that leptin might be a contributory factor in the parturition-related disorders observed in obese women. [ABSTRACT FROM AUTHOR]

Background Intestinal ischemia and reperfusion (I/R) injury leads to abnormalities in motility, namely delay of transit, caused by damage to myenteric neurons. Alterations of the nitrergic transmission may occur in these conditions. This study investigated whether an in vitro I/R injury may affect nitric oxide (NO) production from the myenteric plexus of the guinea pig ileum and which NO synthase (NOS) isoform is involved. Methods The distribution of the neuronal (n) and inducible (i) NOS was determined by immunohistochemistry during 60 min of glucose/oxygen deprivation ( in vitro ischemia) followed by 60 min of reperfusion. The protein and mRNA levels of nNOS and iNOS were investigated by Western-immunoblotting and real time RT-PCR, respectively. NO levels were quantified as nitrite/nitrate. Key Results After in vitro I/R the proportion of nNOS-expressing neurons and protein levels remained unchanged. nNOS mRNA levels increased 60 min after inducing ischemia and in the following 5 min of reperfusion. iNOS-immunoreactive neurons, protein and mRNA levels were up-regulated during the whole I/R period. A significant increase of nitrite/nitrate levels was observed in the first 5 min after inducing I/R and was significantly reduced by Nω-propyl- l-arginine and 1400 W, selective inhibitors of nNOS and iNOS, respectively. Conclusions & Inferences Our data demonstrate that both iNOS and nNOS represent sources for NO overproduction in ileal myenteric plexus during I/R, although iNOS undergoes more consistent changes suggesting a more relevant role for this isoform in the alterations occurring in myenteric neurons following I/R. [ABSTRACT FROM AUTHOR]

The present work is devoted to the study of the Zr4+/Ti4 substitution in the K1/2Bi1/2Ti(1- x)Zr xO3 solid solution ( x = 0.0 to x = 1.0), based upon the K1/2Bi1/2TiO3 (KBT) ferroelectric compound. The tetragonal distortion of KBT is suppressed by this substitution and leads to the cubic compound K1/2Bi1/2ZrO3 (KBZ). These results agree with the values of the ionic radii of the Zr4+ and Ti4 ions ( $r_{{\rm Ti}^{4 + } } $ = 0.605 Å and $r_{{\rm Zr}^{4 + } } $ = 0.72 Å). Close to KBT ( x ≤ 0.05), the symmetry remains tetragonal. For higher values of x, the ' a' lattice parameter (cubic indexing) follows Vegard's law, thus confirming the formation of a solid solution. The transformation from tetragonal to cubic proceeds via an intermediate pseudocubic symmetry (0.1 ≤ x < 0.5), for which the X-ray diffraction peaks present small broadening and asymmetry. For x ≥ 0.5 and up to the KBZ compound ( a ≈ 4.158 Å), the samples are cubic but some extra peaks are also observed, indicating the occurrence of a secondary phase. The microstructure shows fine-grained ceramic samples for the first range, while for the KBZ-rich range the grains are micrometer-sized and associated to very small grains of the secondary phase. Piezoelectricity is observed for the tetragonal and pseudocubic range, the substitution quickly reducing the piezoelectric properties. The measurement of the dielectric properties revealed close to KBT a dielectric anomaly probably associated to the tetragonal-cubic phase transition. For the pseudocubic and cubic range, a broad dielectric anomaly is observed around 300 °C, corresponding to a relaxor behavior. [ABSTRACT FROM AUTHOR]

Ischemic episodes lead to profound functional and structural alterations of the gastrointestinal tract which may contribute to disorders of intestinal motility. Enhancement of glutamate overflow and the consequent activation of NMDA ( N-methyl--aspartate) receptors may participate to such changes by modulating different enteric neurotransmitter systems, including cholinergic motor pathways. The molecular mechanism/s underlying activation of NMDA receptors in the guinea pig ileum were investigated after glucose/oxygen deprivation ( in vitro ischemia) and during reperfusion. The number of ileal myenteric neurons positive for NR1, the functional subunit of NMDA receptors, and its mRNA levels were unchanged after in vitro ischemia/reperfusion. In these conditions, the protein levels of NR1, and of its phosphorylated form by protein kinase C (PKC), significantly increased in myenteric neurons, whereas, the levels of NR1 phosphorylated by protein kinase A (PKA) did not change, with respect to control values. Spontaneous glutamate overflow increased during in vitro ischemia/reperfusion. In these conditions, the NMDA receptor antagonists, (-)-2-amino-5-phosphonopentanoic acid [()-AP5] (10 μmol L) and 5,7-dichlorokynurenic acid (5,7-diClKyn acid) (10 μmol L) and the PKC antagonist, chelerythrine (1 μmol L), but not the PKA antagonist, H-89 (1 μmol L), were able to significantly depress the increased glutamate efflux. The present data suggest that in the guinea pig ileum during in vitro ischemia/reperfusion, NR1 protein levels increase. Such event may rely upon posttranscriptional events involving NR1 phosphorylation by PKC. Increased NR1 levels may, at least in part, explain the ability of NMDA receptors to modulate a positive feedback on ischemia/reperfusion-induced glutamate overflow. [ABSTRACT FROM AUTHOR]

Resection line infiltration (RLI) after surgical treatment represents an unfavorable prognostic factor in advanced gastric cancer. We performed a retrospective analysis of 89 patients with resection line involvement who did not undergo reoperation. On behalf of the Italian Research Group for Gastric Cancer, we present the characteristics and outcome of 89 patients who were submitted to surgical resection for gastric cancer from 1988 to 2001 and did not undergo reoperation because of disease extension or associated pathologies. RLI was significantly higher in patients with T4 tumors and diffuse histological type. Anastomotic leakages were observed in 4.8% of infiltrated esophageal resection margins, whereas 1.9% of infiltrated duodenal resection lines showed duodenal fistulas. Five-year overall survival of patients with RLI was 29%. Prognosis was not affected by RLI in early forms (100% 5-year survival); however, 5-year survival in T2 and T3 stages was significantly lower with respect to the same stages without residual tumor. The influence of RLI on prognosis was confirmed in N0 as well as in N1 and N2 patients. RLI also was an independent prognostic at multivariate analysis (odds ratio = 1.5; 95% confidence interval, 1.08–2.08; P = 0.0144). RLI significantly affects long-term survival of advanced gastric cancer. The impact on prognosis is independent of lymph node involvement. Patients in good general condition for whom radical surgery is possible should be considered for reoperation. [ABSTRACT FROM AUTHOR]

Changing the Side of Pisa Syndrome: A Case of Over-Recovery with Botulinum Toxin Keywords: Pisa syndrome; botulinum toxin; Parkinson's disease; metronome; ultrasound EN Pisa syndrome botulinum toxin Parkinson's disease metronome ultrasound 571 572 2 07/03/20 20200701 NES 200701 Pisa syndrome (PS) is a disabling postural abnormality associated with neurodegenerative diseases, with a prevalence of 9% in Parkinson's disease.[1] Most authors define PS as an involuntary lateral trunk flexion (LTF) >=10°, resolving in the supine position or by passive mobilization.[1] Rarely, PS onset is associated with the "metronome effect", an alternating trunk-leaning behavior toward both sides.[2] Adjustment of dopaminergic therapy and rehabilitation have been proposed as the first-line management of PS, with botulinum toxin (BoNT) representing the second-line treatment.[3] Although robust evidence on the effect of therapy modifications is lacking, the efficacy of BoNT was demonstrated in 2 small randomized controlled trials and 1 case series.[[3], [5]] However, BoNT injection of axial muscles yielded variable results. Iatrogenic metronome effect: (A) Pisa syndrome before botulinum toxin injection, (B) Pisa syndrome 10 days after botulinum toxin injection, and (C) Pisa syndrome 30 days after botulinum toxin injection. gl To our knowledge, this is the first case of PS with an iatrogenic metronome effect attributed to an excellent efficacy of BoNT injection. [Extracted from the article]

Background: Resection line involvement has been indicated as an important prognostic factor for gastric cancer. Its late detection renders the choice of treatment difficult for surgeons. Materials and Methods: We describe the multicenter experience of a group of 11 patients with early gastric carcinoma (EGC) and positive resection confirmed at histological examination who did not undergo surgical retreatment for reasons of associated disease, surgical considerations on duodenal stump, or patient refusal. Results: The gastric margin was involved in 4 patients, and 7 patients had duodenal resection line involvement. No surgical complications or postoperative deaths were observed. Five and 8-year survival was 100% and 86%, respectively. The only patient who relapsed did not have lymph node involvement and died from liver metastases, without local recurrence. Conclusions: It is sometimes difficult to accurately define the resection line in gastric cancer surgery, especially in the early stages of disease, but because of the strongly negative prognostic value of an infiltrated margin, frozen sections are recommended if neoplastic invasion is suspected and a new resection is always recommended if possible. Nevertheless, the good prognosis of resected EGC patients with resection line involvement must be considered before submitting patients with associated diseases to radical surgical retreatment. [ABSTRACT FROM AUTHOR]

Focuses on the calculation of the crystal densities of molecular salts and hydrates using additive volumes for charged groups. Usefulness of salt crystals from the Cambridge structural database; Method by which highly energetic substituents partially make up for the negative electrostatic contribution; Procedure through which estimation of density of hydrate and salt crystals such as the energetic compounds based on ammonium nitrate and nitrogenated heterocycles can be obtained.

This article examines the impact of centralization and decentralization on safety stock for two-echelon distribution systems. In the case of order-point systems, which are widely used in industrial inventory management procurement lead times are equal to the order-delivery cycle time between the central warehouse and the supplier, whereas transit lead times are equal to the order-delivery cycle time between remote warehouses and the central warehouse. The choice between an independent system and a coupled system has a great impact on safety stock holding costs, which are a main component of overall distribution costs. As to the amount of safety stock, the difference between the two systems can range from 10% to 50% for a distribution system made up of about 20 remote warehouses, given a low level of correlation between local demands. An independent system is characterized by a location-based demand aggregation leading to savings in safety stock, since the central warehouse is subject to the overall demand variations of all geographic areas. Conversely, a coupled system is characterized by a time-based demand aggregation, since its stock is capable of meeting local demand variations during the whole time span resulting from the addition of procurement and transit lead times.

(CazBa1 − z)(Ti1 − x − wCoxNbw)O3 − δ lead‐free piezoelectric ceramics are prepared using solid‐state reactions. The use of a Li2O sintering aid enables one to obtain dense ceramics at a temperature of 1100 °C instead of the 1350 °C used for BaTiO3 (BT) in conventional sintering. X‐ray diffraction (XRD) data indicate structural modifications, suggesting insertion of the doping elements into the tetragonal structure. The insertion of Li/Ca/Co/Nb improves piezoelectric properties: for micrograin‐size ceramics, a piezoelectric charge constant and an electromechanical coupling factor of d33 = 255 pC N−1 and kp = 43.5% are reached, respectively. Furthermore, a thermal annealing of the cobalt‐doped sample at 1080 °C under O2 atmosphere leads to d33 = 280 pC N−1 and kp = 44.6%. BaTiO3:Co ceramics present distorted ferroelectric cycles due to the occurrence of an internal bias field. The high mechanical quality factors (Qm > 1000) obtained for the doped BT ceramics afford stability against electrical stress of up to 500 VRMS mm−1, which makes these materials competitive with PZT4 for some applications. [ABSTRACT FROM AUTHOR]