bluuebunny/crossref_metadata_2025 huggingface dataset:
Benchmarking time-series data discretization on inference methods
Authors: Li Yuezhe , Jann Tiffany , Vera-Licona Paola
Published: January 2019

The rapid development in quantitatively measuring DNA, RNA and protein has generated a great interest in the development of reverse-engineering methods, that is, data-driven approaches to infer the network structure or dynamical model of the system. Many reverse-engineering methods require discrete quantitative data as input, while many experimental data are continuous. Some studies have started to reveal the impact that the choice of data discretization has on the performance of reverse-engineering methods. However, more comprehensive studies are still greatly needed to systematically and quantitatively understand the impact that discretization methods have on inference methods. Furthermore, there is an urgent need for systematic comparative methods that can help select between discretization methods. In this work, we consider four published intracellular networks inferred with their respective time-series datasets. We discretized the data using different discretization methods. Across all datasets, changing the data discretization to a more appropriate one improved the reverse-engineering methods’ performance. We observed no universal best discretization method across different time-series datasets. Thus, we propose DiscreeTest, a two-step evaluation metric for ranking discretization methods for time-series data. The underlying assumption of DiscreeTest is that an optimal discretization method should preserve the dynamic patterns observed in the original data across all variables. We used the same datasets and networks to show that DiscreeTest is able to identify an appropriate discretization among several candidate methods. To our knowledge, this is the first time that a method for benchmarking and selecting an appropriate discretization method for time-series data has been proposed.

Availability and implementation

All the datasets, reverse-engineering methods and source code used in this paper are available in Vera-Licona’s lab Github repository: https://github.com/VeraLiconaResearchGroup/Benchmarking_TSDiscretizations.

Supplementary information

Supplementary data are available at Bioinformatics online.
Improved Outcomes With High-dose Isoniazid in Multidrug-resistant Tuberculosis Treatment in Haiti
Authors: Walsh Kathleen F , Vilbrun Stalz Charles , Souroutzidis Ariadne , Delva Sobieskye , Joissaint Guy , Mathurin Laurent , Ocheretina Oksana , Cremieux Pierre , Pape Jean William , Koenig Serena P
Published: January 2019

We report outcomes for a cohort of patients with multidrug-resistant tuberculosis who received high-dose isoniazid in Haiti. Patients who received high-dose isoniazid had a faster time to culture conversion and higher odds of successful outcome, despite high-level isoniazid resistance. This suggests high-dose isoniazid may have effectiveness even with phenotypic resistance.
Prevalence and Antimicrobial Resistance of Mycoplasma genitalium Infection Among Women Living With Human Immunodeficiency Virus in South Africa: A Prospective Cohort Study
Authors: Ong Jason J , Magooa Mahlape Precious , Chikandiwa Admire , Kelly Helen , Didelot Marie-Noelle , Muller Etienne E , Maseko Venessa , Segondy Michel , Delany-Moretlwe Sinead , Kularatne Ranmini , Mayaud Philippe ,   HIV in Africa Research Partnership Study Group, Chikandiwa A , Cutler E , Delany-Moretlwe S , Lewis D A , Magooa M P , Maseko V , Michelow P , Muzah B , Omar T , Puren A , Djigma F , Drabo J , Goumbri-Lompo O , Meda N , Sawadogo B , Simporé J , Yonli A , Zan S , Costes V , Didelot M-N , Doutre S , Leventoux N , Nagot N , Ngou J , Segondy M , Devine A , Gilham C , Gibson L , Kelly H , Legood R , Mayaud P , Weiss H A
Published: January 2019

This prospective cohort study of 622 women living with human immunodeficiency virus (HIV) from Johannesburg (2012) detected Mycoplasma genitalium in 7.4% (95% confidence interval [CI]: 5.5–9.7, 46/622), with detection more likely with lower CD4 counts(adjusted odds ratio [AOR] 1.02 per 10 cells/μL decrease, 95% CI: 1.00–1.03) and higher plasma HIV-1 RNA (AOR 1.15 per log copies/mL increase, 95% CI: 1.03–1.27). No mutations for macrolide/quinolone resistance was detected.
Age-Related Cognitive Impairment: Role of Reduced Synaptobrevin-2 Levels in Deficits of Memory and Synaptic Plasticity
Authors: Orock Albert , Logan Sreemathi , Deak Ferenc
Published: January 2019

Cognitive impairment in the aging population is quickly becoming a health care priority, for which currently no disease-modifying treatment is available. Multiple domains of cognition decline with age even in the absence of neurodegenerative diseases. The cellular and molecular changes leading to cognitive decline with age remain elusive. Synaptobrevin-2 (Syb2), the major vesicular SNAP receptor protein, highly expressed in the cerebral cortex and hippocampus, is essential for synaptic transmission. We have analyzed Syb2 protein levels in mice and found a decrease with age. To investigate the functional consequences of lower Syb2 expression, we have used adult Syb2 heterozygous mice (Syb2+/−) with reduced Syb2 levels. This allowed us to mimic the age-related decrease of Syb2 in the brain in order to selectively test its effects on learning and memory. Our results show that Syb2+/− animals have impaired learning and memory skills and they perform worse with age in the radial arm water maze assay. Syb2+/− hippocampal neurons have reduced synaptic plasticity with reduced release probability and impaired long-term potentiation in the CA1 region. Syb2+/− neurons also have lower vesicular release rates when compared to WT controls. These results indicate that reduced Syb2 expression with age is sufficient to cause cognitive impairment.
An implicit discontinuous Galerkin method for modeling acute edema and resuscitation in the small intestine
Authors: Thompson Travis B , Riviere Beatrice M , Knepley Matthew G
Published: January 2019

Edema, also termed oedema, is a generalized medical condition associated with an abnormal aggregation of fluid in a tissue matrix. In the intestine, excessive edema can lead to serious health complications associated with reduced motility. A $7.5\%$ solution of hypertonic saline (HS) has been hypothesized as an effective means to reduce the effects of edema following surgery or injury. However, detailed clinical edema experiments can be difficult to implement, or costly, in practice. In this manuscript we introduce an implicit in time discontinuous Galerkin method with novel adaptations for modeling edema in the 3D layered physiology of the intestine. The model improves over early work via inclusion of the tissue intrinsic storage coefficient, and the effects of Starling overestimation for high venous pressures. Validation against a recent clinical experiment in HS resuscitation of acute edema is presented; the results support the clinical hypothesis that 7.5% HS solution may be effective in the resuscitation of acute edema formation. New results include an improved view into the effects of resuscitation on the hydrostatic pressure profile of edematous rats, effects on lumenal volume attenuation, relative fluid gain and an estimation of the impacts of both acute edema and resuscitation on intestinal motility.
Popular Progression Differences in Vector Spaces
Authors: Fox Jacob , Pham Huy Tuan
Published: January 2019

Green proved an arithmetic analog of Szemerédi’s celebrated regularity lemma and used it to verify a conjecture of Bergelson, Host, and Kra, which sharpens Roth’s theorem on three-term arithmetic progressions in dense sets. It shows that for every subset of $\mathbb{F}_p^n$ with $n$ sufficiently large, the density of three-term arithmetic progressions with some nonzero common difference is at least the random bound (the cube of the set density) up to an additive $\epsilon $. For a fixed odd prime $p$, we prove that the required dimension grows as an exponential tower of $p$’s of height $\Theta (\log (1/\epsilon ))$. This improves both the lower and upper bound, and is the first example of a result where a tower-type bound coming from applying a regularity lemma is shown to be necessary.
It Is About Trust: Trust in Sources of Tobacco Health Information, Perceptions of Harm, and Use of E-Cigarettes
Authors: Alcalá Héctor E , Shimoga Sandhya V
Published: January 2019

Introduction

Recent research has highlighted disparities in people who perceive as trustworthy sources of e-cigarette health information. Research has yet to examine if trusting a particular source of information is associated with use of e-cigarettes or perceptions of e-cigarette harm. We use a nationally representative survey of American adults to address these gaps in knowledge.

Methods

This study used data from the Health Information National Trends Survey (N = 3738). Logistic regression models were used to calculate odds of ever using e-cigarettes and perceived health harm of e-cigarettes. Trust in seven different sources of e-cigarette health information served as the independent variables. Models accounted for confounders.

Results

Trusting religious organizations “a lot” as sources of e-cigarette health information was associated with lower odds of ever using e-cigarettes and with lower odds of perceiving e-cigarettes as less harmful than conventional cigarettes. Trusting e-cigarette companies “a lot” as sources of e-cigarette health information was associated with lower odds of viewing e-cigarettes as harmful to health.

Conclusion

Trusting health information about e-cigarettes from sources in the medical or public health field was not associated with lower use of e-cigarettes or viewing e-cigarettes as more harmful. Trusting health information from e-cigarette companies yielded perceptions of e-cigarette harm that are consistent with messaging provided by these companies.

Implications

As use of e-cigarettes continues to climb, leveraging different modes of health communication will be critical to both discourage e-cigarette use among never-smokers and, potentially, to encourage use of e-cigarettes as an option to achieve smoking cessation or reduce the harm of tobacco products. Our findings suggest that religious organizations may be helpful in communicating anti-e-cigarette messages.
Effect of Diarrheal Illness During Pregnancy on Adverse Birth Outcomes in Nepal
Authors: Newman Kira L , Gustafson Kathryn , Englund Janet A , Magaret Amalia , Khatry Subarna , LeClerq Steven C , Tielsch James M , Katz Joanne , Chu Helen Y
Published: January 2019

Background

Adverse birth outcomes, including low birthweight, small for gestational age (SGA), and preterm birth, contribute to 60%–80% of infant mortality worldwide. Little published data exist on the association between diarrhea during pregnancy and adverse birth outcomes.

Methods

Data were used from 2 community-based, prospective randomized trials of maternal influenza immunization during pregnancy conducted in rural Nepal from 2011 to 2014. Diarrheal illnesses were identified through longitudinal household-based weekly symptom surveillance. Diarrhea episodes were defined as at least 3 watery bowel movements per day for 1 or more days with 7 diarrhea-free days between episodes. The Poisson and log-binomial regression were performed to evaluate baseline characteristics and association between diarrhea during pregnancy and adverse birth outcomes.

Results

A total of 527 of 3693 women in the study (14.3%) experienced diarrhea during pregnancy. Women with diarrhea had a median of 1 episode of diarrhea (interquartile range [IQR], 1–2 episodes) and 2 cumulative days of diarrhea (IQR, 1–3 days). Of women with diarrhea, 85 (16.1%) sought medical care. In crude and adjusted analyses, women with diarrhea during pregnancy were more likely to have SGA infants (42.6% vs 36.8%; adjusted risk ratio = 1.20; 95% confidence interval, 1.06–1.36; P = .005). Birthweight and preterm birth incidence did not substantially differ between women with diarrhea during pregnancy and those without.

Conclusions

Diarrheal illness during pregnancy was associated with a higher risk of SGA infants in this rural South Asian population. Interventions to reduce the burden of diarrheal illness during pregnancy may have an impact on SGA births in resource-limited settings.
Determining Interrater and Intrarater Levels of Agreement in Students and Clinicians When Visually Evaluating Movement Proficiency During Screening Assessments
Authors: Whelan Darragh , Delahunt Eamonn , O'Reilly Martin , Hernandez Belinda , Caulfield Brian
Published: January 2019

Background

Biomechanical screening assessments are used to provide useful information about an athlete's movement proficiency. Clinically, movement proficiency is typically evaluated visually. This can result in low levels of agreement, leading to difficulties in ensuring consistent athlete assessment.

Objective

The objective was to determine levels of agreement within and between physical therapists and physical therapist students when visually evaluating athletes’ movement proficiency during biomechanical screening assessments.

Design

This was an observational study.

Methods

Twenty-seven physical therapists and 20 physical therapist students assessed 100 video recordings of athletes performing 4 lower-extremity biomechanical screening assessments: squat, lunge, single leg squat, and deadlift. Analysis was completed on conditioned and unconditioned data. In the conditioned data, technique deviations were induced purposefully by the athletes. In the unconditioned data, deviations occurred naturally due to increased weight or movement complexity. In order to determine levels of agreement in the assessments, participants were required to classify the athletes’ movement as acceptable or aberrant. Each participant assessed the same video recordings on 2 separate occasions at least 30 days apart. Agreement levels were determined using Cohen κ and Fleiss κ.

Results

Kappa scores at an interrater level ranged from 0.18 to 0.53, and intrarater agreement ranged from 0.38 to 0.62. Levels of agreement were higher in the conditioned data compared with the unconditioned data. Overall, the lunge and squat produced higher levels of agreement than the deadlift and single-leg squat. Students and physical therapists demonstrated similar levels of agreement.

Limitations

Screening assessments were evaluated through the use of video analysis.

Conclusions

Greater efforts are needed to ensure standardization of movement analysis.
Understanding the Rise in Corporate Cash: Precautionary Savings or Foreign Taxes
Authors: Faulkender Michael W , Hankins Kristine W , Petersen Mitchell A
Published: January 2019

What has driven the dramatic rise in U.S. corporate cash? Using non-public data, we show that the run-up is not uniform across firms but is concentrated in the foreign subsidiaries of multinational firms. Standard precautionary motives explain only domestic cash holdings, not these burgeoning foreign cash balances. Falling foreign tax rates, coupled with relaxed restrictions on income shifting, are the root of the changing foreign cash patterns. Firms with intellectual property have the greatest ability to shift income to low tax jurisdictions, and their foreign subsidiaries are where we observe the largest accumulations of cash.

Received September 6, 2017; editorial decision August 22, 2018 by Editor David Denis. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
HIV Health Care Transition Readiness: Embracing the Opportunity and Challenge
Authors: Jones Sandra C. , Ng Yeow Chye , Ost Shelley R.
Published: January 2019

Because of effective treatment and prolonged survival, thousands of young adult people living with HIV will need to transfer their health care to adult care providers. However, many lack basic essential skills and are not prepared for this transition. Many providers do not assess transition readiness on a regular basis. Validated transition readiness assessment tools can help providers guide interventions based on identified skill and knowledge deficits. Our purpose was to describe the impact of incorporating a validated Transition Readiness Assessment Questionnaire (TRAQ) into clinical practice. A retrospective chart review of 48 patients with HIV, ages 22–24 years, showed that the use of the TRAQ significantly affected provider interventions in the area of medication management (odds ratio: 0.02). Overall, the use of the TRAQ did not increase clinical interventions; however, it enabled providers to identify knowledge or skill deficits not previously addressed and to plan future clinical interventions to meet individual patient needs.
Localized Lichen Myxedematosus With Plasma Cell Light Chain Restriction: Is It the Exception or the Rule?
Authors: Elwyn Lacey B. , Combs Angela , Villada Gabriel , Poulos Evangelos , Cespedes Yvana , Rodriguez-Vazquez Georgette , Albitar Maher , Karai Laszlo
Published: January 2019

Lichen myxedematosus is a chronic cutaneous mucinosis that can present on a spectrum from localized cutaneous lesions to systemic disease of scleromyxedema. The clinical presentation of localized cutaneous lichen myxedematosus is waxy lichenoid papules, nodules, and/or plaques that have histopathologic findings of mucin deposition and a variable degree of fibroblast proliferation. There is an absence of serum paraproteins, and there are no other systemic causes of cutaneous mucinosis such as thyroid disease. The pathogenesis of lichen myxedematosus is unknown. We report 3 cases of localized cutaneous lichen myxedematosus with a light chain–restricted plasmacytic component by in situ hybridization. Our findings deliver an insight for disease pathogenesis and highlight for the first time, the significance of plasma cells in lesions of localized cutaneous lichen myxedematosus. We suggest that plasma cell light chain restriction could represent a clue to distinguish localized cutaneous disease from systemic disease.
Primary Cutaneous Anaplastic Lymphoma Kinase–Positive Large B-Cell Lymphoma
Authors: Kempf Werner , Torricelli Rocco , Zettl Andreas , Zimmermann Anne-Katrin , Berisha Arbeneshe , Ghielmini Michele
Published: January 2019

Large B-cell lymphomas include several subtypes. Recently, anaplastic lymphoma kinase (ALK)-positive large B-cell lymphoma has been delineated as a distinct entity involving mostly lymph nodes and rarely affecting extranodal sites. We describe the first case of a primary cutaneous ALK-positive large B-cell lymphoma in a 48-year-old man with a solitary nodule on the back, and describe the histologic and phenotypic features. Accurate staging confirmed the absence of other lesions, and so surgical excision and postoperative local radiation therapy were initiated and resulted in complete remission. Two years later, extracutaneous spread with involvement of axillary lymph nodes occurred. Complete remission was achieved again by multiagent chemotherapy. Our case demonstrates that a primary cutaneous form of ALK-positive large B-cell lymphoma exists. The immunophenotypic analysis of cutaneous large B-cell lymphomas affecting the skin primarily or secondarily should include the assessment of ALK expression.
Primary Orbital Synovial Sarcoma Mimicking a Periocular Cyst
Authors: Portelli Francesca , Pieretti Giulia , Santoro Nicola , Gorelli Greta , De Giorgi Vincenzo , Massi Daniela , Dei Tos Angelo Paolo , Mazzini Cinzia
Published: January 2019

Synovial sarcoma (SS) is a high-grade soft-tissue sarcoma occurring predominantly in older children and young adults. Only approximately 7% occur in the head and neck region, with SS representing less than 0.1% of all head and neck cancers. Orbital location is exceedingly rare with only 8 cases reported so far in the literature. It is noted for its propensity for late local recurrences and metastases. Histologically, SS is monophasic, biphasic, or poorly differentiated and harbors a specific chromosomal translocation t(X;18)(p11.2;q11.2) in >95% of cases. In this article, we describe a case of monophasic SS primarily arising in the left supero-nasal orbital region in a 24-year-old woman, clinically mistaken for a periocular cyst. The case is peculiar for its highly unusual location and for its clinical deceptively benign appearance.
Corneal Endothelial Cell Density and Morphology After Phacoemulsification in Patients With Primary Open-Angle Glaucoma and Cataracts: 2-Year Results of a Randomized Multicenter Trial
Authors: Ianchulev Tsontcho , Lane Stephen , Masis Marisse , Lass Jonathan H. , Benetz Beth Ann , Menegay Harry J. , Price Francis W. , Lin Shan
Published: January 2019

Purpose:

To evaluate corneal endothelial cell density (ECD) and morphology 2 years after phacoemulsification in subjects from the COMPASS trial (ClinicalTrials.gov, NCT01085357) who had mild-to-moderate primary open-angle glaucoma and visually significant cataracts.

Methods:

The central corneal endothelium was evaluated by serial specular microscopy at 0 to 24 months. ECD, coefficient of variation, and percentage of hexagonal cells were evaluated by a central image analysis reading center and central corneal thickness (CCT) was evaluated by ultrasound pachymetry.

Results:

Of 131 subjects who underwent routine phacoemulsification, analyzable endothelial images at 24 months were available for 126 subjects (96.2%). Mean ± SD central ECD at baseline was 2453 ± 359 cells/mm2, decreasing by 10% ± 14% to 2195 ± 517 cells/mm2 at 3 months (P < 0.001) but stabilizing thereafter with mean endothelial cell loss (ECL) from baseline to 24 months of 9% ± 13% (P < 0.001). Twelve (9.5%) and 10 (7.9%) subjects experienced >30% ECL at 12 and 24 months, respectively. Neither coefficient of variation nor percentage of hexagonal cells changed significantly from baseline at any time point. Mean CCT was similar at baseline (550 ± 35 μm) and at 12 months (551 ± 37 μm) and 24 months (555 ± 35 μm). Age was significantly associated with ECL after cataract surgery (P = 0.02), but baseline intraocular pressure, number of glaucoma medications, and CCT were not. Similar results were observed in patients who underwent CyPass micro-stent implantation accompanying phacoemulsification.

Conclusions:

Phacoemulsification in eyes with mild-to-moderate primary open-angle glaucoma results in early ECL, with ECD stabilizing after 3 months and no effect on other endothelial stress markers up to 2 years postoperatively.
Novel Use of Telemedicine for Corneal Tissue Evaluation in Eye Banking: Establishing a Standardized Approach for the Remote Evaluation of Donor Corneas for Transplantation
Authors: Alabi Rolake O. , Ansin Amy , Clover Jameson , Wilkins John , Rao Naveen K. , Terry Mark A. , Tran Khoa D. , Sales Christopher S.
Published: January 2019

Purpose:

To determine the feasibility of using telemedicine consultations in the evaluation of recovered donor corneas for transplant suitability.

Methods:

This study aims to establish and test the minimum imaging requirements for telemedical consultations of corneal tissue by remote eye bank medical directors. Digital images from the slit lamp, optical coherence tomography, and/or specular microscope were assembled into telemedical consults and emailed to 4 eye bank medical directors (M.A.T., J.W., C.S.S., N.K.R.). Feedback on the minimum image requirements for each corneal finding was collected. After establishing a standardized imaging and presentation protocol, test cases were presented to the medical directors to examine the validity of these remote consults. To establish a benchmark for the study's parameters, one medical director (J.W.) examined each case in person after his initial remote review. Examiners were masked to each other's responses.

Results:

Minimum image requirements for determination of corneal findings were defined and were specific to each anatomic layer of the cornea (epithelial, stromal, or endothelial). Using a defined set of digital images for a set of common corneal findings, the rate of agreement between remote evaluators, eye bank staff, and the in-person evaluator was 100% (11 of 11 examples). For ambiguous test cases, remote evaluators agreed on 80% of the cases (4 of 5).

Conclusions:

Results from this pilot study suggest that telemedical review of corneal tissue using high-quality digital images may be adequate for accurate identification of specific corneal findings commonly encountered by eye banks.
Association Between Sleep Quality, Mood Status, and Ocular Surface Characteristics in Patients With Dry Eye Disease
Authors: Wu Mengliang , Liu Xin , Han Jing , Shao Tingting , Wang Yan
Published: January 2019

Purpose:

To evaluate sleep and mood status in patients with dry eye disease (DED) and analyze the association between sleep quality, mood status, and ocular surface characteristics.

Methods:

Consecutive patients with DED (N = 106) and age- and sex-matched healthy controls (N = 50) were enrolled. Tear fluid break up time (TBUT), corneal fluorescein staining, and Schirmer I tests were performed in the order listed here to evaluate dry eye. A visual analog scale was used to assess dry eye symptom severity. All subjects also completed the Pittsburgh Sleep Quality Index (PSQI, scores ≥5.5 indicated poor sleep), Patient Health Questionnaire (scores ≥5 indicated depression), and General Anxiety Disorder Scale (scores ≥5 indicated anxiety).

Results:

Mean Pittsburgh Sleep Quality Index global score was significantly higher in patients with DED than that in controls (7.8 ± 3.9 vs. 5.4 ± 3.0, respectively; P < 0.001). Patients with DED demonstrated higher respective depression and anxiety scores compared with controls (P < 0.001 and 0.013, respectively). In the DED group, patients with poor sleep quality had more severe DED indicated by shorter TBUT and lower Schirmer I findings. A significant correlation was found between sleep quality and mood status in patients with DED. Regression analysis revealed that shorter TBUT and lower Schirmer I test results were associated with poorer sleep quality (adjusted p = 0.011 and 0.037, respectively). More severe symptoms of dry eye were significantly associated with a higher level of anxiety in patients with DED (adjusted p = 0.011).

Conclusions:

Sleep quality may play an important role in the development of DED by influencing tear secretion and tear film stability and/or by indirectly aggravating anxiety and depression, leading to higher self-reported symptom scores. It is also possible that DED contributes to reduced sleep quality, as well as the development of anxiety and depression.
Posttransplant maintenance therapy for acute leukemias
Authors: Poudel Shyam K. , de Lima Marcos , Metheny Leland
Published: January 2019

Purpose of review

Allogeneic hematopoietic stem cell transplantation cures a significant proportion of patients with hematological malignancies. Unfortunately, leukemia recurrence is the main cause of transplant failure. Risk factors for relapse include presence of minimal residual disease and a variety of well-recognized leukemia prognostic factors. Posttransplant therapy could decrease the risk of leukemia relapse and is under investigation. In this review, we summarize the current research in maintenance therapy for the prevention of acute leukemia recurrence after allogeneic transplant.

Recent findings

Epigenetic modifiers, tyrosine kinase inhibitors, and antibody–drug conjugates are among potential maintenance therapies given their side-effect profile and many are currently under investigation. In the posttransplant setting, the phase I/II data are maturing and have been encouraging enough to lead to the initiation of multicenter phase III randomized clinical trials.

Currently, there is no standard of care for posttransplant maintenance for acute leukemias. Further investigation into the efficacy and safety of posttransplant maintenance is warranted given phase I/II clinical trials results. Beyond chemo-immunotherapy, the use of targeted cellular therapy, such as chimeric antigen receptor T cells, is a potential therapy as well.
Arguments against routine administration of probiotics for NEC prevention
Authors: Pell Lisa G. , Loutet Miranda G. , Roth Daniel E. , Sherman Philip M.
Published: January 2019

Purpose of review

Necrotizing enterocolitis (NEC) is a leading cause of morbidity and mortality among premature neonates. Although randomized trials have shown that probiotics may be efficacious in the prevention of NEC, their use has not been universally adopted in the neonatal intensive care unit (NICU). Caveats regarding routine probiotic supplementation for the prevention of NEC are summarized in this review.

Recent findings

Accumulating evidence indicates that prophylactic probiotic supplementation in preterm infants can reduce the incidence of NEC. However, substantial knowledge gaps, regulatory issues, and implementation challenges should be addressed before probiotics are introduced as standard of care for all preterm neonates. Limitations of published trial data have made it challenging to define regimens that optimize efficacy and safety in specific patient subgroups. Moreover, the current probiotic market lacks rigorous regulatory oversight, which could raise concerns about the quality and safety of probiotic products. Finally, implementation pitfalls include risks of cross-colonization and resource requirements to monitor and mitigate potential adverse events.

Probiotics have shown promise in the prevention of NEC. However, there is insufficient evidence to guide the selection of optimal regimens. Furthermore, issues related to regulatory and institutional oversight should be addressed before supplementation is routinely implemented in NICUs.
Hormonal Contraceptives and the Acquisition of Sexually Transmitted Infections: An Updated Systematic Review
Authors: McCarthy Katharine J. , Gollub Erica L. , Ralph Lauren , van de Wijgert Janneke , Jones Heidi E.
Published: January 2019

Background

Evidence suggests that some forms of hormonal contraception (HC) increase women's risk of non-human immunodeficiency virus sexually transmitted infections (STIs), yet evidence has not been reviewed since 2008. We conducted an updated systematic review to incorporate studies published between January 2009 and June 2017 to examine the relationship between HCs and incident or recurrent STIs.

Methods

We searched PubMed and EMBASE to identify prospective studies comparing risk of Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus (HPV), herpes simplex virus type 2 (HSV-2), Treponema pallidum, or Trichomonas vaginalis, between women using HC versus nonhormonal methods or no methods. We summarize results by type of STI and HC and study quality using an adapted Newcastle-Ottawa Quality Assessment Scale.

Results

Thirty articles met the inclusion criteria. Depo-medroxyprogesterone acetate (DMPA) reduces the risk of trichomoniasis (consistent evidence) and may increase the risk of HSV-2 (strong effect, few studies); inconclusive evidence exists for HPV, chlamydia, gonorrhea, and syphilis. Data on oral contraceptive pills (OCPs; generally not differentiated whether combined or progestin-only pills) suggest that use is associated with a reduced risk of trichomoniasis with inconclusive findings for HSV-2, HPV, chlamydia, gonorrhea, and syphilis. Very few studies included norethisterone enanthate (Net-En) injectable, implants or the levonorgestrel intrauterine device.

Conclusions

Depo-medroxyprogesterone acetate and OCPs reduce the risk of trichomoniasis and DMPA may increase the risk of HSV-2. However, the potential for confounding cannot be ruled out. Future studies should specify the type of injectable or OCP used to increase understanding of biological pathways; more research is needed on implants and hormonal intrauterine devices.
Histologic Response to Neoadjuvant Therapy Is Not Predictive of Favorable Outcomes in High-grade Pleomorphic Soft Tissue Sarcoma
Authors: Cates Justin M.M.
Published: January 2019

The College of American Pathologists recommends reporting the histologic response of soft tissue sarcomas (STS) to neoadjuvant therapy, presumably as an assessment of chemosensitivity and a prognostic indicator, despite lack of evidence of clinical utility as such. This study examines whether extent of neoadjuvant therapy effect in STS is a favorable prognostic factor for disease-free survival. Extent of tumor necrosis and stromal hyalinization/fibrosis were determined in 143 high-grade, nonmetastatic, pleomorphic STS of the extremity or trunk. Multivariable nonlinear Cox proportional hazard regression was used to evaluate the prognostic impact of tumor necrosis and fibrosis. Cross-model comparisons of regression coefficients from nested parametric survival models were used to investigate possible effects of multicollinearity (inverse correlation) between tumor necrosis and fibrosis. Increasing tumor necrosis after neoadjuvant therapy (with or without adjusting for fibrosis) was associated with increased hazard ratios. In contrast, hazard ratios for increasing tumor fibrosis did not significantly change when unadjusted for necrosis, but were similar to necrosis after adjusting for tumor necrosis. This suggests that tumor fibrosis evolves as a reparative response to regional tumor necrosis, a conclusion supported by evidence that extent of tumor fibrosis was positively correlated with interval between initiation of neoadjuvant therapy and surgical resection. Increasing amounts of tumor necrosis observed in STS after neoadjuvant therapy are not indicative of a good therapeutic response or better prognosis. Instead, tumor necrosis simply reflects higher histologic grade and biological aggressiveness. Stromal hyalinization/fibrosis is not an independent prognostic factor either, and likely represents organization of prior tumor necrosis.
Functional Capacity Change Impacts the Quality of Life of Hospitalized Patients Undergoing Hematopoietic Stem Cell Transplantation
Authors: de Almeida Leonardo Barbosa , Mira Pedro Augusto de Carvalho , Fioritto Aline Priori , Malaguti Carla , Hallack Neto Abrahão Elias , Fernandes Trevizan Patrícia , Laterza Mateus Camaroti , Martinez Daniel Godoy
Published: January 2019

Objective

The aim of the study was to compare the quality of life (QOL) of patients undergoing hematopoietic stem cell transplantation who improved their functional capacity during hospitalization (increased functional capacity group) with that of patients who maintained or decreased functional capacity during hospitalization (decreased functional capacity group).

Design

This observational, longitudinal study included 27 hospitalized patients undergoing hematopoietic stem cell transplantation. Patients were divided into increased functional capacity group (16 patients) and decreased functional capacity group (11 patients). Functional capacity (6-min step test), peripheral muscle strength (sit-to-stand test and handgrip strength), and QOL (European Organization for Research and Treatment of Cancer) were assessed at admission and at hospital discharge.

Results

Increased functional capacity patients had increased functional capacity and peripheral muscle strength of the lower and upper limbs at hospital discharge (P < 0.01, <0.01, and 0.02, respectively). The patients in the increased functional capacity group demonstrated an increase in global health and reduced symptoms at discharge (P = 0.02 and 0.03, respectively). No significant differences were observed between groups in the functional domain.

Conclusions

Patients undergoing hematopoietic stem cell transplantation, who have improved functional capacity at discharge, also experience an improved QOL, with no such improvement noted among patients who have stable or reduced functional capacity. We recommend that the treatment protocol for hospitalized patients undergoing hematopoietic stem cell transplantation include an exercise program aimed at improving functional capacity.
Testosterone Replacement Therapy and Rehospitalization in Older Men With Testosterone Deficiency in a Postacute Care Setting
Authors: Al-Lami Rasha A. , Graham James E. , Deer Rachel R. , Westra Jordan , Williams Stephen B. , Kuo Yong-Fang , Baillargeon Jacques
Published: January 2019

Objective

The aim of the study was to examine whether receipt of testosterone replacement therapy was associated with reduced 30-day rehospitalization after postacute care among older men with testosterone deficiency.

Design, Patients, and Methods

We conducted a retrospective cohort study using a 5% national sample of Medicare beneficiaries. We identified 1290 nonsurgical inpatient postacute care discharges between January 1, 2007, and October 31, 2014, for male patients, 66 yrs or older, with a previous diagnosis of testosterone deficiency. Multivariable logistic regression was used to calculate odds ratios and 95% confidence intervals for 30-day postacute care rehospitalization related to receipt of testosterone replacement therapy.

Results

In older men with testosterone deficiency, receipt of testosterone replacement therapy was not associated with rehospitalization (odds ratio = 0.87, 95% confidence interval, 0.59–1.29) in the 30 days after postacute care discharge. These findings persisted after adjustment for quintile of propensity scores (odds ratio = 0.90, 95% confidence interval = 0.62–1.30).

Conclusion

Testosterone replacement therapy was not associated with reduced rehospitalization after postacute care discharge in older men with testosterone deficiency. Further research in this population should examine the effects of testosterone replacement therapy on functional recovery and community independence.
Virological Outcome of Patients With HIV Drug Resistance Attending an Urban Outpatient Clinic in Uganda: A Need for Structured Adherence Counseling and Third-Line Treatment Options
Authors: Baumann Anna , Musaazi Joseph , Kambugu Andrew , Kälin Marisa , Weissberg Dana , Ssemwanga Deogratius , Fehr Jan , Castelnuovo Barbara , Sekaggya-Wiltshire Christine , von Braun Amrei
Published: January 2019

Background:

HIV drug resistance and suboptimal adherence are the main reasons for treatment failure among HIV-infected individuals. As genotypic resistance testing is not routinely available in resource-limited settings such as Uganda, data on transmitted and acquired resistance are sparse.

Methods:

This observational follow-up study assessed the virological outcomes of patients diagnosed with virological failure or transmitted HIV drug resistance in 2015 at the adults' outpatient clinic of the Infectious Diseases Institute in Kampala, Uganda. Initially, 2430 patients on antiretroviral therapy (ART) underwent virological monitoring, of which 190 had virological failure and were subsequently eligible for this follow-up study. Nine patients diagnosed with transmitted drug resistance were eligible. In patients with a viral load > 1000 copies/mL, genotypic resistance testing was performed.

Results:

Of 190 eligible patients, 30 (15.8%) had either died or were lost to follow-up. A total of 148 (77.9%) were included, of which 98 had had a change of ART regimen, and 50 had received adherence counseling only. The majority was now on second-line ART (N = 130, 87.8%). The median age was 39 years (interquartile range: 32–46), and 109 (73.6%) were women. Virological failure was diagnosed in 29 (19.6%) patients, of which 24 (82.8%) were on second-line ART. Relevant drug resistance was found in 25 (86.2%) cases, of which 12 (41.3%) carried dual and 7 (24.1%) triple drug resistance.

Conclusion:

Two years after initial virological failure, most patients followed up by this study had a successful virological outcome. However, a significant proportion either continued to fail or died or was lost to follow-up.
Young Women's Stated Preferences for Biomedical HIV Prevention: Results of a Discrete Choice Experiment in Kenya and South Africa
Authors: Minnis Alexandra M. , Browne Erica N. , Boeri Marco , Agot Kawango , van der Straten Ariane , Ahmed Khatija , Weinrib Rachel , Mansfield Carol ,   on behalf of the TRIO Study Team
Published: January 2019

Background:

Integrating end-user perspectives into the design of new biomedical HIV prevention products is recognized as vital to informing the product development pipeline.

Setting:

Kisumu, Kenya; and Soshanguve, South Africa.

Methods:

We conducted a discrete choice experiment survey with 536 women aged 18–30 years to assess preferences for hypothetical HIV prevention products characterized by the attributes of efficacy, pregnancy prevention, delivery form, dosing frequency, and side effects. Participants included product-experienced women from Tablet, Ring, Injection as Options TRIO, a cross-over clinical study evaluating 3 placebo delivery forms (oral tablets, vaginal rings, and injections), and a product-naive sample recruited from the same communities. Analyses used random parameters logit and latent class models.

Results:

HIV prevention efficacy was a strong determinant of stated choice overall; however, in South Africa, delivery form was just as important, with an injection every 2–3 months most preferred and a daily oral tablet least preferred. In Kenya, product-experienced women preferred monthly injections and least preferred a monthly ring. Respondents indicated a preference for multipurpose prevention technologies that combine HIV and pregnancy protection. Latent class analyses confirmed these findings and delineated heterogeneity in preferences across subgroups defined by age, past experience with the delivery forms, and education.

Conclusions:

Despite an overall preference for products with high efficacy, we identified attributes salient to future uptake and use of HIV prevention products. Preferences for injectable products underscored interest in this pre-exposure prophylaxis delivery form. Likewise, the multipurpose prevention technology feature was valued in both Kenya and South Africa and most influenced interest in vaginal rings.
Patient Perceptions of Gout Management Goals
Authors: Singh Jasvinder A. , Edwards N. Lawrence
Published: January 2019

Objective

To assess patient perceptions of gout management goals.

Methods

We conducted a cross-sectional Internet survey of people who visited the Gout and Uric Acid Education Society’s website to assess patient/respondent perception of gout management goals. We used chi-square test for categorical or t-test for continuous variables.

Results

Among the 320 survey respondents with physician-diagnosed gout, mean age was 57 (SD, 13.4) years, 72% were male, 77% White; mean gout duration was 7.6 years (SD, 11), gout flares in the last year were 5.2 (SD, 6.1), and medical comorbidities were common, 2.7 (SD, 2.6). Two-thirds respondents each reported very severe or severe symptoms from gout and that gout ranked among the top two health conditions with a negative impact on quality of life. During a clinic visit, only one-third of respondents’ physicians spent 50% of more of the time discussing gout treatment. Only 54% respondents were prescribed ULT by their healthcare provider. By patient preference, the best life-long gout treatment strategies were the lowering of the serum urate level and the control of gout symptoms (62%) followed by serum urate lowering (32%). Respondents considered the following as the most important things for making gout treatment satisfactory: (1) patient education; (2) effective physician–patient communication; (3) diet and lifestyle modification; (4) serum urate monitoring and target achievement; (5) pain management and flare prevention; and (6) medication management.

Conclusions

Patient identification of gout symptom control and serum urate level monitoring as the most important treatment goals is informative for clinicians and guideline developers.
The Effect of Blepharoplasty on Our Patient's Quality of Life, Emotional Stability, and Self-Esteem
Authors: Papadopulos Nikolaos A. , Hodbod Michael , Henrich Gerhard , Kovacs Lazlo , Papadopoulos Othon , Herschbach Peter , Machens Hans-Günther
Published: January 2019

Background:

Several studies have been conducted evaluating psychological effects following aesthetic surgery, however few of them following blepharoplasty!

Purpose:

To determine whether blepharoplasty affects quality of life and satisfaction as well as, emotional stability and self-esteem in patients who underwent only blepharoplasty.

Design:

A retrospective study including transdermal blepharoplasty operations between the years 1995 and 2008.

Methods:

A self-developed and indication-specific questionnaire especially for blepharoplasty, as well as the standardized testing instruments FLZM, FPI-R, and RSES, concerning quality of life, body image, personality, and self-esteem was utilized.

Participants:

A total of 123 patients were included in the study. Forty-six patients participated in the study.

Main Outcomes and Measures:

Results were compared with the existing representative norm data from the German speaking countries.

Results:

In the indication-specific questionnaire, 44 patients reported a positive influence on their personal wellbeing, and 33 were more satisfied with their appearance (follow-up 3–95 months; average 48.5 months); 20 felt more self-confident, and 25 felt more attractive.

Statistically significant increased values in quality of life (FLZM) were found in the aspects work (P = 0.02), mobility (
P
 < 0.001) and independence from assistance or help (P < 0.001).

Higher scores concerning personality and self-esteem compared with the respective random sample were found in the questionnaires FPI-R (P = 0.02) and RSES (P < 0.001).

Conclusion and Relevance:

Among plastic surgical interventions, blepharoplasty is a minimal invasive operation, which is very well tolerated by patients. Patients take advantage in personal wellbeing, self-esteem, and different aspects of their daily life.
The Role of Preoperative Computed Tomography in Nonsyndromic Craniosynostosis
Authors: Alnaif Nayif , Zhou Mingsha , Galli Rafael , Azzi Alain J. , Alamri Abdulrahman , Gilardino Mirko
Published: January 2019

Background:

There is currently no consensus on the utility of preoperative computed tomography (CT) in nonsyndromic craniosynostosis. This systematic review and meta-analysis examines the evidence available on the necessity of preoperative CT for the treatment of nonsyndromic craniosynostosis.

Methods:

A comprehensive literature review of the National Library of Medicine (PubMed) database was performed. The following variables were analyzed: concordance of findings between clinical examinations and CT, incidental findings reported on imaging, and the effect of imaging on subsequent management. Concordance between clinical examination/CT and the presence of incidental findings were collected and displayed as descriptive data. The effect of imaging on subsequent diagnosis/management was analyzed by meta-analysis.

Results:

Eleven studies met the inclusion criteria for a total of 728 patients. Overall, physical examination concordance with CT diagnosis was 97.9% (371/379). Overall, incidental findings led to additional imaging/workup in 1.79% of cases (5/278). The results of the meta-analysis revealed that, in the absence of alternative imaging modalities, CT scans significantly altered diagnosis or led to additional investigations in 12 cases (4.8%, 95% confidence interval = 3%–8%). Preoperative CT scans led to additional investigations in 5 cases and detected incomplete/wrong diagnoses in 7 cases.

Conclusions:

The results of the present meta-analysis support the use of preoperative CT scans for nonsyndromic craniosynostosis in the absence of alternative imaging modalities. The results also suggest that in properly selected patients, alternative imaging modalities may be appropriate, potentially obviating the need for CT scans.