bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Intensity and Simultaneous Alcohol and Marijuana use among High School Seniors in the United States
Authors: Patrick Megan E. , Veliz Philip T. , Terry-McElrath Yvonne M.
Published: July 2017

Background

Simultaneous alcohol and marijuana (SAM) use poses threats to health, particularly among adolescents. These risks would be exacerbated to the extent that high-intensity drinking (e.g., 10+ drinks in a row) and marijuana use (e.g., 1+ joints per day) are associated with a higher likelihood of SAM use. The current study examines the extent to which the intensity of alcohol use and of marijuana use are associated with adolescent SAM use prevalence, and whether associations remain after controlling for key covariates known to associate with both alcohol and marijuana use; it identifies alcohol and marijuana use intensity levels associated with the highest risk of adolescent SAM use.

Methods

Data come from nationally representative samples of US 12th graders who participated in the Monitoring the Future study from 2005 to 2014 ( N = 24,203 respondents; 48.4% boys, 51.6% girls).

Results

SAM use during the past year was reported by 20% of 12th graders overall. SAM use prevalence was strongly and positively associated with alcohol and marijuana use intensity even after controlling for covariates. High school seniors at highest risk for engaging in SAM use were those who reported 10+ drinks and those smoking at least 1 joint/day. Approximately 60% of those who had 10–14 or 15+ drinks in a row during the past 2 weeks and 76%–80% of those who had 1 or 2+ joints per day on average during the past 30 days reported SAM use.

Conclusions

Results suggest that high school seniors who consume high quantities of alcohol and marijuana are very likely to consume these substances so that their effects overlap.
Ann Miller: Shaping cells and scientists
Authors: O’Donnell Marie Anne
Published: July 2017

Miller studies how the cytoskeleton controls cellular shape change.
pLoc-mAnimal: predict subcellular localization of animal proteins with both single and multiple sites
Authors: Cheng Xiang , Zhao Shu-Guang , Lin Wei-Zhong , Xiao Xuan , Chou Kuo-Chen
Published: July 2017

Motivation

Cells are deemed the basic unit of life. However, many important functions of cells as well as their growth and reproduction are performed via the protein molecules located at their different organelles or locations. Facing explosive growth of protein sequences, we are challenged to develop fast and effective method to annotate their subcellular localization. However, this is by no means an easy task. Particularly, mounting evidences have indicated proteins have multi-label feature meaning that they may simultaneously exist at, or move between, two or more different subcellular location sites. Unfortunately, most of the existing computational methods can only be used to deal with the single-label proteins. Although the ‘iLoc-Animal’ predictor developed recently is quite powerful that can be used to deal with the animal proteins with multiple locations as well, its prediction quality needs to be improved, particularly in enhancing the absolute true rate and reducing the absolute false rate.

Results

Here we propose a new predictor called ‘pLoc-mAnimal’, which is superior to iLoc-Animal as shown by the compelling facts. When tested by the most rigorous cross-validation on the same high-quality benchmark dataset, the absolute true success rate achieved by the new predictor is 37% higher and the absolute false rate is four times lower in comparison with the state-of-the-art predictor.

Availability and implementation

To maximize the convenience of most experimental scientists, a user-friendly web-server for the new predictor has been established at http://www.jci-bioinfo.cn/pLoc-mAnimal/, by which users can easily get their desired results without the need to go through the complicated mathematics involved.

Supplementary information

Supplementary data are available at Bioinformatics online.
Authenticity, Artifice, and Ovid’s
Heroides
in Mary Stuart’s Casket Sonnets
Authors: DeVos Jessica
Published: July 2017

This article responds to the interpretative legacy emphasizing English reception of Mary Stuart’s Casket Sonnets, by situating the poems within a context of French Renaissance literary production. It begins by elucidating how a specific biographical reading was put into place strategically by the Scottish queen’s political adversaries and disseminated in early print editions, as well as how this tradition continues to inform modern readings. The remainder of the article proposes an alternative reading that highlights the author’s intertextual borrowing from Ovid’s
Heroides
. Particular attention is paid to claims of ‘sincerity’, both as the central literary topos around which the Casket Sonnets are rhetorically structured and as a critical term of assessment applied to the work of Renaissance lyric poets.
3D printed mitral valve models: affordable simulation for robotic mitral valve repair
Authors: Premyodhin Ned , Mandair Divneet , Ferng Alice S , Leach Timothy S , Palsma Ryan P , Albanna Mohammad Z , Khalpey Zain I
Published: July 2017

OBJECTIVES

3D printed mitral valve (MV) models that capture the suture response of real tissue may be utilized as surgical training tools. Leveraging clinical imaging modalities, 3D computerized modelling and 3D printing technology to produce affordable models complements currently available virtual simulators and paves the way for patient- and pathology-specific preoperative rehearsal.

METHODS

We used polyvinyl alcohol, a dissolvable thermoplastic, to 3D print moulds that were casted with liquid platinum-cure silicone yielding flexible, low-cost MV models capable of simulating valvular tissue. Silicone-moulded MV models were fabricated for 2 morphologies: the normal MV and the P2 flail. The moulded valves were plication and suture tested in a laparoscopic trainer box with a da Vinci Si robotic surgical system. One cardiothoracic surgery fellow and 1 attending surgeon qualitatively evaluated the ability of the valves to recapitulate tissue feel through surveys utilizing the 5-point Likert-type scale to grade impressions of the valves.

RESULTS

Valves produced with the moulding and casting method maintained anatomical dimensions within 3% of directly 3D printed acrylonitrile butadiene styrene controls for both morphologies. Likert-type scale mean scores corresponded with a realistic material response to sutures (5.0/5), tensile strength that is similar to real MV tissue (5.0/5) and anatomical appearance resembling real MVs (5.0/5), indicating that evaluators ‘agreed’ that these aspects of the model were appropriate for training. Evaluators ‘somewhat agreed’ that the overall model durability was appropriate for training (4.0/5) due to the mounting design. Qualitative differences in repair quality were notable between fellow and attending surgeon.

CONCLUSIONS

3D computer-aided design, 3D printing and fabrication techniques can be applied to fabricate affordable, high-quality educational models for technical training that are capable of differentiating proficiency levels among users.
Hybrid surgery–radiosurgery therapy for metastatic epidural spinal cord compression: A prospective evaluation using patient-reported outcomes
Authors: Barzilai Ori , Amato Mary-Kate , McLaughlin Lily , Reiner Anne S , Ogilvie Shahiba Q , Lis Eric , Yamada Yoshiya , Bilsky Mark H , Laufer Ilya
Published: July 2017

Background

Patient-reported outcomes (PRO) represent an important measure of cancer therapy effect. For patients with metastatic epidural spinal cord compression (MESCC), hybrid therapy using separation surgery and stereotactic radiosurgery preserves neurologic function and provides tumor control. There is currently a paucity of data reporting PRO after such combined modality therapy for MESCC. Delineation of hybrid surgery–radiosurgery therapy effect on PRO validates the hybrid approach as an effective therapy resulting in meaningful symptom relief.

Patients and Methods

Brief Pain Inventory (BPI) and MD Anderson Symptom Inventory—Spine Tumor (MDASI-SP), PROs validated in the cancer population, were prospectively collected. Patients with MESCC who underwent separation surgery followed by stereotactic radiosurgery were included. Separation surgery included a posterolateral approach without extensive cytoreductive tumor excision. A median postoperative radiosurgery dose of 2700 cGy was delivered. The change in PRO 3 months after the hybrid therapy represented the primary study outcome. Preoperative and postoperative evaluations were analyzed using the Wilcoxon signed-rank test for matched pairs.

Results

One hundred eleven patients were included. Hybrid therapy resulted in a significant reduction in the BPI items “worst” and “right now” pain (P < .0001), and in all BPI constructs (severity, interference with daily activities, and pain experience, P < .001). The MDASI-SP demonstrated reduction in spine-specific pain severity and interference with general activity (P < .001), along with decreased symptom interference (P < .001).

Conclusions

Validated PRO instruments showed that in patients with MESCC, hybrid therapy with separation surgery and radiosurgery results in a significant decrease in pain severity and symptom interference. These prospective data confirm the benefit of hybrid therapy for treatment of MESCC and should facilitate referral of patients with MESCC for surgical evaluation.
Cost-Effectiveness Analysis of Probiotic Use to Prevent Clostridium difficile Infection in Hospitalized Adults Receiving Antibiotics
Authors: Shen Nicole T , Leff Jared A , Schneider Yecheskel , Crawford Carl V , Maw Anna , Bosworth Brian , Simon Matthew S
Published: July 2017

Background

Systematic reviews with meta-analyses and meta-regression suggest that timely probiotic use can prevent Clostridium difficile infection (CDI) in hospitalized adults receiving antibiotics, but the cost effectiveness is unknown. We sought to evaluate the cost effectiveness of probiotic use for prevention of CDI versus no probiotic use in the United States.

Methods

We programmed a decision analytic model using published literature and national databases with a 1-year time horizon. The base case was modeled as a hypothetical cohort of hospitalized adults (mean age 68) receiving antibiotics with and without concurrent probiotic administration. Projected outcomes included quality-adjusted life-years (QALYs), costs (2013 US dollars), incremental cost-effectiveness ratios (ICERs; $/QALY), and cost per infection avoided. One-way, two-way, and probabilistic sensitivity analyses were conducted, and scenarios of different age cohorts were considered. The ICERs less than $100000 per QALY were considered cost effective.

Results

Probiotic use dominated (more effective and less costly) no probiotic use. Results were sensitive to probiotic efficacy (relative risk <0.73), the baseline risk of CDI (>1.6%), the risk of probiotic-associated bactermia/fungemia (<0.26%), probiotic cost (<$130), and age (>65). In probabilistic sensitivity analysis, at a willingness-to-pay threshold of $100000/QALY, probiotics were the optimal strategy in 69.4% of simulations.

Conclusions

Our findings suggest that probiotic use may be a cost-effective strategy to prevent CDI in hospitalized adults receiving antibiotics age 65 or older or when the baseline risk of CDI exceeds 1.6%.
Plasmodium falciparum Histidine-Rich Protein-2 Plasma Concentrations Are Higher in Retinopathy-Negative Cerebral Malaria Than in Severe Malarial Anemia
Authors: Park Gregory S , Opoka Robert O , Shabani Estela , Wypyszynski Alexis , Hanisch Benjamin , John Chandy C
Published: July 2017

Background

Malaria retinopathy has been proposed as marker of “true” cerebral malaria (CM), ie, coma due to Plasmodium falciparum vs coma due to other causes, with incidental P falciparum parasitemia. Plasma P falciparum histidine-rich protein-2 (PfHRP2) concentrations distinguish retinopathy-positive (RP) from retinopathy-negative (RN) CM but have not been compared between RN CM and other forms of severe malaria or asymptomatic parasitemia (AP).

Methods

We compared plasma PfHRP2 concentrations in 260 children with CM (247 examined for retinopathy), 228 children with severe malarial anemia (SMA), and 30 community children with AP.

Results

Plasmodium falciparum HRP2 concentrations were higher in children with RP CM than RN CM (P = .006), with an area under the receiver operating characteristic curve of 0.61 (95% confidence interval, 0.53–0.68). Plasmodium falciparum HRP2 concentrations and sequestered parasite biomass were higher in RN CM than SMA (both P < .03) or AP (both P < .001).

Conclusions

Plasmodium falciparum HRP2 concentrations are higher in children with RN CM than in children with SMA or AP, suggesting that P falciparum is involved in disease pathogenesis in children with CM. Plasmodium falciparum HRP2 concentrations may provide a more feasible and consistent assessment of the contribution of P falciparum to severe disease than malaria retinopathy.
Single Level Proximal Thoracic Pedicle Subtraction Osteotomy for Fixed Hyperkyphotic Deformity: Surgical Technique and Patient Series
Authors: Obeid Ibrahim , Diebo Bassel G , Boissiere Louis , Bourghli Anouar , Cawley Derek T , Larrieu Daniel , Pointillart Vincent , Challier Vincent , Vital Jean Marc , Lafage Virginie
Published: July 2017

BACKGROUND

Thoracic hyperkyphosis can display pathological deterioration, resulting in either hyperlordotic cervical compensation or sagittal malalignment. Various techniques have been described to treat fixed malalignment. Pedicle subtraction osteotomy (PSO) is commonly used in the lumbar spine and frequently limited to the distal thoracic spine. This series focuses on the surgical specificities of proximal thoracic PSO, with clinical and radiological outcomes.

OBJECTIVE

To report the surgical specificities and assess the clinical and radiological outcomes of proximal thoracic osteotomies for correction of rigid kyphotic deformities.

METHODS

This is a retrospective review of 10 consecutive patients who underwent single level proximal thoracic PSO (T2-T5). Preoperative and postoperative full-body EOSTM radiographs, perioperative data, and complications were recorded. The surgical technique and its nuances were described in detail.

RESULTS

Patients had mean age of 41.8 yr and 50% were female. The technique provided correction of segmental and global kyphosis, 26.6° and 29.5°, respectively. Patients reported reciprocal reduction in C2-C7 cervical lordosis (37.6°-18.6°, P < .001), significantly correlating with the reduction of thoracic hyperkyphosis (R = 0.840, P = .002). Mean operative time was 291 min, blood loss 1650 mL, and mean hospital stay was 13.8 d. Three patients reported complications that were resolved, including 1 patient who was revised because of a painful cross link. There were no neurological complications, pseudarthroses, instrumentation breakage, or wound infections at a minimum of 2-yr follow-up.

CONCLUSION

Proximal thoracic PSO can be a safe and effective technique to treat fixed proximal thoracic hyperkyphosis leading to kyphosis reduction and craniocervical relaxation.
Trans-Sulcal Endoport-Assisted Evacuation of Supratentorial Intracerebral Hemorrhage: Initial Single-Institution Experience Compared to Matched Medically Managed Patients and Effect on 30-Day Mortality
Authors: Sujijantarat Nanthiya , Tecle Najib El , Pierson Matthew , Urquiaga Jorge F , Quadri Nabiha F , Ashour Ahmed M , Khan Maheen Q , Buchanan Paula , Kumar Abhay , Feen Eli , Coppens Jeroen
Published: July 2017

BACKGROUND

The surgical management of supratentorial intracerebral hemorrhages (ICH) remains controversial due to large trials failing to show clear benefits. Several minimally invasive techniques have emerged as an alternative to a conventional craniotomy with promising results.

OBJECTIVE

To report our experience with endoport-assisted surgery in the evacuation of supratentorial ICH and its effects on outcome compared to matched medical controls.

METHODS

Retrospective data were gathered of patients who underwent endoport-assisted evacuation between January 2014 and October 2016 by a single surgeon. Patients who were managed medically during the same period were matched to the surgical cohort. Previously published cohorts investigating the same technique were analyzed against the present cohort.

RESULTS

Sixteen patients were identified and matched to 16 patients treated medically. Location, hemorrhage volume, and initial Glasgow Coma Scale (GCS) score did not differ significantly between the 2 cohorts. The mean volume reduction in the surgical cohort was 92.05% ± 7.05%. The improvement in GCS in the surgical cohort was statistically significant (7-13, P = .006). Compared to the medical cohort, endoport-assisted surgery resulted in a statistically significant difference in in-hospital mortality (6.25% vs 75.0%, P < .001) and 30-d mortality (6.25% vs 81.25%, P < .001). Compared to previously published cohorts, the present cohort had lower median preoperative GCS (7 vs 10, P = .02), but postoperative GCS did not differ significantly (13 vs 14, P = .28).

CONCLUSION

Endoport-assisted surgery is associated with high clot evacuation and decreases 30-d mortality compared to a similar medical group.
Vibrotactile Thresholds on the Mastoid and Forehead Position of Deaf Patients Using Radioear B71 and B81
Authors: Fredén Jansson Karl-Johan , Håkansson Bo , Reinfeldt Sabine , Fröhlich Laura , Rahne Torsten
Published: July 2017

Objectives:

The main objective of this study was to measure the vibrotactile thresholds on the mastoid process and forehead positions using patients with bilateral deafness and to compare the results from the two bone conduction vibrators Radioear B71 and B81.

Design:

There is a possibility that the vibrotactile sensation on the skin makes it difficult to discriminate between sound and vibration. The risk is highest for patients who have bone conduction hearing thresholds in proximity to or worse than their vibrotactile thresholds. All measurements were performed similar to regular bone conduction threshold testing using an audiometer-driven bone conduction vibrator and pulsed warble tones, but the patients were instructed to respond only when feeling vibrations of the bone conduction vibrator instead of when hearing sound. Both the posterior forehead position and the mastoid process position on the temporal bone were tested for comparative reasons. In total, 16 patients participated in the study, 31% females and 69% males of age 29 to 77 years. All subjects were cochlear implant recipients, either uni- or bilaterally implanted. They were selected based on their audiogram data showing unmeasurable unaided hearing.

Results:

The force level at which the vibrotactile thresholds were reached, increased with frequency from 125 up to 500 Hz, but remained constant for higher frequencies up to 2 kHz. A statistically significant difference was found between the 2 devices at 125 Hz at both the mastoid process and forehead position, where the vibrotactile threshold seem to be more sensitive for B71, possibly due to contribution of distortion components. There was no statistically significant difference in vibrotactile thresholds between the mastoid process and forehead position in absolute values (force level in dB re 1 µN), but in terms of hearing levels (dB HL) there was an average difference of 10 and 9 dB for B71 and B81, respectively.

Conclusions:

The results indicate that the vibrotactile thresholds can be confounded with bone conduction hearing thresholds measurements up to 500 Hz when using a standard audiometer and in particular when measuring on the forehead position.
sMap3D Corneo-Scleral Topographer Repeatability in Scleral Lens Patients
Authors: DeNaeyer Gregory , Sanders Donald R.
Published: July 2017

Objectives:

To determine repeatability of measurements using the sMap3D Corneo-Scleral Topographer in patients presenting for scleral lens fitting.

Methods:

As part of our standard clinical evaluation, 25 eyes of 23 patients who presented for scleral lens fitting were examined twice in the same day with the sMap3D in this retrospective study. Sagittal height (SAG), sMap3D principal toricity magnitude (as calculated by the instrument software), and steep axis location were measured at a 16-mm chord diameter. Up gaze, primary, and down gaze positions of each eye were imaged and “stitched” by the instrument software into a single corneoscleral topography map from which the measurements were derived.

Results:

The mean difference in SAG between the 2 examinations was 14 μm with an SD of 55 μm. Sixty-eight percent of cases had a difference of ≤50 μm, and 95% of cases had a difference of ≤100 μm. The mean difference in sMap3D principal toricity magnitude between examinations was 0.15 diopter (D) with an SD of 0.38 D. Eighty-four percent of cases had a difference of ≤0.5 D, and all cases had a difference of <1 D. Mean toric axis difference between examinations was 2.5° with an SD of 18.4°. Sixty-four percent of cases had an axis difference of ≤10°, and 84% had an axis difference of ≤15°.

Conclusions:

The sMap3D measurements are repeatable with regard to scleral toricity and SAG values at a 16-mm diameter and thus would be suitable to use for scleral lens fitting.
Refractive and Corneal Aberrometric Changes After Crescentic Lamellar Wedge Resection in Pellucid Marginal Degeneration
Authors: Genç Selim , Çakir Hanefi , Güler Emre , Çalli Ümit
Published: July 2017

Objective:

To evaluate the effectiveness of crescentic corneal lamellar wedge resection for the treatment of pellucid marginal degeneration (PMD) in improving refractive, visual, and corneal aberrometry.

Methods:

The study included 10 eyes of 10 patients who had undergone corneal lamellar wedge resection for PMD. Pellucid marginal degeneration was diagnosed based on the clinical signs and corneal topography. The corneal aberrometry was evaluated with Sirius corneal topography.

Results:

The mean follow-up period was 14.1 months (range, 9–24 months). Uncorrected visual acuity was improved in nine eyes and remained unchanged in 1 case, whereas best-corrected visual acuity was improved in all eyes postoperatively. By vector analysis, the overall mean astigmatic drift at the last visit was calculated to be 13.0±6.3 diopters (D). At last visit, significant reductions were found for all aberrometric measurements. However, the differences were not significant for the measurements of trefoil (P=0.189).

Conclusions:

Corneal lamellar wedge resection is a favorable surgical option for management of PMD, allowing for improved visual acuity, keratometric cylinder, and corneal aberrations.
A Program Aimed at Reducing Anxiety in Pregnant Women Diagnosed With a Small-for-Gestational-Age Fetus
Authors: Arranz Betegón Ángela , García Marta , Parés Sandra , Montenegro Gala , Feixas Georgina , Padilla Nelly , Camacho Alba , Goberna Josefina , Botet Francesc , Gratacós Eduard
Published: July 2017

The objective of this study was to evaluate the effect of anxiety-reducing techniques including music therapy, sophrology, and creative visualization in pregnant women with a fetus diagnosed as small for gestational age and improved fetal and neonatal weight. This was a quasi-experimental study with a nonrandomized clinical trial design. We compared 2 groups of pregnant women with a fetus diagnosed as small for gestational age with no abnormalities on Doppler studies. The control group (n= 93) received standard care, and the intervention group (n= 65), in addition to standard care, underwent a program of 6 sessions led by a midwife or nurse who taught anxiety-reduction techniques. The State-Trait Anxiety Inventory (STAI) including trait and state subscales were completed by both groups at the start of the study, and only the STAI-State subscale was completed again at the end of the study. Comparisons between the 2 groups regarding fetal weight and centile and maternal STAI scores were performed using thettest and the χ2test. There were no significant differences in the STAI-Trait scores between the 2 groups. There were statistically significant differences in the intervention group's STAI-State score percentiles between the start and the end of the study, being lower at the end of the study (P< .001). There were significant differences between the 2 groups in fetal weight trajectory on the basis of fetal weight: the intervention group had a larger weight gain (P< .005). The program designed to reduce anxiety in pregnant women was effective at reducing anxiety in the women in the intervention group, leading to a favorable fetal weight trajectory in this group.
Translating evidence into practice in acute respiratory distress syndrome: teamwork, clinical decision support, and behavioral economic interventions
Authors: Sjoding Michael W.
Published: July 2017

Purpose of review

Although the treatment of the acute respiratory distress syndrome (ARDS) with low tidal volume (LTV) mechanical ventilation improves mortality, it is not consistently administered in clinical practice. This review examines strategies to improve LTV and other evidence-based therapies for patients with ARDS.

Recent findings

Despite the well established role of LTV in the treatment of ARDS, a recent multinational study suggests it is under-utilized in clinical practice. Strategies to improve LTV include audit and feedback, provider education, protocol development, interventions to improve ICU teamwork, computer decision support, and behavioral economic interventions such as making LTV the default-ventilator setting. These strategies typically target all patients receiving invasive mechanical ventilation, effectively avoiding the problem of poor ARDS recognition in clinical practice. To more effectively administer advanced ARDS therapies, such as prone positioning, better approaches for ARDS recognition will also be required.

Multiple strategies can be utilized to improve adherence to LTV ventilation in ARDS patients.
Update in Natural Orifice Translumenal Endoscopic Surgery (NOTES)
Authors: Bernhardt Joern , Sasse Sarah , Ludwig Kaja , Meier Peter N.
Published: July 2017

Purpose of review

The recent developments and clinical applications of natural orifice translumenal endoscopic surgery (NOTES)-procedures and technologies are going to be presented.

Recent findings

In experimental as well as clinical settings, NOTES-procedures are predominantly performed in hybrid technique. Current experimental studies focus on the implementation of new surgical approaches as well as on the training of procedures. One emphasis in the clinical application is transrectal and transanal interventions. Transanal total mesorectal excision is equivalent to laparoscopic procedures but with the benefit of an even less invasive access. Transvaginal cholecystectomy can achieve results that are comparable to surgeries that are performed with laparoscopic techniques alone. An analysis of the German NOTES-Register concerning appendectomies as well as the national performance of NOTES-interventions in Switzerland is presented. Apart from intraabdominal approaches, several centers proclaim transoral thyroidectomies and transoral mediastinoscopies.

NOTES-procedures are performed in animal experiments as well as in clinical setting although with less frequency. At this time, hybrid techniques using rigid instruments are mainly applied.
Cholesterol reduction and macrophage function: role of paraoxonases
Authors: White C. Roger , Anantharamaiah G.M.
Published: July 2017

Purpose of review

Unregulated uptake of oxidized LDL by macrophages to form foam cells is the hallmark for atherosclerosis. The paraoxonase (PON) family of enzymes plays a critical role in attenuating atherosclerotic lesion formation by hydrolyzing lipid peroxides (LOOHs) and preventing the oxidation of LDL particles and by enhancing HDL-mediated cholesterol efflux. Findings in recent years suggest novel mechanisms by which PON isoforms interact with macrophages to regulate cholesterol metabolism and cellular function.

Recent findings

The association of PON with HDL particles facilitates binding of the particle to macrophages and ABCA1-dependent cholesterol efflux. The hydrolysis of membrane phospholipids by PON generates lysophosphatidylcholine which is shown to regulate expression of cholesterol transport proteins. The PON family also regulates multiple aspects of macrophage function. PON attenuates inflammation and prevents induction of apoptosis via activation of a scavenger receptor class B type-1-dependent signaling mechanism. PON limits macrophage-dependent oxidant formation by preventing the activation of the membrane-associated NADPH oxidase and by stabilizing mitochondria. PON also promotes the differentiation of macrophages to an anti-inflammatory phenotype. This function appears to be independent of PON enzymatic activity and, rather, is dependent on the ability of endogenous sulfhydryls to neutralize pro-inflammatory peroxides.

In recent years, the therapeutic efficacy of HDL-based therapies has been subject to dispute. Pharmacological approaches that target an increase in the expression and/or activity of PON may facilitate macrophage cholesterol metabolism and attenuate inflammatory injury.
Hepatic Portocholecystostomy
Authors: Hery Géraldine , Gonzales Emmanuel , Bernard Olivier , Fouquet Virginie , Gauthier Frédéric , Branchereau Sophie
Published: July 2017

Objectives:

Approximately 20% of cases of biliary atresia do not involve the gallbladder, the cystic duct, and the common bile duct. In these cases, a hepatoportocholecystostomy (HPC) may be performed instead of the classical hepatoportoenterostomy (HPE).

Methods:

We reviewed our cohort to investigate the efficacy of HPC and the associated surgical complications and clinical problems.

Results:

From 1984 to 2009, 97 patients underwent HPC in our institution. In the first 6 months of the postoperative period no patient presented with bacterial cholangitis. Nine patients had bile leakage, and 1 patient had a gallbladder obstruction. For these 10 patients, HPC was modified in HPE. Jaundice clearance was maintained after HPE, but 4 of the patients presented 1 or more cholangitis episodes. After 6 months, there were no cases of cholangitis recorded, 2 patients presented bile leakage and 4 patients experienced gallbladder obstruction. After 5 years of follow‐up, 46% of the patients were jaundice free with their native liver and 29.4% were transplanted.

Conclusions:

In patients with biliary atresia with patent extrahepatic bile ducts, hepatoportocholecystomy is a good surgical technique that can prevent cholangitis. These results are counterbalanced by specific surgical complications that need to be known and looked for in the postoperative period.
Attention Deficit Hyperactivity Disorder and Functional Defecation Disorders in Children
Authors: Kuizenga‐Wessel Sophie , Koppen Ilan J.N. , Vriesman Mana H. , Di Lorenzo Carlo , van Dijk Marieke , Beelen Maureen L.R. , Groeneweg Michael , Stoffelsen Reino J. , Benninga Marc A.
Published: July 2017

Objectives:

The aim of the study was to assess the prevalence of attention deficit hyperactivity disorder (ADHD) in children presenting with functional defecation disorders (FDDs) and to assess the prevalence of FDDs in children with ADHD.

Methods:

A cross‐sectional cohort study was carried out between September 2014 and May 2016. Group 1: Parents of children with FDDs according to the Rome III criteria completed the Child Behavior Checklist and the VvGK (Dutch questionnaire based on the American Disruptive Behavior Disorder rating scale). Patients with ADHD subarea scores ≥70 on the Child Behavior Checklist and/or ≥16 on the VvGK were referred for further psychiatric evaluation. Group 2: Parents of children treated for ADHD at a specialized ADHD outpatient clinic completed a standardized questionnaire regarding their child's defecation pattern.

Results:

In group 1 (282 children with FDDs), 10.3% (7.1%–13.5% bias‐corrected and accelerate confidence interval) were diagnosed with ADHD. Group 2 consisted of 198 children with ADHD, 22.7% (17.6–28.8 bias‐corrected and accelerate confidence interval) fulfilled the Rome III criteria for an FDD. Children with both an FDD and ADHD reported urinary incontinence significantly more often compared to children with an FDD or ADHD alone: 57.1% in FDD + ADHD versus 22.8% in FDD alone (P < 0.001) and 31.1% in ADHD + FDD versus 7.8% in ADHD alone (P < 0.001).

Conclusions:

Approximately 10.3% of children with FDDs had ADHD and 22.7% of children with a known diagnosis of ADHD fulfilled the Rome III criteria for an FDD. This observation suggests that screening for behavioral disorders and FDDs should be incorporated into the diagnostic workup of these groups of children.
First in the Nation
Authors: McDonald Audry , Church Samantha , Hixon Laura , Vo Linda , Sleutel Martha
Published: July 2017

Osteoporosis is related to more than 2 million fractures and $19 billion in healthcare costs each year (S. Rawlins, 2014). A fragility fracture (FF) is a low-energy fracture of the distal radius, proximal humerus, ankle, or proximal femur (hip) from minimal trauma such as a fall from a standing height. In addition to cost, FFs often result in the loss of independence and productivity (S. Rawlins, 2014). In 2015, our orthopaedic unit received the first certification ever awarded for FFs. Fragility fracture certification is a new certification demonstrating that a healthcare facility complies with national patient care standards and uses evidence-based practice guidelines to deliver quality outcomes. Orthopaedic nurses have a critical role in optimizing future bone health and fracture prevention. Our story describes the process and challenges faced becoming the first organization in the nation to be successfully surveyed for The Joint Commission's Fragility Fracture Certification.
Noise Reduction to Reduce Patient Anxiety During Cast Removal
Authors: Mahan Susan T. , Harris Marie S. , Lierhaus Anneliese M. , Miller Patricia E. , DiFazio Rachel L.
Published: July 2017

BACKGROUND:

Noise reduction headphones decrease the sound during cast removal. Their effectiveness in decreasing anxiety has not been studied.

PURPOSE:

Compare pediatric patients' anxiety levels during cast removal with and without utilization of noise reduction headphones combined with use of a personal electronic device.

METHODS:

Quality improvement project. Patients randomly assigned to noise reduction headphone group or standard care group during cast removal. Faces, Legs, Activity, Cry, and Consolability Scale and heart rate were evaluated prior to, during, and after cast removal. Data were compared across groups.

RESULTS:

Fifty patients were included; 25 per group. No difference detected between the 2 groups in Faces, Legs, Activity, Cry, and Consolability Scale score prior to (p = .05) or after cast removal (p = .30). During cast removal, the headphone group had lower FLACC Scale scores (p = .03). Baseline heart rate was lower in the headphone group prior to (p = .02) and after (p = .005) cast removal with no difference during cast removal (p = .24).

CONCLUSION:

Utilizing noise reduction headphones and a personal electronic device during the cast removal process decreases patient anxiety.
Self-Reported Rates of Adherence to Aspirin Prescribed as an Antithrombotic Therapy Following Postoperative Total Joint Replacement
Authors: Wittig-Wells Deborah , Shapiro Susan , Higgins Melinda , Samms-McPherson Jacqueline , Winterboer Donald Shane , Johnson Ifeya , Carter Jessica , Jacob Ani
Published: July 2017

BACKGROUND:

Patients may not understand the importance of medication adherence when discharged with aspirin (ASA) as an anticoagulant for venous thromboembolism (VTE) prophylaxis after joint replacement surgery.

PURPOSE:

The purpose of this study was to examine self-reported rates of adherence to postoperative use of ASA for VTE prophylaxis.

METHODS:

This was an exploratory, descriptive study using a convenience sample of 99 participants. Adherence was measured with a 4-question self-reporting tool.

RESULTS:

Thirty-seven percent were male and 76% were Caucasian, and median age was 63 years. Ninety-two percent had the dosage correct, 76% knew how long to take the medication, and 100% of the sample was still taking the ASA; 40% had forgotten to take 1 or more doses of the medication. No associations were noted. Overall compliance was 44%.

CONCLUSION:

A significant number missed 1 or more doses. This is an opportunity for nurses to work with patients on innovative ways to improve adherence.
Visual Acuity and Contrast Sensitivity Development in Children: Sweep Visually Evoked Potential and Psychophysics
Authors: Almoqbel Fahad M. , Irving Elizabeth L. , Leat Susan J.
Published: July 2017

PURPOSE

The purpose of this study was to investigate the development of visual acuity (VA) and contrast sensitivity in children as measured with objective (sweep visually evoked potential) and subjective, psychophysical techniques, including signal detection theory (SDT), which attempts to control for differences in criterion or behavior between adults and children. Furthermore, this study examines the possibility of applying SDT methods with children.

METHODS

Visual acuity and contrast thresholds were measured in 12 children 6 to 7 years old, 10 children 8 to 9 years old, 10 children 10 to 12 years old, and 16 adults. For sweep visually evoked potential measurements, spatial frequency was swept from 1 to 40 cpd to measure VA, and contrast of sine-wave gratings (1 or 8 cpd) was swept from 0.33 to 30% to measure contrast thresholds. For psychophysical measurements, VA and contrast thresholds (1 or 8 cpd) were measured using a temporal two-alternative forced-choice staircase procedure and also with a yes-no SDT procedure. Optotype (logMAR [log of the minimum angle of resolution]) VA was also measured.

RESULTS

The results of the various procedures were in agreement showing that there are age-related changes in threshold values and logMAR VA after the age of 6 years and that these visual functions do not become adult-like until the age of 8 to 9 years at the earliest. It was also found that children can participate in SDT procedures and do show differences in criterion compared with adults in psychophysical testing.

CONCLUSIONS

These findings confirm a slightly later development of VA and contrast sensitivity (8 years or older) and indicate the importance of using SDT or forced-choice procedures in any developmental study to attempt to overcome the effect of criterion in children.
A Randomized Trial of Soft Multifocal Contact Lenses for Myopia Control: Baseline Data and Methods
Authors: Walline Jeffrey J. , Gaume Giannoni Amber , Sinnott Loraine T. , Chandler Moriah A. , Huang Juan , Mutti Donald O. , Jones-Jordan Lisa A. , Berntsen David A.
Published: July 2017

SIGNIFICANCE

The Bifocal Lenses In Nearsighted Kids (BLINK) study is the first soft multifocal contact lens myopia control study to compare add powers and measure peripheral refractive error in the vertical meridian, so it will provide important information about the potential mechanism of myopia control.

PURPOSE

The BLINK study is a National Eye Institute–sponsored, double-masked, randomized clinical trial to investigate the effects of soft multifocal contact lenses on myopia progression. This article describes the subjects’ baseline characteristics and study methods.

METHODS

Subjects were 7 to 11 years old, had −0.75 to −5.00 spherical component and less than 1.00 diopter (D) astigmatism, and had 20/25 or better logMAR distance visual acuity with manifest refraction in each eye and with +2.50-D add soft bifocal contact lenses on both eyes. Children were randomly assigned to wear Biofinity single-vision, Biofinity Multifocal “D” with a +1.50-D add power, or Biofinity Multifocal “D” with a +2.50-D add power contact lenses.

RESULTS

We examined 443 subjects at the baseline visits, and 294 (66.4%) subjects were enrolled. Of the enrolled subjects, 177 (60.2%) were female, and 200 (68%) were white. The mean (± SD) age was 10.3 ± 1.2 years, and 117 (39.8%) of the eligible subjects were younger than 10 years. The mean spherical equivalent refractive error, measured by cycloplegic autorefraction was −2.39 ± 1.00 D. The best-corrected binocular logMAR visual acuity with glasses was +0.01 ± 0.06 (20/21) at distance and −0.03 ± 0.08 (20/18) at near.

CONCLUSIONS

The BLINK study subjects are similar to patients who would routinely be eligible for myopia control in practice, so the results will provide clinical information about soft bifocal contact lens myopia control as well as information about the mechanism of the treatment effect, if one occurs.
Death by “Snow”! A Fatal Forensic Case of Cocaine Leakage in a “Drug Mule” on Postmortem Computed and Magnetic Resonance Tomography Compared With Autopsy
Authors: Flach Patricia Mildred , Gascho Dominic , Fader René , Martinez Rosita , Thali Michael J. , Ebert Lars C.
Published: July 2017

This forensic case presents unique postmortem imaging of a “drug mule” with fatal intoxication due to cocaine leakage on postmortem computed and magnetic resonance (MR) tomography compared with autopsy.

Imaging by postmortem computed and MR tomography was performed before autopsy, histology, and toxicology were commissioned. Forensic imaging revealed 91 hyperdense, uniformly shaped body packs with signs of leakage, which was confirmed by autopsy. Postmortem MR imaging displayed the rarely described hypointense appearance of the body packs in T1- and T2-weighted sequences. Toxicology stated the dosage of cocaine intoxication as lethal.

This case provides an opportunity to image internal cocaine drug containers on postmortem computed and MR tomography. The cause of death could be determined based on imaging and the radiological morphology of these packs by both imaging methods.
Continuous Capnography Reduces the Incidence of Opioid-Induced Respiratory Rescue by Hospital Rapid Resuscitation Team
Authors: Stites Mindy , Surprise Jennifer , McNiel Jennifer , Northrop David , De Ruyter Martin
Published: July 2017

Objective

The aim of this study was to determine the impact of end tidal carbon dioxide or capnography monitoring in patients requiring patient-controlled analgesia (PCA) on the incidence of opioid-induced respiratory depression (OIRD) in the setting of rapid response.

Methods

A retrospective analysis was conducted in an urban tertiary care facility on the incidence of OIRD in the setting of rapid response as defined by a positive response to naloxone from January 2012 to December 2015. In March 2013, continuous capnography monitoring was implemented for all patients using PCA.

Results

The preintervention incidence of OIRD in the setting of rapid response was 0.4% of patients receiving opioids. After the implementation of capnography, the incidence of OIRD in the setting of rapid response was reduced to 0.2%, which was statistically significant (χ2 = 46.246; df, 1; P < 0.0001). The rate of transfers to a higher level of care associated with these events was also reduced by 79% (baseline, 7.6 transfers/month; postintervention, 1.6 transfers/month).

Conclusions

Continuous capnography monitoring in patients receiving PCA significantly reduces the incidence of OIRD in the setting of rapid response and unplanned transfers to a higher level of care.
Intestinal cestodes
Authors: Webb Camille , Cabada Miguel M.
Published: July 2017

Purpose of review

Cestodes infections in humans are among the most prevalent parasitosis worldwide. Although tapeworm infection is often asymptomatic, they can be associated with a range of symptoms. The landscape of cestode infections is changing with rapid diagnosis techniques and advanced molecular diagnosis aiding in identification of species specific epidemiology.

Recent findings

Traditional descriptions of species by location have been challenged with molecular diagnostic techniques, which show variation in distribution of species, thought to be because of globalization and importation of disease.

Main themes in literature

Epidemiology, molecular diagnostic techniques.

Infection by tapeworms is often asymptomatic or accompanied by mild symptoms though can occasionally cause severe disease and contribute to anemia and malnutrition. Tapeworm infection is most prevalent in resource-poor countries but the distribution is worldwide. Epidemiology of infection is changing because of molecular diagnostics, which allow more accurate tracking of species.
Large scale and significant expression from pseudogenes in Sodalis glossinidius - a facultative bacterial endosymbiont
Authors: Goodhead Ian , Blow Frances , Brownridge Philip , Hughes Margaret , Kenny John , Krishna Ritesh , McLean Lynn , Pongchaikul Pisut , Beynon Rob , Darby Alistair C.
Published: July 2017

The majority of bacterial genomes have high coding efficiencies, but there are some genomes of intracellular bacteria that have low gene density. The genome of the endosymbiont Sodalis glossinidius contains almost 50% pseudogenes containing mutations that putatively silence them at the genomic level. We have applied multiple ‘omic strategies, combining: Illumina and Pacific Biosciences Single-Molecule Real Time DNA-sequencing and annotation; stranded RNA-sequencing; and proteome analysis to better understand the transcriptional and translational landscape of Sodalis pseudogenes, and potential mechanisms for their control. Between 53% and 74% of the Sodalis transcriptome remains active in cell-free culture. Mean sense transcription from Coding Domain Sequences (CDS) is four-times greater than that from pseudogenes. Comparative genomic analysis of six Illumina-sequenced Sodalis isolates from different host Glossina species shows pseudogenes make up ~40% of the 2,729 genes in the core genome, suggesting that they are stable and/or Sodalis is a recent introduction across the Glossina genus as a facultative symbiont. These data further shed light on the importance of transcriptional and translational control in deciphering host-microbe interactions. The combination of genomics, transcriptomics and proteomics give a multidimensional perspective for studying prokaryotic genomes with a view to elucidating evolutionary adaptation to novel environmental niches.

Importance

Bacterial genes are generally 1Kb in length, organized efficiently (i.e. with few gaps between genes or operons), and few open reading frames (ORFs) lack any predicted function. Intracellular bacteria have been removed from extracellular selection pressures acting on pathways of declining importance to fitness and thus, these bacteria tend to delete redundant genes in favour of smaller functional repertoires. In the genomes of endosymbionts with a recent evolutionary relationship with their host, however, this process of genome reduction is not complete; Genes and pathways may be at an intermediate stage, undergoing mutation linked to reduced selection and small population numbers being vertically transmitted from mother to offspring in their hosts, resulting in an increase in abundance of pseudogenes and reduced coding capacities. A greater knowledge of the genomic architecture of persistent pseudogenes, with respect to their DNA structure, mRNA transcription and even putative translation to protein products, will lead to a better understanding of the evolutionary trajectory of endosymbiont genomes, many of which have important roles in arthropod ecology.