bluuebunny/crossref_metadata_2025 huggingface dataset:
Note: Eliminating stripe artifacts in light-sheet fluorescence imaging
Authors: Salili S. M. , Harrington M. , Durian D. J.
Published: March 2018

We report two techniques to mitigate stripe artifacts in light-sheet fluorescence imaging. The first uses an image processing algorithm called the multidirectional stripe remover method to filter stripes from an existing image. The second uses an elliptical holographic diffuser with strong scattering anisotropy to prevent stripe formation during image acquisition. These techniques facilitate accurate interpretation of image data, especially in denser samples. They are also facile and cost-effective.
Correlations in Space and Time for a Soft-mode Phase-transforming System
Authors: Mair SL
Published: March 2018

Using molecular dynamics (MD) for a system of.nonlinear (quadruple-quadratic) oscillators on a nearest-neighbour square lattice, the pair-displacement correlations. and the frequency spectrum for the dynamical order-parameter correlation function are obtained as a function of temperature. For temperatures T near Tc' the pair-displacement correlation function (with the long-range order component subtracted out) was found to vary with particle separation r as r- 1/2 exp { - A( T) rj, at least out to the tenth neighbour in the 40x40 particle lattice. This is consistent with predictions for the two-dimensional Ising model for T above, but not below, Tc. The frequency spectrum for the dynamical order-parameter correlation function shows the softening of the damped phonon-like modes as T approaches Tc and the formation of a central peak at Tc' consistent with the presence of soliton-like excitations. For small I T - Tc I an additional broad peak appears at low frequencies. This is interpreted as an additional phonon-like peak, the two quasi-phonon processes being associated with vibration across the potential barrier and vibration in one or other of the two potential wells respectively. Although the squared frequency wi of the soft quasi-phonon is approximately linear with I T - Tc lover a range of temperatures, as T increases the wi curve eventually flattens out.
Temperature Limitation in Evacuated Solar Collector Tubes
Authors: Pailthorpe BA , Collins RE , O'Shea S
Published: March 2018

A recent innovation in evacuated tubular solar collector technology is described. A desorbable gas, which specifically adsorbs on the graphitic solar selective surface, can reversibly degrade the vacuum by providing a heat conduction path at elevated temperatures. The stagnation temperature of the system is thus limited in a controllable manner without significantly degrading the low temperature performance. A simple theory incorporating the Langmuir adsorption isotherm and the Knudsen free molecule transport regime is used to describe the phenomenon.
Euphemism as a discursive strategy in US local and state politics
Authors: Crespo-Fernández Eliecer
Published: March 2018

Euphemism is a discursive strategy that politicians use to approach unsettling, embarrassing, or distasteful, i.e. taboo, topics without appearing inconsiderate to people’s concerns. Following a critical discourse-analytic approach to political language, this paper discusses the communicative functions that euphemism performs in the discourse of local and state politicians from New Jersey (USA) in a sample of language data excerpted from The Star-Ledger, the state’s largest newspaper. The analysis reveals that (metaphorical and non-metaphorical) euphemism constitutes a major strategy of self-protection and positive self-presentation for legislators which allows them – mostly by understatement, periphrasis, and metaphor – first, to refer to socially disadvantaged groups or address delicate subjects without sounding insensitive; second, to criticize their political opponents in a socially acceptable way; and third, to purposely conceal from the public unsettling or controversial topics.
The logic of biologically active small molecules: amazing ability of microorganisms*
Authors: Ubukata Makoto
Published: March 2018

In this review article, I will outline my way of thinking about biologically active small molecules. The structure of liposidomycin B from Streptomyces species resulted in my initial sense that a structure tells its function. A biologically active small molecule may save directly or indirectly a number of people. Even if the molecule has not been used as a therapeutic agent, it can be used as a useful chemical probe for dissecting a living cell into different biochemical pieces. Such biologically active small molecules derived from microorganisms have been primarily found in cultivable microorganisms that make up only 1% of total microbes in nature. Discovery of novel growth factors, zincmethylphyrin, zinc coproporphyrin, and coproporphyrin enabled laboratory cultivation of previously uncultured Leucobacter sp. These findings might expand the possibility for further discovery of novel therapeutic agents or chemical probes.
Application of optimal control strategies to HIV-malaria co-infection dynamics
Authors: Fatmawati  , Windarto  , Hanif Lathifah
Published: March 2018

This paper presents a mathematical model of HIV and malaria co-infection transmission dynamics. Optimal control strategies such as malaria preventive, anti-malaria and antiretroviral (ARV) treatments are considered into the model to reduce the co-infection. First, we studied the existence and stability of equilibria of the presented model without control variables. The model has four equilibria, namely the disease-free equilibrium, the HIV endemic equilibrium, the malaria endemic equilibrium, and the co-infection equilibrium. We also obtain two basic reproduction ratios corresponding to the diseases. It was found that the disease-free equilibrium is locally asymptotically stable whenever their respective basic reproduction numbers are less than one. We also conducted a sensitivity analysis to determine the dominant factor controlling the transmission. sic reproduction numbers are less than one. We also conducted a sensitivity analysis to determine the dominant factor controlling the transmission. Then, the optimal control theory for the model was derived analytically by using Pontryagin Maximum Principle. Numerical simulations of the optimal control strategies are also performed to illustrate the results. From the numerical results, we conclude that the best strategy is to combine the malaria prevention and ARV treatments in order to reduce malaria and HIV co-infection populations.
Application of neem (Azadirachta indica) as biological pesticides in cocoa seed (Theobroma cacao) storage using various local adsorbent media
Authors: Mardiyani S A , Sunawan  , Pawestri A E
Published: March 2018

Cocoa seeds are recalcitrant (the water content is more than 40%) that require special handling. The use of adsorbent media to reduce the decrease in the quality of cocoa seeds and extend their shelf life in this storage has not been widely done. Local adsorbent media such as sawdust, sand and ash have the potential to maintain the viability of cocoa seeds. The objective of this research was to determine the interaction of the application of neem (Azadirachta indica) as biological pesticides and the use of various natural adsorbent media in the storage of cocoa seeds (Theobroma cacao). It was an experimental study with a factorial design composed of three factors. The first factor was the medium adsorbent type for the storage of cocoa seed, which consists of three levels (river sand, ash, and sawdust). The second factor was the concentration of neem leaves for pre-storage treatment with three levels (10, 20, and 30%). The third factor was the storage time (10 and 20 days). The results of the study indicated that the combination of the three factors showed a significant interaction in the height of the plant and the diameter of the stem of the seedling at 28 days after sowing. The fresh weight of the seedlings of the seeds that were stored in ash media gave a better result than the seedlings of seeds that had been stored in the river sand and the sawdust as adsorbent media. The application of 20% extract of neem leaves gave the best influence for the seeds that were stored for 20 days.
Electricity generation from wetlands with activated carbon bioanode
Authors: Sudirjo E. , Buisman C J N , Strik D P B T B
Published: March 2018

Paddy fields are potential non-tidal wetlands to apply Plant Microbial Fuel Cell (PMFC) technology. World widely they cover about 160 million ha of which 13.3 million ha is located in Indonesia. With the PMFC, in-situ electricity is generated by a bioanode with electrochemically active bacteria which use primary the organic matter supplied by the plant (e.g. as rhizodeposits and plant residues). One of limitations when installing a PMFC in a non-tidal wetland is the usage of “expensive” large amounts of electrodes to overcome the poor conductivity of wet soils. However, in a cultivated wetland such as rice paddy field, it is possible to alter soil composition. Adding a conductive carbon material such as activated carbon is believed to improve soil conductivity with minimum impact on plant vitality. The objective of this research was to study the effect of activated carbon as an alternative bioanode material on the electricity output and plants vitality. Lab result shows that activated carbon can be a potential alternative for bioanode material. It can continuously deliver current on average 1.54 A/m3 anode (0.26 A/m2 PGA or 66 mW/m2 PGA) for 98 days. Based on this result the next step is to do a test of this technology in the real paddy fields.
Stereotactic Radiosurgery for Trigeminal Neuralgia in Patients With Multiple Sclerosis: A Multicenter Study
Authors: Xu Zhiyuan , Mathieu David , Heroux France , Abbassy Mahmoud , Barnett Gene , Mohammadi Alireza M , Kano Hideyuki , Caruso James , Shih Han-Hsun , Grills Inga S , Lee Kuei , Krishnan Sandeep , Kaufmann Anthony M , Lee John Y K , Alonso-Basanta Michelle , Kerr Marie , Pierce John , Kondziolka Douglas , Hess Judith A , Gerrard Jason , Chiang Veronica , Lunsford L Dade , Sheehan Jason P
Published: March 2018

BACKGROUND

Facial pain response (PR) to various surgical interventions in patients with multiple sclerosis (MS)-related trigeminal neuralgia (TN) is much less optimal. No large patient series regarding stereotactic radiosurgery (SRS) has been published.

OBJECTIVE

To evaluate the clinical outcomes of MS-related TN treated with SRS.

METHODS

This is a retrospective cohort study. A total of 263 patients contributed by 9 member tertiary referral Gamma Knife centers (2 in Canada and 7 in USA) of the International Gamma Knife Research Consortium (IGKRF) constituted this study.

RESULTS

The median latency period of PR after SRS was 1 mo. Reasonable pain control (Barrow Neurological Institute [BNI] Pain Scores I-IIIb) was achieved in 232 patients (88.2%). The median maintenance period from SRS was 14.1 months (range, 10 days to 10 years). The actuarial reasonable pain control maintenance rates at 1 yr, 2 yr, and 4 yr were 54%, 35%, and 24%, respectively. There was a correlation between the status of achieving BNI-I and the maintenance of facial pain recurrence-free rate. The median recurrence-free rate was 36 mo and 12.2 mo in patients achieving BNI-I and BNI > I, respectively (P = .046). Among 210 patients with known status of post-SRS complications, the new-onset of facial numbness (BNI-I or II) after SRS occurred in 21 patients (10%).

CONCLUSION

In this largest series SRS offers a reasonable benefit to risk profile for patients who have exhausted medical management. More favorable initial response to SRS may predict a long-lasting pain control.
Descending Branch of the Lateral Circumflex Femoral Artery Graft for Posterior Inferior Cerebellar Artery Revascularization
Authors: Strickland Ben A , Bakhsheshian Joshua , Rennert Robert C , Fredrickson Vance L , Lam Jordan , Amar Arun , Mack William , Carey Joseph , Russin Jonathan J
Published: March 2018

BACKGROUND

Posterior inferior cerebellar artery (PICA) revascularization can be achieved with relative ease when a contralateral PICA is present. However, without a contralateral PICA, identification of a suitable vessel alternative can be challenging due to a size mismatch.

OBJECTIVE

To propose the descending branch of the lateral circumflex femoral artery (DLCFA) to be an acceptable, if not preferred, arterial graft for PICA revascularization.

METHODS

Data from patients who underwent PICA revascularization with DLCFA grafts were obtained from an institutional review board-approved prospectively maintained database with informed consent from the patients.

RESULTS

Three patients, all presenting with ruptured aneurysms, were treated with PICA revascularization using the DLCFA. All cases achieved bypass patency and no ischemic events occurred during the bypass procedures. Graft spasm occurred in 2 patients. Two patients that presented with neurological deficits achieved excellent neurological outcomes and 1 suffered an anterior spinal artery stroke during a repeat endovascular treatment 1 wk after revascularization.

CONCLUSION

The DLCFA is favorable for PICA revascularization when a contralateral PICA is not a viable option.
High-energy gamma-ray and neutrino production in star-forming galaxies across cosmic time: Difficulties in explaining the IceCube data
Authors: Sudoh Takahiro , Totani Tomonori , Kawanaka Norita
Published: March 2018

We present new theoretical modeling to predict the luminosity and spectrum of gamma-ray and neutrino emission of a star-forming galaxy, from the star formation rate (ψ), gas mass (Mgas), stellar mass, and disk size, taking into account production, propagation, and interactions of cosmic rays. The model reproduces the observed gamma-ray luminosities of nearby galaxies detected by Fermi better than the simple power-law models as a function of ψ or ψMgas. This model is then used to predict the cosmic background flux of gamma-rays and neutrinos from star-forming galaxies, by using a semi-analytical model of cosmological galaxy formation that reproduces many observed quantities of local and high-redshift galaxies. Calibration of the model using gamma-ray luminosities of nearby galaxies allows us to make a more reliable prediction than previous studies. In our baseline model, star-forming galaxies produce about 20% of the isotropic gamma-ray background unresolved by Fermi, and only 0.5% of IceCube neutrinos. Even with an extreme model assuming a hard injection cosmic-ray spectral index of 2.0 for all galaxies, at most 22% of IceCube neutrinos can be accounted for. These results indicate that it is difficult to explain most of the IceCube neutrinos by star-forming galaxies, without violating the gamma-ray constraints from nearby galaxies.
Five successful pregnancies with antenatal anakinra exposure
Authors: Smith Chelsey J F , Chambers Christina D
Published: March 2018

Objectives

Our aim is to add to the limited existing prospective data on IL-1 inhibitor use in pregnancy.

Methods

Data were obtained from the Organization of Teratology Information Specialists Autoimmune Disease in Pregnancy Project, a prospective cohort study of pregnancy outcomes in the USA and Canada. Eligible women were enrolled prior to 19 weeks’ gestation between 2004 and 2017. Outcomes were obtained by maternal interview and medical record abstraction.

Results

Five pregnancies with anakinra exposure were identified, all resulting in full-term singleton live births with no major or long-term complications. Three maternal subjects used anakinra for adult-onset Still’s disease and two for systemic JIA. For all individuals who discontinued anakinra, some amount of steroid medication was necessary for treatment of disease flare. Two maternal subjects developed oligohydramnios, one also with pregnancy-induced hypertension. Two women had Caesarian sections, one medically indicated and one scheduled. One infant had low birth weight, but follow-up records indicated normal adjusted weight at 1 year. Three women successfully breastfed their infants, at least two of whom continued anakinra while breastfeeding.

Conclusion

Anakinra was used successfully in five full-term pregnancies; however, two subjects developed oligohydramnios, a process that can be linked to fetal renal anomalies. Given previously reported cases of congenital renal anomalies associated with both antenatal anakinra use and maternal hyperthermia, the relationship between maternal IL-1 inhibitor use, uncontrolled maternal febrile disease and fetal outcomes should be further explored.
Effects of 3 Different Methods of Care on the Peristomal Skin Integrity of Children with Percutaneous Endoscopic Gastrostomy Tubes: A Prospective Randomized Controlled Trial
Authors: Pars Hatice , Çavuşoğlu Hicran
Published: March 2018

OBJECTIVE:

There are a limited number of studies examining the effects of products used in stoma care. This study compares the effects of 3 different methods of care on the peristomal skin integrity of children with percutaneous endoscopic gastrostomy (PEG) tubes.

METHODS:

In this randomized controlled study, 60 children were allocated to the 3 study groups (group 1: hydrogel, group 2: soap and water, group 3: saline solution). Dressings were changed daily for all groups during the first week, then weekly for group 1 and daily for groups 2 and 3. The evaluations were performed using a PEG Region Peristomal Skin Integrity Observation Form and devices measuring stoma region pH, moisture, and temperature. One evaluation was performed in a hospital and 4 during home visits in the first month after PEG insertion.

MAIN RESULTS:

Moisture levels in the stoma region were normal in the saline solution group, high in the hydrogel group, and low in the soap and water group (P < .05). Complications potentially affecting peristomal skin integrity in the stoma region (erythema, drainage, hemorrhage, hypergranulation tissue) were observed most frequently in the soap and water group (5%–45%) and least frequently in the hydrogel group (15%–25%). However, there was no statistically significant difference among the groups with respect to these complications (P > .05).

CONCLUSIONS:

Because the dressing requires 6 times fewer changes per month, and wound site infection in the stoma site is minimized, the use of glycerin hydrogel should be considered for inclusion in pediatric stoma care procedures.
Risk Factors for Peritoneal Recurrence in Stage II to III Colon Cancer
Authors: Mayanagi Shuhei , Kashiwabara Kosuke , Honda Michitaka , Oba Koji , Aoyama Toru , Kanda Mitsuro , Maeda Hiromichi , Hamada Chikuma , Sadahiro Sotaro , Sakamoto Junichi , Saji Shigetoyo , Yoshikawa Takaki
Published: March 2018

BACKGROUND:

Most previous reports to analyze risk factors for peritoneal recurrence in patients with colon cancer have been observational studies of a population-based cohort.

OBJECTIVE:

This study aimed to determine the risk factors for peritoneal recurrence in patients with stage II to III colon cancer who underwent curative resection.

DESIGN:

This was a pooled analysis using a combined database obtained from 3 large phase III randomized trials (N = 3714).

SETTINGS:

Individual patient data were collected from the Japanese Foundation for Multidisciplinary Treatment of Cancer clinical trials 7, 15, and 33, which evaluated the benefits of postoperative 5-fluorouracil–based adjuvant therapies in patients with locally advanced colorectal cancer.

PATIENTS:

We included patients who had stage II to III colon cancer and underwent curative resection with over D2 lymph node dissection.

MAIN OUTCOME MEASURES:

Main outcomes measured were risk factors for peritoneal recurrence without other organ metastasis after curative surgery.

RESULTS:

Peritoneal recurrence occurred in 2.3% (86/3714) of all patients undergoing curative resection. Mean duration from operation to peritoneal recurrence was 17.0 ± 10.3 months. Of these patients with peritoneal recurrence, 29 patients (34%) had recurrence in ≥1 other organ. Multivariate analysis showed that age (≥60 y: HR = 0.531; p = 0.0182), pathological T4 (HR = 3.802; p < 0.0001), lymph node involvement (HR = 3.491; p = 0.0002), and lymphadenectomy (D2: HR = 1.801; p = 0.0356) were independent predictors of peritoneal recurrence. The overall survival was lower in patients who developed peritoneal recurrence than in those with other recurrence (HR = 1.594; p = 0.002).

LIMITATIONS:

The regimens of adjuvant chemotherapy were limited to oral 5-fluorouracil.

CONCLUSIONS:

Our findings clarified the risk factors for peritoneal recurrence in patients who underwent curative resection for colon cancer. See Video Abstract at http://links.lww.com/DCR/A609.
Projected Changes in Temperature-related Morbidity and Mortality in Southern New England
Authors: Weinberger Kate R. , Kirwa Kipruto , Eliot Melissa N. , Gold Julia , Suh Helen H. , Wellenius Gregory A.
Published: March 2018

Background:

Climate change is expected to result in more heat-related, but potentially fewer cold-related, emergency department visits and deaths. The net effect of projected changes in temperature on morbidity and mortality remains incompletely understood. We estimated the change in temperature-related morbidity and mortality at two sites in southern New England, United States, through the end of the 21st century.

Methods:

We used distributed lag Poisson regression models to estimate the present-day associations between daily mean temperature and all-cause emergency department visits and deaths in Rhode Island and in Boston, Massachusetts. We estimated the change in temperature-related visits and deaths in 2045–2054 and 2085–2094 (relative to 2001–2010) under two greenhouse gas emissions scenarios (RCP4.5 and RCP8.5) using downscaled projections from an ensemble of over 40 climate models, assuming all other factors remain constant.

Results:

We observed U-shaped relationships between temperature and morbidity and mortality in Rhode Island, with minima at 10.9°C and 22.5°C, respectively. We estimated that, if this population were exposed to the future temperatures projected under RCP8.5 for 2085–2094, there would be 5,976 (95% eCI = 1,630, 11,379) more emergency department visits but 218 (95% eCI = −551, 43) fewer deaths annually. Results were similar in Boston and similar but less pronounced in the 2050s and under RCP4.5.

Conclusions:

We estimated that in the absence of further adaptation, if the current southern New England population were exposed to the higher temperatures projected for future decades, temperature-related emergency department visits would increase but temperature-related deaths would not.
Pilot investigation: randomized-controlled analog trial for alcohol and tobacco smoking co-addiction using contingency management
Authors: Orr Michael F. , Lederhos Smith Crystal , Finlay Myles , Martin Samantha C. , Brooks Olivia , Oluwoye Oladunni A. , Leickly Emily , McDonell Michael , Burduli Ekaterina , Barbosa-Leiker Celestina , Layton Matt , Roll John M. , McPherson Sterling M.
Published: March 2018

Contingency management (CM) is associated with decreases in off-target drug and alcohol use during primary target treatment. The primary hypothesis for this trial was that targeting alcohol use or tobacco smoking would yield increased abstinence in the opposite, nontargeted drug. We used a 2 [CM vs. noncontingent control (NC) for alcohol]×2 (CM vs. NC for smoking tobacco) factorial design, with alcohol intake (through urinary ethyl glucuronide) and tobacco smoking (through urinary cotinine) as the primary outcomes. Thirty-four heavy-drinking smokers were randomized into one of four groups, wherein they received CM, or equivalent NC reinforcement, for alcohol abstinence, smoking abstinence, both drugs, or neither drug. The CM for alcohol and tobacco group had only two participants and therefore was not included in analysis. Compared with the NC for alcohol and tobacco smoking group, both the CM for the tobacco smoking group [odds ratio (OR)=12.03; 95% confidence interval (CI): 1.50–96.31] and the CM for the alcohol group (OR=37.55; 95% CI: 4.86–290.17) submitted significantly more tobacco-abstinent urinalyses. Similarly, compared with the NC for the alcohol and tobacco group, both the CM for smoking (OR=2.57; 95% CI: 1.00–6.60) and the CM for alcohol groups (OR=3.96; 95% CI: 1.47–10.62) submitted significantly more alcohol-abstinent urinalyses. These data indicate cross-over effects of CM on indirect treatment targets. Although this is a pilot investigation, it could help to inform the design of novel treatments for alcohol and tobacco co-addiction.
Potential learning and memory disruptors and enhancers in a simple, 1-day operant task in mice
Authors: Sanku Rajesh K.K. , John Joel S. , Salkovitz Matthew , Ilies Marc A. , Walker Ellen A.
Published: March 2018

The objective of this study was to develop a rapid, 1-day learning and memory assay in mice that is sensitive to the effects of compounds that could impair or enhance acquisition and retrieval. Swiss-Webster, male mice were placed in experimental chambers for a 1-h acquisition session with an intermittent, audible tone. If a nose-poke response occurred during the tone, an Ensure water solution was presented. After 1 h, the mice returned to the chambers for 2 h. Drugs were injected before or after sessions to determine the effects on acquisition and/or retrieval. Mice injected with saline learned a nose-poke response as measured by decreased latencies to earn 10 reinforcers, increased reinforced response rates, and decreased nonreinforced response rates. Scopolamine and acetazolamide impaired retrieval of the nose-poke response, whereas ketamine only modestly impaired retrieval. Doses of 8-OH-DPAT or the novel carbonic anhydrase activator, MAI27, either had no effect or impaired some measures of responding. Neither 8-OH-DPAT nor MAI27 were able to prevent the modest impairments produced by ketamine. The simple, 1-day operant task is a rapid assay that can be used as an initial screen to test the effects of learning and memory disruptors and potentially enhancers.
Pharmacotherapy for Perinatal Depression
Authors: LUSSKIN SHARI I. , KHAN SABRINA J. , ERNST CARRIE , HABIB SALLY , FERSH MADELEINE E. , ALBERTINI ELIZABETH S.
Published: March 2018

Perinatal depression is associated with serious risks for the mother, baby, and family. When considering treating perinatal depression with a drug indicated for the treatment of depression, the major concerns are whether the drug increases the risks of teratogenicity, pregnancy complications, poor neonatal adaptation, or neurodevelopmental disorders. Although different studies have produced different results, the majority have not shown increases in risk for selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, or the noradrenergic/dopaminergic drug bupropion. In this review we will discuss the reproductive safety data for these medications as well as monoamine oxidase inhibitors and benzodiazepines.
Meibomian Gland Dropout in Hematological Patients Before Hematopoietic Stem Cell Transplantation
Authors: Giannaccare Giuseppe , Bonifazi Francesca , Sebastiani Stefano , Sessa Mariarosaria , Pellegrini Marco , Arpinati Mario , Moscardelli Fabiana , Versura Piera , Campos Emilio
Published: March 2018

Purpose:

To perform qualitative and quantitative analysis of meibomian gland (MG) dropout in hematological patients before hematopoietic stem cell transplantation (HSCT) and to correlate it with both ocular surface and hematological characteristics.

Methods:

This prospective study included 46 consecutive patients undergoing HSCT and 30 age- and sex-matched healthy controls. Noninvasive meibography of the lower eyelid, meiboscore (Pult scale), Schirmer test type I, tear film breakup time, and corneal and conjunctival staining were measured. Subjective symptoms were scored by the Ocular Surface Disease Index. The dry eye diagnosis was ascertained according to TFOS DEWS II Criteria. Hematological data included diagnosis (acute leukemias vs. other malignancies), stage of the disease, time from diagnosis to ophthalmological examination, and previous therapy (chemotherapy, radiotherapy, or autograft).

Results:

Hematological patients presented a significantly lower tear film breakup time and a higher meiboscore compared with controls (respectively 4.8 ± 3.0 seconds vs. 11.0 ± 3.0 and 2.0 ± 1.1 vs. 0.9 ± 0.4; P < 0.001). Conversely, other parameters did not differ between both groups. Dry eye was diagnosed in 14 out 46 hematological patients (30.4%). MG loss was significantly higher in hematological patients than in controls (29.8% ± 15.0% vs. 21.2 ± 13.0; P = 0.007) and was higher in the nasal third compared with both central and temporal thirds (respectively, 39.8% ± 21.4% vs. 18.5 ± 15.6 and 25.1 ± 18.3; P < 0.0001). The diagnosis of acute leukemia (β = 0.449; P = 0.003) and the history of previous chemotherapy (β = 0.444; P = 0.003) were associated with lower MG loss.

Conclusions:

Hematological patients presented significantly reduced MG areas even before HSCT, particularly those affected by nonacute malignancies. The topographical pattern of MG dropout resembles that of conventional dry eye.
Cumulative Endothelial Cell Loss in Descemet Membrane Endothelial Keratoplasty Grafts From Preparation Through Insertion With Glass Injectors
Authors: Downes Kenneth , Tran Khoa D. , Stoeger Christopher G. , Chamberlain Winston
Published: March 2018

Purpose:

Evaluation of cumulative Descemet membrane endothelial keratoplasty endothelial cell loss (ECL) from preparation through injection using 2 different glass injectors.

Methods:

Eighteen Descemet membrane endothelial keratoplasty grafts with “S” stamps were prepared by eye bank technicians. Nine grafts were assigned to injection with a modified glass Jones tube injector with a 2.4-mm opening and 9 were assigned to injection with the DORC glass pipette injector (<1.5-mm opening). The grafts were prepared and loaded into the injectors using the standard surgical technique, ejected onto a bed of viscoelastic on a glass slide, and unscrolled using viscoelastic. The grafts were stained with the vital dye Calcein-AM, then digitally imaged and analyzed using FIJI. The percentage of ECL was calculated by measuring the area of nonfluorescent pixels and dividing it by the total graft area pixels. A statistical comparison was performed using a 2-tailed unpaired t test.

Results:

Grafts injected using the DORC injector versus Jones tube injector had ECL of 29.2% ± 8.5% [95% confidence interval (CI)] versus 23.0% ± 5.1% (95% CI), respectively. This difference was not statistically significant (P = 0.17); however, the patterns of ECL on the grafts was different between injectors. Peripheral ECL caused by trephination and surgeon grasp sites accounted for 7.5% ± 1.2% (95% CI).

Conclusions:

There was no statistical difference in ECL between the 2 injectors. There were characteristic differences in patterns of ECL seen between injectors, which may be clinically relevant and indicate the types of stress that grafts are exposed to during passage through various injectors.
Rotavirus Vaccines and Health Care Utilization for Diarrhea in US Children, 2001 to 2015
Authors: Getachew Halle B. , Dahl Rebecca M. , Lopman Benjamin A. , Parashar Umesh D.
Published: March 2018

Background:

Rotavirus vaccination was introduced in the United States in 2006. Our objectives were to examine reductions in diarrhea-associated health care utilization after rotavirus vaccine implementation and to assess direct vaccine effectiveness (VE) in US children.

Methods:

Retrospective cohort study using claims data of US children under 5 years of age. We compared rates of diarrhea-associated health care utilization in prevaccine versus postvaccine introduction years. We also examined VE and duration of protection.

Results:

Compared with the average rate of rotavirus-coded hospitalizations in the prevaccine years, overall vaccine rates were reduced by 75% in 2007 to 2008, 60% in 2008 to 2009, 94% in 2009 to 2010, 80% in 2010 to 2011, 97% in 2011 to 2012, 88% in 2012 to 2013, 98% in 2013 to 2014 and 92% in 2014 to 2015. RotaTeq-adjusted VE was 88% against rotavirus-coded hospitalization among 3–11 months of age, 88% in 12–23 months of age, 87% in 24–35 months of age, 87% in 36–47 months of age and 87% in 48–59 months of age. Rotarix-adjusted VE was 87% against rotavirus-coded hospitalization among 3–11 months of age, 86% in 12–23 months of age and 86% in 24–35 months of age.

Conclusion:

Implementation of rotavirus vaccines has substantially reduced diarrhea-associated health care utilization in US children under 5 years of age. Both vaccines provided good and enduring protection through the fourth year of life against rotavirus hospitalizations.
Preserved Cochlear CISS Signal is a Predictor for Hearing Preservation in Patients Treated for Vestibular Schwannoma With Stereotactic Radiosurgery
Authors: Prabhu Vinay , Kondziolka Douglas , Hill Travis C. , Benjamin Carolina G. , Shinseki Matthew S. , Golfinos John G. , Roland J. Thomas , Fatterpekar Girish M.
Published: March 2018

Background:

Hearing preservation is a goal for many patients with vestibular schwannoma. We examined pretreatment magnetic resonance imaging (MRI) and posttreatment hearing outcome after stereotactic radiosurgery.

Methods:

From 2004 to 2014, a cohort of 125 consecutive patients with vestibular schwannoma (VS) treated via stereotactic radiosurgery (SRS) were retrospectively reviewed. MRIs containing three-dimensional constructive interference in steady state or equivalent within 1 year before treatment were classified by two radiologists for pretreatment characteristics. “Good” hearing was defined as American Academy of Otolaryngology–Head and Neck Surgery class A. Poor hearing outcome was defined as loss of good pretreatment hearing after stereotactic radiosurgery.

Results:

Sixty-one patients met criteria for inclusion. Most had tumors in the distal internal auditory canal (55%), separated from the brainstem (63%), oval shape (64%) without cysts (86%), and median volume of 0.85 ± 0.55 cm3. Pretreatment audiograms were performed a median of 108 ± 173 days before stereotactic radiosurgery; 38% had good pretreatment hearing. Smaller tumor volume (p < 0.005) was the only variable associated with good pretreatment hearing. 49 (80%) patients had posttreatment audiometry, with median follow-up of 197 ± 247 days. Asymmetrically decreased pretreatment cochlear CISS signal on the side of the VS was the only variable associated with poor hearing outcome (p = 0.001). Inter-rater agreement on cochlear three-dimensional constructive interference in steady state preservation was 91%.

Conclusions:

Decreased cochlear CISS signal may indicate a tumor's association with the cochlear neurovascular bundle, influencing endolymph protein concentration and creating an inability to preserve hearing. This important MRI characteristic can influence planning, counseling, and patient selection for vestibular schwannoma treatment.
Novel Finding of Paired Box 5 (PAX5) Cytoplasmic Staining in Well-differentiated Rectal Neuroendocrine Tumors (Carcinoids) and Its Diagnostic and Potentially Prognostic Utility
Authors: Fu Zhiyan , Zuo Chunlai , Sheehan Christine E. , Patil Deepa T. , Lin Jingmei , Yang Zhaohai , Lee Hwajeong
Published: March 2018

Although nuclear immunostaining for paired box protein (PAX5) is widely used in practice, its cytoplasmic localization has not been evaluated. Recently we encountered cytoplasmic granular PAX5 staining in rectal well-differentiated neuroendocrine tumor (WD-NET) in the absence of nuclear staining. We investigated the specificity of this staining pattern for rectal NET (n=21) in comparison with 108 NETs, 1 WD rectal NET with elevated proliferation (WD-NET G3), and 40 poorly differentiated neuroendocrine carcinomas from the gastrointestinal and pancreatobiliary tract and liver. Representative tumor sections were subject to immunohistochemical stain for PAX5 antibody. Immunohistochemistry for 3 L-cell markers, glucagon-like peptide 1 and 2, and peptide YY, was performed on all rectal and appendiceal NETs and all other NETs with cytoplasmic PAX5 staining. Cytoplasmic PAX5 staining was observed in 90% (19/21) of rectal NET, 27% (3/11) of appendiceal, 14% (2/14) of pancreatic, 7% (2/29) of lung, 25% (3/12) metastatic NET in the liver, and 100% (1/1) of renal NET. No PAX5 cytoplasmic staining was seen in all grades of NET in other organs, rectal WD-NET G3, and all neuroendocrine carcinoma. L-cell marker staining was observed in all 21 (100%) rectal, in 3 of 3 (100%) PAX5-positive, and 1 of 7 (14%) PAX5-negative appendiceal NET. Cytoplasmic PAX5 staining is specific for rectal carcinoids. The sensitivity and specificity of PAX5 to detect L-cell type rectal carcinoids is 90% (19/21) and 100% (21/21), respectively. Cytoplasmic localization of the PAX5 protein may be utilized as a surrogate marker to detect L-cell type rectal carcinoids.
Feasibility and Effect of Cervical Resistance Training on Head Kinematics in Youth Athletes
Authors: Eckner James T. , Goshtasbi Alireza , Curtis Kayla , Kapshai Aliaksandra , Myyra Erik , Franco Lea M. , Favre Michael , Jacobson Jon A. , Ashton-Miller James A.
Published: March 2018

Greater neck girth and strength may be associated with a lower risk of sport-related concussion due to mitigation of head accelerations by the neck. However, neck strengthening exercise remains unstudied in youth athletes. Therefore, this pilot study assessed the feasibility and effect of targeted neck strengthening exercises in youth athletes. Seventeen participants were allocated to perform 8-wk manual resistance-based neck strengthening (n= 13) or control resistance exercise (n= 4) programs. Before and after the intervention, participants completed laboratory-based assessments of neck size, strength, and head kinematics during standardized test loading in each plane of motion. Descriptive statistics were calculated to compare pre-post changes between the two groups. All participants safely and successfully completed the intervention. Neck girth and strength increased in both groups, with greater increases in the neck strengthening group. Across all planes of motion, overall changes in head linear and angular velocity decreased in both groups, with greater decreases in ΔV in the neck strengthening group and greater decreases in Δω in controls. These results suggest the potential for resistance exercise training to reduce youth athletes' risk for sport-related concussion by increasing neck girth and strength. Additional research is needed to determine optimal neck strengthening programs.
Repair of Lower Canalicular Laceration Using the Mini-Monoka Stent: Primary and Revisional Repairs
Authors: Kim Taegon , Yeo Chi-Ho , Chung Kyu-Jin , Lee Jun Ho , Kim Yong-Ha
Published: March 2018

Background:

We present our results of primary repair of lower canalicular injury using the Mini-Monoka stent and report our experience with revisional repair of canalicular blocks to treat epiphora following primary repair

Methods:

We performed primary repair in 169 canalicular laceration patients using Mini-Monoka. The primary repair was defined as the first operation proceeded within 48 hours after injury. Revisional repairs were performed in patients who underwent primary repair of canalicular laceration and subsequently complained of epiphora with canalicular block owing to peripheral scarring. In revisional repair, a Mini-Monoka stent was reinserted to maintain the realigned lacrimal pathway.

Results:

The primary repair achieved functional success in 94.7% of patients. After primary repair, nine patients complained of epiphora. Two of 9 patients underwent CDCR and 5 underwent revisional repair of canalicular blockage. The revisional repair achieved functional success in 4 of 5 patients. After revisional repair, scar contracture and asymmetry of the medial canthus or malposition of the lower lacrimal punctum were corrected. Cosmetically, all 5 patients were satisfied with the results. Functionally, one patient complained persistent epiphora and was treated with CDCR.

Conclusions:

We were able to experience simple, safe, and successful primary repair of lower canalicular injuries using the Mini-Monoka stent. If epiphora owing to canalicular block after primary repair and asymmetry of the medial canthus owing to scar contracture or malposition of lacrimal punctum are present, scar release and realignment of the canaliculus with Mini-Monoka insertion at the time of revisional repair are recommended.
A Practical Recommendation for Teaching Neck Anatomy During Neck Dissection in the Operating Room
Authors: Çelik Mehmet , Çomoğlu Şenol , Yağci Ibrahim , Aydemir Levent , Altun Demet , Kiyak Erkan
Published: March 2018

Anatomy knowledge is not only essential for surgeons but also has importance for anyone who performs an invasive procedure on a patient, and provides examination and diagnosis of patients and sharing of these findings to the patient and other medical professionals. It is accepted that most surgical procedures could facilitate anatomic perception in surgical internships. There is an educational tendency to explore innovative instructional tools and methods that can help support current education styles. This study investigates the effect of a green laser pointer on students’ perceptions and educational effectiveness when neck dissection is performed in the operating room.
Improving Postoperative Nasal Airway Patency in Le Fort-Based, Maxillofacial Trauma Patients Via a Modified Nasal Packing Technique
Authors: Wolff Amir , Santiago Gabriel F. , Belzberg Micah , Emodi Omri , Gordon Chad R.
Published: March 2018

Introduction:

Combined mid-face and nasal apparatus trauma injuries pose a significant challenge to airway patency (AW), in the immediate postoperative setting following fracture reduction. As such, the authors describe a modified technique with the goal of maintaining a patent nasal AW, while at the same time, minimizing nasopharyngeal bleeding and nasal AW edema—which can complicate patients requiring intermaxillary fixation (IMF) in the setting of pan-facial trauma.

Methods:

A modified technique was devised to assist the reconstruction surgeon in avoiding the risks associated with tracheostomy placement. In an effort to avoid surgical AW complications and improve nasal AW patency in the setting of concurrent IMF and nasal trauma, the authors developed a 2-stage technique drawing upon knowledge from the literature and the authors’ own experiences.

Technique:

Following safe extubation, the authors insert open lumen nasal splints in both the nostrils, and suture them together to the nasal septum. If additional inner nasal support is required, polyvinyl alcohol nonabsorbable nasal packing dressing is covered with antibiotic ointment, and then placed within the nasal cavity lateral to the open lumen splints—as a way to further bolster the internal valve and mid-vault anatomy.

Discussion:

Given the fact that traditional nasal packing with merocele/gauze dressing in concomitant to IMF reduced patients ability to ventilate, the authors felt that a modified technique should be applied. The authors’ preferred materials in such patients are open lumen splint, which provides nasal AW patency along with some septum support accompanied by merocele dressing. The authors feel that by applying this technique they achieve dual objectives by supporting the traumatized nose and maintaining nasal AW patency.
Anterior Maxillary Segmental Distraction Osteogenesis for Treatment of Maxillary Hypoplasia in Patients With Repaired Cleft Palate
Authors: Lin Xi , Zhou Nuo , Huang Xuanping , Song Shaohua , Li Hongyi
Published: March 2018

Objective:

This study is to present experiences of using anterior maxillary segmental distraction osteogenesis (AMSDO) with internal distractors for treatment of maxillary hypoplasia in patients with repaired cleft palate.

Materials and Methods:

A total of 42 patients of maxillary hypoplasia with repaired cleft palate were included in this study, and underwent AMSDO. Cephalometric analysis and speech quality assessments were performed to evaluate the changes after AMSDO and its long-term effect on stability.

Results:

All cases had successfully accomplished AMSDO. The average SNA (°), NA-FH (°), ANS-PNS (millimeter), and Overjet (millimeter) have change to 80.41°, 89.51°, 55.64 mm, and 2.52 mm, respectively (P < 0.01). Maxillary advancement has reached 13.80 mm on average (ranging from 10.0 mm to 20.0 mm). Speech quality assessment demonstrated that nasal resonance, speech articulation, nasal emission, intelligibility, and velopharyngeal function did not get worse after AMSDO.

Conclusions:

AMSDO has unique advantages as follows: can effectively correct maxillary hypoplasia in patients with repaired cleft palate; can create a space for postoperative orthodontic treatment to solve the crowding teeth situation; the postoperative velopharyngeal function and speech quality show no significant change. The results shown AMSDO is an effective and appropriate treanment for curing maxillary hypoplasia in patients with repaired cleft palate.
Creation of Experimental Human Nose Model With Lyophilized and Decellularized Bovine Cartilage Xenograft
Authors: Demir Can Ilker , Yaşar Emrah Kağan , Davun Kivanç , Gök Aykut , Uzun Ceyhun , Alagöz Murat Şahin
Published: March 2018

The nose anatomy is a functional and aesthetically important organ because of its three-dimensional structure, visible location in the face region, and its connection with the respiratory tract. Aesthetic and reconstructive nasal surgery requires correction of deformations in cartilage and bone structures as well as preservation of the natural connections between all subunits. The minimal mistake made can result in functional or aesthetically bad results. In this study, the authors aimed to create an experimental nose model that help aesthetic and reconstructive nose surgery operations.
Risk Factors for Acute Mesenteric Ischemia in Critically Ill Burns Patients—A Matched Case–Control Study
Authors: Soussi Sabri , Taccori Marina , De Tymowski Christian , Depret François , Chaussard Maïté , Fratani Alexandre , Jully Marion , Cupaciu Alexandru , Ferry Axelle , Benyamina Mourad , Serror Kevin , Boccara David , Chaouat Marc , Mimoun Maurice , Cattan Pierre , Zagdanski Anne-Marie , Anstey James , Mebazaa Alexandre , Legrand Matthieu
Published: March 2018

Objective:

Burn-induced shock can lead to tissue hypoperfusion, including the gut. We performed this study to describe burn patients at risk of acute mesenteric ischemia (AMI) with the aim to identify potential modifiable risk factors.

Methods:

Retrospective case–control study including adult severely burned patients between August 2012 and March 2017. Patients who developed AMI were matched to severely burned patients without AMI at a ratio of 1:3 (same year of admission, Abbreviated Burn Severity Index [ABSI], and Simplified Acute Physiology Score II [SAPSII]). Univariate and multiple regression analyses were performed.

Results:

Of 282 severely burned patients, 15 (5%) were diagnosed with AMI. In the AMI group, patients had a median (interquartile range) total body surface area (TBSA), SAPSII, and ABSI of 55 (25–63)%, 53 (39–70), and 11 (8–13), respectively. The AMI mechanism in all patients was nonocclusive. Decreased cardiac index within the first 24 h (H24 CI), higher sequential organ failure assessment score on day 1 (D1 SOFA), and hydroxocobalamin use were associated with AMI. Odds ratios were 0.18 (95% confidence interval [CI], 0.03–0.94), 1.6 (95% CI, 1.2–2.1), and 4.6 (95% CI, 1.3–15.9), respectively, after matching. Multiple regression analysis showed that only decreased H24 CI and higher D1 SOFA were independently associated with AMI. Ninety-day mortality was higher in the AMI group (93% vs. 46% [P = 0.001]).

Conclusions:

Burns patients with initial low cardiac output and early multiple organ dysfunction are at high risk of nonocclusive AMI.