bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-fire water-quality response in the western United States
Authors: Rust Ashley J. , Hogue Terri S. , Saxe Samuel , McCray John
Published: March 2018

Wildfires are increasing in size and severity in forested landscapes across the Western United States. Not only do fires alter land surfaces, but they also affect the surface water quality in downstream systems. Previous studies of individual fires have observed an increase in various forms of nutrients, ions, sediments and metals in stream water for different post-fire time periods. In this research, data were compiled for over 24 000 fires across the western United States to evaluate post-fire water-quality response. The database included millions of water-quality data points downstream of these fires, and was synthesised along with geophysical data from each burned watershed. Data from 159 fires in 153 burned watersheds were used to identify common water-quality response during the first 5 years after a fire. Within this large dataset, a subset of seven fires was examined further to identify trends in water-quality response. Change-point analysis was used to identify moments in the post-fire water-quality data where significant shifts in analyte concentrations occurred. Evaluating individual fires revealed strong initial increases or decreases in concentrations, depending on the analyte, that are masked when averaged over 5 years. Evidence from this analysis shows significant increases in nutrient flux (different forms of nitrogen and phosphorus), major-ion flux and metal concentrations are the most common changes in stream water quality within the first 5 years after fire. Dissolved constituents of ions and metals tended to decrease in concentration 5 years after fire whereas particulate matter concentration continued to increase. Assembling this unique and extensive dataset provided the opportunity to determine the most common post-fire water-quality changes in the large and diverse Western USA. Results from this study could inform studies in other parts of the world, will help parameterise and validate post-fire water-quality models, and assist communities affected by wildfire to anticipate changes to their water quality.
Successful reprogramming of cellular protein production through mRNA delivered by functionalized lipid nanoparticles
Authors: Yanez Arteta Marianna , Kjellman Tomas , Bartesaghi Stefano , Wallin Simonetta , Wu Xiaoqiu , Kvist Alexander J. , Dabkowska Aleksandra , Székely Noémi , Radulescu Aurel , Bergenholtz Johan , Lindfors Lennart
Published: March 2018

Significance

mRNA treatments represent an exciting approach to cure diseases that cannot be tackled with current therapeutics. However, the delivery of mRNA to target cells remains a challenge, but among the existing alternatives, lipid nanoparticles (LNPs) offer a promising answer to this. Here we determine the structure of LNPs encapsulating mRNA, consisting of a lipid mixture already evaluated in clinical trials. We show that the lipids are not homogeneously distributed across the LNP, and one of the lipids is localized mainly at its surface. The structural information enabled us to design LNPs that successfully modify intracellular protein production in two clinically relevant cell types. Our findings and approach provide a framework for understanding and optimizing vehicles for mRNA delivery.
Local protein solvation drives direct down-conversion in phycobiliprotein PC645 via incoherent vibronic transport
Authors: Blau Samuel M. , Bennett Doran I. G. , Kreisbeck Christoph , Scholes Gregory D. , Aspuru-Guzik Alán
Published: March 2018

Significance

To harness sunlight for growth, plants and algae rapidly convey absorbed excitation energy from antennae pigments to a reaction center, where the excitations convert to chemical energy. In deep water environments, cryptophyte algae survive by using the molecular motion of phycobiliprotein antennae to funnel excitations to low-energy pigments. The mechanism of down-conversion in phycobiliproteins remains controversial: Could specific vibrations resonant with pigment energy gaps support coherence between excited states and thereby enhance the rate of transport by transient delocalization? Here, we demonstrate that down-conversion in a specific phycobiliprotein, PC645, is both incoherent and enhanced by a broad range of high-frequency vibrations. We suggest that a similar incoherent mechanism is appropriate across phycobiliproteins.
Interpreter-mediated drafting of written records in police interviews
Authors: Defrancq Bart , Verliefde Sofie
Published: March 2018

Text drafting is an essential component of many of the contexts in which interpreters are called in to ensure communication (Määttä 2015). As Komter (2006) shows, the drafting process itself can be considered a turn in the interaction. Interpreters involved in such contexts thus perform a communicative pas de quatre, crossing not only the language divide, but also the modal divide (oral vs. written). In this paper, we analyse how an interpreter in a Belgian police interview handles this complex task. It appears that she procedurally and declaratively recognises a written turn in the interaction and uses its authoritative voice to silence the witness by sight-translating the turn as it is being typed on the screen. In line with previous research on interpreters’ handling of dialogues (Hale 1997), the interpreter also shapes turns, including the written turn, to the needs of the addressees: upgrading the register properties of the interviewee’s talk and downgrading those of the written turn.
Indexically Structured Ecological Communities
Authors: Lean Christopher Hunter
Published: March 2018

Ecological communities are seldom, if ever, biological individuals. They lack causal boundaries as the populations that constitute communities are not congruent and rarely have persistent functional roles regulating the communities’ higher-level properties. Instead we should represent ecological communities indexically, by identifying ecological communities via the network of weak causal interactions between populations that unfurl from a starting set of populations. This precisification of ecological communities helps identify how community properties remain invariant, and why they have robust characteristics. This respects the diversity and aggregational nature of these complex systems while still vindicating them as units worthy of investigation.
Evidence Enriched
Authors: Boyd Nora Mills
Published: March 2018

Traditionally, empiricism has relied on the specialness of human observation, yet science is rife with sophisticated instrumentation and techniques. The present article advances a conception of empirical evidence applicable to actual scientific practice. I argue that this conception elucidates how the results of scientific research can be repurposed across diverse epistemic contexts: it helps to make sense of how evidence accumulates across theory change, how different evidence can be amalgamated and used jointly, and how the same evidence can be used to constrain competing theories in the service of breaking local underdetermination.
Understanding sequencing data as compositions: an outlook and review
Authors: Quinn Thomas P , Erb Ionas , Richardson Mark F , Crowley Tamsyn M
Published: March 2018

Motivation

Although seldom acknowledged explicitly, count data generated by sequencing platforms exist as compositions for which the abundance of each component (e.g. gene or transcript) is only coherently interpretable relative to other components within that sample. This property arises from the assay technology itself, whereby the number of counts recorded for each sample is constrained by an arbitrary total sum (i.e. library size). Consequently, sequencing data, as compositional data, exist in a non-Euclidean space that, without normalization or transformation, renders invalid many conventional analyses, including distance measures, correlation coefficients and multivariate statistical models.

Results

The purpose of this review is to summarize the principles of compositional data analysis (CoDA), provide evidence for why sequencing data are compositional, discuss compositionally valid methods available for analyzing sequencing data, and highlight future directions with regard to this field of study.

Supplementary information

Supplementary data are available at Bioinformatics online.
LSMM: a statistical approach to integrating functional annotations with genome-wide association studies
Authors: Ming Jingsi , Dai Mingwei , Cai Mingxuan , Wan Xiang , Liu Jin , Yang Can
Published: March 2018

Motivation

Thousands of risk variants underlying complex phenotypes (quantitative traits and diseases) have been identified in genome-wide association studies (GWAS). However, there are still two major challenges towards deepening our understanding of the genetic architectures of complex phenotypes. First, the majority of GWAS hits are in non-coding region and their biological interpretation is still unclear. Second, accumulating evidence from GWAS suggests the polygenicity of complex traits, i.e. a complex trait is often affected by many variants with small or moderate effects, whereas a large proportion of risk variants with small effects remain unknown.

Results

The availability of functional annotation data enables us to address the above challenges. In this study, we propose a latent sparse mixed model (LSMM) to integrate functional annotations with GWAS data. Not only does it increase the statistical power of identifying risk variants, but also offers more biological insights by detecting relevant functional annotations. To allow LSMM scalable to millions of variants and hundreds of functional annotations, we developed an efficient variational expectation-maximization algorithm for model parameter estimation and statistical inference. We first conducted comprehensive simulation studies to evaluate the performance of LSMM. Then we applied it to analyze 30 GWAS of complex phenotypes integrated with nine genic category annotations and 127 cell-type specific functional annotations from the Roadmap project. The results demonstrate that our method possesses more statistical power than conventional methods, and can help researchers achieve deeper understanding of genetic architecture of these complex phenotypes.

Availability and implementation

The LSMM software is available at https://github.com/mingjingsi/LSMM.

Supplementary information

Supplementary data are available at Bioinformatics online.
FaStore: a space-saving solution for raw sequencing data
Authors: Roguski Łukasz , Ochoa Idoia , Hernaez Mikel , Deorowicz Sebastian
Published: March 2018

Motivation

The affordability of DNA sequencing has led to the generation of unprecedented volumes of raw sequencing data. These data must be stored, processed and transmitted, which poses significant challenges. To facilitate this effort, we introduce FaStore, a specialized compressor for FASTQ files. FaStore does not use any reference sequences for compression and permits the user to choose from several lossy modes to improve the overall compression ratio, depending on the specific needs.

Results

FaStore in the lossless mode achieves a significant improvement in compression ratio with respect to previously proposed algorithms. We perform an analysis on the effect that the different lossy modes have on variant calling, the most widely used application for clinical decision making, especially important in the era of precision medicine. We show that lossy compression can offer significant compression gains, while preserving the essential genomic information and without affecting the variant calling performance.

Availability and implementation

FaStore can be downloaded from https://github.com/refresh-bio/FaStore.

Supplementary information

Supplementary data are available at Bioinformatics online.
Efficacy and Safety of Surgery for Mild Degenerative Cervical Myelopathy: Results of the AOSpine North America and International Prospective Multicenter Studies
Authors: Badhiwala Jetan H , Witiw Christopher D , Nassiri Farshad , Akbar Muhammad A , Mansouri Alireza , Wilson Jefferson R , Fehlings Michael G
Published: March 2018

BACKGROUND

There is controversy over the optimal treatment strategy for patients with mild degenerative cervical myelopathy (DCM).

OBJECTIVE

To evaluate the degree of impairment in baseline quality of life as compared to population norms, as well as functional, disability, and quality of life outcomes following surgery in a prospective cohort of mild DCM patients undergoing surgical decompression.

METHODS

We identified patients with mild DCM (modified Japanese Orthopaedic Association [mJOA] 15 to 17) enrolled in the prospective, multicenter AOSpine CSM-NA or CSM-I trials. Baseline quality of life Short Form-36 version 2 (SF-36v2) was compared to population norms by the standardized mean difference (SMD). Outcomes, including functional status (mJOA, Nurick grade), disability (NDI [Neck Disability Index]), and quality of life (SF-36v2), were evaluated at baseline and 6 mo, 1 yr, and 2 yr after surgery. Postoperative complications within 30 d of surgery were monitored.

RESULTS

One hundred ninety-three patients met eligibility criteria. Mean age was 52.4 yr. There were 67 females (34.7%). Patients had significant impairment in all domains of the SF-36v2 compared to population norms, greatest for Social Functioning (SMD –2.33), Physical Functioning (SMD –2.31), and Mental Health (SMD –2.30). A significant improvement in mean score from baseline to 2-yr follow-up was observed for all major outcome measures, including mJOA (0.87, P < .01), Nurick grade (–1.13, P < .01), NDI (–12.97, P < .01), and SF-36v2 Physical Component Summary (PCS) (5.75, P < .01) and Mental Component Summary (MCS) (6.93, P < .01). The rate of complication was low.

CONCLUSION

Mild DCM is associated with significant impairment in quality of life. Surgery results in significant gains in functional status, level of disability, and quality of life.
New Isolates of Sweet potato feathery mottle virus and Sweet potato virus C: Biological and Molecular Properties, and Recombination Analysis Based on Complete Genomes
Authors: Maina Solomon , Barbetti Martin J. , Martin Darren P. , Edwards Owain R. , Jones Roger A. C.
Published: March 2018

Sweet potato feathery mottle virus (SPFMV) and Sweet potato virus C (SPVC) isolates were obtained from sweetpotato shoot or tuberous root samples from three widely separated locations in Australia’s tropical north (Cairns, Darwin, and Kununurra). The samples were planted in the glasshouse and scions obtained from the plants were graft inoculated to Ipomoea setosa plants. Virus symptoms were recorded in the field in Kununurra and in glasshouse-grown sweetpotato and I. setosa plants. RNA extracts from I. setosa leaf samples were subjected to high-throughput sequencing. New complete SPFMV (n = 17) and SPVC (n = 6) genomic sequences were obtained and compared with 47 sequences from GenBank. Phylogenetic analysis revealed that the 17 new SPFMV genomes all fitted within either major phylogroup A, minor phylogroup II, formerly O; or major phylogroup B, formerly RC. Major phylogroup A’s minor phylogroup I, formerly EA, only appeared when recombinants were included. Numbers of SPVC genomes were insufficient to subdivide it into phylogroups. Within phylogroup A’s minor phylogroup II, the closest genetic match between an Australian and a Southeast Asian SPFMV sequence was the 97.4% nucleotide identity with an East Timorese sequence. Recombination analysis of the 43 SPFMV and 27 SPVC sequences revealed evidence of 44 recombination events, 16 of which involved interspecies sequence transfers between SPFMV and SPVC and 28 intraspecies transfers, 17 in SPFMV and 11 in SPVC. Within SPFMV, 11 intraspecies recombination events were between different major phylogroups and 6 were between members of the same major phylogroup. Phylogenetic analysis accounting for the detected recombination events within SPFMV sequences yielded evidence of minor phylogroup II and phylogroup B but the five sequences from minor phylogroup I were distributed in two separate groups among the sequences of minor phylogroup II. For the SPVC sequences, phylogenetic analysis accounting for the detected recombination events revealed three major phylogroups (A, B, and C), with major phylogroup A being further subdivided into two minor phylogroups. Within the recombinant genomes of both viruses, their PI, NIa-Pro, NIb, and CP genes contained the highest numbers of recombination breakpoints. The high frequency of interspecies and interphylogroup recombination events reflects the widespread occurrence of mixed SPVC and SPFMV infections within sweetpotato plants. The prevalence of infection in northern Australian sweetpotato samples reinforces the need for improved virus testing in healthy sweetpotato stock programs. Furthermore, evidence of genetic connectivity between Australian and East Timorese SPFMV genomes emphasizes the need for improved biosecurity measures to protect against potentially damaging international virus movements.
Applied Pediatric Math: Bridging the Gap Between Theory and Practice for a Diverse Group of Learners
Authors: Murphy Glenn , Murphy Jackie
Published: March 2018

A gap exists between didactic theory and clinical practice when nursing students learn clinical calculations. Educators can provide innovative classroom teaching methods using practical mathematics to decrease this gap. In the simulation lab, students complete weight-based calculations and then administer medications as part of medication skills stations. Math assessments in the psychomotor domain promote application of didactic math content. Implementing math assessments that include a hands-on component facilitates the students’ abilities to take math out of the classroom and apply it in clinical practice, enabling the educator to minimize disparities found when students have different mathematics backgrounds.
Alcohol and Drug Screening, Brief Intervention, and Referral to Treatment (SBIRT) Training and Implementation: Perspectives from 4 Health Professions
Authors: Wamsley Maria , Satterfield Jason M. , Curtis Alexa , Lundgren Lena , Satre Derek D.
Published: March 2018

Objectives:

Screening, Brief Intervention, and Referral to Treatment (SBIRT) can effectively identify and address substance misuse and substance use disorders (SUDs), and can be delivered by a range of trained health professionals. Yet, barriers remain to effective training and implementation of SBIRT in health and social service settings, and models of interprofessional collaboration in SBIRT delivery are underdeveloped.

Methods:

We reviewed current literature regarding SBIRT effectiveness, training, and implementation by physicians, nurses, psychologists, and social workers. An SBIRT expert and representative from each health profession synthesized literature and training experiences to inform the development of interprofessional training and collaborative implementation strategies.

Results:

Each of the health professions involved in SBIRT training and implementation have strengths and weaknesses that influence how SBIRT is taught, learned, and delivered. Some of these are specific to the components of SBIRT, for example, screening versus brief intervention, whereas others depend on profession-driven competencies, for example, motivational interviewing. Professional organizations have encouraged a range of tailored SBIRT training initiatives, but true interprofessional training and the implementation of collaborative, team-based care are largely unrealized.

Conclusions:

SBIRT can be a valuable approach to screening and treatment for SUDs when delivered by a range of healthcare professionals. A more nuanced understanding of the assumptions and characteristics of each profession, informed by the emerging field of implementation science, may shape more effective training curricula and highlight interprofessional models of SBIRT delivery that maximize the strengths of each profession.
Variability Analysis of Manual and Computer-Assisted Preoperative Thoracic Pedicle Screw Placement Planning
Authors: Knez Dejan , Mohar Janez , Cirman Robert J. , Likar Boštjan , Pernuš Franjo , Vrtovec Tomaž
Published: March 2018

Study Design.

A comparison among preoperative pedicle screw placement plans, obtained from computed tomography (CT) images manually by two spine surgeons and automatically by a computer-assisted method.

Objective.

To analyze and compare the manual and computer-assisted approach to pedicle screw placement planning in terms of the inter- and intraobserver variability.

Summary of Background Data.

Several methods for computer-assisted pedicle screw placement planning have been proposed; however, a systematic variability analysis against manual planning has not been performed yet.

Methods.

For 256 pedicle screws, preoperative placement plans were determined manually by two experienced spine surgeons, each independently performing two sets of measurements by using a dedicated software for surgery planning. For the same 256 pedicle screws, preoperative placement plans were also obtained automatically by a computer-assisted method that was based on modeling of the vertebral structures in 3D, which were used to determine the pedicle screw size and insertion trajectory by maximizing its fastening strength through the underlying bone mineral density.

Results.

A total of 1024 manually (2 observers × 2 sets × 256 screws) and 256 automatically (1 computer-assisted method × 256 screws) determined preoperative pedicle screw placement plans were obtained and compared in terms of the inter- and intraobserver variability. A large difference was observed for the pedicle screw sagittal inclination that was, in terms of the mean absolute difference and the corresponding standard deviation, equal to 18.3° ± 7.6° and 12.3° ± 6.5°, respectively for the intraobserver variability of the second observer and for the interobserver variability between the first observer and the computer-assisted method.

Conclusion.

The interobserver variability among the observers and the computer-assisted method is within the intraobserver variability of each observer, which indicates on the potential use of the computer-assisted approach as a useful tool for spine surgery that can be adapted according to the preferences of the surgeon.

Level of Evidence: 3
Molecular Targeted Therapy Approach to Musculoskeletal Tumors
Authors: Ibe Izuchukwu , Haynes Monique , Koo Andrew , Lindskog Dieter , Friedlaender Gary E. , Lee Francis Y.
Published: March 2018

The future of cancer treatment is promising. Although marred by years of plateau in outcomes, new avenues have been identified that are poised to change how we treat cancer. Molecular targeted therapy or targeted therapy is one of these methods. Molecular targeted therapy involves identifying specific pathways or markers that allow cancer cells to flourish. Once identified, specific molecules can be used to block proliferative pathways, thereby negatively impacting tumor growth. Targeting specific pathways that prolong the survival of the cancer cell can lead to a decreased cancer burden and improved patient outcomes. This article reviews the tenets of molecular targeted therapy, common pathways, target acquisition for drug development, and the pathways that have been elucidated in musculoskeletal tumors.
One-Year Outcomes in Patients With Acute Respiratory Distress Syndrome Enrolled in a Randomized Clinical Trial of Helmet Versus Facemask Noninvasive Ventilation
Authors: Patel Bhakti K. , Wolfe Krysta S. , MacKenzie Erica L. , Salem Dhafer , Esbrook Cheryl L. , Pawlik Amy J. , Stulberg Megan , Kemple Crystal , Teele Megan , Zeleny Erin , Macleod Julia , Pohlman Anne S. , Hall Jesse B. , Kress John P.
Published: March 2018

Objectives:

Many survivors of acute respiratory distress syndrome have poor long-term outcomes possibly due to supportive care practices during “invasive” mechanical ventilation. Helmet noninvasive ventilation in acute respiratory distress syndrome may reduce intubation rates; however, it is unknown if avoiding intubation with helmet noninvasive ventilation alters the consequences of surviving acute respiratory distress syndrome.

Design:

Long-term follow-up data from a previously published randomized controlled trial.

Patients:

Adults patients with acute respiratory distress syndrome enrolled in a previously published clinical trial.

Setting:

Adult ICU.

Intervention:

None.

Measurements and Main Results:

The primary outcome was functional independence at 1 year after hospital discharge defined as independence in activities of daily living and ambulation. At 1 year, patients were surveyed to assess for functional independence, survival, and number of institution-free days, defined as days alive spent living at home. The presence of ICU-acquired weakness and functional independence was also assessed by a blinded therapist on hospital discharge. On hospital discharge, there was a greater prevalence of ICU-acquired weakness (79.5% vs 38.6%; p = 0.0002) and less functional independence (15.4% vs 50%; p = 0.001) in the facemask group. One-year follow-up data were collected for 81 of 83 patients (97.6%). One-year mortality was higher in the facemask group (69.2% vs 43.2%; p = 0.017). At 1 year, patients in the helmet group were more likely to be functionally independent (40.9% vs 15.4%; p = 0.015) and had more institution-free days (median, 268.5 [0–354] vs 0 [0–323]; p = 0.017).

Conclusions:

Poor functional recovery after invasive mechanical ventilation for acute respiratory distress syndrome is common. Helmet noninvasive ventilation may be the first intervention that mitigates the long-term complications that plague survivors of acute respiratory distress syndrome managed with noninvasive ventilation.
Development of a Nursing Electronic Medical Record Usability Protocol
Authors: Lyerla Frank , Durbin Christine R. , Henderson Rochelle
Published: March 2018

Assessing usability of an electronic medical record is useful for organizations wishing to customize their electronic medical record and determine the impact on usability. The purpose of this article is to describe the development of a protocol to measure electronic medical record usability from a nursing perspective and to develop a scoring methodology. The Technical Evaluation, Testing, and Validation of the Usability of Electronic Health Records (NISTIR 7804), published by the National Institute of Standards and Technology, guided protocol development. Usability was determined by measuring effectiveness, efficiency, and satisfaction. Satisfaction was measured by the System Usability Scale, while effectiveness and efficiency were measured via performance testing by participants, who completed one of three scenarios. A protocol and scoring formula were developed and used to assess nursing usability, resulting in an overall “C” grade for the electronic medical record. Protocol implementation and the scoring/grading calculations can be replicated to assess electronic medical record usability. The three scenarios used in this protocol will be made available upon request from the primary author to promote the use of electronic medical record usability assessment. Using and expanding upon the government's recommended usability assessment guidelines, we were successful in measuring nursing electronic medical record usability and rating an electronic medical record.
Targeted ultrasound and fine-needle aspiration cytology for sentinel node diagnostics in early-stage melanoma: a validation study
Authors: Ternov Niels K. , Lambine Trine-Lise , Wagenblast Anne L.H. , Clasen-Linde Erik , Oturai Peter S. , Klyver Helle , Nielsen Kristina R. , Nielsen Michael B. , Drzewiecki Krzysztof T. , Chakera Annette H.
Published: March 2018

Ultrasound-guided fine-needle aspiration cytology (US-FNAC) is used to evaluate the involvement of lymph nodes in various malignant diseases. Its value in detecting sentinel lymph node (SN) metastasis preoperatively in melanoma patients is controversial and is the subject of this study. In this prospective validation study, 91 consecutive patients with melanoma clinical stage I (n=64) and II (n=27) were examined with US-FNAC before SN biopsy from 2012 to 2014 at a tertiary center. All patients underwent lymphoscintigraphy before the US-FNAC. Lymph nodes that showed any of the Berlin morphologic criteria on ultrasonography were examined using FNAC. The median Breslow thickness of the melanomas was 1.22 mm (range: 0.47–11.5 mm). Twenty-two percent of the patients had metastases in their SNs, 90% of which were smaller than 2 mm in largest diameter. The percentages of metastases with a size more than 1 mm were 50 and 29%, respectively, in the true-positive and false-negative US groups. The sensitivity, specificity, positive predictive value, and negative predictive value for overall US examination were 30, 81, 24, and 83%, respectively. None of the FNACs contained conclusive malignant cells. The specificity of the FNAC was 76%. Our results show that US-FNAC was not a useful diagnostic tool in our setting as it did not add significantly to the staging and management of patients with mainly thin cutaneous melanomas, perhaps because of the often small size of the SN metastases. It may be useful in the early diagnosis of lymph node metastases in a subgroup of melanoma patients with larger metastases.
Modified Pfannenstiel Open Approach as an Alternative to Laparoscopic Total Proctocolectomy and IPAA: Comparison of Short- and Long-term Outcomes and Quality of Life
Authors: Duraes Leonardo C. , Schroeder Destiny A. , Dietz David W.
Published: March 2018

BACKGROUND:

A laparoscopic approach to total proctocolectomy with IPAA has been suggested to have better short-term outcomes and cosmesis, whereas open surgery by midline incision may result in shorter operative times. We hypothesized that a modified Pfannenstiel open approach would combine the advantages of both techniques.

OBJECTIVE:

The purpose of this study was to compare outcomes of open total proctocolectomy with IPAA using a modified Pfannenstiel incision versus those following the laparoscopic approach.

DESIGN:

This was a retrospective study comparing patients submitted to open IPAA using modified Pfannenstiel incision versus laparoscopy from 1998 to 2014.

SETTINGS:

The study was conducted at a high-volume tertiary referral center.

PATIENTS:

Among 1275 patients, 119 patients underwent the laparoscopic approach and 33 underwent the modified Pfannenstiel approach.

MAIN OUTCOME MEASURES:

Short- and long-term outcomes were evaluated, and quality-of-life questionnaires were assessed.

RESULTS:

Patients who underwent the modified Pfannenstiel approach were younger, more often women, and had lower BMI and ASA classification compared with those who underwent laparoscopy. Surgical time was lower in Pfannenstiel, and no difference was observed in length of hospital stay. No difference was observed in postoperative complications, pouch failure rate, or quality of life. Patients were then matched 1:1 by diagnosis, sex, age (±5 y) and BMI (±5 kg/m2). The Pfannenstiel approach still had a shorter surgical time. No difference was observed in the length of hospital stay, complications, pouch failure, or quality of life. In long-term follow-up, pouchitis symptoms occurred more frequently in Pfannenstiel (mean follow-up = 7.3 y), and seepage was more frequently observed in the laparoscopy group (mean follow-up = 4.2 y). These differences were not observed in matched patients.

LIMITATIONS:

The study was limited by its retrospective design and inherent selection bias.

CONCLUSIONS:

The modified Pfannenstiel approach provides equivalent short- and long-term outcomes and similar quality of life compared with laparoscopy but with a significantly shorter operative time. The modified Pfannenstiel approach to total proctocolectomy with IPAA may be the most efficient method in selected patients. See Video Abstract at http://links.lww.com/DCR/A562.
Factors associated with knowledge about menopause and hormone therapy in middle-aged Brazilian women: a population-based household survey
Authors: de Arruda Amaral Isabel C.G. , Baccaro Luiz F. , Lui-Filho Jeffrey F. , Osis Maria J.D. , Pedro Adriana O. , Costa-Paiva Lúcia
Published: March 2018

Objectives:

The aim of the study was to evaluate knowledge about menopause and hormone therapy (HT) among middle-aged Brazilian women and identify the factors associated with the level of knowledge.

Methods:

A cross-sectional study was conducted with 749 women aged 45 to 60 years, residing in the Metropolitan Region of Campinas, Brazil. The dependent variable was knowledge about menopause and HT evaluated using a numerical score based on the answers given to three questions that had several response options. The independent variables were sociodemographic characteristics, personal habits, and health conditions. Statistical analysis was carried out by Mann–Whitney, Kruskal–Wallis, and a generalized linear model.

Results:

The mean age was 52.5 (±4.4) years. Most of the women were postmenopausal (68%) and 19.5% had a history of current or previous use of HT. The final score for knowledge about menopause ranged from +1 to +11, with a mean of 4.59 (±1.86) and a median of 4. Women with higher levels of schooling (coefficient = 0.64, P < 0.001); with higher socioeconomic status (coefficient = 0.47, P < 0.002); with vaginal dryness (coefficient = 0.47, P = 0.003); who consumed alcohol (coefficient = 0.61, P = 0.006); who use or had ever used any type of treatment to counteract menopausal symptoms (coefficient = 0.41, P = 0.008); with anxiety (coefficient = 0.35, P = 0.037); and with depression (coefficient = 0.31, P = 0.043) possessed greater knowledge about menopause and HT. Women with a higher number (≥3) of vaginal deliveries (coefficient = −0.61, P < 0.001) and a higher body mass index (coefficient = −0.02, P = 0.046) possessed less knowledge about menopause and HT.

Conclusions:

The knowledge about menopause and HT demonstrated by the interviewees was low and possibly related to the time of exposure to qualified information.
Cellular Proliferation and Migration of Human Pterygium Cells: Mitomycin Versus Small-Molecule Inhibitors
Authors: Cao Di , Chu Wai Kit , Ng Tsz Kin , Yip Yolanda W.Y. , Young Alvin L. , Pang Chi Pui , Jhanji Vishal
Published: March 2018

Purpose:

Nutlin is a drug that has been reported to activate p53 in various cell lines. We aim to study the effects of Nutlin in pterygium and compare the effects of Nutlin and mitomycin C (MMC) in pterygium cell lines.

Methods:

Pterygium samples (n = 3) were collected during surgical excision. Normal conjunctival tissues (n = 3) were collected from another quadrant of the same eye. Cell lines were established, and cells from passages 2 to 5 were used. Pterygium and conjunctival cells were treated with different doses of Nutlin and MMC. Cell proliferation and cell migration were measured.

Results:

Cell proliferation was reduced by 39-fold after treatment with 50 μM Nutlin. Cell migration was inhibited with increasing dosages of Nutlin (95% and 28% after treating with 2 and 50 μM Nutlin, respectively). Compared with MMC, Nutlin induced more pterygium cell death and less conjunctival cell death at low doses. At 50% lethal dose for pterygium cells, 95% of conjunctival cells survived after Nutlin treatment, whereas only 63% of conjunctival cells survived after MMC treatment. p21 expression was not detectable in MMC-treated pterygium cells but was detectable after Nutlin treatment.

Conclusions:

In our study, MMC induced cell death in pterygium and conjunctival cell lines, whereas Nutlin had a targeted impact on pterygium cells. Our results implied that MMC inhibited both pterygium cell proliferation and migration through an apoptosis-independent pathway.
Epidemiology of Early-onset Bacterial Neonatal Infections in Madagascar
Authors: Ranosiarisoa Zoly Nantenaina , El Harrif Sélim , Andrianirina André Zo , Duron Sandrine , Simon-Ghediri Marie-José , Ramparany Lova , Robinson Annick Lalaina , Tsifiregna Rosa , Randrianirina Frédérique , Ratsima Elisoa , Raymond Josette , Imbert Patrick
Published: March 2018

Background:

Little is known about early-onset neonatal bacterial infections (EONBI) in Madagascar. Our aim was to determine their epidemiology to improve their management.

Methods:

Inborn neonates at risk for EONBI and admitted in the neonatal unit of 2 tertiary hospitals in Antananarivo, Madagascar, were included in a prospective study from April 2012 to March 2013. Using a clinical algorithm, blood culture, gastric fluid culture and C-reactive protein dosage were performed in newborns at high risk of infection, that is, peri partum fever, prematurity <35 weeks’ gestation or birth weight <2000 g, or presenting with clinical signs of infection. EONBI was defined as a bacteremia occurring within the first week of life.

Results:

Among 307 neonates, 75 (24.4%) had an EONBI caused by 1 (n = 59) or 2 (n = 16) bacteria (91 isolates). Gram-negative bacteria were predominant (n = 62, 82.7%), including Enterobacter cloacae (n = 26), Klebsiella pneumoniae (n = 14), Escherichia coli (n = 7) and Proteus mirabilis (n = 2). Group B Streptococcus, Acinetobacter baumanii and Enterococcus sp. represented 3.6%, 8.2% and 12.1% of the isolates, respectively. All E. cloacae and 12/14 (85.7%) K. pneumoniae were extended-spectrum β-lactamase producers. At all, 41/91 (45.1%) bacteria were multidrug-resistant (MDR) and 34/75 (45.3%) newborns had an EONBI caused by an MDR bacteria. Neonatal asphyxia was the only factor associated with multidrug resistance (odds ratio: 4.52; CI: 1.20–16.94; P = 0.025). The EONBI-related mortality (n = 20/75, 26.7%) rose up to 38.2% (n = 13/34) in case of MDR bacteria.

Conclusions:

The epidemiology of EONBIs in Madagascar is comparable to that found in many low-income countries. Prevention, including improvement of hygiene during resuscitation for neonatal asphyxia, is likely to be more effective in reducing EONBI-related morbidity and mortality than using new antibiotics to counter resistance.
Performance of Tuberculin Skin Tests and Interferon-γ Release Assays in Children Younger Than 5 Years
Authors: Velasco-Arnaiz Eneritz , Soriano-Arandes Antoni , Latorre Irene , Altet Neus , Domínguez José , Fortuny Clàudia , Monsonís Manuel , Tebruegge Marc , Noguera-Julian Antoni
Published: March 2018

Background:

Available data to assess the optimal diagnostic approach in infants and preschool children at risk of tuberculosis (TB) are limited.

Methods:

We conducted a prospective observational study in children younger than 5 years undergoing assessment with both tuberculin skin tests (TST) and QuantiFERON-TB Gold In-Tube (QFT-GIT) assays at 2 tertiary TB units in Barcelona, Spain.

Results:

A total of 383 children were included. One of 304 participants considered uninfected developed active TB during follow-up {median [interquartile range (IQR)]: 47 [30; 48] months}, compared with none of 40 participants with latent TB infection [follow-up since completion of anti-TB treatment: 42 (32; 45) months]. Overall test agreement between TST and QFT-GIT was moderate (κ = 0.551), but very good in children screened after TB contact (κ = 0.801) and in Bacillus Calmette-Guérin (BCG)-unvaccinated children (κ = 0.816). Discordant results (16.8%, all TST+/QFT-GIT−) were mainly observed in new-entrant screening and in BCG-vaccinated children. Children with indeterminate QFT-GIT results were on average younger than those with determinate results (median age: 12 vs. 30 months; P < 0.001). The sensitivity of TSTs and QFT-GIT assays in children with confirmed active TB was 100% (95% confidence interval: 79.4%–100%) and 93.7% (95% confidence interval: 69.8%–99.8%), respectively. In patients with latent TB infection or active TB, there was no correlation between age and antigen-stimulated interferon-γ responses (r = −0.044; P = 0.714).

Conclusions:

In young BCG-unvaccinated children with recent TB contact, a dual testing strategy using TST and QFT-GIT in parallel may not be necessary. However, TST+/QFT-GIT− discordance is common, and it remains uncertain if this constellation indicates TB infection or not. In active TB, QFT-GIT assays do not perform better than TSTs.
Effect of Physical Therapy Interventions in the Acute Care Setting on Function, Activity, and Participation After Total Knee Arthroplasty: A Systematic Review
Authors: Curry Alisa L. , Goehring Meri T. , Bell Jessica , Jette Diane U.
Published: March 2018

Background:

Despite seemingly routine use of physical therapy and its potential importance in reducing complications after total joint arthroplasty in the acute hospital setting, no agreed-upon approach to rehabilitation exists in this setting. In fact, rehabilitation practices and outcomes assessed are quite variable.

Purpose:

To determine the effects of physical therapy interventions in the acute care phase of total knee arthroplasty.

Data Sources:

Ovid Medline, Cochrane Database of Systematic Reviews, CINAHL.

Review Selection Criteria:

Peer-reviewed research from January 1996 to October 2016 of adults with primary total knee arthroplasty receiving any physical therapy intervention related to body systems/function impairments or activity/participation limitations measured within 7 days of surgery. All studies included a comparison group.

Data Extraction:

Two reviewers extracted data and determined study quality.

Data Synthesis:

Qualitative summary considering studies' risk of bias and number favoring interventions for outcomes.

Results:

Thirty-nine studies were included. Interventions included extra therapy, accelerated therapy, cryotherapy, Chinese medicine, lymphatic drainage, mechanical and manual passive motion, active-assistive motion, biofeedback, and electrical stimulation. Most studies included undefined “standard care.” Outcomes varied, with pain and knee motion commonly reported.

Conclusions:

Evidence supports cryotherapy for reducing pain and accelerated therapy for improving range of motion and walking, but quality is low. High-quality studies in these areas are needed.
Cochlear Implantation in Adults With Asymmetric Hearing Loss: Speech Recognition in Quiet and in Noise, and Health Related Quality of Life
Authors: Sladen Douglas P. , Carlson Matthew L. , Dowling Brittany P. , Olund Amy P. , DeJong Melissa D. , Breneman Alyce , Hollander Sara , Beatty Charles W. , Neff Brian A. , Driscoll Colin L.
Published: March 2018

Objective:

To examine the possible speech recognition and health related quality of life (HRQoL) benefits of cochlear implantation among adults with asymmetric sensorineural hearing loss.

Study Design:

Retrospective chart review, single-subject design.

Methods:

A total of 45 adult cochlear implant recipients with asymmetric sensorineural hearing loss where performance for the best-aided condition exceeded 60% correct open set sentence recognition in quiet, and the implanted ear met traditional candidacy criteria. End point testing of the implanted ear was evaluated with use of the Consonant-Vowel Nucleus-Consonant (CNC) word test and AzBio sentence test materials in quiet, and bimodally with the AzBio sentence test materials in noise at +5 dB signal-to-noise ratio (SNR). HRQoL was measured using the Nijmegen Cochlear Implant Questionnaire (NCIQ).

Results:

Measured in quiet, with the non-implanted ear plugged, the average CNC word scores increased from 9.1% preoperatively to 55.7% (p < 0.01) at the 6-month post-activation test interval. Similarly, average AzBio sentence scores in quiet, with the non-implanted ear plugged, increased from 13.9% preoperatively to 73.4% (p < 0.01) at the 6-month post-activation test interval. Finally, in the bilateral/bimodal condition, the AzBio sentence score in +5 dB SNR improved from an average of 26.8% preoperatively to 52.4% (p < 0.01) at the 6-month test interval. Results of the NCIQ showed improved scores on all six subdomains.

Conclusions:

These data demonstrate significant benefit of cochlear implantation among a group of postlingually deafened adults whose preoperative hearing and aided speech recognition fell outside of the currently specified Food and Drug Administration candidacy guidelines. Results of this study support the evaluation of a candidate's speech recognition in noise in the best-aided condition to adequately assess candidacy for a cochlear implant.
Changes in Bone Mineral Density in Women With Breast Cancer
Authors: Kim Soo Hyun , Cho Young Up , Kim Sei Joong , Han Mi Sook
Published: March 2018

Background

Cancer treatment–induced bone loss is an important long-term effect among breast cancer survivors. Little is known, however, about the pattern of bone loss and the factors associated with it.

Objective

The aim of this study was to examine annual bone health changes and factors associated with bone loss for 3 years after diagnosis among women with breast cancer.

Methods

Ninety-nine newly diagnosed women with breast cancer (mean age, 51.1 years) were enrolled in a prospective longitudinal study. Bone mineral density (BMD) was measured with dual-energy x-ray absorptiometry at baseline and yearly for 3 years.

Results

During the 3-year follow-up, the proportion of women who had osteopenia or osteoporosis increased from 33.3% to 62.5%. The BMD of the participants significantly decreased 6.8% in the lumbar spine, 4.6% in the femur neck, and 3.5% in the total hip, with bone loss the greatest in the first year. In multiple linear regression analysis, chemotherapy was significantly associated with bone loss at all sites, and premenopausal status at diagnosis was significantly related to bone loss at the lumbar spine. We found no significant relationship between health behavior status and BMD change at any site.

Conclusion

Women newly diagnosed with breast cancer can lose up to 6.8% of BMD during a 3-year follow-up. Chemotherapy and premenopausal status are important risk factors for bone loss.

Implications for Practice

Identification of premenopausal women at diagnosis and monitoring BMD before and after chemotherapy are key for promoting bone health in women with breast cancer.