bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance and Profitability of Fungicides for Managing Soybean White Mold: A 10-Year Summary of Cooperative Trials
Authors: Barro Jhonatan P. , Meyer Maurício C. , Godoy Claúdia V. , Dias Alfredo R. , Utiamada Carlos M. , Jaccoud Filho David de S. , Wruck Dulândula S. M. , Borges Edson P. , Siqueri Fabiano , Juliatti Fernando C. , Campos Hércules D. , Junior José N. , Carneiro Luciana C. , da Silva Luis H. C. P. , Martins Mônica C. , Balardin Ricardo S. , Zito Roberto K. , Furlan Silvânia H. , Venancio Wilson S. , Del Ponte Emerson M.
Published: March 2019

White mold, caused by Sclerotinia sclerotiorum, is a yield-limiting disease of soybean in Brazil. Uniform fungicide trials have been conducted annually since 2009. Data from 74 cooperative field trials conducted over a 10-year period were assembled. We selected five fungicides applied two times around flowering: dimoxystrobin plus boscalid (DIMO+BOSC), carbendazim plus procymidone (CARB+PROC), fluazinam (FLUZ), fluopyram (FLUO), and procymidone (PROC). For comparison, thiophanate-methyl (TMET) applied four times was also included as a low-cost treatment. Network models were fitted to the log of white mold incidence (percentages) and log of sclerotia mass data (grams/hectare) and to the nontransformed yield data (kilograms/hectare) for each treatment, including the untreated check. Back-transformation of the meta-analytic estimates indicated that the lowest and highest mean (95% confidence interval [CI]) percent reductions in incidence and sclerotia mass were 54.2 (49.3 to 58.7) and 51.6% (43.7 to 58.3) for TMET and 83.8 (79.1 to 87.5) and 87% (81.9 to 91.6) for CARB+PROC, respectively. The overall mean (95% CI) yield responses ranged from 323 kg/ha (247.4 to 400.3) for TMET to 626 kg/ha (521.7 to 731.7) for DIMO+BOSC, but the variance was significantly reduced by a binary variable (30% threshold) describing disease incidence in the untreated check. On average, an increment of 352 kg/ha was estimated for trials where the incidence was >30% compared with the low-disease scenario. Hence, the probability of breaking even on fungicide costs for the high-disease scenario was >65% for the more effective, but more expensive fungicide (FLUZ) than TMET. For the low-disease scenario, profitability was less likely and depended more on variations in fungicide cost and soybean price.
Factors Affecting the Dynamics of Frosty Pod Rot in the Main Cocoa Areas of Santander State, Colombia
Authors: Jaimes Yeirme Y. , Ribeyre Fabienne , Gonzalez Carolina , Rojas Jairo , Furtado Edson L. , Cilas Christian
Published: March 2019

Frosty pod rot (FPR) caused by Moniliophthora roreri is the primary disease affecting cacao production in the major producing countries of the Americas and is one of the major threats to cacao worldwide. The incidence of FPR on clones with different levels of resistance was investigated in four localities of Santander State, Colombia, between July 2013 and May 2015. Dynamics of diseased pods were modeled using boosted regression trees, a machine learning technique that allows regressions to be performed without prior statistical assumptions. The results suggested that FPR epidemics varied according to plot location, clone, weeks of observation, and total pods produced. Dynamics in the phenology of pods had an effect on the epidemics, and this dynamic could partially explain the difference in resistance among clones. Although not total, partial resistance of ICS 95 was confirmed. An important wilt effect was observed, particularly in the resistant clones; consequently, differences in harvested pods were not significant among clones. Pod stripping remains a good practice for the management of the disease and this practice could also have an effect on the pod dynamics and wilt phenomenon.
Biological and Molecular Properties of Wild potato mosaic virus Isolates from Pepino (Solanum muricatum)
Authors: Fribourg Cesar E. , Gibbs Adrian J. , Adams Ian P. , Boonham Neil , Jones Roger A. C.
Published: March 2019

In 1976, a virus with flexuous, filamentous virions typical of the family Potyviridae was isolated from symptomatic pepino (Solanum muricatum) plants growing in two valleys in Peru’s coastal desert region. In 2014, a virus with similar-shaped virions was isolated from asymptomatic fruits obtained from pepino plants growing in six coastal valleys and a valley in Peru’s Andean highlands. Both were identified subsequently as Wild potato mosaic virus (WPMV) by serology or high-throughput sequencing (HTS). The symptoms caused by two old and seven new isolates from pepino were examined in indicator plants. Infected solanaceous hosts varied considerably in their sensitivities to infection and individual isolates varied greatly in virulence. All seven new isolates caused quick death of infected Nicotiana benthamiana plants and more than half of them killed infected plants of Physalis floridana and S. chancayense. These three species were the most sensitive to infection. The most virulent isolate was found to be BA because it killed five of eight solanaceous host species whereas CA was the least severe because it only killed N. benthamiana. Using HTS, complete genomic sequences of six isolates were obtained, with one isolate (FE) showing evidence of recombination. The distances between individual WPMV isolates in phylogenetic trees and the geographical distances between their collection sites were found to be unrelated. The individual WPMV isolates displayed nucleotide sequence identities of 80.9–99.8%, whereas the most closely related virus, Potato virus V (PVV), was around 75% identical to WPMV. WPMV, PVV, and Peru tomato virus formed clusters of similar phylogenetic diversity, and were found to be distinct but related viruses within the overall Potato virus Y lineage. WPMV infection seems widespread and of likely economic significance to pepino producers in Peru’s coastal valleys. Because it constitutes the fifth virus found infecting pepino and this crop is entirely vegetatively propagated, development of healthy pepino stock programs is advocated.
Insects Visiting Drippy Blight Diseased Red Oak Trees Are Contaminated with the Pathogenic BacteriumLonsdalea quercina
Authors: Sitz Rachael A. , Aquino Vincent M. , Tisserat Ned A. , Cranshaw Whitney S. , Stewart Jane E.
Published: March 2019

The focus of investigation in this study was to consider the potential of arthropods in the dissemination of the bacterium involved in drippy blight disease, Lonsdalea quercina. Arthropod specimens were collected and tested for the presence of the bacterium with molecular markers. The bacterium L. quercina was confirmed on 12 different insect samples from three orders (Coleoptera, Hemiptera, and Hymenoptera) and eight families (Buprestidae, Coccinellidae, Dermestidae, Coreidae, Pentatomidae and/or Miridae, Apidae, Formicidae, and Vespidae). Approximately half of the insects found to carry the bacterium were in the order Hymenoptera. Estimates of the insects that are contaminated with the bacterium, and likely carry it between trees, is conservative because the documented insects represent only a subset of the insect orders that were observed feeding on the bacterium or present on diseased trees yet were not able to be tested. The insects contaminated with L. quercina exhibited diverse life histories, where some had a facultative relationship with the bacterium and others sought it out as a food source. These findings demonstrate that a diverse set of insects naturally occur on diseased trees and may disseminate L. quercina.
Prediabetes
Authors: Rariden Christina
Published: March 2019

Prediabetes continues to be a national and worldwide health concern, affecting 84 million adults in the US. Early identification and intervention have been successful in delaying and/or preventing the progression to type 2 diabetes mellitus (T2DM). To curb the increasing prevalence of T2DM, recognizing the importance of identifying and managing prediabetes is paramount.
Failure to Debrief after Critical Events in Anesthesia Is Associated with Failures in Communication during the Event
Authors: Arriaga Alexander F. , Sweeney Rachel E. , Clapp Justin T. , Muralidharan Madhavi , Burson Randall C. , Gordon Emily K. B. , Falk Scott A. , Baranov Dimitry Y. , Fleisher Lee A.
Published: March 2019

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Debriefing after an actual critical event is an established good practice in medicine, but a gap exists between principle and implementation. The authors’ objective was to understand barriers to debriefing, characterize quantifiable patterns and qualitative themes, and learn potential solutions through a mixed-methods study of actual critical events experienced by anesthesia personnel.

Methods

At a large academic medical center, anesthesiology residents and a small number of attending anesthesiologists were audited and/or interviewed for the occurrence and patterns of debriefing after critical events during their recent shift, including operating room crises and disruptive behavior. Patterns of the events, including event locations and event types, were quantified. A comparison was done of the proportion of cases debriefed based on whether the event contained a critical communication breakdown. Qualitative analysis, using an abductive approach, was performed on the interviews to add insight to quantitative findings.

Results

During a 1-yr period, 89 critical events were identified. The overall debriefing rate was 49% (44 of 89). Nearly half of events occurred outside the operating room. Events included crisis events (e.g., cardiac arrest, difficult airway requiring an urgent surgical airway), disruptive behavior, and critical communication breakdowns. Events containing critical communication breakdowns were strongly associated with not being debriefed (64.4% [29 of 45] not debriefed in events with a communication breakdown vs. 36.4% [16 of 44] not debriefed in cases without a communication breakdown; P = 0.008). Interview responses qualitatively demonstrated that lapses in communication were associated with enduring confusion that could inhibit or shape the content of discussions between involved providers.

Conclusions

Despite the value of proximal debriefing to reducing provider burnout and improving wellness and learning, failure to debrief after critical events can be common among anesthesia trainees and perhaps anesthesia teams. Modifiable interpersonal factors, such as communication breakdowns, were associated with the failure to debrief.
Oblique pelvic osteotomy in the treatment of bladder exstrophy in neonates
Authors: Giordano Marco , Di Lazzaro Antonio , Guzzanti Vincenzo , Careri Silvia , Bagolan Pietro , Zaccara Antonio M. , Toniolo Renato M.
Published: March 2019

Bladder exstrophy is a congenital and rare malformation of the lower abdominal wall with exposure of the bladder mucosa to the external environment, and it is related to pelvis abnormalities. Eighteen patients with bladder exstrophy were treated with bilateral oblique pelvic osteotomy in conjunction with urologic reconstruction after they were stabilized by cast. No failure of midline closure was observed (wound dehiscence or recurrence of bladder exstrophy). Follow-up showed no leg length discrepancy or problems in walking. Bilateral oblique pelvic osteotomy is a safe procedure to treat bladder exstrophy, and it results in good orthopedic and urological function.
Exceptional responses with sequential metronomic temozolomide after pembrolizumab failure in patients with metastatic melanoma
Authors: Swami Umang , Monga Varun , Freesmeier Michele , Zhang Weizhou , Bossler Aaron D. , Zakharia Yousef , Milhem Mohammed
Published: March 2019

Pembrolizumab is an effective therapy for patients with metastatic melanoma. However, not all patients derive benefit. It is postulated that an increase in regulatory T cells in melanoma patients can impair the response to immunotherapies. Continuous low-dose temozolomide has shown to cause immunomodulatory effects resulting in CD4 + lymphopenia due to which Treg population can also decrease significantly. Herein, we present a case series of three patients with metastatic melanoma who after progression on pembrolizumab showed a radiological response after just one cycle of metronomic temozolomide (75 mg/m2 daily for 6 weeks on 8-week cycle). This suggests that temozolomide may be a useful alternative for patients with metastatic melanoma after disease progression on pembrolizumab. Further studies with biomarkers are warranted to elucidate which patients will derive benefit from this strategy.
A Case of Dermatitis Herpetiformis With Fibrillar Immunoglobulin A Deposition: A Rare Pattern Not to Be Missed
Authors: Lilo Mohammed T. , Yan Shaofeng , Chapman Michael S. , Linos Konstantinos
Published: March 2019

Dermatitis herpetiformis is a rare, chronic autoimmune disorder characterized by intense pruritic papules and vesicles, which can be associated with celiac disease and other autoimmune disorders. Its histologic characteristic is the accumulation of neutrophils within the papillary dermis with granular deposition of immunoglobulin A (IgA) observed under direct immunofluorescence. Herein, we report a 58-year-old woman who presented with a vesicular rash on the buttocks. The patient reported a recent history of genital herpes, Entamoeba histolytica colitis, recurrent hives, and eczema. A representative biopsy demonstrated features of spongiotic dermatitis and focal papillary dermal neutrophilic aggregates. Direct immunofluorescence revealed fibrillary IgA deposition in the papillary dermis, granular C3 deposition at the dermal–epidermal junction, and dermal papillae. The overall clinical, histologic, and DIF findings were consistent with those of dermatitis herpetiformis. The fibrillar IgA pattern is rare and easily overlooked by the unwary. Pathologists should be aware of this rare pattern, especially when the histologic findings are not classic.
Prognostic Impact of pT Stage and Peritoneal Invasion in Locally Advanced Colon Cancer
Authors: Baguena Gloria , Pellino Gianluca , Frasson Matteo , Roselló Susana , Cervantes Andres , García-Granero Alvaro , Giner Francisco , García-Granero Eduardo
Published: March 2019

BACKGROUND:

TNM stage has been identified as an independent variable for local recurrence and survival after colon cancer resection. It is still unclear whether peritoneal invasion (pT4a) is a risk factor for adverse oncologic outcome or whether these patients have better results compared with contiguous organs infiltration (pT4b), independent from nodal status (pN).

OBJECTIVE:

The purpose of this study was to analyze whether peritoneal invasion is an independent risk factor for worse oncologic outcome after curative colon cancer resection.

DESIGN:

This was a retrospective analysis with multivariate regression of a prospective database, according to Strengthening the Reporting of Observational Studies in Epidemiology Statement.

SETTINGS:

The study was conducted in a specialized colorectal unit of a tertiary hospital.

PATIENTS:

A consecutive series of pT3-pT4a-pT4b patients with colon cancer who underwent curative surgery (1993–2010) were included, and patients with metastasis were excluded.

MAIN OUTCOME MEASURES:

A multivariate Cox regression analysis was performed to assess independent risk factors for 5-year local recurrence, peritoneal carcinomatosis-like recurrence, disease-free survival, and cancer-specific survival.

RESULTS:

A total of 1010 patients were analyzed (79.3% pT3, 9.9% pT4a, and 10.8% pT4b). At diagnosis, 22.0% had obstructive symptoms, and 10.5% had bowel perforation. A total of 72.2% of the surgeries were elective, and in 15.6% en bloc resection of contiguous organs was performed. Median follow-up was 62 months (38–100 mo). For the whole group, 5-year actuarial rates were 8.8% for local recurrence, 2.5% for peritoneal carcinomatosis, 75.5% for disease-free survival, and 81.8% for cancer-specific survival. At multivariate analysis, pT4a stage was an independent risk factor for local recurrence (p = 0.002; HR = 3.1), peritoneal carcinomatosis (p = 0.02; HR = 4.9), worse disease-free survival (p = 0.002; HR = 1.9), and cancer-specific survival (p = 0.001; HR = 2.2). When considering only the 566 patients with ≥12 nodes identified, T stage was still associated with higher local recurrence (p = 0.04) and carcinomatosis rate (p = 0.04), as well as worse disease-free (p = 0.009) and cancer-specific survival (p = 0.014).

LIMITATIONS:

This was a retrospective, single-center study.

CONCLUSIONS:

pT4a stage is an independent risk factor for worse oncologic outcome after curative colon cancer resection compared with pT3 and pT4b stages. The current pT4a-pT4b classification should be reconsidered. Of note, even in pT4a patients, 5-year carcinomatosis rate does not exceed 6%. See Video Abstract at http://links.lww.com/DCR/A926.
2-Methoxyestradiol Attenuates Angiotensin II-Induced Hypertension, Cardiovascular Remodeling, and Renal Injury
Authors: Salah Eman , Bastacky Sheldon I. , Jackson Edwin K. , Tofovic Stevan P.
Published: March 2019

Estradiol may antagonize the adverse cardiovascular effects of angiotensin II (Ang II). We investigated the effects of 2-methoxyestradiol (2-ME), a nonestrogenic estradiol metabolite, on Ang II-induced cardiovascular and renal injury in male rats. First, we determined the effects of 2-ME on Ang II-induced acute changes in blood pressure, renal hemodynamics, and excretory function. Next, we investigated the effects of 2-ME and 2-hydroxyestardiol (2-HE) on hypertension and cardiovascular and renal injury induced by chronic infusion of Ang II. Furthermore, the effects of 2-ME on blood pressure and cardiovascular remodeling in the constricted aorta (CA) rat model and on isoproterenol-induced (ISO) cardiac hypertrophy and fibrosis were examined. 2-ME had no effects on Ang II-induced acute changes in blood pressure, renal hemodynamics, or glomerular filtration rate. Both 2-ME and 2-HE reduced hypertension, cardiac hypertrophy, proteinuria, and mesangial expansion induced by chronic Ang II infusions. In CA rats, 2-ME attenuated cardiac hypertrophy and fibrosis and reduced elevated blood pressure above the constriction. Notably, 2-ME reduced both pressure-dependent (above constriction) and pressure-independent (below constriction) vascular remodeling. 2-ME had no effects on ISO-induced renin release yet reduced ISO-induced cardiac hypertrophy and fibrosis. This study shows that 2-ME protects against cardiovascular and renal injury due to chronic activation of the renin–angiotensin system. This study reports for the first time that in vivo 2-ME reduces trophic (pressure-independent) effects of Ang II and related cardiac and vascular remodeling.
Plasticity in the dynamic pain connectome associated with ketamine-induced neuropathic pain relief
Authors: Rogachov Anton , Bhatia Anuj , Cheng Joshua C. , Bosma Rachael L. , Kim Junseok A. , Osborne Natalie R. , Hemington Kasey S. , Venkatraghavan Lakshmikumar , Davis Karen D.
Published: March 2019

Therapeutic interventions for neuropathic pain, such as the N-methyl-d-aspartate (NMDA) antagonist ketamine, can vary widely in effectiveness. In this study, we conducted a longitudinal functional MRI study to test the hypothesis that the pain-relieving effect of ketamine is the result of reversal of abnormalities in regional low-frequency brain oscillations (LFOs) and abnormal cross-network functional connectivity (FC) of the dynamic pain connectome. We found that (1) ketamine decreased regional LFOs in the posterior cingulate cortex of the default mode network, (2) a machine-learning algorithm demonstrated that treatment-induced brain changes could be used to make generalizable inferences about pain relief, (3) treatment responders exhibited a significant decrease in cross-network static FC between the posterior cingulate cortex and regions of the sensorimotor and salience networks following treatment, (4) the degree of reduced cross-network FC correlated with the amount of pain relief, and (5) ketamine treatment did not produce significant differences in static or dynamic FC within the ascending nociceptive or descending antinociceptive pathway. These findings support the proposition that regional LFOs contribute to cross-network connectivity that underlie the effectiveness of ketamine to produce significant relief from neuropathic pain. Together with our recent findings that pretreatment dynamic FC of the descending antinociceptive pathway can predict ketamine treatment outcomes, these new findings indicate that pain relief from ketamine arises from a combination of flexible pretreatment FC of the descending antinocieptive pathway together with plasticity (reduction) of cross-network connectivity of the default mode network with sensorimotor and salience networks.
Cerebral cortical dimensions in headache sufferers aged 50 to 66 years: a population-based imaging study in the Nord-Trøndelag Health Study (HUNT-MRI)
Authors: Husøy Andreas K. , Håberg Asta K. , Rimol Lars M. , Hagen Knut , Vangberg Torgil R. , Stovner Lars J.
Published: March 2019

Based on previous clinic-based magnetic resonance imaging studies showing regional differences in the cerebral cortex between those with and without headache, we hypothesized that headache sufferers have a decrease in volume, thickness, or surface area in the anterior cingulate cortex, prefrontal cortex, and insula. In addition, exploratory analyses on volume, thickness, and surface area across the cerebral cortical mantle were performed. A total of 1006 participants (aged 50-66 years) from the general population were selected to an imaging study of the head at 1.5 T (HUNT-MRI). Two hundred eighty-three individuals suffered from headache, 80 with migraine, and 87 with tension-type headache, whereas 309 individuals did not suffer from headache and were used as controls. T1-weighted 3D scans of the brain were analysed with voxel-based morphometry and FreeSurfer. The association between cortical volume, thickness, and surface area and questionnaire-based headache diagnoses was evaluated, taking into consideration evolution of headache and frequency of attacks. There were no significant differences in cortical volume, thickness, or surface area between headache sufferers and nonsufferers in the anterior cingulate cortex, prefrontal cortex, or insula. Similarly, the exploratory analyses across the cortical mantle demonstrated no significant differences in volume, thickness, or surface area between any of the headache groups and the nonsufferers. Maps of effect sizes showed small differences in the cortical measures between headache sufferers and nonsufferers. Hence, there are probably no or only very small differences in volume, thickness, or surface area of the cerebral cortex between those with and without headache in the general population.
Blood Biomarkers of Sports-Related Concussion in Pediatric Athletes
Authors: Anzalone Anthony J. , Turner Stephanie M. , Baleztena Angela C. , McGuffin Tiffany , Creed Kalyssa , Jeromin Andreas , Wilson David , Hanlon David , Garrison J. Craig , Blueitt Damond , Oliver Jonathan M.
Published: March 2019

Objective:

To examine changes in blood biomarkers, serum neurofilament light (Nf-L), and plasma tau, as well as the relationship between blood biomarkers and symptom reports, in athletes with a sports-related concussion.

Design:

Prospective cohort study.

Setting:

Private community-based concussion clinic.

Participants:

Athletes aged 13 to 18 years old with a diagnosed sports-related concussion presenting to a concussion clinic within 7 days of injury and noninjured athletes with no history of concussion aged 13 to 23 years old.

Assessment and Main Outcome Measures:

Injured athletes provided a blood sample at the initial clinical evaluation and again at least 6 months after injury. Noninjured athletes provided a single blood sample. All participants completed symptom reports during each visit. Statistical comparisons of biomarker concentrations and symptom reports were conducted.

Results:

The mean rank for tau was significantly lower for concussed athletes compared with nonconcussed athletes. In contrast, the mean rank of Nf-L was higher for concussed athletes than for nonconcussed athletes, although the difference was nonsignificant. Plasma tau was significantly lower postinjury compared with 6 months after injury, whereas serum Nf-L was significantly higher postinjury. There was a weak but significant inverse relationship observed between tau and the number of symptoms reported, but no relationship was observed between Nf-L and the number of symptoms reported.

Conclusions:

These data indicate that in the days following a sports-related concussion, the blood biomarkers tau and Nf-L display contrasting patterns of change but may not be related to self-reported symptom scores.
Direct to consumer versus clinical genetic testing
Authors: Wysocki Kenneth , Osier Nicole
Published: March 2019

There are approximately 250 direct to consumer (DTC) genetic testing companies marketing different testing options such as genetic health risk, carrier status, ancestry, wellness, traits, noninvasive prenatal genetic testing, athleticism, and many others. As a result, choosing the most appropriate test may be daunting when compared with a focused genetic test ordered by a clinician. A wealth of information may be discovered and care must be taken by both consumers and clinicians when deciphering test results. This column highlights considerations when proceeding forward with a DTC genetic test.
Therapeutic Advances in Emergency Cardiology: A Focus on Acute Myocarditis
Authors: Crişan Simina , Tint Diana , Petrescu Lucian
Published: March 2019

Background:

Myocarditis, defined as an inflammation of the myocardium, is an important cause of dilated cardiomyopathy and congestive heart failure. Unfortunately, its diagnosis and etiology is often challenging in clinical practice, and thus, improving diagnosis and therapeutic approach of this cardiac pathology is a matter of great interest.

Areas of Uncertainty:

The etiology of the disease may be represented by not only infectious agents, usually with viral determination, but also autoimmune and systemic diseases or drugs. Regarding diagnostic techniques, endomyocardial biopsy remains the gold standard; but beyond histological findings, an important step in achieving an accurate diagnosis was represented by the use immunohistochemical criteria and noninvasive diagnostic tests such as cardiac magnetic resonance imaging.

Data Sources:

We reviewed current data on the current diagnosis and therapeutic approach of acute myocarditis.

Therapeutic Advances:

In addition to the standard heart failure therapy, some specific therapeutic options are available in selected cases. Viral myocarditis with persistent inflammation and viral clearance may be responsive to immunosuppressive therapy with azathioprine and cortisone or to immunoadsorption technique. Also, some chronic viral myocardial infections may benefit from 6 months of interferon-β therapy.

Conclusions:

The diagnosis of acute myocarditis still remains a great challenge, despite advances related to new diagnostic procedures. Endomyocardial biopsy, an invasive diagnostic tool that is not always usually available in clinical practice, still remains the standard diagnostic technique. Due to the potential evolution of acute myocarditis, identifying new parameters that may allow an early selection of patients with great risk of evolution toward myocardial fibrosis and dilated cardiomyopathy may be a field of great interest for future studies.
Relationship Between Nurse Certification and Clinical Patient Outcomes
Authors: Coelho Paulo
Published: March 2019

Background:

Certification of nurses has been identified as a strategy to improve health care quality. However, the impact nursing certification has on clinical patient outcomes remains unclear.

Purpose:

The purpose was to examine the relationship between nursing certification and clinical outcomes.

Methods:

A systematic review of the literature was conducted through the search of relevant bibliographic databases (CINAHL Plus, PubMed, Medline, and Cochrane Collaboration).

Results:

Nursing certification was found to have a significant inverse relationship to patient falls and health care–associated infections. Significant correlations were not established in outcomes such as pressure injuries and mortality.

Conclusions:

The validation of knowledge through nursing certification has an impact on specific outcomes such as patients falls and health care–associated infections.
Engagement in Research
Authors: Scala Elizabeth , Patterson Barbara J. , Stavarski Debra Haas , Mackay Periwinkle
Published: March 2019

The purposes for this interpretive descriptive study were to gain an understanding of what motivates clinical nurses to be interested and/or engaged in research, describe the motivators for these clinical nurses, and identify common characteristics of these clinical nurses. Results revealed four themes and a clinical nurse profile. Based on findings, educators should encourage clinical nurses who are motivated to participate in nursing research to ignite intrinsic passion, professional growth, and nursing credibility and improve patient outcomes.
Developing and Evaluating Multiple-Choice Tests for Trustworthiness
Authors: Bernhofer Esther I. , Burchill Christian N.
Published: March 2019

This article provides the nursing professional development practitioner an overview of effective development and evaluation of a commonly used measure of knowledge: the multiple-choice test. Basic principles of test development and assessment are important for evaluating learning outcomes. When the steps needed to determine the fairness, validity, and reliability of multiple-choice tests are followed, the resulting knowledge tests will lead to more trustworthy results for the evaluation of nursing professional development activities.
Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies
Authors: Kochanek Patrick M. , Tasker Robert C. , Bell Michael J. , Adelson P. David , Carney Nancy , Vavilala Monica S. , Selden Nathan R. , Bratton Susan L. , Grant Gerald A. , Kissoon Niranjan , Reuter-Rice Karin E. , Wainwright Mark S.
Published: March 2019

Objectives:

To produce a treatment algorithm for the ICU management of infants, children, and adolescents with severe traumatic brain injury.

Data Sources:

Studies included in the 2019 Guidelines for the Management of Pediatric Severe Traumatic Brain Injury (Glasgow Coma Scale score ≤ 8), consensus when evidence was insufficient to formulate a fully evidence-based approach, and selected protocols from included studies.

Data Synthesis:

Baseline care germane to all pediatric patients with severe traumatic brain injury along with two tiers of therapy were formulated. An approach to emergent management of the crisis scenario of cerebral herniation was also included. The first tier of therapy focuses on three therapeutic targets, namely preventing and/or treating intracranial hypertension, optimizing cerebral perfusion pressure, and optimizing partial pressure of brain tissue oxygen (when monitored). The second tier of therapy focuses on decompressive craniectomy surgery, barbiturate infusion, late application of hypothermia, induced hyperventilation, and hyperosmolar therapies.

Conclusions:

This article provides an algorithm of clinical practice for the bedside practitioner based on the available evidence, treatment protocols described in the articles included in the 2019 guidelines, and consensus that reflects a logical approach to mitigate intracranial hypertension, optimize cerebral perfusion, and improve outcomes in the setting of pediatric severe traumatic brain injury.
Simultaneous Testicular and Appendix Testis Torsion
Authors: Vasconcelos-Castro Sofia , Soares-Oliveira Miguel , Campos José Miguel , Estevão-Costa José
Published: March 2019

Torsion of the appendix testis (TAT) and testicular torsion (TT) are the most common causes of acute scrotum in the pediatric population. They usually present as separate conditions and have distinct managements. We report a unique case of a 16-year-old boy with concomitant TAT and TT. The role of TAT as a trigger factor to TT is addressed, and its clinical repercussion on the management of acute scrotum is discussed.
Randomized Trial on Comparison of the Efficacy of Extracorporeal Shock Wave Therapy and Dry Needling in Myofascial Trigger Points
Authors: Luan Shuo , Zhu Zhi-min , Ruan Jing-liang , Lin Cai-na , Ke Song-jian , Xin Wen-jun , Liu Cui-cui , Wu Shao-ling , Ma Chao
Published: March 2019

Objective

The aim of the study was to compare the efficacy of radial extracorporeal shock wave therapy and dry needling in the treatment of myofascial trigger points in the upper trapezius muscle.

Design

A total of 65 patients with myofascial trigger points were randomly divided into extracorporeal shock wave therapy group (n= 32) and dry needling group (n= 33). Patients received 3 wks of treatment at 1-wk intervals (in both groups). Visual analog scale, pressure pain threshold, Neck Disability Index, and shear modulus were evaluated before treatment, immediately after the first therapy, 1 mo, and 3 mos after the completion of the third therapy.

Results

Significant improvements of visual analog scale, pressure pain threshold, and Neck Disability Index scores were observed at all time points after treatment (P< 0.01) in both treatment groups. The shear modulus of myofascial trigger points was reduced in both dry needling group (P< 0.05) and extracorporeal shock wave therapy group (P< 0.01) immediately after the first treatment. Significant reductions in shear modulus were maintained up to 3-mo posttreatment in both groups (P< 0.01). There were no significant differences between the radial extracorporeal shock wave therapy group and dry needling group.

Conclusions

The extracorporeal shock wave therapy is as effective as dry needling for relieving pain, improving function, and reducing shear modulus for patients with myofascial trigger points after a series of three treatments.
Prospective Clinical and Histologic Evaluation of Alveolar Socket Healing Following Ridge Preservation Using a Combination of Hydroxyapatite and Collagen Biomimetic Xenograft Versus Demineralized Bovine Bone
Authors: Taschieri Silvio , Del Fabbro Massimo , Panda Sourav , Goker Funda , Babina Ksenia S. , Tampieri Anna , Mortellaro Carmen
Published: March 2019

Purpose:

This prospective study is aimed at investigating clinically and histologically the effectiveness of a biomimetic magnesium-enriched-hydroxyapatite (MgHA)/collagen-based bone substitute for alveolar socket preservation.

Materials:

Patients scheduled for posterior single tooth extraction were included. The alveolar socket was filled either with MgHA or deproteinized bovine bone matrix (DBBM). In DBBM group, a punch of mucosa was taken from the palate and used to cover the graft. Vertical and horizontal dimensional changes of the alveolar process were assessed clinically with a periodontal probe and with 3-dimensional (3D) analysis of a cast model. Postoperative quality of life was assessed through a questionnaire. After 6 months of healing, an alveolar tissue biopsy was taken for histologic and histomorphometric analysis of the newly formed tissue. After checking normality of the distributions, parametric or nonparametric tests were used for statistical comparisons.

Results:

Twenty patients (12 males, 8 females, mean age 42.8 ± 5.1 years, range 33–50 years) were treated. After 6 months, vertical and horizontal alveolar ridge resorption was similar in the 2 groups. The 3D analysis of the models showed a significantly higher resorption at the buccal side than at the palatal/lingual side. Histomorphometric analysis showed similar new bone formation for MgHA group (23.07 ± 10.3%) and DBBM (22.77 ± 6.95%), and a significantly higher residual material% for DBBM (15.77 ± 1.95%) than MgHA (5.01 ± 1.04%). Significantly less pain was reported in the first 3 days after surgery in patients of the MgHA group.

Conclusion:

The MgHA was as safe and effective as DBBM and may represent a feasible bone substitute for alveolar socket preservation.
Clinical Outcome of Single-port Surgery in Patients With Pathologic T4 Colon Cancer
Authors: Tei Mitsuyoshi , Otsuka Masahisa , Suzuki Yozo , Akamatsu Hiroki
Published: March 2019

Purpose:

The aim of this study was to evaluate the clinical outcomes of single-port surgery (SPS), compared with those of multiport surgery (MPS) in patients with pathologic T4 colon cancer.

Materials and Methods:

A total of 188 patients with proven pathologic T4 colon cancer who underwent laparoscopic surgery from January 2008 to December 2014 were enrolled in this study. These patients were divided into the SPS group (n=94) and the MPS group (n=94). The clinical outcomes were compared between groups.

Results:

The median operative time was significantly shorter in the SPS group than in the MPS group (P=0.045). Postoperative complications did not differ between the groups. The length of postoperative hospital stay was significantly shorter in the SPS group than in the MPS group (P<0.001). Oncological resection rates were similar between groups. The 3-year relapse-free survival rates, the 3-year local recurrence-free survival rates, and the 5-year overall survival rates were similar between groups.

Conclusions:

SPS is safe and feasible in patients with pathologic T4 colon cancer.
Effect of internal chain-like structures on magnetic hyperthermia in non-liquid media
Authors: Zubarev Andrey Yu.
Published: March 2019

This paper deals with a theoretical study of the effect of chain-like aggregates on magnetic hyperthermia in systems of single-domain ferromagnetic particles immobilized in a non-magnetic medium. We assume that the particles form linear chain-like aggregates and the characteristic time of the Néel remagnetization is much longer than the time of medium heating (time of process observation). This is applicable to magnetite particles when the particle diameter exceeds 20–25 nm. Our results show that the appearance of the chains significantly decreases the intensity of heat production.

This article is part of the theme issue ‘Heterogeneous materials: metastable and non-ergodic internal structures’.
On the theory of crystal growth in metastable systems with biomedical applications: protein and insulin crystallization
Authors: Alexandrov Dmitri V. , Nizovtseva Irina G.
Published: March 2019

A generalized theory of nucleation and growth of crystals in a metastable (supercooled or supersaturated) liquid is developed taking into account two principal effects: the diffusion mechanism of the particle-size distribution function in the space of particle radii and the unsteady-state growth rates of individual crystals induced by fluctuations in external temperature or concentration field. A system of the Fokker–Planck and balance integro-differential equations is formulated and analytically solved in a parametric form for arbitrary nucleation kinetics and arbitrary growth rates of individual crystals. The particle-size distribution function and system metastability are found in an explicit form. The Weber–Volmer–Frenkel–Zel'dovich and Meirs kinetic mechanisms, as well as the unsteady-state growth rates of nuclei (Alexandrov & Alexandrova 2019Phil. Trans. R. Soc. A377, 20180209 (doi:10.1098/rsta.2018.0209)), are considered as special cases. Some potential biomedical applications of the present theory for crystal growth from supersaturated solutions are discussed. The theory is compared with experimental data on protein and insulin crystallization (growth dynamics of the proteins lysozyme and canavalin as well as of bovine and porcine insulin is considered). The hat-shaped particle-size distribution functions for lysozyme and canavalin crystals as well as for bovine and porcine insulin are found.

This article is part of the theme issue ‘Heterogeneous materials: metastable and non-ergodic internal structures’.
Heterogeneous materials: metastable and non-ergodic internal structures
Authors: Alexandrov Dmitri V. , Zubarev Andrey Yu.
Published: March 2019

This issue is concerned with structural and phase transitions in heterogeneous and composite materials, the effects of external magnetic fields on these phenomena and the macroscopic properties and behaviour of materials with isotropic and anisotropic internal structures. Using experimental, theoretical and computer methods, these transitions are studied at the atomic and mesoscopic levels. The fundamental specific feature of structural transitions in many heterogeneous media consists of the fact that these transitions are stacked for a long time in non-equilibrium states that appear due to either macroscopic dissipative processes (an alternating magnetic field or hydrodynamic flow, for instance) or system lifetime in a metastable state. It is important to explain and describe these transitional states using the general approach of non-equilibrium physical mechanics. The review and research articles in the issue will cover the whole spectrum of scales (from nano to macro) and materials (from metastable liquids to biological polymers) in order to exhibit recently developed trends in the field of heterogeneous materials. Atomistic modelling, structuring induced by external magnetic fields and hydrodynamic flows, metastable and non-ergodic states, mechanical properties and phenomena in heterogeneous materials—all these are covered.

This article is part of the theme issue ‘Heterogeneous materials: metastable and non-ergodic internal structures’.
Biological Filtering and Substrate Promiscuity Prediction for Annotating Untargeted Metabolomics
Authors: Hassanpour Neda , Alden Nicholas , Menon Rani , Jayaraman Arul , Lee Kyonbum , Hassoun Soha
Published: March 2019

Mass spectrometry coupled with chromatography separation techniques provides a powerful platform for untargeted metabolomics. Determining the chemical identities of detected compounds however remains a major challenge. Here, we present a novel computational workflow, termed Expanded Metabolic Model Annotation (EMMA), that aims to strike a balance between discovering previously uncharacterized metabolites and the computational burden of annotation. EMMA engineers a candidate set, a listing of putative chemical identities to be used during annotation, through an expanded metabolic model (EMM). An EMM includes not only canonical substrates and products of enzymes already cataloged in a database through a reference metabolic model, but also metabolites that can form due to substrate promiscuity. EMMA was applied to untargeted LC-MS data collected from cultures of Chinese hamster ovary (CHO) cells and murine cecal microbiota. EMM metabolites matched, on average, to 23.92% of measured masses, providing a > 7-fold increase in the candidate set size when compared to a reference metabolic model. Many metabolites suggested by EMMA are not catalogued in PubChem. For the CHO cell, we experimentally confirmed the presence of 4-hydroxy-phenyllactate, a metabolite predicted by EMMA that has not been previously identified as part of CHO cell metabolism.
Hidden neural states underlie canary song syntax
Authors: Cohen Yarden , Shen Jun , Semu Dawit , Leman Daniel P. , Liberti William A. , Perkins L. Nathan , Liberti Derek C. , Kotton Darrell , Gardner Timothy J.
Published: March 2019

Coordinated skills such as speech or dance involve sequences of actions that follow syntactic rules in which transitions between elements depend on past actions. Canary songs are comprised of repeated syllables, called phrases, and the ordering of these phrases follows long-range rules, where the choice of what to sing depends on song structure many seconds prior. The neural substrates that support these long-range correlations are unknown. Using miniature head-mounted microscopes and cell-type-specific genetic tools, we observed neural activity in the premotor nucleus HVC as canaries explore various phrase sequences in their repertoire. We find neurons that encode past transitions, extending over 4 phrases and spanning up to 3 seconds and 40 syllables. These neurons preferentially encode past actions rather than future actions, can reflect more than a single song history, and occur mostly during the rare phrases that involve history-dependent transitions in song. These findings demonstrate that network dynamics in HVC reflect preceding behavior context relevant to flexible transitions.
Mechanical stress initiates and sustains the morphogenesis of wavy leaf epidermal cells
Authors: Bidhendi Amir J , Altartouri Bara , Gosselin Frédérick P. , Geitmann Anja
Published: March 2019

Plant cell morphogenesis is governed by the mechanical properties of the cell wall and the resulting cell shape is intimately related to the respective specific function. Pavement cells covering the surface of plant leaves form wavy interlocking patterns in many plants. We use computational mechanics to simulate the morphogenetic process based on experimentally assessed cell shapes, growth dynamics, and cell wall chemistry. The simulations and experimental evidence suggest a multistep process underlying the morphogenesis of pavement cells during tissue differentiation. The mechanical shaping process relies on spatially confined, feedback-augmented stiffening of the cell wall in the periclinal walls, an effect that correlates with experimentally observed deposition patterns of cellulose and de-esterified pectin. We provide evidence for mechanical buckling of the pavement cell walls that can robustly initiate patternsde novoand may precede chemical and geometrical anisotropy.

Highlights

A multistep mechano-chemical morphogenetic process underlies the wavy pattern of epidermal pavement cells.

Microtubule polarization is preceded by an event that breaks mechanical isotropy in the cell wall.

Mechanical models simulate the formation of wavy cell shapes, predict buckling of the cell walls and spatially confined variations in the mechanical properties of leaf epidermal cells.

Stress/strain stiffening following the buckling of the cell walls constitutes a crucial element in a positive feedback loop forming interlocking pavement cells.

Polarization of cortical microtubules, cellulose microfibrils, and de-esterified pectin occur at the necks of wavy pavement cells, matching thein silicoprediction of cell wall stiffening.
A hidden battle in the dirt: soil amoebae interactions withParacoccidioidesspp
Authors: Albuquerque Patrícia , Nicola André Moraes , Magnabosco Diogo Almeida Gomes , Derengowski Lorena da Silveira , Crisóstomo Luana Soares , Xavier Luciano Costa Gomes , de Oliveira Frazão Stefânia , Guilhelmelli Fernanda , de Oliveira Marco Antônio , Hurtado Fabián Andrés , de Melo Teixeira Marcus , Guimaraes Allan J. , Paes Hugo Costa , Bagagli Eduardo , Felipe Maria Sueli Soares , Casadevall Arturo , Silva-Pereira Ildinete
Published: March 2019

Paracoccidioidesspp. are thermodimorphic pathogenic fungi endemic to Latin America. Predation is believed to drive the evolution of virulence for soil saprophytes. We evaluated the presence of environmental amoeboid predators in soil from armadillo burrows whereParacoccidioideshad been previously detected and tested if interaction ofParacoccidioideswith amoebae increased fungal virulence. Nematodes, ciliates and amoebae – all potential predators of fungi – grew in cultures from soil samples. Microscopical observation and ITS sequencing identified the amoebae asAcanthamoebaspp,Allovahlkampfia spelaeaandVermamoeba vermiformis. These three amoebae efficiently ingested, killed and digestedParacoccidioidesspp. yeast cells, as did laboratory-adapted axenicAcanthamoeba castellanii. Sequential co-cultivation ofParacoccidioideswithA. castellaniiselected for phenotypical traits related to survival of the fungus within a natural predator as well as in murine macrophages and in vivo (Galleria mellonellaand mice). This increase in virulence is linked to the accumulation of cell wall alpha-glucans, polysaccharides that masks recognition of fungal molecular patterns by host pattern recognition receptors. Altogether, our results indicate thatParacoccidioidesinhabits a complex environment with multiple amoeboid predators that can exert selective pressure to guide the evolution of virulence traits.