bluuebunny/crossref_metadata_2025 huggingface dataset:
Can sustainable cotton production systems be developed for tropical northern Australia?
Authors: Yeates S. J. , Strickland G. R. , Grundy P. R.
Published: October 2018

This article reviews research coordinated by the Australian Cotton Cooperative Research Centre (CRC) that investigated production issues for irrigated cotton at five targeted sites in tropical northern Australia, north of 21°S from Broome in Western Australia to the Burdekin in Queensland. The biotic and abiotic issues for cotton production were investigated with the aim of defining the potential limitations and, where appropriate, building a sustainable technical foundation for a future industry if it were to follow.
Key lessons from the Cotton CRC research effort were: (1) limitations thought to be associated with cotton production in northern Australia can be overcome by developing a deep understanding of biotic and environmental constraints, then tailoring and validating production practices; and (2) transplanting of southern farming practices without consideration of local pest, soil and climatic factors is unlikely to succeed. Two grower guides were published which synthesised the research for new growers into a rational blueprint for sustainable cotton production in each region. In addition to crop production and environmental impact issues, the project identified the following as key elements needed to establish new cropping regions in tropical Australia: rigorous quantification of suitable land and sustainable water yields; support from governments; a long-term funding model for locally based research; the inclusion of traditional owners; and development of human capacity.
Application of GGE biplot to analyse stability of Iranian tall fescue (Lolium arundinaceum) genotypes
Authors: Dehghani M. R. , Majidi M. M. , Saeidi G. , Mirlohi A. , Amiri R. , Sorkhilalehloo B.
Published: October 2018

This research was carried out to determine stable genotypes and investigate genotype × environment interaction (GE) effects on the forage yields of 24 tall fescue genotypes (Lolium arundinaceum, syn. Festuca arundinacea Schreb.) across 14 test environments (combination of year, location and moisture conditions). The GGE biplot method was used to evaluate the phenotypic stability of forage yield in the studied genotypes. The GGE biplot analysis accounted for 75% of the G + GE variation. According to GGE biplot, in terms of performance, the genotypes were divided into two groups. The first group, with more than the average yield, included G20, G24, G04, G01, G22, G14, G10, G17 and G02. The second group included the remaining genotypes with below-average performance. From the seven foreign genotypes evaluated, G10 and G22 fell in the first group and the rest were clustered in the second group. In the first group, the performance of G24 (from Semnan province) was the most variable (the least stable), whereas the G20 and G14 (both from Isfahan province) were highly stable. In the second group, except for G08 and G16, the performance of genotypes was highly stable. The genotype G20 (from Isfahan province) had superior performance under all of the test environments, suggesting that it has a broad adaptation to the diverse environments. The results obtained in this study demonstrated the efficiency of the GGE biplot technique for selecting genotypes that are stable, high yielding, and responsive.
Factors affecting the cycling of dimethylsulfide and dimethylsulfoniopropionate in coral reef waters of the Great Barrier Reef
Authors: Jones Graham , Curran Mark , Broadbent Andrew , King Stacey , Fischer Esther , Jones Rosemary
Published: October 2018

Environmental context. Levels of atmospheric dimethylsulfide (DMS) and its oxidation products are reputed to affect the microphysics of clouds and the amount of incoming solar radiation to the ocean. Studies of DMS and its precursor compound dimethylsulfoniopropionate (DMSP) at two inshore fringing coral reefs in the Great Barrier Reef highlight pronounced seasonal, diurnal and tidal variation of these compounds, with dissolved DMS and DMSP significantly correlated with sea surface temperatures (SSTs) up to 30°C. During a coral bleaching episode at one of the reef sites, dissolved DMS concentrations decreased when SSTs exceeded 30°C, a result replicated in chamber experiments with staghorn coral. The results raise interesting questions on the role of these organosulfur substances in corals and whether DMS emissions from coral reefs could have an effect on regional climate in the Great Barrier Reef.
Abstract. A study of dissolved dimethylsulfide (DMSw), dissolved and particulate dimethylsulfoniopropionate (DMSPd, DMSPp), and atmospheric dimethylsulfide (DMSa) was carried out at two inshore fringing coral reefs (Orpheus Island and Magnetic Island) in the Great Barrier Reef (GBR) to investigate the variation of these organosulfur substances with season, sea surface temperature, tides, and time of day. Highest concentrations of these organosulfur substances occurred in the summer months at both reefs, with lowest concentrations occurring during winter, suggesting a biological source of these compounds from the reef flats. At the Orpheus Island reef, where more measurements were made, DMSw and DMSPd were significantly correlated with tidal height during the flooding tide over the reef (r = 0.37, P < 0.05; r = 0.58, P < 0.01 respectively), and elevated DMSw and DMSa concentrations generally occurred in the daylight hours, possibly reflecting photosynthetic production of DMSw from the reef flats. Chamber experiments with the staghorn coral Acropora formosa confirmed that corals produce DMSw in the day. DMSw (r = 0.43, P < 0.001) and DMSPd (r = 0.59, P < 0.001) were significantly positively correlated with sea surface temperatures (SST) at the Orpheus Island reef. During severe coral bleaching at the eutrophic Magnetic Island reef in the summer, DMSw concentrations decreased at SSTs greater than 30°C, suggesting that reef production of DMSw decreases during elevated SSTs. This was later confirmed in chamber experiments with Acropora formosa, which showed that when this coral was exposed to temperatures at its bleaching threshold (31°C), decreased production of DMSw occurred. These results suggest that DMS and DMSP in coral zooxanthellae may be functioning as antioxidants, but further experiments are needed to substantiate this.
Measuring dissolved organic matter in estuarine and marine waters: size-exclusion chromatography with various detection methods
Authors: Dulaquais Gabriel , Breitenstein Johann , Waeles Matthieu , Marsac Rémi , Riso Ricardo
Published: October 2018

Environmental contextDissolved organic matter (DOM), a key parameter in aquatic biogeochemistry, is difficult to characterise owing to its variable composition and structure. We report a chromatographic method with carbon, nitrogen and absorbance detection able to record the size distribution of DOM and changes in its composition. The method could be used to identify additional sources to river or coastal waters as well as monitoring the DOM size/reactivity continuum in open oceans.
AbstractWe studied the performance and limitations of size-exclusion chromatography with organic carbon, ultraviolet and organic nitrogen detectors (SEC-OCD-UVD-OND) for characterising dissolved organic matter (DOM) in estuarine and marine waters. We identified a strong salt effect on dissolved organic carbon (DOC) determination; however, calibration gave good results at salinity levels close to those of the sample analysed (ΔS ± 2 psu (practical salinity units)), with limited matrix effects, enabling an accurate measurement of DOC, as demonstrated by an intercalibration exercise. The repeatability, reproducibility and limit of detection (3 ppb for both carbon and nitrogen) for the three detectors demonstrated the robustness of the method for a wide range of natural waters, including carbon-rich freshwaters and deep seawaters with low carbon content (6000 ppb-C to 300 ppb-C). Deeper analysis of the SEC demonstrated that proteins and polysaccharides are partly fractionated within the column, and that terrestrial humic substances, isolated on a XAD-8 resin, can also be eluted in both fractions associated with biopolymers and low-molecular-weight neutrals. Application of the method to the study of DOM along a macrotidal estuary that was influenced by agricultural activities revealed significant changes in its composition despite a conservative DOC distribution. Distinct origins and qualities of high-molecular-weight (>500 kDa) organic compounds were identified for riverine and marine end-members. A new diagram to track changes in DOM lability is proposed to complete the humic-substances diagram.
Investigation of fatigue by Australian general practice registrars: a cross-sectional study
Authors: Morgan Simon , Henderson Kim , Tapley Amanda , Thomson Allison , Wilson Jessica , Scott John , Spike Neil , McArthur Lawrie , van Driel Mieke , Magin Parker
Published: October 2018

INTRODUCTION: Fatigue is the most common undifferentiated problem presenting in general practice. Previous studies have shown that this presentation leads to multiple investigations. There is no published literature describing the management of patients with fatigue by general practice (GP) registrars. AIM: To document the investigation-ordering behaviour of GP registrars in managing patients with a new diagnosis of unexplained fatigue. METHODS: This was a cross-sectional analysis of data from Registrar Clinical Encounters in Training (ReCEnT), an ongoing cohort study of GP registrars? consultations. We established the prevalence of new diagnoses of unexplained fatigue and associations with that diagnosis, the rate of test ordering and the number and types of investigations ordered. RESULTS: 644 registrars contributed data from 68 986 encounters. In 0.78% of patient encounters, a new diagnosis of unexplained fatigue was made. Pathology was ordered in 78.4% of these problems (versus 18.1% in non-fatigue problems), at a rate of 488 tests per 100 new fatigue problems. DISCUSSION: Our study suggests that unexplained fatigue elicits a non-rational approach to test ordering by registrars. These findings contribute to the understanding of GP registrar management of fatigue, and undifferentiated presentations more broadly, and suggest educational approaches to improve practice, including dealing with uncertainty. KEYWORDS: Diagnostic tests, routine; education, medical; family practice; fatigue; general practice
Patient expectations for chronic pain management
Authors: Bhana Neela , Thompson Lee , Alchin John , Thompson Bronwyn
Published: October 2018

INTRODUCTION: In New Zealand, one in six people report chronic pain, but the literature indicates only a 30% pain reduction is typically achieved in about half of treated patients. Most patients expecting a cure of their pain, or even substantial pain reduction, are therefore likely to be disappointed. It is important to align patient expectations with this reality. METHODS: This study analysed the responses of 250 patients referred to a Pain Management Centre to the free-text question: 'What are your main goals or reasons for attending the Pain Management Centre?' Free-text comments were analysed using ethnographic content analysis, an inductive approach in which the themes and subthemes are not predetermined, but emerge from the data during analysis, and thus reflect the issues of importance to patients themselves. FINDINGS: Three themes emerged from the analysis: patients' desire to understand their pain, regain 'normality', and concerns about medication. Responses were divided into those with an expectation of cure, and those who seemed to be more accepting of their pain and who desired management. CONCLUSION: Patients hope to return to what they perceive as normal and to have clear, relevant information about their diagnosis, prognosis and medications. Those desiring cure, or significant pain reduction, present more of a challenge to their general practitioners and the Pain Management Centre. When referring a patient for chronic pain management, there is a need to align patient expectations at the point of referral with what can realistically be achieved. KEYWORDS: Chronic pain; pain management; patient satisfaction; qualitative research
Diversity, phylogenetic relationships and host associations of Calliobothrium and Symcallio (Cestoda: ‘Tetraphyllidea') parasitising triakid sharks
Authors: Bernot James P. , Caira Janine N. , Pickering Maria
Published: October 2018

The laciniate, relatively large-bodied tetraphyllidean tapeworm genus Calliobothrium van Beneden, 1850 parasitises triakid sharks with all but one species found parasitising sharks of the genus Mustelus Linck, 1790. Historically, species of this genus were thought to exhibit a relaxed degree of host specificity relative to species of their sister genus Symcallio Bernot, Caira, & Pickering, 2015. However, several more recent studies have begun to question this difference and, in particular, the conspecificity of specimens identified as the types species, C. verticillatum (Rudolphi, 1819) van Beneden, 1850, from multiple host species. Our results suggest that diversity in the genus Calliobothrium has been under-reported. To explore this situation, specimens previously identified as C. verticillatum were collected from Mustelus asterias Cloquet, 1819 off the United Kingdom and Mustelus canis (Mitchell, 1815) off Connecticut, USA; these sharks each were found to host distinct species both of which are described here. Mustelus asterias was also confirmed to host Symcallio leuckarti (van Beneden, 1850) Bernot, Caira & Pickering, 2015, which is redescribed. In combination with newly collected material from Mustelus palumbes Smith, 1957 off South Africa and data available from GenBank, molecular phylogenetic analyses based on 28S rDNA data for four of the seven known species of Calliobothrium, including both new species and five of the 11 known species of Symcallio, were conducted. The resulting phylogeny supports the mutual monophyly of the two genera, which are readily distinguished based on whether they exhibit proglottid laciniations, and supports subclades of Symcallio with and without hook accessory pieces. These subclades of Symcallio appear to exhibit an intriguing congruence with two known subclades of their host genus, Mustelus.
The enigmatic groundwater amphipod Awacaris kawasawai revisited: synonymisation of the genus Sternomoera, with molecular phylogenetic analyses of Awacaris and Sternomoera species (Crustacea : Amphipoda : Pontogeneiidae)
Authors: Tomikawa Ko , Kyono Masaki , Kuribayashi Keiko , Nakano Takafumi
Published: October 2018

Amphipod crustaceans are dominant in subterranean habitats, and members of eight genera are endemic to groundwater environments in the Japanese Archipelago. The taxonomic status of two of these genera remains unclear, because their original descriptions were incomplete. The descriptions of the enigmatic subterranean monotypic genus Awacaris and its type species, A. kawasawai Uéno, 1971, are revisited here. Awacaris kawasawai was originally described based on specimens from a subterranean stream at Himise Cave, Tokushima Prefecture, Shikoku, Japan. Recently, a new population of A. kawasawai was found at Saruta Cave, Kochi Prefecture, Shikoku. Detailed observation of the newly collected specimens reveals the presence of sternal gills, which is the diagnostic character of the pontogeneiid genus Sternomoera, making the validity of Sternomoera open to question. Phylogenetic analyses using nuclear 28S rRNA and mitochondrial cytochrome c oxidase subunit I markers demonstrate that A. kawasawai forms a well-supported clade with the subterranean S. morinoi Tomikawa and Ishimaru, 2014. In addition, phylogenetic analysis reveals cryptic diversity in epigean species of Sternomoera. Ancestral state reconstruction suggests that catadromous Sternomoera species have evolved from freshwater ancestors. Based on our morphological and phylogenetic analysis of Awacaris and Sternomoera species, it is concluded here that Sternomoera should be treated as a subjective junior synonym of Awacaris.
Bringing new HIV infections to zero – opportunities and challenges offered by antiretroviral-based prevention in Asia, the Pacific and beyond: An overview of this special issue
Authors: Zablotska Iryna B. , Whittaker Bill , de Wit John , Kamarulzaman Adeeba , Ananworanich Jintanat , Wright Edwina , Poynten Isobel Mary , Mayer Kenneth
Published: October 2018

This editorial to the special issue of Sexual Health on antiretroviral-based prevention of HIV infection is dedicated to showcasing research and practice in this area. It aims to promote debate regarding the potential of new antiretroviral-based prevention approaches and the challenges encountered in moving prevention innovations into the community. This special issue covers the breadth of innovative HIV prevention research, including that undertaken in the fields of epidemiology, clinical research, social and behavioural science, public health and policy analysis, and with special emphasis on Asia and the Pacific region. Most importantly, it provides an indication of how the region is progressing towards embracing new prevention approaches to combat HIV epidemics across the region.
Advancing front of old-age human survival
Authors: Zuo Wenyun , Jiang Sha , Guo Zhen , Feldman Marcus W. , Tuljapurkar Shripad
Published: October 2018

Significance

Old-age mortality decline has driven recent lifespan increases, but there is no agreement about the age pattern of old-age deaths. For example, some argue that old-age deaths should become compressed at advanced ages, and others argue that old-age deaths should become more dispersed with age. Here we show, for five decades in 20 developed countries, that old-age survival follows an advancing front, like a traveling wave. We make and test several predictions that support the existence of this front. Our unexpected result underscores the plasticity of old-age human mortality, with deaths steadily delayed as societies develop, and supports an ongoing increase in the age of transition to disability. We find no evidence of an impending limit to human lifespan.
Underutilization of the Current Clinical Capacity to Provide Buprenorphine Treatment for Opioid use Disorders within the Veterans Health Administration
Authors: Valenstein-Mah Helen , Hagedorn Hildi , Kay Chad L. , Christopher Melissa L. , Gordon Adam J.
Published: October 2018

Background: Opioid use disorder (OUD) is a critical concern among US veterans. The Veterans Health Administration (VHA) recommends buprenorphine as a first-line treatment for OUD; however, only 35% of veterans with an OUD currently receive medication treatment. Practical barriers, including the capacity of providers to prescribe, may affect delivery of buprenorphine. We examined the current state of buprenorphine treatment within the VHA. Methods: National VHA administrative databases were queried to identify all providers credentialed to prescribe buprenorphine as of January 2018. Data were extracted on providers’ prescribing capacity (30, 100, or 275 patients concurrently) and number of patients who received buprenorphine in the prior 180 days. Results: A total of 1458 VHA providers were credentialed to prescribe buprenorphine. Forty-three percent of providers had not prescribed buprenorphine to any VHA patients in the past 180 days. Of those that prescribed to at least 1 patient, providers still prescribed to fewer patients than their capacity, regardless of their patient panel size (30, 100, or 275), prescribing to 18.5 patients on average. Conclusions: VHA providers are prescribing buprenorphine below their capacity. A multipronged approach to increase the number of credentialed providers and address barriers to prescribing is needed to ensure that veterans get effective treatment for OUD.
Insuring Well‐Being? Buyer's Remorse and Peace of Mind Effects From Insurance
Authors: Tafere Kibrom , Barrett Christopher B. , Lentz Erin
Published: October 2018

We estimate the causal effects of index insurance coverage on subjective well‐being among livestock herders in southern Ethiopia. By exploiting the randomized distribution of discount coupons and information treatments to instrument for the purchase of index‐based livestock insurance, and three rounds of panel data, we separately identify ex ante welfare gains from insurance that reduces risk exposure and ex post buyer's remorse effects that may arise after the resolution of uncertainty. We find that current insurance coverage generates subjective well‐being gains that are significantly higher than the buyer's remorse effect of an insurance policy that lapsed without paying out. Given the positive correlation in insurance purchase propensity over time, failure to control for potential buyer's remorse effects can bias downward estimates of welfare gains from current insurance coverage.
Linezolid- and Vancomycin-resistant Enterococcus faecium in Solid Organ Transplant Recipients: Infection Control and Antimicrobial Stewardship Using Whole Genome Sequencing
Authors: Abbo Lilian , Shukla Bhavarth S , Giles Amber , Aragon Laura , Jimenez Adriana , Camargo Jose F , Simkins Jacques , Sposato Kathleen , Tran Truc T , Diaz Lorena , Reyes Jinnethe , Rios Rafael , Carvajal Lina P , Cardozo Javier , Ruiz Maribel , Rosello Gemma , Cardona Armando Perez , Martinez Octavio , Guerra Giselle , Beduschi Thiago , Vianna Rodrigo , Arias Cesar A
Published: October 2018

Background

Vancomycin-resistant enterococci are an important cause of healthcare-associated infections and are inherently resistant to many commonly used antibiotics. Linezolid is the only drug currently approved by the US Food and Drug Administration to treat vancomycin-resistant enterococci; however, resistance to this antibiotic appears to be increasing. Although outbreaks of linezolid- and vancomycin-resistant Enterococcus faecium (LR-VRE) in solid organ transplant recipients remain uncommon, they represent a major challenge for infection control and hospital epidemiology.

Methods

We describe a cluster of 4 LR-VRE infections among a group of liver and multivisceral transplant recipients in a single intensive care unit. Failure of treatment with linezolid in 2 cases led to a review of standard clinical laboratory methods for susceptibility determination. Testing by alternative methods including whole genome sequencing (WGS) and a comprehensive outbreak investigation including sampling of staff members and surfaces was performed.

Results

Review of laboratory testing methods revealed a limitation in the VITEK 2 system with regard to reporting resistance to linezolid. Linezolid resistance in all cases was confirmed by E-test method. The use of WGS identified a resistant subpopulation with the G2376C mutation in the 23S ribosomal RNA. Sampling of staff members’ dominant hands as well as sampling of surfaces in the unit identified no contaminated sources for transmission.

Conclusions

This cluster of LR-VRE in transplant recipients highlights the possible shortcomings of standard microbiology laboratory methods and underscores the importance of WGS to identify resistance mechanisms that can inform patient care, as well as infection control and antibiotic stewardship measures.
The chemical imprint of the bursty nature of Milky Way’s progenitors
Authors: Sharma Mahavir , Theuns Tom , Frenk Carlos
Published: October 2018

Carbon-enhanced metal-poor (CEMP) stars with low abundances of neutron capture elements (CEMP-no stars) are ubiquitous among metal-poor stars in the Milky Way. Recent observations have uncovered their two subgroups that differ in the carbon to magnesium ([C/Mg]) abundance ratio. Here, we demonstrate that similar abundance patterns are also present in Milky Way-like galaxies in the eagle cosmological hydrodynamical simulation, where these patterns originate from the fact that stars may form from gas enriched predominantly by asymptotic giant branch (AGB) stars or by type II supernovae. This occurs when stars form in the poorly mixed interstellar medium of Milky Way progenitor galaxies that are undergoing bursty star formation. The CEMP-no stars with lower [C/Mg] form at the onset of a starburst from gas enriched by low-metallicity type II supernovae that power a strong outflow, quenching further star formation. When star formation resumes following cosmological gas accretion, the CEMP-no stars with higher [C/Mg] form, with enrichment by AGB ejecta evident in their higher abundance of barium and lower abundance of magnesium. This suggests that bursty star formation in the progenitors of the Galaxy leaves a permanent imprint in the abundance patterns of CEMP stars.
Comorbidities (excluding lymphoma) in Sjögren’s syndrome
Authors: Pego-Reigosa José M. , Restrepo Vélez Juliana , Baldini Chiara , Rúa-Figueroa Fernández de Larrinoa Íñigo
Published: October 2018

The information about comorbidities (excluding lymphoma) in primary Sjögren’s syndrome (pSS) is relatively scarce. Cardiovascular disease, infections, musculoskeletal conditions or malignancy are likely the most relevant comorbid conditions in pSS. Different infections (particularly oral candidal infections) and fibromyalgia are extremely frequent in the daily clinical practice. On the other hand, the incidence of cardiovascular events and cancer in pSS is low, so information about them comes from large epidemiological studies or meta-analysis. For this reason, preclinical vascular disease is investigated by different techniques, demonstrating the presence of early atherosclerosis in pSS patients. Coronary events could be slightly more frequent in pSS than in the general population. The overall risk of malignancy in pSS patients seems to be slightly increased, likely due to excess occurrence of lymphoma. An association between pSS and thyroid cancer might exist, although it should be confirmed by further investigations.
Personality Traits Predict Meeting the WHO Recommendation of 6 Months' Breastfeeding
Authors: Verbeek Tjitte , Quittner Loes , de Cock Paul , de Groot Nynke , Bockting Claudi L. H. , Burger Huibert
Published: October 2018

Background:

Although personality as well as anxiety and depression are recognized as predictors for breastfeeding initiation, evidence of an association of these factors with 6 months' exclusive breastfeeding as recommended by the World Health Organization (WHO) is sparse.

Purpose:

The purpose of this study was to investigate the associations of personality and symptoms of anxiety and depression during and after pregnancy with meeting the WHO recommendation of 6 months' exclusive breastfeeding.

Methods:

In their first trimester of pregnancy, 5784 pregnant women were enrolled in Dutch primary obstetric care centers and hospitals, of which 2927 completed the breastfeeding assessments 6 months postpartum. We performed logistic regression analyses to test the associations of “big five” personality traits (NEO Five Factor Inventory), anxiety (State-Trait Anxiety Inventory), and depression (Edinburgh Postnatal Depression Scale) symptom levels during pregnancy and postpartum with meeting the WHO recommendation of 6 months' exclusive breastfeeding.

Results:

Agreeableness (odds ratio [OR] = 1.18, P = .006) and openness (OR = 1.31, P < .001) were positively associated with meeting the WHO recommendation, whereas extraversion (OR = 0.83, P = .005) and neuroticism (OR = 1.18, P = .006) were negatively associated. After adjustment for both antenatal and postpartum symptom levels of anxiety and depression, the associations of the agreeableness, extraversion, and openness personality traits remained strong and statistically significant (P < .05).

Implications for Practice:

Patient-centered care should take personality into account in an effort to tailor interventions to optimize breastfeeding behavior.

Implications for Research:

In contrast to earlier findings, personality traits may be of greater importance than symptoms of anxiety and depression for meeting the WHO recommendation of 6 months' exclusive breastfeeding.
A Pilot Study of Mothers' Breastfeeding Experiences in Infants With Cleft Lip and/or Palate
Authors: Kaye Alison , Cattaneo Carol , Huff Helen M. , Staggs Vincent S.
Published: October 2018

Background:

Despite the recognized importance of human milk (HM) use, breastfeeding is often discouraged for infants with cleft lip and/or palate because of their anatomical abnormalities. Poor weight gain may require formula for calorie supplementation. Stresses associated with caring for infants with cleft lip/palate may decrease rates of HM provision to these infants.

Purpose:

This study investigates the experiences of mothers of infants with cleft lip/palate (CL/P) to determine choices and factors associated with providing HM to their infants.

Methods:

A retrospective telephone survey was administered to a cohort of mothers of infants with CL/P.

Results:

Fifty mothers agreed to participate in the survey. Most (78%) initiated use of HM for a median duration of 4 months, 32% provided HM for 6 months or more, and 79% exclusively expressed their HM. Poor supply was the most frequent challenge to providing HM and led to cessation in 46% of the mothers. Formula was used to supplement for poor supply or poor infant weight gain in 90% of the mothers. The best predictors of a mother's use of HM were child not in day care, genetic diagnosis, and gestational age at birth. Only 36% of mothers reported individual encouragement to provide HM, and 18% reported they were specifically discouraged from providing HM for their infants.

Implications for Practice:

Although initiation rates were high, there are opportunities to improve support for mothers to increase duration of HM provision in children with CL/P.

Implications for Research:

This study establishes a baseline for future prospective studies looking at the impact of active encouragement and provision of lactation support within the cleft team setting.
Breastfeeding in Disaster Relief Camps
Authors: Hirani Shela Akbar Ali , Richter Solina , Salami Bukola Oladunni , Vallianatos Helen
Published: October 2018

Breastfeeding is the safest mode of infant feeding during disasters and displacement. Although challenges associated with breastfeeding during humanitarian emergencies are global, they are particularly problematic in low- and middle-income countries such as Pakistan. To examine the factors that affect breastfeeding practices of displaced mothers in disaster relief camps, an integrative review of literature was undertaken. The review suggests that the breastfeeding experiences, behaviors, and practices of displaced mothers are shaped by a combination of gender-based, sociocultural, economic, and geopolitical factors. A thorough understanding of these factors will assist nurses and other stakeholders to improve breastfeeding practices and decrease child deaths in disaster relief camps.
Complications in Brow Lifts: A Systemic Review of Surgical and Nonsurgical Brow Rejuvenations
Authors: Cho Min-Jeong , Carboy Jourdan A. , Rohrich Rod J.
Published: October 2018

Background:

Brow lift has been a part of plastic surgeons’ armamentarium for over a century. Although there are multiple different techniques available, there has been a dearth of literature comparing which technique is better and has lesser complications. In this study, we performed a systemic literature review of all brow lift techniques to determine and compare complication rates of each technique.

Methods:

We performed a computerized search of brow rejuvenation techniques using the MEDLINE database. Data regarding the type of brow lift procedure, number of patients, and complications were collected.

Results:

The systematic review was performed in December of 2017. A total of 326 articles were identified initially, and 76 studies remained after final review. The review showed highest revision rate in the hairline brow lift (7.4%), highest numbness rate in the direct brow lift (5.5%), highest asymmetry rate in the temporal/lateral brow lift (1.5%), and highest alopecia rate in the endoscopic brow lift (2.8%). In addition, we found 5 studies in nonsurgical brow rejuvenation (3 botulinum toxin, 1 fat injection, 1 radiofrequency).

Conclusion:

Our study shows that each brow technique has a different complication profile, and it is important for plastic surgeons to understand the difference. Furthermore, the study demonstrated the lack of randomized prospective outcome studies and standardization of outcome measures in brow rejuvenation. We believe this information would be the key and next frontier in providing technically safe and long-lasting aesthetic outcomes for the patients.
Facial Soft-tissue Mobility: Baseline Dynamics of Patients with Unilateral Facial Paralysis
Authors: Trotman Carroll Ann , Faraway Julian , Hadlock Tessa , Banks Caroline , Jowett Nathan , Jung Hyung Jae
Published: October 2018

Background:

The aims of this observational study were 2-fold: (1) To demonstrate a method and measures to quantify impaired facial soft-tissue movements in patients with facial paralysis; and (2) To quantify the differences in magnitude and velocity of facial soft-tissue movements between patients with facial paralysis and control participants.

Methods:

The study sample that addressed both aims consisted of 20 adults with acute, unilateral, flaccid facial paralysis who presented at the onset of their paralysis, and a control group of 20 healthy adults. Dynamic 3D facial movement data were collected from each participant during 11 facial animations. To compare the movements between the patients and control participants, dynamic modeling comparisons of mean facial movements were computed as well as plots of movement vectors for each animation, in addition, measures of maximum displacement, movement velocity, and asymmetry were computed.

Results:

Dynamic 3D modeling of critical facial landmarks provided precise profiles of zone-specific asymmetries and customized reporting that highlighted areas of importance for individual patients. The dynamic 3D movement data confirmed that the nonparalyzed side of patients’ faces had abnormal directional movements. As expected, the controls had significantly higher excursive facial movements during all animations except during gentle eye closure, which was greater for the patients and the controls had significantly greater movement velocity than the patients. The patients had significantly greater asymmetry for all the animations, and the hierarchy of the asymmetry was such that maximum smile > lip purse > grimace > cheek puff.

Conclusion:

Dynamic 3D modeling appeared to be an effective tool to provide precise profiles of zone-specific asymmetries and customized reports for patients with facial paralysis.
Preoperative Predictors of Mortality in Short-Term Continuous-Flow Ventricular Assist Devices
Authors: Bozso Sabin J. , Buchholz Holger , Pidborochynski Tara , Freed Darren H. , MacArthur Roderick G. G. , Conway Jennifer
Published: October 2018

Short-term continuous-flow ventricular assist devices (STCF-VADs) are increasingly being utilized to support critically ill patients, despite limited information regarding overall outcomes. All adult patients supported with an STCF-VAD between June 2009 and December 2015 were included in this retrospective single-center study. Associations between preoperative characteristics and unsuccessful bridge (death on device or within 30 days postdecannulation) were assessed using logistic regression. A total of 61 patients (77% male) were identified with a median age at implant of 54.6 years. Left VADs were implanted in 51%, right VADs in 21%, and both VADs in 28%, and patients were supported for a median of 11 days. Overall, 23% were weaned to recovery, 13% underwent heart transplantation, 16% converted to long-term VADs, and 48% had an unsuccessful bridge. In multivariable analysis, only renal insufficiency or dialysis (odds ratio = 7.53; p = 0.002) remained a significant independent predictor of an unsuccessful bridge. Short-term continuous-flow VADs can successfully bridge adult patients with mortality around 50%. Preimplant renal insufficiency or dialysis is correlated with an unsuccessful bridge in our patient population, likely reflecting the severity of illness preimplant. Further studies are required to determine whether this factor remains significant in a larger patient population.
Suitability of 3D-Printed Root Models for the Development of Transcatheter Aortic Root Repair Technologies
Authors: Ferrari Enrico , Piazza Giulia , Scoglio Martin , Berdajs Denis , Tozzi Piergiorgio , Maisano Francesco , Von Segesser Ludwig Karl
Published: October 2018

Transcatheter aortic root repair (TARR) is still not available because of the complex anatomy. In order to develop future TARR technologies, a human-derived bench test model is required before performing animal tests. For this purpose, we aimed to validate computed tomography (CT)-derived 3D-printed root models for TARR technologies. Four human CT-derived roots were printed using different resins: Visijet M3 Crystal, Photopolymer gel SUP705, Formlabs flexible resin, and Materialise HeartPrint Flex. A stress test was performed using a 26-mm balloon-expandable Sapien valve deployed in aortic position. The too rigid Visijet M3 Crystal was not tested. Among the others, all but one (HeartPrint Flex, Materialise, Leuven, Belgium) ruptured during the test showing low wall resistances. Further tests were then performed in two roots made of HeartPrint Flex resin. The anatomic validation was performed comparing human CT scan-derived 3D reconstructions and CT scan measurements: a mean difference of 0.57 ± 0.4 mm for aortic annulus diameter and for the distance between the aortic annulus and the coronary ostia was measured. Concerning the coronary arteries, they are of paramount importance for new TARR technologies, and therefore, we tested the coronary flows of the HeartPrint Flex root at different pressure levels. At 60 mm Hg, right and left mean adjusted coronary flows were 471 and 663 ml/min; at 80 mm Hg, right and left mean coronary flows were 551 and 777 ml/min; and at 100 mm Hg, right and left mean coronary flows were 625 and 858 ml/min. In our study, 3D-printed root models correlate well with human anatomy and guarantee physiologic coronary flows for TARR technologies.
Patterns of splenic arterial enhancement on computed tomography are related to changes in portal venous pressure
Authors: McCormick P. Aiden , Malone Dermot E. , Docherty James R. , Kiat Clifford , Christopher Brian T. , Chin Jun Liong
Published: October 2018

Objectives

One of the striking features of splenic imaging is variable heterogeneous gyriform arterial enhancement on dynamic computed tomography (CT). We speculated that these patterns of arterial enhancement may reflect changes in splenic micro-circulation related to changes in portal venous pressure.

Patients and methods

To test this hypothesis, we evaluated arterial phase CT scans performed before and after liver transplantation (n=91), as this is the most effective way of alleviating portal hypertension. We developed novel grading systems to assess heterogeneity. Two control groups were used: patients with cirrhosis undergoing transarterial chemoembolization (TACE) (n=28) and patients with cirrhosis on the liver transplant waiting list who had repeated CT scans (n=28).

Results

Splenic arterial heterogeneity increased in 55% of transplant patients compared with 14% in the TACE patients and 4% in the waiting list patients (P<0.0001). Mean Hounsfield units in areas of splenic enhancement were 71.7±2 before transplant and 90.1±2.5 after transplant (P<0.01). In contrast, there were no significant changes following TACE (86.3±4.2 vs. 83.5±4.5; P=NS) or in waiting list patients (80.9±4.6 vs. 73.8±3.7; P=NS).

Conclusion

We have shown the heterogeneous gyriform enhancement patterns significantly increase following liver transplantation but not after TACE or in waiting list patients. We suggest that these changes are due to the reduction in portal venous pressure and likely reflect changes in splenic micro-circulation. These changes may be important in the pathophysiology of hypersplenism.
Accelerating the Drug Delivery Pipeline for Acute and Chronic Pancreatitis
Authors: Forsmark Christopher E. , Andersen Dana K. , Farrar John T. , Golden Megan , Habtezion Aida , Husain Sohail Z. , Li Liang , Mayerle Julia , Pandol Stephen J. , Uc Aliye , Zhu Zixi , Yadav Dhiraj
Published: October 2018

The lack of effective therapeutic agents specifically tailored for chronic pancreatitis (CP) has hampered clinical care and negatively impacted patients' lives. New mechanistic insights now point to novel therapies, which involve both recently developed and/or repurposed agents. This working group focused on 2 main outcomes for CP: pain and progression of disease. The goal is to frame the essential aspects of trial design including patient-centered outcomes, proposed methods to measure the outcomes of pain and progression, and study design considerations for future trials to facilitate rapid drug development for patients with CP.
Wide-Awake Flexor Pollicis Longus Tendon Reconstruction with Evaluation of the Active Voluntary Contraction of the Ruptured Muscle-Tendon
Authors: Zukawa Mineyuki , Osada Ryusuke , Makino Hiroto , Kimura Tomoatsu
Published: October 2018

The purpose of this study was to investigate the clinical outcome of the wide-awake tendon reconstruction for chronic rupture of the flexor pollicis longus tendon with evaluation of the voluntary active contraction distance of the ruptured musculotendinous unit. Eleven consecutive patients underwent tendon reconstruction under wide-awake surgery. If the total of the passive distraction distance and the active contraction distance of the ruptured flexor pollicis longus musculotendinous unit was greater than 30 mm, tendon grafting was performed. If not, tendon transfer was performed using the fourth flexor digitorum superficialis. Patients were evaluated with total active motion before surgery, during surgery, and in final follow-up and subjectively surveyed with quick Disabilities of the Arm, Shoulder and Hand scores. The final outcomes of tendon grafting and of tendon transfer were compared. Tendon grafting was performed in four patients, and tendon transfer was performed in seven patients. The final follow-up total active motion was 84.3 ± 12.7 percent in the tendon transfer group and 80.7 ± 10.2 percent in the tendon grafting group. There were no significant differences between the two groups in the final follow-up total active motion percentage and quick Disabilities of the Arm, Shoulder and Hand scores. The functional outcomes of both tendon grafting and tendon transfer were acceptable based on evaluating the active contraction distance and passive distraction distance of the ruptured musculotendinous unit during wide-awake surgery. Evaluating these distances may be a useful index to assess the ruptured musculotendinous unit. The greatest advantage of the wide-awake tendon reconstruction is that surgeons can evaluate the ruptured musculotendinous unit and measure total active motion during surgery while adjusting suture tension.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
18F-FDG Uptake in Subcutaneous Fat Preceding Clinical Diagnosis of Human Immunodeficiency Virus–Associated Lipodystrophy
Authors: Caton Michael T. , Miskin Nityanand , Hyun Hyewon
Published: October 2018

A 62-year-old man with human immunodeficiency virus (HIV) on long-standing highly active antiretroviral therapy presented for 18F-FDG PET/CT evaluation of a pulmonary nodule. The examination showed unusual radiotracer distribution accumulating in the subcutaneous and visceral fat with low cerebral and skeletal muscle uptake. Imaging features were consistent with HIV-associated lipodystrophy, an unsuspected diagnosis that was later confirmed on physical examination. Recognition of HIV-associated lipodystrophy by the nuclear medicine physician is critical as altered biodistribution may affect diagnostic yield or be mistaken for infectious pathology.
ACR–ACNM Practice Parameter for the Performance of Fluorine-18 Fluciclovine-PET/CT for Recurrent Prostate Cancer
Authors: Savir-Baruch Bital , Banks Kevin P. , McConathy Jonathan E. , Molchanova-Cook Olga P. , Parent Ephraim E. , Takalkar Amol , Tulchinsky Mark , Yu Jian Q. , Subramaniam Rathan M. , Schuster David M.
Published: October 2018

The American College of Radiology (ACR) and American College of Nuclear Medicine (ACNM) collaborated to develop a clinical practice document for the performance of fluciclovine positron-emission tomography (PET) / computed tomography (CT) in the evaluation of patients with suspected prostate cancer recurrence based on the elevation of prostate-specific antigen (PSA) level (biochemical recurrence) after prior therapy. Prostate cancer is the third leading cause of cancer death in the United States. Up to 50% of patients diagnosed with prostate cancer will develop biochemical failure after initial therapy. The differentiation of local from extraprostatic recurrence plays a critical role in patient management. The use of functional imaging targeting features of cancer metabolism has proven highly useful in this regard. Amino acid transport is upregulated in prostate cancer. Fluciclovine (anti-1-amino-3-F-18-fluorocyclobutane-1-carboxylic acid, FACBC, Axumin™) is an artificial amino acid PET tracer which demonstrates utility in the diagnosis of recurrent prostate cancer with significant added value to conventional imaging.
18F-FDG, 68Ga-DOTATATE and 68Ga-PSMA Positive Metastatic Large Cell Neuroendocrine Prostate Tumor
Authors: Acar Emine , Kaya Gamze Çapa
Published: October 2018

Prostate large cell neuroendocrine tumor is a rare disease. In this case, metastatic areas showing FDG uptake, somatostatin receptor positivity, and PSMA expression are shown in 18F-FDG PET/CT, 68Ga-DOTATATE PET/CT, and 68Ga-PSMA PET/CT in a 70-year-old man with the diagnosis of prostate large cell neuroendocrine carcinoma.
Detection of Hepatic Encephalopathy on 18F-FDG PET/CT Brain Images in a Patient With Decompensated Liver Cirrhosis
Authors: Vankadari Kousik , Mittal Bhagwant Rai , Kumar Rajender , Singh Harmandeep , Bhattacharya Anish , Dhiman Radha Krishan
Published: October 2018

We present a case of decompensated liver cirrhosis with ascites, which had history of asterixis, impaired balance with swaying gait along with mild irritability since 1 month. 18F-fluorodeoxyglucose PET/CT (FDG-PET/CT) performed to rule out malignancy did not reveal any abnormal FDG avid lesion suspicious for malignancy but showed hypermetabolism in the bilateral basal ganglia and thalamus with reduced metabolism in cerebral cortices and cerebellum, suggesting hepatic encephalopathy.