bluuebunny/crossref_metadata_2025 huggingface dataset:
The J-domain cochaperone Rsp1 interacts with Mto1 to organize noncentrosomal microtubule assembly
Authors: Shen Juan , Li Tianpeng , Niu Xiaojia , Liu Wenyue , Zheng Shengnan , Wang Jing , Wang Fengsong , Cao Xinwang , Yao Xuebiao , Zheng Fan , Fu Chuanhai
Published: November 2018

Microtubule biogenesis initiates at various intracellular sites, including the centrosome, the Golgi apparatus, the nuclear envelope, and preexisting microtubules. Similarly, in the fission yeast Schizosaccharomyces pombe, interphase microtubules are nucleated at the spindle pole body (SPB), the nuclear envelope, and preexisting microtubules, depending on Mto1 activity. Despite the essential role of Mto1 in promoting microtubule nucleation, how distribution of Mto1 in different sites is regulated has remained elusive. Here, we show that the J-domain cochaperone Rsp1 interacts with Mto1 and specifies the localization of Mto1 to non-SPB nucleation sites. The absence of Rsp1 abolishes the localization of Mto1 to non-SPB nucleation sites, with concomitant enrichment of Mto1 to the SPB and the nuclear envelope. In contrast, Rsp1 overexpression impairs the localization of Mto1 to all microtubule organization sites. These findings delineate a previously uncharacterized mechanism in which Rsp1-Mto1 interaction orchestrates non-SPB microtubule formation.
Word Knowledge: Exploring the Relationships and Order of Acquisition of Vocabulary Knowledge Components
Authors: González-fernández Beatriz , Schmitt Norbert
Published: November 2018

This study explores the overall nature of the vocabulary knowledge construct by examining the relationships and order of acquisition of multiple word knowledge components. A total of 144 Spanish learners of English were tested on their recognition and recall knowledge of four word knowledge components: the form–meaning link, derivatives, multiple meanings, and collocations. All word knowledge components were strongly intercorrelated, and implicational scaling analyses showed that there is a consistent pattern of acquisition for these components, with recognition knowledge being acquired before recall knowledge across all the different components. Structural equation modelling (SEM) revealed that all components (both recognition and recall) contribute significantly to the global vocabulary construct. However, SEM also suggested that the recognition and recall masteries of any particular word knowledge component must be seen as separate constructs. Overall, findings suggest that the distinction between recognition and recall knowledge is fundamental to the conceptualization of the development of vocabulary knowledge.
High Cancer Burden Among Antiretroviral Therapy Users in Malawi: A Record Linkage Study of Observational Human Immunodeficiency Virus Cohorts and Cancer Registry Data
Authors: Horner Marie-Josèphe , Chasimpha Steady , Spoerri Adrian , Edwards Jessie , Bohlius Julia , Tweya Hannock , Tembo Petros , Nkhambule Franklin , Phiri Eddie Moffo , Miller William C , Malisita Kennedy , Phiri Sam , Dzamalala Charles , Olshan Andrew F , Gopal Satish
Published: November 2018

Background

With antiretroviral therapy (ART), AIDS-defining cancer incidence has declined and non-AIDS–defining cancers (NADCs) are now more frequent among human immunodeficiency virus (HIV)–infected populations in high-income countries. In sub-Saharan Africa, limited epidemiological data describe cancer burden among ART users.

Methods

We used probabilistic algorithms to link cases from the population-based cancer registry with electronic medical records supporting ART delivery in Malawi’s 2 largest HIV cohorts from 2000–2010. Age-adjusted cancer incidence rates (IRs) and 95% confidence intervals were estimated by cancer site, early vs late incidence periods (4–24 and >24 months after ART start), and World Health Organization (WHO) stage among naive ART initiators enrolled for at least 90 days.

Results

We identified 4346 cancers among 28 576 persons. Most people initiated ART at advanced WHO stages 3 or 4 (60%); 12% of patients had prevalent malignancies at ART initiation, which were predominantly AIDS-defining eligibility criteria for initiating ART. Kaposi sarcoma (KS) had the highest IR (634.7 per 100 000 person-years) followed by cervical cancer (36.6). KS incidence was highest during the early period 4–24 months after ART initiation. NADCs accounted for 6% of new cancers.

Conclusions

Under historical ART guidelines, NADCs were observed at low rates and were eclipsed by high KS and cervical cancer burden. Cancer burden among Malawian ART users does not yet mirror that in high-income countries. Integrated cancer screening and management in HIV clinics, especially for KS and cervical cancer, remain important priorities in the current Malawi context.
Computational complexity versus statistical performance on sparse recovery problems
Authors: Roulet Vincent , Boumal Nicolas , d’Aspremont Alexandre
Published: November 2018

We show that several classical quantities controlling compressed-sensing performance directly match classical parameters controlling algorithmic complexity. We first describe linearly convergent restart schemes on first-order methods solving a broad range of compressed-sensing problems, where sharpness at the optimum controls convergence speed. We show that for sparse recovery problems, this sharpness can be written as a condition number, given by the ratio between true signal sparsity and the largest signal size that can be recovered by the observation matrix. In a similar vein, Renegar’s condition number is a data-driven complexity measure for convex programmes, generalizing classical condition numbers for linear systems. We show that for a broad class of compressed-sensing problems, the worst case value of this algorithmic complexity measure taken over all signals matches the restricted singular value of the observation matrix which controls robust recovery performance. Overall, this means in both cases that, in compressed-sensing problems, a single parameter directly controls both computational complexity and recovery performance. Numerical experiments illustrate these points using several classical algorithms.
Automated Requests for Thyroid-Stimulating Hormone and Ferretin Tests in Young Primary Care Patients with Anorexia as an Intervention to Improve Detection of Underlying Conditions
Authors: Salinas Maria , López-Garrigós Maite , Flores Emilio , Leiva-Salinas Carlos
Published: November 2018

Objective

To improve clinical laboratory contribution to the treatment of primary care patients with anorexia through automated computerized strategies.

Methods

We recorded the number of laboratory requests due to anorexia; the demographic data, laboratory values, and presence of pathological values for the applicable patients. In a prospective study, the laboratory information management system (LIMS) automatically added thyroid-stimulating hormone (TSH) and/or ferritin testing when it was not requested by general practitioners for all primary care patients with anorexia who were younger than 16 years.

Results

A total of 3562 patients underwent laboratory testing due to anorexia, of whom 47% were younger than 16 years. The tests in which the results most frequently were abnormal were hemoglobin, ferritin, and TSH. TSH results were abnormal in 20% of patients younger than 16 years. Through the intervention, we detected 3 low ferritin values and 7 cases of pathological TSH levels.

Conclusions

The LIMS required TSH and ferritin testing in young patients even when not requested, potentially avoiding the adverse effects of iron deficiency and thyroid disorders on neurological development and cognition in those patients.
The Network Structure of Tobacco Withdrawal in a Community Sample of Smokers Treated With Nicotine Patch and Behavioral Counseling
Authors: Lydon-Staley David M , Schnoll Robert A , Hitsman Brian , Bassett Danielle S
Published: November 2018

Introduction

Network theories of psychopathology highlight that, rather than being indicators of a latent disorder, symptoms of disorders can causally interact with one another in a network. This study examined tobacco withdrawal from a network perspective.

Methods

Participants (n = 525, 50.67% female) completed the Minnesota Tobacco Withdrawal Scale four times (2 weeks prior to a target quit day, on the target quit day, and 4 and 8 weeks after the target quit day) over the course of 8 weeks of treatment with nicotine patch and behavioral counseling within a randomized clinical trial testing long-term nicotine patch therapy in treatment-seeking smokers. The conditional dependence among seven withdrawal symptoms was estimated at each of the four measurement occasions. Influential symptoms of withdrawal were identified using centrality indices. Changes in network structure were examined using the Network Comparison Test.

Results

Findings indicated many associations among the individual symptoms of withdrawal. The strongest associations that emerged were between sleep problems and restlessness, and associations among affective symptoms. Restlessness and affective symptoms emerged as the most central symptoms in the withdrawal networks. Minimal differences in the structure of the withdrawal networks emerged across time.

Conclusions

The cooccurrence of withdrawal symptoms may result from interactions among symptoms of withdrawal rather than simply reflecting passive indicators of a latent disorder. Findings encourage greater consideration of individual withdrawal symptoms and their potential interactions and may be used to generate hypotheses that may be tested in future intensive longitudinal studies.

Implications

This study provides a novel, network perspective on tobacco withdrawal. Drawing on network theories of psychopathology, we suggest that the cooccurrence of withdrawal symptoms may result from interactions among symptoms of withdrawal over time, rather than simply reflecting passive indicators of a latent disorder. Results indicating many associations among individual symptoms of withdrawal are consistent with a network perspective. Other results of interest include minimal changes in the network structure of withdrawal across four measurement occasions prior to and during treatment with nicotine patch and behavioral counseling.
Holomorphic functions with distinguished properties on infinite dimensional spaces
Authors: Alves Thiago R , Botelho Geraldo
Published: November 2018

In this paper, we develop a method to construct holomorphic functions that exist only on infinite dimensional spaces. The following types of holomorphic functions f:U→ℂ on some open subsets U of an infinite dimensional complex Banach space are constructed: (1) f is bounded holomorphic on U and is continuously, but not uniformly continuously extended to U¯; (2) f is continuous on U¯ and holomorphic of bounded type on U, but f is unbounded on U; (3) f is holomorphic of bounded type on U and f cannot be continuously extended to U¯. The technique we develop is powerful enough to provide, in the cases (2) and (3) above, large algebraic structures formed by such functions (up to the zero function, of course).
Mortgage Dollar Roll
Authors: Song Zhaogang , Zhu Haoxiang
Published: November 2018

Mortgage dollar roll, the most common financing strategy for agency MBS, differs from repo in that the returned collateral can differ from those received. Also, MBS ownership changes hands in the funding period. We show that dollar roll “specialness,” how much implied financing rates fall below MBS repo rates, (1) increases in the value of the cheapest-to-deliver option, (2) decreases in the leverage of primary dealers, (3) decreases in prepayment risk exposure during the financing period, and (4) decreases in MBS returns. The Federal Reserve’s dollar roll sales in quantitative easing operations are associated with lower specialness.

Received February 3, 2016; editorial decision July 30, 2018 by Editor Itay Goldstein. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
COMPARISON OF ORGAN-BASED TUBE CURRENT MODULATION AND BISMUTH SHIELDING IN CHEST CT: EFFECT ON THE IMAGE QUALITY AND THE PATIENT DOSE
Authors: Kotiaho Antti , Manninen Anna-Leena , Nikkinen Juha , Nieminen Miika Tapio
Published: November 2018

The aim of the study was to compare the absorbed doses and image quality of organ-based tube current modulation (OBTCM) and bismuth shielding of breasts and thyroid against regular tube current modulation in chest CT scan. An anthropomorphic phantom and MOSFET dosemeters were used to evaluate absorbed doses. Image quality was assessed from HU and noise. Relative to the reference scan, the average absorbed dose reduction with OBTCM was 5.2% and with bismuth shields 24.2%. Difference in HU values compared to the reference varied between −4.1 and 4.2 HU in OBTCM scan and between −22.2 and 118.6 HU with bismuth shields. Image noise levels varied between 10.0 to 26.3 HU in the reference scan, from 9.6 to 27.7 HU for the OBTCM scan and from 11.9 to 43.9 HU in the bismuth scan. The use of bismuth shields provided greatest dose reduction compared to the investigated OBTCM.
Financialization, financial development and investment. Evidence from European non-financial corporations
Authors: Tori Daniele , Onaran Özlem
Published: November 2018

This article provides estimations of the effects of different financial channels on physical investment in Europe using the balance sheets of publicly listed non-financial corporations (NFCs) for the period 1995–2015. The evidence suggests that both financial payments and financial income have an adverse effect on investment in fixed assets. The negative impacts of increasing financial income are non-linear with respect to company size: they crowd out investment in large companies, and have a positive effect on the investment of relatively smaller companies. Similar to the recent literature on finance-growth nexus, we find an inverted U-shaped relationship between financial development and companies’ investment. However, in contrast to the existing literature, we also find that a higher degree of financial development in the country is associated with a stronger negative effect of financial income on investment.
Preference for Private Sector for Vaccination of Under-Five Children in India and Its Associated Factors: Findings from a Nationally Representative Sample
Authors: Sarveswaran Gokul , Krishnamoorthy Yuvaraj , Sakthivel Manikandanesan , Vijayakumar Karthiga , Priyan Shanthosh , Thekkur Pruthu , Chinnakali Palanivel
Published: November 2018

Background

Understanding the factors associated with private sector preference for vaccination will help in understanding the barriers in seeking public facility and also the steps to improve public–private partnership (PPP) model.

Methods

We analysed the recent National Family Health Survey-4 data (NFHS-4; 2015–16) gathered from Demographic Health Survey programme. Stratification and clustering in the sample design was accounted using svyset command.

Results

Weighted proportion of children receiving private vaccination was 10.0% (95% CI: 9.7–10.3). Children belonging to highest wealth quantile (adjusted Prevalence ratio; aPR-1.58), male child (aPR-1.07) urban area (aPR-1.11), not receiving anganwadi/Integrated Childhood Development Services (aPR-1.71) and receiving antenatal care in private sector was significantly associated with higher proportion of private vaccination.

Conclusion

Current study showed that 1 in 10 <5 years child in India received vaccination from private health facility. Preference for private health facility was found to be influenced by higher socio-economic strata, urban area residence and seeking private health facility for antenatal and delivery services.
Maximizing operating room efficiency by effectively managing elective case cancellation
Authors: Hadeed Michael M. , Patel Vandan D. , Novicoff Wendy M. , Gwathmey Frank Winston
Published: November 2018

Background:

Surgery cancellation and rescheduling affect efficiency and satisfaction, both critical aspects of the modern orthopaedic practice. The purpose of this study was to critically and comprehensively evaluate cancellations to define actionable ways to improve efficiency, with the goal to develop evidence-based, transparent rescheduling policies.

Methods:

A retrospective review was completed of all patients who were scheduled for elective surgery over 1 yr. Outcome measures included rate of cancellation, interval from time of cancellation to scheduled surgery date, risk factors for cancellation, re-schedule rate, re-cancellation rate, and risk factors for re-cancellation.

Results:

There were 7,215 elective surgeries, 13% of which were cancelled prior to surgery. Forty-four percent of surgeries were cancelled within 3 days of the surgery. Of those that were cancelled, 53% were rescheduled, 21% of which had cancelled again, which was significantly higher than the comparison group of first-time cancellations. Those that were cancelled without a correctable reason had significantly more re-cancellations and a lower procedure completion rate.

Conclusions:

When scheduling surgeries, it is more efficient to preference surgeries that have not been previously cancelled, and among previously cancelled surgeries to preference those with a correctable reason for cancellation. While not novel concepts, this study provides an evidence base for rescheduling policies, which can be made transparent for patients. Ultimately, this may improve efficiency as well as patient trust and satisfaction.
Ligature of the deep medial femoral circumflex artery decreases the incidence of transfusion in primary total hip arthroplasty
Authors: Rodríguez Hugo A. , Fiorillo Alvaro A. , Monsalvo Daniel J. , Segura Omar
Published: November 2018

Background:

Primary total hip arthroplasty (THA) is associated with substantial blood loss during the surgical approach and the postoperative period. This causes a decrease in hemoglobin levels up to 5 g/dL, and blood transfusion rates that vary between 30% and 73%. The purpose of this study was to compare the rate of blood transfusions in patients with or without ligature of the deep branch of the medial femoral circumflex artery (MFCA) during THA.

Methods:

A randomized controlled trial of patients who underwent primary THA between January and October 2011 was conducted. Patients were randomly allocated to either ligature or no ligature of the deep branch of the MFCA. The number of units of red blood cells transfused and surgical time were defined as main outcomes. Differences between groups were assessed using Student’s t-test.

Results:

A total of 146 patients were analyzed. Artery ligation reduced the need for blood transfusion in 74% (P<0.001) of patients and was identified as a protective factor in 76% of the sample. A mean decrease in bleeding of 200 cc (P<0.001) and mean increase of 2 minutes (P=0.61) in surgical time were found in the ligature group. This difference in the total surgical time between the two groups was not significant.

Discussion:

Ligature of the deep branch of the MFCA decreases the need for blood transfusion without increasing the surgical time or the difficulty of the procedure. We recommend that surgeons include this step during a THA surgical approach.
Opioid Use Following Operatively Treated Pediatric Elbow and Femur Fractures
Authors: Meyer Zachary I. , Krucylak Paul , Mo Michelle , Miller Mark L. , Wall Lindley B.
Published: November 2018

Background:

Opioids are a commonly utilized component of pain management following pediatric extremity fractures, yet an increasing number of adolescents and children are falling victim to their negative effects. The purpose of this study was to examine opioid use in the pediatric fracture population by determining and comparing the average hospital opioid dosage utilized in the operative pediatric elbow and femur fractures and determining and comparing the average dose prescribed following operative treatment of elbow and femur fractures.

Methods:

All elbow and femur fractures treated operatively between January and December 2016 were identified. Patients aged 0 to 17 years with closed injuries who presented to the emergency department (ED) within 24 hours of injury and underwent operative treatment were included. Demographic information, opioid and nonopioid analgesic medication doses administered in the ED and while inpatient, and postdischarge prescription information were recorded. Opioid doses were converted to oral morphine equivalents.

Results:

In total, 91.9% and 78.1% of patients received opioids during the ED and inpatient periods, respectively. Only 30% of patients in either cohort received a nonopioid analgesic in the ED and only 44% received ibuprofen while inpatient. Average total opioid dose per hour of hospital stay was not significantly different between elbow fracture and femur fracture cohorts, which was unexpected. There was no significant difference between the average opioid dose or number of doses prescribed for postdischarge use between cohorts.

Conclusions:

This study provides data on average hospital opioid and nonopioid use following pediatric elbow and femur fractures. The results reveal inconsistent nonopioid analgesic use and similar hospital opioid use in elbow and femur fracture patients. This study provides baseline analgesic use data for future investigations.

Level of Evidence:

Level IV.
Stathmin is a potential therapeutic target but not a prognostic marker in melanoma: an immunohistochemical study of 323 melanocytic lesions
Authors: Dundr Pavel , Simon Karol , Němejcová Kristýna , Bártů Michaela , Tichá Ivana , Michálková Romana , Jakša Radek , Věcková Zuzana , Kodet Ondřej
Published: November 2018

In several solid tumors, an increased stathmin expression is associated with both poor prognosis and resistance to certain chemotherapy types. However, the data regarding melanocytic lesions are very limited. The goals of our study are as follows: the assessment of stathmin expression in benign and malignant melanocytic lesions, and the significance of its expression for the differential diagnostics between benign and malignant lesions; the analysis of the prognostic significance of stathmin expression in melanoma; and the evaluation of stathmin expression in melanoma and melanoma metastases with respect to possible therapeutic targeting. Immunohistochemical analysis of stathmin expression was done in 323 melanocytic lesions, including 205 primary cutaneous melanomas, 60 melanoma metastases, and 58 melanocytic nevi. Stathmin expression was found in all analyzed groups of melanocytic lesions. Using the H-scoring system, the observed intensity of expression was as follows: melanocytic nevi: 146.1 (mean) and 150 (median); melanomas: 116.7 (mean) and 110 (median); and melanoma metastases: 136.8 (mean) and 140 (median). The stathmin expression was significantly lower in the cohort of primary melanomas when compared with metastases and nevi (P=0.001). The stathmin expression showed no prognostic significance. The high stathmin expression in melanoma suggests that stathmin might be a promising marker for therapeutic targeting in ongoing clinical trials. Compared with several other solid tumors, stathmin expression in melanoma showed no prognostic significance. The potential use of stathmin expression in differential diagnostics is limited by its common expression, and despite the statistically significant differences between nevi and melanoma, it may not be used in this setting.
The Role of Collective Efficacy in Reducing Health Disparities
Authors: Butel Jean , Braun Kathryn L.
Published: November 2018

Many improvements in health equity are spearheaded by community collaborations working to change policy and social norms. But how can collective efficacy (CE), defined as the willingness and ability of a group to work toward a common good, be increased? Eight articles reporting on interventions aiming to reduce health disparities by improving CE were found for this systematic literature review. All studies showed improvements in CE and most found reduction in disparities, but operationalization of CE varied. Findings support a model of how CE can address health disparities, which can guide standardization of CE interventions and measures.
Identifying Food Insecurity in Health Care Settings
Authors: De Marchis Emilia H. , Torres Jacqueline M. , Fichtenberg Caroline , Gottlieb Laura M.
Published: November 2018

This systematic scoping review explores evidence on food insecurity (FI) screening measures, acceptability, and program implementation in health care settings. Validation studies on brief screening tools suggest that instruments exist that adequately measure the construct of FI. Patients and clinicians found FI screening acceptable in a range of clinical settings, though studies are not high quality and rarely reflect substantial patient diversity. Targeted interventions successfully increased screening rates and reduced screening barriers. More research is needed to understand implementation and effectiveness of FI screening in diverse populations to ensure that evolving practices in this area do not widen health inequities.
Detection of Putative Functional Single Nucleotide Polymorphisms in Blood Pressure Loci and Validation of Association Between Single Nucleotide Polymorphism in WBP1L and Hypertension in the Chinese Han Population
Authors: Zhang Huan , Mo Xingbo , Zhou Zhengyuan , Zhu Zhengbao , HuangFu Xinfeng , Guo Zhirong , Zhang Yonghong
Published: November 2018

We have performed a gene-based association study and detected several important blood pressure (BP)-associated genes. In this study, we explored functional variants in these genes by bioinformatics analysis and validated the associations between the functional single nucleotide polymorphisms (SNPs) and hypertension with public data and our in-house data of 857 cases and 927 controls. We found various functional variants in the BP-associated genes, including missense mutations and phosphorylation-related SNPs. Most of these SNPs were associated with expressions of the local genes. Some of these SNPs were associated with coronary artery disease or ischemic stroke. The associations between 12 functional SNPs in 7 genes and BP were validated (P < 5 × 10−7). The intronic SNP rs176185, which may influence promoter histone, enhancer histone, DNase and regulatory motifs and showed cis-eQTL effect on WBP1L, was associated with hypertension in the Chinese Han population (P = 0.0119). Our study detected plenty of potential functional SNPs in the BP-associated genes and demonstrated that rs176185 may be associated with hypertension in the Chinese Han population.
Pharmacokinetics of Daclatasvir, Sofosbuvir, and GS-331007 in a Prospective Cohort of Hepatitis C Virus–Positive Kidney Transplant Recipients
Authors: Schrezenmeier Eva , Hoffmann Friederike , Jaeger Carsten , Schrezenmeier Jens , Lisec Jan , Glander Petra , Algharably Engi , Kreutz Reinhold , Budde Klemens , Duerr Michael , Halleck Fabian
Published: November 2018

Background:

Limited data exist on the pharmacokinetic profile of novel direct-acting antivirals in kidney transplant recipients. Daclatasvir is primarily eliminated through the biliary route and sofosbuvir through the renal route; here, we report the pharmacokinetic profile of combined treatment with these compounds in a prospective study of hepatitis C virus (HCV)-positive kidney transplant recipients (EudraCT: 2014-004551-32).

Methods:

In this study, plasma samples of 16 HCV-positive kidney transplant recipients receiving daclatasvir and sofosbuvir were collected at 4 time points at days 1, 7, 14, 21, 56, and 84 after start of treatment. Inclusion criteria were stable graft function and an estimated glomerular filtration rate (eGFR) >30 mL/min/1.73 m2. Daclatasvir, sofosbuvir, and GS-331007 (inactive metabolite of sofosbuvir) plasma concentrations were determined using ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry.

Results:

All patients showed a rapid virological response with HCV RNA below the detection limit 21 days after the start of therapy (medium time to viral clearance). No difference of the areas under the concentration–time curve (AUC) of daclatasvir, sofosbuvir, and GS-331007 was observed between patients with an eGFR below or ≥60 mL/min. For GS-331007, no relevant changes of trough levels were observed over time. Mean GS-331007 trough levels were 339.5 ± 174.9 ng/mL in patients with an eGFR ≥60 mL/min and 404.3 ± 226 ng/mL in patients with an eGFR <60 mL/min at day 7 (P = 0.52). At day 84, GS-331007 trough levels were 357.8 ± 200.8 and 404.2 ± 70.2 ng/mL in patients with an eGFR ≥60 mL/min and in patients with an eGFR <60 mL/min, respectively (P = 0.51). The accumulation ratios of renally eliminated GS-331007 for AUC and Cmax did not significantly differ between the 2 eGFR groups at day 7.

Conclusions:

An impaired eGFR (30–60 mL/min) does not lead to a dose accumulation of daclatasvir, sofosbuvir, and GS-331007. This study provides the rationale for future studies investigating the pharmacokinetic profile of sofosbuvir-based HCV treatment in kidney transplant recipients with an eGFR <30 mL/min.
Catalase C-262T Polymorphism Is a Risk Factor for Valproic Acid–Induced Abnormal Liver Function in Chinese Patients With Epilepsy
Authors: Ma Linfeng , Pan Yue , Sun Ming , Shen Haonan , Zhao Limei , Guo Yingjie
Published: November 2018

Background:

Individual susceptibility to valproic acid (VPA)-caused hepatotoxicity might result from genetic deficiencies in the detoxification and antioxidant enzymes including glutathione S-transferases (GSTs), catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx). This study aimed to investigate the relationships between GST mu 1 (GSTM1), GST theta 1 (GSTT1), CAT C-262T, GPx1 Pro200Leu, and SOD2 Val16Ala polymorphisms and the risk of abnormal liver function in Chinese epileptic patients treated with VPA monotherapy.

Methods:

According to the levels of liver function indicators, a total of 267 epileptic patients between 1 and 65 years of age were divided into normal liver function group and abnormal liver function group. GSTM1 and GSTT1 polymorphisms were determined using polymerase chain reaction (PCR) amplification based on the absence of a PCR amplification product. CAT, GPx1, and SOD2 polymorphisms were identified using PCR-restriction fragment length polymorphism or direct automated DNA sequencing.

Results:

Carriers of CAT had an increased risk of developing abnormal liver function compared with noncarriers in VPA-treated patients (odds ratio 3.968, P = 0.003). Logistic regression analyses indicated that the CAT genotype was a significant genetic risk factor for VPA-induced liver dysfunction. It suggests that individual susceptibility to VPA-induced liver dysfunction may at least partially result from genetic deficiencies in CAT C-262T.
Rhinoplasty with Barbed Threads
Authors: Lee Hee Young , Yang Hyun Jin
Published: November 2018

Background:

Strong strut structures are necessary for nasal tip projection in Asian rhinoplasty. Traditionally, strut structures have been constructed by open skin incisions.

Methods:

Barbed threads were implanted for rhinoplasties. The threads have multiple sharp barbs and umbrella-like longitudinal splits at both ends. Autologous micronized fat tissue graft was also simultaneously used when volume replacement was necessary.

Results:

Since 2003, barbed threads have been used in approximately 1,200 rhinoplasties for nasal tip projection, dorsal length elongation, and nostril correction. The results of relative length ratios comparing true lateral photographs showed significant increase in tip projection.

Conclusion:

The results of long-term observation (> 6 months) indicate that the surgical procedure of lifting the nasal tips with barbed threads is significantly effective for the anterior projection of nasal tip in Asians.
Using Fat Grafting to Treat Breast Implant Capsular Contracture
Authors: Papadopoulos Sarantos , Vidovic Goran , Neid Matthias , Abdallah Abdallah
Published: November 2018

Capsular contracture is a frequent complication of breast augmentation and reconstruction that affects up to 30% of patients. The authors describe the effect of fat grafting on capsular contracture used in cases with the primary intention of improving soft-tissue characteristics before implant to implant or implant to fat exchange. Fifteen patients (18 breasts) with capsular contracture Baker grade 4 were reviewed. Pain from capsular formation was able to be ameliorated in all cases after lipofilling sessions, with 11 of them achieving analgesia. Afterward, 4 patients underwent implant to implant and 7 patients implant to fat exchange. Four patients chose to keep the implants after the end of fat grafting procedures, due to satisfying cosmetic results and excellent pain management. Fat grafting may be a useful addition to therapies currently used to treat capsular contracture.
Breast-sharing Technique in a Unilateral Mastectomy Patient
Authors: Geerards Daan , Kroeze Alexander J. , Kroeze Vincent J. , Broekhuysen Coralien L.
Published: November 2018

Breast reconstruction patients frequently desire consecutive or simultaneous contralateral breast reduction. When combining the requirements of both autologous breast reconstruction with symmetrizing breast reduction, a 2-staged contralateral pedicled breast sharing is a dignified alternative. We present a 60-year-old woman with a radical mastectomy and adjuvant radiotherapy. On the contralateral side, she had a hypertrophic breast with a desire for reduction mammaplasty. A 2-stage procedure for breast sharing was planned. A preoperative computed tomography scan, to assess the status of the fourth intercostal mammary perforator (IMAP), was performed. After the first procedure, symmastia was evident. Water-assisted liposuction and quilting sutures to the sternal periosteum were applied in a second procedure to correct the symmastia. We preserved the fourth intercostal perforator to provide optimal vascularization. Water-assisted liposuction and quilting sutures were used to correct the remaining symmastia and contributed to the aesthetics of both breasts. A drawback of this procedure is the need for multiple stages. Furthermore, oncological safety should be considered and surgeons should be aware of the risk for venous congestion. Breast-sharing could be a feasible alternative reconstruction for women seeking unilateral breast reconstruction with contralateral breast hypertrophy. It reduces the need for free-flap surgery and subsequent donor-site morbidity. Considering the fact that the contralateral breast must be of significant size, the indication for this type of reconstruction is limited.
Mesenchymal Stromal Cells: Role in the BM Niche and in the Support of Hematopoietic Stem Cell Transplantation
Authors: Crippa Stefania , Bernardo Maria Ester
Published: November 2018

Mesenchymal stromal cells (MSCs) are key elements in the bone marrow (BM) niche where they interact with hematopoietic stem progenitor cells (HSPCs) by offering physical support and secreting soluble factors, which control HSPC maintenance and fate. Although necessary for their maintenance, MSCs are a rare population in the BM, they are plastic adherent and can be ex vivo expanded to reach numbers adequate for clinical use. In light of HSPC supportive properties, MSCs have been employed in phase I/II clinical trials of hematopoietic stem cell transplantation (HSCT) to facilitate engraftment of hematopoietic stem cells (HSCs). Moreover, they have been utilized to expand ex vivo HSCs before clinical use. The available clinical evidence from these trials indicate that MSC administration is safe, as no acute and long‐term adverse events have been registered in treated patients, and may be efficacious in promoting hematopoietic engraftment after HSCT. In this review, we critically discuss the role of MSCs as component of the BM niche, as recent advances in defining different mesenchymal populations in the BM have considerably increased our understanding of this complex environment. Moreover, we will revise published literature on the use of MSCs to support HSC engraftment and expansion, as well as consider potential new MSC application in the clinical context of ex vivo gene therapy with autologous HSC.
“Ghost DMEK” Technique: Circular Peripheral Staining of Descemet's Membrane Endothelial Keratoplasty Grafts
Authors: Livny Eitan , Bahar Irit , Nahum Yoav
Published: November 2018

Purpose:

To describe the ghost Descemet's membrane endothelial keratoplasty (DMEK) technique that allows for real-time evaluation of DMEK graft orientation, location, and folding status within the anterior chamber, by simple observation at the surgical microscope.

Methods:

This is a retrospective case series done in a university hospital. The study included 10 patients who underwent ghost DMEK surgery because of corneal endothelial insufficiency for Fuchs' endothelial dystrophy (N = 5), pseudophakic bullous keratopathy (N = 2), and failed previous posterior lamellar keratoplasty (N = 3). Cases were reviewed for feasibility of graft preparation, intra- and postoperative complications, postoperative clearing of the cornea, corrected distance visual acuity, and endothelial cell loss.

Results:

All graft preparations were uneventful. The circular staining was readily apparent and did not fade away during surgery. Graft orientation and folding status were determined using only direct observation through the operating microscope. Complications included one intraoperative hyphema, one graft detachment requiring rebubbling, and one pupillary block on the first postoperative day, which was resolved surgically. At last visit, 8 of 10 eyes had visual acuity of 6/12 or better and 7 of 10 eyes had visual acuity of 6/8.5 or better. Mean cell loss rates 1 to 3 months postoperatively were 48% ± 17% (range, 22%–71%). All corneas were clear by the first to second postoperative month. Mean follow-up time was 3 months (range, 1–8 months).

Conclusions:

Peripheral staining of DMEK grafts (ghost DMEK) is a simple and effective method for graft visualization in the anterior chamber, obviating the need for trypan blue staining and other techniques and devices currently used for the identification of graft orientation and folding status, thus simplifying and shortening surgery.
Solitary Red–Brown Irregular Plaque on the Buttock
Authors: Chen Jacqueline , Jacob Sharon E.
Published: November 2018

Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. This is a teledermatology case of a solitary red–brown irregular plaque on the buttock.
Effects of ABO Matching of Platelet Transfusions in Critically Ill Children*
Authors: Nellis Marianne E. , Goel Ruchika , Karam Oliver , Cushing Melissa M. , Davis Peter J. , Steiner Marie E. , Tucci Marisa , Stanworth Simon J. , Spinella Philip C.
Published: November 2018

Objectives:

To determine if transfusing ABO compatible platelets has a greater effect on incremental change in platelet count as compared to ABO incompatible platelets in critically ill children.

Design:

Secondary analysis of a prospective, observational study. Transfusions were classified as either ABO compatible, major incompatibility, or minor incompatibility. The primary outcome was the incremental change in platelet count. Transfusion reactions were analyzed as a secondary outcome.

Setting:

Eighty-two PICUs in 16 countries.

Patients:

Children (3 d to 16 yr old) were enrolled if they received a platelet transfusion during one of the predefined screening weeks.

Interventions:

None.

Measurements and Main Results:

Five-hundred three children were enrolled and had complete ABO information for both donor and recipient, as well as laboratory data. Three-hundred forty-two (68%) received ABO-identical platelets, 133 (26%) received platelets with major incompatibility, and 28 (6%) received platelets with minor incompatibility. Age, weight, proportion with mechanical ventilation or underlying oncologic diagnosis did not differ between the groups. After adjustment for transfusion dose, there was no difference in the incremental change in platelet count between the groups; the median (interquartile range) change for ABO-identical transfusions was 28 × 109 cells/L (8–68 × 109 cells/L), for transfusions with major incompatibility 26 × 109 cells/L (7–74 × 109 cells/L), and for transfusions with minor incompatibility 54 × 109 cells/L (14–81 × 109 cells/L) (p = 0.37). No differences in count increment between the groups were noted for bleeding (p = 0.92) and nonbleeding patients (p = 0.29). There were also no differences observed between the groups for any transfusion reaction (p = 0.07).

Conclusions:

No differences were seen in the incremental change in platelet count nor in transfusion reactions when comparing major ABO incompatible platelet transfusions with ABO compatible transfusions in a large study of critically ill children. Studies in larger, prospectively enrolled cohorts should be performed to validate whether ABO matching for platelet transfusions in critically ill children is necessary.
Hypothermia in Young Infants
Authors: Perry Michelle C. , Yaeger Susan K. , Noorbakhsh Katie , Cruz Andrea T. , Hickey Robert W.
Published: November 2018

Objectives

Serious bacterial infections (SBIs) in young infants can present with fever or hypothermia. There are substantial data on fever as a presentation for SBI that help to inform the clinical approach. In contrast, data on hypothermia are lacking, thus leaving clinicians without guidance. We aimed to describe the workup and findings, specifically the occurrence, of SBIs in infants younger than 60 days of life with hypothermia.

Methods

We reviewed the medical records of infants younger than 60 days of life with rectal temperature of less than 36.5°C upon arrival to a children's hospital emergency department between January 2013 and December 2014. Comparisons were made between those who were found to have an SBI and those without. Serious bacterial infection was defined as bacteremia, bacterial meningitis, pneumonia, or urinary tract infection (UTI).

Results

From the 414 patients identified, 104 (25%) underwent a sepsis evaluation of blood, urine, and/or cerebrospinal fluid culture. Serious bacterial infections were identified in 9 patients: 4 with UTI, 1 with pneumonia, 2 with bacteremia, 1 with pneumonia and UTI, and 1 with meningitis and bacteremia. Compared with patients with negative cultures, patients with SBI were older and had elevated absolute band counts and elevated immature-to-total neutrophil ratio.

Conclusions

Approximately a quarter of infants younger than 60 days with hypothermia were evaluated for SBI. Serious bacterial infection was identified in 9% of evaluated infants (2% of all hypothermic infants). Hypothermia can be a presenting sign of SBI.
Ex Vivo Assessment of Porcine Donation After Circulatory Death Lungs That Undergo Increasing Warm Ischemia Times
Authors: Charles Eric J. , Hunter Mehaffey J. , Huerter Mary E. , Sharma Ashish K. , Stoler Mark H. , Roeser Mark E. , Walters Dustin M. , Tribble Curtis G. , Kron Irving L. , Laubach Victor E.
Published: November 2018

Background

Increased utilization of donation after circulatory death (DCD) lungs may help alleviate the supply/demand mismatch between available donor organs and lung transplant candidates. Using an established porcine DCD model, we sought to determine the effect of increasing warm ischemia time (WIT) after circulatory arrest on lung function during ex vivo lung perfusion (EVLP).

Methods

Porcine donors (n = 15) underwent hypoxic cardiac arrest, followed by 60, 90, or 120 minutes of WIT before procurement and 4 hours of normothermic EVLP. Oxygenation, pulmonary artery pressure, airway pressure, and compliance were measured hourly. Lung injury scores were assessed histologically after 4 hours of EVLP.

Results

After EVLP, all 3 groups met all the criteria for transplantation, except for 90-minute WIT lungs, which had a mean pulmonary artery pressure increase greater than 15%. There were no significant differences between groups as assessed by final oxygenation capacity, as well as changes in pulmonary artery pressure, airway pressure, or lung compliance. Histologic lung injury scores as well as lung wet-to-dry weight ratios did not significantly differ between groups.

Conclusions

These results suggest that longer WIT alone (up to 120 minutes) does not predict worse lung function at the conclusion of EVLP. Expanding acceptable WIT after circulatory death may eventually allow for increased utilization of DCD lungs in procurement protocols.
Periodic Limb Movements in a Comatose Patient: Case Report
Authors: Aires Ana , Rocha Helena , Rego Ricardo
Published: November 2018

Periodic limb movements (PLMs) may occur as a primary condition or be associated with other pathologies, such as sleep disorders. However, PLMs have not been described in comatose patients. We report the case of a 66-year-old man, with no history of sleep disorders, who presented PLMs during coma caused by an extensive right hemispheric abscess inducing midline shift. These movements were further characterized by video and electromyographic recordings, which displayed bilateral periodic bursts of the tibialis anterior muscles, occurring every 7 to 15 seconds, with no concomitant electroencephalographic correlate. After a long period of hospitalization, the patient eventually regained consciousness and PLMs seem to persist, only in sleep. To the best of our knowledge, this is the first report showing that PLMs may be observed in a setting where the networks supporting consciousness are lost, namely in a coma of structural etiology.
The structure of temperate phage–bacteria infection networks changes with the phylogenetic distance of the host bacteria
Authors: Wendling Carolin C. , Goehlich Henry , Roth Olivia
Published: November 2018

With their ability to integrate into the bacterial chromosome and thereby transfer virulence or drug-resistance genes across bacterial species, temperate phage play a key role in bacterial evolution. Thus, it is paramount to understand who infects whom to be able to predict the movement of DNA across the prokaryotic world and ultimately the emergence of novel (drug-resistant) pathogens. We empirically investigated lytic infection patterns among
Vibrio
spp. from distinct phylogenetic clades and their derived temperate phage. We found that across distantly related clades, infections occur preferentially within modules of the same clade. However, when the genetic distance of the host bacteria decreases, these clade-specific infections disappear. This indicates that the structure of temperate phage–bacteria infection networks changes with the phylogenetic distance of the host bacteria.