bluuebunny/crossref_metadata_2025 huggingface dataset:
Union of phylogeography and landscape genetics
Authors: Rissler Leslie J.
Published: July 2016

Phylogeography and landscape genetics have arisen within the past 30 y. Phylogeography is said to be the bridge between population genetics and systematics, and landscape genetics the bridge between landscape ecology and population genetics. Both fields can be considered as simply the amalgamation of classic biogeography with genetics and genomics; however, they differ in the temporal, spatial, and organismal scales addressed and the methodology used. I begin by briefly summarizing the history and purview of each field and suggest that, even though landscape genetics is a younger field (coined in 2003) than phylogeography (coined in 1987), early studies by Dobzhansky on the “microgeographic races” of
Linanthus parryae
in the Mojave Desert of California and
Drosophila pseudoobscura
across the western United States presaged the fields by over 40 y. Recent advances in theory, models, and methods have allowed researchers to better synthesize ecological and evolutionary processes in their quest to answer some of the most basic questions in biology. I highlight a few of these novel studies and emphasize three major areas ripe for investigation using spatially explicit genomic-scale data: the biogeography of speciation, lineage divergence and species delimitation, and understanding adaptation through time and space. Examples of areas in need of study are highlighted, and I end by advocating a union of phylogeography and landscape genetics under the more general field: biogeography.
Graptolite community responses to global climate change and the Late Ordovician mass extinction
Authors: Sheets H. David , Mitchell Charles E. , Melchin Michael J. , Loxton Jason , Štorch Petr , Carlucci Kristi L. , Hawkins Andrew D.
Published: July 2016

Significance

Climate change during Late Ordovician mass extinction drove an ecologically selective decline in the abundance of deep-water macrozooplankton, accompanied by a shift to simpler, less even communities. These results indicate that the species abundance structure of planktic communities may be a leading indicator of the effects of climate change on biodiversity and a more sensitive gauge of those effects than taxonomic diversity change alone. Additionally, we present a Bayesian likelihood method of habitat inference that may be applicable to other similar cases.
Comparative phylogeography of the ocean planet
Authors: Bowen Brian W. , Gaither Michelle R. , DiBattista Joseph D. , Iacchei Matthew , Andrews Kimberly R. , Grant W. Stewart , Toonen Robert J. , Briggs John C.
Published: July 2016

Understanding how geography, oceanography, and climate have ultimately shaped marine biodiversity requires aligning the distributions of genetic diversity across multiple taxa. Here, we examine phylogeographic partitions in the sea against a backdrop of biogeographic provinces defined by taxonomy, endemism, and species composition. The taxonomic identities used to define biogeographic provinces are routinely accompanied by diagnostic genetic differences between sister species, indicating interspecific concordance between biogeography and phylogeography. In cases where individual species are distributed across two or more biogeographic provinces, shifts in genotype frequencies often align with biogeographic boundaries, providing intraspecific concordance between biogeography and phylogeography. Here, we provide examples of comparative phylogeography from (i) tropical seas that host the highest marine biodiversity, (ii) temperate seas with high productivity but volatile coastlines, (iii) migratory marine fauna, and (iv) plankton that are the most abundant eukaryotes on earth. Tropical and temperate zones both show impacts of glacial cycles, the former primarily through changing sea levels, and the latter through coastal habitat disruption. The general concordance between biogeography and phylogeography indicates that the population-level genetic divergences observed between provinces are a starting point for macroevolutionary divergences between species. However, isolation between provinces does not account for all marine biodiversity; the remainder arises through alternative pathways, such as ecological speciation and parapatric (semiisolated) divergences within provinces and biodiversity hotspots.
Model confirmation in climate economics
Authors: Millner Antony , McDermott Thomas K. J.
Published: July 2016

Significance

Benefit–cost integrated assessment models (BC-IAMs) combine climate science, impacts studies, and representations of long-run economic growth to estimate the costs and benefits of climate policy. They provide valuable qualitative insights into how policy outcomes might depend on ethical and empirical assumptions. Increasingly, however, BC-IAMs are being used to inform quantitative policy choices, despite their economic components being largely untested, or untestable, over relevant time scales. We demonstrate the potential benefits of model confirmation exercises for policy applications, demonstrating that the economic growth model used by a prominent BC-IAM had little predictive power over the 20th century. Insofar as possible, out-of-sample empirical tests of the economic components of BC-IAMs should inform their future development for real-world applications.
Extracellular vesicles and viruses: Are they close relatives?
Authors: Nolte-‘t Hoen Esther , Cremer Tom , Gallo Robert C. , Margolis Leonid B.
Published: July 2016

Extracellular vesicles (EVs) released by various cells are small phospholipid membrane-enclosed entities that can carry miRNA. They are now central to research in many fields of biology because they seem to constitute a new system of cell–cell communication. Physical and chemical characteristics of many EVs, as well as their biogenesis pathways, resemble those of retroviruses. Moreover, EVs generated by virus-infected cells can incorporate viral proteins and fragments of viral RNA, being thus indistinguishable from defective (noninfectious) retroviruses. EVs, depending on the proteins and genetic material incorporated in them, play a significant role in viral infection, both facilitating and suppressing it. Deciphering the mechanisms of EV-cell interactions may facilitate the design of EVs that inhibit viral infection and can be used as vehicles for targeted drug delivery.
N
-methylation of a bactericidal compound as a resistance mechanism in
Mycobacterium tuberculosis
Authors: Warrier Thulasi , Kapilashrami Kanishk , Argyrou Argyrides , Ioerger Thomas R. , Little David , Murphy Kenan C. , Nandakumar Madhumitha , Park Suna , Gold Ben , Mi Jianjie , Zhang Tuo , Meiler Eugenia , Rees Mike , Somersan-Karakaya Selin , Porras-De Francisco Esther , Martinez-Hoyos Maria , Burns-Huang Kristin , Roberts Julia , Ling Yan , Rhee Kyu Y. , Mendoza-Losana Alfonso , Luo Minkui , Nathan Carl F.
Published: July 2016

Significance

Better understanding of the mechanisms used by bacteria to counter antibacterial agents is essential to cope with the rising prevalence of antimicrobial resistance. Here, we identified the mechanism of resistance of
Mycobacterium tuberculosis
to an antimycobacterial cyano-substituted fused pyrido-benzimidazole. Clones bearing mutations in a transcription factor, Rv2887, markedly up-regulated the expression of
rv0560c
, a putative methyltransferase. Rv0560c
N
-methylated the pyrido-benzimidazole in vitro and in
Mycobacterium tuberculosis
, abrogating its bactericidal activity. Resistant mutants selected in the absence of
rv0560c
led to the identification of the target of the compound, the essential oxidoreductase, decaprenylphosphoryl-β-
d
-ribose 2-oxidase (DprE1). Methylation of an antibacterial compound is a previously uncharacterized mode of antimicrobial resistance.
Growth mindset tempers the effects of poverty on academic achievement
Authors: Claro Susana , Paunesku David , Dweck Carol S.
Published: July 2016

Significance

This study is the first, to our knowledge, to show that a growth mindset (the belief that intelligence is not fixed and can be developed) reliably predicts achievement across a national sample of students, including virtually all of the schools and socioeconomic strata in Chile. It also explores the relationship between income and mindset for the first time, to our knowledge, finding that students from lower-income families were less likely to hold a growth mindset than their wealthier peers but that those who did hold a growth mindset were appreciably buffered against the deleterious effects of poverty on achievement. These results suggest that mindsets may be one mechanism through which economic disadvantage can affect achievement.
Defective HIV-1 proviruses produce novel protein-coding RNA species in HIV-infected patients on combination antiretroviral therapy
Authors: Imamichi Hiromi , Dewar Robin L. , Adelsberger Joseph W. , Rehm Catherine A. , O’Doherty Una , Paxinos Ellen E. , Fauci Anthony S. , Lane H. Clifford
Published: July 2016

Significance

The presence of “defective” HIV-1 proviruses in HIV-infected patients has been well documented. The current consensus view of the “defective” proviruses is that these are dead-end products that do not give rise to progeny virus and thus collectively represent a “graveyard” of viruses. We describe the presence of defective HIV-1 proviruses capable of transcribing novel unspliced HIV-RNA species in HIV-infected patients on combination antiretroviral therapy. We propose that the proviruses persistently present in combination antiretroviral therapy-treated patients are not defective in a conventional sense, but rather represent incomplete forms of proviruses encoding translationally competent HIV-RNA transcripts. Strategies directed toward curing HIV-1 infection and eliminating the state of persistent immune activation need to include approaches designed to eliminate cells harboring such proviruses.
Effect of rapid thermal annealing on optical properties of zinc sulphide thin films
Authors: Kumar H. , Ram P. , Singh M.
Published: July 2016

Zinc sulphide (ZnS) thin films were prepared on clean surface glass substrates by thermal evaporation under pressure of 10−5 Torr. Thickness of thin films was uniform 55 nm measured by ellipsometry. These films were also kept into a quartz glass tube for rapid thermal annealing at 30 and 60 s by using a 500 W halogen lamp for crystalline the structure. The cubic structure of the films was verified by X-ray diffraction and the intensity of predominant peak increases with annealing time. The optical absorption study was carried out by UV–ViS–NIR spectrometer in the range of 200–800 nm. The optical band gap changes from 3.48 to 3.08 eV, with rapid thermal annealing. Thermo electric power studies confirm the n-type nature of ZnS thin films and thermoelectric power increases with increase in temperature. This study is important because ZnS is potentially important material for antireflection coating and window layer material in hetero-junction solar cells.
Rates and Effects of Branding due to Electroshock Observed in Southern California Steelhead in Topanga Creek, California
Authors: Dagit Rosi , Krug Jenna
Published: July 2016

As part of a 7-year lifecycle monitoring study, electroshocking was used to capture and characterize a small population of federally listed endangered southern California steelhead Oncorhynchus mykiss in Topanga Creek, Los Angeles, California. Electroshocking is a tool widely used to study fish populations, despite its potential behavioral and physical effects on individuals. We examined rates of external hemorrhaging (i.e., branding) and its effect on growth rates and survival of recaptured individuals. Rates of branding were low (0–3%) during most November events from 2008 to 2014, but higher during all March events (8–23%) and during the November 2011 event (13%). Overall, 5% of the total captured individuals exhibited branding. Growth rates (mm/d) of individuals recaptured after branding were not significantly different, but on average were 9% lower than average daily growth rates for individuals in the same size-class captured and recaptured in the same time periods. In general, larger fish were more likely to be branded than were smaller fish (P < 0.0001). Although 69% of brandings occurred in pool habitats, which tend to be larger and deeper than other habitats, branding was not significantly more likely to occur in any habitat type (P = 0.13) or in any substrate type (P = 0.16), and mean or maximum depth of habitat was not related to the rate of branding. The population-level effects associated with branding remain unclear. Although important information has been obtained through the use of electroshocking, the cumulative effects of electroshocking-induced injuries to this endangered species need to be considered.

Received March 2, 2015; accepted March 27, 2016 Published online July 19, 2016
Chain‐loaded variable resistance warm‐up improves free‐weight maximal back squat performance
Authors: Mina Minas A. , Blazevich Anthony J. , Giakas Giannis , Seitz Laurent B. , Kay Anthony D.
Published: July 2016

The acute influence of chain‐loaded variable resistance exercise on subsequent free‐weight one‐repetition maximum (1‐RM) back squat performance was examined in 16 recreationally active men. The participants performed either a free‐weight resistance (FWR) or chain‐loaded resistance (CLR) back squat warm‐up at 85% 1‐RM on two separate occasions. After a 5‐min rest, the participants attempted a free‐weight 1‐RM back squat; if successful, subsequent 5% load additions were made until participants failed to complete the lift. During the 1‐RM trials, 3D knee joint kinematics and knee extensor and flexor electromyograms (EMG) were recorded simultaneously. Significantly greater 1‐RM (6.2 ± 5.0%; p < .01) and mean eccentric knee extensor EMG (32.2 ± 6.7%; p < .01) were found after the CLR warm‐up compared to the FWR condition. However, no difference (p > .05) was found in concentric EMG, eccentric or concentric knee angular velocity, or peak knee flexion angle. Performing a CLR warm‐up enhanced subsequent free‐weight 1‐RM performance without changes in knee flexion angle or eccentric and concentric knee angular velocities; thus a real 1‐RM increase was achieved as the mechanics of the lift were not altered. These results are indicative of a potentiating effect of CLR in a warm‐up, which may benefit athletes in tasks where high‐level strength is required.
Deligne-Mostow lattices with three fold symmetry and cone metrics on the sphere
Authors: Pasquinelli Irene
Published: July 2016

Deligne and Mostow constructed a class of lattices inPU(2,1)PU(2,1)using monodromy of hypergeometric functions. Thurston reinterpreted them in terms of cone metrics on the sphere. In this spirit we construct a fundamental domain for the lattices with three fold symmetry in the list of Deligne and Mostow. This is a generalisation of the works of Boadi and Parker and gives a different interpretation of the fundamental domain constructed by Deraux, Falbel, and Paupert.
Combining stock, multispecies, and ecosystem level fishery objectives within an operational management procedure: simulations to start the conversation
Authors: Gaichas Sarah K. , Fogarty Michael , Fay Gavin , Gamble Robert , Lucey Sean , Smith Laurel
Published: July 2016

We explored alternative status determination criteria and reference points that could simplify fisheries management using a simulated multispecies/ecosystem-based operational management procedure. There are four components to the procedure: (i) limit total removals from the ecosystem; (ii) allocate the total removals limit among aggregate species groups; (iii) maintain individual species above minimum stock size thresholds; and (iv) optimize the species mix (within aggregates) based on bio-economic portfolio analysis. In this procedure, “overfishing” criteria are applied only to aggregates of species at the ecosystem and group level, but “overfished” criteria apply at the species/stock level. Previous work using multispecies production models identified conditions where conservation and yield objectives could be balanced: aggregations of species with similar life histories, species interactions, and responses to environmental forcing supported the highest yields while minimizing risks that individual stocks dropped below biomass thresholds. Here, we use a more complex length structured multispecies, multifleet simulation model to explore management procedure steps (i)–(iii). Different species aggregation rules were applied (single species, functional groups, and full system), and yield curves were constructed for each aggregation level by sequentially increasing effort in each of the fleets (alone and simultaneously), while recruitment for each species varied stochastically around a function based on spawning stock biomass. The performance of individual species and each aggregate type was then compared with respect to yield, biomass, and economic revenue objectives under changing environmental conditions. Our results evaluate the trade-offs between these objectives for the 10 species in the simulated system. Overall we found that there are aggregate catch limits that can both maximize yield and revenue while conserving biomass. However, community composition and revenue trade-off over a range of fishing effort. We consider this a starting point for further development with scientists, managers, fishermen, and other stakeholders in the region.
The Missing Link: Connection Is the Key to Resilience in Medical Education
Authors: McKenna Kathleen M. , Hashimoto Daniel A. , Maguire Michael S. , Bynum William E.
Published: July 2016

Awareness of the risks of burnout, depression, learner mistreatment, and suboptimal learning environments is increasing in academic medicine. A growing wellness and resilience movement has emerged in response to these disturbing trends; however, efforts to address threats to physician resilience have often emphasized strategies to improve life outside of work, with less attention paid to the role of belonging and connection at work. In this Commentary the authors propose that connection to colleagues, patients, and profession is fundamental to medical learners’ resilience, highlighting “social resilience” as a key factor in overall well-being. They outline three specific forces that drive disconnection in medical education: the impact of shift work, the impact of the electronic medical record, and the impact of “work–life balance.” Finally, the authors propose ways to overcome these forces in order to build meaningful connection and enhanced resilience in a new era of medicine.
A Qualitative Study of the Experiences and Factors That Led Physicians to Be Lifelong Health Advocates
Authors: Law Marcus , Leung Pearl , Veinot Paula , Miller Daniel , Mylopoulos Maria
Published: July 2016

Purpose

Given the public’s trust and the opportunities to observe and address social determinants of health, physicians are well suited to be health advocates, a key role in the CanMEDS physician competency framework. As some physicians find it difficult to fulfill this role, the authors explored the experiences and influences that led established physicians to be health advocates.

Method

The authors used a phenomenological approach to explore this topic. From March to August 2014, they interviewed 15 established physician health advocates, using a broad definition of health advocacy—that it extends beyond individual patient advocacy to address the root causes of systemic differences in health. Interviews were audio recorded and transcribed verbatim. The transcripts were coded and the data categorized into clusters of meaning, then into themes. Data analysis was conducted iteratively, with data collection continuing until no new information was gathered.

Results

Participants described the factors that contributed to the development of their health advocate identity (i.e., exposure to social injustice, upbringing, schooling, specific formative experiences) and those that facilitated their engagement in health advocacy work (i.e., mentors, training, systemic and organizational supports). They also highlighted how they continue in their role as lifelong advocates (i.e., continuous learning and improvement, self-reflection and self-reflexivity, collaboration, intrinsic satisfaction in the work).

Conclusions

Many factors allow physician health advocates to establish and sustain a commitment to improve the health of their patients and the broader population. Medical schools could use these findings to guide curriculum development related to teaching this physician competency.
Assessment of Spectral and Temporal Resolution in Cochlear Implant Users Using Psychoacoustic Discrimination and Speech Cue Categorization
Authors: Winn Matthew B. , Won Jong Ho , Moon Il Joon
Published: July 2016

Objectives:

This study was conducted to measure auditory perception by cochlear implant users in the spectral and temporal domains, using tests of either categorization (using speech-based cues) or discrimination (using conventional psychoacoustic tests). The authors hypothesized that traditional nonlinguistic tests assessing spectral and temporal auditory resolution would correspond to speech-based measures assessing specific aspects of phonetic categorization assumed to depend on spectral and temporal auditory resolution. The authors further hypothesized that speech-based categorization performance would ultimately be a superior predictor of speech recognition performance, because of the fundamental nature of speech recognition as categorization.

Design:

Nineteen cochlear implant listeners and 10 listeners with normal hearing participated in a suite of tasks that included spectral ripple discrimination, temporal modulation detection, and syllable categorization, which was split into a spectral cue-based task (targeting the /ba/–/da/ contrast) and a timing cue-based task (targeting the /b/–/p/ and /d/–/t/ contrasts). Speech sounds were manipulated to contain specific spectral or temporal modulations (formant transitions or voice onset time, respectively) that could be categorized. Categorization responses were quantified using logistic regression to assess perceptual sensitivity to acoustic phonetic cues. Word recognition testing was also conducted for cochlear implant listeners.

Results:

Cochlear implant users were generally less successful at utilizing both spectral and temporal cues for categorization compared with listeners with normal hearing. For the cochlear implant listener group, spectral ripple discrimination was significantly correlated with the categorization of formant transitions; both were correlated with better word recognition. Temporal modulation detection using 100- and 10-Hz-modulated noise was not correlated either with the cochlear implant subjects’ categorization of voice onset time or with word recognition. Word recognition was correlated more closely with categorization of the controlled speech cues than with performance on the psychophysical discrimination tasks.

Conclusions:

When evaluating people with cochlear implants, controlled speech-based stimuli are feasible to use in tests of auditory cue categorization, to complement traditional measures of auditory discrimination. Stimuli based on specific speech cues correspond to counterpart nonlinguistic measures of discrimination, but potentially show better correspondence with speech perception more generally. The ubiquity of the spectral (formant transition) and temporal (voice onset time) stimulus dimensions across languages highlights the potential to use this testing approach even in cases where English is not the native language.
Hearing and Vestibular Function After Preoperative Intratympanic Gentamicin Therapy for Vestibular Schwanomma as Part of Vestibular Prehab
Authors: Tjernström Fredrik , Fransson Per-Anders , Kahlon Babar , Karlberg Mikael , Lindberg Sven , Siesjö Peter , Magnusson Måns
Published: July 2016

Objective:

To evaluate auditory and vestibular function after presurgical treatment with gentamicin in schwannoma patients.

Background:

The vestibular PREHAB protocol aims at diminishing the remaining vestibular function before vestibular schwannoma surgery, to ensure less acute symptoms from surgery, and initiate a more efficient vestibular rehabilitation already before surgery. However, the potential cochleotoxicity of gentamicin is a concern, since modern schwannoma surgery strives to preserve hearing.

Study design:

Retrospective study.

Setting:

University hospital.

Patients:

Seventeen patients diagnosed with vestibular schwannoma between 2004 and 2011, and took part in vestibular PREHAB program. The patients were of age 21 to 66 years (mean 48.8), 9 females and 8 males.

Intervention:

Intratympanic gentamicin installations before surgery as part of the vestibular PREHAB.

Main outcome measures:

Hearing thresholds, word recognition score, caloric response, subjective visual vertical and horizontal, cVEMP, and vestibular impulse tests.

Results:

Combined analysis of frequency and hearing threshold showed a significant decrease after gentamicin therapy (p < 0.001). Pure-tone average decreased with 7.1 ± 8.5 dB (p = 0.004), and speech recognition with 10%. The treatment resulted in unilateral vestibular deafferentation with no notable reaction to bithermal caloric irrigation (reduction 64%, p < 0.001), loss of the vestibulo-ocular response measured by the head-impulse test, and deviation of subjective horizontal/vertical to the side of the lesion (+2.2 degrees, p = 0.010).

Conclusions:

Intratympanic installations of gentamicin, as part of the vestibular PREHAB, result in unilateral vestibular deafferentation, but constitute a definite risk for high-frequency hearing loss. The hearing results are in line with those reported upon when treating Menière’s disease.
Intra-articular dysplasia of the femoral head in developmental dysplasia of the hip
Authors: Rosenberg Matthew R. , Walton Roger , Rae Emily A. , Bailey Sarah , Nicol Richard O.
Published: July 2016

Central to the current treatment of dysplasia of the hip (DDH) is the concept of congruent reduction of the hip. If the femoral head is aspherical in DDH, this concept needs reconsideration. MRI scans are used to examine the femoral head in children. Diameters of 14 DDH and 12 normal hips were measured in three planes by eight observers on two occasions. Femoral head sphericity was determined using the mathematical concept of eccentricity. In DDH, the femoral head was less spherical, most marked in the coronal plane, yielding a ‘rugby ball’-shaped femoral head. Accordingly, concentric reduction of the femoral head in DDH is impossible.
Cervical Sagittal Alignment in Extensive Fusions for Lenke 3C and 6C Scoliosis
Authors: Yanik Hakan Serhat , Ketenci Ismail Emre , Erdem Sevki
Published: July 2016

Study Design.

A retrospective analysis of cervical sagittal alignment (CSA) in Lenke 3C and 6C adolescent idiopathic scoliosis (AIS).

Objective.

The aim of this study was to evaluate CSA according to upper instrumented vertebra (UIV) level.

Summary of Background Data.

Hypokyphotic effect of extensive fusions of Lenke 3C and 6C curves on thoracic spine leads to kyphotic changes in cervical region. No study has evaluated the CSA in these patients according to UIV level.

Methods.

A total of 55 Lenke 3C and 6C AIS patients who underwent posterior fusion with pedicle screw instrumentation were recruited in this study. Patients were divided into three groups according to UIV level, which was determined preoperatively on the basis of shoulder balance. There were 22, 19, and 14 patients in T2, T3, and T4 groups, respectively. Three groups were similar according to demographic and preoperative coronal and sagittal alignment parameters. Patients were compared at two-year follow-up according to radiographic changes in coronal and sagittal planes. Main sagittal parameters were C2-C7 cervical lordosis (CL), T1 slope, T1-T5, and T5-T12 kyphosis. Clinical outcomes were assessed using scoliosis research society (SRS)-22 and short form (SF)-36 questionnaires.

Results.

In all patients, C2-C7 CL, T5-T12 kyphosis, and T1 slope significantly decreased postoperatively (P < 0.05). The amount of decrease was similar between groups. T1-T5 kyphosis did not change significantly in all groups. Twenty-seven patients had postoperative cervical kyphosis (CK). Thirteen of them had preoperative CL and 14 had CK. Twenty-eight of 41 patients with preoperative CL remained in lordotic CSA postoperatively. SRS-22 and SF-36 scores did not change significantly after the surgery.

Conclusion.

In Lenke 3C and 6C AIS, postoperative CSA is independent from UIV level. Decreased CL is mainly caused by T5-T12 and T1 slope decrease. In order to achieve level shoulders, fusion can be extended to appropriate upper level, without increased risk of CK.

Level of Evidence: 4
Assessment of Cardiac Device Position on Supine Chest Radiograph in the ICU: Introduction and Applicability of the Aortic Valve Location Ratio
Authors: Ouweneel Dagmar M. , Sjauw Krischan D. , Wiegerinck Esther M. A. , Hirsch Alexander , Baan Jan , de Mol Bas A. J. M. , Lagrand Wim K. , Planken R. Nils , Henriques José P. S.
Published: July 2016

Objectives:

The use of intracardiac assist devices is expanding, and correct position of these devices is required for optimal functioning. The aortic valve is an important landmark for positioning of those devices. It would be of great value if the device position could be easily monitored on plain supine chest radiograph in the ICU. We introduce a ratio-based tool for determination of the aortic valve location on plain supine chest radiograph images, which can be used to evaluate intracardiac device position.

Design:

Retrospective observational study.

Setting:

Large academic medical center.

Patients:

Patients admitted to the ICU and supported by an intracardiac assist device.

Interventions:

We developed a ratio to determine the aortic valve location on supine chest radiograph images. This ratio is used to assess the position of a cardiac assist device and is compared with echocardiographic findings.

Measurements and Main Results:

Supine anterior-posterior chest radiographs of patients with an aortic valve prosthesis (n = 473) were analyzed to determine the location of the aortic valve. We calculated several ratios with the potential to determine the position of the aortic valve. The aortic valve location ratio, defined as the distance between the carina and the aortic valve, divided by the thoracic width, was found to be the best performing ratio. The aortic valve location ratio determines the location of the aortic valve caudal to the carina, at a distance of 0.25 ± 0.05 times the thoracic width for male patients and 0.28 ± 0.05 times the thoracic width for female patients. The aortic valve location ratio was validated using CT images of patients with angina pectoris without known valvular disease (n = 95). There was a good correlation between cardiac device position (Impella) assessed with the aortic valve location ratio and with echocardiography (n = 53).

Conclusions:

The aortic valve location ratio enables accurate and reproducible localization of the aortic valve on supine chest radiograph. This tool is easily applicable and can be used for assessment of cardiac device position in patients on the ICU.
Effectiveness of a flamenco and sevillanas program to enhance mobility, balance, physical activity, blood pressure, body mass, and quality of life in postmenopausal women living in the community in Spain: a randomized clinical trial
Authors: Serrano-Guzmán Maria , Aguilar-Ferrándiz María Encarnación , Valenza Carmen Marie , Ocaña-Peinado Francisco Manuel , Valenza-Demet Gerald , Villaverde-Gutiérrez Carmen
Published: July 2016

Objective:

This study aimed to test the effectiveness of a dance therapy program in improving mobility, balance, physical activity, blood pressure (BP), body mass, and quality of life in postmenopausal women in Spain.

Methods:

Fifty-two sedentary postmenopausal women (mean age 69.27 ± 3.85 y) were randomly assigned to receive either dance therapy (n = 27) or self-care treatment advice (n = 25). The intervention group participated in 2 months of dance therapy, three sessions weekly, based on Spanish folk dance (flamenco and sevillanas). The control group was provided a booklet containing physical activity recommendations. Mobility, balance, physical activity, BP, body mass, and quality of life were assessed at baseline and posttreatment in both groups. Statistical analysis was performed using a 2 × 2 analysis of variance (ANOVA).

Results:

Women in the intervention group showed significant improvements in mobility and balance (timed up-and-go test [P = 0.022], cognitive timed up-and-go [P = 0.029], and one-leg stance test results [P = 0.001]), physical activity (total time index [P = 0.045], energy expenditure [P = 0.007], vigorous physical activity [P = 0.001], leisure activity [P = 0.001], moving [P < 0.001], and activity dimension summary [P = 0.001]), and fitness (overall fitness [P = 0.039], cardiorespiratory fitness [P < 0.001], speed-agility [P = 0.001], and flexibility [P = 0.007]) compared with those in the control group. No differences were observed in BP, body mass, or quality of life.

Conclusions:

Spanish dance therapy may be effective to improve mobility, balance, and levels of physical activity and fitness in sedentary postmenopausal women.
Characterizing the trajectories of vasomotor symptoms across the menopausal transition
Authors: Tepper Ping G. , Brooks Maria M. , Randolph John F. , Crawford Sybil L. , El Khoudary Samar R. , Gold Ellen B. , Lasley Bill L. , Jones Bobby , Joffe Hadine , Hess Rachel , Avis Nancy E. , Harlow Sioban , McConnell Daniel S. , Bromberger Joyce T. , Zheng Huiyong , Ruppert Kristine , Thurston Rebecca C.
Published: July 2016

Objective:

The aim of the study was to investigate the heterogeneity of temporal patterns of vasomotor symptoms (VMS) over the menopausal transition and identify factors associated with these patterns in a diverse sample of women.

Methods:

The Study of Women's Health Across the Nation is a multisite longitudinal study of women from five racial/ethnic groups transitioning through the menopause. The analytic sample included 1,455 women with nonsurgical menopause and a median follow-up of 15.4 years. Temporal patterns of VMS and associations with serum estradiol and follicle-stimulating hormone, race/ethnicity, body mass index, and demographic and psychosocial factors were examined using group-based trajectory modeling.

Results:

Four distinct trajectories of VMS were found: onset early (11 years before the final menstrual period) with decline after menopause (early onset, 18.4%), onset near the final menstrual period with later decline (late onset, 29.0%), onset early with persistently high frequency (high, 25.6%), and persistently low frequency (low, 27.0%). Relative to women with persistently low frequency of VMS, women with persistently high and early onset VMS had a more adverse psychosocial and health profile. Black women were overrepresented in the late onset and high VMS subgroups relative to white women. Obese women were underrepresented in the late onset subgroup. In multivariable models, the pattern of estradiol over the menopause was significantly associated with the VMS trajectory.

Conclusions:

These data distinctly demonstrate heterogeneous patterns of menopausal symptoms that are associated with race/ethnicity, reproductive hormones, premenopause body mass index, and psychosocial characteristics. Early targeted intervention may have a meaningful impact on long-term VMS.
Long-term oral bisphosphonate use in relation to fracture risk in postmenopausal women with breast cancer: findings from the Women's Health Initiative
Authors: Drieling Rebecca L. , LaCroix Andrea Z. , Beresford Shirley A.A. , Boudreau Denise M. , Kooperberg Charles , Chlebowski Rowan T. , Gass Margery , Crandall Carolyn J. , Womack Catherine R. , Heckbert Susan R.
Published: July 2016

Objective:

The aim of the study was to examine the association of long-term oral bisphosphonate use, compared with short-term use, with fracture risk among postmenopausal women with breast cancer.

Methods:

We studied 887 postmenopausal women who were enrolled to the Women's Health Initiative from 1993 to 1998, diagnosed with breast cancer after enrollment, and reported current oral bisphosphonate use of 2 years or more on a medication inventory administered in 2008 to 2009. The outcome of any clinical fracture was ascertained by self-report on an annual study form; a subset of fractures was confirmed with medical records. Women were followed from completion of the medication inventory until 2014. The association between duration of bisphosphonate use reported on the medication inventory and fracture was estimated using multivariate Cox proportional hazards survival models that compared 4 to 7 years and 8 or more years of bisphosphonate use with 2 to 3 years of use.

Results:

On average, women were 76 years of age and were followed for 3.7 (SD 1.1) years. There were 142 clinical fractures. In the multivariate-adjusted analysis for fracture risk factors, 8 or more years of bisphosphonate use was associated with higher risk of fracture compared with 2 to 3 years of use (hazard ratio, 1.67 [95% CI, 1.06-2.62]). There was no significant association of 4 to 7 years of use with fracture.

Conclusions:

Bisphosphonate use of 8 or more years was associated with higher risk of any clinical fracture compared with 2 to 3 years of use. Our findings raise concern about potential harm or decreased effectiveness of long-term bisphosphonate use on fracture risk. The findings warrant confirmatory studies.
Cost Analysis of an Office-based Surgical Suite
Authors: LaBove Gabrielle , Davison Steven P.
Published: July 2016

Introduction:

Operating costs are a significant part of delivering surgical care. Having a system to analyze these costs is imperative for decision making and efficiency. We present an analysis of surgical supply, labor and administrative costs, and remuneration of procedures as a means for a practice to analyze their cost effectiveness; this affects the quality of care based on the ability to provide services. The costs of surgical care cannot be estimated blindly as reconstructive and cosmetic procedures have different percentages of overhead.

Methods:

A detailed financial analysis of office-based surgical suite costs for surgical procedures was determined based on company contract prices and average use of supplies. The average time spent on scheduling, prepping, and doing the surgery was factored using employee rates.

Results:

The most expensive, minor procedure supplies are suture needles. The 4 most common procedures from the most expensive to the least are abdominoplasty, breast augmentation, facelift, and lipectomy.

Conclusions:

Reconstructive procedures require a greater portion of collection to cover costs. Without the adjustment of both patient and insurance remuneration in the practice, the ability to provide quality care will be increasingly difficult.
A Meta-Analysis of Early versus Delayed Surgery for Valvular Infective Endocarditis Complicated by Embolic Ischemic Stroke
Authors: Mihos Christos G. , Pineda Andres M. , Santana Orlando
Published: July 2016

Objective

An embolic ischemic stroke occurs in 10% to 40% of patients with valvular infective endocarditis (IE) and confers significant morbidity. The optimal timing of valve surgery in this population is not well defined.

Methods

With the use of PubMed, EMBASE, Ovid, and Cochrane databases, a systematic review identified 14 studies through October 2015 that compared early versus delayed surgery for valvular IE complicated by an ischemic stroke. Early surgery was defined as 3 days or less in one, 7 days or less in eight, and 14 days or less in five studies. Risk ratios (RRs) were calculated by the Mantel-Haenszel method under a fixed- or random-effects model, for the outcomes of perioperative stroke, operative mortality, and 1-year survival.

Results

A total of 833 patients (early surgery, 330; delayed surgery, 503) were included. The majority of operations were for aortic and/or mitral valve IE, with prosthetic valve IE present in 0% to 60%. Infection with Staphylococcus aureus ranged from 19% to 66%, and heart failure prevalence at the time of operation was 24% to 66%. Early surgery was associated with an increased risk of operative mortality (RR, 1.72; 95% confidence interval [CI], 1.27–2.34; P = 0.0005), which was significant regardless of surgery within the first 7 days (RR, 2.19; 95% CI, 1.45–3.31; P = 0.0002) or 14 days (RR, 1.72; 95% CI, 1.12–2.64; P = 0.01) after stroke. Surgical timing did not affect the risk of perioperative ischemic or hemorrhagic stroke or 1-year survival.

Conclusions

In patients with valvular IE complicated by ischemic stroke, early surgery is associated with an increased risk of operative mortality, with no observed benefit in 1-year survival.
Crotalphine desensitizes TRPA1 ion channels to alleviate inflammatory hyperalgesia
Authors: Bressan Elisangela , Touska Filip , Vetter Irina , Kistner Katrin , Kichko Tatjana I. , Teixeira Nathália B. , Picolo Gisele , Cury Yara , Lewis Richard J. , Fischer Michael J.M. , Zimmermann Katharina , Reeh Peter W.
Published: July 2016

Crotalphine is a structural analogue to a novel analgesic peptide that was first identified in the crude venom from the South American rattlesnake Crotalus durissus terrificus. Although crotalphine's analgesic effect is well established, its direct mechanism of action remains unresolved. The aim of the present study was to investigate the effect of crotalphine on ion channels in peripheral pain pathways. We found that picomolar concentrations of crotalphine selectively activate heterologously expressed and native TRPA1 ion channels. TRPA1 activation by crotalphine required intact N-terminal cysteine residues and was followed by strong and long-lasting desensitization of the channel. Homologous desensitization of recombinant TRPA1 and heterologous desensitization in cultured dorsal root ganglia neurons was observed. Likewise, crotalphine acted on peptidergic TRPA1-expressing nerve endings ex vivo as demonstrated by suppression of calcitonin gene-related peptide release from the trachea and in vivo by inhibition of chemically induced and inflammatory hypersensitivity in mice. The crotalphine-mediated desensitizing effect was abolished by the TRPA1 blocker HC030031 and absent in TRPA1-deficient mice. Taken together, these results suggest that crotalphine is the first peptide to mediate antinociception selectively and at subnanomolar concentrations by targeting TRPA1 ion channels.
Efficacy and tolerability of buccal buprenorphine in opioid-experienced patients with moderate to severe chronic low back pain: results of a phase 3, enriched enrollment, randomized withdrawal study
Authors: Gimbel Joseph , Spierings Egilius L.H. , Katz Nathaniel , Xiang Qinfang , Tzanis Evan , Finn Andrew
Published: July 2016

A buccal film of buprenorphine (BBUP) was evaluated for safety and efficacy in a multicenter, double-blind, placebo-controlled, enriched-enrollment, randomized-withdrawal study in opioid-experienced patients (30 to ≤160 mg/d morphine sulfate equivalent) with moderate to severe chronic low back pain taking around-the-clock opioid analgesics. Patients' opioid doses were tapered to ≤30 mg morphine sulfate equivalent before open-label titration with BBUP (range, 150-900 μg every 12 hours). Patients who responded (received adequate analgesia that was generally well tolerated for 14 days) were randomized to receive buprenorphine (n = 254) or placebo (n = 257) buccal film. The primary efficacy variable was the change from baseline to week 12 of double-blind treatment in mean average daily pain-intensity scores using a rating scale of 0 (no pain) to 10 (worst pain imaginable). In the intent-to-treat population, mean pain scores were 6.7 after opioid taper and declined to 2.8 after the BBUP titration period. After randomization, mean pain scores were lower in the BBUP group than in the placebo group; the difference between groups in the mean change from baseline to week 12 was −0.98 (95% CI, −1.32 to −0.64; P < 0.001). A significantly larger percentage of patients receiving BBUP than placebo had pain reductions ≥30% and ≥50% (P < 0.001 for both). In the double-blind portion of the study, the only adverse event reported more frequently with BBUP than placebo and in ≥5% of patients was vomiting (5.5% vs 2.3%). These findings demonstrate the efficacy and tolerability of BBUP in opioid-experienced patients taking around-the-clock opioid treatment for chronic low back pain.
Serum vitamin C and spinal pain: a nationwide study
Authors: Dionne Clermont E. , Laurin Danielle , Desrosiers Thérèse , Abdous Belkacem , Le Sage Natalie , Frenette Jérôme , Mondor Myrto , Pelletier Sylvie
Published: July 2016

Back pain brings about one of the heaviest burden of disease. Despite much research, this condition remains poorly understood, and effective treatments are frustratingly elusive. Thus, researchers in the field need to consider new hypotheses. Vitamin C (ascorbic acid) is an essential cofactor for collagen crosslinks, a key determinant of ligament, tendon, and bone quality. Recent studies have reported high frequency of hypovitaminosis C in the general population. We hypothesized that lack of vitamin C contributes to poor collagen properties and back pain. We conducted this study to examine the associations between serum concentration of vitamin C and the prevalence of spinal pain and related functional limitations in the adult general population. This study used nationwide cross-sectional data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2003–2004. Data were available for 4742 individuals aged ≥20 years. Suboptimal serum vitamin C concentrations were associated with the prevalence of neck pain (adjusted odds ratio [aOR]: 1.5; 95% confidence interval [CI]: 1.2-2.0), low back pain (aOR: 1.3; 95% CI: 1.0-1.6), and low back pain with pain below knee (aOR: 1.3; 95% CI: 1.0-1.9) in the past 3 months, self-reported diagnosis of arthritis/rheumatism (aOR: 1.4; 95% CI: 1.2-1.7), and related functional limitations' score (adjusted difference of means [aB]: 0.03; 95% CI: 0.00-0.05). The prevalence of hypovitaminosis C in the general population is high. Our study shows associations between vitamin C and spinal pain that warrant further investigation to determine the possible importance of vitamin C in the treatment of back pain patients.