bluuebunny/crossref_metadata_2025 huggingface dataset:
Pricing Uncertainty Induced by Climate Change
Authors: Barnett Michael , Brock William , Hansen Lars Peter
Published: December 2019

Geophysicists examine and document the repercussions for the earth’s climate induced by alternative emission scenarios and model specifications. Using simplified approximations, they produce tractable characterizations of the associated uncertainty. Meanwhile, economists write highly stylized damage functions to speculate about how climate change alters macroeconomic and growth opportunities. How can we assess both climate and emissions impacts, as well as uncertainty in the broadest sense, in social decision-making? We provide a framework for answering this question by embracing recent decision theory and tools from asset pricing, and we apply this structure with its interacting components to a revealing quantitative illustration.
Pregnancy outcomes in women with idiopathic inflammatory myopathy, before and after diagnosis—a population-based study
Authors: Che Weng Ian , Hellgren Karin , Stephansson Olof , Lundberg Ingrid E , Holmqvist Marie
Published: December 2019

Objectives

To examine pregnancy outcomes among births to women with idiopathic inflammatory myopathy (IIM) in relation to time of IIM diagnosis using population-based data.

Methods

This study used Swedish nationwide registers to identify all singleton births that occurred between 1973 and 2016 among women diagnosed with IIM between 1998 and 2016 and among women unexposed to IIM. We classified births according to the IIM status of the mother at time of delivery: post-IIM (n = 68), 1–3 years pre-IIM (n = 23), >3 years pre-IIM (n = 710) and unexposed to IIM (n = 4101). Multivariate regression models were used to estimate relative risks of adverse pregnancy outcomes in post-IIM births and pre-IIM births separately, in comparison with their non-IIM comparators.

Results

We found that post-IIM births had increased risks of caesarean section [adjusted relative risk (aRR) = 1.98; 95% CI: 1.08, 3.64], preterm birth (aRR = 3.35; 95% CI: 1.28, 8.73) and low birth weight (aRR = 5.69; 95% CI: 1.84, 17.55) compared with non-IIM comparators. We also noticed higher frequencies of caesarean section and instrumental delivery in 1–3 years pre-IIM births than in the non-IIM comparators.

Conclusion

Women who gave birth after IIM diagnosis had higher risks of caesarean section, preterm birth and low birth weight. These results further underline the importance of special care and close monitoring of women with IIM. Higher frequencies of caesarean section and instrumental delivery in pre-IIM births highlight the need for future research on the influence of subclinical features of IIM on pregnancy outcomes.
Inequality, Poverty, and the Intra-Household Allocation of Consumption in Senegal
Authors: De Vreyer Philippe , Lambert Sylvie
Published: December 2019

Intra-household inequalities have long been a source of concern for policy design, but there is very little evidence about their effects. The current practice of ignoring inequality within households could lead to an underestimation of both overall inequality and poverty levels, as well as to the misclassification of some individuals with regard to their poverty status. Using a novel survey for Senegal in which consumption data were collected at a disaggregated level, this paper quantifies these various effects. In total, two opposing effects, one on mean and one on inequality, compensate each other in terms of the overall poverty rate, but individual poverty statuses are affected. Intra-household consumption inequalities account for 14 percent of inequality in Senegal. This study has also uncovered the fact that household structure and organization are key correlates of intra-household inequality and individual risk of poverty.
Four Consistent Loci Confer Adult Plant Resistance to Leaf Rust in the Durum Wheat Lines Heller#1 and Dunkler
Authors: Li Zhikang , Yuan Chan , Herrera-Foessel Sybil A. , Randhawa Mandeep S. , Huerta-Espino Julio , Liu Demei , Dreisigacker Susanne , Singh Ravi P. , Lan Caixia
Published: December 2019

The durum wheat lines Heller#1 and Dunkler from the International Maize and Wheat Improvement Center Global Wheat Program showed moderate and stable adult plant resistance to leaf rust under high disease pressure over field environments in northwestern Mexico. Leaf rust phenotyping was performed on two recombinant inbred line (RIL) populations derived from crosses of Heller#1 and Dunkler with the susceptible parent Atred#2, conducted under artificially induced Puccinia triticina epidemics in 2013, 2014, 2015, and 2016. The Atred#2 × Heller#1 and Atred#2 × Dunkler populations were genotyped by single nucleotide polymorphism (SNP) platforms and diversity arrays technology markers, respectively. Four leaf rust resistance quantitative trait loci were detected simultaneously in the two RIL populations: Lr46, QLr.cim-2BC, QLr.cim-5BL, and QLr.cim-6BL based on phenotypic data across all four crop seasons. They explained 11.7 to 46.8%, 7.2 to 26.1%, 8.4 to 24.1%, and 12.4 to 28.5%, respectively, of the phenotypic variation for leaf rust resistance in Atred#2 × Heller#1 and 16.3 to 56.6%, 6.7 to 15.7%, 4.1 to 10.1%, and 5.1 to 20.2% of the variation in the Atred#2 × Dunkler population. Only the resistance allele of QLr.cim-2BC was from the susceptible parent Atred#2, and resistance alleles at other loci came from the resistant parents Heller#1 and Dunkler. The SNP markers closely linked to Lr46 and QLr.cim-2BC were converted to kompetitive allele specific PCR markers for use in marker-assisted selection to improve leaf rust resistance through crosses with Heller#1 and Dunkler sources.
Maternal Anemia and Pregnancy Outcomes: A Population-based Study
Authors: Beckert Rachael H. , Baer Rebecca J. , Anderson James G. , Jelliffe-Pawlowski Laura L. , Rogers Elizabeth E.
Published: December 2019

(Abstracted from J Perinatol 2019;39(7):911–919)

Anemia is a common disorder that affects about 40% of pregnancies worldwide and has been associated with adverse events in both the mother and infant. An increased risk of cesarean delivery, red blood cell transfusion, and death has been documented in anemic pregnant women.
Characterization of myelin oligodendrocyte glycoprotein (MOG)35–55-specific CD8+ T cells in experimental autoimmune encephalomyelitis
Authors: Peng Yong , Zhu Fei-Zhou , Chen Zhi-Xing , Zhou Jian-Xiong , Gan Lu , Yang Shan-Shan , Gao Shuai , Liu Qian-Qian
Published: December 2019

Background:

The pathogenesis of multiple sclerosis (MS) is mediated primarily by T cells, but most studies of MS and its animal model, experimental autoimmune encephalomyelitis (EAE), have focused on CD4+ T cells. The aims of the current study were to determine the pathological interrelationship between CD4 and CD8 autoreactive T cells in MS/EAE.

Methods:

Female C57BL/6 mice (n = 20) were induced by myelin oligodendrocyte glycoprotein (MOG)35–55 peptide. At 14 days after immunization, T cells were isolated from the spleen and purified as CD4+ and CD8+ T cells by using CD4 and CD8 isolation kits, and then the purity was determined by flow cytometric analysis. These cells were stimulated by MOG35–55 peptide and applied to proliferation assays. The interferon-gamma (IFN-γ) and interleukin (IL)-4 secretion of supernatant of cultured CD4+ and CD8+ T cells were measured by enzyme-linked immunosorbent assays (ELISA). For adoptive transfer, recipient mice were injected with MOG35–55-specific CD8+ or CD4+ T cells. EAE clinical course was measured by EAE score at 0–5 scale and spinal cord was examined by staining with hematoxylin and eosin and Luxol fast blue staining.

Results:

CD8+CD3+ and CD4+CD3+ cells were 86% and 94% pure of total CD3+ cells after CD8/CD4 bead enrichment, respectively. These cells were stimulated by MOG35–55 peptide and applied to proliferation assays. Although the CD8+ T cells had a generally lower response to MOG35–55 than CD4+ T cells, the response of CD8+ T cells was not always dependent on CD4. CD8
+
T cell secreted less IFN-γ and IL-4 compared with CD4
+
T cells. EAE was induced in wildtype B6 naïve mice by adoptive transfer of MOG35–55-specific T cells from B6 active-induced EAE (aEAE) mice. A similar EAE score and slight inflammation and demyelination were found in naive B6 mice after transferring of CD8
+
T cells from immunized B6 mice compared with transfer of CD4
+
T cells.

Conclusion:

Our data suggest that CD8+ autoreactive T cells in EAE have a lower encephalitogenic function but are unique and independent on pathogenic of EAE rather than their CD4+ counterparts.
ANALYSIS OF TIME TO FAILURE AFTER RETINAL DETACHMENT SURGERY
Authors: Heath Jeffery Rachael C. , Young Braden , Atkins Will , Shadbolt Bruce , Allen Penelope J. , Essex Rohan W.
Published: December 2019

Purpose:

To present the distribution of time to retinal redetachment in eyes undergoing retinal detachment surgery, using a method for adjusting time to outcome in eyes with silicone oil or heavy liquid tamponade (“oil-filled eyes”).

Methods:

Data from two Australian centers were used. Adjusted time to outcome was measured from the date of tamponade removal in oil-filled eyes, unless failure was diagnosed with tamponade in situ.

Results:

188/1257 failures were identified (15.0%). Using unadjusted time to outcome, failures in oil-filled eyes occurred later than non–oil-filled eyes (median time to failure 57 vs. 28 days, P < 0.001). After adjustment, the distribution of time to failure was similar for oil-filled and non–oil-filled eyes (median 25 vs. 28 days, P = 0.68). Larger detachments, eyes with ≥Grade B proliferative vitreoretinopathy and eyes receiving surgery for recurrent detachments were more likely to fail, but the time to failure was similar regardless of risk.

Conclusion:

Adjustment of time to outcome resulted in a similar distribution of time to failure in oil-filled and non–oil filled eyes and was similar in low- and high-risk eyes. The use of adjusted time to outcome will support consistent collection and interpretation of outcomes across different jurisdictions where time to oil removal may vary.
RETINAL OXIMETRY IS ALTERED IN EYES WITH CHOROIDAL MELANOMA BUT NOT IN EYES WITH CHOROIDAL NEVI
Authors: Brouwer Niels J. , Marinkovic Marina , Bleeker Jaco C. , el Filali Mariam , Stefansson Einar , Luyten Gregorius P. M. , Jager Martine J.
Published: December 2019

Purpose:

To compare retinal vessel oxygenation in eyes with an untreated choroidal nevus or choroidal melanoma.

Methods:

The affected and fellow eye of patients with an untreated choroidal nevus (n = 42) or choroidal melanoma (n = 45) were investigated using noninvasive retinal oximetry (Oxymap T1). Oxygen saturation of arterioles (ArtSat) and venules (VenSat) was determined, together with the arteriovenous difference (AV-difference).

Results:

In choroidal nevus patients, retinal oximetry did not differ between the affected and fellow eye: the mean ArtSat was 94.5% and 94.2% (P = 0.56), the VenSat was 60.5% and 61.3% (P = 0.35), and the AV-difference was 34.0% and 32.9% (P = 0.18), respectively. In choroidal melanoma patients, alterations were detected: the mean ArtSat was 94.8% and 93.2% (P = 0.006), the VenSat was 58.0% and 60.0% (P = 0.014), and the AV-difference was 36.8% and 33.2% (P < 0.001), respectively. The largest increase in AV-difference was observed between the retinal halves without the lesion in melanoma eyes compared with the corresponding half in the fellow eye (37.5% vs. 32.1%, P < 0.001).

Conclusion:

Although retinal oximetry was not significantly altered in eyes with a choroidal nevus, eyes with choroidal melanoma showed an increased ArtSat and decreased VenSat, leading to an increased AV-difference. These changes may be caused by inflammation and a higher metabolism, with larger oxygen consumption, leading to altered blood flow and intraocular oxygen relocation.
Plasma miR-200c-3p, miR-100-5p, and miR-1826 serve as potential diagnostic biomarkers for knee osteoarthritis
Authors: Lai Zhen , Cao Yanguang
Published: December 2019

Objective:

To study the potential diagnostic value of plasma miR-200c-3p, miR-100-5p, and miR-1826 levels in knee osteoarthritis (KOA).

Methods:

Real-time quantitative PCR (RT-PCR) was used to measure the expression levels of serum miR-200c-3p, miR-100-5p, and miR-1826 in 150 KOA patients and 150 control controls. In addition, the levels of DNMT3A, ZEB1, MMP13, and CTNNB1 mRNAs in the synovial fluid were also measured by RT-PCR.

Results:

The expression levels of miR-100-5p, miR-200c-3p, and miR-1826 in the synovial fluid of 150 KOA patients were significantly lower than those in 54 controls (P < .001). In the synovial fluid, the miR-100-5p and DNMT3A mRNA levels, miR-100-5p and ZEB1 mRNA levels, miR-200c-3p and MMP13 mRNA levels, and miR-1826 and CTNNB1 mRNA levels were all negatively correlated (r = −0.83, −0.81, −0.83, −0.58, respectively). The AUCs of the diagnosis for KOA using the plasma levels of miR-200c-3p, miR-100-5p, and miR-1826 were 0.755, 0.845, and 0.749, respectively.

Conclusion:

The plasma levels of miR-200c-3p, miR-100-5p, and miR-1826 are of potentially high value in the diagnosis of KOA.
An interdisciplinary approach for laparoscopic removal of a large retroperitoneal pelvic schwannoma attached to vital vessels
Authors: Macciò Antonio , Kotsonis Paraskevas , Aste Laura , Voicu Maria Andreea , Madeddu Clelia , Conti Carlo , Camparini Stefano
Published: December 2019

Rationale:

Retroperitoneal schwannomas are very rare and may grow very close to major abdominal vessels. Since the surgical approach to the retroperitoneal space may be complex due to surrounding vital organs, including major vessels, laparoscopic surgery is challenging and has only been recently adopted. Here, we report a case of laparoscopic resection of a large retroperitoneal schwannoma attached to large vital vessels.

Patient concerns:

A 62-year-old woman presented with a chief complaint of pain in the lower right limb with consequent claudication, which had lasted for approximately 1 year.

Diagnoses:

Magnetic resonance imaging revealed a solid oval mass measuring 45 × 32 × 39 mm, located medially to the right iliopsoas muscle at the level of the intersomatic space between the 5th lumbar vertebra and the 1st sacral vertebra. This mass was inhomogeneously hypointense in T2 due to the presence of cystic areas, with intense and inhomogeneous contrast enhancement, compatible with the diagnosis of a schwannoma. The mass compressed the inferior caval vein near its bifurcation and the right common iliac vein, anteriorly dislocating the ipsilateral iliac arterial axis.

Interventions:

A multidisciplinary team skilled in vascular and pelvic laparoscopy was involved. The patient underwent laparoscopic surgery via an anterior transperitoneal approach with right adnexectomy and radical excision of the tumor. The surgery lasted 120 minutes without intraoperative complications. Blood loss was less than 100 mL. The histologic diagnosis was a benign Schwannoma; grade I according to World Health Organization classification.

Outcomes:

The postoperative course was uneventful. At the 10-month follow-up, the patient had no recurrences and was asymptomatic.

Lessons:

Laparoscopic removal of large retroperitoneal schwannomas, even if attached to major vital vessels, is feasible and safe when performed by experienced surgeons.
Knowledge of and willingness to perform Hands-Only cardiopulmonary resuscitation among college students in Malaysia
Authors: Karuthan Sumitra Ropini , Firdaus Putri Jasmine Filza binti , Angampun Aloha Dee-Afryna George , Chai Xuan Jia , Sagan Chris Dom , Ramachandran Monishak , Perumal Sharmmathevan , Karuthan Mahendra , Manikam Rishya , Chinna Karuthan
Published: December 2019

Worldwide, millions of people die of sudden cardiac arrest every year. This is partly due to limited and sometimes ineffective bystander cardiopulmonary resuscitation (CPR). The need for mouth-to-mouth contact, fear of causing harm, litigation, and the complexity of delivering CPR are the main deterrents. In view of this, the basic life support algorithm has been simplified and lay rescuers are encouraged to perform Hands-Only CPR.

The objective of this study is to assess knowledge on and willingness to perform Hands-Only CPR among Malaysian college students and to determine the relationship between the two.

In an online self-administered survey, college students responded to a questionnaire on demographics, exposure to CPR, knowledge on Hands-Only CPR, and their willingness to perform Hands-Only CPR in 5 different scenarios (family members or relatives, strangers, trauma victims, children, and elderly people).

Data for 393 participants were analyzed. For knowledge, the mean score was 8.6 ± 3.2 and the median score was 9. In the sample, 27% of the respondents did not attend any CPR training before, citing that they were unsure where to attend the course. The knowledge score among those who attended CPR training (M = 3.6, S = 2.9) was significantly higher compared to those who did not (M = 6.7, S = 3.0). Out of the 393 participants, 67.7%, 55%, 37.4%, 45%, and 49.1% were willing to perform Hands-Only CPR on family members or relatives, strangers, trauma victims, children, and elderly people, respectively. There were significant associations (P < .001) between knowledge and willing to perform Hands-Only CPR on family members or relatives (OR = 1.32, 95% CI 1.43, 1.43), strangers (OR = 1.31, 95% CI 1.21, 1.42), trauma victims (OR = 1.21, 95% CI 1.12, 1.31), children (OR = 1.28, 95% CI 1.19, 1.39), and elderly people (OR = 1.36 95% CI 1.25, 1.48).

Based on this study, knowledge on Hands-Only CPR among local college students is not encouraging. Not many know where to attend such courses. There was significant association between knowledge and willingness to perform Hands-Only CPR.
Risk factors for the concomitant occurrence of alcoholic chronic pancreatitis and alcoholic liver cirrhosis: a 10-years cohort study at a tertiary hospital in China
Authors: Tan Jie-Hui , Jin Yang-Chen , Cao Rong-Chang , Zhou Lei , Zhang Guo-Wei
Published: December 2019

Objective

Concomitant occurrence of alcoholic chronic pancreatitis (ACP) and alcoholic liver cirrhosis (ALC) is rare with few reported cases. The present study aimed to identify the potential risk factors of chronic pancreatitis (CP) and liver cirrhosis (LC) in ALC patients and ACP patients, respectively.

Methods

A retrospective analysis was performed on 536 patients with CP and 647 ALC patients without CP (Group A). Among the 536 CP patients, 213 ACP cases were divided into two groups: ACP with LC (Group B, n = 52) and ACP without LC (Group C, n = 161). A comparison between Group A and B was carried out to identify the potential risk factors of CP in ALC patients, while Group B and C were compared to determine the independent risk factors of LC in ACP patients.

Results

Concomitant occurrence of ACP and ALC accounted for 24.4% (52/213) in this cohort. Significant risk factors for CP in ALC patients included smoking [odds ratio (OR), 2.557; 95% confidence interval (CI): 1.531–5.489; P = 0.003] and multiple bouts of acute pancreatitis (OR, 4.813; 95% CI: 3.625–12.971; P < 0.001). Hepatitis B virus (HBV) infection (OR, 4.237; 95% CI: 1.742–7.629; P = 0.012) was the only independent risk factor associated with LC in ACP patients.

Conclusion

HBV infection exacerbated liver damage in ACP patients. Alcoholic patients who smoked and suffered from ongoing bouts of acute pancreatitis are prone to develop CP.
Prepectoral Breast Reconstruction in Nipple-Sparing Mastectomy With Immediate Mastopexy
Authors: Manrique Oscar J. , Arif Chaudhry , Banuelos Joseph , Abu-Ghname Amjed , Martinez-Jorge Jorys , Tran Nho V.
Published: December 2019

Background

Nipple-areola preservation positively impacts quality of life of the patients and helps them to achieve a better psychological and sexual well-being, as well as higher satisfaction with their reconstruction. Patients with large or ptotic breasts, however, represent a technical challenge to surgeons, and nipple-areola preservation may be deferred in this clinical scenario. The aim of this study is to report our experience in patients with large or ptotic breasts who underwent nipple-sparing mastectomy (NSM) and prepectoral implant-based breast reconstruction with immediate mastopexy.

Methods

A single-institution retrospective chart review was performed in all consecutive patients who underwent NSM and prepectoral implant-based breast reconstruction, simultaneously with mastopexy. This procedure was offered preoperatively to patients who had ptotic or large breasts, which could benefit from mastopexy to obtain a better result. Aesthetic outcomes were evaluated using a modified 5-point Likert scale, and satisfaction and quality of life were evaluated using the reconstruction module of the BREAST-Q questionnaire.

Results

Seventeen NSMs with simultaneous mastopexy were performed on 9 patients. All completed reconstruction successfully, and there were no cases of nipple ischemia or necrosis. Global aesthetic evaluation score was 3.77 (±0.95). The Q-scores were as follows: satisfaction with breast was 90, psychosocial well-being was 95, sexual well-being was 80, and physical well-being with chest was 86.

Conclusions

In patients with large and/or ptotic breasts, NSM with prepectoral breast reconstruction and immediate mastopexy showed promising results. However, adequate preoperative planning and intraoperative flap assessment are necessary in order to minimize complications.
Prevalence of Musculoskeletal Symptoms and Ergonomics Among Plastic Surgery Residents
Authors: Kokosis George , Dellon Lee A. , Lidsky Michael E. , Hollenbeck Scott T. , Lee Bernard T. , Coon Devin
Published: December 2019

Background

Musculoskeletal symptoms and injuries among surgeons are underestimated but are increasingly recognized to constitute a major problem. However, it has not been established when symptoms start and what factors contribute to the development of symptoms.

Methods

A 19-question survey approved by our institution's review board, and American Council of Academic Plastic Surgery was sent to all plastic surgery residents enrolled in Accreditation Council for Graduate Medical Education–accredited plastic surgery training programs in the United States. The presence of various musculoskeletal symptoms was calculated, and predictors of these symptoms were evaluated.

Results

We received 104 total responses. Ninety-four percent of residents had experienced musculoskeletal pain in the operating room. The neck was the most commonly affected area (54%) followed by the back (32%) and extremities (12%). Interestingly, 52% of responders developed these symptoms during the first 2 years of their residency. Furthermore, increasing postgraduate year level (P = 0.3) and independent versus integrated status (P = 0.6) had no correlation with pain, suggesting that symptoms began early in training.

Pain symptoms were frequent for 47%, whereas 5% reported experiencing symptoms during every case. The use of a headlight correlated with frequent pain (odds ratio, 2.5; P = 0.027). The use of microscope and loupes did not correlate with frequent pain. Eighty-nine percent of responders were aware of having bad surgical posture, but only 22% had received some form of ergonomics training at their institution. Sixty-four percent of responders believe that the operating room culture does not allow them to report the onset of symptoms and ask for adjustments. This was more common among residents reporting frequent pain (odds ratio, 3.12; P = 0.009).

Conclusions

Plastic surgeons are at high risk for occupational symptoms and injuries. Surprisingly, symptoms start early during residency. Because residents are aware of the problem and looking for solutions, this suggests an opportunity for educational intervention to improve the health and career longevity of the next generation of surgeons.
Morphometric Features of External Opening of the Carotid Canal and Relationship With Some Neighboring Formations on the Skull Base
Authors: Tuncel Çini Nilgün , Babacan Serdar , Ari Ilknur
Published: December 2019

The carotid canal must be taken into account during the surgical procedures since it contains the petrous segment of internal carotid artery. For this reason, we aimed to reveal the morphometric relationship of the carotid canal with related structures. The study was carried out with 11 parameters determined on a total of 52 sex unknown temporal bones belonging to the collection of Bursa Uludag University Faculty of Medicine, Anatomy Department. Measurements were taken by using mechanical sliding calipers and the findings were evaluated using the SPSS 22.0 program. Descriptive statistics of all variables were performed and correlation between the carotid canal and related structures were evaluated with the Spearman correlation analysis. Also, the correlation coefficient values were given. We developed the regression formulas to estimate the location of the carotid canal. There was a relationship between posterior and anterior point of external opening of carotid canal and mastoid process. The distance between the mastoid process-suprameatal spine and mastoid process-posterior root of zygomatic arch is highly correlated with each other.
Open Surgery Versus Closed Treatment of Unilateral Mandibular Condyle Fractures
Authors: Han Xiaodong , Shao Xiaojun , Lin Xiaozhen , Gui Weifu , Zhang Ming , Liang Limin
Published: December 2019

Purpose:

The aim of this meta-analysis was to evaluate the efficacy of open surgery and closed treatment for unilateral moderately displaced mandibular condyle fractures.

Methods:

PubMed, Embase, and Cochrane Library databases were searched according to PRISMA guidelines from inception to October, 2018. Inclusion criteria were based on humans randomized controlled trials in the English literature. Pertinent data were collected and the incidence of the complications was calculated.

Results:

A total of 6 studies with 227 patients were included in the meta-analysis. The results showed that there were no significant differences in incidence of malocclusion (odds ratio [OR], 0.33; 95% confidence interval [CI]: 0.07–1.46; P = 0.14). However, open surgery group had a better maximal mouth opening (WMD = 3.82, 95% CI: 1.93–5.71, P < 0.01), protrusion (WMD = 1.16, 95% CI: 0.42–1.89, P < 0.01) and sum of both laterotrusions (WMD: 2.50, 95% CI: 1.77–3.22, P < 0.01). And the incidence of temporomandibular joint pain was lower than closed treatment group (OR: 0.15, 95% CI: 0.06–0.37, P < 0.01).

Conclusions:

Compared with closed treatment, open surgery has significant advantages in improving mouth opening and mandibular movement, and reducing the incidence of temporomandibular joint pain, provided that open surgery was a promising application in treatment of unilateral moderately displaced mandibular condyle fractures.
Prognostic Impact of Postoperative Lymph Node Metastases After Neoadjuvant Chemoradiotherapy for Locally Advanced Squamous Cell Carcinoma of Esophagus
Authors: Leng Xuefeng , He Wenwu , Yang Hong , Chen Yuping , Zhu Chengchu , Fang Wentao , Yu Zhentao , Mao Weimin , Xiang Jiaqing , Chen Zhijian , Yang Haihua , Wang Jiaming , Pang Qingsong , Zheng Xiao , Liu Hui , Yang Huanjun , Li Tao , Zhang Xu , Li Qun , Wang Geng , Mao Teng , Guo Xufeng , Lin Ting , Liu Mengzhong , Fu Jianhua , Han Yongtao
Published: December 2019

Objective:

To determine the prognostic impact of pathologic lymph node (LN) status and investigate risk factors of recurrence in esophageal squamous cell carcinoma (ESCC) patients with pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (NCRT).

Summary Background Data:

There are no large-scale prospective study data regarding ypN status and recurrence after pCR in ESCC patients receiving NCRT.

Methods:

The NEOCRTEC5010 trial was a prospective multicenter trial that compared the survival and safety of NCRT plus surgery (S) with S in patients with locally advanced ESCC. The relationships between survival and cN, pN, and ypN status were assessed. Potential prognostic factors in patients with ypN+ and pCR were identified.

Results:

A total of 389 ESCC patients (NCRT: 182; S: 207) were included. Patients with pN+ in the S group and ypN+ in the NCRT group had decreased overall survival (OS) and disease-free survival (DFS) compared with pN0 and ypN0 patients, respectively. Partial response at the primary site [hazard ratio (HR), 2.09] and stable disease in the LNs (HR, 3.26) were independent risk factors for lower DFS, but not OS. For patients with pCR, the recurrence rate was 13.9%. Patients with distant LN metastasis had a median OS and DFS of 16.1 months and 14.4 months, respectively. Failure to achieve the median total dose of chemotherapy was a significant risk factor of recurrence and metastasis after pCR (HR, 44.27).

Conclusions:

Persistent pathologic LN metastasis after NCRT is a strong poor prognostic factor in ESCC. Additionally, pCR does not guarantee a cure; patients with pCR should undergo an active strategy of surveillance and adjuvant therapy.
Long-term Impact of Bariatric Surgery on Venous Thromboembolic Risk
Authors: Moussa Osama , Ardissino Maddalena , Tang Alice , Lazzari Laura , Millar Ophelia , Ziprin Paul , Darzi Ara , Khan Omar , Collins Peter , Purkayastha Sanjay
Published: December 2019

Objective:

The aim of this study is to evaluate the effect of bariatric surgery on long-term risk of VTEs in a large cohort of patients with obesity.

Background:

Obesity is a well-established risk factor for VTEs, such as pulmonary embolism and deep vein thrombosis. The rising prevalence of obesity and its associated co-morbidities, including VTE, represent a growing public health issue.

Methods:

A nested, retrospective matched cohort study was designed and conducted on prospectively collected national electronic healthcare records data from the Clinical Practice Research Datalink. Eight thousand, one hundred twelve patients were included in the study: the 4056 patients on the database who had undergone bariatric surgery, and equal numbers of age, sex, and body mass index matched controls. The primary endpoint was the occurrence of VTEs; secondary endpoints were the occurrence of deep vein thrombosis alone, pulmonary embolism alone.

Results:

Patients were followed up for a median of 10.7 years. The bariatric surgery cohort had a significantly lower occurrence of the primary outcome [hazard ratio (HR) 0.601; 95% confidence interval (CI) 0.430–0.841, P = 0.003]; mainly driven by a reduction in deep vein thrombosis (HR 0.523; 95% CI 0.349–0.783, P = 0·002) and not in pulmonary embolism (HR 0.882; 95% CI 0.511–1.521, P = 0.651).

Conclusions:

The results of this nation-wide study set out to characterize the impact of bariatric surgery on long-term risk of thromboembolic events outline a significant reduction in thromboembolic events, driven by a reduction in deep vein thrombosis.
Identification of a novel regulatory pathway for PPARα by RNA-seq characterization of the endothelial cell lipid peroxidative injury transcriptome
Authors: Dou Fangfang , Wu Beiling , Sun Lin , Chen Jiulin , Liu Te , Yu Zhihua , Chen Chuan
Published: December 2019

Endothelial dysfunction caused by endothelial cell injuries is the initiating factor for atherosclerosis (AS), and lipid peroxidative injury is one of a dominant factor for AS pathogenesis. Using RNA-seq, we compared changes in transcriptome expression before and after endothelial cell injury, and found 311 differentially expressed genes (DEGs), of which 258 genes were upregulated and 53 genes were downregulated. The protein–protein interactions (PPIs) between the genes were analysed using the STRING database, and a PPI network of DEGs was constructed. The relationship distributions among these PPIs were analysed by performing network node statistics. We found that in the top 20 DEGs with high connected protein nodes in the PPI network, 16 were upregulated and 4 were downregulated. Gene ontology (GO) functional enrichment analysis and KEGG pathway enrichment analysis on the DEGs were also performed. By comparing the upregulated expressed genes with high connected protein nodes in the PPI network to those related to endothelial cell lipid damage and repair in the GO analysis, we identified seven genes (NOX4, PPARA, CCL2, PDGFB, IL8, VWF, CD36) and verified their expression levels by real-time polymerase chain reaction. The protein interactions between the seven genes were then analysed using the STRING database. The results predicted that CCL2 interacts with NOX4, PPARα, PDGFβ and VWF individually. Thus, we examined the protein expression levels of CCL2, NOX4, PPARα, PDGFβ and VWF, and found that the expression levels of all proteins were significantly upregulated after the lipid peroxidative injury, with CCL2 and PPARα exhibiting the highest expression levels. Therefore, we investigated the interregulatory relationship between CCL2 and PPARα and their roles in the repair of endothelial cell injury. With the help of gene overexpression and knockdown techniques, we discovered that PPARα promotes the repair of endothelial cell injury by upregulating CCL2 expression in human umbilical vein endothelial cells but that CCL2 cannot regulate PPARα expression. Therefore, we believe that PPARα participates in the repair of endothelial cell lipid peroxidative injury through regulating the expression of CCL2.
Influenza A/H4N2 mallard infection experiments further indicate zanamivir as less prone to induce environmental resistance development than oseltamivir
Authors: Tepper Viktoria , Nykvist Marie , Gillman Anna , Skog Erik , Wille Michelle , Lindström Hanna Söderström , Tang Chaojun , Lindberg Richard H. , Lundkvist Åke , Järhult Josef D.
Published: December 2019

Neuraminidase inhibitors (NAIs) are the gold standard treatment for influenza A virus (IAV). Oseltamivir is mostly used, followed by zanamivir (ZA). NAIs are not readily degraded in conventional wastewater treatment plants and can be detected in aquatic environments. Waterfowl are natural IAV hosts and replicating IAVs could thus be exposed to NAIs in the environment and develop resistance. Avian IAVs form the genetic basis for new human IAVs, and a resistant IAV with pandemic potential poses a serious public health threat, as NAIs constitute a pandemic preparedness cornerstone. Resistance development in waterfowl IAVs exposed to NAIs in the water environment has previously been investigated in an in vivo mallard model and resistance development was demonstrated in several avian IAVs after the exposure of infected ducks to oseltamivir, and in an H1N1 IAV after exposure to ZA. The N1 and N2 types of IAVs have different characteristics and resistance mutations, and so the present study investigated the exposure of an N2-type IAV (H4N2) in infected mallards to 1, 10 and 100 µg l−1 of ZA in the water environment. Two neuraminidase substitutions emerged, H274N (ZA IC50 increased 5.5-fold) and E119G (ZA IC50 increased 110-fold) at 10 and 100 µg l−1 of ZA, respectively. Reversion towards wild-type was observed for both substitutions in experiments with removed drug pressure, indicating reduced fitness of both resistant viruses. These results corroborate previous findings that the development of resistance to ZA in the environment seems less likely to occur than the development of resistance to oseltamivir, adding information that is useful in planning for prudent drug use and pandemic preparedness.
Identification of human tendon cell populations in healthy and diseased tissue using combined single cell transcriptomics and proteomics
Authors: Kendal AR , Layton T , Al-Mossawi H , Brown R , Loizou C , Rogers M , Sharp M , Dakin S , Appleton L , Carr A
Published: December 2019

The long-term morbidity of tendon disease in an increasingly active and ageing population represents a growing area of unmet clinical need. Tendon disorders commonly affect the lower limb, ranging from isolated tendon rupture to degenerative joint deformity. In the absence of valid animal models of chronic tendinopathy, traditional methods to isolate and identify crucial sub types involved in disease are limited by the heterogeneity of tendon cells, by their relative paucity in tissue and by the density of the surrounding collagen matrix. To overcome this, we have used next generation CITE-sequencing to combine surface proteomics with in-depth, unbiased gene expression analysis of single cells derived ex vivo from healthy and diseased tendon.

For the first time we have been able to show that human tendon consists of at least eight sub-populations of cells. In addition to endothelial cells, Tc cells, and macrophages, there are five distinct tenocyte populations expressingCOL1Agenes. These consist of a population of resident cells expressing microfibril associated genes (FBN1, VCAN,DCN, EMILIN1,MFAP5), a group ofSCX+ cells co-expressing high levels of pro-inflammatory markers, a population ofAPOD+fibro-adipogenic progenitors (FAPs),TPPP3/PRG4+chondrogenic cells(COMP, CILP, PRG4)andITGA7+ Smooth Muscle-Mesenchymal Cells, recently described in mouse muscle but not, as yet, in human tendon. Surface proteomic analysis identified markers by which these sub-classes could be isolated and targeted in future.

In comparison to healthy tendon, diseased tendon harboured a greater proportion ofSCX+tendon cells and these expressed high levels of pro-inflammatory markers includingCXCL1, CXCL6, CXCL8, PDPNand previously undescribedPTX3. We were also able to show that whereas disease associated genes such asCD248andPDPNwere expressed byCOL1+ tenocytes,IL33was restricted to endothelial cells of chronically diseased tendon.
Attractor dynamics gate cortical information flow during decision-making
Authors: Finkelstein Arseny , Fontolan Lorenzo , Economo Michael N. , Li Nuo , Romani Sandro , Svoboda Karel
Published: December 2019

Decisions about future actions are held in memory until enacted, making them vulnerable to distractors. The neural mechanisms controlling decision robustness to distractors remain unknown. We trained mice to report optogenetic stimulation of somatosensory cortex, with a delay separating sensation and action. Distracting stimuli influenced behavior less when delivered later during delay – demonstrating temporal gating of sensory information flow. Gating occurred even though distractor-evoked activity percolated through the cortex without attenuation. Instead, choice-related dynamics in frontal cortex became progressively robust to distractors as time passed. Reverse-engineering of neural networks trained to reproduce frontal-cortex activity revealed that chosen actions were stabilized via attractor dynamics, which gated out distracting stimuli. Our results reveal a dynamic gating mechanism that operates by controlling the degree of commitment to a chosen course of action.

One Sentence Summary

Mechanisms controlling state-dependent communication between brain regions allow for robust action-selection.
Patterns of gene flow across multiple anthropogenic infrastructures: Insights from a multi-species approach
Authors: Remon Jonathan , Moulherat Sylvain , Cornuau Jérémie H. , Gendron Lucie , Richard Murielle , Baguette Michel , Prunier Jérôme G.
Published: December 2019

1.

Large-scale Transportation Infrastructures (LTIs) are among the main determinants of landscape fragmentation, with strong impacts on animal dispersal movements and metapopulation functioning. Although the detection of LTIs impacts is now facilitated by landscape genetic tools, studies are often conducted on a single species, although different species might react differently to the same obstacle. Multi-specific approaches are thus required to get a better overview of the impacts of human-induced fragmentation. We surveyed four species (a snake, an amphibian, a butterfly and a ground-beetle) in a landscape fragmented by six LTIs: a motorway, a railway, a country road, a gas pipeline, a power line and a secondary road network. We showed that half of the overall explained genetic variability across all species was due to LTIs. While the butterfly was seemingly not impacted by any LTI, the genetic structure of the three other species was mostly influenced by roads, motorway and railway. The power line did not affect any species and the gas pipeline only impacted gene flow in the ground-beetle through forest fragmentation, but other LTIs systematically affected at least two species. LTIs mostly acted as barriers but we showed that some LTIs could somehow promote gene flow, embankments probably providing favourable habitats for vertebrate species. Considering the high variability in species response to LTIs, we argue that drawing general conclusions on landscape connectivity from the study of a single species may lead to counterproductive mitigation measures and that multi-species approaches should be more systematically considered in conservation planning.
Depth in convolutional neural networks solves scene segmentation
Authors: Seijdel N , Tsakmakidis N , De Haan EHF , Bohte SM , Scholte HS
Published: December 2019

Feedforward deep convolutional neural networks (DCNNs) are, under specific conditions, matching and even surpassing human performance in object recognition in natural scenes. This performance suggests that the analysis of a loose collection of image features could support the recognition of natural object categories, without dedicated systems to solve specific visual subtasks. Research in humans however suggests that while feedforward activity may suffice for sparse scenes with isolated objects, additional visual operations (‘routines’) that aid the recognition process (e.g. segmentation or grouping) are needed for more complex scenes. Linking human visual processing to performance of DCNNs with increasing depth, we here explored if, how, and when object information is differentiated from the backgrounds they appear on. To this end, we controlled the information in both objects and backgrounds, as well as the relationship between them by adding noise, manipulating background congruence and systematically occluding parts of the image. Results indicate that with an increase in network depth, there is an increase in the distinction between object- and background information. For more shallow networks, results indicated a benefit of training on segmented objects. Overall, these results indicate that, de facto, scene segmentation can be performed by a network of sufficient depth. We conclude that the human brain could perform scene segmentation in the context of object identification without an explicit mechanism, by selecting or “binding” features that belong to the object and ignoring other features, in a manner similar to a very deep convolutional neural network.
iucn_sim: A new program to simulate future extinctions based on IUCN threat status
Authors: Andermann Tobias , Faurby Søren , Cooke Robert , Silvestro Daniele , Antonelli Alexandre
Published: December 2019

The ongoing environmental crisis poses an urgent need to forecast thewho,where, andwhenof future species extinctions, as such information is crucial for targeting conservation efforts. Commonly, such forecasts are made based on conservation status assessments produced by the International Union for Conservation of Nature (IUCN). However, when researchers apply these IUCN conservation status data for predicting future extinctions, important information is often omitted, which can impact the accuracy of these predictions.

Here we present a new approach and a software for simulating future extinctions based on IUCN conservation status information, which incorporates generation length information of individual species when modeling extinction risks. Additionally, we explicitly model future changes in conservation status for each species, based on status transition rates that we estimate from the IUCN assessment history of the last decades. Finally, we apply a Markov chain Monte Carlo algorithm to estimate extinction rates for each species, based on the simulated future extinctions. These estimates inherently incorporate the chances of conservation status changes and the generation length for each given species and are specific to the simulated time frame.

We demonstrate the utility of our approach by estimating extinction rates for all bird species. Our average extinction risk estimate for the next 100 years across all birds is 6.98 × 10−4extinctions per species-year, and we predict an expected biodiversity loss of between 669 to 738 bird species within that time frame. Further, the rate estimates between species sharing the same IUCN status show larger variation than the rates estimated with alternative approaches, which reflects expected differences in extinction risk among taxa of the same conservation status. Our method demonstrates the utility of applying species-specific information to the estimation of extinction rates, rather than assuming equal extinction risks for species assigned to the same conservation status.
Mountain stoneflies may tolerate warming streams: evidence from organismal physiology and gene expression
Authors: Hotaling Scott , Shah Alisha A. , McGowan Kerry L. , Tronstad Lusha M. , Giersch J. Joseph , Finn Debra S. , Woods H. Arthur , Dillon Michael E. , Kelley Joanna L.
Published: December 2019

Rapid glacier recession is altering the physical conditions of headwater streams. Stream temperatures are predicted to rise and become increasingly variable, putting entire meltwater-associated biological communities at risk of extinction. Thus, there is a pressing need to understand how thermal stress affects mountain stream insects, particularly where glaciers are likely to vanish on contemporary timescales. In this study, we tested the critical thermal maximum (CTMAX) of stonefly nymphs representing multiple species and a range of thermal regimes in the high Rocky Mountains, USA. We then collected RNA-sequencing data to assess how organismal thermal stress translated to the cellular level. Our focal species included the meltwater stonefly,Lednia tumana, which was recently listed under the U.S. Endangered Species Act due to climate-induced habitat loss. For all study species, critical thermal maxima (CTMAX> 20°C) far exceeded the stream temperatures mountain stoneflies experience (< 10°C). Moreover, while evidence for a cellular stress response was present, we also observed constitutive expression of genes encoding proteins known to underlie thermal stress (i.e., heat shock proteins) even at low temperatures that reflected natural conditions. We show that high-elevation aquatic insects may not be physiologically threatened by short-term exposure to warm temperatures and that longer term physiological responses or biotic factors (e.g., competition) may better explain their extreme distributions.