bluuebunny/crossref_metadata_2025 huggingface dataset:
Concise Review of the Effects of Orthopedic Surgery or Trauma on Muscle Function
Authors: Taba Houtan A. , Hagen Jennifer E. , Parvataneni Hari K.
Published: November 2017

Musculoskeletal injury and surgery both impact the short-term and long-term health and function of muscle. Muscle injury is a complicated process that can ultimately result in loss of muscle, formation of scar, and diminished function over the course of weeks to months. The extent of initial trauma (from injury) as well as on-going trauma (eg, from an unstable extremity) determines the amount of muscle damage. This has direct and distinct implications for pain, rehabilitation, and long-term functional outcomes in orthopedic trauma patients. Both the extent and the location of surgical injury of muscle can affect surgical outcomes. As a result, techniques have evolved which aim to minimize muscle injury in trauma procedures, arthroplasty and other elective orthopedic procedures. Exposure related muscle damage in total hip arthroplasty has significant implications for functional outcomes. Much of this is short lived and reversible but permanent weakness and limp can result from muscle injury. In total knee arthroplasty, more prolonged muscle weakness is an unavoidable part of the postoperative recovery and appears unrelated to surgical approach or pain management strategy. In spine surgery, muscle injury is related to persistent postoperative pain and intermuscular or muscle sparing techniques more reliably result in improved functional outcomes. Normal muscle physiology is disrupted by immobilization and neural inhibition from trauma or surgery. It is important to consider the complex and varying nature of muscle injury and recovery in orthopedic patients. Rehabilitation and pain management strategies factoring in these considerations over the entire spectrum of injury and recovery are more effective than strategies that simply focus on the short term.
A Modified Anterior Approach to L 1 Vertebra: An Early Clinical Experience
Authors: Kumar Vishal , Dhatt Sarvdeep S. , John Rakesh
Published: November 2017

Purpose:

To study the results of a new surgical approach to the L1 vertebra which is a modified anterior approach and is extrapleural and retroperitoneal in nature.

Materials and Methods:

Five patients with fracture L1 vertebra underwent surgical decompression and stabilization via this modified anterior approach. In this approach, the L1 vertebra is approached anteriorly without invading the pleural cavity or the peritoneal cavity by gentle, blunt dissection (extrapleural and retroperitoneal approach)

Results:

No significant complications, especially pulmonary complications, were noted in any of the 5 cases.

Conclusions:

This modified anterior approach to L1 vertebra allows effective, circumferential decompression of the thoracolumbar spinal canal without the associated morbidity of the traditional anterior approach. However, comparative studies between the 2 approaches will be needed in the future to more accurately ascertain benefits of this approach.
Intraoperative Techniques for the Plastic Surgeon to Improve Pain Control in Breast Surgery
Authors: Farias-Eisner Gina , Kao Kenneth , Pan Judy , Festekjian Jaco , Gassman Andrew
Published: November 2017

In recent years, there has been a growing emphasis placed on reducing length of hospital stay and health costs associated with breast surgery. Adequate pain control is an essential component of enhanced recovery after surgery. Postoperative pain management strategies include use of narcotic analgesia, non-narcotic analgesia, and local anesthetics. However, these forms of pain control have relatively brief durations of action and multiple-associated side effects. Intraoperative regional blocks have been effectively utilized in other areas of surgery but have been understudied in breast surgery. The aim of this article was to review various intraoperative techniques for regional anesthesia and local pain control in breast surgery and to highlight areas of future technique development.
Prevalence of Spondylolysis in Symptomatic Adolescent Athletes: An Assessment of Sport Risk in Nonelite Athletes
Authors: Selhorst Mitchell , Fischer Anastasia , MacDonald James
Published: November 2017

Objective:

To assess the risk of spondylolysis by sport in nonelite adolescent athletes with low back pain (LBP).

Design:

Retrospective case series.

Setting:

Hospital-based sports medicine clinic.

Patients:

The medical charts of 1025 adolescent athletes with LBP (age 15 ± 1.8 years) were examined; 308 (30%) were diagnosed with a spondylolysis.

Assessment of Risk:

Risk of spondylolysis was assessed in 11 sports for males and 14 sports for females.

Main Outcome Measure:

Relative risk of diagnosis of spondylolysis injury.

Results:

The risk of spondylolysis differed by sex with baseball (54%), soccer (48%), and hockey (44%) having the highest prevalence in males and gymnastics (34%), marching band (31%), and softball (30%) for female athletes. Baseball was the only sport to demonstrate a significant increased risk of spondylolysis.

Conclusions:

The sports with the greatest risk of spondylolysis in adolescent athletes in this study were not consistent with published literature. Clinicians should be cautious generalizing high-risk sports to their practice, as geographic region and level of the athlete may significantly influence the incidence of spondylolysis in the population they are treating.
Long-term management and outcomes after repair of cerebrospinal fluid rhinorrhea related to idiopathic intracranial hypertension
Authors: Schuman Theodore A. , Senior Brent A.
Published: November 2017

Purpose of review

To identify long-term management strategies and outcomes for the treatment of spontaneous cerebrospinal fluid (CSF) rhinorrhea related to idiopathic intracranial hypertension (IIH).

Recent findings

Adjuvant treatments following surgical repair of spontaneous CSF leaks are aimed at normalizing intracranial pressure (ICP) to minimize the risk of recurrence. IIH is closely linked to obesity, and growing evidence suggests that weight loss, both through conservative and surgical approaches, is effective at addressing the root cause of this disorder. Recent data also support the use of acetazolamide and dural venous sinus stenting as adjuncts for reducing ICP.

Spontaneous CSF rhinorrhea associated with IIH represents a challenging clinical entity, with an increased risk of recurrence compared to CSF leaks because of other causes. Adjunct therapies intended to reduce ICP likely improve outcomes after surgical repair, but further research is necessary to better characterize the effects of these treatment modalities.
Registered Nurse and Nursing Assistant Perceptions of Limited English-Proficient Patient-Clinician Communication
Authors: Shuman Clayton , Montie Mary , Galinato Jose , Patak Lance , Titler Marita
Published: November 2017

In this article, the authors discuss implications for nurse administrators from a recent qualitative study regarding nursing personnel perceptions of limited English proficient (LEP) patient-clinician communication. Few studies have examined nursing personnel’s use and perceptions of communication resources when caring for LEP patients.
A Two-Pronged Approach to Retaining Millennial Nurses
Authors: Koppel Jenna , Deline Marisa , Virkstis Katherine
Published: November 2017

Despite increased staff engagement and improved new hire on-boarding, organizations struggle to retain millennial nurses. One dominant trait is shared by organizations that have successfully reduced turnover for this group: investment in select strategies that cement loyalty to the organization. In this article, the authors describe 2 strategies for retaining early-tenure millennial nurses. In the 1st article of this series, the authors described why nursing leaders must supplement their organization’s current investments in engagement with strategies targeted at millennials in their 1st 3 years. This 2nd part of the series will outline these strategies.
An Academic-Practice Partnership Model to Grow and Sustain Advanced Practice Nursing
Authors: Williams Tracy E. , Howard Patricia B.
Published: November 2017

OBJECTIVE

The aims of this article were to describe the implementation of an academic-practice partnership for healthcare system workforce development and provide preliminary outcomes of the associated pilot study.

BACKGROUND

The demand for cross-continuum healthcare delivery models necessitates creation of workforce development structures for advanced practice nursing.

METHODS

An academic-practice partnership specified enrollment of 5 cohorts of BSN staff nurses in a 3-year DNP program. Qualitative methods were used to explore pilot data at midpoint of cohort 1 student progression to determine learning outcomes and DNP projects with potential for impact on organization goals.

RESULTS

Partnership implementation experiences indicate that contractual agreements and an established evaluation plan are keys to academic-practice partnership success. Pilot study findings suggest that curriculum core courses provide a foundation for designing DNP projects congruent with acute and primary care health system goals. Implementing an academic-practice partnership is a strategy for workforce development to increase retention of advanced practice nurses.

CONCLUSION

Academic-practice partnerships can serve as a catalyst for a paradigm shift for changing models of care, thus enhancing workforce development succession planning for sustainable growth in healthcare systems.
Factors Associated With the Implementation of a Nurse Staffing Directive
Authors: Annis Ann M. , Robinson Claire H. , Yankey Nicholas , Krein Sarah L. , Duffy Sonia A. , Taylor Beth , Sales Anne
Published: November 2017

BACKGROUND

In 2010, the Veterans Health Administration issued a Staffing Methodology (SM) Directive to provide a standardized, data-driven method for determining appropriate inpatient nurse staffing.

OBJECTIVE

We aimed to describe experiences and factors related to SM implementation.

METHODS

We administered a Web-based survey to chief nurse executives to obtain their implementation experiences. Structural, process, and outcome factors and barriers associated with self-reported implementation success were identified.

RESULTS

Respondents representing 104 of 117 facilities participated. Almost all facilities (96%) had completed at least 1 cycle of SM, yet only half (52%) rated their implementation highly successful. Early implementation date, higher levels of leadership confidence in SM, and higher frequency in which nursing staff think in terms of hours per patient day were associated with higher SM implementation success. Time, staff training and educational needs, and engagement were common barriers.

DISCUSSION

Understanding factors that influence successful implementation of staffing policies is important to ensuring safe staffing.
The Power and Pitfalls of Big Data Research in Obstetrics and Gynecology: A Consumer's Guide
Authors: Goodin Amie , Delcher Chris , Valenzuela Chelsea , Wang Xi , Zhu Yanmin , Roussos-Ross Dikea , Brown Joshua D.
Published: November 2017

Importance

Research in obstetrics and gynecology (OB/GYN) increasingly relies on “big data” and observational study designs. There is a gap in practitioner-relevant guides to interpret and critique such research.

Objective

This guide is an introduction to interpreting research using observational data and provides explanations and context for related terminology. In addition, it serves as a guide for critiquing OB/GYN studies that use observational data by outlining how to assess common pitfalls of experimental and observational study designs. Lastly, the piece provides a compendium of observational data resources commonly used within OB/GYN research.

Evidence Acquisition

Review of literature was conducted for the collection of definitions and examples of terminology related to observational data research. Data resources were collected via Web search and researcher recommendations. Next, each data resource was reviewed and analyzed for content and accessibility. Contents of data resources were organized into summary tables and matched to relevant literature examples.

Results

We identified 26 observational data resources frequently used in secondary analysis for OB/GYN research. Cost, accessibility considerations for software/hardware capabilities, and contents of each data resource varied substantially.

Conclusions and Relevance

Observational data sources can provide researchers with a variety of options in tackling their research questions related to OB/GYN practice, patient health outcomes, trends in utilization of medications/procedures, or prevalence estimates of disease states. Insurance claims data resources are useful for population-level prevalence estimates and utilization trends, whereas electronic health record–derived data and patient survey data may be more useful for exploring patient behaviors and trends in practice.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objectives

After completing this activity, the learner should be better able to identify and define terminology used in observational data research; compare the features, strengths, and limitations of observational study designs and randomized controlled trials; distinguish between types of observational data (eg, insurance administrative claims, discharges, electronic health record databases, surveys, surveillance data) and weigh the strengths and limitations of research that uses each data type; interpret and critique OB/GYN research that uses observational data and secondary data analysis; and gain exposure and familiarity with a selection of observational data sets used to study topics relevant to obstetrical and gynecological practice and/or health outcomes.
Use of Postmortem Computed Tomography to Detect Bowel Obstruction and its Relationship to the Cause of Death
Authors: Gascho Dominic , Schaerli Sarah , Tuchtan-Torrents Lucile , Thali Michael J. , Gorincour Guillaume
Published: November 2017

Bowel distension frequently indicates bowel obstruction, which is a common diagnosis in clinical radiology. Typically, symptoms and complaints lead to radiological examinations and the detection of the etiology. Untreated intestinal obstructions can lead to a fatal outcome through cardiac failure due to septic shock. Certain of these cases undergo medicolegal investigations depending on the case history, the condition of the decedent, the location of the finding, or recent visits to medical professionals. Computed tomography (CT) is a recommended method in clinical radiology for the detection of bowel obstruction, which is indicated by bowel distension and further radiological signs (eg, the whirl sign, which indicates a volvulus). Postmortem CT (PMCT) has increased worldwide, but PMCT differs from clinical CT; thus, the question of whether PMCT is also reliable for the detection of bowel obstruction in decedents or is negatively affected by postmortem modifications should be discussed. This study consists of 10 cases displaying radiological signs of bowel obstruction. Apart from bowel distension, the most common radiological signs (whirl sign, coffee bean sign, bird beak sign, and u-shape sign) are described and depicted. All decedents underwent autopsy and had a postmortem interval of less than 72 hours. Based on these cases, we assess the reliability of PMCT for detecting bowel obstruction and determining its relationship to the cause of death.
Syphilis of the Aerodigestive Tract
Authors: Tse Julie Y. , Chan May P. , Ferry Judith A. , Deshpande Vikram , Sohani Aliyah R. , Nardi Valentina , Schaffer Andras , Nazarian Rosalynn M. , Zukerberg Lawrence R.
Published: November 2017

Syphilis, a sexually transmitted infection caused by the Gram-negative bacterium Treponema pallidum, is increasing in prevalence in the United States. It has been our experience that primary and secondary syphilis of the aerodigestive tract can afflict a large age spectrum with varied clinical and histopathologic findings, which can lead to diagnostic problems and frequent misdiagnosis. In this study, we describe the histopathologic patterns of syphilis of the aerodigestive tract to expand awareness of its varied appearance. We identify 3 patterns of inflammatory response to syphilis: plasma cell-rich, lymphohistiocytic, and lymphoma-like. We also report the presence of immunoglobulin G4-predominant plasma cells in the inflammatory response as a potential mimicker of immunoglobulin G4-related disease. Lastly, we found that use of T. pallidum immunohistochemical stain is more reliable than Steiner silver stain at the identification of spirochetes. Our study highlights that despite convention, plasma cells are not always abundant in syphilis. Awareness of the histopathologic range of syphilis in the aerodigestive tract by the surgical pathologist can lead to the correct diagnosis and guide appropriate treatment.
Evaluation of Preoperative and Postoperative Patient Satisfaction and Quality of Life in Patients Undergoing Rhinoplasty: A Systematic Review and Meta-Analysis
Authors: Yang Fang , Liu Yin , Xiao Hong , Li Yuan , Cun Huanying , Zhao Yanan
Published: November 2017

Background:

Improvement of nasal aesthetics by means of rhinoplasty is a highly sought-after procedure and leads to increased patient confidence. The aim of the study was to provide a quantitative synthesis of existing data regarding the ability of cosmetofunctional rhinoplasty to improve patient satisfaction and quality of life measured by the Rhinoplasty Outcomes Evaluation scale.

Methods:

Electronic databases were searched for studies evaluating quality of life following aesthetic rhinoplasty. Study results were pooled and analyzed using a random effects model. Effect size was estimated using standardized mean difference at a 95 percent confidence interval. Heterogeneity and benefit were assessed and reported using the I
2 and standard mean difference. Subgroup analyses were performed based on follow-up period and age group segregation.

Results:

A total of 377 articles were retrieved, of which eight studies were included in the final analysis. Overall, patient satisfaction analyzed by pooling eight observational studies improved following cosmetofunctional rhinoplasty (standard mean difference, 5.87; 95 percent CI, 3.55 to 8.19; I
2 = 100 percent). In addition, further subgroup analyses revealed that maximum benefit was derived by younger patients (standard mean difference, 6.69; 95 percent CI, 3.65 to 9.74; I
2 = 99 percent) compared with older patients (standard mean difference, 3.48; 95 percent CI, 3.01 to 3.96; I
2 = 0 percent). Postoperative patient satisfaction levels showed maximum improvement during a follow-up period of 6 to 12 months (standard mean difference, 11.07; 95 percent CI, −8.79 to 32.12; I
2 = 100 percent).

Conclusion:

Cosmetofunctional rhinoplasty improves patients’ quality of life as evidenced by an improvement in Rhinoplasty Outcomes Evaluation scores.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Nose and Lip Graft Variants: A Subunit Anatomical Study
Authors: Duisit Jérôme , Maistriaux Louis , Gerdom Alexander , Vergauwen Martial , Gianello Pierre , Behets Catherine , Lengelé Benoît
Published: November 2017

Background:

In the field of vascularized composite tissue allotransplantation, the surgical design of facial subunit grafts is an evolving concept. The purpose of the present article is to study the possibility of dividing the historical nose and lip face transplant into several morphologic and functional subunit grafts, depending on their respective supply.

Methods:

This study was conducted in 20 adult cadavers. The facial artery and its branches were dissected bilaterally in 16 fresh and four embalmed heads. Nasolabial perfusion was assessed by selective injection of methylene blue and eosin (n = 2) or India ink (n = 2) in the superior labial and distal facial arteries. Dynamic perfusion through the distal facial artery was illustrated by fluoroscopy (n = 3). Three nose–upper lip grafts were harvested and injected with barium sulfate for microangiography computed tomographic analysis. Finally, three isolated nasal and bilabial grafts were procured and their vascular patency assessed by fluoroscopy.

Results:

The distal facial artery can perfuse the entire nose, septum, and upper lip, without any contribution of the superior labial artery. A dense anastomotic network indeed exists between the respective distal rami of both vessels. Furthermore, the exclusion of the superior labial artery from the harvested nasal subunit allowed safe bilabial subunit procurement, from the same specimen.

Conclusions:

The authors’ results demonstrate the feasibility of harvesting nasal and labial subunits, in an isolated or a combined manner. These results can find applications in subunit autologous replantation, allotransplantation, allogenic face partial retransplantation, and the emerging field of vascularized composite tissue engineering.
Gender-Confirmation Surgery Using the Pedicle Transverse Colon Flap for Vaginal Reconstruction: A Clinical Outcome and Sexual Function Evaluation Study
Authors: Manrique Oscar J. , Sabbagh M. Diya , Ciudad Pedro , Martinez-Jorge Jorys , Kiranantawat Kidakorn , Sitpahul Ngamcherd , Nippoldt Todd B. , Charafeddine Ali , Chen Hung-Chi
Published: November 2017

Vaginal reconstruction and vaginoplasty are indicated in vaginal agenesis, following pelvic tumor resection, trauma, and for gender-confirmation surgery. In this article, the authors present the clinical outcomes and sexual function evaluation when using the pedicle transverse colon flap for gender-confirmation surgery in transgender women. This is a retrospective chart review of all transgender women who underwent gender-confirmation surgery using the pedicle transverse colon flap. Demographics, procedure specifics, and surgical outcomes were recorded and analyzed. Sexual function was measured using the Female Sexual Function Index and the Female Genital Self-Image Scale 1 year after surgery. Fifteen patients underwent gender-confirmation surgery using the aforementioned technique. The average age of the patients was 20 years (range, 18 to 32 years), and the average operating room time was 10.1 hours (range, 8 to 12.5 hours). The average length and width of the flaps were 15 and 2.8 cm, respectively. During a 12-year follow-up, two complications were reported: one patient had pain caused by narrowing at the introitus, which required intervention, and one patient had an excessive amount of secretions in the first month, which subsided 3 months after surgery. The mean Female Sexual Function Index score was 28.6 (range, 24 to 31). All patients achieved normal sexual function as indicated by a Female Sexual Function Index score of 25 or more. For the Female Genital Self-Image Scale, the mean total score was 20.0 ± 4.5 (range, 7 to 28). The pedicle transverse colon flap is another valuable alternative method for vaginoplasty with promising results and minor complications.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Cleft-Related Orthognathic Surgery Based on Maxillary Vertical Lengthening of the Anterior Facial Height
Authors: Jeong Woo Shik , Jeong Hyung Hwa , Kwon Soon Man , Koh Kyung S. , Choi Jong Woo
Published: November 2017

Background:

The conventional approach during orthognathic surgery for cleft-related deformities has focused largely on restoration of maxilla retrusion, using the maxillary advancement as a standard treatment objective. However, the authors thought that maxillary vertical shortening and deficient incisor show could be additional key elements of cleft-related deformities. Although slight vertical lengthening can be obtained with only maxillary advancement, it would not be enough to obtain satisfactory aesthetic results in terms of the anterior facial height. The authors hypothesized that vertical deficiency and anteroposterior maxillary retrusion exists in cleft-related deformities. Therefore, orthognathic surgery including intentional vertical lengthening and advancement would be better than the conventional simple advancement.

Methods:

A new approach was used to treat consecutive patients with dentofacial deformities between December of 2007 and December of 2016. Patients with cleft-related dentofacial deformities were included in the study.

Results:

Forty-one patients with cleft-related dentofacial deformities were included. The distance from the nasion to the incisor tip was 76.70 mm; the angle of the lines connecting the sella, nasion, and point A was 74.03 degrees; and the incisor show was 1.02 mm. Corresponding measurements in 40 patients without clefts were 81.57 mm, 80.08 degrees, and 3.38 mm, respectively. Postoperatively, the average vertical lengthening achieved was 0.88 mm in the simple maxillary advancement group and 7.65 mm in the intentional vertical lengthening accompanied by maxillary advancement group.

Conclusion:

The authors’ results suggest that simultaneous maxillary vertical lengthening with horizontal advancement is a viable approach to orthognathic surgery for cleft-related deformities, given the long-term stability of outcomes demonstrated in this study.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Lipopeptide PAM3CYS4 Synergizes N-Formyl-Met-Leu-Phe (fMLP)-Induced Calcium Transients in Mouse Neutrophils
Authors: Ding Renyu , Xu Ganqiong , Feng Yan , Zou Lin , Chao Wei
Published: November 2017

N-Formyl-Met-Leu-Phe (fMLP), a mimic of N-formyl oligopeptides that are released from bacteria, is a potent leukocyte chemotactic factor. It induces intracellular calcium ([Ca2+]i) transient that is important for various neutrophil biological functions, e.g., adhesion, ROS, and cytokine productions. Toll-like receptors (TLRs), an essential part of host innate immunity, regulate neutrophil activities, but their role in [Ca2+]i signaling is less clear. In the present study, we examined the effect of several TLR ligands, including Pam3Cys4 (TLR1/2), lipopolysaccharide (LPS, TLR4), and lipoteichoic acid (LTA, TLR2/6), on calcium signaling and on the fMLP-induced [Ca2+]i transients in mouse neutrophils loaded with Fura-2/AM. We found that unlike fMLP, the three TLR ligands tested did not elicit any detectable Ca2+ flux. However, Pam3Cys4, but not LPS or LTA, markedly synergized the fMLP-induced [Ca2+]i transients, and had no effect on the host component keratinocyte-derived cytokine (KC)- or C5a-induced calcium flux. The effect of Pam3Cys4 on the fMLP-induced [Ca2+]i transients is by enhancing extracellular Ca2+ influx, not intracellular Ca2+ release. Surprisingly, deletion of TLR2 or MyD88 in neutrophils had no impact on the Pam3Cys4's effect, suggesting a TLR2-MyD88-independent mechanism. Finally, using the pan PKC activator and inhibitor, we demonstrated that PKC negatively regulated fMLP-induced [Ca2+]i transients and that inhibition of PKC did not prohibit Pam3Cys4's synergistic effect on the fMLP-induced calcium influx. In conclusion, the present study identified a novel synergistic effect of Pam3Cys4 on fMLP-induced [Ca2+]i transients, a process important for many neutrophil biological functions.
Predictive ability and interobserver reliability of computed tomography findings for angioembolization in patients with pelvic fracture
Authors: Yoshikawa Shunsuke , Shiraishi Atsushi , Kishino Mitsuhiro , Honda Makiko , Urushibata Nao , Sekiya Kosuke , Shoko Tomohisa , Otomo Yasuhiro
Published: November 2017

BACKGROUND

The purpose of this study was to identify computed tomography (CT) findings that predict the need for angioembolization in patients with pelvic fracture.

METHODS

This retrospective cross-sectional study was performed between April 2006 and October 2015 at two urban emergency medical centers in Japan. The study included patients who underwent CT within 3 hours of arrival and were diagnosed with a pelvic fracture. The study outcome was undergoing angioembolization within 24 hours of arrival. Four independent readers blinded to all clinical information interpreted the CT scans for blush, thickness of retroperitoneal hematoma, and diameter and laterality of muscle swelling around the pelvis. Receiver operating characteristics analyses provided area under the receiver-operating characteristic curves (AUROC) and diagnostic indicators at the estimated thresholds including sensitivity, specificity, positive and negative predictive values and diagnostic odds ratio (DOR). The interobserver reliability of all radiographic findings was also evaluated.

RESULTS

Fifty-two of 244 eligible patients underwent angioembolization. The predictive ability in terms of DOR was relatively better with blush on CT scan (sensitivity, 0.57; specificity, 0.86; DOR, 8.05) than with laterality of muscle swelling of 12.9 mm or greater (sensitivity, 0.79; specificity, 0.55; DOR, 4.60; AUROC, 0.75) and thickness of retroperitoneal hematoma of 22.7 mm or greater (sensitivity, 0.65; specificity, 0.74; DOR, 5.39; AUROC, 0.73). The interobserver reliability of blush, laterality of muscle swelling, and thickness of retroperitoneal hematoma was 0.43, 0.54, and 0.70, respectively.

CONCLUSION

All of the tested CT findings failed to show both sufficient predictive ability and sufficient interobserver agreement. Further diagnostic accuracy studies to validate these findings or establish a prediction model incorporating these findings are expected.

LEVEL OF EVIDENCE

Diagnostic, level V.
Soluble Aβ aggregates can inhibit prion propagation
Authors: Sarell Claire J. , Quarterman Emma , Yip Daniel C.-M. , Terry Cassandra , Nicoll Andrew J. , Wadsworth Jonathan D. F. , Farrow Mark A. , Walsh Dominic M. , Collinge John
Published: November 2017

Mammalian prions cause lethal neurodegenerative diseases such as Creutzfeldt–Jakob disease (CJD) and consist of multi-chain assemblies of misfolded cellular prion protein (PrPC). Ligands that bind to PrPCcan inhibit prion propagation and neurotoxicity. Extensive prior work established that certain soluble assemblies of the Alzheimer's disease (AD)-associated amyloid β-protein (Aβ) can tightly bind to PrPC, and that this interaction may be relevant to their toxicity in AD. Here, we investigated whether such soluble Aβ assemblies might, conversely, have an inhibitory effect on prion propagation. Using cellular models of prion infection and propagation and distinct Aβ preparations, we found that the form of Aβ assemblies which most avidly bound to PrPin vitroalso inhibited prion infection and propagation. By contrast, forms of Aβ which exhibit little or no binding to PrP were unable to attenuate prion propagation. These data suggest that soluble aggregates of Aβ can compete with prions for binding to PrPCand emphasize the bidirectional nature of the interplay between Aβ and PrPCin Alzheimer's and prion diseases. Such inhibitory effects of Aβ on prion propagation may contribute to the apparent fall-off in the incidence of sporadic CJD at advanced age where cerebral Aβ deposition is common.
Niclosamide loaded biodegradable chitosan nanocargoes: an
in vitro
study for potential application in cancer therapy
Authors: Naqvi Saba , Mohiyuddin Shanid , Gopinath P.
Published: November 2017

Chitosan nanoparticles can advance the pharmacological and therapeutic properties of chemotherapeutic agents by controlling release rates and targeted delivery process, which eliminates the limitations of conventional anti-cancer therapies and they are also safe as well as cost-effective. The aim of present study is to explore the anti-tumour effect of niclosamide in lung and breast cancer cell lines using biocompatible and biodegradable carrier where nanoparticles loaded with hydrophobic drug (niclosamide) were synthesized, characterized and applied as a stable anti-cancer agent. Niclosamide loaded chitosan nanoparticles (Nic-Chi Np's) of size approximately 100–120 nm in diameter containing hydrophobic anti-cancer drug, i.e. niclosamide, were prepared. Physico-chemical characterization confirms that the prepared nanoparticles are spherical, monodispersed and stable in aqueous systems. The therapeutic efficacy of Nic-Chi Np's was evaluated against breast cancer cell line (MCF-7) and human lung cancer cell line (A549). MTT assay reveals the cell viability of the prepared Nic-Chi Np's against A549 and MCF-7 cells and obtained an IC
50
value of 8.75 µM and 7.5 µM, respectively. Acridine orange/ethidium bromide dual staining results verified the loss of the majority of the cells by apoptosis. Flow cytometer analysis quantified the generation of intracellular reactive oxygen species (ROS) and signified that exposure to a higher concentration (2 × IC
50
) of Nic-Chi Np's resulted in elevated ROS generation. Notably, Nic-Chi Np treatment showed more apoptosis and cell death in MCF-7 as compared to A549. Further, the remarkable induction of apoptosis by Nic-Chi Np's was confirmed by semi-quantitative reverse transcription polymerase chain reaction, scanning electron microscopy and cell-cycle analysis. Thus, Nic-Chi Np's may have a great potential even at low concentration for anti-cancer therapy and may replace or substitute more toxic anti-mitotic drugs in the near future.
Motion of glossy objects does not promote separation of lighting and surface colour
Authors: Lee Robert J. , Smithson Hannah E.
Published: November 2017

The surface properties of an object, such as texture, glossiness or colour, provide important cues to its identity. However, the actual visual stimulus received by the eye is determined by both the properties of the object and the illumination. We tested whether operational colour constancy for glossy objects (the ability to distinguish changes in spectral reflectance of the object, from changes in the spectrum of the illumination) was affected by rotational motion of either the object or the light source. The different chromatic and geometric properties of the specular and diffuse reflections provide the basis for this discrimination, and we systematically varied specularity to control the available information. Observers viewed animations of isolated objects undergoing either lighting or surface-based spectral transformations accompanied by motion. By varying the axis of rotation, and surface patterning or geometry, we manipulated: (i) motion-related information about the scene, (ii) relative motion between the surface patterning and the specular reflection of the lighting, and (iii) image disruption caused by this motion. Despite large individual differences in performance with static stimuli, motion manipulations neither improved nor degraded performance. As motion significantly disrupts frame-by-frame low-level image statistics, we infer that operational constancy depends on a high-level scene interpretation, which is maintained in all conditions.
Spatial correlated games
Authors: Alonso-Sanz Ramón
Published: November 2017

This article studies correlated two-person games constructed from games with independent players as proposed in Iqbal
et al.
(2016
R. Soc. open sci.
3
, 150477. (
doi:10.1098/rsos.150477
)). The games are played in a collective manner, both in a two-dimensional lattice where the players interact with their neighbours, and with players interacting at random. Four game types are scrutinized in iterated games where the players are allowed to change their strategies, adopting that of their best paid mate neighbour. Particular attention is paid in the study to the effect of a variable degree of correlation on Nash equilibrium strategy pairs.
Vertical transmission of Salmonella enterica serotype Paratyphi A leading to abortion
Authors: Sethi Shveta , Gautam Vikas , Gupta Kirti , Suri Vanita , Angrup Archana
Published: November 2017

Introduction. Enteric fever, caused by Salmonella enterica serotype Typhi (typhoid fever) or S. enterica serotype Paratyphi A, B or C (paratyphoid fever), is a major health problem in developing countries. Vertical transmission of Salmonella can cause miscarriage, still birth, preterm labour and neonatal sepsis. In the literature, many cases of vertical transmission of S. enterica Typhi from mother to foetus have been reported, but there are very limited studies showing vertical transmission of S. enterica Paratyphi.

Case presentation. Here, we report a rare case of S. enterica serotype Paratyphi A infection in a pregnant woman resulting in a spontaneous miscarriage. S. enterica serotype Paratyphi A was isolated from placental membrane in culture.

Conclusion. A high index of suspicion, along with timely cultures of relevant samples, like blood and stool, and timely initiation of antibiotic therapy in pregnancy could possibly save the lives of such foetuses.
Mutations in C11ORF70 cause primary ciliary dyskinesia with randomization of left/right body asymmetry due to outer and inner dynein arm defects
Authors: Höben Inga M. , Hjeij Rim , Olbrich Heike , Dougherty Gerard W. , Menchen Tabea , Aprea Isabella , Frank Diana , Pennekamp Petra , Dworniczak Bernd , Wallmeier Julia , Raidt Johanna , Nielsen Kim Gjerum , Philipsen Maria C. , Santamaria Francesca , Venditto Laura , Amirav Israel , Prenzel Freerk , Wu Kaman , Schmidts Miriam , Loges Niki T. , Omran Heymut
Published: November 2017

Primary ciliary dyskinesia (PCD) is characterized by chronic airway disease, male infertility and randomization of the left/right body axis caused by defects of motile cilia and sperm flagella. We identified loss-of-function mutations in the open reading frame C11ORF70 in PCD individuals from five distinct families. Transmission electron microscopy analyses and high resolution immunofluorescence microscopy demonstrate that loss-of-function mutations in C11ORF70 cause immotility of respiratory cilia and sperm flagella, respectively, due to loss of axonemal outer (ODAs) and inner dynein arms (IDAs), indicating that C11ORF70 is involved in cytoplasmic assembly of dynein arms. Expression analyses of C11ORF70 showed that C11ORF70 is expressed in ciliated respiratory cells and that the expression of C11ORF70 is upregulated during ciliogenesis, similar to other previously described cytoplasmic dynein arm assembly factors. Furthermore, C11ORF70 shows an interaction with cytoplasmic ODA/IDA assembly factor DNAAF2, supporting our hypothesis that C11ORF70 is a novel preassembly factor involved in the pathogenesis of PCD. The identification of a novel genetic defect that causes PCD and male infertility is of great clinical importance as well as for genetic counselling.
Genomes from uncultivated prokaryotes: a comparison of metagenome-assembled and single-amplified genomes
Authors: Alneberg Johannes , Karlsson Christofer M. G. , Divne Anna-Maria , Bergin Claudia , Homa Felix , Lindh Markus V. , Hugerth Luisa W. , Ettema Thijs JG. , Bertilsson Stefan , Andersson Anders F. , Pinhassi Jarone
Published: November 2017

Background

Prokaryotes dominate the biosphere and regulate biogeochemical processes essential to all life. Yet, our knowledge about their biology is for the most part limited to the minority that has been successfully cultured. Molecular techniques now allow for obtaining genome sequences of uncultivated prokaryotic taxa, facilitating in-depth analyses that may ultimately improve our understanding of these key organisms.

Results

We compared results from two culture-independent strategies for recovering bacterial genomes: single-amplified genomes and metagenome-assembled genomes. Single-amplified genomes were obtained from samples collected at an offshore station in the Baltic Sea Proper and compared to previously obtained metagenome-assembled genomes from a time series at the same station. Among 16 single-amplified genomes analyzed, seven were found to match metagenome-assembled genomes, affiliated with a diverse set of taxa. Notably, genome pairs between the two approaches were nearly identical (>98.7% identity) across overlapping regions (30-80% of each genome). Within matching pairs, the single-amplified genomes were consistently smaller and less complete, whereas the genetic functional profiles were maintained. For the metagenome-assembled genomes, only on average 3.6% of the bases were estimated to be missing from the genomes due to wrongly binned contigs; the metagenome assembly was found to cause incompleteness to a higher degree than the binning procedure.

Conclusions

The strong agreement between the single-amplified and metagenome-assembled genomes emphasizes that both methods generate accurate genome information from uncultivated bacteria. Importantly, this implies that the research questions and the available resources are allowed to determine the selection of genomics approach for microbiome studies.
A proof-of-principle study of the effect of combined haloperidol and levodopa administration on working memory-related brain activation in humans
Authors: Van Ruitenbeek Peter , Hernaus Dennis , Mehta Mitul Ashok
Published: November 2017

Background and Purpose

Cognitive deficits including impaired working memory are a hallmark feature of schizophrenia. Changes in prefrontal cortex function modulated by dopamine D1 receptors, play a potentially important role in the pathology underlying such deficits. However, pharmacological interventions that selectively engage the D1 receptor are severely restricted for research in humans. The present study is a proof-of-principle for enhancing cognitive performance and associated brain activation via indirect D1 stimulation. Here, we combine the non-selective dopamine agonist L-dopa with the D2-antagonist haloperidol, theoretically producing increased stimulation at the D1 receptor.

Experimental Approach

Fourteen healthy volunteers received placebo or combined carbidopa (125 mg, 100mg L-dopa) plus haloperidol (2 mg) orally on two separate occasions according to a within-subjects cross-over design. Drug-induced differences in brain activity were assessed during an N-back working memory task in a 3T magnetic resonance imaging environment.

Key Results

Drug treatment was associated with a reduction in activity in a large number of brain areas, most prominently occipital/temporal brain areas during 2-back performance, which may be due to the effects of haloperidol specifically. Drug treatment was also associated with greater functional connectivity within parts of the salience network during all N-back trials.

Conclusion and Implications

This preliminary study provides initial evidence for combined L-dopa/haloperidol modulation in cognition-related brain areas and networks, which is relevant for the treatment of cognitive impairments in mental illness.
The Habc Domain of Syntaxin 3 is a Ubiquitin Binding Domain with Specificity for K63-Linked Poly-Ubiquitin Chains
Authors: Giovannone Adrian J. , Reales Elena , Bhattaram Pallavi , Nackeeran Sirpi , Monahan Adam B. , Syed Rashid , Weimbs Thomas
Published: November 2017

Syntaxins are a family of membrane-anchored SNARE proteins that are essential components required for membrane fusion in all eukaryotic intracellular membrane trafficking pathways. Syntaxins contain an N-terminal regulatory domain, termed the Habc domain, that is not highly conserved at the primary sequence level but folds into a three-helix bundle that is structurally conserved among family members. The syntaxin Habc domain has previously been found to be structurally very similar to the GAT domain present in GGA family members and related proteins that are otherwise completely unrelated to syntaxins. Because the GAT domain has been found to be a ubiquitin binding domain we hypothesized that the Habc domain of syntaxins may also bind to ubiquitin. Here, we report that the Habc domain of syntaxin 3 (Stx3) indeed binds to monomeric ubiquitin with low affinity. This domain binds efficiently to K63-linked poly-ubiquitin chains within a narrow range of chain lengths but not to K48-linked poly-ubiquitin chains. Other syntaxin family members also bind to K63-linked polyubiquitin chains but with different chain length specificities. Molecular modeling suggests that residues of the GGA3-GAT domain known to be important for ionic and hydrophobic interactions with ubiquitin have equivalent, conserved residues within the Habc domain of Stx3. We conclude that the syntaxin Habc domain and the GAT domain are both structurally and functionally related, and likely share a common ancestry despite sequence divergence. Binding of K63-linked poly-ubiquitin chains to the Habc domain may regulate the function of syntaxins in membrane fusion or may suggest additional functions of this protein family.
Automated high throughput animal DNA metabarcode classification
Authors: Porter Teresita M. , Hajibabaei Mehrdad
Published: November 2017

Until now, there has been difficulty assigning names to animal barcode sequences isolated directly from eDNA in a rapid, high-throughput manner, providing a measure of confidence for each assignment. To address this gap, we have compiled nearly 1 million marker gene DNA barcode sequences appropriate for classifying chordates, arthropods, and flag members of other major eukaryote groups. We show that the RDP naïve Bayesian classifier can assign the same number of queries 19 times faster than the popular BLAST top hit method and reduce the false positive rate by two-thirds. As reference databases become more representative of current species diversity, confidence in taxonomic assignments should continue to improve. We recommend that investigators can improve the performance of species-level assignments immediately by supplementing existing reference databases with full-length DNA barcode sequences from representatives of local fauna.
Juvenile female rats, but not male rats, show renewal, reinstatement, and spontaneous recovery following extinction of conditioned fear
Authors: Park Chun Hui J. , Ganella Despina E. , Kim Jee Hyun
Published: November 2017

Anxiety disorders emerge early, and girls are significantly more likely to develop anxiety compared to boys. However, sex differences in fear during development are poorly understood. Therefore, we investigated juvenile male and female rats in the relapse behaviors following extinction of conditioned fear. In all experiments, 18-d-old rats first received three white-noise–footshock pairings on day 1. On day 2, extinction involved 60 white-noise alone trials. In experiment 1, we examined renewal by testing the rats in either the same or different context as extinction on day 3. Male rats did not show renewal, however, female rats showed renewal. Experiment 2 investigated reinstatement by giving rats either a mild reminder footshock or context exposure on day 3. When tested the next day, male rats did not show reinstatement, whereas female rats showed reinstatement. Experiment 3 investigated spontaneous recovery by testing the rats either 1 or 5 d following extinction. Male rats did not show any spontaneous recovery whereas female rats did. Taken together, fear regulation appear to be different in males versus females from early in development, which may explain why girls are more prone to suffer from anxiety disorders compared to boys.
A new high-pressure polymorph of phosphoric acid
Authors: Bull Craig L. , Funnell Nicholas P. , Pulham Colin R. , Marshall William G. , Allan David R.
Published: November 2017

The high-pressure structural behaviour of phosphoric acid is described. A compression study of the monoclinic phase, using neutron powder diffraction and X-ray single-crystal diffraction, shows that it converts to a previously unobserved orthorhombic phase on decompression. Compression of this new phase is reported up to 6.3 GPa. The orthorhombic phase is found to be more efficiently packed, with reduced void space, resulting in a larger bulk modulus. Molecule–molecule interaction energies reveal a more extensive network of increased attractive forces in the orthorhombic form relative to the monoclinic form, suggesting greater thermodynamic stability.