bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Primary and Secondary Anterior Septal Reconstruction: A Cohort Study
Authors: Spataro Emily , Olds Cristen , Nuyen Brian , Kandathil Cherian , Most Sam
Published: December 2018

This article compares outcomes in patients presenting for either primary or secondary (revision) anterior septal reconstruction (ASR) to treat caudal septal deviation. Patients undergoing ASR by senior author (S. P. M.) between January 1, 2012 and September 1, 2017, with both preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE) scores documented in the chart were included. Data were compared between patients undergoing primary and secondary ASR by univariable and multivariable logistic regression. A total of 199 patients were included in this study; 128 (64%) underwent primary ASR and 71 (36%) underwent secondary ASR. After multivariable analysis, a greater ratio of females and autologous rib graft harvest in the secondary compared with primary ASR, and decreased odds of inferior turbinate reduction in the secondary group was found. There was no significant difference in NOSE scores between the primary and secondary group, and there were very few complications or revision surgeries. While outcomes are similar between primary and secondary (revision) ASR to treat caudal septal deviation, there was a significantly higher rate of autologous rib harvest, highlighting the importance of addressing deviations of the caudal septum at the primary procedure to reduce morbidity related to rib graft harvest and revision surgery.
Contemporary Trends in the Surgical Management of Nasal Septal Perforations: A Community Survey
Authors: Kridel Russell , Delaney Sean
Published: December 2018

There currently exists an overabundance of publications advocating different septal perforation repair methods. The objective of this article was to examine the preponderance of techniques and trends in the surgical management of septal perforations in the practices of otolaryngologists, rhinologists, and facial plastic surgeons. The study was designed as a multicenter cross-sectional survey. The participants were members of the American Academy of Facial Plastic and Reconstructive Surgery and the American Rhinologic Society. Septal perforation closure rates and perforation repair approach, technique, and interposition graft material preferences were the main outcomes. A total of 320 respondents completed the survey, of whom 75% performed perforation repairs. The success rates in closing perforations < 1 cm, 1–2 cm, and > 2 cm were 84%, 64%, and 31%, respectively. The respondents had a similar preference for the endoscopic (52%) and external rhinoplasty (49%) approaches, followed by the endonasal approach (43%). Bilateral intranasal mucosal advancement flaps (79%) and unilateral intranasal mucosal rotational or advancement flaps (60%) were the favored repair techniques. Most respondents (84%) incorporated an interposition graft and intranasal splints (89%) for the repair, and the most popular interposition graft material was acellular dermis (63%). The self-reported perforation closure success rates in this survey were lower than those published in the literature, a phenomenon possibly explained by the premise that surgeons with favorable outcomes are more apt to share their results. The preferred surgical approach was evenly distributed between the external rhinoplasty and endoscopic approaches and influenced by a surgeon's training, perforation size and location, and the need for concomitant rhinoplasty. This study is the first to characterize contemporary community trends in the surgical closure of septal perforations and demonstrates that while preference for perforation repair approach among the respondents varied, surgeons favored septal perforation repair using bilateral intranasal mucosal advancement flaps with an interposition graft.
Disparities in NOSE Scores and Surgical Approaches among Patients Undergoing Functional Rhinoplasty
Authors: Gray Mingyang , Rousso Joseph , Hirsch Matthew , Rosenberg Joshua , Rozanski Collin
Published: December 2018

Social determinants of health have been widely studied throughout medicine; however, their role relating to functional rhinoplasty has not been previously evaluated. The records of 178 patients who underwent functional rhinoplasty in a single health network from 2013 to 2016 were reviewed. The Nasal Obstruction Symptom Evaluation (NOSE) score was used to assess patient-reported symptoms, and patients with both preoperative and postoperative NOSE scores were included in this study. Basic demographics and surgical techniques were also collected. Differences between NOSE scores and surgical approaches to functional rhinoplasty on the basis of insurance type were measured. One hundred and sixteen patients were included for analysis, the mean age was 34.7 years (standard deviation [SD] = 16.2) and 57 (49.1%) were female. Twenty-one (18.1%) patients had public insurance and, of these, 18 patients had Medicaid. Patients (mean, SD) with Medicaid insurance (56.39, 15.6) had a slightly greater improvement in NOSE scores compared with patients with non-Medicaid insurance (47.90, 25.6) (p = 0.067). There was no statistically significant difference in preoperative NOSE scores or postoperative improvement in NOSE scores between patients with different health insurance. Furthermore, there was no statistically significant difference in surgical approaches. The majority of patients receiving functional rhinoplasty had private insurance. Medicaid patients trended toward a greater NOSE score improvement after functional rhinoplasty, but also had a closer association with a history of nasal trauma and prior surgery. Future study is needed to better understand the association between socioeconomic status and disparities in care. Understanding how social determinants of health affect patients may reveal potential inherent biases, improve delivery of care, and translate to better patient outcomes.
Musculoskeletal Considerations in Female Patients with Chronic Pelvic Pain
Authors: Carrillo Jorge , Witzeman Kathryn , Alappattu Meryl , Lamvu Georgine
Published: December 2018

Persistent pelvic pain conditions are common and affect nearly 25% of the female U.S. population. In a sizable proportion of pelvic pain patients, the pain is caused by musculoskeletal dysfunction; yet, healthcare providers do not routinely evaluate patients for musculoskeletal etiologies. This article provides an overview of the pathophysiology of persistent pelvic pain, as it relates to musculoskeletal disorders. The symptomatology, anatomy, evaluation, and treatment of these disorders are summarized specifically for healthcare providers (including gynecologists) who do not have pelvic musculoskeletal expertise.
Interventional Pain Management and Female Pelvic Pain: Considerations for Diagnosis and Treatment
Authors: Smith Sadie , Eckert Jill
Published: December 2018

Chronic pelvic pain (CPP) is a recurring and/or constant pain of at least six months duration that has resulted in either functional or psychological disability that can require interventional treatments. Chronic pelvic pain can be visceral, somatic, neuropathic, or a combination. Patients with CPP often suffer from concurrent bowel or bladder dysfunction, sexual dysfunction, depression, and anxiety. The complexity of chronic pelvic pain can be challenging to treat, which can lead to frustration for both patients and their physicians. Treatment should involve a comprehensive and multi-modal approach involving psychosocial support, counseling, physical therapy, medication management, and interventional procedures. This manuscript will focus both on the etiologies and the interventional treatment options for chronic pelvic pain.
The Effects of Resection Technique on Implant Migration in Single Radius Posterior-Stabilized Total Knee Replacement
Authors: Teeter Matthew G. , Perry Kevin , Yuan Xunhua , Howard James L. , Lanting Brent A.
Published: December 2018

The purpose of the present study was to measure the effects of gap balancing and resection techniques on migration of a single total knee replacement implant design. A total of 23 patients (24 knees) were recruited on referral to either a surgeon performing gap balancing or a surgeon performing measured resection and followed prospectively. All patients received a fixed bearing, posterior stabilized total knee replacement implant of a single radius femoral component design with cement fixation, and all aspects of care outside of resection technique were identical. Patients underwent radiostereometric analysis (RSA) at 2 weeks (baseline), 6 weeks, 3 months, 6 months, 1 year, and 2 years. Migration of the tibial and femoral components was compared between groups. Tibial component migration was greater at 2 years in the gap balancing group (mean difference = 0.336 mm, p = 0.036), but there was no difference at 1 year. One measured resection and three gap balancing tibial components demonstrated continuous migration > 0.2 mm between years 1 and 2. There was no difference in femoral component migration. Small differences in tibial component migration were found between the gap balancing and measured resection techniques. However, comparing the migration to established predictive thresholds for long-term loosening risk, implants performed with both techniques were found to have equally low revision risk.
Infant Feeding Practices and Perceived Optimal Breastfeeding Interventions among Low-Income Women Delivering at a Baby-Friendly Hospital
Authors: Lewkowitz Adam K. , Raghuraman Nandini , López Julia D. , Macones George A. , Cahill Alison G.
Published: December 2018

Objective To determine infant feeding practices of low-income women at a Baby-Friendly Hospital and to ascertain breastfeeding interventions they believe would increase exclusive breastfeeding.

Study Design This cross-sectional study occurred at a tertiary care Baby-Friendly Hospital. Low-income women without breastfeeding contraindications were recruited at scheduled obstetrician/gynecologist appointments within 6 to 9 months of delivering a term, nonanomalous infant. Participants completed a survey. Outcomes included infant feeding patterns and perceived usefulness of proposed breastfeeding interventions.

Results Of 149 participants, 129 (86.6%) initiated breastfeeding; by postpartum day 2 (PPD2), 47 (31.5%) exclusively breastfed, 51 (34.2%) breastfed with formula, and 51 (34.2%) exclusively formula fed. On a scale of 1 (“strongly agree”) to 5 (“strongly disagree”), women who supplemented with formula on PPD2 were significantly more likely than those who exclusively formula fed to agree education on neonatal behavior, 1 (interquartile range [IQR] 1, 2) versus 2 (IQR 1, 3); p = 0.026 and on-demand access to breastfeeding videos on latch or positioning, 1 (IQR 1, 2) versus 2 (IQR 1, 3), p = 0.043; 1 (IQR 1, 2) versus 2 (IQR 1, 3), p = 0.021, respectively, would have helped them exclusively breastfeed.

Conclusion Though low-income women at a Baby-Friendly Hospital had high breastfeeding initiation rates, the majority used formula by PPD2. To increase breastfeeding rates among low-income women, future interventions should provide appropriate and effective breastfeeding interventions.
Vorsicht bei Patientenfotos und Videodokumentation im Vortrag, bei Publikationen oder auf der Praxishomepage
Authors: Sailer R. , Wienke A.
Published: December 2018

Bei medizinisch-wissenschaftlichen Vorträgen, bei ärztlichen Fort- und Weiterbildungsveranstaltungen, in Fachzeitschriften und auch in der medizinischen Forschung werden regelmäßig Abbildungen von Patienten zur Veranschaulichung von Krankheitsbildern, Behandlungsverfahren oder intraoperativer Situationen verwendet. Dies geschieht in Form der Präsentation von Röntgenbildern, intraoperativen Foto- oder Videoaufnahmen oder Bildern von Körperteilen. Auch bei der Darstellung einzelner ärztlicher Tätigkeiten oder Behandlungsverfahren ist es jedenfalls für bestimmte Eingriffe zulässig, Vorher- und Nachher-Bilder von Patienten auf der Praxishomepage zu veröffentlichen oder in der Praxis oder bei Vorträgen vorzustellen. Die Verwendung und Präsentation solcher Bilder von Patienten oder Abbildungen von Körperteilen ist gerade in der ärztlichen Ausbildung, bei Vorträgen und auch in wissenschaftlichen Publikationen geradezu an der Tagesordnung und selbstverständlich. Dennoch sollte man sich dabei im Klaren darüber sein, dass die Rechte der abgebildeten Persönlichkeiten und derjenigen, welche die Abbildungen (Fotos, Röntgenbilder etc.) hergestellt haben, nicht verletzt werden dürfen. Welche Aspekte hierbei zu beachten sind und wie man sich vor Ansprüchen Dritter auf Unterlassung und Schadensersatz am besten schützen kann, stellen wir im nachfolgenden Beitrag vor:
Nicht nur in den Rachen geschaut – HNO-Infektionen im Kindesalter
Authors: Prelog M.
Published: December 2018

HNO-Infektionen stellen eine der häufigsten Ursachen (70 %) für die Vorstellung beim Pädiater dar. Unkomplizierte obere Atemwegsinfektionen imponieren oft als Rhinitis, Pharyngitis oder Laryngitis und werden zu 90–95 % durch etwa 200 verschiedene Viren verursacht, wobei Rhinoviren, Respiratory-syncitial-(RS)-, Influenza-, Parainfluenza, Adeno-, Coronaviren, humanes Metapneumovirus, Enteroviren und das humane Boca-virus zu den häufigsten Erregern gehören. Von den 5–10 % bakteriell verursachten Infektionen sind als häufigste Erreger Str. pneumoniae, H. influenzae, M. catarrhalis, St. aureus und Str. pyogenes zu nennen. Die Diagnose ist eine Zusammenschau aus Anamnese, klinischer Befunde und der epidemiologischen Situation, eine mikrobiologische Diagnostik ist selten gerechtfertigt. Die Behandlung erfolgt meist symptomatisch, bei bakteriellen Infektionen häufig antibiotisch. Risikofaktoren für einen komplizierten Verlauf sind das erste Lebensjahr, Frühgeburtlichkeit, Immundefekte und schwere chronische Krankheiten. Als Prophylaxe steht die Vermeidung der Erregertransmission (Tröpfchen oder Schmierinfektion) im Vordergrund.
Relationship between specific heat, valence and effective magnetic moment of Sm ions in strongly correlated Sm compounds
Authors: Higashinaka Ryuji , Yamada Akira , Matsuda Tatsuma D. , Aoki Yuji
Published: December 2018

Strongly-correlated electron states emerging in cubic Sm-based compounds, e.g., SmOs4Sb12 and Sm Tr2Al20 (Tr: transition metal elements), have anomalous characteristics, like magnetic-field-insensitive heavy-fermion behaviors and strongly mixed valence of Sm ions. In this paper, we compare key physical parameters of these compounds. The results reveal the existence of the following novel features: (i) the electronic specific heat coefficient γ shows a significant inverse correlation with the effective magnetic moment μeff (γ∼1/μeff2), and (ii) largely enhanced γ appears in intermediate Sm valance states around ∼ +2.8. Other remarkable features are the absence of enhanced Pauli paramagnetism at low temperatures and largely suppressed μeff (down to ∼0.1 μB). These are quite different from those of Ce-based heavy-fermion compounds, pointing to an unconventional mechanism for the formation of Sm-based heavy quasiparticles, possibly caused by complex hybridization processes associated with multi-4 f-electrons of a Sm ion.
Deprivation and inequalities lead to worse outcomes with dabigatran etexilate
Authors: Simpson Bryan H. , Reith David , Medlicott Natalie J. , Smith Alesha
Published: December 2018

ABSTRACT

INTRODUCTION
Dabigatran etexilate is now prescribed for 51% of the patients receiving oral anticoagulation treatment in New Zealand. Its prescribing trends in relation to patient outcomes are, however, largely unknown for these patients.

AIM
To describe patient characteristics, effectiveness and safety of treatment with dabigatran etexilate in the New Zealand population.

METHODS
This retrospective cohort study used administrative health data for patients dispensed dabigatran etexilate between 1 July 2011 and 31 December 2015. Adverse events (haemorrhage) and treatment failure (thromboembolism or cerebrovascular accident) data were extracted and linked to patient-specific demographic data. Baseline patient characteristics were analysed with descriptive statistics to examine trends in dabigatran etexilate prescribing. Raw and adjusted hazard ratios (HRs), including covariates, were derived using Cox proportional hazard models.

RESULTS
In total, 52,413 patients were dispensed dabigatran etexilate. Multivariate analysis indicated the risk of haemorrhagic events were significantly increased for Māori (HR and 95% Confidence Interval (CI): 2.10 (1.54–2.86)) and Pacific Peoples (HR = 2.20 (1.49–3.24)); those aged >80 years (HR = 1.25 (1.08–1.43)); and more deprived populations in quintile 4 (HR = 1.24 (1.08–1.43)) and quintile 5 (HR = 1.30 (1.12–1.50)). There was an increased risk of thromboembolism and cerebrovascular accident among people aged >80 years (HR = 1.79 (1.49–2.15)).

DISCUSSION
Demographic factors are associated with adverse outcomes in patients treated with dabigatran etexilate. Targeted strategies are needed to prescribe dabigatran etexilate more appropriately in these populations.
Rural point-of-care ultrasound of the kidney and bladder: quality and effect on patient management
Authors: Nixon Garry , Blattner Katharina , Muirhead Jill , Kerse Ngaire
Published: December 2018

ABSTRACT

INTRODUCTION
Point-of-care ultrasound (POCUS) of the kidney and bladder are among the most commonly performed POCUS scans in rural New Zealand (NZ).

AIM
To determine the quality, safety and effect on patient care of POCUS of the kidney and bladder in rural NZ.

METHODS
Overall, 28 doctors in six NZ rural hospitals completed a questionnaire both before and after undertaking a POCUS scan over a 9-month period. The clinical records and saved ultrasound images were reviewed by a specialist panel.

RESULTS
The 28 participating doctors undertook 138 kidney and 60 bladder scans during the study. POCUS of the bladder as a test for urinary retention had a sensitivity of 100% (95% CI 88–100) and specificity of 100% (95% CI 93–100). POCUS of the kidney as a test for hydronephrosis had a sensitivity 90% (95% CI 74–96) and specificity of 96% (95% CI 89–98). The accuracy of other findings such as renal stones and bladder clot was lower. POCUS of the bladder appeared to have made a positive contribution to patient care in 92% of cases without evidence of harm. POCUS of the kidney benefited 93% of cases, although in three cases (2%), it may have had a negative effect on patient care.

DISCUSSION
POCUS as a test for urinary retention and hydronephrosis in the hands of rural doctors was technically straightforward, improved diagnostic certainty, increased discharges and overall had a positive effect on patient care.
Research using electronic health records: Balancing confidentiality and public good
Authors: Wallis Katharine A. , Eggleton Kyle S. , Dovey Susan M. , Leitch Sharon , Cunningham Wayne K. , Williamson Martyn I.
Published: December 2018

ABSTRACTGeneral practitioners are increasingly approached to participate in research and share de-identified patient information. Research using electronic health records has considerable potential for improving the quality and safety of patient care. Obtaining individual patient consent for the use of the information is usually not feasible. In this article we explore the ethical issues in using personal health information in research without patient consent including the threat to confidentially and the doctor-patient relationship, and we discuss how the risks can be minimised and managed drawing on our experience as general practitioners and researchers.
Size, depth and position affect the diversity and structure of rock pool communities in an urban estuary
Authors: Schaefer Nina , Dafforn Katherine A. , Johnston Emma L. , Mayer-Pinto Mariana
Published: December 2018

Rock pools provide a range of ecological niches that can support diverse assemblages on rocky shores. As intertidal shores are increasingly lost to developments, understanding the drivers of diversity in rock pools is important for the conservation and construction of these key habitats. In this study we investigated relationships between physical characteristics of rock pools and their biota in an urban estuary. We sampled the biota every 6 weeks for 1 year at sites in the inner and outer zones of Sydney Harbour. In the well-flushed and exposed outer zone, sessile and mobile taxa richness was positively related to rock pool width, whereas only mobile taxa richness was related to depth and volume. In the more urbanised and less exposed inner zone, mobile taxa richness was positively related to rock pool width and volume. In both zones, sessile taxa richness decreased with increasing height on shore. Our results suggest that the biodiversity of intertidal rock pools varies depending on their position in Sydney Harbour and the available species pool. Therefore, restoration efforts should consider rock pool size parameters and local environmental conditions, including location, so designs can be optimised to maximise species diversity in these pools.
Local, transient tensile stress on the nuclear membrane causes membrane rupture
Authors: Zhang Qiao , Tamashunas Andrew C. , Agrawal Ashutosh , Torbati Mehdi , Katiyar Aditya , Dickinson Richard B. , Lammerding Jan , Lele Tanmay P.
Published: December 2018

Cancer cell migration through narrow constrictions generates compressive stresses on the nucleus that deform it and cause rupture of nuclear membranes. Nuclear membrane rupture allows uncontrolled exchange between nuclear and cytoplasmic contents. Local tensile stresses can also cause nuclear deformations, but whether such deformations are accompanied by nuclear membrane rupture is unknown. Here we used a direct force probe to locally deform the nucleus by applying a transient tensile stress to the nuclear membrane. We found that a transient (∼0.2 s) deformation (∼1% projected area strain) in normal mammary epithelial cells (MCF-10A cells) was sufficient to cause rupture of the nuclear membrane. Nuclear membrane rupture scaled with the magnitude of nuclear deformation and the magnitude of applied tensile stress. Comparison of diffusive fluxes of nuclear probes between wild-type and lamin-depleted MCF-10A cells revealed that lamin A/C, but not lamin B2, protects the nuclear membranes against rupture from tensile stress. Our results suggest that transient nuclear deformations typically caused by local tensile stresses are sufficient to cause nuclear membrane rupture.
Comparison of Leaf Moisture Content and Ignition Characteristics among Native Species and Exotic Conifers in Northwestern Patagonia, Argentina
Authors: Bianchi Lucas O , Oddi Facundo J , Muñoz Miriam , Defossé Guillermo E
Published: December 2018

The forest–steppe ecotone in Argentine Patagonia has been planted with non-native Pinus ponderosa, Pseudotsuga menziesii, Pinus radiata, and P. contorta. As in many other planted areas of the Southern Hemisphere, there is great concern about increasing landscape flammability. We determined, under lab conditions, live fuel moisture content (LFMC) and leaf ignition of these conifers, a naturalized poplar, and 13 native species. The mean LFMC was inversely related to leaf ignition of these species. The conifer LFMC was lower than that of most natives, making the conifers the most ignitable species. Pinus ponderosa and Pseudotsuga menziesii showed the spring dip phenomenon (i.e., low LFMC in early spring). Leaf ignition and LFMC may help elucidate some flammability components at species levels. At landscape scales, however, they have to be evaluated along with other landscape traits such as structure and stand composition. Understanding this landscape context will require full-scale experimental ﬁres. Nevertheless, our results provide useful information for fire danger assessment, and also for setting policies aimed at planning and applying appropriate silvicultural techniques for fire prevention and control, and hence reducing fire danger at stand or landscape levels.
A Note on 1-Motives
Authors: André Yves
Published: December 2018

We prove that for $1$-motives defined over an algebraically closed subfield of $\mathbf{C}$, viewed as Nori motives, the motivic Galois group coincides with the Mumford–Tate group. In particular, the Hodge realization of the Tannakian category of Nori motives generated by $1$-motives is fully faithful. This result extends an earlier result by the author, according to which Hodge cycles on abelian varieties are motivated (a weak form of the Hodge conjecture).
Pity the Exiled: Turkish Academics in Exile, the Problem of Compassion in Politics and the Promise of Dis-exile
Authors: Sertdemir Özdemir Seçkin
Published: December 2018

Grounded in the moral responsibility to help those who seek assistance and refuge, humanitarian-aid organizations occupy a central place in our contemporary social life. The question arises as to whether the humanitarian response can provide solutions for those exiled by political persecution. In interdisciplinary work in political philosophy and ethnography, I examine the experiences of politically exiled scholars from Turkey who have received temporary postdoctoral fellowships in European institutions of higher learning through ‘academics at risk’ organizations fashioned on humanitarian principles. Welcomed in their European hostlands as ‘victims’ of and ‘refugees’ from autocratic countries, these academics have become marginalized by an anonymizing victim–saviour discourse perfused with the moral sentiments of pity and compassion. Rejecting the emptying-out of their political agency and critical academic acumen by such humanitarian gestures, they have turned to strategies of ‘dis-exile’ that seek to reintroduce singularity, collective action and solidarity into the political realm.
Evaluation of Three Point-of-Care Tests for Detection of Toxoplasma Immunoglobulin IgG and IgM in the United States: Proof of Concept and Challenges
Authors: Gomez Carlos A , Budvytyte Laura N , Press Cindy , Zhou Lily , McLeod Rima , Maldonado Yvonne , Montoya Jose G , Contopoulos-Ioannidis Despina G
Published: December 2018

Background

The cost of conventional serological testing for toxoplasmosis discourages universal adoption of prenatal monthly screening programs to prevent congenital toxoplasmosis. Point-of-care (POC) technology may constitute a cost-effective approach.

Methods

We evaluated the diagnostic accuracy of 3 Toxoplasma POC tests against gold-standard testing performed at Palo Alto Medical Foundation Toxoplasma Serology Laboratory (PAMF-TSL). The POC tests included the following: Toxo IgG/IgM Rapid Test (Biopanda) and the OnSite Toxo IgG/IgM Combo-Rapid-test that detect IgG and IgM separately, and the Toxoplasma ICT-IgG-IgM-bk (LDBIO) that detects either or both immunoglobulin IgG/IgM in combination. Samples were selected from PAMF-TSL biobank (n = 210) and Centers for Disease Control and Prevention Toxoplasma 1998 Human Serum Panel (n = 100). Based on PAMF-TSL testing, Toxoplasma-infection status was classified in 4 categories: acute infections (n = 85), chronic infections (n = 85), false-positive Toxoplasma IgM (n = 60), and seronegative (n = 80). The POC testing was performed in duplicate following manufacturer’s instructions by investigators blinded to PAMF-TSL results. Sensitivity and specificity were calculated.

Results

A total of 1860 POC tests were performed. For detection of Toxoplasma IgG, sensitivity was 100% (170 of 170; 95% confidence interval [CI], 97.8%–100%) for all 3 POC kits; specificity was also comparable at 96.3% (77 of 80; 95% CI, 89.5%–98.9%), 97.5% (78 of 80; 95% CI, 91.3%–99.6%), and 98.8% (79 of 80; 95% CI, 93.2%–99.9%). However, sensitivity for detection of Toxoplasma IgM varied significantly across POC tests: Biopanda, 62.2% (51 of 82; 95% CI, 51.4%–71.9%); OnSite, 28% (23 of 82; 95% CI, 19.5%–38.6%); and LDBIO combined IgG/IgM, 100% (82 of 82; 95% CI, 95.5%–100%). Diagnostic accuracy was significantly higher for the LDBIO POC kit. The POC kits did not exhibit cross-reactivity for false-positive Toxoplasma-IgM sera.

Conclusions

The 3 evaluated POC kits revealed optimal sensitivity for Toxoplasma-IgG antibodies. The LDBIO-POC test exhibited 100% sensitivity for the combined detection of IgG/IgM in acute and chronic Toxoplasma infection. Biopanda and Onsite POC tests exhibited poor sensitivity for Toxoplasma-IgM detection.
Burden and Characteristics of the Comorbidity Tuberculosis—Diabetes in Europe: TBnet Prevalence Survey and Case-Control Study
Authors: Sane Schepisi Monica , Navarra Assunta , Altet Gomez M Nieves , Dudnyk Andrii , Dyrhol-Riise Anne Margarita , Esteban Jaime , Giorgetti Pier Francesco , Gualano Gina , Guglielmetti Lorenzo , Heyckendorf Jan , Kaluzhenina Anna , Lange Berit , Lange Christoph , Manika Katerina , Miah Jalal , Nanovic Zorica , Pontali Emanuele , Prego Monica Rios , Solovic Ivan , Tiberi Simon , Palmieri Fabrizio , Girardi Enrico
Published: December 2018

Background

The growing burden of diabetes mellitus (DM) is posing a threat to global tuberculosis (TB) control. DM triples the risk of developing TB, modifies the presenting features of pulmonary TB, and worsens TB treatment outcomes. We aimed to analyze the prevalence of DM among TB patients and to describe the characteristics and clinical presentation of TB-DM patients in Europe.

Methods

We performed a cross-sectional survey on the prevalence of DM among consecutively diagnosed adult TB patients in 11 European TB referral centers located in France, Germany, Greece, Italy, Russia, Slovakia, Spain, and the United Kingdom over the period 2007–2015. We also selected DM-TB cases and TB only controls with a 1:3 ratio to perform a case-control analysis, including patients selected from the countries mentioned above plus Norway and Ukraine.

Results

Among 3143 TB enrolled patients, DM prevalence overall was 10.7% and ranged from 4.4% in Greece to 28.5% in the United Kingdom. Patients’ median ages ranged from 36 to 49 years, and all centers had >60% males; the proportion of foreign-born patients varied widely across sites. In the case-control study, DM was independently associated with older age and, among older patients, with being foreign-born. Among patients with pulmonary involvement, cavities on chest imaging were more frequently observed among those with DM.

Conclusions

Diabetes mellitus represents a challenge for TB control in Europe, especially in foreign-born and in elderly patients. Specific screening strategies should be evaluated.
Microsurgical Resection of Low-Grade Spinal Cord Astrocytoma: 2-Dimensional Operative Video
Authors: Pojskić Mirza , Arnautović Kenan I
Published: December 2018

This video demonstrates microsurgical resection of low-grade (Grade I) thoracic spinal cord astrocytoma. Astrocytomas are the most common pediatric intramedullary tumors and occur secondary to ependymomas in adults.
1,2
The treatment goal should be radical gross total resection while preserving neurological function with intraoperative neuromonitoring.
2-4
To our knowledge, this is the first video report on microsurgical resection of low-grade spinal cord astrocytoma.

 A 58-yr-old female presented with gait disturbances has been featured in this video. A spinal MRI revealed T1/T2 hyperintense intramedullary tumor at T4, suggesting spinal cord astrocytoma versus ependymoma. Dura was opened in the midline and tacked to the surrounding muscle tissue with tacking sutures. The arachnoid was opened separately with microscissors, keeping it intact for closure at the end of surgery. Liga clips were applied to hold the arachnoid to the dura. Myelotomy was done in the midline,
5
opening the posterior median sulcus over the length of the tumor and extending proximally and distally a few millimeters beyond the tumor.
3,5
The tumor reduction was achieved by coagulation or debulking. Once sufficient debulking was achieved, dissection of the tumor margins toward surrounding cord was performed. Preoperative recording of motor-evoked potentials (MEPs) compared with continuous intraoperative MEPs were essential for preserving the neurological function and quality of life. The intraoperative finding of a clear tumor plane of resection carries positive prognostic significance and reduces the risk of complications.
2,3,6

 A pathohistological diagnosis showed a low-grade (Grade I) spinal cord astrocytoma (pilocytic). Follow-up MRI showed no sign of tumor or recurrence. The patient recovered fully and was neurologically intact.

Written consent was obtained directly from the patient.
Segregation and the Cost of Money: Race, Poverty, and the Prevalence of Alternative Financial Institutions
Authors: Faber Jacob William
Published: December 2018

Payday lenders, check cashers, and other “alternative” financial services (AFS) have garnered attention from policymakers and advocates for the poor because they are more expensive than traditional banking—constituting what some call a “Ghetto Tax.” This is the first study to explore neighborhood-level AFS geography on the national scale. Leveraging a dataset comprising the universe of AFS in 2015, I show that not only are there substantial differences in AFS presence between white and non-white neighborhoods, but that these disparities are largest in the most segregated metropolitan areas. This finding supports theories that racial segregation creates easily identifiable markets for institutions to avoid, target, and exploit. I further show that while AFS presence declines with neighborhood income, the gap between black and white neighborhoods is widest among high-income neighborhoods, reflecting the unique vulnerability of even affluent blacks to institutional marginalization. This work documents how the overlapping geographies of racial isolation and AFS prevalence shape the very cost of money for different racial groups, illustrating the importance of institutions transmitting the effects of racial isolation.
Effects of Syngenta Enogen Feed Corn containing an α-amylase trait on finishing cattle performance and carcass characteristics1
Authors: Jolly-Breithaupt M L , Harris M E , Nuttelman B L , Burken D B , MacDonald J C , Luebbe M K , Iragavarapu T K , Erickson G E
Published: December 2018

Two experiments evaluated the effects of feeding a new corn hybrid, containing an α-amylase enzyme trait, Syngenta Enogen Feed Corn (SYT-EFC), on feedlot performance and carcass characteristics at two locations. Experiment 1 utilized 300 calffed steers (298.5 ± 16.3 kg of BW) at the University of Nebraska–Lincoln Eastern Nebraska Research and Extension Center Mead, NE. Treatments were designed as a 2 × 2 + 1–factorial arrangement with factors consisting of 1) corn type (SYT-EFC or conventional [CON]) and 2) byproduct type (with or without Sweet Bran [SB]), or a BLEND of STY-EFC and CON without SB. In Exp. 2, 240 crossbred, calf-fed steers (287.6 ± 15.4 kg of BW) were utilized at the University of Nebraska–Lincoln Panhandle Research and Extension Center near Scottsbluff, NE. Steers were fed SYT-EFC, CON, BLEND, or CON with a commercial α-amylase enzyme supplement (CON-E). In Exp. 1, there was an interaction for ADG (P = 0.05) and G:F (P = 0.02). Steers fed SYT-EFC with SB had greater ADG and G:F than CON; however, in diets without SB, SYT-EFC and CON were not different resulting in a 10.1% change in G:F when steers were fed SYT-EFC in SB compared with CON and only 1.6% change between SYT-EFC and CON without SB. Energy values, based on performance data, resulted in a 6.5% and 8.3% change in NEm and NEg, respectively, for steers fed SYT-EFC and CON with SB and 1.6% change for both NEm and NEg for steers fed SYT-EFC and CON without SB. For the main effect of corn trait, steers fed SYT-EFC had greater marbling scores, fat depth, and calculated yield grade compared with CON (P ≤ 0.03). In diets without SB, there was no difference between SYT-EFC, CON, or BLEND for DMI, final BW, ADG, G:F, NEm, or NEg (P ≥ 0.35). In Exp. 2, cattle fed SYT-EFC, BLEND, or CON-E had greater final BW, ADG, and G:F than cattle fed CON (P ≤ 0.03). On average, NEm and NEg were 4.9% and 7.0% greater, respectively, for steers fed amylase enzyme treatments compared with CON (P ≤ 0.01). Hot carcass weights were greater in steers fed α-amylase treatments compared with CON (P < 0.01). Feeding Syngenta Enogen Feed Corn, which contains an α-amylase enzyme trait, at both locations improved feed efficiency in finishing cattle diets containing WDGS or SB.
Reflections on iridescent neck and breast feathers of the peacock,
Pavo cristatus
Authors: Freyer Pascal , Wilts Bodo D. , Stavenga Doekele G.
Published: December 2018

The blue neck and breast feathers of the peacock are structurally coloured due to an intricate photonic crystal structure in the barbules consisting of a two-dimensionally ordered rectangular lattice of melanosomes (melanin rodlets) and air channels embedded in a keratin matrix. We here investigate the feather coloration by performing microspectrophotometry, imaging scatterometry and angle-dependent reflectance measurements. Using previously determined wavelength-dependent refractive indices of melanin and keratin, we interpret the spectral and spatial reflection characteristics by comparing the measured spectra to calculated spectra by effective-medium multilayer and full three-dimensional finite-difference time-domain modelling. Both modelling methods yield similar reflectance spectra indicating that simple multilayer modelling is adequate for a direct understanding of the brilliant coloration of peacock feathers.
Thin-film structural coloration from simple fused scales in moths
Authors: Kilchoer Cédric , Steiner Ullrich , Wilts Bodo D.
Published: December 2018

The metallic coloration of insects often originates from diverse nanostructures ranging from simple thin films to complex three-dimensional photonic crystals. In Lepidoptera, structural coloration is widely present and seems to be abundant in extant species. However, even some basal moths exhibit metallic coloration. Here, we have investigated the origin of the vivid metallic colours of the wing scales of the basal moth
Micropterix aureatella
by spectrophotometry and scanning electron microscopy. The metallic gold-, bronze- and purple-coloured scales share a similar anatomy formed of a fused lower and upper lamina resulting in a single thin film. The optical response of this thin-film scale can be attributed to thin-film interference of the incident light, resulting in the colour variations that correlate with film thickness. Subtle variations in the wing scale thickness result in large visible colour changes that give
Micropterix
moths their colourful wing patterns. This simple coloration mechanism could provide a hint to understand the evolution of structural coloration in Lepidoptera.
Phenotypic variation inHeliconius eratocrosses shows that iridescent structural colour is sex-linked and controlled by multiple genes
Authors: Brien Melanie N. , Enciso-Romero Juan , Parnell Andrew J. , Salazar Patricio A. , Morochz Carlos , Chalá Darwin , Bainbridge Hannah E. , Zinn Thomas , Curran Emma V. , Nadeau Nicola J.
Published: December 2018

Bright, highly reflective iridescent colours can be seen across nature and are produced by the scattering of light from nanostructures.Heliconiusbutterflies have been widely studied for their diversity and mimicry of wing colour patterns. Despite iridescence evolving multiple times in this genus, little is known about the genetic basis of the colour and the development of the structures which produce it.Heliconius eratocan be found across Central and South America, but only races found in western Ecuador and Colombia have developed blue iridescent colour. Here, we use crosses between iridescent and non-iridescent races ofH. eratoto study phenotypic variation in the resulting F2generation. Using measurements of blue colour from photographs, we find that iridescent structural colour is a quantitative trait controlled by multiple genes, with strong evidence for loci on the Z sex chromosome. Iridescence is not linked to the Mendelian colour pattern locus that also segregates in these crosses (controlled by the genecortex). Small-angle X-ray scattering data show that spacing between longitudinal ridges on the scales, which affects the intensity of the blue reflectance, also varies quantitatively in F2crosses.
Functional nanomaterials to augment photosynthesis: evidence and considerations for their responsible use in agricultural applications
Authors: Swift Thomas A. , Oliver Thomas A. A. , Galan M. Carmen , Whitney Heather M.
Published: December 2018

At the current population growth rate, we will soon be unable to meet increasing food demands. As a consequence of this potential problem, considerable efforts have been made to enhance crop productivity by breeding, genetics and improving agricultural practices. While these techniques have traditionally been successful, their efficacy since the ‘green revolution’ has begun to significantly plateau. This stagnation of gains combined with the negative effects of climate change on crop yields has prompted researchers to develop novel and radical methods to increase crop productivity. Recent work has begun exploring the use of nanomaterials as synthetic probes to augment how plants use light. Photosynthesis in crops is often limited by their ability to absorb and exploit solar energy for photochemistry. The capacity to interact with and optimize how plants use light has the potential to increase the productivity of crops and enable the tailoring of crops for different environments and to compensate for predicted climate changes. Advances in the synthesis and surface modification of nanomaterials have overcome previous drawbacks and renewed their potential use as synthetic probes to enhance crop yields. Here, we review the current applications of functional nanomaterials in plants and will make an argument for the continued development of promising new nanomaterials and future applications in agriculture. This will highlight that functional nanomaterials have the clear potential to provide a much-needed route to enhanced future food security. In addition, we will discuss the often-ignored current evidence of nanoparticles present in the environment as well as inform and encourage caution on the regulation of nanomaterials in agriculture.
Structural colours in the frond of
Microsorum thailandicum
Authors: Steiner Lisa Maria , Ogawa Yu , Johansen Villads Egede , Lundquist Clive R. , Whitney Heather , Vignolini Silvia
Published: December 2018

Blue and near-ultraviolet structural colours have often been reported in understorey plants living in deep shade. While this intense blue coloration is very catchy to the eye of a human observer, there are cases in which structural colours can be hidden either by the scattered light interacting with pigments or because they are found in unexpected positions in the plants. Here, we show that the fronds of
Microsorum thailandicum
produce structural coloration on both the adaxial and abaxial epidermal surface. While cellulose helicoidal structures are responsible for this coloration in both epidermal layers, the reflected colours are consistently different: an intense blue reflection is found in the adaxial epidermis while red-shifted and less intense colours are observed in the abaxial epidermis, possibly suggesting photo-adaptation of the plant to the light environment. By comparing the optical properties of the fern with its anatomy we computed the theoretical reflection accounting for the presence of disorder in the cellulose helicoidal architecture.
A three-dimensional computational analysis of magnetic resonance images characterizes the biological aggressiveness in malignant brain tumours
Authors: Pérez-Beteta J. , Martínez-González A. , Pérez-García V. M.
Published: December 2018

Glioblastoma (GBM) is the most frequent and aggressive type of primary brain tumour. The development of image-based biomarkers from magnetic resonance images (MRIs) has been a topic of recent interest. GBMs on pre-treatment post-contrast T1-weighted (w) MRIs often appear as rim-shaped regions. In this research, we wanted to define rim-shape complexity (RSC) descriptors and study their value as indicators of the tumour’s biological aggressiveness. We constructed a set of widths characterizing the rim-shaped contrast-enhancing areas in T1w MRIs, defined measures of the RSC and computed them for 311 GBM patients. Survival analysis, correlations and sensitivity studies were performed to assess the prognostic value of the measurements. All measures obtained from the histograms were found to depend on the class width to some extent. Several measures (FWHM andβR) had high prognostic value. Some histogram-independent measures were predictors of survival: maximum rim width, mean rim width and spherically averaged rim width. The later quantity allowed patients to be classified into subgroups with different rates of survival (mean difference 6.28 months,p= 0.006). In conclusion, some of the morphological quantifiers obtained from pre-treatment T1w MRIs provided information on the biological aggressiveness of GBMs. The results can be used to define prognostic measurements of clinical applicability.
Key physical wood properties in termite foraging decisions
Authors: Oberst Sebastian , Lai Joseph C. S. , Evans Theodore A.
Published: December 2018

As eusocial and wood-dwelling insects, termites have been shown to use vibrations to assess their food, to eavesdrop on competitors and predators and to warn nest-mates. Bioassay choice experiments used to determine food preferences in animals often consider single factors only but foraging decisions can be influenced by multiple factors such as the quantity and quality of the food and the wood as a medium for communication. A statistical analysis framework is developed here to design a single bioassay experiment to study multifactorial foraging choice (Pinus radiata) in the basal Australian termite speciesCoptotermes(C.)acinaciformis(Isoptera: Rhinotermitidae). By employing a correlation analysis, 17 measured physical properties of 1417Pinus radiataveneer discs were reduced to five key material properties: density, moisture absorption, early wood content, first resonance frequency and damping. By applying a fuzzyc-means clustering technique, these veneer discs were optimally paired for treatment and control trials to study food preference by termites based on these five key material properties. A multifactorial analysis of variance was compared to a permutation analysis of the results indicating for the first time thatC. acinaciformistakes into account multiple factors when making foraging decisions.C. acinaciformisprefer denser wood with large early wood content, preferably humid and highly damped. Results presented here have practical implications for food choice experiments and for studies concerned with communication in termites as well as their ecology and coevolution with trees as their major food source.