bluuebunny/crossref_metadata_2025 huggingface dataset:
Distinct Expression Patterns of Carbonic Anhydrase IX in Clear Cell, Microcystic, and Angiomatous Meningiomas
Authors: Chkheidze Rati , Cimino Patrick J , Hatanpaa Kimmo J , White Charles L , Ferreira Manuel , Piccirillo Sara G M , Li Li , Rajaram Satwik , Nyagilo James O , Burns Dennis K , Raisanen Jack M , Cai Chunyu
Published: October 2019

Clear cell, microcytic, and angiomatous meningiomas are 3 vasculature-rich variants with overlapping morphological features but different prognostic and treatment implications. Distinction between them is not always straightforward. We compared the expression patterns of the hypoxia marker carbonic anhydrase IX (CA-IX) in meningiomas with predominant clear cell (n = 15), microcystic (n = 9), or angiomatous (n = 11) morphologies, as well as 117 cases of other World Health Organization recognized histological meningioma variants. Immunostaining for SMARCE1 protein, whose loss-of-function has been associated with clear cell meningiomas, was performed on all clear cell meningiomas, and selected variants of meningiomas as controls. All clear cell meningiomas showed absence of CA-IX expression and loss of nuclear SMARCE1 expression. All microcystic and angiomatous meningiomas showed diffuse CA-IX immunoreactivity and retained nuclear SMARCE1 expression. In other meningioma variants, CA-IX was expressed in a hypoxia-restricted pattern and was highly associated with atypical features such as necrosis, small cell change, and focal clear cell change. In conclusion, CA-IX may serve as a useful diagnostic marker in differentiating clear cell, microcystic, and angiomatous meningiomas.
Adequacy of Timber Trespass Civil Awards: A Louisiana Case Study
Authors: Mcconnell T Eric , Vanderschaaf Curtis L , Holderieath Jason J , Crosby Michael K
Published: October 2019

Timber trespass in Louisiana is a civil offense punishable by restitution of three times the timber’s current market value, yet whether this compensation level alone is adequate at present is unclear. We modeled a loblolly pine plantation across a range of site qualities in Louisiana. First, we estimated financial returns from a traditional sawtimber rotation using historical state timber prices that included three harvests: two thinnings and a final cut; harvest times differed by site quality. We then assumed all timber was taken at the first thinning. Net present value (NPV) determined appropriateness of compensation at 1×, 2×, and 3× stumpage revenues and was compared to the traditional rotation’s NPV. The NPVs were calculated with and without additional settlement for reforestation costs. We concluded that reforestation costs in addition to 3× stumpage value reimbursement were required to negate the effect of timber prices and better the traditional rotation’s NPV.
Author identification of short texts using dependency treebanks without vocabulary
Authors: Gorman Robert
Published: October 2019

How to classify short texts effectively remains an important question in computational stylometry. This study presents the results of an experiment involving authorship attribution of ancient Greek texts. These texts were chosen to explore the effectiveness of digital methods as a supplement to the author’s work on text classification based on traditional stylometry. Here it is crucial to avoid confounding effects of shared topic, etc. Therefore, this study attempts to identify authorship using only morpho-syntactic data without regard to specific vocabulary items. The data are taken from the dependency annotations published in the Ancient Greek and Latin Dependency Treebank. The independent variables for classification are combinations generated from the dependency label and the morphology of each word in the corpus and its dependency parent. To avoid the effects of the combinatorial explosion, only the most frequent combinations are retained as input features. The authorship classification (with thirteen classes) is done with standard algorithms—logistic regression and support vector classification. During classification, the corpus is partitioned into increasingly smaller ‘texts’. To explore and control for the possible confounding effects of, e.g. different genre and annotator, three corpora were tested: a mixed corpus of several genres of both prose and verse, a corpus of prose including oratory, history, and essay, and a corpus restricted to narrative history. Results are surprisingly good as compared to those previously published. Accuracy for fifty-word inputs is 84.2–89.6%. Thus, this approach may prove an important addition to the prevailing methods for small text classification.
Modifying a covarying protein–DNA interaction changes substrate preference of a site-specific endonuclease
Authors: Laforet Marc , McMurrough Thomas A , Vu Michael , Brown Christopher M , Zhang Kun , Junop Murray S , Gloor Gregory B , Edgell David R
Published: October 2019

Identifying and validating intermolecular covariation between proteins and their DNA-binding sites can provide insights into mechanisms that regulate selectivity and starting points for engineering new specificity. LAGLIDADG homing endonucleases (meganucleases) can be engineered to bind non-native target sites for gene-editing applications, but not all redesigns successfully reprogram specificity. To gain a global overview of residues that influence meganuclease specificity, we used information theory to identify protein–DNA covariation. Directed evolution experiments of one predicted pair, 227/+3, revealed variants with surprising shifts in I-OnuI substrate preference at the central 4 bases where cleavage occurs. Structural studies showed significant remodeling distant from the covarying position, including restructuring of an inter-hairpin loop, DNA distortions near the scissile phosphates, and new base-specific contacts. Our findings are consistent with a model whereby the functional impacts of covariation can be indirectly propagated to neighboring residues outside of direct contact range, allowing meganucleases to adapt to target site variation and indirectly expand the sequence space accessible for cleavage. We suggest that some engineered meganucleases may have unexpected cleavage profiles that were not rationally incorporated during the design process.
ReMap 2020: a database of regulatory regions from an integrative analysis of Human and Arabidopsis DNA-binding sequencing experiments
Authors: Chèneby Jeanne , Ménétrier Zacharie , Mestdagh Martin , Rosnet Thomas , Douida Allyssa , Rhalloussi Wassim , Bergon Aurélie , Lopez Fabrice , Ballester Benoit
Published: October 2019

ReMap (http://remap.univ-amu.fr) aims to provide the largest catalogs of high-quality regulatory regions resulting from a large-scale integrative analysis of hundreds of transcription factors and regulators from DNA-binding experiments in Human and Arabidopsis (Arabidopsis thaliana). In this 2020 update of ReMap we have collected, analyzed and retained after quality control 2764 new human ChIP-seq and 208 ChIP-exo datasets available from public sources. The updated human atlas totalize 5798 datasets covering a total of 1135 transcriptional regulators (TRs) with a catalog of 165 million (M) peaks. This ReMap update comes with two unique Arabidopsis regulatory catalogs. First, a catalog of 372 Arabidopsis TRs across 2.6M peaks as a result of the integration of 509 ChIP-seq and DAP-seq datasets. Second, a catalog of 33 histone modifications and variants across 4.5M peaks from the integration of 286 ChIP-seq datasets. All catalogs are made available through track hubs at Ensembl and UCSC Genome Browsers. Additionally, this update comes with a new web framework providing an interactive user-interface, including improved search features. Finally, full programmatically access to the underlying data is available using a RESTful API together with a new R Shiny interface for a TRs binding enrichment analysis tool.
Discussions of lifestyle habits as an integral part of care management: a cross-sectional cohort study in patients with established rheumatoid arthritis in Sweden
Authors: Malm Karina , Bergman Stefan , Bremander Ann , Larsson Ingrid , Andersson Maria L E ,   BARFOT study group
Published: October 2019

Objectives

The primary aim was to determine whether patients with RA recalled having discussions concerning lifestyle habits during their health-care visits. The secondary aim was to study the association between patients' reported lifestyle and their wish to discuss it.

Methods

A postal questionnaire sent to 1542 eligible patients from the Better Anti-Rheumatic Pharmacotherapy (BARFOT) study included questions on lifestyle habits (physical activity, diet, smoking and alcohol), on whether these were discussed during health-care visits and on whether there was an interest in such discussions.

Results

A total of 1061 patients (68%) responded [mean age 67 (s.d. 13) years, 73% women]. Half of the patients (49%) recalled discussions on physical activity, and 23% recalled discussions about diet. Those who reported health-enhancing levels of physical activity were more likely to discuss physical activity with their health professionals. Likewise, patients who reported having a non-traditional mixed diet were more likely to discuss diet. Smoking was discussed with 25% of the patients, more often with current smokers than with non-smokers (32 vs 17%; P < 0.001). Alcohol was discussed with 17% of the patients. Of those patients who reported having hazardous drinking habits, 77% had not discussed alcohol use with any health professional.

Conclusion

Discussions about lifestyle were recalled by half of the patients with established RA. There is a need for improvement, because lifestyle habits may affect the long-term outcome in a chronic disease, such as RA. Patient education concerning lifestyle habits should be an integral part of care management and an interactive process.
ESTIMATION OF UNCERTAINTY IN MEASUREMENT OF DOSE EQUIVALENT AT LABORATORY LEVEL USING CASO4 :Dy-BASED TLD BADGE SYSTEM IN INDIA
Authors: Pradhan S M , Datta D , Pathan Munir S , Srivastava Kshama , Selvam T Palani
Published: October 2019

The objective of this paper is to estimate the combined uncertainty in the measurement of dose equivalent at laboratory level using CaSO4:Dy-based thermoluminescent dosemeter badge system by including variations in the components of the system. The variability of performance of the system is analysed using random effects one way analysis of variance model. The model enables estimation of the overall variance of the performance of the sampled population. The population in the study comprises all possible indicated dose equivalents on irradiation of dosemeters to a specific dose equivalent and radiation quality. Coefficient of variation and combined uncertainty at 95% level of confidence in the measurement of Hp(10) due to S-Cs radiation quality are found to be 6.6 and 14.3%, respectively, at the dose level of 5.31 mSv. The above parameters in the measurement of in-use quantity, i.e. whole body dose or photon dose equivalent are found to be 7.4 and 16.4%, respectively. The performance of the monitoring system on relative response has been observed to be satisfactory. Various factors affecting the variability of performance of the system are identified for further improvement in coefficient of variation.
Seasonal Variation in Host Susceptibility to Fusarium Canker in Young Almond Trees
Authors: Stack Abigail J. , Madra Meera , Gordon Thomas R. , Bostock Richard M.
Published: October 2019

Loss of water that reduces the relative water content (RWC) of bark can occur during processing, cold storage, and planting of bare-root stone fruit trees. In California nurseries and newly planted orchards, this stress can predispose young almond trees (Prunus dulcis) to a canker disease caused primarily by Fusarium species. While reduced bark RWC contributes to disease development, anecdotal observations suggest a seasonal effect on host physiology may also influence disease severity. We evaluated the effect of season and the impact of drying and reduced RWC on susceptibility of almond branch segments excised from orchard trees (cv. Nonpareil) to Fusarium acuminatum, Fusarium avenaceum, Fusarium brachygibbosum, and Fusarium californicum sp. nov. With lesion size as the criterion, excised inoculated branch segments were most susceptible in spring, of intermediate susceptibility during winter dormancy, and least susceptible during summer and fall. Consistent with an earlier study, branches with RWC between 80 and 85% yielded lesions that were significantly larger than lesions from branches with bark that was above or below that range. However, the effect of reduced bark moisture on lesion size was only apparent in the spring. These results affirm the importance of avoiding conditions that diminish moisture status in bare-root almond trees in Fusarium canker disease management, especially during transport and planting operations in the spring, a period of high physiological vulnerability. California nurseries apply fungicides to bare-root trees prior to cold storage to reduce “mold” growth. Of eight fungicides currently registered for use on almond trees, fludioxonil (Scholar), fluopyram/trifloxystrobin (Luna Sensation), and fluxapyroxad/pyraclostrobin (Merivon) were most inhibitory to in vitro mycelial growth of F. acuminatum, F. avenaceum, and F. brachygibbosum. However, our almond branch disease assay did not demonstrate preventive or curative fungicide action against infections by F. acuminatum or F. avenaceum.
CE: Infection in Acute Care: Evidence for Practice
Authors: Houghton Douglas
Published: October 2019

Infection may be either a cause for admission to an acute care hospital or health care associated, a complication of receiving care for another illness in the acute care environment. In recent years, there has been significant research investigating risk factors for infection in the hospital setting, best practices for diagnosis and treatment, and ways to prevent many health care–associated infections. Multidrug-resistant organisms are a consequence of antibiotic overuse, poor environmental hygiene, and our increasing ability to keep chronically ill patients alive longer through invasive intensive care support. This article reviews the evidence on infection in acute care settings, with a focus on community- and hospital-acquired pneumonia, surgical site infections, and Clostridioides difficile infection. Recommendations for integrating this evidence into nursing practice are offered.
Better Cardiac Arrest Outcomes in Hospitals with More Nurses with BSNs
Authors: Rosenberg Karen
Published: October 2019

According to this study:

Patients who experience cardiac arrest in hospitals that have a higher proportion of nurses with BSNs and lower workloads have a better chance of surviving with good cerebral performance.

On general units, each additional patient per nurse was associated with 17% lower odds of surviving to discharge with good cerebral performance.
Healthy Lifestyle Protects Against Dementia
Authors: Rosenberg Karen
Published: October 2019

According to this study:

Both an unfavorable lifestyle and a high genetic risk are independently associated with a higher risk of dementia in older adults.

A favorable lifestyle is associated with a lower risk of dementia, even in people who have a high genetic risk.
Propofol and Sevoflurane Differentially Impact MicroRNAs in Circulating Extracellular Vesicles during Colorectal Cancer Resection
Authors: Buschmann Dominik , Brandes Florian , Lindemann Anja , Maerte Melanie , Ganschow Petra , Chouker Alexander , Schelling Gustav , Pfaffl Michael W. , Reithmair Marlene
Published: October 2019

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Extracellular vesicles and their microRNA cargo are crucial facilitators of malignant cell communication and could mediate effects of anesthetics on tumor biology during cancer resection. The authors performed a proof-of-concept study to demonstrate that propofol and sevoflurane have differential effects on vesicle-associated microRNAs that influence signaling pathways involved in tumor progression and metastasis.

Methods

Circulating vesicles were investigated in a prospective, matched-case pilot study in two cohorts of colorectal cancer patients receiving either propofol (n = 8) or sevoflurane (n = 9), matched for tumor stage and location. Serum was sampled before anesthesia and after tumor resection. Vesicular microRNA profiles were analyzed by next generation sequencing and confirmed by real-time polymerase chain reaction. Next, we assessed perioperative changes in microRNA expression induced by either anesthetic and compared their biologic effects on tumor-relevant pathways. Additionally, vesicles from pre- and postoperative sera were biologic characterized.

Results

Postoperative microRNA profiles were shifted in both groups with overlap in the perioperative response. A total of 64 (48 up, range of log2 fold change 1.07 to 3.76; 16 down, −1.00 to −1.55) and 33 (32 up, 1.02 to 2.98; 1 down, −1.36) microRNAs were significantly regulated (adjusted P value less than 0.05) by propofol and sevoflurane, respectively. Thirty-six (propofol) and five (sevoflurane) microRNAs were specifically responsive to either anesthetic agent. In silico target analyses of microRNA expression patterns indicated an inhibitory effect of propofol on crucial carcinoma-related pathways such as proliferation (z-score, −1.73) and migration (z-score, −1.97), as well as enhanced apoptosis (z-score, 1.19). While size distribution and protein markers of circulating vesicles were not affected by anesthesia, their concentration was reduced after surgery using both anesthetic procedures.

Conclusions

This proof-of-concept study provides preliminary evidence that anesthetic agents have specific effects on microRNA profiles in circulating vesicles. These findings could form the basis for larger and mechanistically oriented outcome studies in cancer patients.
Creating Value by Prioritizing Mental and Social Health After Injury
Authors: Matkin Lars , Ring David
Published: October 2019

Given the strong influence of mental and social health on symptom intensity and magnitude of limitations, attempts to increase value in orthopedic trauma must attend to emotional and social recovery. Low value and potentially harmful interventions after trauma such as excessive reliance on medication, low value surgeries for “delayed healing” or “symptomatic implants,” repeated visits with a physical therapist, and other biomedical interventions often reflect misdiagnosis and mismanagement of social and mental health. A better approach is to anticipate emotional and social recovery; to get social and mental health specialists involved immediately after injury; and to develop strategies that set firm limits on biomedical tests and treatments that are unlikely to contribute to health and risk reinforcing stress, distress, and less effective coping strategies.
Valuing the Recovery Priorities of Orthopaedic Trauma Patients After Injury: Evidence From a Discrete Choice Experiment Within 6 Weeks of Injury
Authors: O'Hara Nathan N. , Mulliken Alexandra , Joseph Katherine , Slobogean Gerard P. , Johal Herman , Cunningham Brian P. , Olaya Stephan , Levy Joseph , Pollak Andrew N. , Klazinga Niek S.
Published: October 2019

Objectives:

To determine the recovery priorities of extremity fracture patients during the subacute phase and the patient factors associated with variation in recovery priorities.

Design:

Discrete choice experiment.

Setting:

Academic trauma center.

Patients:

One hundred ninety-eight patients with a fracture to the appendicular skeleton. Patients with severe traumatic brain injuries, spinal cord injuries, and non–English-speaking patients were excluded.

Main Outcome Measurement:

The relative importance of clinical recovery, work-related recovery, and obtaining disability benefits after injury.

Results:

In the subacute period, clinical recovery was the main priority for fracture patients (mean: 62%, SD: 5.3). Work-related recovery (mean: 27%, SD: 3.9) and the receipt of other disability benefits (mean: 11%, SD: 6.4) were each of significantly less importance. Heterogeneity was observed across these estimates based on the physical demands of preinjury employment, preinjury physical health, preinjury work status, health insurance type, and the severity of the fracture.

Conclusion:

Clinical recovery was of paramount importance for fracture patients during the subacute recovery phase. However, patients also valued resuming work and access to disability benefits. Understanding a patient's recovery priorities early in the clinical care pathway will enable the development of multidisciplinary care plans that are responsive to these priorities and, hence, deliver value-based health care.

Level of Evidence:

Level V. See Instructions for Authors for a complete description of levels of evidence.
Survivor But Not Fully Recovered: The Lived Experience After 1 Year of Surviving Sepsis
Authors: Umberger Reba A. , Thomas Sandra P.
Published: October 2019

Background

Hospital mortality rates related to sepsis have decreased over the last decade, increasing the number of survivors of sepsis who may experience long-term consequences. Yet, little is known about how they perceive their illness experience and its aftermath.

Objective

This study explores the experiences of sepsis survivors after 1 year of their index intensive care unit (ICU) stay.

Methods

This phenomenological study was guided by Merleau-Ponty's philosophy. Participants were adult patients admitted directly to the medical ICU with sepsis who had an ICU stay of at least 48 hours and had been discharged from their index ICU stay for at least 1 year. Participants were invited by letter to participate in face-to-face or telephone interviews and a brief survey. Interviews were audio recorded, transcribed verbatim, and verified. An interpretive group read transcripts aloud to increase rigor of identifying meaning units, existential grounds, and thematic structure.

Results

Eight participants were recruited over 20 months. Participants were primarily white (87.5%) females (75%) with an age range of 37 to 74 years who were interviewed between 1 and 2 years following an index sepsis ICU stay. Five major themes emerged from the transcripts: (1) how they survived, (2) blurring of time versus counting time by events, (3) helpful help versus unhelpful help, (4) powerless versus striving for control, and (5) survivor but not fully recovered.

Discussion

Findings reflected a long trajectory of chronic illness in which the index episode of sepsis was not necessarily what stood out as figural to participants. The meaning of participant experiences must be considered in the context of a health care system that offers little to no systematic follow-up care after sepsis and little prevention. Participants expressed a need for advocacy and follow-up support.
Safety and Efficacy of Nanosecond Pulsed Electric Field Treatment of Sebaceous Gland Hyperplasia
Authors: Munavalli Girish S. , Zelickson Brian D. , Selim Mona M. , Kilmer Suzanne L. , Rohrer Thomas E. , Newman James , Jauregui Lauren , Knape William A. , Ebbers Edward , Uecker Darrin , Nuccitelli Richard
Published: October 2019

BACKGROUND

Nanosecond pulsed electric field (nsPEF) technology involves delivery of ultrashort pulses of electrical energy and is a nonthermal, drug-free technology that has demonstrated favorable effects on cellular structures of the dermis and epidermis.

OBJECTIVE

Determine the tolerability and effectiveness of nsPEF treatment of sebaceous gland hyperplasia (SGH).

METHODS

This study was a prospective, randomized, open-label, multisite, nonsignificant risk trial in which each subject served as their own control. After injection of local anesthetic, high-intensity, ultrashort pulses of electrical energy were used to treat 72 subjects resulting in a total of 222 treated lesions. Subjects returned for 3 to 4 follow-up evaluations with photographs.

RESULTS

At the final study visit, 99.6% of treated SGH lesions were rated clear or mostly clear and 79.3% of the subjects were satisfied or mostly satisfied with the outcome. At 60 days after nsPEF treatment, 55% of the lesions were judged to have no hyperpigmentation and 31% exhibited mild post-treatment hyperpigmentation. At the last observation for all lesions, 32% of the 222 lesions were noted as having slight volume loss.

CONCLUSION

Nanosecond pulsed electric field procedure is well tolerated and is very effective in the removal of SGHs.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03612570.
Repeated Full-Face Aesthetic Combination Treatment With AbobotulinumtoxinA, Hyaluronic Acid Filler, and Skin-Boosting Hyaluronic Acid After Monotherapy With AbobotulinumtoxinA or Hyaluronic Acid Filler
Authors: Cartier Hugues , Hedén Per , Delmar Henry , Bergentz Per , Skoglund Cecilia , Edwartz Carolina , Norberg Maria , Kestemont Philippe
Published: October 2019

BACKGROUND

Full-face aesthetic treatment involving several treatment modalities may improve facial aesthetic outcome.

OBJECTIVE

To evaluate clinical outcomes and patient perceptions of monotherapy with either abobotulinumtoxinA (ABO) or hyaluronic acid (HA) filler followed by full-face combination treatments of ABO, HA filler, and skin-boosting HA (RSB).

MATERIALS AND METHODS

Subjects aged 35 to 50 years were randomized to monotherapy with 50 s.U ABO in the glabella or ≤1 mL HA filler in the nasolabial folds (NLFs)/cheeks. At Month 6 and Month 12, all subjects received combination treatment with ≤50 s.U ABO in the glabella, ≤2 mL HA filler in the NLFs/cheeks (and other facial areas as applicable), and ≤1 mL RSB (additional RSB treatment at Month 7). Assessments included global facial aesthetic appearance and improvement, first impression, perceived age, wrinkle severity, satisfaction questionnaires, and adverse events.

RESULTS

Repeated full-face combination treatment with ABO, HA filler, and RSB was associated with considerably higher levels of aesthetic improvement and subject satisfaction than monotherapy with ABO or HA filler. Improvement rate of glabellar lines was increasing with each treatment.

CONCLUSION

Repeated combination treatment achieved greater change in global facial aesthetic appearance than monotherapy. Aesthetic improvement and subject satisfaction was high and increased with each treatment. All treatments were well tolerated.
DNA: What's your story?
Authors: Jenkins Jean
Published: October 2019

This is a pivotal time in history. We now recognize the implications of our uniquely personal DNA blueprint (i.e., genetics/genomics) for health and illness, and scientific research is rapidly unraveling the secrets of what that blueprint personally means to each of us. Listening to what patients have to say about the use of DNA in their health care can strengthen your role in creating a new paradigm for education and service delivery. Stories are an amazing way to reach out, connect, and learn from others about what they are going through. Stories are important in highlighting the relevancy of DNA in clinical care for patients and providers. The power and potential of the patient voice is something I have been striving to capture as the reality of genomic healthcare unfolds (DNAandU.org). The knowledge base provided by DNA stories has great potential, but only if representative of the voices of many. Nurse practitioners have an important role in accessing stories to learn, to teach, to plan for the future, and to inspire possibilities.
Cochlear MRI Signal Change Following Vestibular Schwannoma Resection Depends on Surgical Approach
Authors: West Niels , Sass Hjalte Christian Reeberg , Møller Martin Nue , Cayé-Thomasen Per
Published: October 2019

Objective:

Information on cochlear MRI signal change following vestibular schwannoma (VS) surgery by the retrolabyrinthine approach (RLA) is nonexisting, and information using the translabyrinthine approach (TLA) is scarce. We aimed to evaluate cochlear MRI fluid signal in patients with a unilateral VS, before and after surgery by the RLA or the TLA, that can have clinical importance for subsequent cochlear implantation feasibility.

Study Design:

Retrospective cohort study.

Setting:

University hospital.

Patients:

One hundred one patients with a unilateral VS.

Intervention:

VS resection by the TLA or the RLA. Pre- and postoperative T2-weighted MRI.

Main Outcome Measure:

Cochlear signal change using a semiquantitative system for grading cochlear asymmetry, with grades ranging from 1 (normal fluid signal both sides) to 4 (no fluid signal one side).

Results:

Seventy-four patients were operated by the TLA and 27 by the RLA. The number of cochleas with grade 3 and 4 asymmetries postoperative was significantly higher than preoperative. The postoperative proportions of grade 1 (TLA 20%, RLA 56%) and grade 2–4 asymmetry (TLA 80%, RLA 44%) were significantly different between the two groups. In the TLA group, 46 patients (62%) demonstrated an increased asymmetry postoperatively, as compared with three patients (11%) in the RLA group.

Conclusions:

Postoperative decrease of cochlear MRI fluid signal is more likely to occur after translabyrinthine surgery (occurring in 62%), as compared with retrolabyrinthine surgery (occurring in 11%). The decrease of cochlear signal may be due to compromised vascularity or fibrosis.
Bilobed Gracilis Flap: A Novel Alternative for Pelvic and Perineal Reconstruction
Authors: Weinstein Brielle , King Kathryn S. , Triggs Wilton , Harrington Michael A. , Pribaz Julian
Published: October 2019

Perineal reconstruction historically has been guided by the vertical rectus abdominis myocutaneous flap. In oncologic patients, because of prior surgical intervention, this donor site is often unavailable, the pelvis has been irradiated, and defects can be deep or irregularly contoured. Using plastic surgery principles of perforators, geometrically defined local tissue rearrangement, and flap inset, the authors have developed a modification of the gracilis flap to include a second soft-tissue arm similar to a bilobed flap. The authors performed five bilobed gracilis/medial circumflex femoral vascular pedicle myocutaneous flaps for perineal reconstruction secondary to oncologic defects and one secondary to Fournier gangrene at a tertiary care center. Oncologic patients had undergone adjuvant chemotherapy and radiation therapy and had compromised abdominal donor sites. Given their results, the authors recommend that a bilobed gracilis flap be used in patients with moderate to large defects, defects that require ample soft-tissue bulk, or in patients with limited abdominal donor sites.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Adrenalectomy Risk Score
Authors: Caiazzo Robert , Marciniak Camille , Lenne Xavier , Clément Guillaume , Theis Didier , Ménégaux Fabrice , Sebag Frederic , Brunaud Laurent , Lifante Jean Christophe , Mirallie Eric , Bruandet Amélie , Pattou François
Published: October 2019

Objective:

To explore the determinants of postoperative outcomes of adrenal surgery in order to build a proposition for healthcare improvement.

Summary of Background Data:

Adrenalectomy is the recommended treatment for many benign and malignant adrenal diseases. Postoperative outcomes vary widely in the literature and their determinants remain ill-defined.

Methods:

We based this retrospective cohort study on the “Programme de médicalisation des systèmes d’information” (PMSI), a national database that compiles discharge abstracts for every admission to French acute health care facilities. Diagnoses identified during the admission were coded according to the French adaptation of the 10th edition of the International Classification of Diseases (ICD-10). PMSI abstracts for all patients discharged between January 2012 and December 2017 were extracted. We built an Adrenalectomy-risk score (ARS) from logistic regression and calculated operative volume and ARS thresholds defining high-volume centers and high-risk patients with the CHAID method.

Results:

During the 6-year period of the study, 9820 patients (age: 55 ± 14; F/M = 1.1) were operated upon for adrenal disease. The global 90-day mortality rate was 1.5% (n = 147). In multivariate analysis, postoperative mortality was independently associated with age ≥75 years [odds ratio (OR): 5.3; P < 0.001], malignancy (OR: 2.5; P < 0.001), Charlson score ≥2 (OR: 3.6; P < 0.001), open procedure (OR: 3.2; P < 0.001), reoperation (OR: 4.5; P < 0.001), and low hospital caseload (OR: 1.8; P = 0.010). We determined that a caseload of 32 patients/year was the best threshold to define high-volume centers and 20 ARS points the best threshold to define high-risk patients.

Conclusion:

High-risk patients should be referred to high-volume centers for adrenal surgery.
Targeting DNA repair in gliomas
Authors: Beckta Jason M. , Bindra Ranjit S. , Chalmers Anthony J.
Published: October 2019

Purpose of review

Gliomas represent a disparate group of malignancies with varying clinical outcomes despite a tremendous amount of time, effort, and resources dedicated to their management and understanding. The most aggressive entity, glioblastoma, has a dismal prognosis with poor local control despite intense local and systemic treatment, including radiation therapy.

Recent findings

Given the heterogeneity in genotype, phenotype, and patient outcomes, researchers and clinicians have turned their attention toward attacking DNA damage response and repair mechanisms in gliomas in an effort to develop novel chemo and radiosensitizers. However, despite extensive work in both the laboratory and the clinic, no sensitizers have yet to emerge as clear options in the treatment of glioma, often because of meager preclinical data or an inability to penetrate the blood–brain barrier.

This review will examine current understanding of molecular DNA repair targets in glioma and their potential exploitation to improve local control and, ultimately, overall survival of patients afflicted with these diseases.
Complete loss of the MHC II pathway in an anglerfish,
Lophius piscatorius
Authors: Dubin Arseny , Jørgensen Tor Erik , Moum Truls , Johansen Steinar Daae , Jakt Lars Martin
Published: October 2019

Genome studies in fish provide evidence for the adaptability of the vertebrate immune system, revealing alternative immune strategies. The reported absence of the major compatibility complex (MHC) class II pathway components in certain species of pipefish (genus
Syngnathus
) and cod-like fishes (order Gadiformes) is of particular interest. The MHC II pathway is responsible for immunization and defence against extracellular threats through the presentation of exogenous peptides to T helper cells. Here, we demonstrate the absence of all genes encoding MHC II components (CD4, CD74 A/B, and both classical and non-classical MHC II
α
/
β
) in the genome of an anglerfish,
Lophius piscatorius
, indicating loss of the MHC II pathway. By contrast, it has previously been reported that another anglerfish,
Antennarius striatus
, retains all MHC II genes, placing the loss of MHC II in the
Lophius
clade to their most recent common ancestor
.
In the three taxa where MHC II loss has occurred, the gene loss has been restricted to four or five core MHC II components, suggesting that, in teleosts, only these genes have functions that are restricted to the MHC II pathway.
Wearable flexible sweat sensors for healthcare monitoring: a review
Authors: Chung Michael , Fortunato Giuseppino , Radacsi Norbert
Published: October 2019

The state-of-the-art in wearable flexible sensors (WFSs) for sweat analyte detection was investigated. Recent advances show the development of integrated, mechanically flexible and multiplexed sensor systems with on-site circuitry for signal processing and wireless data transmission. When compared with single-analyte sensors, such devices provide an opportunity to more accurately analyse analytes that are dependent on other parameters (such as sweat rate and pH) by improving calibration fromin situreal-time analysis, while maintaining a lightweight and wearable design. Important health conditions can be monitored and on-demand regulating drugs can be delivered using integrated wearable systems but require correlation verification between sweat and blood measurements usingin vivovalidation tests before any clinical application can be considered. Improvements are necessary for device sensitivity, accuracy and repeatability to provide more reliable and personalized continuous measurements. With rapid recent development, it can be concluded that non-invasive WFSs for sweat analysis have only skimmed the surface of their health monitoring potential and further significant advancement is sure to be made in the medical field.
Effects of structural damping on acoustic scattering by flexible plates
Authors: Nilton M. M. , de Montesquieu A. S. , Cavalieri A. V. G. , Donadon M. V. , Wolf W. R.
Published: October 2019

We investigate the effects of structural damping on the interaction of a turbulent eddy with flexible plates with respect to the efficiency of aerodynamic noise generation. Potential benefits are studied using a model based on a point-reacting compliant semi-infinite plate on a spring-damper foundation. This scattering problem is solved using the Wiener–Hopf technique. We compare results for semi-infinite compliant plates with finite ones. In both cases, plate vibration lead to reductions of sound radiation, especially at resonance; damping tends to reduce such acoustic benefits. We also present a formulation that considers the effect of structural damping on the acoustic properties of finite elastic plates. Numerical results are obtained by applying a boundary element method to solve the Helmholtz equation subject to the boundary conditions imposed by the plate vibration. Under specific conditions, such as high fluid loading factor and low bending-wave Mach number, the acoustic power scattered by an edge tends to be smaller than that which propagates over the plate as bending waves. Results show that structural damping attenuates these waves and may modify the far-field acoustic pressure, mostly by reducing the scattered sound at structural resonances. All models show that large damping coefficients lead to locally over-damped responses. There is thus an ideal range of structural damping to reduce both plate vibration and acoustic scattering.
The effect of network topology on optimal exploration strategies and the evolution of cooperation in a mobile population
Authors: Erovenko Igor V. , Bauer Johann , Broom Mark , Pattni Karan , Rychtář Jan
Published: October 2019

We model a mobile population interacting over an underlying spatial structure using a Markov movement model. Interactions take the form of public goods games, and can feature an arbitrary group size. Individuals choose strategically to remain at their current location or to move to a neighbouring location, depending upon their exploration strategy and the current composition of their group. This builds upon previous work where the underlying structure was a complete graph (i.e. there was effectively no structure). Here, we consider alternative network structures and a wider variety of, mainly larger, populations. Previously, we had found when cooperation could evolve, depending upon the values of a range of population parameters. In our current work, we see that the complete graph considered before promotes stability, with populations of cooperators or defectors being relatively hard to replace. By contrast, the star graph promotes instability, and often neither type of population can resist replacement. We discuss potential reasons for this in terms of network topology.
The genomic ancestry of the Scandinavian Battle Axe Culture people and their relation to the broader Corded Ware horizon
Authors: Malmström Helena , Günther Torsten , Svensson Emma M. , Juras Anna , Fraser Magdalena , Munters Arielle R. , Pospieszny Łukasz , Tõrv Mari , Lindström Jonathan , Götherström Anders , Storå Jan , Jakobsson Mattias
Published: October 2019

The Neolithic period is characterized by major cultural transformations and human migrations, with lasting effects across Europe. To understand the population dynamics in Neolithic Scandinavia and the Baltic Sea area, we investigate the genomes of individuals associated with the Battle Axe Culture (BAC), a Middle Neolithic complex in Scandinavia resembling the continental Corded Ware Culture (CWC). We sequenced 11 individuals (dated to 3330–1665 calibrated before common era (cal BCE)) from modern-day Sweden, Estonia, and Poland to 0.26–3.24× coverage. Three of the individuals were from CWC contexts and two from the central-Swedish BAC burial ‘Bergsgraven’. By analysing these genomes together with the previously published data, we show that the BAC represents a group different from other Neolithic populations in Scandinavia, revealing stratification among cultural groups. Similar to continental CWC, the BAC-associated individuals display ancestry from the Pontic–Caspian steppe herders, as well as smaller components originating from hunter–gatherers and Early Neolithic farmers. Thus, the steppe ancestry seen in these Scandinavian BAC individuals can be explained only by migration into Scandinavia. Furthermore, we highlight the reuse of megalithic tombs of the earlier Funnel Beaker Culture (FBC) by people related to BAC. The BAC groups likely mixed with resident middle Neolithic farmers (e.g. FBC) without substantial contributions from Neolithic foragers.
Bee pollination outperforms pesticides for oilseed crop production and profitability
Authors: Catarino Rui , Bretagnolle Vincent , Perrot Thomas , Vialloux Fabien , Gaba Sabrina
Published: October 2019

Nature-based agriculture that reduces dependency on chemical inputs requires using ecological principles for sustainable agro-ecosystems, aiming to balance ecology, economics and social justice. There is growing evidence that pollinator-dependent crops with high insect, particularly bee, pollination service can give higher yields. However, the interacting effects between insect pollination and agricultural inputs on crop yields and farm economics remain to be established to reconcile food production with biodiversity conservation. We quantified individual and combined effects of pesticides, insect pollination and soil quality on oilseed rape (
Brassica napus
L.) yield and gross margin, using a total of 294 farmers' fields surveyed between 2013 and 2016. We show that yield and gross margins are greater (15–40%) in fields with higher pollinator abundance than in fields with reduced pollinator abundance. This effect is, however, strongly reduced by pesticide use. Greater yields may be achieved by either increasing agrochemicals or increasing bee abundance, but crop economic returns were only increased by the latter, because pesticides did not increase yields while their costs reduced gross margins.
It's not all black and white: investigating colour polymorphism in manta rays across Indo-Pacific populations
Authors: Venables Stephanie K. , Marshall Andrea D. , Germanov Elitza S. , Perryman Robert J. Y. , Tapilatu Ricardo F. , Hendrawan I Gede , Flam Anna L. , van Keulen Mike , Tomkins Joseph L. , Kennington W. Jason
Published: October 2019

Intraspecific colour polymorphisms have been the focus of numerous studies, yet processes affecting melanism in the marine environment remain poorly understood. Arguably, the most prominent example of melanism in marine species occurs in manta rays (Mobula birostrisandMobula alfredi). Here, we use long-term photo identification catalogues to document the frequency variation of melanism across Indo-Pacific manta ray populations and test for evidence of selection by predation acting on colour morph variants. We use mark–recapture modelling to compare survivorship of typical and melanistic colour morphs in threeM. alfredipopulations and assess the relationship between frequency variation and geographical distance.While there were large differences in melanism frequencies among populations of both species (0–40.70%), apparent survival estimates revealed no difference in survivorship between colour morphs. We found a significant association between phenotypic and geographical distance inM. birostris, but not inM. alfredi. Our results suggest that melanism is not under selection by predation in the testedM. alfredipopulations, and that frequency differences across populations of both species are a consequence of neutral genetic processes.As genetic colour polymorphisms are often subjected to complex selection mechanisms, our findings only begin to elucidate the underlying evolutionary processes responsible for the maintenance and frequency variation of melanism in manta ray populations.
Accumulation over evolutionary time as a major cause of biodiversity hotspots in conifers
Authors: Sundaram Mekala , Donoghue Michael J. , Farjon Aljos , Filer Denis , Mathews Sarah , Jetz Walter , Leslie Andrew B.
Published: October 2019

Biodiversity hotspots are important for understanding how areas of high species richness form, but disentangling the processes that produce them is difficult. We combine geographical ranges, phylogenetic relationships and trait data for 606 conifer species in order to explore the mechanisms underlying richness hotspot formation. We identify eight richness hotspots that overlap known centres of plant endemism and diversity, and find that conifer richness hotspots occur in mountainous areas within broader regions of long-term climate stability. Conifer hotspots are not unique in their species composition, traits or phylogenetic structure; however, a large percentage of their species are not restricted to hotspots and they rarely show either a preponderance of new radiating lineages or old relictual lineages. We suggest that conifer hotspots have primarily formed as a result of lineages accumulating over evolutionary time scales in stable mountainous areas rather than through high origination, preferential retention of relictual lineages or radiation of species with unique traits, although such processes may contribute to nuanced differences among hotspots. Conifers suggest that a simple accumulation of regional diversity can generate high species richness without additional processes and that geography rather than biology may play a primary role in hotspot formation.