bluuebunny/crossref_metadata_2025 huggingface dataset:
Formation of a counter-rotating stellar population in the Large Magellanic Cloud: a Magellanic triplet system?
Authors: Armstrong B , Bekki K
Published: August 2018

The Large Magellanic Cloud is observed to have a counter-rotating stellar population in its disc, which has not been reproduced in previous simulations of the Magellanic system. We propose a new scenario in which the origin of this counter-rotating stellar population is the result of a minor retrograde merger with another dwarf galaxy more than 3 Gyr ago, and investigate this scenario using our hydrodynamical simulations. Our simulations show that such merging can result in a counter-rotating stellar component and a co-rotating gaseous component. We show that this counter-rotating population would not be radially concentrated, but found throughout the Large Magellanic Cloud. The thin disc of the Large Magellanic Cloud is thickened by the merging. We suggest that the Magellanic Clouds were originally a triplet system containing this companion galaxy. We then discuss previous observations of the Magellanic Clouds in the context of a triplet dwarf system, and discuss how such a merger could occur.
X-ray Swift observations of SN 2018cow
Authors: Rivera Sandoval L E , Maccarone T J , Corsi A , Brown P J , Pooley D , Wheeler J C
Published: August 2018

Supernova (SN) 2018cow is an optical transient detected in the galaxy CGCG 137–068. It has been classified as an SN due to various characteristics in its optical spectra. The transient is also a bright X-ray source. We present results of the analysis of ∼62 ks of X-ray observations taken with the Neil Gehrels Swift Observatory over 27 d. We found a variable behaviour in the 0.3–10 keV X-ray light curve of SN 2018cow, with variability time-scales of days. The observed X-ray variability could be due to the interaction between the SN ejecta and a non-uniform circumstellar medium, perhaps related to previous mass ejections from a luminous-blue-variable-like progenitor.
Endoscopic Endonasal Petrosectomy: Anatomical Investigation, Limitations, and Surgical Relevance
Authors: Borghei-Razavi Hamid , Truong Huy Q , Fernandes Cabral David T , Sun Xicai , Celtikci Emrah , Wang Eric , Snyderman Carl , Gardner Paul A , Fernandez-Miranda Juan C
Published: August 2018

BACKGROUND

The endoscopic endonasal approach (EEA) was recently added to the neurosurgical armamentarium as an alternative approach to the petrous apex (PA) region. However, the maximal extension, anatomical landmarks, and indications of this procedure remain to be established.

OBJECTIVE

To investigate the limitations and suggest a classification of PA lesions for endoscopic petrosectomy.

METHODS

Five anatomical specimens were dissected with EEA to the PA. Anatomical landmarks for the surgical steps and maximal limits were noted. Pre- and postprocedural computed tomographic scan and image-guidance were used. Relevant surgical cases were reviewed and presented.

RESULTS

We defined 3 types of petrosectomy: medial, inferior, and inferomedial. Medial petrosectomy was limited within the paraclival internal carotid artery (ICA) anteriorly, lacerum ICA inferiorly, abducens nerve superiorly, and petrous ICA laterally. Among those, abducens nerve and petrous ICA are surgical limits. Full skeletonization of the paraclival ICA and removal of the lingual process are essential for better access to the medial aspect of PA. Inferior petrosectomy was defined by the lacerum foramen synchondrosis anteriorly, jugular foramen inferiorly, internal acoustic canal posteriorly, and PA superolaterally. Those are surgical limits except for the foramen lacerum synchondrosis. The connective tissue at the pterygosphenoidal fissure was a key landmark for the sublacerum approach. Clinical cases in 3 types of PA lesions were presented.

CONCLUSION

The EEA provides access to the medial and inferior aspects of the PA. Several technical maneuvers, including paraclival and lacerum ICA skeletonization, sublacerum approach, and lingual process removal, are key to maximize PA drilling.
Reaching beyond the ‘worried well’: pre-adoption characteristics of participants in ‘Men on the Move’, a community-based physical activity programme
Authors: Kelly Liam , Harrison Michael , Richardson Noel , Carroll Paula , Robertson Steve , Keohane Aisling , Donohoe Alex
Published: August 2018

Background

Issues surrounding gender and men’s health have become an increasing focus of public health globally. Unhealthy lifestyles and lower engagement in health promotion initiatives contributed to lower life expectancy and higher mortality rates among men. This study presents the pre-adoption characteristics of men who registered for ‘Men on the Move’—a community-based physical activity (CBPA) programme, to ascertain whether the programme reached its intended target group, i.e. ‘at-risk’ adult men who did not meet physical activity (PA) guidelines and were likely to have multiple risk factors for cardiovascular disease (CVD).

Methods

Multiple recruitment strategies were adopted to engage the target group and baseline data collection included a range of demographic, self-report and outcome measures.

Results

The recruitment strategy succeeded in reaching the target group, with the majority (n = 927) presenting being previously inactive (89.0%), overweight/obese (89.7%) and having multiple CVD risk factors (53.1% ≥ 2 risk factors). However, the strategy was less successful in engaging ‘hard-to-reach’ groups, with the majority being middle-aged, white, married/cohabiting, educated and employed.

Conclusions

A gender-sensitized, partnership and community outreach recruitment strategy can maximize the reach and recruitment of an ‘at-risk’ cohort for CBPA initiatives, but more targeted approaches are needed to recruit marginalized groups of men.
Colletotrichum acutatum and C. gloeosporioides Species Complexes Associated with Apple in Brazil
Authors: Moreira Rafaele R. , Peres Natalia A. , May De Mio Louise L.
Published: August 2018

Glomerella leaf spot (GLS) is an apple disease that concerns growers due to the increases in severity over the years and the difficulties in control. Species within the Colletotrichum acutatum and C. gloeosporioides species complexes cause GLS, but the proportion of species within each complex in Brazilian apple orchards is not known. The objectives of this study were to identify isolates of Colletotrichum causing GLS on apple orchards in the main Brazilian producing regions to the species level. Two hundred and seven isolates were obtained in orchards in São Paulo (SP), Parana (PR), Santa Catarina (SC), and Rio Grande do Sul (RS) states. Genomic DNA was extracted, and the ITS, GAPDH, CHS-1, and TUB2 genes were amplified and sequenced. The phylogenetic trees were generated using a concatenated alignment. One hundred and fourteen isolates were identified as belonging to the C. acutatum species complex (Cac) and 93 to the C. gloeosporioides species complex (Cgc). Five phylogenetic species were identified: C. melonis (1.9%), C. nymphaeae (47.4%), C. paranaense (2.4%), C. limetticola (3.4%), and C. fructicola (44.9%). In SC, Cgc predominates, but in the states of SP, PR, and RS, Cac was predominant. This is the first report of C. limetticola from apple.
Anesthetics Have Different Effects on the Electrocorticographic Spectra of Wild-type and Mitochondrial Mutant Mice
Authors: Carspecken Charles William , Chanprasert Sirisak , Kalume Franck , Sedensky Margaret M. , Morgan Philip G.
Published: August 2018

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Knockout of the mitochondrial protein Ndufs4 (Ndufs4[KO]) in mice causes hypersensitivity to volatile anesthetics but resistance to ketamine. The authors hypothesized that electrocorticographic changes underlying the responses of Ndufs4(KO) to volatile anesthetics and to ketamine would be similar in mutant and control mice.

Methods

Electrocorticographic recordings at equipotent volatile anesthetic concentrations were compared between genotypes. In separate studies, control and cell type-specific Ndufs4(KO) mice were anesthetized with intraperitoneal ketamine to determine their ED50s.

Results

Ndufs4 (KO) did not differ from controls in baseline electrocorticography (N = 5). Compared to baseline, controls exposed to isoflurane (EC50) lost power (expressed as mean baseline [µV2/Hz]; mean isoflurane [µV2/Hz]) in delta (2.45; 0.50), theta (1.41; 0.16), alpha (0.23; 0.05), beta (0.066; 0.016), and gamma (0.020; 0.005) frequency bands (N = 5). Compared to baseline, at their isoflurane EC50, Ndufs4(KO) maintained power in delta (1.08; 1.38), theta (0.36; 0.26), and alpha (0.09; 0.069) frequency bands but decreased in beta (0.041; 0.023) and gamma (0.020; 0.0068) frequency bands (N = 5). Similar results were seen for both genotypes in halothane. Vesicular glutamate transporter 2 (VGLUT2)-specific Ndufs4(KO) mice were markedly resistant to ketamine (ED50; 125 mg/kg) compared to control mice (ED50; 75 mg/kg; N = 6). At their respective ED95s for ketamine, mutant (N = 5) electrocorticography spectra showed a decrease in power in the beta (0.040; 0.020) and gamma (0.035; 0.015) frequency bands not seen in controls (N = 7).

Conclusions

Significant differences exist between the electrocorticographies of mutant and control mice at equipotent doses for volatile anesthetics and ketamine. The energetic state specifically of excitatory neurons determines the behavioral response to ketamine.
Supervised Machine-learning Predictive Analytics for Prediction of Postinduction Hypotension
Authors: Kendale Samir , Kulkarni Prathamesh , Rosenberg Andrew D. , Wang Jing
Published: August 2018

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Hypotension is a risk factor for adverse perioperative outcomes. Machine-learning methods allow large amounts of data for development of robust predictive analytics. The authors hypothesized that machine-learning methods can provide prediction for the risk of postinduction hypotension.

Methods

Data was extracted from the electronic health record of a single quaternary care center from November 2015 to May 2016 for patients over age 12 that underwent general anesthesia, without procedure exclusions. Multiple supervised machine-learning classification techniques were attempted, with postinduction hypotension (mean arterial pressure less than 55 mmHg within 10 min of induction by any measurement) as primary outcome, and preoperative medications, medical comorbidities, induction medications, and intraoperative vital signs as features. Discrimination was assessed using cross-validated area under the receiver operating characteristic curve. The best performing model was tuned and final performance assessed using split-set validation.

Results

Out of 13,323 cases, 1,185 (8.9%) experienced postinduction hypotension. Area under the receiver operating characteristic curve using logistic regression was 0.71 (95% CI, 0.70 to 0.72), support vector machines was 0.63 (95% CI, 0.58 to 0.60), naive Bayes was 0.69 (95% CI, 0.67 to 0.69), k-nearest neighbor was 0.64 (95% CI, 0.63 to 0.65), linear discriminant analysis was 0.72 (95% CI, 0.71 to 0.73), random forest was 0.74 (95% CI, 0.73 to 0.75), neural nets 0.71 (95% CI, 0.69 to 0.71), and gradient boosting machine 0.76 (95% CI, 0.75 to 0.77). Test set area for the gradient boosting machine was 0.74 (95% CI, 0.72 to 0.77).

Conclusions

The success of this technique in predicting postinduction hypotension demonstrates feasibility of machine-learning models for predictive analytics in the field of anesthesiology, with performance dependent on model selection and appropriate tuning.
Preoperative Epoetin-α with Intravenous or Oral Iron for Major Orthopedic Surgery
Authors: Biboulet Philippe , Bringuier Sophie , Smilevitch Pierre , Loupec Thibault , Thuile Caroline , Pencole Mathieu , Maissiat Guillaume , Dangelser Gaëtan , Capdevila Xavier
Published: August 2018

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Preoperative administration of epoetin-α with iron is commonly used in anemic patients undergoing major orthopedic surgery, but the optimal route of iron intake is controversial. The aim of this study was to compare the clinical effects of erythropoietin in combination with oral or intravenous iron supplementation.

Methods

This study was a prospective, randomized, single-blinded, parallel arm trial. Patients scheduled for elective hip or knee arthroplasty with hemoglobin 10 to 13 g/dl received preoperative injections of erythropoietin with oral ferrous sulfate or intravenous ferric carboxymaltose. The primary endpoint was the hemoglobin value the day before surgery.

Results

One hundred patients were included in the analysis. The day before surgery, hemoglobin, increase in hemoglobin, and serum ferritin level were higher in the intravenous group. For the intravenous and oral groups, respectively, hemoglobin was as follows: median, 14.9 g/dl (interquartile range, 14.1 to 15.6) versus 13.9 g/dl (interquartile range, 13.2 to 15.1), group difference, 0.65 g/dl (95% CI, 0.1 to 1.2; P = 0.017); increase in hemoglobin: 2.6 g/dl (interquartile range, 2.1 to 3.2) versus 1.9 g/dl (interquartile range, 1.4 to 2.5), group difference, 0.7 g/dl (95% CI, 0.3 to 1.1; P < 0.001); serum ferritin: 325 µg/l (interquartile range, 217 to 476) versus 64.5 µg/l (interquartile range, 44 to 107), group difference, 257 µg/l (95% CI, 199 to 315; P < 0.001). The percentage of patients with nausea, diarrhea, or constipation was higher in the oral group, 52% versus 2%; group difference, 50% (95% CI, 35 to 64%; P < 0.0001).

Conclusions

After preoperative administration of erythropoietin, body iron stores and stimulation of the erythropoiesis were greater with intravenous ferric carboxymaltose than with oral ferrous sulfate supplementation.
Preoperative Patient Reported Outcomes Measurement Information System Scores Assist in Predicting Early Postoperative Success in Lumbar Discectomy
Authors: Rubery Paul T. , Houck Jeff , Mesfin Addisu , Molinari Robert , Papuga Mark O.
Published: August 2018

Study Design.

Retrospective review of prospective data.

Objective.

Determine whether patient reported outcome (PRO) data collected prior to lumbar discectomy predicts achievement of a minimal important difference (MID) after surgery. Compare ability of PRO and clinical information to predict achievement of MID in short term follow-up after discectomy.

Summary of Background Data.

We investigated the ability of patient reported outcomes measurement information system (PROMIS) and clinical factors at the preoperative time point to determine patients achieving MID after surgery.

Methods.

PROMIS physical function (PF), pain interference (PI), and depression (D) scores were assessed at evaluation and follow-up for consecutive visits between February, 2015 and September, 2017. Patients with preoperative scores within 30 days prior to surgery and with scores 40 days or more after surgery who completed all PROMIS domains were included yielding 78 patients. MIDs were calculated using a distribution-based method. A multivariate logistic regression model was created, and the ability to predict achieving MID for each of the PROMIS domains was assessed. Cut-off values and prognostic probabilities were determined for this model and models combining preoperative PROMIS with clinical data.

Results.

Preoperative PROMIS scores modestly predict reaching MID after discectomy (areas under the curve [AUC] of 0.62, 0.68, and 0.76 for PF, PI, and D, respectively). Preoperative cut-off scores show patients who have PF and PI scores more than 2 standard deviations, and D more than 1.5 standard deviations worse-off than population mean are likely to achieve MID. The combination of PROMIS with clinical data was the most powerful predictor of reaching MID with AUCs of 0.87, 0.84, and 0.83 for PF, PI, and D.

Conclusion.

PROMIS scores before discectomy modestly predict improvement after surgery. Preoperative PROMIS combined with clinical factors was more predictive of achieving MID than either clinical factors or PROMIS alone.

Level of Evidence: 3
The Impact of Metabolic Syndrome on 30-Day Outcomes Following Elective Anterior Cervical Discectomy and Fusions
Authors: Malik Azeem Tariq , Jain Nikhil , Kim Jeffery , Yu Elizabeth , Khan Safdar N.
Published: August 2018

Study Design.

Retrospective review of prospective registry

Objective.

To analyze the impact of metabolic syndrome (MetS) on 30-day outcomes following elective anterior cervical discectomy and fusions (ACDFs).

Summary of Background Data.

MetS is defined as the presence of a combination of hypertension, diabetes mellitus, and obesity. Past literature has reported MetS to complicate postoperative care in patients undergoing various surgical procedures, including lumbar fusions.

Methods.

The 2015 to 2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using current procedural terminology (CPT) codes 22,551 (single-level) and 22,552 (additional level). Patients undergoing disc arthroplasty, multi-level (>3) fusion, posterior cervical spine surgery, and patients with fracture, tumor, infection were excluded. MetS was defined using a pre-set criteria used by other NSQIP studies as the presence of—(1) diabetes mellitus, (2) hypertension requiring medication, and (3) body mass index (BMI) more than or equal to 30 kg/m2.

Results.

A total of 1384 (8.8%) patients with MetS underwent a cervical fusion. Following adjusted analysis, results showed that presence of MetS was associated with higher odds of a prolonged length of stay more than or equal to 3 days (odds ratios [OR] 1.32 [95% confidence interval [CI] 1.12–1.56]; P = 0.001). No significant association was found between MetS and 30-day complications, 30-day reoperations, 30-day re-admissions, a non-home discharge, and death.

Conclusion.

While MetS was associated with a prolonged length of stay, its presence does not have a large impact on 30-day outcomes following elective ACDF.

Level of Evidence: 3
Data Mining for Adverse Drug Events With a Propensity Score-matched Tree-based Scan Statistic
Authors: Wang Shirley V. , Maro Judith C. , Baro Elande , Izem Rima , Dashevsky Inna , Rogers James R. , Nguyen Michael , Gagne Joshua J. , Patorno Elisabetta , Huybrechts Krista F. , Major Jacqueline M. , Zhou Esther , Reidy Megan , Cosgrove Austin , Schneeweiss Sebastian , Kulldorff Martin
Published: August 2018

The tree-based scan statistic is a statistical data mining tool that has been used for signal detection with a self-controlled design in vaccine safety studies. This disproportionality statistic adjusts for multiple testing in evaluation of thousands of potential adverse events. However, many drug safety questions are not well suited for self-controlled analysis. We propose a method that combines tree-based scan statistics with propensity score–matched analysis of new initiator cohorts, a robust design for investigations of drug safety. We conducted plasmode simulations to evaluate performance. In multiple realistic scenarios, tree-based scan statistics in cohorts that were propensity score matched to adjust for confounding outperformed tree-based scan statistics in unmatched cohorts. In scenarios where confounding moved point estimates away from the null, adjusted analyses recovered the prespecified type 1 error while unadjusted analyses inflated type 1 error. In scenarios where confounding moved point estimates toward the null, adjusted analyses preserved power, whereas unadjusted analyses greatly reduced power. Although complete adjustment of true confounders had the best performance, matching on a moderately mis-specified propensity score substantially improved type 1 error and power compared with no adjustment. When there was true elevation in risk of an adverse event, there were often co-occurring signals for clinically related concepts. TreeScan with propensity score matching shows promise as a method for screening and prioritization of potential adverse events. It should be followed by clinical review and safety studies specifically designed to quantify the magnitude of effect, with confounding control targeted to the outcome of interest.
Drowning in fresh or salt water: respective influence on respiratory function in a matched cohort study
Authors: Michelet Pierre , Dusart Marion , Boiron Laurence , Marmin Julien , Mokni Tarak , Loundou Anderson , Coulange Mathieu , Markarian Thibaut
Published: August 2018

Introduction

For the most severe drowned patients, hypoxemia represents one of the major symptoms. As the influence of the type of water (fresh or salt water) on respiratory function is still unclear, the primary endpoint of this multicenter study was to compare hypoxemia according to the type of water.

Methods

Medical records of adult patients who experienced a drowning event and were consequently admitted to 10 ICU for acute respiratory failure were analyzed retrospectively using data collected over three consecutive summer periods. From an initial cohort of acute respiratory failure drowned patients, patients were matched by age, sex, Glasgow Coma Scale, and occurrence of cardiac arrest (yes or no).

Results

Among an initial cohort of 242 patients, 38 pairs were matched correctly. At the initial assessment, carried out upon ICU admission, hypoxemia was found to be deeper in the fresh water group (PaO2/FiO2: 141 ± 76 vs. 220 ± 122, P < 0.05). However, there was no significant difference in tissue oxygenation (assessed by blood lactate level) between groups. In terms of biology results, sodium levels were higher in the salt water group in the initial assessment (144 ± 6.8 vs. 140 ±5.2 mmol/l, P = 0.004), but no difference was observed later. No difference was recorded in the outcome or length of stay in ICU between groups.

Conclusion

Drowning in fresh water was associated with deeper hypoxemia in the initial assessment. Despite this initial difference, latter respiratory and biological parameters or outcome were similar in both groups.
Exocrine Pancreatic Insufficiency and Malnutrition in Chronic Pancreatitis
Authors: Min May , Patel Boskey , Han Samuel , Bocelli Lisa , Kheder Joan , Vaze Aditya , Wassef Wahid
Published: August 2018

Objectives

The purpose of this study was to examine the impact of exocrine pancreatic insufficiency (EPI) on chronic pancreatitis (CP) patients and to identify challenges with its diagnosis and treatment.

Methods

Ninety-one patients with CP diagnosed with endoscopic ultrasound were identified and assessed for symptoms of EPI, fat-soluble vitamin levels, dual-energy x-ray absorptiometry scan T-scores, and treatment with pancreatic enzyme replacement therapy. All patients were also screened with the Malnutrition Universal Screening Test.

Results

Exocrine pancreatic insufficiency was diagnosed in 84.6% (77/91) of patients based on symptoms of bloating, steatorrhea, or weight loss. Of these patients, 35.2% (19/54) had vitamin A deficiency, 62.5% (55/88) had vitamin D deficiency, and 17.7% (9/51) had vitamin E deficiency. Either osteopenia or osteoporosis was found in 68.9% (31/45). A medium or higher risk for malnutrition based on Malnutrition Universal Screening Test score of 1 or higher was found in 31.5% (28/89). Malnutrition Universal Screening Test score of 1 or higher was associated with an increased risk for osteopenia and osteoporosis on Fisher’s exact test (P = 0.0037).

Conclusions

There is a high prevalence of fat-soluble vitamin deficiencies, osteopathy, and malnutrition in CP patients, which is underestimated due to a lack of effective diagnosis and suboptimal therapies for EPI.
The Impact of Behavioral Health Patients on a Pediatric Emergency Department's Length of Stay and Left Without Being Seen
Authors: Conrad Heather B. , Hollenbach Kathryn A. , Gehlbach Daniel L. , Ferran Karen L. , Barham Tiffani A. , Carstairs Keri L.
Published: August 2018

Objective

Emergency department (ED) boarding of admitted patients negatively impacts ED length of stay (LOS). Behavioral health (BH) patients are often challenging to safely discharge. We examined the association between daily BH census and non-BH LOS and left without being seen (LWBS) rates.

Methods

Retrospective analysis of BH and non-BH patients at a high-volume tertiary care pediatric ED from December 2014 to June 2016 examined the association between BH patients and non-BH LOS and LWBS rates. Behavioral health patients were identified by presence of social work assessment and BH chief complaint and/or final diagnosis. Data were analyzed using 1-sample test of proportions, Student t test, Spearman and Pearson correlations, logistic regression, and odds ratios with 95% confidence intervals.

Results

A total of 143,141 patients were seen, 3% (n = 4351) for BH presentations. Median LOS for discharged non-BH patients was 128 minutes compared with 446 minutes for BH patients. Daily LOS and bed hold hours were significantly longer for BH than for non-BH patients (P < 0.0001 for each analysis). After adjusting for ED census, daily BH census was significantly associated with increasing LWBS rates and non-BH LOS.

Conclusions

Behavioral health census and bed hold hours were significantly associated with increased LOS and LWBS rates and with our inability to meet desired LOS and LWBS rates. These associations support the existence of a threshold where the ED has reached capacity and is no longer able to absorb BH patients. Improving BH facility access may help improve overall pediatric ED patient care.
Impact of Temporomandibular Disorders and Sleep Bruxism on Oral Health-Related Quality of Life of Individuals With Complete Cleft Lip and Palate
Authors: Silva Fernanda Coelho da , Oliveira Thais Marchini de , Almeida Ana Lúcia Pompéia Fraga de , Bastos Roosevelt da Silva , Neppelenbroek Karin Hermana , Soares Simone
Published: August 2018

The temporomandibular disorders (TMDs) and sleep bruxism (SB) affect the quality of life (QoL) of the individuals in general. However, the literature lacks studies on individuals with cleft lip and palate (CLP). Thus, this study aimed to evaluate the impact of TMD and SB on the oral health-related quality of life (OHRQoL) of individuals with CLP. Thirty-six individuals, both genders, aged between 30 and 50 years, at routine treatment in the Dental Prosthesis Sector of Hospital for Rehabilitation of Craniofacial Anomalies—University of São Paulo were selected and divided into the following groups: G1—unilateral complete CLP (n = 22) and G2—bilateral complete CLP (n = 14). Three questionnaires were applied: Oral Health Impact Profile (OHIP-14), SB self-report and Research Diagnosis Criteria for TMD. Fisher test, Mann–Whitney test, and t test were applied to verify values between TMD, SB, gender, and OHIP-14 (P < 0.05). The mean OHIP-14 score was of 5.80, and females had higher (8.58) OHRQoL than males (3.31). There was association with gender and OHRQoL (t test, P = 0.006), TMD with OHRQoL (Mann–Whitney test, P = 0.036), and TMD and SB (Fisher test, P = 0.006). Temporomandibular disorder was diagnosed in 30% of the individuals. Of these, 16.66% did not present SB, while 13.88% presented it. The association TMD versus SB showed statistically significant differences and 83.33% of the individuals reporting SB also had TMD. Based on this study, the authors can conclude that: TMD impacts OHRQoL in CLP patients, females are more affected in their OHRQoL than males, SB was strongly associated with TMD.
Liver Transplantation and Hepatic Resection can Achieve Cure for Hepatocellular Carcinoma
Authors: Pinna Antonio Daniele , Yang Tian , Mazzaferro Vincenzo , De Carlis Luciano , Zhou Jian , Roayaie Sasan , Shen Feng , Sposito Carlo , Cescon Matteo , Di Sandro Stefano , Yi-feng He , Johnson Philip , Cucchetti Alessandro
Published: August 2018

Objective:

The aim of this study was to estimate probabilities of achieving the statistical cure from hepatocellular carcinoma (HCC) with hepatic resection (HR) and liver transplantation (LT).

Background:

Statistical cure occurs when the mortality of a specific population returns to values of that of general population. Resection and transplantation are considered potentially curative therapies for HCC, but their effect on the residual entire life-expectancy has never been investigated.

Methods:

Data from 3286 HCC patients treated with LT (n = 1218) or HR (n = 2068) were used to estimate statistical cure. Disease-free survival (DFS) was the primary survival measure to estimate cure fractions through a nonmixture model. Overall survival (OS) was a secondary measure. In both, patients were matched with general population by age, sex, year, and race/ethnicity. Cure variations after LT were also adjusted for different waiting-list drop-outs.

Results:

Considering DFS, the cure fraction after LT was 74.1% and after HR was 24.1% (effect size >0.8). LT outperformed HR within all transplant criteria considered (effect size >0.8), especially for multiple tumors (>0.9) and even in presence of a drop-out up to 20% (>0.5). Considering OS, the cure fraction after LT marginally increased to 75.8%, and after that HR increased to 40.5%. The effect size of LT over HR in terms of cure decreased for oligonodular tumors (<0.5), became small for drop-out up to ∼20% (<0.2), and negligible for single tumors <5 cm (∼0.1).

Conclusion:

As other malignancies, statistical cure can occur for HCC, primarily with LT and secondarily with HR, depending on waiting-list capabilities and efficacy of tumor recurrence therapies after resection.
Effectiveness of Fibrin Sealant Application on the Development of Staple Line Complications After Sleeve Gastrectomy
Authors: Rebibo Lionel , Dhahri Abdennaceur , Chati Rachid , Cosse Cyril , Huet Emmanuel , Regimbeau Jean-Marc
Published: August 2018

Objectives:

Evaluate the effectiveness of the use of fibrin sealant (FS) for preventing the development of staple line complications (SLCs) after sleeve gastrectomy (SG).

Background:

There is no consensus on the best means of preventing SLCs after SG.

Methods:

This was a prospective, intention-to-treat, randomized, 2 center study of a group of 586 patients undergoing primary SG (ClinicalTrials.gov identifier: NCT01613664) between March 2014 and June 2017. The 1:1 randomization was stratified by center, age, sex, gender, and body mass index, giving 293 patients in the FS group and 293 in the control group (without FS). The primary endpoint (composite criteria) was the incidence of SLCs in each of the 2 groups. The secondary criteria were the mortality rate, morbidity rate, reoperation rate, length of hospital stay, readmission rate, and risk factors for SLC.

Results:

There were no intergroup differences in demographic variables. In an intention-to-treat analysis, the incidence of SLCs was similar in the FS and control groups (1.3% vs 2%, respectively; P = 0.52). All secondary endpoints were similar: complication rate (5.4% vs 5.1%, respectively; P = 0.85), mortality rate (0.3% vs 0%, respectively; P = 0.99), GL rate (0.3% vs 1.3%, respectively; P = 0.18), postoperative hemorrhage/hematoma rate (1% vs 0.7%, respectively; P = 0.68), reoperation rate (1% vs 0.3%, respectively; P = 0.32). Length of stay was 1 day in both groups (P = 0.89), and the readmission rate was similar (5.1% vs 3.4%, respectively; P = 0.32). No risk factors for SLCs were found.

Conclusion:

The incidence of postoperative SLCs did not appear to depend on the presence or absence of FS.
A Randomized Controlled Trial Comparing Epidural Analgesia Versus Continuous Local Anesthetic Infiltration Via Abdominal Wound Catheter in Open Liver Resection
Authors: Bell Richard , Ward Deesa , Jeffery Julie , Toogood Giles J. , Lodge JPeter A. , Rao Krishna , Lotia Sharmeen , Hidalgo Ernest
Published: August 2018

Aim:

To compare outcomes following open liver resection (OLR) between patients receiving thoracic epidural (EP) versus abdominal wound catheters plus patient-controlled analgesia (AWC-PCA).

Method:

Patients were randomized 1:1 to either EP or AWC-PCA within an enhanced recovery protocol. Primary outcome was length of stay (LOS), other variables included functional recovery, pain scores, peak flow, vasopressor and fluid requirements, and postoperative complications.

Results:

Between April 2015 and November 2017, 83 patients were randomized to EP (n = 41) or AWC-PCA (n = 42). Baseline demographics were comparable. No difference was noted in LOS (EP 6 d (3–27) vs AWC-PCA 6 d (3–66), P = 0.886). Treatment failure was 20% in the EP group versus 7% in the AWC-PCA (P = 0.09). Preoperative anesthetic time was shorter in the AWC-PCA group, 49 minutes versus 62 minutes (P = 0.003). EP patients required more vasopressor support immediately postoperatively on day 0 (14% vs 54%, P = <0.001) and day 1 (5% vs 23%, P = 0.021). Pain scores were greater on day 0, afternoon of day 1 and morning of day 2 in the AWC-PCA group however were regarded as low at all time points. No other significant differences were noted in IV fluid requirements, nausea/sedation scores, days to open bowels, length of HDU, and postoperative complications.

Conclusion:

AWC-PCA was associated with reduced treatment failure and a reduced vasopressor requirement than EP up to 2 days postoperatively. While the use of AWC-PCA did not translate into a shorter LOS in this study, it simplified patient management after OLR. EP cannot be routinely recommended following open liver resections.
Complex dynamics in simplified neuronal models: reproducing Golgi cell electroresponsiveness
Authors: Geminiani Alice , Casellato Claudia , Locatelli Francesca , Prestori Francesca , Pedrocchi Alessandra , D’Angelo Egidio
Published: August 2018

Brain neurons exhibit complex electroresponsive properties - including intrinsic subthreshold oscillations and pacemaking, resonance and phase-reset - which are thought to play a critical role in controlling neural network dynamics. Although these properties emerge from detailed representations of molecular-level mechanisms in “realistic” models, they cannot usually be generated by simplified neuronal models (although these may show spike-frequency adaptation and bursting). We report here that this whole set of properties can be generated by theextended generalized leaky integrate-and-fire(E-GLIF) neuron model. E-GLIF derives from the GLIF model family and is therefore mono-compartmental, keeps the limited computational load typical of a linear low-dimensional system, admits analytical solutions and can be tuned through gradient-descent algorithms. Importantly, E-GLIF is designed to maintain a correspondence between model parameters and neuronal membrane mechanisms through a minimum set of equations. In order to test its potential, E-GLIF was used to model a specific neuron showing rich and complex electroresponsiveness, the cerebellar Golgi cell, and was validated against experimental electrophysiological data recorded from Golgi cells in acute cerebellar slices. During simulations, E-GLIF was activated by stimulus patterns, including current steps and synaptic inputs, identical to those used for the experiments. The results demonstrate that E-GLIF can reproduce the whole set of complex neuronal dynamics typical of these neurons - including intensity-frequency curves, spike-frequency adaptation, depolarization-induced and post-inhibitory rebound bursting, spontaneous subthreshold oscillations, resonance and phase-reset, - providing a new effective tool to investigate brain dynamics in large-scale simulations.
Variability of collective dynamics in random tree networks of strongly-coupled stochastic excitable elements
Authors: Khaledi-Nasab Ali , Kromer Justus A. , Schimansky-Geier Lutz , Neiman Alexander B.
Published: August 2018

We study the collective dynamics of strongly diffusively coupled excitable elements on small random tree networks. Stochastic external inputs are applied to the leaves causing large spiking events. Those events propagate along the tree branches and, eventually, exciting the root node. Using Hodgkin-Huxley type nodal elements, such a setup serves as a model for sensory neurons with branched myelinated distal terminals. We focus on the influence of the variability of tree structures on the spike train statistics of the root node. We present a statistical description of random tree network and show how the structural variability translates into the collective network dynamics. In particular, we show that in the physiologically relevant case of strong coupling the variability of collective response is determined by the joint probability distribution of the total number of leaves and nodes. We further present analytical results for the strong coupling limit in which the entire tree network can be represented by an effective single element.

PACS numbers: 87.19.ll, 87.19.lb, 87.19.lc, 05.45.Xt, 05.10.Gg
Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men: a secondary analysis of energy expenditure and physical activity
Authors: Friedman Mark I. , Appel Scott
Published: August 2018

Background

A previously published pilot study assessed energy expenditure (EE) of participants with overweight and obesity after they were switched from a baseline high-carbohydrate diet (BD) to an isocaloric low-carbohydrate ketogenic diet (KD). EE measured using metabolic chambers increased transiently by what was considered a relatively small extent after the switch to the KD, whereas EE measured using doubly labeled water (EEDLW) increased to a greater degree after the response in the chambers had waned. Using a publicly available dataset, we examined the effect of housing conditions on the magnitude of the increase in EEDLW after the switch to the KD and the role of physical activity in that response.

Methods

The 14-day EEDLW measurement period included 4 days when subjects were confined to chambers instead of living in wards. To determine the effect on EEDLW only for the days subjects were living in the wards, we calculated non-chamber EE (EEnonchamber). To assess the role of physical activity in the response to the KD, we analyzed chamber and non-chamber accelerometer data for the BD and KD EEDLW measurement periods.

Results

In comparison with the increase in average 14-day EEDLW of 151 kcal/d ± 63 (P = 0.03) after the switch to the KD, EEnonchamber increased by 203 ± 89 kcal/d (P = 0.04) or 283 ± 116 kcal/d(P = 0.03) depending on the analytical approach. Hip accelerometer counts decreased significantly (P = 0.01) after the switch to the KD, whereas wrist and ankle accelerometer counts did not change.

Conclusions

Switching from the BD to the KD substantially increased EEDLW, but apparently only on days subjects were living in the ward outside the metabolic chamber. Increased physical activity as measured by accelerometry did not appear to account for this effect.
Chromosome-scale assemblies reveal the structural evolution of African cichlid genomes
Authors: Conte Matthew A. , Joshi Rajesh , Moore Emily C. , Nandamuri Sri Pratima , Gammerdinger William J. , Roberts Reade B. , Carleton Karen L. , Lien Sigbjørn , Kocher Thomas D.
Published: August 2018

Background

African cichlid fishes are well known for their rapid radiations and are a model system for studying evolutionary processes. Here we compare multiple, high-quality, chromosome-scale genome assemblies to understand the genetic mechanisms underlying cichlid diversification and study how genome structure evolves in rapidly radiating lineages.

Results

We re-anchored our recent assembly of the Nile tilapia (Oreochromis niloticus) genome using a new high-density genetic map. We developed a newde novogenome assembly of the Lake Malawi cichlid,Metriaclima zebra, using high-coverage PacBio sequencing, and anchored contigs to linkage groups (LGs) using four different genetic maps. These new anchored assemblies allow the first chromosome-scale comparisons of African cichlid genomes.

Large intra-chromosomal structural differences (~2-28Mbp) among species are common, while inter-chromosomal differences are rare (< 10Mbp total). Placement of the centromeres within chromosome-scale assemblies identifies large structural differences that explain many of the karyotype differences among species. Structural differences are also associated with unique patterns of recombination on sex chromosomes. Structural differences on LG9, LG11 and LG20 are associated with reductions in recombination, indicative of inversions between the rock- and sand-dwelling clades of Lake Malawi cichlids.M. zebrahas a larger number of recent transposable element (TE) insertions compared toO. niloticus, suggesting that several TE families have a higher rate of insertion in the haplochromine cichlid lineage.

Conclusion

This study identifies novel structural variation among East African cichlid genomes and provides a new set of genomic resources to support research on the mechanisms driving cichlid adaptation and speciation.
Increasing consensus of context-specific metabolic models by integrating data-inferred cell functions
Authors: Richelle Anne , Chiang Austin W.T. , Kuo Chih-Chung , Lewis Nathan E.
Published: August 2018

Genome-scale metabolic models provide a valuable context for analyzing data from diverse high-throughput experimental techniques. Models can quantify the activities of diverse pathways and cellular functions. Since some metabolic reactions are only catalyzed in specific environments, several algorithms exist that build context-specific models. However, these methods make differing assumptions that influence the content and associated predictive capacity of resulting models, such that model content varies more due to methods used than cell types. Here we overcome this problem with a novel framework for inferring the metabolic functions of a cell before model construction. For this, we curated a list of metabolic tasks and developed a framework to infer the activity of these functionalities from transcriptomic data. We protected the data-inferred tasks during the implementation of diverse context-specific model extraction algorithms for 44 cancer cell lines. We show that the protection of data-inferred metabolic tasks decreases the variability of models across extraction methods. Furthermore, resulting models better capture the actual biological variability across cell lines. This study highlights the potential of using biological knowledge, inferred from omics data, to obtain a better consensus between existing extraction algorithms. It further provides guidelines for the development of the next-generation of data contextualization methods.
Characterization of cis-prenyltransferase complexes in guayule (Parthenium argentatum), an alternative natural rubber-producing plant
Authors: Lakusta Adam M. , Kwon Moonhyuk , Kwon Eun-Joo , Stonebloom Solomon , Scheller Henrik V. , Ro Dae-Kyun
Published: August 2018

Guayule (Parthenium argentatum) is a perennial shrub in the Asteraceae family and synthesizes a high quality, hypoallergenic cis-1,4-polyisoprene (or natural rubber; NR). Despite its potential to be an alternative NR supplier, the enzymes for cis-polyisoprene biosynthesis have not been comprehensively studied in guayule. Recently, implications of the protein complex involving cis-prenyltransferases (CPTs) and CPT-binding proteins (CBPs) in NR biosynthesis were shown in lettuce and dandelion, but such protein complexes have yet to be examined in guayule. Here we identified four guayule genes – three PaCPTs (PaCPT1-3) and one PaCBP, whose protein products form PaCPT/PaCBP complexes. Co-expression of both PaCBP and each of the PaCPTs could complemented the dolichol (a short cis-polyisoprene)-deficient yeast, whereas the individual expressions could not. Microsomes from the PaCPT/PaCBP-expressing yeast efficiently incorporated 14C-isopentenyl diphosphate into dehydrodolichyl diphosphates. Furthermore, co-immunoprecipitation and split-ubiquitin yeast 2-hybrid assays using PaCPTs and PaCBP confirmed the formation of protein complexes. Of the three PaCPTs, transcriptomics analysis indicated that the protein complex formed by PaCPT3 and PaCBP is likely to be the key component in guayule NR biosynthesis. The comprehensive analyses of these PaCPTs and PaCBP here provide the foundational knowledge to generate a high NR-yielding guayule.
Non-coding Class Switch Recombination-related transcription in human normal and pathological immune responses
Authors: Kuri-Magaña Helena , Collado-Torres Leonardo , Jaffe Andrew E. , Valdovinos-Torres Humberto , Ovilla-Muñoz Marbella , Téllez-Sosa Juan M , Bonifaz Alfonzo Laura C , Martinez-Barnetche Jesùs
Published: August 2018

Background

Antibody class switch recombination (CSR) to IgG, IgA or IgE is a hallmark of adaptive immunity, allowing antibody function diversification beyond IgM. CSR involves a deletion of the IgM/IgD constant region genes placing a new acceptor Constant (CH) gene, downstream of the VDJH exon. CSR depends on non-coding (CSRnc) transcription of donor Iμ and acceptor IH exons, located 5’ upstream of each CH coding gene. Although our knowledge of the role of CSRnc transcription has advanced greatly, its extension and importance in healthy and diseased humans is scarce.

Methods

We analyzed CSRnc transcription in 70,603 publicly available RNA-seq samples, including GTEx, TCGA and the Sequence Read Archive (SRA) using recount2, an online resource consisting of normalized RNA-seq gene and exon counts, as well as coverage BigWig files that can be programmatically accessed through R. CSRnc transcription was validated with a qRT-PCR assay for Iμ, Iγ3 and Iγ1 in humans in response to vaccination.

Results

We mapped IH transcription for the human IgH locus, including the less understood IGHD gene. CSRnc transcription was restricted to B cells and is widely distributed in normal adult tissues, but predominant in blood, spleen, MALT-containing tissues, visceral adipose tissue and some so-called “immune privileged” tissues. However, significant Iγ4 expression was found even in non-lymphoid fetal tissues. CSRnc expression in cancer tissues mimicked the expression of their normal counterparts, with notable pattern changes in some common cancer subsets. CSRnc transcription in tumors appears to result from tumor infiltration by B cells, since CSRnc transcription was not detected in corresponding tumor-derived immortal cell lines. Additionally, significantly increased I5 transcription in ileal mucosa in Crohn’s disease with ulceration was found.

Conclusions

CSRnc transcription occurs in multiple anatomical locations beyond classical secondary lymphoid organs, representing a potentially useful marker of effector B cell responses in normal and pathological immune responses. The pattern of IH exon expression may reveal clues of the local immune response (i.e. cytokine milieu) in health and disease. This is a great example of how the public recount2 data can be used to further our understanding of transcription, including regions outside the known transcriptome.