bluuebunny/crossref_metadata_2025 huggingface dataset:
Oregon Medicaid Expenditures After the 2014 Affordable Care Act Medicaid Expansion: Over-time Differences Among New, Returning, and Continuously Insured Enrollees
Authors: Springer Rachel , Marino Miguel , O’Malley Jean P. , Lindner Stephan , Huguet Nathalie , DeVoe Jennifer E.
Published: March 2018

Background:

There is interest in assessing health care utilization and expenditures among new Medicaid enrollees after the 2014 Medicaid expansion. Recent studies have not differentiated between newly enrolled individuals and those returning after coverage gaps.

Objectives:

To assess health care expenditures among Medicaid enrollees in the 24 months after Oregon’s 2014 Medicaid expansions and examine whether expenditure patterns were different among the newly, returning, and continuously insured (CI).

Research Design:

Retrospective cohort study using inverse-propensity weights to adjust for differences between groups.

Subjects:

Oregon adult Medicaid beneficiaries insured continuously from 2014 to 2015 who were either newly, returning, or CI.

Measures:

Monthly expenditures for inpatient care, prescription drugs, total outpatient care, and subdivisions of outpatient care: emergency department, dental, mental and behavioral health, primary care, and specialist care.

Results:

After initial increases, newly and returning insured (RI) outpatient expenditures dropped below CI. Expenditures for emergency department and dental services among the RI remained higher than among the newly insured. Newly insured mental and behavioral health, primary care, and specialist expenditures plateaued higher than RI. Prescription drug expenditures increased over time for all groups, with CI highest and RI lowest. All groups had similar inpatient expenditures over 24 months post-Medicaid expansion.

Conclusions:

Our findings reveal that outpatient expenditures for new nonpregnant, non–dual-eligible Oregon Medicaid recipients stabilized over time after meeting pent-up demand, and prior insurance history affected the mix of services that individuals received. Policy evaluations should consider expenditures over at least 24 months and should account for enrollees’ prior insurance histories.
Chapter 3. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition in Recent Years
Authors: Koletzko Berthold , Shamir Raanan , Broekaert Ilse , Troncone Riccardo
Published: March 2018

The European Society for Paediatric Gastroenterology, Hepatology and Nutrition has experienced an amazing development in the 50 years of its existence. It grew from a small group of 36 friends who held an informal meeting with some 20 oral presentations to share and discuss their clinical and research work, to a large, multiprofessional society that sets widely recognized standards for clinical care and policy and hosts the world's largest congress of Paediatric Gastroenterology, Hepatology and Nutrition with more than 4500 delegates from 100 countries. However, the Society's mission has remained the same: to promote the health of children with special attention to the gastrointestinal tract, liver, and nutritional status, through knowledge creation, the dissemination of science based information, the promotion of best practice in the delivery of care and the provision of high‐quality education. The European Society for Paediatric Gastroenterology Hepatology and Nutrition's success is based on the enthusiasm and engagement of its membership that contribute extensive volunteer work to support child health, while maintaining a positive spirit of collaboration and friendship, which characterises this Society. This article aims at describing recent developments and the current situation of the European Society for Paediatric Gastroenterology Hepatology and Nutrition.
Neurodevelopmental Outcomes in Children With Liver Diseases
Authors: Rodijk Lyan H. , den Heijer Anne E. , Hulscher Jan B.F. , Verkade Henkjan J. , de Kleine Ruben H.J. , Bruggink Janneke L.M.
Published: March 2018

Objective:

The aim of the study was to determine the neurodevelopmental outcomes of children with liver diseases based on a systematical review of the literature.

Method:

A literature search according to the PRISMA statement was conducted using predefined search terms in PubMed, Cochrane Library, and PsycINFO. The inclusion criterion was studies published from 2000 onwards that reported on the neurodevelopmental outcomes of term‐born children with liver diseases. A narrative synthesis was done to appraise the studies.

Results:

Twenty‐five studies were included (1913 children), 19 of which described children after liver transplantation (LTx; 1372 children). Sixty‐seven percentage of the studies on children with liver diseases who survived with their native livers showed low‐average or abnormal scores on specific subscales of cognitive and behavioral measures. In studies on children after LTx, this was 82%. After LTx, 83% of studies demonstrated impaired outcomes on behavior, whereas 42% of children received special education. Motor development was impaired in 82% of studies in children with native liver and after LTx.

Limitations:

Studies were heterogenic because of sample sizes, etiology of liver disease and type of assessment tools used.

Conclusions:

More than two‐third of included studies showed neurodevelopmental deficits in children with liver diseases, affecting all neurodevelopmental areas. Knowledge on risk factors for impaired neurodevelopment is limited and lack of long‐term follow‐up is worrying, especially considering the increasing survival rates, resulting in more at‐risk patients. Studying early predictors and risk factors of abnormal developmental trajectories of children with liver diseases is indicated to assess strategies to improve their long‐term neurodevelopmental outcomes.
Subsequent HIV Diagnosis Risk After Syphilis in a Southern Black Population
Authors: Aziz Sulayman , Sweat David
Published: March 2018

Background

Southern non-Hispanic black persons are disproportionately represented in the HIV epidemic. Those previously diagnosed as having syphilis are at significant risk to become HIV infected within 36 months. Effective prevention strategies such as preexposure prophylaxis should be offered to those at highest risk to maximize prevention efforts.

Methods

HIV-negative persons diagnosed as having primary or secondary (P&S) syphilis during 1998–2014 were matched with incident HIV cases diagnosed during 1998–2016 in Shelby County Tennessee. Person-year HIV incidence rate, Kaplan-Meier survival estimates, and Cox proportional regression model analyses were performed to explore predicting risk factors and quantifying risk factors associated with HIV-free survival time frames.

Results

Among 2032 HIV-negative non-Hispanic black Shelby County residents diagnosed as having P&S syphilis, 139 (6.8%) were subsequently diagnosed as having HIV infection. Men who have sex with men (MSM) experienced the highest incidence of HIV diagnosis rate (4.98 per 100 person-years, 95% confidence interval, 4.76–5.2). Being male, MSM, younger than 30 years, or coinfected with gonorrhea increased risk of HIV acquisition 2.32, 11.80, 1.67, and 2.44 times, respectively, compared with being female, heterosexual men, 30+ years old, or not infected with other sexually transmitted infections.

Conclusions

Among our population diagnosed as having P&S syphilis, 1 in 6 MSM and 1 in 16 persons coinfected with gonorrhea were subsequently diagnosed as having HIV during 36 months of follow-up. These findings have implications for HIV screening and recruitment as priority preexposure prophylaxis candidates.
Positive Bacteriological Analyses in Individuals With Diabetes Mellitus
Authors: Palmiere Cristian , Tettamanti Camilla
Published: March 2018

Increased infection susceptibility in the diabetic population is a controversial issue in the clinical field. The greater frequency of infections in diabetic patients has been speculated as caused by the hyperglycemic environment that favors immune dysfunction. The aim of this study was to investigate the proportion of positive bacterial cultures in a series of diabetic individuals who underwent forensic investigations and assess the frequency of hyperglycemia at the time of death in these cases as well as the percentage of diabetics with cause of death due to bacterial infection. Forensic autopsy cases characterized by positive bacterial cultures and pre-existing diagnosis of diabetes mellitus were included in the study. Initial findings revealed that 12% (7/58 cases) of positive bacterial cultures concerned individuals with a pre-existing diagnosis of diabetes mellitus. Bacterial infection was considered to be the cause of death in 22% (7/31 cases) of diabetics with positive bacterial cultures. Hyperglycemia could be identified in 1 case only at the time of death. These preliminary results highlight the usefulness of systematically performing postmortem bacteriology in the forensic setting to more precisely characterize infectious risk factors in diabetics.
Hand-Arm Bimanual Intensive Therapy Improves Prefrontal Cortex Activation in Children With Hemiplegic Cerebral Palsy
Authors: Surkar Swati M. , Hoffman Rashelle M. , Willett Sandra , Flegle Janice , Harbourne Regina , Kurz Max J.
Published: March 2018

Purpose:

To determine the changes in the prefrontal cortical (PFC) activation following hand-arm bimanual intensive therapy (HABIT) in children with hemiplegic cerebral palsy (HCP).

Methods:

Nine children with HCP and 15 children who were developing typically participated in the study. Children with HCP received 50 hours of HABIT. We assessed pre- and post-HABIT PFC activation using functional near-infrared spectroscopy neuroimaging. Bimanual coordination and motor task performance were assessed using the Assisting Hand Assessment (AHA), the average number of shapes matched, the shape matching errors, the reaction time, the 9-hole peg test, and the box and blocks test.

Results:

The PFC activation decreased following HABIT and became similar to what was seen in the children who were developing typically. Post-HABIT PFC activation improvements paralleled with the improvements seen in the AHA and the behavioral outcomes.

Conclusion:

HABIT potentially improves the PFC's involvement in the action planning of the upper extremity movements in children with HCP.
A Pediatric Service-Learning Program in Physical Therapy Education
Authors: Hou Yu-Jen , Liu Wen-Yu , Lin Yang-Hua , Lien Hen-Yu , Wong Alice M. K. , Chen Chien-Min
Published: March 2018

Purpose:

The purpose of this report was to describe a pediatric service-learning program in entry-level physical therapy (PT) education in Taiwan.

Key Points:

To meet the needs of the local community and provide preclinical service-learning experience to PT students with people with physical disability, a service-learning program of a 2-day camp for children with cerebral palsy (CP) was developed in 2012. To date, 356 entry-level PT students have participated in this program, serving 286 children and their families. Important professional attributes, identified by the World Confederation for Physical Therapy guideline, such as altruism, compassion and caring, cultural competence, personal and professional development, professional duty, social responsibility and advocacy, and teamwork, were in the reflective reports of some of the PT students.

Conclusions:

The experiences provided by this pediatric PT service-learning program appear to have the potential to foster the development of professional attributes in entry-level PT students.
Ethical considerations in the design, execution, and analysis of clinical trials of chronic pain treatments
Authors: Rowbotham Michael C. , McDermott Michael P.
Published: March 2018

Introduction:

In the field of pain research, clinical trials may randomize over 500 subjects and include more than 150 sites spanning over a dozen countries.

Methods:

This review examines the ethical considerations affecting clinical trial design, execution, and analysis of trials for chronic pain. The Belmont Report has been the touchstone for human studies protection efforts since 1979. Commissioned by the U.S. government in response to ethical failures in medical research, such as the Tuskegee Syphilis Study, the report emphasizes 3 basic principles: respect for persons, beneficence, and justice. Trial design and sample size have important ethical implications.

Conclusions:

Measures to enhance trial transparency and combat publication and many other types of bias should be implemented.
Results of the Postmarket Clinical Study of the Sientra 207 Highly Cohesive Gel Breast Implants in Primary and Revision Augmentation
Authors: Schwartz Michael R. , Haws Melinda J. , Phillips Ginny
Published: March 2018

Background:

Board-certified plastic surgeons utilizing the Sientra 207 Highly Cohesive Gel breast implants provided their initial satisfaction with usage and postoperative results on primary and revision augmentation patients, and study participants provided their satisfaction with surgical result.

Methods:

Up to 15 participating investigators at institutional review board–approved sites enrolled up to 180 women who received Sientra 207 implants for primary augmentation or revision augmentation procedures. Investigator and participant assessments were performed preoperatively and postoperatively at 3, 6, and 12 months.

Results:

All participating surgeons found the implants to be easy or very easy to implant, and 92 percentage reported satisfaction with surgical results. Patients receiving these implants reported similarly high rates of satisfaction (94%).

Conclusion:

With this combination of high satisfaction and low complication rates, the Sientra 207 silicone breast implants now provide a welcome addition to plastic surgeons’ breast implant options.
A Novel Small-Animal Model of Irradiated, Implant-Based Breast Reconstruction
Authors: Dassoulas Kasandra R. , Wang Jessica S. , Stovall Madeline M. , Lei Serena S. , Thuman Jenna M. , Salopek Lisa S. , Cottler Patrick S. , Pineros-Fernandez Angela , Kim Taeho , Hui CheukKai B. , Archual Anthony , Lin Kant Y.
Published: March 2018

Background:

There is currently a need for a clinically relevant small-animal model for irradiated, implant-based breast reconstruction. Present models are inadequate in terms of suboptimal location of expander placement and mode of radiation delivery, correlating poorly with the human clinical scenario. The authors hypothesized that by delivering fractionated radiation and placing an expander under the scalp of the animal, they would achieve soft-tissue changes histologically analogous to those seen in human irradiated, implant-based breast reconstruction.

Methods:

This study consisted of 11 immunocompetent, hairless rats divided into three groups as follows: untreated control (n = 3), tissue-expanded scalps (n = 4), and fractionated irradiation plus tissue expansion of the scalp (n = 4). At the completion of the experiment for each group, skin tissue samples were analyzed histologically for vascularity, epidermal and dermal thickness, and collagen fiber alignment or scar formation.

Results:

Expanded rat epidermis was significantly thicker and dermis was more vascular than nonexpanded skin. The authors observed a greater degree of collagen fiber alignment in the expanded group compared with nonexpanded skin. The combination of irradiation and expansion resulted in significant dermal thinning, vascular depletion, and increased scar formation compared with expanded skin alone.

Conclusions:

The authors describe a novel small-animal model for irradiated, implant-based breast reconstruction where histologic analysis shows structural changes in the skin consistent with known effects of radiation therapy and expansion in human skin. This model represents a significant improvement from previous ones and, as such, holds the potential to be used to test new therapeutic agents to improve clinical outcomes.
Vertical Growth Phase as a Prognostic Factor for Sentinel Lymph Node Positivity in Thin Melanomas: A Systematic Review and Meta-Analysis
Authors: Appleton Sarah E. , Fadel Zahir , Williams Jason S. , Bezuhly Michael
Published: March 2018

Background:

The 2010 American Joint Committee on Cancer guidelines recommended consideration of sentinel lymph node biopsy for thin melanoma (Breslow thickness <1.0 mm) with aggressive pathologic features such as ulceration and/or high mitotic rate. The therapeutic benefit of biopsy-based treatment remains controversial. The authors conducted a meta-analysis to estimate the risk and outcomes of sentinel lymph node positivity in thin melanoma, and examined established and potential novel predictors of positivity.

Methods:

Three databases were searched by two independent reviewers for sentinel lymph node positivity in patients with thin melanoma. Study heterogeneity, publication bias, and quality were assessed. Data collected included age, sex, Breslow thickness, mitotic rate, ulceration, regression, Clark level, tumor-infiltrating lymphocytes, and vertical growth phase. Positivity was estimated using a random effects model. Association of positivity and clinicopathologic features was investigated using meta-regression.

Results:

Ninety-three studies were identified representing 35,276 patients with thin melanoma who underwent sentinel lymph node biopsy. Of these patients, 952 had a positive sentinel lymph node biopsy, for an event rate of 5.1 percent (95 percent CI, 4.1 to 6.3 percent). Significant associations were identified between positivity and Breslow thickness greater than 0.75 mm but less than 1.0 mm, mitotic rate, ulceration, and Clark level greater than IV. Seven studies reported on vertical growth phase, which was strongly associated with positivity (OR, 4.3; 95 percent CI, 2.5 to 7.7).

Conclusions:

To date, this is the largest meta-analysis to examine predictors of sentinel lymph node biopsy positivity in patients with thin melanoma. Vertical growth phase had a strong association with biopsy positivity, providing support for its inclusion in standardized pathologic reporting.
Quality of Life in Adults with Nonsyndromic Craniosynostosis
Authors: Mazzaferro Daniel M. , Naran Sanjay , Wes Ari M. , Magee Leanne , Taylor Jesse A. , Bartlett Scott P.
Published: March 2018

Background:

Although studies have analyzed quality of life in children with nonsyndromic craniosynostosis, to date nobody has investigated long-term quality of life in adults with nonsyndromic craniosynostosis. The purpose of this study was to compare quality of life in adult nonsyndromic craniosynostosis patients with a cohort of unaffected controls.

Methods:

The authors queried their institution’s prospectively maintained craniofacial registry for nonsyndromic craniosynostosis patients aged 18 years and older, and administered the validated World Health Organization Quality of Life Biomedical Research and Education Foundation questionnaire. Responses were compared, using a two-sample t test, to an age-matched U.S. normative database provided by the World Health Organization.

Results:

One hundred fifty-one adults met inclusion criteria: 52 were successfully contacted and 32 completed the questionnaire. Average age of respondents was 23.0 ± 6.1 years (range, 18.1 to 42.1 years). Nonsyndromic craniosynostosis patients had a superior quality of life compared with comparative norms in all domains: physical health (17.8 ± 2.7 versus 15.5 ± 3.2; p < 0.001), psychological (16.3 ± 2.9 versus 13.8 ± 3.2; p < 0.001), social (16.9 ± 2.6 versus 13.2 ± 3.6; p < 0.001), and environmental (17.2 ± 2.5 versus 11.7 ± 2.7; p < 0.001). Comparison between single-suture subtypes revealed no difference in any quality-of-life domain (p > 0.05).

Conclusions:

Adult patients previously treated for nonsyndromic craniosynostosis perceive their quality of life to be high, superior to that of a normative U.S. sample. Future work will seek to analyze additional patients and better understand the reasons behind these findings.
Requirements for Successful Trachea Transplantation: A Study in the Rabbit Model
Authors: Den Hondt Margot , Vanaudenaerde Bart , Verbeken Erik , Vranckx Jan J.
Published: March 2018

Background:

Although creating a tracheal tube de novo might appear straightforward, the first clinical applications have shown that reconstruction of long-segment tracheal defects remains challenging. In this study, the authors aimed to refine the baseline requirements of successful trachea transplantation by means of three proof-of-concept models in the rabbit.

Methods:

In each model, one characteristic of a perfect tracheal transplant was eliminated. The first model was developed to map out the immunologic response of vascularized allogenic trachea, transplanted without immunosuppression (n = 6). The second model studied (1) the need for wrapping the transplant with a highly vascularized flap and (2) the source of angiogenesis after autologous trachea transplantation (n = 18). In the third model, the authors examined the importance of an inner epithelial covering (n = 12). All models were compared to a control group of heterotopically transplanted vascularized autologous tracheae (n = 6).

Results:

Embedded in an avascular matrix, allogenic chondrocytes were protected from an overt immune response. Orthotopic transplantation without additional external vascular wrap was successful in a well-vascularized environment. Nonetheless, an external vascular source was essential to maintain viability of the construct. Epithelial covering was necessary to prevent secondary healing. Epithelial migration from the anastomoses or graft was not sufficient to cover long-segment defects.

Conclusions:

These experiments provided ample evidence of the importance of baseline requirements when designing a tracheal transplant study. This study confirmed that different tracheal cell types possess different immunologic sensitivities. External revascularization, preferably in a two-stage procedure, and fast reepithelialization were both paramount to successful transplantation.
Carotid Artery Stiffness and Cognitive Decline Among Women With or at Risk for HIV Infection
Authors: Huck Daniel M. , Hanna David B. , Rubin Leah H. , Maki Pauline , Valcour Victor , Springer Gayle , Xue Xiaonan , Lazar Jason , Hodis Howard N. , Anastos Kathryn , Kaplan Robert C. , Kizer Jorge R.
Published: March 2018

Background:

Vascular stiffness is associated with aging and cognitive impairment in older populations without HIV. HIV has been linked to increased vascular stiffness. We examined whether vascular stiffness relates to cognitive decline at younger ages in women with or at risk for HIV.

Methods:

We evaluated the association of carotid artery stiffness with decline in neuropsychological test performance among participants in the Women's Interagency HIV Study and assessed whether HIV modified the association. Baseline carotid stiffness, defined by the distensibility index, was determined at a single visit using carotid artery ultrasound. Longitudinal neuropsychological testing from 2004–2016 included Trail Making Tests A and B and the Symbol Digit Modalities Test. Relationships were assessed with linear mixed-effect models adjusted for demographic, behavioral, cardiometabolic, and neuropsychological factors.

Results:

Among 1662 women (1192 [72%] HIV+), median baseline age was 41 years (interquartile range 34–47), with 60% non-Hispanic black and 28% Hispanic. Lower baseline distensibility (greater carotid stiffness) was associated with greater decline in neuropsychological test scores over 10-year follow-up as measured by Symbol Digit Modalities Test (adjusted β = −0.06 per SD, P < 0.001), Trail Making Test A (β = −0.08 per SD; P < 0.001), and Trail Making Test B (β = −0.08 per SD; P < 0.001). Changes in cognitive function did not differ by HIV serostatus, or HIV-related factors.

Conclusions:

Higher carotid stiffness was independently associated with faster decline in executive functioning, information processing, and psychomotor speed even in mostly middle-aged minority women and regardless of HIV serostatus. Our study highlights the need for cardiovascular risk factor modification to prevent premature cognitive deterioration in this at-risk population.
Prostate-Specific Membrane Antigen Expression in Adrenocortical Carcinoma on 68Ga–Prostate-Specific Membrane Antigen PET/CT
Authors: Arora Saurabh , Damle Nishikant Avinash , Aggarwal Sameer , Passah Averilicia , Behera Abhishek , Arora Geetanjali , Bal Chandrasekhar , Tripathi Madhavi
Published: March 2018

We present here a case of metastatic adrenocortical carcinoma with bilateral lung nodules. The patient had been treated with mitotane therapy initially and then was later referred for chemotherapy. There was progression of disease noted on the 18F-FDG PET/CT. 68Ga prostate-specific membrane antigen (PSMA) PET/CT was planned to explore the possibility of future treatment with 177Lu-DKFZ-PSMA-617. It revealed peripheral increased uptake of 68Ga-HBED-CC-PSMA equal to liver uptake.
Recombinant Human-Soluble Thrombomodulin Contributes to Reduced Mortality in Sepsis Patients With Severe Respiratory Failure: A Retrospective Observational Study Using a Multicenter Dataset
Authors: Yoshihiro Shodai , Sakuraya Masaaki , Hayakawa Mineji , Ono Kota , Hirata Akira , Takaba Akihiro , Kawamura Natsuki , Tsutsui Toru , Yoshida Kenichi , Hashimoto Yoshihiro
Published: March 2018

Background:

Recombinant human-soluble thrombomodulin (rhTM) is a novel class therapeutic agent for managing disseminated intravascular coagulation. The progression of severe respiratory failure may be related to intra-alveolar coagulation/fibrinolytic disorders. We aimed to determine the efficacy of rhTM in treating sepsis patients with severe respiratory failure.

Methods:

We performed a retrospective observational study using an existing dataset collected from 42 intensive care units (ICUs) in Japan. Of 3,195 patients with severe sepsis or septic shock from the dataset, we selected sepsis patients with severe respiratory failure, and compared patient outcomes based on the administration of rhTM (rhTM group and no rhTM group). Propensity score analysis was performed between the two groups. Outcomes of interest were ICU mortality, hospital mortality, and ventilator-free days (VFDs).

Results:

In this study, 1,180 patients (rhTM, n = 356; no rhTM, n = 824) were analyzed. After adjusting for baseline imbalances with propensity score matching, the survival-time analysis revealed a significant difference between the two groups (hazard ratio, 0.654; 95% confidence interval, 0.439–0.974, P = 0.03). ICU mortality was lower in the rhTM group (rhTM: 22.1% [33/149] vs. no rhTM: 36.2% [54/149], P = 0.01). Hospital mortality was also lower in the rhTM group (35.6% [53/149] vs. 49.7% [74/149], P = 0.02). VFDs trended to be higher in the rhTM group than the no rhTM group (12.8 ± 10.1 days vs. 10.6 ± 10.6 days, P = 0.09).

Conclusions:

Administration of rhTM was positively correlated with a reduction in mortality in sepsis patients with severe respiratory failure.
Technical Performance as a Predictor of Clinical Outcomes in Laparoscopic Gastric Cancer Surgery
Authors: Fecso Andras B. , Bhatti Junaid A. , Stotland Peter K. , Quereshy Fayez A. , Grantcharov Teodor P.
Published: March 2018

Objective:

The purpose of this study was to evaluate the relationship between technical performance and patient outcomes in laparoscopic gastric cancer surgery.

Background:

Laparoscopic gastrectomy for cancer is an advanced procedure with high rate of postoperative morbidity and mortality. Many variables including patient, disease, and perioperative management factors have been shown to impact postoperative outcomes; however, the role of surgical performance is insufficiently investigated.

Methods:

A retrospective review was performed for all patients who had undergone laparoscopic gastrectomy for cancer at 3 teaching institutions between 2009 and 2015. Patients with available, unedited video-recording of their procedure were included in the study. Video files were rated for technical performance, using Objective Structured Assessments of Technical Skills (OSATS) and Generic Error Rating Tool instruments. The main outcome variable was major short-term complications. The effect of technical performance on patient outcomes was assessed using logistic regression analysis with backward selection strategy.

Results:

Sixty-one patients with available video recordings were included in the study. The overall complication rate was 29.5%. The mean Charlson comorbidity index, type of procedure, and the global OSATS score were included in the final predictive model. Lower performance score (OSATS ≤29) remained an independent predictor for major short-term outcomes (odds ratio 6.49), while adjusting for comorbidities and type of procedure.

Conclusions:

Intraoperative technical performance predicts major short-term outcomes in laparoscopic gastrectomy for cancer. Ongoing assessment and enhancement of surgical skills using modern, evidence-based strategies might improve short-term patient outcomes. Future work should focus on developing and studying the effectiveness of such interventions in laparoscopic gastric cancer surgery.
Multiple Solid Organ Transplantation in Telomeropathy: Case Series and Literature Review
Authors: Lebeer Marnix , Wuyts Wim A. , Cassiman David , Laleman Wim , Nevens Frederik , Pirenne Jacques , Monbaliu Diethard , Roskams Tania , Verbeken Eric K. , Neyrinck Arne P. , Van Raemdonck Dirk E. , Verleden Geert M. , Vos Robin
Published: March 2018

Background

Solid organ transplantation is a valid treatment option for selected patients with organ failure due to an underlying telomeropathy; however, the feasibility of multiple-organ transplantation if several organs are compromised is unclear.

Methods

We describe 2 patients with telomeropathy due to heterozygous telomerase RNA component or telomerase reverse transcriptase mutation, who successfully underwent serial or combined liver and lung transplantation for concurrent liver fibrosis/cirrhosis and pulmonary fibrosis.

Results

Despite a challenging posttransplant course, long-term outcomes were favorable, with both patients doing fine now, respectively, 12/20 and 24 months after multiple-organ transplantation.

Conclusions

To our knowledge, this is the first report of multiple solid organ transplantation in documented telomeropathy. These cases highlight current difficulties of timely diagnosis, therapeutic approach, and postoperative complications in telomeropathy patients in whom several organs are affected.
Alzheimer Disease Biomarkers and Driving in Clinically Normal Older Adults
Authors: Allison Samantha , Babulal Ganesh M. , Stout Sarah H. , Barco Peggy P. , Carr David B. , Fagan Anne M. , Morris John C. , Roe Catherine M. , Head Denise
Published: March 2018

Purpose:

Older adults experience impaired driving performance, and modify their driving habits, including limiting amount and spatial extent of travel. Alzheimer disease (AD)-related pathology, as well as spatial navigation difficulties, may influence driving performance and driving behaviors in clinically normal older adults. We examined whether AD biomarkers [cerebrospinal fluid (CSF) concentrations of Aβ42, tau, and ptau181] were associated with lower self-reported spatial navigation abilities, and whether navigation abilities mediated the relationship of AD biomarkers with driving performance and extent.

Methods:

Clinically normal older adults (n=112; aged 65+) completed an on-road driving test, the Santa Barbara Sense of Direction scale (self-report measure of spatial navigation ability), and the Driving Habits Questionnaire for an estimate of driving extent (composite of driving exposure and driving space). All participants had a lumbar puncture to obtain CSF.

Results:

CSF Aβ42, but not tau or ptau181, was associated with self-reported navigation ability. Lower self-reported navigation was associated with reduced driving extent, but not driving errors. Self-reported navigation mediated the relationship between CSF Aβ42 and driving extent.

Conclusions:

Findings suggest that cerebral amyloid deposition is associated with lower perceived ability to navigate the environment, which may lead older adults with AD pathology to limit their driving extent.
Episodic syndromes of childhood associated with migraine
Authors: Gelfand Amy A.
Published: March 2018

Purpose of review

This review covers recent advances in our understanding of episodic syndromes that may be associated with migraine in children and adolescents, as well as what is known about the treatment of these disorders.

Recent findings

The episodic syndromes include benign paroxysmal torticollis, benign paroxysmal vertigo, abdominal migraine, and cyclic vomiting syndrome. Infant colic, or excessive crying in an otherwise healthy and well fed infant, may also fit into this category and is included in the appendix section of the most recent edition of the International Classification of Headache Disorders.

Episodic syndromes are considered to be early life expressions of migraine in the developing brain. Additional research is needed to determine, which acute and preventive treatments are the most effective in managing these disorders.
Y chromosomal noncoding RNAs regulate autosomal gene expression via piRNAs in mouse testis
Authors: Reddy Hemakumar M. , Bhattacharya Rupa , Jehan Zeenath , Mishra Kankadeb , Annapurna Pranatharthi , Tiwari Shrish , Praveena Nissankararao Mary , Alex Jomini Liza , Dhople Vishnu M , Singh Lalji , Sivaramakrishnan Mahadevan , Chaturvedi Anurag , Rangaraj Nandini , Shiju Thomas Michael , Sridevi Badanapuram , Kumar Sachin , Dereddi Ram Reddy , Rayabandla Sunayana M , Jesudasan Rachel A.
Published: March 2018

Majority of the genes expressed during spermatogenesis are autosomal. Mice with different deletions of Yq show sub-fertility, sterility and sperm abnormalities. The connection between Yq deletion and autosomal gene regulation is not well understood. We describe a novel mouse Yq-derived long noncoding RNA,Pirmy, which shows unprecedented number of splice variants in testis. Further,Pirmytranscript variants act as templates for several piRNAs. We identified ten differentially expressed autosome-encoded sperm proteins in mutant mice.Pirmytranscript variants have homology to 5’/3’UTRs of these deregulated autosomal genes. Thus, subfertility in Y-deleted mice appears to be a polygenic phenomenon that is partially regulated epistatically by the Y-chromosome. Our study provides novel insights into possible role of MSY-derived ncRNAs in male fertility and reproduction. Finally, sperm phenotypes from the Y-deleted mice seem to be similar to that reported in inter-specific male-sterile hybrids. Taken together, this study provides novel insights into possible role of Y-derived ncRNAs in male sterility and speciation.
Performance Metrics for an Application-driven Selection and Optimization of Psychophysical Sampling Procedures
Authors: Rinderknecht Mike D. , Lambercy Olivier , Gassert Roger
Published: March 2018

When estimating psychometric functions with sampling procedures, psychophysical assessments should be precise and accurate while being as efficient as possible to reduce assessment duration. The estimation performance of sampling procedures is commonly evaluated in computer simulations for single psychometric functions and reported using metrics as a function of number of trials. However, the estimation performance of a sampling procedure may vary for different psychometric functions. Therefore, the results of these type of evaluations may not be generalizable to a heterogeneous population of interest. In addition, the maximum number of trials is often imposed by time restrictions, especially in clinical applications, making trial-based metrics suboptimal. Hence, the benefit of these simulations to select and tune an ideal sampling procedure for a specific application is limited. We suggest to evaluate the estimation performance of sampling procedures in simulations covering the entire range of psychometric functions found in a population of interest, and propose a comprehensive set of performance metrics for a detailed analysis. To illustrate the information gained from these metrics in an application example, six sampling procedures were evaluated in a computer simulation based on prior knowledge on the population distribution and requirements from proprioceptive assessments. The metrics revealed limitations of the sampling procedures, such as inhomogeneous or systematically decreasing performance depending on the psychometric functions, which can inform the tuning process of a sampling procedure. More advanced metrics allowed directly comparing overall performances of different sampling procedures and select the best-suited sampling procedure for the example application. The proposed analysis metrics can be used for any sampling procedure and the estimation of any parameter of a psychometric function, independent of the shape of the psychometric function and of how such a parameter was estimated. This framework should help to accelerate the development process of psychophysical assessments.
N-hydroxy-pipecolic acid is a mobile signal that induces systemic disease resistance in Arabidopsis
Authors: Chen Yun Chu , Holmes Eric C. , Rajniak Jakub , Kim Jung-Gun , Tang Sandy , Fischer Curt R. , Mudgett Mary Beth , Sattely Elizabeth S.
Published: March 2018

Systemic acquired resistance (SAR) is a global response in plants induced at the site of infection that leads to long-lasting and broad-spectrum disease resistance at distal, uninfected tissues. Despite the importance of this priming mechanism, the identity of the mobile defense signal that moves systemically throughout plants to initiate SAR has remained elusive. In this paper, we describe a new metabolite, N-hydroxy-pipecolic acid (N-OH-Pip), and provide evidence that this molecule is a mobile signal that plays a central role in initiating SAR signal transduction in Arabidopsis thaliana. We demonstrate that FLAVIN-DEPENDENT MONOOXYGENASE 1 (FMO1), a key regulator of SAR-associated defense priming, can synthesize N-OH-Pip from pipecolic acid in planta, and exogenously applied N-OH-PIP moves systemically in Arabidopsis and can rescue the SAR-deficiency of fmo1 mutants. We also demonstrate that N-OH-Pip treatment causes systemic changes in the expression of pathogenesis-related genes and metabolic pathways throughout the plant, and enhances resistance to a bacterial pathogen. This work provides new insight into the chemical nature of a mobile signal for SAR and also suggests that the N-OH-Pip pathway is a promising target for metabolic engineering to enhance disease resistance.
Elucidating synergistic dependencies in lung adenocarcinoma by proteome-wide signaling-network analysis
Authors: Bansal Mukesh , He Jing , Peyton Michael , Kaustagi Manjunath , Iyer Archana , Comb Michael , White Michael , Minna John , Califano Andrea
Published: March 2018

Signaling pathway models are largely based on the compilation of literature data from heterogeneous cellular contexts. Indeed, de novo reconstruction of signaling interactions from large-scale molecular profiling is still lagging, compared to similar efforts in transcriptional and protein-protein interaction networks. To address this challenge, we introduce a novel algorithm for the systematic inference of protein kinase pathways, and applied it to published mass spectrometry-based phosphotyrosine profile data from 250 lung adenocarcinoma (LUAD) samples. The resulting network includes 43 TKs and 415 inferred, LUAD-specific substrates, which were validated at >60% accuracy by SILAC assays, including “novel’ substrates of the EGFR and c-MET TKs, which play a critical oncogenic role in lung cancer. This systematic, data-driven model supported drug response prediction on an individual sample basis, including accurate prediction and validation of synergistic EGFR and c-MET inhibitor activity in cells lacking mutations in either gene, thus contributing to current precision oncology efforts.
Engineering of Primary Human B cells with CRISPR/Cas9 Targeted Nuclease
Authors: Johnson Matthew J. , Laoharawee Kanut , Lahr Walker S. , Webber Beau R. , Moriarity Branden S.
Published: March 2018

B cells offer unique opportunities for gene therapy because of their ability to secrete large amounts of protein in the form of antibody and persist for the life of the organism as plasma cells. Here, we report optimized CRISPR/Cas9 based genome engineering of primary human B cells. Our procedure involves enrichment of CD19+ B cells from PBMCs followed by activation, expansion, and electroporation of CRISPR/Cas9 reagents. We are able expand total B cells in culture 10-fold and outgrow the IgD+IgM+CD27- naïve subset from 35% to over 80% of the culture. B cells are receptive to nucleic acid delivery via electroporation 3 days after stimulation, peaking at Day 7 post stimulation. We tested chemically modified sgRNAs and Alt-R gRNA targeting CD19 with Cas9 mRNA or Cas9 protein. Using this system, we achieved genetic and protein knockout of CD19 at rates over 70%. Finally, we tested sgRNAs targeting the AAVS1 safe harbor site using Cas9 protein in combination with AAV6 to deliver donor template encoding a splice acceptor-EGFP cassette, which yielded site-specific integration frequencies up to 25%. The development of methods for genetically engineered B cells opens the door to a myriad of applications in basic research, antibody production, and cellular therapeutics.
Using the NoiSee workflow to measure signal-to-noise ratios of confocal microscopes
Authors: Ferrand Alexia , Schleicher Kai D. , Ehrenfeuchter Nikolaus , Heusermann Wolf , Biehlmaier Oliver
Published: March 2018

Confocal microscopy is used today on a daily basis in life science labs. This “routine” technique contributes to the progress of scientific projects across many fields by revealing structural details and molecular localization, but researchers need to be aware that detection efficiency and emission light path performance is of major influence in the confocal image quality. By design, a large portion of the signal is discarded in confocal imaging, leading to a decreased signal-to-noise ratio (SNR) which in turn limits resolution. A well-aligned system and high performance detectors are needed in order to generate an image of best quality. However, a convenient method to address system status and performance on the emission side is still lacking. Here, we present a complete method to assess microscope and emission light path performance in terms of SNR, with a comprehensive protocol alongside NoiSee, an easy-to-use macro for Fiji (available via the corresponding update site). We used this method to compare several confocal systems in our facility on biological samples under typical imaging conditions. Our method reveals differences in microscope performance and highlights the various detector types used (multialkali photomultiplier tube (PMT), gallium arsenide phosphide (GaAsP) PMT, and Hybrid detector). Altogether, our method will provide useful information to research groups and facilities to diagnose their confocal microscopes.
Polymorphism of terthiophene with surface confinement
Authors: Resel Roland , Jones Andrew O. F. , Schweicher Guillaume , Fischer Roland , Demitri Nicola , Geerts Yves Henri
Published: March 2018

The origin of unknown polymorphic phases within thin films is still not well understood. This work reports on crystals of the molecule terthiophene which were grown by thermal gradient crystallization using glass-plate substrates. The crystalline domains displayed a plate-like morphology with an extended lateral size of about 100 µm, but a thickness of only a few µm. Specular X-ray diffraction patterns confirmed the presence of a new polymorph of terthiophene. Crystal structure solution from a single crystal peeled from the film revealed a structure with an extremely large unit-cell volume containing 42 independent molecules. In contrast to the previously determined crystal structure of terthiophene, a herringbone packing motif was observed where the terminal ends of the molecules are arranged within one plane (i.e. the molecular packing conforms to the flat substrate surface). This type of molecular packing is obtained by 180° flipped molecules combined with partially random (disordered) occupation. A densely packed interface between terthiophene crystallites and the substrate surface is obtained, this confirms that the new packing motif has adapted to the flat substrate surface.
Global supply chain integration, financing restrictions, and green innovation
Authors: Song Malin , Chen Mei , Wang Shuhong
Published: March 2018

Purpose

The purpose of this paper is to analyze the influence that the financial restrictions of Chinese enterprises exert on their green innovation abilities with their increased integration into the global supply chain (GSC).

Design/methodology/approach

This study uses customs, import, and export data for 222,773 Chinese enterprises and examined them by ownership type, capital density, and degree of pollution.

Findings

The results show that the deeper the integration into the GSC, the looser the financing environment would be, and the stronger the green innovation abilities of the enterprises.

Practical implications

The findings suggest that China should step up privatization of state-owned enterprises, increase government subsidies to private enterprises, and loosen their financing restrictions to address the recent economic decline in the country and ensure smooth and fast economic growth.

Originality/value

This paper is one of the first of its kind to develop and empirically analyze the relationship between the GSC and the financing restrictions and their determinant factors in China. It uniquely contributes to help the authors find approaches to constructing China’s green innovation and has far-reaching implications for other developing countries.
Impact of big data and predictive analytics capability on supply chain sustainability
Authors: Jeble Shirish , Dubey Rameshwar , Childe Stephen J. , Papadopoulos Thanos , Roubaud David , Prakash Anand
Published: March 2018

Purpose

The purpose of this paper is to develop a theoretical model to explain the impact of big data and predictive analytics (BDPA) on sustainable business development goal of the organization.

Design/methodology/approach

The authors have developed the theoretical model using resource-based view logic and contingency theory. The model was further tested using partial least squares-structural equation modeling (PLS-SEM) following Peng and Lai (2012) arguments. The authors gathered 205 responses using survey-based instrument for PLS-SEM.

Findings

The statistical results suggest that out of four research hypotheses, the authors found support for three hypotheses (H1-H3) and the authors did not find support forH4. Although the authors did not find support forH4(moderating role of supply base complexity (SBC)), however, in future the relationship between BDPA, SBC and sustainable supply chain performance measures remain interesting research questions for further studies.

Originality/value

This study makes some original contribution to the operations and supply chain management literature. The authors provide theory-driven and empirically proven results which extend previous studies which have focused on single performance measures (i.e. economic or environmental). Hence, by studying the impact of BDPA on three performance measures the authors have attempted to answer some of the unresolved questions. The authors also offer numerous guidance to the practitioners and policy makers, based on empirical results.