bluuebunny/crossref_metadata_2025 huggingface dataset:
Life Changes Matter More Than Satisfaction or Sanctions/Incentives: An Examination of Mental Health Court Experience Factors Associated with Arrest
Authors: Han Woojae
Published: March 2019

While current evaluation studies have shown consistent and strong evidence of reducing recidivism for mental health court (MHC) programs, few studies have explored the potential factors that may lead to this success. The purpose of this study is to examine the effect of participants’ experiences (i.e., program satisfaction, life changes, sanction/incentives) on justice outcomes in MHC. Data are from the MacArthur MHC Project which includes objective and subjective information from four MHC samples with comparison samples at each site (CAs, MN, and IN; N = 355). Multilevel negative binomial regression was conducted to control for over-dispersion variable and site difference. Findings suggest that more sanctions are associated with increased number of future arrests whereas positive life changes (e.g., daily problems, symptoms, family relationship) are associated with reduced recidivism among MHC participants. Results underscore the importance of actual changes in the offenders’ lives to decrease recidivism. In order to effectively handle offenders with mental illness, who happen to be an over-represented population in the justice system, MHC staff and stakeholders need to work on how the program could change participants’ everyday life issues instead of proving the treatment alone.
GenomeWarp: an alignment-based variant coordinate transformation
Authors: McLean Cory Y , Hwang Yeongwoo , Poplin Ryan , DePristo Mark A
Published: March 2019

Reference genomes are refined to reflect error corrections and other improvements. While this process improves novel data generation and analysis, incorporating data analyzed on an older reference genome assembly requires transforming the coordinates and representations of the data to the new assembly. Multiple tools exist to perform this transformation for coordinate-only data types, but none supports accurate transformation of genome-wide short variation. Here we present GenomeWarp, a tool for efficiently transforming variants between genome assemblies. GenomeWarp transforms regions and short variants in a conservative manner to minimize false positive and negative variants in the target genome, and converts over 99% of regions and short variants from a representative human genome.

Availability and implementation

GenomeWarp is written in Java. All source code and the user manual are freely available at https://github.com/verilylifesciences/genomewarp.

Supplementary information

Supplementary data are available at Bioinformatics online.
Experimental manipulation of reproductive tactics in Seba’s short-tailed bats: consequences on sperm quality and oxidative status
Authors: Meniri Magali , Gohon Florence , Gning Ophélie , Glauser Gaétan , Vallat Armelle , Fasel Nicolas J , Helfenstein Fabrice
Published: March 2019

To reproduce, males have to fertilize the female’s eggs, sometimes in competition with ejaculates of other males. In species where males display alternative reproductive tactics, whereby territorial males secure mating and non-territorial males have to sneak copulations, the latter might be expected to invest relatively more resources towards sperm quality compared with the territorial males. Sperm cells are especially vulnerable to oxidative stress, which reduces male fertility. Therefore, antioxidant resources are expected to modulate sperm quality, and might be allocated differently between reproductive tactics. To test the link between reproductive tactics, redox profile and sperm quality, we experimentally induced changes in the reproductive tactics of 39 captive males Seba’s short-tailed bats Carollia perspicillata. We monitored the blood and ejaculate oxidative balance, and the sperm quality before, 7 days and 21 days after the manipulation of reproductive tactic. Although ejaculates’ oxidative damage was negatively related to sperm velocity, males exhibited similar blood and ejaculates redox profiles and similar sperm quality, regardless of their reproductive tactic. Possibly, these results arise as a consequence of some constraints having been lifted during the experiment. Our results also suggest that, in Seba’s short-tailed bats, the expression of alternative reproductive tactics is not subjected to strong oxidative constraints. Furthermore, our results could reflect an absence of trade-off between pre- and post-copulatory traits in harem males, as they could be selected to invest both in female attraction and sperm quality, as a consequence of their inability to fully monopolize females.
Impella 5.0 therapy as a bridge-to-decision option for patients on extracorporeal life support with unclear neurological outcomes
Authors: Bernhardt Alexander M , Zipfel Svante , Reiter Beate , Hakmi Samer , Castro Liesa , Söffker Gerold , Kluge Stefan , Lubos Edith , Rybczinski Meike , Grahn Hanno , Schrage Benedikt , Becher Peter Moritz , Barten Markus J , Westermann Dirk , Blankenberg Stefan , Reichenspurner Hermann
Published: March 2019

OBJECTIVES

Peripheral venoarterial extracorporeal life support (ECLS) for the treatment of cardiogenic shock has shown to improve survival but is associated with complications. However, if the patient cannot be weaned from ECLS, their therapy options are limited. Although durable left ventricular assist device implantation might be an option in such cases, an unclear neurological outcome is often a contraindication. We hypothesize that Impella 5.0 therapy provides sufficient circulatory support while avoiding ECLS-related complications, thereby allowing for an adequate evaluation of a patient’s neurological state and facilitating further treatment options.

METHODS

We retrospectively reviewed data from 22 ECLS patients (mean age 56.5 ± 10.7 years) with an unclear neurological status who underwent Impella 5.0 implantation between January 2016 and July 2018 in our institution. Neurological status was evaluated on a daily basis using the cerebral performance category score and the modified Rankin scale.

RESULTS

Sixteen patients (72.7%) were resuscitated before ECLS implantation and 13 patients (59.1%) had acute myocardial infarction. The mean duration on ECLS before Impella 5.0 implantation was 9.3 ± 1.7 days. All patients were successfully weaned from ECLS by Impella 5.0 implantation via the axillary artery. The mean duration on Impella 5.0 was 16.3 ± 4.7 days. In surviving patients, both quantitative measurements of cerebral performance improved after 30 days compared to the baseline (P < 0.01). Six patients (27.3%) were bridged to a durable left ventricular assist device. In 9 patients (40.9%), myocardial function recovered during Impella 5.0 support and the device was successfully explanted. The 30-day survival rate was 68.2%.

CONCLUSIONS

Impella 5.0 support provides a bridge-to-decision option for patients following ECLS implantation and leads to left ventricular unloading. It allows further evaluation of a patient’s neurological situation and facilitates further therapy. About two-thirds of patients survived with acceptable neurological outcomes.
Increase in Infant Measles Deaths During a Nationwide Measles Outbreak—Mongolia, 2015–2016
Authors: Lee Christopher T , Hagan Jose E , Jantsansengee Baigalmaa , Tumurbaatar Oyun-Erdene , Altanchimeg Samdan , Yadamsuren Buyanjargal , Demberelsuren Sodbayar , Tserendorj Chinbayar , Munkhtogoo Oyungerel , Badarch Darmaa , Gunregjav Nyamaa , Baatarkhuu Bolortuya , Ochir Chimedsuren , Berman LaShondra , Anderson Raydel , Patel Minal K , Gregory Christopher J , Goodson James L
Published: March 2019

Background

Surveillance data from a large measles outbreak in Mongolia suggested increased case fatality ratio (CFR) in the second of 2 waves. To confirm the increase in CFR and identify risk factors for measles death, we enhanced mortality ascertainment and conducted a case-control study among infants hospitalized for measles.

Methods

We linked national vital records with surveillance data of clinically or laboratory-confirmed infant (aged <12 months) measles cases with rash onset during March–September 2015 (wave 1) and October 2015–June 2016 (wave 2). We abstracted medical charts of 95 fatal cases and 273 nonfatal cases hospitalized for measles, matched by age and sex. We calculated adjusted matched odds ratios (amORs) and 95% confidence intervals (CIs) for risk factors.

Results

Infant measles deaths increased from 3 among 2224 cases (CFR: 0.13%) in wave 1 to 113 among 4884 cases (CFR: 2.31%) in wave 2 (P < .001). Inpatient admission, 7–21 days before measles rash onset, for pneumonia or influenza (amOR: 4.5; CI, 2.6–8.0), but not other diagnoses, was significantly associated with death.

Discussion

Measles infection among children hospitalized with respiratory infections likely increased deaths due to measles during wave 2. Preventing measles virus nosocomial transmission likely decreases measles mortality.
Crocodylian Head Width Allometry and Phylogenetic Prediction of Body Size in Extinct Crocodyliforms
Authors: O’Brien Haley D , Lynch Leigha M , Vliet Kent A , Brueggen John , Erickson Gregory M , Gignac Paul M
Published: March 2019

Synopsis

Body size and body-size shifts broadly impact life-history parameters of all animals, which has made accurate body-size estimates for extinct taxa an important component of understanding their paleobiology. Among extinct crocodylians and their precursors (e.g., suchians), several methods have been developed to predict body size from suites of hard-tissue proxies. Nevertheless, many have limited applications due to the disparity of some major suchian groups and biases in the fossil record. Here, we test the utility of head width (HW) as a broadly applicable body-size estimator in living and fossil suchians. We use a dataset of sexually mature male and female individuals (n = 76) from a comprehensive sample of extant suchian species encompassing nearly all known taxa (n = 22) to develop a Bayesian phylogenetic model for predicting three conventional metrics for size: body mass, snout–vent length, and total length. We then use the model to estimate size parameters for a select series of extinct suchians with known phylogenetic affinity (Montsechosuchus, Diplocynodon, and Sarcosuchus). We then compare our results to sizes reported in the literature to exemplify the utility of our approach for a broad array of fossil suchians. Our results show that HW is highly correlated with all other metrics (all R2≥0.85) and is commensurate with femoral dimensions for its reliably as a body-size predictor. We provide the R code in order to enable other researchers to employ the model in their own research.
Evaluation of Nationwide Referral Pathways, Investigation and Treatment of Suspected Cauda Equina Syndrome in the United Kingdom (ENTICE)
Authors: Vyas Dillon ,   British Neurosurgical Trainee Research Collaborative and Neurology and Neurosurgery Interest Group and Society of British Neurological Surgeons (SBNS)
Published: March 2019

INTRODUCTION

Cauda equina syndrome (CES) is a spinal emergency with clinical symptoms and signs that have low diagnostic accuracy. National guidelines in the United Kingdom (UK) state that all patients should undergo an MRI prior to referral to specialist spinal units and surgery, if required, should be performed at the earliest opportunity. We aimed to evaluate the current practice of investigating and treating suspected CES in the UK.

METHODS

A retrospective, multicentre observational study of the investigation and management of patients with suspected CES was conducted across the UK, including all patients referred to a spinal unit over 6 mo between 1st October 2016 and 31st March 2017.

RESULTS

A total of 28 UK spinal units submitted data on 4441 referrals. Over half of the referrals were made without any previous imaging (n = 2572, 57.9%). The majority of referrals were made out-of-hours (n = 2229/3517, 63.4%), of which 2.9% (n = 45/1529) underwent surgical decompression. Patient location and prereferral imaging were not significantly associated with time intervals from symptom onset or presentation to decompression. Patients investigated outside of the spinal unit experienced significantly longer time intervals from presentation and from referral to undergoing the MRI scan.

CONCLUSION

This is the largest known study of the investigation and management of suspected CES. We found that the majority of referrals were made without adequate investigations. Most patients were referred out-of-hours and many were transferred for an MRI without subsequently requiring surgery. Cases not transferred experienced delays if undergoing an MRI scan outside of the spinal unit.
Producing Neurospheroids and Hydrogels to Create a Three-dimensional in Vitro Model for the Use of Conduits in Peripheral Nerve Regeneration
Authors: Shete Devyani , Batth Aran , Nijhawan Aditi , Choudhary Jaffer , Thompson Ian
Published: March 2019

INTRODUCTION

Peripheral nerve regeneration is a complex challenge that requires suitable nerve guidance systems to bridge the severed ends of 2 nerves back together. Current polymeric conduits on the market provide good cellular growth but are limited by the length of gap defect they can repair, and complete functional recovery is rare. This project focused on creating a three-dimensional (3D) in Vitro spheroidal sprouting assay for peripheral nerve regeneration, as well as producing and testing different polymeric hydrogels as potential scaffold materials for the conduit.

METHODS

Different concentrations of chitosan, methylcellulose (MC) and sodium alginate were produced, as well as blends of these materials. These hydrogels were seeded with 3D neurospheroids, along with NG108-15 (neuronal) cells and Schwann cells to test their biocompatibility.

RESULTS

MTT assays showed the mean absorbance of chitosan gels with NG108-15 cells at 24 hr (P < .001) and 72 hr (P > .05) was similar/slightly higher than the negative control. Live-Dead data showed 93.4% of live cells at DIV7 on MC: Ch blends, compared to 72% with chitosan alone.

CONCLUSION

Overall, both chitosan and MC were nontoxic and biocompatible with NG108-15 and Schwann cells. Blending chitosan with MC improved its chemical and physical properties. The cells formed spheroids that well on a gel; this pseudo-3D structure is excellent for research purposes compared to 2D as it mimics the body's internal environment.
Predicting Recovery After Mild TBI
Authors: Booker James
Published: March 2019

INTRODUCTION

Mild Traumatic Brain Injury (MTBI) is often treated as a homogenous group in current practice. Stratifying patients more accurately may result in the implementation of more effective, individualized treatment. We aimed to identify prognostic indicators of recovery 1-yr following MTBI.

METHODS

Using a prospective, observational study design, a large MTBI population (N = 596) was recruited following admission to the Emergency Department. Data was collected at brain injury clinics between August 2011 and July 2015. Functional recovery at 1-yr was assessed using the Glasgow Outcome Scale-Extended (GOSE).

RESULTS

A follow-up rate of 92% was achieved. The most common aetiologies of MTBI were falls (n = 222) and road traffic collisions (n = 154). Distribution of Glasgow Coma Scale (GCS) was 15 (n = 363), 14 (n = 156) and 13 (n = 77). Multiordinal logistic regression of the GOSE found that psychiatric history (P < .001), alcohol intoxication (P = .011), assault (P = .022) and GCS <15 (P = < .001), led to worse outcome. An abnormal CT scan was not a predictor of functional recovery.

CONCLUSION

Our findings indicate that after MTBI, patients with previous psychiatric history, GCS <15, aetiology of assault and alcohol intoxication result in worse long-term outcomes. Future work into developing a full prognostic model for MTBI may help to tailor individual treatment and improve long-term outcomes.
Incorporating Precesarean Vaginal Preparation Into Standard of Care for Obstetrics
Authors: Duffy Cassandra R. , D'Alton Mary E. , Han Yiping W. , Goldenberg Robert L. , Gyamfi-Bannerman Cynthia
Published: March 2019

Postoperative infections remain a serious concern after cesarean delivery, the most common major surgical procedure in the United States. Multiple strategies have been proposed to combat this problem, including the addition of azithromycin to the standard preoperative antibiotic prophylaxis. However, as obstetricians, we have failed to uniformly adopt precesarean vaginal preparation despite convincing evidence from randomized controlled trials that this technique reduces postoperative rates of endometritis by more than 50%. This reduction is similar to that seen with the addition of azithromycin. Vaginal preparation with povidone-iodine solution may target the same genital pathogens as azithromycin, which are commonly implicated in endometritis, a polymicrobial infection that may be under-addressed by our current antiseptic techniques. A recent review of maternal–fetal medicine fellows' practices at the time of cesarean delivery and recent publications on precesarean vaginal cleansing suggest that this practice has not yet gained hold in the United States.
Thyroid Function in Health Care Workers Exposed to Ionizing Radiation
Authors: Luna-Sánchez Shirley , del Campo MT , Morán Julio Valverde , Fernández Ignacio Mahillo , Checa Fernando José Sancho , de la Hoz Rafael E.
Published: March 2019

Objectives

To analyze possible alterations of thyroid function related to dosimetric values in health care workers exposed to ionizing radiation.

Materials and Methods

Forty-six health care workers exposed to ionizing radiation at a tertiary hospital previously exposed to ionizing radiation were included in the study. Age, sex, history of thyroid diseases, thyroid hormones, work post, service, dosimetric values of previous year, and 5 y period were considered. Alterations of thyroid function and other variables were analyzed by exact logistic regression univariate model.

Results

7.1% workers showed an increased serum thyroid-stimulating hormone without free T3 or free T4 alteration. A significant relationship between workers with increased thyroid-stimulating hormone and dosimetric values of previous year (odds ratio 6.35, 95% confidence interval 1.20–98.1, p = 0.021) and previous 5 y period of radiation exposure (odds ratio 1.72, 95% confidence interval 1.12–3.34, p = 0.007) was obtained.

Conclusion

An increased risk of subclinical hypothyroidism related to radiation doses was observed in this pilot study on a group of health care workers exposed to ionizing radiation.
Total Artificial Heart Salvage of a Heterotopic Heart Transplant Patient
Authors: Gregoric Igor D. , Akay M. Hakan , Salas de Armas Ismael A. , Patel Manish K. , Nathan Sriram S. , Akkanti Bindu , Stojanovic Stevan , Radovancevic Rajko , Kar Biswajit
Published: March 2019

Rescuing heterotopic heart transplantation (HHT) patients remains a challenge in the field. When a 41-year-old patient was transferred to our service, we chose a novel approach that is reported herein. The HHT had been performed over 20 years ago, and in 2016, because of complications, the patient was listed for transplant with a 1A status. For the first time, the SynCardia 50cc total artificial heart (TAH) (SynCardia Systems, LLC, Tucson, AZ) was used in an HHT patient. Investigators attained approval to use the SynCardia 50cc investigational device, as this was an emergent case with few options. The donor heart from the HHT was left in place, alongside the TAH. By leaving the donor heart from the HHT, the need for long and tedious extensive dissection around the right lung was eliminated; thereby reducing the potential risk of lung parenchymal injury, massive bleeding, and complex air leaks. The procedure was successful, and the patient underwent a successful orthotopic heart transplantation six months after being placed on TAH.
DermaPort: A Novel Ported Vascular Access System for Hemodialysis
Authors: Lobl Thomas J. , Janis Abram D. , Moran Buzz
Published: March 2019

Safe, ported access to the body for hemodialysis and other medical uses is increasingly necessary for modern medical therapy. Long-term hemodialysis offers unique challenges with its requirements for high blood flow, chronic implantation, and risks of infection. Although widely used, the polyester, cuffed, delete word and space hemodialysis catheter is far from ideal, and there is a need for an improved vascular access system to allow catheter adjustment and replacement, to reduce infections and to reduce medical costs. The DermaPort ported vascular access system (PVAS) was developed to meet this need. This report describes the design and testing of the PVAS port in vitro and in vivo. The results demonstrate that the system provides superior tissue integration coupled with infection–resisting slidability, allowing reposition and exchange of an indwelling catheter. Within 3 weeks, there was strong tissue ingrowth and establishment of a sterile barrier and over 13 weeks there was no evidence of infection or marsupialization. Additionally, an explanted PVAS sample from a 38 patient human clinical study showed the bulk of the metal mesh was associated with a macrophage—giant cell response and contained collagen and vascular elements. From these data, we conclude that the PVAS permitted stable ported access following a single stage implant procedure.
Examining the Capacity of Registered Nurses to Deliver Culturally Competent Health Care to Veterans and Their Families
Authors: Bonzanto Tamara , Swan Beth Ann , Gaughan John P.
Published: March 2019

Background:

Although more than 75% of veterans and their families are accessing care in non-Veterans Affairs (VA) settings, there is little information about health care workers, specifically registered nurses (RNs)' ability to provide culturally competent and appropriate care to military veterans and their families.

Purpose:

The purpose was to examine the capacity of RNs working in non-VA hospitals to deliver culturally competent health care to military veterans and their families.

Methods:

A prospective survey design was carried out with nurses from a large academic health system. The RAND Corporation's Ready to Serve web-based survey was adapted with permission for use with RNs employed in civilian urban and community hospitals. In addition to reporting descriptive statistics on demographics and each individual item, a score was calculated to define high cultural competency.

Results:

Twenty-five (4%) RNs demonstrated the capacity to deliver culturally competent health care.

Conclusions:

This study revealed significant gaps in the capacity of nurses to deliver culturally competent care to military veterans and their families.
The effects of aging on hydromorphone-induced thermal antinociception in healthy female cats
Authors: Simon Bradley T. , Scallan Elizabeth M. , Monteiro Beatriz P. , Steagall Paulo V.M.
Published: March 2019

Introduction:

This study aimed to evaluate the effects of aging on hydromorphone-induced thermal antinociception in cats.

Methods:

In a prospective, randomized, blinded, controlled design, 10 healthy female cats received each of the following treatments intramuscularly: hydromorphone (0.1 mg/kg) and 0.9% saline (0.05 mL/kg) with a 1-week washout between treatments at 6, 9, and 12 months of age. Skin temperature and thermal thresholds (TTs) were recorded before and up to 12 hours after injection. Data were analyzed using a repeated-measures linear mixed model (α = 0.05).

Results:

After saline treatment, TT was not significantly different from baseline at any time point for any age group. After hydromorphone treatment, TT was significantly higher than baseline at 6 months for up to 1 hour, and at 9 and 12 months for up to 4 hours. Peak TT at 6, 9, and 12 months were 50.4 ± 2.7, 50.9 ± 2.0, and 53.6 ± 2.0°C at 0.5, 1, and 1 hours, respectively. Mean TT was significantly higher after hydromorphone treatment when compared with saline treatment at 9 and 12 months for up to 4 hours but not at 6 months. Magnitude of antinociception was consistently larger at 12 months when compared with 6 months of age. Hydromorphone provided a shorter duration and smaller magnitude of antinociception at 6 months when compared with 9 and 12 months.

Conclusion:

Pediatric cats may require more frequent dosing of hydromorphone than adults.
The Anterolateral Thigh Flap for Achilles Tendon Reconstruction: Functional Outcomes
Authors: Ehrl Denis , Heidekrueger Paul I. , Schmitt Andreas , Liska Franz , Ninkovic Milomir , Giunta Riccardo , Broer P. Niclas
Published: March 2019

Background:

Following Achilles tendon rupture and repair, reruptures or infections are not infrequent. Consequently, several surgical techniques have been described to decrease complication rates. This study aimed to evaluate the outcomes of the free composite fasciocutaneous anterolateral thigh flap including fascia lata for reconstruction of combined complex soft-tissue and Achilles tendon defects.

Methods:

Within an 8-year period, 34 patients having undergone microvascular Achilles tendon reconstruction fulfilled inclusion criteria for this study: 25 of these patients (73.5 percent) returned for follow-up examination, seven of whom (28.0 percent) underwent additional bilateral contact pressure and power measurements. The data were screened for patients’ demographics, intraoperative and perioperative details, flap survival, surgical complications, and overall long-term outcomes.

Results:

Mean follow-up time was 40.8 months. The Thompson test was negative in all patients. The pain score assessed by the Numerical Rating Scale at the reconstructed site was low overall, but showed significant differences between rest and activity (p < 0.05). The assessment of the Vancouver Scar Scale showed very good results with both techniques. The measurements of the peak pressures, power while walking, and foot contact area did not show differences between the operated and nonoperated sides (p > 0.05), whereas range of motion revealed significant differences (p < 0.05).

Conclusions:

In patients who suffer complex Achilles tendon injury requiring free flap coverage, the composite anterolateral thigh flap including fascia lata provides a reliable and safe approach with very good functional and aesthetic outcomes. It should be considered one of the first reconstructive options.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Overlapping Surgery in Plastic Surgery: An Analysis of Patient Safety and Clinical Outcomes
Authors: Parikh Rajiv P. , Sharma Ketan , Thornton Melissa , Brown Gabriella , Myckatyn Terence M.
Published: March 2019

Background:

Overlapping surgery is an important and controversial health care issue. To date, there is minimal evidence on the safety of overlapping surgery in plastic surgery. The purpose of this study was to evaluate and compare outcomes for patients undergoing overlapping surgery versus nonoverlapping surgery in plastic surgery.

Methods:

This is a retrospective cohort study of consecutive patients undergoing plastic surgery procedures at a tertiary academic center between January of 2016 and January of 2018. Demographic and procedural characteristics, clinical outcomes, and adverse events were analyzed for patients undergoing overlapping versus nonoverlapping surgery. An a priori power analysis was performed, and chi-square, Wilcoxon rank sum, and bivariate logistic regression tests were used for analyses.

Results:

Eight hundred sixty-six patients constituted the study population: 555 (64.1 percent) underwent nonoverlapping surgery and 311 (35.9 percent) underwent overlapping surgery. There was no significant difference (p > 0.050) in mean age, body mass index, tobacco use, American Society of Anesthesiologists rating, or Charlson Comorbidity Index score between cohorts. Comparison of nonoverlapping and overlapping cases revealed no differences in complications (12.1 percent versus 11.9 percent; p = 0.939), reoperations (6.1 percent versus 6.8 percent; p = 0.717), readmissions (3.6 percent versus 3.5 percent; p = 0.960), or emergency room visits (4.7 percent versus 4.8 percent; p = 0.927). Stratification by procedure demonstrated no difference (p > 0.050) in complications between cohorts. Median operative time was significantly longer for overlapping operations (105 minutes versus 83 minutes; p = 0.004).

Conclusions:

This study supports the safety of overlapping surgery in plastic surgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
A stochastic spatial model for heterogeneity in cancer growth
Authors: Queiroga Alexandre Sarmento , Morais Mauro César Cafundó , Tortelli Tharcisio Citrangulo , Chammas Roger , Ramos Alexandre Ferreira
Published: March 2019

Establishing a quantitative understanding of tumor heterogeneity, a major feature arising from the evolutionary processes taking place within the tumor microenvironment, is an important challenge for cancer biologists. Recently established experimental techniques enabled summarizing the variety of tumor cell phenotypes in proliferative or migratory. In the former, cells mostly proliferate and rarely migrate, while the opposite happens with cells having the latter phenotype, a “go-and-grow” description of heterogeneity. In this manuscript we present a discrete time Markov chain to simulate the spatial evolution of a tumor which heterogeneity is described by cells having those two phenotypes. The cell density curves have two qualitatively distinct temporal regimes, as they recover the Gompertz curve widely used for tumor growth description, and a bi-phasic growth which temporal shape resembles the tumor growth dynamics under influence of immunoediting. We also show how our representation of heterogeneity gives rise to variable spatial patterning even when the tumors have similar size and dynamics.

Author summary

We present a spatial stochastic model to represent the growth of a tumor as a structure having cells of two phenotypes: one whose cells have division as their predominant transition, and another where cells are mostly migrating. The migratory phenotype results from a transformation of the proliferative. Our proposition is based on the assumption that a tumor grows initially within a limited region while its cells are capable of acquire nutrients. During that phase, the cancer cells start changing their phenotype because of stress in their microenvironment and exhaustion of nutrients that lead them to become more migratory and capable of generating metastasis. Our model enables us to recover the usual dynamics observed in tumor growth such as a logistic-like curve, called Gompertz model, widely observed, or the bi-phasic growth observed characterized by equilibrium phase interspersed between two growth regimes. Our approach also enable us to understand the internal spatial and temporal structure of the two sub-populations and can be useful to investigate the phenomena underpinning heterogeneous tumor growth, a feature that helps on the design of treatment strategies based on mitigating heterogeneity related drug resistance.
3D association of ER, PR and Her2 at protein levels to aid sub-grouping of breast cancer patients in routine clinical practice
Authors: Lv Jiahong , Yu Guohua , Li Lei , Zhang Yunyun , Zhang Wenfeng , Lv Yan , Zhang Jiandi , Tang Fangrong
Published: March 2019

Treatments of patients with solid tumors frequently rely on the relative and semi-quantitative assessment of tissue protein biomarkers by immunohistochemistry (IHC). The perspective of transition to absolute and quantitative assessment of tissue biomarkers is hindered by lack of a suitable method, especially for Formalin Fixed Paraffin Embedded (FFPE) tissues. In this study, we explored the feasibility of Quantitative Dot Blot (QDB) method as a universal platform to quantitate tissue biomarkers as absolute and continuous variables in FFPE samples by measuring unprecedentedly the protein levels of Estrogen Receptor (ER), Progesterone Receptor (PR), Her2 and Ki67 simultaneously in 1048 FFPE samples. When using measured Her2, ER and PR levels as coordinates to develop 3D scatterplot, we observed a distinct distribution pattern of the samples with natural segregation of three groups as the likely phenotypical projection of known intrinsic subtypes. Thus, we have achieved a major milestone in this transition by identifying the first practice method for daily clinical practice, and one clinical usage in 3D subtyping of samples for prediction and prognosis. This study may serve as basis for a new field of Quantitative Diagnosis where diagnosis, prognosis and prediction are derived from database analysis of protein biomarkers as absolute and continuous variables.
Non-enzymatically oxidized arachidonic acid regulates mouse spermatogenic cell T-type Ca2+currents
Authors: Bondarenko O. , Corzo G. , Santana F.L. , del Río-Portilla F. , Darszon A. , López-González I.
Published: March 2019

During spermatogenesis, phospholipids and fatty acids (FAs) play an important role both as structural components of spermatogenic cell plasma membranes and as molecular messengers that trigger the differentiation of the male germ cell line. However, spontaneous oxidation of plasma membrane phospholipids and FAs causes a decrease in mammalian fertility. In the present report, we examine the effects of non-enzymatically oxidized arachidonic acid (AAox) on mouse spermatogenic T-type Ca2+currents (ICaT) due to their physiological relevance during spermatogenesis. AAoxeffects on the biophysical parameters of ICaTwere significantly different from those previously reported for AA. AAoxleft shifted the I-V curve peak and both activation and steady-state inactivation curves. ICaTdeactivation kinetics were slower in presence of AAoxand the time for its recovery from inactivation increased significantly. Therefore, the fraction of inactivated Ca2+channels of spermatogenic cells is increased at voltages where they are usually active. The inhibition of ICaTby AAoxcould contribute to the infertility phenotype and to the observed apoptotic state of spermatogenic cells induced by oxidized FAs.
Handling and Adequacy of Iodine at Household Level: Community Based Cross-sectional Survey in Dega Damot District, West Gojjam Zone, Amhara Regional State, Ethiopia
Authors: Afework Aschalew , Mulu Wondemagegn , Abate Almayehu , Lule Abel
Published: March 2019

Introduction

Iodine is essential for regulation of physical growth and neural development. Although, fortification of iodine has been practiced decades before and iodized salt is available, handling and cultural food preparation may affect the content of iodine in the dishes. Moreover, Dega Damot is mountainous area that may lose its iodine via erosion. Therefore, this study aimed at determining the handling and adequacy of iodine in the salt in Dega Damot district, West Gojjam Zone, Ethiopia.

Method

Community based cross-sectional study was conducted from October 24 to November 15, 2017 on 802 households. Stratified multi-stage sampling was employed to select households. A total of 422 and 380 house-holds from low land and high land, respectively took part in the study. For the interview either the husband or the spouse was selected randomly. Data on handling were collected by face-to-face interview using structured questionnaires. The concentration of iodine was determined using Rapid Test Kit. Descriptive statistics were used to describe relevant findings on the handling of iodized salt. Both bivariate and multivariate logistic regressions were analyzed to identify associated factors.

Result

From 802 samples tested, 37 (4.6%) had iodine greater than 15parts per million. The majority (94.5%) of the respondents have been roasting their salt for ‘Dikus’ preparation where as 91.1% of the households stored their salt in open containers. Salts with closed containers (AOR=3.22, CI=1.31-7.89), unroasted salts [AOR=5.23, CI=1.25-22.11], good knowledge on handling [AOR=5.55, CI=1.64-18.77], salts from high land area [AOR=2.11, 9CI=1.02-4.37], were significantly associated with adequacy of iodine Conclusions: Adequate utilization of iodine was very low. Roasting of salt was common. These phenomena may be continued because ‘Dikus’ preparation is cultured in this population. We recommend the supplementation of packed iodized salt in the dishes
Hemimetabolous insects elucidate the origin of sexual development via alternative splicing
Authors: Wexler Judith , Delaney Emily K. , Belles Xavier , Schal Coby , Wada-Katsumata Ayako , Amicucci Matthew , Kopp Artyom
Published: March 2019

Insects are the only animals in which sexual differentiation is controlled by sex-specific RNA splicing. Thedoublesex(dsx) transcription factor produces distinct male and female protein isoforms (DsxM and DsxF) under the control of the RNA splicing factortransformer(tra).traitself is also alternatively spliced so that a functional Tra protein is only present in females; thus, DsxM is produced by default, while DsxF expression requires Tra. The sex-specific Dsx isoforms are essential for both male and female sexual differentiation. This pathway is profoundly different from the molecular mechanisms that control sex-specific development in other animal groups. In animals as different as vertebrates, nematodes, and crustaceans, sexual differentiation involves male-specific transcription ofdsx-related transcription factors that are not alternatively spliced and play no role in female sexual development. To understand how the unique splicing-based mode of sexual differentiation found in insects evolved from a more ancestral transcription-based mechanism, we examineddsxandtraexpression in three basal, hemimetabolous insect orders. We find that functional Tra protein is limited to females in the kissing bugRhodnius prolixus(Hemiptera), but is present in both sexes in the lousePediculus humanus(Phthiraptera) and the cockroachBlattella germanica(Blattodea). Although alternatively spliceddsxisoforms are seen in all these insects, they are sex-specific in the cockroach and the kissing bug but not in the louse. InB. germanica, RNAi experiments show thatdsxis necessary for male, but not female, sexual differentiation, whiletracontrols female development via adsx-independent pathway. Our results suggest that the distinctive insect mechanism based on thetra-dsxsplicing cascade evolved in a gradual, mosaic process: sex-specific splicing ofdsxpredates its role in female sexual differentiation, while the role oftrain regulatingdsxsplicing and in sexual development more generally predates sex-specific expression of the Tra protein. We present a model where the canonicaltra-dsxaxis originated via merger between expandingdsxfunction (from males to both sexes) and narrowingtrafunction (from a general splicing factor to the dedicated regulator ofdsx).
An investigation of the promotion effects of uncertain level discount: evidence from China
Authors: Tan Hongying , Akram Umair , Sui Yujia
Published: March 2019

Purpose

Uncertain level discount (ULD) is a type of promotion combining regular discount (RD) with uncertainty. The purpose of this paper is to explore the impact of ULD on consumers’ perceived quality compared with RD and to identify the relevant influencing mechanism and boundary for the effectiveness of ULD.

Design/methodology/approach

Three online experiments were conducted with 445 participants from China. First, experiment 1 compares the attractiveness of ULD and RD. Second, experiment 2 evaluates the impacts of ULD and RD on consumers’ perceived quality and clarifies the mechanism in this process. Finally, experiment 3 examines the moderating effect of product knowledge.

Findings

ULD has the same level of attractiveness as RD with equivalent expected discount value for consumers. Besides, consumers in ULD give higher ratings to product quality compared with those in RD, and the lower diagnosticity of price cues in ULD underlies the differential effects of ULD vs RD. Furthermore, product knowledge moderates the relationship between the two promotions and perceived quality.

Practical implications

The findings provide valuable guidance for managers to conduct promotional campaigns. ULD is an effective promotion to attract consumers to purchase with keeping consumers’ perceived quality high, and such effectiveness will rise for products that consumers are unfamiliar with. Managers can make rational use of ULD to achieve positive promotion results in both the short and long term.

Originality/value

Few studies pay attention to the long-term effects of the uncertain promotion. This research profoundly investigates the impact of ULD on perceived quality, which complements existing studies from a more integrated perspective that combines short- and long-term effects. Also, this research identifies the mechanism based on the cue diagnosticity theory and puts forward a new explanation for positive uncertainty in uncertain promotions. Finally, this research applies the impact of product knowledge on information process strategies into the uncertain promotion, which clarifies the utility boundary of ULD from a new perspective and offers a more comprehensive understanding for this promotion.
Wave refocusing for linear diffractor using the time‐reversal principle
Authors: Keydar Shemer , Landa Evgeny
Published: March 2019

One of the problems encountered in a variety of near‐surface investigations is detecting and mapping localized heterogeneities. The heterogeneities may be classified under two kinds of objects: (1) a point diffractor that can be considered as an approximation of a small quasi‐isometric, such as small karstic cavities and caves; (2) a linear diffractor roughly approximating an elongated object, such as a tube or fault plane. The point and linear diffractors generate two types of seismic diffraction: tip and edge waves, respectively. During the last few decades, different methods were proposed by many researchers for detecting these heterogeneities utilizing seismic waves diffracted by them. An alternative method for detecting point diffractors using a time‐reversal principle combined with focusing analysis is proposed in this study: we present an extension of the time‐reversal method for linear diffractors. It consists of a coherent summation of seismic energy along edge‐diffraction traveltimes. Real data examples show the feasibility and efficiency of the proposed method.
Three‐dimensional electrical exploration methods for the mapping of polymetallic targets in Gansu Province, China
Authors: Gong Shengping , Yang Yabin , Lin Pinrong , Wu Wenli , Zheng Caijun , Shi Fusheng , Wu Xiaoping , Weng Aihua , Zhang Guangzhi , Gu Guanwen , Ye Yixin
Published: March 2019

We describe a three‐dimensional electrical exploration system, and its use in carrying out a three‐dimensional survey on a polymetallic deposit located in China's Gansu Province. A time‐domain‐induced polarization method, along with a controlled‐source audiomagnetotelluric method, was used to survey the same station points for comparison. Then, a three‐dimensional inversion based on the incomplete Gauss–Newton method (for time‐domain‐induced polarization) and a nonlinear conjugate gradient (for controlled‐source audiomagnetotelluric) method were developed and applied in order to model the data sets. Four subsurface targets were mapped by the three‐dimensional electrical exploration method. A strong correlation was found between the zones of the revealed ore‐bearing anomalies and the geological setting. Using the results of the three‐dimensional electrical exploration, we revealed the spatial distribution of the ore‐bearing stratum, as well as the relationship between the ore bodies and the stratum. The results potentially provided evidence for future interpretations of deep geological structures, along with evaluations of mineral resources.
Plagiarism and data falsification are the most common reasons for retracted publications in obstetrics and gynaecology
Authors: Chambers LM , Michener CM , Falcone T
Published: March 2019

Objective

To determine the number of retracted articles and to examine the reasons for retraction within the obstetrics and gynaecology literature.

Design

Retrospective review of the PubMed database.

Setting

N/A.

Population

Obstetrics and gynaecology articles published from indexation until June 2018.

Methods

Articles were identified using keywords for retracted articles in obstetrics and gynaecology. Descriptive statistics were performed.

Main outcome measures

Incidence of article retraction, the reasons given for retraction, and article demographics.

Results

A total of 176 articles were identified with a median time to retraction of 2 years; over three‐quarters were retracted within the last decade (n = 136; 77.3%). The median journal impact factor was 2.5 (range of 0.26–52.67). Subspecialties with the highest number of retractions were gynaecological oncology (n = 76; 43.2%), gynaecology (n = 36; 20.5%), and obstetrics (n = 31; 17.6%). Among 176 first authors, 18 authors (10.2%) had two or more retracted articles. Clinical research articles accounted for approximately one‐half of the retracted articles (n = 87; 49.4%). Among the clinical studies, 10.2% (n = 18) were randomised control trials, 16.5% (n = 29) were prospective trials and 13.1% (n = 23) were retrospective studies. Plagiarism (n = 40; 22.7%) and data falsification (n = 37; 21.0%) were the most common reasons given for retraction.

Conclusion

Article retraction within the obstetrics and gynaecology literature is increasing. The most frequently cited reasons for article retractions were plagiarism, errors in data, fabricated results, article duplication, and compromised peer review. Consequences of article retractions to patient care and the scientific community can be significant. The thorough screening of manuscripts prior to publication should be prioritised.

Tweetable abstract

The rate of retraction in obstetrics and gynaecology is increasing; the most common reason for retraction is plagiarism.
Decidual stromal cells promote the differentiation of CD56brightCD16−NK cells by secreting IL‐24 in early pregnancy
Authors: Yang Hui‐Li , Zhou Wen‐Jie , Lu Han , Lei Sha‐Ting , Ha Si‐Yao , Lai Zhen‐Zhen , Zheng Zi‐Meng , Ruan Lu‐Yu , He Yin‐Yan , Li Da‐Jin , Li Ming‐Qing , Shao Jun
Published: March 2019

Problem

Decidual stromal cells (DSCs) are important origins of cytokines to modulate maternal‐fetal immunotolerance and provide a feasible environment for embryo implantation and development. Interleukin (IL)‐24 is a multifunctional cancer killing cytokine and a pleiotropic immunoregulator with complex potency according to tissue or cell types. Its role in establishment and maintenance of normal pregnancy is largely unknown. The aim of our study was to investigate the function and significance of IL‐24 and its receptor in the coordination between DSCs and natural killer cells (NK) in early pregnancy.

Method of study

The levels of IL‐24 in DSC, endometrial stromal cell (ESC), peripheral blood NK cells (pNK), or decidual NK cells (dNK) culture supernatants were detected by enzyme‐linked immunosorbent assay (ELISA), and the levels of IL‐24 receptors were determined by real‐time reverse transcriptase‐polymerase chain reaction (RT‐PCR) and flow cytometry assays. The effect of IL‐24 on the functions of decidual NK cells was analyzed by flow cytometry assays in vitro.

Results

The concentration of IL‐24 in culture supernatant of DSCs was significantly higher than that of ESCs. Both eNK (endometrial NK cells) and dNK highly expressed IL‐24 receptors (IL‐20R1 and IL‐22R1), especially on CD56dim eNK. However, there were extremely low levels of IL‐20R1 and IL‐22R1 on pNK. Recombinant human IL‐24 or DSCs‐secreted IL‐24 downregulated the levels of CD16, Granzyme B, perforin, and interferon (IFN)‐γ and upregulated the levels of inhibitory receptors killer‐cell immunoglobulin‐like receptor (KIR)2DL1 and KIR3DL1, or immunotolerant or angiogenic cytokines (eg, transforming growth factor (TGF)‐β, IL‐10, and IL‐8), and elevated the percentage of CD56brightCD16−dNK in vitro.

Conclusion

These data suggest that DSCs promote the differentiation of CD56brightCD16−NK with high levels of inhibitory receptors, immunotolerant, and angiogenic cytokines by secreting IL‐24 during decidualization in early pregnancy.