bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential of summer-active temperate (C3) perennial forages to mitigate the detrimental effects of supraoptimal temperatures on summer home-grown feed production in south-eastern Australian dairying regions
Authors: Langworthy Adam D. , Rawnsley Richard P. , Freeman Mark J. , Pembleton Keith G. , Corkrey Ross , Harrison Matthew T. , Lane Peter A. , Henry David A.
Published: July 2018

In many south-eastern Australian dairying regions, supraoptimal ambient temperatures (Ta > 30°C) often challenge the perennial ryegrass (Lolium perenne L.)-dominated feed-base during the summer months. A glasshouse experiment was undertaken to identify alternative summer-active temperate (C3) perennial forages more tolerant of supraoptimal temperature stress (day/night Ta of 38/25°C) than perennial ryegrass. Supraoptimal temperature stress was imposed both with and without irrigation. Chicory (Cichorium intybus L.) was the only species to survive 18 days of combined supraoptimal temperature stress and non-irrigation. Lucerne (Medicago sativa L.), plantain (Plantago lanceolata L.), and tall fescue (Festuca arundinacea Schreb.) survived 12 days of this treatment. Twelve days of exposure to these conditions caused death of perennial ryegrass, prairie grass (Bromus catharticus Vahl.), cocksfoot (Dactylis glomerata L.), birdsfoot trefoil (Lotus corniculatus L.), and red clover (Trifolium pratense L.). Irrigation (daily to through drainage) mitigated detrimental effects of imposed supraoptimal temperature stress on the growth and survival of all species. Chicory and to a lesser extent lucerne, plantain, and tall fescue may have a role to play in south-eastern Australian dairying regions, where supraoptimal temperature stress is a frequent and ongoing issue.
Social equity and primary healthcare financing: lessons from New Zealand
Authors: Foley Jonathan
Published: July 2018

This paper reviews the effect of a primary care financing scheme introduced in New Zealand as a component of the New Zealand Primary Health Care Strategy, a comprehensive reform of the way that primary healthcare was governed, financed and delivered. The population-based funding formulae incorporated an area-based measure of social deprivation and ethnicity in an explicit attempt to improve access to care for certain population groups and fund social interventions aimed at addressing conditions that lead to improved health outcomes. The New Zealand experience shows that introducing a nationwide, comprehensive program to improve access and reduce health disparities is possible. However, the effect of this effort on reducing health disparities is not entirely clear because success ultimately relies on local implementation of a complex set of interventions that need to be evaluated more rigorously. In addition, the partial subsidies for first contact care that came with the Strategy have been shown to improve access, but, the success of this approach relies on compliance by private-practising general practitioners with a fee reduction regimen, which is subject to local variation.
Metabolic syndrome and weight management programs in primary care: a comparison of three international healthcare systems
Authors: Sturgiss Elizabeth , Madigan Claire Deborah , Klein Doug , Elmitt Nicholas , Douglas Kirsty
Published: July 2018

Lifestyle behaviours are contributing to the increasing incidence of chronic disease across all developed countries. Australia, Canada and the UK have had different approaches to the role of primary care in the prevention and management of lifestyle-related diseases. Both obesity and metabolic syndrome have been targeted by programs to reduce individual risk for chronic disease such as type 2 diabetes. Three interventions are described – for either obesity or metabolic syndrome – that have varying levels of involvement of GPs and other primary care professionals. The structure of a healthcare system for example, financing and physical locations of primary care clinicians, shapes the development of primary care interventions. The type of clinicians involved in interventions, whether they work alone or in teams, is influenced by the primary care setting and resource availability. Australian clinicians and policymakers should take into account the healthcare system where interventions are developed when translating interventions to the Australian context.
Ycf48 involved in the biogenesis of the oxygen-evolving photosystem II complex is a seven-bladed beta-propeller protein
Authors: Yu Jianfeng , Knoppová Jana , Michoux Franck , Bialek Wojciech , Cota Ernesto , Shukla Mahendra K. , Strašková Adéla , Pascual Aznar Guillem , Sobotka Roman , Komenda Josef , Murray James W. , Nixon Peter J.
Published: July 2018

Significance

The oxygen-evolving photosystem II (PSII) complex is essential for driving the light reactions of photosynthesis and for producing the oxygen we breathe. Accessory proteins, most of unknown function, are vital for assembling and maintaining PSII activity. Here we provide structural information on Ycf48/HCF136, which is involved in the early steps of PSII assembly and the repair of PSII following damage by light. We show that Ycf48 is a seven-bladed beta-propeller and that a highly conserved arginine patch is important for function. We propose a role for Ycf48 in coordinating the binding of chlorophyll to protein during insertion of chlorophyll-binding proteins into the membrane. Our work provides insights into the assembly of the photosynthetic apparatus used to harvest sunlight.
Promoter-mediated diversification of transcriptional bursting dynamics following gene duplication
Authors: Tunnacliffe Edward , Corrigan Adam M. , Chubb Jonathan R.
Published: July 2018

Significance

Gene transcription occurs in discontinuous bursts. Although bursts are conserved in all forms of life, the causes and implications of bursting are not clear. Here we delineate a specific cause of bursts and contextualize the significance of bursting, using analysis of a gene family encoding 17 identical actin proteins. Although the genes show similar developmental expression, which is coupled in single cells, they show strong differences in bursting dynamics. These distinct bursting patterns indicate that different signals regulate the individual genes and suggest expansion of the family may have allowed diversification of actin gene regulation. By exchanging the promoters of genes, we show that the dominant driver of bursting dynamics is the gene promoter, not the genome context.
Acetyl-
l
-carnitine deficiency in patients with major depressive disorder
Authors: Nasca Carla , Bigio Benedetta , Lee Francis S. , Young Sarah P. , Kautz Marin M. , Albright Ashly , Beasley James , Millington David S. , Mathé Aleksander A. , Kocsis James H. , Murrough James W. , McEwen Bruce S. , Rasgon Natalie
Published: July 2018

Significance

Identifying biological targets in major depressive disorder (MDD) is a critical step for development of effective mechanism-based medications. The epigenetic agent acetyl-
l
-carnitine (LAC) has rapid and enduring antidepressant-like effects in LAC-deficient rodents. Here, we found that LAC levels were decreased in patients with MDD versus age- and sex-matched healthy controls in two independent study centers. In subsequent exploratory analyses, the degree of LAC deficiency reflected both the severity and age of onset of MDD. Furthermore, the lowest LAC levels were found in patients with treatment-resistant depression, whereby history of emotional neglect and being female predicted decreased LAC levels. These translational findings suggest that LAC may serve as a candidate biomarker to help the diagnosis of a clinical endophenotype of MDD.
Distinguishing neural correlates of context-dependent advantageous- and disadvantageous-inequity aversion
Authors: Gao Xiaoxue , Yu Hongbo , Sáez Ignacio , Blue Philip R. , Zhu Lusha , Hsu Ming , Zhou Xiaolin
Published: July 2018

Significance

Despite extensive research on disadvantageous inequity, little is known about advantageous inequity and whether these two types of inequity involve differential neurocognitive mechanisms. We address these questions from the perspective of context dependency and suggest that these two types of inequity are associated with differential neurocognitive substrates, subserved by different brain regions and in particular by the spatial gradient in insular activity. Our findings shed light on how social contexts (i.e., interpersonal guilt) are integrated into social decision making and suggest that the resistance to unequal situations when individuals are in disadvantageous status may primarily stem from their emotional responses, whereas the resistance to unequal situations when individuals are in advantageous status may involve advanced cognitive functions such as mentalizing.
Fatty-acid derivative acts as a sea lamprey migratory pheromone
Authors: Li Ke , Brant Cory O. , Huertas Mar , Hessler Edward J. , Mezei Gellert , Scott Anne M. , Hoye Thomas R. , Li Weiming
Published: July 2018

Significance

Anadromous fishes are those that migrate from the ocean into freshwater to reproduce and need to orient toward a suitable spawning stream or risk leaving no offspring. These migrants are known to use olfactory cues to guide stream selection, but the cues’ identities are not known. Incidentally, it is well-known that stream-dwelling larval sea lampreys emit a pheromone that guides conspecific adults ascending freshwater streams. We identified this pheromone as a fatty-acid derivative that attracts migratory adults into the baited channel in a natural spawning stream. These results illustrate an olfactory mechanism whereby lampreys reliably identify and orient toward a proven spawning ground over a large spatial scale and implicate a potential strategy for sea lamprey control.
Central role of autophagic UVRAG in melanogenesis and the suntan response
Authors: Yang Yongfei , Jang Gyu-beom , Yang Xuanjun , Wang Qiaoxiu , He Shanshan , Li Shun , Quach Christine , Zhao Shihui , Li Fan , Yuan Zengqiang , Lee Hye-Ra , Zhong Hanbing , Liang Chengyu
Published: July 2018

Significance

Skin pigmentation provides first-line protection against UV radiation (UVR) that increases the risk of skin cancers. However, mechanisms underlying this process remain poorly understood. Here, we identified the autophagic tumor suppressor
UVRAG
as a bona fide player in melanosome biogenesis by targeting biogenesis of lysosome-related organelles complex 1 (BLOC-1) independently of autophagy. UVRAG maintains the localization and stability of BLOC-1 to facilitate the sorting/delivery of melanogenic cargoes. Reduced levels of UVRAG rendered cells unresponsive to UVR–α-MSH–MITF signaling and defective melanocyte development in vivo. Moreover, UVRAG-mediated melanogenesis and tanning response were impaired in oncogene-driven melanoma. This study represents a description of a noncanonical role of autophagy factor in melanogenic remodeling and also provides mechanistic insights into UVRAG in pigmentation disorder and UV-associated cancer.
Estrogen receptor-1 is a key regulator of HIV-1 latency that imparts gender-specific restrictions on the latent reservoir
Authors: Das Biswajit , Dobrowolski Curtis , Luttge Benjamin , Valadkhan Saba , Chomont Nicolas , Johnston Rowena , Bacchetti Peter , Hoh Rebecca , Gandhi Monica , Deeks Steven G. , Scully Eileen , Karn Jonathan
Published: July 2018

Significance

The molecular mechanisms leading to the creation and maintenance of the latent HIV reservoir remain incompletely understood. Unbiased shRNA screens showed that the estrogen receptor acts as a potent repressor of proviral reactivation in T cells. Antagonists of ESR-1 activate latent HIV-1 proviruses while agonists, including β-estradiol, potently block HIV reactivation. Using a well-matched set of male and female donors, we found that ESR-1 plays an important role in regulating HIV transcription in both sexes. However, women are much more responsive to estrogen and appear to harbor smaller inducible RNA reservoirs. Accounting for the impact of estrogen on HIV viral reservoirs will therefore be critical for devising curative therapies for women, a group representing 51% of global HIV infections.
Lymphocytic choriomeningitis virus Clone 13 infection causes either persistence or acute death dependent on IFN-1, cytotoxic T lymphocytes (CTLs), and host genetics
Authors: Oldstone Michael B. A. , Ware Brian C. , Horton Lucy E. , Welch Megan J. , Aiolfi Roberto , Zarpellon Alessandro , Ruggeri Zaverio M. , Sullivan Brian M.
Published: July 2018

Significance

T cell exhaustion and successful therapy to restore T cell function initially uncovered with lymphocytic choriomeningitis virus (LCMV) Clone (Cl) 13 infection is important for understanding and treating persistent viral infections and cancers in mice and humans. Here, we report that Cl 13 infection in multiple inbred mouse strains elicits opposite phenotypes: acute death in 7 to 9 d associated with a robust T cell response contrasted to suppression of T cell response leading to persistent infection with normal life span. Death was due to pulmonary vascular leakage of fluids and cells into the lung, leading to respiratory failure. Death can be aborted by blocking interferon-1 signaling or deleting CD8 T cells.
Unexpected synergistic HIV neutralization by a triple microbicide produced in rice endosperm
Authors: Vamvaka Evangelia , Farré Gemma , Molinos-Albert Luis M. , Evans Abbey , Canela-Xandri Anna , Twyman Richard M. , Carrillo Jorge , Ordóñez Raziel A. , Shattock Robin J. , O’Keefe Barry R. , Clotet Bonaventura , Blanco Julian , Khush Gurdev S. , Christou Paul , Capell Teresa
Published: July 2018

Significance

Our paper provides an approach for the durable deployment of anti-HIV agents in the developing world. We developed a transgenic rice line expressing three microbicidal proteins (the HIV-neutralizing antibody 2G12 and the lectins griffithsin and cyanovirin-N). Simultaneous expression in the same plant allows the crude seed extract to be used directly as a topical microbicide cocktail, avoiding the costs of multiple downstream processes. This groundbreaking strategy is realistically the only way that microbicidal cocktails can be manufactured at a cost low enough for the developing world, where HIV prophylaxis is most in demand.
MOTHER-OF-FT-AND-TFL1
represses seed germination under far-red light by modulating phytohormone responses in
Arabidopsis thaliana
Authors: Vaistij Fabián E. , Barros-Galvão Thiago , Cole Adama F. , Gilday Alison D. , He Zhesi , Li Yi , Harvey David , Larson Tony R. , Graham Ian A.
Published: July 2018

Significance

Seeds sense environmental conditions, such as light quality, to regulate their germination. Light enriched in the far-red wavelength, such as under-the-canopy light (shade), increases abscisic acid (ABA) and decreases gibberellin (GA) levels, the phytohormones repressing and promoting germination, respectively. We have discovered that
MFT
functions as a key repressor of germination under far-red light conditions by modulating ABA and GA responses.
Acid-sensing ion channels emerged over 600 Mya and are conserved throughout the deuterostomes
Authors: Lynagh Timothy , Mikhaleva Yana , Colding Janne M. , Glover Joel C. , Pless Stephan A.
Published: July 2018

Significance

The conversion of extracellular chemical signals into electrical current across the cell membrane is a defining characteristic of the nervous system. This is mediated by proteins, such as acid-sensing ion channels (ASICs), membrane-bound receptors whose activation by decreased extracellular pH opens an intrinsic membrane-spanning sodium channel. Curiously, ASICs had only been reported in vertebrates, despite the homology of many other ion channels in vertebrates and invertebrates. Using molecular phylogenetics and electrophysiological recordings, we discover ASICs from tunicates, lancelets, sea urchins, starfish, and acorn worms. This shows that ASICs evolved much earlier than previously thought and suggests that their role in the nervous system is conserved across numerous animal phyla.
Heme ameliorates dextran sodium sulfate-induced colitis through providing intestinal macrophages with noninflammatory profiles
Authors: Kayama Hisako , Kohyama Masako , Okuzaki Daisuke , Motooka Daisuke , Barman Soumik , Okumura Ryu , Muneta Masato , Hoshino Katsuaki , Sasaki Izumi , Ise Wataru , Matsuno Hiroshi , Nishimura Junichi , Kurosaki Tomohiro , Nakamura Shota , Arase Hisashi , Kaisho Tsuneyasu , Takeda Kiyoshi
Published: July 2018

Significance

Following hemorrhage in damaged tissues, hemoglobin induces macrophages (Mϕs) possessing ability to protect against tissue inflammation. Hemorrhage-appearing mucosa is observed in patients with inflammatory bowel disease. However, heme-mediated modulation of intestinal Mϕ activity remains poorly understood. Here, we provide evidence that Spi-C induced by heme is a key molecule for providing noninflammatory gene expression patterns of intestinal CX
3
CR1
high
Mϕs. We found that the
Spic
deficiency in intestinal Mϕs resulted in increased sensitivity to dextran sodium sulfate-induced colitis. Heme-mediated Spi-C inhibited a subset of LPS-induced genes such as
Il6
and
Il1a
by intestinal CX
3
CR1
high
Mϕs through inhibition of IRF5-NF-κB p65 complex formation. These results reveal a mechanism modulating the noninflammatory phenotype of intestinal Mϕs and may help identify targets for therapy of intestinal inflammation.
Temporal dynamics of pair-rule stripes in living
Drosophila
embryos
Authors: Lim Bomyi , Fukaya Takashi , Heist Tyler , Levine Michael
Published: July 2018

Significance

Classical studies of gene activity in development focused on spatial limits due to the use of fixed tissues for analysis. The advent of live-imaging methods provides an opportunity to examine the temporal control of gene expression. Here, we used quantitative live-imaging methods to visualize dynamic shifts in the endogenous expression of
eve
and
ftz
pair-rule stripes in the early
Drosophila
embryo. We suggest that these temporal dynamics add to the complexity encoded by the segmentation gene network.
Observers, victims or part of the problem? Exploring affective images of climate change obtained by word associations / ¿Observadores, víctimas o parte del problema? Explorando las imágenes afectivas del cambio climático obtenidas mediante asociaciones de palabras
Authors: Heras-Hernández Francisco , Meira-Cartea Pablo A. , Benayas Javier
Published: July 2018

How do Spaniards frame climate change? Is it something negative and depressing? Is it an environmental question or a human issue? What is their perceived role? Are they mere observers, victims or part of the problem? To explore these issues, in a series of opinion polls prepared in Spain in 2008, 2010 and 2012, the interviewed persons were asked, ‘Which is the first thought or image that comes to your mind whenever you hear talk of climate change?’ A large majority of the registered associations mention adverse effects or contain negative appraisals. The preponderance of the associations related to the effects of climate change over those that refer to its causes or solutions indicate that the respondents see themselves more as affected by the consequences than as causal agents or actors capable of providing proper answers. Clear similarities between this social framing and the media framing have been found.
Transcriptional regulation of cell shape during organ morphogenesis
Authors: Sivakumar Aravind , Kurpios Natasza A.
Published: July 2018

The emerging field of transcriptional regulation of cell shape changes aims to address the critical question of how gene expression programs produce a change in cell shape. Together with cell growth, division, and death, changes in cell shape are essential for organ morphogenesis. Whereas most studies of cell shape focus on posttranslational events involved in protein organization and distribution, cell shape changes can be genetically programmed. This review highlights the essential role of transcriptional regulation of cell shape during morphogenesis of the heart, lungs, gastrointestinal tract, and kidneys. We emphasize the evolutionary conservation of these processes across different model organisms and discuss perspectives on open questions and research avenues that may provide mechanistic insights toward understanding birth defects.
A NUMB–EFA6B–ARF6 recycling route controls apically restricted cell protrusions and mesenchymal motility
Authors: Zobel Martina , Disanza Andrea , Senic-Matuglia Francesca , Franco Michel , Colaluca Ivan Nicola , Confalonieri Stefano , Bisi Sara , Barbieri Elisa , Caldieri Giusi , Sigismund Sara , Pece Salvatore , Chavrier Philippe , Di Fiore Pier Paolo , Scita Giorgio
Published: July 2018

The endocytic protein NUMB has been implicated in the control of various polarized cellular processes, including the acquisition of mesenchymal migratory traits through molecular mechanisms that have only been partially defined. Here, we report that NUMB is a negative regulator of a specialized set of understudied, apically restricted, actin-based protrusions, the circular dorsal ruffles (CDRs), induced by either PDGF or HGF stimulation. Through its PTB domain, NUMB binds directly to an N-terminal NPLF motif of the ARF6 guanine nucleotide exchange factor, EFA6B, and promotes its exchange activity in vitro. In cells, a NUMB–EFA6B–ARF6 axis regulates the recycling of the actin regulatory cargo RAC1 and is critical for the formation of CDRs that mark the acquisition of a mesenchymal mode of motility. Consistently, loss of NUMB promotes HGF-induced cell migration and invasion. Thus, NUMB negatively controls membrane protrusions and the acquisition of mesenchymal migratory traits by modulating EFA6B–ARF6 activity.
ARID5B regulates metabolic programming in human adaptive NK cells
Authors: Cichocki Frank , Wu Cheng-Ying , Zhang Bin , Felices Martin , Tesi Bianca , Tuininga Katie , Dougherty Phillip , Taras Emily , Hinderlie Peter , Blazar Bruce R. , Bryceson Yenan T. , Miller Jeffrey S.
Published: July 2018

Natural killer (NK) cells with adaptive immunological properties expand and persist in response to human cytomegalovirus. Here, we explored the metabolic processes unique to these cells. Adaptive CD3−CD56dimCD57+NKG2C+ NK cells exhibited metabolic hallmarks of lymphocyte memory, including increased oxidative mitochondrial respiration, mitochondrial membrane potential, and spare respiratory capacity. Mechanistically, we found that a short isoform of the chromatin-modifying transcriptional regulator, AT-rich interaction domain 5B (ARID5B), was selectively induced through DNA hypomethylation in adaptive NK cells. Knockdown and overexpression studies demonstrated that ARID5B played a direct role in promoting mitochondrial membrane potential, expression of genes encoding electron transport chain components, oxidative metabolism, survival, and IFN-γ production. Collectively, our data demonstrate that ARID5B is a key regulator of metabolism in human adaptive NK cells, which, if targeted, may be of therapeutic value.
Knockdown of a disintegrin A metalloprotease 12 (ADAM12) during adipogenesis reduces cell numbers, delays differentiation, and increases lipid accumulation in 3T3-L1 cells
Authors: Coles Chantal A. , Maksimovic Jovana , Wadeson Jenny , Fahri Fahri T. , Webster Tracie , Leyton Carolina , McDonagh Matthew B. , White Jason D.
Published: July 2018

Mouse models have shown that a disintegrin A metalloprotease 12 (ADAM12) is implicated during adipogenesis; the molecular pathways are not well understood. Stealth RNA interference was used to knock down ADAM12 in 3T3-L1 cells. Using gene profiling and metabolic enzymatic markers, we have identified signaling pathways ADAM12 impacts upon during proliferation, differentiation, and maturation of adipocytes. ADAM12 reduced cell numbers in proliferating preadipocytes, delayed differentiation of preadipocytes to adipocytes, and increased lipid accumulation in mature adipocytes. The pathway most affected by ADAM12 knockdown was regulation of insulin-like growth factor (IGF) activity by insulin-like growth factor binding proteins (IGFBPs); ADAM12 is known to cleave IGFBP3 and IGFBP5. The IGF/mTOR signaling pathway was down-regulated, supporting a role for ADAM12 in the IGFBP/IGF/mTOR-growth pathway. PPARγ signaling was also down-regulated by ADAM12 knockdown. Gene ontology (GO) analysis revealed that the extracellular matrix was the cellular compartment most impacted. Filtering for matrisome genes, connective tissue growth factor ( Ctgf) was up-regulated. CTGF and IGBP3 can interact with PPARγ to hinder its regulation. Increased expression of these molecules could have influenced PPARγ signaling reducing differentiation and an imbalance of lipids. We believe ADAM12 regulates cell proliferation of preadipocytes through IGFBP/IGF/mTOR signaling and delays differentiation through altered PPAR signaling to cause an imbalance of lipids within mature adipocytes.
Disadvantaged Early-Life Socioeconomic Circumstances Are Associated With Low Respiratory Function in Older Age
Authors: Cheval Boris , Chabert Clovis , Orsholits Dan , Sieber Stefan , Guessous Idris , Blane David , Kliegel Matthias , Janssens Jean-Paul , Burton-Jeangros Claudine , Pison Christophe , Courvoisier Delphine S , Boisgontier Matthieu P , Cullati Stéphane
Published: July 2018

Background

Poor lung function in late life may stem from early-life risk factors, but the epidemiological evidence is inconsistent. We investigated whether individuals who experienced disadvantageous socioeconomic circumstances (SEC) in early life showed lower levels of respiratory function in older age, a steeper decline over time, and whether these relationships were explained by adult-life SEC, body mass index, and physical inactivity in older age.

Methods

We used data from the Survey of Health Ageing and Retirement in Europe (2004–2015). Participants’ peak expiratory flow (PEF) was assessed with a mini-Wright peak flow meter at second, fourth, and sixth waves. Confounder-adjusted linear mixed-effect models were used to examine the associations between early-life SEC and PEF in older age. A total of 21,734 adults aged 50–96 years (46,264 observations) were included in the analyses.

Results

Older adults with disadvantaged early-life SEC showed lower levels of PEF compared with those with advantaged early-life SEC. The association between early-life SEC and late-life PEF persisted after adjusting for adult-life SEC, smoking, physical inactivity, and body mass index. PEF declined with age, but the effect of early-life SEC on this decline was not consistent across robustness and sensitivity analyses.

Conclusions

Early life is a sensitive period for respiratory health. Further considering the effect of SEC arising during this period may improve the prevention of chronic respiratory diseases.
American Dionysus: Carl W. Hamilton (1886–1967), collector of Italian Renaissance art
Authors: Johnston Tiffany L
Published: July 2018

For nearly a decade Carl W. Hamilton was in possession of one of the most important private collections of Italian Renaissance painting in America. A self-made millionaire from humble beginnings, the young Hamilton captivated the art dealer Joseph Duveen and Duveen’s foremost experts in Italian Renaissance painting, Bernard and Mary Berenson. By inspiring and instructing Hamilton, Duveen and the Berensons hoped to focus his wealth and ambition to create a great collection and thereby profit by both him and the glory of his achievement. Though Hamilton’s personal collection proved ephemeral, many of his most important works of art nevertheless found their way into American public collections. Furthermore, Hamilton’s formative collecting experience – which developed his prejudices and preferences, sharpened his keen negotiating skills and solidified his zeal for collecting – helped to shape two significant collections of Old Masters in the Carolinas: the Museum & Gallery at Bob Jones University and the North Carolina Museum of Art.
Information Management and Pricing in Platform Markets
Authors: Jullien Bruno , Pavan Alessandro
Published: July 2018

We study platform markets in which the information about users’ preferences is dispersed. First, we show how the dispersion of information introduces idiosyncratic uncertainty about participation decisions and how the latter shapes the elasticity of the demands and the equilibrium prices. We then study the effects on profits, consumer surplus, and welfare of platform design, blogs, forums, conferences, advertising campaigns, post-launch disclosures, and other information management policies affecting the agents’ ability to predict participation decisions on the other side of the market.
The Duration of Symptoms Does Not Impact Clinical Outcomes Following Lumbar Decompression Surgery
Authors: Movassaghi Kamran , Basques Bryce A. , Louie Philip K. , Khan Jannat M. , Derman Peter B. , Nolte Michael T. , Paul Justin C. , Goldberg Edward J. , An Howard S.
Published: July 2018

Study Design.

A retrospective cohort analysis.

Objective.

The aim of this study was to assess whether duration of symptoms (DOS) has an effect on clinical outcomes in patients undergoing lumbar decompression.

Summary of Background Data.

The success of surgical interventions for lumbar spinal stenosis varies depending on numerous factors, including DOS. However, existing literature does not provide a clear indication of the outcome of lumbar decompression surgery in regard to DOS secondary to nerve root compression.

Methods.

Analysis of patients who underwent primary lumbar laminectomy from 2008 through 2015 by one of two senior orthopedic spine surgeons was conducted. Exclusion criteria were as follows: previous lumbar surgery, patient under 18 years of age at time of surgery, or postoperative follow-up less than 3 months. Patients were divided into groups on the basis of preoperative DOS: less than 1 year and 1 year or greater. Patient-reported outcomes were obtained using Oswestry Disability Index (ODI) scores, Visual Analog Scales (VAS) scores for the back and leg, 12-Item Short Form Mental and Physical Survey (SF-12) scores, and Veterans Rand 12-Item Health Mental and Physical Survey (VR-12) scores. Patients were surveyed about expectations and postoperative satisfaction.

Results.

Two hundred ten patients were assessed; 108 with DOS of less than 1 year and 102 with DOS of 1 year or more. On multivariate analysis, patients with DOS of 1 year or greater presented with significantly lower SF-12 scores (P = 0.043). No significant differences existed in other outcome survey scores. Reoperation rates were not significantly different (P = 0.904). Both groups reported high levels of satisfaction (odds ratio 0.42, P = 0.483) and that surgery met or exceeded their expectations (odds ratio 1.00, P = 0.308).

Conclusion.

Symptom chronicity did not significantly affect postoperative clinical outcomes, reoperation rates, or patient satisfaction. Nonoperative treatment of lumbar spinal stenosis is often successful but may delay operative intervention. However, results of this study suggest that the delay does not negatively impact surgical outcomes.

Level of Evidence: 3
Maintenance Treatment for Patients With Mantle Cell Lymphoma
Authors: Vidal Liat , Gafter‐Gvili Anat , Dreyling Martin , Ghielmini Michele , Witzens‐Harig Mathias , Shpilberg Ofer , Unterhalt Michael , Rummel Mathias , Gurion Ronit
Published: July 2018

Supplemental Digital Content is available in the text
Secretory Carcinoma of the Lacrimal Gland: A Rare Case Report
Authors: Bortz John G. , Zhang Paul J. L. , Eagle Ralph C. , Yong Jennifer J. , Milman Tatyana
Published: July 2018

Secretory carcinoma is a salivary gland malignancy that recapitulates secretory carcinoma of the breast, along with its shared ETV6-NTRK3 gene fusion. Characterization of histopathologic, immunohistochemical, and molecular genetic features of this neoplasm has led to reclassification of a heterogeneous group of salivary gland carcinomas as secretory carcinoma and to identification of this neoplasm in other gland-containing tissues. The authors describe a 52-year-old man who presented with a 2-week history of diplopia and a well-circumscribed right orbital mass. The tumor was resected via lateral orbitotomy approach. Pathologic evaluation demonstrated secretory carcinoma, previously not described in the main lacrimal gland. Recognition of lacrimal gland secretory carcinoma may lead to reappraisal of morphologically similar, but biologically heterogeneous lacrimal gland neoplasms, providing an insight into this tumor’s clinical presentation and prognosis. Accurate diagnosis of this malignancy has important management and prognostic implications, particularly with emergence of targeted therapies.
Hepatitis, Interstitial Nephritis, and Pancreatitis in Association With Clozapine Treatment
Authors: Lally John , al Kalbani Hana , Krivoy Amir , Murphy Kieran C. , Gaughran Fiona , MacCabe James H.
Published: July 2018

Purpose/Background

Clozapine is the criterion standard in treatment-resistant schizophrenia. We sought to review data on several inflammatory effects associated with clozapine, specifically interstitial nephritis, hepatitis, and pancreatitis.

Methods/Procedures

We conducted a systematic review to identify studies, published up until December 2017, describing clozapine-induced hepatitis, nephritis, and pancreatitis. The primary objective was to characterize the clinical characteristics associated with each of the specific inflammatory reactions to clozapine.

Findings/Results

We identified 42 cases of inflammatory reactions associated with clozapine treatment- 20 :cases of clozapine-induced hepatitis, 11 cases of nephritis, and 11 of pancreatitis. The mean (SD) age was 38.8 (11.9) years. The mean (SD) dose of clozapine used was 252.4 (133.7) mg. Time to onset of pancreatitis (17.9 [11.2] days; range 4–35 days) was shorter than that for hepatitis (34.2 [20.1] days; range, 12–90 days) and nephritis (27.9 [27.0]; range, 8–90 days) but was not statistically significant (F = 2.267, P = 0.117). The mean (SD) time to recovery was shorter for cases of pancreatitis (15.7 [18.4] days) compared with cases of hepatitis (25.9 [16.5] days) and nephritis (24.5 [18.9] days). Three cases with hepatitis died. Seven of the cases had a clozapine rechallenge (hepatitis [n = 3], nephritis [n = 1], pancreatitis [n = 3]), with 5 having a recurrence at a mean (SD) onset of 3.5 (2.5) days (range, 1–7 days); 2 hepatitis cases were successfully rechallenged.

Implications/Conclusions

Clozapine-induced hepatitis, nephritis, and pancreatitis are uncommon adverse events, reflected in the paucity of case studies in the literature. Early recognition of the signs and symptoms of clozapine-associated hepatitis, nephritis, and pancreatitis is important, as when identified, clozapine should be urgently discontinued. Clozapine is associated with evidence of benign inflammatory processes; the extent to which hepatitis, and other inflammatory reactions, may be on a continuum with these more benign and self-limiting reactions is unclear, and this can only be resolved by prospectively following cohorts of clozapine-treated patients.
Multidirectional Instability of the Shoulder: Treatment Options and Considerations
Authors: Best Matthew J. , Tanaka Miho J.
Published: July 2018

Multidirectional instability (MDI) is a debilitating condition that involves chronic subluxation or dislocation of the shoulder in >1 direction. Numerous proposed mechanisms of MDI exist, which occurs in the setting of redundant capsular tissue. Symptoms can range from recurrent dislocations or subluxations to vague aching pain that disrupts activities of daily living. Magnetic resonance imaging is often performed during evaluation of this condition, although magnetic resonance arthrography may provide more detailed images of the patulous capsule. In the absence of a well-defined traumatic cause, such as a labral tear, initial treatment for MDI is a structured rehabilitation program with exercises aimed at strengthening the rotator cuff and periscapular muscles to improve scapular kinematics. Patients with recalcitrant symptoms may benefit from surgical stabilization, including open capsular shift or arthroscopic capsular plication, aimed at decreasing capsular volume and improving stability.
The Overhead Athletes Shoulder
Authors: Bakshi Neil , Freehill Michael T.
Published: July 2018

The overhead athlete places tremendous forces across the shoulder which result in necessary adaptive, but also potentially pathologic structural change. In this chapter we aim to review the biomechanics of throwing, the mechanisms of injury with overhead sports, the detailed history, and physical examination in this population, and concluding with specific diagnoses and the various treatment options.
Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas
Authors: Hanada Keiji , Kurihara Keisuke , Itoi Takao , Katanuma Akio , Sasaki Tamito , Hara Kazuo , Nakamura Masafumi , Kimura Wataru , Suzuki Yutaka , Sugiyama Masanori , Ohike Nobuyuki , Fukushima Noriyoshi , Shimizu Michio , Ishigami Kousei , Gabata Toshifumi , Okazaki Kazuichi
Published: July 2018

Objective

The aim of this study was to evaluate the clinicopathological features of solid pseudopapillary neoplasms (SPNs).

Methods

In this retrospective study, 288 SPNs were analyzed.

Results

Overall, 214 patients (74%) were female. Distant metastases occurred in 4 patients, and splenic vein tumor thrombus occurred in 1 patient. Although imaging findings showed large (>2.0 cm) SPNs with clear, regular border, and heterogeneous internal structure, small SPNs appeared as almost entirely solid. Surgical resection was performed in 278 cases. The 5-year survival rate was 98.8%. Six patients had tumor recurrence after the initial resection. The detection rate in typical pathological findings was low for small SPNs. Tumor extension to the pancreatic parenchyma was detected in greater than 70% of the cases. Tumor invasion to adjacent organs was detected in 13 cases. One was given a diagnosis of apparent high-grade malignant transformation.

Conclusions

The proportion of male cases was higher than that in previous studies, and there were statistically significant differences in the onset age and tumor diameter between male and female patients. Therefore, women seemed to have an early occurrence of SPNs, suggesting a difference in the developmental stage between men and women. Images and pathological findings of SPNs varied according to tumor size. Our findings indicated that SPN patients have excellent survival after margin-negative surgical resection.
Implementing Posthospital Interprofessional Care Team Visits to Improve Care Transitions and Decrease Hospital Readmission Rates
Authors: Baldwin Stacy M. , Zook Sharon , Sanford Julie
Published: July 2018

Purpose/Objectives:

Today's health care climate is composed of patients who experience complex conditions with multiple comorbidities, requiring higher utilization of acute care services. It is imperative for acute care and primary care landscapes to bridge silos and form collaborative relationships to ensure safe and effective transitions of care from hospital to home. An interprofessional, posthospital follow-up clinic (Discharge Clinic) is one approach that can be used to improve transitions of care and decrease preventable hospital readmissions. The purpose of the Discharge Clinic is to improve transitions of care and decrease 30-day hospital readmission rates. The clinic's objective is to utilize an interprofessional care team to improve transitions of care posthospital, for complex care patients.

Primary Practice Setting:

The posthospital Discharge Clinic is an innovative, interprofessional clinic located in a large western state that was initiated to improve transitions of care for its patients discharged from an acute care setting. The interprofessional care team consists of a certified family nurse practitioner, a clinical pharmacist, a nurse case manager, and a social worker.

Findings/Conclusions:

In 2013, Medicare and private coverage data reveal 30-day readmission rates of 17.3% and 8.6%, respectively (Agency for Health Care Quality and Research, 2013). From February 2016 to September 2016, Discharge Clinic project participants achieved a 30-day readmission rate of 2.7%. The Discharge Clinic enrolled 75 patients in the project (n = 75). The 30-day readmission rate achieved by the Discharge Clinic represents a significant decrease compared with national benchmark data. Two patients enrolled in the project were readmitted within 30 days of hospital discharge. For fiscal year 2015, the medical group's estimated cost of readmissions was $7,156,800 and 30-day all-cause readmission rate was 12.3%. This equated to the Discharge Clinic's estimated impact in reducing readmissions at 9.63% and an estimated savings of $689,199.84. The Discharge Clinic estimated its operating costs at $354,000, which gave a total estimated net savings of $335,199.84.

Implications for Case Management Practice:

The current health care landscape is composed of an aging population, rising in complexity. New approaches are needed to bridge gaps between acute care and primary care settings. The Discharge Clinic serves as an innovative model that health systems throughout the country can replicate to improve transitions of care for complex patients. The interprofessional care team model can be implemented to advance and bridge the management of acute and ambulatory care patient populations.
Cognitive and Behavioral Consequences of Pediatric Delirium: A Pilot Study*
Authors: Meyburg Jochen , Ries Markus , Zielonka Matthias , Koch Karin , Sander Anja , von Haken Rebecca , Reuner Gitta
Published: July 2018

Objectives:

To investigate the long-term impact of postoperative delirium in children.

Design:

Single-center point prevalence study.

Setting:

Twenty-two bed PICU.

Patients:

Forty-seven patients 1–16 years old.

Interventions:

Standardized neuropsychologic follow-up investigation after a mean time of 17.7 ± 2.9 months after PICU discharge.

Measurements and Main Results:

Pediatric delirium did not have significant long-term impact on global cognition, executive functions, or behavior. Severity of delirium did not influence the outcome. Different predictors were identified for later cognitive functioning, executive functions, and behavioral problems. Younger age was confirmed to be a relevant risk factor for delirium as well as for the cognitive and behavioral outcome.

Conclusions:

Contrary to the findings in adults, there was no clear association between pediatric delirium and long-term cognition or behavior in this cohort. However, this is a first pilot study with several limitations that should promote more comprehensive prospective trials.
Contribution of SPECT/CT to Evaluate Urinary Leakage Suspicion in Renal Transplant Patients
Authors: Yazici Bulent , Oral Aylin , Akgün Aysegül
Published: July 2018

It is known that renal scintigraphy is the best imaging modality in the diagnosis of urinary leakage. Usually, only planar images are diagnostic but sometimes they are unclear when urinoma is small and adjacent to kidney or bladder. In other respects, planar images can be false-positive in the case of increased blood flow of abdominal wall. We suggested using SPECT/CT in differential diagnosis. An atlas of SPECT/CT is presented, which includes 3 cases that urinoma was diagnosed by SPECT/CT, which were unclear on planar images, and one case that urinary leakage suspicion on planar image was ruled out by SPECT/CT.
Hidden burden of venous thromboembolism after trauma: A national analysis
Authors: Rattan Rishi , Parreco Joshua , Eidelson Sarah A. , Gold Joann , Dharmaraja Arjuna , Zakrison Tanya L. , Dante Yeh D. , Ginzburg Enrique , Namias Nicholas
Published: July 2018

BACKGROUND

Trauma patients are at increased risk for venous thromboembolism (VTE). One in four trauma readmissions occur at a different hospital. There are no national studies measuring readmissions to different hospitals with VTE after trauma. Thus, the true national burden in trauma patients readmitted with VTE is unknown and can provide a benchmark to improve quality of care.

METHODS

The Nationwide Readmission Database (2010–2014) was queried for patients ≥18 years non-electively admitted for trauma. Patients with VTE or inferior vena cava filter placement on index admission were excluded. Outcomes included 30-day and 1-year readmission to both index and different hospitals with a new diagnosis of VTE. Multivariable logistic regression identified risk factors. Results were weighted for national estimates.

RESULTS

Of the 5,151,617 patients admitted for trauma, 1.2% (n = 61,800) were readmitted within 1 year with VTE. Of those, 29.6% (n = 18,296) were readmitted to a different hospital. Risk factors for readmission to a different hospital included index admission to a for-profit hospital (OR 1.33 [1.27–1.40], p < 0.001), skull fracture (OR 1.20 [1.08–1.35], p < 0.001), Medicaid (OR 1.16 [1.06–1.26], p < 0.001), hospitalization >7 days (OR 1.12 [1.07–1.18], p < 0.001), and the lowest quartile of median household income for patient ZIP code (OR 1.13 [1.07–1.19], p < 0.01). The yearly cost of 1-year readmission for VTE was $256.9 million, with $90.4 million (35.2%) as a result of different hospital readmission.

CONCLUSIONS

Previously unreported, over one in three patients readmitted with VTE a year after hospitalization for trauma, accounting for over a third of the cost, present to another hospital and are not captured by current metrics. Risk factors are unique. This has significant implications for benchmarking, outcomes, prevention, and policy.

LEVEL OF EVIDENCE

Epidemiological study, level II.
Safety of early tracheostomy in trauma patients after anterior cervical fusion
Authors: Lozano Claudia P. , Chen Kevin A. , Marks Joshua A. , Jenoff Jay S. , Cohen Murray J. , Weinstein Michael S.
Published: July 2018

BACKGROUND

Cervical spine injuries (CSIs) can have major effects on the respiratory system and carry a high incidence of pulmonary complications. Respiratory failure can be due to spinal cord injuries, concomitant facial fractures or chest injury, airway obstruction, or cognitive impairments. Early tracheostomy (ET) is often indicated in patients with CSI. However, in patients with anterior cervical fusion (ACF), concerns about cross-contamination often delay tracheostomy placement. This study aimed to demonstrate the safety of ET within 4 days of ACF.

METHODS

Retrospective chart review was performed for all trauma patients admitted to our institution between 2001 and 2015 with diagnosis of CSI who required both ACF and tracheostomy, with or without posterior cervical fusion, during the same hospitalization. Thirty-nine study patients with ET (within 4 days of ACF) were compared with 59 control patients with late tracheostomy (5–21 days after ACF). Univariate and logistic regression analyses were performed to compare risk of wound infection, length of intensive care unit and hospital stay, and mortality between both groups during initial hospitalization.

RESULTS

There was no difference in age, sex, preexisting pulmonary or cardiac conditions, Glasgow Coma Scale score, Injury Severity Score, Chest Abbreviated Injury Scale score, American Spinal Injury Association score, cervical spinal cord injury levels, and tracheostomy technique between both groups. There was no statistically significant difference in surgical site infection between both groups. There were no cases of cervical fusion wound infection in the ET group (0%), but there were five cases (8.47%) in the late tracheostomy group (p = 0.15). Four involved the posterior cervical fusion wound, and one involved the ACF wound. There was no statistically significant difference in intensive care unit stay (p = 0.09), hospital stay (p = 0.09), or mortality (p = 0.06) between groups.

CONCLUSION

Early tracheostomy within 4 days of ACF is safe without increased risk of infection compared with late tracheostomy.

LEVEL OF EVIDENCE

Evidence, level III.