bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetically encoded orientation probes for F-actin for fluorescence polarization microscopy
Authors: Nakai Nori , Sato Keisuke , Tani Tomomi , Saito Kenta , Sato Fumiya , Terada Sumio
Published: May 2019

Fluorescence polarization microscopy, which can visualize both position and orientation of fluorescent molecules, is useful for analyzing architectural dynamics of proteins in vivo, especially that of cytoskeletal proteins such as actin. Fluorescent phalloidin conjugates and SiR-actin can be used as F-actin orientation probes for fluorescence polarization microscopy, but a lack of appropriate methods for their introduction to living specimens especially to tissues, embryos, and whole animals hampers their applications to image the orientation of F-actin. To solve this problem, we have developed genetically encoded F-actin orientation probes for fluorescence polarization microscopy. We rigidly connected circular permutated green fluorescent protein (GFP) to the N-terminal α-helix of actin-binding protein Lifeact or utrophin calponin homology domain (UtrCH), and normal mEGFP to the C-terminal α-helix of UtrCH. After evaluation of ensemble and single particle fluorescence polarization with the instantaneous FluoPolScope, one of the constructs turned out to be suitable for practical usage in live cell imaging. Our new, genetically encoded F-actin orientation probe, which has a similar property of an F-actin probe to conventional GFP-UtrCH, is expected to report the 3D architecture of the actin cytoskeleton with fluorescence polarization microscopy, paving the way for both the single molecular orientation imaging in cultured cells and the sub-optical resolution architectural analysis of F-actin networks analysis of F-actin in various living systems.
Costs of Oral Complications of Cancer Therapies: Estimates and a Blueprint for Future Study
Authors: Elting Linda S , Chang Yu-Chia
Published: May 2019

Oral complications of cancer treatment are common; however, their clinical and economic importance is often underappreciated. We reviewed the literature on the economic implications of oral complications, updating a previous report in the predecessor to this issue. We searched the Medline and Scopus databases for papers published as of December 31, 2017 that described the economic consequences of preventing and managing oral complications and reviewed the literature reporting the costs of oral mucositis, xerostomia, and osteonecrosis. Cost estimates were inflated to 2017 US dollars. We identified 16 papers describing the cost of managing mucositis, eight describing the cost of osteoradionecrosis, one describing the cost of bisphosphonate-associate osteonecrosis of the jaw, and four describing the cost of xerostomia. The incremental cost of oral mucositis was approximately $5000–$30 000 among patients receiving radiation therapy and $3700 per cycle among patients receiving chemotherapy. The incremental cost of mucositis-related hospitalization among stem cell transplant recipients exceeded $70 000. Conservative management of osteoradionecrosis (antibiotics, debridement) costs $4000–$35 000, although estimates as high as $74 000 have been reported. Hyperbaric oxygen therapy may add $10 000–$50 000 to the cost of therapy. Sialogogues are required for years for the management of xerostomia at a cost of $40–$200 per month. Serious (hospitalization, hyperbaric oxygen therapy) or long-term (sialogogues) outcomes are the major drivers of cost. Future research should address patients’ out-of-pocket costs and the costs of oral complications of new treatments. Multisite studies, particularly those conducted by cooperative groups, should be prioritized.
How Errors Cumulate: Two Examples
Authors: Tourangeau Roger
Published: May 2019

This article examines the relationship among different types of nonobservation errors (all of which affect estimates from nonprobability internet samples) and between nonresponse and measurement errors. Both are examples of how different error sources can interact. Estimates from nonprobability samples seem to have more total error than estimates from probability samples, even ones with very low response rates. This finding suggests that the combination of coverage, selection, and nonresponse errors has greater cumulative effects than nonresponse error alone. The probabilities of having internet access, joining an internet panel, and responding to a particular survey request are probably correlated and, as a result, may lead to greater covariances with survey variables than response propensities alone; the biases accentuate one another. With nonresponse and measurement error, the two sources seem more or less uncorrelated, with one exception—those most prone to social desirability bias (those in the undesirable categories) are also less likely to respond. In addition, the propensity for unit nonresponse seems to be related to item nonresponse.
Three years of Sun-as-a-star radial-velocity observations on the approach to solar minimum
Authors: Collier Cameron A , Mortier A , Phillips D , Dumusque X , Haywood R D , Langellier N , Watson C A , Cegla H M , Costes J , Charbonneau D , Coffinet A , Latham D W , Lopez-Morales M , Malavolta L , Maldonado J , Micela G , Milbourne T , Molinari E , Saar S H , Thompson S , Buchschacher N , Cecconi M , Cosentino R , Ghedina A , Glenday A , Gonzalez M , Li C-H , Lodi M , Lovis C , Pepe F , Poretti E , Rice K , Sasselov D , Sozzetti A , Szentgyorgyi A , Udry S , Walsworth R
Published: May 2019

The time-variable velocity fields of solar-type stars limit the precision of radial-velocity determinations of their planets’ masses, obstructing detection of Earth twins. Since 2015 July, we have been monitoring disc-integrated sunlight in daytime using a purpose-built solar telescope and fibre feed to the HARPS-N stellar radial-velocity spectrometer. We present and analyse the solar radial-velocity measurements and cross-correlation function (CCF) parameters obtained in the first 3 yr of observation, interpreting them in the context of spatially resolved solar observations. We describe a Bayesian mixture-model approach to automated data-quality monitoring. We provide dynamical and daily differential-extinction corrections to place the radial velocities in the heliocentric reference frame, and the CCF shape parameters in the sidereal frame. We achieve a photon-noise-limited radial-velocity precision better than 0.43 m s−1 per 5-min observation. The day-to-day precision is limited by zero-point calibration uncertainty with an RMS scatter of about 0.4 m s−1. We find significant signals from granulation and solar activity. Within a day, granulation noise dominates, with an amplitude of about 0.4 m s−1 and an autocorrelation half-life of 15 min. On longer time-scales, activity dominates. Sunspot groups broaden the CCF as they cross the solar disc. Facular regions temporarily reduce the intrinsic asymmetry of the CCF. The radial-velocity increase that accompanies an active-region passage has a typical amplitude of 5 m s−1 and is correlated with the line asymmetry, but leads it by 3 d. Spectral line-shape variability thus shows promise as a proxy for recovering the true radial velocity.
Common envelope evolution on a moving mesh
Authors: Prust Logan J , Chang Philip
Published: May 2019

We outline the methodology of simulating common envelope evolution (CEE) with the moving-mesh code manga. We extend manga to include multiple time-steps. This provides substantial speedups for problems with large dynamic range. We describe the implementation of realistic equations of state relevant in stellar structure and the generation of suitable initial conditions. We then carry out two example simulations of a 2 M⊙ red giant with a 0.36 M⊙ core and a 1 M⊙ companion undergoing CEE for 240 days. In one simulation the red giant is set into corotation with the orbital motion and in the other it is non-rotating. We find that the separation between the companion and red giant core shrinks from 52 R⊙ to 3.6 R⊙ and 3.2 R⊙, respectively, ending with an eccentricity of 0.1. We also find that 66 and 63 per cent of the envelope mass is ejected. This is higher than in many previous works. Several reasons for this are discussed. These include our inclusion of recombination energy. Our simulations show that putting giants in corotation increases the fraction of mass ejected from the system and results in a larger final orbital separation. We conclude that the entire envelope of the red giant might be ejected during the plunge phase of CEE in this region of parameter space.
The tidal parameters of TRAPPIST-1b and c
Authors: Brasser R , Barr A C , Dobos V
Published: May 2019

The TRAPPIST-1 planetary system consists of seven planets within 0.05 au of each other, five of which are in a multiresonant chain. These resonances suggest the system formed via planet migration; subsequent tidal evolution has damped away most of the initial eccentricities. We used dynamical N-body simulations to estimate how long it takes for the multiresonant configuration that arises during planet formation to break. From there we use secular theory to pose limits on the tidal parameters of planets b and c. We calibrate our results against multilayered interior models constructed to fit the masses and radii of the planets, from which the tidal parameters are computed independently. The dynamical simulations show that the planets typically go unstable 30 Myr after their formation. Assuming synchronous rotation throughout, we compute $\frac{k_2}{Q} \gtrsim 2\times 10^{-4}$ for planet b and $\frac{k_2}{Q} \gtrsim 10^{-3}$ for planet c. Interior models yield (0.075–0.37) × 10−4 for TRAPPIST-1b and (0.4–2) × 10−4 for TRAPPIST-1c. The agreement between the dynamical and interior models is not too strong, but is still useful to constrain the dynamical history of the system. We suggest that this two-pronged approach could be of further use in other multiresonant systems if the planet’s orbital and interior parameters are sufficiently well known.
Cistrome-GO: a web server for functional enrichment analysis of transcription factor ChIP-seq peaks
Authors: Li Shaojuan , Wan Changxin , Zheng Rongbin , Fan Jingyu , Dong Xin , Meyer Clifford A , Liu X Shirley
Published: May 2019

Characterizing the ontologies of genes directly regulated by a transcription factor (TF), can help to elucidate the TF’s biological role. Previously, we developed a widely used method, BETA, to integrate TF ChIP-seq peaks with differential gene expression (DGE) data to infer direct target genes. Here, we provide Cistrome-GO, a website implementation of this method with enhanced features to conduct ontology analyses of gene regulation by TFs in human and mouse. Cistrome-GO has two working modes: solo mode for ChIP-seq peak analysis; and ensemble mode, which integrates ChIP-seq peaks with DGE data. Cistrome-GO is freely available at http://go.cistrome.org/.
WebGestalt 2019: gene set analysis toolkit with revamped UIs and APIs
Authors: Liao Yuxing , Wang Jing , Jaehnig Eric J , Shi Zhiao , Zhang Bing
Published: May 2019

WebGestalt is a popular tool for the interpretation of gene lists derived from large scale -omics studies. In the 2019 update, WebGestalt supports 12 organisms, 342 gene identifiers and 155 175 functional categories, as well as user-uploaded functional databases. To address the growing and unique need for phosphoproteomics data interpretation, we have implemented phosphosite set analysis to identify important kinases from phosphoproteomics data. We have completely redesigned result visualizations and user interfaces to improve user-friendliness and to provide multiple types of interactive and publication-ready figures. To facilitate comprehension of the enrichment results, we have implemented two methods to reduce redundancy between enriched gene sets. We introduced a web API for other applications to get data programmatically from the WebGestalt server or pass data to WebGestalt for analysis. We also wrapped the core computation into an R package called WebGestaltR for users to perform analysis locally or in third party workflows. WebGestalt can be freely accessed at http://www.webgestalt.org.
Can youth get the contraception they want? Results of a pilot study in the province of Quebec
Authors: Di Meglio Giuseppina , Yeates Jessica , Seidman Gillian
Published: May 2019

Objectives

Canadian contraceptive providers report many barriers to access to contraception, and perceive youth as particularly vulnerable to these barriers. This study explores Quebec youth’s experience of obtaining contraception.

Methods

A convenience sample of Quebec youth (aged 14 to 21 years) participated in an online anonymous survey of their experiences obtaining contraception. Data were collected between June 1, 2016 and December 31, 2016.

Results

One hundred and five youth were eligible to participate. Of these, 95 had used at least one form of contraception. Twelve (13%) reported not being able to obtain their preferred method of contraception, with cost being the most common barrier (N=10). Eleven participants (12%) stopped using their preferred contraceptive method: cost was a factor in four cases, and difficulty with access to the clinic/prescription in seven. Youth who required confidential access experienced more difficulty obtaining contraception (P<0.01).

Conclusion

Despite benefitting from universal pharmacare and a network of youth sexual and reproductive health clinics, Quebec youth still experience barriers to obtaining and continuing their preferred contraceptive. Youth who desire confidential care are more likely to experience difficulty obtaining contraception.
Genome Sequence Resource of aPuccinia striiformisIsolate Infecting Wheatgrass
Authors: Li Yuxiang , Xia Chongjing , Wang Meinan , Yin Chuntao , Chen Xianming
Published: May 2019

Stripe rust caused by Puccinia striiformis is a disastrous disease of cereal crops and various grasses. To date, 14 stripe rust genomes are publicly available, including 13 P. striiformis f. sp. tritici and 1 P. striiformis f. sp. hordei. In this study, one isolate (11-281) of P. striiformis collected from wheatgrass (Agropyron cristatum), which is avirulent to most of standard differential genotypes of wheat and barley, was sequenced, assembled, and annotated. The sequences were assembled to a draft genome of 84.75 Mb, which is comparable with previously sequenced P. striiformis f. sp. tritici and P. striiformis f. sp. hordei isolates. The draft genome comprised 381 scaffolds and contained 1,829 predicted secreted proteins. The high-quality draft genome of the isolate is a valuable resource in shedding light on the evolution and pathogenicity of P. striiformis.
Social Interactions of Clerks: The Role of Engagement, Imagination, and Alignment as Sources for Professional Identity Formation
Authors: Adema Marieke , Dolmans Diana H.J.M. , Raat Janet (A.N.) , Scheele Fedde , Jaarsma A. Debbie C. , Helmich Esther
Published: May 2019

Purpose

Participating in clinical practice shapes students’ identities, but it is unclear how students build meaningful relationships while “dipping into” various social contexts. This study explored with whom students interacted, which social relationships they built, and how these relationships contributed to the formation of a professional identity.

Method

In this longitudinal study at University Medical Center Groningen, University of Groningen, the Netherlands, 9 undergraduate medical students recorded experiences of thinking about themselves as future professionals (September 2015 to March 2017). The authors conducted template analysis using both open coding and a priori themes derived from Wenger’s modes of belonging to communities of practice: engagement, imagination, and alignment.

Results

The authors received 205 recorded experiences. While rotating, students used engagement, imagination, and alignment to give meaning to clinical workplace social interactions. Participants considered relationships with doctors, patients, and peers as preconditions for engaging in meaningful experiences. Although imagination and alignment were less represented, discussing imagination with peers and physicians stimulated a deeper understanding of what it means to become a physician. Explicitly being invited “to the table” and awareness of the benefits of being a clerk were instances of alignment that stimulated the development of identities as future doctors.

Conclusions

To understand the nature of professional identity formation, Wenger’s modes of belonging must be considered. Where engagement is very prevalent, imagination and alignment are less spontaneously mentioned and therefore more difficult to foster. Looking for ways to support imagination and alignment is important for students’ sensemaking process of becoming a doctor.
Changes in Whole Brain Dynamics and Connectivity Patterns during Sevoflurane- and Propofol-induced Unconsciousness Identified by Functional Magnetic Resonance Imaging
Authors: Golkowski Daniel , Larroque Stephen Karl , Vanhaudenhuyse Audrey , Plenevaux Alain , Boly Melanie , Di Perri Carol , Ranft Andreas , Schneider Gerhard , Laureys Steven , Jordan Denis , Bonhomme Vincent , Ilg Rüdiger
Published: May 2019

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

A key feature of the human brain is its capability to adapt flexibly to changing external stimuli. This capability can be eliminated by general anesthesia, a state characterized by unresponsiveness, amnesia, and (most likely) unconsciousness. Previous studies demonstrated decreased connectivity within the thalamus, frontoparietal, and default mode networks during general anesthesia. We hypothesized that these alterations within specific brain networks lead to a change of communication between networks and their temporal dynamics.

Methods

We conducted a pooled spatial independent component analysis of resting-state functional magnetic resonance imaging data obtained from 16 volunteers during propofol and 14 volunteers during sevoflurane general anesthesia that have been previously published. Similar to previous studies, mean z-scores of the resulting spatial maps served as a measure of the activity within a network. Additionally, correlations of associated time courses served as a measure of the connectivity between networks. To analyze the temporal dynamics of between-network connectivity, we computed the correlation matrices during sliding windows of 1 min and applied k-means clustering to the matrices during both general anesthesia and wakefulness.

Results

Within-network activity was decreased in the default mode, attentional, and salience networks during general anesthesia (P < 0.001, range of median changes: –0.34, –0.13). Average between-network connectivity was reduced during general anesthesia (P < 0.001, median change: –0.031). Distinct between-network connectivity patterns for both wakefulness and general anesthesia were observed irrespective of the anesthetic agent (P < 0.001), and there were fewer transitions in between-network connectivity patterns during general anesthesia (P < 0.001, median number of transitions during wakefulness: 4 and during general anesthesia: 0).

Conclusions

These results suggest that (1) higher-order brain regions play a crucial role in the generation of specific between-network connectivity patterns and their dynamics, and (2) the capability to interact with external stimuli is represented by complex between-network connectivity patterns.
Toll-like Receptor 7 Contributes to Inflammation, Organ Injury, and Mortality in Murine Sepsis
Authors: Jian Wenling , Gu Lili , Williams Brittney , Feng Yan , Chao Wei , Zou Lin
Published: May 2019

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Sepsis remains a critical illness with high mortality. The authors have recently reported that mouse plasma RNA concentrations are markedly increased during sepsis and closely associated with its severity. Toll-like receptor 7, originally identified as the sensor for single-stranded RNA virus, also mediates host extracellular RNA-induced innate immune responses in vitro and in vivo. Here, the authors hypothesize that innate immune signaling via Toll-like receptor 7 contributes to inflammatory response, organ injury, and mortality during polymicrobial sepsis.

Methods

Sepsis was created by (1) cecal ligation and puncture or (2) stool slurry peritoneal injection. Wild-type and Toll-like receptor 7 knockout mice, both in C57BL/6J background, were used. The following endpoints were measured: mortality, acute kidney injury biomarkers, plasma and peritoneal cytokines, blood bacterial loading, peritoneal leukocyte counts, and neutrophil phagocytic function.

Results

The 11-day overall mortality was 81% in wild-type mice and 48% in Toll-like receptor 7 knockout mice after cecal ligation and puncture (N = 27 per group, P = 0.0031). Compared with wild-type septic mice, Toll-like receptor 7 knockout septic mice also had lower sepsis severity, attenuated plasma cytokine storm (wild-type vs. Toll-like receptor 7 knockout, interleukin-6: 43.2 [24.5, 162.7] vs. 4.4 [3.1, 12.0] ng/ml, P = 0.003) and peritoneal inflammation, alleviated acute kidney injury (wild-type vs. Toll-like receptor 7 knockout, neutrophil gelatinase-associated lipocalin: 307 ± 184 vs.139 ± 41-fold, P = 0.0364; kidney injury molecule-1: 40 [16, 49] vs.13 [4, 223]-fold, P = 0.0704), lower bacterial loading, and enhanced leukocyte peritoneal recruitment and phagocytic activities at 24 h. Moreover, stool slurry from wild-type and Toll-like receptor 7 knockout mice resulted in similar level of sepsis severity, peritoneal cytokines, and leukocyte recruitment in wild-type animals after peritoneal injection.

Conclusions

Toll-like receptor 7 plays an important role in the pathogenesis of polymicrobial sepsis by mediating host innate immune responses and contributes to acute kidney injury and mortality.
Glucocorticoid-induced osteoporosis update
Authors: Adami Giovanni , Saag Kenneth G.
Published: May 2019

Purpose of review

Steroid-induced osteoporosis or glucocorticoid-induced osteoporosis (GIOP) is a common form of secondary osteoporosis and is a cause of increased morbidity and mortality. The pathogenesis of GIOP includes decreased bone formation and increased bone resorption. Clinicians can rely on several effective medications for the treatment and prevention of GIOP, including antiresorptive drugs (i.e. bisphosphonates) and bone anabolic drugs (i.e. teriparatide).

Recent findings

Recent studies have further highlighted that GIOP is a major public health concern and have provided new insights on the pathogenesis of GIOP, in particular, the dose-dependent effects of glucocorticoids on bone. New evidence on the real-world effectiveness of established GIOP therapies have been recently published as well as the results of the 24-months denosumab randomized controlled trial in GIOP.

GIOP and fragility fractures are important adverse events related to the long-term use of glucocorticoids. Recent studies have provided additional data on the epidemiology and pathogenesis of GIOP and on the efficacy and effectiveness of GIOP therapies.
Harnessing the power of social media: how can it help in axial spondyloarthritis research?
Authors: Reuter Katja , Danve Abhijeet , Deodhar Atul
Published: May 2019

Purpose of review

Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease that is relatively unknown among the general public. Most patients with axSpA are young or middle-aged adults and more likely to use some social media. This review highlights trends in the application of social media and different ways in which these tools do already or may benefit clinical research, delivery of care, and education in rheumatology, particularly in the field of axSpA.

Recent findings

This article discusses four areas in the biomedical field that social media has infused with novel ideas: (i) the use of patient-generated health data from social media to learn about their disease experience, (ii) delivering health education and interventions, (iii) recruiting study participants, and (iv) reform, transfer, and disseminate medical education. We conclude with promising studies in rheumatology that have incorporated social media and suggestions for future directions.

Rheumatologists now have the opportunity to use social media and innovate on many aspects of their practice. We propose further exploration of multiple ways in which social media might help with the identification, diagnosis, education, and research study enrollment of axSpA patients. However, standardization in study design, reporting, and managing ethical and regulatory aspects will be required to take full advantage of this opportunity.
Soft Tissue Issues and Considerations in Total Knee Arthroplasty
Authors: Padilla Jorge A. , Teo Greg , Vigdorchik Jonathan M. , Schwarzkopf Ran , Long William J.
Published: May 2019

Total knee arthroplasty is projected to increase beyond substantial numbers due to an aging population. An important factor to avoid common complications is meticulous attention to soft tissue and skin healing. Comprehensive knowledge of wound healing and vascular anatomy provides a stable foundation for the physician and surgeon. This is complimented by updated information on common complications and preoperative optimization of undesirable factors that could hinder the success of a total knee arthroplasty. The need for prophylactic intervention may be determined during the preoperative evaluation and is recommended in patients with severe compromise of the overlying soft tissues. Meticulous surgical technique and careful handling of the surrounding soft tissues is imperative to prevent postoperative skin issues. Postoperative considerations and treatments are now available to avoid progression of complications to failure of prosthesis.
Reducing Risk in Total Joint Arthroplasty: Vascular Status
Authors: Romero Jose , Westrich Geoffrey
Published: May 2019

Complications following total joint arthroplasty place a significant burden on patients and the health care system. Patients with vascular disease are at increased risk of perioperative complications and appropriate patient screening and optimization are required to reduce perioperative risks. This article will provide a brief update on the literature and consensus recommendations regarding (1) patients with increased bleeding risk and increased venous thromboembolic event risk, (2) patients with a history of peripheral vascular disease, and (3) patients with lymphedema.
Patellar Tendon Reconstruction With Achilles Tendon Allograft For Nonrepairable Patellar Tendon Rupture
Authors: George Michael S. , Jorgensen Joel R.
Published: May 2019

Patellar tendon reconstruction in the setting of a nonrepairable patellar tendon rupture can be a technically difficult and extensive procedure. An alternative surgical technique for patellar tendon reconstruction with Achilles tendon allograft utilizes tibial tubercle interference fixation for the bone plug. This technique uses simple instrumentation and is less traumatic to the knee which may allow an easier patient recovery.
Bilateral Facial Apocrine Fibrosing Hamartoma Mimicking Microcystic Adnexal Carcinoma
Authors: Llamas-Velasco Mar , Fraga Javier , Schaller Jörg , Requena Luis , Daudén Esteban , Rütten Arno
Published: May 2019

An otherwise healthy 50-year-old woman was evaluated for the presence of 2 erythematous, and slightly pruritic plaques, involving both cheeks for 30 years. Left-side skin biopsy showed a diffuse proliferation of ductal structures horizontally arranged and involving the reticular dermis that resembled tubular adenoma embedded in a sclerotic stroma and surrounded by a peculiar periductal desmoplasia. Nuclear atypia or mitosis was not found. Contralateral biopsy showed identical findings. Differential diagnosis included microcystic adnexal carcinoma (MAC) and plaque-like syringoma and a peculiarly horizontally arranged tubular adenoma. We ruled out MAC as the lesions were long-standing, without infundibular cysts, solid strands, or perineural infiltration. Our case closely resembled those previously described as sweat duct proliferation associated with aggregates of elastic tissue and atrophoderma vermiculatum, although striking differences were observed, as our case did not present aggregates of elastic tissue, did not involve the papillary and superficial reticular dermis, and presented evidences of decapitation secretion as a sign of apocrine differentiation. We consider our case as a MAC simulator and we propose the descriptive name of bilateral facial apocrine fibrosing hamartoma.
Contact Lens–Associated Microbial Keratitis in a Tertiary Eye Care Center in Turkey
Authors: Karaca Irmak , Barut Selver Ozlem , Palamar Melis , Egrilmez Sait , Aydemir Sohret , Yagci Ayse
Published: May 2019

Objectives:

To evaluate the risk factors, causative microorganisms, and presenting features of infection in patients with contact lens–associated microbial keratitis (CLAMK) admitted to a tertiary referral center in Turkey.

Methods:

A retrospective review of the medical records of 62 patients who were diagnosed as CLAMK in our clinic between 2012 and 2018 was conducted.

Results:

The mean age of the patients (22 men and 40 women) at the time of diagnosis was 24.5±8.3 years (range, 16–48). The mean best-corrected visual acuity (BCVA) was 0.7±0.9 log of minimal angle of resolution (logMAR) (0–3) before treatment and increased to 0.1±0.1 logMAR (0–0.4) at the end of the follow-up. All patients, except one using rigid gas-permeable CL, were frequent replacement soft CL users. Thirty-one (50%) patients declared overnight wear, and 37 (58.9%) patients declared showering or swimming in CLs regularly. Cultures of either corneal scrapings or CL materials were positive in 40 (64.5%) eyes, 12 (19.4%) of which had mixed infections. Thirteen strains of microorganisms were demonstrated, among which there were seven (53.8%) gram-negative bacteria, one (7.7%) gram-positive bacteria, four (30.7%) fungi, and Acanthamoeba (7.7%). The most common pathogen was Pseudomonas aeruginosa, followed by Serratia marcescens and Stenotrophomonas maltophilia. According to culture results, P. aeruginosa infections were associated with significantly worse BCVA. Keratitis foci were either centrally or paracentrally located in 39 (62.9%) eyes, and 16 eyes (25.8%) presented with hypopyon.

Conclusion:

Along with growing number of CL users, CLAMK constitutes an important problem with possibly worse visual outcomes. Thus, in addition to meticulous treatment, management of risk factors and behavioral modifications is crucial.
Toxic Keratitis After Application of Custard Apple Seed for Head Lice Infestation
Authors: Gandhi Preethika , Radhakrishnan Naveen , Khaitan Isha , Srinivasan Muthiah , Prajna Venkatesh N.
Published: May 2019

Purpose:

To report the clinical features and outcomes of toxic keratitis after application of powdered custard apple seeds for hair washing for head lice infestation.

Methods:

Retrospective review of all patients with toxic keratitis after application of powdered custard apple seed for head lice infestation during the time period from January 2015 to December 2017. Demographic details, clinical features, and visual outcomes were documented.

Results:

Thirty-one eyes of 19 patients with toxic keratitis after application of crushed custard apple seeds for head lice infestation were included in the study. Eighteen females and 1 male with a median age of 14 years [interquartile range (IQR) 12–34 years] presented with severe epiphora, congestion, photophobia, and defective vision (median logMar visual acuity 0.4, IQR 0.2–0.8) after application of custard apple seed powder for hair washing. Ten eyes (32.2%) had an epithelial defect (median size 9 mm2, IQR 5–12 mm2), and 21 (67.7%) eyes had punctate epithelial erosions. All the patients were treated with topical antibiotics, and at 3 days follow-up, all of them had resolution of symptoms and signs with a median logarithm of the minimum angle of resolution (logMAR) visual acuity of 0 (IQR 0–0.2).

Conclusions:

Health education about the harmful effect of this traditional practice for head lice infestation will prevent further similar events.
Family Outcomes for Families of 4–5-Year-Old Children on the Autism Spectrum Who Have Received Early Childhood Intervention in Australia
Authors: Adams Dawn , Keen Deb , Heussler Helen S. , Wicks Rachelle , Roberts Jacqueline
Published: May 2019

Early childhood intervention (ECI) services for children on the autism spectrum commonly espouse a family-centered approach but outcomes studies often focus solely upon the child. Mothers of 96 children on the spectrum (aged 4–5 years) completed a measure of access to ECI and the Family Outcomes Survey—Revised. Family outcomes after ECI were generally positive, although a notable proportion of mothers rated that their child still did not participate in social, recreational, or religious activities that they would want to (15.6%) and that as parents, they did not know about post-ECI options (14.6%). Family outcomes and perceived helpfulness of ECI did not differ with demographic data with the exception of Accessing the community subscale, which was significantly higher in families with incomes above AUD$80,000.
Quantitative sensory testing and predicting outcomes for musculoskeletal pain, disability, and negative affect: a systematic review and meta-analysis
Authors: Georgopoulos Vasileios , Akin-Akinyosoye Kehinde , Zhang Weiya , McWilliams Daniel F. , Hendrick Paul , Walsh David A.
Published: May 2019

Hypersensitivity due to central pain mechanisms can influence recovery and lead to worse clinical outcomes, but the ability of quantitative sensory testing (QST), an index of sensitisation, to predict outcomes in chronic musculoskeletal disorders remains unclear. We systematically reviewed the evidence for ability of QST to predict pain, disability, and negative affect using searches of CENTRAL, MEDLINE, EMBASE, AMED, CINAHL, and PubMed databases up to April 2018. Title screening, data extraction, and methodological quality assessments were performed independently by 2 reviewers. Associations were reported between baseline QST and outcomes using adjusted (β) and unadjusted (r) correlations. Of the 37 eligible studies (n = 3860 participants), 32 were prospective cohort studies and 5 randomised controlled trials. Pain was an outcome in 30 studies, disability in 11, and negative affect in 3. Meta-analysis revealed that baseline QST predicted musculoskeletal pain (mean r = 0.31, 95% confidence interval [CI]: 0.23-0.38, n = 1057 participants) and disability (mean r = 0.30, 95% CI: 0.19-0.40, n = 290 participants). Baseline modalities quantifying central mechanisms such as temporal summation and conditioned pain modulation were associated with follow-up pain (temporal summation: mean r = 0.37, 95% CI: 0.17-0.54; conditioned pain modulation: mean r = 0.36, 95% CI: 0.20-0.50), whereas baseline mechanical threshold modalities were predictive of follow-up disability (mean r = 0.25, 95% CI: 0.03-0.45). Quantitative sensory testing indices of pain hypersensitivity might help develop targeted interventions aiming to improve outcomes across a range of musculoskeletal conditions.
The current surgical treatment of pancreatic neuroendocrine neoplasms in China: a national wide cross-sectional study
Authors: Wu Wenming , Jin Gang , Li Haimin , Miao Yi , Wang Chunyou , Liang Tingbo , Ou Jinrui , Zhao Yongfu , Yuan Chunhui , Li Yixiong , Lou Wenhui , Wu Zheng , Qin Renyi , Wang Huaizhi , Hao Jihui , Yu Xianjun , Huang Heguang , Tan Guang , Liu Xubao , Xu Kesen , Wang Lei , Yang Yinmo , Hao Chunyi , Wang Weilin , Guo Kejian , Wei Junmin , Wang Yifan , Peng Chenghong , Wang Xuefeng , Cai Shouwang , Jiang Jianxin , Wu Xinmin , Yu Xiao , Li Fei , Zhao Yupei
Published: May 2019

Objective:

The aim of this study is to investigate the current status of the diagnosis and treatment of patients with pancreatic neuroendocrine neoplasms (pNENs) undergoing surgery in China.

Methods:

This is a multicenter cross-sectional study performed in China. Data from patients with pNENs undergoing surgery at 33 high-volume medical centers, where the number of pancreatectomies exceeds 20 cases per year, were collected and analyzed between March 1, 2016 and February 28, 2017.

Results:

In total, 392 patients with pNENs were enrolled. The male to female ratio was 1.4. The majority of patients were aged between 40 and 70 years. 65.6% of the patients had non-functional tumors. Among those with functional tumors, the percentages of insulinomas, gastrinomas, glucagonomas, and vasoactive intestinal peptide-secreting tumors were 94.8%, 1.5%, 2.2%, and 1.5%, respectively. Multidisciplinary team (MDT) discussion was conducted for 39.0% of the patients. Minimally invasive surgery was performed on 31.1% of the 392 patients. The incidence of grade B/C pancreatic fistula formation was 4.4%. A total of 89.0% of the surgeries achieved R0 resection, and 41.6% of the tumors were well differentiated. Lymph node metastasis was present in 8.9% of the patients. The percentages of patients with grades G1, G2, and G3 disease were 49.2%, 45.7%, and 5.1%, respectively.

Conclusion:

This multicenter cross-sectional study systematically presents the current status of the diagnosis and treatment of patients with pNENs undergoing surgery in China. MDT consultation for pNENs has not been widely implemented in China. Although the incidence of surgical complications is relatively low, minimally invasive procedures should be further promoted. This study shows us how to improve the outcomes of these patients.
Bone Health in Adaptive Sports Athletes
Authors: Blauwet Cheri A. , Borgstrom Haylee E. , Tenforde Adam S.
Published: May 2019

Adaptive sports athletes represent a growing population within the athletic community worldwide. Given potential cardiometabolic and psychosocial benefits of adaptive sports participation, the impact on bone health and injury risk in adaptive athletes is of increasing clinical interest. Impaired bone health as a result of low energy availability has been well described in able-bodied athletic women and, more recently, men as part of the female athlete triad and Relative Energy Deficiency in Sport (RED-S). However, the applicability of these models to adaptive athletes remains unclear given altered physiology and biomechanics compared with able-bodied counterparts. Thus, a literature review was completed to characterize the influence of adaptive sports participation and associated risk factors for impaired bone health in this unique population. To date, limited investigations demonstrate a consistent, positive effect of sports participation on bone health. Risk factors for impaired bone health include low energy availability and micronutrient deficiency.
Impact of Adaptive Sports Participation on Quality of Life
Authors: Diaz Robert , Miller Emily K. , Kraus Emily , Fredericson Michael
Published: May 2019

The health benefits of regular recreational physical activity are well known in reducing secondary health consequences of a sedentary lifestyle in the general population. However, individuals with physical disabilities participate less frequently in recreational activity compared with those without disabilities. Although evidence on the impact of recreational physical activity on quality of life in this population is in its infancy, regular recreational and sports activity participation has shown to have a positive association with improvements in quality of life, life satisfaction, community reintegration, mood, and employment in those with disabilities. Facilitators of participating in adaptive sports include a desire to improve social support, physical fitness, health, and fun. Unfortunately, those with disabilities face numerous barriers to participate in adaptive sports including accessibility, transportation, awareness, finances, and physical and cognitive impairments. Further studies are needed to investigate facilitators and barriers to participating in adaptive sports to capitalize on the physical and psychosocial benefits of regular recreational activity. The aim of this article is to review the available literature on the effects of adaptive sports participation on quality of life.
Acute Kidney Injury, Fluid Overload, and Outcomes in Children Supported With Extracorporeal Membrane Oxygenation for a Respiratory Indication
Authors: Mallory Palen P. , Selewski David T. , Askenazi David J. , Cooper David S. , Fleming Geoffrey M. , Paden Matthew L. , Murphy Laura , Sahay Rashmi , King Eileen , Zappitelli Michael , Bridges Brian C.
Published: May 2019

This study seeks to evaluate the association between acute kidney injury (AKI), fluid overload (FO), and mortality in children supported with extracorporeal membrane oxygenation (ECMO) for refractory respiratory failure. This retrospective observational cohort study was performed at six tertiary care children’s hospital intensive care units, studying 424 patients < 18 years of age supported with ECMO for ≥ 24 hours for a respiratory indication from January 1, 2007, to December 31, 2011. In a multivariate analysis, FO level at ECMO initiation was not associated with hospital mortality, whereas peak FO level during ECMO was associated with hospital mortality. For every 10% increase in peak FO during ECMO, the odds of hospital mortality were approximately 1.2 times higher. Every 10% increase in peak FO during ECMO resulted in a significant relative change in the duration of ECMO hours by a factor of 1.08. For hospital survivors, every 10% increase in peak FO level during ECMO resulted in a significant relative change in the duration of mechanical ventilation hours by a factor of 1.13. In this patient population, AKI and FO are associated with increased mortality and should be considered targets for medical interventions including judicious fluid management, diuretic use, and renal replacement therapy.
The HeartMate 6
Authors: Daneshmand Mani A. , Bishawi Muath , Milano Carmelo A. , Schroder Jacob N.
Published: May 2019

The need for biventricular support poses significant challenges for patients who require a mechanical bridge to transplantation. Recent improvements in ventricular assist device (VAD) technology has made possible the use of two centrifugal flow VADs as a total artificial heart (TAH) replacement. The HeartMate 3 (HM3; [Full MagLev, Abbott Laboratories, Chicago, Illinois]) was recently approved as a destination therapy; this VAD has a number of unique advantages that allow for its off-label use for biventricular support. Here, we describe the use of two HM3s as a TAH in a patient as a bridge to transplant.
Assessment of inter-rater agreement between physicians and their patients regarding medication adherence in a clinical questionnaire study
Authors: Otsu Yuki , Kai Mamiko , Suematsu Yasunori , Kiyomi Fumiaki , Saku Keijiro , Kamimura Hidetoshi , Miura Shin-ichiro
Published: May 2019

While it is important to treat lifestyle-related diseases for the primary and secondary prevention of cardiovascular diseases, medication adherence is still poor. Although various causes of poor adherence have been reported, the differences between physicians and their patients regarding the recognition of medication adherence have not been well-investigated.

We administered a questionnaire about medication adherence to 300 outpatients and their 23 cardiologists at the Department of Cardiology, Fukuoka University Hospital. The questionnaires for patients and physicians included acceptable total number of drug doses and dosing schedule, forgetting to take the medicine, and dose-reduction or -increase based on self-judgement. The patients were 70.6 ± 12.3 years old and 61.0% (n = 183) were male. Patients reported that it was acceptable to receive 0–5 doses twice daily. The patients were divided into two groups: an agreement group, in which physicians and their patients had the same answer to the question regarding forgetting medication (203 cases; 67.7%), and a disagreement group (97 cases; 32.3%). Overall, the inter-rater agreement between physicians and patients with regard to forgetting medication was significant, but slight (κ coefficient = 0.12). In a multivariate analysis, absence of hypertension [odds ratio (OR): 0.21, 95% confidence interval (CI): 0.09–0.50, P < .001), β-blocker usage (OR: 1.86, 95% CI: 1.11–3.12, P = .02), and biguanide usage (OR: 4.04, 95% CI: 1.43–11.41, P = .01) were independent predictors of disagreement with regard to forgetting medication.

The inter-rater agreement between physicians and patients with regard to medication adherence was slight. An increase in inter-rater agreement should improve medication adherence.
The association between serum vitamin D and inflammatory bowel disease
Authors: Zhao Jianmin , Wang Yunfeng , Gu Qing , Du Zhiquan , Chen Weichang
Published: May 2019

Patients with inflammatory bowel disease have an increased risk of vitamin D deficiency and this may impact upon the disease activity. This study explored the association between serum vitamin D levels and inflammatory bowel disease in a Chinese population.

Sixty-five patients with ulcerative colitis (UC) and 50 with Crohn's disease (CD) were investigated between January 2015 and December 2016 at the Kunshan Second People's Hospital, China. A control group of 120 healthy volunteers was also selected. Serum vitamin D levels were detected and compared between groups and among patients with different disease activity.

The serum vitamin D levels in the UC (10.27 ± 4.05 ng/mL) and CD (11.13 ± 3.96 ng/mL) groups were lower than in the control group (12.96 ± 5.18 ng/mL) (P < .05). In the UC group, during the moderate (9.21 ± 3.26 ng/mL) and severe (7.58 ± 3.81 ng/mL) periods, serum vitamin D levels were significantly lower compared with during remission (12.18 ± 3.69 ng/mL) and the mild period (11.35 ± 4.08 ng/mL) (P < .05). In the CD group, serum vitamin D levels were significantly lower during the moderate (10.28 ± 3.57 ng/mL) and severe (8.52 ± 3.72 ng/mL) periods compared with remission (13.97 ± 5.61 ng/mL) (P < .05).

Patients with UC and CD are both prone to vitamin D deficiency. Serum vitamin D was significantly lower with aggravating disease status. Therefore, vitamin D may be involved in the development of inflammatory bowel disease in a Chinese population.
Plasma exchange improves outcome of sepsis-associated liver failure
Authors: Ye Xiaolin , Wang Fei , Ding Yueping , Ma Dannv , Lv Bin
Published: May 2019

Rationale:

Sepsis-associated liver failure is characterized by increased bilirubin levels and coagulation disorders, which has a significant impact on mortality due to the insufficient understanding of its complicated pathogenesis pathophysiology and a lack of standardized treatment.

Patient concerns:

A 56-year-old woman presented signs of sepsis on the 2nd day after undergoing ureteroscopy for left ureter and laparoscopy for lysis of adhesions around left ureter due to hydronephrosis. Her condition seemed to have been improved after treatment, but the bilirubin levels suddenly increased drastically with presence of coagulation disorders.

Diagnosis:

Laboratory tests combined with her medical history confirmed the diagnosis as sepsis-associated liver failure.

Interventions:

Plasma exchange was applied after hepatoprotective drugs, and other supportive therapies were given which did not significantly improve the condition.

Outcomes:

Laboratory liver function tests indicated the restoration of damaged liver function after plasma exchange was performed and the patient was soon transferred from intensive care unit back to the general ward.

Lessons:

Plasma exchange might be a vital and effective therapy to improve outcome of sepsis associated liver failure especially when conventional support therapy is ineffective.