bluuebunny/crossref_metadata_2025 huggingface dataset:
A new species of Cyrtopodium (Orchidaceae: Cyrtopodiinae) from Belize

Authors: ROMERO-GONZÁLEZ GUSTAVO A. , CARNEVALI GERMÁN , DUNO RODRIGO , CETZAL-IX WILLIAM R. , RAMÍREZ-MORILLO IVÓN M. , TAMAYO-CEN IVÁN , HOLST BRUCE
Published: November 2019

A new species of Cyrtopodium from Belize, C. vestitum, is described and illustrated. Its flowers are indistinguishable from those of Cyrtopodium macrobulbon, but the pseudobulbs are relatively shorter and thicker, ovoid ellipsoid, bearing proportionately more, densely packed internodes, and the leaves do not present an articulation, i.e., an abscission layer, between the sheath and the blade and are thus marcescent. A comparative anatomy study of this tissue is presented, contrasting its presence in C. macrobulbon and the lack thereof in the new species. This species should be considered Endangered (EN) because of its restricted geographical distribution in central Belize. An updated key to the species of Cyrtopodium from North America, the Caribbean, and Central America is also included.
New genus, new species and new records of marine acotylean flatworms (Platyhelminthes: Polycladida: Acotylea) from Oaxaca, southern Mexican Pacific
Authors: RAMOS-SÁNCHEZ MARIELA , BAHIA JULIANA , BASTIDA-ZAVALA J. ROLANDO
Published: November 2019

The acotylean polyclads are characterized by the absence of a ventral sucker located posteriorly to the female gonopore. These flatworms are mostly marine, benthic or pelagic, except by two species, one freshwater Limnostylochus borneensis and other semi-terrestrial Myoramyxa pardalota. Oaxaca is a state located in the southern Mexican Pacific, where only three acotyleans species have been formally recorded until now. After sampling littoral to sublittoral zones, a total of 34 specimens were collected and fixed in frozen formalin. Some specimens were stained with Mayer´s carmalum and hematoxylin and cleared in methyl salicylate for whole mounts; the portion containing the reproductive structures of other specimens were dissected and histologically processed in sagittal and frontal sections. Four species were identified as belonging to four genera and three families. The new genus Bisacculosuteri gen. nov. is established, close to the genus Itannia, but lacking double ventral suckers placed on both sides of the female gonopore. Two species are new to science: Bisacculosuteri marcelae sp. nov., characterized by a highly branched central pharynx, prominent seminal vesicle, a penis papilla with stylet, paired strongly muscularized uterine sac and uterine vesicles; and Paraplanocera oligoglenoides sp. nov., with translucent body, light brown pigmentation and black dots distributed in the pharyngeal and reproductive regions, and an oval cirrus sac with intramuscular surrounding hollow spaces and armored with spines and conspicuous teeth. The third species is Euplanoida cf. pacificola that could not be determined as the nominal species, due to ambiguity in its description. The fourth species, Bivesiculoplana lamothei, was previously described from the region and now is recorded in new localities and hosts from Oaxaca.
A systematic review of Rhinopetitia Géry (Teleostei, Characiformes, Characidae) with descriptions of four new species and redescription of R. myersi Géry
Authors: MENEZES NAÉRCIO A. , NETTO-FERREIRA ANDRE L.
Published: November 2019

Rhinopetitia was known for a long time only by R. myersi, its type species, described from the Ilha do Bananal, Rio Araguaia basin, Tocantins, Brazil. Another recently described species, R. potamorhachia, was considered to differ from R. myersi by having the outer and inner rows of premaxillary teeth with seven to nine cusps, a midlateral dark stripe and a dark humeral blotch (versus outer and inner rows of premaxillary and of maxillary teeth with three to five cusps, and the absence of a dark midlateral stripe). Recently collected specimens from the Araguaia and Tocantins river basins are considered to belong to R. myersi, allowing to better characterize this species which is redescribed herein. Four new species are recognized for the genus, all from Brazil: 1) Rhinopetitia paucirastra, new species, collected from the upper Rio Tocantins drainage, state of Goiás, distinguished from all its congeners mainly by the presence of rudimentary and fewer gill rakers in external row on first gill arch; 2) R. oligolepis, new species originating from the Rio Jamanxim, Rio Tapajós drainage, state of Pará, differing from its congeners by having 4 longitudinal scale rows from dorsal-fin origin to lateral line; 3) R. melanohumeralis, new species, collected from small streams tributaries of the upper Rio Tapajós, and the upper Rio Xingu basins, states of Pará and Mato Grosso, that has the body as deep as in R. paucirastra but has well-developed and more gill rakers in the external row on first branchial arch; and 4) R. nigrofasciata, new species, collected in small tributaries of the upper portions of the Rio Tapajós and Rio Xingu basins, states of Pará and Mato Grosso, with the body narrower than in R. paucirastra and R. melanohumeralis.
A new species of Ungla (Neuroptera: Chrysopidae) that exhibits remarkable homoplasy in male secondary sexual characters
Authors: TAUBER CATHERINE A.
Published: November 2019

A new and very unusual species of green lacewings, Ungla pseudomeleoma sp. nov. is described from Peru. Males of this species exhibit a remarkable example of generic-level homoplasy with Meleoma. Its abdominal and genitalic features are completely consistent with the genus Ungla. However, its external sexually dimorphic features resemble those of both Ungla and Meleoma. Females of the new species also express cranial modifications that resemble those of some female Meleoma species.
Revision of Myiocephalus Marshall (Hymenoptera: Braconidae: Euphorinae), with description of one new species
Authors: TAN JIANGLI , VAN ACHTERBERG CORNELIS , TIAN XIAOXIA , ZHANG RUONAN
Published: November 2019

The Palaearctic species of Myiocephalus Marshall, 1898 (Braconidae, Euphorinae) are revised and a new species (M. zwakhalsi sp. n.) from Austria is described and illustrated. A key to the Palaearctic species is provided. Myiocephalus niger Fischer, 1957, is a new record for China and the Nearctic Myiocephalus laticeps (Provancher, 1886) is re-instated as valid species. A lectotype is designated for Aphidius hedini Fahringer, 1929.
A new species of Rhathymus Lepeletier & Serville, 1828 (Hymenoptera: Apidae: Rhathymini) from Guatemala
Authors: AYALA RICARDO , HINOJOSA-DÍAZ ISMAEL A. , ARMAS-QUIÑONEZ ANA GABRIELA
Published: November 2019

A new species of the bee genus Rhathymus Lepeletier & Serville, 1828 is described and figured as Rhathymus atitlanicus Ayala, Hinojosa-Díaz and Armas-Quiñonez. The new species is from the department of Sololá, Guatemala, and can be distinguished based on the black integument contrasting with the orange color of the wings.
An interesting new species of Kamimuria (Plecoptera: Perlidae) from China, with notes on K. grandispinata Du & Sun
Authors: LI WEIHAI , MO RAORAO , YANG JUAN
Published: November 2019

Kamimuria circumspina sp. n. from Wuling Mountains in Guizhou Province, China, is described as new to science. The morphological characters of the new species are discussed and compared with similar perlid taxa and congeners. Kamimuria grandispinata Du & Sun is rediscovered from the same mountain range.
A new relictual species of Earthworm (Oligochaeta: Megascolecidae) from Central Australia
Authors: DYNE GEOFFREY R.
Published: November 2019

Graliophilus zeilensis is described from Mount Zeil in the West MacDonnell Ranges. While Mt Zeil is the highest mountain in the Northern Territory of Australia, the average rainfall for the bioregion is less than 250 mm annually, well below the limit previously thought to support native earthworms. This record considerably extends the range of Graliophilus, which was formerly restricted to southern Australia. It also provides further evidence of a former continent-wide distribution of earthworms which has been confined to increasingly smaller refugia during the gradual desertification of much of Australia’s interior.
Delays in Administration of the Second Antibiotic Dose in Patients With Severe Sepsis and Septic Shock
Authors: Randolph Jana L. , Chan Kin , Albright Amanda , Chen Aleda
Published: November 2019

Purpose: The aim of this study was to determine the incidence of significant delays in administration of the second antibiotic dose in patients treated for severe sepsis and septic shock at a single community teaching hospital as well as to assess patient outcomes associated with second dose delays. Methods: This single-center, retrospective chart review evaluated patients who received at least 2 antibiotic doses for severe sepsis or septic shock. Patients were classified as having experienced a significant second dose delay if the actual interval between the first and the second antibiotic doses was greater than or equal to 125% of the recommended dosing interval. Results: Of 197 patients, 38 (19.3%) experienced a significant second antibiotic dose delay. The rate of significant delays was 17.1% in patients treated initially in the emergency department and 30.3% in patients treated initially in another inpatient location. Conclusions: This single-center study found a 19.3% rate of significant delays in antibiotic second dose administration in patients with severe sepsis and septic shock. This study was not powered to identify differences in outcomes in patients with and without significant second dose delays. Additional large-scale studies are needed to investigate the impact of antibiotic second dose delays on outcomes in patients with sepsis.
Racial/Ethnic Diversity in Academic Public Health: 20-Year Update
Authors: Goodman Melody S. , Plepys Christine M. , Bather Jemar R. , Kelliher Rita M. , Healton Cheryl G.
Published: November 2019

Objective:

This study is a follow-up to an examination of the racial/ethnic composition of public health students (1996) and faculty (1997) at schools of public health that was conducted 20 years ago. We examined data on the race/ethnicity of students, graduates, and faculty among Association of Schools and Programs of Public Health (ASPPH)–member institutions during 2016-2017 and how these data have changed in the past 20 years.

Methods:

We obtained data on the race/ethnicity of students (in 1996 and 2016), graduates (in 1996 and 2016), and faculty (in 1997 and 2017) at ASPPH-member institutions from the ASPPH Data Center. We tabulated frequencies, percentages, and 20-year percentage-point changes by race/ethnicity. We examined data for all current ASPPH-member institutions and for comparable subcohorts of 1996 and 1997 member institutions that are current ASPPH members.

Results:

In graduate student enrollment, the 20-year increase in each nonwhite racial/ethnic subgroup was ≤5 percentage points. Among tenured faculty, the 20-year increase was greatest among Asians (8 percentage points) but was <3 percentage points for black, Hispanic, and Native American faculty.

Conclusions:

The increasing racial/ethnic diversity among students, graduates, and faculty in schools and programs of public health contributes to parallel increases in racial/ethnic diversity in the public health workforce. Schools and programs of public health should recruit clusters of racial/ethnic minority students using holistic application review processes, provide enrolled students with racially/ethnically diverse role models and mentors, and dedicate staffing to ensure a student-centered approach. In addition, those who mentor racially/ethnically diverse students and junior faculty should be rewarded.
Stress radiography in the diagnosis and assessment of the outcomes of surgical treatment of chronic anterolateral ankle instability
Authors: Tarczyńska Marta , Sekuła Przemysław , Gawęda Krzysztof , Szubstarski Mateusz , Przybylski Piotr , Czekajska-Chehab Elżbieta
Published: November 2019

Background

In about 20–40% of patients, damage to the soft tissues surrounding the ankle leads to recurrent and chronic pain with signs of instability of the talus in the tibiofibular fork.

Purpose

The aim of the study was to assess the usefulness of stress X-ray images in the diagnosis of long-term outcomes of conservative versus surgical treatment of anterolateral ankle instability.

Material and Methods

Thirty patients with chronic ankle instability (CAI) were recruited for the study. The participants were divided into two groups. The first group consisted of 15 non-operatively treated individuals diagnosed with anterior talofibular ligament (ATFL) damage. The second group consisted of 15 patients who had undergone surgical reconstruction of the ATFL. In both groups of patients, the contralateral normal limb was used as a control. In all patients, anteroposterior and lateral view stress radiographs of both ankles were taken using the TELOS Stress Device (GA – III/E, Hungen, Germany).

Results

Statistical tests showed that the surgically treated patients had a significantly greater ankle stability compared to the non-surgically treated patients ( P = 0.001 for talar tilt angle and P = 0.009 for anterior drawer distance). The results obtained in this study indicate that this method can also be used in postoperative assessment of the function of the reconstructed lateral ankle ligaments.

Conclusions

Stress radiography is a reliable and safe tool for diagnosing CAI. This imaging method is an objective instrument that can be successfully used in postoperative assessment of the function of the reconstructed ATFL.
Feasibility of contrast-enhanced MRI derived textural features to predict overall survival in locally advanced breast cancer
Authors: Chronaiou Ioanna , Giskeødegård Guro Fanneløb , Goa Pål Erik , Teruel Jose , Hedayati Roja , Lundgren Steinar , Huuse Else Marie , Pickles Martin D , Gibbs Peter , Sitter Beathe , Bathen Tone Frost
Published: November 2019

Background

The prognosis for women with locally advanced breast cancer (LABC) is poor and there is a need for better treatment stratification. Gray-level co-occurrence matrix (GLCM) texture analysis of magnetic resonance (MR) images has been shown to predict pathological response and could become useful in stratifying patients to more targeted treatments.

Purpose

To evaluate the ability of GLCM textural features obtained before neoadjuvant chemotherapy to predict overall survival (OS) seven years after diagnosis of patients with LABC.

Material and Methods

This retrospective study includes data from 55 patients with LABC. GLCM textural features were extracted from segmented tumors in pre-treatment dynamic contrast-enhanced 3-T MR images. Prediction of OS by GLCM textural features was assessed and compared to predictions using traditional clinical variables.

Results

Linear mixed-effect models showed significant differences in five GLCM features (f1, f2, f5, f10, f11) between survivors and non-survivors. Using discriminant analysis for prediction of survival, GLCM features from 2 min post-contrast images achieved a classification accuracy of 73% ( P < 0.001), whereas traditional prognostic factors resulted in a classification accuracy of 67% ( P = 0.005). Using a combination of both yielded the highest classification accuracy (78%, P < 0.001). Median values for features f1, f2, f10, and f11 provided significantly different survival curves in Kaplan–Meier analysis.

Conclusion

This study shows a clear association between textural features from post-contrast images obtained before neoadjuvant chemotherapy and OS seven years after diagnosis. Further studies in larger cohorts should be undertaken to investigate how this prognostic information can be used to benefit treatment stratification.
Accuracy and precision of cardiac output estimation by an automated, brachial cuff-based oscillometric device in patients with shock
Authors: Papaioannou Theodore G , Xanthis Dimitrios , Argyris Antonis , Vernikos Pavlos , Mastakoura Georgia , Samara Stamatia , Floros Ioannis T , Protogerou Athanase D , Tousoulis Dimitrios
Published: November 2019

Non-invasive monitoring of cardiac output is a technological and clinical challenge, especially for critically ill, surgically operated, or intensive care unit patients. A brachial cuff-based, automated, oscillometric device used for blood pressure and arterial stiffness ambulatory monitoring (Mobil-O-Graph) provides a non-invasive estimation of cardiac output values simultaneously with regular blood pressure measurement. The aim of the study was to evaluate the feasibility of this apparatus to estimate cardiac output in intensive care unit patients and to compare the non-invasive estimated cardiac output values with the respective gold standard method of thermodilution during pulmonary artery catheterization. Repeated sequential measurements of cardiac output were performed, in random order, by thermodilution (reference) and Mobil-O-Graph (test), in 24 patients hospitalized at intensive care unit. Reproducibility and accuracy of the test device were evaluated by Bland–Altman analysis, intraclass correlation coefficient, and percentage error. Mobil-O-Graph underestimated significantly the cardiac output by −1.12 ± 1.38 L/min ( p < 0.01) compared to thermodilution. However, intraclass correlation coefficient was >0.7 indicating a fair agreement between the test and the reference methods, while percentage error was approximately 39% which is considered to be within the acceptable limits. Cardiac output measurements were reproducible by both Mobil-O-Graph (intraclass correlation coefficient = 0.73 and percentage error = 27.9%) and thermodilution (intraclass correlation coefficient = 0.91 and percentage error = 26.7%). We showed for the first time that cardiac output estimation in intensive care unit patients using a non-invasive, automated, oscillometric, cuff-based apparatus is reproducible (by analyzing two repeated cardiac output measurements), exhibiting similar precision to thermodilution. However, the accuracy of Mobil-O-Graph (error compared to thermodilution) could be considered fairly acceptable. Future studies remain to further examine the reliability of this technology in monitoring cardiac output or stroke volume acute changes which is a more clinically relevant objective.
Post-treatment serological changes in some patients with early syphilis exhibit a parabolic trend
Authors: Liu Yong , Bian Que-Qiao , Zhang Shu-Huan , Wang Jun , Wang Zhen-Ming , Li Jun-Yue
Published: November 2019

Early syphilis accounts for a large proportion of patients with syphilis. Non- Treponema pallidum tests are commonly used to assess treatment effectiveness by analyzing the serological titer before treatment and six months after treatment. However, serological changes during the first three months after completion of treatment have not been completely understood. This prompted us to investigate whether serum titers of patients exhibit a continuous decrease post-treatment and to assess the trend of change in serological titer during this period. One hundred and seventy-three eligible patients with early syphilis were included in the analysis. Pre-treatment serological titers and those at three and six months post-treatment were compared and analyzed. Serological recovery was defined as a 4-fold or greater decrease in titer from pre-treatment level. Forty patients (23.1%) were found to have an increased serum titer at three months after treatment. Among the 40 patients, 13 patients had primary syphilis, 5 patients had secondary syphilis, and 22 patients had early latent syphilis. The proportion of patients with primary syphilis was higher, and their initial titers were significantly lower. No significant differences were observed with respect to age, gender, or initial treatment. The assessment results of 17 patients (9.8% of the total patients) change. Serological changes in some patients exhibit a parabolic pattern that may affect the clinician’s assessment of patient recovery. Therefore, more frequent assessment of serological titer might be required within the first six months post-treatment.
Near infrared inspection technology of bottled explosive liquid in airports
Authors: Itozaki Hideo
Published: November 2019

Near infrared inspection technology of bottled explosive liquid has been developed to be used in airports for anti-terrorism. Near infrared absorbance of 700 nm–1000 nm is used to inspect liquids in a bottle. Influence of bottle’s color can be avoided if the second derivative of absorbance at wavelength of more than 800 nm is used to inspect colored bottles. Suspension liquid such as milk can be inspected by reflected light. As various bottled liquids are carried into the airport by passengers, hundreds of bottled liquid such as beverages (soft and hard drinks), cosmetics, perfumes, medicines, shampoos, and so on were collected and their near infrared absorbance spectra were obtained to make a database of discrimination. Correlation coefficient is used to discriminate these liquids. And safe liquid or explosives was identified instantly. An ultrasonic pulse method was also applied to inspection of liquid in a metal can. Kumahira Co. Ltd developed a commercialized product. It was certified by the most reliable evaluation organization European Civil Aviation Conference. In 2019, more than 300 devices have been installed in Japanese airports for anti-terrorism, and some of them have been installed in Japanese Customs to inspect smuggling drugs. The liquid inspection technology can be applied not only in airports but also in many kinds of public places for the safety of public. Near infrared technology has large potential to be applied in more and more fields.
Fortune’s Wheel and God’s Whip: Religious Attitudes and Secular Power in Hugo Falcandus’s Liber de Regno Siciliae
Authors: Bellato Giulia
Published: November 2019

Hugo Falcandus, the author of the Liber (or Historia) de Regno Siciliae (1154–69), is a contentious figure among historians of the twelfth century. Often disgruntled and embittered, he wrote about the reigns of two Sicilian kings, William I and II, in a text rife with classicising references and personal judgements. Most unusually for a medieval writer from this period, his Liber appears free of any religious elements or framework. This article conducts a search for God in Falcandus’s work and challenges the view that the divine element is entirely ignored by this author. By doing so and through a comparative approach, it also aims at re-contextualising his writings within the production of texts on secular power and authority taking place in the twelfth century. It will show that the apparent lack of a religious framework is a result of the author’s political vision and that Falcandus is a product and a representative of broader ideological changes sweeping through medieval Europe during his time.
Toward automated identification and quantification of meso-scale damage modes in plain weave glass/epoxy composite laminates
Authors: Bonyi Enock , Kioko Bridgit , Meyer Christopher S , Adesina Oreoluwa , Obafemi-Babatunde Taofeek , Guy Janelle , O'Brien Daniel J , (Gama) Haque Bazle Z , Gillespie John W , Aslan Kadir
Published: November 2019

We investigated three different automated methods for identification and quantification of meso-scale damage on single-layer composite laminates subjected to ballistic impact by a 5.5 mm (0.22 caliber) right circular cylindrical steel projectile. These methods were based on the combined use of high-resolution optical imaging, fluorescence microscopy, and image detection software. High-resolution images of impacted composite samples were processed using either ImageJ alone (method 1, for sample size of 20 × 20 cm2) or ImageJ plus MATLAB (method 2, for sample size of 20 × 20 cm2), or fluorescence images were processed using ImageJ plus MATLAB (method 3, for sample size of 6 × 5 cm2). These methods were used for identification and grouping of horizontal and vertical transverse tow cracks, and 45° matrix cracks. The identified and grouped damage modes were quantified based on spatial pixel count related to damage modes, and quantified damage modes were used to generate a digital damage map using a separate MATLAB code for all three methods. Finally, the advantages and shortcomings of each of these three automated methods for identification and quantification of meso-scale damage modes were evaluated via comparison to a baseline manual method for identifying and quantifying the damage modes on the same samples.
Improved Benefit Risk Profile of Rivaroxaban in a Subpopulation of the MAGELLAN Study
Authors: Spyropoulos Alex C. , Lipardi Concetta , Xu Jianfeng , Lu Wentao , Suh Eunyoung , Yuan Zhong , Levitan Bennett , Sugarmann Chiara , De Sanctis Yoriko , Spiro Theodore E. , Barnathan Elliot S. , Raskob Gary E.
Published: November 2019

Acutely ill medical patients are at risk of venous thromboembolism (VTE) and VTE-related mortality during hospitalization and posthospital discharge, but widespread adoption of extended thromboprophylaxis has not occurred. We analyzed a subpopulation within the MAGELLAN study of extended thromboprophylaxis with rivaroxaban to reevaluate the benefit risk profile. We identified 5 risk factors for major and fatal bleeding after a clinical analysis of the MAGELLAN study and analyzed efficacy and safety with these patients excluded (n = 1551). Risk factors included: active cancer, dual antiplatelet therapy at baseline, bronchiectasis/pulmonary cavitation, gastroduodenal ulcer, or bleeding within 3 months before randomization. We evaluated efficacy, safety, and benefit risk using clinically comparable endpoints in the subpopulation. At day 10, rivaroxaban was noninferior to enoxaparin (relative risk [RR] = 0.82, 95% confidence interval [CI] = 0.58-1.15) and at day 35 rivaroxaban was significantly better than enoxaparin/placebo (RR = 0.68, 95% CI = 0.53-0.88) in reducing VTE and VTE-related death. Major bleeding was reduced at day 10 (RR = 2.18, 95% CI = 1.07-4.44 vs 1.19, 95% CI = 0.54-2.65) and at day 35 (2.87, 95% CI = 1.60-5.15 vs 1.48, 95% CI = 0.77-2.84) for MAGELLAN versus this subpopulation, respectively. The benefit risk profile was favorable in this subpopulation treated for 35 days, with the number needed to treat ranging from 55 to 481 and number needed to harm from 455 to 1067 for all pairwise evaluations. Five exclusionary criteria defined a subpopulation of acutely ill medical patients with a positive benefit risk profile for in-hospital and extended thromboprophylaxis with rivaroxaban.
Bilateral exudative retinal detachment in undiagnosed ocular syphilis after treatment with corticosteroids
Authors: Aguilar-González Marina , Fernández-Santodomingo Alex Samir , Marín-Payá Emma , Rahhal-Ortuño Miriam , Udaondo Patricia
Published: November 2019

A case of a young Caucasian male who presented bilateral papilledema is described. He was misdiagnosed with bilateral anterior optic neuritis, developing panuveitis and exudative bilateral retinal detachment after being treated with megadoses of corticosteroids. He was finally diagnosed with ocular syphilis and treated with intravenous aqueous crystalline penicillin for 14 days, with complete resolution of his symptoms.
Comparison of six methods for the intraocular lens power calculation in high myopic eyes
Authors: Ji Jiali , Liu Yan , Zhang Jing , Wu Xinhua , Shao Wanyu , Ma Bo , Luo Min
Published: November 2019

Purpose:

The aim of this study was to compare the accuracy of Barrett Universal II and Hill-Radial Basis Function with other four popular formulas for the calculation of intraocular lens power in high myopic eyes.

Methods:

A total of 56 eyes with an axial length of more than 26.0 mm were retrospectively reviewed. Six intraocular lens power calculation methods, including Barrett Universal II, Hill-Radial Basis Function, SRK/T, Haigis, Holladay 2 and Holladay 1, were evaluated. The difference between the postoperative actual refraction and the refraction predicted by the six methods was evaluated as the prediction error. The absolute prediction error was also calculated.

Results:

The mean numerical prediction error ± standard deviation of the six intraocular lens power calculation methods, in order of lowest to highest, was Barrett Universal II (0.37 ± 0.54 D), Hill-Radial Basis Function (0.40 ± 0.56 D), SRK/T (0.44 ± 0.56 D), Haigis (0.53 ± 0.54 D), Holladay 2 (0.88 ± 0.62 D) and Holladay 1 (1.00 ± 0.60 D). The median absolute errors predicted by the Barrett (0.46 D), Hill-Radial Basis Function (0.47 D), SRK/T (0.53 D) and Haigis (0.58 D) were significantly lower than those of the Holladay 1 (0.90 D) and Holladay 2(1.10 D; all p < 0.001). There was no significant difference among the median absolute errors of Barrett, Hill-Radial Basis Function, SRK/T and Haigis (all p > 0.05).

Conclusion:

The prediction errors differed for each method in the selection of intraocular lens power for the long eyes. In terms of overall accuracy, the Barrett Universal II formula provided the lowest prediction error. The Hill-Radial Basis Function method was comparable to the theoretical formulas, such as SRK/T and Haigis.
A new biarticular cement spacer technique for infected total hip and knee arthroplasty with massive bone loss
Authors: Sanz-Ruiz Pablo , Matas-Diez Jose Antonio , Villanueva-Martinez Manuel , Carbo-Laso Esther , Lopez-Torres Irene Isabel , Vaquero-Martín Javier
Published: November 2019

Introduction:

The management of massive femoral bone defects following prosthetic infection remains a surgical challenge, particularly when the entire femur is affected.

Methods:

We present the first results of a new biarticular cement spacer with antibiotic technique using a cephalomedullary nail for the treatment of infected hip arthroplasty involving complete femoral bone loss.

Results:

5 patients with a minimum follow-up of 1 year were included. In all cases 2-stage replacement due to hip periprosthetic infection was carried out, with the need for a biarticular complete femoral spacer in view of the magnitude of the bone defect. The infection was resolved in all patients, with no complications (spacer fracture or dislocation) associated to spacer use, and the patients were all able to maintain the sitting position with active knee movements between the 2 surgical stages. Improvement with respect to preoperative functional status was observed in all cases, as evidenced by the Harris Hip Score (HHS) (from 24.2 to 73; p < 0.001) and 12-Item Short-Form Health Survey (SF-12) (from 16.8 to 33.2; p = 0.001), with a lessened need for walking aids.

Discussion:

The described technique offers a possible solution to a number of complications observed with the use of spacers in massive defects, affording greater patient comfort and autonomy while waiting to receive total femoral replacement.
L2 Spanish morphosyntactic development through collaborative writing: An analysis of mood production, text length and syntactic complexity
Authors: Gallego Muriel
Published: November 2019

This study discusses the impact of interactionist output-oriented approaches, specifically, the effects of collaborative text reconstruction on subjunctive recognition and production in the written modality by English-dominant Spanish second-language learners. It also examines whether students’ text length and text complexity increase after treatment. A total of 104 fifth-semester Spanish learners participated in the study and were assigned to three conditions: control ( n = 36), dictogloss ( n = 33) and dictogloss plus explicit instruction ( n = 35). In order to measure target form recognition and production as well as text quality, participants completed a pre-, post- and delayed-post-test that included a guided written task and a recognition task. Results indicated that participants in both treatment groups increased their production of the subjunctive mood in the written modality in expected contexts at similar rates, which was also maintained over time. Participants also increased recognition rates, irrespective of group, pointing to a lack of relationship between this type of collaborative text reconstruction and subjunctive recognition. Lastly, an effect of group and time was also observed for text length and syntactic complexity, as participants in the treatment groups produced significantly longer texts, as well as a higher number of complement clauses.
Limb Salvage in Diabetic Patients With Ischemic Heel Ulcers
Authors: Meloni Marco , Izzo Valentina , Giurato Laura , Brocco Enrico , Gandini Roberto , Uccioli Luigi
Published: November 2019

The purpose of this study is to investigate the outcomes of diabetic individuals with ischemic heel ulcers. The study group was composed of a consecutive sample of persons with diabetic ischemic foot ulcers managed by a preset multidisciplinary limb salvage protocol, including revascularization through endovascular technique. The outcome measures were healing, major amputation (above the ankle), and death at 1-year of follow-up. The outcomes between patients with heel ulcers (HUs) and without (NHUs) were compared. A total of 254 patients were recruited. There were 50/254 (19.7%) HUs and 204/254 (79.3%) NHUs. Overall, 190/254 (74.8%) patients healed. The rate of healing for HUs and NHUs was 30/50 (60%) and 160/204 (78.4%); P = .03, respectively. Major amputation occurred in 24/254 (9.4%) patients. The rates of major amputation for HUs and NHUs were 10/50 (20%) and 14/204 (6.9%; P = .002), respectively; 40/254 (15.7%) patients died, unhealed. The rates of mortality for HUs and NHUs were 10/50 (20%) and 30/204 (14.7%; P = .07), respectively. In HUs patients, absence of infection [95% CI = 3.1 (1.6-5.5); P = .002] and superficial ulcers [95% CI = 4.4 (2.2-9.3); P = .0001] were independent predictors of healing, whereas revascularization failure [95% CI = 8.1 (1.5.0-19.4); P = .0001], involvement of the plantar arch [95% CI = 6.3 (2.0-15.4); P = .0001], and dialysis [95% CI = 2.2 (1.3-4.5); P = .006] were independent predictors of major amputation. A multidisciplinary approach achieves good rate of limb salvage in people with diabetic ischemic heel ulcers.
Surgical Offloading Techniques Should be Used More Often and Earlier in Treating Forefoot Diabetic Ulcers: An Evidence-Based Review
Authors: Yammine Kaissar , Assi Chahine
Published: November 2019

Conservative treatment is the basis for diabetic foot ulcer (DFU) management, whereas surgical treatment is usually reserved for patients with failed, recurrent, or nonresponsive infected wounds. However, many reports demonstrated good to excellent results following surgery. Evidence synthesis on surgical offloading techniques and clear guidelines regarding the timing of surgery are lacking. The present study aimed to investigate the evidence behind surgical offloading techniques and propose a cutoff time for surgical indication following failed conservative treatment of neuropathic diabetic forefoot ulcers. Electronic databases were searched from inception to identify the best evidence level articles related to non-vascular surgical treatment of DFUs, such as metatarsal head resection, resection arthroplasty, metatarsal osteotomy, Achilles tendon lengthening, gastrocnemius recession, and flexor tenotomy, that have been employed for managing DFUs. Based on the highest level of evidence available, surgery was found to generate better values than standard conservative care for all outcomes except for the transfer rate. In particular, surgical bony offloading procedures demonstrated significantly better outcomes than standard conservative nonsurgical care in terms of higher healing rates, shorter healing durations, and lower recurrence rates. Moreover, 96% of DFUs healed in <1 month following surgical bony offloading, whereas 68% of ulcers healed within 3 months after standard care. The findings could challenge the classical guidelines of DFU management. This evidence-based review indicates that surgical offloading could be used more often and be proposed earlier during the course of ulcer management. The results imply that a period of 12 weeks could be considered a reasonable cutoff value to consider surgical treatment for patients with nonhealing DFUs.
Nasopharyngeal Hyalinizing Clear Cell Carcinoma: A Case Report and Review of the Literature
Authors: Malfitano Madison J. , Norris Meghan N. , Stepp Wesley H. , Santarelli Griffin D. , Samulski T. Danielle , Senior Brent A. , Ebert Charles S. , Thorp Brian D. , Zanation Adam M. , Kimple Adam J.
Published: November 2019

Background

Hyalinizing clear cell carcinomas (HCCCs) are rare, low-grade, malignant tumors which most often arise from the minor salivary glands primarily in palate and tongue but can arise in any location with minor salivary glands including the nasopharynx.

Methods

A case report of primary nasopharyngeal HCCC is presented. Because of the rarity of this tumor and location, a literature search was conducted to determine the most common presenting symptoms, treatment strategies, and outcomes.

Results

A 48-year-old man underwent biopsy of a 4.5 cm mass of the right nasopharynx with pathology suggesting an intermediate grade mucoepidermoid carcinoma. After discussing management with the patient, an endoscopic resection was performed. Final pathology revealed an HCCC which was confirmed after negative Mastermind-like 2 (MAML2) and positive Ewing sarcoma breakpoint region 1 (ESWR1) gene rearrangements on fluorescence in situ hybridization (FISH) studies. Literature review of other nasopharyngeal HCCC cases shows diverse presentation and overall excellent prognosis through surgical and radiation therapy.

Conclusion

HCCCs are rare, low-grade malignant tumors of the minor salivary glands and can present as a nasopharyngeal mass. Presenting symptoms are diverse but frequently involve otologic and sinonasal disturbances. HCCC is an indolent tumor with an excellent prognostic outcome when treated appropriately with surgical resection and adjuvant radiotherapy.
Occipital Neuralgia Treated With Acupuncture: A Case Report
Authors: Mallory Molly , Bauer Brent , Chon Tony
Published: November 2019

We present a case report of a patient whose occipital neuralgia symptoms were substantially improved after a single acupuncture treatment with complete resolution after only a short course of care. The patient, a 78-year-old woman, presented to our institution’s neurology department with symptoms of posterior neck pain and electrical sensations in her head which had been present for more than 1 year. With a desire to avoid pharmacologic intervention or invasive procedures, the patient requested acupuncture treatment. The patient received 5 acupuncture treatments over the course of 8 days with substantial resolution of her head pain after a single treatment. This case is suggestive that acupuncture may be a beneficial treatment for patients with occipital neuralgia.
Thrombocytoasthenia and Thrombocytopathia—Old Names and New Diseases
Authors: BRAUNSTEINER H. , PAKESCH F.
Published: November 2019

Thrombocytoasthenia is a well defined disease, due to defective pseudopod formation and lack of spreading of platelets, i.e., defective adhesivity in contact with wettable surfaces. This defect persists in pathologic or normal plasma, serum, heated serum and barium adsorbed serum. The platelets behave normally, however, in saline or plasma substitutes. There is a manifest or latent defect of clot retraction, which can be revealed by thrombelastography. This disturbance seems to be in relation with the primary platelet disorder, and can not be corrected by addition of serotonin. Coagulation factors are normal.

Under the name of thrombocytopathia, possibly heterogenous diseases have been provisionally classified into three groups. In some patients a diminution of thromboplastic activity of platelets is ascertained. The platelets may also show marked morphologic anomalies. This group has been designated as "thrombocytopathia." In the majority of patients a deficiency of thromboplastic activity of platelets is only found temporarily or the results are only moderately pathologic. This group has been designated as "probable thrombocytopathia." The third group includes patients with a normal thromboplastic activity of platelets. As indicated with existing methods; more sensitive tests, still on trial, may give positive results. This group has been designated as "possible thrombocytopathia."

Capillary microscopy gave normal results in patients of all three groups. The relation to "vascular pseudohemophilia" is briefly discussed.
Studies on Spontaneous In Vitro Autohemolysis in Hemolytic Disorders
Authors: YOUNG LAWRENCE E. , IZZO MARY JANE , ALTMAN KURT I. , SWISHER SCOTT N.
Published: November 2019

Measurements of spontaneous lysis (autohemolysis) of red cells in sterile defibrinated blood after 48 or more hours of incubation at body temperature were found useful in the investigation of certain hemolytic states. Abnormally rapid autohemolysis was demonstrated most consistently in hereditary spherocytosis, but was also found in other types of spherocytosis and in several examples of non-spherocytic hemolytic anemia. Autohemolysis above the normal range can be regarded as strong presumptive evidence of a hemolytic disorder, but a normal rate of autohemolysis by no means excludes the possibility of a hemolytic process in any given case.

Abnormalities of hereditary spherocytes causing increased autohemolysis were shown to be correlated with those responsible for spherocytosis as reflected in osmotic fragility tests. There appeared to be closer correlation with abnormalities causing increased osmotic fragility of the cells after 24 hours incubation. The autohemolysis test and the osmotic fragility test on incubated red cells were found to be equally sensitive in their capacity to detect spherocytosis of the hereditary type.

Addition of adenosine, guanosine or inosine caused moderate to marked reduction in autohemolysis of nearly all types of red cells tested. Lysis of incubated spherocytes from active cases of autoimmune hemolytic disease was more markedly inhibited by a small amount of adenosine than was the lysis of hereditary spherocytes.

Glucose regularly caused marked inhibition of autohemolysis of hereditary spherocytes and of red cells from patients with acute leukemia. The effect of glucose on HS red cells might have been due in part to a lowering of pH by formation of lactic acid since acidification of the blood with lactic, citric or hydrochloric acid also caused substantial reduction in autohemolysis.

Glucose caused slight to marked increase in lysis of red cells in certain other cases of spherocytosis, notably in autoimmune hemolytic disease and in myeloid metaplasia. Addition of lactic acid to the blood from several of these patients had similar effect.

In 2 atypical cases of chronic spherocytosis, with hematologically normal relatives, autohemolysis was accelerated by addition of glucose to the blood samples. Adenosine had little effect until after splenectomy when both glucose and adenosine inhibited hemolysis, much the same as in blood from typical cases of hereditary spherocytosis.

It seems likely that when the abnormalities of carbohydrate metabolism of the red cells in certain hemolytic disorders are better understood, measurements of autohemolysis may be modified so as to enhance their usefulness in detecting and differentiating the various hemolytic states. It also seems likely that further studies on in vitro autohemolysis will help to elucidate some hemolytic mechanisms operating in vivo.
Experimental Megaloblastic Anemia in Young Guinea Pigs
Authors: SLUNGAARD ROLV K. , HIGGINS GEORGE M.
Published: November 2019

Megaloblastosis has been produced in young guinea pigs by feeding them purified diets deficient its pteroylglutamic acid (PGA) or vitamin B12 or both. The withholding of ascorbic acid from the diet did not produce megaloblastosis but it greatly enhanced its development when PGA was also withheld. Spontaneous remission took place in several instances.

The possible role of growth of the animal and changes in the bacterial flora of the gastrointestinal tract has been discussed. Bacteriologic studies appeared to indicate a possible interrelationship between the occurrence of Escherichia coli in the stools of guinea pigs consuming deficient diets and the development of megaloblastosis. Diarrhea and infections are considered important in the pathogenesis of megaloblastic anemia but infections were not observed in animals of the present study. However, diarrhea was a prominent feature and appeared to be a factor associated with megaloblastosis.

Anemia was usually present in association with megaloblastosis; however, megaloblastosis of a mild degree appearing in some of the animals fed the diets deficient in PGA or vitamin B12 was not accompanied by anemia. When ascorbic acid was withheld in addition, then anemia always developed.

A dimorphic picture of macrocytosis and microcytosis was found most commonly in the peripheral blood of animals with megaloblastosis. This has been explained on the basis of regenerative macrocytosis or as a disturbance of the maturation of erythrocytes in such deficiencies.

Data obtained from peripheral blood are not a reliable indicator of megaloblastosis, nor is the clinical condition of the animal indicative of the pathologic state.

One animal which had been fed a diet deficient in vitamin B12 and PGA and which showed megaloblasts in its bone marrow was given injections of vitamin B12. The megaloblastosis was corrected but the animal died on the sixteenth day of treatment.

Two animals fed diets deficient in PGA and ascorbic acid were subsequently given injections of PGA and ascorbic acid. The results demonstrated that administration of ascorbic acid alone did not interrupt the development of severe megaloblastosis in the continuing absence of PGA. When PGA was given, reticuocytosis then ensued and there was a reversal of megaloblastic erythropoiesis.
The Effect of Transfusions of Erythrocytes on Untreated Pernicious Anemia
Authors: MASON JAMES D. , LEAVELL BYRD S.
Published: November 2019

1. Three patients with untreated pernicious anemia were transfused with packed erythrocytes to produce a normal hematocrit before they were treated with vitamin B12. One patient with untreated pernicious anemia was transfused with 250 cc. plasma prior to therapy with vitamin B12. No significant changes were noted in this patient who received plasma.

2. Following erythrocyte transfusions the bone marrows of these patients were considered to show the megaloblastic type of maturation with a reduction in percentage of the early megaloblasts (Stages I and II). The ME ratio of the marrows increased. A decrease in the absolute reticulocyte count occurred. No change occurred in the peripheral leukocyte and platelet counts and there was no significant change in the clinical condition of the patients.

3. After therapy with vitamin B12, at a time when the hematocrits were normal, the bone marrows became normoblastic, a small but definite reticulocytosis occurred, the leukocyte and platelet counts returned to normal, and there was subjective improvement in the condition of the patient.

4. It is concluded that in these three patients with untreated pernicious anemia multiple transfusions of packed erythrocytes decreased erythropoiesis but did not cause any basic change in the type of erythrocyte maturation.
Hemostasis in Thrombocytopenic Bleeding Following Infusion of Stored, Frozen Platelets
Authors: KLEIN EDMUND , TOCH RUDOLF , FARBER SIDNEY , FREEMAN GUSTAVE , FIORENTINO ROSEMARY
Published: November 2019

Platelets concentrated and stored in their own plasma at -15 C. up to 6 weeks were administered to severely ill, thrombocytopenic, bleeding children in whom hemostasis had not been attained by other measures. Eighteen of 29 infusions in 15 children appeared to result in transitory hemostasis.

Transient elevation of the blood pressure and local vasoconstriction accompanied the administration of platelet material. No evidence of serious toxicity or thrombosis has been encountered.