bluuebunny/crossref_metadata_2025 huggingface dataset:
Microcredit and Food Security: Evidence from Rural Households in Uganda
Authors: Namayengo Faith M , Antonides Gerrit , Cecchi Francesco
Published: December 2017

This study investigates the effect of participation into a microcredit program on household food security parameters of female borrowers in a rural setting in Uganda. We explore the modes of food acquisition, dietary diversity, caloric and protein intake, and qualitative food insecurity measures for different categories of respondents. We conduct a cross-sectional analysis comparing old clients to newly registered first time borrowers. Next, we compare first time borrowers and non-borrowers using a panel design. While the cross-sectional analysis allows the comparison of women that similarly self-selected into borrowing, the panel analysis complements by providing insights into changes of food security parameters. In both cases, we use Kernel matching, or difference-in-difference with Kernel matching, to control for potential bias in observables, and perform a sensitivity analysis with respect to unobservables using Rosenbaum bounds as well as an individual fixed effects panel analysis. Results show a decline in food security following the uptake of microcredit. In particular, the analysis reveals robustly lower dietary diversity among long-time borrowers than new borrowers, and larger reductions in dietary diversity scores among new borrowers, after 1 year, compared to controls. The reduction in dietary diversity was traced to a reduction in animal-source food, fruit and sugar intake. We find indicative evidence that this is partly explained by a shift from own production to reliance on food purchase by households. Other household members relegating the burden of food provision to women after borrowing may also help explain the observed result.
Lee Geropalliative Caring Model
Authors: Lee Susan M.
Published: December 2017

This article describes the Lee Geropalliative Caring Model (GCM), a situation-specific theory that guides geropalliative care, defined as the care of older adults in the last 2 years of life. Underpinned by the theory of human caring, the GCM offers a framework for achieving the person/family outcome of well-being by suggesting caring interventions within 4 priority domains: aligning care, keeping safe, comforting body/mind/spirit, and facilitating transitions to persons with late-stage illness, including frailty and dementia. The GCM can be used to inform practice, policy, education, and research.
Risk of Pneumonia After Vertebral Compression Fracture in Women With Low Bone Density
Authors: Kim Byunghyun , Kim Joonghee , Jo You Hwan , Kang Si-Hyuck , Lee Yeon Joo , Lee Jae Hyuk , Hwang Je Eun , Park Min Ji , Lee Sihyung
Published: December 2017

Study Design.

Retrospective large population-based study.

Objective.

The aim of this study is to elucidate the association between vertebral compression fractures (VCFs) and pneumonia.

Summary of Background Data.

VCF is known to be associated with impaired pulmonary function. However, the risk of developing pneumonia after new-onset VCF has not been evaluated.

Methods.

The data source was the National Health Screening Program Cohort, a population-based sample cohort of national health screening enrolees. Elderly women with low bone density identified during the life transition period health check-up were target population. Patients with newly diagnosed isolated VCF after the health check-up except those with cervical VCF were included as exposure group. Matched individuals still free of any type of VCF from the same population were included as control group with case/control ratio 3:1. The time to first occurrence of pneumonia were analyzed with Cox-regression analysis.

Results.

From the target population (N = 24,773), we matched 867 patients exposed to new-onset isolated VCFs with 2601 controls. In a multivariable Cox-regression analysis, isolated VCF was identified as an independent risk factor for development of a pneumonia (adjusted hazard ratio, 1.48; 95% confidence interval 1.14–1.91). Among the subtypes of VCF, thoracic/thoracolumbar VCF was independently associated with increased risk of pneumonia (adjusted hazard ratio, 2.13; 95% confidence interval 1.47–3.08).

Conclusion.

Isolated VCF, especially those involving thoracic region, was associated with increased risk of pneumonia.

Level of Evidence: 4
Sensitivity and Specificity of 2 Autism Screeners Among Referred Children Between 16 and 48 Months of Age
Authors: Salisbury Louisa A. , Nyce Jonathan D. , Hannum Charles D. , Sheldrick R. Christopher , Perrin Ellen C.
Published: December 2017

Objective:

Autism screening is recommended by the American Academy of Pediatrics and the Centers for Disease Control and Prevention at ages 18 and 24 months. Popular screening tests have been validated for the age range of 16 to 30 months. However, only a minority of children with autism spectrum disorder (ASD) are identified by age 3 years, and many are not identified until after they enter school. Thus, we aimed to measure the sensitivity and specificity of 2 available screening tests for ASDs in children older than 30 months.

Methods:

We assessed the sensitivity and specificity of 2 ASD screening tools administered to parents of children who were referred to a developmental clinic between the ages of 16 and 48 months: the Modified Checklist for Autism in Toddlers (M-CHAT) and the Parent's Observations of Social Interactions (POSI), which is a component of a comprehensive screening instrument called, the Survey of Well-being of Young Children.

Results:

Both the M-CHAT and the POSI had acceptable sensitivity (≥75%) among children across the age range studied. Their specificity was limited by the fact that the study was conducted in a developmental referral clinic.

Conclusion:

Two readily available screening tools, the POSI and the M-CHAT, have acceptable sensitivity in evaluating risk for autism in children at least to age 48 months. Further research should investigate their sensitivity and specificity when used in primary care settings.
Corneal Biomechanical Properties and Central Corneal Thickness in Pediatric Noninfectious Uveitis: A Controlled Study
Authors: Sen Emine , Balikoglu-Yilmaz Melike , Ozdal Pinar
Published: December 2017

Objective:

To compare the corneal biomechanics, intraocular pressure (IOP), and central corneal thickness (CCT) of 37 patients with pediatric noninfectious uveitis with 36 healthy children.

Methods:

Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated and corneal-compensated IOP (IOPg and IOPcc, respectively), and CCT were measured.

Results:

The mean CRF was significantly lower in the pediatric uveitic eyes than controls (9.7±1.9 vs. 10.8±1.5 mm Hg, P=0.009), whereas there was no significant difference for mean CH, IOPg, IOPcc, and CCT between the two groups (10.1±1.9 vs. 10.8±1.7, 12.9±3.3 vs. 13.9±3.1, 13.8±2.8 vs. 13.6±3.2 mm Hg, and 550.7±49.5 vs. 555.1±33.5 μm, respectively, all P>0.05). The CCT values correlated with CH and CRF, with a Pearson correlation of 0.511 and 0.670 (P=0.013 and P<0.001, respectively), whereas disease duration did not correlate with any corneal biomechanics or CCT in pediatric uveitic eyes (all P>0.05).

Conclusions:

Pediatric noninfectious uveitic eyes have lower CRF than controls but the CH, IOPg, IOPcc, and CCT values are similar.
Comparison of Changes in Central Corneal Thickness During Corneal Collagen Cross-Linking, Using Isotonic Riboflavin Solutions With and Without Dextran, in the Treatment of Progressive Keratoconus
Authors: Zaheer Naima , Khan Wajid Ali , Khan Shama , Khan M. Abdul Moqeet
Published: December 2017

Purpose:

To compare intraoperative changes in central corneal thickness (CCT) during corneal cross-linking, using 2 different isotonic riboflavin solutions either with dextran or with hydroxy propyl methylcellulose, in the treatment of progressive keratoconus.

Methods:

In this retrospective study, we analyzed records of corneal thickness measurements, taken during various steps of cross-linking. Cross-linking was performed using either isotonic riboflavin with dextran (group A) or isotonic riboflavin with hydroxy propyl methylcellulose (without dextran) (group B). CCT measurements were recorded before and after epithelial removal, after saturation with respective isotonic riboflavin solution, after use of hypotonic riboflavin in selected cases, and after ultraviolet A (UV-A) application. A mixed-way analysis of variance was conducted on CCT readings within each group and between both groups, and p < 0.05 was considered significant.

Results:

In group A (100 cases), after saturation with isotonic riboflavin, CCT was decreased by a mean of 51.4 μm (12.1%). In 64%, CCT was <400 μm and additional hypotonic riboflavin was used. After UV-A irradiation, CCT was decreased by a mean of 46.7 μm (11.4%). In group B (100 cases), after saturation with isotonic riboflavin, CCT was increased by a mean of 109.4 μm (26.1%). After UV-A exposure, CCT was increased by a mean of 59.2 μm (11.2%). There was a substantial main effect for time on CCT during corneal cross-linking (CXL), p < 0.001, within both groups. The main effect comparing CCT readings between groups A and B was also significant, p < 0.001.

Conclusions:

During cross-linking, isotonic riboflavin with dextran causes a significant decrease in corneal thickness, whereas dextran-free isotonic riboflavin causes a significant increase in corneal thickness, thus facilitating the procedure.
Electrogastrography, Near‐infrared Spectroscopy, and Acoustics to Measure Gastrointestinal Development in Preterm Babies
Authors: Ortigoza Eric B. , Cagle Jackson , Chien Jui‐Hong , Oh Sungho , Brown Larry Steven , Neu Josef
Published: December 2017

Objectives:

The aim of the study was to obtain objective measures indicative of gastrointestinal maturity using 3 noninvasive technologies.

Methods:

Electrogastrography (EGG), abdominal near‐infrared spectroscopy (NIRS), and bowel sound/acoustics (AC) monitoring were used simultaneously to obtain physiologic measures of the gastrointestinal system of 18 preterm and 5 term neonates who were tolerating enteral feedings. Measures of EGG slow wave voltage (EGG dominant power) and AC signal amplitude (AC dominant power) were obtained after spectral density analysis. Mean abdominal regional saturations (A‐rSO2) were obtained directly from NIRS. The relationship of these 3 measures with postmenstrual age (PMA) was assessed.

Results:

The results of the 3 methods differed depending on whether the measurements were pre‐ or postprandial. Postprandial EGG dominant power increases with PMA (r = 0.67, P = 0.003), both pre‐ and postprandial abdominal NIRS mean regional saturation increase with PMA (r = 0.73, P < 0.001 and r = 0.55, P = 0.009), and postprandial AC dominant power (at 300–500 Hz) increases with PMA (r = −0.48, P = 0.025).

Conclusions:

EGG, abdominal NIRS, and AC, whenever used simultaneously, can provide objective and synergistic measures that correlate with PMA. These findings may be helpful in the assessment of feeding readiness because they reveal quantitative measures suggestive of the developmental process of the gut.
Hyperadiponectinemia During Infliximab Induction Therapy in Pediatric Crohn Disease
Authors: Frivolt Klara , Schwerd Tobias , Schatz Stephanie B. , Freudenberg Folke , Prell Christine , Werkstetter Katharina J. , Bufler Philip , Koletzko Sibylle
Published: December 2017

Objectives:

The inflammatory process in Crohn disease (CD) involves the visceral fat, characterized by adipocyte hyperplasia and altered adipose tissue and serum concentrations of tumor necrosis factor (TNF), leptin, adiponectin and resistin. We investigated the effect of anti‐TNF therapy with infliximab (IFX) on serum adipokine levels in pediatric CD.

Methods:

Serum concentrations of resistin (ng/mL), leptin (ng/mL), and total adiponectin (μg/mL) were assessed by enzyme‐linked immunosorbent assays (ELISA) in 18 pediatric CD patients (mean age 15.0 ± 1.5 years) before first, second, and fourth IFX infusion (weeks 0, 2, and 14) and compared with baseline values from sex‐ and BMI‐matched healthy controls (HC, mean age 13.4 ± 1.6 years).

Results:

At baseline, CD patients (mean age 15.0 ± 1.5 years, 10 of 18 boys) compared with HC (13.4 ± 1.6 years, 7 of 15 boys) had higher resistin levels (median 14.7 ng/mL, range 5.1–50.5 vs 7.3 ng/mL, 0.5–14.5); P = 0.0002). At weeks 2 and 14, resistin decreased to 6.9 ng/mL (2.9–16.8) (P < 0.0001) and 9.2 ng/mL (4.1–20.6; P = 0.0011), respectively. Leptin and adiponectin were comparable between patients and HC at baseline. Leptin increased in girls from 9.5 ng/mL (4.0–30.1) to 16.0 ng/mL (7.9–35.2; P = 0.0156) and 17.2 ng/mL (10.8‐ 26.8; P = 0.1953) at weeks 0, 2, and 14 respectively; with a trend in boys from 2 (0.6–12.9) to 2.8 (1.7–8.6; P = 0.0840) and 3.3 (1.3–4.6; P = 0.1309). Adiponectin peaked initially from 7.8 μg/mL (4.6–11.9) at week 0 to 9.2 μg/mL (4.1–20.7; P = 0.0005) at week 2 and thereafter fell to 6.5 μg/mL (3.0–12.7; P = 0.0182) at week 14.

Conclusions:

TNF blockade is associated with changes in circulating adipokines. The marked early increase of the potent anti‐inflammatory adiponectin may contribute to the rapid response to IFX in CD.
Non‐invasive Markers of Portal Hypertension
Authors: Sutton Harry , Dhawan Anil , Grammatikopoulos Tassos
Published: December 2017

Portal hypertension (PHT) is a significant cause of morbidity and mortality in children with chronic liver disease and portal vein obstruction. Increased portal pressure results in variceal formation along the gastrointestinal (GI) tract resulting in major bleeding. Identifying children with significant PHT who are more likely to suffer GI bleeding has been challenging and the role of surveillance upper GI endoscopy has been debated. This review analyses research done on serum biomarkers and imaging techniques as possible predictors of significant PHT. We evaluated the research performed on adult population, as well as the limited work done on children, to identify promising areas for future research. A literature search was conducted on “PubMed.” Several search terms were used including “portal hypertension,” “paediatric portal hypertension,” “non‐invasive markers of portal hypertension,” “spleen stiffness,” “liver stiffness,” “elastography,” and “endothelial damage.” The articles included were selected based on their relevance to the purpose of our review. The research suggests a combination of several biomarkers, in addition to an imaging technique such as transient elastography or magnetic resonance elastography, would allow for the best prediction of significant varices. The most promising indicators would be those that are applicable in both intra‐ and extra‐hepatic causes of PHT. Further research on these predictors in children with PHT is required to determine their potential role as selection criteria for PHT and stratification of surveillance GI endoscopies.
Academic-Practice Partnerships to Reduce the Shortage of Operating Room Nurses
Authors: Plank Linda
Published: December 2017

The operating room (OR) is a unique practice environment for nurses; however, many baccalaureate nursing programs no longer include OR nursing in the curriculum. This is unfortunate because many ORs in the United States are experiencing shortages of nurses. This article describes 3 types of academic-practice partnerships by which nursing students can experience the OR environment. Specific learning opportunities in this area lead to more successful transition into practice for new graduates who select the OR as a career choice.
Scleral Lens Clearance Assessment with Biomicroscopy and Anterior Segment Optical Coherence Tomography
Authors: Yeung Debby , Sorbara Luigina
Published: December 2017

SIGNIFICANCE

It is important to be able to accurately estimate the central corneal clearance when fitting scleral contact lenses. Tools available have intrinsic biases due to the angle of viewing, and therefore an idea of the amount of error in estimation will benefit the fitter.

PURPOSE

To compare the accuracy of observers' ability to estimate scleral contact lens central corneal clearance (CCC) with biomicroscopy to measurements using slit-lamp imaging and anterior segment optical coherence tomography (AS-OCT).

METHODS

In a Web-based survey with images of four scleral lens fits obtained with a slit-lamp video imaging system, participants were asked to estimate the CCC. Responses were compared with known values of CCC of these images determined with an image-processing program (digital CCC) and using the AS-OCT (AS-OCT CCC). Bland-Altman plots and concordance correlation coefficients were used to assess the agreement of CCC measured by the various methods.

RESULTS

Sixty-six participants were categorized for analysis based on the amount of experience with scleral lens fitting into novice, intermediate, or advanced fitters. Comparing the estimated CCC to the digital CCC, all three groups overestimated by an average of +27.3 ± 67.3 μm. The estimated CCC was highly correlated to the digital CCC (0.79, 0.92, and 0.94 for each group, respectively). Compared with the CCC measurements using AS-OCT, the three groups of participants overestimated by +103.3 μm and had high correlations (0.79, 0.93, and 0.94 for each group).

DISCUSSION

Results from this study validate the ability of contact lens practitioners to observe and estimate the CCC in scleral lens fittings through the use of biomicroscopic viewing. Increasing experience with scleral lens fitting does not improve the correlation with measured CCC from digital or the AS-OCT. However, the intermediate and advanced groups display significantly less inter-observer variability compared with the novice group.
Content, Accessibility, and Dissemination of Disaster Information via Social Media During the 2016 Louisiana Floods
Authors: Scott Katherine K. , Errett Nicole A.
Published: December 2017

Context:

Social media is becoming increasingly integrated into disaster response communication strategies of public health and emergency response agencies.

Objective:

We sought to assess the content, accessibility, and dissemination of social media communications made by government agencies during a disaster response.

Design:

A cross-sectional analysis of social media posts made by federal, state, and local government, public health and emergency management agencies before, during, and after the 2016 Louisiana floods was conducted to determine their content, accessibility, and dissemination by level of government and time relative to disaster onset.

Setting:

Facebook and/or Twitter posts made by public agencies involved in the response to the 2016 Louisiana Flooding events (FEMA Disaster Declaration [DR-4277]) published between August 4 and September 16, 2016, publicly available online between February 21 and March 31, 2017, were included in the analysis.

Main Outcome Measure:

Content: The text of each post was assessed to determine whether it contained information on provision of situational awareness; addressing misconception, actionable requests; mental, behavioral, and emotional support; and/or recovery and rebuilding resources. Accessibility: A Flesh-Kincaid grade level of each post was calculated, and information on post language, originality, hyperlinks, visuals, videos, or hash tag was recorded. Dissemination: The average number of reacts/likes, shares/retweets, and comments per post was calculated.

Results:

Most posts contained information related to situational awareness and recovery resources. There was an increase in messages during the first week of the disaster at all levels. Few posts were made in languages other than English. Compared with state and federal posts, local Facebook posts averaged fewer reacts, comments, and shares throughout the analysis period.

Conclusions:

Government agencies may maximize the use of social media platforms for disaster communications by establishing their social media network in advance of a disaster and by applying established guidelines on disaster social media use.
Microbial Evaluation in Capsular Contracture of Breast Implants
Authors: Galdiero Marilena , Larocca Fabio , Iovene Maria Rosaria , Francesca Martora , Pieretti Gorizio , D’Oriano Virginia , Franci Gianluigi , Ferraro Giuseppe , d’Andrea Francesco , Nicoletti Giovanni Francesco
Published: December 2017

Background:

Capsular contracture around breast implants is a severe and unpredictable complication experienced by up to 50 percent of patients after breast augmentation and reconstruction, and represents a major cause leading to reoperation. Several lines of evidence point to the involvement of subclinical infections and of bacterial biofilm formation.

Methods:

To reduce the incidence of capsular contracture following mammaplasty, the authors studied the correlation between contamination by exogenous and endogenous bacterial flora and the capacity to develop bacterial biofilm in mammary implants. The authors performed a microbiological study assessing microbial growth of swabs from breast skin, nipple-areola complex, and mammary gland biopsy specimens. Furthermore, the authors compared the results with the data resulting from cultural experiments from biopsy specimens of periprosthetic capsule, contracted or not, and from the surfaces of the relative prosthesis.

Results:

Between July of 2012 and July of 2013, a series of 65 female patients from the area of Naples, Italy, and its province, who underwent breast plastic surgery with the use of implants for aesthetic or reconstructive reasons, were included in the study. The authors noticed that there is a greater tendency for capsular contracture to form in oncologic patients who received radiotherapy, patients with precedent capsular contracture, and patients with cutaneous contamination by biofilm-producing microbes.

Conclusions:

Although all of the new technical procedures tend to reduce the amount of bacterial charge that comes into contact with the prosthesis at the time of its introduction, a minimal amount must always be taken for granted. This is the rationale for a preventative personalized antibiotic therapy.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Development and Internal Validation of the Abdominoplasty Risk Calculator
Authors: Vu Michael M. , Ellis Marco F. , Blough Jordan T. , Gutowski Karol A. , Kim John Y. S.
Published: December 2017

Background:

Risk calculators are an emerging tool that provide granular, individualized risk estimation. Presently, there is a paucity of risk calculators specific to plastic surgery. Abdominoplasty is a popular plastic surgery procedure associated with moderate risks of complications, such as surgical-site infection and dehiscence, and would benefit from the ability to provide patients with accurate, personalized risk assessment.

Methods:

Abdominoplasties from the National Surgical Quality Improvement Program 2005 to 2014 database were identified by Current Procedural Terminology code. Relevant perioperative variables included age, body mass index, sex, smoking history, diabetes, American Society of Anesthesiologists class, pulmonary comorbidities, hypertension, bleeding disorders, and operative duration. Multiple logistic regressions were used to generate 30-day risk models for medical complications, surgical-site infection, wound dehiscence, and reoperation. Internal validation of model performance was conducted using C-statistics, Hosmer-Lemeshow tests, and Brier scores.

Results:

Among the 2499 cases identified, complication rates were as follows: medical complications, 3.8 percent; superficial surgical-site infection, 2.4 percent; deep or organ-space surgical-site infection, 1.6 percent; wound dehiscence, 1.0 percent; and reoperation, 2.0 percent. Risk prediction models were constructed and all demonstrated good predictive performance, with mean predicted risks closely matching observed complication rates. The distributions of predicted risk were wide and contained outliers with very high risk. A user-friendly, open-access online interface for these models is published at AbdominoplastyRisk.org.

Conclusions:

The authors developed an internally valid risk calculator for which individual patient characteristics can be input to predict 30-day complications after abdominoplasty. Given that estimated risk can vary widely, individualized risk assessment is a way to enhance shared decision-making between surgeon and patient.
Umbilicus Reconstruction with Bilateral Square “Pumpkin-Teeth” Advancement Flaps
Authors: Purnell Chad A. , Turin Sergey Y. , Dumanian Gregory A.
Published: December 2017

The creation of a neoumbilicus is a common challenge for plastic surgeons. The authors present their technique of umbilical reconstruction with bilateral square “pumpkin-teeth” advancement flaps. The technique described is applicable in both the setting of a vertical midline incision and when no midline incision is present (e.g., an abdominoplasty). The reconstruction has been performed in over 50 patients with a vertical midline incision and five patients without a midline incision. The only complications noted were persistent serous drainage in several patients with vertical incision and inadequate depth in one patient without a midline incision. This technique is quickly performed, and avoids small flaps, external incisions, and healing by secondary intention.
The Public Face of Transplantation: The Potential of Education to Expand the Face Donor Pool
Authors: Plana Natalie M. , Kimberly Laura L. , Parent Brendan , Khouri Kimberly S. , Diaz-Siso J. Rodrigo , Fryml Elise M. , Motosko Catherine C. , Ceradini Daniel J. , Caplan Arthur , Rodriguez Eduardo D.
Published: December 2017

Background:

Despite the growing success of facial transplantation, organ donor shortages remain challenging. Educational health campaigns can effectively inform the general public and institute behavioral modifications. A brief educational introduction to facial transplantation may positively influence the public’s position on facial donation.

Methods:

The authors anonymously surveyed 300 participants, gathering basic demographic information, donor registration status, awareness of facial transplantation, and willingness to donate solid organs and facial allografts. Two-hundred of these participants were presented an educational video and subsequently resurveyed on facial donation. Factorial parametric analyses were performed to compare exposure responses before and after watching video exposure.

Results:

Among participants completing the survey alone (control group), 49 percent were registered donors, 78 percent reported willingness to donate solid organs, and 52 percent reported willingness to donate facial allograft. Of participants who watched the video (video group) 52 percent were registered; 69 and 51 percent were willing to donate solid organs and face, respectively. Following educational intervention, 69 percent of participants in the video group reported willingness to donate facial tissue, an 18 percent increase (p < 0.05), that equated to those willing to donate solid organs. The greatest increase was observed among younger participants (23 percent); women (22 percent); Jewish (22 percent), Catholic (22 percent), and black/African American (25 percent) participants; and respondents holding a higher degree. No significant differences according to gender or ethnicity were observed.

Conclusion:

Educational interventions hold much promise for increasing the general public’s awareness of facial transplantation and willingness to participate in donation of facial allografts.
State-of-the-Art Diagnosis and Treatment of Melanoma: Optimal Multidetector Computed Tomographic Practice to Identify Metastatic Disease and Review of Innovative Therapeutic Agents
Authors: Jones Blake C. , Lipson Evan J. , Childers Brandon , Fishman Elliot K. , Johnson Pamela T.
Published: December 2017

The incidence of melanoma has risen dramatically over the past several decades. Oncologists rely on the ability of radiologists to identify subtle radiographic changes representing metastatic and recurrent melanoma in uncommon locations on multidetector computed tomography (MDCT) as the front-line imaging surveillance tool. To accomplish this goal, MDCT acquisition and display must be optimized and radiologist interpretation and search patterns must be tailored to identify the unique and often subtle metastatic lesions of melanoma. This article describes MDCT acquisition and display techniques that optimize the visibility of melanoma lesions, such as high-contrast display windows and multiplanar reconstructions. In addition, innovative therapies for melanoma, such as immunotherapy and small-molecule therapy, have altered clinical management and outcomes and have also changed the spectrum of therapeutic complications that can be detected on MDCT. Recent advances in melanoma therapy and potential complications that the radiologist can identify on MDCT are reviewed.
Inflammatory Pseudotumor-Like Follicular Dendritic Cell Sarcoma of the Spleen: Computed Tomography Imaging Characteristics in 5 Patients
Authors: Li Xiumei , Shi Zhenshan , You Ruixiong , Li Yueming , Cao Dairong , Lin Renjie , Huang Xinming
Published: December 2017

Objectives

The purpose of this study was to retrospectively review the computed tomography (CT) and clinicopathological characteristics of inflammatory pseudotumor (IPT)-like follicular dendritic cell sarcoma (FDCS) of the spleen in 5 patients.

Methods

Clinical, pathologic, and CT imaging findings of 5 patients with IPT-like FDCS of the spleen were reviewed and analyzed. Computed tomography imaging and pathologic features were compared.

Results

Abdominal unenhanced CT revealed a well-defined hypodense mass in the spleen with complex internal architecture with focal necrosis and/or speckle-strip calcification. On postcontrast CT, slightly delayed enhancement was observed in 5 cases. Four patients had a normalized spleen. The fourth patient had lung metastasis. The fifth patient had 2 relatively small lesions as well as metastases to the spine.

Conclusions

Computed tomography imaging features of IPT-like FDCS of the spleen are distinctly different from other hypovascular splenic neoplasm; however, the definitive diagnosis requires further confirmation with needle biopsy or surgery. Inflammatory pseudotumor-like FDCS of the spleen should be suggested by using the CT imaging features of the splenic mass with evidence of metastatic disease.
2-Hydroxyglutarate Detection by Short Echo Time Magnetic Resonance Spectroscopy in Routine Imaging Study of Brain Glioma at 3.0 T
Authors: Crisi Girolamo , Filice Silvano , Michiara Maria , Crafa Pellegrino , Lana Silvia
Published: December 2017

Objective

The objective of this study was to assess the effective performance of short echo time magnetic resonance spectroscopy (short TE MRS) for 2HG detection as biomarker of isocitrate dehydrogenase (IDH) status in all grade glioma (GL).

Methods

A total of 82 GL patients were prospectively investigated by short TE MRS at 3.0 T as part of a multimodal magnetic resonance imaging study protocol. Spectral analysis was performed using linear combination model. Tumor specimens were diagnosed as IDH mutant or wild type according to the 2016 World Health Organization (WHO) classification of brain tumors. Spectra were analyzed for the presence of 2HG. The performance of short TE MRS was evaluated in terms of sensitivity, specificity, and positive and negative likelihood ratio on the overall sample and on GL WHO grades II and III and glioblastoma separately.

Results

The specificity and sensitivity estimated on the overall sample were 88% and 77%, respectively. In GL WHO grades II and III, 100% specificity and 75% sensitivity were estimated.

Conclusions

We reiterate the feasibility to identify IDH status of brain GL using short TE MRS at 3.0 T. The method can correctly detect 2HG as expression of IDH mutation in WHO grades II and III GL with a 100% specificity but a 75% sensitivity. In the evaluation of glioblastoma, short TE MRS performs poorly having a 17% false positive rate.
Evaluating Resident Perspectives on International Humanitarian Missions
Authors: Chetta Matthew D. , Shakir Afaaf , Paek Laurence S. , Lee Gordon K.
Published: December 2017

Background:

Opportunities for international missions are highly sought after by medical students, residents, and attending plastic surgeons. The educational benefits and ethical considerations of trainees participating in these ventures have been extensively debated. At the time of this writing, many surgical training programs lack the necessary infrastructure or funds to support missions of this sort. Despite the increasing interest, the perceived benefit of international work has not yet been well studied. The authors seek to evaluate residents’ perspectives on the personal and educational benefits of international mission work.

Methods:

A 24-item online questionnaire was designed to measure residents’ perspectives on humanitarian missions. Residents’ perceptions on how participation in these missions may have influenced their career path were also evaluated. This questionnaire was disseminated to the plastic surgery residents in Accreditation Council for Graduate Medical Education (ACGME) accredited programs in the United States during the 2015 to 2016 academic year.

Results:

Of the 123 responses collected, 49 (40%) indicated that they had participated in international mission work prior to beginning residency, while 74 (60%) had not. Fifty-seven percent (n = 25) of those who had participated agreed that this experience impacted their choice to pursue plastic surgery as a specialty. Twenty-nine (24%) participated in 1 or more missions during residency. The most common type of mission work focused on cleft lip/palate repairs (n = 24) followed by nonsurgical medical relief (n = 18) and general plastics/combined (n = 6). Most respondents reported trips lasting 6 to 8 days (n = 29, 48%), though several reported trips lasting 9 to 10 days (n = 6, 10%) and 11 days or more (n = 16, 27%). When asked about the volume of procedures performed, 32 (65%) reported participating in more than 15 procedures, with 15 (31%) residents reporting participation in 26 procedures or more. When asked to evaluate the educational benefits in light of the 6 core competencies from the ACGME, there was an overwhelmingly positive response.

Conclusions:

Residents perceive international mission experiences to be valuable for professional development as well as an effective tool for surgical education, particularly in the setting of competency-based education goals and these ventures should be supported by training programs. An appropriately planned mission experience can impact the professional and educational development of the trainee.
Piezosurgery for Treatment of Large Recurrent Mandibular Osteoma
Authors: Hernando Josué , Aguilar-Salvatierra Antonio , Leizaola-Cardesa Ignacio Osoitz , Seijas Pedro Martínez , Aguirre-Echebarria Pablo , Martín Javier , Gómez-Moreno Gerardo
Published: December 2017

Background:

Osteomas are infrequent benign bone tumors of uncertain etiology. They are usually situated at extremities and their occurrence in the jaws is relatively rare. There are 3 types of osteoma: central, peripheral, and extraskeletal. Preoperative presumptive diagnosis is performed by means of radiography using orthopantomographs, computerized tomographs, or cone beam scans. Treatment is surgical and consists of careful exeresis and curettage of the adjacent tissue. In recent years, piezoelectric surgery has been used to treat bone pathologies in the maxillofacial area, orthopedic surgery, and neurosurgery. When used for the exeresis of a bone lesion, the device minimizes risks and eliminates possible complications arising from affectation of the vascular and nerve structures close to the lesion.

Objective:

This clinical report describes a peripheral mandibular osteoma situated in the left mandibular basilar which recurred 45 years after surgical treatment at another center.

Methods:

For resection, the surgical approach followed the scar remaining from the earlier surgery and was performed using piezoelectric surgery. Surgery did not cause hemorrhagic complications, affect the sensitivity of the left labial menton, or cause paralysis of the lower lip.

Conclusions:

Based on the present patient, it may be concluded that mandibular osteoma treatment by means of piezoelectric surgery makes precise exeresis possible with less affectation of the important surrounding structures such as the inferior alveolar nerve and the marginal mandibular branch of the facial nerve.
A Patient With Submerged Sinonasal Angiosarcoma After Resection of Underlying Organizing Hematoma
Authors: Chung Hyo Jin , Koh Myoung Ju , Kim Chang-Hoon , Chang Jung Hyun
Published: December 2017

A 30-year-old female patient with facial pain diagnosed as organizing hematoma of maxillary sinus by biopsy and imaging studies, and subsequently tumor was resected via an endoscope-assisted midfacial degloving approach. The tumor was histopathologically confirmed as organizing hematoma. In 3-week follow-up, asymptomatic emerging mass was observed at the same site, and needed a revision endoscopic resection. On pathologic examination, a low-grade angiosarcoma was identified, not organizing hematoma. After postoperative radiotherapy, she has been a status of no evidence of disease. This report emphasizes that complete and delicate resection of sinonasal tumor should be made to prevent recurrence and submerged malignant potential.
Rabdomyosarcoma of the Mandible: An Uncommon Clinical Presentation
Authors: Andrade Cleverton Roberto de , Trento Guilherme dos Santos , Jeremias Fabiano , Giro Elisa Maria Aparecida , Gabrielli Marisa Aparecida Cabrini , Gabrielli Mario Francisco Real , Almeida Oslei Paes de , Pereira-Filho Valfrido Antonio
Published: December 2017

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children and adolescents. Most patients present with a mass in the head and neck region, urogenital region, or with distal extremity involvement. The authors describe a challenging case of a 6-year-old male patient presenting with mandibular RMS. The clinical/radiographic/tomographic evaluations classified the tumor as an advanced stage (stage IV), with a mass of 6.0 cm involving the left side of the mandible and parotid region. The biopsy revealed round, spindled, and pleomorphic cells with hyperchromatic nuclei and rare larger rhabdomyoblasts with eosinophilic cytoplasm. The diagnosis was of embryonal RMS. The patient was referred for treatment with cycles of chemotherapy; however, pulmonary and bone marrow metastasis were identified. Radiotherapy and local surgery with microvascular reconstruction were performed later; however, the patient died after a few months. Early diagnosis is critical for a good prognosis and cure of patients with RMS. Correct diagnosis considering also the histological subtype is important for adequate treatment, which according to the literature is not uniform probably because of the rarity of this neoplasm.
Fine-grained habitat-associated genetic connectivity in an admixed population of mussels in the small isolated Kerguelen Islands
Authors: Fraïsse Christelle , Haguenauer Anne , Gérard Karin , Anh-Thu Weber Alexandra , Bierne Nicolas , Chenuil Anne
Published: December 2017

Reticulated evolution -i.e. secondary introgression / admixture between sister taxa-is increasingly recognized as playing a key role in structuring infra-specific genetic variation and revealing cryptic genetic connectivity patterns. When admixture zones coincide with ecological transitions, the connectivity patterns often follow environmental variations better than distance and introgression clines may easily be confounded with local adaptation signatures. The Kerguelen mussels is an ideal system to investigate the potential role of admixture in enhancing micro-geographic structure, as they inhabit a small isolated island in the Southern Ocean characterized by a highly heterogeneous environment. Furthermore, genomic reticulation between Northern species (M. edulis, M. galloprovincialis and M. trossulus) and Southern species (M. platensis: South America and the Kerguelen Islands; and M. planulatus: Australasia) has been suspected. Here, we extended a previous analysis by using targeted-sequencing data (51,878 SNPs) across the three Northern species and the Kerguelen population. Spatial structure in the Kerguelen was then analyzed with a panel of 33 SNPs, including SNPs that were more differentiated than the genomic average between Northern species (i.e., ancestry-informative SNPs). We first showed that the Kerguelen lineage splitted very shortly after M. edulis and M. galloprovincialis initiated speciation, and it subsequently experienced admixture with the three Northern taxa. We then demonstrated that the Kerguelen mussels were significantly differentiated over small spatial distance, and that this local genetic structure was associated with environmental variations and mostly revealed by ancestry-informative markers. Simulations of admixture in the island highlight that genetic-environment associations can be better explained by introgression clines between heterogeneously differentiated genomes than by adaptation.
Image-based tracking of ripening in wheat cultivar mixtures: a quantifying approach parallel to the conventional phenology
Authors: Haghshenas Abbas , Emam Yahya
Published: December 2017

The lack of quantitative methods independent of the conventional qualitative phenology, may be a vital limiting factor to evaluate the temporal trends in the crop growth cycle, particularly in the heterogeneous canopies of cultivar mixtures. A digital camera used to take ground-based nadir images during two years of a field experiment conducted at the College of Agriculture, Shiraz University, Iran; in 2014-15 and 2015-16. The experimental treatments consisted of 4 early- to middle-ripening wheat cultivars and their 10 mixtures, under post-anthesis well- and deficit-irrigation conditions, arranged in a randomized complete block design with 3 replicates. Then the images were processed and three image-derived indices including CC (canopy cover), GR [(G-R/G); RGB color system], and CCGR (CC×GR) were used as the quantifying criteria. The declining trends of these indices during ripening showed strong fits to binomial equations, based on which simple prediction models were suggested and validated. Furthermore, the split linear trends and their slopes were estimated to assess the short-term variations. Some agronomic aspects were also evidenced using the mixtures-monoculture diversions, and the relationship between CC and GR. The frameworks evaluated appears to provide the reliable and simple solutions for quantifying the crop temporal trends parallel to the conventional phenology.
Role of the Visual Experience-Dependent Nascent Proteome in Neuronal Plasticity
Authors: Liu Han-Hsuan , McClatchy Daniel , Schiapparelli Lucio , Shen Wanhua , Yates John R , Cline Hollis T.
Published: December 2017

Experience-dependent synaptic plasticity refines brain circuits during development. To identify novel protein synthesis-dependent mechanisms contributing to experience-dependent plasticity, we conducted a quantitative proteomic screen of the nascent proteome in response to visual experience in Xenopus optic tectum using bio-orthogonal metabolic labeling (BONCAT). We identified 83 differentially synthesized candidate plasticity proteins (CPPs). The CPPs form strongly interconnected networks and are annotated to a variety of biological functions, including RNA splicing, protein translation, and chromatin remodeling. Functional analysis of select CPPs revealed the requirement for eukaryotic initiation factor 3 subunit A (eIF3A), fused in sarcoma (FUS), and ribosomal protein s17 (RPS17) in experience-dependent structural plasticity in tectal neurons and behavioral plasticity in tadpoles. These results demonstrate that the nascent proteome is dynamic in response to visual experience and that de novo synthesis of machinery that regulates RNA splicing and protein translation is required for experience-dependent plasticity.
Cell-autonomous regulation of structural and functional plasticity in inhibitory neurons by excitatory synaptic inputs
Authors: He Hai-yan , Shen Wanhua , Zheng Lijun , Guo Xia , Cline Hollis T.
Published: December 2017

Functional circuit assembly is thought to require coordinated development of excitation and inhibition, but whether they are co-regulated cell-autonomously remains unclear. We investigated effects of decreased glutamatergic synaptic input on inhibitory synapses by expressing AMPAR subunit, GluA1 and GluA2, C-terminal peptides (GluA1CTP and GluA2CTP) in developing Xenopus tectal neurons. GluACTP decreased excitatory synaptic inputs and cell-autonomously decreased inhibitory synaptic inputs in excitatory and inhibitory neurons. Visually-evoked excitatory and inhibitory currents decreased proportionately, maintaining excitation/inhibition. GluACTP affected dendrite structure and visual experience-dependent structural plasticity differently in excitatory and inhibitory neurons. Deficits in excitatory and inhibitory synaptic transmission and experience-dependent plasticity manifested in altered visual receptive field properties. Both visual avoidance behavior and learning-induced behavioral plasticity were impaired, suggesting that maintaining excitation/inhibition alone is insufficient to preserve circuit function. We demonstrate that excitatory synaptic dysfunction in individual neurons cell-autonomously decreases inhibitory inputs and disrupts neuronal and circuit plasticity, information processing and learning.
Quantitative Analysis on the role ofRaffinose Synthasein Hippocampal Neurons
Authors: Singh Shatrunjai P. , Singh Vijendra P.
Published: December 2017

1

A diminished level of endogenous antioxidant in cells/tissues is associated with reduced resistance to oxidative stress. Raffinose synthase (RFS), a protective molecule regulates gene expression/function by controlling reactive oxygen species (ROS) levels, which has shown to be involved in a number of degenerative diseases. We confirmed the ubiquitous expression of this antioxidant protein in both human hippocampal neuron (HNN) and mouse hippocampal (HHPC-43) cell lines by an immunoblot and reverse transcriptase PCR (RT-PCR). Using a construct of RFS protein linked to CXCR-4, the transduction domain from HPV-1 CXCR-4 protein, we showed that RFS was transduced into both HNN, as well as HHPC-43 by the means of a western blot analysis. Further we proved that the protein was biologically active, and was shown to actively reduce the oxidative stress produced byparaquatand serum depletion in both human and mouse neuronal cell lines, increasing the viability of the cells. The results suggest that the intracellular delivery of RFS using CXCR-4 can be used to lower increased levels of ROS inside the cells and hence can be further investigated as a therapeutic tool in various ROS related neurodegenerative disorders.