bluuebunny/crossref_metadata_2025 huggingface dataset:
Alteration of flavonoid pigmentation patterns during domestication of food crops
Authors: Paauw Misha , Koes Ronald , Quattrocchio Francesca M
Published: March 2019

Flavonoids are plant pigments that provide health benefits for human and animal consumers. Understanding why domesticated crops have altered pigmentation patterns and unraveling the molecular/genetic mechanisms that underlie this will facilitate the breeding of new (healthier) varieties. We present an overview of changes in flavonoid pigmentation patterns that have occurred during crop domestication and, where possible, link them to the molecular changes that brought about the new phenotypes. We consider species that lost flavonoid pigmentation in the edible part of the plant at some point during domestication (like cereals). We also consider the converse situation, for example eggplant (aubergine), which instead gained strong anthocyanin accumulation in the skin of the fruit during domestication, and some varieties of citrus and apple that acquired anthocyanins in the fruit flesh. Interestingly, the genes responsible for such changes are sometimes closely linked to, or have pleiotropic effects on, important domestication genes, suggesting accidental and perhaps inevitable changes of anthocyanin patterning during domestication. In other cases, flavonoid pigmentation patterns in domesticated crops are the result of cultural preferences, with examples being found in varieties of citrus, barley, wheat, and maize. Finally, and more recently, in some species, anthocyanins seem to have been the direct target of selection in a second wave of domestication that followed the introduction of industrial food processing.
Aethionema arabicum: a novel model plant to study the light control of seed germination
Authors: Mérai Zsuzsanna , Graeber Kai , Wilhelmsson Per , Ullrich Kristian K , Arshad Waheed , Grosche Christopher , Tarkowská Danuše , Turečková Veronika , Strnad Miroslav , Rensing Stefan A , Leubner-Metzger Gerhard , Mittelsten Scheid Ortrun
Published: March 2019

The timing of seed germination is crucial for seed plants and is coordinated by internal and external cues, reflecting adaptations to different habitats. Physiological and molecular studies with lettuce and Arabidopsis thaliana have documented a strict requirement for light to initiate germination and identified many receptors, signaling cascades, and hormonal control elements. In contrast, seed germination in several other plants is inhibited by light, but the molecular basis of this alternative response is unknown. We describe Aethionema arabicum (Brassicaceae) as a suitable model plant to investigate the mechanism of germination inhibition by light, as this species has accessions with natural variation between light-sensitive and light-neutral responses. Inhibition of germination occurs in red, blue, or far-red light and increases with light intensity and duration. Gibberellins and abscisic acid are involved in the control of germination, as in Arabidopsis, but transcriptome comparisons of light- and dark-exposed A. arabicum seeds revealed that, upon light exposure, the expression of genes for key regulators undergo converse changes, resulting in antipodal hormone regulation. These findings illustrate that similar modular components of a pathway in light-inhibited, light-neutral, and light-requiring germination among the Brassicaceae have been assembled in the course of evolution to produce divergent pathways, likely as adaptive traits.
Key changes in gene expression identified for different stages of C4 evolution in Alloteropsis semialata
Authors: Dunning Luke T , Moreno-Villena Jose J , Lundgren Marjorie R , Dionora Jacqueline , Salazar Paolo , Adams Claire , Nyirenda Florence , Olofsson Jill K , Mapaura Anthony , Grundy Isla M , Kayombo Canisius J , Dunning Lucy A , Kentatchime Fabrice , Ariyarathne Menaka , Yakandawala Deepthi , Besnard Guillaume , Quick W Paul , Bräutigam Andrea , Osborne Colin P , Christin Pascal-Antoine
Published: March 2019

C4 photosynthesis is a complex trait that boosts productivity in tropical conditions. Compared with C3 species, the C4 state seems to require numerous novelties, but species comparisons can be confounded by long divergence times. Here, we exploit the photosynthetic diversity that exists within a single species, the grass Alloteropsis semialata, to detect changes in gene expression associated with different photosynthetic phenotypes. Phylogenetically informed comparative transcriptomics show that intermediates with a weak C4 cycle are separated from the C3 phenotype by increases in the expression of 58 genes (0.22% of genes expressed in the leaves), including those encoding just three core C4 enzymes: aspartate aminotransferase, phosphoenolpyruvate carboxykinase, and phosphoenolpyruvate carboxylase. The subsequent transition to full C4 physiology was accompanied by increases in another 15 genes (0.06%), including only the core C4 enzyme pyruvate orthophosphate dikinase. These changes probably created a rudimentary C4 physiology, and isolated populations subsequently improved this emerging C4 physiology, resulting in a patchwork of expression for some C4 accessory genes. Our work shows how C4 assembly in A. semialata happened in incremental steps, each requiring few alterations over the previous step. These create short bridges across adaptive landscapes that probably facilitated the recurrent origins of C4 photosynthesis through a gradual process of evolution.
Widespread Pressure Pain Hyperalgesia Is Not Related to Pain in Patients with Parkinson’s Disease
Authors: Ferreira-Sánchez María R , Moreno-Verdú Marcos , Cano-de-la-Cuerda Roberto , Fernández-de-las-Peñas César , Güeita-Rodríguez Javier , Ortega-Santiago Ricardo
Published: March 2019

Objective

Pain is one of the most frequent nonmotor impairments in Parkinson’s disease (PD) and is hypothesized to be associated with altered nociceptive pain processing. Our aims were to investigate differences in widespread pressure pain sensitivity between PD patients with and without pain and healthy controls and to assess the relationship of health-related quality of life and sleep quality with pressure pain sensitivity.

Methods

Nineteen PD patients with pain (12 men, age = 68 ± 9 years), 19 PD patients without pain (11 men, age = 69 ± 8 years), and 19 matched controls participated. Pressure pain thresholds (PPTs) were assessed bilaterally over the cervical spine, the second metacarpal, and the tibialis anterior by an assessor blinded to the subject’s condition. Patients were assessed in a dopamine-medicated (ON) state. Pain intensity (numerical pain rating scale, 0–10), health-related quality of life (39-item Parkinson’s Disease Questionnaire), and sleep quality (Pittsburgh Sleep Quality Index) were also assessed.

Results

No significant differences existed between PD patients, with or without pain, and healthy controls on PPTs over the cervical spine, the second metacarpal, or the tibialis anterior muscle (all P > 0.3). PPTs were lower in females than in males in all groups (P < 0.01). In PD patients with pain, worse quality of sleep was associated with higher widespread pressure pain sensitivity (–0.607 < r < –0.535, P < 0.05). No other significant association was observed.

Conclusions

This study revealed no differences in widespread pressure hyperalgesia between PD patients with or without pain (ON state) and controls. Although dopamine may modulate pain responses, other mechanisms seems to also be implicated in altered nociceptive pain processing in patients with PD.
Early use of alcohol associated with sociodemographic, nutritional and lifestyle factors: survival analysis with Brazilian students
Authors: Pinto T J P , Mendonça E P , Bloch K V , Cunha G M , Coutinho E S F
Published: March 2019

Background

To evaluate the early age of onset (AOO) of alcohol consumption and its association with sociodemographic, nutritional and lifestyle characteristics.

Methods

A national cross-sectional multi-centered study assessed 12–17-year old adolescents from 1247 public and private schools in 124 Brazilian municipalities with more than 100 000 habitants. Our variable of interest was the AOO of alcohol consumption. Covariates comprised sociodemographic status, lifestyle habits and nutritional parameters. We used adapted survival models to investigate the association between covariates and the AOO of alcohol consumption.

Results

From a sample of 67 672 adolescents, 50% were females. The mean AOO of alcohol consumption was 12.9 years. Male adolescents had a lower mean age of alcohol experimentation when compared to females in Northeast and South regions. The difference between private and public school for AOO was observed only for the Northeast Region (12.6 versus 13.1, respectively). Adolescents who reported smoking or mental health problems or from the Southern Region presented earlier alcohol use. Physical activity and overweight were positively associated with earlier use of alcohol.

Conclusions

There is no homogeneity in the AOO of alcohol consumption among adolescents, which should be considered when formulating public policies and government campaigns directed toward reducing alcohol consumption.
Is NPP proportional to GPP? Waring’s hypothesis 20 years on
Authors: Collalti A , Prentice I C
Published: March 2019

Gross primary production (GPP) is partitioned to autotrophic respiration (Ra) and net primary production (NPP), the latter being used to build plant tissues and synthesize non-structural and secondary compounds. Waring et al. (1998; Net primary production of forests: a constant fraction of gross primary production? Tree Physiol 18:129–134) suggested that a NPP:GPP ratio of 0.47 ± 0.04 (SD) is universal across biomes, tree species and stand ages. Representing NPP in models as a fixed fraction of GPP, they argued, would be both simpler and more accurate than trying to simulate Ra mechanistically. This paper reviews progress in understanding the NPP:GPP ratio in forests during the 20 years since the Waring et al. paper. Research has confirmed the existence of pervasive acclimation mechanisms that tend to stabilize the NPP:GPP ratio and indicates that Ra should not be modelled independently of GPP. Nonetheless, studies indicate that the value of this ratio is influenced by environmental factors, stand age and management. The average NPP:GPP ratio in over 200 studies, representing different biomes, species and forest stand ages, was found to be 0.46, consistent with the central value that Waring et al. proposed but with a much larger standard deviation (±0.12) and a total range (0.22–0.79) that is too large to be disregarded.
Associations Between Sleep Disturbance and Chronic Pain Intensity and Function
Authors: Burgess Helen J. , Burns John W. , Buvanendran Asokumar , Gupta Rajnish , Chont Melissa , Kennedy Mary , Bruehl Stephen
Published: March 2019

Objectives:

Sleep disturbance and chronic pain are related. The present study evaluated both direct and indirect (mediated) pathways through which sleep disturbance might be related to chronic pain intensity and function.

Methods:

In total, 87 individuals (64% female) with chronic low back pain but not using opioids daily completed questionnaires assessing their sleep disturbance, chronic pain intensity, function, depression, anxiety, positive affect, and catastrophizing.

Results:

Greater sleep disturbance was associated with greater pain intensity, worse function, greater emotional distress, lower positive affect, and higher levels of catastrophizing. Cross-sectional mediation analyses revealed that the positive associations between sleep disturbance and chronic pain intensity were conveyed statistically not only by significant indirect effects of elevated emotional distress, lower positive affect, and greater catastrophizing associated with sleep disturbance, but also by significant direct effects of sleep disturbance on chronic pain intensity. Similarly, we found that the associations between sleep disturbance and impaired function were conveyed statistically not only by significant indirect effects of elevated chronic pain intensity associated with sleep disturbance, but also by significant direct effects of sleep disturbance on function.

Discussion:

Sleep disturbance was related significantly with chronic pain intensity and function by both direct and indirect pathways. These results are consistent with an emerging literature highlighting the potential significance of sleep disturbance in chronic pain patients, and provide further support for addressing sleep disturbance in the assessment and management of chronic pain.
Three-Dimensional–Printed Uterine Model for Surgical Planning of a Cesarean Delivery Complicated by Multiple Myomas
Authors: Mackey Amy , Ng Joshua I. , Core Jason , Nguyen Linh , Cross Devon , Lim Philip , Woodfield Courtney , Pugliese Robert , Ku Bon
Published: March 2019

BACKGROUND:

Uterine myomas encountered at cesarean delivery increase the complexity and risk of the procedure. Preoperative planning of such deliveries may help optimize patient outcomes. The application of three-dimensional printing technology is rapidly expanding in many surgical specialties. We created a three-dimensional–printed model from the magnetic resonance images (MRIs) of a gravid uterus with multiple myomas for surgical planning of cesarean delivery.

INSTRUMENT:

A three-dimensional–printed uterine model from MRIs of a pregnant patient with multiple uterine myomas as a tool for planning cesarean delivery.

EXPERIENCE:

A 33-year-old woman with a myomectomy history presented to our institution for prenatal care. Initial ultrasound imaging revealed multiple uterine myomas. A three-dimensional–printed uterine model, based on subsequent MRI, was created for presentation at an obstetric multidisciplinary meeting. The model accurately represented the number, size, and locations of uterine myomas, aiding surgical planning, including skin and uterine incisions. At the time of cesarean delivery, the model was directly correlated with patient anatomy to further determine the optimal placement of uterine incision. Maternal and fetal outcomes were excellent.

CONCLUSION:

Three-dimensional–printed models, through improved surgical planning, could optimize outcomes for patients with uterine myomas undergoing cesarean delivery.
Etonogestrel Subdermal Implant–Associated Regression of Endometrial Intraepithelial Neoplasia
Authors: Wong Sunnie , Naresh Amber
Published: March 2019

BACKGROUND:

Endometrial intraepithelial neoplasia is a precursor lesion to endometrial adenocarcinoma. Total hysterectomy is the preferred management, but systemic or locally acting progestin therapies are acceptable alternatives. The use of the etonogestrel subdermal implant for treatment of endometrial intraepithelial neoplasia has not been studied.

CASE:

A 36-year-old woman, G2P2002, with obesity presented with abnormal uterine bleeding. Her endometrial specimen demonstrated endometrial intraepithelial neoplasia. She declined both hysterectomy and conventional medical management. The etonogestrel implant was offered as an alternative to no treatment. After etonogestrel implant insertion, serial biopsies showed regression of endometrial intraepithelial neoplasia. Sixteen months after implant insertion, biopsy showed inactive and atrophic endometrium.

CONCLUSION:

The etonogestrel subdermal implant should be considered for further study for the treatment of endometrial intraepithelial neoplasia in women who decline surgical management.
Importance of Estimated Blood Loss in Resource Utilization and Complications of Hysterectomy for Benign Indications
Authors: English Emily M. , Bell Sarah , Kamdar Neil S. , Swenson Carolyn W. , Wiese Hallie , Morgan Daniel M.
Published: March 2019

OBJECTIVE:

To identify the variation in estimated blood loss at the time of hysterectomy for benign indications and to analyze how blood loss is associated with measures of resource utilization and complications.

METHODS:

We conducted a retrospective cohort study and analyzed hysterectomy for benign indications at hospitals in the Michigan Surgical Quality Collaborative between January 1, 2013, and May 30, 2015. A sensitivity analysis was performed to identify how estimated blood loss was associated with measures of utilization (transfusion, readmission, reoperation, and length of stay) and postoperative complications. A hierarchical logistic regression model was used to identify patient level factors independently associated with estimated blood loss greater than 400 mL and to calculate a risk- and reliability-adjusted rate for each hospital.

RESULTS:

There were 18,033 hysterectomies for benign indications from 61 hospitals included for analysis. The median estimated blood loss was 100 mL, and the 90th percentile estimated blood loss was 400 mL. A sensitivity analysis demonstrated increased risks of transfusion, readmission, reoperation, length of stay, and major postoperative complications with estimated blood loss greater than 400 mL. The proportion of hysterectomies at hospitals in the collaborative with estimated blood loss greater than 400 mL ranged from 3.5% to 16.9% after risk and reliability adjustments. The risk factors with the highest adjusted odds for estimated blood loss greater than 400 mL included abdominal surgery compared with laparoscopic hysterectomy (adjusted odds ratio [aOR] 2.8, CI 2.3–3.5), surgical time longer than 3 hours (aOR 3.9, CI 3.3–4.5), and specimen weight greater than 250 g compared with less than 100 g (aOR 4.8, CI 3.9–5.8). Adhesive disease, low surgeon volume, being younger than 40 years of age, having a body mass index greater than 35, and the need for a preoperative transfusion were also statistically significantly associated with estimated blood loss greater than 400 mL.

CONCLUSION:

There is fivefold variation in the hospital rate of hysterectomies with an estimated blood loss greater than 400 mL (90th percentile)—a threshold associated with significantly higher rates of health care utilization and complications. Avoidance of abdominal hysterectomy when possible may reduce intraoperative blood loss and associated sequelae.
Wound Complication Rates After Vulvar Excisions for Premalignant Lesions
Authors: Mullen Mary M. , Merfeld Emily C. , Palisoul Marguerite L. , Massad L. Stewart , Woolfolk Candice , Powell Matthew A. , Mutch David G. , Thaker Premal H. , Hagemann Andrea R. , Kuroki Lindsay M.
Published: March 2019

OBJECTIVE:

To assess the rate of wound complications and evaluate the effectiveness of antibiotic prophylaxis in vulvar wide local excision procedures.

METHODS:

We performed a single-institution, retrospective cohort study of women undergoing vulvar surgery for premalignant lesions between January 2007 and January 2017. The primary outcome was a composite wound complication rate that included breakdown or infection within 8 weeks postoperatively. Data were analyzed using Fisher exact or χ2 test, Student t-test, and Poisson regression.

RESULTS:

Wound complications occurred in 154 (28.7%) of the 537 patients. Mean age was 52 years; most patients were white (83.1%), cigarette smokers (65.2%), had no prior vulvar treatment (54.4%), and had a preoperative diagnosis of high-grade squamous intraepithelial lesion (vulvar HSIL) (70.0%). The presence of other predisposing factors was similar between groups. In multivariate analysis, smoking (odds ratio [OR] 1.64, 95% CI 1.14–2.38) and primary rather than repeat vulvar surgery (OR 1.99, 95% CI 1.31–3.01) were associated with increased risk for wound complications. There was no significant difference in wound complications between women who received preoperative antibiotics and those who did not (30.4% vs 27.4%, P=.45), although the mean length of wound separation in the antibiotic group was shorter (1 vs 2 cm, P=.03).

CONCLUSION:

Wound complications are common among women undergoing surgery for vulvar HSIL, and interventional trials are warranted to evaluate the role of smoking cessation and prophylactic antibiotics to reduce postoperative morbidity.
Quantification of Risk Factors for Cervical Ossification of the Posterior Longitudinal Ligament in Korean Populations
Authors: Shin Jaeyong , Choi Ja Young , Kim Yong Wook , Chang Jee Suk , Yoon Seo Yeon
Published: March 2019

Study Design.

Case-control study.

Objective.

To quantify risk factors for cervical ossification of the posterior longitudinal ligament (OPLL) using a large nationwide cohort in Korea, a country with a high prevalence of OPLL.

Summary of Background Data.

OPLL is a pathological calcification of the posterior longitudinal ligament of the spine. OPLL progression can cause spinal cord injury that results in disability. Considering neurologic deficits and disability caused by OPLL, identifying OPLL risk factors for early prediction have important health benefits.

Methods.

The nationwide population-based matched cohort study was conducted using the Korean National Health Insurance Service cohort data. We selected patients with a primary diagnosis of OPLL involving cervical lesion (International Classification of Diseases-10 code: M48.82, M48.83). A matched cohort without cervical OPLL was enrolled by randomly matching patients by sex, age, year of diagnosis, and residential area to the OPLL group with a ratio of 1:9. Logistic regression analyses were performed to identify risk associated with OPLL development using odds ratios (OR) and 95% confidence intervals (CI).

Results.

Comorbidities, such as hypertension (OR = 1.283, 95% CI 1.071–1.538), ischemic stroke (OR = 1.386, 95% CI 1.017–1.889), diabetes mellitus (OR = 1.331, 95% CI 1.098–1.615), hypothyroidism (OR = 1.562, 95% CI 1.165–2.094), and osteoporosis (OR = 1.456, 95% CI 1.151–1.842), were significantly associated with the prospective development of OPLL, with low predictive value.

Conclusion.

OPLL was significantly associated with comorbidities such as hypertension, ischemic stroke diabetes mellitus, hypothyroidism, and osteoporosis. Our findings can provide helpful information for OPLL prediction and offer important health benefits.

Level of Evidence: 3
Development of Deployable Predictive Models for Minimal Clinically Important Difference Achievement Across the Commonly Used Health-related Quality of Life Instruments in Adult Spinal Deformity Surgery
Authors: Ames Christopher P. , Smith Justin S. , Pellisé Ferran , Kelly Michael P. , Gum Jeffrey L. , Alanay Ahmet , Acaroğlu Emre , Pérez-Grueso Francisco Javier Sánchez , Kleinstück Frank S. , Obeid Ibrahim , Vila-Casademunt Alba , Burton Douglas C. , Lafage Virginie , Schwab Frank J. , Shaffrey Christopher I. , Bess Shay , Serra-Burriel Miquel
Published: March 2019

Study Design.

Retrospective analysis of prospectively-collected, multicenter adult spinal deformity (ASD) databases.

Objective.

To predict the likelihood of reaching minimum clinically important differences in patient-reported outcomes after ASD surgery.

Summary of Background Data.

ASD surgeries are costly procedures that do not always provide the desired benefit. In some series only 50% of patients achieve minimum clinically important differences in patient-reported outcomes (PROs). Predictive modeling may be useful in shared-decision making and surgical planning processes. The goal of this study was to model the probability of achieving minimum clinically important differences change in PROs at 1 and 2 years after surgery.

Methods.

Two prospective observational ASD cohorts were queried. Patients with Scoliosis Research Society-22, Oswestry Disability Index , and Short Form-36 data at preoperative baseline and at 1 and 2 years after surgery were included. Seventy-five variables were used in the training of the models including demographics, baseline PROs, and modifiable surgical parameters. Eight predictive algorithms were trained at four-time horizons: preoperative or postoperative baseline to 1 year and preoperative or postoperative baseline to 2 years. External validation was accomplished via an 80%/20% random split. Five-fold cross validation within the training sample was performed. Precision was measured as the mean average error (MAE) and R2 values.

Results.

Five hundred seventy patients were included in the analysis. Models with the lowest MAE were selected; R2 values ranged from 20% to 45% and MAE ranged from 8% to 15% depending upon the predicted outcome. Patients with worse preoperative baseline PROs achieved the greatest mean improvements. Surgeon and site were not important components of the models, explaining little variance in the predicted 1- and 2-year PROs.

Conclusion.

We present an accurate and consistent way of predicting the probability for achieving clinically relevant improvement after ASD surgery in the largest-to-date prospective operative multicenter cohort with 2-year follow-up. This study has significant clinical implications for shared decision making, surgical planning, and postoperative counseling.

Level of Evidence: 4
The Relationship Between Endplate Pathology and Patient-reported Symptoms for Chronic Low Back Pain Depends on Lumbar Paraspinal Muscle Quality
Authors: Bailey Jeannie F. , Fields Aaron J. , Ballatori Alex , Cohen Danielle , Jain Deeptee , Coughlin Dezba , O’Neill Conor , McCormick Zachary , Han Misung , Krug Roland , Demir-Deviren Sibel , Lotz Jeffrey C.
Published: March 2019

Study Design.

Cross-sectional cohort study of chronic low back pain (CLBP) patients and matched controls.

Objective.

To explore the interplay between vertebral endplate damage and adjacent paraspinal muscle (PSM) quality, and to test their association in a cohort of patients with CLBP and matched controls.

Summary of Background Data.

Nonspecific CLBP is challenging to diagnose, in part, due to uncertainty regarding the source of pain. Delineating interactions among potential CLBP mechanisms may enhance diagnosis and treatment customization.

Methods.

We collected advanced MRI imaging on 52 adult subjects, including 38 CLBP patients and 14 age- and sex-matched asymptomatic control subjects. Mean multifidus and erector spinae fat fraction (FF) was measured throughout the spine using an IDEAL MRI sequence. Presence of cartilage endplate (CEP) defects was determined at each disc level using UTE MRI. Logistic regression was used to test association of PSM FF, CEP defects, modic changes (MC), disc degeneration, and their interplay.

Results.

We observed that CEP defects were the strongest predictor of nonspecific CLBP (OR: 14.1, P < 0.01) even after adjusting for MC and disc degeneration (OR: 26.1, P = 0.04). PSM quality did not independently distinguish patient and control groups, except for patients with high self-reported disability.

At specifically L4L5, CEP damage was most prevalent and CEP damage was significantly associated with CLBP (OR: 3.7, 95% CI: 1.2–21.5, P = 0.03). CEP damage at L4L5 was predictive of CLBP when adjacent to PSMs with greater FF (MF, OR 14.7, P = 0.04; ES, OR: 17.3, P = 0.03), but not when PSM FF was lower and comparable to values in control, asymptomatic subjects.

Conclusion.

These results demonstrate the clinically important reciprocity between passive and dynamic spinal stabilizers, and support the notion that therapies targeting the PSMs may provide clinical benefit even in the presence of other spinal pathologies.

Level of Evidence: 4
Counting Efficiencies Determined by Monte Carlo Methods for In Vivo Measurement of 131I Activity in Thyroid
Authors: Park MinSeok , Kwon Tae-Eun , Ha Wi-Ho , Kim Chan Hyeong , Park Sunhoo , Jin Young Woo
Published: March 2019

The counting efficiencies obtained using a physical neck phantom are typically used in the measurement of 131I activity in the thyroid. It is well known, however, that the geometrical discrepancies between the physical neck phantom and the anatomy of the subject can significantly influence the counting efficiencies. Thus, it is necessary to consider the anatomical characteristics of individuals if we need to accurately determine the activity of 131I in the thyroid. This study aims to produce individualized counting efficiencies for thyroid measurement, considering the age, sex, and overlying tissue thickness of the subject being measured by Monte Carlo simulation. Simulations were performed using a series of computational human phantoms of different ages and sexes. The difference in counting efficiencies, depending on the age and sex of the phantom, were found to range from −26 to 3% for the phantoms and monitoring systems considered in the present study. The overlying tissue thickness of the computational phantoms was also modified to find the relationship between the counting ratio of the 80.2 and 364 keV gammas from 131I and the overlying tissue thickness. The equations for estimating the overlying tissue thickness of a subject were then derived from the relationships between counting ratios and overlying tissue thickness. Finally, in the present study, a set of equations representing the variation in counting efficiencies for the 364 keV peak as a function of the overlying tissue thickness were derived, which can be used to determine individualized counting efficiencies for the subject being measured. These individualized counting efficiencies considering the overlying tissue thickness given a subject’s age and sex can provide accurate estimates of 131I activity for internal dosimetry.
Does the Application of a Lycra Arm Sleeve Change Shoulder Biomechanics in Young Healthy People? A Mechanistic Study
Authors: Kumar Praveen , Desai Ashni , Elliot Lottie
Published: March 2019

Introduction

Glenohumeral subluxation (GHS) is commonly reported in people with stroke. Lycra sleeves provide a compressive and supportive effect, influencing the neuromuscular activity in the affected body segment. A recent study reported reduction in GHS (acromion-greater tuberosity [AGT] distance) after application of Lycra arm sleeve; however, its mechanism on the shoulder region as a whole is unclear. The aim of this study was to investigate if application of a Lycra sleeve changes the AGT distance, muscle activity around the shoulder region, and scapular position.

Methods

Healthy participants aged older than 18 years were recruited. Measurements were taken before and immediately after application of the sleeve. Portable diagnostic ultrasound, surface electromyography, and a tape measure were used to measure AGT distance, muscle activity (biceps, triceps, deltoid, and supraspinatus), and position of the scapula, respectively.

Results

Thirty-one participants (11 men, 20 women) with mean age 25 ± 10 years participated. Paired test showed significant mean reduction of 0.12 cm (95% confidence interval [CI], 0.07–0.16 cm) in AGT distance measurements (t = 5.112, df = 30, P = 0.003) and scapula measurements (0.3 cm; 95% CI, 0.04–0.4 cm; t = 2.501; df = 30, P < 0.01) when compared without and with sleeve application.

Conclusions

Future research should investigate the effects of the Lycra sleeve on people with GHS in the different phases of rehabilitation.
The Accuracy of a Home‐performed Faecal Calprotectin Test in Paediatric Patients With Inflammatory Bowel Disease
Authors: Lerchova Tereza , Hradsky Ondrej , Copova Ivana , Potuznikova Kristyna , Gonsorcikova Lucie , Bronsky Jiri
Published: March 2019

Objectives:

Owing to the invasiveness of endoscopy, the use of biomarkers, especially faecal calprotectin (FC), has become standard for remission assessment. This study aimed to compare the accuracy for detection of endoscopic activity using recently developed FC home test using smartphone application (FC‐IBDoc) against standard enzyme‐linked immunosorbent assay (ELISA).

Methods:

In all, 102 consecutive observations (89 participants) were included in prospective observational study. FC‐IBDoc was performed parallelly with FC‐ELISA in paediatric patients with inflammatory bowel disease indicated for endoscopy. Both tests were performed by trained staff. Mucosal healing was defined using Simple Endoscopic Score for Crohn disease (CD) ⩽2 in patients with CD (n = 44), ulcerative colitis (UC) Endoscopic Index of Severity ⩽4 in patients with UC (n = 27) and Rutgeerts score i0 and i1 without colon involvement in patients with CD after ileocaecal resection (n = 19).

Results:

Out of 102 endoscopic findings 23 were assessed as mucosal healing. We found an association of the mucosal healing scores of the entire group both with FC‐ELISA (P = 0.002) and FC‐IBDoc (P = 0.001). The area under the receiver operating characteristic curve for FC‐ELISA was 0.883 (95% confidence interval 0.807–0.960), with optimal cut‐off at 136.5 μg/g. The area under the receiver operating characteristic curve for FC‐IBDoc was 0.792 (95% confidence interval 0.688–0.895) with optimal cut‐off at 48 μg/g. The FC‐ELISA was more accurate than FC‐IBDoc when tested by a Delong test (P = 0.023).

Conclusions:

Standard FC‐ELISA for FC evaluation is more reliable predictor of mucosal healing than the FC‐IBDoc in paediatric patients with inflammatory bowel disease. The cut‐off values for both tests were incongruous.
Resting Energy Expenditure of Children With End‐stage Chronic Liver Disease Before and After Liver Transplantation
Authors: Kyrana Eirini , Williams Jane E. , Wells Jonathan C. , Dhawan Anil
Published: March 2019

Objectives:

Our objective was to test the hypothesis that children with end‐stage chronic liver disease (ESCLD) are hypermetabolic when compared to healthy children, and that this hypermetabolism persists for at least 6 months after liver transplant.

Methods:

Seventeen patients with end‐stage chronic liver disease and 14 healthy controls had their resting energy expenditure measured (mREE) by indirect calorimetry. Weight, height, and body mass index were converted to standard deviation (SD) scores. Children older than 5 years had air displacement plethysmography and patients older than 5 years also had whole body dual‐energy X‐ray absorptiometry with characterization of fat mass (FM), fat‐free mass (FFM), and bone‐free fat free (lean) mass.

Results:

When compared to the prediction equation 44% of the patients and 50% of the healthy controls were hypermetabolic. The younger patients (0–5 years) had a lower mREE than the healthy controls but were significantly lighter and shorter than their healthy counterparts. mREE correlated strongly for all children with age, weight, height, and FFM. There was a strong negative correlation between age and mREE/kg in both patients (rs = −0.94, P < 0.01) and controls (rs = −0.91, P < 0.01). Almost 84% of the variance in mREE was explained by age (P < 0.001). There were no significant differences between resting energy expenditure (REE)/FFM between the 2 groups. mREE/kg before liver transplant correlated with mREE/kg after transplant (Pearson r = 0.83, P < 0.01).

Conclusions:

REE mostly reflected the size of the child. The patients were not hypermetabolic when compared to the healthy children. The main determinant of REE/kg after transplant was REE/kg before transplant.
Mediators of Physical Activity Behavior Change in the “Girls on the Move” Intervention
Authors: Robbins Lorraine B. , Wen Fujun , Ling Jiying
Published: March 2019

Background

The minimal effect of interventions to date on increasing young adolescent girls’ physical activity (PA) may be due to inadequate understanding of the mechanisms underlying behavior change, yet sparse research testing a PA intervention has examined the capacity of theories to explain PA, particularly when using objective measures.

Objectives

The aim of the study was to examine whether constructs from the health promotion model and self-determination theory mediated changes in moderate-to-vigorous physical activity (MVPA) following a 17-week intervention.

Methods

The study was a secondary analysis of data from a group randomized trial, including 12 intervention and 12 control schools in the Midwestern United States. Data were collected in 2012–2016. Girls (fifth- to eighth-grade, N = 1,519) completed surveys on perceived benefits and enjoyment of PA, PA self-efficacy, social support and motivation for PA, and barriers to PA and wore accelerometers.

Results

The final path model had a good fit: χ2(4) = 2.48, p = .648; goodness-of-fit index = 1; comparative fit index = 1; root-mean-square error of approximation = 0; standardized root-mean-square residual = 0.01. For MVPA change from baseline to postintervention, enjoyment (B = 24.48, p < .001) and social support (B = 30.48, p < .001) had a positive direct effect, whereas the intervention had a positive indirect effect through enjoyment and social support (B = 9.13, p < .001). Enjoyment (B = −13.83, p < .001) and social support (B = −17.22, p < .001) had a negative indirect effect on MVPA change from postintervention to follow-up.

Discussion

Enjoyment of PA and social support for PA may be important mediators of PA in young adolescent girls and warrant consideration when designing interventions.
Emergency Department Testing Patterns for Sexually Transmitted Diseases in North Texas
Authors: Barnes Arti , Jetelina Katelyn K. , Betts Andrea C. , Mendoza Theresa , Sreeramoju Pranavi , Tiro Jasmin A.
Published: March 2019

Background

Little is known about population-level sexually transmitted disease (STD) testing in emergency departments (EDs). We sought to explore STD testing patterns in EDs in a large, urban metroplex in North Texas, a high prevalence region.

Methods

Emergency department claims data were extracted from the Dallas Fort Worth Hospital Council databank for patients attending 54 EDs in 4 counties (Dallas, Tarrant, Collin, and Denton) who were tested for an STD during an ED visit between July 2014 and June 2015. We analyzed patterns of testing for 3 types of STD tests: (1) combined gonorrhea and chlamydia DNA-based tests, (2) human immunodeficiency virus (HIV) antibody tests, and (3) syphilis serological tests.

Results

Emergency departments administered at least 1 STD test to 65,702 unique patients over 1 year; most were ethnoracial minorities (73%), female (72%), and had no known insurance (59%). Only 8% of patients received more than 1 of these tests at that same visit; of those, 90% were cotested for HIV. The most common diagnosis code associated with STD testing was “genital/urinary symptoms” (31%). The majority of tests took place at the ED of a single county-funded hospital (42%). Only 36% of all patients had visits that were deemed true emergencies.

Conclusions

Most patients tested for syphilis, HIV, or chlamydia/gonorrhea in EDs received only 1 test type at that visit, and most visits were nonemergent in nature. Given shared risk factors for multiple STD and high coinfection rates, EDs serving high-risk populations could consider STD cotesting to help reduce transmission of undiagnosed, untreated infections.
Acute Vision Loss After Ophthalmic Artery Embolization of Meningioma
Authors: Torres Guadalupe , T. Kini Ashwini , Al Othman Bayan , Lee Andrew G.
Published: March 2019

A 40-year-old man presented with acute-onset painless visual loss after preoperative embolization for a large skull base meningioma through the ophthalmic artery. We describe the clinical presentation of an isolated ipsilateral afferent and efferent pupillary defect in this patient who had radiographic documentation of embolization material in the intraorbital ophthalmic artery. Although ophthalmic and retinal artery occlusions have been described previously after endovascular embolization, our patient had a unique clinicoradiologic presentation.
Commentary on Braga et al
Authors: Chanpattana Worrawat , McCall William V.
Published: March 2019

This commentary reflects upon the study of Braga et al of open-label continuation electroconvulsive therapy (ECT) plus clozapine in treatment-resistant schizophrenia (TRS), as reported in this issue of The Journal of ECT. The evidence base for ECT in TRS is scant, and the study of Braga et al is a step forward. However, their report raises other important questions including (1) what is the proper frequency of continuation ECT in TRS, and (2) should TRS patients, even TRS patients who have failed clozapine, receive acute ECT + clozapine, or is ECT + conventional antipsychotics sufficient? In this commentary, we examine these questions and outline a future research strategy for TRS that includes large simple trials.
Effect of mixed natural extract treatment on quality characteristics of fresh-cut lettuce during storage
Authors: Lee Hyeon-Jeong , Choi Ji-Young , Heo Su-Hyeon , Bae Su-In , Kim Ji-Yoon , Moon Kwang-Deog
Published: March 2019

The purpose of this study was to evaluate the quality of fresh-cut lettuce after a washing treatment with differing concentrations of mixed natural extract. Five different treatments were employed: distilled water, sodium hypochlorite (Cl), 20% mixed natural extract (Na-1), 60% mixed natural extract (Na-3), and 100% mixed natural extract (Na-5). Measurements of carbon dioxide concentration, enzymatic activities, total aerobic bacteria, and sensory evaluation were investigated on day 1, 2, 3, and 5 at 5℃. The CO2 concentration in lettuce treated with Cl was significantly higher than that in other samples on day 5, and it remained generally low during the storage period in that treated with Na-5. The enzymatic activities (POD (peroxidase) and PAL (phenylalanine ammonia lyase) activities) in lettuce treated with Na-5 and Na-3 were low during the storage, and were significantly higher in lettuce treated with Cl than that in other samples on day 5. Total aerobic microbial count increased during storage, specifically on day 5, and was 6.53±0.08 log CFU/g in lettuce treated with Cl, while those in lettuce treated with Na-5 was 6.22±0.18 log CFU/g and significantly different. In case of sensory evaluation, there was no significant difference between the washing treatments in off flavor and smell. Color and overall acceptability in Na-5 was higher than that treated with Cl. The results revealed that the washing treatment of mixed natural extracts primarily containing rosemary extracts could be used to wash fresh-cut lettuce.
Evaluation of phytochemical contents and physiological activity in Panax ginseng sprout during low-temperature aging
Authors: Cho A-Ro , Pyo Min-Jung , Kang Min-Jung , Shin Jung-Hye
Published: March 2019

To investigate the phytochemical componetns and physiological activity of Panax ginseng sprout (PGS) during low-temperature aging, sprouts were aged at 40 and 60℃ for 0.5, 1, 2, 3, and 4 days. The crude saponin content in PGS aged at 60℃ was found to be higher at an early aging time. However, with aging, the content at 40℃, increased rapidly, and become significantly higher in the PGS aged at 60℃. The total content of phenolic compounds gradually increased with aging, with the highest content being 341.3 gallic acid equivalent (GAE) mg/100 g on day 4 at 40℃ and 431.5 GAE mg/100 g on day 3 at 60℃. Among the ginsenosides, the Re, Rb1, and Rg1 contents were higher and the total content was higher at the early aging time in sprouts aged at 60℃, however, there were no significant differences in the contents on day 4. The 2,2-diphenyl-1-picrylhydrazyl and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging activities increased with aging of PGS. The ABTS activities in PGS aged at 40℃ and 60℃ were highest on day 3 and 2, respectively. Thus, the ginsenoside content and physiological activity of the PGS increased throughout the aging process. The optimal aging temperature and time were 3 days at 40℃ and 2 days at 60℃.
Microbial inactivation modeling and salting characteristics of shredded kimchi cabbages (Brassica pekinensis L.) treated with radio frequency heating
Authors: Choi Eun Ji , Park Hae Woong , Lee Jung Gyu , Chun Ho Hyun
Published: March 2019

This study investigated the effect of radio frequency (RF) heating at 27.12 MHz on the inactivation of pre-existing microorganisms and salting characteristics of shredded kimchi cabbages. Samples of shredded kimchi cabbages were subjected to 27.12 MHz RF heating at different power levels (1,000 and 1,500 W) or to hot water (HW) at 60 and 70℃. RF heating at 1,500 W for 3 min reduced the populations of aerobic bacteria, yeast and molds, coliforms, and lactic acid bacteria in the shredded kimchi cabbage samples by 2.56, 1.26, 4.36, and 4.31 log CFU/g, respectively; moreover, survival plots fitted using the Weibull model for 1,500 W RF heating yielded Dr values of 1.92, 2.66, 1.81, and 0.75 min, respectively. The salinity of shredded kimchi cabbages treated with RF and HW heating increased more rapidly than that of the control during salting. With respect to the moisture content and hardness in the shredded kimchi cabbages, no significant differences were observed among the treatments, after salting for 4 h. In addition, the surface temperature distributions of the RF-heated samples were relatively uniform compared to those of the HW-heated samples. These results clearly indicated that the RF heating technology has the potential to decontaminate kimchi cabbages of pre-existing microorganisms, before the salting process.
Breast cancer classification based on proteotypes obtained by SWATH mass spectrometry
Authors: Bouchal Pavel , Schubert Olga T. , Faktor Jakub , Capkova Lenka , Imrichova Hana , Zoufalova Karolina , Paralova Vendula , Hrstka Roman , Liu Yansheng , Ebhardt H. Alexander , Budinska Eva , Nenutil Rudolf , Aebersold Ruedi
Published: March 2019

Accurate breast cancer classification is vital for patient management decisions, and better tumour classification is expected to enable more precise and eventually personalized treatment to improve patient outcomes. Here, we present a novel quantitative proteotyping approach based on SWATH mass spectrometry and establish key proteins for breast tumour classification derived from proteotype data. The study was based on 96 tissue samples representing five breast cancer subtypes according to conventional classification. Correlation of SWATH proteotype patterns indicated groups that largely recapitulate these subtypes. However, the proteotype-based classification also revealed varying degrees of heterogeneity within the conventional subtypes, with triple negative tumours being the most heterogeneous. Proteins that contributed most strongly to the proteotype-based classification include INPP4B, CDK1, and ERBB2, which are associated with oestrogen receptor status, tumour grade, and HER2 status, respectively. While these three key proteins exhibited high levels of correlation between protein and transcript levels (R>0.67), general correlation did not exceed R=0.29, indicating the value of protein-level measurements of biomarkers and disease-regulated genes. Overall, our data shows how large-scale protein-level measurements by next-generation proteomics can lead to improved patient stratification for precision medicine.