bluuebunny/crossref_metadata_2025 huggingface dataset:
Flunarizine as prophylaxis for episodic migraine: a systematic review with meta-analysis
Authors: Stubberud Anker , Flaaen Nikolai Melseth , McCrory Douglas C. , Pedersen Sindre Andre , Linde Mattias
Published: December 2018

Based on few clinical trials, flunarizine is considered a first-line prophylactic treatment for migraine in several guidelines. In this meta-analysis, we examined the pooled evidence for its effectiveness, tolerability, and safety. Prospective randomized controlled trials of flunarizine as a prophylaxis against migraine were identified from a systematic literature search, and risk of bias was assessed for all included studies. Reduction in mean attack frequency was estimated by calculating the mean difference (MD), and a series of secondary outcomes—including adverse events (AEs)—were also analyzed. The database search yielded 879 unique records. Twenty-five studies were included in data synthesis. We scored 31/175 risk of bias items as “high,” with attrition as the most frequent bias. A pooled analysis estimated that flunarizine reduces the headache frequency by 0.4 attacks per 4 weeks compared with placebo (5 trials, 249 participants: MD −0.44; 95% confidence interval −0.61 to −0.26). Analysis also revealed that the effectiveness of flunarizine prophylaxis is comparable with that of propranolol (7 trials, 1151 participants, MD −0.08; 95% confidence interval −0.34 to 0.18). Flunarizine also seems to be effective in children. The most frequent AEs were sedation and weight increase. Meta-analyses were robust and homogenous, although several of the included trials potentially suffered from high risk of bias. Unfortunately, reporting of AEs was inconsistent and limited. In conclusion, pooled analysis of data from partially outdated trials shows that 10-mg flunarizine per day is effective and well tolerated in treating episodic migraine—supporting current guideline recommendations.
An Innovative Doctor of Physical Therapy Experiential Learning Opportunity With Older Adults: A Description of a Unique Academic and Long-Term Care Partnership
Authors: Lojovich Jeanne , Olson-Kellogg Becky , Davila Heather
Published: December 2018

Background and Purpose.

Despite the dramatic increase in older adults and the reality that this population often comprises a substantial proportion of physical therapists' client base, many Doctor of Physical Therapy (DPT) students feel unprepared or less willing to provide care to older adults after graduation.

Method/Model Description and Evaluation.

The University of Minnesota DPT program developed a unique model for all first-year DPT students to gain experiential learning with older adults through a year-long Clerkship experience. In addition to regular assessments of student learning, a pre/postmeasure of student attitudes toward older adults and a thematic analysis of student reflective journals were conducted.

Outcomes.

Students entered the DPT program with positive attitudes toward older adults. Although limited changes in student attitudes was observed over time through the quantitative pre/postmeasure, student reflective journals revealed more nuance, with many students describing gains in knowledge and confidence in practicing with older adults, as well as more positive attitudes toward older adults and geriatrics over time.

Discussion and Conclusion.

The University of Minnesota DPT first-year Clerkship experience is a unique experiential learning program that provides DPT students hands-on experience with older adults over an academic year in a real-life setting. This innovative approach dually contributes to the development of DPT students' essential competencies and has been shown to be beneficial to first-year DPT students in developing positive attitudes toward and comfort in working with older adults, thereby advancing toward a more prepared physical therapist workforce in the area of geriatrics.
Superficial Siderosis of the Central Nervous System: Neurotological Findings Related to Magnetic Resonance Imaging
Authors: Wagner Franca , Buchwalder Melanie , Wiest Roland , Caversaccio Marco D. , Vibert Dominique
Published: December 2018

Objective:

To compare the neurotological results of five patients suffering from progressive hearing loss and ataxia due to superficial siderosis (SS) with the magnetic resonance imaging (MRI) findings.

Study Design:

Retrospective case review.

Setting:

Primary and hospital care center.

Participants:

Five adult patients with neurotological symptoms of SS underwent MRI with acquisition of our temporal bone protocol including 3D-constructive interference in steady state (3D-CISS) and susceptibility-weighted imaging (SWI). All patients underwent a complete neurotological examination, the results of which were compared with the imaging findings.

Main Outcome Measures:

Cochleovestibular deficits were present in all five patients as determined by uni- or bilateral bithermal caloric testing and/or video head impulse tests. Sacculocollic reflex was present with increased P1 and N1 latencies on both sides in all patients. MRI revealed an extensive hypointense SWI signal outlining the surface of the brain and the VIIIth cranial nerve in all five patients. Desynchronization of the brainstem auditory evoked potentials (BAEP) and partial or complete absence of the visual suppression of vestibulo-ocular reflex during the pendular rotatory test was particularly consistent with the lesions of the cochleovestibular nerves as well as the cerebellar atrophy seen on MRI.

Conclusion:

The MRI results with SWI were related to neurotological findings in patients suffering from sensorineural deafness with ataxia due to SS. Our findings support the integration of the SWI and 3D-CISS sequences into the MRI protocol for all patients referred for evaluation of the extent of SS.
Recent advances in venovenous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome
Authors: Schmidt Matthieu , Franchineau Guillaume , Combes Alain
Published: December 2018

Purpose of review

To summarize results of the most recent trials on venovenous extracorporeal membrane oxygenation (VV-ECMO) in severe acute respiratory distress syndrome (ARDS) and to elaborate on the unmet needs regarding VV-ECMO management in this setting.

Recent findings

Although it was terminated early for futility (i.e., failure to demonstrate a difference in 60-day mortality of 20%), the ECMO to Rescue Lung Injury in Severe ARDS trial of VV-ECMO for severe ARDS reported a nonsignificant, but clinically important, reduction in mortality (35 vs. 46%; relative risk 0.76; 95% confidence interval 0.55–1.04, P = 0.09). Refractory hypoxemia led to rescue ECMO in 28% of controls, who had more severe ARDS at inclusion, were extremely sick at the time of ECMO cannulation and for whom mortality was 57%. Beyond the rescue of patients dying of refractory hypoxemia, ECMO may now be used early in severe ARDS patients to reduce the intensity of mechanical ventilation and to minimize ventilator-induced lung injury. Future research in the field should focus on identification of patients who are more likely to benefit from this technique and the right timing for its initiation, optimization of daily management of patients under ECMO to further reduce complications, and selection of optimal ventilator management on ECMO.

VV-ECMO is a reasonable therapeutic option for patients with severe ARDS and major hypoxemia or excessive pressures. Future trials should be designed to optimize patients’ management while on VV-ECMO support.
Tumor risk and surveillance for children with hereditary disorders affecting growth
Authors: Brzezinski Jack , Michaeli Orli , Wasserman Jonathan D.
Published: December 2018

Purpose of review

Hereditary disorders affecting growth (both overgrowth and growth retardation) are frequently associated with heightened risk of neoplastic disease. This review summarizes the tumor spectra associated with these conditions and identifies disease-specific screening approaches.

Recent findings

An understanding of the molecular events underlying many of these growth disorders has evolved significantly over the past several years. Recognition of genotype–phenotype associations, in many cases, informs the cancer risk profile. Additionally, accumulating data suggest a benefit of rational presymptomatic surveillance for at-risk individuals, with a reduction in tumor-associated morbidity. Recent clinical practice recommendations have established risk-driven paradigms for tumor surveillance in the context of hereditary tumor predisposition syndromes, including those affecting growth.

Clinicians caring for children with growth disorders should be aware of syndromic associations and the associated cancer risks. Knowledge of tumor spectra and recommended surveillance strategies may facilitate tumor diagnosis at an early stage and reduce morbidity of the disease and associated treatments.
Overview development and applications of CRISPR-Cas systems after a decade of research with a glance at anti-CRISPR proteins
Authors: Lohrasbi Vahid , Shirmohammadlou Neda , Jahanshahi Aidin , Razavi Shabnam
Published: December 2018

CRISPR and its associated proteins that are called, the CRISPR-Cas systems, confers adaptive immunity against exogenic elements in many bacteria and also most archaea. Unlike the restriction modification system that provides a defense against any foreign DNA lacking a protective methyl-tag in the target site, the CRISPR-Cas systems are invader-specific, adaptive, and heritable. This immunity is gained by integrating short fragments of foreign DNA into CRISPR loci. CRISPR-derived transcripts assemble with Cas proteins to target similar foreign nucleic acids for degradation. Moreover, in recent years investigation of anti-CRISPR proteins has provided important new insight into CRISPR-Cas systems. Here we review an update on the development and the applications of CRISPR-Cas systems and discuss the potential of these phage-resistance machineries.
Connecting Communities
Authors: Caramanica Laura , Emerson Christie , Al-Harthy Shinunah , Al Awaisi Huda , Hooks Dwayne
Published: December 2018

Addressing health inequities and the social determinants of health for all people of the world is a primary goal of the World Health Organization. This article describes how a “Connecting Communities educational program” enabled nurse leaders from academic institutions from different sides of the globe to develop a reciprocal relationship of mutual interest around the topics of the nursing role in population health and care delivery. Grant funding resulted in the sharing of knowledge, expertise, and experiences directed toward encouraging the development of nurses as global citizens, with a broader view on what influences health and well-being. This initiative demonstrates how nurses can contribute to the improvement of world health and address the social determinants of health while practicing locally but thinking and contributing globally.
Nursing Leadership in Guam
Authors: Hattori-Uchima Margaret , Wood Kathryn
Published: December 2018

Guam, an unincorporated territory of the United States, is one of the ten (10) US Affiliated Pacific Islands. The geographic location in the western Pacific Ocean, as well as the ties to the US position Guam as a strategic hub between the continental US, Asia, and the Pacific region. Health disparities in Guam and the Micronesian region are significant, and the non-communicable disease crisis is worsening, threatening the existing poor health infrastructure on the islands. Migration of islanders from the Micronesian region, whose countries also suffer health disparities, adds to the burden of the weak health care system on Guam. A critical nursing workforce shortage plagues the health care community, and strong nursing leadership is needed to address the problems. Nurse leaders, through many organizations, are working to implement strategies to address the issues facing the islands. Increased collaboration with partners on the island, on the US mainland, and globally, are necessary to effectively address Guam's health care concerns.
Beyond a Single Country's Borders
Authors: Benton David C. , Ferguson Stephanie L.
Published: December 2018

We live and work in an increasingly connected global environment where actions in one part of the world can have consequences for all of us. This article examines, through the use of bibliometric analysis, the extent to which nursing scholars are engaged in the policy debate surrounding trade in services. Results demonstrate that, in comparison to medical colleagues, the nursing profession is more regionally orientated, focused on more operational-based themes and orientated to Mode 4: Mobility of the Profession. However, with the impetus of initiatives such as Nursing Now, opportunities exist to increase nurses' contribution to policy in today's ever more connected supranational environment. To be effective, and if quantum rather than incremental progress is to be made, more scholarship on policy-oriented topics is needed. An increased output of PhD-prepared nurses is essential. Collaborative working in multidisciplinary policy teams must become the norm, so nurses can demonstrate their unique and essential contribution to addressing the many and complex challenges that health systems now face. This is what is required if nurses are to be equipped to make robust evidence-based arguments at national and supranational levels.
From Brainstorming to Strategic Plan: The Framework for the Society for the Advancement of Disaster Nursing
Authors: Langan Joanne C. , Lavin Roberta Proffitt , Griffin Anne Reid , Veenema Tener Goodwin , Dobalian Aram
Published: December 2018

Professional health care societies play a critical role in promoting excellence in patient care, educating and certifying their members on evidence-based practices, and pursuing relevant research agendas to advance the science in the field. Disaster nursing is a subspecialty of professional nursing characterized by a unique knowledge base and set of skills and abilities not used in normal daily health care activities. A disaster or large-scale public health emergency creates a sudden, unanticipated surge of patients with health care needs that far exceeds the capacity of the health care system. This creates a significant burden and risk for the nurses participating in the response. Recognizing the critical need to define scope of practice and core standards for disaster nursing and to promote greater nursing leadership in disaster preparedness and response, a group of subject matter experts established a professional society to provide leadership and guidance. The strategic planning process as described by M. Kwestel et al was used as the overarching framework for describing the design, development, and implementation of the new society. Establishment of the Society for the Advancement of Disaster Nursing is a definitive step toward improving national nurse readiness in the United States.
The CNO US Healthcare Immersion Program, Part 2
Authors: Cato Dawna L. , Bowles John R. , Carmack Veronica , Liu Fuyang , McFadden Mary T.
Published: December 2018

As global leaders, US nurses will have an increasingly recognized role and responsibility in shaping health care in all countries. They should be at the forefront of changing and improving health systems to achieve universal health. Currently, a major health care reform is underway that requires a shift in the professional nursing footprint of China's nurse leaders. These leaders must garner knowledge capital to reinforce ethics, regulations, and standards; use current best practices; implement a comprehensive performance evaluation process; and capture the spirit of caring within their health care environments. Therefore, China is seeking US immersion opportunities for their emerging nurse leaders. Although US Immersion Programs exist, there is scant literature related to international precepting and how transformational learning occurs within this experience. This article introduces a transformational learning experience between US International Nurse Preceptors and a Chief Nursing Officer from Yinchuan, China.
The CNO US Healthcare Immersion Program, Part 1
Authors: Cato Dawna L. , Walker Kathy , Aders Deborah , Liu Fuyang , McFadden Mary T.
Published: December 2018

As a result of recent global health events, US health care leaders are strengthening international relationships to share best practices, health research, and support of workforce capacity. The Institute for Healthcare Improvement, the National Academies of Sciences, Engineering, and Medicine, the American Nurses Credentialing Center, and the Joint Commission International have all committed to expanding their vision and mission to improve health and health care globally. To support excellence in international health care delivery, the authors embarked on a Chief Nursing Officer (CNO) US Healthcare Immersion Program. The purpose of the program is to introduce the US nursing leadership competences to China CNO colleagues in preparation for their future role with health care reform.
Integrating Human Immunodeficiency Virus Testing Into Syphilis Partner Services in Mississippi to Improve Human Immunodeficiency Virus Case Finding
Authors: Avoundjian Tigran , Stewart James , Peyton David , Lewis Christie , Johnson Kendra , Glick Sara N. , Golden Matthew R. , Khosropour Christine M.
Published: December 2018

Background

Mississippi has the 10th highest rate of new human immunodeficiency virus (HIV) infections in the United States. The Mississippi State Department of Health (MSDH) integrated partner HIV testing into syphilis partner services (PS) in 2014, but the effectiveness of this as an HIV case finding strategy has not been evaluated.

Methods

We identified all early syphilis (primary, secondary, and early latent) case records reported from July 1, 2014, to December 31, 2016, excluding case records for people concurrently newly diagnosed with HIV. Among sex partners of these people, we identified new diagnoses of early syphilis and HIV. We calculated the number needed to interview as the number of syphilis index case patients interviewed divided by the number of partners newly diagnosed with early syphilis or HIV.

Results

A total of 1535 (95%) of the 1619 early syphilis index case patients were interviewed for PS. These case patients named 2267 partners, of whom 1868 (82%) were contacted by MSDH. Among partners, 1508 (81%) tested for syphilis and 745 (56%) of 1321 partners not previously diagnosed with HIV were tested for HIV. Partner services identified 696 new early syphilis case patients (46%) and 24 (3.2%) new HIV case patients among partners. Sixty-four index case patient interviews were needed to identify 1 new case of HIV, and 2 interviews were needed to identify 1 new case of syphilis among partners.

Conclusions

Syphilis PS allowed MSDH to interact with 1592 men who have sex with men over a 30-month period and was effective for identifying people newly infected with early syphilis and HIV. Increasing HIV testing among partners of syphilis case patients could increase HIV case finding in Mississippi.
Novel NTRK3 Fusions in Fibrosarcomas of Adults
Authors: Yamazaki Fumito , Nakatani Fumihiko , Asano Naofumi , Wakai Susumu , Sekimizu Masaya , Mitani Sachiyo , Kubo Takashi , Kawai Akira , Ichikawa Hitoshi , Yoshida Akihiko
Published: December 2018

NTRK fusions in malignant tumors are therapeutic targets of tyrosine kinase inhibitors. Because they occur only in a small subset of mesenchymal tumors, knowledge regarding the corresponding histology is important to effectively identify patients who could benefit from targeted therapy. In this study, using RNA sequencing, we identified novel NTRK3 fusions involving related partner genes in 2 adult bone and soft tissue tumors that met the current histologic criteria of fibrosarcoma. Case 1 involved the left radius of a 38-year-old woman, whereas in case 2, the right thigh of a 26-year-old man was affected. Histologically, both tumors consisted of the long fascicular growth of long spindle cells. The tumor in case 1 additionally showed focal myxoid changes. Tumor cells had nonpleomorphic, atypical nuclei, and lacked evidence of a specific line of differentiation. Both tumors showed widespread CD34 immunoreactivity and very limited expression of actin. RNA sequencing detected in-frame fusion transcripts of STRN (exon 3)-NTRK3 (exon 14) in case 1 and STRN3 (exon 3)-NTRK3 (exon 14) in case 2, which were confirmed by reverse transcription polymerase chain reaction and Sanger sequencing. Pan-TRK immunostaining was diffusely positive in both cases. Fluorescence in situ hybridization showed signal patterns compatible with NTRK3 rearrangements in both cases, with case 2 additionally harboring a CDKN2A homozygous deletion. This study expands the clinicopathologic and genetic spectrum of sarcomas associated with NTRK fusions, and suggests that CD34-positive fibrosarcoma of bone and soft tissue could be a good candidate for NTRK testing.
The HTN3-MSANTD3 Fusion Gene Defines a Subset of Acinic Cell Carcinoma of the Salivary Gland
Authors: Andreasen Simon , Varma Sushama , Barasch Nicholas , Thompson Lester D.R. , Miettinen Markku , Rooper Lisa , Stelow Edward B. , Agander Tina K. , Seethala Raja R. , Chiosea Simion I. , Homøe Preben , Wessel Irene , Larsen Stine R. , Erentaite Daiva , Bishop Justin A. , Ulhøi Benedicte P. , Kiss Katalin , Melchior Linea C. , Pollack Jonathan R. , West Robert B.
Published: December 2018

The spectrum of tumors arising in the salivary glands is wide and has recently been shown to harbor a network of tumor-specific fusion genes. Acinic cell carcinoma (AciCC) is one of the more frequently encountered types of salivary gland carcinoma, but it has remained a genetic orphan until recently when a fusion between the HTN3 and MSANTD3 genes was described in one case. Neither of these 2 genes is known to be implicated in any other malignancy. This study was undertaken to investigate whether the HTN3-MSANTD3 fusion is a recurrent genetic event in AciCC and whether it is a characteristic of one of its histological variants. Of the 273 AciCCs screened, 9 cases showed rearrangement of MSANTD3 by break-apart fluorescence in situ hybridization, 2 had 1 to 2 extra signals, and 1 had gain, giving a total of 4.4% with MSANTD3 aberrations. In 6 of 7 available cases with MSANTD3 rearrangement, the HTN3-MSANTD3 fusion transcript was demonstrated with real-time polymerase chain reaction. Histologically, all fusion-positive cases were predominantly composed of serous tumor cells growing in solid sheets, with serous tumor cells expressing DOG-1 and the intercalated duct-like cell component being CK7 positive and S-100 positive in 6/9 cases. All but one case arose in the parotid gland, and none of the patients experienced a recurrence during follow-up. In contrast, the case with MSANTD3 gain metastasized to the cervical lymph nodes and lungs. In conclusion, we find the HTN3-MSANTD3 gene fusion to be a recurrent event in AciCC with prominent serous differentiation and an indolent clinical course.
Correlation Analysis of Magnetic Resonance Imaging-Based Graft Maturity and Outcomes After Anterior Cruciate Ligament Reconstruction Using International Knee Documentation Committee Score
Authors: Li Qiang , Zhang Yuyang , Zhan Liqiong , Han Qiong , Wu Maohou , Zhang Nanxin
Published: December 2018

Objective

The correlation between the signal/noise quotient values of an anterior cruciate ligament graft and the International Knee Documentation Committee Subjective Knee Form 2000 scores after anterior cruciate ligament reconstruction was evaluated.

Design

Magnetic resonance imaging and clinical evaluation using International Knee Documentation Committee scores were used to calculate the signal intensity of the graft maturity at the 6-mo and 12-mo follow-up points postoperatively. The associations between the signal/noise quotient values at the 6-mo follow-up point and International Knee Documentation Committee scores at the 12-mo follow-up point were evaluated.

Results

A total of 42 male patients completed our trial and returned to normal activity level before the surgery. The mean ± SD age of these patients was 29.07 ± 8.11 yrs (range, 17–47 yrs). The mean ± SD body mass index was 26.00 ± 2.59 kg/m2. Notably, the Pearson correlation analysis showed that the International Knee Documentation Committee scores obtained at 12 mos were significantly associated with the signal/noise quotient values measured in the sixth month and twelfth month, respectively (r = −0.454, P = 0.003; r = −0.478, P = 0.001).

Conclusions

According to this study, early measurement of graft maturity might predict the clinical outcome afterward. The sensitive predictive value of signal/noise quotient could be used to maximize the patient outcomes.
Gout in the Gilded Age
Authors: Pinals Robert S.
Published: December 2018

Richard Morris Hunt, a distinguished American architect of the late 19th century (the Gilded Age), had onset of gout at age 41 years. His attacks became more frequent and severe, eventually leading to chronic pain and disability. His medical care by highly regarded physicians resulted in very limited benefit, but through his dedication and work ethic, he remained productive until his death at age 67 years.
18F-FDG PET and Bone Scintigraphy of Epithelioid Hemangioendothelioma
Authors: Hubaut Marc-Antoine , Jaillard Alice , Eloy Capucine , Petyt Gregory
Published: December 2018

We report the case of a 31-year-old woman with left foot bones located epithelioid hemangioendothelioma. It is a rare type of vascular tumor, locally aggressive with metastatic potential. It was revealed by a chronic isolated left foot pain. Conventional imaging showed multiple osteolytic lesions of the bones, appearing aggressive. Both bone scintigraphy and 18F-FDG PET showed an increased uptake of these lesions and confirmed the limited extent to distal extremity of the left lower limb. Final diagnosis was given on a surgical biopsy. Patient was treated by hyperthermic chemotherapy using isolated limb perfusion.
Chronic Vasitis After Mesh Herniorrhaphy
Authors: Seo Minjung , Ha Nam Du , Jo Jae-Cheol , Park Seol Hoon
Published: December 2018

We report two cases of supra-scrotal vasitis incidentally detected in patients who had undergone mesh herniorrhaphy. PET/CT in patients undergoing lymphoma work-up and health check-up revealed hypermetabolic dilatation of vas deferens in the external iliac area. There were no symptoms, and blood test results did not indicate acute inflammation. Interestingly, both had undergone herniorrhaphy for inguinal hernia. Herniorrhaphy is reported to cause vasal complications such as obstruction or inflammation, although most are asymptomatic and probably under-reported. Chronic vasitis after herniorrhaphy may be a potential cause for false positive findings on 18F-FDG PET/CT in patients undergoing work-up for various oncological indications.
FDG PET/CT Course of Pembrolizumab-Associated Multiorgan Sarcoidosis
Authors: Lu Yang
Published: December 2018

An 80-year-old man with metastatic melanoma had been receiving treatment with pembrolizumab from September 2015 until June 2017. Series FDG PET/CT scans from March 7, 2017, to June 14, 2018, showed the course of biopsy-proven pembrolizumab-induced sarcoidosis. Reported here is the first case of multiorgan sarcoidosis induced by pembrolizumab and its self-resolving course on FDG PET/CT.
Pleural Mesothelioma Detects by 18F-Choline PET/CT in a Patient With Biochemical Recurrence of Prostate Cancer
Authors: Rensi Marco , Ferretti Guido , Di Gregorio Fernando , Evangelista Laura
Published: December 2018

A 73-year-old man with a prostate cancer treated by radical prostatectomy in 2006. For a biochemical recurrence of disease (prostate-specific antigen level, 0.1 ng/mL) during hormonal therapy, patient underwent 18F-choline PET/CT that showed a significant uptake in a diffuse right pleural thickening. The patient was sent to pleurectomy decortication showing an epithelioid pleural mesothelioma. This case highlighted that a histopathological evaluation is mandatory in case of a significant radiolabeled choline uptake in pleural lesions.
Detailed Fetal Anatomic Ultrasound Examination
Authors: Fratto Victoria M. , Chang Aileen , Anton Tracy , Sun Heather Y. , Lamale-Smith Leah M. , Pretorius Dolores H.
Published: December 2018

This study evaluates the impact of extended cardiac views on examination time, repeat imaging, and anomaly detection before and after implementation of 76811 guidelines (American Institute of Ultrasound in Medicine Consensus 2014). It is a retrospective study of singleton pregnancies undergoing detailed ultrasound imaging at 18 weeks' gestation or greater before and after the protocol change in an academic, tertiary care fetal center. Views required prior to 2014: 4-chamber, left outflow tract, right outflow tract. Additional views required after 2014: bicaval, aortic arch, 3-vessel, and 3-vessel trachea. Fetuses with known anomalies were excluded. Rates of detection of congenital heart disease (CHD), examination completion, repeat examination recommendation, fetal echocardiogram recommendation, completion by body mass index, and cardiac examination time were determined. Six hundred twenty-four subjects were included, 217 before and 407 after protocol change. Views obtained were as stated in the American Institute of Ultrasound in Medicine/Society for Maternal-Fetal Medicine consensus. Detection of CHD was not improved. Examination times increased by 20% (6.4 vs 7.7 minutes, P < 0.05). Number of incomplete studies increased by 130% (11% to 26%, P < 0.05). Twice as many patients were referred for repeat examination (6% vs 13%, P < 0.05). Completion rates were negatively correlated with body mass index. Recommendations for fetal echocardiogram were unchanged (5% vs 6%, P = 0.6). Additional imaging did not increase detection rate of CHD (3% vs 2%, P = 0.3). Extended cardiac views resulted in increased examination time, more incomplete examinations, and more repeat examinations without changing detection rates of CHD.
Using a Sternocleidomastoid Muscle Flap to Close an Iatrogenic Tracheoesophageal Fistula in a Patient With Advanced Laryngeal Cancer
Authors: Chuang Fu-Chieh , Tung Kwang-Yi , Huang Wen-Chen , Yu Chia-Meng , Yao Wen-Teng
Published: December 2018

Background

An iatrogenic tracheoesophageal (TE) fistula is one possible complication after total laryngectomy with flap reconstruction. We used sternocleidomastoid (SCM) rotation flap to close a TE fistula.

Methods and Results

A 69-year-old man with laryngeal cancer underwent total laryngectomy with radial forearm free flap reconstruction. A tracheostoma stenosis was noticed 7 months after the tracheostomy tube was removed. The patient underwent tracheostoma dilatation; the iatrogenic TE fistula was noticed 1 month later. We used SCM rotation flap to close the TE fistula. The postoperative course was uneventful. A barium esophagogram showed no leakage in the esophagus.

Conclusions

Tracheoesophageal fistula can be reconstructed with an SCM rotation flap. If the TE fistula is of a suitable size, this reconstructive strategy is effective and simple to close persistent TE fistula and avoid further airway complications.
Ischemic stroke and infectious diseases in low-income and middle-income countries
Authors: Fernandes Breno Franco Silveira , Caramelli Paulo
Published: December 2018

Purpose of review

To address the important relationships between stroke and infection, focusing on the most frequent infections found in low-income and middle-income countries.

Recent findings

Stroke is one of the leading causes of mortality and disability worldwide, with a great proportion of the stroke burden occurring in low-income and middle-income countries. Infectious diseases are still a great health problem in developing countries and it is possible that the proportion of infection-related strokes is greater in these nations. Infectious diseases and stroke have a bidirectional relationship. Common infections may act as risk factors and can trigger stroke through different mechanisms in their acute phase. Several intracranial and systemic infections can cause stroke as a direct complication, such as Chagas disease, neurosyphilis, tuberculous meningitis, and neurocysticercosis. These conditions are of particular interest to low-income and middle-income countries, but also relevant to high-income nations because of increasing migration. Finally, infection is a frequent poststroke complication, with great impact in the patient outcome.

Infectious diseases and stroke are common problems in low-income and middle-income countries. More studies are necessary to fully elucidate the real impact of infectious diseases on stroke burden, especially in countries where epidemiological data are still scarce.
Assessment of vision in concussion
Authors: Akhand Omar , Balcer Laura J. , Galetta Steven L.
Published: December 2018

Purpose of review

To review emerging vision-based assessments in the evaluation of concussion.

Recent findings

Involvement of the visual pathways is common following concussion, the mildest form of traumatic brain injury. The visual system contains widely distributed networks that are prone to neurophysiologic changes after a concussion, resulting in visual symptoms and ocular motor dysfunction. Vision-based testing is increasingly used to improve detection and assess head injury. Several rapid automatized naming (RAN) tasks, such as the King-Devick test and the Mobile Universal Lexicon Evaluation System, show capacity to identify athletes with concussion. Video-oculography (VOG) has gained widespread use in eye-tracking and gaze-tracking studies of head trauma from which objective data have shown increased saccadic latencies, saccadic dysmetria, errors in predictive target tracking, and changes in vergence in concussed individuals.

RAN tasks demonstrate promise as rapid screening tools for concussion. Further investigation will involve assessment of the role for age, characterization of learning effects over repeated measurements, and identification of optimal thresholds for clinically significant performance decrements. Various RAN tasks are likely to be functionally distinct, engaging different neural networks according to the demands of each task. Measures of saccades, smooth pursuit eye-movements, the vestibulo-ocular reflex and, more recently, disparity vergence are candidate vision-based markers for concussion. Work to adopt these assessments to the sideline or clinical environments is ongoing.
Associations between neurochemical receptor genes, 2D:4D, impulsivity and relationship quality
Authors: Pearce Eiluned , Wlodarski Rafael , Machin Anna , Dunbar Robin I. M.
Published: December 2018

The ratio between the second and fourth digits (2D:4D) has been widely used as a proxy for fetal exposure to androgens and has been linked to a number of sociosexual traits in humans. However, the role of genes in this equation remains unknown. Here (
N
= 474), we test, firstly, for associations between 2D:4D and single-nucleotide polymorphisms (SNPs) in nine neurochemical receptor genes (
AR, OXTR, AVPR1A, OPRM1, DRD1/2, ANKK1, 5HTR1A/2A
), and secondly, whether digit ratios mediate the relationship between genetic variation and sociosexuality. We demonstrate significant associations between
AR
,
OPRM1
and
AVPR1A
and 2D:4D. Moreover, mediation analysis indicates that, in women,
AR
and
OPRM1
variation drives digit ratios, which are related positively to impulsivity and, for
OPRM1
, negatively to romantic relationship quality. Although these findings are subject to multiple testing issues, this study provides preliminary evidence that in women genetic factors may affect both impulsivity and perceived relationship quality through influencing factors indexed by digit ratios.
Habitat fragmentation, biodiversity loss and the risk of novel infectious disease emergence
Authors: Wilkinson David A. , Marshall Jonathan C. , French Nigel P. , Hayman David T. S.
Published: December 2018

The number of microbes on Earth may be 10
30
, exceeding all other diversity. A small number of these can infect people and cause disease. The diversity of parasitic organisms likely correlates with the hosts they live in and the number mammal hosts for zoonotic infections increases with species richness among mammalian orders. Thus, while habitat loss and fragmentation may reduce species diversity, the habitat encroachment by people into species-rich areas may increase the exposure of people to novel infectious agents from wildlife. Here, we present a theoretical framework that exploits the species–area relationship to link the exposure of people to novel infections with habitat biodiversity. We model changes in human exposure to microbes through defined classes of habitat fragmentation and predict that increased habitat division intrinsically increases the hazard from microbes for all modelled biological systems. We apply our model to African tropical forests as an example. Our results suggest that it is possible to identify high-risk areas for the mitigation and surveillance of novel disease emergence and that mitigation measures may reduce this risk while conserving biodiversity.
From the Trinity (
A
3
,
B
3
,
H
3
) to an
ADE
correspondence
Authors: Dechant Pierre-Philippe
Published: December 2018

In this paper, we present novel
ADE
correspondences by combining an earlier induction theorem of ours with one of Arnold's observations concerning Trinities, and the McKay correspondence. We first extend Arnold's indirect link between the Trinity of symmetries of the Platonic solids (
A
3
,
B
3
,
H
3
) and the Trinity of exceptional four-dimensional root systems (
D
4
,
F
4
,
H
4
) to an explicit Clifford algebraic construction linking the two ADE sets of root systems (
I
2
(
n
),
A
1
×
I
2
(
n
),
A
3
,
B
3
,
H
3
) and (
I
2
(
n
),
I
2
(
n
)×
I
2
(
n
),
D
4
,
F
4
,
H
4
). The latter are connected through the McKay correspondence with the ADE Lie algebras (
A

n

,
D

n

,
E
6
,
E
7
,
E
8
). We show that there are also novel indirect as well as direct connections between these ADE root systems and the new ADE set of root systems (
I
2
(
n
),
A
1
×
I
2
(
n
),
A
3
,
B
3
,
H
3
), resulting in a web of three-way ADE correspondences between three ADE sets of root systems.
Age-related response to an acute innate immune challenge in mice: proteomics reveals a telomere maintenance-related cost
Authors: Criscuolo François , Sorci Gabriele , Behaim-Delarbre Margaux , Zahn Sandrine , Faivre Bruno , Bertile Fabrice
Published: December 2018

Ageing is characterized by the impairment of the acute innate immune response and the upregulation of low-grade inflammation, i.e. inflammaging. At the cellular level, telomeres are considered as a marker of biological ageing as their length is progressively eroded in the absence of repair mechanisms. However, the link between telomeres and inflammaging remains underexplored. We aimed to identify proteins that are differentially expressed between age classes in response to an acute inflammatory challenge. We challenged young (two months) and old (12 months) C57BL/6 mice using bacterial lipopolysaccharide (LPS) and measured telomere length and proteomic profiles in splenocytes. In total, 233 out of the 1966 proteins we quantified differed among experimental groups. A hierarchical clustering analysis revealed that nine of those 233 proteins were differently expressed among the experimental groups. Young mice responded to LPS by increasing the expression of proteins involved in the innate immune response, and interestingly, in telomere length maintenance. However, this regulation was impaired at older ages. These results are in agreement with the assumption that the strength of selection declines with age, potentially explaining the maintenance of costly, dysregulated, immune responses at old age. We suggest that the immune response is competing with the telomere maintenance process, highlighting how telomeres reflect the ageing trade-off even in a species where telomere length is not related to lifespan.
Pharmacological Restoration of Visual Function in a Zebrafish Model of von-Hippel Lindau Disease
Authors: Ward Rebecca , Slater Kayleigh , Ali Zaheer , Reynolds Alison L , Jensen Lasse D , Kennedy Breandán N
Published: December 2018

Von Hippel-Lindau (VHL) syndrome is rare, autosomal dominant disorder, characterized by hypervascularised tumour formation in multiple organ systems. Vision loss associated with retinal capillary hemangioblastomas remains one of the earliest complications of VHL disease. The mortality ofVhl-/-micein uterorestricted modelling of VHL disease in this mammalian model. Zebrafish harbouring a recessive germline mutation in thevhlgene represent a viable, alterative vertebrate model to investigate associated ocularloss-of-functionphenotypes. Previous studies reported neovascularization of the brain, eye and trunk together with odema in thevhl-/-zebrafish eye. In this study, we demonstratevhl-/-zebrafish almost entirely lack visual function. Furthermore, hyaloid vasculature networks in thevhl-/-eye are improperly formed and this phenotype is concomitant with development of an ectopic intraretinal vasculature. Sunitinib, a multi tyrosine kinase inhibitor, market authorised for cancer, reversed the ocular behavioural and morphological phenotypes observed invhl-/-zebrafish. We conclude that the zebrafishvhlgene contributes to the endogenous molecular barrier that prevents development of intraretinal vasculature and that sunitinib can improve visual function and hyaloid vessel patterning while reducing abnormally formed ectopic intraretinal and choroidal vessels invhl-/-zebrafish.
Synthetic Biology Research and Innovation Profile 2018: Publications and Patents
Authors: Shapira Philip , Kwon Seokbeom
Published: December 2018

A profile of synthetic biology research and innovation is presented using data on publications and patents worldwide and for the UK and selected benchmark countries. The search approach used to identify synthetic biology publications identifies a core set of synthetic biology papers, extracts and refines keywords from these core records, searches for additional papers using those keywords, and supplements with articles published in dedicated synthetic biology journals and curated synthetic biology special collections. For the period from 2000 through to mid-July 2018, 11,369 synthetic biology publication records are identified worldwide. For patents, the search approach uses the same keywords as for publications then identifies further patents using a citation-tree search algorithm. The search covered patents by priority year from 2003 to early August 2018. Following geographical matching, 8,460 synthetic biology basic patent records were identified worldwide. Using this data, analyses of publications are presented which look at the growth of synthetic biology outputs, top countries and leading organizations, international co-authoring, leading subject categories, citations, synthetic biology on the map of science, and funding sponsorship. For patents, the analysis examines growth in patenting, national variations in publications compared with patenting, leading patent assignees, and the positioning of synthetic biology on a visualized map of patents.
Bilateral Asymmetry of the Forearm Bones as Possible Evidence of Antemortem Trauma in the StW 573 Australopithecus Skeleton from Sterkfontein Member 2 (South Africa)
Authors: Heile A.J. , Pickering Travis Rayne , Heaton Jason L. , Clarke R.J.
Published: December 2018

The 3.67-million-year-old StW 573 Australopithecus skeleton is important for the light it sheds on the paleobiology of South African species of that genus, including, as discussed here, how the possible pathology of the specimen informs our understanding of Australopithecus behavior. The StW 573 antebrachium exhibits bilateral asymmetry, with significantly more longitudinally curved left forearm bones than right. Arguing from a comparative perspective, we hypothesize that these curvatures resulted from a fall onto a hyperextended, outstretched hand. It is unlikely that the fall was from a significant height and might have occurred when the StW 573 individual was a juvenile. This type of plastic deformation of the forearm bones is well-documented in modern human clinical studies, especially among children between the ages of four and ten years who tumble from bicycles or suffer other common, relatively low-impact accidents. Left untreated, such injuries impinge normal supination and pronation of the hand, a condition that could have had significant behavioral impact on the StW 573 individual.
Leaf economics guides slow-fast adaptation across the geographic range of A. thaliana
Authors: Sartori Kevin , Vasseur François , Violle Cyrille , Baron Etienne , Gerard Marianne , Rowe Nick , Ayala-Garay Oscar , Christophe Ananda , JalÓN Laura Garcia De , Masclef Diane , Harscouet Erwan , Granado Maria Del Rey , Chassagneux Agathe , Kazakou Elena , Vile Denis
Published: December 2018

The slow-fast continuum describes how resource allocation constrains life-history strategies in many organisms. In plants, it is reflected by a trade-off at the leaf level between the rate of carbon assimilation and lifespan, the so-called Leaf Economics Spectrum (LES). However, it is still unclear how the LES is connected to the slow-fast syndrome, and reflects adaptation to climate. Here, we measured growth, morpho-physiological and life-history traits at both leaf and whole-plant levels in 384 natural accessions of Arabidopsis thaliana. We examined the extent to which the LES continuum parallels the slow-fast continuum, and compared trait variation to neutral genetic differentiation between lineages. We found that the LES is tightly linked to variation in whole-plant functioning, relative growth rate and life history. A genetic analysis further suggested that phenotypic differentiation is linked to the evolution of different slow-fast strategies in contrasted climates. Together, our findings shed light on the physiological bases of the slow-fast continuum, and its role for plant adaptation to climate.
Natural selection contributed to immunological differences between human hunter-gatherers and agriculturalists
Authors: Harrison Genelle F , Sanz Joaquin , Boulais Jonathan , Mina Michael J , Grenier Jean-Christophe , Leng Yumei , Dumaine Anne , Yotova Vania , Bergey Christina M. , Elledge Stephen J. , Schurr Erwin , Quintana-Murci Lluis , Perry George H. , Barreiro Luis B.
Published: December 2018

The shift from a hunter-gatherer (HG) to an agricultural (AG) mode of subsistence is believed to have been associated with profound changes in the burden and diversity of pathogens across human populations. Yet, the extent to which the advent of agriculture may have impacted the evolution of the human immune system remains unknown. Here we present a comparative study of variation in the transcriptional responses of peripheral blood mononuclear cells to bacterial and viral stimuli between Batwa rainforest hunter-gatherers and Bakiga agriculturalists from Uganda. We observed increased divergence between hunter-gatherers and agriculturalists in the transcriptional response to viruses compared to that for bacterial stimuli. We demonstrate that a significant fraction of these transcriptional differences are under genetic control, and we show that positive natural selection has helped to shape population differences in immune regulation. Across the set of genetic variants underlying inter-population immune response differences, however, the signatures of positive selection were disproportionately observed in the rainforest hunter-gatherers. This result is counter to expectations based on the popularized notion that shifts in pathogen exposure due to the advent of agriculture imposed radically heightened selective pressures in agriculturalist populations.