bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between Juvenile Fish Condition and Survival to Adulthood in Steelhead
Authors: Evans A. F. , Hostetter N. J. , Collis K. , Roby D. D. , Loge F. J.
Published: October 2017

Understanding how individual characteristics are associated with survival is important to programs aimed at recovering fish populations of conservation concern. To evaluate whether individual fish characteristics observed during the juvenile life stage were associated with the probability of returning as an adult, juvenile steelhead Oncorhynchus mykiss from two distinct population segments (DPSs; Snake River and upper Columbia River) were captured, photographed to determine external condition (body injuries, descaling, signs of disease, fin damage, and ectoparasites), measured, classified by rearing type (hatchery, wild), marked with a PIT tag, and released to continue out‐migration to the Pacific Ocean during 2007–2010. The PIT tags of returning adults were interrogated in fishways at hydroelectric dams on the lower Columbia River 1–3 years following release as juveniles. Juvenile‐to‐adult survival models were investigated independently for each DPS and indicated that similar individual fish characteristics were important predictors of survival to adulthood for both steelhead populations. The data analysis provided strong support for survival models that included explanatory variables for fish length, rearing type, and external condition, in addition to out‐migration year and timing. The probability of a juvenile surviving to adulthood was positively related to length and was higher for wild fish compared with hatchery fish. Survival was lower for juveniles with body injuries, fin damage, and external signs of disease. Models that included variables for descaling and ectoparasite infestation, however, had less support than those that incorporated measures of body injuries, fin damage, and disease. Overall, results indicated that individual fish characteristics recorded during the juvenile life stage can be used to predict adult survivorship in multiple steelhead populations.

Received August 20, 2013; accepted February 14, 2014
Fine‐Scale Movements and Home Ranges of Red Snapper around Artificial Reefs in the Northern Gulf of Mexico
Authors: Piraino Maria N. , Szedlmayer Stephen T.
Published: October 2017

Red Snapper Lutjanus campechanus are generally associated with artificial reef habitats in the northern Gulf of Mexico, but whether this association results in fish production is still controversial. Information on fine‐scale habitat use patterns would be helpful in evaluating this. Little is known about the fine‐scale movement patterns of Red Snapper around artificial reefs. The present study examined fine‐scale (∼1‐m accuracy) movements of Red Snapper with the Vemco VR2W Positioning System. This system enabled continuous monitoring of tagged fish from 100 to 694 d. Locations of individual fish were recorded approximately every 10 min and totaled over 1.9 million accurate locations of Red Snapper from August 2010 through May 2012. Red Snapper showed close association with the reef structure (mean ± SD distance = 26.3 ± 35.4 m) but differential habitat use in relation to both diel and seasonal periods. Home range areas (95% kernel density estimates [KDE]) were significantly larger during day than night periods and showed the lowest area use at dawn and dusk. Monthly home ranges (95% KDE) and core areas (50% KDE) were significantly larger in spring, summer, and fall than in winter and were significantly correlated with water temperature, suggesting colder winter temperatures reduced Red Snapper movement. Home range area was significantly correlated with fish size (407–590 mm standard length), and the fish in this study showed the highest site fidelity (88% still present after >10 months) of any Red Snapper in other previous studies. Red Snapper also showed use of multiple reefs within the monitoring area, as home ranges (95% KDE) showed a second peak around other artificial reefs. The high site fidelity, long‐term use, and concentrated use of multiple artificial reefs confirm the importance of structured habitat for Red Snapper.

Received September 1, 2013; accepted February 27, 2014
Sampling Little Fish in Big Rivers: Larval Fish Detection Probabilities in Two Lake Erie Tributaries and Implications for Sampling Effort and Abundance Indices
Authors: Pritt Jeremy J. , DuFour Mark R. , Mayer Christine M. , Roseman Edward F. , DeBruyne Robin L.
Published: October 2017

Larval fish are frequently sampled in coastal tributaries to determine factors affecting recruitment, evaluate spawning success, and estimate production from spawning habitats. Imperfect detection of larvae is common, because larval fish are small and unevenly distributed in space and time, and coastal tributaries are often large and heterogeneous. We estimated detection probabilities of larval fish from several taxa in the Maumee and Detroit rivers, the two largest tributaries of Lake Erie. We then demonstrated how accounting for imperfect detection influenced (1) the probability of observing taxa as present relative to sampling effort and (2) abundance indices for larval fish of two Detroit River species. We found that detection probabilities ranged from 0.09 to 0.91 but were always less than 1.0, indicating that imperfect detection is common among taxa and between systems. In general, taxa with high fecundities, small larval length at hatching, and no nesting behaviors had the highest detection probabilities. Also, detection probabilities were higher in the Maumee River than in the Detroit River. Accounting for imperfect detection produced up to fourfold increases in abundance indices for Lake Whitefish Coregonus clupeaformis and Gizzard Shad Dorosoma cepedianum. The effect of accounting for imperfect detection in abundance indices was greatest during periods of low abundance for both species. Detection information can be used to determine the appropriate level of sampling effort for larval fishes and may improve management and conservation decisions based on larval fish data.

Received August 12, 2013; accepted March 7, 2014
Fishway Bottleneck Relief Models: a Case Study using Radio‐Tagged Pacific Lampreys
Authors: Keefer Matthew L. , Caudill Christopher C. , Moser Mary L.
Published: October 2017

Structural or operational changes to fishways can improve fish passage efficiency, but there is often uncertainty regarding which improvements will be most effective. We developed a “bottleneck relief” model using Kaplan–Meier methods to help managers assess where remediation efforts are likely to provide the largest increases in fishway passage. The simulation model uses a matrix of observed efficiency estimates from fishway subsections and incorporates multiple passage attempts by individual tagged fish. In a case study application to test the model, we used radiotelemetry data from 2,170 adult Pacific Lampreys Entosphenus tridentatus at Bonneville Dam (Columbia River, Washington–Oregon), which features multiple fishways and low lamprey passage success (mean fishway passage efficiency ∼0.50; n = 10 years). The model was run iteratively to test potential dam passage benefits from improving efficiency in 20 individual fishway segments. The highest benefits were for improvements at top‐of‐fishway segments and at sites where passage routes converged. Benefits were lower for segments used by fewer fish, segments located downstream from serious bottlenecks, and segments with a limited scope for improvement (i.e., efficiency was already high). The model provides a flexible and objective method for assessing complex fish passage problems and informing remediation decision making.

Received December 19, 2013; accepted March 11, 2014
Preparation of chemical conversion super-black films on ZK61M magnesium alloy
Authors: Yan Zhenwei , Tan Zhaojun , Yuan Xianjie
Published: October 2017

Four different super-black conversion films on ZK61M magnesium alloys were investigated in this work. Macro- and micro-morphologies of the conversion films were observed using a digital camera and scanning electron microscope, respectively. Salt spray testing and electrochemical measurements were used to examine the corrosion resistance of the conversion films. The emissivities of the conversion films were measured using the Fourier transform infrared spectrometry. The results show that all conversion films reduced the corrosion rate of the magnesium alloy substrates effectively; in particular, the film prepared using 230 g L−1 HF + 150 g L−1 Na2Cr2O7·2H2O + 2.5 g L−1 CaF2 mixed solution had a higher corrosion resistance. Moreover, the emissivities of the conversion films prepared using 230 g L−1 HF + 180 g L−1 Na2Cr2O7·2H2O + 270 g L−1 HNO3 and 230 g L−1 HF + 150 g L−1 Na2Cr2O7·2H2O + 2.5 g L−1 CaF2 mixed solutions were very high; the values exceeded 0.9 at room temperature.
Genetic Composition of Largemouth Bass in Puerto Rico Reservoirs
Authors: Peterson Nick R. , Lutz-Carrillo Dijar , Neal J. Wesley
Published: October 2017

The Largemouth Bass Micropterus salmoides includes two recognized subspecies, the Northern Largemouth Bass (NLMB; M. salmoides salmoides) and the Florida Largemouth Bass (FLMB; M. salmoides floridanus), which can hybridize to produce introgressed Largemouth Bass (ILMB; NLMB × FLMB). Largemouth Bass were introduced into Puerto Rico by using source populations from unknown origins (1915), a natural intergrade zone (1946 and 1947; ILMB), and peninsular Florida (1957; FLMB). All subsequent supplemental stocking efforts used broodstock collected from reservoirs in Puerto Rico with an effort to preferentially propagate non-introgressed FLMB. Here, we document contemporary FLMB-specific alleles and genotypes, changes in allele frequencies over the last decade, and differences in size structure between genotypes of the FLMB and its hybrids (ILMB) in Puerto Rico. Among 12 island reservoirs, FLMB alleles were prevalent at rates similar to estimates from a decade earlier, and the proportion of FLMB alleles (0.77–0.85) was less than that of the hatchery broodstock. No NLMB genotypes were resolved, and the proportion of FLMB genotypes ranged from 0.03 to 0.64. Length frequency distributions differed between the FLMB and ILMB types (Kolmogorov D-statistic = 0.172, P = 0.026), with FLMB observed more frequently in larger size-classes. Given their greater sizes and potentially greater longevity, we suggest that FLMB should be used exclusively for future stocking efforts in Puerto Rico.

Received January 25, 2017; accepted July 3, 2017 Published online October 11, 2017
Detection Efficiency of a Portable PIT Antenna for Two Small-Bodied Fishes in a Piedmont Stream
Authors: Kelly Brett B. , Cary Joshua B. , Smith Alisha D. , Pregler Kasey C. , Kim Seoghyun , Kanno Yoichiro
Published: October 2017

Passive integrated transponder (PIT) tags have been used to infer demography and behavior of lotic fishes, but their application has mostly been limited to salmonids. We studied the efficiency of a portable PIT antenna in a small Piedmont stream (mean width = 2.4 m) in South Carolina by comparing two tag sizes (8- and 12-mm full-duplex tags) applied to two nongame species (Mottled Sculpin Cottus bairdii and Creek Chub Semotilus atromaculatus). A 285-m stream reach was blocked off under base flow conditions in September 2016, and 8- or 12-mm PIT tags were implanted in 67 Creek Chub (62–138 mm TL) and 65 Mottled Sculpin (60–88 mm TL). Starting at 1 d after tagging, the study reach was sampled with the portable PIT antenna twice daily for five consecutive days, during which apparent survival of tagged fish was assumed. Generalized linear mixed-effects models with a logistic link identified that detection efficiency depended on species, tag size, body length, and the species × body length interaction. Mottled Sculpin had detection rates of 56% (8-mm tags) and 79% (12-mm tags), with 67% of detections occurring in riffle-dominated sections, whereas Creek Chub had 3% (8-mm tags) and 16% (12-mm tags) detection rates, with 62% of detections occurring in pool-dominated sections. Detection efficiency decreased with body size in Creek Chub but not in Mottled Sculpin; the observed decrease for Creek Chub was most likely attributable to an ontogenetic habitat shift. The reasonably high detection efficiency of Mottled Sculpin, even with 8-mm tags, suggested that the portable PIT antenna can be a viable option for some species in small streams, allowing individual-based approaches to studying small-bodied species or earlier life stages without the need for repeated physical capture and handling.

Received May 13, 2017; accepted October 2, 2017Published online November 10, 2017
Helminthosporic acid functions as an agonist for gibberellin receptor
Authors: Miyazaki Sho , Jiang Kai , Kobayashi Masatomo , Asami Tadao , Nakajima Masatoshi
Published: October 2017

Helminthosporol was isolated from a fungus, Helminthosporium sativum, as a natural plant growth regulator in 1963. It showed gibberellin-like bioactivity that stimulated the growth of the second leaf sheath of rice. After studying the structure–activity relationship between the compound and some synthesized analogs, it was found that helminthosporic acid (H-acid) has higher gibberellin-like activity and chemical stability than helminthosporol. In this study, we showed that (1) H-acid displays gibberellin-like activities not only in rice but also in Arabidopsis, (2) it regulates the expression of gibberellin-related genes, (3) it induces DELLA degradation through binding with a gibberellin receptor (GID1), and (4) it forms the GID1-(H-acid)-DELLA complex to transduce the gibberellin signal in the same manner as gibberellin. This work shows that the H-acid mode of action acts as an agonist for gibberellin receptor.
An enzymatic method for the production of 6-oxohexanoic acid from 6-aminohexanoic acid by an enzyme oxidizing ω-amino compounds from Phialemonium sp. AIU 274
Authors: Yamada Miwa , Ooe Mitsuaki , Sasaki Tomoko , Miyazaki Masao , Isobe Kimiyasu
Published: October 2017

An enzymatic method for 6-oxohexanoic acid production was developed using 6-aminohexanoic acid and an ω-amino group-oxidizing enzyme (ω-AOX) from Phialemonium sp. AIU 274. 6-Oxohexanoic acid was produced from 6-aminohexanoic acid with 100% yield by incubation with 0.3 U of the ω-AOX and 20 U of catalase at 30 °C for 30 h in 0.1 M potassium phosphate buffer (pH 7.0).
Resonances for the Laplacian on Riemannian symmetric spaces: The case of 𝑆𝐿(3,ℝ)/𝕊𝕆(3)
Authors: Hilgert J. , Pasquale A. , Przebinda T.
Published: October 2017

We show that the resolvent of the Laplacian on

S
L

(
3
,

R

)

/

S
O

(
3
)

\mathrm {SL}(3,\mathbb {R})/\mathrm {SO}(3)

can be lifted to a meromorphic function on a Riemann surface which is a branched covering of

C

\mathbb C

. The poles of this function are called the resonances of the Laplacian. We determine all resonances and show that the corresponding residue operators are given by convolution with spherical functions parameterized by the resonances. The ranges of these operators are infinite dimensional irreducible

S
L

(
3
,

R

)

\mathrm {SL}(3,\mathbb {R})

-representations. We determine their Langlands parameters and wave front sets. Also, we show that precisely one of these representations is unitarizable. Alternatively, they are given by the differential equations which determine the image of the Poisson transform associated with the resonance.
Castelnuovo-Mumford regularity of Koszul cycles and Koszul homologies
Authors: Lamei Kamran , Nemati Navid
Published: October 2017

We extend to one dimensional quotients the result of A. Conca and S. Murai on the convexity of the regularity of Koszul cycles. By providing a relation between the regularity of Koszul cycles and Koszul homologies we prove a sharp regularity bound for the Koszul homologies of a homogeneous ideal in a polynomial ring under the same conditions.
A generally applicable lightweight method for calculating a value structure for tools and services in bioinformatics infrastructure projects
Authors: Mayer Gerhard , Quast Christian , Felden Janine , Lange Matthias , Prinz Manuel , Pühler Alfred , Lawerenz Chris , Scholz Uwe , Glöckner Frank Oliver , Müller Wolfgang , Marcus Katrin , Eisenacher Martin
Published: October 2017

Sustainable noncommercial bioinformatics infrastructures are a prerequisite to use and take advantage of the potential of big data analysis for research and economy. Consequently, funders, universities and institutes as well as users ask for a transparent value model for the tools and services offered. In this article, a generally applicable lightweight method is described by which bioinformatics infrastructure projects can estimate the value of tools and services offered without determining exactly the total costs of ownership. Five representative scenarios for value estimation from a rough estimation to a detailed breakdown of costs are presented. To account for the diversity in bioinformatics applications and services, the notion of service-specific ‘service provision units’ is introduced together with the factors influencing them and the main underlying assumptions for these ‘value influencing factors’. Special attention is given on how to handle personnel costs and indirect costs such as electricity. Four examples are presented for the calculation of the value of tools and services provided by the German Network for Bioinformatics Infrastructure (de.NBI): one for tool usage, one for (Web-based) database analyses, one for consulting services and one for bioinformatics training events. Finally, from the discussed values, the costs of direct funding and the costs of payment of services by funded projects are calculated and compared.
An omnibus test for differential distribution analysis of microbiome sequencing data
Authors: Chen Jun , King Emily , Deek Rebecca , Wei Zhi , Yu Yue , Grill Diane , Ballman Karla
Published: October 2017

Motivation

One objective of human microbiome studies is to identify differentially abundant microbes across biological conditions. Previous statistical methods focus on detecting the shift in the abundance and/or prevalence of the microbes and treat the dispersion (spread of the data) as a nuisance. These methods also assume that the dispersion is the same across conditions, an assumption which may not hold in presence of sample heterogeneity. Moreover, the widespread outliers in the microbiome sequencing data make existing parametric models not overly robust. Therefore, a robust and powerful method that allows covariate-dependent dispersion and addresses outliers is still needed for differential abundance analysis.

Results

We introduce a novel test for differential distribution analysis of microbiome sequencing data by jointly testing the abundance, prevalence and dispersion. The test is built on a zero-inflated negative binomial regression model and winsorized count data to account for zero-inflation and outliers. Using simulated data and real microbiome sequencing datasets, we show that our test is robust across various biological conditions and overall more powerful than previous methods.

Availability and implementation

R package is available at https://github.com/jchen1981/MicrobiomeDDA.

Supplementary information

Supplementary data are available at Bioinformatics online.
Radial head resection and hemi-interposition arthroplasty in patients with multiple hereditary exostoses: description of a new surgical technique
Authors: Flipsen Mark , Ham John S. , van der Zwan Arnard L. , Mader Konrad
Published: October 2017

Multiple hereditary exostoses (MHE) are a rare disorder characterized by the growth of bony protrusions. Elbow involvement is found in a considerable number of patients and varies from the presence of a simple osteochondroma to severe forearm deformities and radial head dislocation. Patients encounter a variety of symptoms, for example, pain, functional impairment, and cosmetic concerns. Several types of surgical procedures, therefore, can be offered, ranging from excision of symptomatic osteochondromas to challenging reconstructions. In this paper, we will discuss the essential basics of visualizing, planning, and treatment options of forearm deformities in MHE. In more detail, we will describe our current surgical technique as a salvage procedure for Masada type II forearm deformities in patients with MHE.
Quantification of Propionic Acid in the Bovine Spinal Disk After Infection of the Tissue With Propionibacteria acnes Bacteria
Authors: Magnitsky Sergey , Dudli Stefan , Tang Xinyan , Kaur Jaskanwaljeet , Diaz Joycelyn , Miller Steve , Lotz Jeffrey C.
Published: October 2017

Study Design.

Research.

Objective.

The goal of this study was to investigate whether Propionibacteria acnes infection of the intervertebral disc can be detected noninvasively by nuclear magnetic resonance (NMR) spectroscopy.

Summary of Background Data.

Microbiological studies of surgical samples suggest that a significant subpopulation of back pain patients may have occult disc infection with P. acnes bacteria. This hypothesis is further supported by a double-blind clinical trial showing that back pain patients with Modic type 1 changes may respond to antibiotic treatment. Because significant side effects are associated with antibiotic treatment, there is a need for a noninvasive method to detect whether specific discs in back pain patients are infected with P acnes bacteria.

Methods.

P. acnes bacteria were obtained from human patients. NMR detection of a propionic acid (PA) in the bacteria extracts was conducted on 500 MHz high-resolution spectrometer, whereas in vivo NMR spectroscopy of an isolated bovine disk tissue infected with P. acnes was conducted on 7 T magnetic resonance imaging scanner.

Results.

NMR spectra of P. acnes metabolites revealed a distinct NMR signal with identical chemical shits (1.05 and 2.18 ppm) as PA (a primary P. acne metabolite). The 1.05 ppm signal does not overlap with other bacteria metabolites, and its intensity increases linearly with P. acnes concentration. Bovine disks injected with P. acnes bacteria revealed a very distinct NMR signal at 1.05 ppm, which linearly increased with P. acnes concentration.

Conclusion.

The 1.05 ppm NMR signal from PA can be used as a marker of P. acnes infection of discs. This signal does not overlap with other disc metabolites and linearly depends on P. acnes concentration. Consequently, NMR spectroscopy may provide a noninvasive method to detect disc infection in the clinical setting.

Level of Evidence: N/A
Outcomes of ICU Patients With a Discharge Diagnosis of Critical Illness Polyneuromyopathy: A Propensity-Matched Analysis
Authors: Kelmenson Daniel A. , Held Natalie , Allen Richard R. , Quan Dianna , Burnham Ellen L. , Clark Brendan J. , Ho P. Michael , Kiser Tyree H. , Vandivier R. William , Moss Marc
Published: October 2017

Objectives:

To assess the impact of a discharge diagnosis of critical illness polyneuromyopathy on health-related outcomes in a large cohort of patients requiring ICU admission.

Design:

Retrospective cohort with propensity score–matched analysis.

Setting:

Analysis of a large multihospital database.

Patients:

Adult ICU patients without preexisting neuromuscular abnormalities and a discharge diagnosis of critical illness polyneuropathy and/or myopathy along with adult ICU propensity-matched control patients.

Interventions:

None.

Measurements and Main Results:

Of 3,567 ICU patients with a discharge diagnosis of critical illness polyneuropathy and/or myopathy, we matched 3,436 of these patients to 3,436 ICU patients who did not have a discharge diagnosis of critical illness polyneuropathy and/or myopathy. After propensity matching and adjusting for unbalanced covariates, we used conditional logistic regression and a repeated measures model to compare patient outcomes. Compared to patients without a discharge diagnosis of critical illness polyneuropathy and/or myopathy, patients with a discharge diagnosis of critical illness polyneuropathy and/or myopathy had fewer 28-day hospital-free days (6 [0.1] vs 7.4 [0.1] d; p < 0.0001), had fewer 28-day ventilator-free days (15.7 [0.2] vs 17.5 [0.2] d; p < 0.0001), had higher hospitalization charges (313,508 [4,853] vs 256,288 [4,470] dollars; p < 0.0001), and were less likely to be discharged home (15.3% vs 32.8%; p < 0.0001) but had lower in-hospital mortality (13.7% vs 18.3%; p < 0.0001).

Conclusions:

In a propensity-matched analysis of a large national database, a discharge diagnosis of critical illness polyneuropathy and/or myopathy is strongly associated with deleterious outcomes including fewer hospital-free days, fewer ventilator-free days, higher hospital charges, and reduced discharge home but also an unexpectedly lower in-hospital mortality. This study demonstrates the clinical importance of a discharge diagnosis of critical illness polyneuropathy and/or myopathy and the need for effective preventive interventions.
Dysphagia in Mechanically Ventilated ICU Patients (DYnAMICS): A Prospective Observational Trial
Authors: Schefold Joerg C. , Berger David , Zürcher Patrick , Lensch Michael , Perren Andrea , Jakob Stephan M. , Parviainen Ilkka , Takala Jukka
Published: October 2017

Objectives:

Swallowing disorders may be associated with adverse clinical outcomes in patients following invasive mechanical ventilation. We investigated the incidence of dysphagia, its time course, and association with clinically relevant outcomes in extubated critically ill patients.

Design:

Prospective observational trial with systematic dysphagia screening and follow-up until 90 days or death.

Settings:

ICU of a tertiary care academic center.

Patients:

One thousand three-hundred four admissions of mixed adult ICU patients (median age, 66.0 yr [interquartile range, 54.0–74.0]; Acute Physiology and Chronic Health Evaluation-II score, 19.0 [interquartile range, 14.0–24.0]) were screened for postextubation dysphagia. Primary ICU admissions (n = 933) were analyzed and followed up until 90 days or death. Patients from an independent academic center served as confirmatory cohort (n = 220).

Interventions:

Bedside screening for dysphagia was performed within 3 hours after extubation by trained ICU nurses. Positive screening triggered confirmatory specialist bedside swallowing examinations and follow-up until hospital discharge.

Measurements and Main Results:

Dysphagia screening was positive in 12.4% (n = 116/933) after extubation (18.3% of emergency and 4.9% of elective patients) and confirmed by specialists within 24 hours from positive screening in 87.3% (n = 96/110, n = 6 missing data). The dysphagia incidence at ICU discharge was 10.3% (n = 96/933) of which 60.4% (n = 58/96) remained positive until hospital discharge. Days on feeding tube, length of mechanical ventilation and ICU/hospital stay, and hospital mortality were higher in patients with dysphagia (all p < 0.001). The univariate hazard ratio for 90-day mortality for dysphagia was 3.74 (95% CI, 2.01–6.95; p < 0.001). After adjustment for disease severity and length of mechanical ventilation, dysphagia remained an independent predictor for 28-day and 90-day mortality (excess 90-d mortality 9.2%).

Conclusions:

Dysphagia after extubation was common in ICU patients, sustained until hospital discharge in the majority of affected patients, and was an independent predictor of death. Dysphagia after mechanical ventilation may be an overlooked problem. Studies on underlying causes and therapeutic interventions seem warranted.
Personal and Professional Characteristics of U.S. Dual-Boarded Critical Care Cardiologists in 2015
Authors: Blumenthal Daniel M. , Mikhael Bassem , Lawler Patrick R. , Yeh Robert W. , Metlay Joshua P. , Dudzinski David M.
Published: October 2017

Objectives:

Evaluate the characteristics of U.S. physicians who are board certified in cardiology and critical care medicine (“dual-boarded cardiologists”).

Design:

Retrospective cross-sectional study using a comprehensive database of licensed U.S. physicians linked to Medicare claims.

Setting:

The United States.

Subjects:

Dual-boarded cardiologists.

Measurements and Main Results:

We used a comprehensive physician database to identify all physicians who were board certified in cardiology and critical care medicine before July 2015. We assessed physicians’ characteristics and compared dual-boarded cardiologists with and without active board certification in critical care medicine and estimated the maximum proportion of 2014 Medicare Cardiac ICU admissions treated by dual-boarded cardiologists. Among 473 dual-boarded cardiologists, 16 (3.4%) were women; 468 (99%) and 85 (18%) maintained active board certification in cardiology and critical care medicine, respectively. Overall, 98 dual-boarded cardiologists (21%) submitted 1,215 total claims for critical care services in 2014. Compared to dual-boarded cardiologists without active board certification in critical care medicine, those with active certification had more publications (median publications: 6.5 vs 3.0; p = 0.002), were more likely to be professors (22.3% vs 9.5%; p = 0.003), and were more likely to bill Medicare for critical care services (29% vs 17.8%; p = 0.002). We estimated that no more than 0.47% of all 2014 Medicare Cardiac ICU admissions were treated by a dual-boarded cardiologist.

Conclusions:

Dual-boarded cardiologists appear to deliver a small proportion of all Cardiac ICU services received by Medicare beneficiaries. Optimizing the modern Cardiac ICU workforce will require greater efforts to promote and support the training of dual-boarded cardiologists.
Novel Sternal Protection Device for Cardiac Surgery via Median Sternotomy Incision
Authors: Marasco Silvana F. , McGiffin David C. , Zimmet Adam D. , Soils Pablo C. , Bingham Judy M. , Moshinsky Randall A.
Published: October 2017

Objective

Sternal bleeding during cardiac surgery is currently controlled using bone wax or other chemical substances that may result in adverse effects and affect wound healing and recovery. The purpose of this study was to identify a safe, cost-effective, and easy-to-use technique to reduce sternal bleeding and sternal trauma during cardiac surgery.

Methods

After sternotomy, a sternal protection device was placed over each hemisternal section before insertion of the retractor and remained in situ until the end of surgery. Sternal bleeding and ease of use were assessed and recorded during surgery. Sternal trauma was assessed and recorded within 5 minutes of removal of the device, and overall satisfaction (Global Impression) and any intraoperative adverse events or device malfunction were reported at surgery completion. Patients were followed up 24 hours and 4 weeks after surgery.

Results

Twelve patients completed the study. Adverse events reported were not considered related to the device. No sternal trauma was identified in any patient. In 9 of 11 patients, sternal bleeding was reduced after insertion of the device. The device was generally considered easy to use, although some difficulty was encountered when used with the Internal Mammary Artery retractor.

Conclusions

Our data suggest that the device is safe and able to reduce sternal bleeding during surgery using sternal retractors. We recommend further studies in a larger population of patients with a control group to evaluate the device's ability to reduce the morbidity associated with sternal bleeding and sternal trauma.
Staged Repair of a Ruptured Thoracic Aortic Aneurysm Having an Aorto-Parenchymal Fistula
Authors: Yoshitake Akihiro , Okamoto Kazuma , Kasai Mio , Shimizu Hideyuki
Published: October 2017

Ruptured thoracic aortic aneurysms, having aorto-bronchial or pulmonary parenchymal fistulations, are life-threatening conditions, and current surgical treatment results are not satisfactory. Herein, we describe a 69-year-old man with a ruptured thoracic aortic aneurysm and aorto-pulmonary parenchymal fistulation that was successfully treated using a staged repair. The first stage involved an emergency thoracic endovascular aortic repair for salvage and the second stage involved radical pulmonary parenchymal repair with removal of the stent graft and aortic reconstruction for long-term survival.
Renal dysfunction and cirrhosis
Authors: Durand François , Olson Jody C. , Nadim Mitra K.
Published: October 2017

Purpose of review

Hepatorenal syndrome (HRS) does not represent the predominant phenotype of acute kidney injury (AKI) in cirrhosis. Early recognition of HRS helps initiate appropriate therapy. The aims of this review are to present redefinition of AKI, to list new biomarkers, to report recent data on vasopressors in HRS and to propose criteria for simultaneous liver and kidney transplantation (SLKT).

Recent findings

Urine output, which was not part of the definition of AKI might be reconsidered as it has an independent prognostic value. Biomarkers (NGAL and IL-18) could help identify ATN. However, cut-off values have to be clarified. Vasopressors with albumin represent first option in HRS. Continuous infusion of terlipressin has a better safety profile than intravenous boluses. SLKT should be considered whenever native kidney recovery is unlikely [i.e. prolonged renal replacement therapy (RRT) and/or GFR less than 25 ml/min for 6 weeks prior to transplantation].

New definitions and recent biomarkers may help differentiate HRS from ATN at an earlier stage. Urine output should be reconsidered in the definitions. Even in patients who are not candidates for transplantation, a short trial of RRT is justified whenever needed. SLKT should be considered whenever posttransplant renal recovery is unlikely.
Favorable liver cancer mortality-to-incidence ratios of countries with high health expenditure
Authors: Wang Chi-Chih , Tsai Ming-Chang , Peng Cheng-Ming , Lee Hsiang-Lin , Chen Hsuan-Yi , Yang Tzu-Wei , Sung Wen-Wei , Lin Chun-Che
Published: October 2017

Objective

Health expenditure is a marker associated with an advanced healthcare system, which contributes toward the good prognosis of patients. Mortality-to-incidence ratios (MIRs) are one of the predictors that reflect the prognosis of cancer patients. There remains some uncertainty on the correlation of MIRs of liver cancer with the health expenditure of countries.

Methods

We therefore analyzed the correlation of MIRs from the GLOBOCAN 2012 database with the WHO rankings and the total expenditures on health/gross domestic product from WHO by linear regression analyses. A total of 29 countries were selected in this study according to the data quality and the incidence number.

Results

The results showed high rates of incidence/mortality and MIRs in less developed regions (0.92 vs. 0.96 for more vs. less developed regions). Among the continents, Asia has the highest incidence/mortality in case number, crude rate, and age-standardized rate. In terms of the MIR, Northern America has the lowest MIR and Latin America and the Caribbean have the highest MIRs (0.82 and 1.04, respectively). Finally, favorable MIRs are associated significantly with good WHO ranking and high expenditures on gross domestic product (P=0.048 and 0.025, respectively).

Conclusion

The MIR variation for liver cancer is thus found to be associated with the health expenditure and WHO ranking.
Complete Resolution of Lymphoid Interstitial Pneumonia in a Patient With Juvenile Myelomonocytic Leukemia Treated With Allogeneic Bone Marrow Transplant: Killing 2 Birds With 1 Stone
Authors: Vatsayan Anant , Talati Ravi , Nagle Kristen , Cabral Linda , Cammock Sloane , Dimarino Amy , Egler Rachel , Saab Shahrazad , Dalal Jignesh
Published: October 2017

Lymphoid interstitial pneumonia (LIP) is a rare disease characterized by benign reactive polyclonal proliferation of bronchus-associated lymphoid tissue after exposure to inhaled or circulating antigen(s), leading to a disease symptomatology similar to idiopathic interstitial pneumonia. Its association with diseases that are caused due to immune dysregulation (autoimmune diseases, congenital/acquired immunodeficiency, and allogeneic bone marrow transplant) and response to immunomodulatory/suppressive medications suggests an immunologic pathophysiology. Although LIP has been reported in association with lymphoproliferative diseases like Castleman disease, it has never been described in patients with leukemia. We report the first case of LIP in a patient with juvenile myelomonocytic leukemia (JMML) who was found to have a novel germline mutation of unknown significance in additional sex combs-like-1 (ASXL1) gene and a pathogenic somatic mutation of protein tyrosine phosphatase, nonreceptor type 11 (PTPN11) gene at diagnosis. The patient underwent a matched unrelated bone marrow transplant for JMML with complete resolution of JMML and LIP with no recurrence to date. We also emphasize the importance of considering LIP in differential diagnosis of pulmonary lesions seen in conjunction with hematologic malignancies and distinguishing it from malignant infiltration of the lung.
Complications and Patient-Reported Outcomes after Abdominally Based Breast Reconstruction: Results of the Mastectomy Reconstruction Outcomes Consortium Study
Authors: Erdmann-Sager Jessica , Wilkins Edwin G. , Pusic Andrea L. , Qi Ji , Hamill Jennifer B. , Kim Hyungjin Myra , Guldbrandsen Gretchen E. , Chun Yoon S.
Published: October 2017

Background:

Abdominal flap reconstruction is the most popular form of autologous breast reconstruction. The current study compared complications and patient-reported outcomes after pedicled transverse rectus abdominis myocutaneous (TRAM), free TRAM, deep inferior epigastric perforator (DIEP), and superficial inferior epigastric artery (SIEA) flaps.

Methods:

Patients undergoing abdominally based breast reconstruction at 11 centers were prospectively evaluated for abdominal donor-site and breast complications. Patient-reported outcomes were measured by the BREAST-Q and Patient-Reported Outcomes Measurement Information System surveys. Mixed-effects regression models were used to assess the effects of procedure type on outcomes.

Results:

Seven hundred twenty patients had 1-year follow-up and 587 had 2-year follow-up. Two years after reconstruction, SIEA compared with DIEP flaps were associated with a higher rate of donor-site complications (OR, 2.7; p = 0.001); however, SIEA flaps were associated with higher BREAST-Q abdominal physical well-being scores compared with DIEP flaps at 1 year (mean difference, 4.72, on a scale from 0 to 100; p = 0.053). This difference was not significant at 2 years. Abdominal physical well-being scores at 2 years postoperatively were lower in the pedicled TRAM flap group by 7.2 points (p = 0.006) compared with DIEP flaps and by 7.8 points (p = 0.03) compared with SIEA flaps, and in the free TRAM flap group, scores were lower by 4.9 points (p = 0.04) compared with DIEP flaps. Bilateral reconstruction had significantly lower abdominal physical well-being scores compared with unilateral reconstruction.

Conclusions:

Although all abdominally based flaps are viable breast reconstruction options, DIEP and SIEA flaps are associated with higher abdominal physical well-being than pedicled and free TRAM flaps. Although SIEA flaps offer the advantage of not violating the fascia, higher rates of donor-site complications may diminish patient satisfaction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, II.
The Addition of Platelet-Rich Plasma to Facial Lipofilling: A Double-Blind, Placebo-Controlled, Randomized Trial
Authors: Willemsen Joep C. N. , Van Dongen Joris , Spiekman Maroesjka , Vermeulen Karin M. , Harmsen Martin C. , van der Lei Berend , Stevens H. P. Jeroen
Published: October 2017

Background:

Lipofilling is a treatment modality to restore tissue volume, but it may also rejuvenate the aging skin. Platelet-rich plasma has been reported to augment the efficacy of lipofilling, both on graft take and rejuvenation, by altering the adipose-derived stem cells. The authors hypothesized that addition of platelet-rich plasma would increase the rejuvenating effect and shorten recovery time.

Methods:

The study conducted was a single-center, double-blind, placebo-controlled, randomized trial (2012 to 2015). In total, a well-defined cohort of 32 healthy female patients enrolled in the study, with 25 completing the follow-up. All patients underwent aesthetic facial lipofilling with either saline or platelet-rich plasma added. Outcome was determined by changes in skin elasticity, volumetric changes of the nasolabial fold, recovery time, and patient satisfaction during follow-up (1 year).

Results:

Platelet-rich plasma did not improve the outcome of facial lipofilling when looking at skin elasticity improvement, graft volume maintenance in the nasolabial fold. Reversal of the correlation between age and elasticity, however, might suggest a small effect size, and thus might not be significant with our small study population.

Conclusions:

This randomized, double-blind, placebo-controlled study clearly has shown that platelet-rich plasma significantly reduces postoperative recovery time but does not improve patient outcome when looking at skin elasticity, improvement of the nasolabial fold, or patient satisfaction. The reversal of the correlation between age and elasticity might indicate some effect on skin but requires more power in future studies.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, II.
Split-Overlapping Genioplasty: Surgical Technique, Morphological and Radiological Long-Term Outcomes
Authors: Roul-Yvonnet Flore , Quilichini Julien , Leyder Patrick
Published: October 2017

Background:

The overlapping bone flap genioplasty, described by Tessier, was developed to treat major retrognathia or long and retruded chins. For 15 years, we have used a modified version of this technique to avoid its drawbacks. The aim of this article is to describe our modification and evaluate the long-term morphologic and radiologic outcomes.

Patients and Method:

The authors included every split-overlapping genioplasty performed in our department between 2004 and 2014. Demographics, surgical data, and complications were recorded. Radiologic bone resorption was evaluated comparing preoperative, day-1 postoperative, and year-1 postoperative cephalometric x-rays. Morphologic outcomes were evaluated on standardized pre- and postoperative views using an analogic Likert scale.

Surgical Technique:

The main modification of the procedure consists in separating the posterior cortex of the transplant using a reciprocating saw. After overlapping the reduced transplant onto the mandible, the posterior cortex is used as an apposition graft to soften the labiomental crease.

Results:

Forty-seven patients were analyzed during this period. In 44 patients, the procedure was combined with mandibular and/or maxillary osteotomy. The average reduction of symphysis height was 5 mm, and the average pogonion advancement was 4.3 mm. After 1 year, we recorded 7% average bone resorption. No major complications (nerve injury, hematoma, among others) were reported. Morphologic outcomes were deemed satisfactory or very satisfactory in the vast majority of cases.

Conclusion:

Split-overlapping genioplasty is a safe and reliable procedure with stable, long-lasting outcomes. This versatile technique is particularly useful for the correction of a massive symphysis or high and retruded chins.
Fluctuations of Estimated Glomerular Filtration Rate Outside Kidney Disease Improving Global Outcomes Diagnostic Criteria for Acute Kidney Injury in End-Stage Liver Disease Outpatients and Outcome Postliver Transplantation
Authors: Fiacco Federica , Melandro Fabio , Umbro Ilaria , Zavatto Assunta , Cappoli Andrea , Poli Edoardo , Ginanni Corradini Stefano , Merli Manuela , Tinti Francesca , Nofroni Italo , Berloco Pasquale B. , Rossi Massimo , Mitterhofer Anna Paola
Published: October 2017

Background

Renal dysfunction in end-stage liver disease (ESLD) results from systemic conditions that affect both liver and kidney with activation of vasoconstrictor systems. In this setting, estimated glomerular filtration rate (eGFR) may undergo variations often outside Kidney Disease Improving Global Outcomes criteria for acute kidney injury (AKI) diagnosis, whose meaning is not clear. The aim of this study was to evaluate eGFR variations in ESLD outpatients listed for liver transplant (liver Tx) and the association with post-Tx outcome.

Methods

Fifty-one patients with ESLD were retrospectively evaluated from listing to transplant (L-Tx time), intraoperatively (Tx time), and up to 5 years post-Tx time. Variations between the highest and the lowest eGFR occurring in more than 48 hours, not satisfying Kidney Disease Improving Global Outcomes guideline, were considered as fluctuations (eGFR-F). Fluctuations of eGFR greater than 50% were defined as eGFR drops (DeGFR). Early graft dysfunction, AKI within 7 days, chronic kidney disease, and short- and long-term patient survivals were considered as outcomes.

Results

All patients presented eGFR-F, whereas DeGFR were observed in 18 (35.3%) of 51 (DeGFR+ group). These patients presented higher levels of Model for End-stage Liver Disease score, pre-Tx bilirubin and significantly greater incidence of post-Tx AKI stages 2 to 3 compared with patients without drops (DeGFR−). DeGFR was the only independent predictive factor of the occurrence of post-Tx AKI. The occurrence of AKI post-Tx was associated with the development of chronic kidney disease at 3 months and 5 years post-Tx.

Conclusions

Drops of eGFR are more frequently observed in patients with a worse degree of ESLD and are associated with a worse post-Tx kidney outcome.
Individual ant workers show self-control
Authors: Wendt Stephanie , Czaczkes Tomer J.
Published: October 2017

Often, the first option is not the best. Self-control can allow humans and animals to improve resource intake under such conditions. Self-control in animals is often investigated using intertemporal choice tasks—choosing a smaller reward immediately or a larger reward after a delay. However, intertemporal choice tasks may underestimate self-control, as test subjects may not fully understand the task. Vertebrates show much greater apparent self-control in more natural foraging contexts and spatial discounting tasks than in intertemporal choice tasks. However, little is still known about self-control in invertebrates. Here, we investigate self-control in the black garden ant
Lasius niger
. We confront individual workers with a spatial discounting task, offering a high-quality reward far from the nest and a poor-quality reward closer to the nest. Most ants (69%) successfully ignored the closer, poorer reward in favour of the further, better one. However, when both the far and the close rewards were of the same quality, most ants (83%) chose the closer feeder, indicating that the ants were indeed exercising self-control, as opposed to a fixation on an already known food source.
Sensory anatomy of the most aquatic of carnivorans: the Antarctic Ross seal, and convergences with other mammals
Authors: Loza Cleopatra Mara , Latimer Ashley E. , Sánchez-Villagra Marcelo R. , Carlini Alfredo A.
Published: October 2017

Transitions to and from aquatic life involve transformations in sensory systems. The Ross seal,
Ommatophoca rossii
, offers the chance to investigate the cranio-sensory anatomy in the most aquatic of all seals. The use of non-invasive computed tomography on specimens of this rare animal reveals, relative to other species of phocids, a reduction in the diameters of the semicircular canals and the parafloccular volume. These features are independent of size effects. These transformations parallel those recorded in cetaceans, but these do not extend to other morphological features such as the reduction in eye muscles and the length of the neck, emphasizing the independence of some traits in convergent evolution to aquatic life.