bluuebunny/crossref_metadata_2025 huggingface dataset:
Bayesian Hierarchical Modelling of Individual Expert Assessments in the Development of a General-Population Job-Exposure Matrix
Authors: Sauvé Jean-François , Sylvestre Marie-Pierre , Parent Marie-Élise , Lavoué Jérôme
Published: September 2019

The CANJEM job-exposure matrix compiles expert evaluations of 31 673 jobs from four population-based case–control studies conducted in Montreal. For each job, experts had derived indices of intensity, frequency, and probability of exposure to 258 agents. CANJEM summarizes the exposures assigned to jobs into cells defined by occupation/industry, agent, and period. Some cells may, however, be less populated than others, resulting in uncertain estimates. We developed a modelling framework to refine the estimates of sparse cells by drawing on information available in adjacent cells. Bayesian hierarchical logistic and linear models were used to estimate the probability of exposure and the geometric mean (GM) of frequency-weighted intensity (FWI) of cells, respectively. The hierarchy followed the Canadian Classification and Dictionary of Occupations (CCDO) classification structure, allowing for exposure estimates to be provided across occupations (seven-digit code), unit groups (four-digit code), and minor groups (three-digit code). The models were applied to metallic dust, formaldehyde, wood dust, silica, and benzene, and four periods, adjusting for the study from which jobs were evaluated. The models provided estimates of probability and FWI for all cells that pulled the sparsely populated cells towards the average of the higher-level group. In comparisons stratified by cell sample size, shrinkage of the estimates towards the group mean was marked below 5 jobs/cell, moderate from 5 to 9 jobs/cell, and negligible at ≥10 jobs/cell. The modelled probability of three-digit cells were slightly smaller than their descriptive estimates. No systematic trend in between-study differences in exposure emerged. Overall, the modelling framework for FWI appears to be a suitable approach to refine CANJEM estimates. For probability, the models could be improved by methods better adapted to the large number of cells with no exposure.
AssessORF: combining evolutionary conservation and proteomics to assess prokaryotic gene predictions
Authors: Korandla Deepank R , Wozniak Jacob M , Campeau Anaamika , Gonzalez David J , Wright Erik S
Published: September 2019

Motivation

A core task of genomics is to identify the boundaries of protein coding genes, which may cover over 90% of a prokaryote's genome. Several programs are available for gene finding, yet it is currently unclear how well these programs perform and whether any offers superior accuracy. This is in part because there is no universal benchmark for gene finding and, therefore, most developers select their own benchmarking strategy.

Results

Here, we introduce AssessORF, a new approach for benchmarking prokaryotic gene predictions based on evidence from proteomics data and the evolutionary conservation of start and stop codons. We applied AssessORF to compare gene predictions offered by GenBank, GeneMarkS-2, Glimmer and Prodigal on genomes spanning the prokaryotic tree of life. Gene predictions were 88–95% in agreement with the available evidence, with Glimmer performing the worst but no clear winner. All programs were biased towards selecting start codons that were upstream of the actual start. Given these findings, there remains considerable room for improvement, especially in the detection of correct start sites.

Availability and implementation

AssessORF is available as an R package via the Bioconductor package repository.

Supplementary information

Supplementary data are available at Bioinformatics online.
Adjuvanted Recombinant Glycoprotein E Herpes Zoster Vaccine
Authors: Levin Myron J , Weinberg Adriana
Published: September 2019

The adjuvanted recombinant glycoprotein E herpes zoster (HZ) vaccine is superior to the live attenuated HZ vaccine, with an efficacy >90% against HZ in healthy immunocompetent adults aged ≥50 years after vaccination. In pivotal studies, the efficacy of the new vaccine varied very little with the age of the vaccinee and decreased only by 5–10% in the 3.5 years after immunization. This nonlive vaccine was successfully administered to small cohorts of immunocompromised individuals; initial trials showed efficacy of >60–80% in several such settings. Potential drawbacks include the requirement for 2 vaccine doses separated by 2–6 months, local and systemic reactogenicity that is significantly greater than observed with commonly used vaccines, and the inclusion of a strong adjuvant that has been minimally studied in clinical settings where it might be problematic, such as in people with autoimmune diseases. Postmarketing studies are underway to address some of the drawbacks.
Perioperative Dietary Therapy in Inflammatory Bowel Disease
Authors: Adamina Michel , Gerasimidis Konstantinos , Sigall-Boneh Rotem , Zmora Oded , de Buck van Overstraeten Anthony , Campmans-Kuijpers Marjo , Ellul Pierre , Katsanos Konstantinos , Kotze Paulo Gustavo , Noor Nurulamin , Schäfli-Thurnherr Judit , Vavricka Stephan , Wall Catherine , Wierdsma Nicolette , Yassin Nuha , Lomer Miranda
Published: September 2019

Background and Aims

The incidence of inflammatory bowel disease [IBD] is rising worldwide and no cure is available. Many patients require surgery and they often present with nutritional deficiencies. Although randomised controlled trials of dietary therapy are lacking, expert IBD centres have long-established interdisciplinary care, including tailored nutritional therapy, to optimise clinical outcomes and resource utilisation. This topical review aims to share expertise and offers current practice recommendations to optimise outcomes of IBD patients who undergo surgery.

Methods

A consensus expert panel consisting of dietitians, surgeons, and gastroenterologists, convened by the European Crohn’s and Colitis Organisation, performed a systematic literature review. Nutritional evaluation and dietary needs, perioperative optimis ation, surgical complications, long-term needs, and special situations were critically appraised. Statements were developed using a Delphi methodology incorporating three successive rounds. Current practice positions were set when ≥80% of participants agreed on a recommendation.

Results

A total of 26 current practice positions were formulated which address the needs of IBD patients perioperatively and in the long term following surgery. Routine screening, perioperative optimisation by oral, enteral, or parenteral nutrition, dietary fibre, and supplements were reviewed. IBD-specific situations, including management of patients with a restorative proctocolectomy, an ostomy, strictures, or short-bowel syndrome, were addressed.

Conclusions

Perioperative dietary therapy improves the outcomes of IBD patients who undergo a surgical procedure. This topical review shares interdisciplinary expertise and provides guidance to optimise the outcomes of patients with Crohn’s disease and ulcerative colitis. taking advantage of contemporary nutrition science.
Comparative Genomic Analysis of the Pheromone Receptor Class 1 Family (V1R) Reveals Extreme Complexity in Mouse Lemurs (Genus, Microcebus) and a Chromosomal Hotspot across Mammals
Authors: Hunnicutt Kelsie E , Tiley George P , Williams Rachel C , Larsen Peter A , Blanco Marina B , Rasoloarison Rodin M , Campbell C Ryan , Zhu Kevin , Weisrock David W , Matsunami Hiroaki , Yoder Anne D
Published: September 2019

Sensory gene families are of special interest for both what they can tell us about molecular evolution and what they imply as mediators of social communication. The vomeronasal type-1 receptors (V1Rs) have often been hypothesized as playing a fundamental role in driving or maintaining species boundaries given their likely function as mediators of intraspecific mate choice, particularly in nocturnal mammals. Here, we employ a comparative genomic approach for revealing patterns of V1R evolution within primates, with a special focus on the small-bodied nocturnal mouse and dwarf lemurs of Madagascar (genera Microcebus and Cheirogaleus, respectively). By doubling the existing genomic resources for strepsirrhine primates (i.e. the lemurs and lorises), we find that the highly speciose and morphologically cryptic mouse lemurs have experienced an elaborate proliferation of V1Rs that we argue is functionally related to their capacity for rapid lineage diversification. Contrary to a previous study that found equivalent degrees of V1R diversity in diurnal and nocturnal lemurs, our study finds a strong correlation between nocturnality and V1R elaboration, with nocturnal lemurs showing elaborate V1R repertoires and diurnal lemurs showing less diverse repertoires. Recognized subfamilies among V1Rs show unique signatures of diversifying positive selection, as might be expected if they have each evolved to respond to specific stimuli. Furthermore, a detailed syntenic comparison of mouse lemurs with mouse (genus Mus) and other mammalian outgroups shows that orthologous mammalian subfamilies, predicted to be of ancient origin, tend to cluster in a densely populated region across syntenic chromosomes that we refer to as a V1R “hotspot.”
On discount rates for economic evaluations in global health
Authors: Haacker Markus , Hallett Timothy B , Atun Rifat
Published: September 2019

Choices on discount rates have important implications for the outcomes of economic evaluations of health interventions and policies. In global health, such evaluations typically apply a discount rate of 3% for health outcomes and costs, mirroring guidance developed for high-income countries, notably the USA. The article investigates the suitability of these guidelines for global health [i.e. with a focus on low- and middle-income countries (LMICs)] and seeks to identify best practice. Our analysis builds on an overview of the academic literature on discounting in health evaluations, existing academic or government-related guidelines on discounting, a review on discount rates applied in economic evaluations in global health, and cross-country macroeconomic data. The social discount rate generally applied in global health of 3% annually is inconsistent with rates of economic growth experienced outside the most advanced economies. For low- and lower-middle-income countries, a discount rate of at least 5% is more appropriate, and one around 4% for upper-middle-income countries. Alternative approaches—e.g. motivated by the returns to alternative investments or by the cost of financing—could usefully be applied, dependent on policy context. The current practise could lead to systematic bias towards over-valuing the future costs and health benefits of interventions. For health economic evaluations in global health, guidelines on discounting need to be adapted to take account of the different economic contexts of LMICs.
Dimension Theory and Degenerations of de Jonquières Divisors
Authors: Ungureanu Mara
Published: September 2019

This paper aims at settling the issue of the validity of the de Jonquières formulas. Consider the space of divisors with prescribed multiplicity, or de Jonquières divisors, contained in a linear series on a smooth projective curve. Under the assumption that this space is zero dimensional, the de Jonquières formulas compute the expected number of de Jonquières divisors. Using degenerations to nodal curves we show that, for a general curve equipped with a complete linear series, the space is of expected dimension, which shows that the counts are in fact true. This implies that in the case of negative expected dimension a general linear series on a general curve does not admit de Jonquières divisors of the expected type.
Glycopeptidolipid Genotype Correlates With the Severity of Mycobacterium abscessus Lung Disease
Authors: Li Bing , Ye Meiping , Zhao Lan , Guo Qi , Chen Jianhui , Xu Benyong , Zhan Mengling , Zhang Yongjie , Zhang Zhemin , Chu Haiqing
Published: September 2019

Background

Smooth and rough colony morphotypes of Mycobacterium abscessus are associated with virulence, but some isolates form both smooth and rough colonies, impeding successful morphotype identification. Reportedly, smooth/rough morphotypes are also related to the glycopeptidolipid (GPL) genotype. However, the accuracy of GPL genotyping to discriminate morphotypes and the relationship between GPL genotype and clinical characteristics of M abscessus lung disease have not been verified.

Methods

A retrospective analysis of colony morphology, GPL genotype, and clinical data from 182 patients with M abscessus lung disease was conducted.

Results

Of 194 clinical isolates, 126 (65.0%), 15 (7.7%), and 53 (27.3%) exhibited rough, smooth, and mixed colony morphotypes, respectively. Glycopeptidolipid genotyping indicated that 86.7% (13 of 15) of smooth isolates belonged to the GPL-wild type (WT) group, whereas 98.4% (124 of 126) of rough isolates belonged to the GPL-mutant type (MUT) group. Therefore, GPL genotyping accurately distinguished between smooth and rough morphotypes. Mixed colony morphotypes were also divided into GPL-WT (18.9%) and GPL-MUT (81.1%) groups. Further analysis revealed that patients infected with the GPL-MUT group presented with significantly worse baseline clinical characteristics and exacerbated episodes of lung disease.

Conclusions

Glycopeptidolipid genotyping accurately distinguishes smooth and rough colony morphotypes. Patients infected with the GPL-MUT genotype exhibit worse clinical characteristics and are at a higher risk of exacerbated lung disease.
A Pandrug-Resistant Providencia Carrying Two blaIMP Carbapenemase-Encoding Genes Including blaIMP-69, a New blaIMP Variant, on a Newly Identified Worldwide-Distributed IncC Plasmid
Authors: Zhang Xiaoxia , Wang Chengcheng , Feng Yu , Long Haiyan , Zong Zhiyong
Published: September 2019

Imipenemase (IMP) is a metallo-β-lactamase that confers resistance to almost all β-lactams. Identification of IMP genes is essential for understanding and combatting antibiotic resistance. In this study, we report a pandrug-resistant Providencia strain from a human rectal swab. This strain carried 2 blaIMP carbapenemase genes, blaIMP-69 and blaIMP-4. IMP-69 is a novel IMP variant with an amino acid substitution at A21T compared with IMP-8. blaIMP-69 was found in a blaIMP-69-aacA4 array of an integron on a 165-kilobase (kb) IncC self-transmissible plasmid, whereas blaIMP-4 was located in a blaIMP-4-qacG-aacA4-catB3 array of an integron on a 19-kb nonself-transmissible plasmid. Such coexistence has the potential to allow the generation of new, hybrid blaIMP variants by homologous recombination. The blaIMP-69-carrying IncC plasmid belonged to the core-genome plasmid multilocus sequence typing (cgPMLST) 3.5 type. We found that cgPMLST 3.5 IncC plasmids have been circulating worldwide for decades and may represent a common vehicle mediating the spread of antimicrobial resistance.
Applications of cerebrospinal fluid circulating tumor DNA in the diagnosis of gliomas
Authors: Zhao Zhenyu , Zhang Cheng , Li Mi , Shen Yiping , Feng Shiyu , Liu Jialin , Li Fangye , Hou Lei , Chen Zhong , Jiang Jingjing , Ma Xiaodong , Chen Ling , Yu Xinguang
Published: September 2019

Objective

The 2016 World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS) was revised to include molecular biomarkers as diagnostic criteria. However, conventional biopsies of gliomas were spatially and temporally limited. This study aimed to determine whether circulating tumor DNA (ctDNA) from cerebrospinal fluid (CSF) could provide more comprehensive diagnostic information to gliomas.

Methods

Combined with clinical data, we analyzed gene alterations from CSF and tumor tissues of newly diagnosed patients, and detected mutations of ctDNA in recurrent patients. We simultaneously analyzed mutations of ctDNA in different glioma subtypes, and in lower-grade gliomas (LrGG) versus glioblastoma multiforme (GBM).

Results

CSF ctDNA mutations had high concordance rates with tumor DNA (tDNA). CSF ctDNA mutations of PTEN and TP53 were commonly detected in recurrent gliomas patients. IDH mutation was detected in most of CSF ctDNA derived from IDH-mutant diffuse astrocytomas, while CSF ctDNA mutations of RB1 and EGFR were found in IDH-wild-type GBM. IDH mutation was detected in LrGG, whereas Rb1 mutation was more commonly detected in GBM.

Conclusions

CSF ctDNA detection can be an alternative method as liquid biopsy in gliomas.
Automatic Kalman-filter-based wavelet shrinkage denoising of 1D stellar spectra
Authors: Gilda Sankalp , Slepian Zachary
Published: September 2019

We propose a non-parametric method to denoise 1D stellar spectra based on wavelet shrinkage followed by adaptive Kalman thresholding. Wavelet shrinkage denoising involves applying the discrete wavelet transform (DWT) to the input signal, ‘shrinking’ certain frequency components in the transform domain, and then applying inverse DWT to the reduced components. The performance of this procedure is influenced by the choice of base wavelet, the number of decomposition levels, and the thresholding function. Typically, these parameters are chosen by ‘trial and error’, which can be strongly dependent on the properties of the data being denoised. We here introduce an adaptive Kalman-filter-based thresholding method that eliminates the need for choosing the number of decomposition levels. We use the ‘Haar’ wavelet basis, which we found to provide excellent filtering for 1D stellar spectra, at a low computational cost. We introduce various levels of Poisson noise into synthetic PHOENIX spectra, and test the performance of several common denoising methods against our own. It proves superior in terms of noise suppression and peak shape preservation. We expect it may also be of use in automatically and accurately filtering low signal-to-noise galaxy and quasar spectra obtained from surveys such as SDSS, Gaia, LSST, PESSTO, VANDELS, LEGA-C, and DESI.
Chromatin and other obstacles to base excision repair: potential roles in carcinogenesis
Authors: Caffrey Paul J , Delaney Sarah
Published: September 2019

DNA is comprised of chemically reactive nucleobases that exist under a constant barrage from damaging agents. Failure to repair chemical modifications to these nucleobases can result in mutations that can cause various diseases, including cancer. Fortunately, the base excision repair (BER) pathway can repair modified nucleobases and prevent these deleterious mutations. However, this pathway can be hindered through several mechanisms. For instance, mutations to the enzymes in the BER pathway have been identified in cancers. Biochemical characterisation of these mutants has elucidated various mechanisms that inhibit their activity. Furthermore, the packaging of DNA into chromatin poses another obstacle to the ability of BER enzymes to function properly. Investigations of BER in the base unit of chromatin, the nucleosome core particle (NCP), have revealed that the NCP acts as a complex substrate for BER enzymes. The constituent proteins of the NCP, the histones, also have variants that can further impact the structure of the NCP and may modulate access of enzymes to the packaged DNA. These histone variants have also displayed significant clinical effects both in carcinogenesis and patient prognosis. This review focuses on the underlying molecular mechanisms that present obstacles to BER and the relationship of these obstacles to cancer. In addition, several chemotherapeutics induce DNA damage that can be repaired by the BER pathway and understanding obstacles to BER can inform how resistance and/or sensitivity to these therapies may occur. With the understanding of these molecular mechanisms, current chemotherapeutic treatment regiments may be improved, and future therapies developed.
The internal interaction in RBBP5 regulates assembly and activity of MLL1 methyltransferase complex
Authors: Han Jianming , Li Tingting , Li Yanjing , Li Muchun , Wang Xiaoman , Peng Chao , Su Chen , Li Na , Li Yiwen , Xu Ying , Chen Yong
Published: September 2019

The Mixed Lineage Leukemia protein 1 (MLL1) plays an essential role in the maintenance of the histone H3 lysine 4 (H3K4) methylation status for gene expression during differentiation and development. The methyltransferase activity of MLL1 is regulated by three conserved core subunits, WDR5, RBBP5 and ASH2L. Here, we determined the structure of human RBBP5 and demonstrated its role in the assembly and regulation of the MLL1 complex. We identified an internal interaction between the WD40 propeller and the C-terminal distal region in RBBP5, which assisted the maintenance of the compact conformation of the MLL1 complex. We also discovered a vertebrate-specific motif in the C-terminal distal region of RBBP5 that contributed to nucleosome recognition and methylation of nucleosomes by the MLL1 complex. Our results provide new insights into functional conservation and evolutionary plasticity of the scaffold protein RBBP5 in the regulation of KMT2-family methyltransferase complexes.
AID–RNA polymerase II transcription-dependent deamination of IgV DNA
Authors: Pham Phuong , Malik Sohail , Mak Chiho , Calabrese Peter C , Roeder Robert G , Goodman Myron F
Published: September 2019

Activation-induced deoxycytidine deaminase (AID) initiates somatic hypermutation (SHM) in immunoglobulin variable (IgV) genes to produce high-affinity antibodies. SHM requires IgV transcription by RNA polymerase II (Pol II). A eukaryotic transcription system including AID has not been reported previously. Here, we reconstitute AID-catalyzed deamination during Pol II transcription elongation in conjunction with DSIF transcription factor. C→T mutations occur at similar frequencies on non-transcribed strand (NTS) and transcribed strand (TS) DNA. In contrast, bacteriophage T7 Pol generates NTS mutations predominantly. AID-Pol II mutations are strongly favored in WRC and WGCW overlapping hot motifs (W = A or T, R = A or G) on both DNA strands. Single mutations occur on 70% of transcribed DNA clones. Mutations are correlated over a 15 nt distance in multiply mutated clones, suggesting that deaminations are catalyzed processively within a stalled or backtracked transcription bubble. Site-by-site comparisons for biochemical and human memory B-cell mutational spectra in an IGHV3-23*01 target show strongly favored deaminations occurring in the antigen-binding complementarity determining regions (CDR) compared to the framework regions (FW). By exhibiting consistency with B-cell SHM, our in vitro data suggest that biochemically defined reconstituted Pol II transcription systems can be used to investigate how, when and where AID is targeted.
GAD65 as a potential marker for cognitive performance in an adult population with prediabetes
Authors: Tsai C -K , Kao T -W , Lee J -T , Wang C -C , Chou C H , Liang C -S , Yang F -C , Chen W -L
Published: September 2019

Background

Diabetes mellitus (DM) is a well-known risk factor for cognitive dysfunction in aged populations. However, there are inconsistent reports about impaired fasting glucose or prediabetes as an independent risk factor for cognitive function. Glutamic acid decarboxylase 65 (GAD65) is the key enzyme responsible for γ-aminobutyric acid synthesis in the central nervous system. Antibodies against GAD65 (GAD65Abs) are not only detected in approximately 80% of early-onset type 1 DM, but also linked to several neurological disorders.

Aim

This study aims to investigate the association between GAD65Ab titer levels and cognitive performance. In addition, we assessed the effect of GAD65Ab on cognitive function in adults with normal fasting glucose, prediabetes and DM.

Methods

A total of 328 subjects aged 49.10 ± 5.72 years were enrolled from the Third Health and Nutrition Examination Survey dataset. Cognitive performance was assessed by three computerized neurobehavioral tests, including the serial digit learning test, simple reaction time test (SRTT) and symbol-digit substitution test (SDST).

Results

Subjects with higher GAD65Ab titers had significantly poorer cognitive function in the SRTT and SDST (P < 0.05). Additionally, GAD65Ab was associated with cognitive decline in non-diabetic adults after adjusting for a number of relevant variables (P < 0.05 in both SRTT and SDST).

Conclusions

These results indicate that GAD65Ab may be a potential marker for cognitive impairment in non-diabetic adults.
Rootstock determines the drought resistance of poplar grafting combinations
Authors: Han Qingquan , Guo Qingxue , Korpelainen Helena , Niinemets Ülo , Li Chunyang
Published: September 2019

To increase yield and/or enhance resistance to diseases, grafting is often applied in agriculture and horticulture. Interspecific grafting could possibly be used in forestry as well to improve drought resistance, but our understanding of how the rootstock of a more drought-resistant species can affect the grafted plant is very limited. Reciprocal grafts of two poplar species, Populus cathayana Rehder (less drought-resistant, C) and Populus deltoides Bart. ex Marsh (more drought-resistant, D) were generated. Four grafting combinations (scion/rootstock: C/C, C/D, D/D and D/C) were subjected to well-watered and drought stress treatments. C/D and D/C had a higher diameter growth rate, leaf biomass, intrinsic water-use efficiency (WUEi) and total non-structural carbohydrate (NSC) content than C/C and D/D in well-watered condition. However, drought caused greater differences between P. deltoides-rooted and P. cathayana-rooted grafting combinations, especially between C/D and D/C. The C/D grafting combination showed higher resistance to drought, as indicated by a higher stem growth rate, net photosynthetic rate, WUEi, leaf water potential, proline concentration and NSC concentration and maintenance of integrity of the leaf cellular ultrastructure under drought when compared with D/C. D/C exhibited severely damaged cell membranes, mitochondria and chloroplasts under drought. The scion genotype caused a strong effect on the root proline concentration: the P. cathayana scion increased the root proline concentration more than the P. deltoides scion (C/C vs D/C and C/D vs D/D) under water deficit. Our results demonstrated that mainly the rootstock was responsible for the drought resistance of grafting combinations. Grafting of the P. cathayana scion onto P. deltoides rootstock resulted in superior growth and biomass when compared with the other three combinations both in well-watered and drought stress conditions.
Getting Objective About Subjective Age: Introduction to a Special Issue
Authors: Rudolph Cort W , Kunze Florian , Zacher Hannes
Published: September 2019

Researchers have become increasingly interested in age-related constructs other than chronological age, which has been found to explain only small amounts of variance in many important work outcomes. In this editorial that accompanies our special issue of Work, Aging and Retirement on “the multitude of age constructs,” we seek to attain three related goals: First, we provide an overview of our editorial process. Second, we offer brief summaries of the five papers that are included in this special issue. Third, and perhaps representing our most substantive contribution here, we present answers to six “big picture” questions about subjective age to inform future scholarly work. We conclude that, although many important questions about alternative age constructs remain to be answered, the papers in this special issue represent excellent examples of novel work in this arena and suggest several opportunities for how future research could more rigorously and critically apply these constructs to the study of work, aging and retirement.
Workplace Subjective Age Multidimensionality: Generation, Age, Tenure, Experience (GATE)
Authors: North Michael S , Shakeri Angela
Published: September 2019

Although less subjective age focused than other scholarly fields, organizational behavior (OB) faces a familiar challenge: comprehending an aging, increasingly age-diverse workforce, yet finding chronological age alone to be a limited predictor of key work outcomes (e.g., performance). A recent OB framework posits that going beyond chronological age necessitates disentangling distinct age-based constructs: perceived Generation (birth cohort), Age (life stage), Tenure (length of time with organization), and Experience (skill set accumulated over time; GATE). Although this framework originated as a means of enhancing predictions for a rapidly aging workforce, this commentary argues that GATE also provides a framework for understanding bases of subjective age itself, including an important distinction between more subjective elements (generation, life stage) versus more objective elements (tenure, experience). Future research on subjective age might well consider applying GATE elements in order to enhance a multidimensional understanding of subjective age underpinnings.
Patterns of Prescription Opioid Use in Women With Endometriosis: Evaluating Prolonged Use, Daily Dose, and Concomitant Use With Benzodiazepines
Authors: Lamvu Georgine , Soliman Ahmed M. , Manthena Shivaji R. , Gordon Keith , Knight Julie , Taylor Hugh S.
Published: September 2019

(Abstracted from Obstet Gynecol 2019;133:1120–1130)

Misuse and abuse of prescription opioids has increased dramatically in recent years and is reported to be the fastest-growing drug problem in the United States. Of the more than 350,000 deaths attributed to opioid overdose since 1999, an estimated 40% involved prescription opioids.
Association of State Medicaid Expansion Status With Low Birth Weight and Preterm Birth
Authors: Brown Clare C. , Moore Jennifer E. , Felix Holly C. , Stewart M. Kathryn , Bird T. Mac , Lowery Curtis L. , Tilford J. Mick
Published: September 2019

(Abstracted from JAMA 2019;321(16):1598–1609)

Prematurity and low birth weight contributed an estimated 36% to infant mortality in 2013 and are associated with adverse consequences, including increased risk of infant mortality and chronic health conditions throughout the infant's life. In the United States, rates of prematurity and birth weight are higher than in most developed nations, with black infants twice as likely than white infants to be born at low birth weight and 1.5 times as likely to be premature compared with white infants.
Vaginal Progesterone, Oral Progesterone, 17-OHPC, Cerclage, and Pessary for Preventing Preterm Birth in At-Risk Singleton Pregnancies: An Updated Systematic Review and Network Meta-analysis
Authors: Jarde A. , Lutsiv O. , Beyene J. , McDonald S. D.
Published: September 2019

(Abstracted from BJOG 2019;126(5):556–567)

Around the world, approximately 15 million pregnancies each year end in preterm birth (before 37 weeks' gestation), a major contributor to child morbidity and mortality. To reduce the risk of preterm birth for women at increased risk, interventions include progesterone, cervical cerclage, and cervical pessary.
CFTR Variants and Renal Abnormalities in Males With Congenital Unilateral Absence of the Vas Deferens (CUAVD): A Systematic Review and Meta-analysis of Observational Studies
Authors: Cai Hongcai , Qing Xingrong , Niringiyumukiza Jean Damascene , Zhan Xuxin , Mo Dunsheng , Zhou Yuanzhong , Shang Xuejun
Published: September 2019

(Abstracted from Genet Med 2019;21(4):826–836.)

Congenital absence of the vas deferens (CAVD) is a urological disease classified into 3 subtypes: congenital bilateral absence of the vas deferens (CBAVD), congenital unilateral absence of the vas deferens (CUAVD), and congenital bilateral partial aplasia of the vas deferens. The most common subtype is CBAVD (prevalence of 1%–2%), but CUAVD (prevalence of 0.5%–1.0%) also may be discovered during evaluations for infertility or surgical procedures involving male genitalia.
Pelvic Organ Prolapse Repair Using the Uphold Vaginal Support System: 5-Year Follow-up
Authors: Rahkola-Soisalo Päivi , Mikkola Tomi S. , Altman Daniel , Falconer Christian
Published: September 2019

(Abstracted from Female Pelvic Med Reconstr Surg 2019;25: 200–205)

Use of mesh-augmented pelvic organ prolapse repair is widely debated. Outcome measures of mesh-augmented repair such as symptom relief, prolapse recurrence, and complications largely derive from short-term evaluations with follow-up time ranging from 1 to 3 years.
DHEA Use to Improve Likelihood of IVF/ICSI Success in Patients With Diminished Ovarian Reserve: A Systematic Review and Meta-analysis
Authors: Schwarze Juan Enrique , Canales Johana , Crosby Javier , Ortega-Hrepich Carolina , Villa Sonia , Pommer Ricardo
Published: September 2019

(Abstracted from JBRA Assist Reprod 2018;22(4):369–374)

Despite advances in in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), poor ovarian response (POR) remains a challenging issue. The frequency of POR is estimated to occur in 5% to 18% of IVF/ICSI cycles and has a corresponding pregnancy rate of 2% to 4%.
Eosinophilic otitis media and comorbid asthma
Authors: Seo Yukako , Nonaka Manabu , Pawankar Ruby
Published: September 2019

Purpose of review

Eosinophilic otitis media (EOM) is an intractable otitis media characterized by numerous eosinophils infiltrating the middle ear cavity, which is part of the upper airway. EOM shows a high rate of comorbidity with asthma. They are considered to have a ‘one airway, one disease’ relationship. Here, we summarize our current knowledge regarding the characteristics of EOM, EOM's relationship with asthma and the efficacy of optimal treatments for EOM.

Recent findings

The greater the severity of asthma, the more pronounced the development of EOM. Asthma control is usually inadequate in asthmatics who develop EOM, and appropriate strengthening of asthma inhalation therapy leads to improvement in the EOM. EOM severity can be divided into mild, moderate, and severe. Intratympanic infusion therapy using a topical steroid such as triamcinolone acetone is effective for mild EOM, whereas moderate EOM requires a systemic steroid in addition to triamcinolone acetone, and severe EOM forms granulation tissue that requires surgical removal. Recently, the effectiveness of molecularly targeted drugs is being reported, but more data need to be accumulated.

EOM and asthma are closely related. Optimal asthma treatment is important for treating EOM. Treatments commensurate with the severity of EOM are being developed.
Total shoulder arthroplasty: risk factors for a prolonged length of stay. A retrospective cohort study
Authors: Hartwell Matthew J. , Nelson Patrick , Johnson Daniel J. , Nicolay Richard W. , Christian Robert A. , Selley Ryan S. , Terry Michael A. , Tjong Vehniah K.
Published: September 2019

Background:

Recent studies describe safe outcomes for outpatient total shoulder arthroplasty. This study identifies risk factors for hospital admissions exceeding 24 hr.

Methods:

The National Surgical Quality Improvement Program database was queried for billing codes related to total shoulder arthroplasty. Patients were grouped according to length of stay, ≤24 hr or >24 hr. Univariate and multivariate analyses were used to identify patient demographics, preoperative comorbidities, and intraoperative risk factors for prolonged hospitalizations.

Results:

Of the 14,339 patients who met the inclusion criteria, 6,507 patients (45.3%) had a length of stay ≤24 hr. Multivariate analysis identified age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.03), American Society of Anesthesiology classification (OR, 1.5; 95% CI, 1.4-1.6), diabetes (OR, 1.7; 95% CI, 1.4-2.0), chronic obstructive pulmonary disease (OR, 1.4; 95% CI, 1.2-1.6), congestive heart failure (OR, 2.7; 95% CI, 1.3-5.3), dialysis (OR, 2.5; 95% CI, 1.3, 4.8), history of a bleeding disorder (OR, 1.5; 95% CI, 1.2-1.9), and operative time (OR, 1.01; 95% CI, 1.01-1.01) as risk factors for prolonged hospitalization. Male gender was a protective factor for prolonged hospitalization (OR, 0.50; 95% CI, 0.46-0.53).

Conclusions:

Female gender, increasing age, American Society of Anesthesiology classification, operative time, or a history of diabetes, chronic obstructive pulmonary disease, congestive heart failure, or a bleeding disorder are risk factors for prolonged hospitalization following total shoulder arthroplasty.

Level of Evidence:

Level III.
Factors influencing time to union of diaphyseal humeral fractures after plate fixation: A retrospective cohort study
Authors: Frantz Travis L. , Meschbach Nicole T. , Niedermeier Steven R. , Pettit Robert J. , Plummer Darren R. , Harrison Ryan K.
Published: September 2019

Background:

We sought to determine time to union of diaphyseal humeral fractures treated with plate fixation and to identify underlying contributing factors.

Methods:

A retrospective cohort study of patients at a Level 1 trauma center from January, 2006 to December, 2016 was performed. The clinical intervention studied was surgical plate fixation, and the main outcome measure was time to union.

Results:

One hundred and thirty-five patients were included, with mean age of 40.67 (range: 18-90) and body mass index of 29.8 (range: 18.5-74.4). The mean time to union was 19.0 wk with a nonneurological complication rate of 8.9% (eight nonunions [5.95%], one malunion, one implant failure, and two infections). There was no correlation between age or body mass index and time to union. No difference was seen in time to union when comparing males versus females (17.9 vs. 20.1; P=0.3477), smokers versus nonsmokers (22.8 vs. 20.3, P=0.4237), anterior versus posterior approach (18.5 vs. 19.3; P=0.5798), and bridging versus rigid technique (17.6 vs. 19.6; P=0.4453). There was no difference in time to union between proximal, middle, or distal diaphyseal fracture location. There was a trend toward longer time to union in open fractures versus closed and a significantly increased risk of nonunion in open fractures (22.2% vs. 3.4%; P=0.0110). Overall time to union is slightly increased when compared to previously published data.

Conclusions:

Open fracture results in both increased time to union and rate of nonunion after plate fixation. There is no difference in time to union between surgical approaches and techniques, as well as in age, body mass index, gender, smoking, or fracture location.

Level of Evidence:

Level III.
Clinical significance of bone morphogenetic protein in osteosarcoma: A systematic review
Authors: Lin James S. , Santiago Juan E. , Mayerson Joel L. , Scharschmidt Thomas J.
Published: September 2019

Background:

The literature suggests that endogenous bone morphogenetic proteins (BMP) have both beneficial and deleterious effects on osteosarcoma. Therapeutic use of exogenous BMP after osteosarcoma resection to enhance skeletal reconstruction is controversial.

Methods:

We conducted a systematic review to determine the association of endogenous BMP expression and overall survival for osteosarcoma patients to determine the association of BMP expression and metastasis, and to evaluate the extent of clinical evidence regarding use of recombinant human BMP (rhBMP) in patients with osteosarcoma.

Results:

Eight studies were included; all except one reported on endogenous BMPs or BMP receptor. The four clinical studies on an association between BMPs and prognosis had mixed results; one associated BMP-7 expression with improved overall survival (OS) in osteosarcoma, while another found no correlation between BMP-6, 7, or 8 with OS. In contrast, one found a negative correlation between BMP expression and prognosis. The final study of these four investigated BMP-2 single nucleotide polymorphisms (SNP) in osteosarcoma and reported an association of a specific SNP mutation with improved prognosis. All three studies addressing metastasis reported increased risk for metastasis of osteosarcoma with either BMP-2 receptor or BMP-2 or 4 expression. Only one study evaluated application of therapeutic rhBMP-2 after osteosarcoma resection, finding no effect on clinical outcomes and no detrimental effects such as tumor recurrence.

Conclusions:

Endogenous BMP or BMP receptor expression may be associated with osteosarcoma metastasis but are of uncertain prognostic significance. Any harmful or beneficial effects of exogenous therapeutic BMP application in this setting are unproven.
Proximal femoral reconstructions: A European “Italian” experience. A case series
Authors: Trovarelli Giulia , Pala Elisa , Cappellari Alessandro , Angelini Andrea , Ruggieri Pietro
Published: September 2019

Background:

The aim of the study was to analyze our experience with a single system of modular proximal femoral replacement, evaluating oncologic results, complications, and functional results.

Methods:

We reviewed data on 38 patients (21 men and 17 women; mean age 59 y) treated with proximal femoral reconstructions by two orthopaedic surgeons. Reconstruction was performed in all patients with a MUTARS® modular proximal femoral prosthesis and an acetabular reconstruction in eight patients. Diagnoses included primary bone sarcomas (21), bone metastases (15), and radioinduced osteonecrosis (2). The stem was press fit in 11 patients and cemented in 27.

Results:

At a mean follow-up of 1.9 yr, 12 patients were alive with no evidence of disease, three have no evidence of disease after treatment of a recurrence or metastasis, 12 were alive with disease, and nine had died. The two with osteonecrosis were not included in this analysis. Complications occurred in seven patients: four type I (wound dehiscence in one and dislocation in three), one type II, one type IV, and one type V failures, while type III failures did not occur. At last follow-up, 89% of patients (34/38) had retained their implant. The mean Musculoskeletal Tumor Society (MSTS) score was 24.7 (14-30), with excellent or good results in all patients except one.

Conclusion:

The overall survival of this prosthesis was satisfactory with good implant survival in proximal femoral reconstruction. The most frequent cause of failure was dislocation. The incidence of infection was low. Functional results were good or excellent.

Level of Evidence:

IV; case series.
Validated Radiographic Scoring System for Lateral Compression Type 1 Pelvis Fractures
Authors: Beckmann James , Haller Justin M. , Beebe Michael , Ali Ashley , Presson Angela , Stuart Ami , Sagi Henry Claude , Kubiak Erik
Published: September 2019

Objectives:

To develop a radiographic fracture scoring system for lateral compression type 1 (LC-1) pelvic fractures based on OTA/AO survey data and to preliminarily evaluate this system within an LC-1 pelvis fracture cohort.

Design:

Survey study with validation patient cohort.

Setting:

Two Level 1 academic trauma centers.

Patients/Participants:

Attendings (n=111) at the 2013 OTA/AO national meeting reviewed imaging from 27 LC-1 fractures and indicated surgical recommendations (“yes/no”). A separate LC-1 fracture cohort (33 patients) was used to evaluate the scoring system.

Intervention:

The LC-1 scoring system (range: 5–14) based on radiographic morphology of sacral, superior ramus (SR), and inferior ramus (IR) fracture components.

Main Outcome Measurement:

Numeric scores were compared against (1) OTA/AO attendees' operative recommendations and (2) LC-1 cohort treatment and outcomes.

Results:

Operative tendency of OTA/AO survey respondents—defined as the percent of “yes” responses to recommend surgical stabilization—was highly correlated with radiographic findings: sacral displacement {odds ratio (OR) = 18.9 [95% confidence interval (CI): 11.7–30.6]}; sacral column 2–3 versus 1 [OR = 5.7 (95% CI: 3.9–8.3)]; Denis classification [OR = 10 (95% CI: 6.7–14.9); IR displacement OR = 3.4 (95% CI: 2.3–4.8)]; and SR fracture [OR = 1.9 (95% CI: 1.3–2.8)]. Total scores <7 were 81% accurate in predicting nonoperative treatment. Total scores >9 were 89% accurate in predicting an operative recommendation. In the LC-1 cohort, scoring accuracy was 100% (95% CI: 85%–100%).

Conclusions:

Based on survey results and patient cohort data, scores <7 predict nonoperative treatment recommendation, scores >9 indicate surgical recommendations, and scores 7–9 indicate indeterminate stability that should be further evaluated.
Concomitant Posterolateral Corner Injuries in Skeletally Immature Patients With Acute Anterior Cruciate Ligament Injuries
Authors: Kinsella Stuart D. , Rider Sean M. , Fury Matthew S. , Tepolt Frances A. , Ecklund Kirsten , Kocher Mininder S.
Published: September 2019

Background:

Missed posterolateral corner (PLC) injuries are a known cause of anterior cruciate ligament reconstruction (ACL) failure in the adult population. Failed ACL reconstruction causes significant morbidity in the skeletally immature pediatric population. There is little literature on the character and potential significance of PLC injuries in skeletally immature patients.

Methods:

Magnetic resonance imaging studies of the knee at a tertiary care children’s hospital for patients who underwent an ACL reconstruction without PLC surgery were retrospectively reviewed. Demographic variables were obtained through chart review, and magnetic resonance imaging studies were evaluated for PLC (popliteus, fibular collateral ligament, popliteofibular ligament, and arcuate ligament) injury, and ACL, medial collateral ligament (MCL), bone bruise, fracture, and meniscal pathology by an experienced pediatric musculoskeletal radiologist.

Results:

A total of 50 patients with a mean age at 13.3 years at injury were analyzed. PLC injuries were found in 26 patients (52%), with 7 patients (14%) having a complete tear of a component of the PLC. There was no association between sex (P=0.35), Segond fracture (P=0.09), meniscus injury (P=0.92), or MCL injury (P=0.24) with the risk of PLC injury. There was an association between patient age and PLC injury (P=0.02). For each additional year of age, the odds of PLC injury increased by 1.8 times (odds ratio, 1.8; 95% confidence interval, 1.4-2.2). There was no association between PLC injury and ACL graft failure (P=0.19).

Conclusions:

Missed PLC injuries are a significant source of morbidity and poor clinical outcomes in the management of concomitant ACL injuries in adults. This study demonstrates the prevalence of PLC injuries in the setting of concomitant ACL injuries in the unique skeletally immature patient population. Incomplete PLC injuries are relatively common. Complete PLC injuries are relatively uncommon. PLC injury was more common in older patients. No other concomitant injury predicted the likelihood of PLC injury. Further research is needed regarding the risk of ACL reconstruction failure from associated PLC injury and the indications for PLC reconstruction in skeletally immature patients.

Level of Evidence:

Level IV—diagnostic study.