bluuebunny/crossref_metadata_2025 huggingface dataset:
Protein–protein interaction sites prediction by ensemble random forests with synthetic minority oversampling technique
Authors: Wang Xiaoying , Yu Bin , Ma Anjun , Chen Cheng , Liu Bingqiang , Ma Qin
Published: December 2018

Motivation

The prediction of protein–protein interaction (PPI) sites is a key to mutation design, catalytic reaction and the reconstruction of PPI networks. It is a challenging task considering the significant abundant sequences and the imbalance issue in samples.

Results

A new ensemble learning-based method, Ensemble Learning of synthetic minority oversampling technique (SMOTE) for Unbalancing samples and RF algorithm (EL-SMURF), was proposed for PPI sites prediction in this study. The sequence profile feature and the residue evolution rates were combined for feature extraction of neighboring residues using a sliding window, and the SMOTE was applied to oversample interface residues in the feature space for the imbalance problem. The Multi-dimensional Scaling feature selection method was implemented to reduce feature redundancy and subset selection. Finally, the Random Forest classifiers were applied to build the ensemble learning model, and the optimal feature vectors were inserted into EL-SMURF to predict PPI sites. The performance validation of EL-SMURF on two independent validation datasets showed 77.1% and 77.7% accuracy, which were 6.2–15.7% and 6.1–18.9% higher than the other existing tools, respectively.

Availability and implementation

The source codes and data used in this study are publicly available at http://github.com/QUST-AIBBDRC/EL-SMURF/.

Supplementary information

Supplementary data are available at Bioinformatics online.
Prevalence of Human Papillomavirus, Human Immunodeficiency Virus, and Other Sexually Transmitted Infections Among Men Who Have Sex With Men in Togo: A National Cross-sectional Survey
Authors: Ferré Valentine Marie , Gbeasor-Komlanvi Fifonsi A , Collin Gilles , Dagnra Anoumou Claver , Le Hingrat Quentin , Jaquet Antoine , Salou Mounerou , Descamps Diane , Charpentier Charlotte , Ekouevi Didier Koumavi
Published: December 2018

Background

Sub-Saharan Africa is a region of both high human immunodeficiency virus (HIV) and anal cancer incidence. We conducted the first national study in Togo to assess human papillomavirus (HPV), HIV, and other sexually transmitted infection (STI) prevalence among men who have sex with men (MSM).

Methods

A multicentric cross-sectional study was conducted among MSM recruited in 4 Togolese cities. Anal swabs were collected to test HPV, herpes simplex virus (HSV), and 7 STIs.

Results

Among the 207 MSM, HIV and high-risk HPV (hrHPV) overall prevalence were 26.1% and 44.9%, respectively. The most common hrHPV types were HPV-35 (15.0%) and HPV-16 (13.0%). Prevalence of hrHPV and multiple HPV infections were higher among HIV-infected than among HIV-uninfected MSM (85.2% vs 30.7%, P < 10–5 and 85.2% vs 28.7%, P < 10–5, respectively). Other STIs, except hepatitis B virus, were also more prevalent among HIV-infected MSM (Neisseria gonorrhoeae, P = .03; Mycoplasma genitalium, P = .04; HSV-2, P = .001; and a trend for Chlamydia trachomatis, P = .06). In multivariate analysis (adjusted odds ratio [95% confidence interval]), HIV (10.1 [4.0–25.6]), living in Lomé (2.8 [1.1–7.1]), HSV-2 excretion (26.7 [2.9–244.3]), C. trachomatis (11.7 [2.3–58.9]), and M. genitalium infection (9.6 [3.1–29.9]) were associated with increased risk of hrHPV infection.

Conclusions

We report a high burden of anal STIs with an unusual hrHPV type distribution among MSM, highlighting the critical need of implementation of a national strategy regarding prevention of STIs and vaccination against HPV.
Blood Viral Load in Symptomatic Congenital Cytomegalovirus Infection
Authors: Marsico Concetta , Aban Immaculada , Kuo Huichien , James Scott H , Sanchez Pablo J , Ahmed Amina , Arav-Boger Ravit , Michaels Marian G , Ashouri Negar , Englund Janet A , Estrada Benjamin , Jacobs Richard F , Romero José R , Sood Sunil K , Whitworth Suzanne , Jester Penelope M , Whitley Richard J , Kimberlin David W ,   Collaborative Antiviral Study Group (CASG)
Published: December 2018

Background

Viral loads (VLs) frequently are followed during treatment of symptomatic congenital cytomegalovirus disease, but their predictive value is unclear.

Methods

Post hoc analysis of 2 antiviral studies was performed. Seventy-three subjects were treated for 6 weeks and 47 subjects were treated for 6 months. Whole blood VL was determined by real-time polymerase chain reaction before and during therapy.

Results

Higher baseline VL was associated with central nervous system involvement (3.82 log, range 1–5.65 vs 3.32 log, range 1–5.36; P = .001), thrombocytopenia (3.68 log, range 1–5.65 vs 3.43 log, range 1–5.36; P = .03), and transaminitis at presentation (3.73 log, range 1–5.60 vs 3.39 log, range 1–5.65; P = .009), but with overlap in the amount of virus detected between groups. In subjects treated for 6 months, lower VL at presentation correlated with better hearing outcomes at 12 months, but VL breakpoints predictive of hearing loss were not identified. Sustained viral suppression during 6 months of therapy correlated with better hearing outcomes at 6, 12, and 24 months (P = .01, P = .0007, P = .04), but a majority without viral suppression still had improved hearing.

Conclusions

In infants with symptomatic congenital cytomegalovirus disease, higher whole blood VL before initiation of antiviral therapy has no clinically meaningful predictive value for long-term outcomes.
Validation of the St. Paul’s Endoscopy Comfort Scale (SPECS) for Colonoscopy
Authors: Telford Jennifer , Tavakoli Iran , Takach Oliver , Kwok Ricky , Harris Natasha , Yonge Jordan , Galorpart Cherry , Whittaker Scott , Amar Jack , Rosenfeld Gregory , Ko Hin Hin , Lam Eric , Ramji Alnoor , Bressler Brian , Enns Robert
Published: December 2018

Aims

Patient comfort during colonoscopy is an important measure of quality, which can improve patient satisfaction and compliance with future procedures. Our aim was to develop and validate a pain assessment tool based on objective behavioural cues tailored to outpatients undergoing colonoscopy: St. Paul’s endoscopy comfort score (SPECS).

Methods

A single-centre, prospective study was conducted in consecutive adults undergoing planned outpatient colonoscopy. Patient comfort was independently assessed by the physician, nurse and a research assistant (observer) using the SPECS and the Gloucester scale (GS). In addition, the nurse-assessed patient comfort score (NAPCOMS), nonverbal pain Assessment tool (NPAT) and Richmond agitation sedation scale (RASS) were completed by the observer. Data on subject demographics, sedation dose and duration of the procedure were collected. Following the procedure, patients completed a patient satisfaction questionnaire, including a visual analogue scale (VAS) to measure their overall perceived pain during the procedure.

Results

The study enrolled 350 subjects. The SPECS showed excellent inter-rater reliability among all three raters with an intra-class coefficient (ICC) of 0.81 (95% CI, 0.78–0.84), while the GS showed good reliability with an ICC of 0.77 (95% CI, 0.73–0.80). The SPECS demonstrated moderate agreement with the patient-reported VAS ratings.

Conclusions

The St. Paul’s endoscopy comfort score was successfully validated, demonstrating excellent inter-rater reliability.
Unequivocal identification of an underestimated opportunistic yeast species, Cyberlindnera fabianii, and its close relatives using a dual-function PCR and literature review of published cases
Authors: Arastehfar Amir , Fang Wenjie , Al-Hatmi Abdullah M S , Afsarian Mohammad Hosein , Daneshnia Farnaz , Bakhtiari Mina , Sadati Sara Khanjari , Badali Hamid , Khodavaisy Sadegh , Hagen Ferry , Liao Wanqing , Pan Weihua , Zomorodian Kamiar , Boekhout Teun
Published: December 2018

Although Cyberlindnera fabinaii is a rare opportunist yeast species, its ability to cause septicemia, produce biofilm, and rapid acquisition of resistance to fluconazole and voriconazole, reinforced the urge for its identification from its closely related species. Widely used biochemical assays mainly identify Cyberlindnera fabinaii as Cyberlindnera jadinii and Wickerhamomyces anomalus, resulting in underestimation of this yeast in clinical settings. Moreover, the urge for a reliable molecular means of identification remains unsolved for 28 years. In order to unequivocally differentiate Cy. fabianii, Cy. mississipiensis, Cy. jadinii, and W. anomalus, we designed a dual-function multiplex polymerase chain reaction (PCR) assay. Challenging our dual-function multiplex PCR assay with 30 most clinically important yeast species, proved its specificity. Although conventional PCR could differentiate four target species, the real-time PCR counterpart due to Tm overlap misidentified Cy. mississipiensis as Cy. jadinii. Alongside of presenting a comprehensive literature review of published cases of Cy. fabianii from 1990 to 2018, we collected various clinical isolates from Tehran, Shiraz, and Fasa (July 1, 2017, to December 31, 2017) to find a passive relative distribution of these closely-related species in Iran. Subjecting our Iranian collection of yeast isolates to matrix-assisted laser desorption/ionization–time of flight (MALDI-TOF) MS and LSU and ITS rDNA sequencing revealed six isolates of Cy. fabianii (central venous catheter n = 2 and vaginal swabs n = 4) and one isolate of Cy. jadinii (vaginal swabs). Due to the use of biochemical assays in global ARTEMIS study, we encourage reidentification of clinical isolates of Cy. jadinii and Cy. jadinii using MALDI-TOF or Sanger sequencing that might lead to correcting the distribution of this fungus.
The association of health-related quality of life and cognitive function in patients receiving memantine for the prevention of cognitive dysfunction during whole-brain radiotherapy
Authors: Laack Nadia N , Pugh Stephanie L , Brown Paul D , Fox Sherry , Wefel Jeffrey S , Meyers Christina , Choucair Ali , Khuntia Deepak , Suh John H , Roberge David , Wendland Merideth M , Bruner Deborah
Published: December 2018

Background

This study evaluated the association between health-related quality of life (HRQOL) and cognition in patients receiving memantine for prevention of cognitive dysfunction during whole-brain radiotherapy (WBRT).

Methods

Adult patients with brain metastases received WBRT and were randomized to receive placebo or memantine, 20 mg per day, within 3 days of initiating radiotherapy, for 24 weeks. The Functional Assessment of Cancer Therapy-Brain module (FACT-Br) and Medical Outcomes Scale-Cognitive Functioning Scale (MOS-C) were completed in coordination with serial standardized tests of cognitive function.

Results

Of the 508 eligible patients, 442 (87%) consented to participate in the HRQOL portion and contributed to baseline analyses. Evaluable patients at 24 weeks (n = 246) included surviving patients completing FACT-Br, MOS-C, and objective cognitive assessments (n = 146, 59%) and patients alive at time of missed assessment (n = 100, 41%). Baseline cognitive function correlated significantly with FACT-Br and MOS-C self-reports. All domains of objective cognitive function showed declines over time. Neither FACT-Br nor MOS-C differed between the treatment arms. Emotional and functional well-being subscales of the FACT improved over time while the remainder of the FACT-Br domains remained stable. MOS-C scores declined over time.

Conclusion

Baseline cognitive function correlated significantly with FACT-Br and MOS-C scores. No by-arm differences in HRQOL were observed despite differences in objective cognitive function. Patient attrition and poor testing compliance remain significant problems in studies of cognitive function of brain metastases patients and further effort is needed to improve compliance with testing and sensitivity of patient-reported measures.
The use of ultrasound to measure muscle depth and area in postmortem Holstein dairy calves
Authors: Davis Jessica H , Rossow Heidi A
Published: December 2018

Monitoring growth of neonatal dairy calves is a useful management tool to assist producers in achieving goals for reproduction and performance. The goal of this study was to examine ultrasound as an in vivo tool to quantify longissimus dorsi muscle (ribeye) linear depth and extensor carpi radialis (ECR) and semitendinosus (ST) muscle cross-sectional areas in postmortem preweaned Holstein calves. Postmortem preweaned calves (n = 137, age 13.1 d ± 15.5 SD, body weight 36.5 kg ± 7.2 SD) were obtained from two California calf ranches between April and July 2013. Two operators collected ultrasound images of the ribeye, ECR, and ST muscles using an Aloka 500V equipped with a 5-cm 7.5-MHz linear transducer. Ultrasound ribeye linear depth and ECR and ST cross-sectional areas were calculated using the Ultrasound Image Capture System. Ultrasound measurements were compared to dissected (carcass) measures. Carcass ribeye linear depth was estimated using a ruler. Dissected ECR and ST muscle cross-sectional areas were estimated by tracing muscle cross sections onto transparency paper and then photocopying, cutting out, and weighing individual paper muscle tracings. Weights of the tracings were then converted to areas using the known area of a standard 8.5 × 11 inch paper. Data were analyzed by regressing carcass estimates on observed ultrasound measurements. The coefficient of determination (R2) indicated that ultrasound measurements were most closely associated with carcass measurements for the ST muscle (R2 = 0.60, 0.62 for operator 1 and 2, respectively) when compared to the ribeye and ECR muscles (R2 = 0.27, 0.41 for ribeye and 0.43, 0.32 for ECR for operator 1 and 2, respectively). The mean bias showed consistent underestimation by the ultrasound measurements when predicting carcass measurements for all three muscles and for both operators (ribeye bias = 0.15, 0.40; ECR bias = 0.95, 1.15; and ST bias = 0.73, 0.27 for operator 1 and 2, respectively). Operator contributed significantly in explaining a proportion of the variation in the regression equation for the ST muscle only, whereas calf body weight contributed significantly in explaining a proportion of the variation in the regression equation for all three muscles. The results of this study demonstrated that ultrasound measurements of the ST were the most accurate for quantifying the cross-sectional area when compared to both the ECR and ribeye in postmortem Holstein calves.
Pathways for translating behavioral medicine research to practice and policy
Authors: Sallis James F
Published: December 2018

Researchers are encouraged to become involved in translating research findings to policy and practice for the purpose of enhancing health impact. A model of five pathways of research translation is proposed that allows researchers to use a pathway that fits their needs: research, practice, business, policy, and public opinion pathways.
Prospective Evaluation of a Rapid Functional Assay for Heparin-Induced Thrombocytopenia Diagnosis in Critically Ill Patients*
Authors: Gkalea Vasiliki , Khaterchi Amir , Levy Pierre , Jourdi Georges , Elalamy Ismail
Published: December 2018

Objectives:

Overdiagnosis of heparin-induced thrombocytopenia remains an unresolved issue in the ICU leading to the unjustified switch from heparin to alternative anticoagulants or delays in anticoagulation. Platelet function assays significantly improve the specificity of heparin-induced thrombocytopenia diagnosis, but they are not readily available, involve technical difficulties and have a long turnaround time. We evaluated the performance of a rapid and easy to perform functional assay for heparin-induced thrombocytopenia diagnosis in ICU patients, known as “heparin-induced multiple electrode aggregometry.”

Design:

In this observational prospective study patients were tested with the immunoglobulin G enzyme-linked immunosorbent assay, the serotonin release assay and heparin-induced multiple electrode aggregometry. Heparin-induced multiple electrode aggregometry was assessed against heparin-induced thrombocytopenia diagnosis (clinical picture in favor, serotonin release assay, and immunoglobulin G enzyme-linked immunosorbent assay positive) and serotonin release assay.

Setting:

Medical or surgical ICU of 35 medical centers.

Patients:

Patients suspected for heparin-induced thrombocytopenia hospitalized in medical or surgical ICU from January 2013 to May 2013.

Interventions:

None.

Measurements and Main results:

Heparin-induced thrombocytopenia diagnosis was retained in 12 patients (14%). Using heparin-induced thrombocytopenia diagnosis as reference, heparin-induced multiple electrode aggregometry showed an excellent negative predictive value and sensitivity, at 98% and 92% respectively. Its positive predictive value and specificity were 100%. Receiver operating characteristic analysis with the serotonin release assay as reference showed an optimal heparin-induced multiple electrode aggregometry cut-off at 1,300 AU × minutes (specificity, 100%; sensitivity, 90%; area under the curve, 0.98; 95% CI, 0.95–1.0). The Kappa coefficient between heparin-induced multiple electrode aggregometry and the serotonin release assay was at 0.90%.

Conclusions:

Heparin-induced multiple electrode aggregometry performed very well in heparin-induced thrombocytopenia diagnosis in ICU patients and agreed with the gold standard test for heparin-induced thrombocytopenia diagnosis, the serotonin release assay. Heparin-induced multiple electrode aggregometry is a reliable and rapid platelet functional assay that could decrease heparin-induced thrombocytopenia overdiagnosis in the ICU setting.
Prediction of ICU Delirium: Validation of Current Delirium Predictive Models in Routine Clinical Practice*
Authors: Green Cameron , Bonavia William , Toh Candice , Tiruvoipati Ravindranath
Published: December 2018

Objectives:

To investigate the ability of available delirium risk assessment tools to identify patients at risk of delirium in an Australian tertiary ICU.

Design:

Prospective observational study.

Setting:

An Australian tertiary ICU.

Patients:

All patients admitted to the study ICU between May 8, 2017, and December 31, 2017, were assessed bid for delirium throughout their ICU stay using the Confusion Assessment Method for ICU. Patients were included in this study if they remained in ICU for over 24 hours and were excluded if they were delirious on ICU admission, or if they were unable to be assessed using the Confusion Assessment Method for ICU during their ICU stay. Delirium risk was calculated for each patient using the prediction of delirium in ICU patients, early prediction of delirium in ICU patients, and Lanzhou models. Data required for delirium predictor models were obtained retrospectively from patients medical records.

Interventions:

None.

Measurements and Main Results:

There were 803 ICU admissions during the study period, of which 455 met inclusion criteria. 35.2% (n = 160) were Confusion Assessment Method for ICU positive during their ICU admission. Delirious patients had significantly higher Acute Physiology and Chronic Health Evaluation III scores (median, 72 vs 54; p < 0.001), longer ICU (median, 4.8 vs 1.8 d; p < 0.001) and hospital stay (16.0 vs 8.16 d; p < 0.001), greater requirement of invasive mechanical ventilation (70% vs 21.4%; p < 0.001), and increased ICU mortality (6.3% vs 2.4%; p = 0.037). All models included in this study displayed moderate to good discriminative ability. Area under the receiver operating curve for the prediction of delirium in ICU patients was 0.79 (95% CI, 0.75–0.83); recalibrated prediction of delirium in ICU patients was 0.79 (95% CI, 0.75–0.83); early prediction of delirium in ICU patients was 0.72 (95% CI, 0.67–0.77); and the Lanzhou model was 0.77 (95% CI, 0.72–0.81).

Conclusions:

The predictive models evaluated in this study demonstrated moderate to good discriminative ability to predict ICU patients’ risk of developing delirium. Models calculated at 24-hours post-ICU admission appear to be more accurate but may have limited utility in practice.
Surgery-First Orthognathic Surgery for Severe Facial Asymmetry Combined With Mandibular Distraction Osteogenesis Using a Three-Dimensional Internal Distractor
Authors: Watanabe Yorikatsu , Sasaki Ryo , Matsuno Isao , Akizuki Tanetaka
Published: December 2018

Severe facial asymmetry in adults with hemifacial microsomia or other types of mandibular hypoplasia is challenging to treat with simultaneous maxillomandibular distraction osteogenesis using an external distractor combined with intermaxillary fixation (IMF). Using an external distractor also produces significant distress for patients for at least 8 weeks. Furthermore, mandibular-driven distraction tends to elongate the midface, with difficulty positioning of the center of the maxilla in the center of the face and horizontalization of the occlusal plane. To overcome these disadvantages, the authors performed repositioning of the Le Fort I segment intraoperatively to restore maxillary roll levering, followed by mandibular distraction using a 3-dimensional internal distractor with a variable angle for better control and tolerable postoperative distraction osteogenesis. This approach is based on the surgery-first concept. During the operation, the Le Fort I segment was fixed centrally in the center of the face and horizontally in the occlusal plane based on a computer-aided surgical simulation. Before mandibular corticotomy, a 3-dimensional internal distractor was placed on the affected side. Finally, vertical ramus osteotomy of the unaffected side was performed. After completion of distraction with IMF using elastic bands, IMF was released. The distractor was removed after a 6-month postoperative consolidation period. This method has been used in 5 patients with severe facial asymmetry, which were all successfully treated without complication. These cases show that this method can be used for severe facial asymmetry in adults, based on the surgery-first concept of minimizing the duration of orthodontic treatment and optimizing facial aesthetics.
Anatomic Landmarks in Transoral Oropharyngeal Surgery
Authors: Mirapeix Rosa M. , Tobed Secall Marc , Pollán Guisasola Carlos , Garcia Lorenzo Jacinto , Lluansí Planella Jordi , Viña Soria Constanza , Palau Viarnès Mar , Virós Porcuna David
Published: December 2018

Introduction:

Minimally invasive transoral surgery for oropharyngeal cancer is a challenge for head and neck surgeons because of the inside-out anatomic presentation and the confined workspace. This study was performed to describe the main neurovascular and muscular landmarks in a transoral approach. The authors propose an anatomic stratification for this surgery.

Materials and Methods:

Lateral wall of the oropharynx and base of the tongue of 15 formalin-fixed heads (30 sides) and 5 fresh cadaveric heads (10 sides) sagittal sectioned were dissected from the inside outwards. Dissection of 7 fresh cadaveric heads via an endoscopic transoral approach was also performed.

Results:

The lateral oropharyngeal wall was divided into 3 layers from medial to lateral, based in the styloid muscle diaphragm. The first layer, medial to styloid muscles, includes the tonsillar vascularization and the lingual branch of the glossopharyngeal nerve. The second layer, lateral to constrictor muscles, includes the pharyngeal venous plexus, the glossopharyngeal nerve, and the lingual artery. The third layer, lateral to styloid diaphragm, includes the parapharyngeal and submandibular spaces, the carotid vessels and lingual, vagus, glossopharyngeal and hypoglossal nerves. The base of the tongue was divided into central and lateral parts, which contain the lingual artery and lingual branches of the glossopharyngeal nerve. The main landmarks to find the neurovascular structures in each layer are described.

Conclusion:

The authors propose an anatomic division, which helps to plan oropharynx and base of the tongue surgery. This anatomic stratification is useful to surgeons when performing a reconstruction of the oropharynx with a transoral approach.
Significance of Medial Osteotomy on the Olfactory Function in Patients Who Underwent Septorhinoplasty
Authors: Elbistanli Mustafa Suphi , Koçak Hasan Emre , Çelik Mustafa , Acipayam Harun , Alakhras Wesam M.E. , Koç Arzu Karaman , Evren Cenk
Published: December 2018

Objective:

This study was designed to explore the impact of medial osteotomy on olfactory function.

Methods:

This nonrandomized, prospective study included 60 adult patients who underwent open technique septoplasty (group 1), rhinoplasty with only lateral osteotomy (group 2), and septorhinoplasty with medial and lateral osteotomies (group 3). Olfactory functions were evaluated by using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test. The CCCRC test includes the butanol threshold test and smell identification test using common smells. The butanol threshold test and smell identification test scores of each group were recorded preoperatively and at 1st and 4th months and compared.

Results:

Each group is consisted of 20 patients. The preoperative smell identification test and butanol threshold test scores were similar in each group. The smell identification test, butanol threshold test, and CCCRC olfactory test scores of the 1st month were statistically significantly low in group 3. There was no statistically significant difference between the groups at 4th month postoperatively.

Conclusion:

The present study is the first analysis of the effect of medial osteotomy on olfactory function. Medial osteotomy may decrease the olfactory function in early time, but afterwards olfaction could recover at preoperative levels.
A Novel Approach for the Reconstruction of Premaxilla by Archwise Distraction in Bilateral Cleft Lip and Palate
Authors: Yilmaz Hanife Nuray , Karabiber Gulden , Erverdi Nejat
Published: December 2018

Interdental distraction osteogenesis has been introduced as a successful treatment protocol for repairing large clefts. In this article, a new method for reconstruction of the premaxilla in 2 bilateral cleft lip and palate patients is introduced. The aim was to distract the lateral segments through the curve of the dental arch, achieve complete closure of the gaps, and use the premaxilla as a bone graft. Patient 1 (20-year-old female) had double jaw surgery before but presented residual alveolar cleft and small premaxilla. Patient 2 (21-year-old male) had anterior and posterior crossbite and caries of teeth on premaxilla. Following the preliminary fixed orthodontic treatment in both patients, archwise distraction protocol was performed. The distraction duration and the achieved amount of new bone per side were 4 weeks/22 mm and 5 weeks/25 mm in Patients 1 and 2, respectively. At the end of a 2-month retention period, docking side surgery was performed and premaxilla was used as the bone graft. The protocol was very effective for not only closure of the large cleft defects but also the reconstruction of the premaxilla. Anteroposterior relationship and the patients’ profiles were considerably and positively affected.
Comparison of the Effects of Two Different Analgesics on Bone Regeneration During Mandibular Distraction Osteogenesis
Authors: Sabuncuoglu Fidan Alakus , Ersahan Seyda , Amasyali Mihri , Avunduk Mustafa Cihat
Published: December 2018

Introduction:

Mandibular distraction osteogenesis (DO) is frequently used in the management of bone defects and craniofacial deformities, with analgesics commonly administered to relieve acute postoperative pain. This experimental animal study investigated the effects of 2 analgesics, acetaminophen and acemetacin, on bone regeneration after DO.

Materials and methods:

This study was conducted with 14 mature male New Zealand rabbits (2.8–3.2 kg) randomized into 2 groups of 7. Mandibular osteotomies were performed under optimal operating conditions, and a custom-made distractor was applied to the mandible of each subject, with distraction initiated after a 5-day latency period at a rate of 1.0 mm/d (2 × 0.5 mm/d) for 10 days. Analgesics were administered via oral gavage during the latency period and for the first 5 days of the distraction period for 10 days in total, with group I receiving acetaminophen (200 mg/kg/d) and group II receiving acemetacin (5 mg/kg/d). Subjects were sacrificed and their mandibles dissected at the end of 4 weeks postoperatively. Bone mineral density (BMD) and bone mineral content (BMC) were measured using dual-energy X-ray absorptiometry (DEXA), and histomorphometric analysis was performed to evaluate the quality of newly formed bone. Paired group comparisons of non-normally distributed numerical variables were made using the Mann–Whitney U test, with a P value of <0.05 considered statistically significant.

Results:

No significant differences in BMC and BMD values of intact bone, newly formed bone, or bone around the pin site were observed between the 2 groups. Histometric analysis also indicated acetaminophen and acemetacin to have similar effects on bone regeneration during distraction.

Conclusion:

Acemetacin may be an alternative to acetaminophen for treating pain associated with DO, given the similarities in the effects of the 2 analgesics on bone regeneration. However, this finding should be supported by further experimental and human studies.
Use of Modified Islanded Paramedian Forehead Flap for Complex Periocular Facial Reconstruction
Authors: Tripathy Satyaswarup , Garg Akhil , John Jerry R. , Sharma Ramesh Kumar
Published: December 2018

The paramedian forehead flap is a workhorse flap for reconstructing the nose and periorbital regions. Many variants are described including an islanded flap. However, eyebrow reconstruction is not usually performed with these flaps. The authors describe a patient suffering from postburn scarring medial to the left eye, including loss of the left eyebrow. He underwent a single-stage transfer of the paramedian forehead flap. The flap incorporated scalp hair, which restored the missing eyebrow hair after transfer. The donor defect closed primarily. The paramedian forehead flap is amenable to customization by including a segment of hair-bearing scalp to concomitantly reconstruct the nasal dorsum and eyebrow.
Using Computer-Aided Design/Computer-Aided Manufacturing for Autogenous, Split Calvarial Bone Graft-based Cranioplasty: Optimizing Reconstruction of Large, Complex Skull Defects
Authors: Musavi Leila , Macmillan Alexandra , Lopez Joseph , Dorafshar Amir H.
Published: December 2018

Background:

While autologous split calvarial bone is an ideal graft material in cranioplasty, selection of a donor site can be challenging and limited in the reconstruction of complicated cranial defects. Computer-aided design and manufacturing (CAD/CAM) may improve donor-site harvest and contouring and mitigate operative complications in split calvarial bone graft-based cranioplasty for complex patients, but has not previously been studied in this unique setting.

Methods:

In this study, a retrospective review of patients who presented to the institution and underwent split-calvarial bone graft-based cranioplasty using CAD/CAM to optimize reconstruction of full-thickness cranial defects ≥30 cm2 was performed. Patient demographics, complications from past operations, intraoperative variables, and immediate and long-term postoperative outcomes were recorded. The CAD/CAM predicted and actual postoperative graft measurements were compared.

Results:

Five patients were identified who fulfilled inclusion criteria. Mean age at operation was 43 years and mean size of cranial defect was 69 cm2. Mean operative time was 443 minutes and mean estimated blood loss was 450 mL. There were no dural tears, sagittal sinus bleeds, or other intraoperative complications. There were no immediate postoperative complications requiring extended hospital stay or reoperation. The postoperative graft surface areas were on average within 2.1% of the planned graft and this difference was not statistically significant (P = 0.28). All patients expressed satisfaction with cranial contour postoperatively.

Conclusion:

Based on the early experience, the use of CAD/CAM enhances calvarial graft selection and improves contour accuracy in the reconstruction of complex skull defects with minimal complications.
Anterior Cranial Vault Reconstruction With Distraction for Primary and Secondary Craniosynostosis Repair
Authors: Barrientos Stephan , Miller Jason
Published: December 2018

Traditional fronto-orbital advancement continues to be a useful operation for correction of craniosynostosis involving the coronal or metopic sutures. Recently, distraction osteogenesis has been used to correct a variety of cranial deformities. Studies have mostly focused on posterior vault distraction due to its simplicity and greater volume gain when compared with anterior vault distraction. However, certain patients are not candidates for posterior distraction due to anterior deformity and need for expansion of the frontal skull. The authors have developed a technique that allows for both reshaping as well as distraction of the anterior cranial vault.

This was a retrospective chart review performed between March 2012 and October 2016 at a single institution by a single plastic surgeon. Thirty-nine (39) patients were included in this study. The indications for surgical intervention were signs of increased intracranial pressure or severe anterior skull deformity in the setting of craniosynostosis. The authors reviewed patient characteristics, length of follow-up, number of previous and subsequent surgeries, complications, and rate of relapse.

The average age of patients undergoing the procedure was 5.2 years (range 6 months–15 years). Twenty-four (24) patients had 1 previous surgery, 3 had 2 previous surgeries, 1 had 3 previous surgeries, and 11 had no previous surgeries. The average follow-up was 2.5 years (range 6 months–4 years). One patient had a broken activation wire requiring return to the operating room. Three (3) patients (2 Apert and 1 Crouzon) underwent subsequent posterior vault distraction surgery. All patients demonstrated significant improvement in forehead cosmesis.

Anterior cranial vault reconstruction with distraction is a safe alternative to traditional cranial vault reconstruction. It can improve forehead shape and position in older children who have had previous surgery as well as patients with severe anterior skull deformity associated with craniosynostosis.
Postoperative Visual Loss: A Report of One Patient With Unilateral Blindness After Orthognathic Surgery
Authors: Delmotte Constance , Depeyre Arnaud , Barthelemy Isabelle , Ferri Joel
Published: December 2018

Introduction:

Blindness after orthognathic surgery may be the result of the surgical procedure itself or the consequence of factors induced by general anesthesia. However, the exact mechanism between is not known. The purpose of this article is to present a case of a postoperative visual loss after orthognathic surgery under general anesthesia concluding with a brief literature review about this topic.

Report of case:

We report the case of a patient who suffered unilateral blindness with homolateral frontal paresthesia after orthognathic procedure in 2 steps. He presented intraoperative bradycardia with a potential undiagnosed hypertension, associated with significant blood loss and volume resuscitation by colloids and cristalloids.

Postoperative examination concluded to posterior ischemic optic neuropathy.

Discussion and Conclusion:

By a systematic literature review, we discuss about surgical and anesthesic causes of postoperative visual loss, and particularly pathophysiology mechanism of posterior ischemic optic neuropathy. Some predisposition and risk factors have been identified and need to be taken into account.
ICTV virus taxonomy profile: Sarthroviridae
Authors: Sahul Hameed A. S. , Ninawe A. S. , Nakai T. , Chi S. C. , Johnson K. L. ,   ICTV Report Consortium
Published: December 2018

The family Sarthroviridae includes a single genus, Macronovirus, which in turn includes a single species, Macrobrachium satellite virus 1. Members of this species, named extra small virus, are satellite viruses of Macrobrachium rosenbergii nodavirus, an unclassified virus related to members of the family Nodaviridae. Both viruses have isometric, spherical virions, infect giant freshwater prawns and together cause white tail disease, which is responsible for mass mortalities and severe economic losses in hatcheries and farms. Infection is caused by both vertical and horizontal transmission of virus. Aquatic insects act as a carrier to transmit the disease in prawns. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the taxonomy of the Sarthroviridae, which is available at www.ictv.global/report/sarthroviridae.
A distributed lattice of aligned atoms exists in a protein structure: A hierarchical clustering study of displacement parameters in bovine trypsin
Authors: Gagnér Viktor Ahlberg , Lundholm Ida , Garcia-Bonete Maria-Jose , Rodilla Helena , Friedman Ran , Zhaunerchyk Vitali , Bourenkov Gleb , Schneider Thomas , Stake Jan , Katona Gergely
Published: December 2018

Low-frequency vibrations are crucial for protein structure and function, but only a few experimental techniques can shine light on them. The main challenge when addressing protein dynamics in the terahertz domain is the ubiquitous water that exhibit strong absorption. In this paper, we observe the protein atoms directly using X-ray crystallography in bovine trypsin at 100 K while irradiating the crystals with 0.5 THz radiation alternating on and off states. We observed that the anisotropy of atomic displacements increases upon terahertz irradiation. Atomic displacement similarities develop between chemically related atoms and between atoms of the catalytic machinery. This pattern likely arise from delocalized polar vibrational modes rather than delocalized elastic deformations or rigid-body displacements. This method can ultimately reveal how the alignment of chemically related atoms and the underlying polar vibrational dynamics make a protein structure stable.
A Hybrid Model for the Effects of Treatment and Demography on Malaria Superinfection
Authors: Henry John M.
Published: December 2018

As standard mathematical models for the transmission of vector-borne pathogens with weak or no apparent sterilizing immunity, Susceptible-Infected-Susceptible (SIS) systems such as the Ross-Macdonald equations are a useful starting point for modeling the impacts of interventions on prevalence for diseases that cannot superinfect their hosts. In particular, they are parameterizable from quantities we can estimate such as the force of infection (FOI), the rate of natural recovery from a single infection, the treatment rate, and the rate of demographic turnover. However, malaria parasites can superinfect their host which has the effect of increasing the duration of infection before total recovery. Queueing theory has been applied to capture this behavior, but a problem with current queueing models is the exclusion of factors such as demographic turnover and treatment. These factors in particular can affect the entire shape of the distribution of the multiplicity of infection (MOI) generated by the superinfection process, its transient dynamics, and the population mean recovery rate. Here we show the distribution of MOI can be described by an alternative hyper-Poisson distribution. We then couple our resulting equations to a simple vector transmission model, extending previous Ross-Macdonald theory.
Determinants of high residual post-PCV13 pneumococcal vaccine type carriage in Blantyre, Malawi: a modelling study
Authors: Lourenço J. , Obolski U. , Swarthout T.D. , Gori A. , Bar-Zeev N. , Everett D. , Kamng’ona A.W. , Mwalukomo T.S. , Mataya A.A. , Mwansambo C. , Banda M. , Gupta S. , French N. , Heyderman R.S.
Published: December 2018

Background

In November 2011, Malawi introduced the 13-valent pneumococcal conjugate vaccine (PCV13) into the routine infant schedule. Four to seven years after introduction (2015-2018), rolling prospective nasopharyngeal carriage surveys were performed in the city of Blantyre. Carriage of Streptococcus pneumoniae vaccine serotypes (VT) remained higher than reported in developed countries, and VT impact was surprisingly asymmetric across age-groups. A dynamic transmission model was fit to survey data using a Bayesian Markov-chain Monte Carlo approach, to obtain insights into the determinants of post-PCV13 age-specific VT carriage.

Results

Accumulation of naturally acquired immunity with age and age-specific transmission potential were both key to reproducing the observed data. VT carriage reduction peaked sequentially over time, earlier in younger and later in older age-groups. Estimated vaccine efficacy (protection against carriage) was 66.87% (95% CI 50.49-82.26%), similar to previous estimates. Ten-year projected vaccine impact (VT carriage reduction) among 0-9 years old was lower than observed in other settings, at 76.23% (CI 95% 68.02-81.96%), with sensitivity analyses demonstrating this to be mainly driven by a high local force of infection.

Conclusions

We have identified both vaccine-related and host-related determinants of post-PCV13 pneumococcal VT transmission in Blantyre with vaccine impact determined by age-related characteristics of the local force of infection. These findings are likely to be generalisable to other Sub-Saharan African countries in which PCV impact has been lower than desired, and have implications for the interpretation of post-PCV carriage studies and future vaccination programs.
Plasma proteome profiling to detect and avoid sample-related biases in biomarker studies
Authors: Geyer Philipp E. , Voytik Eugenia , Treit Peter V. , Doll Sophia , Kleinhempel Alisa , Niu Lili , Müller Johannes B. , Bader Jakob , Teupser Daniel , Holdt Lesca M. , Mann Matthias
Published: December 2018

Plasma and serum are rich sources of information regarding an individual’s health state and protein tests inform medical decision making. Despite major investments, few new biomarkers have reached the clinic. Mass spectrometry (MS)-based proteomics now allows highly specific and quantitative read-out of the plasma proteome. Here we employ Plasma Proteome Profiling to define contamination marker panels to assess plasma samples and the likelihood that suggested biomarkers are instead artifacts related to sample handling and processing. We acquire deep reference proteomes of erythrocytes, platelets, plasma and whole blood of 20 individuals (>6000 proteins), and compare serum and plasma proteomes. Based on spike-in experiments we determine contamination-associated proteins, many of which have been reported as biomarker candidates as revealed by a comprehensive literature survey. We provide sample preparation guidelines and an online resource (www.plasmaproteomeprofiling.org) to assess overall sample-related bias in clinical studies and to prevent costly miss-assignment of biomarker candidates.
Generating an Artificial Nest Building Pufferfish in a Cellular Automaton Through Behavior Decomposition
Authors: Portegys Thomas E.
Published: December 2018

A species of pufferfish builds fascinating circular nests on the sea floor to attract mates. This project simulates the nest building behavior in a cellular automaton using the Morphognosis model. The model features hierarchical spatial and temporal contexts that output motor responses from sensory inputs. By considering the biological neural network of the pufferfish as a black box, decomposing only its external behavior, an artificial counterpart can be generated. In this way a complex biological system producing a behavior can be filtered into a system containing only functions that are essential to reproduce the behavior. The derived system not only has intrinsic value as an artificial entity but also might help to ascertain how the biological system produces the behavior.
Outpatient antibiotic prescribing and demographic factors associated with state-level septicemia mortality rates in US adults
Authors: Goldstein Edward , Lipsitch Marc
Published: December 2018

Background

Rates of septicemia/sepsis mortality and hospitalization in the US have risen significantly during the recent years, and antibiotic use may contribute to those rates through various mechanisms.

Methods

We used multivariable linear regression to relate state-specific rates of outpatient prescribing overall for fluoroquinolones, penicillins, macrolides, and cephalosporins between 2013-2014 to state-specific rates of septicemia mortality (ICD-10 codes A40-41 present as either the underlying or contributing causes of death) in each of the following age groups of adults: (18-49y, 50-64y, 65-74y, 75-84y, 85+y) between 2013-2014, adjusting for median household income, average annual temperature, age-specific percentages of state residents who (i) lived below the poverty level, (ii) were African American, (iii) lacked health insurance (in non-elderly age groups), and random effects associated with the different US Health and Human Services (HHS) regions.

Results

Rates of penicillin prescribing were positively associated with septicemia mortality rates in the analyses for persons aged 65-74y, 75-84y and over 85y. Rates of cephalosporin prescribing were positively associated with septicemia mortality rates in the analyses for persons aged 18-49y and 65-74y. Rates of fluoroquinolone prescribing were positively associated with septicemia mortality rates in the analyses for persons aged 18-49y. Percent African Americans in a given age group was positively associated with septicemia mortality rates in the analyses for age groups over 65y, and 18-49y. Percent of residents in a given age group living below the poverty level was positively associated with septicemia mortality rates in the analysis for persons aged 65-74y.

Conclusions

Our results suggest that rates of penicillin prescribing are associated with rates of septicemia mortality in older US adults, while rates of cephalosporin prescribing are associated with rates of septicemia mortality in persons aged 18-49y and 65-74y, and rates of fluoroquinolone prescribing are associated with rates of septicemia mortality in persons aged 18-49y. Further studies are needed to better understand the potential effect of antibiotic replacement in the treatment of different syndromes, such as replacement of fluoroquinolones by other antibiotics, possibly penicillins and cephalosporins following the recent US FDA guidelines on restriction of fluoroquinolone use, on the rates of sepsis mortality.
Approximating instantaneous vaccine efficacy from cumulative vaccine efficacy
Authors: Zandvoort Kevin van , Clark Andrew , Jit Mark , Flasche Stefan
Published: December 2018

Few methods exist to estimate vaccine efficacy and its decay following immunisation. Existing methods are largely based on survival analyses such as Poisson or Cox-regression, applied to individual-level data from randomised placebo-controlled trials (RCTs), however, such are often not easily available for analysing pooling evidence across trials. Hence, cumulative vaccine efficacy (VE), the commonly reported endpoint, is implicitly assumed a reasonable proxy for the instantaneous vaccine efficacy (iVE). This assumption is violated if the relative risk (RR) of vaccinated vs unvaccinated is not constant over time, i.e. if vaccine efficacy changes after immunisation. We propose a method to overcome this issue. We use estimates of VE stratified by time since completed immunisation, and estimate time-dependent iVE. We validate the method against simulated data for two forms of vaccine protection: all-or-nothing protection and leaky protection. We illustrate how VE estimates are biased by time-dependent effects in the baseline force of infection and in iVE. Our proposed method improves upon available iVE estimation techniques, particularly if the vaccine induced leaky-like protection and the disease outcome is rare.