bluuebunny/crossref_metadata_2025 huggingface dataset:
The Political Economy of Growth and Development in India
Authors: Corbridge Stuart , Harriss John , Jeffrey Craig
Published: October 2017

This article examines two puzzling trends that have characterized India’s economic growth. The first is how and why the political economy of development in India discarded an earlier model of import-substitution industrialization that was widely supported by the country’s dominant proprietary groups. The second is why, despite India’s economic success, poor people have remained mired in extreme poverty compared to China and some other countries in East and Southeast Asia. The article begins by looking at India’s economic development between 1950 and 1980 and then turns to economic reforms pursued by various governments. It also considers some of the factors that led India to embrace a more concerted agenda of pro-market reforms in the 1990s, including the economic crisis of 1990–1991 and elite politics.
Philosophical Dimensions of Shinran’s Pure Land Buddhist Path
Authors: Hirota Dennis
Published: October 2017

Shinran is widely recognized as one of the most original and seminal figures in the Japanese intellectual tradition. His importance in the Buddhist tradition turns on his insight into the recalcitrance of self-attachment even in religious discipline and on his self-reflective exploration of unenlightened, conditioned existence in vigorous engagement with the Buddhist path. These enable him to trace, from an existential perspective, the nonduality of the karmically created and the uncreated that is taught to characterize wisdom or reality in Mahayana tradition. The pivotal themes of his thought—self-will or “self-power” (jiriki), “calculative thinking” (hakarai), the linguisticality of human existence, “provisional” and “true” hermeneutical modes of Buddhist engagement, temporality, “naturalness” or the self-giving of reality (jinen), and “the attainment of awakening by the person who is evil” (akunin jōbutsu)—resonate with several concerns of recent Western thought.
Freedom, Slavery, and Identity in Renaissance Florence
Authors: Patterson Orlando
Published: October 2017

Renaissance Florence paid homage to the values and rights associated with freedom. It was governed by a body of citizens rather than by a prince, and Florentines did not take their right of self-government for granted. Indeed, Florentines treated freedom as both prerequisite and ultimate expression of virtue. Yet, somehow Florence also was the scene of a burgeoning of urban-domestic slavery. Was this simply a mismatch of rhetoric with sociological reality? This chapter explores the life and times of Leon Battista Alberti, author of the most penetrating exploration of the slavery-into-freedom dialectic of any modern Western writer. Because of his own life circumstances, including illegitimacy, Alberti was able to see the essence of the slave condition, and its dialectical relation to freedom, and express it cogently in his writings.
A nonpharmacologic approach to managing insomnia in primary care
Authors: Taylor Kelsey , Bilan Nataliya , Tsytsyna Nadzeya , Mandel Ellen D.
Published: October 2017

Insomnia, or inadequate or poor sleep leading to significant distress or impairment in functioning, is a prevalent disorder treated by primary care providers (PCPs). With millions of people across the United States suffering from insomnia, PCPs must understand the disorder's pathophysiology, perpetuating factors, and treatment, as well as its effect on patient health and the economy. Although PCPs traditionally treat insomnia with pharmaceuticals, behavioral measures are effective and should be used whenever possible. This article reviews clinically relevant principles of diagnosing and treating insomnia, highlighting nonpharmacologic treatments.
Functional genomics of stromal cells in chronic inflammatory diseases
Authors: Slowikowski Kamil , Wei Kevin , Brenner Michael B. , Raychaudhuri Soumya
Published: October 2017

Purpose of review

Stroma is a broad term referring to the connective tissue matrix in which other cells reside. It is composed of diverse cell types with functions such as extracellular matrix maintenance, blood and lymph vessel development, and effector cell recruitment. The tissue microenvironment is determined by the molecular characteristics and relative abundances of different stromal cells such as fibroblasts, endothelial cells, pericytes, and mesenchymal precursor cells. Stromal cell heterogeneity is explained by embryonic developmental lineage, stages of differentiation to other cell types, and activation states. Interaction between immune and stromal cell types is critical to wound healing, cancer, and a wide range of inflammatory diseases. Here, we review recent studies of inflammatory diseases that use functional genomics and single-cell technologies to identify and characterize stromal cell types associated with pathogenesis.

Recent findings

High dimensional strategies using mRNA sequencing, mass cytometry, and fluorescence activated cell-sorting with fresh primary tissue samples are producing detailed views of what is happening in diseased tissue in rheumatoid arthritis, inflammatory bowel disease, and cancer. Fibroblasts positive for CD90 (Thy-1) are enriched in the synovium of rheumatoid arthritis patients. Single-cell RNA-seq studies will lead to more discoveries about the stroma in the near future.

Stromal cells form the microenvironment of inflamed and diseased tissues. Functional genomics is producing an increasingly detailed view of subsets of stromal cells with pathogenic functions in rheumatic diseases and cancer. Future genomics studies will discover disease mechanisms by perturbing molecular pathways with chemokines and therapies known to affect patient outcomes. Functional genomics studies with large sample sizes of patient tissues will identify patient subsets with different disease phenotypes or treatment responses.
Robot-Assisted Ventral Mesh Rectopexy for Rectal Prolapse: A 5-Year Experience at a Tertiary Referral Center
Authors: van Iersel Jan J. , Formijne Jonkers Hendrik A. , Paulides Tim J.C. , Verheijen Paul M. , Draaisma Werner A. , Consten Esther C.J. , Broeders Ivo A.M.J.
Published: October 2017

BACKGROUND:

Laparoscopic ventral mesh rectopexy is being increasingly performed internationally to treat rectal prolapse syndromes. Robotic assistance appears advantageous for this procedure, but literature regarding robot-assisted ventral mesh rectopexy is limited.

OBJECTIVE:

The primary objective of this study was to assess the safety and effectiveness of robot-assisted ventral mesh rectopexy in the largest consecutive series of patients to date.

DESIGN:

This study is a retrospective cross-sectional analysis of prospectively collected data.

SETTINGS:

The study was conducted in a tertiary referral center.

PATIENTS:

All of the patients undergoing robot-assisted ventral mesh rectopexy for rectal prolapse syndromes between 2010 and 2015 were evaluated.

MAIN OUTCOME MEASURES:

Preoperative and postoperative (mesh and nonmesh) morbidity and functional outcome were analyzed. The actuarial recurrence rates were calculated using the Kaplan–Meier method.

RESULTS:

A total of 258 patients underwent robot-assisted ventral mesh rectopexy (mean ± SD follow-up = 23.5 ± 21.8 mo; range, 0.2 – 65.1 mo). There were no conversions and only 5 intraoperative complications (1.9%). Mortality (0.4%) and major (1.9%) and minor (<30 d) early morbidity (7.0%) were acceptably low. Only 1 (1.3%) mesh-related complication (asymptomatic vaginal mesh erosion) was observed. A significant improvement in obstructed defecation (78.6%) and fecal incontinence (63.7%) were achieved for patients (both p < 0.0005). At final follow-up, a new onset of fecal incontinence and obstructed defecation was induced or worsened in 3.9% and 0.4%. The actuarial 5-year external rectal prolapse and internal rectal prolapse recurrence rates were 12.9% and 10.4%.

LIMITATIONS:

This was a retrospective study including patients with minimal follow-up. No validated scores were used to assess function. The study was monocentric, and there was no control group.

CONCLUSIONS:

Robot-assisted ventral mesh rectopexy is a safe and effective technique to treat rectal prolapse syndromes, providing an acceptable recurrence rate and good symptomatic relief with minimal morbidity. See Video Abstract at http://links.lww.com/DCR/A427.
Crohn’s Disease of the Pouch: A True Diagnosis or an Oversubscribed Diagnosis of Exclusion?
Authors: Lightner Amy L. , Fletcher Joel G. , Pemberton John H. , Mathis Kellie L. , Raffals Laura E. , Smyrk Thomas
Published: October 2017

BACKGROUND:

After IPAA, 8% of patients with ulcerative colitis are later diagnosed with Crohn’s disease of the pouch, associated with an increased rate of pouch failure. No study has reported on how often the clinical diagnosis is correlated with histologic findings of Crohn’s disease in the excised pouch.

OBJECTIVE:

The purpose of this study was to determine whether the clinical diagnosis is consistent with pathologic confirmation at pouch excision.

SETTINGS:

The study was conducted at a tertiary IBD referral center.

PATIENTS:

Patients with chronic ulcerative colitis who underwent pouch excision for presumed Crohn’s disease of the pouch were included.

MAIN OUTCOME MEASURES:

Preoperative evaluation and pathologic variables at the time of pouch excision were measured.

RESULTS:

A total of 35 patients underwent pouch excision for Crohn’s disease of the pouch based on a combination of clinical, radiographic, and endoscopic findings. Seven (20%) had surgical pathology consistent with Crohn’s disease at pouch excision. There were no differences in those 7 patients and the remaining 28 in terms of diagnosis at colectomy, primary pouch symptoms, prepouch inflammation, ulceration, or granulomas at endoscopy. In the nonpathology-confirmed Crohn’s disease, 40% (n = 11) had an anastomotic leak at time of IPAA versus 0% in the Crohn’s disease group, and 86% (n = 24) had symptoms of pouch dysfunction within 5 months of ileostomy reversal versus 13 months in the Crohn’s disease group. Of 28 without pathology-confirmed Crohn’s disease, 100% (n = 28) were treated with antibiotics, 68% (n = 19) with steroids, 59% (n = 16) with immunomodulators, and 57% (n = 15) with biologic therapy for Crohn’s disease of the pouch.

LIMITATIONS:

The study was limited by its single-center scope and lack of an established definition for Crohn’s disease of the pouch.

CONCLUSIONS:

Pathologic confirmation of Crohn’s disease was given to only one fifth of patients who underwent pouch excision for Crohn’s disease of the pouch. Given the histologic variability in Crohn’s disease, it may be unreasonable to expect histologic confirmation in every case; still, the diagnosis of Crohn’s disease of the pouch may be overly ascribed, resulting in unnecessary immunosuppressive medications and exclusion from consideration for pouch reconstructive surgery. See Video Abstract at http://links.lww.com/DCRA432.
Telemedicine Applications in Obstetrics and Gynecology
Authors: GREINER ANDREA L.
Published: October 2017

This article reviews principles to consider when setting up a telemedicine (TM) program to provide care to women in the field of obstetrics and gynecology. There are different types of TM encounters and clinical applications vary widely. The consensus among patients and providers is that TM is convenient to provide needed subspecialty medical care when it is not available locally. These programs are clinically successful, but economic and cost-effectiveness data are lacking. Federal reimbursement policy is limited for TM. State policy on coverage and reimbursement varies significantly from state to state and is the main driver on whether TM programs are successful.
Reactivation and Dissemination of Tuberculosis to Extrapulmonary Sites in Patients With Hematologic Malignancies
Authors: Garcia Reicelle D. , Nanjappa Sowmya , Casanas Beata C. , Rihana Nancy , Greene John N.
Published: October 2017

The increased utilization of immunosuppressive, antineoplastic agents in patients with hematologic malignancies and hematopoietic stem cell transplant recipients impairs humoral and cellular immunity. As a result, susceptibility to infectious diseases, including reactivation/development of tuberculosis and its dissemination to extrapulmonary sites, is a serious concern. Tuberculosis dissemination to extrapulmonary sites can mimic both clinical and radiological presentations of other etiologic agents. Thus, early diagnosis is often challenging. We present 3 cases of tuberculosis infection, of which 2 disseminated to extrapulmonary sites in patients with hematologic malignancies, along with literature review, clinical presentation, diagnostic evaluation, and differential diagnosis.
Reflections on 50 Years of Neuroscience Nursing: Publication Trends in Neurotrauma
Authors: McNett Molly , Keiser Megan , Douglas Heather , McNair Norma D.
Published: October 2017

In 2018, the American Association of Neuroscience Nurses will celebrate its 50th anniversary as the premier member organization for neuroscience nurses. In recent decades, one of the highest rated member benefits has been the ability for members to join special focus groups (SFGs). The SFGs were initiated to allow an avenue for information sharing and communication for neuroscience nurses in a variety of subspecialties. In this anniversary edition, the neurotrauma SFG presents a review of trends in the publication of articles in the Journal of Neuroscience Nursing related to neurotrauma. Findings from this article illustrate how these publications have impacted the nursing care of patients who have sustained traumatic injuries of the central and peripheral nervous system and the integral role of neuroscience nurses throughout the decades.
Decline of Low-Frequency Hearing in People With Ski-Slope Hearing Loss; Implications for Electrode Array Insertion
Authors: Schuurbiers Jasper , Dingemanse Gertjan , Metselaar Mick
Published: October 2017

Hypothesis:

The decline of low-frequency hearing in people with ski-slope hearing loss varies and might depend on etiology.

Background:

People with ski-sloping hearing loss might benefit from cochlear implantation with preservation of residual hearing. To reduce the risk of losing low-frequency hearing after implantation, the electrode-array can be inserted partially up to the desired frequency. That, however, obstructs electrical stimulation of lower frequencies. To decide between complete or partial insertion, knowledge regarding the natural decline of low-frequency hearing is helpful.

Methods:

Patients with at least two ski-slope audiograms over time were selected. We calculated progression at lower frequencies for 320 patients. Etiologies for hearing loss were retrieved from medical records. Progression of hearing loss was analyzed separately for patients with uni- and bilateral hearing losses. Relative progression of hearing loss was obtained by comparing progression to a reference group.

Results:

Average progression of PTA was 1.73 dB/yr and was not significantly different in the bilateral and unilateral group. Etiologies that did not show significantly more progression compared with the reference group could be identified as single or short-lasting pathologic events, whereas long-lasting conditions had significant more progression of PTA.

Conclusion:

Patients with a ski-slope hearing loss that was caused by a single or short-lasting event have low progression rate and are viable for partial insertion to minimize the risk of damaging residual low-frequency hearing. In the absence of such an event, complete insertion should be considered because faster than normal deterioration of low-frequency hearing over time will probably limit the advantage of preservation of residual hearing.
Pediatric Calvarial Bone Thickness in Patients With and Without Aural Atresia
Authors: Tomlinson Andrew R. , Hudson Michael L. , Horn Karl L. , Bell Erin M. , Petersen Timothy R. , Kraai Tania L.
Published: October 2017

Objective:

To compare temporal bone thickness along a three-dimensional arc of potential osseointegrated implant sites for bone-anchored hearing aids in children with and without aural atresia using computed tomographic imaging (CT).

Study Design:

Retrospective case review.

Setting:

Tertiary children's hospital.

Patients:

Children with or without aural atresia aged less than 11 years who had a temporal bone CT.

Intervention (s):

Calvarial bone volume on CT was rendered in three-dimensional and thickness was reconstructed and measured at up to 12 defined sites along an arc of recommended implant sites.

Main Outcome Measure (s):

Determining whether a majority of observed potential implant sites have 2, 3, or 4 mm of bone thickness while controlling for age differences and atresia status.

Results:

A total of 40 atretic (from 34 patients) and 34 control (from 34 patients) temporal bones were compared using CT. Likelihood ratio tests indicated that diagnosis did not have a statistically significant effect on whether patients reached thresholds of 2, 3, or 4 mm at most observed sites (p = 0.781, 0.773, and 0.529, respectively) when adjusting for age. For all children measured, 93% had >50% of measured points greater than or equal to 2 mm thick.

Conclusion:

Most children had greater than 2 mm of temporal bone thickness at >50% of the sites measured regardless of age or atresia diagnosis. The likelihood of reaching 4 mm of thickness at most sites improves with age. In unilateral patients, there was not a significant difference in thickness between affected and unaffected sides. There was also no significant difference in thickness when comparing patients with atresia to those without.
Dizziness Handicap Inventory Score Is Highly Correlated With Markers of Gait Disturbance
Authors: Zanotto Damiano , Mamuyac Erin M. , Chambers Adam R. , Nemer John S. , Stafford John A. , Agrawal Sunil K. , Lalwani Anil K.
Published: October 2017

Objective:

To evaluate the association between Dizziness Handicap Inventory—Screening version (DHI-S) score and spatiotemporal gait parameters using SoleSound, a newly developed, inexpensive, portable footwear-based gait analysis system.

Study Design:

Cross-sectional.

Patients:

One hundred eighteen patients recruited from otology clinic.

Intervention(s):

Subjects completed the DHI-S survey and four uninterrupted walking laps wearing SoleSound instrumented footwear on a hard, flat surface for 100 m.

Main Outcome Measure(s):

For each subject, mean and coefficient of variation (CV) of stride length, cadence, walking speed, foot-ground clearance, double-support time, swing period, and stance-to-swing were computed by considering 40 strides of steady-state walking within each lap. Linear regression models were employed to study correlations between these variables and DHI-S scores after adjusting for age, sex, and race/ethnicity.

Results:

Patients with higher DHI-S score took shorter steps and less steps per minute (−0.017 m and −1.1 steps/min per every four-point increase in DHI-S score, p < 0.05) than patients with a lower DHI-S score, with slower walking speed (−0.025 m/s per every four-point increase in DHI-S score, p < 0.01). Additionally, patients with higher DHI-S scores showed larger variability in all analyzed temporal parameters (+0.1% for CV of cadence, +0.5% for CV of double support period, +0.2% for CV of swing period, and +0.4% for CV of stance-to-swing, per every four-point increase in DHI-S score, p < 0.01).

Conclusion:

SoleSound was effective in measuring a wide range of gait parameters. Patients’ self-perception of vestibular handicap, as assessed with DHI-S, is associated with deterioration in measurable gait parameters independent of age.
Successful Treatment of Invasive Conidiobolus Infection During Therapy for Acute Lymphoblastic Leukemia
Authors: Erker Craig , Huppler Anna R. , Walsh Thomas J. , McCormick Michael E. , Suchi Mariko , Bhatt Neel S. , Kehl Susan C. , Southwood Jessica , Harker-Murray Paul
Published: October 2017

Invasive fungal infections are a serious cause of morbidity and mortality in patients with hematologic malignancies. Conidiobolus species are molds within the order Entomophthorales and may disseminate to become rapidly fatal in immunocompromised individuals. This species of fungal infections are often multidrug resistant (MDR) and present unique therapeutic challenges. Reports of Conidiobolus infections are rare in pediatric oncology. We report the successful treatment of an adolescent male with B-cell lymphoblastic leukemia and MDR invasive sinopulmonary Conidiobolus infection with emphasis on early and aggressive neutrophil support with surgical debridement. The strategies described could be applied to other MDR fungal infections.
A Pilot Study to Increase the Efficiency of HIV Outreach Testing Through the Use of Timely and Geolocated HIV Viral Load Surveillance Data
Authors: Jennings Jacky M. , Schumacher Christina , Perin Jamie , Myers Tanya , Fields Nathan , Greiner Safi Amelia , Chaulk Patrick
Published: October 2017

Background

Eliminating HIV transmission in a population necessitates identifying population reservoirs of HIV infection and subgroups most likely to transmit. HIV viral load is the single most important predictor of HIV transmission. The objective of this analysis was to evaluate whether a public health practice pilot project based on community viral load resulted in increases in the proportion of time spent testing in high viral load areas (process measure) and 3 outcome measures—the number and percent of overall HIV diagnoses, new diagnoses, and high viral load positives—in one mid-Atlantic US city with a severe HIV epidemic.

Methods

The evaluation was conducted during three, 3-month periods for 3 years and included the use of community viral load, global positioning system tracking data, and statistical testing to evaluate the effectiveness of the pilot project.

Results

The proportion of time spent outreach testing in high viral load areas (69%–84%, P < 0.001) and the overall number and percent of HIV positives ((60 (3%) to 127 (6%), P < 0.001) significantly increased for 3 years. The number and percent of new diagnoses (3 (0.1%) to 6 (0.2%)) and high viral load positives (5 (0.2%) to 9 (0.4%)) increased, but the numbers were too small for statistical testing.

Discussion

These results suggest that using community viral load to increase the efficiency of HIV outreach testing is feasible and may be effective in identifying more HIV positives. The pilot project provides a model for other public health practice demonstration projects.
Creating Innovative Sexually Transmitted Infection Testing Options for University Students: The Impact of an STI Self-testing Program
Authors: Habel Melissa A. , Brookmeyer Kathryn A. , Oliver-Veronesi Robin , Haffner Michelle M.
Published: October 2017

Background

National-level data suggest that sexually transmitted infection (STI) testing rates among young adults are low. The purpose of this study was to evaluate the acceptability of an STI self-testing program at a university health center. Few evaluations on the acceptability of collegiate self-testing programs and their effect on testing uptake have been conducted.

Methods

To assess acceptability and uptake of self-testing (urine and self-collected vaginal swab), we conducted a brief self-administered survey of students accessing a large US-based university health center from January to December 2015.

Results

In 2015, University Health Services experienced a 28.5% increase in chlamydia (CT)/gonorrhea (GC) testing for male individuals and 13.7% increase in testing for female students compared to 2013 (baseline). In 2015, 12.4% of male students and 4.8% of female students tested positive for CT/GC via clinician testing, whereas 12.9% of male students and 12.4% of female students tested positive via self-testing. Female students were more likely to test positive for CT/GC when electing to test via self-test versus a clinician test (χ
2(1, N = 3068) = 36.54, P < 0.01); no significant difference in testing type was observed for male students. Overall, 22.5% of students who opted for the self-test option completed the acceptability survey; 63% reported that their main reason for testing was unprotected sex. In the past year, 42% reported 4 or more partners. The majority were very satisfied and likely to use the service again (82%).

Conclusions

Self-testing may be an efficient and effective way to provide STI testing for students and increase testing uptake. Self-reports of multiple partners, unprotected sex, and detected infections suggest that at-risk students are using the service.
Incidence of Wrong-Site Surgery List Errors for a 2-Year Period in a Single National Health Service Board
Authors: Geraghty Alistair , Ferguson Lorna , McIlhenny Craig , Bowie Paul
Published: October 2017

Introduction

Wrong-site/side surgical “never events” continue to cause considerable harm to patients, healthcare professionals, and organizations within the United Kingdom. Incidence has remained static despite the mandatory introduction of surgical checklists. Operating theater list errors have been identified as a regular contributor to these never events. The aims of the study were to identify and to learn from the incidence of wrong-site/side list errors in a single National Health Service board.

Methods

The study was conducted in a single National Health Service board serving a population of approximately 300,000. All theater teams systematically recorded errors identified at the morning theater brief or checklist pause as part of a board-wide quality improvement project. Data were reviewed for a 2-year period from May 2013 to April 2015, and all episodes of wrong-site/side list errors were identified for analysis.

Results

No episodes of wrong-site/side surgery were recorded for the study period. A total of 86 wrong-site/side list errors were identified in 29,480 cases (0.29%). There was considerable variation in incidence between surgical specialties with ophthalmology recording the largest proportion of errors per number of surgical cases performed (1 in 87 cases) and gynecology recording the smallest proportion (1 in 2671 cases). The commonest errors to occur were “wrong-side” list errors (62/86, 72.1%).

Discussion

This is the first study to identify incidence of wrong-site/site list errors in the United Kingdom. Reducing list errors should form part of a wider risk reduction strategy to reduce wrong-site/side never events. Human factors barrier management analysis may help identify the most effective checks and controls to reduce list errors incidence, whereas resilience engineering approaches should help develop understanding of how to best capture and neutralize errors.
Iodine and Fat Quantification for Differentiation of Adrenal Gland Adenomas From Metastases Using Third-Generation Dual-Source Dual-Energy Computed Tomography
Authors: Martin Simon S. , Weidinger Sebastian , Czwikla Rouben , Kaltenbach Benjamin , Albrecht Moritz H. , Lenga Lukas , Vogl Thomas J. , Wichmann Julian L.
Published: October 2017

Objectives

The aim of this study was to investigate the value of third-generation dual-source dual-energy computed tomography (DECT) iodine and fat quantification in differentiating adrenal gland adenomas from metastases.

Materials and Methods

Sixty-two patients (38 men and 24 women; mean age, 69.1 years) underwent clinically indicated DECT of the abdomen on a third-generation dual-source scanner. Examinations were retrospectively included due to detected adrenal masses. For each adrenal lesion, unenhanced and contrast-enhanced attenuation values, as well as dual-energy iodine density and fat fraction, were recorded. Additional magnetic resonance imaging data, positron emission tomography/computed tomography scans, interval imaging follow-up, and histopathological analysis were used as the reference standard for all adrenal lesions. Mean values of unenhanced and contrast-enhanced attenuation, as well as material densities, were compared between adenomas, metastases, and normal adrenal glands. Furthermore, the diagnostic accuracy of unenhanced, contrast-enhanced, and material density analysis was assessed between adrenal adenomas and metastases.

Results

Adrenal adenomas showed significant differences regarding iodine density and fat fraction values (1.3 ± 0.4 mg/mL and 34.2% ± 12.6%) in comparison with adrenal metastases (3.2 ± 1.4 mg/mL and 10.7% ± 7.8%) and normal adrenal glands (1.7 ± 0.6 mg/mL and 18.7% ± 12.0%) (all P ≤ 0.004). Analysis of unenhanced attenuation values revealed no significant differences between healthy adrenal parenchyma (19.1 ± 15.6 HU) and adrenal metastases (26.9 ± 16.2 HU) (P = 0.135). Iodine density and fat fraction analysis showed significantly higher diagnostic accuracy for the diagnosis of adenomas (sensitivity, 97% and 89%; specificity, 96% and 89%, respectively) compared with unenhanced and contrast-enhanced evaluation (sensitivity, 65% and 58%; specificity, 73% and 85%, respectively) (P ≤ 0.023). The combined diagnostic value of iodine density and fat fraction analysis revealed a sensitivity of 97% and a specificity of 100%.

Conclusions

Third-generation dual-source DECT iodine and fat quantification allow for differentiation between adrenal adenomas and metastases with high diagnostic accuracy.
Vasopressors Do Not Influence Cerebral Critical Closing Pressure During Systemic Inflammation Evoked by Experimental Endotoxemia and Sepsis in Humans
Authors: van den Brule Judith Maria Dimphena , Stolk Roeland , Vinke Elisabeth Janine , van Loon Lex Maxim , Pickkers Peter , van der Hoeven Johannes Gerardus , Kox Matthijs , Hoedemaekers Cornelia Wilhelmina Elisabeth
Published: October 2017

Aim:

The aim of this study was to investigate the effects of different vasopressors on the cerebral vasculature during experimental human endotoxemia and sepsis. We used the critical closing pressure (CrCP) as a measure of cerebral vascular tone.

Methods:

We performed a prospective pilot study, at the intensive care department (ICU) of a tertiary care university hospital in the Netherlands, in 40 healthy male subjects during experimental human endotoxemia (administration of bacterial lipopolysaccharide [LPS]) and in 10 patients with severe sepsis or septic shock.

Subjects in the endotoxemia study were randomized to receive a 5 h infusion of either 0.05 μg/kg/min noradrenaline (n = 10, “LPS-nor”), 0.5 μg/kg/min phenylephrine (n = 10, “LPS-phenyl”), 0.04 IU/min vasopressin (n = 10, “LPS-AVP”), or saline (n = 10, “LPS-placebo”) starting 1 h before intravenous administration of 2 ng/kg LPS. In patients with sepsis, fluid resuscitation and vasopressor use was at the discretion of the medical team, aiming at normovolemia and a mean arterial pressure (MAP) > 65 mm Hg, using noradrenaline.

The mean flow velocity in the middle cerebral artery (MFVMCA) was measured by transcranial Doppler (TCD) with simultaneously recording of heart rate, arterial blood pressure, respiratory rate, and oxygen saturation. CrCP was estimated using the cerebrovascular impedance model.

Results:

The CrCP decreased in the LPS-placebo group from 52.6 [46.6–55.5] mm Hg at baseline to 44.1 [41.2–51.3] mm Hg at 270 min post-LPS (P = 0.03). Infusion of phenylephrine increased the CrCP in the period before LPS administration from 46.9 [38.8–53.4] to 53.8 [52.9–60.2] mm Hg (P = 0.02), but after LPS administration, a similar decrease was observed compared with the LPS-placebo group. Noradrenaline or vasopressin prior to LPS did not affect the CrCP. The decrease in CrCP after LPS bolus was similar in all treatment groups. The CrCP in the sepsis patients equaled 35.7 [34.4–42.0] mm Hg, and was lower compared with that in the LPS-placebo subjects from baseline until 90 min after LPS (P < 0.01).

Conclusions:

Experimental human endotoxemia results in a decreased CrCP due to a loss of vascular resistance of the arterial bed. Vasopressors did not prevent this decrease in CrCP. Findings in patients with sepsis are comparable to those found in subjects after LPS administration.

Patients with sepsis, despite treatment with vasopressors, have a risk for low cerebral blood flow and ischemia.
Defense Automated Neurobehavioral Assessment Accurately Measures Cognition in Patients Undergoing Electroconvulsive Therapy for Major Depressive Disorder
Authors: Hollinger Kristen R. , Woods Steven R. , Adams-Clark Alexis , Choi So Yung , Franke Caroline L. , Susukida Ryoko , Thompson Carol , Reti Irving M. , Kaplin Adam I.
Published: October 2017

Objectives

The Defense Automated Neurobehavioral Assessment (DANA) is an electronic cognitive test battery. The present study compares DANA to the standard Mini-Mental State Examination (MMSE) in subjects undergoing electroconvulsive therapy for the treatment of major depressive disorder.

Methods

Seventeen inpatient subjects in the Johns Hopkins Hospital Department of Psychiatry were administered longitudinal paired DANA and MMSE tests (7.6 ± 4.1 per patient) from January 10, 2014 to September 26, 2014. Regression analyses were conducted (with or without MMSE scores of 30) to study the impact of the MMSE upper limit, and within-subject regression analyses were conducted to compare MMSE and DANA scores over time.

Results

Statistically significant relationships were measured between DANA and MMSE scores. Relationships strengthened when MMSE scores of 30 were omitted from analyses, demonstrating a ceiling effect of the MMSE. Within-subject analyses revealed relationships between MMSE and DANA scores over the duration of the inpatient stay.

Conclusions

Defense Automated Neurobehavioral Assessment is an electronic, mobile, repeatable, sensitive, and valid method of measuring cognition over time in depressed patients undergoing electroconvulsive therapy treatment. Automation of the DANA allows for more frequent cognitive testing in a busy clinical setting and enhances cognitive assessment sensitivity with a timed component to each test.
Consistent Reanalysis of Genome-wide Imprinting Studies in Plants Using Generalized Linear Models Increases Concordance across Datasets
Authors: Wyder Stefan , Raissig Michael T. , Grossniklaus Ueli
Published: October 2017

Genomic imprinting leads to different expression levels of maternally and paternally derived alleles. Over the last years, major progress has been made in identifying novel imprinted candidate genes in plants, owing to affordable next-generation sequencing technologies. However, reports on sequencing the transcriptome of hybrid F1 seed tissues strongly disagree about how many and which genes are imprinted. This raises questions about the relative impact of biological, environmental, technical, and analytic differences or biases. Here, we adopt a statistical approach, frequently used in RNA-seq data analysis, which properly models count overdispersion and considers replicate information of reciprocal crosses. We show that our statistical pipeline outperforms other methods in identifying imprinted genes in simulated and real data. Accordingly, reanalysis of genome-wide imprinting studies inArabidopsisand maize shows that, at least for theArabidopsisdataset, an increased agreement across datasets can be observed. For maize, however, consistent reanalysis did not yield in a larger overlap between the datasets. This suggests that the discrepancy across publications might be partially due to different analysis pipelines but that technical, biological, and environmental factors underlie much of the discrepancy between datasets. Finally, we show that the set of genes that can be characterized regarding allelic bias by all studies with minimal confidence is small (~8,000/27,416 genes forArabidopsisand ~12,000/39,469 for maize). In conclusion, we propose to use biologically replicated reciprocal crosses, high sequence coverage, and a generalized linear model approach to identify differentially expressed alleles in developing seeds.
Pangenomic analysis reveals pathogen-specific regions and novel effector candidates inFusarium oxysporumf. sp.cepae
Authors: Armitage Andrew D. , Taylor Andrew , Sobczyk Maria K. , Baxter Laura , Greenfield Bethany P.J. , Bates Helen J. , Wilson Fiona , Jackson Alison C. , Ott Sascha , Harrison Richard J. , Clarkson John P.
Published: October 2017

A reference-quality assembly ofFusarium oxysporumf. sp.cepae(Foc), the causative agent of onion basal rot has been generated along with genomes of additional pathogenic and non-pathogenic isolates. Phylogenetic analysis confirmed a single origin of the Foc pathogenic lineage.

Genome alignments with otherF. oxysporumff. spp. and non pathogens revealed high levels of syntenic conservation of core chromosomes but little synteny between lineage specific (LS) chromosomes. Four LS contigs in Foc totaling 3.9 Mb were designated as pathogen-specific (PS). A two-fold increase in segmental duplication events was observed between LS regions of the genome compared to within core regions or from LS regions to the core.

RNA-seq expression studies identified candidate effectors expressedin planta, consisting of both known effector homologs and novel candidates. FTF1 and a subset of other transcription factors implicated in regulation of effector expression were found to be expressedin planta.
Response to Qian et al (2017): Daily and seasonal climate variations are both critical in the evolution of species’ elevational range size
Authors: Chan Wei-Ping , Chen I-Ching , Colwell Robert K. , Liu Wei-Chung , Huang Cho-ying , Shen Sheng-Feng
Published: October 2017

In their recent critique, Qian et al. (2017) claimed that the results of structural equation modeling analysis (SEM) in Chan et al. (2016) were flawed. Here, we show that the source of the difference in their re-analysis is that Qian et al. did not follow the standard, iterative process of SEM, which allows researchers to evaluate which model offers the best account of the data in both absolute and relative senses. Here, we provide step-by-step instructions to reproduce our published results. All of Qian et al.’s concerns regarding SEM can be put to rest. Moreover, in our original paper we used three distinct statistical methods—hierarchical partitioning, SEM, and stationary bootstrap—to show that different temporal scales of environmental variability can differentially impact the elevational range size (ERS) of species. It is time to move on to probing the pressing issue of how and why climatic variability impacts ERS.
Ocular and uteroplacental pathology in macaque congenital Zika virus infection
Authors: Mohr Emma L. , Block Lindsey N. , Newman Christina M. , Stewart Laurel M. , Koenig Michelle , Semler Matthew , Breitbach Meghan E. , Teixeira Leandro B.C. , Zeng Xiankun , Weiler Andrea M. , Barry Gabrielle L. , Thoong Troy H. , Wiepz Gregory J. , Dudley Dawn M. , Simmons Heather A. , Mejia Andres , Morgan Terry K. , Shahriar Salamat M. , Kohn Sarah , Antony Kathleen M. , Aliota Matthew T. , Mohns Mariel S. , Hayes Jennifer M. , Schultz-Darken Nancy , Schotzko Michele L. , Peterson Eric , Capuano Saverio , Osorio Jorge E. , O’Connor Shelby L. , Friedrich Thomas C. , O’Connor David H. , Golos Thaddeus G.
Published: October 2017

Congenital Zika virus (ZIKV) infection impacts fetal development and pregnancy outcomes. We infected a pregnant rhesus macaque with a Puerto Rican ZIKV isolate in the first trimester. The pregnancy was complicated by preterm premature rupture of membranes (PPROM) and fetal demise 49 days post infection (gestational day 95). Significant pathology at the maternal-fetal interface included acute chorioamnionitis, placental infarcts, and leukocytoclastic vasculitis of the myometrial radial arteries. ZIKV RNA was disseminated throughout the fetus tissues and maternal immune system at necropsy, as assessed by quantitative RT-PCR for viral RNA. Replicating ZIKV was identified in fetal tissues, maternal lymph node, and maternal spleen by fluorescent in situ hybridization for viral replication intermediates. Fetal ocular pathology included a choroidal coloboma, suspected anterior segment dysgenesis, and a dysplastic retina. This is the first report of ocular pathology and prolonged viral replication in both maternal and fetal tissues following congenital ZIKV infection in rhesus macaques. PPROM followed by fetal demise and severe pathology of the visual system have not been described in macaque congenital infection previously; further nonhuman primate studies are needed to determine if an increased risk for PPROM is associated with congenital Zika virus infection.

Author summary

A ZIKV infection during pregnancy is associated with malformations in fetal development including, but not limited to, ocular and brain anomalies, such as microcephaly, and stillbirth. The development of an accurate pregnancy model to study the effects of ZIKV will provide insight into vertical transmission, ZIKV tissue distribution, and fetal injury and malformations. Non-human primates closely resemble human in terms of the reproductive system, immunity, placentation and pregnancy. Our study demonstrates that the rhesus macaque is a compelling model in which to study ZIKV during pregnancy due to similar outcomes between the human and rhesus macaque. These similarities include prolonged viremia, vertical transmission, adverse pregnancy outcomes and fetal pathology, including defects in the visual system.
Comparing average network signals and neural mass signals in systems with low-synchrony
Authors: Tewarie P. , Daffertshofer A. , van Dijk B.W.
Published: October 2017

1

Neural mass models are accepted as efficient modelling techniques to model empirical observations such as disturbed oscillations or neuronal synchronization. Neural mass models are based on the mean-field assumption, i.e. they capture the mean-activity of a neuronal population. However, it is unclear if neural mass models still describe the mean activity of a neuronal population when the underlying neural network topology is not homogenous. Here, we test whether the mean activity of a neuronal population can be described by neural mass models when there is neuronal loss and when the connections in the network become sparse. To this end, we derive two neural mass models from a conductance based leaky integrate-and-firing (LIF) model. We then compared the power spectral densities of the mean activity of a network of inhibitory and excitatory LIF neurons with that of neural mass models by computing the Kolmogorov-Smirnov test statistic. Firstly, we found that when the number of neurons in a fully connected LIF-network is larger than 300, the neural mass model is a good description of the mean activity. Secondly, if the connection density in the LIF-network does not exceed a crtical value, this leads to desynchronization of neurons within the LIF-network and to failure of neural mass description. Therefore we conclude that neural mass models can be used for analysing empirical observations if the neuronal network of interest is large enough and when neurons in this system synchronize.
Time-resolved neural reinstatement and separation during memory decisions in human hippocampus
Authors: Lohnas Lynn J. , Duncan Katherine , Doyle Werner K. , Devinsky Orrin , Davachi Lila
Published: October 2017

Mnemonic decision-making has long been hypothesized to rely on hippocampal dynamics that bias memory processing toward the formation of new memories or the retrieval of old ones. Successful memory encoding would be best optimized by pattern separation, whereby two highly similar experiences can be represented by underlying neural populations in an orthogonal manner. By contrast, successful memory retrieval is thought to be supported by a recovery of the same neural pattern laid down during encoding. Here we examined how hippocampal pattern completion and separation emerge over time during memory decisions. We measured electrocorticography activity in the human hippocampus and posterior occipitotemporal cortex (OTC) while participants performed continuous recognition of items that were new, repeated (old), or highly similar to a prior item (similar).During retrieval decisions of old items, both regions exhibited significant reinstatement of multivariate high frequency activity (HFA) associated with encoding. Further, the extent of reinstatement of encoding patterns during retrieval was correlated both with the strength (HFA power) of hippocampal encoding and with the strength of hippocampal retrieval. Evidence for encoding pattern reinstatement was also seen in OTC on trials requiring fine-grained discrimination of similar items. By contrast, hippocampal activity showed evidence for pattern separation during these trials. Together, these results underscore the critical role of the hippocampus in supporting both reinstatement of overlapping information and separation of similar events.

Significance Statement

One of the biggest computational challenges the memory systems faces is to disambiguate highly similar experiences while at the same time preserving and reinstating prior memories. Remarkably, hippocampal processes have been implicated in both of these functions. However, how this is accomplished is unknown. Leveraging the spatiotemporal resolution of electrocorticography, we found evidence for memory reinstatement in both the hippocampus and occipitotemporal cortex. Reinstatement was differentiated in time across these two regions with earlier reinstatement evident in occipitotemporal cortex. Interestingly, when a current experience was very similar, but not identical to a prior one, occipitotemporal cortical activity still showed reinstatement of the prior memory but hippocampal activity differentiated or disambiguated these two similar experiences.
Phylofactorization - theory and challenges
Authors: Washburne Alex D.
Published: October 2017

Data from biological communities are composed of species connected by the phylogeny. A greedy algorithm ‘phylofactorization’ - was developed to construct an isometric log-ratio transform whose balances correspond to edges along which traits arose, controlling for previously made inferences.

In this paper, the general theory of phylofactorization is presented as a graph-partitioning algorithm. A special case-regression phylofactorization-chooses coordinates based on sequential maximization of objective functions from regression on “contrast” variables such as an isometric log-ratio transform. The connections between regression phylofactorization and other methods is discussed, including matrix factorization, hierarchical regression, factor analysis and latent variable models. Open challenges in the statistical analysis of phylofactorization are presented, including criteria for choosing the number of factors and approximating null-distributions of commonly used test statistics and objective functions. As a graph-partitioning algorithm, cross-validation of phylo factorization across datasets requires graph-topological considerations, such as how to deal with novel nodes and edges and whether or not to control for partition order. Overcoming these challenges can accelerate our analysis of phylogenetically-structured data and allow annotations of edges in an online tree of life.