bluuebunny/crossref_metadata_2025 huggingface dataset:
L2 talk as social accomplishment
Authors: Eskildsen Søren W. , Markee Numa
Published: March 2018

This position paper builds on ethnomethodological conversation analysis to make a number of interrelated, empirically derived claims about speaking a second language and learning to do it as a social endeavor. We will show that: (1) language is primarily action, that linguistic units are primarily designed and used for and learned as actions in situ; (2) language is occasioned and environmentally contingent, and speaking is turn-taking that presupposes an ability to monitor other people’s talk; and (3) language, learning and cognition are socially distributed, co-constructed, embodied and embedded in local situations. They are each other’s ongoing continuations or extensions, made visible by verbal and bodily behavior. They rely on other people’s actions in situ as language is co-constructed and language-as-action emerges.
Exploring the spoken learner English constructicon
Authors: Gilquin Gaëtanelle
Published: March 2018

This study, which is set in the field of Applied Construction Grammar, seeks to identify the constructions that are typical of higher intermediate to advanced spoken learner English. It does so by relying on the recurrent sequences of part-of-speech (POS) tags extracted from the Louvain International Database of Spoken English Interlanguage (LINDSEI) and its native counterpart. This corpus-driven approach reveals that learner speech mainly consists of basic constructions like [NP] or [Subj V], although longer and more complex constructions can be found among the less frequent sequences. The chapter also discusses methodological issues (such as the link between POS tag sequences and constructions), as well as theoretical matters (including the place of speech in Construction Grammar).
Creating and using the space for speaking within the foreign language classroom
Authors: Bygate Martin
Published: March 2018

Oral and written language differ in terms of the processing they involve, and the patterns of spoken and written discourse. These in turn imply differences in the challenges each presents to learners. I will consider how these can be distinctive to speaking, and suggest some implications for language teaching and research. I suggest that these characteristics imply a need to create ‘pedagogic spaces’ for the teaching of speaking, and that for these tasks are a crucial tool. Using examples I identify two particular ways in which tasks can contribute. Firstly the design of tasks can influence the kinds of oral discourse students engage in. Secondly tasks can be used to structure and motivate whole class talk through and across lessons.
Speaking in a second language
Authors: Alonso Rosa Alonso
Published: March 2018

This concluding chapter presents an overview of the speaking skill in the history of language teaching from the Grammar Translation Method to current Task-based Approach. It then moves on to the role of speaking in current usage-based perspectives, which view language as a social activity and where the social and the cognitive are no longer considered separate entities. As meaning is at the centre and language is considered to emerge out of usage, spoken interaction is promoted and speaking is considered both a social and a cognitive construct. We will observe how the different chapters in the volume fall within usage-based approaches and some of them provide usage-based inspired pedagogy. Finally, future research directions are proposed.
Stakeholder engagement in tourism.
Authors: McCabe S.
Published: March 2018

This chapter considers stakeholder engagement as a critical and core activity of strategic management that will ultimately lead to competitive advantage in tourism. The chapter begins by defining stakeholders and outlining social exchange theory and stakeholder theory. It then goes on to discuss the literature on stakeholder engagement in tourism. Approaches and strategies for stakeholder engagement and management are discussed.
New strategic developments in tourism.
Authors: Vargas-Sánchez A. , Moutinho L.
Published: March 2018

This chapter emphasizes the importance of a new strategic thinking in the current business environment of tourism. The future of business and the impact of emerging technologies are examined, as well as their strategic implications. The importance of an ethical approach is emphasized, showing how corporate social responsibility has adopted this role.
Assessment of peanut allergen Ara h1 in processed foods using a SWCNTs-based nanobiosensor
Authors: Sobhan Abdus , Oh Jun-Hyun , Park Mi-Kyung , Kim Seung Wook , Park Chulhwan , Lee Jinyoung
Published: March 2018

The goals of this research were to develop a rapid single-walled carbon nanotube (SWCNT)-based biosensor and to employ it to commercial food products for Ara h1 detection. The SWCNT-based biosensor was fabricated with SWCNTs immobilized with antibody (pAb) through hybridization of 1-pyrenebutanoic acid succinimidyl ester (1-PBASE) as a linker. The resistance difference (ΔR) was calculated by measuring linear sweep voltammetry (LSV) using a potentiostat. Resistance values increased as the concentration of Ara h1 increased over the range of 1 to 105 ng/L. The specific binding of anti-Ara h1 pAb to antigen including Ara h1 was confirmed by both indirect ELISA kit and biosensor assay. The biosensor was exposed to extracts prepared from commercial processed food containing peanuts, or no peanuts, and could successfully distinguish the peanut containing foods. In addition, the application of present biosensor approach documented the precise detection of Ara h1 concentrations in commercially available peanut containing foods.
Correlative live and super-resolution imaging reveals the dynamic structure of replication domains
Authors: Xiang Wanqing , Roberti M. Julia , Hériché Jean-Karim , Huet Sébastien , Alexander Stephanie , Ellenberg Jan
Published: March 2018

Chromosome organization in higher eukaryotes controls gene expression, DNA replication, and DNA repair. Genome mapping has revealed the functional units of chromatin at the submegabase scale as self-interacting regions called topologically associating domains (TADs) and showed they correspond to replication domains (RDs). A quantitative structural and dynamic description of RD behavior in the nucleus is, however, missing because visualization of dynamic subdiffraction-sized RDs remains challenging. Using fluorescence labeling of RDs combined with correlative live and super-resolution microscopy in situ, we determined biophysical parameters to characterize the internal organization, spacing, and mechanical coupling of RDs. We found that RDs are typically 150 nm in size and contain four co-replicating regions spaced 60 nm apart. Spatially neighboring RDs are spaced 300 nm apart and connected by highly flexible linker regions that couple their motion only <550 nm. Our pipeline allows a robust quantitative characterization of chromosome structure in situ and provides important biophysical parameters to understand general principles of chromatin organization.
Prolonged fever in peritoneal tuberculosis: A case report
Authors: Zein U , Irwandi S , Habib H , Lim H , Pasha M , Janis I , Saragih R H , Ginting Y
Published: March 2018

Peritoneal tuberculosis may lead to delayed diagnosis because of the nonspecific features such as fever, abdominal distension, abdominal tenderness, ascites, and weight loss. Here, wereported a case of prolonged fever and abdominal pain which was due to peritoneal tuberculosis. Initial examinations including acomplete blood test and serologic tests did not lead to the diagnosis. A final diagnosis was made by abdominal CT-scan and laparoscopy combined with histopathological studies. Antituberculous medications provided a good clinical response in this patient.
Human Immunization With a Polymorphic Malaria Vaccine Candidate Induced Antibodies to Conserved Epitopes That Promote Functional Antibodies to Multiple Parasite Strains
Authors: Feng Gaoqian , Boyle Michelle J , Cross Nadia , Chan Jo-Anne , Reiling Linda , Osier Faith , Stanisic Danielle I , Mueller Ivo , Anders Robin F , McCarthy James S , Richards Jack S , Beeson James G
Published: March 2018

Human immunization with a polymorphic malaria vaccine candidate, MSP2, induced functional cross-reactive antibodies targeting conserved epitopes. This contrasts with naturally acquired antibodies, which target polymorphic epitopes, mediating immune escape. Findings reveal potential to overcome antigenic diversity for effective malaria vaccines.
Prevalence of Schizophrenia in Idiopathic Normal Pressure Hydrocephalus
Authors: Vanhala Vasco , Junkkari Antti , Korhonen Ville E , Kurki Mitja I , Hiltunen Mikko , Rauramaa Tuomas , Nerg Ossi , Koivisto Anne M , Remes Anne M , Perälä Jonna , Suvisaari Jaana , Lehto Soili M , Viinamäki Heimo , Soininen Hilkka , Jääskeläinen Juha E , Leinonen Ville
Published: March 2018

BACKGROUND

Idiopathic normal pressure hydrocephalus (iNPH) is a progressive and potentially treatable neurodegenerative disease affecting elderly people, characterized by gait impairment and ventricular enlargement in brain imaging. Similar findings are seen in some patients with schizophrenia (SCZ).

OBJECTIVE

To determine the prevalence of SCZ among patients suffering from probable or possible iNPH and the specific effects of comorbid SCZ on the outcome of the cerebrospinal fluid (CSF) shunting.

METHODS

All medical records of the 521 iNPH patients in the NPH registry were retrospectively analyzed from 1991 until 2017. The prevalence of comorbidity of SCZ was determined and compared to that of general aged (≥65 yr) population in Finland.

RESULTS

We identified a total of 16 (3.1%) iNPH patients suffering from comorbid SCZ. The prevalence of SCZ among the iNPH patients was significantly higher compared to the general population (3.1% vs 0.9%, P < .001). All iNPH patients with comorbid SCZ were CSF shunted and 12 (75%) had a clinically verified shunt response 3 to 12 mo after the procedure. The CSF shunt response rate did not differ between patients with and without comorbid SCZ.

CONCLUSION

SCZ seems to occur 3 times more frequently among iNPH patients compared to the general aged population in Finland. The outcome of the treatment was not affected by comorbid SCZ and therefore iNPH patients suffering from comorbid SCZ should not be left untreated. These results merit validation in other populations. In addition, further research towards the potential connection between these chronic conditions is warranted.
Evaluating the effects of fish meal source and level on growth performance of nursery pigs1,2
Authors: Jones Aaron M , Wu Fangzhou , Woodworth Jason C , Tokach Mike D , Goodband Robert D , DeRouchey Joel M , Dritz Steve S
Published: March 2018

Three experiments were conducted to determine the effects of fish meal source on nursery pig growth performance. In experiment 1, 250 pigs (PIC 327 × 1,050, initially 7.1 ± 1.00 kg) were fed either a corn-soybean meal-based diet, a diet containing 8.3% enzymatically treated soybean meal (HP 300, Hamlet Protein, Findlay, OH), or diets containing 6% fish meal from one of three sources (IPC 790, The Scoular Company, Minneapolis, MN; Special Select Menhaden, Omega Proteins, Houston, TX; LT Prime Menhaden, Daybrook Fisheries Inc., New Orleans, LA; source 1, 2, and 3, respectively). In a completely randomized design, there were five pigs per pen and 10 pens per treatment with diets fed for 13 d. There was no evidence for differences in ADG or ADFI among pigs fed the three fish meal sources; however, pigs fed source 1 had marginally decreased (P = 0.068) G:F compared with pigs fed diets with other protein sources. In experiment 2, 350 barrows (DNA Line 200 × 400; initially 6.5 ± 0.90 kg) were assigned to one of seven dietary treatments including the same control diet and diets containing the three fish meal sources used in experiment 1, but fed at 3% or 6%. There were five pigs per pen and 10 pens per treatment with diets fed for 14 d. A source × level interaction (linear, P < 0.05) for ADG and G:F was observed. Increasing fish meal source 1 increased ADG and G:F; however, pigs fed source 2 had improved ADG and G:F at 3%, but decreased performance at 6% compared with control pigs. Pigs fed source 3 had no further improvements in ADG or G:F beyond the 3% inclusion. Fishmeal analysis for total volatile N, and modified Torry digestibility did not appear to correspond with any growth performance differences measured in experiments 1 or 2. In experiment 3, 700 barrows (DNA Line 200 × 400, initially 6.5 ± 0.84 kg) were fed a control diet or four diets with 6% fish meal (source 3) containing either 0.87%, 8.70%, 16.52%, or 24.35% fish solubles. There were five pigs per pen and 28 pens per treatment with diets fed for 21 d. Overall, pigs fed diets with fish meal had increased (P < 0.05) ADG and ADFI compared with pigs fed the control diet. There was no evidence for differences in growth performance as fish solubles increased. In conclusion, inconsistencies were observed in growth responses to different fish meal sources, but the amount of fish solubles, total volatile N, or modified Torry digestibility of fishmeal does not appear to explain these differences.
The End of Life Costs for Medicare Patients With Advanced Ovarian Cancer
Authors: Urban Renata R. , He Hao , Alfonso Raphael , Hardesty Melissa M. , Goff Barbara A.
Published: March 2018

(Abstracted from Gynecol Oncol 2018;148:336–341)

Most patients with advanced ovarian cancer will ultimately die of the disease. End-of-life care for ovarian cancer patients is often associated with a considerable expenditure of resources and costs.
Cost-effectiveness of Treatments for Heavy Menstrual Bleeding
Authors: Spencer Jennifer C. , Louie Michelle , Moulder Janelle K. , Ellis Victoria , Schiff Lauren D. , Toubia Tarek , Siedhoff Matthew T. , Wheeler Stephanie B.
Published: March 2018

(Abstracted from Am J Obstet Gynecol 2017;217(5):574.e1–574.e9)

In the United States, heavy menstrual bleeding accounts for one-third of all gynecology visits. Multiple treatment options exist for women with symptoms that cannot be controlled with more conservative methods such as oral contraceptives.
Clinical Profile of Children With Cerebral Palsy Born Term Compared With Late- and Post-term: A Retrospective Cohort Study
Authors: Frank R. , Garfinkle J. , Oskoui M. , Shevell M. I.
Published: March 2018

(Abstracted from BJOG 2017;124:1738–1745)

Cerebral palsy (CP) is an early-onset nonprogressive movement disorder of cerebral origin, and preterm birth (<37 weeks' gestation) is one of the strongest predictors of CP. There exists a gap in knowledge on whether the clinical profile of children with CP born late/postterm differs from those born early/full term.
Cord Blood Banking for Potential Future Transplantation
Authors: Shearer William T. , Lubin Bertram H. , Cairo Mitchell S. , Notarangelo Luigi D.
Published: March 2018

(Abstracted from Pediatrics 2017;140(5):e20172695)

Cord blood transplantation provides an array of treatment possibilities, from transplanting hematopoietic stem cells in children to the definitive treatment of certain hematological malignancies, immunodeficiencies, metabolic diseases, and hemoglobinopathies. Cord blood is noninvasively gathered from the placenta of newborn infants that would otherwise be discarded.
Serum Exoglycosidases in Children and Adolescents With Harmful Alcohol Use
Authors: Waszkiewicz Napoleon , Olański Witold , Chojnowska Sylwia , Kołakowska Urszula , Plewa Katarzyna , Mielech Włodzimierz , Bagniuk-Plewa Anna , Wasilewska Anna , Szulc Agata , Szajda Sławomir Dariusz , Zwierz Krzysztof
Published: March 2018

Objective:

There is a lack of accurate alcohol-use biomarkers in children/adolescents due to a short drinking duration/rapid normalization of elevated markers. We checked if lysosomal exoglycosidases, elevated earlier in binge-drinking young adults, can be applicable in children/adolescents as markers of harmful alcohol use.

Methods:

The serum activities (pKat/mL) of α-fucosidase (FUC), β-galactosidase (GAL), β-glucuronidase (GLU), β-hexosaminidase (HEX; its HEX A and HEX B isoenzymes), and α-mannosidase (MAN) were determined in 20 healthy controls (C) and 25 children/adolescents with harmful alcohol use (intoxicated by alcohol at hospital admission –AI1 and on the next day –AI2).

Results:

The serum HEX A and alanine aminotransferase (ALT) activity was significantly higher in the AI1 group than in the control. The activities of FUC, GAL, GLU, HEX B, and MAN were lower in the AI group. We found fair and poor accuracy, respectively, for increased enzymes HEX A and ALT. We found fair accuracy for decreased HEX B (AI1) and MAN (AI1), good accuracy for GLU (AI2), FUC (AI2), GAL (AI1, AI2), MAN (AI2), and excellent for FUC (AI1). Correlations were found: ALT with C-reactive protein (CRP), HEX A with white blood cell (WBC) count, blood alcohol concentration with FUC, MAN and HEX B, and WBC with FUC.

Conclusions:

Decreased FUC, GLU, GAL, MAN values, and especially FUC (AI1) have the potential to be markers of harmful alcohol use in children/adolescents. The raised activity of HEX A and ALT points to the need for further research to check another inflammatory agent as potential alcohol marker in children and adolescents. Samples need to be collected before intravenous fluid therapy.
Analysis of Opioid Use Following Curative Cancer Treatment at a Large Urban Safety-net Hospital
Authors: Cass Amanda S. , Alese Joyce T. , Kim Chaejin , Curry Marjorie A. , LaFollette Jennifer A. , Chen Zhengjia , Alese Olatunji B.
Published: March 2018

Objectives:

This study examined the pattern of use and factors predicting prolonged prescription opioid medications among cancer patients following treatment with curative intent.

Materials and Methods:

Patients diagnosed with cancer over a 3-year period at a large urban safety-net hospital were included. Univariate and multivariate analyses was used to identify factors associated with continued opioid use.

Results:

Of the 199 patients included in the study, 38% continued to receive an opioid prescription well beyond the acute diagnosis and treatment phase. Mean age was 60.3 years, with a female preponderance (63%). Surgical resection only (31.6%) and the combination of surgery, chemotherapy, and radiation (19.7%) were the commonest treatment modalities. Pain-related comorbidities predating cancer diagnosis were reported in 53.3% of the patients, and about 33% were also on pain-modifying medications (odds ratio [OR], 3.58; 95% confidence interval [CI], 1.92-6.77; Fisher exact test P<0.001). Average number of prescriptions received per patient was 4.8 (range, 1 to 31), over an average of 9.5 months (range, 1.2 to 28.1 mo). Mean morphine milligram equivalents prescribed per prescription was 319 mg (range, 48 to 2475 mg). According to multivariate model, patients who received chemotherapy (OR, 7.25; 95% CI, 2.09-25.17; P=0.0018), or pain-modifying medications (OR, 4.61; 95% CI, 2.25-9.44; P<0.0001) were significantly more likely to continue to receive prescriptions for opioids.

Discussion:

Treatment with chemotherapy, pain-modifying medications, cancer stage, and interval between diagnosis and treatment are the best predictors for continuous opioid use. The current epidemic of opioid misuse and abuse makes examination current practices and identifification of areas of improvement imperative.
INTRAVITREAL GAS INJECTION WITH LASER PHOTOCOAGULATION FOR HIGHLY MYOPIC FOVEOSCHISIS
Authors: Zhu Xiaobo , Shen Peiyang , Li Chu , Li Han , Huang Hao , Shi Kangpei , Wang Lei , Zhang Xiaotong , Lu Lin
Published: March 2018

Purpose:

To evaluate the effects of gas tamponade combined with laser photocoagulation without vitrectomy in patients with highly myopic foveoschisis.

Methods:

This retrospective noncomparative case series included 30 eyes of 23 patients with highly myopic foveoschisis who were treated by intravitreal injection of 0.5 to 0.7 mL C3F8 combined with laser photocoagulation 1 week later, and remained in the face-down position for 3 weeks. The patients were followed up for at least 6 months after the treatment. The refractive status, best-corrected visual acuity, and anatomical parameters of retina observed with the optical coherence tomography before and after the treatment were recorded.

Results:

The mean age of the 23 patients (6 men and 17 women) was 50.4 ± 15.1 years. The average follow-up duration was 20.8 ± 20.6 months. At the final follow-up, 23 eyes (76.7%) completely (17 eyes) or partially (6 eyes) resolved. Seventeen eyes had complete data of optical coherence tomography parameters, the mean central foveal thickness decreased significantly from 505.24 ± 466.22 μm to 186.41 ± 95.36 μm (P = 0.01), and the mean maximal macular thickness from 687.88 ± 397.00 μm to 313.65 ± 83.07 μm (P = 0.001). The mean final logarithm of the minimum angle of resolution best-corrected visual acuity (Snellen equivalent) of the 30 eyes ranged from 1.6 (20/800) to 0.2 (20/32), showing a slight improvement from 0.91 ± 0.44 (20/163) preoperatively to 0.90 ± 0.39 (20/160) postoperatively (P = 0.87).

Conclusion:

C3F8 tamponade combined with laser photocoagulation could be an alternative treatment for highly myopic foveoschisis.
Invasive Gastrointestinal Mucormycosis
Authors: Gupta Shalu , Jayashree Muralidharan , Chakrabarti Arunaloke , Sodhi Kushaljit S. , Kanojia Ravi Prakash , Mitra Suvradeep
Published: March 2018

We report 3 previously healthy children of postneonatal age who developed fatal form of gastrointestinal mucormycosis after systemic inflammatory response syndrome, shock and metabolic acidosis. Abdominal distension and peritonitis were secondary complications. The study highlights the importance of clinical suspicion of gastrointestinal mucormycosis when the triad of shock requiring vasoactive drugs, metabolic acidosis and abdominal distension is present.
Osteoarticular Infections Following Open or Penetrating Trauma in Children in the Post-Community-Acquired Methicillin-resistant Staphylococcus aureus Era: The Impact of Enterobacter cloacae
Authors: McNeil J. Chase , Vallejo Jesus G. , Hultén Kristina G. , Kaplan Sheldon L.
Published: March 2018

Background:

Most cases of pediatric osteoarticular infections (OAIs) are hematogenous in nature and caused by Staphylococcus aureus. OAI in children can also occur through direct inoculation of microorganisms secondary to penetrating or open trauma. No studies in the United States have evaluated the microbiology or outcomes of trauma-related OAI (TROAI) in children in the era of community-acquired methicillin-resistant S. aureus (CA-MRSA).

Methods:

Cases were identified from the inpatient infectious diseases consultation database at Texas Children’s Hospital from January 2011 to December 2016. TROAI cases were those in which OAI developed following a clear history of penetrating trauma, open fracture, crush injury or traumatic amputation. Only cases with radiographic evidence of bone abscess, gross appearance of infection at the time of surgery and/or positive cultures from bone or joint were included. Complications included recurrence of infection, pathologic fracture or chronic osteomyelitis.

Results:

During the study period, 692 consultations for OAI were performed, with 34 meeting inclusion criteria. In 68%, at least 1 organism was isolated, and the most commonly isolated organisms were S. aureus (32% overall, 21% MRSA) and Enterobacter cloacae (24%). Polymicrobial infections occurred in 38% of patients. Eighty-five percentage of patients had at least 1 surgical procedure, and 38% underwent ≥ 2 procedures. Eighty-two percentage of patients were discharged on oral therapy. Complications developed in 15% of patients and were more commonly associated with E. cloacae (80% vs. 14%, P = 0.007) and fungi (P = 0.03).

Conclusion:

TROAI are relatively uncommon in children but cause significant morbidity. While MRSA contributes substantially to TROAI, the highly diverse microbiology emphasizes the importance of obtaining cultures for microbiologic diagnosis and management. Clinicians should be aware of the frequency of E. cloacae in TROAI and its high risk for sequelae.
Province‐wide Biliary Atresia Home Screening Program in British Columbia
Authors: Woolfson Jessica P. , Schreiber Richard A. , Butler Alison E. , MacFarlane Julie , Kaczorowski Janusz , Masucci Lisa , Bryan Stirling , Collet Jean Paul
Published: March 2018

Background and Objectives:

Biliary atresia (BA), a rare newborn liver disease, is the leading cause of liver‐related death in children. Early disease recognition and timely surgical Kasai hepatoportoenterostomy (KP) offers long‐term survival without liver transplant. Universal BA screening in Taiwan using infant stool color cards (ISCCs) has proven effectiveness. We report our experience with infant stool color card (ISCC) BA screening in a province‐wide program in British Columbia (BC). The objective of this study is to assess program performance and cost from launch April 1, 2014 to March 31, 2016.

Methods:

ISCCs distributed to families upon maternity ward discharge. Parents were instructed to monitor their infant's stool color for 1 month and contacted the screening center with concerns. The number of live births, ISCC distribution, BA cases, and costs were recorded. Cases with Program screen success had both acholic stool recognition (ISCC screen success) and timely referral for BA.

Results:

All 126 maternity units received ISCCs. Of 87,583 live births there were 6 BA cases. Of the 5 cases with ISCC Screen Success 3 had Program Screen Success. The median KP age in the program screen success and failure groups was 49 (42–52) and 116 (49–184) days, respectively. Program sensitivity was 50%, specificity 99%, positive predictive value 4%, and negative predictive value 99%. A random sample of 1054 charts at BC Children's Hospital found an ISCC distribution rate of 94%. After a phase‐in period, the annual program cost was $30,033.82, and the ISCC cost per birth was $0.68.

Conclusions:

The screening program has high specificity and distribution with low cost. Successful program case identification had earlier age at KP. Program modifications aim to improve sensitivity. Longer‐term studies will determine program impact on health outcomes.
So You're Thinking About the Journey to Magnet® Recognition…?
Authors: Graystone Rebecca
Published: March 2018

The Director of the Magnet Recognition Program® presents a list of resources available to organizations either on the journey to Magnet® or contemplating setting this prestigious designation of nursing excellence as a goal.
Intrauterine Device Use and Cervical Cancer Risk: A Systematic Review and Meta-analysis
Authors: Cortessis Victoria K. , Barrett Malcolm , Wade Niquelle Brown , Enebish Temuulen , Perrigo Judith L. , Tobin Jessica , Zhong Charlie , Zink Jennifer , Isiaka Vanessa , Muderspach Laila I. , Natavio Melissa , McKean-Cowdin Roberta
Published: March 2018

(Abstracted from Obstet Gynecol 2017;130:1226–1236)

The third most common malignancy among women worldwide is cervical cancer. Control relies primarily on screening to detect premalignant cervical lesions, which is followed by their removal.
Headaches Through a Woman's Life
Authors: Bushman Elisa T. , Varner Michael W. , Digre Kathleen B.
Published: March 2018

Importance

Headaches affect women across their life span, with menses, pregnancy, and menopause being times that pose unique challenges in diagnosis and treatment. The correct diagnosis and treatment of headache can prevent unnecessary interventions, the worsening of chronic headache disorders, and complications of secondary headaches.

Objective

The objective of this article is to educate women's health care providers about the diagnosis, differential diagnosis, and treatment of headache during menses, pregnancy, the puerperium, and menopause to improve the quality of care for women with chronic and acute headache.

Evidence Acquisition

Current articles were reviewed addressing headache during menses, pregnancy, the postpartum period, and menopause. Articles with the highest level of evidence were compiled in this article to provide a summary of recommendations.

Results

Multiple diagnostic and therapeutic options for chronic and acute headache are available for women regardless of their stage in life or comorbidities.

Conclusions and Relevance

The effects of headaches span a woman's life span, with puberty and menopause being times of increased frequency. Pregnancy is an at-risk time for women to develop secondary headache disorders. All women's health care providers should know how to screen for, diagnose, and treat headache at all stages of a woman's life. Effective treatment options are available for acute and chronic headache both during and outside pregnancy.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objectives

After completing this activity, the learner should be better able to define the differences between primary and secondary headache disorders, interpret the differential diagnosis and treatment of menstrual-related migraines, analyze the diagnosis and treatment of headache in pregnancy, educate patients about secondary headaches in the postpartum period, discuss headache prevalence and treatment of headache during menopause, and propose treatment recommendations to women regardless of their comorbidities or stage in life.
Healthy People for the 21st Century: Understanding Use of Healthy People 2020 as a Web-Based Initiative
Authors: Heffernan Megan , Fromknecht Catharine Q. , McGowan Angela K. , Blakey Carter , Oppenheimer Caitlin Carroll
Published: March 2018

Objective:

This study assesses how the nation's preeminent health promotion and disease prevention initiative, Healthy People, is utilized by key stakeholders.

Methods:

A Web-based survey was administered to assess awareness and use of Healthy People among state, local, tribal health organizations and other key stakeholder groups. Follow-up interviews were conducted with a subset of respondents.

Results:

Awareness and use of Healthy People have remained high among state, local, and tribal stakeholders. Healthy People 2020 is most frequently used as a data source. The Leading Health Indicators (LHIs) are an important element of the initiative, and nearly 90% of organizations that use the LHIs found them valuable. Awareness and use of other tools and resources are more limited.

Conclusions:

Healthy People continues to be a valued resource among public health stakeholders; however, continued outreach is needed to promote the use of tools and resources available on healthypeople.gov for this decade and beyond. Healthy People is a national initiative used most frequently as a data source by state and local health departments, tribal organizations, and other public health practitioners.
When do co-infections matter?
Authors: McArdle Andrew J. , Turkova Anna , Cunnington Aubrey J.
Published: March 2018

Purpose of review

Advances in diagnostic methods mean that co-infections are increasingly being detected in clinical practice, yet their significance is not always obvious. In parallel, basic science studies are increasingly investigating interactions between pathogens to try to explain real-life observations and elucidate biological mechanisms.

Recent findings

Co-infections may be insignificant, detrimental, or even beneficial, and these outcomes can occur through multiple levels of interactions which include modulation of the host response, altering the performance of diagnostic tests, and drug–drug interactions during treatment. The harmful effects of chronic co-infections such as tuberculosis or Hepatitis B and C in association with HIV are well established, and recent studies have focussed on strategies to mitigate these effects. However, consequences of many acute co-infections are much less certain, and recent conflicting findings simply highlight many of the challenges of studying naturally acquired infections in humans.

Tackling these challenges, using animal models, or careful prospective studies in humans may prove to be worthwhile. There are already tantalizing examples where identification and treatment of relevant co-infections seems to hold promise for improved health outcomes.
Treatment of an Uncommon High-Pressure Orbital Injection Injury
Authors: Kelpin John P. , Fahrenkopf Matthew P. , Van Pelt Andrea E.
Published: March 2018

Injection injuries occur most commonly in the hand and digits; however, there are a limited number of reports in the literature describing injection injuries involving the orbit. High-pressure orbital injection injuries pose a number of unique challenges to the treating physician, and the approach to treating these injuries remains controversial. Often times, the extent of tissue damage is not fully appreciated at presentation, which may lead to missed diagnoses or inadequate initial treatment. In this study, the authors describe a rare incidence of high-pressure orbital injection injury. A 19-year-old male presented to the emergency department after injection of his left orbit with oil-based paint. Worsening clinical symptoms and increasing intraocular pressures within the first 24 hours necessitated take back to the operating room for orbital decompression and debridement. After an initial improvement in symptoms, the patient's clinical status deteriorated again, requiring further orbital decompression and additional periorbital debridement. Two weeks after initial presentation, soft tissue reconstruction of the surgical wounds was performed with full thickness skin grafts. The patient's globe and vision were both preserved. Orbital injection injuries, though rare, are potential globe threatening injuries. Physicians should have a low threshold for intervention and patient's must be observed closely over the first 72 hours after injury. Early diagnosis, prompt debridement, and a multidisciplinary approach are keys to improving patient outcomes.
Patient-Reported Quality of Life in the Highest Functioning Patients With Treacher Collins Syndrome
Authors: de Oliveira Jéssica Pereira , Lodovichi Fernando Felipe , Gomes Miria Benincasa , Custódio Eda Marconi , Denadai Rafael , Raposo-Amaral Cesar Augusto , Ghizoni Enrico , Raposo-Amaral Cassio Eduardo
Published: March 2018

Background:

Treacher Collins syndrome has a wide variation of clinical presentation, including airway obstruction and hearing loss. The objective of this study was to assess patient-rated quality of life in Treacher Collins syndrome, who received multidisciplinary treatment at a specialized craniofacial hospital, and to compare their quality of life with a control sample.

Methods:

Treacher Collins patients under treatment in a multidisciplinary setting were assessed with the World Health Organization Quality of Life (WHOQOL-100) questionnaire. The Siviero scale was used to classify quality of life as unsatisfactory (scores below 25), intermediate (scores between 25 and 75), and satisfactory (scores above 75). Quality of life comparison between Treacher Collins patients and 2342 unaffected individuals from a previous database was performed using the analysis of variance test. Differences were considered significant at P < 0.05.

Results:

Treacher Collins patients demonstrated an overall intermediate and satisfactory (score >60%) quality of life in almost all WHOQOL-100 facets and domains. The comparison of the scores between unaffected individuals and Treacher Collins patients demonstrated a significant difference (P < 0.05) in the environment domain.

Conclusion:

The highest functioning Treacher Collins syndrome patients under multidisciplinary treatment presented intermediate and satisfactory quality of life, consistent with quality of life scores of unaffected controls. In the environment domain, Treacher Collins patients presented even higher scores of quality of life than the control group.

Clinical Question/Level of Evidence:

Therapeutic, III.
Novel Application of Ultrasonic Bone Aspirator for Hump Nose
Authors: Kim Jooyeon , Choi Gwan , Kwon Jae Hwan
Published: March 2018

Objective:

This study was conducted to introduce and evaluate the efficacy of an ultrasonic bony aspirator in rhinoplasty for hump removal.

Design:

Retrospective study.

Setting:

University medical center.

Patients:

Twenty patients who underwent hump removal using an ultrasonic bone aspirator from October 2013 to November 2016 were enrolled in the study.

Main Outcome Measures:

Patients were followed for >3 months after surgery. External nose status and surgical results were investigated using photographs. Postoperative complications were evaluated.

Results:

Of the 30 patients enrolled in this study, 11 were females and 19 were males. Preoperative nasal deformities of all patients were characterized as bony humps. Postoperative dorsal status was significantly improved. There were no obvious complications such as over or under correction, delayed healing, infection, soft tissue injury, or deformity of the nasal dorsum.

Conclusion:

Application of an ultrasonic bone aspirator to remove humps in rhinoplasty is easy, safe, and effective.
Zygomaticofacial, Zygomaticoorbital, and Zygomaticotemporal Foramina
Authors: Coutinho Danielle Carvalho Oliveira , Martins-Júnior Paulo Antônio , Campos Isabela , Custódio Antônio Luís Neto , Silva Micena Roberta Miranda Alves e
Published: March 2018

This study aimed to assess the anatomical and morphometric characteristics of the main zygomaticofacial (ZFF), zygomaticoorbital (ZOF), and zygomaticotemporal (ZTF) foramina in Brazilian dry skulls. 61, 69, and 42 skulls for ZFF, ZOF, and ZTF were evaluated by a single calibrated examiner for format, transverse and vertical diameters, and distances from the foramina to anatomical landmarks. Paired t test, Wilcoxon test, Pearson and Spearman correlations were used. Circular outline was the predominant format for ZFF and ZTF, while oval format was the most frequent for ZOF. Median distances from ZFF to frontozygomatic and zygomaticomaxillary sutures were higher on right and left sides of the skulls, respectively (P < 0.005). Mean ZOF transverse diameter was significantly higher on the right sides of the skulls and presented positive correlation between sides (P < 0.05). No differences were observed for mean vertical diameter and distance from the ZOF to the inferolateral angle of the orbit (P > 0.05). No significant difference was found for distance from the ZTF to zygomatic arch between sides (P > 0.05), although there was a positive correlation (P < 0.05). Significant differences were found when analyzing the anatomical and morphometric aspects of ZFF, ZOF, and ZTF.
Surgical Treatment of Rhinosinusitis-Related Orbital Complications: Factors Affecting Irreversible Blindness
Authors: Ismi Onur , Vayisoğlu Yusuf , Bal Kemal Koray , Helvaci Ilter , Görür Kemal , Ozcan Cengiz
Published: March 2018

If left untreated, rhinosinusitis can rarely cause a devastating complication irreversible blindness (IB). Despite new technologies in endoscopic sinus surgery and use of new broad-spectrum antibiotics, IB outcome is still a problem for surgically treated orbital complication of paranasal sinus infection (OCPSI) patients, and factors leading to IB outcome are not actually known. The aim of this study was to assess the factors leading to the IB outcome for surgically treated OCPSI patients. Results of 25 surgically treated OCPSI patients in our clinic were combined with surgically treated OCPSI patients reported through the PubMed database search from the year 2007. Patients were divided into 2 groups: IB group and recovery group. Patients having at least 1 immune status-related additional risk factor (ARF) were more common in the IB group, having an at least 1 ARF had 1.683 risk value of IB outcome (RR: 1.683, P = 0.006). IB patients had statistically significant higher mean (21.87 ± 40.35, P = 0.005) time interval (days) (TI) between onset of ophthalmological symptoms and surgical intervention compared to recovery group patients (2.92 ± 2.53). ROC curve analysis for an estimation of IB outcome according to the TI value demonstrated that a cut-off value of ≥2.5 days had the ideal sensitivity (87.5%) and specificity (71.9%) that resulted in IB outcome. (80.5% power, P = 0.008) IB and recovery group patients did not differ according to orbital complication type according to Chandler's classification (P = 0.492) and white blood cell count status (P = 0.584). In conclusion, OCPSI patients with ARFs and delayed admission after onset of orbital symptoms have a higher risk of IB outcome. These patients deserve prompt evaluation and early surgical intervention to prevent blindness. With future studies, new surgical criteria, including the ARF status and onset of ophthalmological symptoms (≥2.5 days) may be added to classical surgical criteria to prevent IB for OCPSI cases.
The “Flap Suture Anchoring” Technique for Safe Oral Floor Reconstruction With Preservation of Alveolar Process
Authors: Wu Wei , Yang Yaowu , Zhang Pu , Sun Moyi
Published: March 2018

Flaps-based microsurgery is routinely applied to reconstruct oral floor defects caused by oncologic resection. To prevent orocutaneous fistulae, flaps are frequently sutured with buccal vestibule mucosa after sacrificing the alveolar process. The patients suffered denture loss and irreversible structural damage. For reliable oral floor reconstruction with preservation of alveolar process, the authors introduced the flap “suture anchoring” technique. Oral floor, hemiglossal-oral floor, and tongue base-parapharyngeal wall-oral floor defects were included in this study. The flap anchoring technique involves structural oral floor reconstruction with a chimeric anterolateral thigh-free flap or radial forearm flap with adipofascial tissue extension. The dead space in oral floor is filled with vastus lateralis muscle or adipofascial tissue, then holes are drilled on the alveolar bone among tooth root, beneath the attached gingiva. Skin paddle is sutured with 4-0 sutures through the alveolar holes thus anchored to the mandible. By applying this technique, there was no wound infection or orocutaneous fistulae in all patients postoperatively, even experienced postoperative radiotherapy. In addition, a soft and natural jaw-tongue furrow could be formed to allow the free movement of tongue. Taken together, the flap anchoring technique offers a safe and reliable approach to recover oral function and preservation of occlusion.
Accessory Submandibular Salivary Gland Forming a “Horseshoe” With the Main Submandibular Salivary Gland: A Unique Variation
Authors: Nayak Satheesha B.
Published: March 2018

Presence of accessory submandibular salivary gland (ASSG) is an extremely rare variation. Knowledge of its relations could be very useful to oral and maxillofacial surgeons, head and neck surgeons, and radiologists. During dissection classes, an ASSG was noted between the mylohyoid and hyoglossus muscles. The main submandibular salivary gland had superficial and deep parts. The deep part was narrow and measured about 5 cm. The lingual nerve passed between the superficial and deep parts. The accessory submandibular gland was situated below and parallel to the deep part of SSG. It also measured 5 cm. The ASSG had its own duct, which joined the duct of main gland. The ASSG and the deep part of the SSG were united at the lateral border of geniohyoid muscle to give a characteristic “horseshoe” appearance. The ASSG overlapped both lingual and hypoglossal nerves.
Identification and prioritization of gene sets associated with schizophrenia risk by co-expression network analysis in human brain
Authors: Radulescu Eugenia , Jaffe Andrew E , Straub Richard E , Chen Qiang , Shin Joo Heon , Hyde Thomas M , Kleinman Joel E , Weinberger Daniel R
Published: March 2018

Schizophrenia polygenic risk is plausibly manifested by complex transcriptional dysregulation in the brain, involving networks of co-expressed and functionally related genes. The main purpose of this study was to identify and prioritize co-expressed gene sets in a hierarchical manner, based on the strength of the relationships with clinical diagnosis and with the polygenic risk for schizophrenia. Weighted Gene Co-expression Network Analysis (WGCNA) was applied to RNA-quality adjusted DLPFC RNA-Seq data from the LIBD Postmortem Human Brain Repository (90 controls, 74 schizophrenia; Caucasians) to construct co-expression networks and detect modules of co-expressed genes. After internal and external validation, modules of selected interest were tested for enrichment in biological ontologies, association with schizophrenia polygenic risk scores (PRS), with diagnosis and for enrichment in genes within the significant GWAS loci reported by the Psychiatric Genomic Consortium (PGC2). The association between schizophrenia genetic signals and modules of co-expression converged on one module showing a significant association with diagnosis, PRS and significant overlap with 36 PGC2 loci genes, deemed as tier 1 (strongest candidates for drug targets). Fifty-three PGC2 loci genes were in modules associated only with diagnosis (tier 2) and 59 in modules unrelated to diagnosis or PRS (tier 3). In conclusion, our study highlights complex relationships between gene co-expression networks in the brain and polygenic risk for SCZ and provides a strategy for using this information in selecting potentially targetable gene sets for therapeutic drug development.
Full-length de novo viral quasispecies assembly through variation graph construction
Authors: Baaijens Jasmijn A. , Van der Roest Bastiaan , Köster Johannes , Stougie Leen , Schönhuth Alexander
Published: March 2018

Motivation

Viruses populate their hosts as a viral quasispecies: a collection of genetically related mutant strains. Viral quasispecies assembly refers to reconstructing the strain-specific haplotypes from read data, and predicting their relative abundances within the mix of strains, an important step for various treatment-related reasons. Reference-genome-independent (“de novo”) approaches have yielded benefits over reference-guided approaches, because reference-induced biases can become overwhelming when dealing with divergent strains. While being very accurate, extant de novo methods only yield rather short contigs. It remains to reconstruct full-length haplotypes together with their abundances from such contigs.

Method

We first construct a variation graph, a recently popular, suitable structure for arranging and integrating several related genomes, from the short input contigs, without making use of a reference genome. To obtain paths through the variation graph that reflect the original haplotypes, we solve a minimization problem that yields a selection of maximal-length paths that is optimal in terms of being compatible with the read coverages computed for the nodes of the variation graph. We output the resulting selection of maximal length paths as the haplotypes, together with their abundances.

Results

Benchmarking experiments on challenging simulated data sets show significant improvements in assembly contiguity compared to the input contigs, while preserving low error rates. As a consequence, our method outperforms all state-of-the-art viral quasispecies assemblers that aim at the construction of full-length haplotypes, in terms of various relevant assembly measures. Our tool, Virus-VG, is publicly available at https://bitbucket.org/jbaaijens/virus-vg.