bluuebunny/crossref_metadata_2025 huggingface dataset:
Control of motor coordination by astrocytic tonic GABA release through modulation of excitation/inhibition balance in cerebellum
Authors: Woo Junsung , Min Joo Ok , Kang Dae-Si , Kim Yoo Sung , Jung Guk Hwa , Park Hyun Jung , Kim Sunpil , An Heeyoung , Kwon Jea , Kim Jeongyeon , Shim Insop , Kim Hyung-Gun , Lee C. Justin , Yoon Bo-Eun
Published: April 2018

Significance

Tonic inhibition plays critical roles in cognitive functions under physiological and pathological conditions by controlling neuronal excitability. Although we have previously reported that cerebellar tonic inhibition is critically dependent on both the synthesis of GABA through monoamine oxidase B (MAOB) enzyme and the release via the bestrophin 1 (Best1) channel, the role of astrocytic GABA in cerebellar function in vivo has remained elusive. Here, we report that a reduction of tonic GABA release by genetic or pharmacological removal of Best1 or MAOB caused enhanced neuronal excitability, synaptic transmission, and motor performance on the rotarod test, whereas an augmentation of tonic GABA release by astrocyte-specific overexpression of MAOB caused opposite results. Our findings suggest the actions of astrocytic GABA in excitation/inhibition balance and motor coordination.
The role of prosody in early speech segmentation and
word-referent mapping
Authors: Teixidó Maria , François Clément , Bosch Laura , Männel Claudia
Published: April 2018

This chapter reviews electrophysiological studies on early word-form
segmentation and word-referent mapping, with a focus on the role of
prosody in these early abilities closely related to vocabulary
acquisition. First, we will review event-related brain potential
(ERP) studies on word segmentation showing the impact of lexical
stress cues, infant-directed speech (IDS) properties and melodic
information on word-form extraction. Then, we will review research
on word-referent mapping, revealing the scarcity of ERP studies
specifically exploring the contribution of prosody in this domain.
Throughout the chapter we will emphasize how electrophysiological
methods offer a more fine-grained perspective of the brain processes
supporting segmentation and mapping abilities, often revealing
infants’ sensitivities to auditory input before overt responses from
behavioral methods can be obtained.
Set in time
Authors: Rusiewicz Heather Leavy , Esteve-Gibert Núria
Published: April 2018

The purpose of this chapter is to discuss the relationship between
prosody, gesture, and spoken language production from a
developmental perspective. The coordination of prosody and manual
movements from theoretical, behavioral and neuroanatomical
perspectives will be explored. We focus on how gesture landmarks
coordinate with prosodic prominence from infants to school-aged
children, and we compare these results with adult patterns. The
reviewed literature shows that gesture movements, prosody, and
speech abilities in general, develop in a parallel and dynamic way,
the emergence of a specific ability in one modality entraining the
emergence of a parallel ability in another modality. Lastly,
implications of the coordination of prosody and gesture for children
with communication disorders will be explored.
Prosodic phonology in acquisition
Authors: Kehoe Margaret M.
Published: April 2018

This chapter investigates how the theory of prosodic phonology has
been applied to child language data, focusing on children’s early
words. First, we consider early accounts of prosodic structure
development in which the tools of prosodic phonology were used to
explain the shape of children’s word productions. We then go on to
consider later accounts in which factors apart from prosodic
structure, such as the frequency of input forms, perceptual bias,
and segmental factors, have been integrated into recent models.
Referring to findings on a wide range of languages (e.g., Spanish,
Catalan, Portuguese, Hebrew, Greek, and Japanese) we examine support
for the minimal word, a bimoraic constraint on word production, and
compare prosodic structure development across different groups of
languages.
Children’s development of internal state prosody
Authors: Armstrong Meghan E. , Hübscher Iris
Published: April 2018

Infants have access to the prosodic aspects of their ambient language
even prior to birth, but many aspects of prosody are produced and
comprehended well after infancy. One of these aspects includes
prosody related to internal states such as beliefs,
desires, feelings and emotions. In this chapter, we review the
literature on prosody related to internal states, paying special
attention to prosodic meanings associated with
emotions and belief states and
drawing from production and comprehension studies of preschool- and
school-aged children. We show that there are many parallels in the
development of these two aspects of prosody, suggesting the
usefulness of studying them in tandem. Implications for these
findings are discussed as well as fruitful directions for future
work.
Get the focus right across languages
Authors: Chen Aoju
Published: April 2018

Languages differ in both the use of prosody in focus marking and
prosodic systems. In the light of recent studies of acquisition of
prosodic focus marking in typologically different languages, we
argue that typological differences have direct influences on
acquisition of prosodic focus marking. More specifically,
differences in reliance on phonetic uses of prosody and transparency
of how prosody is used phonologically to encode focus can lead to
cross-linguistic differences in rate of acquisition. Differences in
whether the prosodic means involved are also used for lexical
purposes and in interface between prosody and word order can trigger
cross-linguistic differences in route of acquisition.
Old Norse Nicknames: Origins and Terminology
Authors: Peterson Paul R.
Published: April 2018

Nicknames, which occur in all cultures and time periods, play a unique role in highlighting identity. The pool of first names has always been relatively limited, thus most people were identified by their nicknames, especially before surnames became commonplace. The quantity of nicknames in Old Norse literature is large, and recurring nicknames provide a tool for understanding narrative transmission, cultural history, and etymology. Medieval explanations for giving nicknames are suspect, but they provide a glimpse into the possible reasons for so many of them coming down to us. An overview on nickname terminology is provided, as well as literary examples showing the fluidity of medieval terminology in nickname narrative explanations. The overall approach is therefore to explore the ways in which nicknames are described in the literature and how this information aids in understanding medieval Norse society and culture through its naming customs.
Phenomenal intentionality: reductionism vs. primitivism
Authors: Woodward Philip
Published: April 2018

This paper explores the relationship between phenomenal properties and intentional properties. In recent years a number of philosophers have argued that intentional properties are sometimes necessitated by phenomenal properties, but have not explained why or how. Exceptions can be found in the work of Katalin Farkas and Farid Masrour, who develop versions of reductionism regarding phenomenally-necessitated intentionality (or ‘phenomenal intentionality’). I raise two objections to reductive theories of the sort they develop. Then I propose a version of primitivism regarding phenomenal intentionality. I argue that primitivism avoids the pitfalls of reductionism while promising broad explanatory payoffs.
Hierarchical recruitment of ribosomal proteins and assembly factors remodels nucleolar pre-60S ribosomes
Authors: Biedka Stephanie , Micic Jelena , Wilson Daniel , Brown Hailey , Diorio-Toth Luke , Woolford John L.
Published: April 2018

Ribosome biogenesis involves numerous preribosomal RNA (pre-rRNA) processing events to remove internal and external transcribed spacer sequences, ultimately yielding three mature rRNAs. Removal of the internal transcribed spacer 2 spacer RNA is the final step in large subunit pre-rRNA processing and begins with endonucleolytic cleavage at the C2 site of 27SB pre-rRNA. C2 cleavage requires the hierarchical recruitment of 11 ribosomal proteins and 14 ribosome assembly factors. However, the function of these proteins in C2 cleavage remained unclear. In this study, we have performed a detailed analysis of the effects of depleting proteins required for C2 cleavage and interpreted these results using cryo–electron microscopy structures of assembling 60S subunits. This work revealed that these proteins are required for remodeling of several neighborhoods, including two major functional centers of the 60S subunit, suggesting that these remodeling events form a checkpoint leading to C2 cleavage. Interestingly, when C2 cleavage is directly blocked by depleting or inactivating the C2 endonuclease, assembly progresses through all other subsequent steps.
Scalable preprocessing for sparse scRNA-seq data exploiting prior knowledge
Authors: Mukherjee Sumit , Zhang Yue , Fan Joshua , Seelig Georg , Kannan Sreeram
Published: April 2018

Motivation

Single cell RNA-seq (scRNA-seq) data contains a wealth of information which has to be inferred computationally from the observed sequencing reads. As the ability to sequence more cells improves rapidly, existing computational tools suffer from three problems. (i) The decreased reads-per-cell implies a highly sparse sample of the true cellular transcriptome. (ii) Many tools simply cannot handle the size of the resulting datasets. (iii) Prior biological knowledge such as bulk RNA-seq information of certain cell types or qualitative marker information is not taken into account. Here we present UNCURL, a preprocessing framework based on non-negative matrix factorization for scRNA-seq data, that is able to handle varying sampling distributions, scales to very large cell numbers and can incorporate prior knowledge.

Results

We find that preprocessing using UNCURL consistently improves performance of commonly used scRNA-seq tools for clustering, visualization and lineage estimation, both in the absence and presence of prior knowledge. Finally we demonstrate that UNCURL is extremely scalable and parallelizable, and runs faster than other methods on a scRNA-seq dataset containing 1.3 million cells.

Availability and implementation

Source code is available at https://github.com/yjzhang/uncurl_python.

Supplementary information

Supplementary data are available at Bioinformatics online.
BlockFeST: Bayesian calculation of region-specific FST to detect local adaptation
Authors: Pfeifer Bastian , Lercher Martin J
Published: April 2018

The fixation index FST can be used to identify non-neutrally evolving loci from genome-scale SNP data across two or more populations. Recent years have seen the development of sophisticated approaches to estimate FST based on Markov-Chain Monte-Carlo simulations. Here, we present a vectorized R implementation of an extension of the widely used BayeScan software for codominant markers, adding the option to group individual SNPs into pre-defined blocks. A typical application of this new approach is the identification of genomic regions, genes, or gene sets containing SNPs that evolved under directional selection.

Availability and implementation

The R implementation of our method, which builds on the powerful population genetics and genomics software PopGenome, is available freely from CRAN.

Supplementary information

Supplementary data are available at Bioinformatics online.
Predicting gene structure changes resulting from genetic variants via exon definition features
Authors: Majoros William H , Holt Carson , Campbell Michael S , Ware Doreen , Yandell Mark , Reddy Timothy E
Published: April 2018

Motivation

Genetic variation that disrupts gene function by altering gene splicing between individuals can substantially influence traits and disease. In those cases, accurately predicting the effects of genetic variation on splicing can be highly valuable for investigating the mechanisms underlying those traits and diseases. While methods have been developed to generate high quality computational predictions of gene structures in reference genomes, the same methods perform poorly when used to predict the potentially deleterious effects of genetic changes that alter gene splicing between individuals. Underlying that discrepancy in predictive ability are the common assumptions by reference gene finding algorithms that genes are conserved, well-formed and produce functional proteins.

Results

We describe a probabilistic approach for predicting recent changes to gene structure that may or may not conserve function. The model is applicable to both coding and non-coding genes, and can be trained on existing gene annotations without requiring curated examples of aberrant splicing. We apply this model to the problem of predicting altered splicing patterns in the genomes of individual humans, and we demonstrate that performing gene-structure prediction without relying on conserved coding features is feasible. The model predicts an unexpected abundance of variants that create de novo splice sites, an observation supported by both simulations and empirical data from RNA-seq experiments. While these de novo splice variants are commonly misinterpreted by other tools as coding or non-coding variants of little or no effect, we find that in some cases they can have large effects on splicing activity and protein products and we propose that they may commonly act as cryptic factors in disease.

Availability and implementation

The software is available from geneprediction.org/SGRF.

Supplementary information

Supplementary information is available at Bioinformatics online.
Latent variable modeling for the microbiome
Authors: Sankaran Kris , Holmes Susan P
Published: April 2018

The human microbiome is a complex ecological system, and describing its structure and function under different environmental conditions is important from both basic scientific and medical perspectives. Viewed through a biostatistical lens, many microbiome analysis goals can be formulated as latent variable modeling problems. However, although probabilistic latent variable models are a cornerstone of modern unsupervised learning, they are rarely applied in the context of microbiome data analysis, in spite of the evolutionary, temporal, and count structure that could be directly incorporated through such models. We explore the application of probabilistic latent variable models to microbiome data, with a focus on Latent Dirichlet allocation, Non-negative matrix factorization, and Dynamic Unigram models. To develop guidelines for when different methods are appropriate, we perform a simulation study. We further illustrate and compare these techniques using the data of Dethlefsen and Relman (2011, Incomplete recovery and individualized responses of the human distal gut microbiota to repeated antibiotic perturbation. Proceedings of the National Academy of Sciences108, 4554–4561), a study on the effects of antibiotics on bacterial community composition. Code and data for all simulations and case studies are available publicly.
SILAC-based phosphoproteomics reveals new PP2A-Cdc55-regulated processes in budding yeast
Authors: Baro Barbara , Játiva Soraya , Calabria Inés , Vinaixa Judith , Bech-Serra Joan-Josep , de LaTorre Carolina , Rodrigues João , Hernáez María Luisa , Gil Concha , Barceló-Batllori Silvia , Larsen Martin R , Queralt Ethel
Published: April 2018

Background

Protein phosphatase 2A (PP2A) is a family of conserved serine/threonine phosphatases involved in several essential aspects of cell growth and proliferation. PP2ACdc55 phosphatase has been extensively related to cell cycle events in budding yeast; however, few PP2ACdc55 substrates have been identified. Here, we performed a quantitative mass spectrometry approach to reveal new substrates of PP2ACdc55 phosphatase and new PP2A-related processes in mitotic arrested cells.

Results

We identified 62 statistically significant PP2ACdc55 substrates involved mainly in actin-cytoskeleton organization. In addition, we validated new PP2ACdc55 substrates such as Slk19 and Lte1, involved in early and late anaphase pathways, and Zeo1, a component of the cell wall integrity pathway. Finally, we constructed docking models of Cdc55 and its substrate Mob1. We found that the predominant interface on Cdc55 is mediated by a protruding loop consisting of residues 84–90, thus highlighting the relevance of these aminoacids for substrate interaction.

Conclusions

We used phosphoproteomics of Cdc55-deficient cells to uncover new PP2ACdc55 substrates and functions in mitosis. As expected, several hyperphosphorylated proteins corresponded to Cdk1-dependent substrates, although other kinases' consensus motifs were also enriched in our dataset, suggesting that PP2ACdc55 counteracts and regulates other kinases distinct from Cdk1. Indeed, Pkc1 emerged as a novel node of PP2ACdc55 regulation, highlighting a major role of PP2ACdc55 in actin cytoskeleton and cytokinesis, gene ontology terms significantly enriched in the PP2ACdc55-dependent phosphoproteome.
Exon-specific U1 snRNAs improve ELP1 exon 20 definition and rescue ELP1 protein expression in a familial dysautonomia mouse model
Authors: Donadon Irving , Pinotti Mirko , Rajkowska Katarzyna , Pianigiani Giulia , Barbon Elena , Morini Elisabetta , Motaln Helena , Rogelj Boris , Mingozzi Federico , Slaugenhaupt Susan A , Pagani Franco
Published: April 2018

Familial dysautonomia (FD) is a rare genetic disease with no treatment, caused by an intronic point mutation (c.2204+6T>C) that negatively affects the definition of exon 20 in the elongator complex protein 1 gene (ELP1 also known as IKBKAP). This substitution modifies the 5′ splice site and, in combination with regulatory splicing factors, induces different levels of exon 20 skipping, in various tissues. Here, we evaluated the therapeutic potential of a novel class of U1 snRNA molecules, exon-specific U1s (ExSpeU1s), in correcting ELP1 exon 20 recognition. Lentivirus-mediated expression of ELP1-ExSpeU1 in FD fibroblasts improved ELP1 splicing and protein levels. We next focused on a transgenic mouse model that recapitulates the same tissue-specific mis-splicing seen in FD patients. Intraperitoneal delivery of ELP1-ExSpeU1s-adeno-associated virus particles successfully increased the production of full-length human ELP1 transcript and protein. This splice-switching class of molecules is the first to specifically correct the ELP1 exon 20 splicing defect. Our data provide proof of principle of ExSpeU1s-adeno-associated virus particles as a novel therapeutic strategy for FD.
Citizen science records describe the distribution and migratory behaviour of a piscivorous predator, Pomatomus saltatrix
Authors: Brodie S , Litherland L , Stewart J , Schilling H T , Pepperell J G , Suthers I M
Published: April 2018

Understanding the processes driving species distributions is a key question in ecology, yet obtaining pertinent data for many species can be challenging. Tag-recapture data from voluntary recreational fisheries programmes is an undervalued citizen science data resource and can provide valuable observation records for data-poor species. Here, we highlight the utility of such data by compiling four tag-recapture datasets (n = 20 878 tags) to describe the movements and distribution of a piscivorous predator, tailor Pomatomus saltatrix, with respect to their environment. We compared species distribution models that explored a trade-off between temporal duration and spatial extent. Both models revealed sea surface temperature (SST) was an important factor in describing the distribution and density of tailor. However, the model with broader spatial extent indicated a non-linear response to SST, peaking at 21.5°C, while the model with temporal longevity showed a linear SST response. This disjunct showcases the importance of building models across an adequate geographic extent to ensure covariate responses are not truncated. This is the first study to comprehensively describe the distribution and migrations of adult tailor across their eastern Australian distribution. The results are discussed in light of ocean warming along eastern Australia, and the subsequent implications for using tag-recapture data in fisheries management.
Clinical Updates in Women’s Health Care Summary: Asthma
Authors: Namazy Jennifer A. , Schatz Michael , Dombrowski Mitchell
Published: April 2018

Asthma is a common and potentially life-threatening lung disease. The prevalence of asthma is higher in women than in men. This monograph provides an overview of the pathophysiology, evaluation, and management of asthma in women. Management approaches in reproductive-aged, pregnant, and postmenopausal patients are addressed.
How to Optimally Fit a Hearing Aid for Bimodal Cochlear Implant Users: A Systematic Review
Authors: Vroegop Jantien L. , Goedegebure André , van der Schroeff Marc P.
Published: April 2018

Objectives:

Bimodal hearing has shown to improve speech recognition in quiet and in noise and to improve sound localization compared with unilateral cochlear implant (CI) use alone. Fitting the CI and hearing aid (HA) separately has been described well, but HA fitting procedures for bimodal CI users are not well researched or widely accepted. The aim of the present study was to systematically review the literature on the effect of different HA fitting strategies on auditory performance in bimodal CI users.

Design:

Original articles, written in English, were identified through systematic searches in Medline (OvidSP), Embase, Web of Science, Scopus, CINAHL, Cochrane, PubMed publisher, and Google Scholar. The quality of the studies was assessed on five aspects: methodologic quality (with the methodological index for nonrandomized studies score), number of subjects, quality of the description of contralateral hearing loss, quality of HA verification, and direct comparison of HA fitting procedures based on auditory performance.

Results:

A total of 1665 records were retrieved, of which 17 were included for systematical reviews. Critical appraisal led to three high-quality studies, 10 medium-quality studies, and four low-quality studies. The results of the studies were structured according to four topics: frequency response, frequency translation/transposition, dynamic range compression, and loudness. In general, a bimodal benefit was found in most studies, using various strategies for the HA fitting. Using a standard prescription rule such as National Acoustics Laboratory formula-non-linear 1, National Acoustics Laboratory formula-non-linear 2, or desired sensation level is a good starting point in children and adults.

Conclusions:

Although a bimodal benefit was found in most studies, there is no clear evidence how certain choices in HA fitting contribute to optimal bimodal performance. A generally accepted HA prescription rule is an essential part of most fitting procedures used in the studies. Current evidence suggests that frequency lowering or transposition is not beneficial. Individual fine tuning based on loudness or general preference is often applied, but its additional value for auditory performance should be investigated more thoroughly. Good quality comparative studies are needed to further develop evidence-based fitting procedures in case of bimodal listening.
Lower-extremity rotational profile and toe-walking in preschool children with autism spectrum disorder
Authors: Arik Atilla , Aksoy Cemalettin , Aysev Ayla , Akçakin Melda
Published: April 2018

The aim of this study was to establish the torsional and toe-walking profiles of children with autism spectrum disorder (ASD), and to analyze the correlations between torsion, toe-walking, autism severity score, and age. In total, 79 consecutive children with autism were examined to determine their hip rotations, thigh–foot angle, degree of toe-walking, and autism severity. Femoral and tibial torsion values, of the preschool patients, were compared statistically with age-matched controls. The hip rotation profile of the patients was similar to the normal group. Nearly a half of the patients with ASD present excessive external tibial torsion. The difference in the tibial torsion between patients and normal children was statistically significant. A weak correlation was found only between tibial torsion and the autism severity score, but no correlation was found between the other parameters. External tibial torsion is the cardinal and persistent orthopedic manifestation among patients with ASD. Toe-walking is the second most common such manifestation and is an independent orthopedic feature in these patients. External tibial torsion may potentially contribute toward the described gait abnormalities in patients with ASD.
Comparison of the Clinical Accuracy Between Point-to-Point Registration and Auto-Registration Using an Active Infrared Navigation System
Authors: Zhao Jingwei , Liu Yajun , Fan Mingxing , Liu Bo , He Da , Tian Wei
Published: April 2018

Study Design.

A model experiment.

Objective.

To measure and compare the clinical accuracy of point-to-point registration (PR) and auto-registration (AR) in an operative set using an active infrared navigation system.

Summary of Background Data.

PR and AR are two major registration methods of navigation assisted spinal surgery. No previous study compared the difference between the two methods with respect to clinical accuracy.

Methods.

A novel method was used to measure the clinical accuracy of the navigation system under an operative set using a Sawbone model with titanium beads on the surface, which was essential to measure the accuracy numerically, instead of a real patient. Both the operative set and the procedure mimicked a regular surgery. The clinical accuracy was defined as the average distance between the “navigation coordinate” and the “image coordinate.” The clinical accuracy of the PR using preoperative computed tomography (CT) images and the AR using intraoperative CT images was measured and compared.

Results.

The average clinical accuracy of PR was different among different segments. The accuracy of the most accurate segment, which provided the reference points during the PR, was 1.10 mm. In the two segments adjacent to the reference segment, the clinical accuracy deteriorated to 1.37 and 1.50 mm. The accuracy of the farther segments was worse. In comparison, the clinical accuracy of different segments of AR was of no significant difference. The average accuracy of AR was 0.74 mm, which was significantly better than the best accuracy of PR.

Conclusion.

AR is better than PR with respect to clinical accuracy in navigation assisted spinal surgery.

Level of Evidence: N/A
Lordosis Recreation in Transforaminal and Posterior Lumbar Interbody Fusion
Authors: Robertson Peter A. , Armstrong William A. , Woods Daniel L. , Rawlinson Jeremy J.
Published: April 2018

Study Design.

Controlled cadaveric study of surgical technique in transforaminal and posterior lumbar interbody fusion (TLIF and PLIF)

Objective.

To evaluate the contribution of surgical techniques and cage variables in lordosis recreation in posterior interbody fusion (TLIF/PLIF).

Summary of Background Data.

The major contributors to lumbar lordosis are the lordotic lower lumbar discs. The pathologies requiring treatment with segmental fusion are frequently hypolordotic or kyphotic. Current posterior based interbody techniques have a poor track record for recreating lordosis, although recreation of lordosis with optimum anatomical alignment is associated with better outcomes and reduced adjacent segment change needing revision. It is unclear whether surgical techniques or cage parameters contribute significantly to lordosis recreation.

Methods.

Eight instrumented cadaveric motion segments were evaluated with pre and post experimental radiological assessment of lordosis. Each motion segment was instrumented with pedicle screw fixation to allow segmental stabilization. The surgical procedures were unilateral TLIF with an 18° lordotic and 27 mm length cage, unilateral TLIF (18°, 27 mm) with bilateral facetectomy, unilateral TLIF (18°, 27 mm) with posterior column osteotomy (PCO), PLIF with bilateral cages (18°, 22 mm), and PLIF with bilateral cages (24°, 22 mm). Cage insertion used and “insert and rotate” technique.

Results.

Pooled results demonstrated a mean increase in lordosis of 2.2° with each procedural step (lordosis increase was serially 1.8°, 3.5°, 1.6°, 2.5°, and 1.6° through the procedures). TLIF and PLIF with PCO increased lordosis significantly compared with unilateral TLIF and TLIF with bilateral facetectomy. The major contributors to lordosis recreation were PCO, and PLIF with paired shorter cages rather than TLIF.

Conclusion.

This study demonstrates that the surgical approach to posterior interbody surgery influences lordosis gain and PCO optimizes lordosis gain in TLIF. The bilateral cages used in PLIF are shorter and associated with further gain in lordosis. This information has the potential to aid surgical planning when attempting to recreate lordosis to optimize outcomes.

Level of Evidence: N/A
COMBINATION THERAPY OF INTRAVITREAL RANIBIZUMAB AND SUBTHRESHOLD MICROPULSE PHOTOCOAGULATION FOR MACULAR EDEMA SECONDARY TO BRANCH RETINAL VEIN OCCLUSION
Authors: Terashima Hiroko , Hasebe Hiruma , Okamoto Fumiki , Matsuoka Naoki , Sato Yayoi , Fukuchi Takeo
Published: April 2018

Purpose:

To determine the efficacy of the combination therapy of intravitreal ranibizumab (IVR) and 577-nm yellow laser subthreshold micropulse laser photocoagulation (SMLP) for macular edema secondary to branch retinal vein occlusion cystoid macular edema.

Methods:

Retrospective, consecutive, case–control study. Forty-six eyes of 46 patients with treatment-naive branch retinal vein occlusion cystoid macular edema were enrolled. The IVR + SMLP group consisted of 22 patients who had undergone both SMLP and IVR. Intravitreal ranibizumab group consisted of 24 patients who had undergone IVR monotherapy. Intravitreal ranibizumab therapy was one initial injection and on a pro re nata in both groups, and SMLP was performed at 1 month after IVR in the IVR + SMLP group. Preoperatively and monthly, best-corrected visual acuity and central retinal thickness were evaluated using swept source optical coherence tomography.

Results:

Best-corrected visual acuity and central retinal thickness significantly improved at 6 months in IVR + SMLP and IVR groups. Best-corrected visual acuity and central retinal thickness were not significantly different between the two groups at any time points. The number of IVR injections during initial 6 months in IVR group (2.3 ± 0.9) was significantly greater (P = 0.034) than that in IVR + SMLP group (1.9 ± 0.8).

Conclusion:

The combination therapy of IVR and SMLP can treat branch retinal vein occlusion cystoid macular edema effectively, by decreasing the frequency of IVR injections while maintaining good visual acuity.
DETECTION OF TYPE 1 CHOROIDAL NEOVASCULAR MEMBRANES USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN TUBERCULAR POSTERIOR UVEITIS
Authors: Aggarwal Kanika , Agarwal Aniruddha , Sharma Aman , Sharma Kusum , Gupta Vishali ,   for the OCTA Study Group
Published: April 2018

Purpose:

To study optical coherence tomography angiography (OCTA) and multimodal imaging features of Type 1 inflammatory choroidal neovascularization (CNV) in tubercular serpiginous-like choroiditis and response to anti–vascular endothelial growth factor therapy.

Methods:

In this study, multimodal imaging was performed using OCTA, enhanced-depth imaging optical coherence tomography, fluorescein angiography, and indocyanine green angiography. Correlation of OCTA with other imaging modalities in the detection of CNV was performed. The changes in CNV configuration after anti–vascular endothelial growth factor therapy were assessed.

Results:

In this study, nine eyes (8 patients; 5 females; mean age: 32.5 ± 11.57 years) with diagnosis of tubercular serpiginous-like choroiditis were included. All the eyes had presence of low-lying pigment epithelial detachments on enhanced-depth imaging optical coherence tomography. Using OCTA, it was possible to detect Type 1 CNV in all eyes. Type 1 CNV networks comprised fine anastomotic network of vessels, some of which had a hairpin loop configuration. After anti–vascular endothelial growth factor therapy, there was a decrease in branching and anastomosis. The visual acuity significantly improved from 0.49 ± 0.26 (20/60 Snellen equivalent) at baseline to 0.26 ± 0.17 (20/36 Snellen equivalent) (P = 0.03) in all eyes.

Conclusion:

Type 1 CNV can occur among patients with tubercular serpiginous-like choroiditis, leading to significant visual loss even in the healed stages of the disease. Optical coherence tomography angiography can help in the detection of Type 1 CNV where conventional multimodal imaging, including fluorescein angiography and OCT, fails to make a definitive diagnosis and thereby guide the initiation of anti–vascular endothelial growth factor therapy.
Robotic Beating Heart Totally Endoscopic Coronary Artery Bypass in Higher-Risk Patients
Authors: Balkhy Husam H. , Nisivaco Sarah , Kitahara Hiroto , McCrorey Mackenzie , Patel Brooke
Published: April 2018

Objective

Patients with a high Society of Thoracic Surgeons (STS) predicted risk of mortality undergoing coronary artery bypass surgery are known to have worse outcomes. Less invasive approaches have been shown to improve morbidity and mortality for these patients. In this study, we examined perioperative outcomes in higher-risk patients undergoing robotic totally endoscopic beating heart coronary artery bypass surgery.

Methods

The STS predicted risk of mortality was reviewed for patients undergoing robotic totally endoscopic beating heart coronary artery bypass surgery at our institution between January 2013 and May 2017. We identified a higher-risk cohort (n = 50) and compared them to a lower-risk cohort (n = 220) during the same period. The higher-risk group was formed from patients with the 50 highest STS scores. Perioperative data were collected retrospectively.

Results

There were 50 patients in the higher-risk group (mean STS score = 7.05 ± 4.9, mean age = 73 years) and 220 patients in the lower-risk group (mean STS score = 0.89 ± 0.6, mean age = 64 years). The higher-risk group had significantly greater rates of renal insufficiency, peripheral vascular disease, and lower ejection fraction. The incidence of postoperative re-exploration for bleeding, stroke, myocardial infarction, and prolonged ventilation was similar. Perioperative blood transfusion and hospital length of stay were greater in the higher-risk group. Mortality was lower in the higher-risk group (0% vs 1.8% P = 0.045). Cardiac-related mortality was similar at midterm follow-up.

Conclusions

We conclude that beating heart totally endoscopic beating heart coronary artery bypass surgery can be performed in patients with a higher STS predicted risk of mortality with excellent outcomes. Further studies are warranted to evaluate long-term results of totally endoscopic beating heart coronary artery bypass surgery in this challenging group of patients.
The C-Port Distal Coronary Anastomotic Device is Comparable with a Hand-Sewn Anastomosis
Authors: Balkhy Husam H. , Nisivaco Sarah M. , Husain Aliya N. , Jeevanandam Valluvan , Arif Quidsia
Published: April 2018

Coronary artery bypass surgery is most commonly performed using a hand-sewn technique with a continuous monofilament suture. The C-Port distal anastomotic device is a miniature stapler designed to create an arteriotomy and attach the graft to the coronary artery all in one step. It is the only distal coronary anastomotic device currently approved for clinical use and can be useful in facilitating less invasive coronary surgery. This report examines the histological attributes of such an anastomosis in a patient who underwent heart transplantation approximately 1 year after robotic totally endoscopic stapled coronary bypass using the C-Port anastomotic device. There have been no previous reports of histological examination of this type of bypass graft in humans in the literature. We found that the C-Port single-shot stapled coronary anastomotic device had a similar histological appearance to a traditional hand-sewn technique using monofilament suture. The amount of inflammation around the anastomosis using the two techniques was found to be comparable in this histological case study in an explanted human heart. There was no evidence of increased neointimal hyperplasia. These findings add to the already known equivalent clinical patency rates of the C-Port device in coronary bypass procedures.
An Integrative Review of Nurse-Authored Research to Improve Health Equity and Human Rights for Criminal-Justice-Involved People
Authors: Goshin Lorie S. , Colbert Alison M. , Carey John F.
Published: April 2018

Background

An estimated 10 million people are incarcerated internationally, including 2.1 million people in the United States. Criminal justice involvement is a social determinant of individual and family health disparities. Health care in correctional and forensic psychiatric facilities is nurse driven. The unique contributions of nurse authors to the research literature on health equity and humane conditions for this population have not been aggregated, nor have the nursing research gaps in this area been systematically identified. This article determines the volume and country location of nurse-authored research in this area and analyzes the research by population (prisons, jails, community supervision, forensic psychiatry), clinical foci, and research methods.

Methods

We conducted an integrative review of research literature published in English between 1990 and 2017.

Results

Our search revealed 283 data-based articles written by 349 nurse authors, representing Asia, Australia, Europe, and North and South Americas. Most research occurred in prisons (53.3%) and focused on mental health/substance use (32.5%), infectious disease (21.6%), or correctional health services (15.6%). Almost one third of articles across clinical foci sampled nurses, not patients.

Implications

Although there is clearly a cadre of nurse researchers working in this area, it remains a relatively small group focused most closely on mental health, infectious disease, and the correctional nursing experience. Gaps and opportunities for important nursing contributions remain, especially in reproductive health, meeting the needs of community-supervised people, and explicitly connecting this work with its human rights implications.
Longitudinal Evaluation of Bone-Anchored Hearing Aid Implant Stability Using the Advanced System for Implant Stability Testing (ASIST)
Authors: Westover Lindsey , Faulkner Gary , Hodgetts William , Kamal Fraaz , Lou Edmond , Raboud Don
Published: April 2018

Objective:

This study aims to provide a clinical evaluation of the Advanced System for Implant Stability Testing (ASIST) for assessment of implant stability for bone-anchored hearing aid patients. We evaluate the longitudinal changes in implant interface stability during the first year following surgery.

Methods:

ASIST measurements were collected for 39 patients selected to receive a bone anchored hearing aid for hearing loss. Measurements were collected at the time of surgery and at 3 days, 2 weeks, 1 month, 3 months, 6 months, and 12 months following surgery. Longitudinal changes in ASIST Stability Coefficient (ASC) were determined for each patient. Correlations were investigated between initial implant stability as measured by the ASC and clinical parameters such as operating surgeon, patient age at surgery, and implant type.

Results:

ASC values ranged from 11.9 to 137.0 (31.9 ± 18.0). On average, there was a slight decrease in ASC up to 3 months after surgery followed by an increase up to 1 year. Preliminary results presented in this study suggest that there may be differences in the initial stability between operating surgeons (p = 0.0012; p = 0.0049) and there was a trend toward possible differences between different implant types.

Conclusion:

We have shown promising results using the ASIST in a clinical setting for longitudinal evaluation of bone–implant interface integrity. Isolating the interface properties from the implant–abutment system allows for objective comparisons across patients that are not possible with other stability measurement systems.
Immunogenicity of a Brucella abortus 55-kDa recombinant surface protein conjugated with detoxified lipopolysaccharide in black and albino type C mouse model
Authors: Yahyaie Sara , Nojoomi Farshad , Shafiei Morvarid , Ghasemian Abdolmajid
Published: April 2018

Objective:

Brucellaspp. causes zoonotic infections. Lipopolysaccharide (LPS) is a major antigenicBrucellastructure stimulating a T-independent response. For eliciting cell-mediated immunity against LPS, it should be conjugated with a polypeptide antigen. The aim of this study was to evaluate the immunogenicity ofBrucella abortus55-kDa recombinant surface protein (BC55) conjugated with detoxified LPS in black and albino type C (BALB/c) mouse model.

Materials and methods:

TheB. abortus bc55gene was amplified and cloned into pET32a (+) plasmid. The recombinant vectors were transferred intoEscherichia coliGM2163 and the expression of the recombinant protein was induced by 1-mmol/l isopropyl β-d-1-thiogalactopyranoside. The BC55 protein was purified using a nickel resin column and, next, conjugated with detoxified LPS and injected subcutaneously to BALB/c mice including five groups.B. abortus544 and PBS were used as positive and negative controls, respectively. Recovered bacteria from spleen of mice were compared with those of members of the control group.

Results:

The BC55 with 57-kDa size was purified by resin–nickel column method. The conjugation of BC55 + dLPS induced major immune response, significantly higher than each of the dLPS, PBS, and BC55 protein components.

Conclusion:

The conjugation of BC55 + dLPS induced responses significantly higher than each of the dLPS, PBS, and BC55 protein components. In addition, the dLPS + BC55 conjugate not only had efficient results in the induction of immune responses as a new vaccination strategy, it (also) can reduce the number ofB. abortusin spleen.
Physician Confidence in Dental Trauma Treatment and the Introduction of a Dental Trauma Decision-Making Pathway for the Pediatric Emergency Department
Authors: Cully Matthew , Cully Jennifer , Nietert Paul J. , Titus M. Olivia
Published: April 2018

Objectives

The objectives of this study were to (1) survey and report the awareness and confidence of pediatric emergency medicine physicians in the management of dental trauma and (2) determine the prevalence of dental trauma decision-making pathway utilization in the pediatric emergency department.

Methods

A survey was distributed through e-mail to the pediatric emergency medicine discussion list via Brown University LISTSERV. The survey study included 10 questions and was multiple-choice. The survey contained questions about physician confidence and their use of a dental trauma decision-making pathway.

Results

A total of 285 individuals responded to the survey. Somewhat confident was the most common response (61%) followed by not confident (20%) and confident (19%) by respondents in treating dental trauma. Forty-one percent of respondents felt comfortable, 39% somewhat comfortable, 19% not comfortable, and 1% not sure in replanting an avulsed tooth. Only 6% of respondents reported that their pediatric emergency department always or sometimes uses a dental trauma decision-making pathway, whereas 78% of pediatric emergency departments do not.

Conclusions

We believe that the adoption of a decision-making pathway will provide timely management, improve emergency physician comfort, and enhance outcomes for pediatric patients presenting with a dental trauma. A future multicenter review will aim to evaluate these goals based on the utilization of our dental trauma decision-making pathway.
Frequency and Predictors of Communication About High Blood Pressure in Rheumatoid Arthritis Visits
Authors: Bartels Christie Michels , Johnson Heather , Alcaraz Voelker Katya , Ogdie Alexis , McBride Patrick , Jacobs Elizabeth A. , Zhao Ying-Qi , Smith Maureen
Published: April 2018

Background/Objective

Given heightened cardiovascular disease (CVD) risk in rheumatoid arthritis (RA) and that higher blood pressure (BP) represents greater CVD risk, we hypothesized that higher BP would predict more BP-related communication in rheumatology visits. We examined predictors of documented BP communication during RA clinic visits.

Methods

This was a retrospective cohort study of RA patients identified in electronic health record records with uncontrolled hypertension (HTN) receiving both primary and rheumatology care. Trained abstractors reviewed RA visit notes for “BP communication” using a standardized tool to elicit documentation about BP or HTN beyond recording vital signs. We used multivariate logistic regression to examine the impact of BP category (American Heart Association: ideal normotension, pre-HTN, and stages I and II HTN) on odds ratios (95% confidence intervals) of BP communication.

Results

Among 1267 RA patients, 40% experienced BP elevations meeting the definition of uncontrolled HTN. Of 2677 eligible RA visits, 22% contained any documented BP communication. After adjustment, models predicted only 31% of visits with markedly high BPs 160/100 mm Hg or greater would contain BP communication. Compared with stage I, stage II elevation did not significantly increase communication (odds ratio, 2.0 [95% confidence interval, 1.4–2.8] vs. 1.5 [1.2–2.2]), although both groups' odds exceeded pre-HTN and normotension. Less than 10% of eligible visits resulted in documented action steps recommending follow-up of high BP.

Conclusions

Regardless of BP magnitude, most RA clinic visits lacked documented communication about BP despite compounded CVD risk. Future work should study how rheumatology clinics can facilitate follow-up of high BPs to address HTN as the most common and reversible CVD risk factor.
Hypertonic Saline Solution Reduces Microcirculatory Dysfunction and Inflammation in a Rat Model of Brain Death
Authors: Correia Cristiano de Jesus , Armstrong Roberto , Carvalho Priscila Oliveira de , Simas Rafael , Sanchez Daniela Crisina Janolli , Breithaupt-Faloppa Ana Cristina , Sannomiya Paulina , Moreira Luiz Felipe Pinho
Published: April 2018

Background:

Brain death (BD) induces hemodynamic instability with microcirculatory hypoperfusion, leading to increased organ inflammation and dysfunction. This study investigated the effects of 7.5% hypertonic saline solution (HSS) on mesenteric microcirculatory dysfunction and inflammation in a rat model of BD.

Methods:

Male Wistar rats were anesthetized and mechanically ventilated. BD was induced by rapidly inflating an intracranial balloon catheter. The rats were randomly divided into: SH, sham-operated rats subjected to trepanation; NS, rats treated with NaCl 0.9%, 4 mL/kg immediately after BD; T1, rats treated with HSS (NaCl 7.5%, 4 mL/kg) immediately or 60 min after BD, T60. All groups were analyzed 180 min after the start of the experiment.

Results:

Rats in BD groups presented with a similar hypertensive peak, followed by hypotension. Proportion of perfused small vessels was decreased in the NS group (46%) compared with the SH group (74%, P = 0.0039). HSS restored the proportion of perfused vessels (T1 = 71%, P = 0.0018). The anti-endothelial nitric oxide synthase (eNOS) protein expression significantly increased in rats given HSS (T1, and T60, P = 0.0002). Similar results were observed regarding endothelin-1 (P < 0.0001). Increased numbers of rolling (P = 0.0015) and migrated (P = 0.0063) leukocytes were observed in the NS group compared with the SH group. Rats given HSS demonstrated an overall reduction in leukocyte–endothelial interactions. The ICAM-1 levels increased in the NS group compared with the SH group, and decreased in the HSS-treated groups (P = 0.0002).

Conclusions:

HSS may improve the density of mesenteric perfused small vessels due to its effects on eNOS and endothelin-1 protein expression, and reduces inflammation by decreasing leukocyte adhesion and migration in a rat model of BD.