bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing Speech Recognition in Spanish-English Bilingual Children with the Computer-Assisted Speech Perception Assessment (CASPA): Initial Report
Authors: García Paula B. , Rosado Rogers Lydia , Nishi Kanae
Published: February 2016

This study evaluated the English version of Computer-Assisted Speech Perception Assessment (E-CASPA) with Spanish-English bilingual children. E-CASPA has been evaluated with monolingual English speakers ages 5 years and older, but it is unknown whether a separate norm is necessary for bilingual children. Eleven Spanish-English bilingual and 12 English monolingual children (6 to 12 years old) with normal hearing participated. Responses were scored by word, phoneme, consonant, and vowel. Regardless of scores, performance across three signal-to-noise ratio conditions was similar between groups, suggesting that the same norm can be used for both bilingual and monolingual children.
Does a Weekly Didactic Conference Improve Resident Performance on the Pediatric Domain of the Orthopaedic In-Training Examination?
Authors: Franklin Corinna C. , Bosch Patrick P. , Grudziak Jan S. , Dede Ozgur , Ramirez Rey N. , Mendelson Steven A. , Ward W. Timothy , Brooks Maria , Kenkre Tanya , Lubahn John D. , Deeney Vincent F. , Roach James W.
Published: February 2016

Background:

Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents’ performance on the OITE’s pediatric domain.

Methods:

In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot). This includes all topics in pediatric orthopaedic surgery and has teaching faculty present, and occurs weekly with all residents attending. A neighboring program [UMPC Pittsburgh (Pitt)] shares in these conferences, but only during their pediatric rotation. We sought to determine the effectiveness of the conference by comparing the historic scores from each program on the pediatric domain of the OITE examination to scores after the institution of the conference, and by comparing the 2 programs’ scores.

Results:

Both programs demonstrated improvement in OITE scores. In 2008, the mean examination score was 19.6±4.3 (11.0 to 30.0), and the mean percentile was 57.7±12.6 (32.0 to 88.0); in 2014, the mean examination score was 23.5±4.2 (14.0 to 33.0) and the mean percentile was 67.1±12.1 (40.0 to 94.0). OITE scores and percentiles improved with post graduate year (P<0.0001). Compared with the preconference years, Hamot residents answered 3.99 more questions correctly (P<0.0001) and Pitt residents answered 2.93 more questions correctly (P<0.0001). Before the conference, site was not a predictor of OITE score (P=0.06) or percentile (P=0.08); there was no significant difference found between the mean scores per program. However, in the postconference years, site did predict OITE scores. Controlling for year in training, Hamot residents scored higher on the OITE (2.3 points higher, P=0.003) and had higher percentiles (0.07 higher, P=0.004) than Pitt residents during the postconference years.

Conclusions:

This study suggests that adding a didactic pediatric lecture improved residents’ scores on the OITE and indirectly suggests that more frequent attendance is associated with better scores.

Level of Evidence:

Level III—retrospective case-control study.
Surgical Site Infections following Spine Surgery for Non-idiopathic Scoliosis
Authors: Salsgiver Elizabeth , Crotty Jennifer , LaRussa Samuel J. , Bainton Nicole M. , Matsumoto Hiroko , Demmer Ryan T. , Thumm Brian , Vitale Michael G. , Saiman Lisa
Published: February 2016

Background:

Surgical site infections (SSIs) following spine surgery in children and adolescents with nonidiopathic scoliosis are associated with increased morbidity and health care costs. Potentially modifiable risk factors for SSIs merit additional study in this population.

Methods:

A single-center, retrospective cohort study was performed from August 2008 through December 2013 in children and adolescents undergoing surgery for nonidiopathic scoliosis to determine the trends in SSI rate and causative microorganisms. A standardized perioperative antimicrobial prophylaxis regimen was developed from September-October 2008. Potential risk factors for SSIs were assessed by multivariable analysis using Poisson regression models. Fusion procedures and growing construct procedures were analyzed separately.

Results:

In all, 268 patients underwent 536 surgical procedures of whom 192 underwent 228 fusion procedures, 89 underwent 308 growing construct procedures, and 13 underwent both procedures during the study period. Twenty-one SSIs (3.9% of surgical procedures and 7.8% of patients) occurred within 90 days of surgery, 17 SSIs occurred after fusion procedures (4.5% of procedures and 8.9% of patients), and 4 SSIs occurred after growing construct procedures (1.3% of procedures and 4.5% of patients). There were 9 polymicrobial SSIs (42.9%). Of the 31 bacterial pathogens isolated, 48% were Gram-negative organisms. Among patients undergoing fusion procedures, SSIs were associated with underdosing of preoperative cefazolin [relative risk (RR)=4.99; 95% confidence interval (CI), 1.89-17.43; P=0.012] and tobramycin (RR=5.86; 95% CI, 1.90-18.06; P=0.002), underdosing of intraoperative (RR=5.65; 95% CI, 2.13-14.97; P=0.001) and postoperative (RR=3.86; 95% CI, 1.20-12.40; P=0.023) tobramycin, and any preoperative or intraoperative underdosing (RR=4.89; 95% CI, 1.70-14.12; P=0.003), after adjustment for duration of surgery. No factors were associated with SSIs in those undergoing growing construct procedures. During the study period, the SSIs rate declined (P<0.0001).

Conclusions:

Underdosing of tobramycin and preoperative cefazolin were associated with an increased SSI risk among patients undergoing fusion procedures. Future multicenter studies should further investigate the generalizability of these findings.

Level of Evidence:

Level II—retrospective study.
Calcaneofibular Ligament Transfer for Recurrent Peroneal Tendon Subluxation in Pediatric and Young Adult Patients
Authors: Stenquist Derek S. , Gonzalez Tyler A. , Tepolt Frances A. , Kramer Dennis E. , Kocher Mininder S.
Published: February 2016

Background:

Peroneal tendon subluxation is an uncommon cause of lateral ankle pain and instability but can be disabling for some young patients. Surgical management may be required to restore function for patients who fail nonoperative management. The purpose of this study was to determine the functional outcomes after surgical management of peroneal tendon subluxation in pediatric and adolescent patients.

Methods:

A retrospective review of patients presenting to our institution over a 10-year period yielded 18 cases of recurrent subluxation refractory to nonoperative management in 14 children or young adults (mean age 15.0 y). All patients failed nonoperative management and were treated operatively with isolated calcaneofibular ligament transfer to construct a new soft tissue restraint for the peroneal tendons. Patients were evaluated clinically and sent validated questionnaires, including the Foot and Ankle Ability Measure (FAAM) and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale.

Results:

All 18 ankles of 14 patients had minimum 2-year follow-up. Ten of 18 ankles (55.6%) returned the outcome surveys at an average of 5.7 years after the index procedure (range, 2. 0 to 9.7 y). The average FAAM activities of daily living score was 93.5 (±2.9) and the sports subscale was 77.8 (±6.1). The mean AOFAS subjective scaled score was 84.3 (±4.5). All patients returned to sports and recreational activity. Complications included 1 case of recurrent subluxation (1/18, 5.5%) treated with revision to a Chrisman-Snook procedure and 4 ankles (4/18, 22.2%) with stiffness or arthrofibrosis treated with a secondary procedure of peroneal tendon release or lysis of adhesions.

Conclusions:

Surgical management with rerouting of the peroneal tendons under the calcaneofibular ligament appears to be safe and effective for young patients with chronic peroneal tendon subluxation. It provides a low rate of recurrent subluxation, excellent stability, and good long-term functional outcomes. However, the potential for postoperative stiffness appears to be a limitation to the procedure and necessitates aggressive physical therapy to maintain ankle motion.

Level of Evidence:

Level IV— retrospective case series.
A New Radiographic Classification System for Developmental Hip Dysplasia is Reliable and Predictive of Successful Closed Reduction and Late Pelvic Osteotomy
Authors: Ramo Brandon A. , De La Rocha Adriana , Sucato Daniel J. , Jo Chan-Hee
Published: February 2016

Background:

The Tonnis radiographic classification of developmental dysplasia of the hip (DDH) has been used as a prognostic indicator for patients with walking-age DDH. The International Hip Dysplasia Institute (IHDI) classification, a new radiographic classification system, has been proposed to be more reliable by its creators. We sought to validate its reliability using independent observers, to compare it to the Tonnis method, and to assess its prognostic significance in a large cohort of patients.

Methods:

A consecutive series of walking-age DDH patients were examined radiographically and classified by the Tonnis and IHDI schemes by 3 independent observers. Interobserver agreement was determined using the Kappa method. Clinical data were collected on patients with regard to success of closed reduction, need for later pelvic osteotomy, and presence of subsequent radiographic avascular necrosis (AVN). The prognostic value of the Tonnis and IHDI classifications to predict these clinical outcomes was determined.

Results:

A total of 287 hips were available for analysis of the classification schemes. In total, 235 hips underwent attempted closed reduction and were eligible for analysis of successful closed reduction, and 131 hips had >4-year follow-up and were utilized for analysis of late pelvic osteotomy and AVN. Both classifications showed excellent interobserver reliability and in general, there was nonstatistically significant better reliability for the IHDI versus the Tonnis classification. In multivariate analysis, both IHDI and Tonnis classifications were found to be predictive of successful closed reduction and need for late pelvic osteotomy. Both methods showed trends toward being predictive of AVN rate, without statistical significance.

Conclusions:

The IHDI classification is subjectively more facile to use and has excellent interrelater agreement for classifying the radiographic severity of DDH. It is also reliable in predicting success of closed reduction and need for late pelvic osteotomy. Significance: practitioners and researchers should consider the IHDI classification as a useful classification scheme and prognosticator when considering treatment options for late-presenting DDH.

Significance:

Practitioners and researchers should consider the IHDI classification as a useful classification scheme and prognosticator when considering treatment options for late-presenting DDH.

Level of Evidence:

Level III.
Treatment of Unstable Slipped Capital Epiphysis Via the Modified Dunn Procedure
Authors: Persinger Freddie , Davis Richard L. , Samora Walter P. , Klingele Kevin E.
Published: February 2016

Background:

The modified Dunn procedure has been shown to be safe and effective in treating unstable slipped capital femoral epiphysis (SCFE). We present a consecutive series of unstable SCFE managed by a single surgeon with a focus on timing of surgical intervention, postoperative complications, and radiographic results.

Methods:

Thirty-one consecutive unstable SCFEs were treated. Demographics, presentation time to time of operation, surgical times, and complications were recorded. Bilateral hip radiographs at latest follow-up were utilized to record slip angle, α angle, greater trochanteric height, and femoral neck length.

Results:

Thirty-one consecutive hips in 30 patients were reviewed: 15 males (50%) and 15 females (50%), average age 12.37 years (range, 8.75 to 14.8 y), 20 left hips (65%) and 11 right hips (35%). Mean follow-up was 27.9 months (range, 1 to 82 mo). Time from presentation to intervention averaged 13.9 hours (range, 2.17 to 23.4 h). Two patients (6%) developed avascular necrosis at average 19 weeks postoperative. Three patients (10%) developed mild heterotopic ossification requiring no treatment. Two patients (6%) required removal of symptomatic hardware. One patient had hardware failure and in no patients was nonunion, delayed union, or postoperative hip subluxation/dislocation seen. Three patients (10%) presented with bilateral, stable SCFE requiring contralateral in situ pinning. Five patients (16%) had sequential SCFE requiring treatment with 1 patient having an acute, unstable SCFE 10 months after the previous realignment. Mean postoperative slip angle measured 2.5 degrees (range, +19 to −9.4 degrees) (SD, 7.2), α angle 47.43 degrees (range, 34 to 64 degrees) (SD, 7.49), greater trochanteric height averaged 3.5 mm below the center of femoral head (−17.5 to +25 mm), and mean femoral neck length difference measured −7.75 mm (range, −1.8 to −18.6 mm).

Conclusions:

A single surgeon series of unstable SCFEs treated by a modified Dunn procedure showed a 6% incidence of avascular necrosis and low complication rates at latest follow-up. Radiographs showed restoration of the slip angle, α angle, femoral neck length, and greater trochanteric height. This series reveals the safety and effectiveness of the modified Dunn procedure for unstable SCFE.

Level of Evidence:

Level III—retrospective review.
Extended Ciprofloxacin Release Using Vitamin E Diffusion Barrier From Commercial Silicone-Based Soft Contact Lenses
Authors: Shayani Rad Maryam , Mohajeri Seyed Ahmad
Published: February 2016

Objectives:

Ciprofloxacin (Cipro) is an antibiotic, widely used in form of ophthalmic drops (0.3%) for the treatment of eye infections. In this study, vitamin E was used as a hydrophobic barrier to improve and prolong the amount and time of Cipro release from silicone-based soft contact lenses.

Methods:

Three different commercial contact lenses (Air Optix, Biofinity, and Acuvue Oasys) were soaked in vitamin E solutions (0.1 and 0.2 g/mL). The effect of vitamin E on Cipro loading amount and drug releasing profile was evaluated in artificial tear. Swelling properties and diameter changes of the lenses were also investigated in aqueous media in presence and absence of vitamin E.

Results:

The data indicated that vitamin E, as a hydrophobic barrier, significantly decreased the water content of silicone-based soft contact lenses. After vitamin E loading, a 5% to 18% increase was observed in lens diameter in the hydrated state, whereas the lens diameter increased by 11% to 23% in the dry state. In all commercial lenses, vitamin E loading in a 0.2-g/mL solution caused a 27.94% to 37.08% increase in Cipro binding. The results indicated that applying vitamin E loading solutions, with 0.1 and 0.2 g/mL concentrations, could effectively enhance Cipro release time from 2 hr (in a pure non-vitamin E–loaded lens) to 14 to 17 and 30 to 33 days, respectively. These values showed an increase by a factor of 168 to 204 and 360 to 396 in Cipro release time after using vitamin E loading solutions with 0.1 and 0.2 g/mL concentrations, respectively, compared with pure non-vitamin E–loaded soft contact lenses.

Conclusions:

This study indicated that vitamin E acts as an effective hydrophobic barrier, in increasing the Cipro loading capacity of silicone-based contact lenses and prolonging the drug release into the artificial tear.
Infrabrow Skin Excision Associated With Upper Blepharoplasty to Address Significant Dermatochalasis With Lateral Hooding in Select Asian Patients
Authors: Osaki Midori Hentona , Osaki Tammy Hentona , Osaki Teissy
Published: February 2016

Purpose:

In Asian patients, lateral hooding in the aging upper eyelid is prominent and frequently seen. Removal of the redundant skin of this region during classic blepharoplasty tends to produce a resultant prolonged scar. Furthermore, as the height of the eyelid skin excision increases, suturing of the thick upper skin to the thin pretarsal skin can result in upper lid fullness. This study documents the combination of infrabrow skin excision and upper blepharoplasty to address lateral hooding in select patients of Asian ancestry.

Methods:

This study is a retrospective chart review of patients who underwent infrabrow skin excision associated with upper blepharoplasty. The inclusion criteria were moderate and severe upper eyelid dermatochalasis in patients with high eyebrows and lateral hooding; residual lateral hooding following previous blepharoplasty.

Results:

Thirty-two eyelids of 16 female patients of Japanese ancestry underwent infrabrow skin excision associated with upper blepharoplasty. The mean age of patients was 68.87 ± 7.88 years (57–82 years). Mean follow up was 37.25 ± 18.96 months (9–72 months). Patients were evaluated at 1, 3, 6, and 9 months at least. The Strasser system for evaluation of surgical results was applied at 3 months. All patients had scores indicating good results and were satisfied with the cosmetic outcome and improvement of visual field after surgery. No complications related to wound dehiscence, lagophthalmos, hypertrophic scars, or sensory changes were observed.

Conclusion:

The combination of infrabrow skin excision and upper blepharoplasty was effective to address moderate and severe dermatochalasis with lateral hooding in select patients of Japanese ancestry.
Therapeutic advances for primary biliary cholangitis: the old and the new
Authors: Wang Li , Zhang Feng-Chun , Zhang Xuan
Published: February 2016

Primary biliary cholangitis (PBC, primary biliary cirrhosis) is an autoimmune cholestatic liver disease characterized by chronic nonsuppurative destructive cholangitis and the presence of serum antimitochondrial antibodies. Ursodeoxycholic acid is the only drug approved by the US Food and Drug Administration to treat PBC. However, one-third of patients show incomplete responses to ursodeoxycholic acid and a poor prognosis. A number of old and new medications have been used in these patients, such as fibrates, glucocorticoids, immunosuppressants, obeticholic acid, mesenchymal stem cells, biological agents (anti-interleukin-12, cytotoxic T-lymphocyte antigen 4 immunoglobulin, anti-CD20), and antifibrotic drugs. This article reviews the therapeutic advances of these old and new medications in patients with PBC.
Hepatitis B and C prevalence in Portugal: disparity between the general population and high-risk groups
Authors: Carvalhana Sofia C. , Leitão Jorge , Alves Ana C. , Bourbon Mafalda , Cortez-Pinto Helena
Published: February 2016

Background and aims

The prevalence of anti-HCV and HBsAg in Portugal has been shown to be elevated in high-risk groups, such as intravenous drug-users and incarcerated individuals. However, in the general population, prevalence remains largely unknown. The aims of this study were to estimate the prevalence of anti-HCV and HBsAg in the general Portuguese population and identify associated risk factors.

Materials and methods

We carried out a nationwide, population-based cross-sectional study of adults resident in mainland Portugal. Serology for HBsAg, anti-HBc, anti-HBs, and anti-HCV was performed. Anti-HCV-positive individuals were tested for HCV RNA by PCR.

Results

Of 1685 participants, 50.6% were men, mean age 50.2±18.3 years. In terms of hepatitis C, the prevalence of anti-HCV was 0.54% [95% confidence interval (CI): 0.2–0.9] and 0.12% (95% CI: 0.0–0.3) were viremic, with peak prevalence among individuals 35–64 years of age (0.8%), men (0.8%), and individuals from Lisbon and Tagus Valley region (1.9%).

In terms of hepatitis B, the estimated prevalence of HBsAg was 1.45% (95% CI: 0.9–2.0). A higher prevalence was found in individuals who were 35–64 years old (2.2%), in men (2.5%), and in the Northern region (2.6%).

The presence of positive serological markers of hepatitis C virus and hepatitis B virus infection did not correlate with elevated aminotransferases, race, place of birth, and alcohol consumption.

Conclusion

These results suggest a low endemicity for both hepatitis B and hepatitis C in the general population, in contrast to a very high prevalence in risk groups, thus suggesting that targeted screening to high-risk groups may be more cost-effective than general population screening.
Overexpression of SIRT1 is Associated With Poor Outcomes in Patients With Ovarian Carcinoma
Authors: Mvunta David H. , Miyamoto Tsutomu , Asaka Ryoichi , Yamada Yasushi , Ando Hirofumi , Higuchi Shotaro , Ida Koichi , Kashima Hiroyasu , Shiozawa Tanri
Published: February 2016

Sirtuin 1 (SIRT1), originally identified as a longevity gene, regulates DNA repair and metabolism by deacetylating target proteins such as p53. SIRT1 plays a key role in the pathophysiology of metabolic diseases and neurodegenerative disorders, and is considered to protect against age-related diseases including cancer. In contrast, SIRT1 may be oncogenic because its overexpression has been detected in many cancers. The aim of the present study was to clarify the expression and the role of SIRT1 in ovarian carcinoma (OvCa). The expression of SIRT1 was evaluated immunohistochemically in 16 cases of normal ovaries, 35 cases of endometriosis with/without carcinoma, and 68 cases of OvCa (endometrioid, 16; clear cell, 20; mucinous, 16; serous, 16). Staining results were evaluated semiquantitatively by the Immunoreactive Scoring System, and the relationships with clinicopathologic features and outcomes of patients were analyzed. The expression of SIRT1 was higher in endometrioid, mucinous, and clear-cell carcinomas than in the inclusion cysts of normal ovaries, but not in serous carcinoma (P=0.038). The expression of SIRT1 on OvCa did not correlate with age, stage, location of metastasis, or capsular penetration. However, elevated SIRT1 expression was a significant predictor of shorter survival in univariate (P=0.038) and multivariate (P=0.037) survival analyses, regardless of the tumor stage. Results of the present study suggest a positive role for SIRT1 in the development of OvCa and its potential as a novel therapeutic target.
Characterizing Molecular Variants and Clinical Utilization of Next-generation Sequencing in Advanced Breast Cancer
Authors: Gurda Grzegorz T. , Ambros Tadeu , Nikiforova Marina N. , Nikiforov Yuri E. , Lucas Peter C. , Dabbs David J. , Lee Adrian V. , Brufsky Adam M. , Puhalla Shannon L. , Bhargava Rohit
Published: February 2016

Women with advanced breast carcinomas have few therapeutic options. Recent advances in genomic profiling represent a new paradigm of cancer classification and treatment, but experience with genomic testing in a clinical setting remains limited. We retrospectively determined the genomic variants and correlate these with histology [histomorphologic subtype, nuclear grade, standard immunohistochemistry (IHC)] and clinical utilization (ordering, turnaround time, report review, and targeted therapy). Among 48 patients, 2 showed no genetic alterations, 11 (23%) showed variants of unclear significance only and 35 (73%) showed variant(s) affecting function (VaF) and/or variants of unclear significance. Overall, 119 variants were observed in 20 of 50 tested genes. Each patient had a unique molecular profile, with numerous (n=58) variants not previously reported in breast cancer. VaF detected in more than 2 patients included: TP53 (n=21), PIK3CA (n=20), and FGFR1 (n=3). VaF comprised 46 single nucleotide variants (79%), 7 amplifications (12%), 3 frameshifts (5%), 1 insertion (2%), and 1 deletion (2%). The tested samples had very high Ki67 index (average 57%±23%) and approximately half were hormone receptor and HER2 negative (25/46, 54%). Metastatic breast carcinomas showed a higher average VaF versus breast-localized tumors (1.3±0.99 vs. 0.18±0.60, P<0.05). Next-generation sequencing reports were promptly reported and reviewed (average 1 to 2 d) and 7 (∼25%) of potentially eligible patients received targeted therapy. Advanced breast cancers show unique landscapes of genetic variants. Most testing was done in late disease, often in metastatic and receptor-negative carcinomas. Next-generation sequencing results were promptly reported and reviewed, but the utilization of targeted therapies was limited.
Expression Pattern of the BCL6 and ITM2B Proteins in Normal Human Brains and in Alzheimer Disease
Authors: Baron Beverly W. , Pytel Peter
Published: February 2016

We reported that the integral membrane 2B gene (ITM2B, also called BRI2) is a target of BCL6 repression in lymphomas. Molecular alterations in ITM2B are associated with 2 neurodegenerative diseases, Familial British and Danish dementia, and dysregulation of ITM2B function has been implicated in the pathogenesis of Alzheimer disease (AD). Although ITM2B expression has been studied, the distribution of BCL6 in human brain has not been described. Our goal is to analyze BCL6 and ITM2B localization in normal human brains and in AD by immunohistochemistry to understand their relationship. We found that, in general, they have a reciprocal relationship. BCL6 expression is present in isolated cortical neurons, granule cells in the cerebellum, scattered glial cells, and in some cells of the ependyma and choroid plexus. ITM2B is expressed in most cortical neurons, neurons of the hippocampus and dentate nucleus, cerebellar Purkinje and granule cells, and (newly described here) in focal neurons in the basal ganglia, many neurons of the thalamus and brainstem, many cells in the ependyma and choroid plexus, and in the smooth muscle of blood vessels. ITM2B expression is prominent in plaques in AD-containing dystrophic neurites but absent in neurofibrillary tangles; BCL6 expression is absent in neurofibrillary tangles and in the nuclei of cells associated with plaques in AD. It is essential to understand the localization of BCL6 and ITM2B in the brain before considering manipulation of their expression as a potential therapeutic tool.
The Potential Diagnostic Utility of TROP-2 in Thyroid Neoplasms
Authors: Liu Haiyan , Shi Jianhui , Lin Fan
Published: February 2016

Objectives:

Human trophoblast cell-surface marker (TROP-2) has been reported to be overexpressed in various human carcinomas (CAs) and suggested to be a prognostic marker for some CAs. The diagnostic utility of TROP-2 in CAs has not been explored.

Methods:

Immunohistochemical evaluation of TROP-2 expression on tissue microarray sections of 136 thyroid neoplasms, surgical specimens of 61 atypical thyroid follicular-patterned lesions [including 33 papillary thyroid carcinomas (PTCs), 17 atypical follicular neoplasms (AFNs), and 11 adenomatoid nodules with focal nuclear atypia (ANFNA)], and 20 benign thyroid lesions, as well as 10 cytology specimens of PTCs was performed. For comparison, immunoassay for Hector Battifora mesothelial-1 (HBME-1), galectin-3, and cytokeratin 19 was performed on the 61 atypical thyroid follicular-patterned lesions.

Results:

Strong membranous staining with TROP-2 was seen in 94% (33/35) of classic PTCs and 81% (30/37) of confirmed follicular variant PTCs on tissue microarray and routine surgical sections, as well as 100% (10/10) of PTCs on cytology specimens; it was not observed in follicular adenomas (n=51) or CAs (n=37), AFNs or ANFNA (n=28), benign (n=20) or normal (n=15) thyroid tissue. In contrast, the expression of HBME-1 and galectin-3 was identified in 100% (33/33) of surgical cases of PTCs and in 57% (16/28) and 50% (14/28) of AFNs and ANFNA, respectively.

Conclusions:

Our findings demonstrate that a membranous TROP-2 staining pattern is highly specific for PTC, which may serve as a potential diagnostic marker aiding in the accurate classification of morphologically equivocal thyroid follicular-patterned lesions.
Multifocal FIGO Stage IA1 Squamous Carcinoma of the Cervix: Criteria for Identification, Staging, and its Good Clinical Outcome
Authors: Day Elizabeth , Duffy Siobhan , Bryson Gareth , Syed Sheeba , Shanbhag Smruta , Burton Kevin , Lindsay Rhona , Siddiqui Nadeem , Millan David
Published: February 2016

Multifocal squamous cervical carcinomas account for up to 25% of IA1 tumors identified on excisional biopsy, yet there are no uniformly accepted histopathologic criteria for defining and staging these lesions. Here, we use a strict case definition and meticulous specimen processing from colposcopist to pathologist to identify and follow-up 25 cases of multifocal IA1 cervical squamous carcinomas identified in excisional biopsies. We stage these tumors using the dimensions of the largest focus and a minimum of 2 mm between each foci to define multifocality. The cases are followed up for a median of 7 yr with no episodes of tumor recurrence or metastasis. We also show that the prevalence of residual preinvasive (20%) and invasive disease (5%) on repeat excision/surgery are comparable to data available for unifocal IA1 cases. Our study supports the hypothesis that multifocal lesions should be staged according to largest individual focus of invasion and we emphasize the importance of meticulous specimen handling to appropriately identify multifocal tumors. In addition, our analysis suggests that outcomes are comparable to unifocal lesions and supports the hypothesis that they may be managed in a similar manner.
Disentangling incomplete lineage sorting and introgression to refine species-tree estimates for Lake Tanganyika cichlid fishes
Authors: Meyer Britta S. , Matschiner Michael , Salzburger Walter
Published: February 2016

Adaptive radiation is thought to be responsible for the evolution of a great portion of the past and present diversity of life. Instances of adaptive radiation, characterized by the rapid emergence of an array of species as a consequence to their adaptation to distinct ecological niches, are important study systems in evolutionary biology. However, because of the rapid lineage formation in these groups, and the occurrence of hybridization between the participating species, it is often difficult to reconstruct the phylogenetic history of species that underwent an adaptive radiation. In this study, we present a novel approach for species-tree estimation in rapidly diversifying lineages, where introgression is known to occur, and apply it to a multimarker dataset containing up to 16 specimens per species for a set of 45 species of East African cichlid fishes (522 individuals in total), with a main focus on the cichlid species flock of Lake Tanganyika. We first identified, using age distributions of most recent common ancestors in individual gene trees, those lineages in our dataset that show strong signatures of past introgression. This led us to formulate three hypotheses of introgression between different lineages of Tanganyika cichlids: the ancestor of Boulengerochromini (or of Boulengerochromini and Bathybatini) received genomic material from the derived H-lineage; the common ancestor of Cyprichromini and Perissodini experienced, in turn, introgression from Boulengerochromini and/or Bathybatini; and the Lake Tanganyika Haplochromini and closely related riverine lineages received genetic material from Cyphotilapiini. We then applied the multispecies coalescent model to estimate the species tree of Lake Tanganyika cichlids, but excluded the lineages involved in these introgression events, as the multispecies coalescent model does not incorporate introgression. This resulted in a robust species tree, in which the Lamprologini were placed as sister lineage to the H-lineage (including the Eretmodini), and we identify a series of rapid splitting events at the base of the H-lineage. Divergence ages estimated with the multispecies coalescent model were substantially younger than age estimates based on concatenation, and agree with the geological history of the Great Lakes of East Africa. Finally, we formally tested the three hypotheses of introgression using a likelihood framework, and find strong support for introgression between some of the cichlid tribes of Lake Tanganyika.
A common founding clone with TP53 and PTEN mutations gives rise to a concurrent germ cell tumor and acute megakaryoblastic leukemia
Authors: Lu Charles , Riedell Peter , Miller Christopher A. , Hagemann Ian S. , Westervelt Peter , Ozenberger Bradley A. , O'Laughlin Michelle , Magrini Vincent , Demeter Ryan T. , Duncavage Eric J. , Griffith Malachi , Griffith Obi L. , Wartman Lukas D.
Published: February 2016

We report the findings from a patient who presented with a concurrent mediastinal germ cell tumor (GCT) and acute myeloid leukemia (AML). Bone marrow pathology was consistent with a diagnosis of acute megakaryoblastic leukemia (AML M7), and biopsy of an anterior mediastinal mass was consistent with a nonseminomatous GCT. Prior studies have described associations between hematological malignancies, including AML M7 and nonseminomatous GCTs, and it was recently suggested that a common founding clone initiated both cancers. We performed enhanced exome sequencing on the GCT and the AML M7 from our patient to define the clonal relationship between the two cancers. We found that both samples contained somatic mutations in PTEN (C136R missense) and TP53 (R213 frameshift). The mutations in PTEN and TP53 were present at ∼100% variant allele frequency (VAF) in both tumors. In addition, we detected and validated five other shared somatic mutations. The copy-number analysis of the AML exome data revealed an amplification of Chromosome 12p. We also identified a heterozygous germline variant in FANCA (S858R), which is known to be associated with Fanconi anemia but is of uncertain significance here. In summary, our data not only support a common founding clone for these cancers but also suggest that a specific set of distinct genomic alterations (in PTEN and TP53) underlies the rare association between GCT and AML. This association is likely linked to the treatment resistance and extremely poor outcome of these patients. We cannot resolve the clonal evolution of these tumors given limitations of our data.
Homodimerization of Ehd1 Is Required to Induce Flowering in Rice
Authors: Cho Lae-Hyeon , Yoon Jinmi , Pasriga Richa , An Gynheung
Published: February 2016

In plants, flowering time is elaborately controlled by various environment factors. Ultimately, florigens such as FLOWERING LOCUS T (FT) or FT-like molecules induce flowering. In rice (Oryza sativa), Early heading date 1 (Ehd1) is a major inducer of florigen gene expression. Although Ehd1 is highly homologous to the type-B response regulator (RR) family in the cytokinin signaling pathway, its precise molecular mechanism is not well understood. In this study, we showed that the C-terminal portion of the protein containing the GARP DNA-binding (G) domain can promote flowering when overexpressed. We also observed that the N-terminal portion of Ehd1, carrying the receiver (R) domain, delays flowering by inhibiting endogenous Ehd1 activity. Ehd1 protein forms a homomer via a 16-amino acid region in the inter domain between R and G. From the site-directed mutagenesis analyses, we demonstrated that phosphorylation of the Asp-63 residue within the R domain induces the homomerization of Ehd1, which is crucial for Ehd1 activity. A type-A RR, OsRR1, physically interacts with Ehd1 to form a heterodimer. In addition, OsRR1-overexpressing plants show a late-flowering phenotype. Based on these observations, we conclude that OsRR1 inhibits Ehd1 activity by binding to form an inactive complex.
Innovative management for organizational sustainability in higher education
Authors: Barnard Zenia , Van der Merwe Derek
Published: February 2016

Purpose

– The purpose of this paper is to provide an overview of the innovative management strategies at the University of Johannesburg (UJ) during volatile post-merger years, in its quest for a sustainable future. It illustrates how the institution went from a place of relative uncertainty and volatility to a place of progression and stability by adapting to its environment and challenging circumstances.

Design/methodology/approach

– A holistic and inter-disciplinary approach is taken by the authors to demonstrate that organizational innovation and sustainability do not happen in isolation. The paper includes a literature review to contextualize the challenging environment in which the UJ was established and functions. A brief description of the strategic goals of the university is provided as a framework from within which the innovative management activities were launched. Data and information from the UJ’s stakeholder reports were used as measurement tools to determine the progress in reaching strategic targets.

Findings

– Innovation in higher education reported on in this paper is a result of many planning sessions, policy and procedure formulations, brainstorming and benchmarking exercises, performance reviews, management interventions and statistical analyses. A set of necessary and sufficient conditions for innovation in sustainable development in higher education include decisive leadership on strategic direction; regular, flexible and inclusive planning; regular culture climate surveys; constant monitoring of progress; and strategic agility that is essential to promote innovation among the entire workforce.

Originality/value

– The challenges, context and approaches provided in this paper serve as a frame of reference for other institutions of higher learning that face similar challenges in a dynamic, diverse and volatile environment.
Using energy profiles to identify university energy reduction opportunities
Authors: Maistry Nandarani , Annegarn Harold
Published: February 2016

Purpose

– The purpose of this paper is to outline efforts at the University of Johannesburg, a large metropolitan university in Gauteng province, to examine energy efficiency within the context of the green campus movement, through the analysis of electricity consumption patterns. The study is particularly relevant in light of the cumulative 230 per cent increase in electricity costs between 2008 and 2014 in South Africa that has forced institutions of higher education to seek ways to reduce energy consumption.

Design/Methodology/Approach

– A quantitative research design was adopted for the analysis of municipal electricity consumption records using a case study approach to identify trends and patterns in consumption. The largest campus of the University of Johannesburg, which is currently one of the largest residential universities in South Africa, was selected as a case study. Average diurnal consumption profiles were plotted according to phases of the academic calendar, distinguished by specific periods of active teaching and research (in-session); study breaks, examinations and administration (out-of-session); and recesses. Average profiles per phase of the academic calendar were constructed from the hourly electricity consumption and power records using ExcelTM pivot tables and charts.

Findings

– It was found that the academic calendar has profound effects on energy consumption by controlling the level of activity. Diurnal maximum consumption corresponds to core working hours, peaking at an average of 2,500 kWh during “in-session” periods, 2,250 kWh during “out-of-session” periods and 2,100 kWh during recess. A high base load was evident throughout the year (between 1,300 and 1,650 kWh), mainly attributed to heating and cooling. By switching off the 350 kW chiller plant on weekdays, a 9 per cent electricity reduction could be achieved during out-of-session and recess periods. Similarly, during in-session periods, a 6 per cent reduction could be achieved.

Practical implications

– Key strategies and recommendations are presented to stimulate energy efficiency implementation within the institution.

Originality Value

– Coding of consumption profiles against the academic calendar has not been previously done in relation to an academic institution. The profiles were used to establish the influence of the academic calendar on electricity consumption, which along with our own observation were used to identify specific consumption reduction opportunities worth pursuing.
An academic home for play: games as unifying influences in higher education
Authors: Herro Danielle , Clark Rebecca
Published: February 2016

Purpose

– This paper aims to address opportunities and tensions when creating game-based learning practices in higher education. By detailing examples from a university in the Southeastern USA and the communities it serves, we suggest game-based research and learning be approached as a unifying influence adaptable across contexts.

Design/methodology/approach

– We use a working example methodology where someone with expertise “works through” a well-known issue while making the thinking overt. In this manner, we reveal processes, successes and challenges infusing game-based learning in higher education to deepen understanding between fields and encourage research and practice with games across disciplines.

Findings

– The working example demonstrates that games served as a unifying influence in three primary ways, which included redesigning courses and implementing programmatic changes; using existing programs to promote interdisciplinary teaching and research; and increasing outreach and partnerships. In each example, games served to strengthen or support the initiatives.

Originality/value

– This paper extends literature on the value of games to promote research and learning. Significantly, it provides an example for others in game-based learning fields to consider when building similar programs in higher education.
Experimental animal model for analyzing immunobiological responses following vaccination with formalin‐inactivated respiratory syncytial virus
Authors: Sawada Akihito , Nakayama Tetsuo
Published: February 2016

Formalin‐inactivated respiratory syncytial virus (FI‐RSV) vaccine was developed in the 1960s. However, this vaccine does not prevent infection in RSV‐naïve recipients and has the paradoxical effect of increasing the severity of RSV illness following natural infection, which has been a major obstacle to developing RSV vaccines. Several experimental animal models for determining the cause of the severe symptoms in FI‐RSV recipients have been developed. In the present study, cotton rats immunized with FI‐RSV were challenged with RSV and histopathological findings and recovery of infectious virus were studied. Copy numbers of mRNA of Th1 and Th2 cytokines were measured in lung tissues to gain better understanding of their immune responses. Infiltration of inflammatory cells and prominent interstitial pneumonitis were observed in the FI‐RSV group, as was induction of mRNA of Th2 cytokines such as IL‐4, IL‐10, IL‐13 and RANTES. Rats immunized with recombinant measles virus expressing the RSV F protein (MVAIK/RSV/F) and those treated with anti‐RSV mAb (palivizumab) showed very mild interstitial pneumonitis. Amounts of mRNA of IL‐1β, IFN‐γ and IL‐4 were higher in the MVAIK/RSV/F group. Administration of palivizumab before RSV challenge decreased the severity of interstitial pneumonitis in the FI‐RSV group. FI‐RSV induced skewed Th2 responses, resulting in severe inflammatory responses.
Germination patterns in three terrestrial orchids relate to abundance of mycorrhizal fungi
Authors: McCormick Melissa K. , Taylor D. Lee , Whigham Dennis F. , Burnett Robert K.
Published: February 2016

The spatial distribution of plants, which is often generated by patterns of seed recruitment, is an important determinant of population dynamics, especially for orchids with seeds that must be exposed to appropriate mycorrhizal fungi.

We compared the distribution and abundance of target mycorrhizal fungi detected in the soil using DNA‐based molecular techniques and germination in seed packets of Goodyera pubescens, Liparis liliifolia and Tipularia discolor.

We further examined Tulasnella spp. associated with G. pubescens to determine whether areas with abundant host fungi resulted from multiple genets of the same species or from a single widespread fungal genet.

We found that target fungi were more likely to be detected using soil DNA assays than by seed germination. Based on soil DNA, fungi were more widespread than suggested by seed germination, which most often reflected the presence of abundant mycorrhizal fungi in the soil. Fungi were more likely to be abundant close to established orchids. Established plants of G. pubescens that were < 50 cm apart associated with a single abundant fungal genet, while those > 50 cm apart associated with multiple fungal genets.

Synthesis. This study demonstrates the importance of using multiple methods to detect the distribution and abundance of target fungi and suggests that fungal ‘hot spots’ may be keys to the dynamics of orchid populations.
The Limits of Anticolonialism: The British Labour Movement and the End of Empire in Guiana
Authors: Mawby Spencer
Published: February 2016

The Labour Party's ambivalent attitude to anticolonial nationalism is well known but its place in the conflicts between the party's revisionists and the left has been less fully elaborated, while the influence of British trade unions in the formation of party policy on decolonization has been cast to the margins of the historiography. Events in British Guiana are representative of this tendency because, while the activities of the American Federation of Labor‐Congress of Industrial Organizations have been detailed by a number of historians, including Stephen Rabe, Robert Waters, Gary Daniels and Lily Ramcharan, the impact of the British TUC has been largely ignored. The Labour Party's support for the suspension of the Guianese constitution by the Churchill government in 1953 and their willingness to implement Conservative plans for constitutional reform in 1964 demonstrate that the party's liberationist faction were unable to overturn the Cold War agenda espoused by the right wing of the parliamentary party and anti‐communists in the trade union movement. A study of the international labour politics of the 1950s and 1960s suggests both that the fate of the Guianese left was inextricably tied to conflicts in the British Labour party and that trade union leaders in the metropolis offered powerful support to revisionists in making the case for prioritizing Atlanticism over colonial liberation.