bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection ofFusarium oxysporumf. sp.fragariaefrom Infected Strawberry Plants
Authors: Burkhardt Alyssa , Henry Peter M. , Koike Steven T. , Gordon Thomas R. , Martin Frank
Published: October 2018

Isolates of the Fusarium oxysporum species complex have been characterized as plant pathogens that commonly cause vascular wilt, stunting, and yellowing of the leaves in a variety of hosts. F. oxysporum species complex isolates have been grouped into formae speciales based on their ability to cause disease on a specific host. F. oxysporum f. sp. fragariae is the causal agent of Fusarium wilt of strawberry and has become a threat to production as fumigation practices have changed in California. F. oxysporum f. sp. fragariae is polyphyletic and limited genetic markers are available for its detection. In this study, next-generation sequencing and comparative genomics were used to identify a unique genetic locus that can detect all of the somatic compatibility groups of F. oxysporum f. sp. fragariae identified in California. This locus was used to develop a TaqMan quantitative polymerase chain reaction assay and an isothermal recombinase polymerase amplification (RPA) assay that have very high sensitivity and specificity for more than 180 different isolates of the pathogen tested. RPA assay results from multiple field samples were validated with pathogenicity tests of recovered isolates.
Escalation and de-escalation in HER2 positive early breast cancer
Authors: Dieci Maria Vittoria , Vernaci Grazia , Guarneri Valentina
Published: October 2018

Purpose of review

Current standard for HER2+ early breast cancer patients includes chemotherapy and trastuzumab for 1 year. The purpose of this article is to review available evidence on escalated treatment strategies for high-risk patients and de-escalated treatments for patients at low risk of relapse or high risk of cardiac toxicity.

Recent findings

Recent results have led to the approval of two adjuvant escalated treatment strategies: pertuzumab and trastuzumab combined with chemotherapy for up to 1 year for high-risk patients; extension of adjuvant anti-HER2 treatment with 1 year of neratinib. However, these treatments are associated with increased costs and toxicity, therefore careful patients’ selection is highly required. With regard to de-escalated treatments, the anthracycline-free regimen of adjuvant paclitaxel and 1 year trastuzumab has entered clinical practice for early-stage patients. One year of trastuzumab remains the standard; however, shorter trastuzumab could be an option for low-risk patients and in case of increased risk of cardiotoxocity. Chemotherapy-free regimens are attractive but deserve further evaluation.

There have been advances in treatment individualization for HER2+ early breast cancer patients. Integration of promising biomarkers into risk classification will further help progressing in the field.
Immunotherapy in patients with early stage resectable nonsmall cell lung cancer
Authors: Ghysen Katrien , Vansteenkiste Johan
Published: October 2018

Purpose of review

‘Early-stage’ nonsmall cell lung cancer (NSCLC) refers to stage I and stage II disease, and selected cases of stage IIIA disease where complete tumor resection is feasible. Surgery is the standard treatment for early NSCLC, but the overall 5-year survival remains below 50%. The addition of adjuvant cisplatin-based chemotherapy to surgery improved 5-year survival rates by 5–10%, but no significant therapeutic innovation has been established thereafter. We review recent and ongoing studies looking how immunotherapy may improve the outcome of these patients.

Recent findings

Antigen-specific immunotherapy (cancer vaccination) did not fulfill its promise in a large phase III randomized trial in completely resected early-stage NSCLC. Over the past few years, immunotherapy with immune checkpoint inhibition (ICI) has led to remarkable progress in nononcogene addicted metastatic NSCLC. We review ongoing clinical investigations that want to translate these benefits to earlier stages of NSCLC. Both adjuvant and neoadjuvant large randomized controlled trials with ICI are ongoing.

Although from a mechanistic perspective the neoadjuvant administration may be preferred, it is crucial that both adjuvant and neoadjuvant trials are recruited as planned, to have a balanced view how ICI therapy may ultimately improve cure rates in these patients.
A plasma microRNA biomarker of melanoma as a personalised assessment of treatment response
Authors: van Laar Ryan K. , Lincoln Mitchel T. , van Laar Barton J.
Published: October 2018

New tools for monitoring response to primary melanoma treatment are needed to reduce recurrence rates and patient anxiety. A previously developed plasma-based microRNA signature (MEL38) was measured in four melanoma patient samples obtained before and 12–14 days after treatment (i.e. surgical excision), as well as in two nonmelanoma controls. The value of the MEL38 score and selected individual genes were compared between the time points. The MEL38 scores of the four patients with melanoma became more ‘normal like’ after tumour excision, with a statistically significant 15% mean reduction. MicroRNAs involved in tumour suppression were upregulated in the postexcision samples and those involved in facilitating treatment resistance and tumour invasion were downregulated. Based on these limited preliminary data, the MEL38 signature may have clinical utility in assessing an individual patient’s response to the most common form of melanoma treatment. Additional studies are needed on larger, clinically diverse patient cohorts, sampled over longer periods of time.
Brief Mindfulness Meditation With Night Nursing Unit Staff
Authors: Resnicoff Marci , Julliard Kell
Published: October 2018

Nurses and nursing assistants working at night on an inpatient unit are under signicant stress. Because mindfulness reduces stress and enhances workplace life, this qualitative study explored night shift staff attitudes toward brief group mindfulness practice. For 8 months, 3 times a week, the staff was called together at the nursing station around midnight and led through 2 to 5 minutes of guided mindfulness meditation. Six months after these groups ended, perceptions of this experience were gathered from 5 nurses and 5 nursing assistants via interviews and open-ended questionnaires. Data were analyzed using inductive thematic analysis, with themes identied as they emerged from the data. The study findings noted that several participants were slow to recognize the value of the practice, but this shifted so that by the end, all participants felt positively about participating. Most perceived its benet for themselves as well as for others in the following areas: relationship to self and family, ability to focus, teamwork, decreased stress, improved attitude, and increased compassion toward patients. This brief team mindfulness intervention had many benets for participants and patients but took time to achieve staff buy-in. Future research should examine the generalizability of these findings and clarify implementation strategies.
Beyond competencies: Practice standards for emergency nurse practitioners—A model for specialty care clinicians, educators, and employers
Authors: Ramirez Elda , Schumann Lorna , Agan Donna , Hoyt Karen Sue , Wilbeck Jennifer , Tyler Diane , Evans Dian Dowling
Published: October 2018

Background/purpose:

The growth of advanced practice nursing specialties requires additional expertise for practice that goes beyond entry-level competencies, knowledge, skills, and abilities. A practice standards model for specialty nurse practitioners (PSMSNPs) is introduced that differentiates entry-to-practice population foci competencies from advanced specialty practice standards.

Objectives:

(a) Differentiate competencies and practice standards in context to specialty NPs using the emergency specialty as the exemplar, (b) articulate the process to develop the PSMSNP that evolved from an evidence-based practice analysis of NPs working in emergency care, (c) apply the PSMSNP for adaptation to other specialties, and (d) provide implications for the utilization of the PSMSNP by educators, clinicians, and employers.

Data sources:

American Academy of Nurse Practitioners Certification Board’s Practice Analysis of Emergency Nurse Practitioners, Consensus Model for APRN Regulation, Future of Nursing report, Peer Nursing Report, Strong Model of Advanced Practice, Entrustable Professional Activities, Emergency Medicine Milestones Project, and the Advancing Healthcare Transformation: A New Era for Academic Nursing report.

Conclusions:

The PSMSNP has been defined and adapted to other specialties and threaded through other models of practice for educators, clinicians, and employers. The adaptability of this model differentiates the core population foci and unique practice variables of specialty NPs. National boards of nursing, hospital credentialing committees, colleges, and universities can use this model to establish standards for specialty evaluation and guide clinical practice.

Implications for practice:

The implementation of the PSMSNP will support the delineation of the specialty. This model will fulfill the American Nurses Association and Consensus Model specialty constructs.
Continuous renal replacement therapy during extracorporeal membrane oxygenation: why, when and how?
Authors: Ostermann Marlies , Connor Michael , Kashani Kianoush
Published: October 2018

Purpose of review

The use of extracorporeal membrane oxygenation (ECMO) is increasing rapidly. Patients on ECMO have a high risk of developing acute kidney injury (AKI) and needing renal replacement therapy (RRT). The aim of this review is to describe different strategies of combining RRT and ECMO and to outline their advantages and drawbacks.

Recent findings

Fluid overload is the most common indication for RRT during ECMO, and continuous renal replacement therapy (CRRT) is the most commonly used modality. The optimal timing for initiation of CRRT should be individualized based on degree of fluid overload and severity of AKI-related metabolic derangements. In ECMO patients, CRRT can be provided via an integrated approach (i.e. in-line haemofilter or a fully integrated CRRT device) or a parallel system with separate ECMO and RRT circuits. In-depth knowledge of the resulting intra-circuit pressure changes, risks of air entrapment and haemolysis, and implications for ultrafiltration and solute clearance are essential. There is no evidence that the different methods of combining ECMO and CRRT impact mortality.

In patients on ECMO, CRRT can be provided via an integrated approach or independently via parallel systems. An in-depth understanding of the advantages and drawbacks of the different techniques is required.
Feeding Interventions Are Associated With Improved Outcomes in Children With Laryngeal Penetration
Authors: Duncan Daniel R. , Larson Kara , Davidson Kathryn , May Kara , Rahbar Reza , Rosen Rachel L.
Published: October 2018

Objectives:

To determine if children with laryngeal penetration on videofluoroscopic swallow study (VFSS) who received feeding interventions (thickened liquids, change in liquid flow rate, and/or method of liquid delivery) had improved symptoms and decreased hospitalizations compared with those without intervention.

Methods:

We performed a retrospective cohort study of children under 2 years with laryngeal penetration on VFSS at our institution in 2015 to determine initial and follow‐up VFSS findings, symptom improvement at follow‐up, and hospitalization risk before and after VFSS. Proportions were compared with Fisher exact test and hospitalizations with paired t tests.

Results:

We evaluated 137 subjects with age 8.93 ± 0.59 months who had laryngeal penetration without aspiration on VFSS. Fifty‐five percent had change in management, with 40% receiving thickening and 15% a change in flow rate. There was significant improvement in symptoms for children that had feeding intervention and this improvement was the greatest with thickening (OR 41.8, 95% CI 12.34–141.69, P < 0.001). On repeat VFSS, 26% had evidence of aspiration that was not captured on initial VFSS. Subjects had decreased total and pulmonary hospitalizations with feeding intervention and decreased pulmonary nights with thickening (P < 0.05).

Conclusions:

Laryngeal penetration appears to be clinically significant in children with oropharyngeal dysphagia and interventions to decrease its occurrence are associated with improved outcomes including decreased symptoms of concern and hospitalization nights. Thickening or other feeding intervention should be considered for all symptomatic children with laryngeal penetration on swallow study.
A Novel Donkey Milk–derived Human Milk Fortifier in Feeding Preterm Infants
Authors: Bertino Enrico , Cavallarin Laura , Cresi Francesco , Tonetto Paola , Peila Chiara , Ansaldi Giulia , Raia Melissa , Varalda Alessia , Giribaldi Marzia , Conti Amedeo , Antoniazzi Sara , Moro Guido E. , Spada Elena , Milani Silvano , Coscia Alessandra
Published: October 2018

Objectives:

The purpose of the present randomized controlled clinical trial was to compare the use of donkey milk–derived fortifier (DF) with commercial bovine milk–derived fortifier (BF) in very preterm or very‐low‐birth‐weight newborns, in terms of feeding tolerance.

Methods:

This trial included 156 newborns born at <32 weeks of gestational age and/or with a birth weight ⩽1500 g. Newborns were randomized 1:1 to receive enteral feeding with either a BF‐arm, or a new, DF‐arm for 21 days. The fortification protocol was the same for both study arms, and the 2 diets were designed to be isoproteic and isocaloric. Feeding tolerance was assessed by a standardized protocol.

Results:

The risk of feeding intolerance tended to be lower in DF‐arm than in BF‐arm, with a relative risk reduction of 0.63 (95% confidence interval: −0.29, +0.90). The mean number of episodes per newborn of feeding intolerance and feeding interruptions (any duration) were consistently lower in the DF‐arm than in the BF‐arm. Episodes of bilious gastric residuals and vomiting were significantly lower in the DF‐arm. Time needed to reach full enteral feeding (150 mL · kg−1 · day−1) and daily weight increase between the first day of exclusive enteral feeding (ie, without administering intravenous fluids) and discharge were similar in the BF‐ and DF‐arms.

Conclusions:

These results suggest that DF improve feeding tolerance when compared with standard bovine‐derived fortifiers, with a similar auxological outcome.
Intracellular Localization of Microbial Transglutaminase and Its Influence on the Transport of Gliadin in Enterocytes
Authors: Stricker Sebastian , de Laffolie Jan , Rudloff Silvia , Komorowski Lars , Zimmer Klaus‐Peter
Published: October 2018

Objective:

Celiac disease (CD) is a systemic inflammatory disorder, characterized by the destruction of duodenal epithelium. The CD8+ T cells involved are associated with cross‐presentation. In addition to other factors, the rising prevalence of CD might be induced by microbial transglutaminase (mTG) an enzyme frequently used in food production that shares enzymatic and antigenic properties of tissue transglutaminase (TG2), the autoantigen in CD. We hypothesized that mTG and gliadin are transported into the endoplasmic reticulum (ER), indicating cross‐presentation of both antigens.

Methods:

Apical incubation of duodenal biopsies from CD and control patients was performed with mTG alone or with mTG and simultaneously with Frazer's fraction. Evaluation was carried out by immunofluorescence and electron microscopy.

Results:

Approximately 6% to 9% of the intracellular mTG and gliadin were transported to the ER of enterocytes. RACE cells (Rapid uptake of Antigen into the Cytosol of Enterocytes) displayed an enhanced antigen uptake into a dilated ER. mTG strongly localized at the basolateral membrane and the lamina propria.

Conclusions:

mTG and gliadin are transported to the ER of enterocytes and to a greater extent to the ER of RACE cells, suggesting cross‐presentation of exogenous antigens. The strong localization of mTG at the basolateral membrane and the lamina propria may also indicate a potential antigenic interaction with cells of the immune system. Since mTG may not only been taken up with food stuffs but could also be released by bacteria within the intestinal microbiota, further investigations are needed regarding the role of mTG in CD pathogenesis.
Fecal Microbiota Transplant for Recurrent Clostridium difficile Infection in Pediatric Inflammatory Bowel Disease
Authors: Cho Stanley , Spencer Elizabeth , Hirten Robert , Grinspan Ari , Dubinsky Marla C.
Published: October 2018

Objectives:

Recurrent Clostridium difficile infection (RCDI) increases morbidity and mortality in patients with inflammatory bowel disease (IBD). Fecal microbiota transplant (FMT) is known to be very effective for RCDI in non‐IBD patients with cure rates up to 91%. The same success rates of FMT have not been reported in patients with IBD with RCDI, and the data in pediatrics are limited. We aimed to determine the effectiveness of FMT for RCDI in established pediatric patients with IBD.

Methods:

We performed a retrospective chart review of pediatric patients with IBD and RCDI (≥3 episodes) who underwent FMT via colonoscopy at a tertiary care IBD center. The primary outcome was the rate of RCDI within 60 days post‐FMT. The secondary outcomes were recurrence rate by 6 months, rate of colectomy, and time to recurrence.

Results:

Of the 8 eligible patients, 6 had ulcerative colitis, 1 had IBD‐unspecified, and 1 had Crohn disease. Median (interquartile range) age was 13 (11–14) years. All patients were on vancomycin at FMT. Two patients (25%) had RCDI by 60 days post‐FMT and another 3 patients had RCDI between 60 days and 6 months. The median time to recurrence was 101 (40–139) days. Two patients (25%) who developed recurrence went to colectomy after FMT.

Conclusions:

With a cure rate of 75% at 60 days, FMT administered for the treatment of RCDI may be an effective treatment option in pediatric IBD. However, there appears to be a significant rate of late recurrence of C difficile infection after 60 days in these patients.
Staff Nurses’ Perspectives of Resources Needed During Floating
Authors: Hoffman Ann , von Sadovszky Victoria
Published: October 2018

OBJECTIVE

The aim of this study was to examine nurses’ perceptions regarding the resources needed during floating.

BACKGROUND

Most studies report on patterns of floating and the characteristics of float pool nurses. No studies exist regarding staff nurses’ views of the types of resources needed to support floating.

METHODS

Staff nurses in a pediatric hospital (N = 220) completed an electronic survey of both open- and close-ended questions. Close-ended data were analyzed with frequencies and percentages. Open-ended data were content-analyzed and then frequencies and percentages of categories of responses were performed. χ
2 Analyses were used to examine relationships between the variables.

RESULTS

There were no significant relationships between resources and years at the institution and number of times floated in past year. The top 3 categories of resources needed to float by nurse participants included having an assigned a resource/buddy, mini-orientation, and electronic updates about the units they are floating to.

CONCLUSIONS

These findings underscore common frustrations nurses experience during floating and ways that nurse executives can create a more satisfactory floating environment and increase nursing satisfaction.
Immunohistochemical Expression of Microfibrillar-associated Protein 5 (MFAP5) in Invasive Breast Carcinoma of No Special Type
Authors: Dawoud Marwa M. , Abouelfadl Dalia , Abdou Asmaa G. , Elkhouly Enas A.B.
Published: October 2018

Breast cancer (BC) remains the most prevalent female cancer in Egypt and worldwide. Microfibrillar-associated protein 5 (MFAP5) is a multifunctional glycoprotein. Although MFAP5 gene was among the genes that found globally expressed in human cancers, it had been only recently reported in few cancer research studies. This is a retrospective study that has been conducted on 66 Egyptian patients who had invasive carcinoma of no special type. Immunohistochemical staining for MFAP5 was applied on the archival formalin-fixed paraffin-embedded blocks. Staining was assessed semiquantitatively and correlated with the available clinicopathologic parameters and immunohistochemical subtypes of BC. MFAP5 epithelial cytoplasmic expression was observed in 89.4% (59/66) of cases. In contrast, nuclear expression was seen in non-neoplastic breast lobules and premalignant lesions adjacent to tumors that also exhibited constant staining in myoepithelial layer. Statistical analysis of epithelial cytoplasmic expression revealed association of MFAP5 expression with tumor size (P=0.046), high histologic grade (P=0.007), presence of lymph node metastasis (P=0.014), poor Nottingham Prognostic Index (NPI) (P=0.001), late stage (P=0.008), immunohistochemical subtypes of BC (P=0.018), and increased microvessel density using CD34 immunostianing (P=0.04). MFAP5 cytoplasmic expression was also observed in an adjacent duct carcinoma in situ component in 37/45 cases (82.2%). This study showed that MFAP5 is a novel myoepithelial cell marker that appears to be upregulated in duct epithelium in duct carcinoma in situ and invasive carcinoma of no special type during tumorogenesis and that its cytoplasmic expression in invasive tumors seems to have a poor prognostic role manifested by its association with poor prognostic parameters such as high grade, late stage, lymph node invasion, and increased microvessel density.
Early Surgical Treatment in Anterior Synostotic Plagiocephaly: Is This the Best Choice?
Authors: Gasparini Giulio , Saponaro Gianmarco , Moro Alessandro , De Angelis Paolo , Pelo Sando
Published: October 2018

At the end of craniofacial growth, in anterior synostotic plagiocephaly, some aesthetical deficiencies may still be evident. This can depend on an inadequate initial correction or on altered postoperative growth or even on the combination of the 2 factors.

Aesthetic alterations can result from various factors that could potentially affect the skeleton, the skin, subcutaneous, and muscular tissues.

The pathological changes in the cutaneous and subcutaneous tissues are greater in patients who have undergone multiple surgical treatments of the frontoorbital area. The aim of this observational cohort study is to assess the residual aesthetic and functional impairment at the end of skeletal growth, in patients affected by anterior synostotic plagiocephaly who have undergone surgery at an early age. The purpose is to investigate whether early surgery can still be considered unavoidable in patients with this malformation.

Between July 2012 and February 2015, patient's data were retrieved from our archives among the patients referred to our department from 2003 to 2012 for Anterior Synostotic Plagiocephaly at an early age.

The authors studied this patient with CT scans and photographic documentation. On CT scans, the authors have assessed skeletal alterations, soft tissues alterations, and muscular tissue alterations. With photographic documentation, the authors have studied the perception of the malformation among external subjects.

From this study it was possible to demonstrate that is many esthetical alterations are to still to be found in patients treated with an early surgical approach; for this reason in children without early complications, the authors suggest that surgical treatment should be delayed after the end of craniofacial growth.
The Ex Vivo Time of Fresh Autologous Cartilage Before Transplantation and Cartilage Absorption Degree
Authors: Fan Qing-Chun , Tian Hua , Wang Xu-Kai
Published: October 2018

Objective:

This study aims to determine the relationship between the time of autogenous cartilage in vitro and the degree of absorption in animal experiments.

Methods:

New Zealand white rabbits were randomly divided into 3 groups according to the time of cartilage in vitro: 1-hour group, 2-hour group, and 3-hour group. A volume of ear cartilage was taken and transplanted into the back, according to the group. After 1 month, the volume was taken out and remeasured. Then, these were compared by scanning electron microscopy and hematoxylin and eosin staining.

Results:

The cartilage bulk absorption level of different groups is different (P < 0.05). There was statistical significance when the 3-hour group was compared with the other 2 groups (P < 0.05). This shows that cartilage volume absorption level becomes higher after 3 hours. Scanning electron microscopy revealed that before and after transplantation, the arrangement of collagen fibers and the gap between these fibers changed. Hematoxylin and eosin staining revealed that there were some morphological changes in chondrocytes, and the degree of chondrocyte apoptosis increased with time, which was accompanied by granulation tissue formation. In addition, the cartilage tissue survived after transplantation.

Conclusion:

The change in cartilage volume was more obvious after 3 hours of autogenous fresh cartilage transplantation, when compared with that of the first 2 hours. The longer the time of light microscopy was, the longer the apoptosis of cartilage cells, the more serious the destruction of collagen fibers and the cartilage matrix, and the greater the absorption of cartilage and the new chondrocytes.
Assessment of Neurologic Disorders and Rare Intracranial Anomalies Associated With Cleft Lip and Palate
Authors: Kucukguven Arda , Calis Mert , Topaloglu Haluk , Ozgur Figen
Published: October 2018

Accompanying neurologic disorders directly affect psychosocial development of cleft lip and/or cleft palate (CLP) patients and make it difficult for their family to look after them properly. The aim of this study was to investigate the diversity and the incidence of additional neurologic malformations in children with CLP and to evaluate their effects on cleft care. All patients who applied to our Cleft and Craniofacial Center between July 2014 and July 2017 were included in the study. Demographic and perioperative data such as gender, cleft type, syndromic status of the patient, associated neurologic anomalies, timing and duration of operation, hospitalization period, and follow-up period in the intensive care unit are all recorded. All patients received an interdisciplinary evaluation including pediatric neurology specialists in terms of mental and/or motor developmental delay, epilepsy, and other neurologic disorders. After detailed neurologic examination, 83 (3.8%) out of 2190 were reported as having a neurologic defect. The most leading neurologic disorder was found to be mental-motor retardation in 57 children followed by epileptiform disorders detected in 36 children. In 22 patients, rare intracranial pathologies were detected on magnetic resonance imaging. According to our results, having a neurologic pathology increases the need for intensive care unit stay by 5 times in these patients. There was statistically significant relationship between hospitalization period, age of cleft surgery, and neurologic pathologies in these patients. Neurologic disorders could complicate cleft care, cause delays in the planned surgery schedule, and increase perioperative and postoperative morbidity.
Clinical Outcomes Between Atrophic and Nonatrophic Mandibular Fracture in Elderly Patients
Authors: Kim Tae Gon , Chung Kyu Jin , Lee Jin Ho , Kim Yong-Ha , Lee Jun Ho
Published: October 2018

The number of elderly patients with mandibular fracture is rapidly increasing. To improve outcome, it is important to understand the age-related characteristics of mandibular fracture. Thus, the aim of this study is to analyze the impact of atrophic change on mandibular fracture in elderly patients. The retrospective study was conducted in patients aged ≥65 years old, who underwent surgery for the treatment of mandibular fracture in our hospital from March 2006 until March 2015. Patient characteristics, such as age and gender, causes of injury, anatomic location of fracture, height of mandibular body, extent of atrophy, location of surgical sites, postoperative outcomes, and the follow-up period, were examined. Descriptive statistics were compared between atrophic and nonatrophic mandibles. The patients included 17 males and 12 females and the mean age was 71.9 years old. The average follow-up period was 6.06 months. Regarding occlusion and complications, there were no statistical differences between the atrophic and nonatrophic mandibular fractures. As major complications, nonunion occurred in 2 patients and malunion in 1 patient. There was no mortality associated with anesthesia or surgery. Atrophic and nonatrophic mandibular fractures in elderly patients can be treated successfully with surgery. There was no significant difference with respect to major complications between patients with atrophic and nonatrophic mandibular fractures.
Three-Year Follow-Up of a Patient With Unilateral Cleft Lip and Palate Treated With Maxillary Protraction and Alveolar Bone Grafting: An Approach Exploring the Potential Power of Growth
Authors: Chen Zhengxi , Shi Jiajun , Jin Can , Chen Zhiyi , Tong Qian , Li Zhujun , Chen Zhenqi
Published: October 2018

Clinically, patients with operated unilateral cleft lip and palate always present with a concave profile, depressed midface, maxillary hypoplasia, narrow upper dental arch, and class III malocclusion. In this clinical report, the authors describe the successful orthodontic treatment of a patient with unilateral cleft lip and palate. A boy, 7 years 11 months of age, with a history of unilateral cleft lip and cleft palate presented with a Class I malocclusion on Skeletal Class III base. A satisfactory occlusion and a favorable lateral profile were achieved after maxillary protraction (face mask) combined with fixed appliance treatment, including alveolar bone grafting surgery. An acceptable occlusion and facial proportion were maintained after a 3-year retention period. These results suggest orthodontic treatment with growth interference is an effective option for a patient with cleft lip and palate.
The Treatment of Lower Jaw Defects Using Vascularized Fibula Graft and Dental Implants
Authors: Khachatryan Levon , Khachatryan Grigor , Hakobyan Gagik
Published: October 2018

This study is based on an analysis of the results of treatment of 21 patients with mandibular defects of different localization and etiology who underwent reconstruction with fibula free flap. Postoperative clinical and radiographic controls were made regularly, the criteria for implant success were assessed.

The postoperative evolution of the patients was favorable, with the integration of the fibula vascularized grafts. Complete engraftment of bone autografts and wound healing was obtained in all observations. In all 21 patients, fibula flaps provided adequate conditions for implant placement. The coefficient of osteointegration of implants 3 years after bone grafting was 97%.

Using a vascularized autograft from the fibula to replace the defects of the lower jaw provides the conditions for a full rehabilitation of patients. The methods of reconstructive surgery and implantation make it possible to successfully perform the replacement of defects in the maxillofacial region, being one of the methods medical and social rehabilitation of patients with this pathology.
A New Approach to Presurgical Nasoalveolar Molding in Patients With Unilateral Cleft Lip and Palate and Severe Cleft Width
Authors: Titiz Serap , Gözlüklü Ozgür
Published: October 2018

The aim of this study was to describe a new approach to the presurgical orthopedic treatment of unilateral cleft lip and palate patients with severe cleft width. Modified nostril retainers manufactured from soft acrylic were used for the nasal molding. This technique enables the separation of the nasal molding without having to reduce the cleft width to 5 mm. Nasal molding with the modified nostril retainer resulted in the patient and the physician experiencing a more comfortable treatment period.
Therapeutic opportunities and pitfalls in the treatment of axon degeneration
Authors: Simon David J. , Watkins Trent A.
Published: October 2018

Purpose of review

The current review analyzes recent findings that suggest that axon degeneration is a druggable process in the treatment of neurodegenerative disorders and a subset of traumas.

Recent findings

Emerging evidence reveals that axon degeneration is an active and regulated process in the early progression of some neurodegenerative diseases and acute traumas, which is orchestrated through a combination of axon-intrinsic and somatically derived signaling events. The identification of these pathways has presented appealing drug targets whose specificity for the nervous system and phenotypes in mouse models offers significant clinical opportunity.

As the biology of axon degeneration becomes clear, so too has the realization that the pathways driving axon degeneration overlap in part with those that drive neuronal apoptosis and, importantly, axon regeneration. Axon-specific disorders like those seen in CIPN, where injury signaling to the nucleus is not a prominent feature, have been shown to benefit from disruption of Sarm1. In injury and disease contexts, where involvement of somatic events is prominent, inhibition of the MAP Kinase DLK exhibits promise for neuroprotection. Here, however, interfering with somatic signaling may preclude the ability of an axon or a circuit to regenerate or functionally adapt following acute injuries.
Governing artificial intelligence: ethical, legal and technical opportunities and challenges
Authors: Cath Corinne
Published: October 2018

This paper is the introduction to the special issue entitled: ‘Governing artificial intelligence: ethical, legal and technical opportunities and challenges'. Artificial intelligence (AI) increasingly permeates every aspect of our society, from the critical, like urban infrastructure, law enforcement, banking, healthcare and humanitarian aid, to the mundane like dating. AI, including embodied AI in robotics and techniques like machine learning, can improve economic, social welfare and the exercise of human rights. Owing to the proliferation of AI in high-risk areas, the pressure is mounting to design and govern AI to be accountable, fair and transparent. How can this be achieved and through which frameworks? This is one of the central questions addressed in this special issue, in which eight authors present in-depth analyses of the ethical, legal-regulatory and technical challenges posed by developing governance regimes for AI systems. It also gives a brief overview of recent developments in AI governance, how much of the agenda for defining AI regulation, ethical frameworks and technical approaches is set, as well as providing some concrete suggestions to further the debate on AI governance.

This article is part of the theme issue ‘Governing artificial intelligence: ethical, legal, and technical opportunities and challenges’.
Ethical governance is essential to building trust in robotics and artificial intelligence systems
Authors: Winfield Alan F. T. , Jirotka Marina
Published: October 2018

This paper explores the question of ethical governance for robotics and artificial intelligence (AI) systems. We outline a roadmap—which links a number of elements, including ethics, standards, regulation, responsible research and innovation, and public engagement—as a framework to guide ethical governance in robotics and AI. We argue that ethical governance is essential to building public trust in robotics and AI, and conclude by proposing five pillars of good ethical governance.

This article is part of the theme issue ‘Governing artificial intelligence: ethical, legal, and technical opportunities and challenges’.
Democratizing algorithmic news recommenders: how to materialize voice in a technologically saturated media ecosystem
Authors: Harambam Jaron , Helberger Natali , van Hoboken Joris
Published: October 2018

The deployment of various forms of AI, most notably of machine learning algorithms, radically transforms many domains of social life. In this paper we focus on the news industry, where different algorithms are used to customize news offerings to increasingly specific audience preferences. While this personalization of news enables media organizations to be more receptive to their audience, it can be questioned whether current deployments ofalgorithmic news recommenders(ANR) live up to their emancipatory promise. Like in various other domains, people have little knowledge of what personal data is used and how such algorithmic curation comes about, let alone that they have any concrete ways to influence these data-driven processes. Instead of going down the intricate avenue of trying to make ANR more transparent, we explore in this article ways to give people more influence over the information news recommendation algorithms provide by thinking about and enabling possibilities to expressvoice. After differentiating four ideal typical modalities of expressing voice (alternation, awareness, adjustment and obfuscation) which are illustrated with currently existing empirical examples, we present and argue foralgorithmic recommender personaeas a way for people to take more control over the algorithms that curate people's news provision.

This article is part of a theme issue ‘Governing artificial intelligence: ethical, legal, and technical opportunities and challenges’.
Root Anatomy based on Root Cross-Section Image Analysis with Deep Learning
Authors: Wang Chaoxin , Li Xukun , Caragea Doina , Bheemanahalli Raju , Jagadish S.V. Krishna
Published: October 2018

The aboveground plant efficiency has improved significantly in recent years, and the improvement has led to a steady increase in global food production. The improvement of belowground plant efficiency has the potential to further increase food production. However, the belowground plant roots are harder to study, due to inherent challenges presented by root phenotyping. Several tools for identifying root anatomical features in root cross-section images have been proposed. However, the existing tools are not fully automated and require significant human effort to produce accurate results. To address this limitation, we propose a fully automated approach, called Deep Learning for Root Anatomy (DL-RootAnatomy), for identifying anatomical traits in root cross-section images. Using the Faster Region-based Convolutional Neural Network (Faster R-CNN), the DL-RootAnatomy models detect objects such as root, stele and late metaxylem, and predict rectangular bounding boxes around such objects. Subsequently, the bounding boxes are used to estimate the root diameter, stele diameter, and late metaxylem number and average diameter. Experimental evaluation using standard object detection metrics, such as intersection-over-union and mean average precision, has shown that our models can accurately detect the root, stele and late metaxylem objects. Furthermore, the results have shown that the measurements estimated based on predicted bounding boxes have very small root mean square error when compared with the corresponding ground truth values, suggesting that DL-RootAnatomy can be used to accurately detect anatomical features. Finally, a comparison with existing approaches, which involve some degree of human interaction, has shown that the proposed approach is more accurate than existing approaches on a subset of our data. A webserver for performing root anatomy using our deep learning pre-trained models is available at https://rootanatomy.org, together with a link to a GitHub repository that contains code that can be used to re-train or fine-tune our network with other types of root-cross section images. The labeled images used for training and evaluating our models are also available from the GitHub repository.
Attention explores space periodically at the theta frequency
Authors: Senoussi Mehdi , Moreland James C. , Busch Niko A. , Dugué Laura
Published: October 2018

Voluntary attention is at the core of a wide variety of cognitive functions. Attention can be oriented to and sustained at a location, or reoriented in space to allow processing at other locations – critical in an ever-changing environment. Numerous studies have investigated attentional orienting in time and space but little is known about the spatio-temporal dynamics of attentional reorienting. Here, we explicitly manipulated attentional reorienting using a cueing procedure in a 2-AFC orientation discrimination task. We interrogated attentional distribution by flashing two probe stimuli with various delays between the pre-cue and target stimuli. Then, we used the probabilities of both probes and none of the probes being correctly reported to solve a second-degree equation, which estimates the report probability at each probe location. We demonstrated that attention reorients periodically at ∼4 Hz (theta) between the two stimulus locations. We further characterized the processing dynamics at each stimulus location, and demonstrated that attention samples each location periodically at ∼11 Hz (alpha). Finally, simulations support our findings and show that this method is sufficiently powered, making it a valuable tool for studying the spatio-temporal dynamics of attention.
Cell Mechanics at the Rear Act To Steer the Direction of Cell Migration
Authors: Allen Greg M. , Lee Kun Chun , Barnhart Erin L. , Tsuchida Mark A. , Wilson Cyrus A. , Gutierrez Edgar , Groisman Alexander , Mogilnerd Alex , Theriot Julie A.
Published: October 2018

Motile cells navigate complex environments by changing their direction of travel, generating left-right asymmetries in their mechanical subsystems to physically turn. Currently little is known about how external directional cues are propagated along the length scale of the whole cell and integrated with its force-generating apparatus to steer migration mechanically. We examine the mechanics of spontaneous cell turning in fish epidermal keratocytes and find that the mechanical asymmetries responsible for turning behavior predominate at the rear of the cell, where there is asymmetric centripetal actin flow. Using experimental perturbations we identify two linked feedback loops connecting myosin II contractility, adhesion strength and actin network flow in turning cells that are sufficient to recreate observed cell shapes and trajectories in a computational model. Surprisingly, asymmetries in actin polymerization at the cell leading edge play only a minor role in the mechanics of cell turning – that is, cells steer from the rear.

Highlights

Fish keratocytes can migrate with persistent angular velocity, straight or in circles.

Asymmetry in protrusion at the leading edge is not sufficient to generate persistent turning.

Asymmetries in myosin II contraction, actin flow and adhesion at the cell rear cause turns.

Our new computational model of migration predicts observed cell trajectories.
Characterisation of the faecal virome of captive and wild Tasmanian devils using virus-like particles metagenomics and meta-transcriptomics
Authors: Chong Rowena , Shi Mang , Grueber Catherine E , Holmes Edward C , Hogg Carolyn , Belov Katherine , Barrs Vanessa R
Published: October 2018

Background

The Tasmanian devil is an endangered carnivorous marsupial threatened by devil facial tumour disease (DFTD). While research on DFTD has been extensive, little is known about the viruses present in devils, and whether any of these are of potential conservation relevance for this endangered species.

Methods

Using both metagenomics based on virus-like particle (VLP) enrichment and sequence-independent amplification (VLP metagenomics), and meta-transcriptomics based on bulk RNA sequencing, we characterised and compared the faecal viromes of captive and wild Tasmanian devils.

Results

A total of 54 devil faecal samples collected from captive (n = 2) and wild (n = 4) populations were processed for virome characterisation using both approaches. We detected many novel, highly divergent viruses, including vertebrate viruses, bacteriophage and other dietary associated plant and insect viruses. In total, 18 new vertebrate viruses, including novel sapelovirus, astroviruses, bocaviruses, papillomaviruses and gammaherpesvirus were identified, as well as known mammalian pathogens including rabbit haemorrhagic disease virus 2 (RHDV2). Captive devils showed significantly lower levels of viral diversity than wild devils. Comparison of the two methodological approaches revealed substantial differences in the number and types of viruses detected, with meta-transcriptomics mainly identifying RNA viruses, and VLP metagenomics largely identifying DNA viruses.

Conclusion

This study has greatly expanded our knowledge of eukaryotic viruses in the Tasmanian devil and provides important baseline information that will contribute to the conservation and captive management of this endangered species. In addition, our results showed that a combination of VLP metagenomics and meta-transcriptomics may be a more comprehensive approach to virome characterisation than either method alone.
An intrinsic neural eye tracker in primary visual cortex
Authors: Morris Adam P. , Krekelberg Bart
Published: October 2018

Humans and other primates rely on eye movements to explore visual scenes and to track moving objects. As a result, the image that is projected onto the retina – and propagated throughout the visual cortical hierarchy – is almost constantly changing and makes little sense without taking into account the momentary direction of gaze. How is this achieved in the visual system? Here we show that in primary visual cortex (V1), the earliest stage of cortical vision, neural representations carry an embedded “eye tracker” that signals the direction of gaze associated with each image. Using chronically implanted multi-electrode arrays, we recorded the activity of neurons in V1 during tasks requiring fast (exploratory) and slow (pursuit) eye movements. Neurons were stimulated with flickering, full-field luminance noise at all times. As in previous studies 1-4, we observed neurons that were sensitive to gaze direction during fixation, despite comparable stimulation of their receptive fields. We trained a decoder to translate neural activity into metric estimates of (stationary) gaze direction. This decoded signal not only tracked the eye accurately during fixation, but also during fast and slow eye movements, even though the decoder had not been exposed to data from these behavioural states. Moreover, this signal lagged the real eye by approximately the time it took for new visual information to travel from the retina to cortex. Using simulations, we show that this V1 eye position signal could be used to take into account the sensory consequences of eye movements and map the fleeting positions of objects on the retina onto their stable position in the world.