bluuebunny/crossref_metadata_2025 huggingface dataset:
Parallel Evolutionary Optimization Algorithms for Peptide-Protein Docking
Authors: Poluyan Sergey , Ershov Nikolay
Published: February 2018

In this study we examine the possibility of using evolutionary optimization algorithms in protein-peptide docking. We present the main assumptions that reduce the docking problem to a continuous global optimization problem and provide a way of using evolutionary optimization algorithms. The Rosetta all-atom force field was used for structural representation and energy scoring. We describe the parallelization scheme and MPI/OpenMP realization of the considered algorithms. We demonstrate the efficiency and the performance for some algorithms which were applied to a set of benchmark tests.
Simulation of Collective Excitations in Long Josephson Junction Stacks
Authors: Rahmonov Ilhom , Shukrinov Yury , Atanasova Pavlina , Zemlyanaya Elena , Streltsova Oksana , Zuev Maxim , Plecenik Andrej , Irie Akinobu
Published: February 2018

The phase dynamics of a stack of long Josephson junctions has been studied. Both inductive and capacitive couplings between Josephson junctions have been taken into account in the calculations. The IV-curve, the dependence on the bias current of the radiation power and dynamics of each JJs of the stack have been investigated. The coexistence of the charge traveling wave and fluxon states has been observed. This state can be considered as a new collective excitation in the system of coupled Josephson junctions. We demonstrate that the observed collective excitation leads to the decrease of radiation power from the system.
A Novel Synthesis of N-Sulfonylformamidines from N-Sulfonyl­sulfonamides
Authors: Rhee Hakjune , Jeong Yuri , Ban Jaeyoung , Lim Minkyung
Published: February 2018

N-Sulfonylformamidines were synthesized from N-sulfonylsulfonamides by reacting with p-toluenesulfonyl chloride (TsCl) and N,N
-disubstituted formamides. In this reaction, it was expected that mixing TsCl with the N,N-disubstituted formamide would generate an iminium salt (Vilsmeier reagent). The reaction avoids the use of metal catalysts and hazardous reagents, and the desired N-sulfonylformamidines were obtained in 60% to quantitative yields.
Microsurgical Resection of Suprasellar Craniopharyngioma—Technical Purview
Authors: Nanda Anil , Narayan Vinayak , Mohammed Nasser , Savardekar Amey , Patra Devi
Published: February 2018

Objectives Complete surgical resection is an important prognostic factor for recurrence and is the best management for craniopharyngioma. This operative video demonstrates the technical nuances in achieving complete resection of a suprasellar craniopharyngioma.

Design and Setting The surgery was performed in a middle-aged lady who presented with the history of progressive bitemporal hemianopia and excessive sleepiness over 8 months. On imaging, suprasellar craniopharyngioma was identified. The tumor was approached through opticocarotid cistern and lamina terminalis. Exposure of bilateral optic nerves, right internal carotid artery, anterior cerebral artery, and its perforator branches was then afforded and the tumor was gross totally resected.

Results The author demonstrates step-by-step technique of microsurgical resection of suprasellar craniopharyngioma. The narrow corridor to deeper structures, intricacies of multiple perforator vessels, and the technique of arachnoid and capsule dissection are the main challenging factors for the gross total resection of craniopharyngioma. The tumor portion which lies under the ipsilateral optic nerve is a blind spot region with a high chance of leaving residual tumor. Mobilization of optic nerve may endanger visual function too. The use of handheld mirror [‘mirror-technique’] helps in better visualization of this blind spot and achieve complete excision.

Conclusions The technical pearls of craniopharyngioma surgery include the optimum utilization of translamina terminalis route, wide opening of the cisterns, meticulous separation of deep perforator vessels, capsular mobilization/traction avoidance, and the use of “mirror-technique” for blind-spot visualization. These surgical strategies help to achieve complete resection without causing neurological deficit.

The link to the video can be found at: https://youtu.be/9wHJ4AUpG50.
Endoscopic Endonasal Transoculomotor Triangle Approach for the Resection of a Pituitary Adenoma with Ambient Cistern Extension
Authors: Zenonos Georgios , Wang Eric , Fernandez-Miranda Juan
Published: February 2018

Objectives The current video presents the nuances of the endoscopic endonasal transoculomotor triangle approach for the resection of a pituitary adenoma with extension into the ambient cistern.

Design The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging.

Setting The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution.

Participants The case refers to a 62-year-old female who presented with vision loss and headaches, and was found to have a pituitary adenoma with extension into the ambient cistern.

Main Outcome Measures The main outcome measures consist of the reversal of the patient symptoms (headaches), the recurrence-free survival based on imaging, as well as the absence of any complications.

Results The patient's headaches improved. There was no evidence of recurrence.

Conclusions The endoscopic endonasal transoculomotor triangle approach is safe and effective for addressing pituitary tumors which extend into the ambient cistern.

The link to the video can be found at: https://youtu.be/EBLwEWhohxY.
Extended Endoscopic Endonasal Resection of a Suprasellar and Third Ventricular Retrochiasmatic Craniopharyngioma with a Narrow Pituitary Gland–Optic Chiasm Interval: Techniques to Optimize Resection
Authors: Kenning Tyler , Pinheiro-Neto Carlos
Published: February 2018

The extended endoscopic endonasal approach can be utilized to surgically treat pathology within the suprasellar space. This relies on a sufficient corridor and interval between the superior aspect of the pituitary gland and the optic chiasm. Tumors located in the retrochiasmatic space and within the third ventricle, however, may not have a widened interval through which to work. With mass effect on the superior and posterior aspect of the optic chiasm, the corridor between the chiasm and the pituitary gland might even be further narrowed. This may negate the possibility of utilizing the endoscopic endonasal approach for the management of pathology in this location. We present a case of a retrochiasmatic craniopharyngioma with a narrow resection corridor that was treated with the extended endoscopic approach and we review techniques to potentially overcome this limitation.

The link to the video can be found at: https://youtu.be/ogRZj-aBqeQ.
The Impact of Computed Tomography on Decision Making in Tibial Plateau Fractures
Authors: Castiglia Marcello , Nogueira-Barbosa Marcello , Messias Andre , Salim Rodrigo , Fogagnolo Fabricio , Schatzker Joseph , Kfuri Mauricio
Published: February 2018

Schatzker introduced one of the most used classification systems for tibial plateau fractures, based on plain radiographs. Computed tomography brought to attention the importance of coronal plane-oriented fractures. The goal of our study was to determine if the addition of computed tomography would affect the decision making of surgeons who usually use the Schatzker classification to assess tibial plateau fractures. Image studies of 70 patients who sustained tibial plateau fractures were uploaded to a dedicated homepage. Every patient was linked to a folder which contained two radiographic projections (anteroposterior and lateral), three interactive videos of computed tomography (axial, sagittal, and coronal), and eight pictures depicting tridimensional reconstructions of the tibial plateau. Ten attending orthopaedic surgeons, who were blinded to the cases, were granted access to the homepage and assessed each set of images in two different rounds, separated to each other by an interval of 2 weeks. Each case was evaluated in three steps, where surgeons had access, respectively to radiographs, two-dimensional videos of computed tomography, and three-dimensional reconstruction images. After every step, surgeons were asked to present how would they classify the case using the Schatzker system and which surgical approaches would be appropriate. We evaluated the inter- and intraobserver reliability of the Schatzker classification using the Kappa concordance coefficient, as well as the impact of computed tomography in the decision making regarding the surgical approach for each case, by using the chi-square test and likelihood ratio. The interobserver concordance kappa coefficients after each assessment step were, respectively, 0.58, 0.62, and 0.64. For the intraobserver analysis, the coefficients were, respectively, 0.76, 0.75, and 0.78. Computed tomography changed the surgical approach selection for the types II, V, and VI of Schatzker (p < 0.01). The addition of computed tomography scans to plain radiographs improved the interobserver reliability of Schatzker classification. Computed tomography had a statistically significant impact in the selection of surgical approaches for the lateral tibial plateau.
TFCC Injuries: Meta-Analysis and Comparison of Diagnostic Imaging Modalities
Authors: Treiser Matthew , Crawford Kayva , Iorio Matthew
Published: February 2018

Background Imaging of the triangular fibrocartilaginous complex (TFCC) remains difficult, as no single imaging modality demonstrates perfect sensitivity and specificity.

Purpose This study performs a meta-analysis of multiple previous publications to guide noninvasive imaging selection for the diagnosis of TFCC injuries.

Methods A literature search was performed and conducted. Studies were included that compared the diagnostic accuracy of magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and computed tomography (CT)/computed tomographic arthrography (CTA) for the evaluation of TFCC injuries. All studies included either arthroscopic or open surgical findings as the “gold standard.” A meta-analysis was performed comparing the diagnostic accuracy of MRA, MRI, and CT for the detection of TFCC injuries.

Results Initial search returned 2,568 candidate articles. Studies were then reviewed and narrowed yielding a total of 28 independent studies (20 MRI, 9 MRA, 4 CT/CTA with some studies including multiple modalities) considered in the qualitative data synthesis. Pooling of the raw data in a meta-analysis demonstrated sensitivities of 0.76 (0.72–0.80), 0.78(0.70–0.84), and 0.89 (0.81–0.95) for MRI, MRA, and CT arthrogram, respectively, with specificities of 0.82 (0.77–0.86), 0.85 (0.77–0.92), and 0.89 (0.81–0.95), respectively. Additionally, across all imaging modalities, diagnostic accuracy was highest for central TFCC lesions versus peripheral lesions.

Conclusion This study represents the largest meta-analysis to date to compare multiple imaging modalities for the diagnosis of TFCC injuries. Pooled data demonstrated that CTA and MRA had statistically equivalent sensitivity and specificity for the diagnosis of TFCC injuries. Diagnostic accuracy was highest for central TFCC injuries.
Posterolateral Corner Reconstruction Using the Anatomical Two-Tailed Graft Technique: Clinical Outcomes in the Multiligament Injured Knee
Authors: Woodmass Jarret , Sanders Thomas , Johnson Nick , Wu Isabella , Krych Aaron , Stuart Michael , Levy Bruce
Published: February 2018

Injury to the posterolateral corner (PLC) of the knee can lead to both varus and rotational instability. Multiple PLC reconstruction techniques have been described, including one-tailed graft (fibula-based constructs) or two-tailed graft (combined fibula- and tibia-based constructs). The purpose of our study was to evaluate the clinical outcomes of anatomical two-tailed graft reconstruction of the PLC in the setting of multiligament knee injuries (MKLIs) with grade III varus instability. Patients were identified through a prospective MLKI database between 2004 and 2013. Patients who received fibular collateral ligament and PLC reconstructions using a two-tailed graft and had a minimum follow-up of 2 years were included. Patients were assessed for clinical laxity grade, range of motion, and functional outcomes using Lysholm and International Knee Documentation Committee (IKDC) scores. Twenty patients (16 male, 4 female) with a mean age of 30.7 (range: 16–52) and a mean follow-up of 52.2 months (range: 24–93 months) were included. Knee dislocation (KD) grades included: 4 KD-1, 10 KD 3-L, 5 KD-4, and 1 KD-5. No patients had isolated PLC injuries. Mean IKDC and Lysholm score were 73.1 ± 25.8 and 78 ± 26, respectively. Mean range of motion was –1.1 to 122.8. In full extension, two patients (10%) had grade 1 laxity to varus stress. In 30 degrees of knee flexion, five (25%) patients had grade 1 laxity, and two (10%) had grade 2 laxity. Anatomical two-tailed PLC reconstruction can reliably restore varus stability when performed on patients with MLKIs and type C posterolateral instability with hyperextension external rotation recurvatum deformity. Satisfactory functional outcome scores were achieved in the majority of patients. This study supports the use of an anatomical two-tailed PLC reconstruction in the multiligament injured knee. The level of evidence is IV, case series.
Prävention der Krankenhaus-erworbenen Anämie
Authors: Wolf Katrin
Published: February 2018

Mit der immer älter werdenden Bevölkerung steigt die Inzidenz behandlungspflichtiger Erkrankungen und
Operationen und damit das Risiko für perioperative Blutverluste mit irreversiblem Verlust von Erythrozyten und
erforderlichen Bluttransfusionen. Allein in deutschen Krankenhäusern lag die Zahl der chirurgischen Eingriffe
im Jahr 2016 bei 16,7 Millionen. Mehr als jeder 2. hospitalisierte Patient erleidet eine im Krankenhaus
erworbene Anämie aufgrund von Behandlungsprozessen, Blutverlusten im Verlauf von Laboruntersuchungen, okkulten
Blutungsquellen oder gestörter Erythropoese. Gegenmaßnahmen durch entsprechendes umfassendes Patient Blood
Management sind daher essenziell, um patienteneigene Blutressourcen unter Einsatz moderner Möglichkeiten,
Initiativen zur Prozessoptimierung und innovativer Konzepte so weit wie möglich zu schonen. Neben der
Reduktion des diagnostisch notwendigen Blutvolumens bieten die Implementierung von Gerinnungsalgorithmen
mithilfe von Gerinnungsfaktorkonzentraten und Antifibrinolytika wie Tranexamsäure und Point-of-care
Gerinnungsdiagnostik sowie das Auffangen, Reinigen und Wiederzuführen von Wundblut, die maschinelle
Autotransfusion (MAT), wertvolle Möglichkeiten, den Einsatz von allogenen Blutprodukten und damit von
allergischen, hämolytischen sowie nicht hämolytischen Nebenwirkungen so gering wie möglich zu halten.
Endoscopy assistants influence the quality of colonoscopy
Authors: Holme Øyvind , Pedersen Ina , Medhus Asle , Aabakken Lars , Glomsaker Tom , Kvamme Jan , Løberg Magnus , Bretthauer Michael , Seip Birgitte , Kjellevold Øystein , Jørgensen Anita , Furholm Siv , Hoff Geir , de Lange Thomas
Published: February 2018

Background Colonoscopy performance varies between endoscopists, but little is known about the impact of endoscopy assistants on key performance indicators. We used a large prospective colonoscopy quality database to perform an exploratory study to evaluate differences in selected quality indicators between endoscopy assistants.

Methods All colonoscopies reported to the Norwegian colonoscopy quality assurance register Gastronet can be used to trace individual endoscopy assistants. We analyzed key quality indicators (cecum intubation rate, polyp detection rate, colonoscopies rated as severely painful, colonoscopies with sedation or analgesia, and satisfaction with information) for colonoscopies performed between 1 January 2013 and 31 December 2014. Differences between individual assistants were analyzed by fitting multivariable logistic regression models, with the best performing assistant at each participating hospital as reference. All models were adjusted for the endoscopist.

Results 63 endoscopy assistants from 12 hospitals assisted in 15 365 colonoscopies. Compared with their top performing peers from the same hospital, one assistant was associated with cecum intubation failure, four with poor polyp detection, nine with painful colonoscopy, 16 with administration of sedation or analgesics during colonoscopy, and three with patient dissatisfaction about information given relating to the colonoscopy. The number of procedures during the study period or lifetime experience as an endoscopy assistant were not associated with any quality indicator.

Conclusion In this exploratory study, there was little variation on important colonoscopy quality indicators between endoscopy assistants. However, there were differences among assistants that may be clinically important. Endoscopy assistants should be subject to quality surveillance similarly to endoscopists.
How dependent are bell miners (Manorina melanophrys) on lantana (Lantana camara) as part of their habitat?
Authors: Lambert Kathryn T. A. , McDonald Paul G.
Published: February 2018

Context
The bell miner (Manorina melanophrys) is thought to prefer the dense vegetation of Lantana camara, a dominating noxious weed, to nest in compared with native plant communities in northern New South Wales and south-eastern Queensland. As miner numbers seemed to have increased with increased availability of nesting habitat, larger numbers of despotic bell miners territorially reduce native avian diversity. The resultant high insect numbers in the canopy lead to dieback. It is unknown to what extent the native bell miner relies on lantana for nesting sites and if restoration through removal of lantana, resulting in an influx of native species, changes food availability and thus foraging behaviours.

Aims
The objective of our study was to understand the relationship between the presence of lantana and bell miners by determining: (1) bell miner behaviours in response to different understorey types; (2) bell miner nesting choices on a broad scale; (3) nesting preference for each site on a broad scale; and (4) whether nest height is related to fledging success.

Methods
Fifty individual bell miners were observed within five colonies (four containing comparison quadrats of treated and intact lantana as part of a restoration study and one containing water vine for comparison as a pristine site; n=10 per treatment) during four seasons. Five bouts of gleaning, probing or sallying were observed, noting height and plant species. Nest sites were examined over a large area, noting plant species present, nest height and plant height.

Key results
Bell miners used gleaning as the primary foraging tactic primarily in eucalypts (93%; n=600, mean=13.6m±0.29, s.e.). Bell miners generally nested in understorey vegetation (83.5% of nests observed) at a mean height of 2.7m in 37 different plant species, native and exotic. Nest height did not influence the probability of broods fledging.

Conclusions
Bell miners exhibit considerable nest plasticity, and the removal of lantana as an oft-used nesting habitat is unlikely to lead to relocation by this species.

Implications
Instead, future research needs to focus on canopy insect assemblages in bell miner colonies, a potentially more important determinant of bell miner distribution.
P38 activation induces the dissociation of tristetraprolin from Argonaute 2 to increase ARE-mRNA stabilization
Authors: Qi Mei-Yan , Song Jing-Wen , Zhang Zhuo , Huang Shuang , Jing Qing
Published: February 2018

Tristetraprolin (TTP) destabilizes AU-rich element (ARE)-containing mRNA by directly binding with their 3′UTR. P38 stimulation substantially increases ARE-mRNA stability, at least through repressing TTP. However, the mechanism by which P38 keeps TTP inactive has not been fully understood. TTP and ARE-mRNA localize to processing bodies (PBs), the mRNA granules associated with mRNA silencing. Here, we detected the influence of P38 on TTP localization within PBs and found that P38 regulates TTP localization within PBs. Through luciferase-based systems, we demonstrated that PBs depletion significantly increased ARE-mRNA stability inhibited by TTP. Additionally, we provided evidence that the microRNA-induced silencing complex (miRISC) core member Ago2 is required for TTP distribution within PBs. Importantly, the cooperation of TTP and Ago2 is a prerequisite for effective ARE-mRNA degradation. Moreover, Dcp1a and Dcp2 act downstream of Ago2 and TTP engaging in ARE-mRNA decay. Finally, we demonstrated that P38 activation represses the interaction between TTP and Ago2 due to TTP phosphorylation, which impairs TTP localization within PBs and ARE-mRNA degradation. Collectively, our study revealed a novel mechanism through which P38 activation repressed the cooperation of TTP with Ago2, thus ensuring that ARE-mRNA does not associate with PBs and remains stable.
The synaptotagmin C2B domain calcium-binding loops modulate the rate of fusion pore expansion
Authors: Bendahmane Mounir , Bohannon Kevin P. , Bradberry Mazdak M. , Rao Tejeshwar C. , Schmidtke Michael W. , Abbineni Prabhodh S. , Chon Nara L. , Tran Sherleen , Lin Hai , Chapman Edwin R. , Knight Jefferson D. , Anantharam Arun
Published: February 2018

In chromaffin cells, the kinetics of fusion pore expansion vary depending on which synaptotagmin isoform (Syt-1 or Syt-7) drives release. Our recent studies have shown that fusion pores of granules harboring Syt-1 expand more rapidly than those harboring Syt-7. Here we sought to define the structural specificity of synaptotagmin action at the fusion pore by manipulating the Ca2+-binding C2B module. We generated a chimeric Syt-1 in which its C2B Ca2+-binding loops had been exchanged for those of Syt-7. Fusion pores of granules harboring a Syt-1 C2B chimera with all three Ca2+-binding loops of Syt-7 (Syt-1:7C2B123) exhibited slower rates of fusion pore expansion and neuropeptide cargo release relative to WT Syt-1. After fusion, this chimera also dispersed more slowly from fusion sites than WT protein. We speculate that the Syt-1:7 C2B123 and WT Syt-1 are likely to differ in their interactions with Ca2+ and membranes. Subsequent in vitro and in silico data demonstrated that the chimera exhibits a higher affinity for phospholipids than WT Syt-1. We conclude that the affinity of synaptotagmin for the plasma membrane, and the rate at which it releases the membrane, contribute in important ways to the rate of fusion pore expansion.
Global Existence for a System of Quasi-Linear Wave Equations in 3D Satisfying the Weak Null Condition
Authors: Hidano Kunio , Yokoyama Kazuyoshi
Published: February 2018

We show global existence of small solutions to the Cauchy problem for a system of quasi-linear wave equations in three space dimensions. The feature of the system lies in that it satisfies the weak null condition, though we permit the presence of some quadratic nonlinear terms which do not satisfy the null condition. Due to the presence of such quadratic terms, the standard argument no longer works for the proof of global existence. To get over this difficulty, we extend the ghost weight method of Alinhac so that it works for the system under consideration. The original theorem of Alinhac for the scalar unknowns is also refined.
Arthroscopic-assisted Tibiotalocalcaneal Intramedullary Nail Arthrodesis With Reamer-Irrigator-Aspirator Bone Grafting
Authors: Martin Kevin D. , Englert Cody R. , Unangst Alicia M.
Published: February 2018

Severe hindfoot arthritis often requires a multilevel fusion which can be performed with a variety of techniques. The operating surgeon must take several elements into account when choosing a surgical technique as patients requiring a hindfoot fusion has often had multiple surgeries or have compromised soft tissue envelopes. Regardless of the technique used, meticulous joint preparation is paramount and often compliments the means of internal fixation. Beyond joint preparation and internal fixation, the surgeon must also decide if bone grafting is necessary and if so how to obtain the sufficient amount. Given the aforementioned difficulties we propose an arthroscopic ankle and subtalar preparation utilizing a soft tissue noninvasive distraction technique followed by the use of a reamer-irrigator-aspirator system to provide autograft bone grafting followed by intramedullary nailing. This technique maximizes healing potential, minimizing soft tissue injury, and avoids a secondary bone graft harvest site while providing superior biomechanical properties.

Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
OUTCOME OF ENDOVASCULAR PROCEDURES ON OCULAR FINDINGS IN TAKAYASU ARTERITIS
Authors: Dogra Mohit , Kumar Ashok , Bajgai Priya , Gupta Vishali , Bansal Reema , Dogra Mangat R. , Vijayvergiya Rajesh , Singh Ramandeep
Published: February 2018

Purpose:

To evaluate the outcome of endovascular procedures on ocular findings in patients with Takayasu arteritis.

Methods:

Retrospective study of patients who underwent percutaneous endovascular stenting of aortic arch arteries for Takayasu arteritis (TA) and who had documented retinopathy findings before and after the procedure. Change in visual acuity, regression of retinopathy, and development of complications after endovascular procedure were studied over a follow-up of 6 months.

Results:

Ten eyes of five patients were included. Eyes which had Stage II or less of retinopathy before the endovascular procedure had favorable outcome; however, those with advanced stage of retinopathy at presentation had poor outcomes. Patients who underwent revascularization of both-sided arteries within 1 month had better anatomical and functional outcomes as compared with those who underwent sequential endovascular procedures on their arteries after a gap of 3 months or more.

Conclusion:

Percutaneous endovascular stenting of aortic arch arteries, affected in TA, can lead to reversal of retinopathy changes and restoration of vision if done before neovascular complications set in.
RETINAL MICROVASCULATURE ALTERATION IN PARACENTRAL ACUTE MIDDLE MACULOPATHY AND ACUTE MACULAR NEURORETINOPATHY: A QUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY STUDY
Authors: Kulikov Alexei N. , Maltsev Dmitrii S. , Leongardt Tatiana A.
Published: February 2018

Purpose:

To present a series of idiopathic paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) cases and to compare the microvascular retinal status of PAMM/AMN eyes with those of healthy individuals.

Methods:

Six eyes with PAMM and two eyes with AMN in a total of six patients were included in this study. Multimodal retinal imaging, including optical coherence tomography angiography, was performed in all patients. The vessel density of the superficial capillary plexus and deep capillary plexus, as well as the area, circularity, and angle of the superficial foveal avascular zone (FAZ) were measured and compared with the same parameters in age-matched healthy individuals.

Results:

The optical coherence tomography angiography showed a decreased vessel density of both superficial capillary plexus and deep capillary plexus in PAMM/AMN eyes versus control eyes (12.2 ± 0.74 vs. 14.0 ± 1.62 mm−1 [P = 0.01] in superficial capillary plexus and 18.5 ± 1.2 vs. 20.2 ± 1.0 mm−1 [P = 0.02] in deep capillary plexus). There was no statistically significant change in the FAZ area between PAMM/AMN and healthy eyes. However, FAZ circularity in PAMM/AMN eyes was statistically significantly lower compared with healthy eyes (0.64 ± 0.09 and 0.77 ± 0.07, respectively; P = 0.01). The angle of FAZ was statistically significantly higher in PAMM/AMN eyes compared with healthy eyes (27.6 ± 16.2 and 11.2 ± 5.5°, respectively; P = 0.005).

Conclusion:

Paracentral acute middle maculopathy and AMN eyes demonstrated not only an isolated alteration of deep retinal circulation but also general nonspecific changes in retinal microvasculature, including a decrease in the vessel density of the superficial capillary plexus and distortion of the FAZ.
HAND-HELD OPTICAL COHERENCE TOMOGRAPHY MONITORING OF CHEMORESISTANT RETINOBLASTOMA
Authors: Malik Kunal , Welch R. Joel , Shields Carol L.
Published: February 2018

Purpose:

Retinoblastoma (Rb) is a potentially fatal intraocular malignancy in children, and hand-held optical coherence tomography (HH-OCT) can assist in submillimeter detection and monitoring after treatment of Rb. Retinoblastoma located in the macula, or those with chemoresistance, can be among the most difficult to manage. We describe HH-OCT features in a case of chemoresistant macular Rb that eventually responded to plaque radiotherapy after failing intravenous chemotherapy and intraarterial chemotherapy.

Methods:

Observational case report.

Results:

A 15-month-old girl with leukocoria was found to have Group D Rb in the right eye of 6-mm thickness and macular Group B Rb in the left eye of 4-mm thickness. She was treated with 6-monthly cycles of systemic intravenous chemotherapy and focal consolidation therapies to both eyes, with tumor regression in both eyes. However, macular tumor in the left eye demonstrated subsequent recurrence, from regressed thickness of 792 μm on HH-OCT to a dome-shaped hyperreflective retinal mass of >2000 μm thickness. Three cycles of intraarterial chemotherapy were sufficient for tumor regression down to 977 μm thickness on HH-OCT. Six months later, macular tumor in the left eye recurred again to >2000 μm thickness and necessitated plaque radiotherapy using apex dose of 35 Gy over 95.25 hours. Hand-held OCT confirmed rapid tumor regression to 722 μm after plaque treatment and regression remained stable at 6-month follow-up.

Conclusion:

Hand-held OCT was critical in assessment of Rb after failed intravenous chemotherapy and intraarterial chemotherapy and later documenting regression after plaque radiotherapy. Hand-held OCT is vital in providing cross-sectional imaging and measurements of small macular and paramacular Rbs.
Relative Impact of Different Strategies for Allocating Federal Funds for Syphilis Prevention
Authors: Chesson Harrell W. , Owusu-Edusei Kwame
Published: February 2018

Background

Improvements in resource allocation can increase the benefits of federally funded sexually transmitted disease (STD) prevention activities. The purpose of this study was to illustrate how different strategies for allocating federal funds to subnational districts for syphilis prevention might affect the incidence of syphilis at the national level.

Methods

We modeled syphilis rates by district and year using an equation based on a previous analysis of state-level syphilis elimination funding and syphilis case rates from 1998 to 2005 in the United States. We used the model to illustrate the potential impact of 3 different strategies for allocating supplemental federal funds to subnational districts to support syphilis prevention activities a hypothetical country with 18 subnational districts. The 3 strategies were based on each district's (1) population size, (2) syphilis incidence rate, or (3) number of syphilis cases. The hypothetical country was similar to the United States in overall population and syphilis burden.

Results

Without the supplemental federal funds, there would be an estimated 48,600 incident infections annually in the hypothetical country. With the supplemental federal funds, the annual number of infections would be reduced to 27,800 with a population-based allocation of funding to each district, 26,700 with a rate-based allocation, and 24,400 with a case-based allocation of funding.

Conclusions

Allocating federal STD prevention funds to districts based on burden of disease can be an efficient strategy, although this efficiency may be reduced or eliminated when high-burden districts have less ability to provide adequate STD prevention services than lower-burden districts.
Multistate Syphilis Outbreak Among American Indians, 2013 to 2015
Authors: Bowen Virginia B. , Peterman Thomas A. , Calles Dinorah L. , Thompson Antoine R. , Kirkcaldy Robert D. , Taylor Melanie M.
Published: February 2018

This article summarizes a multistate outbreak of heterosexual syphilis, including 134 cases of syphilis in adults and adolescents and at least 2 cases of congenital syphilis, which occurred on an American Indian reservation in the United States during 2013–2015. In addition to providing salient details about the outbreak, the article seeks to document the case-finding and treatment activities undertaken, their relative success or failure, and the lessons learned from a coordinated, multiagency response. Of 134 adult cases of syphilis, 40% were identified by enhanced, interagency contact tracing and partner services, 26% through symptomatic testing, and 16% through screening of asymptomatic individuals as the result of an electronic medical record screening prompt. A smaller proportion of cases were identified by community screening events in high-morbidity communities; high-risk venue-based screening events; other screening, including screening upon request; and prenatal screening at first trimester, third trimester, and day of delivery. Future heterosexual syphilis outbreak responders should act quickly to coordinate a package of high-yield case-finding and treatment activities—potentially including activities that seek to do the following: (1) increase prenatal screening, (2) improve community awareness and symptomatic test seeking, (3) educate providers and improve general screening for syphilis, (4) implement electronic medical record reminders for providers, (5) screen high-morbidity communities and at high-risk venues, and (6) form novel partnerships to accomplish partner services work when the context does not allow for traditional, disease intervention specialist–only partner services.
Psychometric Properties of Korean Version of the Second Victim Experience and Support Tool (K-SVEST)
Authors: Kim Eun-Mi , Kim Sun-Aee , Lee Ju-Ry , Burlison Jonathan D. , Oh Eui Geum
Published: February 2018

Objectives

“Second victims” are defined as healthcare professionals whose wellness is influenced by adverse clinical events. The Second Victim Experience and Support Tool (SVEST) was used to measure the second-victim experience and quality of support resources. Although the reliability and validity of the original SVEST have been validated, those for the Korean tool have not been validated. The aim of the study was to evaluate the psychometric properties of the Korean version of the SVEST.

Methods

The study included 305 clinical nurses as participants. The SVEST was translated into Korean via back translation. Content validity was assessed by seven experts, and test-retest reliability was evaluated by 30 clinicians. Internal consistency and construct validity were assessed via confirmatory factor analysis. The analyses were performed using SPSS 23.0 and STATA 13.0 software.

Results

The content validity index value demonstrated validity; item- and scale-level content validity index values were both 0.95. Test-retest reliability and internal consistency reliability were satisfactory: the intraclass consistent coefficient was 0.71, and Cronbach α values ranged from 0.59 to 0.87. The CFA showed a significantly good fit for an eight-factor structure (χ2 = 578.21, df = 303, comparative fit index = 0.92, Tucker-Lewis index = 0.90, root mean square error of approximation = 0.05).

Conclusions

The K-SVEST demonstrated good psychometric properties and adequate validity and reliability. The results showed that the Korean version of SVEST demonstrated the extent of second victimhood and support resources in Korean healthcare workers and could aid in the development of support programs and evaluation of their effectiveness.
A novel rat model of extremity trauma for prehospital pain management research
Authors: Xiang Lusha , Klemcke Harold G. , Wienandt Nathan A. , Ryan Kathy L. , Hinojosa-Laborde Carmen
Published: February 2018

BACKGROUND

Pain management is important in prehospital care of patients with extremity trauma (ET). The goal of this study was to establish a rat model of ET for prehospital pain research and validate it using pain behaviors and analgesics.

METHODS

Rats were anesthetized using isoflurane, and ET was induced in one hindlimb via clamping retrofemoral tissues for 30 seconds, followed by closed fibula fracture. Rats regained consciousness after ET. Pain responses in the injured hindlimb to thermal hyperalgesia (paw withdrawal latency [PWL]), mechanical allodynia (paw withdrawal pressure [PWP]), and weight bearing (WB) were determined before and 90 minutes after ET. Morphine (2 mg/kg), fentanyl (10 μg/kg), sufentanil (1 μg/kg), ketamine (5 mg/kg), or vehicle (saline) were then administered via intravenous (i.v.) injection, followed by PWL, PWP, and WB assessments at 10 minutes, 40 minutes, 80 minutes, and 120 minutes after analgesia.

RESULTS

After ET, PWL, PWP, and WB were significantly decreased by 61 ± 4%, 64 ± 8%, and 65 ± 4%, respectively, compared with pre-ET values. These pain behaviors were maintained for 3 hours to 4 hours. Compared with the saline group, opioid analgesics significantly increased PWL for at least 80 minutes, with sufentanil exhibiting the highest analgesic effect. An increase in PWL was only observed at 10 minutes after ketamine. The PWP was transiently increased with opioid analgesics for 10 minutes to 40 minutes, but was not changed with ketamine. Weight bearing was improved with opioid analgesics for at least 2 hours, but only for up to 80 minutes with ketamine.

CONCLUSION

Our ET model includes long bone fracture and soft tissue injury, but no fixation surgery, mimicking prehospital ET. Our model produces acute, steady, and reproducible trauma-related pain behaviors, and is clinically relevant regarding the pain behaviors and established responses to common analgesics. This model of acute pain due to ET is ideal for prehospital pain management research.
Complications in tube thoracostomy: Systematic review and meta-analysis
Authors: Hernandez Matthew C. , El Khatib Moustafah , Prokop Larry , Zielinski Martin D. , Aho Johnathon M.
Published: February 2018

BACKGROUND

Tube thoracostomy (TT) complications and their reported rates are highly variable (1–40%) and inconsistently classified. Consistent TT complication classification must be applied to compare reported literature to standardize TT placement. We aim to determine the overall TT-related complication rates in patients receiving TT for traumatic indications using uniform definitions.

METHODS

Systematic review and meta-analysis was performed assessing TT-related complications. Comprehensive search of several databases (1975–2015) was conducted. We included studies that reported on bedside TT insertion (≥22 Fr) in trauma patients. Data were abstracted from eligible articles by independent reviewers with discrepancies reconciled by a third. Analyses were based on complication category subtypes: insertional, positional, removal, infection/immunologic/education, and malfunction.

RESULTS

Database search resulted in 478 studies; after applying criteria 29 studies were analyzed representing 4,981 TTs. Injury mechanisms included blunt 60% (49–71), stab 27% (17–34), and gunshot 13% (7.8–10). Overall, median complication rate was 19% (95% confidence interval, 14–24.3). Complication subtypes included insertional (15.3%), positional (53.1%), removal (16.2%), infection/immunologic (14.8%), and malfunction (0.6%). Complication rates did not change significantly over time for insertional, immunologic, or removal p = 0.8. Over time, there was a decrease in infectious TT-related complications as well as an increase in positional TT complications.

CONCLUSION

Generation of evidence-based approaches to improve TT insertion outcomes is difficult because a variety of complication classifications has been used. This meta-analysis of complications after TT insertion in trauma patients suggests that complications have not changed over time remaining stable at 19% over the past three decades.

LEVEL OF EVIDENCE

Systematic review and meta-analysis, level III.
Universal screening for intimate partner and sexual violence in trauma patients—What about the men? An Eastern Association for the Surgery of Trauma Multicenter Trial
Authors: Zakrison Tanya L. , Rattan Rishi , Milian Valdés Davel , Ruiz Xiomara , Gelbard Rondi , Cline John , Turay David , Luo-Owen Xian , Namias Nicholas , George Jessica , Yeh Dante , Pust Daniel , Williams Brian H.
Published: February 2018

BACKGROUND

A recent Eastern Association for the Surgery of Trauma–supported multicenter trial demonstrated a similar rate of intimate partner and sexual violence (IPSV) between male and female trauma patients, regardless of mechanism. Our objective was to perform a subgroup analysis of our affected male cohort because this remains an understudied group in the trauma literature.

METHODS

We conducted a recent Eastern Association for the Surgery of Trauma-supported, cross-sectional, multicenter trial over one year (March 2015 to April 2016) involving four Level I trauma centers throughout the United States. We performed universal screening of adult trauma patients using the validated Hurt, Insult, Threaten, Scream and sexual violence screening surveys. Risk factors for male patients were identified. χ2 Test compared categorical variables with significance at p values less than 0.05. Parametric data are presented as mean ± standard deviation.

RESULTS

A total of 2,034 trauma patients were screened, of which 1,281 (63%) were men. Of this cohort, 119 (9.3%) men screened positive for intimate partner violence, 14.1% for IPSV, and 6.5% for sexual violence. On categorical analysis of the Hurt, Insult, Threaten, Scream screen, the proportion of men that were physically hurt was 4.8% compared to 4.3% for women (p = 0.896). A total of 4.8% of men screened positive for both IPSV. The total proportion of men who presented with any history of intimate partner violence, sexual violence, or both (IPSV) was 15.8%. More men affected by penetrating trauma screened positive for IPSV (p < 0.00001). The IPSV positivity in men was associated with mental illness, substance abuse, and trauma recidivism.

CONCLUSION

One of every 20 men that present to trauma centers is a survivor of both IPSV, with one of every six men experiencing some form of violence. Men are at similar risk for physical abuse as women when this intimate partner violence occurs. The IPSV is associated with penetrating trauma in men. Support programs for this population may potentially impact associated mental illness, substance abuse, trauma recidivism, and even societal-level violence.

LEVEL OF EVIDENCE

Epidemiological study, level II.
Past and present role of extracorporeal membrane oxygenation in combat casualty care: How far will we go?
Authors: Cannon Jeremy W. , Mason Phillip E. , Batchinsky Andriy I.
Published: February 2018

Advanced extracorporeal therapies have been successfully applied in the austere environment of combat casualty care over the previous decade. In this review, we describe the historic underpinnings of extracorporeal membrane oxygenation, review the recent experience with both partial and full lung support during combat operations, and critically assess both the current status of the Department of Defense extracorporeal membrane oxygenation program and the way forward to establish long-range lung rescue therapy as a routine capability for combat casualty care.
Working dogs transfer different tasks in reciprocal cooperation
Authors: Gfrerer Nastassja , Taborsky Michael
Published: February 2018

Direct reciprocity can establish stable cooperation among unrelated individuals. It is a common assumption of direct reciprocity models that agents exchange like with like, but this is not necessarily true for natural interactions. It is yet unclear whether animals apply direct reciprocity rules when successive altruistic help involves different tasks. Here, we tested whether working dogs transfer help from one to another cooperative task in an iterated prisoner's dilemma paradigm. In our experiment, individual dogs received help to obtain food from a conspecific, which involved a specific task. Subsequently, the focal subject could return received favour by using a different task. Working dogs transferred the cooperative experience received through one task by applying an alternative task when they helped a previously cooperative partner. By contrast, they refrained from helping previously defecting partners. This suggests that dogs realize the cooperative act of a conspecific, which changes their propensity to provide help to that partner by different means. The ability of animals to transfer different tasks when helping a social partner by satisfying the criteria of direct reciprocity might explain the frequent occurrence of reciprocal cooperation in nature.
Generational shift in spring staging site use by a long-distance migratory bird
Authors: Verhoeven Mo A. , Loonstra A. H. Jelle , Hooijmeijer Jos C. E. W. , Masero Jose A. , Piersma Theunis , Senner Nathan R.
Published: February 2018

In response to environmental change, species have been observed altering their migratory behaviours. Few studies, however, have been able to determine whether these alterations resulted from inherited, plastic or flexible changes. Here, we present a unique observation of a rapid population-level shift in migratory routes—over 300 km from Spain to Portugal—by continental black-tailed godwits
Limosa limosa limosa
. This shift did not result from adult godwits changing staging sites, as adult site use was highly consistent. Rather, the shift resulted from young godwits predominantly using Portugal over Spain. We found no differences in reproductive success or survival among individuals using either staging site, indicating that the shift resulted from developmental plasticity rather than natural selection. Our results therefore suggest that new migratory routes can develop within a generation and that young individuals may be the agents of such rapid changes.
The extra burden of motherhood: reduced dive duration associated with pregnancy status in a deep-diving mammal, the northern elephant seal
Authors: Hückstädt Luis A. , Holser Rachel R. , Tift Michael S. , Costa Daniel P.
Published: February 2018

The cost of pregnancy is hard to study in marine mammals, particularly in species that undergo pregnancy while diving continuously at sea such as elephant seals (genus
Mirounga
). We analysed the diving behaviour of confirmed pregnant and non-pregnant northern elephant seals (
M. angustirostris
,
n
= 172) and showed that after an initial continuous increase in dive duration, dives of pregnant females become shorter after week 17. The reasons for this reduction in dive duration remain unknown, but we hypothesize that increased fetal demand for oxygen could be the cause. Our findings reveal an opportunity to explore the use of biologging data to investigate pregnancy status of free-ranging marine mammals and factors that could affect pregnancy success.