bluuebunny/crossref_metadata_2025 huggingface dataset:
The Pleurobemini (Bivalvia : Unionida) revisited: molecular species delineation using a mitochondrial DNA gene reveals multiple conspecifics and undescribed species
Authors: Inoue Kentaro , Hayes David M. , Harris John L. , Johnson Nathan A. , Morrison Cheryl L. , Eackles Michael S. , King Tim L. , Jones Jess W. , Hallerman Eric M. , Christian Alan D. , Randklev Charles R.
Published: June 2018

The Pleurobemini (Bivalvia: Unionida) represent approximately one-third of freshwater mussel diversity in North America. Species identification within this group is challenging due to morphological convergence and phenotypic plasticity. Accurate species identification, including characterisation of currently unrecognised taxa, is required to develop effective conservation strategies because many species in the group are imperiled. We examined 575 cox1 sequences from 110 currently recognised species (including 13 Fusconaia and 21 Pleurobema species) to understand phylogenetic relationships among pleurobemine species (mainly Fusconaia and Pleurobema) and to delineate species boundaries. The results of phylogenetic analyses showed no geographic structure within widespread species and illustrated a close relationship between Elliptio lanceolata and Parvaspina collina. Constraint tests supported monophyly of the genera Fusconaia and Pleurobema, including the subgenus P. (Sintoxia). Furthermore, results revealed multiple conspecifics, including P. hanleyianum and P. troschelianum, P. chattanoogaense and P. decisum, P. clava and P. oviforme, P. rubrum and P. sintoxia, F. askewi and F. lananensis, and F. cerina and F. flava. Species delimitation analyses identified three currently unrecognised taxa (two in Fusconaia and one in Pleurobema). Further investigation using additional genetic markers and other lines of evidence (e.g. morphology, life history, ecology) are necessary before any taxonomic changes are formalised.
Fragile X-related protein 1 (FXR1) regulates cyclooxygenase-2 (COX-2) expression at the maternal–fetal interface
Authors: Li Xiao-Cui , Song Meng-fan , Sun Feng , Tian Fu-Ju , Wang Yu-mei , Wang Bei-ying , Chen Jin-Hong
Published: June 2018

Cyclooxygenase-2 (COX-2) is regulated post-transcriptionally by the AU-rich element (ARE) in the 3′-untranslated region (UTR) of its mRNA. However, the mechanism of COX-2 induction in infertility has not been thoroughly elucidated to date. The aim of this study was to examine the association between COX-2 and fragile X-related protein 1 (FXR1) in trophoblasts. Using quantitative reverse transcription polymerase chain reaction, our results showed that FXR1 mRNA expression levels were significantly decreased in trophoblasts from recurrent miscarriage patients compared with healthy controls; conversely, COX-2 mRNA expression levels were increased in patient samples. We also observed that FXR1 was highly expressed in human placental villi during early pregnancy. Furthermore, we used western blotting and immunofluorescence to analyse the expression levels of FXR1 and COX-2 in HTR-8 cells that were treated with tumour necrosis factor α; we observed that the expression of COX-2 was clearly increased in HTR-8 cells treated with FXR1 small interfering RNA, whereas the expression of COX-2 was effectively decreased in HTR-8 cells with FXR1 overexpressed via a plasmid. Importantly, bioinformatics analysis identified FXR1 binding sites in the 3′-UTR region of COX-2 and firefly luciferase reporter assay analysis verified that FXR1 binds directly to the 3′-UTR region of COX-2. ELISA assays showed that overexpression of FXR1 enhanced vascular endothelial growth factor-A and interleukin-8 expression in HTR-8 cells, whereas conversely, knockdown of FXR1 effectively repressed these effects. In conclusion, the results of this study indicate that FXR1 is a novel COX-2 regulatory factor.
Understanding Turkish water nationalism and its role in the historical hydraulic development of Turkey
Authors: Conker Ahmet
Published: June 2018

Turkey is fully engaged in its “hydraulic mission,” very extensively and rapidly “developing” water resources throughout its territory. The extensive hydraulic development attempts conducted by the Turkish government create local, national, inter-state, and transnational contestations among the different interest groups. A great deal of scholarly literature has analyzed the rationale behind Turkey's massive-scale hydraulic development. While some studies link Turkey's hydraulic mission to its energy and food security, others highlight the importance of domestic conflicts, as in the case of the Kurdish issue in the southeast. However, few works examine the relationship between hydraulic development and state- and nation-making processes in the early period of the republic. This paper seeks to analyze the role of hydraulic development in state- and nation-making in the context of Turkey by looking at the institutional documents published by official authorities and speeches made by key politicians. Drawing mainly upon the theory of water nationalism and its related conceptual frameworks, this study argues that hydraulic development has formed one of the important components of the modernization process in Turkey, thereby playing a significant role in its state- and nation-making processes.
A randomized clinical trial of the effectiveness of 0.018-inch and 0.022-inch slot orthodontic bracket systems: part 2—quality of treatment
Authors: Yassir Yassir A , El-Angbawi Ahmed M , McIntyre Grant T , Revie Gavin F , Bearn David R
Published: June 2018

Objective

To compare the quality of orthodontic treatment between 0.018-inch and 0.022-inch slot bracket systems.

Subjects and methods

Eligible participants aged 12 years or over were allocated to the 0.018-inch or 0.022-inch slot MBT appliance (3M-Unitek, Monrovia, California, USA) using block randomization in groups of 10. Outcome measures included: 1. ABO cast-radiograph evaluation (CR-EVAL), 2. peer assessment rating (PAR) scores, 3. incisor inclination, and 4. patient perception using the Index of Orthodontic Treatment Need aesthetic component (IOTN AC) and three validated questionnaires before, during and after treatment. Parametric tests [independent samples t-test and two-way analysis of variance (ANOVA)] and non-parametric tests (chi-square with Fisher’s exact tests and Mann–Whitney U-test) assessed differences between groups (P < 0.05).

Results

Of the 187 participants randomized (1:1 ratio), 34 withdrew or were excluded (protocol deviations or poor cooperation). There were 77 patients in the 0.018-inch slot group and 76 patients in the 0.022-inch slot group (overall mean age: 19.1 years). Baseline characteristics were similar between groups (P > 0.05). The mean total ABO CR-EVAL scores were 34.7 and 34.5; mean percentage PAR score reduction 74.1 per cent and 77.1 per cent; mean change for maxillary incisor inclination 2.9 degrees and 1.6 degrees and for mandibular incisor inclination 2.7 degrees and 1.4 degrees for the 0.018-inch and 0.022-inch groups, respectively. Improvement in patient perception of aesthetics after treatment was statistically significant for both groups (P < 0.05). However, there were no statistically significant differences between the two treatment groups for ABO CR-EVAL, percentage PAR score reduction, incisor inclination, and patient perception of treatment (P > 0.05). No adverse events were observed during treatment.

Limitations

It was impossible to blind clinicians or patients to allocation and oral hygiene and periodontal outcomes were not assessed.

Conclusions

There were no statistically or clinically significant differences in the quality of occlusal outcomes, incisor inclination and patient perception of treatment between 0.018-inch and 0.022-inch slot bracket systems.

Registration

The trial was registered with ClinicalTrials.gov on 5 March 2014, registration number: NCT02080338.

Protocol

The protocol was published at DOI: 10.1186/1745-6215-15-389.
Assessing the impact of health system organizational structure on hospital electronic data sharing
Authors: Holmgren A Jay , Ford Eric W
Published: June 2018

Objective

Horizontal consolidation in the hospital industry has gained momentum in the United States despite concerns over rising costs and lower quality. Hospital systems frequently point to potential gains in interoperability and electronic exchange of patient information as consolidation benefits. We sought to assess whether hospitals in different health system structures varied in their interoperable data sharing.

Materials and methods

We created a cross-sectional national hospital sample from the 2014 AHA Annual Survey and 2015 IT Supplement. We combined the existing taxonomy of health system organizational forms and the ONC’s functionality-based, technology-agnostic definition of interoperability. We used logistic regression models to assess the relationship between health systems’ organizational forms and interoperability engagement, controlling for hospital characteristics.

Results

We found that interoperability engagement varied greatly across hospitals in different health system structures, with facilities in more centralized health systems more likely to be interoperable. Hospitals in one system type, featuring centralized insurance product development but diverse service offerings across member organizations, had significantly higher odds of being engaged in interoperable data sharing in our multivariate regression results.

Discussion

The heterogeneity in health system interoperability engagement indicates that incentives to share data vary greatly across organizational strategies and structures. Our results suggest that horizontal consolidation in the hospital industry may not bring significant gains in interoperability progress unless that consolidation takes a specific business alignment form.

Conclusion

Policymakers should be wary of claims that horizontal consolidation will lead to interoperability gains. Future research should explore the specific mechanisms that lead to greater interoperability in certain health system organizational structures.
Muscle RING-finger protein-1 (MuRF1) functions and cellular localization are regulated by SUMO1 post-translational modification
Authors: Heras Gabriel , Namuduri Arvind Venkat , Traini Leonardo , Shevchenko Ganna , Falk Alexander , Bergström Lind Sara , Jia Mi , Tian Geng , Gastaldello Stefano
Published: June 2018

The muscle RING-finger protein-1 (MuRF1) is an E3 ubiquitin ligase expressed in skeletal and cardiac muscle tissues and it plays important roles in muscle remodeling. Upregulation of MuRF1 gene transcription participates in skeletal muscle atrophy, on contrary downregulation of protein expression leads to cardiac hypertrophy. MuRF1 gene point mutations have been found to generate protein aggregate myopathies defined as muscle disorder characterized by protein accumulation in muscle fibers. We have discovered that MuRF1 turned out to be also a target for a new post-translational modification arbitrated by conjugation of SUMO1 and it is mediated by the SUMO ligases E2 UBC9 and the E3 PIASγ/4. SUMOylation takes place at lysine 238 localized at the second coiled-coil protein domain that is required for efficient substrate interaction for polyubiquitination. We provided evidence that SUMOylation is essential for MuRF1 nuclear translocation and its mitochondria accumulation is enhanced in hyperglycemic conditions delivering a stabilization of the overall SUMOylated proteins in cultured myocytes. Thus, our findings add this SUMO1 post-translational modification as a new concept to understand muscle disorders related to the defect in MuRF1 activity.
Metal pollution of low-mass Population III stars through accretion of interstellar objects like ‘Oumuamua
Authors: Tanikawa Ataru , Suzuki Takeru K , Doi Yasuo
Published: June 2018

We calculate the accretion mass of interstellar objects (ISOs) like ‘Oumuamua on to low-mass Population III stars (Pop. III survivors), and estimate the surface pollution of Pop. III survivors. The ISO number density estimated from the discovery of ‘Oumuamua is so high (∼0.2 au−3) that Pop. III survivors have chances of colliding with ISOs ≳ 105 times per 1 Gyr. ‘Oumuamua itself would be sublimated near Pop. III survivors, since its size is small; ∼100 m. However, ISOs with size ≳3 km would reach the Pop. III survivor surfaces. Supposing an ISO cumulative number density with size larger than D is n∝D−α, Pop. III survivors can accrete ISO mass ≳10−16 M⊙, or ISO iron mass ≳10−17 M⊙, if α < 4. This iron mass is larger than the accretion mass of interstellar medium (ISM) by several orders of magnitude. Taking into account material mixing in the convection zone of Pop. III survivors, we find that their surface pollution is typically [Fe/H] ≲ −8 in most cases; however, the surface pollution of Pop. III survivors with 0.8 M⊙ can be [Fe/H] ≳ −6 because of the very shallow convective layer. If we consider Pop. III survivors located at the Galactocentric distance of 8 kpc, the dependence of the metal pollution is as follows. If α > 4, Pop. III survivors have no chance at colliding with ISOs with D ≳ 3 km, and remain metal-free. If 3 < α < 4, Pop. III survivors would be most polluted by ISOs up to [Fe/H] ∼ −7. If α < 3 up to D ∼ 10 km, Pop. III survivors could hide in metal-poor stars so far discovered. Pop. III survivors would be more polluted with decreasing Galactocentric distance. Although the metal pollution depends on α and the Galactocentric distance, we first show the importance of ISOs for the metal pollution of Pop. III survivors.
Patient-reported Allergies are Associated With Preoperative Psychological Distress and Less Satisfying Patient Experience in a Lumbar Spine Surgery Population
Authors: Levin Jay M. , Boyle Spencer , Winkelman Robert D. , Tanenbaum Joseph E. , Abdullah Kalil G. , Steinmetz Michael P. , Mroz Thomas E.
Published: June 2018

Study Design:

This was a retrospective cohort study.

Objective:

The main objectives of this study were: (1) to determine whether patient-reported allergies (PRAs) are associated with patient satisfaction scores, and (2) to clarify the association between PRAs and preoperative anxiety and depression in a lumbar spine surgery population.

Summary of Background Data:

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is currently used to measure the patient experience and there is concern that psychosocial factors are unaccounted for. Interestingly, PRAs have been linked to concurrent mood and other psychiatric disorders, as well as poor clinical outcomes in the orthopedic surgery setting.

Methods:

HCAHPS survey data, patient demographics, surgical characteristics, and preoperative health status were obtained for each patient. Allergies were categorized as medical (ie, medications) and environmental (ie, food, animals). Univariable and multivariable logistic regression models were used to determine whether the number of medical and environmental PRAs are associated with HCAHPS scores. In addition, multivariable logistic regression was used to analyze the association between PRAs and psychological distress.

Results:

In 421 patients included, PRAs were associated with lower HCAHPS scores under several dimensions of the patient experience of care, including: nursing communication, pain management, communication about medicines, and transition of care. Medical PRAs was an independent predictor of low satisfaction with communication about a medication’s side effects [odds ratio (OR), 0.88; P=0.03] and understanding the purpose for new medications (OR, 0.90; P=0.03). Environmental PRAs was an independent predictor of low satisfaction with both communication about a medication’s side effects (OR, 0.68; P=0.03), and pain control (OR, 0.67; P=0.01). Moreover, having a PRA (OR, 1.64; P=0.04) was associated with EuroQol-5 Dimensions anxiety/depression and having an environmental PRA (OR, 2.13; P=0.03) was associated with depression.

Conclusions:

These findings highlight the potential utility of PRAs to help identify patients with psychological distress who are at risk for a poor experience of lumbar spine surgery.
A Journey with Amyotrophic Lateral Sclerosis
Authors: Jeffery Deborah , Fish Anne F.
Published: June 2018

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Motor neurons are affected in certain patterns, such as cervical, thoracic, lumbar, and bulbar (facial) regions. Although initial presentations can vary, eventually upper and lower motor neurons are lost in the two types of ALS: familial and sporadic. A case study highlighting the reality of living with bulbar ALS relays Sister A's journey from early to late ALS. Etiology, pathophysiology, diagnosis, treatment, and clinical care are discussed.
Staying Faithful to Your Faith
Authors: Kroning Maureen
Published: June 2018

The author describes how treatment for a transgender patient was complicated, due to the healthcare facility's lack of staff training. After an education program was implemented, the author wrote an article about the need for training for LGBT care, then faced a quandary about submitting the article to a Christian or secular nursing journal. Through her college administrator's support, the author's commitment to living her faith in every arena was strengthened.
Population of Patients With Traumatic Brain Injury in Skilled Nursing Facilities:
Authors: Lueckel Stephanie N. , Teno Joan M. , Stephen Andrew H. , Benoit Eric , Kheirbek Tareq , Adams Charles A. , Cioffi William G. , Thomas Kali S.
Published: June 2018

Objective:

To describe the natural history of patients with traumatic brain injury (TBI) admitted to skilled nursing facilities (SNFs) following hospitalizations.

Setting:

Between 2005 and 2014.

Participants:

Adults who had incident admissions to skilled nursing facilities (SNFs) with a diagnosis of TBI.

Design:

Retrospective review of the Minimum Data Set.

Main Measures:

Main variables were cognitive and physical function, length of stay, presence of feeding tube, terminal condition, and dementia.

Results:

Incident admissions to SNFs increased annually from 17 247 patients to 20 787 from 2005 to 2014. The percentage of patients with activities of daily living score 23 or more decreased from 25% to 14% (P < .05). The overall percentage of patients with severe cognitive impairment decreased from 18% to 10% (P < .05). More patients had a diagnosis of dementia in 2014 compared with previous years (P < .05), and the presence of a terminal condition increased from 1% to 1.5% over the 10-year period (P < .05). The percentage of patients who stayed fewer than 30 days was noted to increase steadily over the 10 years, starting with 48% in 2005 and ending with 53% in 2013 (P < .05).

Conclusion:

Understanding past trends in TBI admissions to SNFs is necessary to guide appropriate discharge and predict future demand, as well as inform SNF policy and practice necessary to care for this subgroup of patients.
The Utility of the Mayo-Portland Adaptability Inventory Participation Index (M2PI) in US Military Veterans With a History of Mild Traumatic Brain Injury
Authors: O'Rourke Justin , Critchfield Edan , Soble Jason , Bain Kathleen , Fullen Chrystal , Eapen Blessen
Published: June 2018

Objective:

To examine the utility of the Mayo-Portland Adaptability Inventory–4th Edition Participation Index (M2PI) as a self-report measure of functional outcome following mild traumatic brain injury (mTBI) in US Military veterans.

Setting:

Department of Veterans Affairs Polytrauma Rehabilitation Center specialty hospital.

Participants:

On hundred thirty-nine veterans with a history of self-reported mTBI.

Design:

Retrospective cross-sectional examination of data collected from regular clinical visits.

Main Measures:

M2PI, Neurobehavioral Symptoms Inventory with embedded validity measures, Posttraumatic Stress Disorder Checklist–Military Version.

Results:

Forty-one percent of the sample provided symptom reports that exceeded established cut scores on embedded symptom validity tests. Invalid responders had higher levels of unemployment and endorsed significantly greater functional impairment, posttraumatic stress symptoms, and postconcussive complaints. For valid responders, regression analyses revealed that self-reported functioning was primarily related to posttraumatic stress complaints, followed by postconcussive cognitive complaints. For invalid responders, posttraumatic stress complaints also predicted self-reported functioning.

Conclusion:

Caution is recommended when utilizing the M2PI to measure functional outcome following mTBI in military veterans, particularly in the absence of symptom validity tests.
FOCAL DISRUPTIONS IN ELLIPSOID ZONE AND INTERDIGITATION ZONE ON SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN PACHYCHOROID PIGMENT EPITHELIOPATHY
Authors: Lee Jae Hyung , Kim Jun Yong , Jung Byung Ju , Lee Won Ki
Published: June 2018

Purpose:

To describe a distinctive focal disruption of the ellipsoid zone (EZ)/interdigitation zone (IZ) determined by spectral-domain optical coherence tomography in eyes with pachychoroid pigment epitheliopathy.

Methods:

Twenty patients with focal EZ/IZ disruptions associated with pachychoroid without history or findings indicative of subretinal fluid were evaluated. Detailed clinical/imaging characteristics and their longitudinal changes were evaluated.

Results:

A total of 27 lesions from 21 eyes were included. The mean subfoveal choroidal thickness was 450 μm. In six of seven eyes with previous imaging data to compare, characteristic drusenoid lesions associated with thick choroid preceded focal EZ/IZ disruptions at the corresponding sites. Dilated outer choroidal vessels were noted beneath the focal EZ/IZ disruption in 24 lesions (88.9%), with attenuation of choriocapillaris in 18 lesions (66.7%). The external limiting membrane was intact in all lesions. All except three eyes did not show morphologic changes, and mean visual acuity was maintained (Snellen equivalent, 20/25) during a mean follow-up period of 20 months.

Conclusion:

Focal disruptions of the EZ/IZ band can develop in pachychoroid eyes in the absence of subretinal fluid, with a stable clinical course, and possibly as a result of regression of drusenoid lesions. This may represent an atrophic form of pachychoroid manifestation.
Changes in the ABCD Keratoconus Grade After Intracorneal Ring Segment Implantation
Authors: Sedaghat Mohammad-Reza , Momeni-Moghaddam Hamed , Belin Michael W. , Zarei-Ghanavati Siamak , Akbarzadeh Reyhaneh , Sabzi Fatemeh , Yekta Abbas-Ali , Sadeghi Allahabadi Javad
Published: June 2018

Purpose:

To assess the changes in the ABCD keratoconus staging system 6 months after intracorneal ring segment implantation.

Methods:

Fifty eyes of 50 patients with keratoconus who were implanted with the Keraring (Mediphacos, Belo Horizonte, Brazil) using the femtosecond laser were assessed. Preoperative and postoperative assessments included determination of distance uncorrected visual acuity and distance corrected visual acuity (DCVA), refraction, and Scheimpflug tomography with the Pentacam HR. In the ABCD keratoconus staging system, the elements A, B, C, and D stand for anterior and posterior radii of curvature in a 3.0-mm zone centered on the thinnest point (TP), corneal thickness at the TP, and DCVA, respectively.

Results:

Keraring implantation produced significant flattening changes (preoperatively vs. postoperatively) in the anterior (6.60 ± 0.48 vs. 7.22 ± 0.57 mm, P < 0.001) and posterior (4.99 ± 0.47 vs. 5.16 ± 0.53 mm, P = 0.002) radii of curvature of the 3-mm zone centered on the corneal TP associated with a statistically significant improvement in the DCVA (0.56 ± 0.24 vs. 0.70 ± 0.22 in the decimal notation, P = 0.001) with no significant change in the corneal thickness at the TP (P = 0.285). The most changes occurred in element A of the ABCD keratoconus classification. Also, a 1-stage change was observed for element B, whereas elements C and D did not show changes in their postoperative stages after ring implantation. ABCD keratoconus staging before ring implantation was A2B3C2D1 and changed to A1B2C2D1 6 months after surgery.

Conclusions:

The ABCD staging system provides a more comprehensive guide that better illustrates the structural changes and visual acuity as one aspect of visual function after the implantation of the intrastromal corneal ring segments.
Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support: An In Vivo Study
Authors: Saeed Omar , Rangasamy Sabarivinoth , Reyes Gil Morayma , Goldstein Daniel J. , Billett Henny H. , Jorde Ulrich P. , Patel Snehal R.
Published: June 2018

Acquired von Willebrand Syndrome (AVWS) in patients undergoing continuous-flow left ventricular assist device support is due to the loss of von Willebrand factor (vWF) high molecular weight multimers (HMWMs) by shear-mediated mechanisms. We investigated whether reducing speed in vivo would mitigate the shear effect. In outpatients (n = 6) with a HeartMate II, pump speed was decreased to 8,000 rpm for 6 hours. At baseline (9,140 ± 189 rpm), patients had an AVWS as evidenced by low vWF activity:antigen ratios (0.58 ± 0.13, normal >0.7) and reduced HMWMs. After 6 hours, there was no significant change in either the vWF activity:antigen ratio or the HMWMs. Decreasing pump speed does not ameliorate AVWS.
Medical Therapy As Compared To Surgical Device Exchange for Left Ventricular Assist Device Thrombosis: A Systematic Review and Meta-Analysis
Authors: Luc Jessica G.Y. , Tchantchaleishvili Vakhtang , Phan Kevin , Dunlay Shannon M. , Maltais Simon , Stulak John M.
Published: June 2018

Pump thrombosis is a major adverse event in patients supported on continuous-flow left ventricular assist devices (CF-LVAD). The aim of this systematic review and meta-analysis was to determine the outcomes of various treatment approaches for pump thrombosis, including surgical as compared to medical therapy. Electronic search was performed to identify all studies in the English literature addressing surgical and medical management of pump thrombosis in the modern CF-LVAD era. All identified articles were systematically assessed for inclusion and exclusion criteria. In the meta-analysis, because of significant overlap of the data, reports based on trials, registries, and individual cohort studies were analyzed separately. Forty-three studies were included in the analysis (2 trials, 4 registry reports, and 37 individual cohort studies). 2,281/28,728 (10.6%) patients developed pump thrombosis, of which 44.4% and 55.1% were supported on the HeartWare and HeartMate II, respectively. To avoid overlap in studies and to seek more granular data, pooled individual cohort studies were found to be representative of the entire population, and further in-depth analysis of this category was performed. Of the 610/5,545 (11.8%) patients with pump thrombosis in these individual cohort studies, 225 patients had surgical pump exchange, and 186 were treated medically. Surgical therapy resulted in higher success as compared to medical therapy (81.3% vs. 45.4%; p < 0.001), lower 30 day mortality rate (16.7% vs. 34.5%; p = 0.013) and recurrence rate (11.8% vs. 38.3%; p < 0.001). Meta-regression of all studies demonstrates a possible temporal increase of pump thrombosis rate (p = 0.040). Surgical pump exchange is superior to medical therapy with a higher success rate of pump thrombosis resolution, lower mortality rate, and lower recurrence rate. Randomized controlled prospective studies are needed to compare these clinical approaches and their resultant outcomes to guide decision-making for the management of CF-LVAD thrombosis.
Prospective Changes in Vestibular and Ocular Motor Impairment After Concussion
Authors: Elbin R. J. , Sufrinko Alicia , Anderson Morgan N. , Mohler Samantha , Schatz Philip , Covassin Tracey , Mucha Anne , Collins Michael W. , Kontos Anthony P.
Published: June 2018

Background and Purpose:

The utility of prospective changes on the Vestibular/Ocular Motor Screening (VOMS) assessment are unknown, and 2 methods of scoring are published in the literature. Total scores are the total symptom scores for each VOMS component, and change scores are the difference between the pretest total symptom score and component total symptom scores. This study documented prospective changes in vestibular and ocular motor impairments and symptoms in high school athletes with concussion using the total and change scoring methods and compared the percentage of scores over clinical cutoffs using the total and change scoring methods for the VOMS.

Methods:

Sixty-three athletes (15.53 ± 1.06 years) completed the VOMS at baseline (ie, preinjury), 1 to 7 days, and 8 to 14 days after concussion. A series of repeated-measures multivariate analyses of variance were conducted on total and change scores. A 2-way repeated-measures analysis of variance was performed on the near-point convergence distance. A series of χ2 analyses compared scores exceeding clinical cutoffs between the total and change scoring methods.

Results:

Total scoring revealed impairments (Wilks λ = 0.39, F
16,47 = 4.54, P < 0.001, η2 = 0.61) on all VOMS components at 1 to 7 and 8 to 14 days compared to baseline. Change scoring revealed postinjury impairments compared with baseline (Wilks λ = 0.58, F
14,49 = 2.52, P = 0.009, η2 = 0.42) on all components at 1 to 7 days; however, impairments at 8 to 14 days were revealed only for the vertical vestibular oculomotor reflex and vestibular motor sensitivity components. Total scoring identified significantly more scores over cutoffs at 1 to 7 days (χ1,63
2 = 5.97, P = 0.02) compared with change scores.

Discussion and Conclusions:

Both total and change scoring methods on the VOMS are useful for identifying impairments following concussion.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A230)
Evaluation of a Paradigm to Investigate Detection of Road Hazards when Using a Bioptic Telescope
Authors: Bowers Alex R. , Bronstad P. Matthew , Spano Lauren P. , Huq Bidisha , Tang Xiaolan , Doherty Amy , Peli Eli , Luo Gang
Published: June 2018

SIGNIFICANCE

A new driving simulator paradigm was developed and evaluated that will enable future investigations of the effects of the ring scotoma in bioptic drivers with diverse vision impairments and different telescope designs.

PURPOSE

The ring scotoma may impair detection of peripheral hazards when viewing through a bioptic telescope. To investigate this question, we developed and tested a sign-reading and pedestrian-detection paradigm in a driving simulator.

METHODS

Twelve normally sighted subjects with simulated acuity loss (median 20/120) used a 3.0× monocular bioptic to read 36 road signs while driving in a simulator. Thirteen of 21 pedestrian hazards appeared and ran on the road for 1 second within the ring scotoma while participants were reading signs through the bioptic. Head movements were analyzed to determine whether the pedestrian appeared before or only while using the bioptic. Six subjects viewed binocularly, and six viewed monocularly (fellow eye patched). Two patients with real visual acuity loss in one eye and no light perception in the other performed the same tasks using their own telescopes.

RESULTS

For the monocular simulated acuity loss group, detection rates were significantly higher when the pedestrian appeared before using the bioptic than when it appeared while using the bioptic and was likely within the area of the ring scotoma (77% vs. 28%, P < .001). For the binocular simulated acuity loss group, there was no significant difference in detection rates for pedestrians that appeared before or while using the bioptic (80% vs. 91%, P = .20). The two monocular patients detected only 17% of pedestrians that appeared while looking through the bioptic.

CONCLUSIONS

Our results confirm the utility of the testing paradigm and suggest that the fellow eye of normally sighted observers with simulated acuity loss was able to compensate for the ring scotoma when using a monocular bioptic telescope in a realistic driving task.
Expression of PAX3 Distinguishes Biphenotypic Sinonasal Sarcoma From Histologic Mimics
Authors: Jo Vickie Y. , Mariño-Enríquez Adrián , Fletcher Christopher D.M. , Hornick Jason L.
Published: June 2018

Biphenotypic sinonasal sarcoma (BSNS) is a distinctive, anatomically restricted, low-grade spindle cell sarcoma that shows considerable histologic overlap with other cellular spindle cell neoplasms. This tumor type shows both myogenic and neural differentiation, which can be demonstrated by immunohistochemistry; however, the available diagnostic markers are relatively nonspecific. BSNS is characterized byPAX3rearrangements, withMAML3as the most common fusion partner. Our aim was to determine whether immunohistochemistry using a monoclonal PAX3 antibody could distinguish BSNS from potential histologic mimics, as well as to evaluate a widely available polyclonal PAX8 antibody, which is known to cross-react with other paired box transcription factor family members. Immunohistochemistry for PAX3 and PAX8 was performed on whole sections of 15 BSNS (10 with confirmedPAX3rearrangement) and 10 cases each of the following histologic mimics: malignant peripheral nerve sheath tumor, monophasic synovial sarcoma, spindle cell rhabdomyosarcoma (RMS), solitary fibrous tumor, sinonasal hemangiopericytoma, and cellular schwannoma, as well as alveolar RMS (which harborsPAX3orPAX7gene rearrangements). BSNS showed consistent expression of PAX3 (15/15), all multifocal-to-diffuse and most with moderate-to-strong intensity of staining. One single case of spindle cell RMS showed PAX3 expression (1/10), and all other histologic mimics were completely PAX3-negative. In contrast, nuclear staining for PAX8 was present in all 15 BSNS, 7/10 malignant peripheral nerve sheath tumor, 3/10 cellular schwannomas, 2/10 sinonasal hemangiopericytomas, 1/10 synovial sarcoma, 1 spindle cell RMS, and 1 solitary fibrous tumor. All cases of alveolar RMS were positive for PAX8, and most were also positive for PAX3 (8/10). Immunohistochemical expression of PAX3 is highly sensitive (100%) and specific (98%) for BSNS. A polyclonal PAX8 antibody also stains BSNS (likely due to cross-reactivity with PAX3) but has much lower specificity (75%), with frequent expression in numerous mimics.
The Relationships Between Cold Ischemia Time, Kidney Transplant Length of Stay, and Transplant-related Costs
Authors: Serrano Oscar K. , Vock David M. , Chinnakotla Srinath , Dunn Ty B. , Kandaswamy Raja , Pruett Timothy L. , Feldman Roger , Matas Arthur J. , Finger Erik B.
Published: June 2018

Background

Recent changes in policies guiding allocation of transplant kidneys are predicted to increase sharing between distant geographic regions. The potential exists for an increase in cold ischemia time (CIT) with resulting increases in delayed graft function (DGF) and transplant-related costs (TRC). We sought to explore the impact of CIT on metrics that may influence TRC.

Methods

Between 2006 and 2014, 81 945 adult solitary deceased donor kidney transplants were performed in the United States; 477 (0.6%) at our institution. Regression models were constructed to describe the relationship between CIT on DGF and length of stay (LOS). Using hospital accounting data, we created regression models to evaluate the effect of DGF on LOS and TRC.

Results

In multivariable models, longer CIT was associated with an increased rate of DGF (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.38-1.44) and increased LOS (OR, 1.04; 95% CI, 1.02-1.05). Recipients at our institution who developed DGF had longer LOS (OR, 1.71; 95% CI, 1.50-1.95), suggesting that the effect is partially mediated by DGF. After adjusting for LOS, neither CIT nor DGF were independently associated with increased TRC. However, an increased LOS resulted in an increase in TRC by US $3422 (95% CI, US $3180 to US $3664) per additional day, indicating that the effect of CIT on TRC is partially mediated through LOS.

Conclusions

The prolongation of CIT is associated with an increase in DGF rates and LOS, resulting in increased TRC. This study raises the need to balance increased access of traditionally underserved populations to kidney transplant with the inadvertent increase in TRC.
Random sorting of Campylobacter jejuni phase variants due to a narrow bottleneck during colonization of broiler chickens
Authors: Wanford Joseph J. , Lango-Scholey Lea , Nothaft Harald , Hu Yue , Szymanski Christine M. , Bayliss Christopher D.
Published: June 2018

Phase variation (PV), involving stochastic switches in gene expression, is exploited by the human pathogen Campylobacter jejuni to adapt to different environmental and host niches. Phase-variable genes of C. jejuni modulate expression of multiple surface determinants, and hence may influence host colonization. Population bottlenecks can rapidly remove the diversity generated by PV, and strict single-cell bottlenecks can lead to propagation of PV states with highly divergent phenotypes. Using a combination of high-throughput fragment size analysis and comparison with in vivo and in silico bottleneck models, we have characterized a narrow population bottleneck during the experimental colonization of broiler chickens with C. jejuni strain 81-176. We identified high levels of variation in five PV genes in the inoculum, and subsequently, massively decreased population diversity following colonization. Each bird contained a dominant five-gene phasotype that was present in the inoculum indicative of random sorting through a narrow, non-selective bottleneck during colonization. These results are evidence of the potential for confounding effects of PV on in vivo studies of Campylobacter colonization factors and poultry vaccine studies. Our results are also an argument for population bottlenecks as mediators of stochastic variability in the propensity to survive through the food chain and cause clinical human disease.
Genetic Diversity in Common Carp Stocks from a Natural Reservoir Assayed by Randomly Amplified Polymorphic DNA Markers
Authors: Mahboob Shahid , Al-Ghanim K. A. , Al-Mulhim Norah M. A.
Published: June 2018

Background

The common carp(Cyprinus carpio)is a freshwater fish that is cultured throughout the world.C. carpiobelongs to the family Cyprinidae, the largest family among freshwater teleosts, accounting for 10 % of total fish production. Specifically, the common carp is cultured in more than 100 countries in worldwide and accounts for over 3 million metric tons of total annual freshwater fish production. The population of common carp (C.carpio) is declining in freshwater reservoirs because of various human activities, such as overfishing, pollution, hybridization with domestic carp, and loss of breeding grounds because of habitat degradation.

Results

In total, 30 specimens were collected from each of four different locations (WH1, WH2, WH3 and WH4) in the reservoir. Five random decamer primers were used to assay polymorphisms within and between the population ofC. carpio.A total of 60 bands were produced by these primers, out of which 50 bands were polymorphic and 10 bands were monomorphic. The mean highest polymorphism (100 %) was observed in the specimen collected from WHS4 stock, followed by 89.05, 87.62 and 76.66 % of the fish collection from WH3, WH2, and WH4, respectively. Nei’s genetic distance values ranged from 0.0006 to 0.1005. Highest and lowest genetic distance were 0.1005 and 0.006 in fish collected from WH1 and WH2, respectively. Average value of heterozygosity ranged from 0.3008 to 0.3748. AC. carpioUPGMA dendrogram was constructed to observe fish phylogeny. Phylogenetic clusters by RAPD indicated that fish stock of WH2, WH3, and WH4 were closely related to each other.

Conclusion

It was concluded that RAPD analysis can be successfully used as a marker to generate information regarding the percent homology within stock of common carp, which may be used to trace the progeny to the parents and is helpful for the improvement of breeding programs.
Robust Mouse Tracking in Complex Environments using Neural Networks
Authors: Geuther Brian Q. , Deats Sean P. , Fox Kai J. , Murray Steve A. , Braun Robert E. , White Jacqueline K. , Chesler Elissa J. , Lutz Cathleen M. , Kumar Vivek
Published: June 2018

The ability to track animals accurately is critical for behavioral experiments. For video-based assays, this is often accomplished by manipulating environmental conditions to increase contrast between the animal and the background, in order to achieve proper foreground/background detection (segmentation). However, as behavioral paradigms become more sophisticated with ethologically relevant environments, the approach of modifying environmental conditions offers diminishing returns, particularly for scalable experiments. Currently, there is a need for methods to monitor behaviors over long periods of time, under dynamic environmental conditions, and in animals that are genetically and behaviorally heterogeneous. To address this need, we developed a state-of-the-art neural network-based tracker for mice, using modern machine vision techniques. We test three different neural network architectures to determine their performance on genetically diverse mice under varying environmental conditions. We find that an encoder-decoder segmentation neural network achieves high accuracy and speed with minimal training data. Furthermore, we provide a labeling interface, labeled training data, tuned hyperparameters, and a pre-trained network for the mouse behavior and neuroscience communities. This general-purpose neural network tracker can be easily extended to other experimental paradigms and even to other animals, through transfer learning, thus providing a robust, generalizable solution for biobehavioral research.
Online parallel accumulation − serial fragmentation (PASEF) with a novel trapped ion mobility mass spectrometer
Authors: Meier Florian , Brunner Andreas-David , Koch Scarlet , Koch Heiner , Lubeck Markus , Krause Michael , Goedecke Niels , Decker Jens , Kosinski Thomas , Park Melvin A. , Bache Nicolai , Hoerning Ole , Cox Jüergen , Räther Oliver , Mann Matthias
Published: June 2018

In bottom-up proteomics, peptides are separated by liquid chromatography with elution peak widths in the range of seconds, while mass spectra are acquired in about 100 microseconds with time-of-fight (TOF) instruments. This allows adding ion mobility as a third dimension of separation. Among several formats, trapped ion mobility spectrometry (TIMS) is attractive due to its small size, low voltage requirements and high efficiency of ion utilization. We have recently demonstrated a scan mode termed parallel accumulation – serial fragmentation (PASEF), which multiplies the sequencing speed without any loss in sensitivity (Meier et al., PMID: 26538118). Here we introduce the timsTOF Pro instrument, which optimally implements online PASEF. It features an orthogonal ion path into the ion mobility device, limiting the amount of debris entering the instrument and making it very robust in daily operation. We investigate different precursor selection schemes for shotgun proteomics to optimally allocate in excess of 100 fragmentation events per second. More than 800,000 fragmentation spectra in standard 120 min LC runs are easily achievable, which can be used for near exhaustive precursor selection in complex mixtures or re-sequencing weak precursors. MaxQuant identified more than 6,400 proteins in single run HeLa analyses without matching to a library, and with high quantitative reproducibility (R > 0.97). Online PASEF achieves a remarkable sensitivity with more than 2,900 proteins identified in 30 min runs of only 10 ng HeLa digest. We also show that highly reproducible collisional cross sections can be acquired on a large scale (R > 0.99). PASEF on the timsTOF Pro is a valuable addition to the technological toolbox in proteomics, with a number of unique operating modes that are only beginning to be explored.
An in vivo translation-reporter system for the study of protein synthesis in zebrafish embryos
Authors: Garcez Palha Inês , Anselme Isabelle , Schneider-Maunoury Sylvie , Giudicelli François
Published: June 2018

Control of gene expression at the translation level is increasingly regarded as a key feature in many biological processes. Simple, inexpensive, and reliable procedures to visualise sites of protein production are required to allow observation of the spatiotemporal patterns of mRNA translation at subcellular resolution. We present a method, named SPoT (for Subcellular Patterns of Translation), developed upon the original TimeStamp technique (Lin et al., 2008), consisting in the expression of a fluorescent protein fused to a tagged, self-cleavable protease domain. Addition of a cell-permeable protease inhibitor instantly stabilizes newly produced, tagged protein allowing to distinguish recently synthesized protein from more ancient one. After a brief protease inhibitor treatment, the ratio of tagged vs non-tagged forms is highest at sites where proteins are the most recent, i.e. sites of synthesis. Therefore, by comparing tagged and non-tagged protein it is possible to spotlight sites of translation. By specifically expressing the SPoT cassette in neurons of transgenic zebrafish embryos, we reveal sites of neuronal protein synthesis in diverse cellular compartments during early development.
Faster emergence behavior from ketamine/xylazine anesthesia with atipamezole versus yohimbine
Authors: Mees Lukas , Fidler Jonathan , Kreuzer Matthias , Fu Jieming , Pardue Machelle M. , García Paul S.
Published: June 2018

Recent interest in reversal of the hypnotic effects of anesthesia has mainly focused on overcoming a surge in GABA-mediated inhibitory signaling through activation of subcortical arousal circuits or antagonizing GABA receptors. Here we examine the reversal of anesthesia produced from non-GABA agents ketamine/xylazine and the effects of antagonists of adrenoreceptors. These antagonists vary in selectivity and produce temporally unique waking behavior post-anesthesia. We compared two antagonists with differential selectivity for α1-vs. α2-receptors, yohimbine (YOH, 1:40 selectivity) and atipamezole (ATI, 1:8500). Adult mice received intraperitoneal injections of either YOH (4.3 mg/kg), ATI (0.4 mg/kg), or saline after achieving sustained loss of righting following injection of ketamine/xylazine (ketamine: 65.0 mg/kg; xylazine: 9.9 mg/kg). Behaviors indicative of the post-anesthesia, re-animation sequence were carefully monitored and the timing of each behavior relative to anesthesia induction was compared. Both YOH and ATI hastened behaviors indicative of emergence, but ATI was faster than YOH to produce certain behaviors, including whisker movement (YOH: 21.9±1.5 min, ATI: 17.5±0.5 min, p=0.004) and return of righting reflex (RORR) (YOH: 40.6±8.8 min, ATI: 26.0±1.2 min, p<0.001). Interestingly, although YOH administration hastened early behavioral markers of emergence relative to saline (whisking), the completion of the emergence sequence (time from first marker to appearance of RORR) was delayed with YOH. We attribute this effect to antagonism of α1receptors by yohimbine. Also notable was the failure of either antagonist to hasten the re-establishment of coordinated motor behavior (e.g., attempts to remove adhesive tape on the forepaw placed during anesthesia) relative to the end of emergence (RORR). In total, our work suggests that in addition to pharmacokinetic effects, re-establishment of normal waking behaviors after anesthesia involves neuronal circuits dependent on time and/or activity.