bluuebunny/crossref_metadata_2025 huggingface dataset:
Determining Temperature-Dependent Development and Mortality Parameters of the Swede Midge (Diptera: Cecidomyiidae)
Authors: Liu Jenny , Mori Boyd A , Olfert Owen , Hallett Rebecca H
Published: April 2019

The swede midge (Contarinia nasturtii Kieffer) is an invasive insect in North America whose feeding has caused a decline of over 60% of total canola acreage in Ontario, Canada since 2011. Temperature-dependent development and mortality information are important to develop an effective pest management strategy for this insect; as the most comprehensive study on C. nasturtii development was completed on populations from the United Kingdom in the 1960s, new geographically relevant information is needed. Contarinia nasturtii eggs, larvae, pupae, and adults were reared from wild populations collected from Elora, Ontario, and allowed to develop at different temperatures. Resulting development rates were fit to a series of growth models and the model with the best relative goodness-of-fit was selected to represent the given life stage. Eggs from Ontario populations developed more quickly than their UK counterparts at temperatures below approximately 17°C, but more slowly at temperatures above 17°C. The same phenomenon was observed in larvae at 20°C. Pupae from both populations had similar development rates, and adult longevity was similar as well. This information will inform the management of C. nasturtii, and may help prevent its spread to other canola-producing regions of North America.
Perinephric invasion as a prognostic factor in non-metastatic renal cell carcinoma: analysis of a nation-wide registry program
Authors: Kume Haruki , Homma Yukio , Shinohara Nobuo , Obara Wataru , Kondo Tsunenori , Kimura Go , Fujimoto Hiroyuki , Nonomura Norio , Hongo Fumiya , Sugiyama Takayuki , Takahashi Masayuki , Kanayama Hiro-omi , Fukumori Tomoharu , Eto Masatoshi
Published: April 2019

Objectives

Perinephric fat invasion (PFI) of renal cell carcinoma (RCC) is known to be associated with adverse pathological features and poor prognosis. We analyzed these associations using a sub-group of the RCC registry of The Cancer Registration Committee of the Japanese Urological Association.

Methods

The study cohort of 2998 non-metastatic cases was retrieved from RCC registry (3648 in total). We compared clinicopathological characteristics of cases with PFI (n = 256) and without PFI (n = 2742), and investigated the impact of PFI on cancer-specific survival using univariate and multivariate analyses.

Results

Compared with non-PFI cases, PFI cases were older (P = 0.003), and more likely to be hypertensive (P = 0.034) and symptomatic at presentation (P < 0.001). PFI tumors were larger (P < 0.001), and more often have sarcomatoid component (P < 0.001) and tumor thrombus (P < 0.001). Cancer-specific survival was significantly shorter in cases with PFI than without (P < 0.001). The difference in survival tended to be greater in cases with large tumors but was significant in small tumor sub-groups. Cancer-specific survival was significantly shorter in cases with both PFI and renal vein involvement (RVI) in comparison to those with PFI or RVI alone (P = 0.011, P = 0.007, respectively). On multivariate analysis PFI with and without sinus fat invasion remained as an independent risk factor along with symptom at presentation, low body mass index, hypertension, multiple tumors, large tumor size (>7.0 cm), sarcomatoid component and RVI.

Conclusions

PFI was associated with advanced age and aggressive pathological features. PFI is an independent prognostic factor in non-metastatic RCC.
Rubble and Rebirth: Postwar Rejuvenation and the Erasure of History
Authors: Honeck Mischa
Published: April 2019

This article weaves together different postwar moments in the first half of the twentieth century to investigate how rejuvenationist narratives of a “fresh start” helped societies across the divides of geography and ideology to recuperate from the ravages of war. Apart from initiating boys and girls into ideologically specific and gendered regimes of citizenship, the older generation crafted reverse rites of passage to absolve themselves of responsibility for violent conflicts that had resulted in unspeakable death and suffering. Youth organizations became key sites for making young bodies useful to the dual task of regenerating war-torn nations and exonerating those whose actions had contributed to war in the first place. The need for acquitting the old was particularly pressing in light of disputes about who was to blame for the loss of young lives—disputes that often carried the tonality of ageism rather than party politics. If recapturing the innocence of youth became tantamount to deflecting questions of guilt and accountability, then bonding with youth allowed powerful men (less so women) who bore the scars of struggle to engage in deliberate acts of erasure. The disremembering of age and history endowed the ruling classes with seemingly innocuous possibilities, especially the possibility to acquire a clean slate on which to forge new collective identities within the redemptive framework of youth. Just as history is distorted by memory, rejuvenation opened up new futures while giving license to forgetting troubling pasts.
Decisions made in terror: Testing the relationship between terrorism and immigration
Authors: Cruz Erik , D’Alessio Stewart J , Stolzenberg Lisa
Published: April 2019

A contentious issue regarding immigration is the contempt that many natives hold for immigrants. Studies report that enhanced job competition, the potential for cultural misunderstandings, and security fears are salient in predicting native population discontent for immigrants. However, the threat posed by terrorism has been overlooked in prior research. Using data drawn from twenty mostly European countries and a nonlinear hierarchical modeling statistical procedure, we find that acts of terrorism are associated with a substantive decrease in the desire for outgroup immigration. No effect of terrorism on ingroup immigration is observed. The theoretical implications of these findings are discussed.
Textural Character of Gabbroic Rocks from Pito Deep: a Record of Magmatic Processes and the Genesis of the Upper Plutonic Crust at Fast-Spreading Mid-Ocean Ridges
Authors: Brown T C , Cheadle M J , John B E , Coogan L A , Gee J S , Karson J A , Swapp S M
Published: April 2019

The tectonic window at Pito Deep, in the southern Pacific Ocean, permits study of the formative processes of uppermost East Pacific Rise (EPR) gabbroic ocean crust. Here we present a detailed microstructural and crystallographic study of 17 gabbroic samples from the uppermost ∼800 m of plutonic crust exposed in the Pito Deep Rift. We integrate two- and three-dimensional measurements of crystal size, shape, spatial distribution and orientation, with petrographic observations and geochemical data to constrain the formation of fast spread gabbroic ocean crust. The shallowest samples, collected < 55 metres below the sheeted dikes (mbsd), have evolved bulk-rock compositions, elongate plagioclase crystals, a clear plagioclase shape- and crystallographic-preferred orientation, and preserve only minor amounts of intracrystalline strain. The characteristics of these rocks and their proximity to the sheeted dike complex, suggests they formed by crystallization at the lateral tip of an axial melt lens that solidified as it moved off axis. Underlying samples from 96–724 mbsd, record more primitive bulk-rock compositions, less elongate plagioclase crystals and exhibit increasing strength of both plagioclase shape- and crystallographic-preferred orientation with depth below the sheeted dikes. These samples host plagioclase crystals that show increasing intracrystalline strain with depth, suggesting magmatic to hypersolidus submagmatic flow within the mush zone beneath the axial melt lens. These observations, together with inclined-to-steeply dipping mineral layering preserved below ∼180 mbsd, are interpreted to record the downward transport of crystal-rich magma originating at the bottom of the melt lens through the uppermost kilometre of the mush zone at the EPR. The location of initial crystallization along the floor of the axial melt lens determines the magmatic processes that affect the crystal-rich magma en route to solidification as lower ocean crust.
Energy, amino acid, and phosphorus digestibility and energy prediction of thermally processed food waste sources for swine1
Authors: Fung Leonard , Urriola Pedro E , Shurson Gerald C
Published: April 2019

Recycling energy and nutrients from food waste into animal feed decreases the environmental impact of food animal production. However, recycling energy and nutrients from various food waste sources into swine feeding programs is constrained by the high variability and lack of data on the digestibility of energy and nutrients. Therefore, the objectives of this study were to evaluate the digestibility of energy, amino acids, and phosphorus in thermally dried food waste sources fed to growing pigs and to compare in vivo determined digestibility values with those obtained from in vitro digestibility procedures and published prediction equations to determine the accuracy of using these nutritional evaluation methods. Pigs (n = 36; initial body weight = 16.37 ± 1.9 kg) were utilized to determine digestible energy (DE) and metabolizable energy (ME) content, as well as standardized total tract digestibility (STTD) of phosphorus and standardized ileal digestibility (SID) of amino acids in three sources of dehydrated food waste in three separate trials. Initial body weight of pigs at the beginning of each digestibility trial was used as the blocking factor in a randomized complete block design. Diets were formulated to contain 30% food waste derived from fish waste (FW), supermarket waste (containing bakery, fruits and vegetables, meat, and deli foods from a single supermarket; SMW), and fruit and vegetable waste (FVW). The DE and ME content of FW (DE = 5,057 kcal/kg; ME = 4,820 kcal/kg) and SMW (DE = 5,071 kcal/kg; ME = 4,922 kcal/kg) were not different (P > 0.05), whereas FVW had the least (P < 0.05) DE (2,570 kcal/kg) and ME (2,460 kcal/kg) content compared with FW and SMW. Digestibility of crude protein and amino acids was greater (P < 0.05) in FW and SMW compared with FVW. The in vitro digestibility procedure can be used to approximate the digestibility of dry matter (DM) and energy in SMW, FW, and FVW compared with in vivo estimates, but significant error exists depending on the chemical characteristics of each food waste source. However, use of the prediction equations and digestibility data obtained from the in vitro procedure resulted in high accuracy in estimating DE content of FW (observed = 5,058 kcal/kg DM vs. predicted = 4,948 kcal/kg DM), SMW (observed = 5,071 kcal/kg DM vs. predicted 4,978 kcal/kg DM), and FVW (observed = 2,570 kcal/kg DM vs. predicted 2,814 kcal/kg DM) sources.
Evolutionary history of field mice (Murinae: Apodemus), with emphasis on morphological variation among species in China and description of a new species
Authors: Ge Deyan , Feijó Anderson , Cheng Jilong , Lu Liang , Liu Rongrong , Abramov Alexei V , Xia Lin , Wen Zhixin , Zhang Weiyong , Shi Lei , Yang Qisen
Published: April 2019

Mice of the genus Apodemus are widely distributed across Eurasia. Several species of this genus are hosts of important zoonotic diseases and parasites. The evolutionary history and dispersal routes of these mice remain unclear and the distribution of these species in China was poorly explored in previous studies. We here investigate the divergence times and historical geographical evolution of Apodemus and study the taxonomy of species in China by integrating molecular and morphological data. The crown age of this genus is dated to the Late Miocene, approximately 9.84 Mya. Western and Central Asia were inferred as the most likely ancestral area of this genus. Moreover, we recognize nine living species of Apodemus in China: Apodemus uralensis, A. agrarius, A. chevrieri, A. latronum, A. peninsulae, A. draco, A. ilex, A. semotus and A. nigrus sp. nov., the last from the highlands (elevation > 1984 m) of Fanjing Mountain in Guizhou Province and Jinfo Mountain in Chongqing Province. This new species diverged from A. draco, A. semotus and A. ilex approximately 4.53 Mya. The discovery of A. nigrus highlights the importance of high mountains as refugia and ‘isolated ecological islands’ for temperate species in south-eastern China.
Digital Imaging to Evaluate Root System Architectural Changes Associated with Soil Biotic Factors
Authors: Mattupalli Chakradhar , Seethepalli Anand , York Larry M. , Young Carolyn A.
Published: April 2019

Root system architecture is critical for plant growth, which is influenced by several edaphic, environmental, genetic, and biotic factors including beneficial and pathogenic microbes. Studying root system architecture and the dynamic changes that occur during a plant’s lifespan, especially for perennial crops growing over multiple growing seasons, is still a challenge because of the nature of their growing environment. We describe the utility of an imaging platform called RhizoVision Crown to study root system architecture of alfalfa, a perennial forage crop threatened by Phymatotrichopsis root rot (PRR) disease. Phymatotrichopsis omnivora is the causal agent of PRR disease that reduces alfalfa stand longevity. During the lifetime of the stand, PRR disease rings enlarge and the field can be categorized into three zones based upon plant status: asymptomatic, disease front and survivor. To study root system architectural changes associated with PRR, a 4-year-old 25.6-ha alfalfa stand infested with PRR was selected at the Red River Farm, Burneyville, OK during October 2017. Line transect sampling was conducted from four actively growing PRR disease rings. At each disease ring, six line transects were positioned spanning 15 m on either side of the disease front with one alfalfa root crown sampled at every 3 m interval. Each alfalfa root crown was imaged with the RhizoVision Crown platform using a backlight and a high-resolution monochrome CMOS camera enabling preservation of the natural root system integrity. The platform’s image analysis software, RhizoVision Analyzer, automatically segmented images, skeletonized, and extracted a suite of features. Data indicated that the survivor plants compensated for damage or loss to the taproot through the development of more lateral and crown roots, and that a suite of multivariate features could be used to automatically classify roots as from survivor or asymptomatic zones. Root growth is a dynamic process adapting to ever changing interactions among various phytobiome components. By utilizing the low-cost, efficient, and high-throughput RhizoVision Crown platform, we quantified these changes in a mature perennial forage crop.
Evaluation of High-Resolution Melting for Rapid Differentiation of Phytophthora Hybrids and Their Parental Species
Authors: Ratti Maria F. , Farrer Rhys A. , Cano Liliana M. , Faedda Roberto , Goss Erica M.
Published: April 2019

Phytophthora species hybrids have been repeatedly reported as causing damaging diseases to cultivated and wild plants. Two known hybrids, P. andina and P. × pelgrandis, are pathogens of Solanaceae and ornamentals, respectively, although the extent of their host ranges are unknown. P. andina emerged from hybridization of P. infestans and an unidentified related species, whereas P. × pelgrandis emerged from P. nicotianae and P. cactorum. Considering that hybrids and parental species can coexist in the same regions and to distinguish them usually requires cloning or whole genome sequencing, we aimed to develop a rapid tool to distinguish them. Specifically, we used high-resolution melting (HRM) assays to differentiate genotypes based on their amplicon melting profiles. We designed primers for P. × pelgrandis and parental species based on available sequences of P. nicotianae and P. cactorum nuclear genes containing polymorphisms between species. For P. andina, heterozygous sites from Illumina short reads were used for the same purpose. We identified multiple amplicons exhibiting differences in melting curves between parental species and hybrids. We propose HRM as a rapid method for differentiation of P. andina and P. × pelgrandis hybrids from parental species that could be employed to advance research on these pathogens.
Depressive Symptoms Among Women With Endometriosis: A Systematic Review and Meta-analysis
Authors: Gambadauro Pietro , Carli Vladimir , Hadlaczky Gergö
Published: April 2019

(Abstracted from Am J Obstet Gynecol 2019;220:230–241)

Endometriosis is a complex chronic disorder defined by ectopic endometrial-like tissue. It is thought to affect 10% of reproductive-age women.
Brexanolone Injection in Postpartum Depression: Two Multicenter, Double-Blind, Randomized, Placebo-Controlled, Phase 3 Trials
Authors: Meltzer-Brody Samantha , Colquhoun Helen , Riesenberg Robert , Epperson C. Neill , Deligiannidis Kristina M. , Rubinow David R. , Li Haihong , Sankoh Abdul J. , Clemson Christine , Schacterle Amy , Jonas Jeffrey , Kanes Stephen
Published: April 2019

(Abstracted from Lancet 2018;392:1058–1070)

Postpartum depression effects 10% to 20% of women who give birth worldwide, and approximately 40% to 80% of cases are considered moderate to severe. The burden of this disorder is multifactorial, with financial, social, and health-related consequences for mothers and families.
Comparing the Hadlock Fetal Growth Standard to the Eunice Kennedy Shriver National Institute of Child Health and Human Development Racial/Ethnic Standard for the Prediction of Neonatal Morbidity and Small for Gestational Age
Authors: Blue Nathan R. , Beddow Meghan E. , Savabi Mariam , Katukuri Vivek R. , Chao Conrad R.
Published: April 2019

(Abstracted from Am J Obstet Gynecol 2018;219:474.e1–474.e12)

The fetal growth standard in widest use was published by Hadlock more than 25 years ago and was derived from a small, homogeneous cohort. In 2015, The Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Study published updated standards that are specific to race/ethnicity.
Gestational Age, Health, and Educational Outcomes in Adolescents
Authors: Berry Mary J. , Foster Tim , Rowe Kate , Robertson Oliver , Robson Bridget , Pierse Nevil
Published: April 2019

(Abstracted from Pediatrics 2018;142(5):e20181016)

Advances in perinatal medicine over the last 20 years have improved survival for preterm infants; however, with increasing survival, more information is needed about the long-term impact of preterm birth, particularly in periviable infants (gestation <25 weeks and/or birth weight <500 g). Other large cohort studies have examined the morbidity and mortality experienced by extremely preterm infants and have described increased hospital readmissions, impacts on behavior and academic performance at school, and other early childhood effects, but they have not considered the longer-term consequences or were performed during a different era of perinatal care.
Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable Cancers
Authors: Johnson Skyler B. , Park Henry S. , Gross Cary P. , Yu James B.
Published: April 2019

(Abstracted from JAMA Oncol 2018;4:1375–1381)

Complementary medicine (CM) refers to integration of unproven nonmedical methods with conventional therapies, whereas alternative medicine is use of unproven methods instead of conventional therapy. In the United States, complementary and alternative medicine is a multibillion-dollar industry.
Dynamic Measurement in Health Professions Education: Rationale, Application, and Possibilities
Authors: Dumas Denis , McNeish Daniel , Schreiber-Gregory Deanna , Durning Steven J. , Torre Dario M.
Published: April 2019

Dynamic measurement modeling (DMM) is a psychometric paradigm that uses longitudinal data to estimate individual students’ growth in measured skills over the course of an educational program (i.e., growth scores). DMM represents a more formal way of assessing learning progress across the health professions education continuum. In this article, the authors provide justification for this approach in health professions education and demonstrate its proof-of-concept use with three time points of United States Medical Licensing Examination Step exams to generate growth scores for 454 current and recent medical learners. The authors demonstrate that learners vary substantially on their growth scores, and those growth scores exhibit psychometric reliability. In addition, growth scores significantly and positively correlated with indicators of medical learner readiness (e.g., undergraduate grade point average and Medical College Admission Test scores). These growth scores were also capable of significantly and positively correlating with future ratings of clinical competencies during internship as assessed through a survey sent to their program directors at the end of the first postgraduate year (e.g., patient care, interpersonal skills). These preliminary findings of reliability and validity for DMM growth scores provide initial evidence for further investigation into the suitability of a dynamic measurement paradigm in health professions education.
Opioid Overdose in the Hospital Setting: A Systematic Review
Authors: Danovitch Itai , Vanle Brigitte , Van Groningen Nicole , Ishak Waguih , Nuckols Teryl
Published: April 2019

Objective:

Our objective was to determine the percentage of opioid overdose events among medical and surgical inpatient admissions, and to identify risk factors associated with these events.

Methods:

We searched PubMed and CINAHL databases from inception through July 30, 2017 and identified additional studies from reference lists and other reviews. Articles were included if they reported original research on the rate of opioid overdoses or opioid-related adverse events, and the adverse events occurred in a general medical hospital during an inpatient stay. We extracted information on study population, design, results, and risk for bias using the Newcastle-Ottawa Quality Assessment Scale. We performed this review in accordance with recently suggested standards and report our findings as per the Meta-Analyses and Systematic Reviews of Observational Studies guidelines.

Results:

Thirteen studies met our eligibility criteria. The percentage of opioid overdoses ranged from 0.06% to 2.50% of hospitalizations. The majority of studies used only 1 method of event detection. Risk factors for overdose included older age, infancy, medical comorbidity, substance use disorder diagnosis, combining opioids with other sedatives, and admission to hospitals with higher opioid-prescribing rates.

Conclusions:

Opioid overdose in the inpatient setting is a serious preventable harm and is likely underestimated in much of the current literature. Improved detection methods are needed to more accurately measure the rate of inpatient opioid overdose. Refined estimates of opioid overdose should be used to drive safety and quality improvement initiatives in hospitals.
Transfusion-related Acute Lung Injury in the Perioperative Patient
Authors: McVey Mark J. , Kapur Rick , Cserti-Gazdewich Christine , Semple John W. , Karkouti Keyvan , Kuebler Wolfgang M.
Published: April 2019

Transfusion-related acute lung injury is a leading cause of death associated with the use of blood products. Transfusion-related acute lung injury is a diagnosis of exclusion which can be difficult to identify during surgery amid the various physiologic and pathophysiologic changes associated with the perioperative period. As anesthesiologists supervise delivery of a large portion of inpatient prescribed blood products, and since the incidence of transfusion-related acute lung injury in the perioperative patient is higher than in nonsurgical patients, anesthesiologists need to consider transfusion-related acute lung injury in the perioperative setting, identify at-risk patients, recognize early signs of transfusion-related acute lung injury, and have established strategies for its prevention and treatment.
Defective FasL expression is associated with increased resistance to melanoma liver metastases and enhanced natural killer cell activity
Authors: Neelam Sudha , Mellon Jessamee , Wilkerson Amber , Niederkorn Jerry Y.
Published: April 2019

The objective was to determine if the absence of FasL signaling would affect melanoma liver metastases by influencing the antimelanoma properties of liver natural killer (NK) cells. Melanoma liver metastases were induced in wild-type C57BL/6 mice and the gld/gld mutant C57BL/6 mouse strain that expresses a defective form of FasL (CD95L) that fails to engage and signal via the Fas receptor (CD95). Liver metastases were produced by intrasplenic injection of B16LS9 melanoma cells. Liver NK cell activity directed against murine B16LS9 melanoma cells was determined in a 24 h in-vitro cytotoxicity assay. Liver NK cells, NK T cells, and the NK cell surface activation marker, NKG2D, were measured by flow cytometry. Mice expressing defective FasL displayed reduced, rather than enhanced, melanoma liver metastases that coincided with increased liver NK cell-mediated tumor cell cytotoxicity. Enhanced cytotoxicity was not mediated by perforin, tumor necrosis factor-α, or tumor necrosis-associated apoptosis-inducing ligand but was closely associated with elevated interferon-γ in the tumor-bearing liver. FasL-defective gld/gld mice also displayed reduced numbers of liver NK T cells, which have been previously implicated in suppression on liver NK cell activity. The absence of functional FasL in the liver correlates with a heightened, not diminished, resistance to melanoma liver metastases. The resistance to liver metastases coincides with a significant, albeit transient, increase in liver NK cytotoxicity and elevated levels of interferon-γ in the liver.
Two-stage Prosthetic Prepectoral Breast Reconstruction: Comparing Tissue Expansion with Carbon Dioxide and Saline
Authors: Chopra Karan , Singh Devinder , Hricz Nick , Brassard Kylie , Orlov Virginia , Holton III Luther H.
Published: April 2019

Background:

The AeroForm tissue expander is a carbon dioxide-filled breast tissue expander that allows gradual, needle-free expansion using a hand-held remote controller. This study evaluates 2-stage, prepectoral tissue expander-to-implant breast reconstruction with the carbon-dioxide tissue expanders and compares the outcomes to our recent experience with saline tissue expanders.

Methods:

This was a retrospective study of consecutive patients from a single institution. The subjects consisted of women who underwent mastectomy and either immediate or delayed breast reconstruction with AeroForm or saline tissue expanders. Outcomes encompassed postoperative complications including mastectomy flap necrosis, infection requiring readmission and/or intravenous antibiotics, capsular contracture, hematoma, seroma, skin dehiscence, extrusion, premature explant, and loss of communication with the device (AeroForm) or rupture of the device (saline).

Results:

This study evaluated 115 patients with 185 breast reconstructions. Of the 185 breast reconstructions, 74 (40%) utilized AeroForm tissue expanders and 111 (60%) utilized traditional saline tissue expanders. Treatment was successful in 100% and 94% in the AeroForm and saline groups, respectively (P = 0.025). The incidence of adverse events was greater in the saline group (45.9% versus 32.4%). Surgical-site infection occurred more commonly in the saline group (5.4% versus 0%). Full-thickness skin necrosis occurred at a significantly higher rate in the saline cohort as compared with AeroForm (5.4% versus 0%).

Conclusions:

The use of AeroForm tissue expanders offers notable advantages for breast reconstruction. This device when employed in the prepectoral space may be associated with reduced infection rates and decreased utilization of healthcare and patient resources.
A Novel Plastic Surgical Technique for Treating Congenital Entropion in Asians
Authors: Iwayama Takanori , Hashikawa Kazunobu , Fukumoto Takeshi
Published: April 2019

Congenital entropion is an ocular condition involving malpositioning of the eyelid, which can result in ocular pain, conjunctival epiphora, or photophobia. Noninvasive treatment is effective in some cases; however, surgical treatment is indicated when keratitis and ocular irritating symptoms occur. There is no consensus regarding the most appropriate surgical technique. Moreover, some patients complain of changes in their appearance or unwanted incision scars after surgery. In particular, individuals with certain types of Asian heritage exhibit a lower eyelid morphology that differs from that of white individuals, caused by orbital fat locational difference. Subciliary muscle bulges cause swelling in the lower eyelid called Namidabuluro and are considered to create a youthful and beautiful appearance in Asians. Accordingly, some Asian individuals tend to be sensitive about changes to the appearance of the lower eyelid. To our knowledge, no report has yet described changes to Namidabukuro during congenital entropion repair in Asians. We describe a novel surgical technique for congenital entropion repair with the creation of cosmetically natural Namidabuluro in an East Asian cohort. The study included 8 lower eyelids of 4 Japanese female patients. Scarring was not noticeable in any of the 4 cases. Eversion of the cilia and the creation of cosmetically natural Namidabuluro were accomplished in all cases. There has been no case of recurrence yet. The novel surgical technique we developed enables not only the treatment of congenital entropion but also the creation of cosmetically acceptable Namidabuluro, resulting in increased patient satisfaction.
Spanish Translation, Cultural Adaptation, and Validation of the Standardized Cosmesis and Health Nasal Outcomes Survey Questionnaire
Authors: Perez-Garcia Irene C. , Peñaranda Augusto , Cobo Roxana , Hernandez Ana V. , Moubayed Sami P. , Most Sam P.
Published: April 2019

Background:

The Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) questionnaire is a new instrument that was developed to evaluate both functional and cosmetic components of rhinoplasty. It is a reliable, consistent, and validated patient-reported outcome measure that is not available in Spanish.

Methods:

The SCHNOS questionnaire was forward translated, back translated, and culturally adapted following international guidelines. Its psychometric validity was tested with native Spanish speakers in 2 centers in Colombia. The authors measured internal consistency, correlation, and reproducibility to determine validity of the instrument.

Results:

The final Spanish version of the SCHNOS was administered to 76 native Spanish speakers. Both the SCHNOS-O (obstructive domain) and SCHNOS-C (cosmetic domain) showed a high internal consistency with Cronbach’s alpha of 0.84 and 0.94, respectively. The Spearman correlations between the items of SCHNOS-O (0.38–0.82) and SCHNOS-C (0.49–0.88) were positive and significant. Spearman’s rank correlation in the test–retest analysis for SCHNOS-O (r = 0.87) and SCHNOS-C (r = 90) was positive and statistically significant. There was statistical significance in responses obtained for SCHNOS-O (P < 0.001) but not for SCHNOS-C (P = 0.222).

Conclusions:

In this study, the SCHNOS was successfully translated and culturally adapted into Spanish. The Spanish version of the SCHNOS was shown to be a reliable and valid instrument that we recommend it should be used in Spanish-speaking patients who are having functional or cosmetic rhinoplasty.
A Simple Skin Incision Design for Pediatric Superficial Branch of Superficial Circumflex Iliac Artery
Authors: Kato Motoi , Watanabe Shoji , Watanabe Azusa , Utsunomiya Hiroki , Yokoyama Takayuki , Iida Takuya
Published: April 2019

Background:

Superficial circumflex iliac artery (SCIA) perforator flap is one of the demanding flaps. However, little is known about SCIA anatomy, which is crucial for successful SCIA perforator flap elevation, in children. We assessed the efficacy of our incision design to detect the superficial branch of the SCIA in vivo.

Methods:

Eleven consecutive pediatric patients who required harvesting (eg, skin grafts or vascularized lymph node transfer) were assessed. All possible congenital vascular malformation cases were excluded. To reduce potential bias, all groin procedures were performed on the contralateral side of malformations. After inguinal area mapping, 1.5-cm skin incision was made. From the window opened by the skin incision, tiny perforation to the skin surface was detected for further dissection. Following the tiny branch, the main trunk of the superficial circumflex vascular bundle was dissected. The whole vascular bundle, artery, and major vein from the bundle were dissected and their sizes were measured.

Results:

Of the 11 patients, 4 were boys; the age range was 5 months to 14 years (mean age: 3.2 years). Vessel bundle size was 0.7–1.5 (mean: 1.1 mm). In all cases, the bundle was detected within 5 min (1–5, mean: 2.5 min). No vascular damage was observed, and all arteries pulsated well, without requiring additional skin incision. The superficial branch of the SCIA was mainly detected right below the initial skin incision.

Conclusions:

Our skin incision design can effectively detect the SCIA in pediatric patients and may be used in adult patients.
What should I use next if clinical evaluation and echocardiographic haemodynamic assessment is not enough?
Authors: Messina Antonio , Greco Massimiliano , Cecconi Maurizio
Published: April 2019

Purpose of review

To provide an integrated clinical approach to the critically ill patients in shock.

Recent findings

The complexity behind shock mechanism has improved in the last decades; as consequence, conventional generalized practices have been questioned, in favour of different approaches, titrated to patient's individual response. Bedside clinical examination has been demonstrated to be a reliable instrument to recognize the mismatch between cardiac function and peripheral oxygen demand. Mottling skin and capillary refill time have been recently proposed using a semi-quantitative approach as reliable tool to guide shock therapy; lactate, ΔCO2 and ScVO2 are also useful to track the effect of the therapies overtime. Critical care echocardiography is useful to assess the source of the shock, to choice the correct the therapy and to customize the therapy. Finally, a more sophisticated and invasive calibrated monitoring should be promptly adopted in case of refractory or mixed shock state to titrate the therapy on predefined goals, avoiding the inappropriate use of fluids and vasoactive drugs.

Bedside haemodynamic assessment in critically ill patients should be considered an integrated approach supporting the decision-making process and should be based on clinical examination and critical care echocardiography.
A systematic review and meta-analysis of naproxen for prevention heterotopic ossification after hip surgery
Authors: Zhang Ai-Hua , Chen Xiang , Zhao Qing-Xia , Wang Ke-Lai
Published: April 2019

Background:

The aim of this study was to assess the efficacy of naproxen in preventing heterotopic ossification (HO) after hip surgery (total hip arthroplasty [THA] and hip arthroscopy).

Methods:

Using databases (PubMed, EMBASE, and Web of Science), we conducted an electronic, systematic search of randomized controlled trials (RCTs) comparing naproxen versus placebo on HO after hip surgery. The risk ratio (RR) of the dichotomous data, weighted mean difference (WMD) of continuous data, and 95% confidence intervals (CIs) were calculated to assess the effects of naproxen in patients with hip surgery.

Results:

A total of 4 studies including 269 patients were analyzed. Risk of bias was relatively high in allocation concealment and blinding. Compared with control group, administration naproxen was associated with a significantly reduction of the occurrence of HO at final follow-up after hip surgery (P < .05). What's more, naproxen was associated with a reduction of the Brooker I and II HO (P < .05). However, there was no significant difference between the Brooker III HO between naproxen and control groups (P > .05). Furthermore, there was no significant difference between the complications (P > .05) between naproxen and control groups.

Conclusion:

Naproxen has a beneficial role in reducing the total occurrence of HO, Brooker I and II HO after hip surgery. However, conclusions are limited due to the lack of high-quality studies. More high quality studies may help in a more reliable therapy for HO.
Comparative efficacy of 13 antimicrobial dressings and different securement devices in reducing catheter-related bloodstream infections
Authors: Dang Fang-Ping , Li Hui-Ju , Tian Jin-Hui
Published: April 2019

Purpose:

The purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial dressings for prevention of catheter-related blood infections (CRBSI) and rank these antimicrobial dressings for practical consideration.

Methods:

We searched the PubMed, Cochrane library, Embase, earlier relevant meta-analysis and reference lists of included studies for randomized controlled trials (RCTs) that compared dressings for prevention of CRBSI. Two authors independently extracted data from each included RCT according to a predesigned Excel spreadsheet and assessed the methodological quality of included RCTs using the Cochrane risk of bias tool. Data was analyzed using the WinBUGS (V.1.4.3) and the Stata (V.15.0).

Results:

Finally, 35 RCTs involving 8494 patients and evaluating 13 dressings were included. Network meta-analysis showed that transparent dressing may be the best way to prevent CRBSI. Suture and bordered polyurethane dressing might have the lowest risk of CRBSI rate per 1000 catheter-days, and sutureless securement device might lead to the lowest incidence of catheter failure.

Conclusions:

This network meta-analysis indicated that transparent dressings may be selected for the prevention of CRBSI in patients with central venous catheters, which is of importance in future research. Although evidence is scant, more attention should be paid to head-to-head comparisons of the most commonly used dressings in this field.
Comparative efficacy and safety of bridging strategies with direct mechanical thrombectomy in large vessel occlusion
Authors: Pan Xiaohua , Liu Guorong , Wu Bo , Liu Xiuzhen , Fang Yong
Published: April 2019

Background:

Whether bridging strategies[intravenous thrombolysis (IVT) + mechanical thrombectomy (MT)] are superior to mechanical thrombectomy alone for large vessel occlusion(LVO) is still uncertain. A systematic review and meta-analysis was conducted to investigate and evaluate comparative efficacy and safety of bridging strategies vs direct MT in patients with LVO.

Methods:

The PubMed, EMBASE and Cochrane library databases were searched to evaluate the efficacy and safety of bridging strategies with direct MT in LVO. Functional independence, mortality, symptomatic intracranial hemorrhage (sICH) and successful recanalization were assessed. The risk ratio (RR) and its 95% confidence interval (CI) were calculated.

Results:

The proportion of patients who received MT + IVT was significantly higher in functional independence and successful recanalization rate than MT alone patients. However, pooled results showed that the mortality of patients who received MT + IVT was significantly lower than that of MT alone patients. Moreover, no significant differences were observed in the incidence of sICH between the 2 groups.

Conclusion:

The findings of our meta-analysis confirmed that bridging strategies improved functional outcomes, successful recanalization rate and reduced mortality rates. Moreover, the incidence of sICH showed no differences between the bridging strategies and MT alone treatments. However, the conduct of high-quality randomized clinical trials that directly compare both strategies is warranted.
Reliability of PD-L1 assays using small tissue samples compared with surgical specimens
Authors: Kim Insu , Kim Ahrong , Lee Chang Hun , Lee Geewon , Kim Ahreum , Jo Eun Jung , Kim Mi-Hyun , Mok Jeongha , Lee Kwangha , Kim Ki Uk , Park Hye-Kyung , Lee Min Ki , Eom Jung Seop
Published: April 2019

Programmed death ligand 1 (PD-L1) immunohistochemistry (IHC) assays are widely used for complementary or companion diagnostic purposes during treatment with immune checkpoint inhibitors. However, limited information is available on the clinical reliability of the PD-L1 IHC assay using small biopsy samples.

Participants included 46 patients with nonsmall cell lung cancer who underwent PD-L1 testing using 3 PD-L1 IHC assays (22C3, SP142, and SP263) for both small biopsy samples and surgical specimens from November 2017 to June 2018. The PD-L1 IHC assay results were analyzed with cut-off values of 1%, 5%, 10%, and 50%. The PD-L1 IHC results obtained from the surgical specimens were regarded as the reference values.

The 22C3, SP142, and SP263 PD-L1 IHC assays were performed in 26 (57%), 20 (43%), and 46 (100%) patients, respectively. Biopsy methods included radial probe endobronchial ultrasound using a guide sheath, endobronchial ultrasound-guided transbronchial needle aspiration, bronchoscopic biopsy, and percutaneous needle aspiration in 26 (57%), 4 (9%), 12 (25%), and 4 (9%) patients, respectively. The 22C3, SP142, and SP263 PD-L1 assays had concordance rates of 73–96, 65–80, and 72%–91%, respectively, compared with the reference values.

PD-L1 testing with 3 commercial PD-L1 IHC assays using small biopsy samples is reliable in patients with nonsmall cell lung cancer.
Obstructive hydrocephalus associated with spontaneous dural arteriovenous fistula
Authors: Zhang Chang Wei , Fu Wei , Richard Seidu A. , Xie Xiao Dong
Published: April 2019

Rationale:

Dural arteriovenous fistulae (DAVF) are vascular disorders depicted with direct interconnection between dural arteries and cerebral venous sinuses and/or cortical veins. Only a hand full of cases have been reported in literature. DAVF obstructing the 3rd ventricle and quadrigeminal cistern resulting in hydrocephalus is very rare.

Patient concerns:

We present a 55-year-old female with 2 years history of headaches and blurring of vision. Cranial nerves examinations were unremarkable.

Diagnoses:

Magnetic Resonance Imaging (MRI) and digital subtraction angiography showed multiple tortuous vascular malformation in the 3rd ventricle and quadrigeminal cistern resulting in obstructive hydrocephalus (OHC).

Interventions:

We utilized endovascular embolization treatment option to obliterate the lesion. We used Onyx embolization agent (ev3 Neurovascular, Irvine, CA) to embolize the lesion via the transarterial route.

Outcomes:

The OHC resolved spontaneously after the endovascular embolization of the DAVF. The patient recovered with no further neurologic complication. Two years follow-up reveal no recurrence of the DAVF as well as hydrocephalus.

Lessons:

Adequate knowledge on the vascular anatomy is very crucial in managing DAVF.
Ulcerative colitis with mucosal lesions in duodenum
Authors: Li Muran , Liu Yandi , Cui Jifang , Qin Hai , Shi Yang , Zhang Shiwu , Zhao Yongjie
Published: April 2019

Rationale:

Ulcerative colitis (UC) is a chronic, nonspecific, inflammatory disease of the colon. Colorectal is the main target organ of UC, while other digestive tract involvement is rare. This report describes 2 rare cases of duodenal mucosa lesions in patients with UC after total colectomy.

Patient concerns:

In case 1, a patient of 45-year-old with intermittent diarrhea and bloody mucosanguineous feces who was diagnosed as UC, revealed diffuse erosive ulcers in the descending duodenum through gastroscopy after total colectomy. In case 2, a 55-year-old Chinese female with UC, aggravated to colon cancer and received total colectomy. Eighteen months after surgery, the patient was admitted to hospital following upper abdominal pain and acid regurgitation. A gastroscopy found inflammation in the descending part of the duodenum.

Diagnosis:

UC, duodenal mucosa lesions

Interventions:

In case 1, the patient was treated with oral mesalazine (1 g/tid) and hydrocortisone (0.3 g/d) but symptoms did not improve, and the treatment was changed to oral methylprednisolone (0.6 g/d) and a hydrocortisone enema (0.1 g/late). Finally, the patient underwent a total colectomy and ileostomy. In case 2, the patient was treated with sulfasalazine, mesalazine, and intermittent hormone enemas. A total colectomy and ileostomy were performed with the patient after diagnosed as colon cancer. After surgery, the patient received N1-(2 tetrahydrofuryl)-5-fluorouracil (FT-207), 8 g, 300 mg, and 100 mg oxaliplatin chemotherapy, and biologic therapy.

Outcomes:

In case 1, the patient presented with duodenal necrosis and died of septic shock. In case 2, the patient recovered well without recurrence by taking proton pump inhibitor.

Lessons:

The occurrence of UC related ulcerative gastroduodenal mucosal lesions may be associated with progressing UC or total colitis that does not respond to hormone therapy, leading to requirement of total colectomy.
Cardiac amyloidosis as a rare cause of heart failure
Authors: Gao Ming , Liu Quan , Chen Liping
Published: April 2019

Rationale:

Cardiac amyloidosis is a rare condition that is difficult to diagnose, because the clinical manifestations are often varied and nonspecific. The presence and degree of cardiac involvement are the main prognosis determinants, with a median survival of 6 months expected when presented with heart failure. Moreover, the optimal treatment for cardiac amyloidosis is still unclear.

Patient concerns:

We report a case of a 50-year-old man who was admitted with evolution of progressive dyspnea. Two months before the present admission, the patient was diagnosed with bacterial pneumonia complicated by bilateral parapneumonic effusion that required drainage.

Diagnosis:

Electrocardiography demonstrated poor R-wave progression in leads V1-V3 with right axis deviation and low voltage criteria. Echocardiography revealed diffuse left ventricular hypertrophy with normal ventricular cavity size, severe diastolic dysfunction, and sparkling and granular texture of the ventricle wall. Serum free light-chain analysis showed an altered kappa/lambda ratio of 0.01 with lambda light chains greatly elevated. A periumbilical fat aspirate sample confirmed amyloidosis. Bone marrow examination confirmed benign monoclonal gammopathy with 8.5% plasma cells, and biopsy stained for Congo red was negative.

Intervention:

A combination of bortezomib with cyclophosphamide and dexamethasone treatment was initiated.

Outcome:

Unfortunately, 5 days after the second therapy with bortezomib, the patient died.

Lessons:

Cardiac amyloidosis should be seriously considered in any adult with signs or nonspecific symptoms of cardiac distress, most notably congestive heart failure due to underlying restrictive cardiomyopathy.