bluuebunny/crossref_metadata_2025 huggingface dataset:
Extrakranielle Schwannome im Kopf-Hals-Bereich: Klinische Implikationen anhand von 20 Fällen
Authors: Höing Benedikt , Stuck Boris A. , Kansy Benjamin , Hussain Timon , Schlüter Anke , Holtmann Laura , Ringelstein Adrian , Mattheis Stefan , Lang Stephan , Dominas Nina
Published: July 2017

Hintergrund Schwannome sind seltene, benigne Tumore, die von den Gliazellen des peripheren Nervensystems (Schwannsche Zellen)
ausgehen. Während es für intrakranielle Schwannome, insbesondere die des N. vestibularis, etablierte Therapiestrategien gibt, liegen zu den
extrakraniellen Schwannomen weniger belastbare Daten vor.

Methode Es wurde eine retrospektive Analyse von 20 Patienten mit histopathologisch gesicherten extrakraniellen Schwannomen im
Kopf-Hals-Bereich mit einem Schwerpunkt auf Tumorlokalisation und postoperativem funktionellem Therapieergebnis durchgeführt.

Ergebnisse Die Schwannome im vorliegenden Kollektiv entstammten vornehmlich dem N. facialis (n = 4), dem N. vagus (n = 4) oder dem
sympathischen Grenzstrang (n = 3). Die häufigsten Primärsymptome waren Schwellungen (n = 12) und Schmerzen (n = 3). MRT (n = 13),
Ultraschall (n = 12) und CT (n = 3) wurden zur Diagnostik eingesetzt. In 18 Fällen wurde ein chirurgischer Behandlungsansatz gewählt (n = 14
komplette Exstirpation, n = 3 Teilexstirpation, n = 1 unbekannter Resektionsumfang). Komplette Schwannomexstirpationen von
motorisch-efferentenNerven (n = 10) machten ein Absetzen des Nervens häufiger erforderlich, wenn bereits präoperativ ein motorisches Defizit
bestand (3 von 4 = 75 % bei präoperativem Defizit vs. 2 von 6 = 33 % ohne präoperatives Defizit).

Schlussfolgerung Extrakranielle Schwannome stellen seltene, meist vom N. facialis, dem sympathischen Grenzstrang oder den kaudalen
Hirnnerven ausgehende, benigne Tumore des HNO-Trakts dar, die in der Regel chirurgisch therapiert werden. Mit postoperativen motorischen
Defiziten bei kompletten Exstirpationen muss insbesondere bei bereits präoperativ bestehenden Funktionsstörungen gerechnet werden.
Keratokonus: heutige Therapieoptionen
Authors: Raiskup Frederik , Lenk Janine , Herber Robert , Gatzioufas Zisis , Spörl Eberhard
Published: July 2017

Die Inzidenz des Keratokonus wird in aktuellen Studien deutlich höher geschätzt als bisher angenommen, somit wird diese Hornhautektasie nicht mehr zu den seltenen Erkrankungen gezählt. Als einer der bedeutendsten Risikofaktoren für die Entstehung des Keratokonus wurde neben Atopie und Down-Syndrom das chronische Augenreiben definiert. Dies ist der durch Verhaltenstraining und konsequente Aufklärung einzig wirklich modifizierbare Risikofaktor. Weitere Therapieoptionen beinhalten Maßnahmen zur Visusverbesserung wie die Anpassung von Brillen und formstabilen Kontaktlinsen, die Implantation kornealer Ringsegmente oder phaker intraokularer Linsen. Im Falle einer Krankheitsprogression bietet das korneale Crosslinking ein effektives und sicheres Verfahren, sodass das Erfordernis einer Hornhauttransplantation in dieser Indikation immer seltener wird. Neuere Studien sehen auch einen positiven Effekt einer Kombination der bisher bei Keratokonus kontraindizierten photorefraktiven Keratektomie und dem Crosslinking. Die perforierende Keratoplastik stellt allerdings weiterhin den Goldstandard der chirurgischen Behandlung des Keratokonus im fortgeschrittenen Stadium dar, wobei in den letzten Jahren auch die lamellären Verfahren immer mehr in den Vordergrund rücken.
Comparison of B-Mode with B-Flow Sonography for the Evaluation of Femoral Arteries in Infants
Authors: Groth Michael , Dammann Elena , Arndt Florian , Ernst Marielle , Herrmann Jochen
Published: July 2017

Purpose To evaluate femoral arteries (FAs) in infants in the context of catheter angiography with B-mode (BMS) and B-flow sonography (BFS) and to compare both methods for vessel delineation and reliability of vessel diameter measurements.

Methods 21 consecutive infants who underwent ultrasound for the evaluation of FAs before or after cardiac catheterization were retrospectively included in this study. The diameter of the FAs and the maximum length of the vessel section displayed on a single ultrasound plane were recorded by two radiologists for BMS and BFS. The visual image quality was rated by one observer. Statistics included intraclass correlation coefficient, Bland-Altman analysis, Fisher´s exact test and t-test.

Results The intraobserver as well as interobserver correlation was excellent for BMS (0.7922 and 0.6521) and BFS (0.8094 and 0.7637). The Bland-Altman analysis revealed limits of agreement for BMS between +/–0.73 mm (intraobserver) and +/–0.55 mm (interobserver) and for BFS between +/–0.83 mm (intraobserver) and +/–0.7 mm (interobserver). BFS allowed visualization of a longer stretch of the FA than BMS (length 3.54 +/–0.85 vs. 2.21 +/–0.9 cm, p < 0.0001). The image quality was significantly higher for BFS (p = 0.0043).

Conclusion Since BFS shows excellent reproducibility for vessel measurements and superior image quality in infants, if available, BFS should be included in standard protocols when realistic measurements are required.

Key Points 

Citation Format
Bistability in mushroom-type metamaterials
Authors: Fernandes David E. , Silveirinha Mário G.
Published: July 2017

Here, we study the electromagnetic response of asymmetric mushroom-type metamaterials loaded with nonlinear elements. It is shown that near a Fano resonance, these structures may have a strong tunable, bistable, and switchable response and enable giant nonlinear effects. By using an effective medium theory and full wave simulations, it is proven that the nonlinear elements may allow the reflection and transmission coefficients to follow hysteresis loops, and to switch the metamaterial between “go” and “no-go” states similar to an ideal electromagnetic switch.
Probing ultrafast changes of spin and charge density profiles with resonant XUV magnetic reflectivity at the free-electron laser FERMI
Authors: Gutt C. , Sant T. , Ksenzov D. , Capotondi F. , Pedersoli E. , Raimondi L. , Nikolov I. P. , Kiskinova M. , Jaiswal S. , Jakob G. , Kläui M. , Zabel H. , Pietsch U.
Published: July 2017

We report the results of resonant magnetic XUV reflectivity experiments performed at the XUV free-electron laser FERMI. Circularly polarized XUV light with the photon energy tuned to the Fe M2,3 edge is used to measure resonant magnetic reflectivities and the corresponding Q-resolved asymmetry of a Permalloy/Ta/Permalloy trilayer film. The asymmetry exhibits ultrafast changes on 240 fs time scales upon pumping with ultrashort IR laser pulses. Depending on the value of the wavevector transfer Qz, we observe both decreasing and increasing values of the asymmetry parameter, which is attributed to ultrafast changes in the vertical spin and charge density profiles of the trilayer film.
A novel approach to estimating the Doppler shift frequency from quadrature mixer output
Authors: Wang M. Y. , Liu A. D. , Zhou C. , Hu J. Q. , Li H. , Lan T. , Xie J. L. , Ding W. X. , Liu W. D. , Yu C. X.
Published: July 2017

Doppler backscattering systems (DBSs) have been widely used in magnetic confinement fusion devices to measure the density fluctuations and propagation velocity of turbulence. However, the received signals of a DBS usually include both zero-order reflection and backscattering components, which results in interference in calculating the Doppler shift frequency from the backscattering components. A novel method is introduced here for estimating the Doppler shift frequency by separating the zero-order reflection and backscattering components using the cross-phase spectrum between the I-signal and Q-signal from a quadrature mixer, based on the difference in symmetrical characteristics between the zero-order reflection and backscattering signal spectra. It is proven that this method is more effective than traditional approaches, such as multiple signal classification and fast Fourier transformation, for extracting Doppler shift information.
Infrared optical absorption from hybrid 3-D a-Si:H/ZnO nanowire structures
Authors: Iheanacho Bright C. , Wong William S.
Published: July 2017

Hydrogenated amorphous silicon (a-Si:H) thin films were coated onto hydrothermally synthesized disordered zinc oxide (ZnO) nanowire networks to form three dimensional (3-D) hybrid nanowire/thin-film structures. The optical absorption of the hybrid structure was extended from the visible regime up to infrared wavelengths of 2.5 μm compared to a planar thin-film structure. By modulating the defect density of the a-Si:H shell, the optical absorption at 2.3 μm could be varied from 14% to 56%. The extended optical absorption was due to an increased effective thin-film thickness of the a-Si:H shell by three orders of magnitude through the 3-D ZnO-core/a-Si:H-shell structure and modulation of the defects within the a-Si:H shell layer.
Local structure of amorphous Ag5In5Sb60Te30 and In3SbTe2 phase change materials revealed by X-ray photoelectron and Raman spectroscopic studies
Authors: Sahu Smriti , Manivannan Anbarasu , Shaik Habibuddin , Mohan Rao G.
Published: July 2017

Reversible switching between highly resistive (binary “0”) amorphous phase and low resistive (binary “1”) crystalline phase of chalcogenide-based Phase Change Materials is accredited for the development of next generation high-speed, non-volatile, data storage applications. The doped Sb-Te based materials have shown enhanced electrical/optical properties, compared to Ge-Sb-Te family for high-speed memory devices. We report here the local atomic structure of as-deposited amorphous Ag5In5Sb60Te30 (AIST) and In3SbTe2 (IST) phase change materials using X-ray photoelectron and Raman spectroscopic studies. Although AIST and IST materials show identical crystallization behavior, they differ distinctly in their crystallization temperatures. Our experimental results demonstrate that the local environment of In remains identical in the amorphous phase of both AIST and IST material, irrespective of its atomic fraction. In bonds with Sb (∼44%) and Te (∼56%), thereby forming the primary matrix in IST with a very few Sb-Te bonds. Sb2Te constructs the base matrix for AIST (∼63%) along with few Sb-Sb bonds. Furthermore, an interesting assimilation of the role of small-scale dopants such as Ag and In in AIST, reveals rare bonds between themselves, while showing selective substitution in the vicinity of Sb and Te. This results in increased electronegativity difference, and consequently, the bond strength is recognized as the factor rendering stability in amorphous AIST.
Size effect in Pd77.5Cu6Si16.5 metallic glass micro-wires: More scattered strength with decreasing diameter
Authors: Yang G. N. , Li Z. , Guo F. M. , Luo Y. , Han Z. D. , Lu Z. C. , Wei J. Q. , Shao Y. , Yao K. F.
Published: July 2017

A size effect of more scattered strength with decreasing diameter is revealed by tension experiments on melt-spinning fabricated Pd77.5Cu6Si16.5 metallic glass microwires, and is explained from a perspective of structural inhomogeneity and a higher structure sensitivity of metallic glasses under tension condition and in a large aspect ratio. Such a result differs from the understanding of “the smaller the stronger” in the compression behaviors of metallic glasses, but indicates that the shear bands in metallic glasses actually could nucleate in a wide stress range. This finding could provide experimental evidence for the inhomogeneous structure and size effect in metallic glasses at the micro-scale, and could help the further study of their mechanical behaviors and substantial deformation mechanism.
Starch and protein digestive dynamics in low-protein diets supplemented with crystalline amino acids
Authors: Liu S. Y. , Selle P. H.
Published: July 2017

Digestive dynamics of starch and protein is defined as digestion of starch and protein, absorption of glucose and amino acids from the gut lumen and their transition across enterocytes to enter the portal circulation. Digestive dynamics consider the extent, rate and site of nutrient digestion along the small intestine and the bilateral, post-enteral bioavailability of glucose and amino acids. The underlying premise is that glucose and amino acids should be made available in appropriately balanced quantities at the sites of protein synthesis for efficient protein deposition and growth performance. Previous studies have suggested that feed conversion efficiency may be enhanced by rapidly digestible protein and that crystalline amino acids could be considered sources of ‘rapid protein’. At present, crystalline lysine, methionine and threonine are routinely included in broiler diets; moreover, an increasing array of both essential and non-essential crystalline amino acids is becoming commercially available. Despite unrestricted feed access in commercial chicken-meat production systems during the period of illumination, it appears that the intermittent feed consumption patterns of broiler chickens still provide scope for asynchronies in digestion and absorption of nutrients, which affects broiler performance. A better understanding of the post-enteral, bilateral bioavailability of glucose and amino acids in low-protein diets containing high levels of synthetic amino acids is clearly desirable and this applies equally to the relationship between crystalline and protein-bound amino acids.
Sediment accretion and accumulation of P, N and organic C in depressional wetlands of three ecoregions of the United States
Authors: Lane C. R. , Autrey B. C.
Published: July 2017

Wetland depressions without surface channel connections to aquatic systems are substantial sinks for nitrogen (N), phosphorus (P) and organic carbon (org. C). We assessed accretion, N, P and org.-C accumulation rates in 43 depressional wetlands across three ecoregions of the USA (Erie Drift Plain, EDP; Middle Atlantic Coastal Plain, MACP; Southern Coastal Plain, SCP) using caesium-137 (137Cs). The mean sediment accretion rate in minimally affected (reference) sites was 0.6±0.4mmyear–1 and did not differ among ecoregions. Accumulation rates for N and org. C averaged 3.1±3.1gNm–2year–1 and 43.4±39.0g org. Cm–2year–1 respectively, and did not differ across minimally affected sites. Phosphorus accumulation rates were significantly greater in EDP (0.10±0.10gPm–2year–1) than MACP (0.01±0.01gPm–2year–1) or SCP (0.04±0.04gPm–2year–1) sites. Land-use modality and wetland-type effects were analysed in SCP, with few differences being found. Depressional wetlands sequester substantive amounts of nutrients and C; their cumulative contributions may significantly affect landscape nutrient and C dynamics because of the abundance of wetland depressions on the landscape, warranting further investigation and potential watershed-scale conservation approaches.
Trends in mica–mica adhesion reflect the influence of molecular details on long-range dispersion forces underlying aggregation and coalignment
Authors: Li Dongsheng , Chun Jaehun , Xiao Dongdong , Zhou Weijiang , Cai Huacheng , Zhang Lei , Rosso Kevin M. , Mundy Christopher J. , Schenter Gregory K. , De Yoreo James J.
Published: July 2017

Significance

Crystal growth through nanoparticle assembly appears to be a common phenomenon in synthetic, biological, and geochemical settings, and can lead to formation of hierarchical structures with unique properties tied to this nonclassical assembly process, but the underlying forces driving assembly are poorly understood. Using custom-made single-crystal atomic force microscopy tips, we measured the adhesion force between mica surfaces in the solvent-separate regime as a function of crystallographic orientation and solution parameters. The observed dependencies are predicted using a continuum description of the electrostatic and electrodynamic interactions that includes short-range molecular details. The findings show that the attractive interaction driving nanoparticle assembly and orientation results from the coupling between the short-range solution response and the long-range van der Waals interactions.
Mechanism-based inactivator of isocitrate lyases 1 and 2 fromMycobacterium tuberculosis
Authors: Pham Truc V. , Murkin Andrew S. , Moynihan Margaret M. , Harris Lawrence , Tyler Peter C. , Shetty Nishant , Sacchettini James C. , Huang Hsiao-ling , Meek Thomas D.
Published: July 2017

Significance

Tuberculosis, caused byMycobacterium tuberculosis(Mtb) bacteria, is the most prevalent infectious disease, affecting one-third of the global population, especially in developing countries. First-line therapies to treat this disease are losing efficacy due to the emergence of drug resistance. Accordingly, new therapeutic agents of novel mechanisms of action remain an urgent medical need. The isocitrate lyases (ICL1 and ICL2) comprise metabolically essential enzymes ofMtb, are absent in mammals, and thereby provide therapeutically important drug targets for tuberculosis. Here, we describe the first example of a mechanism-based inactivator of ICL1 and ICL2 that could provide a starting point for the development of new drugs to treat tuberculosis.
Visualization as assemblage
Authors: Dávila Patricio
Published: July 2017

The Anti-Eviction Mapping Project is an example of critical visualization practice that interrogates both its own conditions of production and how who is represented is also affected by the representations. In order to describe and analyze this form of practice the notion of assemblage as well as tools from actor-network theory are employed. These concepts allow the researcher or designer to consider how visualizations operate beyond its existence as a discrete representation but rather as a process that weaves a network of humans and non-humans together which is especially relevant to a critical engagement in information visualization practice.
One view is not enough
Authors: Dörk Marian , Pietsch Christopher , Credico Gabriel
Published: July 2017

As cultural institutions are digitizing their artifacts and interlinking their collections, new opportunities emerge to engage with cultural heritage. However, it is the often comprehensive and complex nature of collections that can make it difficult to grasp their distribution and extent across a variety of dimensions. After a brief introduction to the research area of collection visualizations, this paper presents a design study visualizing an aggregated collection from diverse cultural institutions in Germany. We detail our iterative design process leading to prototypical implementations of four stylistically and functionally coordinated visualizations, each one focusing on different facets of the collection.
Designing diagrams for Wikipedia
Authors: Mauri Michele , Pini Azzurra , Ciuccarelli Paolo
Published: July 2017

Despite the high usage of diagrams and images in Wikipedia, as well as across all Wikimedia projects, few studies have been conducted on the role of visual contents within the online encyclopedia and on the collaborative creation of diagrams. This article describes research that brought a group of designers into Wikipedia, with the goal of exploring how information designers act on this platform and how other users react to their involvement. Inspired by the WikiEdu Program, we engaged postgraduate design students in the creation of diagrams for Wikipedia and then followed the reactions of both users and designers to their work. The results of the experiment have been evaluated using built-in Wikipedia functions (e.g., page history and discussion pages) and through an anonymous survey among the students involved. This experience brought to light the different consideration granted to images and diagrams with respect to texts on the online encyclopedia. It also allowed a reflection on the role of designers in the knowledge production process, as well as on the meaning of producing “open” contents, which are meant to be improved by other people.
Proving the value of visual design in scientific communication
Authors: Cheng Karen , Chen Yeechi , Larson Kevin , Rolandi Marco
Published: July 2017

This study examines how scientists respond to visual design in scientific communications. Specifically, we determine the impact of visual design on the Graphical Abstract (GA), an overview figure that attracts potential readers and visually summarizes what a paper is about. We show that GAs designed in accordance with classic visual design principles significantly enhance readers’ first impressions of a paper. Well-designed GAs make papers seem more interesting, more clearly written and more scientifically rigorous. These results confirm that visual design enhances rather than detracts from the perception of intellectual and scientific competence.
Visualising medical evidence on sepsis treatment
Authors: Stahl-Timmins Will
Published: July 2017

Visual information can have a range of benefits for busy health practitioners. At The BMJ, we often use visuals to provide quick summaries of information from at times lengthy articles. This paper presents a case study of the design process for an interactive graphic on sepsis treatment, aiming to update doctors working in intensive care units of current evidence. Through explaining this design process, four major challenges for the use of interactive graphics in science publishing are highlighted: (1) how to identify suitable knowledge for visualisations; (2) how to select an appropriate depth of information for a particular project; (3) how interactive graphics can be a permanent part of the scientific record, and (4) how they can be deployed across a range of platforms and devices.
The domestications and the domesticators of Asian rice
Authors: van Driem George
Published: July 2017

Rice genetics has now provided molecular evidence for three distinct domestications of Asian rice, giving rise to ahu, indica and japonica rice and subsequently involving the multidirectional introgression of favoured alleles between these three families of Oryza sativa cultivars. The phylogeography of Asian wild and cultivated rice species also permits inferences with regard to the likely geographical range within which these three domestication processes involving Asian cultivated rice unfolded. Evidence from linguistic palaeontology permits the identification of two language families whose linguistic ancestors pose the likeliest candidates for the earliest rice domesticators, Austroasiatic and Hmong-Mien. The linguistic arguments and population genetic evidence on Asian rice are assessed. Recent advances in palaeobotany as well as a number of currently prevalent misunderstandings in rice archaeology are discussed. Another set of evidence from linguistic palaeontology involving reconstructible etyma denoting megafauna in light of the early Holocene distribution of these megafaunal species provides a geographical indication for the location of the early Austroasiatic homeland. Furthermore, the molecular genetics of human populations are discussed in order to shed light on the prehistory and geography of the Austroasiatic, Hmong-Mien and other language families. Finally, a synthesis of the disparate sets of evidence is presented.
DOOR: a prokaryotic operon database for genome analyses and functional inference
Authors: Cao Huansheng , Ma Qin , Chen Xin , Xu Ying
Published: July 2017

The rapid accumulation of fully sequenced prokaryotic genomes provides unprecedented information for biological studies of bacterial and archaeal organisms in a systematic manner. Operons are the basic functional units for conducting such studies. Here, we review an operon database DOOR (the Database of prOkaryotic OpeRons) that we have previously developed and continue to update. Currently, the database contains 6 975 454 computationally predicted operons in 2072 complete genomes. In addition, the database also contains the following information: (i) transcriptional units for 24 genomes derived using publicly available transcriptomic data; (ii) orthologous gene mapping across genomes; (iii) 6408 cis-regulatory motifs for transcriptional factors of some operons for 203 genomes; (iv) 3 456 718 Rho-independent terminators for 2072 genomes; as well as (v) a suite of tools in support of applications of the predicted operons. In this review, we will explain how such data are computationally derived and demonstrate how they can be used to derive a wide range of higher-level information needed for systems biology studies to tackle complex and fundamental biology questions.
VCF-Explorer: filtering and analysing whole genome VCF files
Authors: Akgün Mete , Demirci Hüseyin
Published: July 2017

The decreasing cost in high-throughput technologies led to a number of sequencing projects consisting of thousands of whole genomes. The paradigm shift from exome to whole genome brings a significant increase in the size of output files. Most of the existing tools which are developed to analyse exome files are not adequate for larger VCF files produced by whole genome studies. In this work we present VCF-Explorer, a variant analysis software capable of handling large files. Memory efficiency and avoiding computationally costly pre-processing step enable to carry out the analysis to be performed with ordinary computers. VCF-Explorer provides an easy to use environment where users can define various types of queries based on variant and sample genotype level annotations. VCF-Explorer can be run in different environments and computational platforms ranging from a standard laptop to a high performance server.

Availability and implementation

VCF-Explorer is freely available at: http://vcfexplorer.sourceforge.net/.

Supplementary information

Supplementary data are available at Bioinformatics online.
DynaPho: a web platform for inferring the dynamics of time-series phosphoproteomics
Authors: Hsu Chia-Lang , Wang Jian-Kai , Lu Pei-Chun , Huang Hsuan-Cheng , Juan Hsueh-Fen
Published: July 2017

Large-scale phosphoproteomics studies have improved our understanding of dynamic cellular signaling, but the downstream analysis of phosphoproteomics data is still a bottleneck. We develop DynaPho, a useful web-based tool providing comprehensive and in-depth analyses of time-course phosphoproteomics data, making analysis intuitive and accessible to non-bioinformatics experts. The tool currently implements five analytic modules, which reveal the transition of biological pathways, kinase activity, dynamics of interaction networks and the predicted kinase-substrate associations. These features can assist users in translating their larger-scale time-course phosphoproteomics data into valuable biological discoveries.

Availability and implementation

DynaPho is freely available at http://dynapho.jhlab.tw/.

Supplementary information

Supplementary data are available at Bioinformatics online.
Effect of Soybean Cyst Nematode Resistance Source and Seed Treatment on Population Densities of Heterodera glycines, Sudden Death Syndrome, and Yield of Soybean
Authors: Kandel Yuba R. , Wise Kiersten A. , Bradley Carl A. , Chilvers Martin I. , Byrne Adam M. , Tenuta Albert U. , Faghihi Jamal , Wiggs Stith N. , Mueller Daren S.
Published: July 2017

A three-year study was conducted in Illinois, Indiana, Iowa, Michigan, and Ontario, Canada, from 2013 through 2015 to determine the effect of soybean (Glycine max) cultivars’ source of soybean cyst nematode (SCN; Heterodera glycines) resistance on SCN population densities, sudden death syndrome (SDS; caused by Fusarium virguliforme), and yield of soybean. Five cultivars were evaluated with and without fluopyram seed treatment at each location. Cultivars with no SCN resistance had greater SDS severity, greater postharvest SCN egg counts (Pf), and lower yield than cultivars with plant introduction (PI) 548402 (Peking) and PI 88788-type of SCN resistance (P < 0.05). Cultivars with Peking-type resistance had lower Pf than those with PI 888788-type and no SCN resistance. In two locations with HG type 1.2-, cultivars with Peking-type resistance had greater foliar disease index (FDX) than cultivars with PI 88788-type. Fluopyram seed treatment reduced SDS and improved yield compared with a base seed treatment but did not affect SCN reproduction and Pf (P > 0.05). FDX and Pf were positively correlated in all three years (P < 0.01). Our results indicate that SDS severity may be influenced by SCN population density and HG type, which are important to consider when selecting cultivars for SCN management.
The ethics/advocacy connection
Authors: Smith Mary Atkinson
Published: July 2017

What are the ethical leadership qualities of nurses, and how do these traits contribute to competent, safe patient care?
A Technique of Awake Bronchoscopic Endotracheal Intubation for Respiratory Failure in Patients With Right Heart Failure and Pulmonary Hypertension
Authors: Johannes Jimmy , Berlin David A. , Patel Parimal , Schenck Edward J. , West Frances Mae , Saggar Rajan , Barjaktarevic Igor Z.
Published: July 2017

Objective:

Patients with pulmonary hypertension and right heart failure have a high risk of clinical deterioration and death during or soon after endotracheal intubation. The effects of sedation, hypoxia, hypoventilation, and changes in intrathoracic pressure can lead to severe hemodynamic instability. In search for safer approach to endotracheal intubation in this cohort of patients, we evaluate the safety and feasibility of an alternative intubation technique.

Data Sources:

Retrospective data analysis.

Study Selection:

Two medical ICUs in large university hospitals in the United States.

Data Extraction:

We report a case series of nine nonconsecutive patients with compromised right heart function, pulmonary hypertension, and severe acute hypoxemic respiratory failure who underwent endotracheal intubation with a novel technique combining awake bronchoscopic intubation supported with nasally delivered noninvasive positive pressure ventilation or high-flow nasal cannula.

Data Synthesis:

All patients were intubated in the first attempt without major complications and eight patients (88%) were alive 24 hours after intubation. Systemic hypotension was the most frequent complication following the procedure.

Conclusions:

Awake bronchoscopic intubation supported with a noninvasive positive pressure delivery systems may be feasible alternative to standard direct laryngoscopy approach. Further studies are needed to better assess its safety and applicability.
Effects of the Smartphone Application “Safe Patients” on Knowledge of Patient Safety Issues Among Surgical Patients
Authors: Cho Sumi , Lee Eunjoo
Published: July 2017

Recently, the patient’s role in preventing adverse events has been emphasized. Patients who are more knowledgeable about safety issues are more likely to engage in safety initiatives. Therefore, nurses need to develop techniques and tools that increase patients’ knowledge in preventing adverse events. For this reason, an educational smartphone application for patient safety called “Safe Patients” was developed through an iterative process involving a literature review, expert consultations, and pilot testing of the application. To determine the effect of “Safe Patients,” it was implemented for patients in surgical units in a tertiary hospital in South Korea. The change in patients’ knowledge about patient safety was measured using seven true/false questions developed in this study. A one-group pretest and posttest design was used, and a total of 123 of 190 possible participants were tested. The percentage of correct answers significantly increased from 64.5% to 75.8% (P < .001) after implementation of the “Safe Patients” application. This study demonstrated that the application “Safe Patients” could effectively improve patients’ knowledge of safety issues. This will ultimately empower patients to engage in safe practices and prevent adverse events related to surgery.
Subtotal Colectomy for Colon Cancer Reduces the Need for Subsequent Surgery in Lynch Syndrome
Authors: Renkonen-Sinisalo Laura , Seppälä Toni T. , Järvinen Heikki J. , Mecklin Jukka-Pekka
Published: July 2017

BACKGROUND:

The risk of metachronous colorectal cancer is high after surgical resection for first colon cancer in Lynch syndrome.

OBJECTIVE:

This study aimed to examine whether extended surgery decreases the risk of subsequent colorectal cancer and improves long-term survival.

DESIGN:

This was a retrospective study.

SETTING:

Data were collected from a nationwide registry.

PATIENTS:

Two hundred forty-two Lynch syndrome pathogenic variant carriers who underwent surgery for a first colon cancer from 1984 to 2009 were included.

INTERVENTIONS:

Patients underwent standard segmental colectomy (n = 144) or extended colectomy (n = 98) for colon cancer. Patients were followed a median of 14.6 up to 25 years.

MAIN OUTCOME MEASURES:

Risk of subsequent colorectal cancer in either group, overall and disease-specific survival, and operative mortality were the primary outcomes measured.

RESULTS:

Subtotal colectomy decreased the risk of subsequent colorectal cancer (HR, 0.20; 95% CI, 0.08–0.52; p = 0.001), compared with segmental resection. Subsequent colorectal cancer decreased in MLH1 carriers. The MSH2 carriers showed no statistical difference, possibly because of their small number. Disease-specific and overall survival within 25 years did not differ between the standard and extended surgeries (82.7% vs 87.2%, p = 0.76 and 47.2% vs 41.4%, p = 0.83). The cumulative risk of subsequent colorectal cancer was 20% in 10 years and 47% within 25 years after standard resection and 4% and 9% after extended surgery. The cumulative risk of metachronous colorectal cancer was 7% within 25 years after subtotal colectomy with ileosigmoidal anastomosis. One patient died of postoperative septicemia within 30 days after segmental colectomy.

LIMITATIONS:

Data on surgical procedures were primarily collected retrospectively.

CONCLUSIONS:

Lynch syndrome pathogenic variant carriers may undergo subtotal colectomy to manage first colon cancer and avoid repetitive abdominal surgery and to reduce the remaining bowel to facilitate easier endoscopic surveillance. It provides no survival benefit, compared with segmental colon resection. See Video Abstract at http://links.lww.com/DCR/A319.
Does a Defunctioning Stoma Impair Anorectal Function After Low Anterior Resection of the Rectum for Cancer? A 12-Year Follow-up of a Randomized Multicenter Trial
Authors: Gadan Soran , Floodeen Hannah , Lindgren Rickard , Matthiessen Peter
Published: July 2017

BACKGROUND:

Anorectal function after low anterior resection of the rectum for cancer is often impaired, and long-term outcome has not frequently been reported.

OBJECTIVE:

We evaluated anorectal function 12 years after rectal resection with regard to whether patients had a defunctioning temporary stoma at the initial rectal resection.

DESIGN:

An exploratory cross-sectional investigation of a previously randomized study population.

SETTINGS:

Twenty-one Swedish hospitals performing rectal cancer surgery during a 5-year period participated in the trial.

PATIENTS:

Patients operated on with low anterior resection for cancer were included.

INTERVENTIONS:

Patients were randomly assigned to receive or not receive a temporary defunctioning stoma.

MAIN OUTCOME MEASURES:

We evaluated anorectal function 12 years after low anterior resection in patients who were initially randomly assigned to temporary stoma or not, by means of using the low anterior resection syndrome score questionnaire, which assesses incontinence for flatus, incontinence for liquid stools, defecation frequency, clustering, and urgency. Self-perceived health status was evaluated by the EQ-5D-3L questionnaire.

RESULTS:

Eighty-nine percent (87/98) of the patients responded to the questionnaires, including 46 with and 41 without an initial temporary stoma. Patient demography was comparable between the groups. No differences regarding major, minor, and no low anterior resection syndrome categories were found between the groups. The stoma group had increased incontinence for flatus (p = 0.03) and liquid stools (p = 0.005) and worse overall low anterior resection syndrome score (p = 0.04) but no differences regarding frequency, clustering, and urgency.

LIMITATIONS:

The study was limited by its sample size (n = 98) based on a previously randomized trial population (n = 234).

CONCLUSIONS:

After low anterior resection for cancer, the incidence of the categories major, minor, and no low anterior resection syndrome were comparable in the stoma and the no-stoma groups. Incontinence for flatus and liquid stools was more commonly reported by patients who were randomly assigned to temporary stoma, as compared with those without, which may indicate an association between temporary stoma and impaired anorectal function. See Video Abstract at http://links.lww.com/DCR/A413.
Therapeutic Drug Monitoring of Gentamicin Peak Concentrations in Critically Ill Patients
Authors: Hodiamont Caspar J. , Janssen Julie M. , de Jong Menno D. , Mathôt Ron A. , Juffermans Nicole P. , van Hest Reinier M.
Published: July 2017

Background:

Adequate gentamicin peak concentrations (Cmax) are important for optimal clinical efficacy. Within a critically ill patient, substantial variability in Cmax can occur over time, hampering the usefulness of therapeutic drug monitoring (TDM). The aim of this study was to evaluate the effect of gentamicin dosing based on Cmax after the first dose on gentamicin target attainment in critically ill patients.

Methods:

From gentamicin-treated critically ill patients, dosing information, clinical parameters, and serum concentrations were collected prospectively. A population pharmacokinetic model was developed using nonlinear mixed-effects modeling to estimate Cmax after each dose. To evaluate the usefulness of routine TDM, percentages of Cmax within (%Cther, 15–20 mg/L), above (>20 mg/L), and below (%Csubther, <15 mg/L) the therapeutic range after the first and second doses were compared. In addition, simulations were performed to evaluate the impact of TDM.

Results:

Four hundred sixteen measurements from 59 patients receiving 130 gentamicin doses were included. In the 30 patients who received >1 dose, TDM increased %Cther from 40% after a first median dose of 5.0 mg/kg to 50% after the second dose, and decreased %Csubther from 47% to 30%. Simulations using a 5 mg/kg starting dose revealed %Cther after the second dose of 28.4% without and 36.8% with TDM and %Csubther of 56.9% and 29.3%, respectively. Increasing the simulated starting dose to 6 mg/kg increased %Cther after the first dose from 27.7% to 33.5% and decreased %Csubther from 58.6% to 35.6%. TDM after a first dose of 6 mg/kg had no substantial effect on %Cther or %Csubther after the second dose.

Conclusions:

Gentamicin dosing based on Cmax after the first dose increased %Cther and decreased %Csubther, but did not result in therapeutic Cmax in half of the patients. When simulating a higher starting dose, %Csubther after the first dose decreased, and TDM showed no additional influence. These data suggest that a starting dose of 6 mg/kg should be considered and that repeated Cmax measurements are not of added value.
Brain processing of the temporal dimension of acute pain in short-term memory
Authors: Khoshnejad Mina , Roy Mathieu , Martinu Kristina , Chen Jen-I , Cohen-Adad Julien , Grondin Simon , Rainville Pierre
Published: July 2017

The dynamics of noxious sensation shapes pain perception, yet the memory of the temporal dimension of pain remains almost completely unexplored. Here, brain activity during the memory of pain duration was contrasted with that associated with the memory of pain intensity using functional magnetic resonance imaging and a delayed reproduction task. Participants encoded, maintained during a short delay, and reproduced (1) the “duration” of pain (ie, onset-to-offset), (2) the “dynamics” of pain (ie, evolution of pain over time), or (3) the intensity of pain (ie, control with no explicit temporal processing required). Results show that the inferior frontal gyrus/insula and adjacent striatal structures as well as the supramarginal and middle temporal gyri are activated in the duration task compared to the control intensity task. Specific examination of the memory delay of the duration task further revealed activation in the supramarginal gyrus extending to the parietal operculum (possibly SII) and primary somatosensory cortex (SI). In contrast, the memory delay of the dynamic task involved the bilateral supplementary motor area and the frontoparietal attentional network. Although SI, SII, and insula may contribute to the memory trace of pain sensation, other areas less commonly reported in pain studies are associated with time processing and may therefore contribute to the processing of temporal aspects of pain. Results further suggest a differential role of core timing regions of the brain depending on specific task instructions and attentional allocations to the single dimension of time, as compared to the joint processing of both time and intensity.
Connection of a Renal Replacement Therapy or Plasmapheresis Device to the ECMO Circuit
Authors: Laverdure Florent , Masson Laurent , Tachon Guillaume , Guihaire Julien , Stephan François
Published: July 2017

In patients under extracorporeal membrane oxygenation (ECMO) support requiring renal replacement therapy or plasmapheresis, connecting such extracorporeal therapy device to the ECMO circuit provides many advantages compared with central venous catheterization. However, high pressures of the ECMO circuit limit the usefulness of this technique. We propose a new approach to connect extracorporeal therapy lines to the ECMO circuit. Inlet line is connected to the oxygenator, and outlet line is connected either to the femoral artery antegrade perfusion cannula in case of venoarterial ECMO or to the lateral vent of the return cannula in case of venovenous ECMO. We report the successful management of 21 patients using this connection, with much longer hemofilter average lifetime than previously reported.
The Role of Esophageal Hypersensitivity in Functional Heartburn
Authors: Kondo Takashi , Miwa Hiroto
Published: July 2017

Functional heartburn (FH) is defined as a functional esophageal disorder characterized by symptoms of chronic heartburn with no apparent correlation to acid or nonacid reflux. In addition, its symptoms persist despite the lack of organic abnormalities or inflammation, esophageal motility disorders, or metabolic disorders. Although conditions presenting with esophageal symptoms without endoscopic abnormalities were previously categorized as nonerosive reflux disease, such conditions are now classified into 3 categories under Rome IV criteria: nonerosive reflux disease, reflux hypersensitivity, and FH. Although many aspects of FH remain unclear, its onset mechanism is considered to be strongly associated with peripheral or central sensitization, given the fact that its symptoms seem to be unrelated to gastroesophageal reflux. In addition, the cause of such hypersensitivity is an interesting topic in itself, and psychological factors, such as stress followed by increasing esophageal permeability are gaining attention as factors that can potentially influence this condition. There is a great unmet clinical need for therapeutic drugs that can be used to treat FH, and the development of novel drugs, diagnostic tests and biomarkers is eagerly awaited.
Bariatric endoscopy: state-of-the-art
Authors: Kumbhari Vivek , Hill Christine , Sullivan Shelby
Published: July 2017

Purpose of review

This review aims to present the current state of the field, highlight recent developments, and describe the clinical outcomes of these endoscopic bariatric and metabolic procedures.

Recent findings

There are an increasing number of devices and techniques that are available for the endoluminal treatment of obesity. It is now possible to offer FDA approved endoscopic therapies for patients with BMI as high as 55 kg/m2. Although tremendous advances have been made, there is room for additional emphasis with regards to the metabolic improvements seen with these therapies, in addition to highlighting weight loss outcomes. Furthermore, for optimal outcomes, it is imperative that all endoluminal techniques are combined with at least a moderate intensity diet and lifestyle intervention for a minimum of 12 months.

This field bridges a gap between lifestyle counseling with or without pharmaceutical treatment and the most effective treatment of obesity, bariatric surgery. Owing to its minimally invasive nature, endoscopic metabolic and bariatric therapy has the potential to appeal patients who either do not qualify or do not want bariatric surgery and have not been adequately treated with medical therapy. In addition, these therapies may be beneficial early on in the onset of obesity.
Immunology of pancreatitis and environmental factors
Authors: Lee Bomi , Zhao Qinglan , Habtezion Aida
Published: July 2017

Purpose of review

This report reviews recent aspects of pancreatitis immunology and environmental factors that link to development and progression of disease.

Recent findings

Limited human and animal model studies have recently attempted to understand immune mechanisms that lead to the pathogenesis of acute and chronic pancreatitis. Based on these studies innate immune responses emerge as critical elements in disease pathogenesis and severity of inflammation. The immune basis for environmental factors such as smoking, which are highly associated with disease progression highlight novel cross talk mechanisms between immune and nonimmune pancreatic cells such as the pancreatic stellate cells.

Better understanding of immune responses and signaling pathways are emerging as important contributors in pancreatitis development and progression. Such mechanisms are likely to offer future targetable therapies that can either halt or reverse disease progression.
Protein changes in non-LDL-lipoproteins in familial hypercholesterolemia: implications in cardiovascular disease manifestation and outcome
Authors: Badimon Lina , Padró Teresa , Cubedo Judit
Published: July 2017

Purpose of review

Familial hypercholesterolemia, represents one of the most extreme clinical entities associated with premature coronary artery disease (CAD). However, clinical manifestation of CAD varies across cohorts and individual patients suggesting the existence of additional non-LDL factors potentially contributing to their cardiovascular burden.

Recent findings

Changes in HDL-associated proteins appear as one of the potential additional factors contributing to the cardiovascular risk in familial hypercholesterolemia. Specifically, the content of Apo M-SP1 in HDL3 has been directly associated with cholesterol efflux capacity. In addition, a coordinated decrease in the content of Apo L1 and LCAT in HDL3 has been related to the presence of corneal arcus and to bad prognosis in familial hypercholesterolemia patients after an acute ischemic event. In fact, HDL3 particles of familial hypercholesterolemia patients have diminished antioxidant and anti-inflammatory function.

The identification of the specific changes in HDL-associated proteins that contribute to the increased cardiovascular risk of familial hypercholesterolemia patients could be useful for the development of novel therapeutic targets. These novel strategies, in combination with current lipid-lowering therapies, may help to reduce the residual risk found in these patients.