bluuebunny/crossref_metadata_2025 huggingface dataset:
Availability of carbon and nitrogen in soil affects Metarhizium robertsii root colonization and transfer of insect-derived nitrogen
Authors: Barelli Larissa , Behie Scott W , Bidochka Michael J
Published: September 2019

The endophytic, insect pathogenic fungus, Metarhizium, exchanges insect-derived nitrogen for photosynthate as part of a symbiotic association similar to well-known mycorrhizal relationships. However, little is known about this nitrogen transfer in soils where there is an abundance of nitrogen and/or carbon. Here, we applied D-glucose and ammonium nitrate to soil to examine the effect on root colonization and transfer of labelled nitrogen (15N) from an insect (injected with 15N-ammonium sulfate) to Metarhizium robertsii, into leaves of the common bean, Phaseolus vulgaris, over the course of 28 days. Application of exogenous carbon and/or nitrogen to soils significantly reduced detectable 15N in plant leaves. Metarhizium root colonization, quantified with real-time PCR, revealed colonization persisted under all conditions but was significantly greater on roots in soil supplemented with glucose and significantly lower in soil supplemented with ammonium nitrate. Fungal gene expression analysis revealed differential expression of sugar and nitrogen transporters (mrt, st3, nrr1, nit1, mep2) when Metarhizium was grown in pure broth culture or in co-culture with plant roots under various carbon and nitrogen conditions. The observation that Metarhizium maintained root colonization in the absence of nitrogen transfer, and without evidence of plant harm, is intriguing and indicates additional benefits with ecological importance.
Lnc-TCL6 is a potential biomarker for early diagnosis and grade in liver-cirrhosis patients
Authors: Li Lei-Jia , Wu Xiao-Ying , Tan Si-Wei , Xie Zi-Jun , Pan Xue-Mei , Pan Shun-Wen , Bai Wu-Ri-Na , Li Hai-Jiao , Liu Hui-Ling , Jiang Jie , Wu Bin
Published: September 2019

Background

Long non-coding RNAs (lncRNAs) have been applied as biomarkers in many diseases. However, scarce biomarkers are available in single lncRNA differential expression associated with different clinical stages of liver cirrhosis (LC). The aim of the study is to identify some lncRNAs that can serve as non-invasive sensitive biomarkers for early diagnosis and grade of LC.

Methods

Blood lncRNA expression was evaluated in three independent cohorts with 305 participants including healthy controls, hepatitis B virus (HBV) carriers, and patients with chronic hepatitis B (CHB) or LC. First, candidate lncRNAs were screened by CapitalBiotech microarray to diagnose cirrhosis. Quantitative reverse-transcriptase polymerase chain reaction was then used to investigate the expression of selected lncRNAs in the whole group of cirrhosis and different Child–Pugh classes. Ultimately, the diagnostic accuracy of the promising biomarker was examined and validated via Mann–Whitney test and receiver-operating characteristics analysis.

Results

Lnc-TCL6 was identified as a sensitive biomarker for early diagnosis of LC (Child–Pugh A) compared with healthy controls (area under the ROC curve [AUC] = 0.636), HBV carriers (AUC = 0.671), and CHB patients (AUC = 0.672). Furthermore, lnc-TCL6 showed a favourable capacity in discriminating among different Child–Pugh classes (AUC: 0.711–0.837). Compared with healthy controls, HBV carriers, and CHB patients, the expression of lnc-TCL6 was obviously up-regulated in Child–Pugh A patients and, conversely, significantly down-regulated in Child–Pugh C patients.

Conclusions

Lnc-TCL6 is a novel potential biomarker for early diagnosis of LC and is a possible predictor of disease progression.
The Impact of Multiple Rounds of Indoor Residual Spraying on Malaria Incidence and Hemoglobin Levels in a High-Transmission Setting
Authors: Zinszer Kate , Charland Katia , Vahey Sarah , Jahagirdar Deepa , Rek John C , Arinaitwe Emmanuel , Nankabirwa Joaniter , Morrison Kathryn , Sadoine Margaux L , Tutt-Guérette Marc-Antoine , Staedke Sarah G , Kamya Moses R , Greenhouse Bryan , Rodriguez-Barraquer Isabel , Dorsey Grant
Published: September 2019

Background

Indoor residual spraying (IRS) is widely used as a vector control measure, although there are conflicting findings of its effectiveness in reducing malaria incidence. The objective of this study was to estimate the effect of multiple IRS rounds on malaria incidence and hemoglobin levels in a cohort of children in rural southeastern Uganda.

Methods

The study was based upon a dynamic cohort of children aged 0.5–10 years enrolled from August 2011 to June 2017 in Nagongera Subcounty. Confirmed malaria infections and hemoglobin levels were recorded over time for each participant. After each of 4 rounds of IRS, malaria incidence, hemoglobin levels, and parasite density were evaluated and compared with pre-IRS levels. Analyses were carried out at the participant level while accounting for repeated measures and clustering by household.

Results

Incidence rate ratios comparing post-IRS to pre-IRS incidence rates for age groups 0–3, 3–5, and 5–11 were 0.108 (95% confidence interval [CI], .078–.149), 0.173 (95% CI, .136–.222), and 0.226 (95% CI, .187–.274), respectively. The mean hemoglobin levels significantly increased from 11.01 (pre-IRS) to 12.18 g/dL (post-IRS).

Conclusions

Our study supports the policy recommendation of IRS usage in a stable and perennial transmission area to rapidly reduce malaria transmission.
Metabolic syndrome and related risk factors among adults in the northern West Bank, a cross-sectional study
Authors: Damiri Basma , Badran Luna , Safadi Deya , Sawalha Ahmad , Yasin Younis , Sawalha Mahmoud , Amir Moath
Published: September 2019

Background

Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors that includes central obesity, insulin resistance, dyslipidaemia and hypertension. The aim of this study was to establish the prevalence of MetS and its associated risk factors among adult Palestinians using the International Diabetes Federation definition.

Methods

A total of 1348 subjects ages 18–65 y were recruited in a cross-sectional study that was conducted in 2018–2019 in the northern West Bank.

Results

A total of 1082 subjects participated; 51.7% were men. The prevalence of MetS was high (44.9%), and higher among women (46.1%) than men (44.2%) (p<0.001). The prevalence increased significantly with increasing age and body mass index (BMI) in both genders (p<0.001). However, metabolically obese but normal weight individuals (MONW) (8.4%) were also identified, with a slight increase among women (9.4%) compared with men (7.5%) (p=0.56). MetS was more likely to be prevalent among participants with increased fasting blood sugar (5.8 times), increased triglyceride (7.4 times), increased blood pressure (4.5 times) and BMI ≥25 (19.9 times) (p<0.001). The prevalence of MetS was higher among rural (50.3%) vs urban (39.3%) residents and refugees (33.8%).

Conclusions

With increasing age and obesity, clustering of MetS components increased remarkably in both genders. Effective prevention and treatment strategies for MetS and its risk factors should be developed targeting different ages and genders.
Decentering Responsibilization: Towards a Nomos of Governmentality in Mexico
Authors: Emerson R Guy
Published: September 2019

This paper charts the mechanics of civic responsibility in preventing violence. Attention centers on divergent practices of responsibilization in Puebla, Mexico, which emanate from both state rationales associated with citizen security initiatives and from community-based measures that confound such official logics. Situated in the workings of governmentality beyond advanced liberalism, the paper proposes a decentering of responsibilization. This requires two steps. First, analysis returns to governmentality as the intersection of technologies of domination and the self but locates the former in relation to nomos rather than logos. That is, responsibilization occurs not exclusively in relation to codes of conduct consistent with official determinations (logos) but also as a socially developed order that exceeds the political, economic, and rational dimensions of government (nomos). Second, it positions technologies of the self amid Michel Foucault's work on the empiricohistorical construction of care of the self. This is a situated care, wherein a responsible individual emerges from the constituent complexity of the social order and her interdependence with other living forms. Far from an art of government wherein individual participation becomes the corollary to the withdrawal of the state, civic responsibility in Puebla is socially embedded and, therefore, need not align with institutional power.
Genetic Structure of Northern Fowl Mite (Mesostigmata: Macronyssidae) Populations Among Layer Chicken Flocks and Local House Sparrows (Passeriformes: Passeridae)
Authors: McCulloch John B , Owen Jeb P , Hinkle Nancy C , Mullens Bradley A , Busch Jeremiah W
Published: September 2019

The northern fowl mite (NFM) Ornithonyssus sylviarum Canestrini and Fanzago is a blood-feeding ectoparasite found on many wild bird species and is a pest of poultry in the United States. It is unknown where NFM infestations of poultry originate, which has made it difficult to establish preventative biosecurity or effective control. We used microsatellite markers to evaluate genetic variation within and among NFM populations to determine routes of introduction onto farms and long-term persistence. We compared NFM from flocks of chickens (Gallus gallus) on different farms in California, Washington, and Georgia, and we compared NFM collected over a 5-yr interval. On three farms we collected NFM from chickens and house sparrows (Passer domesticus) nesting on each farm, which we used to assess movement between host species. There was strong genetic structure among mites from different poultry farms and low estimates of migration between farms. There were significant differences between mites on chickens and house sparrows on two farms where sparrows nested near flocks, indicating no exchange of mites. Only one farm showed evidence of NFM movement between chickens and sparrows. There was high genetic similarity between mites collected 5 yr apart on each of two farms, indicating that NFM infestations can persist for long periods. The genetic patterns did not reveal sources of NFM infestations on chicken farms. The data suggest that NFMs are strongly differentiated, which likely reflects periodic population declines with flock turnover and pesticide pressure.
Differential Gene Expression for Age Estimation of Forensically Important Sarcophaga peregrina (Diptera: Sarcophagidae) Intrapuparial
Authors: Shang Yanjie , Ren Lipin , Yang Li , Wang Shiwen , Chen Wei , Dong Jianan , Ma Hongming , Qi Xuan , Guo Yadong
Published: September 2019

Sarcophaga peregrina is an important flesh fly species for estimating the minimum postmortem interval (PMImin) in forensic entomology. The accurate determination of the developmental age is a crucial task for using necrophagous sarcophagids to estimate PMImin. During larval development, the age determination is straight forward by the morphological changes and variation of length, weight, and width; however, the age estimation of sarcophagid intrapuparial is more difficult due to anatomical and morphological changes not being visible. The analysis of differentially expressed genes (DEGs) during sarcophagid metamorphosis is a potential method for age estimation of intrapuparial. In the present study, real-time quantitative polymerase chain reaction (RT-qPCR) was used to analyze the differential gene expression level of S. peregrina intrapuparial in different constant temperatures (35°C, 25°C, and 15°C). In addition, the appropriate reference genes of S. peregrina were selected in the intrapuparial and at different temperatures to obtain reliable and valid gene expression profiles. The results indicated that two candidate genes (18S rRNA and 28S rRNA) were the most reliable reference genes, and four DEGs (Hsp90, A-alpha, AFP, AFBP) have the potential to be used to more accuracy estimate the age of S. peregrina intrapuparial.
Professionalization through symbolic and social capital: Evidence from the careers of elite consultants
Authors: Kipping Matthias , Bühlmann Felix , David Thomas
Published: September 2019

This article contributes to the debate about how more recent professions, especially those related to management, might achieve a semblance of ‘professionalism’ in the absence of the conditions that facilitated the creation of the traditional professions such as medicine, law or accounting in the 19th century. Much of the recent literature has either argued that these professions had to rely on some form of ‘image professionalism’ or that the professionalization process was ‘captured’ by the dominant firms within the professional field, with the aim of creating corporate, firm-internal rather than open labor markets for these professionals. Building on Bourdieu’s notions of symbolic and social capital, we suggest an alternative pathway to professionalization in stratified professional fields. We namely argue that a career at one of the ‘elite’ professional service firms (PSFs) can provide privileged access to positions at other firms within the same field. Hence, such a career constitutes a form of closure regime and allows, at least to some degree, the external labor mobility so typical of traditional professions. We explore this alternative pathway to professionalization by analyzing a novel and unique historical data set of former McKinsey consultants, identifying a number of boundary conditions that seem to facilitate such intraprofessional careers and others, which, over time, might weaken it. We conclude by pointing to a number of broader contributions from our research.
Optimizing multitelescope observations of gravitational-wave counterparts
Authors: Coughlin Michael W , Antier Sarah , Corre David , Alqassimi Khalid , Anand Shreya , Christensen Nelson , Coulter David A , Foley Ryan J , Guessoum Nidhal , Mikulski Timothy M , Mualla Mouza Al , Reed Draco , Tao Duo
Published: September 2019

The ever-increasing sensitivity of the network of gravitational-wave detectors has resulted in the accelerated rate of detections from compact binary coalescence systems in the third observing run of Advanced LIGO and Advanced Virgo. Not only has the event rate increased, but also the distances to which phenomena can be detected, leading to a rise in the required sky volume coverage to search for counterparts. Additionally, the improvement of the detectors has resulted in the discovery of more compact binary mergers involving neutron stars, revitalizing dedicated follow-up campaigns. While significant effort has been made by the community to optimize single telescope observations, using both synoptic and galaxy-targeting methods, less effort has been paid to coordinated observations in a network. This is becoming crucial, as the advent of gravitational-wave astronomy has garnered interest around the globe, resulting in abundant networks of telescopes available to search for counterparts. In this paper, we extend some of the techniques developed for single telescopes to a telescope network. We describe simple modifications to these algorithms and demonstrate them on existing network examples. These algorithms are implemented in the open-source software gwemopt, used by some follow-up teams, for ease of use by the broader community.
Searching for the shadows of giants: characterizing protoclusters with line of sight Lyman-α absorption
Authors: Miller Joel S A , Bolton James S , Hatch Nina
Published: September 2019

We use state-of-the-art hydrodyamical simulations from the Sherwood, EAGLE, and Illustris projects to examine the signature of Mz = 0 ≃ 1014 M⊙ protoclusters observed in Ly α absorption at z ≃ 2.4. We find that there is a weak correlation between the mass overdensity, δm, and the Ly α effective optical depth relative to the mean, $\delta _{\tau _\textrm{eff}}$, averaged over $15~h^{-1}\, \textrm{cMpc}$ scales, although scatter in the δm–$\delta _{\tau _\textrm{eff}}$ plane means it is not possible to uniquely identify large-scale overdensities with strong Ly α absorption. Although all protoclusters are associated with large-scale mass overdensities, most sightlines through protoclusters in a ∼106$\rm cMpc^{3}$ volume probe the low column density Ly α forest. A small subset of sightlines that pass through protoclusters exhibit coherent, strong Ly α absorption on $15h^{-1}\rm \, cMpc$ scales, although these correspond to a wide range in mass overdensity. Assuming perfect removal of contamination by Ly α absorbers with damping wings, more than half of the remaining sightlines with $\delta _{\tau _{\rm eff}}\gt 3.5$ trace protoclusters. It is furthermore possible to identify a model-dependent $\delta _{\tau _{\rm eff}}$ threshold that selects only protoclusters. However, such regions are rare: excluding absorption caused by damped systems, less than 0.1 per cent of sightlines that pass through a protocluster have $\delta _{\tau _{\rm eff}}\gt 3.5$, meaning that any protocluster sample selected in this manner will also be highly incomplete. On the other hand, coherent regions of Ly α absorption also provide a promising route for identifying and studying filamentary environments at high redshift.
Group pre-processing versus cluster ram-pressure stripping: the case of ESO156−G029
Authors: Džudžar Robert , Kilborn Virginia , Murugeshan Chandrashekar , Meurer Gerhardt , Sweet Sarah M , Putman Mary
Published: September 2019

We report on observations of ESO156−G029, member of a galaxy group which is positioned at the virial radius of cluster Abell 3193. ESO156−G029 is located ∼1.4 Mpc in projected distance from the brightest cluster galaxy NGC1500. We show that ESO156−G029 has disturbed gas kinematics and a highly asymmetric neutral hydrogen (H i) distribution, which are consequences of group pre-processing, and possibly of ram pressure. Based on the current data we propose a scenario in which ESO156−G029 had a minor gas-rich merger in the past and now starts to experience ram pressure. We infer that the galaxy will undergo rapid evolution once it gets closer to the cluster centre (less than 0.5 Mpc) where ram pressure is strong enough to begin stripping the H i from the galaxy.
Archaeal Ribosomal Proteins Possess Nuclear Localization Signal-Type Motifs: Implications for the Origin of the Cell Nucleus
Authors: Melnikov Sergey , Kwok Hui-Si , Manakongtreecheep Kasidet , van den Elzen Antonia , Thoreen Carson C , Söll Dieter
Published: September 2019

Eukaryotic cells are divided into the nucleus and the cytosol, and, to enter the nucleus, proteins typically possess short signal sequences, known as nuclear localization signals (NLSs). Although NLSs have long been considered as features unique to eukaryotic proteins, we show here that similar or identical protein segments are present in ribosomal proteins from the Archaea. Specifically, the ribosomal proteins uL3, uL15, uL18, and uS12 possess NLS-type motifs that are conserved across all major branches of the Archaea, including the most ancient groups Microarchaeota and Diapherotrites, pointing to the ancient origin of NLS-type motifs in the Archaea. Furthermore, by using fluorescence microscopy, we show that the archaeal NLS-type motifs can functionally substitute eukaryotic NLSs and direct the transport of ribosomal proteins into the nuclei of human cells. Collectively, these findings illustrate that the origin of NLSs preceded the origin of the cell nucleus, suggesting that the initial function of NLSs was not related to intracellular trafficking, but possibly was to improve recognition of nucleic acids by cellular proteins. Overall, our study reveals rare evolutionary intermediates among archaeal cells that can help elucidate the sequence of events that led to the origin of the eukaryotic cell.
Departmental Select Committees: The Reform of the Century?
Authors: Norton Philip
Published: September 2019

A set of departmental select committees was agreed by the UK House of Commons in 1979 and has become a core feature of British parliamentary life. This introductory survey examines the genesis of the committees and the extent to which they constituted an evolutionary or radical change to the way that the House of Commons conducted itself. Proposals for such committees were not new, but achieving their realisation was possible only when a reform agenda was complemented by ministerial leadership and, fundamentally, by political will favouring change on the part of MPs. The development of the committees, their membership and work and engagement with those outside Parliament, forms the basis of this issue.
Hume’s Dictum and Metaethics
Authors: Moberger Victor
Published: September 2019

This paper explores the metaethical ramifications of a coarse-grained criterion of property identity, sometimes referred to as Hume's dictum. According to Hume's dictum, properties are identical if and only if they are necessarily co-extensive. Assuming the supervenience of the normative on the natural, this criterion threatens the non-naturalist view that there are instantiable normative properties which are distinct from natural properties. In response, non-naturalists typically point to various counterintuitive implications of Hume's dictum. The paper clarifies this strategy and defends it against objections by Bart Streumer and Ralf Bader. In addition, it is argued that proponents of naturalist and supernaturalist views, along with proponents of a certain kind of nihilism, should also reject Hume's dictum. This shows that non-naturalists can also attack the criterion indirectly, by pointing to partners in guilt. Also, it shows that not just any opponent of non-naturalism can appeal to Hume's dictum. Only certain nihilists can.
The far-field limit profile functions of two overlapped dyons
Authors: Kiamari Motahareh , Deldar Sedigheh
Published: September 2019

We study the profile functions of two overlapped dyons at infinity. We assume that the superposition of two dyons satisfies the Yang–Mills (Y–M) equation and then we find new equations of motion for individual dyons which no longer satisfy the original Y–M equation. By solving these new equations we find that the profile functions of two overlapped dyons of the same type at infinity look like the profile functions of one dyon. However, the superposition of two dyons of different types gives a trivial holonomy and therefore no contribution in the confinement phase is observed.
Comments on the dispersion relation method to vector–vector interaction
Authors: Molina R , Geng L S , Oset E
Published: September 2019

We study in detail the method proposed recently to study the vector–vector interaction using the $N/D$ method and dispersion relations, which concludes that, while, for $J=0$, one finds bound states, in the case of $J=2$, where the interaction is also attractive and much stronger, no bound state is found. In that work, approximations are done for $N$ and $D$ and a subtracted dispersion relation for $D$ is used, with subtractions made up to a polynomial of second degree in $s-s_\mathrm{th}$, matching the expression to $1-VG$ at threshold. We study this in detail for the $\rho\rho$ interaction and to see the convergence of the method we make an extra subtraction matching $1-VG$ at threshold up to $(s-s_\mathrm{th})^3$. We show that the method cannot be used to extrapolate the results down to 1270 MeV where the $f_2(1270)$ resonance appears, due to the artificial singularity stemming from the “on-shell” factorization of the $\rho$ exchange potential. In addition, we explore the same method but folding this interaction with the mass distribution of the $\rho$, and we show that the singularity disappears and the method allows one to extrapolate to low energies, where both the $(s-s_\mathrm{th})^2$ and $(s-s_\mathrm{th})^3$ expansions lead to a zero of $\mathrm{Re}\,D(s)$, at about the same energy where a realistic approach produces a bound state. Even then, the method generates a large $\mathrm{Im}\,D(s)$ that we discuss is unphysical.
YouTube resources for synthetic biology education
Authors: Dy Aaron J , Aurand Emily R , Friedman Douglas C
Published: September 2019

Online video resources have increasingly become a common way to effectively share scientific research ideas and engage viewers at many levels of interest or expertise. While synthetic biology is a comparatively young field, it has accumulated online videos across a spectrum of content and technical depth. Such video content can be used to introduce viewers to synthetic biology, supplement college course content, teach new lab skills and entertain. Here, we compile online videos concerning synthetic biology into public YouTube playlists tailored for six different, though potentially overlapping, audiences: those wanting an introduction to synthetic biology, those wanting to get quick overviews of specific topics within synthetic biology, those wanting teaching or public lectures, those wanting more technical research lectures, those wanting to learn lab protocols and those interested in the International Genetically Engineered Machine competition.
Variation in Entrustment When Sharing a Single Assessment System Between University- and Community-Based Residency Programs: A Comparison
Authors: Warm Eric J. , Kinnear Benjamin , Kelleher Matthew , Sall Dana , Schauer Daniel P. , Friedstrom Scott
Published: September 2019

Purpose

Given resource constraints, many residency programs would consider adopting an entrustment-based assessment system from another program if given the opportunity. However, it is unclear if a system developed in one context would have similar or different results in another. This study sought to determine if entrustment varied between programs (community based and university based) when a single assessment system was deployed in different contexts.

Method

The Good Samaritan Hospital (GSH) internal medicine residency program adopted the observable practice activity (OPA) workplace-based assessment system from the University of Cincinnati (UC). Comparisons for OPA-mapped subcompetency entrustment progression for programs and residents were made at specific timepoints over the course of 36 months of residency. Data collection occurred from August 2012 to June 2017 for UC and from September 2013 to June 2017 for GSH.

Results

GSH entrustment ratings were higher than UC for all but the 11th, 15th, and 36th months of residency (P < .0001) and were also higher for the majority of subcompetencies and competencies (P < .0001). The rate of change for average monthly entrustment was similar, with GSH having an increase of 0.041 each month versus 0.042 for UC (P = .73). Most residents progressed from lower to higher entrustment, but there was significant variation between residents in each program.

Conclusions

Despite the deployment of a single entrustment-based assessment system, important outcomes may vary by context. Further research is needed to understand the contributions of tool, context, and other factors on the data these systems produce.
Nitrous Oxide Impairs Axon Regeneration after Nervous System Injury in Male Rats
Authors: Stewart Krista J. , Iskandar Bermans J. , Meier Brenton M. , Rizk Elias B. , Hariharan Nithya , Koueik Joyce , Andrei Adin-Christian , Hogan Kirk J.
Published: September 2019

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Nitrous oxide can induce neurotoxicity. The authors hypothesized that exposure to nitrous oxide impairs axonal regeneration and functional recovery after central nervous system injury.

Methods

The consequences of single and serial in vivo nitrous oxide exposures on axon regeneration in four experimental male rat models of nervous system injury were measured: in vitro axon regeneration in cell culture after in vivo nitrous oxide administration, in vivo axon regeneration after sharp spinal cord injury, in vivo axon regeneration after sharp optic nerve injury, and in vivo functional recovery after blunt contusion spinal cord injury.

Results

In vitro axon regeneration 48 h after a single in vivo 70% N2O exposure is less than half that in the absence of nitrous oxide (mean ± SD, 478 ± 275 um; n = 48) versus 210 ± 152 um (n = 48; P < 0.0001). A single exposure to 80% N2O inhibits the beneficial effects of folic acid on in vivo axonal regeneration after sharp spinal cord injury (13.4 ± 7.1% regenerating neurons [n = 12] vs. 0.6 ± 0.7% regenerating neurons [n = 4], P = 0.004). Serial 80% N2O administration reverses the benefit of folic acid on in vivo retinal ganglion cell axon regeneration after sharp optic nerve injury (1277 ± 180 regenerating retinal ganglion cells [n = 7] vs. 895 ± 164 regenerating retinal ganglion cells [n = 7], P = 0.005). Serial 80% N2O exposures reverses the benefit of folic acid on in vivo functional recovery after blunt spinal cord contusion (estimate for fixed effects ± standard error of the estimate: folic acid 5.60 ± 0.54 [n = 9] vs. folic acid + 80% N2O 5.19 ± 0.62 [n = 7], P < 0.0001).

Conclusions

These data indicate that nitrous oxide can impair the ability of central nervous system neurons to regenerate axons after sharp and blunt trauma.
Superior Trunk Block Provides Noninferior Analgesia Compared with Interscalene Brachial Plexus Block in Arthroscopic Shoulder Surgery
Authors: Kang RyungA , Jeong Ji Seon , Chin Ki Jinn , Yoo Jae Chul , Lee Jong Hwan , Choi Soo Joo , Gwak Mi Sook , Hahm Tae Soo , Ko Justin Sangwook
Published: September 2019

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Interscalene brachial plexus block of the C5–C6 roots provides highly effective postoperative analgesia after shoulder surgery but usually results in hemidiaphragmatic paresis. Injection around the superior trunk of the brachial plexus is an alternative technique that may reduce this risk. The authors hypothesized that the superior trunk block would provide noninferior postoperative analgesia compared with the interscalene block and reduce hemidiaphragmatic paresis.

Methods

Eighty patients undergoing arthroscopic shoulder surgery were randomized to receive a preoperative injection of 15 ml of 0.5% ropivacaine and 5 μg · ml−1 epinephrine around either (1) the C5–C6 nerve roots (interscalene block group) or (2) the superior trunk (superior trunk block group). The primary outcome was pain intensity 24 h after surgery measured on an 11-point numerical rating score; the prespecified noninferiority limit was 1. Diaphragmatic function was assessed using both ultrasonographic measurement of excursion and incentive spirometry by a blinded investigator before and 30 min after block completion.

Results

Seventy-eight patients completed the study. The pain score 24 h postoperatively (means ± SDs) was 1.4 ± 1.0 versus 1.2 ± 1.0 in the superior trunk block (n = 38) and interscalene block (n = 40) groups, respectively. The mean difference in pain scores was 0.1 (95% CI, −0.3 to 0.6), and the upper limit of the 95% CI was lower than the prespecified noninferiority limit. Analgesic requirements and all other pain measurements were similar between groups. Hemidiaphragmatic paresis was observed in 97.5% of the interscalene block group versus 76.3% of the superior trunk block group (P = 0.006); paresis was complete in 72.5% versus 5.3% of the patients, respectively. The decrease in spirometry values from baseline was significantly greater in the interscalene block group.

Conclusions

The superior trunk block provided noninferior analgesia compared with interscalene brachial plexus block for up to 24 h after arthroscopic shoulder surgery and resulted in significantly less hemidiaphragmatic paresis.
Limited Endoscopic-Assisted Wedge Resection for Excision of Colon Polyps
Authors: Leicher Laura W. , de Vos tot Nederveen Cappel Wouter H. , van Westreenen Henderik L.
Published: September 2019

BACKGROUND:

Combined endoscopic laparoscopic surgical removal is used for polyps in the colon that are not suitable for endoscopic removal because of size, location, or scarring. However, the placement of a linear stapler can be challenging. Currently a wedge resection is mostly documented in the cecum or ascending colon.

OBJECTIVE:

We report on our experience with limited endoscopy-assisted wedge resections in the entire colon.

DESIGN:

A retrospective study was performed.

SETTINGS:

This was a single-center study.

PATIENTS:

Eight patients were included between March 2015 and April 2016.

INTERVENTIONS:

The laparoscopic surgical technique consisted of placing a suture under endoscopic view through the base of the polyp into the lumen. Subsequently, traction was given on the suture to enable stapling of a wedge of the colon.

MAIN OUTCOME MEASURES:

Medical data were collected (ie, indication for referral for surgery, location and size of the polyp, duration of surgical procedure, length of hospital stay, and perioperative and postoperative complications). Operative time was defined as the total time of general anesthesia.

RESULTS:

Eight patients, with a mean age of 74.5 years (range, 68.0–82.0 years), were treated. The main indications for laparoscopic resection were the size and difficult location of the polyp. There were no complications. Mean operative time was 132 minutes. Five patients were discharged the day after surgery, and the other 3 patients were admitted for a total of 2 days.

LIMITATIONS:

The study was limited by its small sample size.

CONCLUSIONS:

Our study found that limited endoscopy-assisted wedge resection is a feasible and easy technique for the removal of colon polyps and residual adenomatous tissue in scars that are not accessible for endoscopic removal. Because of traction given on the suture through the base of the polyp, the linear stapler is easily used for wedge resections of polyps, even for those that are not in favorable positions.
Short- and Long-term Outcomes of Laparoscopic Total Mesenteric Excision for Neuroendocrine Tumors of the Rectum
Authors: Takatsu Yukiko , Fukunaga Yosuke , Nagasaki Toshiya , Akiyoshi Takashi , Konishi Tsuyoshi , Fujimoto Yoshiya , Nagayama Satoshi , Ueno Masashi
Published: September 2019

BACKGROUND:

To our knowledge, no studies to date have assessed the short- and long-term outcomes of laparoscopic total mesenteric excision in patients with neuroendocrine tumors of the rectum.

OBJECTIVE:

The purpose of this study was to investigate the short- and long-term outcomes of patients who underwent laparoscopic rectal resection plus total mesenteric excision for rectal neuroendocrine tumors at our institution.

DESIGN:

This was a single center, retrospective study.

SETTINGS:

The study was conducted at a tertiary care facility.

PATIENTS:

Eight-two patients with neuroendocrine tumors who underwent rectal resection with total mesenteric excision, 77 laparoscopically, between June 2005 and August 2015 were included.

INTERVENTIONS:

Laparoscopic rectal resection and total mesenteric excision were the study interventions.

MAIN OUTCOME MEASURES:

Demographic characteristics and surgical and postoperative outcomes were measured.

RESULTS:

Median tumor size was 8.8 mm (range, 3.0–35.0 mm); 63.6% of tumors were located in the lower rectum, with the median distance from the tumor to the anal verge being 50.0 mm (range, 20.0–130.0 mm). Anal preservation was achieved in all of the patients. Anastomotic leakage occurred in 5 patients (6.5%), but there were no deaths. Seventy-one patients (92.2%) had tumor invasion confined to the submucosa. Lymph node metastasis was present in 29 patients (37.7%), including 26 (33.8%) with perirectal and 5 (6.5%) with lateral lymph node metastasis. The median follow-up period in 59 patients was 42 months (range, 11–113 months), and the 3-year overall survival rate was 97.8%.

LIMITATIONS:

The study was limited by its single-center, retrospective analysis.

CONCLUSIONS:

Laparoscopic rectal resection with total mesenteric excision is safe in patients with rectal neuroendocrine tumors, with good short- and long-term outcomes. Because rectal neuroendocrine tumors are smaller and show superficial invasion, the rate of anal preservation may be high.
Outcome and Salvage Surgery Following “Watch and Wait” for Rectal Cancer after Neoadjuvant Therapy: A Systematic Review
Authors: Kong Joseph C. , Guerra Glen R. , Warrier Satish K. , Ramsay Robert G. , Heriot Alexander G.
Published: September 2019

BACKGROUND:

Currently there is no reliable test to predict pathological complete response following neoadjuvant chemoradiotherapy for rectal cancer. However, there is increasing interest in using clinical complete response as a surrogate marker, allowing a subset of patients with locally advanced rectal cancer to be allocated into a “watch and wait” pathway. Little is known about the oncological safety of the “watch and wait” approach or the rate of salvage surgery in cases of tumor regrowth. This information is critical for the implementation of this approach.

OBJECTIVE:

The aim of this study is to assess the rate of salvage surgery and associated oncological outcomes for patients who develop a tumor regrowth with the “watch and wait” approach.

DATA SOURCES:

Relevant studies were identified through PubMed, Embase, and Google Scholar search.

STUDY SELECTION:

A systematic review was undertaken of studies assessing patients selected for the “watch and wait” approach according to PRISMA guidelines.

MAIN OUTCOME MEASURES:

The associated tumor regrowth, salvage surgery, and disease-free and overall survival rates were assessed.

RESULTS:

Five retrospective and 4 prospective observational studies were included into the analysis, with a total of 370 patients in the “watch and wait” group, of which 256 (69.2%) had persistent clinical complete response. Of those who had tumor regrowth, salvage surgery was possible in 83.8%. There was no difference in overall survival and disease-free survival between patients who received immediate surgery and the “watch and wait” group.

LIMITATIONS:

The limitations of this study include its retrospective nature and small sample size. Furthermore, there is significant heterogeneity between study protocols, including the short median follow-up, given that tumor regrowth and distant metastasis may manifest at a later time point.

CONCLUSION:

The majority of patients with tumor regrowth can be salvaged with definite surgery after “watch and wait.” However, there is insufficient evidence to draw firm conclusions on the oncological safety of this approach; therefore, it is currently not the standard of care for locally advanced rectal cancer.
Efficacy and Safety of High-Intensity Focused Ultrasound for Noninvasive Abdominal Subcutaneous Fat Reduction
Authors: Hong Ji Yeon , Ko Eun Jung , Choi Sun Young , Kwon Tae-Rin , Kim Jong Hwan , Kim Soo Yeon , Kim Beom Joon
Published: September 2019

BACKGROUND

Demand for noninvasive body contouring has increased.

OBJECTIVE

We evaluated the efficacy and safety of a thermal high-intensity focused ultrasound (HIFU) device for abdominal body shaping.

PATIENTS AND METHODS

Adults with a body mass index ≤30 kg/m2 and an abdominal subcutaneous fat tissue thickness ≥2.5 cm were enrolled for HIFU treatment at energy levels of 150 J/cm2 (first session) and 135 J/cm2 (second session). The primary end point was a change from baseline waist circumference at post‐treatment Week 8. Secondary efficacy end points were: changes in body weight, waist/hip ratio, and fat thickness assessed by ultrasound, caliper, and a fat CT scan. The Global Aesthetic Improvement Scale was evaluated by both investigators and subjects.

RESULTS

The primary assessment achieved statistical significance, showing a reduction of 3.43 cm in mean waist circumference. The treatment effect was cumulative, with a steady decrease in waist circumference and fat thickness. The mean pain scores immediately after treatment were 4.45 ± 2.74 on a scale of 1 to 10 with 10 being the most painful, which decreased to 1.10 ± 1.33 after 1 week.

CONCLUSION

High-intensity focused ultrasound is an effective and safe treatment modality for reducing waist circumference in nonobese individuals with focal fat accumulation.
Safety of Periocular Mohs Reconstruction: A Two-Center Retrospective Study
Authors: Clark Matthew L. , Kneiber Diana , Neal Donald , Etzkorn Jeremy , Maher Ian A.
Published: September 2019

BACKGROUND

Repair of periocular defects poses unique functional and aesthetic challenges. Data on the safety of periocular repairs by Mohs surgeons are limited.

OBJECTIVE

Analyze the frequency and types of postreconstruction complications encountered with periocular repairs performed by Mohs surgeons, identify risk factors associated with complications, and enumerate interventions for complications encountered.

MATERIALS AND METHODS

An institutional review board–approved retrospective study on periocular repairs performed by Mohs surgeons at 2 academic institutions between 07 2013 and 06 2016. Patients undergoing periocular Mohs surgery were identified via billing codes. Patient demographics and surgery details were recorded. Follow-up visit notes were reviewed for postoperative complications and interventions performed.

RESULTS

Two hundred ten cases were included in the analysis. The most common locations for postreconstruction complications were the medial canthus (57%) and lower eyelid (37%). The complications identified included medial canthal webbing (4.3%), hypertrophic scarring (4.3%), ectropion (1.9%), infection (1.4%), pincushioning (1.4%), and epiphora (1.0%). The most common postoperative intervention was intralesional triamcinolone. Scar revision was performed in 2.4% of all cases.

CONCLUSION

Periocular repairs performed by Mohs surgeons have a similar safety profile as repairs performed by oculoplastic surgeons.
Sequential Scalp Assessment in Hair Regeneration Therapy Using an Adipose-Derived Stem Cell–Conditioned Medium
Authors: Narita Keigo , Fukuoka Hirotaro , Sekiyama Takuya , Suga Hirotaka , Harii Kiyonori
Published: September 2019

BACKGROUND

An adipose-derived stem cell–conditioned medium (ADSC-CM) reportedly exerts skin-rejuvenating and hair growth-promoting effects. In the therapeutic application of ADSC-CM for alopecia, changes to the interfollicular scalp remain unclear although some evidence has indicated hair growth-promoting effects.

OBJECTIVE

To evaluate the effects of ADSC-CM not only on hair follicles, but also on the interfollicular scalp.

METHODS

Forty patients (21 men, 19 women; age range, 23–74 years) with alopecia were treated by intradermal injection of ADSC-CM every month for 6 months. Eighty fixed sites on patients were investigated by trichograms, physiological examinations, and ultrasonographic examinations at 4 time points (before treatment and 2, 4, and 6 months after the initial treatment).

RESULTS

Hair density and anagen hair rate increased significantly. As physiological parameters, transepidermal water loss value gradually increased, with significant differences at 4 and 6 months after the initial treatment, but hydration state of the stratum corneum and skin surface lipid level showed no obvious changes. As ultrasonographic parameters, dermal thickness and dermal echogenicity were increased significantly.

CONCLUSION

Intradermal administration of ADSC-CM on the scalp has strong potential to provide regenerative effects for hair follicles and the interfollicular scalp. An adipose-derived stem cell–conditioned medium offers a promising prospect as an alternative treatment for alopecia.
An 18-year Study of Malignant Melanoma in Childhood and Adolescence
Authors: Al-Himdani Sarah , Naderi N. , Whitaker I.S. , Jones N.W.
Published: September 2019

Background:

Malignant melanoma is rare in childhood and adolescence. Diagnostic uncertainty and misdiagnosis often lead to delayed treatment.

Methods:

We evaluated children and adolescents under 20 years of age presenting with malignant melanoma at our institution over an 18-year period. Data were collected, analyzed, and interpreted, following which findings were compared with the existing literature.

Results:

Twenty-four patients were included in the study with mean follow-up of 61.8 months. Males comprised 54% of cases. On presentation, 33% of children had melanoma of s thickness 2–4 mm and 34% had stage III disease. Younger children presented with thicker melanomas, differing subtypes, and more advanced stage disease compared with older children. Extremities were the most common sites affected (42%). Dissection of the draining lymph node basins was undertaken in 38% of cases. Overall survival was 92%.

Conclusions:

Tumor subtype, biology, hormonal influence, and lymph node status are all important prognostic factors in malignant melanoma in childhood and adolescence. Compared with adults, children presenting with thicker melanomas and more advanced stage disease generally have more favorable outcomes and a better survival. Plastic surgeons, commonly encountering skin lesion in children, must maintain a high index of suspicion so that early excision and sentinel lymph node biopsy may be promptly offered to patients with melanoma.
EFFECT OF LUBRICANTS ON CORNEAL THICKNESS AFTER VITRECTOMY
Authors: Siegel Diane T. , Hubbard G. Baker , Yan Jiong , Cribbs Blaine , Jain Nieraj , Yeh Steve , Bui Diem , Smith Jesse , Barb Scott , Pearce William , Ward Laura , Hendrick Andrew M.
Published: September 2019

Purpose:

This study examines the impact of corneal surface lubricants used during pars plana vitrectomy on corneal edema.

Methods:

This prospective, observational, clinical study occurred at an academic institution. Participants were individuals aged 18 years and older who had already consented to undergo pars plana vitrectomy, without pre-existing corneal pathology. A corneal lubricant was chosen by the surgeon. Corneal thickness was measured preoperatively and postoperatively using pachymetry and anterior segment optical coherence tomography (AS-OCT). Main outcome measure was change in corneal thickness as measured by pachymetry.

Results:

Forty-one patients completed the study protocol. The 23 subjects in the SHCS group had a significantly smaller increase in corneal thickness as measured by pachymetry compared with the 18 subjects in the HPMC group (29.9 μm vs. 58.1 μm, P value 0.02). When measured by anterior segment optical coherence tomography, the SHCS group had a smaller increase in corneal thickness compared with the HPMC group (0.04 mm vs. 0.06 mm, P value 0.09) but did not reach significance.

Conclusion:

SHCS is associated with reduced postoperative increase in corneal pachymetry as compared to HPMC.