bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of two groups of quinoa (Chenopodium quinoa Willd.) accessions with different seed colours for adaptation to the Mediterranean environment
Authors: De Santis Giuditta , Ronga Domenico , Caradonia Federica , D Ambrosio Tiziana , Troisi Jacopo , Rascio Agata , Fragasso Mariagiovanna , Pecchioni Nicola , Rinaldi Michele
Published: December 2018

Agronomic and seed-quality traits in 17 quinoa (Chenopodium quinoa Willd.) accessions grouped according to seed colour (i.e. ochre and yellow) were investigated and compared with the white commercial cultivar Regalona-Baer. These accessions were previously selected from a range of accessions of diverse origin and seed colour for their potential value in a breeding program for cultivars adapted to the southern Italian environment. Field trials were conducted over 2 years in Foggia, southern Italy. The aim was to identify elite genotypes suited to the Mediterranean Basin in terms of high yields and seed quality, by using principal component analysis (PCA) and hierarchical cluster analysis. The genotype and year effects were statistically significant for most parameters investigated, whereas the genotype×year interaction was significant only for seed quality. There were significant differences between the two seed-colour groups for most of the investigated traits, but not for total dry weight, days to flowering, and soluble and insoluble fibre. The major difference between the accessions and cv. Regalona-Baer was lower seed yield for the ochre seed group (30% lower, on average); this was associated with increased plant height (13% higher, on average), greater number of days to maturity (+6 days, on average) and shorter panicle length (21% shorter, on average). These results were observed for both growing seasons. The seed yield of the yellow seed group was similar to Regalona-Baer. Focusing on individual accessions, PCA indicated that accessions Q12, Q18 and Q26 were similar to Regalona-Baer for seed yield, 1000-seed weight, seed area and seed perimeter, and accession Q4 had the highest protein and kaempferol contents for both years. Seed area and perimeter, harvest index, and 1000-seed weight showed positive associations with seed yield, whereas days to flowering, days to maturity and quality traits were negatively correlated with seed yield for both years. Cluster analysis carried out on all of the agronomic and seed-quality traits did not show clear clustering of the accessions based on seed colour alone. The results of this study confirm that both the ochre and yellow quinoa seed groups included elite accessions that can be used directly in future selection programs for the development of high-yielding varieties well adapted to the Mediterranean environment.
Review of agriculture-nutrition linkages in South Asia.
Authors: Bhavani R. V. , Rampal Priya
Published: December 2018

The paper reviews the evidence of agriculture-nutrition linkages with particular reference to South Asia from studies published during the period 2012-2018. South Asia houses the largest population of undernourished people in the world and a majority of the population in the region is dependent on agriculture and allied activities and live in rural areas. Following a review of agriculture nutrition linkage, the paper reviews recent work in South Asia focusing on the pathway of agriculture as an asset and source of food and the role of women in agriculture. The evidence from reviews of agriculture nutrition linkage finds lack of robust evidence of impact on nutrition outcomes. The studies from South Asia highlight the importance of production diversity, agriculture and land productivity and enabling factors of WASH and women's empowerment, for impact on dietary diversity and nutrition outcomes. This points to need for policy focus in these areas. Most of the studies were based on secondary data and the search yielded very few intervention-based studies; there were also no studies from Pakistan. The importance of leveraging agriculture for nutrition in order to progress towards the Sustainable Development Goals (SDGs) is now well accepted. Along with efforts to improve dietary diversity through agriculture, long-term intervention studies with robust design targeting nutrition indicators can help better inform policy.
Setting Neuro-Fuzzy PID Control In Plant Nonlinear Active Suspension
Authors: Andrew Ferdinandus Aprildy Randy , Nugraha Anggara Trisna , Jamaaluddin Jamaaluddin
Published: December 2018

The main problem in vibration in the vehicle is caused by the road surface. For that reason it is necessary to regulate the vibration of the vehicle suspension directly related to the road surface. Neuro-fuzzy PID controller is used to set the active suspension of the vehicle. The suspension model used is the active suspension quarter-car with nonlinear model. Faulty road surfaces are used as a disturbance in the system, interference changes in amplitude (height / depth) in the range of -25cm to 25cm. The simulation results show the performance of the PID neuro-fuzzy setting method that can overcome 77% of the amount of road noise.
A development process of enterprise applications with microservices
Authors: Vera-Rivera F H
Published: December 2018

This paper presents a development process of enterprises applications with microservices. We identify the construction phases, practices, fundamentals, methods and tools that are being used in the development of microservices based enterprise applications. After identifying and proposing the development process, it is validated and tested in the construction of an application called Sinplafut. By using microservices the size of enterprise applications is reduced and easier to manage, deployment, scaling, test and replace using the resources offered by cloud computing. In this way the costs and efforts necessary to maintain the application in the cloud are considerably reduced.
Technological innovation of the footwear sector companies in Cucuta and its metropolitan area
Authors: Romero Y A , Monroy R , Gelves J F
Published: December 2018

The objective of this research was to analyze the technological innovation of footwear companies in Cúcuta and its metropolitan area. A sample of 32 companies that are currently working (legal character) was selected. For the analysis of the technological innovation of the footwear sector companies, an information gathering instrument was applied where they were asked about the different organizational aspects, their technological innovation capabilities and innovation processes. In the dimension of innovation capacity, the level of human talent training, the orientation of human talent towards innovation, the financial liquidity for investment of R & D projects and the activities of collaboration and interaction with other organizations were addressed. In the innovation processes, the companies evaluated the development of new products, participation in technological innovation projects in process, participation in projects of technological innovation in product and existence of a Department of R+D+i. In the analysis, it was identified that companies in the footwear sector must strengthen their skills in human talent training and implement a culture of innovation within the organization that allows them to strengthen their innovation.
Which quartic double solids are rational?
Authors: Cheltsov Ivan , Przyjalkowski Victor , Shramov Constantin
Published: December 2018

We study the rationality problem for nodal quartic double solids. In particular, we prove that nodal quartic double solids with at most six singular points are irrational and nodal quartic double solids with at least eleven singular points are rational.
Nicotine Effects on White Matter Microstructure in Young Adults
Authors: Kangiser Megan M , Thomas Alicia M , Kaiver Christine M , Lisdahl Krista M
Published: December 2018

Objective

Nicotine use is widely prevalent among youth, and is associated with white matter microstructural changes as measured by diffusion tensor imaging (DTI). In adults, nicotine use is generally associated with lower fractional anisotropy (FA), but in adolescents/young adults (≤30 years), microstructure appears healthier, indicated by higher FA. This cross-sectional study examined associations between nicotine use and white matter microstructure using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in young adults.

Methods

Fifty-three participants (18 nicotine users [10 female]/35 controls [17 female]) ages 18–25 underwent MRI scan, neuropsychological battery, toxicology screening, and drug use interview. Nicotine group associations with FA and MD were examined in various white matter tracts. In significant tracts, AD and RD were measured. Exploratory correlations were conducted between significant tracts and verbal memory and sustained attention/working memory performance.

Results

Nicotine users exhibited significantly lower FA than controls in the left anterior thalamic radiation, left inferior longitudinal fasciculus, left superior longitudinal fasciculus—temporal, and left uncinate fasciculus. In these tracts, AD and RD did not differ, nor did MD differ in any tract. White matter quality was positively correlated with sustained attention/working memory performance.

Conclusions

Cigarette smoking may disrupt white matter microstructure. These results are consistent with adult studies, but inconsistent with adolescent/young adult studies, likely due to methodological and sample age differences. Further studies should examine longitudinal effects of nicotine use on white matter microstructure in a larger sample.
Optimal Gene Filtering for Single-Cell data (OGFSC)—a gene filtering algorithm for single-cell RNA-seq data
Authors: Hao Jie , Cao Wei , Huang Jian , Zou Xin , Han Ze-Guang
Published: December 2018

Motivation

Single-cell transcriptomic data are commonly accompanied by extremely high technical noise due to the low RNA concentrations from individual cells. Precise identification of differentially expressed genes and cell populations are heavily dependent on the effective reduction of technical noise, e.g. by gene filtering. However, there is still no well-established standard in the current approaches of gene filtering. Investigators usually filter out genes based on single fixed threshold, which commonly leads to both over- and under-stringent errors.

Results

In this study, we propose a novel algorithm, termed as Optimal Gene Filtering for Single-Cell data, to construct a thresholding curve based on gene expression levels and the corresponding variances. We validated our method on multiple single-cell RNA-seq datasets, including simulated and published experimental datasets. The results show that the known signal and known noise are reliably discriminated in the simulated datasets. In addition, the results of seven experimental datasets demonstrate that these cells of the same annotated types are more sharply clustered using our method. Interestingly, when we re-analyze the dataset from an aging research recently published in Science, we find a list of regulated genes which is different from that reported in the original study, because of using different filtering methods. However, the knowledge based on our findings better matches the progression of immunosenescence. In summary, we here provide an alternative opportunity to probe into the true level of technical noise in single-cell transcriptomic data.

Availability and implementation

https://github.com/XZouProjects/OGFSC.git

Supplementary information

Supplementary data are available at Bioinformatics online.
Deciphering the complexity of human non-coding promoter-proximal transcriptome
Authors: Mapelli Sarah N , Napoli Sara , Pisignano Giuseppina , Garcia-Escudero Ramon , Carbone Giuseppina M , Catapano Carlo V
Published: December 2018

Motivation

Long non-coding RNAs (lncRNAs) have gained increasing relevance in epigenetic regulation and nuclear functional organization. High-throughput sequencing approaches have revealed frequent non-coding transcription in promoter-proximal regions. However, a comprehensive catalogue of promoter-associated RNAs (paRNAs) and an analysis of the possible interactions with neighboring genes and genomic regulatory elements are missing.

Results

Integrating data from multiple cell types and experimental platforms we identified thousands of paRNAs in the human genome. paRNAs are transcribed in both sense and antisense orientation, are mostly non-polyadenylated and retained in the cell nucleus. Transcriptional regulators, epigenetic effectors and activating chromatin marks are enriched in paRNA-positive promoters. Furthermore, paRNA-positive promoters exhibit chromatin signatures of both active promoters and enhancers. Promoters with paRNAs reside preferentially at chromatin loop boundaries, suggesting an involvement in anchor site recognition and chromatin looping. Importantly, these features are independent of the transcriptional state of neighboring genes. Thus, paRNAs may act as cis-regulatory modules with an impact on local recruitment of transcription factors, epigenetic state and chromatin loop organization. This study provides a comprehensive analysis of the promoter-proximal transcriptome and offers novel insights into the roles of paRNAs in epigenetic processes and human diseases.

Availability and implementation

Genomic coordinates of predicted paRNAs are available at https://figshare.com: https://doi.org/10.6084/m9.figshare.7392791.v1 and https://doi.org/10.6084/m9.figshare.4856630.v2.

Supplementary information

Supplementary data are available at Bioinformatics online.
Health Burden, Support Adequacy, and Depressive Symptoms in Older Men With HIV
Authors: Ogletree Aaron M , Brennan-Ing Mark , Blieszner Rosemary , Karpiak Stephen E , Sands Laura P
Published: December 2018

Background and Objectives

Older adults with HIV face greater health burden than HIV-uninfected counterparts. Little is known about resources that might mediate the influence of physiological health burden on psychological well-being. Informed by the stress process model, we assessed the influence of multifaceted health burden indicators on depressive symptoms and evaluated the mediating effects of social support adequacy.

Research Design and Methods

This cross-sectional study used structural equation modeling with data from 640 older men who participated in the Research on Older Adults with HIV study in the United States. Health burden assessment included number of age-related chronic conditions, multiple HIV-related chronic conditions, and self-rated health. Perceptions of instrumental and emotional support adequacy measured support as a coping resource. Depressed mood as assessed by the 10-item Center for Epidemiologic Studies Depression Scale was the indicator of psychological well-being.

Results

Higher incidence of age-related conditions and worse self-rated health was significantly associated with more depressed mood. Self-rated health and HIV-related conditions showed a significant indirect effect on depressed mood via emotional support adequacy.

Discussion and Implications

Each dimension of health burden demonstrated a distinct pathway to psychological well-being for men with HIV, which should be considered when prioritizing care plans. Complementing research on medical interventions for people with HIV, these findings suggest that nonpharmacological interventions may be important for improving overall well-being.
Bayesian sparse linear regression with unknown symmetric error
Authors: Chae Minwoo , Lin Lizhen , Dunson David B
Published: December 2018

We study Bayesian procedures for sparse linear regression when the unknown error distribution is endowed with a non-parametric prior. Specifically, we put a symmetrized Dirichlet process mixture of Gaussian prior on the error density, where the mixing distributions are compactly supported. For the prior on regression coefficients, a mixture of point masses at zero and continuous distributions is considered. Under the assumption that the model is well specified, we study behavior of the posterior with diverging number of predictors. The compatibility and restricted eigenvalue conditions yield the minimax convergence rate of the regression coefficients in $\ell _1$- and $\ell _2$-norms, respectively. In addition, strong model selection consistency and a semi-parametric Bernstein–von Mises theorem are proven under slightly stronger conditions.
Tropheryma whipplei Endocarditis: Case Presentation and Review of the Literature
Authors: McGee Michael , Brienesse Stephen , Chong Brian , Levendel Alexander , Lai Katy
Published: December 2018

Whipple’s disease is a rare infective condition, classically presenting with gastrointestinal manifestations. It is increasingly recognized as an important cause of culture-negative endocarditis. We present a case of Whipple’s endocarditis presenting with heart failure. A literature review identified 44 publications documenting 169 patients with Whipple’s endocarditis. The average age was 57.1 years. There is a clear sex predominance, with 85% of cases being male. Presenting symptoms were primarily articular involvement (52%) and heart failure (41%). In the majority of cases, the diagnosis was made on examination of valvular tissue. Preexisting valvular abnormalities were reported in 21%. The aortic valve was most commonly involved, and multiple valves were involved in 64% and 23% of cases, respectively. Antibiotic therapy was widely varied and included a ceftriaxone, trimethoprim, and sulfamethoxazole combination. The average follow-up was 20 months, and mortality was approximately 24%. Physician awareness is paramount in the diagnosis and management of this rare condition.
The Never-Ending Story? Or, Does the Roman Catholic Church Remain Vulnerable to Charges of Improper Handling of Clergy Child Sex Abuse?
Authors: Nash Patrick S
Published: December 2018

This article explores whether the Roman Catholic Church’s response to the clergy child sex abuse scandal shields it from further charges of improper handling of cases. It begins by noting the current topicality of institutionalized abuse and how several high-profile public inquiries have recently been established to investigate child sex abuse across a range of secular and religious organizational settings. Although numerous religious institutions have become embroiled in clergy child abuse crises, the Catholic Church has come in for particular scrutiny and condemnation on account of its distinctive institutional characteristics which have exacerbated its own abuse scandal in a uniquely severe way. The Church’s own understanding of this issue is that a culture of antinomianism has taken root within the clerical hierarchy and that, were canon law to be applied properly, the crisis would be resolved. This contrasts quite dramatically with the typical external understanding of the crisis which sees the canonical legal system as part of the problem, namely the Church’s refusal to cooperate fully with the secular criminal justice system and effective assumption of a criminal jurisdiction of its own. The article concludes with a final prognosis of the prospects of fundamental legal and cultural change.
Evaluation of two-stage weaning and trace mineral injection on receiving cattle growth performance and behavior
Authors: Rauch Jordan C , Stokes Rebecca S , Shike Daniel W
Published: December 2018

The objective was to evaluate the effects of two-stage weaning and injectable trace mineral (ITM) on receiving cattle growth performance and behavior. Angus and Simmental × Angus steers (n = 136; body weight [BW] = 200 ± 26 kg) were utilized in a 2 × 2 factorial design. Calves were blocked by source, and assigned to one of four treatments: 1) two-stage weaning and ITM (2MM), 2) two-stage weaning and saline injection (2SAL), 3) abrupt weaning and ITM (AbtMM), or 4) abrupt weaning and saline injection (AbtSAL). On d−6, calves were weighed, plastic calf weaner devices (used to prevent calf from nursing) were inserted in two-stage weaned calves, and ITM or saline injections (1 mL/45.4 kg BW) were administered. On day 0, plastic calf weaner devices were removed, and calves were weighed and shipped 272 km to Urbana, IL. Steer behavior was observed the 2 d following separation from dam. Receiving period was day 0 to 42 and growing period was day 42 to 124. Data were analyzed using the MIXED procedure of SAS and pen (six per treatment) was the experimental unit. Abruptly weaned calves had greater (P < 0.01) preweaning average daily gain (ADG) than two-stage weaned calves. Treatment did not affect (P ≥ 0.16) ADG during the receiving or growing period; however, calves that received ITM tended (P 0.06) to have greater ADG from day 0 to 124. During the receiving period, abruptly weaned calves tended (P = 0.08) to eat more than two-stage calves and ITM calves ate more (P = 0.03) than calves that received saline. There was a weaning strategy × ITM interaction (P < 0.01) for dry matter intake (DMI) from day 0 to 124; 2MM calves ate more (P < 0.01) than 2SAL, but DMI was not different (P = 0.58) between AbtMM and AbtSAL calves. There was a weaning strategy × ITM interaction (P < 0.01) for gain-to-feed ratio (G:F) from day 0 to 124; 2SAL calves had greater (P = 0.05) G:F than AbtSAL, with 2MM and AbtMM calves being intermediate and not different (P = 0.38) than each other. Two-stage weaning decreased (P ≤ 0.02) the percentage of calves walking, standing, and vocalizing, and increased (P ≤ 0.02) the percentage of calves lying and eating following separation from dam. Two-stage weaning decreased preweaning ADG and behavioral signs of stress at feedlot arrival, but had no effect on overall growth. In addition, ITM had no effect on calf BW or behavior, but increased overall DMI in two-stage weaned calves compared to abruptly weaned calves and tended to increase overall ADG regardless of weaning strategy.
The time is now: a call for action to translate recent momentum on tackling tropical snakebite into sustained benefit for victims
Authors: Harrison Robert A , Casewell Nicholas R , Ainsworth Stuart A , Lalloo David G
Published: December 2018

Like the other WHO-listed Neglected Tropical Diseases (NTDs), snakebite primarily affects rural, impoverished tropical communities that lack adequate health resources. The annual 138 000 deaths and 400 000 disabilities suffered by these subsistence farming communities means that snakebite is an additional cause and consequence of tropical poverty. Unlike most of the NTDs, however, snakebite is a medical emergency, and requires rapid treatment in a hospital equipped with effective antivenom, beds and appropriately trained staff. The lack of such facilities in the remote areas most affected by snakebite, and the high treatment costs, explains why most victims, particularly in sub-Saharan Africa, consult traditional healers rather than seek hospital care. Whilst affordable, there is no evidence that traditional treatments are effective. The number of snakebite victims that die, unregistered, in the community is threefold higher than hospital-recorded deaths.

After decades of inertia, WHO benefitted from advocacy interventions and the support of key agencies, including Médecins Sans Frontières, the Wellcome Trust, the Kofi Annan Foundation and the Global Snakebite Initiative, to recently institute transformative actions for reducing the public health burden of tropical snakebite. It is imperative that WHO and the other stakeholders now gain the support and investment of governments, research funders and donor agencies to ensure that this recent momentum for change is translated into sustained benefit to snakebite victims.
Determining the Sources of Primary and Secondary Inoculum and Seasonal Inoculum Dynamics of Fungal Pathogens Causing Fruit Rot of Deciduous Holly
Authors: Lin Shan , Peduto Hand Francesca
Published: December 2018

Fruit rot of deciduous holly, caused by species of the genera Alternaria, Colletotrichum, Diaporthe, and Epicoccum, is affecting plant production in Midwestern and Eastern U.S. nurseries. To determine the sources of inoculum, dormant twigs and mummified fruit were collected, and leaf spot development was monitored throughout the season from three Ohio nurseries over two consecutive years. Mummified fruit was the main source of primary inoculum for species of Alternaria and Epicoccum, whereas mummified fruit and bark were equally important for species of Colletotrichum and Diaporthe. Brown, irregular leaf spots developed in the summer, and disease incidence and severity increased along with leaf and fruit development. Coalesced leaf spots eventually resulted in early plant defoliation. When tested for their pathogenicity on fruit, leaf spot isolates were able to infect wounded mature fruit and induce rot symptoms, which indicated that leaf spots could serve as a source of secondary inoculum for fruit infections. In addition, spore traps were used to monitor seasonal inoculum abundance in the nurseries. Fruit rot pathogens were captured by the spore traps throughout the season, with peak dissemination occurring during flowering. In this study, we also attempted to understand the role of environmental factors on leaf spot development. Although leaf spot incidence and severity were negatively correlated to mean maximum, minimum and average temperature, a decrease in temperature also coincided with leaf senescence. The role of temperature on leaf spot development should be further studied to fully interpret these results.
Innovative Delivery of Cu(II) Ions by a Nanostructured Hydroxyapatite: Potential Application in Planta to Enhance the Sustainable Control of Plasmopara viticola
Authors: Battiston Enrico , Antonielli Livio , Di Marco Stefano , Fontaine Florence , Mugnai Laura
Published: December 2018

Downy mildew caused by Plasmopara viticola is probably the most serious disease affecting grapevine (Vitis vinifera), and it is capable of causing consistent yield losses. In organic viticulture, the only acceptable and effective means to control the disease is by applications of copper-based fungicides. However, the use of copper in agriculture is expected to be further restricted by European countries because of its critical ecotoxicological and phytotoxicological profile. Research on ways to reduce the effective amounts of copper by developing innovative formulations as well as optimization of the distribution and persistence of copper-based pesticides for downy mildew control seems to be a promising approach. This research investigated the delivery properties of biomimetic synthetic hydroxyapatite (HA) to enhance the biological activity of Cu(II) ions. To this aim, four Cu(II) compounds were formulated with the innovative HA component and applied in an in vitro antifungal assay against Botrytis cinerea, a common grapevine pathogen suitable for in vitro activity tests, and finally, in in planta efficacy assays against P. viticola under greenhouse conditions. The in vitro results highlighted a different inhibition activity for each Cu(II) compound and indicated a different interaction between the cupric compounds and HA, potentially related to different delivery mechanisms of Cu(II) from HA. Under greenhouse conditions, additional findings on the biological activity of the applied formulations were gained, especially on the efficacy of various concentrations of HA in the formulations, the influence of dose variation of the formulation and the treatment efficiency, and the persistence under rain-washing effect. This study revealed promising findings on the formulation based on the HA particles and the soluble Cu(II) compound, which resulted in reduced disease severity and incidence in all of the experimental conditions, including the lower Cu(II) dosage and the rain-washing effect. This suggests that coformulation of the three insoluble Cu(II) compounds with HA might significantly enhance the adsorption and release of Cu(II) ions by HA particles.
Choice of ANesthesia for EndoVAScular Treatment of Acute Ischemic Stroke (CANVAS): Results of the CANVAS Pilot Randomized Controlled Trial
Authors: Sun Jian , Liang Fa , Wu Youxuan , Zhao Yan , Miao Zhongrong , Zhang Li , Gelb Adrian W. , Chan Matthew T.V. , Peng Yuming , Han Ruquan
Published: December 2018

Background:

The effect of choice of anesthesia on clinical outcome for endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) remains unclear.

Methods:

We conducted a pilot trial of 43 patients with acute anterior circulation ischemic stroke having EVT. Patients were randomly allocated to receive general anesthesia or conscious sedation. We documented the rate of recruitment and rate of conversion from conscious sedation to general anesthesia. In addition, we recorded the change in National Institute of Health stroke scale (NIHSS) on day 7, the rate of successful reperfusion and measured neurological function by certified researchers using modified Rankin Score (mRS 0 to 2) at 90 days.

Results:

The recruitment rate was 31.4% and majority of patients were excluded because of delay in hospital presentation and posterior circulation stroke. The rate of conversion from conscious sedation to general anesthesia was 18.2%. This was primarily related to excessive sedation and uncontrolled movement. Change in NIHSS score, rate of successful reperfusion and functional recovery were similar between groups.

Conclusions:

It was feasible to randomize AIS patients receiving either general anesthesia or conscious sedation for EVT.
Socioeconomic Predictors of Surgical Resection and Survival for Patients With Osseous Spinal Neoplasms
Authors: Deb Sayantan , Brewster Ryan , Pendharkar Arjun Vivek , Veeravagu Anand , Ratliff John , Desai Atman
Published: December 2018

Summary of Background Data:

Primary osseous spinal neoplasms (POSNs) include locally aggressive tumors such as osteosarcoma, chondrosarcoma, Ewing sarcoma, and chordoma. For such tumors, surgical resection is associated with improved survival for patients. Socioeconomic predictors of receiving surgery, however, have not been studied.

Objective:

To examine the independent effect of race on receiving surgery and survival probability in patients with POSN.

Study Design:

A total of 1904 patients from the SEER program at the National Cancer Institute database, all diagnosed with POSN of the spinal cord, vertebral column, pelvis, or sacrum from 2003 through 2012 were included in the study. Race was reported as white or nonwhite. Treatment included receiving surgery and no surgery.

Materials and Methods:

Multivariable logistic regression was used to determine odds of receiving surgery based on race. Survival probability based on and race and surgery status was analyzed by Cox proportional hazards model and Kaplan-Meir curves. Results were adjusted for age at diagnosis, sex, socioeconomic status (composite index), tumor size, and tumor grade. Data were analyzed with SAS version 9.4.

Results:

The study found that white patients were significantly more likely to receive surgery (odds ratio=3.076, P<0.01). Furthermore, nonwhite race was associated with significantly shorter survival time [hazard ratio (HR)=1.744, P<0.05]. Receiving surgery was associated with improved overall survival (HR=2.486, P<0.01). After adjusting for receiving surgery, white race remained significantly associated with higher survival probability (HR=2.061, P<0.05).

Conclusions:

This national study of patients with typically aggressive POSN found a significant correlation between race and the likelihood of receiving surgery. The study also found race to be a significant predictor of overall survival, regardless of receiving surgical treatment. These findings suggest an effect of race on receiving treatment and survival in patients with POSN, regardless of socioeconomic status. Further studies are required to understand reasons underlying these findings, and how they may be addressed.
Does l-Methylfolate Supplement Methylphenidate Pharmacotherapy in Attention-Deficit/Hyperactivity Disorder?
Authors: Surman Craig , Ceranoglu Atilla , Vaudreuil Carrie , Albright Brittany , Uchida Mai , Yule Amy , Spencer Andrea , Boland Heidi , Grossman Rebecca , Rhodewalt Lauren , Fitzgerald Maura , Biederman Joseph
Published: December 2018

Purpose/Background

Interventions for attention-deficit/hyperactivity disorder (ADHD) may be inadequate for some patients. There is evidence that supplementation with l-methylfolate augments antidepressant agent effects and thus might also augment ADHD treatment effects by a common catecholaminergic mechanism.

Methods

Forty-four adults with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of ADHD participated in a randomized, double-blind, placebo-controlled, 12-week trial of 15 mg of l-methylfolate in combination with osmotic-release oral system methylphenidate. Osmotic-release oral system methylphenidate was dose optimized over the first 6 weeks. We evaluated the effects on ADHD symptoms, self-report on the Behavior Rating Inventory of Executive Function of executive function, methylphenidate dosing, neuropsychological test measures, the Adult ADHD Self-report scale, emotional dysregulation, social adjustment, and work productivity, as well as moderating effects of body mass index, autoantibodies to folate receptors, and select genetic polymorphisms.

Results

l-Methylfolate was well tolerated, with no significant effect over placebo except improvement from abnormal measures on the mean adaptive dimension of the ASR scale (χ2 = 4.36, P = 0.04). Methylphenidate dosing was significantly higher in individuals on l-methylfolate over time (χ2 = 7.35, P = 0.007). Exploratory analyses suggested that variation in a guanosine triphosphate cyclohydrolase gene predicted association with higher doses of methylphenidate (P < 0.001).

Conclusions

l-Methylfolate was associated with no change in efficacy on measures relevant to neuropsychiatric function in adults with ADHD, other than suggestion of reduced efficacy of methylphenidate. Further investigation would be required to confirm this effect and its mechanism and the genotype prediction of effects on dosing.
Management of pediatric low-grade glioma
Authors: de Blank Peter , Bandopadhayay Pratiti , Haas-Kogan Daphne , Fouladi Maryam , Fangusaro Jason
Published: December 2018

Purpose of review

Pediatric low-grade gliomas (pLGGs) have been treated with similar therapies for the last 30 years. Recent biological insights have allowed a new generation of targeted therapies to be developed for these diverse tumors. At the same time, technological advances may redefine the late toxicities associated with radiation therapy. Understanding recent developments in pLGG therapy is essential to the management of these common pediatric tumors.

Recent findings

It is now well understood that aberrations of the mitogen-activated protein kinase pathway are key to oncogenesis in low-grade gliomas. This understanding, along with the development of available targeted agents, have heralded a new era of understanding and treatment for these patients. Promising, sustained responses are now being seen in early phase trials among patients with multiply recurrent/progressive disease. Also, newer and highly conformal radiation approaches such as proton beam radiotherapy maintain efficacy of radiation but limit radiation-associated toxicities.

Novel therapies offer the potential for tumor control with greatly reduced toxicities. However, late effects of these therapies are just now being explored. Improved radiation approaches and targeted agents have the potential to redefine traditional therapy for pLGG.
A High-Intensity Exercise Boot Camp for Persons With Parkinson Disease: A Phase II, Pragmatic, Randomized Clinical Trial of Feasibility, Safety, Signal of Efficacy, and Disease Mechanisms
Authors: Landers Merrill R. , Navalta James W. , Murtishaw Andrew S. , Kinney Jefferson W. , Pirio Richardson Sarah
Published: December 2018

Background and Purpose:

The feasibility, safety, and efficacy of a high-intensity multimodal exercise program (aerobic, strengthening, and balance training) have not been well vetted in persons with Parkinson disease (PD). Thus, the primary aim was to determine whether a high-intensity multimodal exercise boot camp (HIBC) was both feasible and safe in persons with PD. The secondary aim was to determine whether the program would produce greater benefit than a usual care, low-intensity exercise program (UC). An exploratory aim was to determine whether these programs affected putative disease-modifying mechanisms.

Methods:

Twenty-seven participants (19 men and 8 women) were randomized into 8 weeks of either the HIBC or UC supervised by physical therapists. For feasibility, participation, and meeting, Centers for Disease Control and Prevention (CDC) exercise guidelines were assessed. For safety, adverse events were monitored. For efficacy, the following outcome domains were assessed before and after participation: balance, motor activity, endurance and fatigue, strength, mental health, and quality of life. For disease-modifying mechanisms, circulating brain-derived neurotrophic factor (BDNF) and its genotype, superoxide dismutase, and cytokines (tumor necrosis factor-α, interleukin-6, and interleukin-10) were monitored.

Results:

The HIBC was better at attaining CDC guidelines (P = 0.013) and spent more minutes in higher-intensity exercise per week (P < 0.001). There were no differences in adverse events (P = 0.419). The HIBC experienced significant improvements in 7/31 outcomes versus 3/31 in the UC arm. BDNF improved significantly for both groups from pre- to posttests (Ps ≤ 0.041) and an improved anti-inflammatory was observed for both groups.

Discussion and Conclusions:

A high-intensity multimodal exercise boot camp was feasible and safe in persons with PD. Compared with usual care, there were no differences in adverse events. Moreover, the high-intensity multimodal exercise program produced more improvement across more domains than usual care. Our results also suggest a possible link between improvement in outcomes and an improved anti-inflammatory milieu.

Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A244).
A Fatal Case of Acute Renal Failure From Envenoming Syndrome After Massive Bee Attack
Authors: Hughes Rhome L.
Published: December 2018

Envenoming syndrome is a systemic toxic reaction to the inoculation of large volume of insect venom, typically after a swarm attack from bees. Africanized honey bees are notorious for their aggressive nature, and human deaths resulting from Africanized honey bee attacks are consistently reported. Whereas anaphylaxis is the most common lethal mechanism of injury, delayed deaths can also occur as a consequence of severe venom toxicity with resultant end organ damage. Acute renal failure complicating massive envenomation is a rare but potentially fatal outcome after Africanized honey bee attack and may be heralded by laboratory evidence of rhabdomyolysis.
A Therapeutic Exercise Program Improves Pain and Physical Dimension of Health-Related Quality of Life in Young Adults
Authors: Rodríguez-Romero Beatriz , Bello Olalla , Vivas Costa Jamile , Carballo-Costa Lidia
Published: December 2018

Objective

The aim of this study was to evaluate the effects of an exercise therapy program on pain and physical dimension of health-related quality of life for young adults with musculoskeletal pain.

Design

This is a randomized controlled single-blind trial. Fifty-seven subjects (58% women) were randomly assigned to experimental [n = 28, 21.4 (2.9) yrs] and control [n = 29, 21.0 (4.2) yrs] groups. The experimental group participated in a 9-wk stabilization exercise therapy program, 60 mins/wk, whereas the control group did not exercise, with a preintervention and postintervention assessment. Primary outcome was Physical Component Summary of SF-36. Secondary outcomes were Nordic Musculoskeletal Questionnaire, Visual Analogue Scale, Oswestry Disability Index, Neck Disability Index, and Trunk Flexor Endurance Test. The Shapiro-Wilk, independent t test or Mann-Whitney U test, X2, or Fisher's exact test were used for statistical analysis.

Results

After intervention, the experimental group improved by 3.2 (4.5) points on the Physical Component Summary (P = 0.01), decreased prevalence of low back pain in the last month (P = 0.02) and cervical disability (P = 0.02), and increased flexor trunk endurance (P = 0.005).

Conclusions

This study confirmed that a 9-wk progressive exercise therapy program can improve physical health and reduce the prevalence of cervical disability and low back pain in the last month in young adults with musculoskeletal pain.
Outcome of Patients with Complete Unilateral Cleft Lip and Palate: 20-Year Follow-Up of a Treatment Protocol
Authors: Pai Betty C. J. , Hung Yi-Tan , Wang Ruby S. H. , Lo Lun-Jou
Published: December 2018

Background:

The treatment plan for cleft lip and palate varies among centers and requires long-term evaluation of its final outcome.

Methods:

A consecutive series of patients born from 1994 to 1996 were reviewed. Inclusion criteria were complete unilateral cleft lip and palate, undergoing all treatment procedures performed by the team, and continuous follow-ups until 20 years of age. Exclusion criteria were incomplete data, having microform cleft lip on the contralateral side, presence of the Simonart band, and other abnormalities.

Results:

A total of 72 patients were included. Average age at final evaluation was 21.3 years; 83.3 percent of patients underwent one-stage rotation-advancement lip repair and 16.7 percent underwent two-stage repair with an initial adhesion cheiloplasty. All patients underwent palate repair using the two-flap method at an average age of 12.3 months. Velopharyngeal insufficiency occurred and required surgical interventions in 19.4 percent during the preschool age and in 16.7 percent at the time of alveolar bone grafting; 56.9 percent of patients underwent secondary lip/nose revision during the growing age. Regular orthodontic treatment was administered to 34.7 percent of patients between 12 and 16 years of age. Orthodontic treatment and orthognathic surgery were applied in 37.5 percent of the patients after maturity. The average number of surgical procedures to complete the treatment was 4.8 per patient.

Conclusions:

This treatment protocol provided generally acceptable final outcome after the 20-year follow-up. Some results were less ideal and have resulted in modifications of the planning and methods in the protocol.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Delivery of External Volume Expansion through Microdeformational Interfaces Safely Induces Angiogenesis in a Murine Model of Intact Diabetic Skin with Endothelial Cell Dysfunction
Authors: Wei Shuyi , Orgill Dennis P. , Giatsidis Giorgio
Published: December 2018

Background:

External volume expansion promotes angiogenesis in tissues by inducing a subcritical hypoxia, mechanically stimulating endothelia, and creating mild inflammation. Application of external volume expansion to less-vascularized tissues with endothelial cell dysfunction poses a risk for ineffectiveness or ischemic damage. The authors investigated the effects of external volume expansion on a murine model of type 2 diabetes mellitus and tested whether the adoption of microdeformational interfaces optimizes its angiogenic properties while limiting complications to tissues.

Methods:

Adult diabetic mice received stimulation with external volume expansion on their dorsal skin using a standard cup-shaped silicone interface, a polyurethane foam-shaped interface, or a silicone microarray chamber interface; controls received no treatment. Skin damage was assessed visually on the last day of stimulation and 5 days later. At 5-day follow-up, skin specimens (n = 5 per group) were procured and analyzed by histology to assess angiogenesis, adipose tissue and skin remodeling, and inflammation.

Results:

All treatments significantly increased the density of blood vessels in skin compared to controls; the polyurethane foam-shaped interface showed the most robust effect (+80 percent). No relevant complications were observed using a polyurethane foam-shaped interface or silicone microarray chamber interface, but a cup-shaped silicone interface led to substantial skin damage and caused intense inflammation, fibrosis of the subcutaneous tissue, and dermal remodeling.

Conclusion:

The adoption of external volume expansion with microdeformational interfaces allows the effective and safe preconditioning of tissues with endothelial cell dysfunction and could improve outcomes in diabetic patients at high risk for surgical complications.
Diurnal Cortisol in a Sample of Socioeconomically Disadvantaged Chinese Children: Evidence for the Shift-and-Persist Hypothesis
Authors: Chen Lihua , Li Xiaoming , Imami Ledina , Lin Danhua , Zhao Junfeng , Zhao Guoxiang , Zilioli Samuele
Published: December 2018

Objective

Low socioeconomic status (SES) is one of the most well-established social determinants of health. However, little is known about what can protect the health of individuals (especially children) living in low-SES circumstances. This study explored whether the psychological strategy of “shift-and-persist” protects low-SES children from stress-related physiological risks, as measured through blunted (unhealthy) diurnal cortisol profiles.

Methods

A sample of 645 children (aged 8–15 years) from low-SES backgrounds and having at least one HIV-positive parent completed a battery of psychological scales. Diurnal cortisol assessments included collection of saliva samples four times a day for 3 days, from which three cortisol parameters (cortisol at awakening, cortisol awakening response, and cortisol slope) were derived.

Results

Higher levels of shift-and-persist, considered as a single variable, were associated with higher cortisol at awakening (B = 0.0119, SE = 0.0034, p < .001) and a steeper cortisol slope (B = −0.0007, SE = 0.0003, p = .023). These associations remained significant after adjusting for covariates and did not vary by age. In supplementary analyses, where shifting and persisting were treated as separate variables, the interaction between these two coping strategies significantly predicted cortisol at awakening (B = 0.0250, SE = 0.0107, p = .020) and the cortisol slope (B = −0.0022, SE = 0.0011, p = .040), suggesting that the combination of shift-and-persist is important for predicting diurnal cortisol profiles.

Conclusions

Our findings demonstrate that shift-and-persist is associated with healthier diurnal cortisol profiles among socioeconomically disadvantaged children and introduce the possibility that this coping strategy is protective against other stressors, such as those uniquely faced by children in our study (i.e., being affected by parental HIV).