bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetes and Blood Glucose Disorders Under Anti-PD1
Authors: Magis Quentin , Gaudy-Marqueste Caroline , Basire Agnes , Loundou Anderson , Malissen Nausicaa , Troin Laura , Monestier Sandrine , Mallet Stéphanie , Hesse Sylvie , Richard Marie-Aleth , Valéro René , Beliard Sophie , Grob Jean-Jacques
Published: February 2018

Acute type 1 diabetes (AD1) is a rare but definitive immune-related adverse event associated with anti-PD1. Most of the reported cases are close to what has been described as “fulminant type 1 diabetes.” We sought to determine whether anti-PD1 could impair glycoregulation and whether occurrence of AD1 could be anticipated by prior glycemic changes. Fasting glycemia collected before, under, and after treatment in melanoma patients treated with anti-PD1 over a period of 36 months were retrospectively analyzed. Glycemic trend analyses were performed using linear regression analysis. In total, 1470 glucose values were monitored in 163 patients treated for a mean duration of 5.96 months. Three patients developed an AD1 (1, 84%). Two other cases were observed in the same period in a still-blinded trial of anti-PD1 versus ipilimumab. All cases of AD1 occurred in patients with a normal pretreatment glycemia, and there was no detectable drift of glycemia before ketoacidosis onset. In 4 of 5 cases of AD1, the HLA subgroups were DRB01* 03 or 04, known to increase type 1 diabetes risk in the general population. In the 28 patients with preexisting type 2 diabetes, there was a slight trend for glycemia increase with anti-PD1 infusions (0.05 mmol/L/infusion P=0.004). In the 132 patients with normal pretreatment glycemia, there was a slight trend for a decrease of glycemia with anti-PD1 infusions (−0.012/mmol/L/infusion P=0.026). These data suggest that the monitoring of glycemia under anti-PD1 cannot help to anticipate AD1, and there is no general tendency to glycemic disorder. HLA genotyping before treatment may help to focus surveillance in patients with the HLA DRB1*03/04 group.
Dissociation between morphine-induced spinal gliosis and analgesic tolerance by ultra-low-dose α2-adrenergic and cannabinoid CB1-receptor antagonists
Authors: Grenier Patrick , Wiercigroch David , Olmstead Mary C. , Cahill Catherine M.
Published: February 2018

Long-term use of opioid analgesics is limited by tolerance development and undesirable adverse effects. Paradoxically, spinal administration of ultra-low-dose (ULD) G-protein-coupled receptor antagonists attenuates analgesic tolerance. Here, we determined whether systemic ULD α2-adrenergic receptor (AR) antagonists attenuate the development of morphine tolerance, whether these effects extend to the cannabinoid (CB1) receptor system, and if behavioral effects are reflected in changes in opioid-induced spinal gliosis. Male rats were treated daily with morphine (5 mg/kg) alone or in combination with ULD α2-AR (atipamezole or efaroxan; 17 ng/kg) or CB1 (rimonabant; 5 ng/kg) antagonists; control groups received ULD injections only. Thermal tail flick latencies were assessed across 7 days, before and 30 min after the injection. On day 8, spinal cords were isolated, and changes in spinal gliosis were assessed through fluorescent immunohistochemistry. Both ULD α2-AR antagonists attenuated morphine tolerance, whereas the ULD CB1 antagonist did not. In contrast, both ULD atipamezole and ULD rimonabant attenuated morphine-induced microglial reactivity and astrogliosis in deep and superficial spinal dorsal horn. So, although paradoxical effects of ULD antagonists are common to several G-protein-coupled receptor systems, these may not involve similar mechanisms. Spinal glia alone may not be the main mechanism through which tolerance is modulated.
Descemet Membrane Endothelial Keratoplasty (DMEK) Under Previous DMEK for Secondary Endothelial Graft Failure
Authors: Alió del Barrio Jorge L. , Vega-Estrada Alfredo , Alió Jorge L.
Published: February 2018

Purpose:

To describe an alternative treatment option for secondary Descemet membrane endothelial keratoplasty (DMEK) graft failure, using a second DMEK graft without primary graft removal (“DMEK under DMEK”).

Methods:

A 72-year-old patient with pseudophakic bullous keratopathy in the left eye underwent an 8.25-mm second DMEK under an 8.5-mm failed DMEK because of previous graft rejection and subsequent secondary failure.

Results:

Corrected distance visual acuity improved from 0.2 (decimal scale) before surgery to 0.56 (best visual potential due to concomitant preexisting macular damage) from the first month after surgery and up to sixth-month follow-up. Complete corneal transparency was achieved from the first postoperative day and remained until the end of the follow-up. Pachymetry returned to normal values within the first month. No intraoperative or postoperative complications were observed.

Conclusions:

A second DMEK graft without peeling or removing the first DMEK graft is an alternative treatment option for DMEK graft secondary failure. This approach is able to achieve full anatomical and functional restoration of the prefailure status. This technique allows a second graft surgery to be easier, faster, and with less intraoperative risks (as a result of a potential difficult host descemetorhexis). Future studies with larger samples and a longer follow-up are necessary to confirm the short and long-term outcomes of this new DMEK under DMEK approach.
Delayed Generalized Necrotic Purpuric Rash in a C6-deficient 12-year-old Girl Treated for Group W Meningococcal Disease
Authors: Gaschignard Jean , Hassani Nailati , El Sissy Carine , Bonacorsi Stéphane , Dauger Stéphane , Chomton Maryline , Taha Muhamed-Kheir , Levy Michael
Published: February 2018

We report an unusual case of generalized necrotic purpuric rash that started 48 hours after the initiation of effective third-generation cephalosporin therapy to treat Neisseria meningitidis W infection in a 12-year-old girl. The course was favorable with no shock, and she recovered completely without sequelae. This infection revealed C6 deficiency in our patient.
Differences in Certification and the Effect on Team Climate Among Community Health Workers in Texas
Authors: Siemon Mark , Kreglo Brenna , Boursaw Blake
Published: February 2018

The purpose of this study was to compare team climate among Texas community health workers (CHWs)/promotoras who were certified by the 2 different methods: (a) completing a state-approved training program, and (b) providing evidence of work experience (grandfathering). Analysis of survey results found no significant differences in Team Climate Inventory scores between CHWs who were certified either through state-approved training or through work experience. This research provides some preliminary evidence in support of experience-based certification, but there continues to be a need for more research evaluating CHW certification requirements and the impact of state certification of CHWs on population health outcomes.
Identifying Poor-Performing Hospitals in the Medicare Hospital-Acquired Condition Reduction Program: An Assessment of Reliability
Authors: Soltoff Samuel , Koenig Lane , Demehin Akinluwa A. , Foster Nancy E. , Vaz Christopher
Published: February 2018

Centers for Medicare and Medicaid Services (CMS) estimated that Medicare's Hospital-Acquired Condition Reduction Program (HAC-RP) would reduce hospital payments by $364 million in fiscal year 2016. Although observers have questioned the validity of certain HAC-RP measures, less attention has been paid to the determination of low-performing hospitals (bottom quartile) and the reliability of penalty assignment. This study used publicly available data from CMS's Hospital Compare to simulate the consistency of hospitals' scores and the assignment of penalties under repeated measurement with no change in each hospital's underlying quality. The simulation showed that 64.0% of all hospitals and 40.6% of hospitals subject to payment penalty are statistically significantly different from the penalty threshold at the 95% confidence level. The proportion of hospitals statistically different from the threshold showed significant variation by ownership status, teaching status, bed size, and other factors. The simulation further showed that due only to chance, 18.0% of penalized hospitals would escape penalty on repeated measurement. Policymakers should consider alterations to the HAC-RP to improve its reliability.
Relationship Between Accountable Care Organization Status and 30-Day Hospital-wide Readmissions: Are All Accountable Care Organizations Created Equal?
Authors: Mask Andrew , Adepoju Omolola E.
Published: February 2018

Objective:

We compare hospital readmission rates by accountable care organization (ACO) status with national readmission averages, to determine whether ACO affiliation influences 30-day hospital-wide readmission rates.

Methods:

Data from the 2015 American Hospital Association Survey of Care Systems and Payment database were merged with Centers for Medicare and Medicaid's 2015 Hospital Compare Deaths and Readmissions data set. A multinomial logistic regression model is used to examine readmission rates, categorized as better, no different, or worse, in comparison to national averages, by ACO status.

Results:

Compared with Non-ACO hospitals and holding the covariates constant, the relative risk of having better than national average readmissions was 1.85 in Medicare ACO hospitals (p = .36). Compared with facilities in the Northeast region, the relative risk of having better than national average readmissions was 2.21 for facilities in the West (p = .10). Facilities in the Midwest and Southern regions had a lower risk of having better than national average rates (Relative Risk: 0.90 and 0.23, respectively; p = .83 and .06, respectively). As hospital beds increase, facilities have significantly lower risks of having worse than national average readmissions.

Conclusions:

Overall, the ACO status did not significantly improve readmissions. However, Medicare ACOs performed better than non-Medicare ACOs and those hospitals without any reported ACO arrangements.
Toward Optimizing Global Learning Opportunities for US Physical Therapy Students: A Description of Current Practices and Initial Recommendations
Authors: Audette Jennifer , Peterson Cathy , Svien Lana
Published: February 2018

Purpose.

To examine and describe the structure, curricular objectives, and outcome measurement practices of faculty developing and providing international opportunities in physical therapy education programs and to provide guidance and initial recommendations for faculty.

Background.

Physical therapy educational programs are adding international opportunities as a way to address the increasingly global nature of the profession. Guidelines to enhance practice, optimize the experience, and provide structure for managing risk are warranted.

Methods.

A researcher-developed survey was distributed to 216 physical therapy education programs and professional listservs. Respondents from 56 programs (26%) returned the survey. Data were analyzed descriptively.

Results.

Most respondents cited global understanding as critical to the physical therapy profession, and the reason for involving students in global learning opportunities. Knowledge of the host site, sustainability, and potential strength of partnership were cited as the most important factors when choosing an international community partner. Risk management efforts included supplemental insurance, availability of emergency contact information, safe transportation and housing plans, and plans for adverse occurrences.

Conclusion.

This study supplements previous literature in designing international student experiences. Activities addressing clear purposes and expected outcomes for all participants, including the community partner, and the university-community partnership before, during, and after the experience are essential.
Happy 40th Year—You've Come a Long Way, CAPTE!
Authors: Harris Mary Jane , Hinman Martha R. , Marcoux Beth C. , Swisher Laura L.
Published: February 2018

Background and Purpose.

The purpose of this article is to review the 40-year history of the Commission on Accreditation in Physical Therapy Education (CAPTE), highlight its contributions and controversies, and reflect on how it has influenced the physical therapy profession.

Position and Rationale.

It is our contention that CAPTE has played a pivotal role in shaping the direction of physical therapy education since its inception in 1977, and that it will continue to do so in the future despite multiple challenges related to expanding government regulations, an ever-changing health care delivery system, a proliferation of new programs, ongoing faculty shortages, and growing concerns over an unsustainable model for clinical education. The evolution of CAPTE's accreditation standards over the past 40 years has also been instrumental in advancing physical therapy education, practice, and research as they continue to raise the bar for faculty qualifications, scholarly expectations, curricular content, and the designated entry-level degree for physical therapy practitioners. Although these and other issues will continue to challenge CAPTE's resources and processes, we are confident that CAPTE will adapt as needed to fulfill its mission of assuring quality and continuous improvement in physical therapy education.

Discussion and Conclusion.

The physical therapy profession can take pride in the outstanding reputation that CAPTE has established as a model of best practices in specialized accreditation. By reflecting on CAPTE's 40-year history and present status, we have shown how well CAPTE has served the interests of the public and the profession. In looking forward, we share CAPTE's vision for becoming an autonomous, self-governing body that sets global standards which will positively affect physical therapy education and practice for years to come.
Faculty-Lived Experiences Integrating Technology-Assisted Educational Practices Into an Entry-Level Physical Therapy Curriculum
Authors: Donlan Pamela , Alpert Shannon
Published: February 2018

Introduction.

Across the nation, innovative technologies have changed instructional practices throughout higher education. In physical therapist education programs, faculty must work to integrate technology into a complex academic curriculum that prepares students to be hands-on health care practitioners. The purpose of this study was to uncover how physical therapy (PT) faculty make sense of their lived experiences integrating innovative technology-assisted educational practices into their entry-level curriculums.

Methods.

Ten participants were recruited from the PT department at an urban university in the northeastern United States. An interpretative phenomenological analysis was used to explore participants' experiences and gather data through individualized, semistructured interviews.

Results.

Data analysis yielded three superordinate themes: awareness of barriers, appreciation for educational contributions, and respect for program integrity. Findings revealed that faculty experienced internal and external barriers that affected technology integration efforts. In addition, they were encouraged by the ability of technology to reach diverse learners and promote metacognition and were enthusiastic about the pedagogical advantages of student input. Furthermore, in-person instruction and intentional, judicious technology integration was perceived as crucial to program integrity.

Discussion and Conclusion.

Exploration of faculty experiences gave rise to a unique subtheme of sense of dependence as a barrier that has not been directly reported in the literature. Similarly, respect for program integrity formed a unique superordinate theme that is worthy of future research. Findings are relevant to administrators and PT faculty as they work to advance quality pedagogy. They are also of value to technical support specialists because they strive to provide technology-based training and guidance and of value to students because they seek to expand their knowledge.
Simple Hysterectomy for Residual Cervical Intraepithelial Neoplasm
Authors: Binyamin Liat , Segev Meirav , Peled Yoav , Krissi Haim , Sabah Gad , Raban Oded , Jakobson-Setton Ariella , Ben-Haroush Avi , Eitan Ram
Published: February 2018

Objective

Many patients undergo hysterectomy for the treatment of cervical dysplasia. Factors that correlate with residual high-grade squamous intraepithelial lesions (HGSIL) at hysterectomy are not clear. We set out to determine preoperative features that may predict residual disease for patients treated for cervical dysplasia.

Materials and Methods

A retrospective database was reviewed for women who underwent simple hysterectomy for HGSIL between 1990 and 2013. Clinical data included age, history of dysplasia, initial treatment, follow-up colposcopy, indications for surgery, time elapsed between initial treatments, and pathology findings after hysterectomy. Significant residual disease was defined as HGSIL or cervical carcinoma. Statistical analyses were performed with the SPSS, independent Student t test, and Pearson χ2 test. Significance was set at p < .05.

Results

Eighty-three women met the study criteria. The indication for hysterectomy was residual histological finding at conization pathology in 30 women and patients' request in 53 women. Residual disease was found in 42 hysterectomy specimens: in 16 of 30 with residual histological finding and in 26 of the 53 patients' request. Reason for the hysterectomy was not statistically significant for residual disease (p = .708). Median age of patients with residual disease was 46.5 years versus 44.1 years for those without residua (p = .02). Postmenopausal patients had a higher rate of residual disease, 12 (32.4%) of the 28 premenopausal patients and 25 (67.6%) of the 54 postmenopausal patients (p = .04). Conization margin status was not associated with residual disease (p = .878).

Conclusions

Older women and those in menopause are at significantly higher risk of residual disease at hysterectomy.
Effect of High-Risk Human Papillomavirus but Normal Cytology at Test of Cure on Achieving Colposcopy Standards
Authors: Kalampokas Emmanouil , Wilson Judith , Gurumurthy Mahalakshmi , Cruickshank Margaret E.
Published: February 2018

Objective

In United Kingdom., test of cure after treatment of any grade of cervical intraepithelial neoplasia (CIN) incorporates high-risk human papillomavirus (Hr-HPV) test and cytology at 6-month follow-up. The aims of the study were to determine the rate of recurrent CIN in women who are Hr-HPV positive and cytology negative and to explore possible associated risk factors.

Methods

A retrospective observational cohort study was performed in women treated for any grade CIN between 2010 and 2015 from a regional population, who were Hr-HPV positive and cytology negative at first follow-up.

Results

A total of 2729 women were identified as treated for any grade CIN, and 213 (7.8%) were re-referred to colposcopy having Hr-HPV–positive test and negative cytology at test of cure. Their mean age was 31.56 years (range = 19–62 years). The mean time of follow-up per woman was 30.50 months (range = 2–63 months). At colposcopy, 171 (80.3%) had colposcopy examination only and 42 women (19.7%) had a biopsy. Twenty-four cases (11.3%) of CIN were identified of which 4 (1.9%) were CIN 2/3. Eleven women (5.2%) in total had a repeat treatment. Five women (2.3%) had biopsy-proven CIN 2/3 within 12-months after treatment. No cases of CIN 3+ after negative colposcopy were identified during the follow-up period.

Conclusions

The incorporation of Hr-HPV testing yielded a very small number of women with residual CIN within 12 months of treatment. Our results suggest that women who are Hr-HPV positive and cytology negative after treatment of CIN with normal and adequate colposcopy could be discharged to routine recall if confirmed by larger national data.
Anticipating the Impact of Human Papillomavirus Vaccination on US Cervical Cancer Prevention Strategies
Authors: Massad L. Stewart
Published: February 2018

Cervical cancer prevention guidelines are benchmarked to risk of cervical precancer. In younger age cohorts, vaccination against high-risk types of human papillomavirus (HPV) has reduced HPV 16/18 prevalence and cervical intraepithelial neoplasia. Lower prevalence of precancer will impair the sensitivity of cytology and colposcopy, but negative predictive value will rise. Training and skills maintenance will become more difficult as abnormalities become less common. Primary screening with HPV assays will become more attractive but will require HPV genotyping as most positive HPV tests will reflect non-16/18 infections with lower oncogenicity. Screening will begin later and will occur at longer intervals. Colposcopy and treatment thresholds will become more stringent. Historical data sets will become inappropriate for guidelines development. As women immunized using nonavalent vaccine reach screening age, these trends will become still more pronounced.
Pylera and sequential therapy for first-line Helicobacter pylori eradication: a culture-based study in real clinical practice
Authors: Fiorini Giulia , Zullo Angelo , Saracino Ilaria M. , Gatta Luigi , Pavoni Matteo , Vaira Dino
Published: February 2018

Background and aims

Italian guideline suggests 10-day sequential or bismuth-based quadruple therapies for first-line Helicobacter pylori treatment. Comparison between these regimens is lacking. We assessed the efficacy of these therapies in clinical practice and evaluated the role of primary bacterial resistance toward clarithromycin and metronidazole.

Patients and methods

Consecutive patients with H. pylori infection were enrolled. Bacterial culture with antibiotics susceptibility testing was attempted in all cases. Patients received either a sequential therapy with esomeprazole 40 mg for 10 days plus amoxicillin 1000 mg for the first 5 days followed by clarithromycin 500 mg and tinidazole 500 mg (all twice daily) for the remaining 5 days, or bismuth-based therapy with esomeprazole 20 mg twice daily and Pylera 3 tablets four times daily for 10 days. H. pylori eradication was assessed by using 13C-urea breath test.

Results

A total of 495 patients were enrolled. Following sequential (250 patients) and quadruple (245 patients) therapies, the eradication rate were 92 and 91%, respectively, at intention-to-treat analysis and 96 and 97%, respectively, at per protocol analysis. Overall, the pattern of bacterial resistance did not significantly affect the cure rate, but the presence of clarithromycin and metronidazole dual resistance tended to reduce the success rate of both sequential (84.8 vs. 90.1%; P=0.4) and quadruple (85 vs. 94.1%; P=0.06) therapies. Adverse events occurred more frequently with the quadruple than with sequential therapy (56.9 vs. 25.8%; P<0.001).

Conclusion

In our country, sequential and bismuth-based quadruple therapy achieved similarly high eradication rates as first-line treatments for H. pylori infection in clinical practice.
Concept-Based Curricula
Authors: Brussow Jennifer A. , Roberts Karin , Scaruto Matthew , Sommer Sheryl , Mills Christine
Published: February 2018

As nursing education struggles to address a rapidly changing health care system, overcrowded curricula, and an increased focus on clinical reasoning skills, many programs have adopted or transitioned to concept-based curricula (CBCs), which are structured around key concepts and exemplars. Despite CBC’s promised benefits, the process of developing a CBC framework may pose a challenge to programs. To address this barrier, a national study was conducted to develop a representative list of concepts and exemplars. This initiative expands on prior work by suggesting a leveled approach to positioning exemplars within a curricular sequence.
Three-Year Changes in Physical Activity and Subsequent Loss of Ability to Walk 400 m in Older Adults
Authors: Martinez-Gomez David , Bandinelli Stefania , Del-Panta Vieri , Talluri Eleonora , Guralnik Jack M. , Ferrucci Luigi
Published: February 2018

We examined the associations of maintaining or increasing physical activity (PA) for a 3-yr follow-up with subsequent incident inability to complete the 400-m walk test (i.e., mobility disability) for 6 yrs of follow-up in older adults. This study included 421 participants 65 yrs and older. The 400-m walk test was assessed at baseline and at 3-, 6-, and 9-yr follow-up. Physical activity was self-reported through a 6-point rating scale at baseline and 3-yr follow-up. Three-year cumulative PA (i.e., average at baseline and at 3-yr follow-up) and its changes (i.e., from baseline to 3-yr follow-up) were linked to subsequent incidence of mobility disability for 6 yrs of follow-up (i.e., from 3- to 9-yr follow-up), after adjustment for potential covariates. After the 3-yr period, incidence of mobility disability for the subsequent 6 yrs of follow-up occurred in 129 participants. The odds ratio (95% confidence interval) of incident mobility disability associated with 1-category increase in cumulative PA was 0.63 (0.41–0.97, P = 0.036). The odds ratio (95% confidence interval) of incident mobility disability associated with 1-category increase in changes in PA was 0.56 (0.38–0.84, P = 0.005). Hence, maintaining or increasing PA levels is associated with a reduced risk of mobility disability among older adults.
Incidence of Obstetric Anal Sphincter Injuries After Training to Protect the Perineum
Authors: Yeung Jennifer , Stecher Anna , Crisp Catrina C. , Mazloomdoost Donna , Smith Benjamin , Kleeman Steven D. , Pauls Rachel N.
Published: February 2018

Objectives

Obstetric anal sphincter injuries (OASISs) are a devastating postpartum complication; reducing rates is paramount to improving quality of care. In Norway, implementation of a perineal protection program decreased the incidence of OASIS by 48%. We sought to assess impact on OASIS rates following a similar program.

Methods

This institutional review board–approved, retrospective cohort study was performed in an academic hospital system. The periods of analysis were November 2014 through October 2015 for the preintervention arm and November 2015 through October 2016 for the postintervention arm. From November 2 to 6, 2015, 2 Norwegian experts conducted a didactic and hands-on, on-site workshop focusing on perineal protection. The experts were then present on labor and delivery wards to reinforce perineal protection in live deliveries. Teachings were emphasized at departmental meetings for the remainder of the year. Data were extracted from electronic medical records and manually audited.

Results

The rate of vaginal delivery was similar among both periods (6504 and 6650; P = 0.059). Obstetric anal sphincter injury rates decreased from 211 (3.2%) preintervention to 189 (2.8%) after the workshop. Although this represented 32 fewer injuries, it was not statistically significant (P = 0.179). Obstetric anal sphincter injuries following forceps-assisted deliveries did decline significantly from 103 (28%) to 81 (21%) (P = 0.014). In addition, incidence of fourth-degree lacerations during resident deliveries decreased significantly from 10 (0.6%) to 3 (0.2%) (P = 0.047).

Conclusions

An educational workshop focusing on perineal support was not associated with a significant reduction in overall OASIS rates. Nevertheless, decreased forceps-related OASIS and fourth-degree lacerations rates support positive influence of the intervention.
Cranberry Supplementation Does Not Reduce Urinary Tract Infections in Patients With Indwelling Catheters After Pelvic Reconstructive Surgery
Authors: Shatkin-Margolis Abigail , Warehime Jenna , Pauls Rachel N.
Published: February 2018

Objectives

Urinary tract infections (UTIs) are common after pelvic reconstructive surgery, likely due to high rates of urinary retention. We sought to determine if prescription of cranberry capsules reduced UTIs in postoperative patients requiring catheter use.

Methods

This was an institutional review board–approved retrospective cohort study. Two 6–month periods were compared: April to September 2015, before cranberry capsules were incorporated, and April to September 2016, after cranberry capsules were implemented. Our study population included patients discharged with a catheter after pelvic reconstructive surgery. All charts were reviewed for demographics, perioperative data, and urine cultures up to 6 weeks postoperatively. A UTI was defined as treatment with antibiotics or positive cultures. Statistical analysis was performed; logistic regression evaluated for relationships between UTI and other factors. Our a priori sample size calculation determined 88 subjects per group would be necessary.

Results

Over the 2 periods, 167 patients met inclusion criteria: 71 before and 96 after cranberry implementation. The 2 cohorts were similar in all data. Regarding incidence of UTI, rates were overall high and not significantly different between groups (76% before cranberry vs 69% with cranberry; P = 0.299). The median duration of catheter use was 8 days in both cohorts. The UTI was most likely to occur in the second week after surgery. Logistic regression revealed no associations between age, surgery type, duration of catheter use, and UTI.

Conclusions

In this retrospective study, prescription of cranberry capsules did not significantly reduce UTI rates among patients with urinary catheters after pelvic reconstructive surgery.
Changes in the Vaginal Microenvironment as Related to Frequency of Pessary Removal
Authors: Fregosi Nicole J. , Hobson Deslyn T.G. , Kinman Casey L. , Gaskins Jeremy T. , Stewart J. Ryan , Meriwether Kate V.
Published: February 2018

Objective

The aim of the study was to describe the effect of frequency of pessary removal on the vaginal microenvironment.

Methods

We performed a secondary analysis of a multicenter randomized trial of hydroxyquinoline gel in women presenting for pessary fitting. Patients had vaginal secretions analyzed at baseline, 2 weeks, and 3 months. Patients were stratified by frequency of pessary removal at least once daily, at least once weekly, and less often than once weekly. These groups were compared for prevalence of Lactobacillus predominance (primary outcome), anaerobic predominance, Mobiluncus prominence, vaginal symptoms, and bacterial vaginosis by Nugent criteria, and correction for confounding variables was performed.

Results

One hundred thirty-seven women were included in this analysis: 34 (25%) removed the pessary daily, 54 (39%) at least weekly, and 49 (36%) less often than once weekly. Women who removed the pessary less often than weekly were older (P < 0.01), using more hormone therapy (P = 0.03), and more likely to have bacterial vaginosis at baseline (P < 0.01). At 2 weeks, the predominance of Lactobacillus in the group removing pessary daily was higher (41% daily vs 24% weekly vs 9% longer, P = 0.03) and this persisted after confounder correction (P < 0.01). Women who removed their pessary less than weekly were more likely to have anaerobic predominance at 3 months (P = 0.04).

Conclusions

Women who remove their pessaries less often than once weekly have an increased prevalence of anaerobes at 3 months, but no difference in vaginal symptoms or pessary satisfaction.
J. Marion Sims and the Vesicovaginal Fistula: Historical Understanding, Medical Ethics, and Modern Political Sensibilities
Authors: Wall L. Lewis
Published: February 2018

Objectives

To review the historical background surrounding the early work of Dr. J. Marion Sims, who developed the first consistently successful surgical technique for the repair of obstetric vesicovaginal fistulas by operating on a group of young, enslaved, African American women who had this condition between 1846 and 1849.

Methods

Review of primary source documents on Sims and his operations, early 19th century clinical literature on the treatment of vesicovaginal fistula, the introduction of ether and chloroform anesthesia into surgical practice, and the literature on the early 19th century medical ethics pertaining to surgical innovation. The goals are to understand Sims's operations within the clinical context of the 1840s and to avoid the problems of “presentism,” in which beliefs, attitudes, and practices of the 21st century are anachronistically projected backward into the early 19th century. The object is to judge Sims within the context of his time, not to hold him accountable to standards of practice which were not developed until a century after his death.

Results

A narrative of what Sims did is presented within the context of the therapeutic options available to those with fistula in the early 19th century.

Conclusions

Review of the available material demonstrates that Sims' first fistula operations were legal, that they were carried out with express therapeutic intent for the purpose of repairing these women's injuries, that they conformed to the ethical requirements of his time, and that they were performed with the patients' knowledge, cooperation, assent, and assistance.
Dedication
Authors: Sloane Hans
Published: February 2018

May it please your Lordship, The Royal Society of London, instituted to promote arts, and sciences, observing your Lordships great learning and goodness, did themselves the honour to choose your Lordship their President, which your Lordship condescended to accept of.
Secretory vesicle trafficking in awake and anesthetized mice: differential speeds in axons versus synapses
Authors: Knabbe Johannes , Nassal Joris , Verhage Matthijs , Kuner Thomas
Published: February 2018

Neuronal dense core vesicles (DCVs) transport many cargo molecules like neuropeptides and neurotrophins to their release sites in dendrites or axons. The transport properties of DCVs in axons of the intact mammalian brain are unknown. We used viral expression of a DCV cargo reporter (NPY-Venus/Cherry) in the thalamus and two-photon in vivo imaging to visualize axonal DCV trafficking in thalamo-cortical projections of anesthetized and awake mice. We found an average speed of 1 μm/s, maximal speeds of up to 5 μm/s and a pausing fraction of ~11%. Directionality of transport differed between anesthetized and awake mice. In vivo microtubule +-end extension imaging using Macf18-GFP revealed microtubular growth at 0.12 μm/s and provided positive identification of antero- and retrograde axonal transport. Consistent with previous reports, anterograde transport was faster (~2.1 μm/s) than retrograde transport (~1.4 μm/s). In summary, DCVs are transported with faster maximal speeds and lower pausing fraction in vivo compared to previous results obtained in vitro. Finally, we found that DCVs slowed down upon presynaptic bouton approach. We propose that this mechanism promotes synaptic localization and cargo release.

Key points

Despite their immense physiological and pathophysiological importance, we know very little about the biology of dense core vesicle (DCV) trafficking in the intact mammalian brain.

DCVs are transported at similar average speeds in the anesthetized and awake mouse brain compared to neurons in culture, yet maximal speed and pausing fraction of transport were higher.

Microtubule +-end extension imaging visualized microtubular growth at 0.12 μm/s and revealed that DCVs were transported faster in the anterograde direction.

DCV transport slowed down upon presynaptic bouton approach, possibly promoting synaptic localization and cargo release.

Our work provides a basis to extrapolate DCV transport properties determined in cultured neurons to the intact mouse brain and reveal novel features such as slowing upon bouton approach and brain state-dependent trafficking directionality.
White matter plasticity and reading instruction: Widespread anatomical changes track the learning process
Authors: Huber Elizabeth , Donnelly Patrick M. , Rokem Ariel , Yeatman Jason D.
Published: February 2018

White matter tissue properties correlate with children’s performance across domains ranging from reading, to math, to executive function. We use a longitudinal intervention design to examine experience-dependent growth in reading skills and white matter in a group of grade school aged, struggling readers. Diffusion MRI data were collected at regular intervals during an 8-week, intensive reading intervention. These measurements reveal large-scale changes throughout a collection of white matter tracts, in concert with growth in reading skill. Additionally, we identify tracts whose properties predict reading skill but remain fixed throughout the intervention, suggesting that some anatomical properties may stably predict the ease with which a child learns to read, while others dynamically reflect the effects of experience. These results underscore the importance of considering recent experience when interpreting cross-sectional anatomy-behavior correlations. Widespread changes throughout the white matter may be a hallmark of rapid plasticity associated with an intensive learning experience.
Physical exercise increases overall brain oscillatory activity but does not influence inhibitory control in young adults
Authors: Ciria Luis F. , Perakakis Pandelis , Luque-Casado Antonio , Sanabria Daniel
Published: February 2018

Extant evidence suggests that acute exercise triggers a tonic power increase in the alpha frequency band at frontal locations, which has been linked to benefits in cognitive function. However, recent literature has questioned such a selective effect on a particular frequency band, indicating a rather overall power increase across the entire frequency spectrum. Moreover, the nature of task-evoked oscillatory brain activity associated to inhibitory control after exercising, and the duration of the exercise effect, are not yet clear. Here, we investigate for the first time steady state oscillatory brain activity during and following an acute bout of aerobic exercise at two different exercise intensities (moderate-to-high and light), by means of a data-driven cluster-based approach to describe the spatio-temporal distribution of exercise-induced effects on brain function without prior assumptions on any frequency range or site of interest. We also assess the transient oscillatory brain activity elicited by stimulus presentation, as well as behavioural performance, in two inhibitory control (flanker) tasks, one performed after a short delay following the physical exercise and another completed after a rest period of 15’ post-exercise to explore the time course of exercise-induced changes on brain function and cognitive performance. The results show that oscillatory brain activity increases during exercise compared to the resting state, and that this increase is higher during the moderate-to-high intensity exercise with respect to the light intensity exercise. In addition, our results show that the global pattern of increased oscillatory brain activity is not specific to any concrete surface localization in slow frequencies, while in faster frequencies this effect is located in parieto-occipital sites. Notably, the exercise-induced increase in oscillatory brain activity disappears immediately after the end of the exercise bout. Neither transient (event-related) oscillatory activity, nor behavioral performance during the flanker tasks following exercise showed significant between-intensity differences. The present findings help elucidate the effect of physical exercise on oscillatory brain activity and challenge previous research suggesting improved inhibitory control following moderate-to-high acute exercise.
ChIPSeqSpike: A R/Bioconductor package for ChIP-Seq data scaling according to spike-in control
Authors: Descostes Nicolas , Tsirigos Aristotelis , Reinberg Danny
Published: February 2018

Motivation

Chromatin Immuno-Precipitation followed by Sequencing (ChlP-Seq) is used to determine the binding sites of any protein of interest. ChIP-Seq data suffer from being more qualitative than quantitative. The recent use of Spike-in controls along with the standard protocol tackled this problem. However, no dedicated tool is available for a robust evaluation of this new ChIP-seq approach

Results

We developed ChIPSeqSpike, an R/Bioconductor package that enables ChIP-Seq spike-in normalization, assessment and analysis. Ready to use scaled bigwig files and scaling factors values are obtained as output. ChIPSeqSpike also provides tools for ChIP-Seq spike-in assessment and analysis through a versatile collection of graphical functions.

Availability

The package is implemented in R (as of version 3.4) and is available from Bioconductor at the URL: https://www.bioconductor.org/packages/3.7/bioc/html/ChIPSeqSpike.html, where installation and usage instructions can be found.

Contact

nicolas.descostes@nyumc.org
RAD sequencing and a hybrid Antarctic fur seal genome assembly reveal rapidly decaying linkage disequilibrium, global population structure and evidence for inbreeding
Authors: Humble Emily , Dasmahapatra Kanchon K , Martinez-Barrio Alvaro , Gregório Inês , Forcada Jaume , Polikeit Ann-Christin , Goldsworthy Simon D , Goebel Michael E , Kalinowski Joern , Wolf Jochen , Hoffman Joseph I
Published: February 2018

Recent advances in high throughput sequencing have transformed the study of wild organisms by facilitating the generation of high quality genome assemblies and dense genetic marker datasets. These resources have the potential to significantly advance our understanding of diverse phenomena at the level of species, populations and individuals, ranging from patterns of synteny through rates of linkage disequilibrium (LD) decay and population structure to individual inbreeding. Consequently, we used PacBio sequencing to refine an existing Antarctic fur seal (Arctocephalus gazella) genome assembly and genotyped 83 individuals from six populations using restriction site associated DNA (RAD) sequencing. The resulting hybrid genome comprised 6,169 scaffolds with an N50 of 6.21 Mb and provided clear evidence for the conservation of large chromosomal segments between the fur seal and dog (Canis lupus familiaris). Focusing on the most extensively sampled population of South Georgia, we found that LD decayed rapidly, reaching the background level ofr2= 0.09 by around 26 kb, consistent with other vertebrates but at odds with the notion that fur seals experienced a strong historical bottleneck. We also found evidence for population structuring, with four main Antarctic island groups being resolved. Finally, appreciable variance in individual inbreeding could be detected, reflecting the strong polygyny and site fidelity of the species. Overall, our study contributes important resources for future genomic studies of fur seals and other pinnipeds while also providing a clear example of how high throughput sequencing can generate diverse biological insights at multiple levels of organisation.
Reaction of Hydrogen sulfide homeostasis genes under biotic and abiotic stress condition in rice – computational approach
Authors: Alagarasan Ganesh , Ramalingam Jegadeesan
Published: February 2018

Gaseous molecules are widespread signaling compounds, regulating the cell development process in all major plant parts. For many decades, hydrogen sulfide molecule is considered mainly for its deleterious effects on plant system. The increasing recent experimental evidence and phenomenal concepts on H2S molecule further advance our understanding of H2S interaction with plant tissues. In addition, the H2S messenger molecule is found to have positive effects on plant growth, in limited condition, to maintain the balanced homeostasis. To meet the increasing demand, and to sustain the crop yield, various crop improvement programs have been followed. However, there is a concern that traditional plant improvement method and increasing climate change has a negative impact on crop production. A major approach to combating plant stress is to evaluate and explore the alternate source mechanism(s). Towards this aim, it will be valuable to characterize the genes involved in H2S homeostasis in the staple food crop rice pan-genome. In this research, we identified 15 H2S homeostasis genes in rice and used it for the ~3k rice pan-genome analysis to find out the genetic relatedness based on single nucleotide polymorphism data. Multidimensional scale plot of 15 H2S homeostasis genes among the rice cultivars, and RNA-seq experimental data analysis under various biotic and abiotic stress shows the functional genes involved in biotic and abiotic stress. This study provides new insights into plant stress management in crop breeding and suggests how H2S gene(s) can be utilized to improve the agronomic traits in rice and other food crops.
A pseudogene of caffeic acid-o-methyltransferase (COMT) in Acacia mangium: Comparative analysis with other COMT plant promoters
Authors: Abdul Latif Azmah , Tam Sheh May , Ratnam Wickneswari
Published: February 2018

Acacia mangium is a prominent tree species in the forest plantation industry of Southeast Asia, grown mainly to produce pulp and paper, and to a lesser extent wood chips and solid wood products. Lignin, a natural complex polymer used by plants for structural support and defence, has to be chemically removed during the production of quality paper. Delignification is very expensive and moreover, is an environmental pollutant. Understanding the complex mechanisms that underlie the regulation of lignin biosynthetic genes requires in-depth knowledge of not only the genes involved but also their regulatory elements. Using Thermal Asymmetric Interlaced PCR, a 770 bp promoter sequence with 93% identity with COMT1 gene from Acacia auriculiformis × A. mangium hybrid was isolated from A. mangium. Bioinformatics analysis revealed the presence of cis acting elements commonly found in other lignin biosynthesis genes such as TATA box, CAAT box, W box, AC-I and AC-11 elements. However, a nonsense mutation that created a premature stop codon was found on the first exon. Modelling of MYB transcription factor binding site on this newly isolated pseudogene shows it has binding sites for important transcription factors involved in lignin biosynthesis both in Arabidopsis thaliana and Eucalyptus grandis. Given the remarkable structures of its regulatory region, the possible structure of its transcript was detected using Mfold. Results show the transcript are capable of forming stem loop structures, a characteristic commonly attributed to presence of miRNA. Possible functions of pseudoAmCOMT1 were discussed.
Selective and context-dependent social and behavioral effects of Δ9-tetrahydrocannabinol in weakly electric fish
Authors: Neeley Brandon , Overholt Tyler , Artz Emily , Kinsey Steven G , Marsat Gary
Published: February 2018

Cannabinoid (CB) receptors are widespread in the nervous system and influence a variety of behaviors. Weakly electric fish has been a useful model system in the study of the neural basis of behavior but we know nothing of the role played by the CB system. Here, we determine the overall behavioral effect of a CB receptor agonist (i.e., Δ9-tetrahydrocannabinol, THC) in the weakly electric fish A. leptorhynchus. Using various behavioral paradigms involving social stimuli, we show that THC decreases locomotor behavior as in many species and influences the communication and social behavior. Across the different experiments we found that the propensity to emit communication signals (chirps) and to seek social interactions was affected in a context-dependent manner. We explicitly tested this hypothesis by comparing the behavioral effects of THC injection in fish placed in a novel versus familiar social and physical environments. THC-injected fish were less likely to chirp than control in familiar situation but not in novel ones. The tendency to be in close proximity was affected only in novel environments whith control fish clustering more than THC-injected ones. By identifying behaviors affected by CB agonists, our study can guide further comparative and neurophysiological studies of the role of the CB system using weakly electric fish as a model.