bluuebunny/crossref_metadata_2025 huggingface dataset:
Eyelid Reconstruction
Authors: Grob Seanna R. , Kikkawa Don O. , Park D. J. John
Published: July 2019

Eyelid reconstruction is indicated in the setting of trauma, following cancer excision, for congenital deformities, and for age-related degeneration. As the eyelids have a large impact on the appearance of the eyes, the aesthetic result of reconstruction is as important as the restoration of eyelid function in ocular surface protection and lubrication. In this chapter, the authors discuss the operative care of patients with defects of varying extent involving the upper and lower eyelids, as well as common degenerative conditions such as eyelid margin malrotation and eyelid malposition, such as ptosis, retraction, entropion, and ectropion. Planning for repair should begin during the initial examination. The surgeon can evaluate the size of an eyelid lesion and attempt to predict the size of the possible defect after excision.
Forehead Flap for Nasal Reconstruction
Authors: Matros Evan , Pribaz Julian J.
Published: July 2019

The forehead flap is an essential part of any plastic surgeon’s reconstructive armamentarium because of its reliability and resemblance to native nasal soft tissues. It is considered the workhorse flap for any large or multi-subunit defect. While flap transfer can be completed in two stages, more refined outcomes can be achieved when performed in three stages, including the replacement of nasal lining. Secondary revisions and aesthetic corrections are useful adjunctive procedures that can be performed after the initial swelling has subsided to improve the final outcome.
The Rectus Abdominis Flap
Authors: Mueller Melissa , Evans Gregory R. D.
Published: July 2019

The rectus abdominis flap is a versatile, workhorse flap. It is ideal for head and neck reconstruction requiring large, soft tissue bulk without bony reconstruction, particularly for defects of the tongue, orbits, maxilla, cheek, posterior mandible, and cranial base. Its ability to be folded upon itself and harvested with multiple skin paddles makes it versatile for complex three-dimensional and multilaminar defects. Its pedicle size and length and consistent vascular anatomy make the flap a reliable choice for head and neck reconstruction. Its indications in head and neck reconstruction and technique in harvest are elaborated in this chapter.
Ulnar Forearm Flap
Authors: Salibian Arthur
Published: July 2019

The ulnar artery supplies approximately 80% of the forearm skin, making it ideal for use in large head and neck or intraoral defects. Unlike the radial forearm flap, the ulnar forearm flap has consistent proximal perforators that allow designing smaller, thicker flaps for isolated defects. The flap can be used as a reverse flow flap based on the distal ulnar artery to utilize the larger proximal surface area of the forearm. The venous drainage through the basilic vein or the extended vein from the arm allows large-caliber anastomosis to the ipsilateral or contralateral internal or external jugular vein.
Nipple-Sparing Surgery
Authors: Lane Karen T. , Daar David A.
Published: July 2019

Nipple-sparing mastectomy (NSM) has gained increasing popularity as an option for treatment over the typical skin-sparing mastectomy (SSM). Proper patient selection is of utmost importance, and, in recent years, surgeons have expanded their eligibility criteria for NSM. While no standard operative technique exists, various incision locations have proven advantageous depending on patient and oncologic characteristics. Consideration of the appropriate reconstructive method must be included, and potential nipple necrosis and locoregional recurrence require diligent postoperative assessment. Enhanced coordination among all members of the breast cancer treatment team, including the patient, is essential to ensure successful treatment and recovery.
Replantation
Authors: Kleiber Grant M. , Brandt Keith E.
Published: July 2019

Successful replantation depends on multiple variables. A coordinated effort of emergency transport services, emergency room personnel, operating room staff, anesthesiologists and postoperative nursing is required for success. The need for this team approach has led to the development of several specialized replantation centers worldwide. The authors discuss the various mechanisms of injury and their chances for successful replantation. This chapter examines the indications and contraindications for appropriate replantation. Also provided are many useful techniques for vessel and nerve repair, bony fixation, tendon repair, and soft tissue coverage. The chapter also discusses postoperative management, rehabilitation, and follow-up.
Endoscopic Carpal Tunnel Release
Authors: Hazel Antony , Jones Neil F.
Published: July 2019

Conventional open carpal tunnel release surgery is one of most successful procedures in hand surgery and has been demonstrated to be an effective treatment for carpal tunnel syndrome. However, a known sequelae in some individuals who undergo the procedure is “pillar” pain. In an effort to avoid this condition and help people return to work more quickly, the endoscopic technique was developed. Endoscopic carpal tunnel release offers a minimally invasive alternative to other traditional techniques with similar outcomes. By placing the incision proximal to the transverse carpal ligament there is potential for decreased scar sensitivity and pillar pain. The technique is technically demanding. The superficial palmar arch and common digital nerve to the ring and middle fingers are at risk for injury during the procedure. With adherence to anatomical landmarks and the proper visualization, the surgery may be safely performed.
Infections
Authors: Oates Scott D.
Published: July 2019

Because of their exposed nature during human activities, infections of the hand are common. The anatomy of the hand and fingers also lends itself to unique types of infections that do not occur in other areas of the body, such as paronychia, felons, and fungal infections. Because of these unique types of infections, early surgical intervention is often necessary to prevent long-term functional sequelae. This requires healthcare providers to be knowledgeable of the signs and symptoms of these distinct infections in order to effectively treat these patients. This chapter describes many common hand infections and their treatment options.
The evolution of kicked stellar-mass black holes in star cluster environments - II. Rotating star clusters
Authors: Webb Jeremy J , Leigh Nathan W C , Serrano Roberto , Bellovary Jillian , Ford K E Saavik , McKernan Barry , Spera Mario , Trani Alessandro A
Published: July 2019

In this paper, we continue our study on the evolution of black holes (BHs) that receive velocity kicks at the origin of their host star cluster potential. We now focus on BHs in rotating clusters that receive a range of kick velocities in different directions with respect to the rotation axis. We perform N-body simulations to calculate the trajectories of the kicked BHs and develop an analytic framework to study their motion as a function of the host cluster and the kick itself. Our simulations indicate that for a BH that is kicked outside of the cluster’s core, as its orbit decays in a rotating cluster the BH will quickly gain angular momentum as it interacts with stars with high rotational frequencies. Once the BH decays to the point where its orbital frequency equals that of local stars, its orbit will be circular and dynamical friction becomes ineffective since local stars will have low relative velocities. After circularization, the BH’s orbit decays on a longer time-scale than if the host cluster was not rotating. Hence BHs in rotating clusters will have longer orbital decay times. The time-scale for orbit circularization depends strongly on the cluster’s rotation rate and the initial kick velocity, with kicked BHs in slowly rotating clusters being able to decay into the core before circularization occurs. The implication of the circularization phase is that the probability of a BH undergoing a tidal capture event increases, possibly aiding in the formation of binaries and high-mass BHs.
Ultra-deep tidal disruption events: prompt self-intersections and observables
Authors: Darbha Siva , Coughlin Eric R , Kasen Daniel , Nixon Chris
Published: July 2019

A star approaching a supermassive black hole (SMBH) can be torn apart in a tidal disruption event (TDE). We examine ultra-deep TDEs, a new regime in which the disrupted debris approaches close to the black hole’s Schwarzschild radius, and the leading part intersects the trailing part at the first pericentre passage. We calculate the range of penetration factors β versus SMBH masses M that produce these prompt self-intersections using a Newtonian analytic estimate and a general relativistic (GR) geodesic model. We find that significant self-intersection of Solar-type stars requires β ∼ 50–127 for M/M⊙ = 104, down to β ∼ 5.6–5.9 forM/M⊙ = 106. We run smoothed particle hydrodynamic (SPH) simulations to corroborate our calculations and find close agreement, with a slightly shallower dependence on M. We predict that the shock from the collision emits an X-ray flare lasting t ∼ 2 s with L ∼ 1047 erg s−1 at E ∼ 2 keV, and the debris has a prompt accretion episode lasting t ∼ several minutes. The events are rare and occur with a rate $\dot{N} \lesssim 10^{-7}$ Mpc−3 yr−1. Ultra-deep TDEs can probe the strong gravity and demographics of low-mass SMBHs.
Clues to the nature of dark matter from first galaxies
Authors: Stoychev Boyan K , Dixon Keri L , Macciò Andrea V , Blank Marvin , Dutton Aaron A
Published: July 2019

We use 38 high-resolution simulations of galaxy formation between redshift 10 and 5 to study the impact of a 3 keV warm dark matter (WDM) candidate on the high-redshift Universe. We focus our attention on the stellar mass function and the global star formation rate and consider the consequences for reionization, namely the neutral hydrogen fraction evolution and the electron scattering optical depth. We find that three different effects contribute to differentiate warm and cold dark matter (CDM) predictions: WDM suppresses the number of haloes with mass less than few 109 M⊙; at a fixed halo mass, WDM produces fewer stars than CDM, and finally at halo masses below 109 M⊙, WDM has a larger fraction of dark haloes than CDM post-reionization. These three effects combine to produce a lower stellar mass function in WDM for galaxies with stellar masses at and below 107 M⊙. For z > 7, the global star formation density is lower by a factor of two in the WDM scenario, and for a fixed escape fraction, the fraction of neutral hydrogen is higher by 0.3 at z ∼ 6. This latter quantity can be partially reconciled with CDM and observations only by increasing the escape fraction from 23 per cent to 34 per cent. Overall, our study shows that galaxy formation simulations at high redshift are a key tool to differentiate between dark matter candidates given a model for baryonic physics.
Formation and material supply of an active-region filament associated with newly emerging flux
Authors: Wang Jincheng , Yan Xiaoli , Guo Qiaoling , Kong Defang , Xue Zhike , Yang Liheng , Li Qiaoling
Published: July 2019

With the observations of Solar Dynamics Observatory(SDO)/Atmospheric Imaging Assembly (AIA) 304 $\rm \mathring{\rm A}$ and New Vacuum Solar Telescope (NVST) H α bands, we present the formation of an active-region filament in active region NOAA 11903 during the period from 02:00 to 10:00 ut on 2013 November 25. A series of jets occurring in the vicinity of the south-western footpoint of the filament directly ejected cool and hot plasmas to filament height and supplied material for the filament. Some newly emerging flux is found in the vicinity of the south-western footpoint of the filament during these jets. In this paper, we mainly focus on the material supply for the formation of the filament. The plasma mass uploaded by the jets and the mass of the filament are estimated, which manifest the fact that the mass carried by the jets can supply sufficient material for the formation of the filament. We found two types of jets; one is H α jet, and the other is EUV jet. The significant finding is that some cool jets seen in the H α band but not in the SDO/AIA bands could also eject the cool material for the filament. These results suggest that cool plasma in the low atmosphere can be directly injected into the upper atmosphere and become the filament material by two types of jets. Moreover, the newly emerging flux with the non-potential field plays an important role in the appearance of the jets and the magnetic structure of the filament.
The first power spectrum limit on the 21-cm signal of neutral hydrogen during the Cosmic Dawn at z = 20–25 from LOFAR
Authors: Gehlot B K , Mertens F G , Koopmans L V E , Brentjens M A , Zaroubi S , Ciardi B , Ghosh A , Hatef M , Iliev I T , Jelić V , Kooistra R , Krause F , Mellema G , Mevius M , Mitra M , Offringa A R , Pandey V N , Sardarabadi A M , Schaye J , Silva M B , Vedantham H K , Yatawatta S
Published: July 2019

Observations of the redshifted 21-cm hyperfine line of neutral hydrogen from early phases of the Universe such as Cosmic Dawn and the Epoch of Reionization promise to open a new window onto the early formation of stars and galaxies. We present the first upper limits on the power spectrum of redshifted 21-cm brightness temperature fluctuations in the redshift range z = 19.8–25.2 (54–68 MHz frequency range) using 14 h of data obtained with the LOFAR-Low Band Antenna (LBA) array. We also demonstrate the application of a multiple pointing calibration technique to calibrate the LOFAR-LBA dual-pointing observations centred on the North Celestial Pole and the radio galaxy 3C220.3. We observe an unexplained excess of $\sim 30\!-\!50{{\ \rm per\ cent}}$ in Stokes / noise compared to Stokes V for the two observed fields, which decorrelates on ≳12 s and might have a physical origin. We show that enforcing smoothness of gain errors along frequency direction during calibration reduces the additional variance in Stokes I compared Stokes V introduced by the calibration on sub-band level. After subtraction of smooth foregrounds, we achieve a 2σ upper limit on the 21-cm power spectrum of $\Delta _{21}^2 \lt (14561\, \text{mK})^2$ at $k\sim 0.038\, h\, \text{cMpc}^{-1}$ and $\Delta _{21}^2 \lt (14886\, \text{mK})^2$ at $k\sim 0.038 \, h\, \text{cMpc}^{-1}$ for the 3C220 and NCP fields respectively and both upper limits are consistent with each other. The upper limits for the two fields are still dominated by systematics on most k modes.
Planetesimals around stars with TESS (PAST) – I. Transient dimming of a binary solar analogue at the end of the planet accretion era
Authors: Gaidos E , Jacobs T , LaCourse D , Vanderburg A , Rappaport S , Berger T , Pearce L , Mann A W , Weiss L , Fulton B , Behmard A , Howard A W , Ansdell M , Ricker G R , Vanderspek R K , Latham D W , Seager S , Winn J N , Jenkins J M
Published: July 2019

We report detection of quasi-periodic (1.5-d) dimming of HD 240779, the solar-mass primary in a 5 arcsec visual binary (also TIC 284730577), by the Transiting Exoplanet Survey Satellite. This dimming, as has been shown for other ‘dipper’ stars, is likely due to occultation by circumstellar dust. The barycentric space motion, lithium abundance, rotation, and chromospheric emission of the stars in this system point to an age of ≈125 Myr, and possible membership in the AB Doradus moving group. As such it occupies an important but poorly explored intermediate regime of stars with transient dimming between young stellar objects in star-forming regions and main-sequence stars, and between UX Orionis-type Ae/Be stars and M-type ‘dippers’. HD 240779, but not its companion BD+10 714B, has Wide-field Infrared Survey Explorer (WISE)-detected excess infrared emission at 12 and 22 μm indicative of circumstellar dust. We propose that infrared emission is produced by collisions of planetesimals during clearing of a residual disc at the end of rocky planet formation, and that quasi-periodic dimming is produced by the rapid disintegration of a ≳100 km planetesimal near the silicate evaporation radius. Further studies of this and similar systems will illuminate a poorly understood final phase of rocky planet formation like that which produced the inner Solar system.
The Battle of Muhammad Mahmoud Street in Cairo: The Politics and Poetics of Urban Violence in Revolutionary Time*
Authors: Ryzova Lucie
Published: July 2019

The battle of Muhammad Mahmoud Street in November 2011, pitching protestors against security forces in a five-day long stand-off, represented a crucial episode of Egypt's 25 January Revolution. Part riot and part carnival, this event opens up a number of questions for historians. This article examines the battle on three distinct scales, paying particular attention to time and temporality. The first scale is the battle's position within the temporality of the Egyptian revolution. The article argues that revolutionary situations are best understood through concepts of liminal time, and that the winter of 2011, rather than the initial stage of the Tahrir Square sit-in in January–February, represented the crucial phase of the revolutionary process in Egypt. A second scale zooms in on street action, focusing on the nexus of class, masculinity and urban violence. Here, raw experiences on the ground inform subjective meanings of ‘violence', ‘politics' and ‘revolution' from the perspective of those who were most directly involved in their making. These experiences also reveal different temporal horizons experienced by diverse participants, which, however, did not remain unchanged as events unfolded. The third scale is historically comparative, delving into spontaneously enacted riotous and carnivalesque urban violence as reflected in classic literature on riots and carnivals in different contexts. The battle of November 2011 allow us to see the generic affinity between these liminal events and the persistence of the riotous and carnivalesque within modern revolutionary situations, as it may help us understand the resurgence of riots within the contemporary world.
The Effect of Exercise on Cancer-Related Cognitive Impairment and Applications for Physical Therapy: Systematic Review of Randomized Controlled Trials
Authors: Campbell Kristin L , Zadravec Kendra , Bland Kelcey A , Chesley Elizabeth , Wolf Florian , Janelsins Michelle C
Published: July 2019

Background

Cancer-related cognitive impairment (CRCI), often called “chemo-brain” or “chemo-fog,” is a common side effect among adults with cancer, which can persist well after treatment completion. Accumulating evidence demonstrates exercise can improve cognitive function in healthy older adults and adults with cognitive impairments, suggesting exercise may play a role in managing CRCI.

Purpose

The purpose was to perform a systematic review of randomized controlled trials (RCTs) to understand the effect of exercise on CRCI.

Data Sources

Relevant literature was retrieved from CINAHL, Medline (Ovid), and EMBASE.

Study Selection

Eligible articles were RCTs that prescribed aerobic, resistance, combined aerobic/resistance, or mind-body (eg, yoga or Qigong) exercise during or following cancer treatment and included cognitive function outcome measures.

Data Extraction

Descriptive information and Cohen d effect sizes were directly extracted or calculated for included trials.

Data Synthesis

Twenty-nine trials were included in the final analysis. A statistically significant effect of exercise on self-reported cognitive function, both during and postadjuvant treatment, was reported in 12 trials (41%) (Cohen d range: 0.24–1.14), most commonly using the EORTC QLQ-C30. Ten trials (34%) performed neuropsychological testing to evaluate cognitive function; however, only 3 trials in women with breast cancer reported a significant effect of exercise (Cohen d range: 0.41–1.47).

Limitations

Few RCTs to date have evaluated the effect of exercise on CRCI as a primary outcome. Twenty-six trials (90%) in this review evaluated CRCI as secondary analyses.

Conclusions

Evidence supporting exercise as a strategy to address CRCI is limited. Future research evaluating CRCI as a primary outcome, including self-reported and objective measures, is needed to confirm the possible role of exercise in preventing and managing cognitive impairments in adults with cancer.
Scholarly understanding, mediating artefacts and the social impact of research in the educational sciences
Authors: Esko Terhi , Miettinen Reijo
Published: July 2019

This article focuses on the social impact of educational sciences. It introduces a framework for studying the social impact of research and uses it to analyze the social impact of the work of a research group studying learning difficulties at the University of Jyväskylä, Finland. The framework suggests that the social impact of research can be understood in terms of the context of impact. This context is composed of four interacting dimensions: epistemic, artefactual, social-institutional, and spatial-geographical dimensions. In addition, the paper suggests that the understanding of the phenomena to be studied and mediating artefacts based on this understanding play a key role in the expansion of the social impact in the educational sciences. The article provides a means of analyzing the narratives of longer-term impact of research and suggests that even in education—a classical area of advancing public good—the distribution of mediating artefacts is increasingly likely to be realized through markets.
Cognitive reserve-mediated neural modulation of emotional control and regulation in people with late-life depression
Authors: Huang Chih-Mao , Fan Yang-Teng , Lee Shwu-Hua , Liu Ho-Ling , Chen Yao-Liang , Lin Chemin , Lee Tatia M C
Published: July 2019

Late-life depression (LLD) is an affective disorder that is highly prevalent among older people. Cognitive reserve (CR) refers to an active process that facilitates the flexibility and efficiency of the neural networks to compensate for impairments that emerge in consequence of brain pathology. The current functional magnetic resonance imaging study investigated whether and how CR affects emotional regulation, level of depression severity and neural activity associated with affective control during emotional Stroop (eStroop) task. Altogether, 90 older people participated in this study, 50 of whom suffered from LLD. We used years of education and verbal fluency capacity as proxies for CR. Clinical participants with relatively higher CR presented with milder degrees of depression, better eStroop performance and stronger neural activity in the middle frontal gyrus (MFG) involved with exercising affective control. Results of the mediation analysis indicated that both education and verbal fluency significantly mediated the association between the depression severity and MEG activity. These results suggest a negative association between CR and age-related clinical symptoms of emotional dysregulation. Our neurobehavioral findings provide supportive evidence that CR implies efficiency of top-down emotional regulation and operates as a protective factor against emotional and cognitive vulnerability in the aging brain.
The Extension of Particularized Trust to Generalized and Out-Group Trust: The Constraining Role of Collectivism
Authors: Glanville Jennifer L , Shi Qianyi
Published: July 2019

A central line of inquiry into the sources of generalized trust concerns how particularized trust (trust in known others) extends to generalized trust (default expectations about the trustworthiness of people in general). While we know that there is considerable cross-national variability in the strength of the relationship between particularized and generalized trust, little is known about the contextual factors that shape the degree to which particularized trust spills over to more diffuse forms of trust. We argue that collectivism plays a key role in the extension of trust. The nature of social interactions in low collectivism societies is conducive to the trust and distrust built up within social interactions extending to generalized and out-group trust, whereas high levels of collectivism should dampen the ability of particularized trust to extend. Analyzing data on over 52,000 respondents from 39 countries from Waves 5 and 6 of the World Values Survey, we find that the predicted effects particularized trust on generalized and out-group trust are substantially smaller in more collectivist countries. Our results also suggest that collectivism and individualism matter more for generalized and out-group trust for individuals who have higher levels of particularized trust.
Unmasking Racism: Students of Color and Expressions of Racism in Online Spaces
Authors: Eschmann Rob
Published: July 2019

Expressions of racism in the post-Civil Rights Era are expected to be more covert than overt and more unconscious than conscious. But some internet-based communication takes place in technological contexts that are not bound by the same norms as face-to-face interactions, and can structure more explicit presentations of racist ideologies. I explore the changing expressions of racism in online spaces and their effects on students of color using in-depth interviews with 27 undergraduate students of color and their reactions to and interpretations of an online, anonymous student forum. I argue that covert racism is unmasked in online environments, and that exposure to unmasked racial ideologies can challenge students’ racial worldviews, adaptive coping responses to racism, relationships to White students and institutions, and dominant racial narratives.
Influence of weaning date and late gestation supplementation on beef system productivity I: animal performance1
Authors: Luebbe Kelsey M , Stalker Leslie A , Klopfenstein Terry J , Funston Richard N
Published: July 2019

A 4-yr experiment examined how weaning date and prepartum nutrition affected productivity in a spring (March and April) calving system. Crossbred beef cows (479 ± 59 kg, n = 144) were used in a completely randomized design with a 2 × 4 factorial treatment arrangement: 1) cows were weaned in early October or early December; and 2) during late gestation cows were fed on a dry matter basis a 32% crude protein supplement at 0, 0.41, or 0.82 kg/cow/d on dormant upland range or grazed corn residue without supplement. Cow body condition score (BCS) was affected (P ≤ 0.01) by treatment prior to parturition and breeding but was similar (P > 0.27) among all treatments in October. Dams on a higher nutritional plane during winter treatment had greater (P < 0.01) BCS and body weight (BW) prior to parturition and breeding. Subsequent pregnancy rates (88% to 97%) were not influenced (P > 0.76) by weaning date, but tended (P = 0.10) to be lower for cows grazing winter range without supplement. Calves born to dams grazing winter range without supplement had lower (P < 0.01) BW in October and adjusted weaning BW. Pre-breeding BW of heifers weaned in December born to cows grazing winter range without supplement was lower (P < 0.01) than contemporaries born to cows in all other treatment combinations. However, postweaning (0.48 kg/d) and postbreeding (0.42 kg/d) average daily gain, percentage cycling before breeding (33%), and pregnancy rate (81%) was similar (P > 0.12). Within weaning date, steers born to cows grazing winter range without supplement had lower (P < 0.05) hot carcass weight (HCW) than contemporaries born to cows grazing corn residue. Cows weaned in December had decreased BW and BCS but similar pregnancy rates as cows weaned in October. Weaning date and dam maternal nutrition had minimal impact on heifer progeny pregnancy rate. Steer progeny born to dams on a higher nutritional plane had similar HCW at slaughter when adjusted to equal fat thickness.
Development of Novel Wheat-Rye Chromosome 4R Translocations and Assignment of Their Powdery Mildew Resistance
Authors: Ma Pengtao , Han Guohao , Zheng Qi , Liu Shiyu , Han Fangpu , Wang Jing , Luo Qiaoling , An Diaoguo
Published: July 2019

Rye (Secale cereale L.) is an important gene donor for wheat improvement because of its many valuable traits, especially disease resistance. Development of novel wheat-rye translocations with disease resistance can contribute to transferring resistance into common wheat. In a previous study, a wheat-rye T4BL·4RL and T7AS·4RS translocation line (WR41-1) was developed by distant hybridization, and it was speculated that its resistance to powdery mildew, caused by Blumeria graminis f. sp. tritici (Bgt), was derived from rye based on pedigree analysis. To make accurate use of chromosome 4R in wheat improvement, a set of new 4R translocations involving different arm translocations (e.g., 4RS monosomic, 4RL monosomic, 4RL disomic, 4RS monosomic plus 4RL monosomic, 4RS monosomic plus 4RL disomic, and 4RS disomic plus 4RL disomic translocations) was developed from crosses with common wheat. Those translocations were characterized by genomic in situ hybridization and expressed sequence tag simple sequence repeat marker analysis. To confirm the source of powdery mildew resistance, the translocation plants were tested against Bgt isolate E09. The results indicated that all translocations with 4RL were resistant at all tested growth stages, whereas those with only 4RS translocation or no alien translocation were susceptible. This further indicated that the powdery mildew resistance of WR41-1 was derived from the alien chromosome arm 4RL. To effectively use 4RL resistance in wheat improvement, two competitive allele-specific PCR markers specific for chromosome arm 4RL were developed to detect the alien chromosome in the wheat genome. These new translocation lines with diagnostic markers can efficiently serve as important bridges for wheat improvement.
Phenotypically and Genotypically Heterogeneous Strains of Pseudomonas syringae Associated With Alfalfa Leaf Spot Disease in Iran
Authors: Ansari Maryam , Taghavi S. Mohsen , Zarei Sadegh , Mehrb-Moghadam Soraya , Mafakheri Hamzeh , Hamidizade Mozhde , Osdaghi Ebrahim
Published: July 2019

In this study, we provide a polyphasic characterization of 18 Pseudomonas spp. strains associated with alfalfa leaf spot symptoms in Iran. All of the strains were pathogenic on alfalfa, although the aggressiveness and symptomology varied among the strains. All strains but one were pathogenic on broad bean, cucumber, honeydew, and zucchini, whereas only a fraction of the strains were pathogenic on sugar beet, tomato, and wheat. Syringomycin biosynthesis genes (syrB1 and syrP) were detected using the corresponding PCR primers in all of the strains isolated from alfalfa. Phylogenetic analyses using the sequences of four housekeeping genes (gapA, gltA, gyrB, and rpoD) revealed that all of the strains except one (Als34) belong to phylogroup 2b of P. syringae sensu lato, whereas strain Als34 placed within phylogroup 1 close to the type strain of P. syringae pv. apii. Among the phylogroup 2b strains, nine strains were phylogenetically close to the P. syringae pv. aptata clade, whereas the remainder were scattered among P. syringae pv. atrofaciens and P. syringae pv. syringae strains. Pathogenicity and host range assays of the bacterial strains evaluated in this study on a set of taxonomically diverse plant species did not allow us to assign a “pathovar” status to the alfalfa strains. However, these results provide novel insight into the host range and phylogenetic position of the alfalfa-pathogenic members of P. syringae sensu lato, and they reveal that phenotypically and genotypically heterogeneous strains of the pathogen cause bacterial leaf spot of alfalfa.
A Novel Group of Rhizobium tumorigenes-Like Agrobacteria Associated with Crown Gall Disease of Rhododendron and Blueberry
Authors: Kuzmanović Nemanja , Behrens Patric , Idczak Elke , Wagner Stefan , Götz Monika , Spröer Cathrin , Bunk Boyke , Overmann Jörg , Smalla Kornelia
Published: July 2019

Crown gall is an economically important and widespread plant disease caused by tumorigenic bacteria that are commonly affiliated within the genera Agrobacterium, Allorhizobium, and Rhizobium. Although crown gall disease was reported to occur on rhododendron, literature data regarding this disease are limited. In this study, an atypical group of tumorigenic agrobacteria belonging to the genus Rhizobium was identified as a causative agent of crown gall on rhododendron. Genome analysis suggested that tumorigenic bacteria isolated from rhododendron tumors are most closely related to Rhizobium tumorigenes, a new tumorigenic bacterium discovered recently on blackberry in Serbia. However, R. tumorigenes and novel rhododendron strains belong to separate species and form a homogenous clade within the genus Rhizobium, which we named the “tumorigenes” clade. Moreover, tumorigenic bacteria isolated from rhododendron seem to carry a distinct tumor-inducing (Ti) plasmid, compared with those carried by R. tumorigenes strains and Ti plasmids described thus far. To facilitate rapid identification of bacteria belonging to the “tumorigenes” clade, regardless of whether they are pathogenic or not, a conventional PCR method targeting putative chromosomal gene-encoding flagellin protein FlaA was developed in this study. Finally, our results suggested that this novel group of tumorigenic agrobacteria occurs on blueberry but it cannot be excluded that it is distributed more widely.
Late-Career Faculty: Individual and Institutional Perspectives
Authors: Leslie Karen
Published: July 2019

The demographic shift toward older populations of physicians is well documented across much of the globe. As a result, it is becoming imperative that academic organizations generate research to inform understanding of both individual and institutional needs relating to these faculty members. The 2 reports by Skarupski and colleagues in this issue of Academic Medicine build on the research that is available, expose some new areas for consideration, and raise new lines of inquiry for researchers interested in studying late-career faculty and faculty transitions. The author of this Invited Commentary aims to situate Skarupski and colleagues’ findings relative to what the academic medicine community knows—and does not know—about late-career faculty members, the institutions that employ these faculty, and the complex relationships therewith. Specifically, the author explores the following: the demographics of those considering retirement; the connection between identity and retirement decisions; the alignment between institutional and faculty member needs; institution preparedness; mentoring; and theoretical constructs and areas for inquiry that may inform future investigations.
Intersectionality and Critical Realism
Authors: Aspinall Cathleen , Jacobs Stephen , Frey Rosemary
Published: July 2019

This article presents intersectionality theory with critical realism as a philosophical framework for studying nursing leadership. In response to gaps in the current leadership literature, the aim is to develop an approach that addresses how the multiple social positions nurses hold can create an intersecting matrix of oppression that impacts on their opportunities to develop as leaders. The result is a theoretical foundation, which can inform the methodological framework of future studies. Providing evidence by which a reader can judge the merits of a chosen methodology, it sets the case for integrating intersectionality with critical realism for studying nursing leadership.
Functional and radiological outcome in patients with acute Monteggia fracture treated surgically: a comparison between closed reduction and external fixation versus closed reduction and elastic stable intramedullary nailing
Authors: Yuan Zhe , Xu HongWen , Li YiQiang , Li JingChun , Liu YanHan , Canavese Federico
Published: July 2019

The aim of this study was to compare the clinical and radiological outcomes in children with acute Monteggia fracture treated by two different surgical techniques. Twenty-six children treated by either closed reduction and external fixation (group A) or elastic stable intramedullary nails (group B) were retrospectively reviewed. Clinical outcome was evaluated with the Quick DASH questionnaire. Overall, both surgical techniques provided similar excellent healing rates and good clinical outcomes (P > 0.05), as well as radiological outcomes (P > 0.05). Radiographically, no secondary displacement, wire migration, consolidation delays, non-union, malunion or re-fractures were noted. However, two patients (7.6%), one in group A (1/15; 6.7%) and one in group B (1/11; 9.1%), developed heterotopic ossification at the level of the ulna. Clinical functional outcomes were similar between the two groups of patients. The mean overall Quick DASH score was 0.79 (range, 0–18.2). However, six in group A (40%) and one in group B (9.1%) complained of the clinical appearance and had intermittent residual pain on the injured side. In conclusion, both elastic stable intramedullary nailing and external fixation can achieve satisfactory clinical and radiographic outcomes in children with acute Monteggia fractures. However, the rate of residual pain and less satisfactory clinical appearance was higher in patients managed by external fixation compared to those treated by elastic stable intramedullary nailing. According to our results, elastic stable intramedullary nailing should be used as primary treatment option in children with acute Monteggia fracture requiring surgical management.
Agreement With Consensus Statements on End-of-Life Care: A Description of Variability at the Level of the Provider, Hospital, and Country*
Authors: Long Ann C. , Brumback Lyndia C. , Curtis J. Randall , Avidan Alexander , Baras Mario , De Robertis Edoardo , Efferen Linda , Engelberg Ruth A. , Kross Erin K. , Michalsen Andrej , Mularski Richard A. , Sprung Charles L.
Published: July 2019

Objectives:

To develop an enhanced understanding of factors that influence providers’ views about end-of-life care, we examined the contributions of provider, hospital, and country to variability in agreement with consensus statements about end-of-life care.

Design and Setting:

Data were drawn from a survey of providers’ views on principles of end-of-life care obtained during the consensus process for the Worldwide End-of-Life Practice for Patients in ICUs study.

Subjects:

Participants in Worldwide End-of-Life Practice for Patients in ICUs included physicians, nurses, and other providers. Our sample included 1,068 providers from 178 hospitals and 31 countries.

Interventions:

None.

Measurements and Main Results:

We examined views on cardiopulmonary resuscitation and withholding/withdrawing life-sustaining treatments, using a three-level linear mixed model of responses from providers within hospitals within countries. Of 1,068 providers from 178 hospitals and 31 countries, 1% strongly disagreed, 7% disagreed, 11% were neutral, 44% agreed, and 36% strongly agreed with declining to offer cardiopulmonary resuscitation when not indicated. Of the total variability in those responses, 98%, 0%, and 2% were explained by differences among providers, hospitals, and countries, respectively. After accounting for provider characteristics and hospital size, the variance partition was similar. Results were similar for withholding/withdrawing life-sustaining treatments.

Conclusions:

Variability in agreement with consensus statements about end-of-life care is related primarily to differences among providers. Acknowledging the primary source of variability may facilitate efforts to achieve consensus and improve decision-making for critically ill patients and their family members at the end of life.
Checkpoints inhibitors in the (neo)adjuvant setting of solid tumors: lessons learnt and perspectives
Authors: Kotecki Nuria , Awada Ahmad
Published: July 2019

Purpose of review

The aim of this review is to provide an overview of the current development of immuno-oncology in the (neo)adjuvant setting.

Recent findings

Several checkpoint inhibitors (CPis) have been approved for the treatment of advanced solid cancers, mostly for unresectable metastatic setting. Thus, the next logical step is to explore the potential of CPi in earlier stages of the disease.

There are currently many ongoing trials investigating immunotherapy agents in the early setting in various tumor types, involving various CPis and other innovative immunotherapies, as well as combinations with either chemotherapy or radiotherapy. So far, reported results in melanoma, nonsmall-cell lung cancer, and nonmuscle-invasive bladder cancer among others are promising. The neoadjuvant setting offers a high potential for translational research and identification of biomarkers with clinical utility.
Adolescent-Reported Sleep/Wake Patterns in the Relationships Between Inhibitory Control and Internalizing and Externalizing Problems
Authors: Basch Molly C. , Stromberg Sarah E. , Krietsch Kendra , Chardon Marie L. , Reynolds Cheyenne M. , Acharya Ratna , Janicke David M.
Published: July 2019

Objective:

Youth with poorer inhibitory control are more likely to experience internalizing and externalizing problems, placing them at risk for poorer psychological, academic, and social functioning. Modifying inhibitory control is challenging; therefore, research is needed to identify alternative targets to reduce internalizing and externalizing problems in youth. Sleep/wake patterns may serve as alternative targets, given their relationships with poorer inhibitory control and greater internalizing and externalizing problems. This study examines the mediating role of sleep/wake patterns in the relationships between youth inhibitory control and internalizing and externalizing problems.

Method:

One hundred fifty-five adolescent (ages 12–15 years) and parent dyads completed the Behavioral Rating Inventory of Executive Function, Pediatric Symptom Checklist, and Adolescent Sleep-Wake Scale, short version. Bootstrapped mediations examined indirect relationships between inhibitory control and internalizing and externalizing through sleep/wake patterns.

Results:

Analyses revealed that problematic sleep/wake patterns partially mediated the relationship between poorer inhibitory control and greater internalizing, explaining 19% of the variance in internalizing problems. In addition, problematic sleep/wake patterns partially mediated the relationship between poorer inhibitory control and greater externalizing, explaining 58% of the variance in externalizing problems.

Conclusion:

The results suggest that sleep/wake patterns may be a mechanism through which deficits in inhibitory control increase youth risk for internalizing and externalizing problems. Because sleep/wake patterns are frequently modified through adoption of health behaviors conducive to good sleep, assessing for problematic patterns in adolescents who present with internalizing and externalizing problems may offer providers a relatively modifiable target to reduce the emotional and behavioral problems of youth with poorer inhibitory control abilities.
Primary Cutaneous Umbilical Melanoma: The Michigan Experience
Authors: Charles Kristy B. , Chan May P. , Smith Noah R. , Orsini Amy P. , Noh Iris K. , Kozlow Jeffrey H. , Johnson Timothy M. , Cha Kelly B.
Published: July 2019

BACKGROUND

Primary cutaneous umbilical melanoma is rare. Thorough information regarding its characteristics and treatment, including use of sentinel lymph node biopsy (SLNB) staging, is difficult to obtain. The unique anatomy of the umbilicus adds to the complexity of diagnosing and treating melanoma at this site.

OBJECTIVE

To improve understanding of diagnosis and treatment of primary cutaneous umbilical melanoma through presenting 7 new cases and reviewing 39 cases in the literature.

MATERIALS AND METHODS

The University of Michigan melanoma database query and review of the literature regarding reported cases of primary umbilical melanoma.

RESULTS

In 7 new and 39 previously reported cases of primary cutaneous umbilical melanoma, we describe signs and symptoms, histopathologic features, differential diagnosis, relevant anatomical considerations, and definitive treatment including SLNB when applicable.

CONCLUSION

Our series, combined with a thorough literature review and compilation of findings, provides a better understanding and appreciation of melanoma in the unique anatomical site of the umbilicus, with a reminder to carefully examine the umbilicus during a full skin examination in patients at risk of melanoma. Primary umbilical melanoma presents and can be appropriately treated similarly to cutaneous melanoma in other sites, with attention to relevant anatomy.
Estimating Outcome-Exposure Associations when Exposure Biomarker Detection Limits vary Across Batches
Authors: Boss Jonathan , Mukherjee Bhramar , Ferguson Kelly K. , Aker Amira , Alshawabkeh Akram N. , Cordero José F. , Meeker John D. , Kim Sehee
Published: July 2019

Limit of detection (LOD) issues are ubiquitous in exposure assessment. Although there is an extensive literature on modeling exposure data under such imperfect measurement processes, including likelihood-based methods and multiple imputation, the standard practice continues to be naïve single imputation by a constant (e.g.,

JOURNAL/epide/04.03/00001648-201909000-00017/inline-graphic1/v/2023-09-08T093844Z/r/image-tiff

). In this article, we consider the situation where, due to the practical logistics of data accrual, sampling, and resource constraints, exposure data are analyzed in multiple batches where the LOD and the proportion of censored observations differ across batches. Compounding this problem is the potential for nonrandom assignment of samples to each batch, often driven by enrollment patterns and biosample storage. This issue is particularly important for binary outcome data where batches may have different levels of outcome enrichment. We first consider variants of existing methods to address varying LODs across multiple batches. We then propose a likelihood-based multiple imputation strategy to impute observations that are below the LOD while simultaneously accounting for differential batch assignment. Our simulation study shows that our proposed method has superior estimation properties (i.e., bias, coverage, statistical efficiency) compared to standard alternatives, provided that distributional assumptions are satisfied. Additionally, in most batch assignment configurations, complete-case analysis can be made unbiased by including batch indicator terms in the analysis model, although this strategy is less efficient relative to the proposed method. We illustrate our method by analyzing data from a cohort study in Puerto Rico that is investigating the relation between endocrine disruptor exposures and preterm birth.