bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Hypertension on Hospitalizations for Cardiovascular Diseases in a Worksite Population: An Epidemiologic Study Using Claims Data for Workers
Authors: Fukushima Ayako , Khabtheni Wafa , Guelfucci Florent , Onishi Yoshie , Sugiyama Daisuke , Okamura Tomonori , Toumi Mondher
Published: November 2018

BACKGROUND

Few of studies investigated the effect of antihypertensives among working population. We aimed to describe the impact of hypertension with and without antihypertensives on hospitalizations because of cardiovascular diseases (CVDs) in the Japanese working population.

METHODS

This retrospective study included adults aged 40–64 years whose systolic and diastolic blood pressure (BP) readings taken between 2008 and 2015 were available in the Japanese claims database. Individuals were categorized as treated (T) or untreated (UT) depending on their hypertension treatment history. Time to first CVD-related hospitalization was compared among individuals with different BP levels using Cox models that included baseline characteristics with either baseline BP level or a time-dependent variable reflecting BP changes over time.

RESULTS

Of 740,784 UT individuals (male: 61.9%, mean age: 47.9 years), 2,121 individuals were hospitalized due to a CVD over a 957.3-day average follow-up. Among 72,828 T individuals (male: 74.3%, mean age: 53.7 years), the corresponding figure was 470 individuals over an 813.4-day average follow-up. The risk of hospitalization increased with baseline hypertension severity among UT (hazard ratios [HRs] = 1.93, 2.82, and 6.32 for grade 1, grade 2, and grade 3, respectively; P < 0.0001, reference: optimal) but not among T individuals. UT individuals with hypertension at any given time had a significantly higher probability of hospitalization compared to nonhypertensive individuals (HR = 1.74, P < 0.0001).

CONCLUSIONS

This study adds quantitative evidence on the impact of hypertension on the risk of CVD-related hospitalization in the Japanese working population. It suggests that antihypertensive treatment had beneficial effects in this relatively young, working population aged 40–64 years.
SGTK: a toolkit for visualization and assessment of scaffold graphs
Authors: Kunyavskaya Olga , Prjibelski Andrey D
Published: November 2018

Scaffolding is an important step in every genome assembly pipeline, which allows to order contigs into longer sequences using various types of linkage information, such as mate-pair libraries and long reads. In this work, we operate with a notion of a scaffold graph—a graph, vertices of which correspond to the assembled contigs and edges represent connections between them. We present a software package called Scaffold Graph ToolKit that allows to construct and visualize scaffold graphs using different kinds of sequencing data. We show that the scaffold graph appears to be useful for analyzing and assessing genome assemblies, and demonstrate several use cases that can be helpful for both assembly software developers and their users.

Availability and implementation

SGTK is implemented in C++, Python and JavaScript and is freely available at https://github.com/olga24912/SGTK.

Supplementary information

Supplementary data are available at Bioinformatics online.
ProteomicsBrowser: MS/proteomics data visualization and investigation
Authors: Peng Gang , Wilson Rashaun , Tang Yishuo , Lam TuKiet T , Nairn Angus C , Williams Kenneth , Zhao Hongyu
Published: November 2018

Large-scale, quantitative proteomics data are being generated at ever increasing rates by high-throughput, mass spectrometry technologies. However, due to the complexity of these large datasets as well as the increasing numbers of post-translational modifications (PTMs) that are being identified, developing effective methods for proteomic visualization has been challenging. ProteomicsBrowser was designed to meet this need for comprehensive data visualization. Using peptide information files exported from mass spectrometry search engines or quantitative tools as input, the peptide sequences are aligned to an internal protein database such as UniProtKB. Each identified peptide ion including those with PTMs is then visualized along the parent protein in the Browser. A unique property of ProteomicsBrowser is the ability to combine overlapping peptides in different ways to focus analysis of sequence coverage, charge state or PTMs. ProteomicsBrowser includes other useful functions, such as a data filtering tool and basic statistical analyses to qualify quantitative data.

Availability and implementation

ProteomicsBrowser is implemented in Java8 and is available at https://medicine.yale.edu/keck/nida/proteomicsbrowser.aspx and https://github.com/peng-gang/ProteomicsBrowser.

Supplementary information

Supplementary data are available at Bioinformatics online.
Brain Functional Organization Associated With Language Lateralization
Authors: Wang Shuai , Van der Haegen Lise , Tao Lily , Cai Qing
Published: November 2018

Although it is well-established that human language functions are mostly lateralized to the left hemisphere of the brain, little is known about the functional mechanisms underlying such hemispheric dominance. The present study investigated intrinsic organization of the whole brain at rest, by means of functional connectivity and graph theoretical analysis, with the aim to characterize brain functional organization underlying typical and atypical language dominance. We included healthy left-handers, both those with typical left-lateralized language and those with atypical right-lateralized language. Results show that 1) differences between typical and atypical language lateralization are associated with functional connectivity within the language system, particularly with weakened connectivity between left inferior frontal gyrus and several other language-related areas; and 2) for participants with atypical language dominance, the degree of lateralization is linked with multiple functional connectivities and graph theoretical metrics of whole brain organization, including local efficiency and small-worldness. This is the first study, to our knowledge, that linked the degree of language lateralization to global topology of brain networks. These results reveal that typical and atypical language dominance mainly differ in functional connectivity within the language system, and that atypical language dominance is associated with whole-brain organization.
Validation of the person-centred coordinated care experience questionnaire (P3CEQ)
Authors: Lloyd Helen , Fosh Ben , Whalley Ben , Byng Richard , Close James
Published: November 2018

Background

Measuring patient experiences of healthcare is increasingly emphasized as a mechanism to measure, benchmark and drive quality improvement, clinical effectiveness and patient safety at both national and local NHS level. Person-centred coordinated care (P3C) is the conjunction of two constructs; person-centred care and care coordination. It is a complex intervention requiring support for changes to organizational structure and the behaviour of professionals and patients. P3C can be defined as: ‘care and support that is guided by and organized effectively around the needs and preferences of individuals’. Despite the vast array of PRMS available, remarkably few tools have been designed that efficiently probe the core domains of P3C. This paper presents the psychometric properties of a newly developed PREM to evaluate P3C from a patient perspective.

Methods

A customized EMIS search was conducted at 72 GP practices across the South West (Somerset, Devon and Cornwall) to identify 100 patients with 1 or more LTCs, and are frequent users of primary healthcare services. Partial Credit Rasch Modelling was conducted to identify dimensionality and internal consistency. Ecological validity and sensitivity to change were assessed as part of intervention designed to improve P3C in adults with multiple long-term conditions; comparisons were drawn between the P3CEQ and qualitative data.

Results

Response rate for the P3CEQ was 32.82%. A two-factor model was identified. Rasch analysis confirmed unidimensionality of each factor (using infit MSQ values between 0.5 and 1.5). High internal consistency was established for both factors; For the Person-centred scale Cronbach’s Alpha = 0.829, Person separation = 0.756 and for the coordination scale Cronbach’s alpha = 0.783, person separation = 0.672.

Conclusions

The P3CEQ is a valid and reliable measure of P3C. The P3C is considered to have strong face, construct and ecological validity, with demonstrable sensitivity to change in a primary healthcare intervention.
Low-Carbohydrate Diet Score and Macronutrient Intake in Relation to Survival After Colorectal Cancer Diagnosis
Authors: Song Mingyang , Wu Kana , Meyerhardt Jeffrey A , Yilmaz Omer , Wang Molin , Ogino Shuji , Fuchs Charles S , Giovannucci Edward L , Chan Andrew T
Published: November 2018

Background

A low-carbohydrate diet may improve cancer survival, but relevant clinical evidence remains limited.

Methods

We followed 1542 stages I to III colorectal cancer (CRC) patients who completed a validated food frequency questionnaire between 6 months and 4 years after diagnosis. We calculated overall, animal-, and plant-rich, low-carbohydrate diet scores and examined their associations with CRC-specific and overall mortality using Cox proportional hazards regression after adjusting for potential predictors for cancer survival. We also assessed the intake and changes of macronutrients after diagnosis. Statistical tests were two-sided.

Results

Although no association was found for overall and animal-rich low-carbohydrate diet score, plant-rich, low-carbohydrate diet, which emphasizes plant sources of fat and protein with moderate consumption of animal products, was associated with lower CRC-specific mortality (hazard ratio [HR] comparing extreme quartiles = 0.37, 95% confidence interval [CI] = 0.25 to 0.57, Ptrend < .001). Carbohydrate intake was associated with higher CRC-specific mortality, and this association was restricted to carbohydrate consumed from refined starches and sugars (HR per one-SD increment = 1.36, 95% CI = 1.14 to 1.62, Ptrend < .001). In contrast, replacing carbohydrate with plant fat and protein was associated with lower CRC-specific mortality, with the HR per one-SD increment of 0.81 (95% CI = 0.69 to 0.95, Ptrend = .01) for plant fat and 0.77 (95% CI = 0.62 to 0.95, Ptrend = .02) for plant protein. Similar results were obtained for overall mortality and when changes in macronutrient intake after diagnosis were assessed.

Conclusion

Plant-rich, low-carbohydrate diet score was associated with lower mortality in patients with nonmetastatic CRC. Substituting plant fat and protein for carbohydrate, particularly that from refined starches and sugars, may improve patients’ survival.
Genetic Predisposition to Symptomatic Lumbar Disk Herniation in Pediatric and Young Adult Patients
Authors: Theodore Nicholas , Ahmed Ali Karim , Fulton Travis , Mousses Spyro , Yoo Christopher , Goodwin Courtney Rory , Danielson Jill , Sciubba Daniel M. , Giers Morgan B. , Kalani Mohammad Yashar S.
Published: November 2018

Study Design.

Case-control whole-genome sequencing analysis of a highly select, young cohort with symptomatic lumbar disk herniation (LDH) compared with the standard variation in a large reference population.

Objective.

To assess genetic influences predisposing pediatric and young adult patients to symptomatic LDH.

Summary of Background Data.

LDH has traditionally been attributed to natural weakening or mechanical insult, but recent literature supports a potential genetic influence.

Methods.

Young patients with symptomatic, clinically confirmed LDH who underwent surgical treatment were included. Patients were younger than the average age of presentation, limiting the influence of environmental risks. DNA collected from these patients was compared with a reference genome (1000 Genomes Project). A genome-wide association study using whole-genome sequencing was used to characterize genetic mutations potentially associated with LDH.

Results.

Among the 61 candidate genes flagged, 20 had missense mutations in 2 or more LDH cases. Missense mutations in collagen-encoding genes were observed in 12 of 15 patients (80%). A potential association with clinical presentation was indicated by odds ratios of key single-nucleotide polymorphism (SNP) variants in genes that encode collagen. Relative to the reference population, the LDH cohort demonstrated two statistically significant SNP variants in the gene encoding for aggrecan, a protein that facilitates load-bearing properties in the cartilaginous end plate. Aggrecan genes SNPs rs3817428 and rs11638262 were significantly associated with decreased odds of symptomatic LDH: odds ratio 0.05 (0.02–0.11) and 0.04 (0–0.26), respectively (P < 1 × 10–7 for both).

Conclusion.

These results suggest that collagen-encoding variants may be a genetic risk factor for LDH. They also shed new light on the role of variants that impact aggrecan, which sustains the cartilaginous end plate. Genetic predisposition to LDH may therefore be related to a multimodal combination of mutations that affect the nucleus pulposus, annulus fibrosus, and the cartilaginous end plates.

Level of Evidence: 4
Positive precepting: Identifying NP student learning levels and needs
Authors: Pearson Tamera , Hensley Tonya
Published: November 2018

Background and Purpose:

Clinical preceptors are vital partners in the education of nurse practitioner (NP) students. This article describes NP student learning stages and proposes strategies preceptors can use to facilitate precepting NP students who enter clinical rotations at varied learner levels.

Methods:

Searches were conducted in the Cumulative Index to Nursing and Allied Health Literature and PubMed and EBSCOhost interfaces to MEDLINE using terms related to NPs, students, higher education, and preceptorship. Because only 10 publications met the inclusion criteria focusing on precepting NP students at different levels, literature from related health fields are included in the discussion.

Conclusions:

Benner's Novice to Expert Model is applied to NP education in primary care settings to describe the clinical levels of learning. Clinical teaching methods that focus on either preceptor- or student-led communication are described, followed by a discussion of the association between methods and levels of learners.

Implications for Practice:

Nurse practitioners who precept NP students at various levels of their clinical learning can apply specific teaching methods that are delineated in this article. By recognizing the unique needs of NP students at different levels, preceptors can help facilitate their experiential learning.
Surgery for Chronic Otitis Media Causes Greater Taste Disturbance Than Surgery for Otosclerosis
Authors: Berling Holm Katarina , Bornefalk-Hermansson Anna , Knutsson Johan , von Unge Magnus
Published: November 2018

Objectives:

Patients with otosclerosis more often complain about postoperative taste disturbance than patients with chronic otitis media, which seems paradoxical. We aim to investigate if and potentially why this seems to be the case, since the chorda tympani nerve (CTN) is thought to be severely traumatized less frequently during surgery in the former than in the latter.

Study Design:

Prospective cohort study.

Setting:

Department of Otorhinolaryngology at Hospital of Vastmanland, Vasteras, Sweden.

Patients:

Sixty-five adults undergoing primary middle ear surgery were included. Thirty-seven were operated on for chronic suppurative otitis media with or without cholesteatoma (CSOM) and 28 for otosclerosis.

Interventions:

Middle ear surgery due to otosclerosis or CSOM. Subjective and objective taste measurements and quality of life (QoL) questionnaire.

Main Outcome Measures:

Taste was assessed using electrogustometry (EGM) and the filter paper disc (FPD) method before and up to 1 year after surgery. Questionnaires on taste disturbance, including a visual analogue scale (VAS), and QoL were completed before and up to 1 year after surgery.

Results:

Subjective taste disturbance anytime during the 1-year follow-up were reported by 62 and 46%, respectively. The difference in EGM 1 week after surgery compared with preoperative EGM was significantly greater among CSOM patients than otosclerosis. One year postoperatively, the difference is non-significant.

Conclusion:

Surgery for CSOM causes greater initial and more long-lasting taste disturbances as compared with surgery for otosclerosis. One-year postoperative taste normalizes for both CSOM and otosclerosis patients according to VAS and EGM measurements. No real change in QoL was seen 1-year postoperatively.

Level of evidence:

Level 2 evidence is prospective observational research with an experimental design.
Assessing the methodological and reporting quality of network meta-analyses in Chinese medicine
Authors: Yang Fengwen , Wang Hucheng , Zou Jiahan , Li Xuemei , Jin Xinyao , Cao Yawen , Tian Jinhui , Ge Long , Lee Myeong Soo , Zhang Junhua
Published: November 2018

Background

An increasing number of network meta-analyses (NMAs) in traditional Chinese medicine (TCM) have been published recently, but the quality of them was lack of assessment. This study aims to evaluate the methodological and reporting quality of NMAs in TCM.

Methods

Six electronic databases, including PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, China National Knowledge Infrastructure (CNKI), Wanfang and Chinese Biomedical Literature Database (CBM) from inception to January 2018, were searched. NMAs of TCM were included. A measurement tool to assess the methodological quality of systematic reviews (AMSTAR) and the PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions (PRISMA-NMA) were used to assess the methodological and reporting quality of the included NMAs.

Results

A total of 40 NMAs, including 2535 randomized controlled trials (RCTs), were included. They were published between December 2012 and November 2017. The median score and interquartile range of methodological and reporting quality was 7 (6–8) and 22 (19.1–27.1). Serious methodological flaws existed in the following aspects: the status of publication (22.5%), a list of studies provided (0%), assessment of publication bias (37.5%), and conflicts of interest (12.5%). Several items need to be improved in reporting, especially for Protocol and registration (2.5%), Data items (22.5%), Risk of bias across studies (Methods section) (37.5%), Results of individual studies (27.5%), Risk of bias across studies (Results section) (40%), Results of additional analyses (35%), and Funding (15%).

Conclusions

The methodological and reporting quality of NMAs in TCM is moderate. Identified shortcomings of published NMAs should be taken into consideration in further trainings of authors and editors of NMAs in TCM. Future researchers should be encouraged to apply PRISMA-NMA, and a recognized tool for the assessment of NMA methodology was wanted.
The association between statin use and endometrial cancer survival outcome
Authors: Li Jia , Liu Ruijuan , Sun Zhengdi , Tang Shifeng , Wang Lu , Liu Cun , Zhao Wenge , Yao Yan , Sun Changgang
Published: November 2018

Background:

Previous studies on the association between statin use and survival outcomes in gynecologic cancers have presented conflicting results. No independent studies to elucidate the association between statin use and survival outcomes of endometrial cancer (EC) have been conducted.

Methods:

To gather updated evidence, we carried out an extensive literature search on Medline (PubMed and OvidSP), Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), wanfang data, and Vip network to identify all potential studies on the effect of statins on the prognosis of endometrial carcinoma. The design and quality of all studies were evaluated, and a fixed-effects model was used to calculate pooled hazard ratios (HRs) for overall survival (OS) and disease-specific survival (DSS).

Results:

Of the 219 articles screened, 9 articles were eligible, including 8 articles and 1 abstract. A total of 5923 patients with endometrial cancer who used statins were identified. Statin use was related to increased overall survival (HR, 0.80; 95% confidence interval [CI], 0.66–0.95, without significant heterogeneity, I
2 = 52%, P = .080). Statin users also had increased disease-specific survival (HR, 0.69; 95% CI, 0.61–0.79, I
2 = 0.0%).

Conclusion:

Statins are beneficial to the survival outcome of patients with endometrial cancer. The selection of statins as a 1st-line agent seems justified for endometrial carcinoma.
Management of disseminated intravascular coagulation in a patient with hepatic angiosarcoma
Authors: Rosen Emily A. , Vallurupalli Mounica , Choy Edwin , Lennerz Jochen K. , Kuter David J.
Published: November 2018

Rationale:

Hepatic angiosarcoma is a rare endothelial cell tumor that may lead to concurrent consumptive coagulopathies including disseminated intravascular coagulation (DIC). This report details a multifaceted approach to managing DIC in a patient with advanced-stage hepatic angiosarcoma, which continued to progress after a brief response to taxane-based chemotherapy.

Patient concerns:

A 55-year-old man with a recent history of hemorrhoids and hemarthroses presented with acute rectal bleeding. He was found to have concurrent hepatomegaly, abnormal liver function tests, anemia, thrombocytopenia, and coagulopathy.

Diagnoses:

DIC in the setting of hepatic angiosarcoma.

Interventions:

The patient's acute bleeding in the setting of DIC was controlled with a combination of antifibrinolytic agents to prevent clot breakdown, heparin products to prevent deposition of new clot, and romiplostim to increase platelet production. His angiosarcoma was treated with various combinations of chemotherapy, including taxane-based chemotherapy, doxorubicin, and pazopanib.

Outcomes:

The patient's DIC and acute bleeding on initial presentation improved following treatment with unfractionated heparin and low-molecular weight heparin maintenance therapy. It is unclear if the chemotherapy to treat the hepatic angiosarcoma played a significant role in the improvement of DIC.

Lessons:

Laboratory measurement of prothrombin fragment 1.2, a byproduct of prothrombin conversion to thrombin, proved to be a useful way to monitor this patient's DIC over time.
Exploring the use of single-port surgery in the conservative management of hepatic portal vein gas
Authors: Taniguchi Kohei , Asakuma Mitsuhiro , Nagayabu Kazuya , Takashima Syogo , Iida Ryo , Hirokawa Fumitoshi , Umegaki Osamu , Neo Masashi , Takasu Akira , Uchiyama Kazuhisa
Published: November 2018

Rationale:

Hepatic portal vein gas (HPVG) is known as a sign of a lethal condition resulting from bowel necrosis. Recently, the detection rate of non-life-threatening cases of HPVG has increased due to the technological development of imaging, i.e., computed tomography (CT). However, it is difficult to determine accurately whether surgical treatment is necessary because of its lethal potential.

Patient concerns:

A 74-year-old woman suddenly complained about lower abdominal pain and vomiting after an operation for cervical spondylosis myelopathy. Her vital signs were slightly unstable and she was perspiring and exhibited pallor. Muscular defense was not clear, though her abdomen was tender and slightly distended.

Diagnosis:

CT results showed massive HPVG. However, laboratory investigation did not clearly indicate bowel necrosis. Also, a contrast-CT scan was not performed due to her chronic renal dysfunction and asthma.

Intervention:

Exploration was performed by single-port surgery (SPS) instead of exploratory laparotomy.

Outcome:

This approach showed no ischemic bowel and so conservative therapies were undertaken with confidence. The HPVG disappeared 2 days later, and she recover completely from the illness.

Lessons:

HPVG requires immediate and reliable decision for management. However, unnecessary exploratory laparotomy should be avoided. Hence, a novel strategy should be considered in light of innovative surgical procedures. Our experience suggested that SPS was useful as an exploratory tool for the management of HPVG.
Septic arthritis of the pediatric hip: update on diagnosis and treatment
Authors: Mooney James F. , Murphy Robert F.
Published: November 2018

Purpose of review

To review the clinical diagnosis, management and natural history of septic arthritis of the hip (SAH) in the pediatric patient, and to highlight new information that may improve the management of these patients.

Recent findings

The basics of management of possible pediatric SAH have remained largely unchanged for generations. New questions have been raised regarding the role and timing of advanced imaging (MRI) in the evaluation of patients with possible SAH. Published criteria have been derived to guide the need for MRI studies in these patients. Validation of these guidelines continues. Recent reviews have highlighted the possibility of Lyme disease as a potential cause of monoarticular pediatric hip pain. The role of PCR technology in the diagnosis and management of SAH remains unclear at this time.

The child with a limp remains a common and urgent clinical concern. There may be expanded roles for MRI and PCR to better diagnose and treat the involved joint itself, as well as any associated nonarticular area of infection. Lyme disease should remain on the list of possible differential diagnoses in this population, particularly in geographic areas where the disease vector is known to be endemic.
Biochemical Differences Between Vitreous Humor and Cerebral Spinal Fluid in a Death From Diabetic Ketoacidosis
Authors: Garland Jack , Philcox Winston , Kesha Kilak , McCarthy Sinead , Lam Leo , Palmiere Cristian , O'Regan Toni , Stables Simon , Tse Rexson
Published: November 2018

Biochemical analysis of cerebrospinal fluid (CSF) and vitreous humor (VH) forms an important diagnostic ancillary test at autopsy. Cerebrospinal fluid can be sampled from the ventricular system (VA) and from lumbar puncture (LP), whereas VH can be sampled from the orbits. Biochemical electrolytes seem to vary between VH and CSF collected from different sites, but whether there is any difference in glucose and β-hydroxybutyrate is unclear. We present a case report of a 21-year-old man who died of diabetic ketoacidosis confirmed at autopsy. Ventricular system, LP, and VH were biochemically analyzed and showed that glucose was highest in VH (41 mmol/L) and was 6 and 8 mmol/L higher than CSF in the LP and VA, respectively. β-Hydroxybutyrate was also highest in VH (20 mmol/L) and was 5 and 6 mmol/L higher than LP and VA, respectively. Our findings suggest that postmortem CSF glucose and β-hydroxybutyrate may not truly reflect that of VH and vary between CSF sampling sites.
Chest Radiograph Alone Is Sufficient as the Foreign Body Survey for Children Presenting With Coin Ingestion
Authors: Shatani Naoya , Alshaibani Sara , Potts James , Phillips Bruce , Bray Heather
Published: November 2018

Objectives

Radiographic survey of the entire aerodigestive tract (nares to anus) is common practice in children presenting to the emergency department following coin ingestion. The purpose of our study was to determine the optimal protocol for radiographic survey post–coin ingestion. We hypothesized that for children presenting with a clear history of coin ingestion a frontal chest radiograph including the entire esophagus is adequate to guide treatment.

Methods

We reviewed the clinical history and radiographic surveys of 134 patients presenting with suspected or witnessed coin ingestion to the emergency department of a tertiary care pediatric hospital between January 2012 and June 2016. Patient demographics, presenting symptoms, anatomic coverage of survey, type, number and location of radiopaque foreign bodies, intervention, and follow-up were recorded.

Results

Coins were identified on radiographic surveys in 109 of 134 patients; 25 of 134 patients had no coin. Of those with coins, none of 109 had coin(s) in the airway, 42 of 109 had coin(s) in the esophagus, and 67 of 109 had coin(s) distal to the esophagus. Of those with esophageal coins, 35 of 42 reported symptoms, 7 of 42 were asymptomatic, 40 of 42 underwent endoscopic coin removal, and 2 of 42 had no intervention. Of 92 of 134 surveyed patients with no coin or coin distal to the esophagus, 30 of 92 reported symptoms, 62 of 92 were asymptomatic, 90 of 92 had no further intervention, and 2 of 92 eventually underwent endoscopic coin removal for specific indications (abdominal pain, delayed passage). When there was no coin found in the esophagus, the negative predictive value for intervention was 97.8%.

Conclusions

Following a clear history of coin ingestion, a frontal chest radiograph including the entire length of the esophagus provides sufficient information to direct patient management.
Florid Scurvy in an Autistic Child on a Ketogenic Diet
Authors: Ahmad Syed Amir , Al Thobiti Tariq A. , El Toum Manal , Al Harbi Fahad
Published: November 2018

Ketogenic diets used for treating various neurological disorders can have potentially serious adverse effects. Among these is scurvy, a rarely reported, yet potentially fatal adverse effect of the ketogenic diet caused by vitamin C deficiency. We report a case of a 5-year-old patient with autism, who presented with scurvy secondary to the dietary restrictions of a ketogenic diet. Our review of the literature showed a single previously reported case of vitamin C deficiency in a patient on ketogenic diet. We have also reviewed the clinical indications and adverse effects of ketogenic diets with special reference to scurvy. This case emphasizes the importance of vitamin supplements in patients consuming a special diet.
Nursing Interventions Improve Continuous Positive Airway Pressure Adherence in Obstructive Sleep Apnea With Excessive Daytime Sleepiness: A Systematic Review
Authors: López-López Laura , Torres-Sánchez Irene , Cabrera-Martos Irene , Ortíz-Rubio Araceli , Granados-Santiago Maria , Valenza Marie Carmen
Published: November 2018

Purpose

The purpose of this systematic review was to summarize the effectiveness of interventions in the literature to improve adherence to continuous positive airway pressure (CPAP) treatment in patients with excessive daytime sleepiness.

Methods

In this review, we considered only randomized controlled trials that included interventions to improve CPAP adherence in adult obstructive sleep apnea (OSA) patients with high daytime sleepiness.

Findings

Eight trials were included in this review. The types of interventions to improve adherence to CPAP can be grouped into educational, technological, pharmacological, and multidimensional interventions.

Conclusions and Clinical Relevance

Educational programs can increase CPAP adherence in OSA patients. As nurses are the main clinicians responsible for device use for patients, the therapeutic strategies to improve CPAP adherence are important in their clinical setting. Therefore, the nursing work related to the use of CPAP has a great impact on the quality of life and mortality of patients with OSA.
Two-Team Surgical Approach to Improve Retroperitoneal Nerve Identification in the Treatment of Groin Pain
Authors: George Taylor , Williams Eric H. , Franklin Richard , Lee Dellon A.
Published: November 2018

Background

An estimated 700,000 groin hernia repairs are performed in the United States each year. Studies have shown that up to 50% of patients who undergo groin hernia repair are affected by persistent pain beyond the first few days after surgery. At 2 to 5 years after either open or laparoscopic, mesh or without mesh, 10% to 12% of these patients will have persistent and disabling pain. If the ilioinguinal, iliohypogastric, or genitofemoral nerves are injured below the transversalis muscle layer, the traditional external, open approach to nerve resection will not help these patients. The traditional internal, laparoscopic, approach to the retroperitoneum can be used for nerve resection, but identification of the correct nerve is difficult. Therefore, we have developed a 2-team, dual approach, combining open and endoscopic approaches to solve this problem.

Methods

A retrospective review of the electronic medical records was performed to identify all patients who underwent a dual approach for groin denervation after persistent postherniorraphy pain. This dual approach included an external incision paired with a laparoscopic, retroperitoneal approach to identify and/or transect the ilioinguinal, iliohypogastic, lateral femoral cutaneous, and genital branch of the genitofemoral nerve. Inclusion criteria are persistent groin pain with alleviation after preoperative nerve block and either a failed attempt at an external approach groin denervation or pain after a primary laparotomy/laparoscopy procedure.

Results

Thirteen patients met the inclusion criteria. All patients underwent a dual approach, and nerves were identified and confirmed in both the external groin and laparoscopic approaches. When placed on a scale from excellent/good to fair/poor relief of pain, 10 patients (77%) described excellent/good relief and 3 (23%) continued to have persistent pain.

Conclusions

A combined open surgical procedure, to identify the lateral femoral cutaneous nerve, and a laparoscopic procedure in the retroperitoneum have demonstrated the feasibility of this approach to identify correctly the nerve to be resected to relieve disabling groin pain.
Application of Computer-Assisted Navigation System in Acute Zygomatic Fractures
Authors: Yang Cristhiam , Lee Min-Chao , Pan Chun-Hao , Chen Chih-hao , Chen Chien-Tzung
Published: November 2018

Objective

To compare the surgical results of early treatment of zygomatic fractures with and without the use of the computer-assisted navigation system.

Methods

All patients with unilateral traumatic zygomatic fractures treated within 30 days after the injury at a single center between June 2012 and May 2017 were studied retrospectively. Primary outcome was defined by the displacement at 5 junctional sutures of zygomatic bone, the change at each point before and after the reconstruction, and the patient's subjective scoring of their appearance. Secondary outcome included the length of the operation and hospital stay, the number of incisional approaches, the fixation points, the maximal mouth opening, and the sequelae upon follow-up.

Results

Twenty-eight patients were enrolled in this study. Fourteen of them received surgery with the help of a computer-assisted navigation system (navigation group), and 14 patients were treated without its assistance (control group). Before the surgery, the mean displacement of each junctional suture and the mean total displacement between both groups were comparable. Postoperative computed tomography showed that the mean total displacement was significantly less for the navigation group than the control group (0.53 vs 2.93 mm, P = 0.001), and the displacement of zygomaticosphenoid suture was smaller (0 vs 0.9 mm, P = 0.009). Patients in the navigation group underwent surgery via the single buccal-gingival approach without the need for longer operation time. There were no significant differences in the length of hospital stay, maximal mouth opening, or cheek numbness. All patients recovered without major complications and were comparatively satisfied with their final appearance.

Conclusions

The navigation system has been demonstrated to be a useful tool for improving the symmetry in delayed or secondary reconstruction of zygomatic fractures. This study showed its effectiveness and safety in cases of early treatment as well, achieving a more accurate correction in a less invasive manner.
Adjuvant Radiotherapy After Keloid Excision
Authors: Hsueh Wei-Ting , Hung Kuo-Shu , Chen Yu-Chen , Huang Yen-Tsung , Hsu Chao-Kai , Ogawa Rei , Hsueh Yuan-Yu
Published: November 2018

Background

Surgical excision with adjuvant radiotherapy has gained attention as an effective treatment of keloid. The Asian population is challenged with a high incidence of keloid occurrence with a specific genetic predominance. The annual reported incidence of new keloid cases in Taiwan is around 30,000, but the disease control rate and effectiveness by means of surgical excision with adjuvant radiotherapy is not yet clear.

Methods

A retrospective chart review of the included consecutive keloid patients receiving surgical excision and radiotherapy was performed from 2013 to 2016 in a single institute. The reported risk factors were collected to investigate according to the outcome analysis. The Vancouver Scar Scale and the Japan Scar Workshop (JSW) Scar Scale were used to evaluate the correlation with keloid recurrence.

Results

In this series, the overall recurrence rate was 32%, reported with an average follow-up of 28 months. Independent risk factors varied according to the different outcome variables. Only JSW classification score independently predicted the risk of keloid recurrence (odds ratio, 1.305; P = 0.02). Both the Vancouver Scar Scale and the JSW system showed a good correlation with keloid recurrence (correlation efficiency, 0.529 and 0.54; P = 0.0437 and 0.0165, respectively).

Conclusions

This preliminary report revealed convincing evidence of feasibility and effectiveness of applying adjuvant radiotherapy after keloid excision in the Taiwanese population. A more delicate biological equivalent dose of radiotherapy with an effective local control should be considered to improve the final outcome.
Young People With Biliary Atresia Requiring Liver Transplantation: A Distinct Population Requiring Specialist Care
Authors: Samyn Marianne , Davenport Mark , Jain Vandana , Hadzic Nedim , Joshi Deepak , Heneghan Michael , Dhawan Anil , Heaton Nigel
Published: November 2018

Background.

Young people (YP) born with biliary atresia (BA) are an emerging population for adult hepatologists with 40% to 45% of children entering adolescence with their native liver intact. For those requiring liver transplantation (LT) during adolescence, disparity on the waiting list and post-LT outcome for young adults compared with younger and older age groups has stimulated discussion about the optimal timing of listing. In this study, we review our experience of YP with BA requiring LT during adolescence and young adulthood.

Methods.

Retrospective, single-center review of patients with BA requiring LT > 11 years.

Results.

Thirty-six YP (16 male) underwent LT between 1991 and 2014 at a median age of 16.6 (interquartile range [IQR], 14.2 to 19.5) years. The commonest indications for listing were refractory cholangitis (31%), synthetic failure (25%), and variceal bleeding (14%). Patients listed by the adult team (n = 14) waited longer than those listed by the pediatric team (10 [IQR, 7.7 to 24.6] vs 5.8 [IQR, 4.0 to 15.1] months;P< 0.05) and were more likely to require intensive care support at time of listing (29% vs 5%;P< 0.05). Admission to intensive care unit at listing was associated with poorer patient and graft survival and support from a multidisciplinary liver transition service improved survival. Liver disease severity scores did not correlate with time on waiting list or outcome.

Conclusions.

YP with BA requires close monitoring by specialists familiar with their condition and timing for LT needs to be fine-tuned to avoid clinical decompensation and improve long-term outcomes.
Thalamocortical network: a core structure for integrative multimodal vestibular functions
Authors: Brandt Thomas , Dieterich Marianne
Published: November 2018

Purpose of review

To apply the concept of nonreflexive sensorimotor and cognitive vestibular functions and disturbances to the current view of separate right and left thalamocortical systems.

Recent findings

The neuronal modules for sensorimotor and cognitive functions are organized in so-called provincial hubs with intracommunity connections that interact task-dependently via connector hubs. Thalamic subnuclei may serve not only as provincial hubs but also in higher order nuclei as connector hubs. Thus, in addition to its function as a cortical relay station of sensory input, the human thalamus can be seen as an integrative hub for brain networks of higher multisensory vestibular function. Imaging studies on the functional connectivity have revealed a dominance of the right side in right-handers at the upper brainstem and thalamus. A connectivity-based parcellation study has confirmed the asymmetrical organization (i.e., cortical dominance) of the parieto-insular vestibular cortex, an area surrounded by other vestibular cortical areas with symmetrical (nondominant) organization. Notably, imaging techniques have shown that there are no crossings of the vestibular pathways in between the thalamic nuclei complexes. Central vestibular syndromes caused by lesions within the thalamocortical network rarely manifest with rotational vertigo. This can be explained and mathematically simulated by the specific coding of unilateral vestibular dysfunction within different cell systems, the angular velocity cell system (rotational vertigo in lower brainstem lesions) in contrast to the head direction cell system (directional disorientation and swaying vertigo in thalamocortical lesions).

The structural and functional separation of the two thalamic nuclei complexes allowed a lateralization of the right and left hemispheric functions to develop. Furthermore, it made possible the simultaneous performance of sensorimotor and cognitive tasks, which require different spatial reference systems in opposite hemispheres, for example, egocentric manipulation of objects (handedness) and allocentric orientation of the self in the environment by the multisensory vestibular system.
The role of citizen science in addressing grand challenges in food and agriculture research
Authors: Ryan S. F. , Adamson N. L. , Aktipis A. , Andersen L. K. , Austin R. , Barnes L. , Beasley M. R. , Bedell K. D. , Briggs S. , Chapman B. , Cooper C. B. , Corn J. O. , Creamer N. G. , Delborne J. A. , Domenico P. , Driscoll E. , Goodwin J. , Hjarding A. , Hulbert J. M. , Isard S. , Just M. G. , Kar Gupta K. , López-Uribe M. M. , O'Sullivan J. , Landis E. A. , Madden A. A. , McKenney E. A. , Nichols L. M. , Reading B. J. , Russell S. , Sengupta N. , Shapiro L. R. , Shell L. K. , Sheard J. K. , Shoemaker D. D. , Sorger D. M. , Starling C. , Thakur S. , Vatsavai R. R. , Weinstein M. , Winfrey P. , Dunn R. R.
Published: November 2018

The power of citizen science to contribute to both science and society is gaining increased recognition, particularly in physics and biology. Although there is a long history of public engagement in agriculture and food science, the term ‘citizen science’ has rarely been applied to these efforts. Similarly, in the emerging field of citizen science, most new citizen science projects do not focus on food or agriculture. Here, we convened thought leaders from a broad range of fields related to citizen science, agriculture, and food science to highlight key opportunities for bridging these overlapping yet disconnected communities/fields and identify ways to leverage their respective strengths. Specifically, we show that (i) citizen science projects are addressing many grand challenges facing our food systems, as outlined by the United States National Institute of Food and Agriculture, as well as broader Sustainable Development Goals set by the United Nations Development Programme, (ii) there exist emerging opportunities and unique challenges for citizen science in agriculture/food research, and (iii) the greatest opportunities for the development of citizen science projects in agriculture and food science will be gained by using the existing infrastructure and tools of Extension programmes and through the engagement of urban communities. Further, we argue there is no better time to foster greater collaboration between these fields given the trend of shrinking Extension programmes, the increasing need to apply innovative solutions to address rising demands on agricultural systems, and the exponential growth of the field of citizen science.
Activation of Multiple Signalling Pathways by P152Lp53 Mutant Reveals New Gain-of-function Implicating Tumorigenesis
Authors: Singh Siddharth , Kumar Manoj , Kumar Sanjeev , Sen Shrinka , Upadhyay Pawan , Naveen M , Tomar Vivek S. , Dutt Amit , Kundu Tapas K.
Published: November 2018

TP53 is the most frequently mutated tumor suppressor gene in context of all varieties of cancer, yet biochemical characterization of several reported mutations with probable biological significance have not been accomplished. We have identified a relatively rare proline to leucine mutation (P152L) in p53 in an Indian oral cancer patient sample at the fade end of its DNA binding domain (DBD). Although P152Lp53 DBD potentially binds to DNA, the full length protein is completely devoid of DNA binding ability at its cognate site. Interestingly, P152Lp53 can efficiently tetramerize. Significantly, this mutant when expressed in p53 null cell line, was found to induce cell mobility, proliferation, and invasion as compared to vector control. Also, enhanced tumorigenic potential was observed when cells expressing P152Lp53 were xenografted into nude mice, the mechanistic details of which were also investigated upon where several of the pathways were found to be upregulated such as Cell-Cell/Cell-ECM signalling, EGFR signalling, Rho-GTPase signalling. Taken together, this study establishes P152Lp53 as a new gain of function mutant.
R&D value of Chinese manufacturing listed companies
Authors: Tongliang An , Wenyi Wang
Published: November 2018

Purpose

The way to measure the value of an enterprise’s R&D investments remains elusive for theoretical and empirical study on innovation economics. The paper aims to discuss this issue.

Design/methodology/approach

This paper expands the asset-value model pioneered by Griliches (1981) and applies it for the first time to the Chinese stock market to calculate the value of R&D investment instilled by Chinese manufacturing listed companies (CMLCs) from 2003 to 2014.

Findings

The authors find that: the assets-value model can better explain the enterprise value composition of CMLCs; with equal input, the value of R&D is higher than that of tangible assets, and lower than that of organizational assets; compared with the developed countries, the R&D value of CMLCs is lower; and the R&D value of CMLCs saw a downward trend from 2007 to 2014.

Originality/value

Furthermore, by rationally estimating the value of organizational assets and non-tradable shares, and innovatively introducing semi-annual momentum indicators from the perspective of behavioral finance to control the influence of investor sentiment on enterprise value, this paper tries to develop the asset-value model and provides a feasible solution to the problem of measuring the value of Chinese enterprises’ R&D investment.