bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors and Correlates of Pediatric Postburn Pruritus in Preschool Children of Ages 0 to 4
Authors: Stewart Dylan , Caradec Jill , Ziegfeld Susan , Reynolds Elizabeth , Ostrander Rick , Parrish Carisa
Published: July 2019

Pruritus is a common problem following burn injuries; however, the literature to date has focused on adult survivors and/or pediatric survivors of large burns. The current study examines acute postburn pruritus in children under the age of 4 years (N = 256) with smaller burns (mean TBSA = 3.99%), which represents the most common type of patient typically treated in pediatric burn centers. Parents rated their child for pruritus, irritability, and sleep disturbances; additionally, parents completed a self-report of distress. Nearly half (47.3%) were rated by parents as displayed some level of pruritus, with the greatest proportion rated as mild. Regression analysis indicated that child minority status, greater burn TBSA, and more days elapsed since burn predicted higher levels of pruritus. In turn, pruritus was positively correlated with child irritability, delayed sleep onset, sleep disturbance, and parent distress. Thus, our results indicate that parent-rated pruritus in young pediatric burn patients is important to evaluate, as itch is significantly associated with other important clinical outcomes as early as the first month of the burn for pediatric patients and their parents.
Oral Mucosal Injury Caused by Targeted Cancer Therapies
Authors: Carrozzo M , Eriksen J Grau , Bensadoun R -J , Boers-Doets C B , Lalla R V , Peterson D E
Published: July 2019

Targeted cancer therapies have fundamentally transformed the treatment of many types of cancers over the past decade, including breast, colorectal, lung, and pancreatic cancers, as well as lymphoma, leukemia, and multiple myeloma. The unique mechanisms of action of these agents have resulted in many patients experiencing enhanced tumor response together with a reduced adverse event profile as well. Toxicities do continue to occur, however, and in selected cases can be clinically challenging to manage. Of particular importance in the context of this monograph is that the pathobiology for oral mucosal lesions caused by targeted cancer therapies has only been preliminarily investigated. There is distinct need for novel basic, translational, and clinical research strategies to enhance design of preventive and therapeutic approaches for patients at risk for development of these lesions. The research modeling can be conceptually enhanced by extrapolating “lessons learned” from selected oral mucosal conditions in patients without cancer as well. This approach may permit determination of the extent to which pathobiology and clinical management are either similar to or uniquely distinct from oral mucosal lesions caused by targeted cancer therapies. Modeling associated with oral mucosal disease in non-oncology patients is thus presented in this context as well. This article addresses this emerging paradigm, with emphasis on current mechanistic modeling and clinical treatment. This approach is in turn designed to foster delineation of new research strategies, with the goal of enhancing cancer patient treatment in the future.
Overcoming the structural surface effect with a realistic treatment of turbulent convection in 1D stellar models
Authors: Jørgensen Andreas Christ Sølvsten , Weiss Achim
Published: July 2019

State-of-the-art 1D stellar evolution codes rely on simplifying assumptions, such as mixing length theory, in order to describe superadiabatic convection. As a result, 1D stellar structure models do not correctly recover the surface layers of the Sun and other stars with convective envelopes. We present a method that overcomes this structural drawback by employing 3D hydrodynamic simulations of stellar envelopes: at every time-step of the evolution interpolated 3D envelopes are appended to the 1D structure and are used to supply realistic boundary conditions for the stellar interior. In contrast to previous attempts, our method includes mean 3D turbulent pressure. We apply our method to model the present Sun. The structural shortcomings of standard stellar models lead to systematic errors in the stellar oscillation frequencies inferred from the model. We show that our method fully corrects for this error. Furthermore, we show that our realistic treatment of superadiabatic convection alters the predicted evolution of the Sun. Our results hence have important implications for the characterization of stars. This has ramifications for neighbouring fields, such as exoplanet research and galactic archaeology, for which accurate stellar models play a key role.
A low-complexity region in human XRN1 directly recruits deadenylation and decapping factors in 5′–3′ messenger RNA decay
Authors: Chang Chung-Te , Muthukumar Sowndarya , Weber Ramona , Levdansky Yevgen , Chen Ying , Bhandari Dipankar , Igreja Catia , Wohlbold Lara , Valkov Eugene , Izaurralde Elisa
Published: July 2019

XRN1 is the major cytoplasmic exoribonuclease in eukaryotes, which degrades deadenylated and decapped mRNAs in the last step of the 5′–3′ mRNA decay pathway. Metazoan XRN1 interacts with decapping factors coupling the final stages of decay. Here, we reveal a direct interaction between XRN1 and the CCR4–NOT deadenylase complex mediated by a low-complexity region in XRN1, which we term the ‘C-terminal interacting region’ or CIR. The CIR represses reporter mRNA deadenylation in human cells when overexpressed and inhibits CCR4–NOT and isolated CAF1 deadenylase activity in vitro. Through complementation studies in an XRN1-null cell line, we dissect the specific contributions of XRN1 domains and regions toward decay of an mRNA reporter. We observe that XRN1 binding to the decapping activator EDC4 counteracts the dominant negative effect of CIR overexpression on decay. Another decapping activator PatL1 directly interacts with CIR and alleviates the CIR-mediated inhibition of CCR4–NOT activity in vitro. Ribosome profiling revealed that XRN1 loss impacts not only on mRNA levels but also on the translational efficiency of many cellular transcripts likely as a consequence of incomplete decay. Our findings reveal an additional layer of direct interactions in a tightly integrated network of factors mediating deadenylation, decapping and 5′–3′ exonucleolytic decay.
Cytoplasmic DNA can be detected by RNA fluorescence in situ hybridization
Authors: Greenberg Eliraz , Hochberg-Laufer Hodaya , Blanga Shalev , Kinor Noa , Shav-Tal Yaron
Published: July 2019

Fluorescence in situ hybridization (FISH) can be used for the intracellular detection of DNA or RNA molecules. The detection of DNA sequences by DNA FISH requires the denaturation of the DNA double helix to allow the hybridization of the fluorescent probe with DNA in a single stranded form. These hybridization conditions require high temperature and low pH that can damage RNA, and therefore RNA is not typically detectable by DNA FISH. In contrast, RNA FISH does not require a denaturation step since RNA is single stranded, and therefore DNA molecules are not detectable by RNA FISH. Hence, DNA FISH and RNA FISH are mutually exclusive. In this study, we show that plasmid DNA transiently transfected into cells is readily detectable in the cytoplasm by RNA FISH without need for denaturation, shortly after transfection and for several hours. The plasmids, however, are usually not detectable in the nucleus except when the plasmids are efficiently directed into the nucleus, which may imply a more open packaging state for DNA after transfection. This detection of plasmid DNA in the cytoplasm has implications for RNA FISH experiments and opens a window to study conditions when DNA is present in the cytoplasm.
The effect of sex and body weight on lung volumes during sleep
Authors: Avraam Joanne , Dawson Andrew , Rochford Peter D , Brazzale Danny J , O’donoghue Fergal J , Trinder John , Jordan Amy S
Published: July 2019

Study Objectives

Low lung volumes are thought to contribute to obstructive sleep apnea (OSA). OSA is worse in the supine versus lateral body position, men versus women, obese versus normal-weight (NW) individuals and REM versus NREM sleep. All of these conditions may be associated with low lung volumes. The aim was to measure FRC during wake, NREM, and REM in NW and overweight (OW) men and women while in the supine and lateral body positions.

Methods

Eighty-one healthy adults were instrumented for polysomnography, but with nasal pressure replaced with a sealed, non-vented mask connected to an N2 washout system. During wakefulness and sleep, repeated measurements of FRC were made in both supine and right lateral positions.

Results

Two hundred eighty-five FRC measures were obtained during sleep in 29 NW (body mass index [BMI] = 22 ± 0.3 kg/m2) and 29 OW (BMI = 29 ± 0.7 kg/m2) individuals. During wakefulness, FRC differed between BMI groups and positions (supine: OW = 58 ± 3 and NW = 68 ± 3% predicted; lateral OW = 71 ± 3, NW = 81 ± 3% predicted). FRC fell from wake to NREM sleep in all participants and in both positions by a similar amount. As a result, during NREM sleep FRC was lower in OW than NW individuals (supine 46 ± 3 and 56 ± 3% predicted, respectively). FRC during REM was similar to NREM and no sex differences were observed in any position or sleep stage.

Conclusions

Reductions in FRC while supine and with increased body weight may contribute to worsened OSA in these conditions, but low lung volumes appear unlikely to explain the worsening of OSA in REM and in men versus women.
Isolated rapid eye movement sleep behavior disorder and cyclic alternating pattern: is sleep microstructure a predictive parameter of neurodegeneration?
Authors: Melpignano Andrea , Parrino Liborio , Santamaria Joan , Gaig Carles , Trippi Irene , Serradell Monica , Mutti Carlotta , Riccò Matteo , Iranzo Alex
Published: July 2019

Objective

To evaluate the role of sleep cyclic alternating pattern (CAP) in patients with isolated REM sleep behavior disorder (IRBD) and ascertain whether CAP metrics might represent a marker of phenoconversion to a defined neurodegenerative condition.

Methods

Sixty-seven IRBD patients were included and classified into patients who phenoconverted to a neurodegenerative disease (RBD converters: converter REM sleep behavior disorder [cRBD]; n = 34) and remained disease-free (RBD non-converters: non-converter REM sleep behavior disorder [ncRBD]; n = 33) having a similar follow-up duration. Fourteen age- and gender-balanced healthy controls were included for comparisons.

Results

Compared to controls, CAP rate and CAP index were significantly decreased in IRBD mainly due to a decrease of A1 phase subtypes (A1 index) despite an increase in duration of both CAP A and B phases. The cRBD group had significantly lower values of CAP rate and CAP index when compared with the ncRBD group and controls. A1 index was significantly reduced in both ncRBD and cRBD groups compared to controls. When compared to the ncRBD group, A3 index was significantly decreased in the cRBD group. The Kaplan-Meier curve applied to cRBD estimated that a value of CAP rate below 32.9% was related to an average risk of conversion of 9.2 years after baseline polysomnography.

Conclusion

IRBD is not exclusively a rapid eye movement (REM) sleep parasomnia, as non-rapid eye movement (non-REM) sleep microstructure can also be affected by CAP changes. Further studies are necessary to confirm that a reduction of specific CAP metrics is a marker of neurodegeneration in IRBD.
Yes…and! Actor Improvisation Enhances Psychiatric-Mental Health Nursing Education
Authors: Foley David M. , Robinson Jacqueline
Published: July 2019

Based on a comparative dearth of simulation products to support the attainment of key skills in psychiatric-mental health nursing, the authors developed scripted scenarios to provide students with exposure to low-incidence/high-risk simulated clinical scenarios in the classroom setting. Acting students from the university’s theater school were provided with character sketches and information on psychopathology-psychopharmacology to add a sense of authenticity to the performances. In turn, students questioned the actor-patients in character. The actor-patients employed the improvisational technique of “yes…and” to further develop their characters and provide deeper opportunities for faculty-student engagement and psychiatric-mental health nursing skills development.
Overcoming Barriers to Accessing Obstetric Care in Underserved Communities
Authors: Burlone Suzanne , Moore Lisa , Johnson Wendy
Published: July 2019

Changes in the current workforce of obstetrician–gynecologists and other health care providers of obstetric care, as well as changes in the delivery of health care services, prompt health care leaders to consider alternative strategies for approaching the essential shortage of obstetric care providers and facilities. Geographic variations in health care needs and resources require a tailored approach by individual communities and local health care providers. New and emerging technologies can support a range of innovative solutions to health care access limitations. This article describes an alternative model for remote obstetric care and quality review in Santa Fe, New Mexico, that is applicable to any community facing limited access to full-spectrum obstetric care.
The impact of social media in orthopaedics
Authors: Goyal Dhruv K.C. , Galetta Matthew S. , Fang Taolin , Mangan John , Lendner Mayan , Vaccaro Alexander R. , Kepler Christopher K. , Schroeder Gregory D. , Sharan Alok D.
Published: July 2019

In recent years, alternative forms of impact measurement, known as “altmetrics”, have been proposed as a potential supplement to the more traditional citation-based metric system in determining the influence of orthopaedic literature on the community. As social media grows increasingly more pervasive into mainstream society, so too does its presence in the health care field, especially in the realm of orthopaedics; therefore, it is necessary to determine the influence social media has both on orthopaedic care and the dissemination of orthopaedic literature to the academic community.
Skeletal traction pin diameter and deflection under load: a biomechanical evaluation with clinical correlation
Authors: Evans Cody L. , Hadeed Michael M. , Casp Aaron J. , Yarboro Seth R.
Published: July 2019

Background:

There is scant literature to guide the placement of skeletal traction. The purpose of this study was to test a tensioned traction bow, a nontensioned traction bow, and a traction set up without a bow to measure the amount of pin deflection. By quantifying the deflection of various traction systems under load, guidelines can be provided regarding equipment selection for skeletal traction. The goal was to develop a protocol to minimize the equipment necessary and time to traction placement.

Methods:

A Sawbones® skeletal traction model was designed to measure the amount of deflection of Steinmann pins of various diameters using a Kirschner tensioning bow, a Böhler (nontensioning) device, and a simple design using only weight and nylon cord. Increasing weight was added to each system and deflection recorded. Data were then evaluated to determine the smallest pin diameter that can reasonably withstand a weight of 35 pounds using the cord-only traction design.

Results:

Overall, larger pins deflected less. When comparing the traction systems, the tensioned bow had the least deflection, followed by the nontensioned bow, and the cord-only system. In the cord-only system, the 2.8-mm pin was the smallest diameter that successfully withstood the maximum weight without failing. The cord-only design was left in place for 48 hr without further increase in deflection.

Conclusions:

A simple skeletal traction design consisting of a 2.8-mm smooth Steinmann pin, segment of nylon cord, and weight can be applied with limited tools in a safe and efficient manner.
The Community Orthopaedic Surgeon Taking Trauma Call: Lateral Humeral Condyle Fracture Pearls and Pitfalls
Authors: Ho Christine A. , Mehlman Charles T.
Published: July 2019

Lateral condyle fractures are second only to supracondylar humeral fractures when it comes to pediatric elbow fractures. Whether minimally displaced or substantially displaced, these growth plate fractures may present significant treatment challenges. These include nonunion, malunion, avascular necrosis, and growth disturbance. It must be remembered that lateral condyle fractures often represent significantly displaced intra-articular fractures involving the epiphysis that demand anatomic reduction and stable internal fixation. This article focuses on some of the pertinent pearls and pitfalls regarding these common elbow injuries using ample clinical examples.
The Community Orthopaedic Surgeon Taking Trauma Call: Pediatric Midshaft Clavicle Fracture Pearls and Pitfalls
Authors: Vargas-Vila Mario A. , Mehlman Charles T. , Pennock Andrew T.
Published: July 2019

Pediatric diaphyseal clavicle fractures are a common injury, particularly in the adolescent athlete. There are no consensus guidelines for operative versus nonoperative management of these injuries; however, there has been a dramatic increase in operative treatment over the past 15 years, primarily guided by literature pertaining to the adult population. Despite this trend, current literature suggests that the majority of these injuries can be treated nonoperatively with good functional outcomes, high rates of return to sport, and low incidence of complications such as nonunion, symptomatic malunion, and refracture. For the rare patient treated nonoperatively who develops a symptomatic nonunion or malunion, delayed corrective surgery remains a viable treatment option. When surgical fixation is pursued, good outcomes have been universally reported, but the optimal indication for surgery remains elusive in this adolescent population.
Interprofessional Learning to Improve Communication in Challenging Healthcare Conversations: What Clinicians Learn From Each Other
Authors: Bell Sigall K. , Langer Thorsten , Luff Donna , Rider Elizabeth A. , Brandano Jessica , Meyer Elaine C.
Published: July 2019

Introduction:

Although contemporary health care involves complex interactions among clinicians of varying professions, opportunities to learn together are relatively few. The authors assessed participants' views about the educational value of learning with colleagues of mixed health care professions in communication and relational skills training focused on challenging conversations.

Methods:

Between 2010 and 2013, 783 participants enrolled in 46 workshops hosted by the Institute for Professionalism and Ethical Practice at Boston Children's Hospital, Boston, USA. Participants received pre–, post–, and 3-month follow-up questionnaires with quantitative and qualitative questions about their experiences learning with clinicians of varying professions (“interprofessional learning”). Descriptive statistics and chi-square tests were used to compare participant groups. Responses to open-ended questions were coded according to standard principles of content analysis.

Results:

Seven hundred twenty-two (92%) participants completed surveys. Previous interprofessional learning was reported by 60% of respondents, but generally comprised <30% of their education. Clinicians with <3 years of work experience were least likely to have previous interprofessional learning. Nearly all (96%) participants reported interprofessional colleagues contributed valuably to their learning. Asked specifically what they learned, participants described five themes: Stronger Teamwork, Patient-Centered Focus, Specific Communication Skills, Content-Specific Knowledge, and Shared Global Values. After 3 months, 64% of respondents reported that workshop participation helped make their interactions with interprofessional colleagues more collaborative.

Discussion:

Communication skills training for challenging health care conversations is a valuable opportunity for interprofessional learning and generates sustained positive attitudes about collaboration. Clinicians learn from their colleagues a deeper understanding of each other's professional roles, challenges, and unique contributions; specific communication approaches; and a sense of belonging to a collaborative community reinforcing the patient at the center of care.
Association of Simple Step Test With Readiness for Exercise in Youth After Concussion
Authors: Fyffe Andrew , Bogg Tina , Orr Rhonda , Browne Gary J.
Published: July 2019

Objectives:

We hypothesized that a submaximal step test would be associated with readiness to commence graded exercise in children and adolescents with concussion.

Methods:

Children and adolescents aged 8 to 18 years performed standard concussion clinical assessment for vestibular/ocular and balance impairment, and exercise examination utilizing the 3-minute Kasch Pulse Recovery test (KPR) and a symptom-limited graded exercise test (GXT). Outcome measures included activity readiness and symptom exacerbation.

Results:

Forty-five participants (mean age 13.2 ± 2.1 years, 76% male) had a confirmed concussion (73% sports-related). Some participants required follow-up testing giving 75 clinical presentations. Sensitivity and specificity of the KPR were 100% and 95.7%, respectively. Area under the receiver operating characteristics curve was 0.979. Activity readiness to GXT and KPR was strongly associated (χ2= 21.672,P< .001), while symptom exacerbation showed a significant correlation between testing methods (r= 0.796,P< .001). Better exercise performance on GXT and KPR was significantly correlated with normal Vestibular/Ocular Motor Screening (rs= −0.380,P= .010, andrs= −0.281,P= .017, respectively) and Modified Balance Error Scoring System (rs= −0.452,P< .001, andrs= −0.301,P= .010, respectively).

Conclusion:

The KPR is a simple and practical tool to determine whether it is appropriate for a child or adolescent with concussion to commence graded exercise.
A Randomized Trial Comparing Outcomes of 3 Types of Peripheral Intravenous Catheters
Authors: Galang Heather , Hubbard-Wright Chandra , Hahn Donna S. , Yost Gina , Yoder Laura , Maduro Ralitsa S. , Morgan Merri K. , Zimbro Kathie S.
Published: July 2019

Background:

There was an increase in peripheral intravenous catheter (PIVC) complications and adverse patient events after product conversion during the merger between a rural hospital and a larger hospital system. A review of the existing literature identified a gap in evidence evaluating 2 closed PIVC systems compared with an open PIVC system.

Purpose:

The purpose of the current project was to ascertain whether open or closed PIVCs are best for patients, staff, and the health care system in terms of 3 main criteria: quality, safety, and cost.

Methods:

A prospective, 2-site randomized controlled trial was used to compare outcomes.

Results:

There were no differences in the complication rates between catheter types. There was a statistically significant increase in blood leakage and a decrease in clinician satisfaction with the open-system catheter.

Conclusions:

Our project supports current clinical recommendation that a closed PIVC system, regardless of type, is not only safer and cost-effective but also preferred by patients and clinicians.
Integrating Safe Patient Handling and Early Mobility
Authors: Wyatt Susan , Meacci Katie , Arnold Margaret
Published: July 2019

Background:

Safe Patient Handling and Mobility (SPHM) programs reduce staff injuries from lifting and repositioning patients. Early Mobility programs improve many patient-centered outcomes. Reframing SPHM equipment as mobilization tools can help safely mobilize hospitalized patients to their highest abilities.

Problem:

Combining SPHM and Early Mobility programs is logical, but to date, no one has articulated the process of integration.

Intervention:

A quality improvement process was developed at the Phoenix Veterans Affairs Health Care System to integrate an Early Exercise and Progressive Mobility initiative in the intensive care unit into an ongoing SPHM program using the Iowa Model for Evidence-Based Implementation.

Results:

Integration of these programs was possible through extensive collaboration between stakeholders throughout planning, implementation, and refinement phases. Interdisciplinary Early Exercise and Progressive Mobility simulation training, standardized assessment, communication of patient status, and appropriate equipment use facilitated staff confidence to safely mobilize patients.

Conclusions:

Successful integration of Early Exercise and Progressive Mobility and SPHM was achieved at the Phoenix Veterans Affairs Health Care System.
Delineation of the Nursing Supervisor Role
Authors: Glasofer Amy , Bertino Lapinsky Anne
Published: July 2019

OBJECTIVE

The purpose of this study was to describe a sample of nursing supervisors and their work.

BACKGROUND

The role of the nursing supervisor is not well understood. The supervisor population is poorly defined, as are their ideal academic preparation and work activities.

METHODS

This study followed the American Nurses Credentialing Center® framework for role delineation studies. A convenience sample of 50 nursing supervisors from New Jersey was recruited to complete an online survey including demographic data and prioritization of work activities.

RESULTS

Participants represented a homogeneous and aging workforce with diverse professional preparation. Exploratory factor analysis revealed 6 categories of nurse supervisor work including administrative presence, leadership liaison, patient safety and experience, patient care advocacy, throughput, and external response. Work activities were prioritized.

CONCLUSIONS

Nurse supervisors prioritized responding to emergencies above all other responsibilities. This study should be replicated in a nationwide sample of nurse supervisors.
Imaging Characteristics of Coexisting Primary Pulmonary Carcinoid Tumor and Multiple Myeloma on 18F-FDG and 68Ga-DOTATATE PET/CT
Authors: Lu Yang
Published: July 2019

A 69-year-old man with recurrent multiple myeloma underwent FDG PET/CT evaluation. A pulmonary nodule without higher-than-background FDG avidity was later biopsied as a low-grade neuroendocrine tumor. On further 68Ga-DOTATATE PET/CT evaluation of patient’s neuroendocrine tumor, the lytic myeloma lesions revealed only mild DOTATATE avidity while the primary pulmonary neuroendocrine tumor showed intense DOTATATE uptake. The distinct imaging characteristics of different primary malignancies correlated with their underlying different pathology.
Vascular Parkinsonism by Infarctions at Different Locations on 18F-FP-CIT PET/CT
Authors: Kim Chanwoo , Kim Deog Yoon , Hong Il Ki
Published: July 2019

Cerebral vascular lesions are integral to the diagnosis of vascular parkinsonism (VP). The VP, also referred to as lower body parkinsonism, is frequently caused by subcortical white matter lesions, but lesions at any levels of the nigro-striato-thalamo-cortical pathway can also cause VP, thus giving rise to various symptoms other than gait disturbance. Previous dopamine transporter imaging studies using SPECT showed heterogeneous patterns suggesting diverse contributing lesions to VP. Here we present 3 cases of VP demonstrated by 18F-FP-CIT PET/CT, visualizing vascular lesions at different levels between the midbrain and motor cortex. Distinctive clinical manifestations of them recapitulate the pathogenesis of VP.
Cutaneous Bone Formation Associated With Melanocytic Nevus
Authors: Erinanc Hilal , Turk Emin
Published: July 2019

Aim:

Cutaneous bone formation is an uncommon lesion of the skin. It may be primary or secondary. Secondary lesions are mostly associated with melanocytic nevi. Although many different theories have been proposed to explain the etiology, extraskeletal bone formation is complex and poorly understood phenomenon.

Here the authors report a series of melanocytic nevi with cutaneous bone formation and the authors described morphologic and clinicopathologic features such as age, sex, location, focus number and size of the lesion.

Material and Method:

Through a single center, this retrospective study presents total number of 20 patients with melanocytic nevus with or without osseous metaplasia. Histologic and clinicopathologic features such as age, sex, location, focus, and size of lesion were compared.

Results:

Lesions were identified in 10 female patients. All of the cases were seen in the head and neck region such as face, forehead, eyebrow, lip, and neck and most of them were solitary. The nevi were usually associated with the single focus of ossification. Most of patients (50%) had acne symptoms and treatment anamnesis. Granulomatous dermal inflammation was seen in 2 patients. There was no difference in nevus morphology and the size of the nevi between the osteonevi and the other types of nevi.

Conclusion:

In conclusion, this study revealed that although it is rare it has distinctive features such as female patients, face location, and acne anamnesis. Therefore it may be speculated that the osteogenic factors may be involved with inflammatory-induced metaplastic ossification and tend to be related female sex.
Cardiac Glucose and Fatty Acid Transport After Experimental Mono- and Polytrauma
Authors: Lackner Ina , Weber Birte , Knecht Deborah , Horst Klemens , Relja Borna , Gebhard Florian , Pape Hans-Christoph , Huber-Lang Markus , Hildebrand Frank , Kalbitz Miriam
Published: July 2019

Objective:

The aim of this study was to define the influence of trauma on cardiac glucose and fatty acid transport. The effects were investigated in vivo in a porcine mono- and polytrauma model and in vitro in human cardiomyocytes, which were treated simultaneously with different inflammatory substances, mimicking posttraumatic inflammatory conditions.

Methods and Results:

In the porcine fracture- and polytrauma model, blood glucose concentrations were measured by blood gas analysis during an observation period of 72 h. The expression of cardiac glucose and fatty acid transporters in the left ventricle was determined by RT-qPCR and immunofluorescence. Cardiac and hepatic glycogen storage was examined. Furthermore, human cardiomyocytes were exposed to a defined trauma-cocktail and the expression levels of glucose- and fatty acid transporters were determined. Early after polytrauma, hyperglycemia was observed. After 48 and 72 h, pigs with fracture- and polytrauma developed hypoglycemia. The propofol demand significantly increased posttrauma. The hepatic glycogen concentration was reduced 72 h after trauma. Cardiac glucose and fatty acid transporters changed in both trauma models in vivo as well as in vitro in human cardiomyocytes in presence of proinflammatory mediators.

Conclusions:

Monotrauma as well as polytrauma changed the cardiac energy transport by altering the expression of glucose and fatty acid transporters. In vitro data suggest that human cardiomyocytes shift to a state alike myocardial hibernation preferring glucose as primary energy source to maintain cardiac function.
Breathlessness and the brain: the role of expectation
Authors: Marlow Lucy L. , Faull Olivia K. , Finnegan Sarah L. , Pattinson Kyle T.S.
Published: July 2019

Purpose of review

Breathlessness debilitates countless people with a wide range of common diseases. For some people, the experience of breathlessness is poorly explained by the findings of medical tests. This disparity complicates diagnostic and treatment options and means that disease-modifying treatments do not always have the expected effect upon symptoms. These observations suggest that brain processing of respiratory perceptions may be somewhat independent of disease processes. This may help to explain the dissonance observed in some patients between physical disease markers and the lived experience of breathlessness.

Recent findings

A body of breathlessness research using functional neuroimaging has identified a relatively consistent set of brain areas that are associated with breathlessness. These areas include the insula, cingulate and sensory cortices, the amygdala and the periaqueductal gray matter. We interpret these findings in the context of new theories of perception that emphasize the importance of distributed brain networks. Within this framework, these perceptual networks function by checking an internal model (a set of expectations) against peripheral sensory inputs, instead of the brain acting as a passive signal transducer. Furthermore, other factors beyond the physiology of breathlessness can influence the system.

A person's expectations and mood are major contributors to the function of the brain networks that generate perceptions of breathlessness. Breathlessness, therefore, arises from inferences made by the brain's integration of both expectations and sensory inputs. By better understanding individual differences across these contributing perceptual factors, we will be better poised to develop targeted and individualized treatments for breathlessness that could complement disease-modifying therapies.
Pharmacodynamics, Efficacy, and Safety of IPX203 in Parkinson Disease Patients With Motor Fluctuations
Authors: Modi Nishit B. , Mittur Aravind , Dinh Phillip , Rubens Robert , Gupta Suneel
Published: July 2019

Objectives

IPX203 is an investigational oral extended-release capsule formulation of carbidopa and levodopa. The pharmacodynamics and efficacy of IPX203 were compared with immediate-release carbidopa-levodopa (IR CD-LD) in this open-label, rater-blinded, multicenter, crossover study in patients with advanced Parkinson disease (PD).

Methods

Twenty-eight patients were randomized to 2 weeks of treatment with IR CD-LD followed by IPX203 or IPX203 followed by IR CD-LD. Pharmacokinetic and motor assessments were conducted on days 1 and 15 of each treatment period. Efficacy was assessed using a 3-day PD diary. Pharmacodynamics were assessed by rater-blinded Movement Disorder Society—Unified Parkinson's Disease Rating Scale Part III and Investigator Assessment of Subject's Motor State.

Results

After a single dose, levodopa concentrations were sustained above 50% of peak concentration for 4.6 hours with IPX203 versus 1.5 hours with IR CD-LD (P < 0.0001). Based on the PD diary, patients experienced significantly less Off time with IPX203 as a percentage of waking hours than IR CD-LD (mean 19.3% vs 33.5%, respectively; P < 0.0001), translating into 2.3 hours less Off time than IR CD-LD with most of this improvement (1.9 hours) being Good On time. There was no significant difference in the amount of On time with troublesome dyskinesia between treatments. Pharmacodynamic assessments demonstrated similar outcomes in favor of IPX203 on day 1 and a significant predose benefit on motor examination after multiple dosing.

Conclusions

IPX203 demonstrated a sustained effect to reduce Off time and improve Good On time in patients with PD and motor fluctuations. Both treatments were well tolerated.
Rapid evolution and conserved function of the piRNA pathway
Authors: Parhad Swapnil S. , Theurkauf William E.
Published: July 2019

Transposons are major genome constituents that can mobilize and trigger mutations, DNA breaks and chromosome rearrangements. Transposon silencing is particularly important in the germline, which is dedicated to transmission of the inherited genome. Piwi-interacting RNAs (piRNAs) guide a host defence system that transcriptionally and post-transcriptionally silences transposons during germline development. While germline control of transposons by the piRNA pathway is conserved, many piRNA pathway genes are evolving rapidly under positive selection, and the piRNA biogenesis machinery shows remarkable phylogenetic diversity. Conservation of core function combined with rapid gene evolution is characteristic of a host–pathogen arms race, suggesting that transposons and the piRNA pathway are engaged in an evolutionary tug of war that is driving divergence of the biogenesis machinery. Recent studies suggest that this process may produce biochemical incompatibilities that contribute to reproductive isolation and species divergence.
Emergent matriliny in a matrifocal, patrilineal population: a male coalitionary perspective
Authors: Macfarlan Shane J. , Quinlan Robert J. , Post Emily
Published: July 2019

Daughter-biased parental investment and limited paternal care promote matrifocality and matrilineal descent, both of which are forms of matricentric social organization. However, matrifocality can occur under patrilineal descent. We hypothesize that matrilineal descent could emergently organize social relationships if a society were normatively patrilineal but matrifocal. Furthermore, in matrifocal environments, male and female social lives are envisioned as sex-specific adaptive strategies. Males purportedly form large, flexible social support networks that conflict with conjugal partnership investment owing to a tradeoff in the allocation of effort associated with either investing in male social support or provisioning the conjugal household. However, no quantitative analyses exist about the effect of conjugal partnership formation on male social relations in matrifocal communities. Here we examine whether matrilineal kinship organizes male same-sex social relationships and the effect of conjugal partnerships on male social support in a normatively patrilineal, but matrifocal village. We find that matrilineal kinship influences male social support networks, but not labour cooperation. Consistent with a tradeoff associated with investing in male social support or a conjugal union, we find that labouring with a conjugal partner, but not conjugal partnership itself, reduces male labour and social support outcomes. Our results suggest new insights into men's roles in matricentric social organization: (1) matriliny can emerge in patrilineal systems when household economics shift toward matrifocality in which matrilineal descent is used to organize male social support, and (2) the degree to which this shift occurs depends on the proportion of men who invest in same-sex social networks as opposed to a conjugal partner and offspring.

This article is part of the theme issue ‘The evolution of female-biased kinship in humans and other mammals’.
The evolution of infanticide by females in mammals
Authors: Lukas Dieter , Huchard Elise
Published: July 2019

In most mammalian species, females regularly interact with kin, which is expected to reduce aggressive competitive behaviour among females. It may thus be difficult to understand why infanticide by females has been reported in numerous species and is sometimes perpetrated by groupmates. Here, we investigate the evolutionary determinants of infanticide by females by combining a quantitative analysis of the taxonomic distribution of infanticide with a qualitative synthesis of the circumstances of infanticidal attacks in published reports. Our results show that female infanticide is widespread across mammals and varies in relation to social organization and life history, being more frequent where females breed in groups and have intense bouts of high reproductive output. Specifically, female infanticide occurs where the proximity of conspecific offspring directly threatens the killer's reproductive success by limiting access to critical resources for her dependent progeny, including food, shelters, care or a social position. By contrast, infanticide is not immediately modulated by the degree of kinship among females, and females occasionally sacrifice closely related infants. Our findings suggest that the potential direct fitness rewards of gaining access to reproductive resources have a stronger influence on the expression of female aggression than the indirect fitness costs of competing against kin.

This article is part of the theme issue ‘The evolution of female-biased kinship in humans and other mammals’.
Differences between sons and daughters in the intergenerational transmission of wealth
Authors: Borgerhoff Mulder Monique , Towner Mary C. , Baldini Ryan , Beheim Bret A. , Bowles Samuel , Colleran Heidi , Gurven Michael , Kramer Karen L. , Mattison Siobhán M. , Nolin David A. , Scelza Brooke A. , Schniter Eric , Sear Rebecca , Shenk Mary K. , Voland Eckart , Ziker John
Published: July 2019

Persistent interest lies in gender inequality, especially with regard to the favouring of sons over daughters. Economists are concerned with how privilege is transmitted across generations, and anthropologists have long studied sex-biased inheritance norms. There has, however, been no focused cross-cultural investigation of how parent–offspring correlations in wealth vary by offspring sex. We estimate these correlations for 38 wealth measures, including somatic and relational wealth, from 15 populations ranging from hunter–gatherers to small-scale farmers. Although small sample sizes limit our statistical power, we find no evidence of ubiquitous male bias, at least as inferred from comparing parent–son and parent–daughter correlations. Rather we find wide variation in signatures of sex bias, with evidence of both son and daughter-biased transmission. Further, we introduce a model that helps pinpoint the conditions under which simple mid-point parent–offspring wealth correlations can reveal information about sex-biased parental investment. Our findings are relevant to the study of female-biased kinship by revealing just how little normative descriptors of kinship systems, such as patrilineal inheritance, capture intergenerational correlations in wealth, and how variable parent–son and parent–daughter correlations can be.

This article is part of the theme issue ‘The evolution of female-biased kinship in humans and other mammals'.
A worldwide view of matriliny: using cross-cultural analyses to shed light on human kinship systems
Authors: Surowiec Alexandra , Snyder Kate T. , Creanza Nicole
Published: July 2019

Although matriliny and matrilocality are relatively rare in contemporary human populations, these female-based descent and residence systems are present in different cultural contexts and across the globe. Previous research has generated numerous hypotheses about which cultural traits are associated with the stability or loss of matrilineal descent. In addition, several studies have examined matrilineal descent with phylogenetic analyses; however, the use of language phylogenies has restricted these analyses to comparisons within a single language family, often confined to a single continent. Cross-cultural comparisons are particularly informative when they account for the relationships between widely distributed populations, as opposed to treating each population as an independent sample or focusing on a single region. Here, we study the evolution of descent systems on a worldwide scale. First, we test for significant associations between matriliny and numerous cultural traits that have been theoretically associated with its stability or loss, such as subsistence strategy, animal domestication, mating system, residence pattern, wealth transfer and property succession. In addition, by combining genetic and linguistic information to build a global supertree that includes 16 matrilineal populations, we also perform phylogenetically controlled analyses to assess the patterns of correlated evolution between descent and other traits: for example, does a change in subsistence strategy generally predict a shift in the rules of descent, or do these transitions happen independently? These analyses enable a worldwide perspective on the pattern and process of the evolution of matriliny and matrilocality.

This article is part of the theme issue ‘The evolution of female-biased kinship in humans and other mammals’.
Prevailing I292V PB2 mutation in avian influenza H9N2 virus increases viral polymerase function and attenuates IFN-β induction in human cells
Authors: Gao Weihua , Zu Zhipeng , Liu Jiyu , Song Jingwei , Wang Xinyu , Wang Chenxi , Liu Litao , Tong Qi , Wang Mingyang , Sun Honglei , Sun Yipeng , Liu Jinhua , Chang Kin-Chow , Pu Juan
Published: July 2019

Adaptation of PB2 protein is important for the establishment of avian influenza viruses in mammalian hosts. Here, we identify I292V as the prevalent mutation in PB2 of circulating avian H9N2 and pandemic H1N1 viruses. The same dominant PB2 mutation is also found in most human isolates of emergent avian H7N9 and H10N8 viruses. In human cells, PB2-292V in H9N2 virus has the combined ability of conferring higher viral polymerase activity and stronger attenuation of IFN-β induction than that of its predecessor PB2-292I. IFN-β attenuation is accompanied by higher binding affinity of PB2-292V for host mitochondrial antiviral signalling protein, an important intermediary protein in the induction of IFN-β. In the mouse in vivo model, PB2-292V mutation increases H9N2 virus replication with ensuing increase in disease severity. Collectively, PB2-292V is a new mammalian adaptive marker that promotes H9N2 virus replication in mammalian hosts with the potential to improve transmission from birds to humans.
Multiple timescales account for adaptive responses across sensory cortices
Authors: Latimer Kenneth W. , Barbera Dylan , Sokoletsky Michael , Awwad Bshara , Katz Yonaton , Nelken Israel , Lampl Ilan , Fairhall Adrienne , Priebe Nicholas J.
Published: July 2019

Sensory systems encounter remarkably diverse stimuli in the external environment. Natural stimuli exhibit timescales and amplitudes of variation that span a wide range. Mechanisms of adaptation, ubiquitous feature of sensory systems, allow for the accommodation of this range of scales. Are there common rules of adaptation across different sensory modalities? We measured the membrane potential responses of individual neurons in the visual, somatosensory and auditory cortices to discrete, punctate stimuli delivered at a wide range of fixed and nonfixed frequencies. We find that the adaptive profile of the response is largely preserved across these three areas, exhibiting attenuation and responses to the cessation of stimulation which are signatures of response to changes in stimulus statistics. We demonstrate that these adaptive responses can emerge from a simple model based on the integration of fixed filters operating over multiple time scales.
The PAX3 and 7 homeodomains have evolved unique determinants that influence DNA-binding, structure and communication with the paired domain
Authors: Corry Gareth N. , Sykes Brian D. , Underhill D. Alan
Published: July 2019

The PAX (paired box) family is a collection of metazoan transcription factors defined by the paired domain, which confers sequence-specific DNA-binding. Ancestral PAX proteins also contained a homeodomain, which can communicate with the paired domain to modulate DNA-binding. In the present study, we sought to identify determinants of this functional interaction using the paralogous PAX3 and 7 proteins. First, we evaluated a group of heterologous paired domains and homeodomains for the ability to bind DNA cooperatively through formation of a ternary complex (paired domain:homeodomain:DNA). This revealed that capacity for ternary complex formation was unique to the PAX3 and 7 homeodomains and therefore not simply a consequence of DNA-binding. We also found PAX3 and 7 were distinguished by an extended region of conservation N-terminal to the homeodomain (NTE). Phylogenetic analyses established the NTE was restricted to PAX3/7 orthologs of segmented metazoans, indicating it arose in a bilaterian precursor prior to separation of deuterostomes and protostomes. In DNA-binding assays, presence of the NTE caused a decrease in monomeric binding by the PAX3 homeodomain that reflected a lack of secondary structure in 1D-1H-NMR. Nevertheless, this inhibitory effect could be overcome by homeodomain dimerization or cooperative binding with the paired domain, establishing that protein interactions could induce homeodomain folding in the presence of the NTE. Strikingly, the PAX7 counterpart did not impair homeodomain binding, revealing inherent differences that could account for its distinct target profile in vivo. Collectively, these findings identify critical determinants of PAX3 and 7 activity, which contribute to their functional diversification.