bluuebunny/crossref_metadata_2025 huggingface dataset:
PATIENT DOSE IN DIGITAL RADIOGRAPHY UTILISING BMI CLASSIFICATION
Authors: Metaxas Vasileios I , Messaris Gerasimos A , Lekatou Aristea N , Petsas Theodore G , Panayiotakis George S
Published: October 2018

Dose audit is important towards optimisation of patients’ radiation protection in diagnostic radiography. In this study, the effect of the body mass index (BMI) on radiation dose received by 1869 adult patients undergoing chest, abdomen, lumbar spine, kidneys and urinary bladder (KUB) and pelvis radiography in an X-ray room with a digital radiography system was investigated. Patients were categorised into three groups (normal, overweight and obese) based on the BMI values. The patients’ entrance surface air kerma (ESAK) and the effective dose (ED) were calculated based on the X-ray tube output, exposure parameters and technical data, as well as utilising appropriate conversion coefficients of the recorded kerma area product (KAP) values. The local diagnostic reference levels (LDRLs) were established at the 75th percentile of the distribution of ESAK and KAP values. Statistically, a significant increase was found in ESAK, KAP and ED values, for all examinations, both for overweight and obese patients compared to normal patients (Mann–Whitney test, p < 0.0001). Regarding the gender of the patients, a statistically significant increase was found in the dose values for male patients compared to female patients, except for the chest LAT examinations (Mann–Whitney test, p = 0.06). The percentage increase for chest PA, chest LAT, abdomen AP, lumbar spine AP, lumbar spine LAT, pelvis AP and KUB AP in overweight patients was 75%, 100%, 136%, 130%, 70%, 66% and 174% for median ESAK, 67%, 81%, 135%, 134%, 85%, 63% and 172% for median KAP, as well as 89%, 54%, 146%, 138%, 82%, 57% and 183% for median ED values, respectively. For obese patients, the corresponding increases were 200%, 186%, 459%, 345%, 203%, 150% and 785% for median ESAK, 200%, 185%, 423%, 357%, 227%, 142% and 597% for median KAP, as well as 222%, 156%, 446%, 363%, 218%, 136% and 625% for median ED. The corresponding LDRLs for overweight patients were 0.17 mGy, 1.21 mGy, 3.74 mGy, 7.70 mGy, 7.99 mGy, 4.07mGy, 5.03 mGy and 0.13 Gy cm2, 0.69 Gy cm2, 2.35 Gy cm2, 2.10 Gy cm2, 2.59 Gy cm2, 2.13 Gy cm2, 2.49 Gy cm2 in terms of ESAK and KAP values, respectively, while in the case of obese patients were 0.28 mGy, 1.82 mGy, 7.26 mGy, 15.10 mGy, 13.86 mGy, 6.89 mGy, 13.40 mGy and 0.21 Gy cm2, 1.10 Gy cm2, 4.68 Gy cm2, 4.01 Gy cm2, 4.80 Gy cm2, 3.27 Gy cm2, 6.02 Gy cm2, respectively. It can be concluded that overweight and obese patients received a significantly increased radiation dose. Careful adjustment of imaging protocols is needed for these patients to reduce patient dose, while keeping the image quality at an acceptable level. Additional studies need to be conducted for these patient groups, that could further contribute to the development of radiation protection culture in diagnostic radiography.
Interprofessional Graduate Students’ Perspectives on Caring for Vulnerable Populations
Authors: Wright Patricia Moyle , Hanson Mary Jane S.
Published: October 2018

The purpose of this focus group study was to explore graduate students’ clinical experiences with vulnerable populations, perceived barriers to care, and ethical issues related to caring for disenfranchised groups. Furthermore, based on their experiences, the students were asked to share suggestions for curricular changes that could enhance care for vulnerable populations through interdisciplinary collaboration and multidisciplinary projects. The responses of the participants add to what is known about the care of vulnerable populations, offering a first-hand description of students’ preparation for work with vulnerable populations and the interdisciplinary team.
Developing an Instrument for Evidence-Based Peer Review of Faculty Online Teaching
Authors: Shelton Lora R. , Hayne Arlene N.
Published: October 2018

Peer review is a long-standing practice in academia that can supply valuable information for summative or formative evaluation. The purpose of this article is to present an evidence-based peer review instrument developed by faculty to assess faculty teaching and practice in the online environment. The peer review instrument was designed using the community of inquiry framework and best practices for online teaching. The elements of teaching presence, social presence, and cognitive presence serve as the basis for expected faculty behaviors.
Caring for Critically Ill Patients with the ABCDEF Bundle: Results of the ICU Liberation Collaborative in Over 15,000 Adults
Authors: Pun Brenda T. , Balas Michele C. , Barnes-Daly Mary Ann , Thompson Jennifer L. , Aldrich J. Matthew , Barr Juliana , Byrum Diane , Carson Shannon S. , Devlin John W. , Engel Heidi J. , Esbrook Cheryl L. , Hargett Ken D. , Harmon Lori , Hielsberg Christina , Jackson James C. , Kelly Tamra L. , Kumar Vishakha , Millner Lawson , Morse Alexandra , Perme Christiane S. , Posa Patricia J. , Puntillo Kathleen A. , Schweickert William D. , Stollings Joanna L. , Tan Alai , D’Agostino McGowan Lucy , Ely E. Wesley
Published: October 2018

Objective:

Decades-old, common ICU practices including deep sedation, immobilization, and limited family access are being challenged. We endeavoured to evaluate the relationship between ABCDEF bundle performance and patient-centered outcomes in critical care.

Design:

Prospective, multicenter, cohort study from a national quality improvement collaborative.

Setting:

68 academic, community, and federal ICUs collected data during a 20-month period.

Patients:

15,226 adults with at least one ICU day.

Interventions:

We defined ABCDEF bundle performance (our main exposure) in two ways: 1) complete performance (patient received every eligible bundle element on any given day) and 2) proportional performance (percentage of eligible bundle elements performed on any given day). We explored the association between complete and proportional ABCDEF bundle performance and three sets of outcomes: patient-related (mortality, ICU and hospital discharge), symptom-related (mechanical ventilation, coma, delirium, pain, restraint use), and system-related (ICU readmission, discharge destination). All models were adjusted for a minimum of 18 a priori determined potential confounders.

Measurements and Results:

Complete ABCDEF bundle performance was associated with lower likelihood of seven outcomes: hospital death within 7 days (adjusted hazard ratio, 0.32; CI, 0.17–0.62), next-day mechanical ventilation (adjusted odds ratio [AOR], 0.28; CI, 0.22–0.36), coma (AOR, 0.35; CI, 0.22–0.56), delirium (AOR, 0.60; CI, 0.49–0.72), physical restraint use (AOR, 0.37; CI, 0.30–0.46), ICU readmission (AOR, 0.54; CI, 0.37–0.79), and discharge to a facility other than home (AOR, 0.64; CI, 0.51–0.80). There was a consistent dose-response relationship between higher proportional bundle performance and improvements in each of the above-mentioned clinical outcomes (all p < 0.002). Significant pain was more frequently reported as bundle performance proportionally increased (p = 0.0001).

Conclusions:

ABCDEF bundle performance showed significant and clinically meaningful improvements in outcomes including survival, mechanical ventilation use, coma, delirium, restraint-free care, ICU readmissions, and post-ICU discharge disposition.
The patient-centered oncology care on health care utilization and cost: A systematic review and meta-analysis
Authors: Liang Hailun , Tao Lei , Ford Eric W. , Beydoun May A. , Eid Shaker M.
Published: October 2018

Background

Optimal cancer care entails coordination among multiple providers and continued follow-up and surveillance over time. The patient-centered care brings opportunities to improve the delivery of cancer care. The adoption of patient-centered oncology care (PCOC) is in its infancy. Evidence synthesis on the model’s effectiveness is scant.

Purposes

This is the first systemic review and meta-analysis on associations of PCOC with cancer patients’ adverse health care utilization, cost, patient satisfaction, and quality of care.

Methods

Our study was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) framework. Quality appraisal was performed using Downs and Black’s quality checklist. Study-level effect sizes of adverse health care utilization were computed using Cohen’s d and summarized using forest plots. Funnel plots were constructed to examine publication bias.

Results

Of 334 studies that were reviewed, 10 met eligibility criteria and were included into the final analysis. Many included studies implemented almost all six of patient-centered care core attributes, plus three additional attributes that specifically addressed cancer patients’ needs, including triage pathways, standardized and evidence-based symptom management, as well as support patient navigation. PCOC patients had lower utilization of inpatient care (standardized means difference [SMD] = −0.027, p = .049). Overall positive effect of PCOC on emergency department use was small and not significant (SMD = −0.023, p = .103). With regard to cost and quality of care, our narrative summaries showed an overall positive direction, though we found limitations in individual study quality that precluded a meta-analysis.

Public Implication

The results showed that it is possible to utilize patient-centered model to support best practice of cancer care. Early evidence shows that the PCOC model has potential to improve health care utilization, cost, and quality of care, but limited numbers of included articles and heterogeneity of those studies implied that more rigorous research is expected to further investigate the model’s effects.
Comprehensive analysis of long noncoding RNA expression in dorsal root ganglion reveals cell-type specificity and dysregulation after nerve injury
Authors: Baskozos Georgios , Dawes John M. , Austin Jean S. , Antunes-Martins Ana , McDermott Lucy , Clark Alex J. , Trendafilova Teodora , Lees Jon G. , McMahon Stephen B. , Mogil Jeffrey S. , Orengo Christine , Bennett David L.
Published: October 2018

Dorsal root ganglion (DRG) neurons provide connectivity between peripheral tissues and the spinal cord. Transcriptional plasticity within DRG sensory neurons after peripheral nerve injury contributes to nerve repair but also leads to maladaptive plasticity, including the development of neuropathic pain. This study presents tissue and neuron-specific expression profiling of both known and novel long noncoding RNAs (LncRNAs) in the rodent DRG after nerve injury. We have identified a large number of novel LncRNAs expressed within the rodent DRG, a minority of which were syntenically conserved between the mouse, rat, and human, and including, both intergenic and antisense LncRNAs. We have also identified neuron type–specific LncRNAs in the mouse DRG and LncRNAs that are expressed in human IPS cell–derived sensory neurons. We show significant plasticity in LncRNA expression after nerve injury, which in mice is strain and gender dependent. This resource is publicly available and will aid future studies of DRG neuron identity and the transcriptional landscape in both the naive and injured DRG. We present our work regarding novel antisense and intergenic LncRNAs as an online searchable database, accessible from PainNetworks (http://www.painnetworks.org/). We have also integrated all annotated gene expression data in PainNetworks, so they can be examined in the context of their protein interactions.
Vti1b promotes TRPV1 sensitization during inflammatory pain
Authors: Sondermann Julia R. , Barry Allison M. , Jahn Olaf , Michel Niklas , Abdelaziz Reham , Kügler Sebastian , Gomez-Varela David , Schmidt Manuela
Published: October 2018

Sensitization of the transient receptor potential ion channel vanilloid 1 (TRPV1) is critically involved in inflammatory pain. To date, manifold signaling cascades have been shown to converge onto TRPV1 and enhance its sensitization. However, many of them also play a role for nociceptive pain, which limits their utility as targets for therapeutic intervention. Here, we show that the vesicle transport through interaction with t-SNAREs homolog 1B (Vti1b) protein promotes TRPV1 sensitization upon inflammation in cell culture but leaves normal functioning of TRPV1 intact. Importantly, the effect of Vti1b can be recapitulated in vivo: Virus-mediated knockdown of Vti1b in sensory neurons attenuated thermal hypersensitivity during inflammatory pain without affecting mechanical hypersensitivity or capsaicin-induced nociceptive pain. Interestingly, TRPV1 and Vti1b are localized in close vicinity as indicated by proximity ligation assays and are likely to bind to each other, either directly or indirectly, as suggested by coimmunoprecipitations. Moreover, using a mass spectrometry–based quantitative interactomics approach, we show that Vti1b is less abundant in TRPV1 protein complexes during inflammatory conditions compared with controls. Alongside, we identify numerous novel and pain state-dependent binding partners of native TRPV1 in dorsal root ganglia. These data represent a unique resource on the dynamics of the TRPV1 interactome and facilitate mechanistic insights into TRPV1 regulation. We propose that inflammation-related differences in the TRPV1 interactome identified here could be exploited to specifically target inflammatory pain in the future.
A Pilot, Randomized Clinical Trial of Bedtime Doses of Prazosin Versus Placebo in Suicidal Posttraumatic Stress Disorder Patients With Nightmares
Authors: McCall William Vaughn , Pillai Anilkumar , Case Doug , McCloud Laryssa , Nolla Tiffany , Branch Fallon , Youssef Nagy A. , Moraczewski Jason , Tauhidul Liniya , Pandya Chirayu D. , Rosenquist Peter B.
Published: October 2018

Purpose/Background

Observational studies show an association between nightmares and suicide. Prazosin is proposed as a nightmare treatment. This pilot, randomized clinical trial tested whether treatment of nightmares with prazosin would reduce suicidal ideas in suicidal posttraumatic stress disorder (PTSD) patients.

Methods/Procedures

Twenty adult, suicidal PTSD patients with nightmares were blindly and randomly assigned 1:1 to escalating doses of prazosin versus placebo at bedtime only for 8 weeks. All participants had comorbid mood disorders and received stable doses of mood disorder medication. Outcomes of interest were measured weekly and included severity of suicidal ideation, nightmares, PTSD, insomnia, and depression. Longitudinal mixed-effects models assessed change in outcomes over time.

Findings/Results

All psychometric measures improved over 8 weeks. However, nighttime measures of nightmares and insomnia showed significantly less improvement in the prazosin group, whereas there was no significant change in daytime measures of suicidal ideation and daytime-only PTSD symptoms. Two patients required emergency psychiatric hospitalization, but there were no suicide attempts and no deaths.

Implications/Conclusions

This study confirmed an effect of nighttime-only prazosin on nighttime symptoms of insomnia and nightmares in suicidal PTSD patients who are experiencing nightmares. Surprisingly, the effect was in the direction opposite of what we expected. Furthermore, prazosin showed no signal on daytime measures including suicidal ideation. The results do not support a larger study of nighttime-only prazosin in suicidal PTSD patients but leave open the possibility of benefit from daytime administration of prazosin.
Perception Versus Reality: Estimated and Actual Online Content Consumption Comparisons and Relationships to Classroom Performance
Authors: Richardson Michael V. , Bliss Rebecca , Welton Wade , Papa Evan
Published: October 2018

Introduction.

As students and faculty are increasingly becoming more comfortable with technology, physical therapy programs are using the flipped classroom (FC) to provide an environment more conducive to active and problem-based learning. Most literature on students in graduate level health care professional programs rely on subjective student report. To our knowledge, no studies have compared objective actual student consumption of online content to subjective student perception of online content consumption. Nor have studies explored the relationship between actual online content consumption and classroom performance. In this study, we compared estimated and actual online content consumption as well as its relationship to student performance. We hypothesized that students would inaccurately estimate online content viewing amounts and that a positive correlation would exist between online content consumption and student performance.

Methods.

Upon completion of a patient mobility training course, 46 year-one physical therapist students estimated their weekly online content consumption. In this cross-sectional study design, we compared these estimations with student usage data provided by an online learning management system. Additionally, we compared examination grades and overall course grades to average weekly viewing times. A Pearson's product moment correlation assessed the relationship between weekly viewing time and student performance. Discriminant ability of weekly viewing time was assessed with receiver operating characteristic curve analyses.

Results.

At least 40% of the students overestimated their online consumption. Students overestimated their weekly viewing by 63.2%. Weekly viewing time was correlated with percentile class ranks.

Discussion and Conclusion.

Students chronically overestimated online content consumption. Physical therapy faculty should be aware of discrepancies between objective actual and subjective perceived consumption of online content and may consider implementing an open feedback loop relative to actual preparation for the FC since this study also found a positive relationship between weekly viewing time and student performance.
Parametric Covariability in the Standard Model of the Saccadic Main Sequence
Authors: Busettini Claudio , Christy Jennifer Braswell
Published: October 2018

SIGNIFICANCE

Saccades present a direct relationship between the size of the movement (SACSIZE) and its peak velocity (SACPEAK), the main sequence, which is traditionally quantified using the model SACPEAK = V
max × (1 − e
−SACSIZE/SAT). This study shows that V
max and SAT are not veridical indicators of saccadic dynamics.

PURPOSE

Alterations in saccadic dynamics are used as a diagnostic tool. Are the 95% reference ranges (RRs) of V
max and SAT correctly quantifying the variability in saccadic dynamics of a population?

METHODS

Visually driven horizontal and vertical saccades were acquired from 116 normal subjects using the Neuro Kinetics Inc. Concussion Protocol with a 100-Hz I-Portal NOTC Vestibular System, and the main sequence models were computed.

RESULTS

The 95% RRs of V
max, the asymptotic peak velocity, and SAT, the speed of the exponential rise toward V
max, were quite large. The finding of a strong correlation between V
max and SAT suggests that their variability might be, in part, a computational interaction. In fact, the interplay between the two parameters greatly reduced the actual peak velocity variability for saccades less than 15°. This correlation was not strong enough to support the adoption of a one-parameter model, where V
max is estimated from SAT using the regression parameters. We also evaluated the effects of interpolating the position data to a simulated acquisition rate of 1 kHz. Interpolation had no effect on the population average of V
max and brought a decrease of the average SAT by roughly 8%.

CONCLUSIONS

The 95% RRs of V
max and SAT, treated as independent entities, are not a veridical representation of the variability in saccadic dynamics inside a population, especially for small saccades. We introduce a novel three-step method to determine if a data set is inside or outside a reference population that takes into account the correlation between V
max and SAT.
Case Series: Bilateral Homonymous Visual Field Defects Due to Bilateral Ischemic Strokes
Authors: Papageorgiou Eleni , Anthis Nikolaos , Stathi Theodora , Tsironi Evangelia , Asproudis Ioannis
Published: October 2018

SIGNIFICANCE

Bilateral strokes are rare and should be considered when patients present with bilateral visual field loss characterized by patterns consistent with right and left-sided homonymous visual field defects. Perimetry, dilated funduscopy, and immediate neuroimaging are mandatory for diagnosis, because patients may present with vague symptoms. These cases reflect the retinotopic features of the striate cortex.

PURPOSE

The purposes of this study were to describe the unusual presentation of bilateral homonymous visual field defects in three patients with bilateral ischemic strokes and to discuss the clinical and neuroanatomical correlations.

CASE REPORTS

Neuro-ophthalmological examination including perimetry and brain magnetic resonance imaging (MRI) was performed in three patients with bilateral homonymous scotomas. Two of three patients presented with superior altitudinal hemianopia, resulting from right and left homonymous superior quadrantanopia due to bilateral occipital strokes below the calcarine fissure. A 57-year-old man (patient 1) with a history of atrial fibrillation presented with driving difficulties. Perimetry revealed bilateral superior altitudinal hemianopia. Brain MRI demonstrated a subacute right occipital stroke and a chronic left occipital stroke, both inferior to the calcarine fissure. An 83-year-old woman (patient 2) presented with reading disorders. Perimetry showed a left incomplete homonymous hemianopia and a right horizontal wedge-shaped homonymous scotoma. Brain MRI showed a chronic ischemic stroke in the left occipital lobe and acute ischemia in the right thalamus. A 40-year-old man (patient 3) was referred with headache, disorientation, and bilateral blurry vision. Perimetry showed bilateral superior altitudinal hemianopia, and MRI demonstrated acute bilateral occipital ischemia. Patients 1 and 2 suffered sequential bilateral strokes and were not aware of the initial scotoma, whereas patient 3 presented with bilateral concurrent strokes.

CONCLUSIONS

Bilateral homonymous visual field defects due to bilateral strokes are rare. Patient history, a careful neuro-ophthalmological examination, and correlation of visual field defect patterns with neuroimaging should prompt the clinician to the presence of this unique entity.
Unwanted Astigmatism and High-order Aberrations One Year after Excimer and Femtosecond Corneal Surgery
Authors: Bohac Maja , Koncarevic Mateja , Dukic Adrijana , Biscevic Alma , Cerovic Vesna , Merlak Maja , Gabric Nikica , Patel Sudi
Published: October 2018

SIGNIFICANCE

Small incision lenticule extraction (SMILE) is advanced as the most minimally invasive and least traumatic corneal procedure for correcting refractive errors using a single laser. Although SMILE obtains similar results to femtosecond laser in situ keratomileusis (LASIK) with spherical myopia, it has deficiencies in astigmatism correction.

PURPOSE

The purpose of this study was to compare refractive outcomes and high-order aberrations (HOAs) between SMILE and femtosecond LASIK corneal procedures at 1 year post-operative.

METHODS

Ninety-two patients (181 eyes) with myopia/myopic astigmatism underwent either SMILE (group 1) or femtosecond LASIK (group 2). The refractive target was to achieve emmetropia in all cases. Data were analyzed to determine significance of change in refraction and HOAs. Furthermore, astigmatism was subjected to vector analysis using the Thibos (calculation of change, Δ, in J
0 and J
45 values) and Alpins (calculation of difference, ΔC, between target-induced astigmatism [TIA] and surgically induced astigmatism) methods.

RESULTS

Forty-five patients (89 eyes) from group 1 and 47 patients (92 eyes) from group 2 completed the study. The main significant (P ≤ .001) findings were as follows: (a) residual astigmatism was greater in group 1; (b) group 1, ΔJ
0 = 1.015J
0 + 0.040 (R = 0.861), ΔJ
45 = 1.082J
45 + 0.019 (R = 0.792), ΔC = 0.401TIA + 0.323 (R = 0.489), and mean spherical aberration increased from −0.003 (SD, ±0.059; 95% confidence interval [CI], −0.015 to 0.009) to 0.028 μm (SD, ±0.041; 95% CI, −0.037 to −0.020); and (c) group 2, ΔJ
0 = 0.952J
0 − 0.005 (R = 0.921), ΔJ
45 = 0.962J
45 − 0.002 (R = 0.923), ΔC = 0.187TIA + 0.101 (R = 0.272), mean coma reduced from 0.114 (SD, ±0.087; 95% CI, 0.096 to 0.132) to 0.077 μm (SD, ±0.059; 95% CI, 0.065 to 0.089), and trefoil from 0.089 (SD, ±0.049; 95% CI, 0.079 to 0.0990) to 0.056 μm (SD, ±0.047; 95% CI, 0.046 to 0.066).

CONCLUSIONS

In comparison with SMILE, femtosecond LASIK offered better precision in the overall control of astigmatism and HOAs.
The Area under the Main Sequence as an Alternative Method to Measure Saccadic Dynamics
Authors: Busettini Claudio , Braswell Christy Jennifer
Published: October 2018

SIGNIFICANCE

This study shows that the area under the main sequence (MSAREA) is a valid alternative to the standard peak-velocity main sequence in measuring saccadic dynamics. A one-parameter area model, MSAREA = G
PW = 1.55 × SACSIZE1.55, with SACSIZE as the size of the saccade, 1.55 as a power factor, and G
PW = 1.55 as a gain parameter, is presented.

PURPOSE

SACPEAK = V
max × (1 − e
−SACSIZE/SAT) is the traditional model used to describe the saccadic main sequence, the relationship between the size of the movement and its peak velocity (SACPEAK). In the previous article, we have shown that there is a strong linear correlation between the two parameters V
max and SAT, which severely affects the model's clinical applicability. The purpose of this study is to see if, by using the MSAREA as an alternative approach, we can overcome the limitations of the traditional model.

METHODS

Participants and main sequence data are the same as the previous study. A trapezoidal integration was used to estimate the MSAREAs as a function of SACSIZE.

RESULTS

A two-parameter area model was computed to determine the range of variability of its parameters and R
2 values. These were then used as reference values in the search for one-parameter alternatives. The one-parameter model MSAREA = G
PW = 1.55 × SACSIZE1.55 performed well for all data sets. We tested its validity by performing a comparison with other one-parameter area models.

CONCLUSIONS

Area models are superior to peak-velocity models in terms of R
2 and stability and can be reduced to robust one-parameter expressions with only limited degradation in R
2. This not only greatly simplifies the determination if a set is inside or outside a reference population but also allows for direct comparisons between sets, with the saccadic dynamics expressed by a simple linear gain factor (G
PW = 1.55).
Mantle Cell Lymphoma of the Lacrimal Gland
Authors: Ana-Magadia Marian Grace , Takahashi Yasuhiro , Valencia Ma. Regina Paula , Kakizaki Hirohiko
Published: October 2018

The authors present 2 female patients of mantle cell lymphoma (MCL) involving the lacrimal gland. The patients include a 75-year-old female and a 59-year-old female. Both patients presented with palpable upper eyelid masses. The first patient was previously diagnosed with gastric and ileocecal MCLs and underwent chemotherapy with remission. The second patient had distant lesions in the muscular limbs that were confirmed to be MCL after the diagnosis of lacrimal gland MCL. Both patients underwent chemotherapy with complete remission.
Preference and Perception of Enhanced Images During Endonasal Endoscopic Surgery
Authors: Mulazimoglu Selcuk , Anadolu Yucel , Beton Suha , Basak Hazan , Yorulmaz Irfan , Meco Cem
Published: October 2018

Image enhancement is used widely in endoscopic sinonasal surgery. It is yet to be established whether image enhancement has advantages over white-light endoscopy. The authors aimed to evaluate the preferences and subjective visual perception of image enhancement in diagnostic images acquired at the beginning of endonasal endoscopic surgeries. An online survey consisting of 12 endoscopic images, 4 enhanced with Clara mode, 4 enhanced with Chroma mode, and 4 enhanced with Clara+Chroma mode, was distributed. The enhanced images were randomly presented with nonenhanced white-light images. These images were captured at the beginning of endonasal endoscopic surgeries for septal perforation, septal deviation, and chronic rhinosinusitis. Survey respondents (n = 205) included 81 otorhinolaryngologists, 94 other specialty physicians (35 endoscopy/laparoscopy users and 59 nonusers), and 30 nonmedical image experts. They were asked to choose superior images according to brightness, contrast and sharpness, depth of field, and overall preference. A quantitative study was also conducted to evaluate different enhancement modes. The authors found that Clara enhanced brightness and Chroma enhanced contrast and sharpness significantly (P < 0.001). Overall, 91.8% chose Clara and 91.7% chose Clara+Chroma-enhanced images for brightness enhancement. For contrast and sharpness, 87% chose Clara+Chroma and 86.7% chose Chroma. There was no significant difference between perception scores among the groups. Our survey group showed a significantly high overall preference for enhanced images. This preference was independent of profession or experience, but closely related to the quantitative enhancement of the specific mode. Continuous use of image enhancement in endonasal surgery may have advantages over white-light endoscopy.
Genial Tubercle Fracture
Authors: Sasaki Ryo , Okamoto Toshihiro , Sangu Noriko , Watanabe Yorikatsu , Ando Tomohiro
Published: October 2018

Genial tubercle fracture is a rare mandibular fracture. It is classified into 2 different types based on the mechanism of injury, including type I, associated with an atrophied edentulous mandible or denture, and type II, associated with mandibular fracture. Although type I usually can be treated by only observation, type II may cause obstruction of the pharyngeal airway due to hematoma and edema of the floor of the mouth. In this report, genial tubercle fracture associated with mandibular fracture caused by a traffic accident was reported. Reconstructed 3-dimensional images of the pharyngeal airway indicated that there was almost no airway space around the intratracheal tube at the naso- and oropharynx.
Early Initiation of Continuous Renal Replacement Therapy Induces Fast Hypothermia and Improves Post-Cardiac Arrest Syndrome in a Porcine Model
Authors: Xu Jiefeng , Chen Qijiang , Jin Xiaohong , Wu Chunshuang , Li Zilong , Zhou Guangju , Xu Yongan , Qian Anyu , Li Yulin , Zhang Mao
Published: October 2018

Rapid induction of hypothermia early after resuscitation can be an effective strategy against post-cardiac arrest syndrome (PCAS). Preliminary data suggested that continuous renal replacement therapy (CRRT) might be an efficient method to rapidly induce hypothermia. In this study, we investigated the efficacy of cooling induced by CRRT and its effects on the outcomes of PCAS in a porcine model.

Thirty-two male domestic pigs weighing 36 ± 2 kg were randomized into 4 groups: sham control (n = 5), normothermia (n = 9), surface cooling (SC, n = 9), and CRRT (n = 9). Sham animals underwent the surgical preparation only. The animal model was established by 8 min of untreated ventricular fibrillation and then 5 min of cardiopulmonary resuscitation. At 5 min after resuscitation, the animals were cooled by either the combination of an earlier 8-h CRRT and later 16-h SC or the whole 24-h SC in the 2 hypothermic groups. For the other 2 groups, a normal temperature of 38.0 ± 0.5°C was maintained throughout the experiment.

Blood temperature was decreased to 33°C within 28 min in animals treated with CRRT, which was significantly faster than that in the SC group requiring 185 min to achieve target temperature. Post-resuscitation myocardial dysfunction, brain injury, and systemic inflammation were significantly improved in the 2 hypothermic groups compared to the normothermia group. However, the improvement was significantly greater in the CRRT group than in the SC group.

In conclusion, fast hypothermia was successfully induced by CRRT and significantly alleviated the severity of PCAS in a porcine model.
Informative for Decision Making? The Spectrum and Consistency of Outcomes After Living Kidney Donation Reported in Trials and Observational Studies
Authors: Hanson Camilla S. , Sautenet Benedicte , Craig Jonathan C. , Chapman Jeremy R. , Knoll Greg , Reese Peter P. , Tong Allison
Published: October 2018

Background

Evidence about outcomes after living kidney donation is needed both to inform donor acceptance criteria, and to guide the decisions of potential donors and their healthcare providers about donation. However, the scope and heterogeneity of outcomes reported in research and their relevance to decision making is uncertain. To determine the spectrum and consistency of outcomes reported in randomized trials and observational studies in living kidney donors 18 years or older.

Methods

Electronic databases were searched for randomized trials and observational studies reporting outcomes in adult living kidney donors published from January 2011 to May 2017. All outcome domains and measurements were extracted, and their frequency and characteristics were evaluated.

Results

Of the 268 eligible studies, 14 (5%) were randomized and 254 (95%) observational. Overall, 136 (51%) studies were short-term (≤1 year follow up) and reported 109 outcome domains, of which 51 (47%) were classified as clinical, 35 (32%) were surrogate, and 23 (21%) were donor-reported. The 5 most commonly reported domains were kidney function (154, 58%), time to discharge (96, 36%), blood loss (85, 32%), operative time (79, 30%) and blood pressure (74, 28%). Quality of life (13%), mortality (16%), end-stage kidney disease (10%) and cardiovascular events (9%) were reported infrequently.

Conclusions

The outcomes of living kidney donation reported in contemporary trials and observational studies are numerous, heterogeneous, and often focused on short-term surgical complications. Consistent reporting of outcomes relevant to decision making is needed to better inform and prepare donors for outcomes after donation.
Hydrogenotrophic methanogens of the mammalian gut: functionally similar, thermodynamically different - A modelling approach
Authors: Muñoz-Tamayo Rafael , Popova Milka , Tillier Maxence , Morgavi Diego P. , Morel Jean-Pierre , Fonty Gérard , Morel-Desrosiers Nicole
Published: October 2018

Methanogenic archaea occupy a functionally important niche in the gut microbial ecosystem of mammals. Our purpose was to quantitatively characterize the dynamics of methanogenesis by integrating microbiology, thermodynamics and mathematical modelling. For that,in vitrogrowth experiments were performed with pure cultures of key methanogens from the human and ruminant gut, namelyMethanobrevibacter smithii, Methanobrevibacter ruminantiumandMethanobacterium formicium. Microcalorimetric experiments were performed to quantify the methanogenesis heat flux. We constructed an energetic-based mathematical model of methanogenesis. Our model captured efficiently the dynamics of methanogenesis with concordance correlation coefficients of 0.94 for CO2, 0.99 for H2and 0.97 for CH4. Together, experimental data and model enabled us to quantify metabolism kinetics and energetic patterns that were specific and distinct for each species despite their use of analogous methane-producing pathways. Then, we testedin silicothe interactions between these methanogens under anin vivosimulation scenario using a theoretical modelling exercise.In silicosimulations suggest that the classical competitive exclusion principle is inapplicable to gut ecosystems and that kinetic information alone cannot explain gut ecological aspects such as microbial coexistence. We suggest that ecological models of gut ecosystems require the integration of microbial kinetics with nonlinear behaviours related to spatial and temporal variations taking place in mammalian guts. Our work provides novel information on the thermodynamics and dynamics of methanogens. This understanding will be useful to construct new gut models with enhanced prediction capabilities and could have practical applications for promoting gut health in mammals and mitigating ruminant methane emissions.
Nanoscale organization of rotavirus replication machineries
Authors: Garcés Yasel , Martínez José L. , Hernández David T. , Hernández Haydee O. , Méndez Mayra , Wood Christopher D. , Rendón Mancha Juan Manuel , Silva-Ayala Daniela , López Susana , Guerrero Adán , Arias Carlos F.
Published: October 2018

Rotavirus genome replication and assembly take place in cytoplasmic electron dense inclusions termed viro-plasms (VPs). Previous conventional optical microscopy studies observing the intracellular distribution of rotavirus proteins and their organization in VPs have lacked molecular-scale spatial resolution, due to inherent spatial resolution constraints. In this work we employed super-resolution microscopy to reveal the nanometric-scale organization of VPs formed during rotavirus infection, and quantitatively describe the structural organization of seven viral proteins and viral dsRNA within and around the VPs. The observed viral components are spatially organized as 6 concentric layers, in which NSP5 localizes at the center of the VPs, surrounded by a layer of NSP2 and NSP4 proteins, followed by an intermediate zone comprised of the VP1, VP2, VP6 proteins and the dsRNA. In the outermost zone, we observed a ring of VP4 and finally a layer of VP7. These findings show that rotavirus VPs are highly organized organelles.
Nitrogen starvation induces persister cell formation inEscherichia coli
Authors: Brown Daniel R.
Published: October 2018

To cope with fluctuations in their environment bacteria have evolved multiple adaptive stress responses. One such response is the nitrogen regulation stress response, which allows bacteria such asEscherichia colito cope with and overcome conditions of nitrogen limitation. This response is directed by the two-component system NtrBC, where NtrC acts as the major transcriptional regulator to activate the expression of genes to mount the response. Recently we showed that NtrC directly regulates the expression of therelAgene, the major (p)ppGpp synthetase inE. coli, coupling the nitrogen regulation stress and stringent responses. As elevated levels of (p)ppGpp have been implicated in the formation persister cells, here we investigated whether nitrogen starvation promotes their formation and whether the NtrC-RelA regulatory cascade plays a role in this. The results reveal that both nitrogen starvedE. coliform a higher percentage of persister cells than non-starved cells, and that both NtrC and RelA are important for this process. This provides novel insights into how the formation of persisters can be promoted in response to a nutritional stress.

Importance

Bacteria often reside in environments where nutrient availability is scarce and therefore they have evolved adaptive responses to rapidly cope with conditions of feast and famine. Understanding the mechanisms that underpin the regulation of how bacteria cope with this stress is a fundamentally important question in the wider context of understanding the biology of the bacterial cell and bacterial pathogenesis. Two major adaptive mechanisms to cope with starvation are the nitrogen regulation (ntr) stress and stringent responses. Here I describe how these bacterial stress responses are coordinated under conditions of nitrogen starvation to promote the formation of antibiotic tolerant persister cells by elevating levels of the secondary messenger (p)ppGpp.
Ecological niche modeling the potential geographic distribution of fourCulicoidesspecies of veterinary significance in Florida
Authors: Sloyer Kristin E. , Burkett-Cadena Nathan D. , Yang Anni , Corn Joseph L. , Vigil Stacey L. , McGregor Bethany L. , Wisely Samantha M. , Blackburn Jason K.
Published: October 2018

Epizootic hemorrhagic disease (EHD) is a viral arthropod-borne disease affecting wild and domestic ruminants. EHD virus (EHDV) is transmitted to vertebrate animal hosts by biting midges in the genusCulicoides. Culicoides sonorensisLatreille is the only confirmed vector of EHDV in the United States but is considered rare in Florida and not sufficiently abundant to support EHDV transmission. This study used ecological niche modeling to map the potential geographical distributions and associated ecological variable space of fourCulicoidesspecies suspected of transmitting EHDV in Florida, includingCulicoides insignis, Culicoides stellifer, Culicoides debilipalpisandCulicoides venustus.Models were developed with the Genetic Algorithm for Rule Set Production in DesktopGARP v1.1.3 using species occurrence data from field sampling along with environmental variables from WorldClim and Trypanosomiasis and Land use in Africa. For threeCulicoidesspecies (C.insignis, C. stelliferandC. debilipalpis) 96 – 98% of the presence points were predicted across the Florida landscape (63.77% – 72.53%). ForC. venustus, models predicted 98.00% of presence points across 27.42% of Florida. Geographic variations were detected between species.Culicoides insigniswas predicted to be restricted to peninsular Florida, and in contrast,C. venustuswas predicted to be primarily in north Florida and the panhandle region.Culicoides stelliferandC. debilipalpiswere predicted nearly statewide. Environmental conditions also differed by species, with some species’ ranges predicted by more narrow ranges of variables than others. The Normalized Difference Vegetation Index (NDVI) was a major predictor ofC. venustusandC. insignispresence. ForC. stellifer, Land Surface Temperature, Middle Infrared were the most limiting predictors of presence. The limiting variables forC. debilipalpiswere NDVI Bi-Annual Amplitude and NDVI Annual Amplitude at 22.45% and 28.09%, respectively. The model outputs, including maps and environmental variable range predictions generated from these experiments provide an important first pass at predicting species of veterinary importance in Florida. Because EHDV cannot exist in the environment without the vector, model outputs can be used to estimate the potential risk of disease for animal hosts across Florida. Results also provide distribution and habitat information useful for integrated pest management practices.
InteractiveXRDFit: a new tool to simulate and fit X-ray diffractograms of oxide thin films and heterostructures
Authors: Lichtensteiger Céline
Published: October 2018

InteractiveXRDFit is a custom-made MATLAB program that calculates the X-ray diffracted intensity for oxide thin films and heterostructures based on a library of inorganic materials.
Whole powder pattern modelling macros for TOPAS
Authors: Scardi Paolo , Azanza Ricardo Cristy L. , Perez-Demydenko Camilo , Coelho Alan A.
Published: October 2018

Macros implementing the main concepts of the whole powder pattern modelling approach have been written for TOPAS. Size and strain broadening components of the diffraction line profiles can be convolved with the instrumental profile already available among the standard commands of TOPAS. Specific macros are presented with examples of applications including plastically deformed powders and atomistic simulations. A macro is presented for the modelling of surface relaxation effects in spherical nanocrystals.
Direct observation of the ZrIV interaction with the carboxamide bond in a noncovalent complex between Hen Egg White Lysozyme and a Zr-substituted Keggin polyoxometalate
Authors: Vandebroek Laurens , Van Meervelt Luc , Parac-Vogt Tatjana N.
Published: October 2018

The successful cocrystallization of the noncovalent complex formed between (Et2NH2)8[{α-PW11O39Zr-(μ-OH)(H2O)}2]·7H2O Keggin polyoxometalate (2) and Hen Egg White Lysozyme (HEWL) protein is reported. The resulting structural model revealed interaction between monomeric [Zr(PW11O39)]4−(1), which is a postulated catalytically active species, and the protein in two positions in the asymmetric unit. The first position (occupancy 36%) confirms the previously observed binding sites on the protein surface, whereas the second position (occupancy 14%) provides novel insights into the hydrolytic mechanisms of ZrIV-substituted polyoxometalates. The new interaction site occurs at the Asn65 residue, which is directly next to the Asp66–Gly67 peptide bond that was identified recently as a cleavage site in the polyoxometalate-catalysed hydrolysis of HEWL. Furthermore, in this newly discovered binding site, the monomeric polyoxometalate 1 is observed to bind directly to the side chain of the Asn65 residue. This binding of ZrIV as a Lewis-acid metal to the carbonyl O atom of the Asn65 side chain is very similar to the intermediate state proposed in density functional theory (DFT) studies in which ZrIV activates the peptide bond via interaction with its carbonyl O atom, and can be thus regarded as a model for interaction between ZrIV and a peptide bond.
Synthesis and characterization of carbonate-encapsulated ytterbium- and yttrium-containing polyoxotungstates
Authors: Kaushik Reetam , Khan Imran , Saini Mukesh Kumar , Hussain Firasat , Sadakane Masahiro
Published: October 2018

A sandwiched-type carbonate-encapsulated yttrium-containing arsenotungstate(III) has been synthesized under mild reaction conditions. The polyanion [NaCH3COO{Y2(H2O)3(B-α-AsW9O33)2(W2O5)(CO3)}]12− (1) was isolated as a solid crystalline material by the reaction of a YIII salt with the sodium salt of trilacunary [AsW9O33]9− in sodium acetate solution. The sodium salt of the polyanion, i.e. Na12[Na(CH3COO){Y2(AsW9O33)2(W2O5)(CO3)(H3O)3}]·22H2O (1a), was characterized by various analytical techniques, such as FT–IR, single-crystal X-ray diffraction (SC–XRD), TGA (thermogravimetric analysis), 13C NMR and ESI–MS (electrospray ionization mass spectrometry). SC–XRD studies revealed that the polyanion crystallizes in the triclinic space group P\overline{1}. The structure showed that the polyanion is a carbonate-encapsulated sandwich-type species, consisting of two trilacunary B-α-[AsW9O33]9−, with a lone-pair-containing AsIII heteroatom, together with two extra tungsten centres and two yttrium cations at the sandwich position, where CH3COO− and Na+ ions act as linkers between the two polyanion units. In addition, we have also synthesized two carbonate-encapsulated germanotungstates(IV), without lone-pair-containing heteroatoms, with the formula [Ln3(A-β-GeW9O34)2(CO3)(H2O)3]13− [Ln = YIII (2) and YbIII (3)], i.e. Y2K3Na4[Y3(A-β-GeW9O34)2(CO3)(H2O)3]·19H2O (2a) and YbK8Na2[Yb(A-β-GeW9O34)2(CO3)(H2O)3]·16H2O (3a), and characterized them by FT–IR, SC–XRD, TGA and ESI–MS. Here, the lanthanide ions act as linkers, extending the structures into higher dimensions. Sodium and potassium ions also play a key role as linkers, further extending the structure. The packing shows the presence of certain hydrophilic pores within the structure.
Recent advances in isopolyoxotungstates and their derivatives
Authors: Liu Ya-Jie , Jin Meng-Tian , Chen Li-Juan , Zhao Jun-Wei
Published: October 2018

During the past decade, isopolyoxotungstates (iso-POTs) and their derivatives have been greatly developed due to their unique structures and potential applications in luminescence, magnetism, catalysis etc. This brief review is principally focused on the main research progress on iso-POTs, iso-POT-based transition-metal derivatives, iso-POT-based rare-earth derivatives, iso-POT-based organometallic derivatives and iso-POT-based heterometallic derivatives, and gives a summary of some representative examples of their syntheses, structures and related properties. In addition, an outlook on the future of this area is presented in the final section. We believe that this systematic commentary on iso-POTs and their derivatives will not only disclose a rich set of iso-POT structures, but also reveal a more promising direction for the further functionalization of iso-POTs.