bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of kinetics of protein folding with non-redundant contact information
Authors: Censoni Luciano , Martínez Leandro
Published: June 2018

Motivation

The majority of the inter-residue distances in a protein structure are correlated given a fixed topology. Here, we investigate whether we are able to predict a structure’s folding rate, which is known to depend on the complexity of its fold, while considering only a small, uncorrelated fraction of its contacts.

Results

We define an expression for the probabilistic information content associated to the relative position of a pair of amino acid residues in a protein structure. By means of fitting the protein chain to a self-avoiding random walk model, we derive a probability distribution for the distance between residues as a function of their separation along the sequence. We then show that the average information content for all residue pairs in a structure, considered as an estimate of its fold’s complexity, is well correlated to the logarithm of its folding rate. Moreover, the same information content measure may be exploited to rank contacts and identify redundancies, allowing the prediction the structure’s folding rate with similar accuracy while taking into account less than 5% of its contacts.

Availability and implementation

An implementation of the described model and the experimental data are available at http://github.com/luciano-censoni/sarw-lnkf.
Life After Exile: Former Catholic Émigrés and the Legacy of Flight in Marian England
Authors: Smith Frederick E
Published: June 2018

Over the last twenty years, a wealth of studies on early modern exile movements across Europe have emphasised the many problems experienced by émigrés, in particular when justifying their flight in the eyes of their compatriots back home. However, most of these studies see such difficulties coming to an end upon the return of émigrés to their native lands. Homecoming exiles were supposedly treated as quasi-martyrs for the faith and lauded as heroes. Taking as its case-study those English Catholic émigrés from the reigns of Henry VIII and Edward VI who returned home following Mary I’s accession, this article challenges the idea that the difficulties of dislocation ended abruptly upon repatriation. It shows that, while on the face of it they were awarded unparalleled levels of patronage for their sacrifices for the faith, being appointed to positions of power and influence within the Marian Church and state, former émigrés continued to grapple with the baggage of exile status long after they set foot on English soil. In this way, this study not only highlights the need to reconsider some recent assessments of the success of the Marian Counter-Reformation, but, more broadly, it suggests that prevailing narratives regarding the heroic homecomings of early modern exiles may be the legacy of the exiles’ own attempts to mitigate the lingering difficulties of dislocation.
Prayer and Faith: Spiritual Coping among American Indian Women Cancer Survivors
Authors: Roh Soonhee , Burnette Catherine E , Lee Yeon-Shim
Published: June 2018

Although cancer disparities among American Indian (AI) women are alarming, research on spiritual coping among this population is virtually nonexistent. This is particularly problematic, given the importance of medical practitioners’ discussing the topic with cancer patients, along with the centrality of spirituality to many AI patients. The purpose of this article was to explore AI women cancer survivors’ spiritual coping with their experiences. Using a community-based participatory research approach, this qualitative descriptive study included a sample of 43 AI women cancer survivors (n = 14 breast cancer, n = 14 cervical cancer, and n = 15 colon and other types of cancer). Qualitative content analysis revealed that most participants (76 percent, n = 32) cited prayer as an important part of their cancer recovery and coping strategies. Many participants expressed how prayer and spirituality connected them to family, to faith communities, and to others. In addition to prayer, over a third (36 percent, n = 15) of participants emphasized faith as a recovery and coping strategy. Results indicate that most women drew great comfort, strength, hope, and relief from their spiritual and faith traditions, indicating that religious and spiritual practices may be an important protective factor against the strain of the cancer experience.
Feeding plasticity more than metabolic rate drives the productivity of economically important filter feeders in response to elevated CO2 and reduced salinity
Authors: Rastrick Samuel P S , Collier Victoria , Graham Helen , Strohmeier Tore , Whiteley Nia M , Strand Øivind
Published: June 2018

Climate change driven alterations in salinity and carbonate chemistry are predicted to have significant implications particularly for northern costal organisms, including the economically important filter feeders Mytilus edulis and Ciona intestinalis. However, despite a growing number of studies investigating the biological effects of multiple environmental stressors, the combined effects of elevated pCO2 and reduced salinity remain comparatively understudied. Changes in metabolic costs associated with homeostasis and feeding/digestion in response to environmental stressors may reallocate energy from growth and reproduction, affecting performance. Although these energetic trade-offs in response to changes in routine metabolic rates have been well demonstrated fewer studies have investigated how these are affected by changes in feeding plasticity. Consequently, the present study investigated the combined effects of 26 days’ exposure to elevated pCO2 (500 µatm and 1000 µatm) and reduced salinity (30, 23, and 16) on the energy available for growth and performance (Scope for Growth) in M. edulis and C. intestinalis, and the role of metabolic rate (oxygen uptake) and feeding plasticity [clearance rate (CR) and absorption efficiency] in this process. In M. edulis exposure to elevated pCO2 resulted in a 50% reduction in Scope for Growth. However, elevated pCO2 had a much greater effect on C. intestinalis, with more than a 70% reduction in Scope for Growth. In M. edulis negative responses to elevated pCO2 are also unlikely be further affected by changes in salinity between 16 and 30. Whereas, under future predicted levels of pCO2C. intestinalis showed 100% mortality at a salinity of 16, and a >90% decrease in Scope for Growth with reduced biomass at a salinity of 23. Importantly, this work demonstrates energy available for production is more dependent on feeding plasticity, i.e. the ability to regulate CR and absorption efficiency, in response to multiple stressors than on more commonly studied changes in metabolic rates.
Dirac Induction for Rational Cherednik Algebras
Authors: Ciubotaru Dan , De Martino Marcelo
Published: June 2018

We introduce the local and global indices of Dirac operators for the rational Cherednik algebra $\mathsf{H}_{t,c}(G,\mathfrak{h})$, where $G$ is a complex reflection group acting on a finite-dimensional vector space $\mathfrak{h}$. We investigate precise relations between the (local) Dirac index of a simple module in the category $\mathcal{O}$ of $\mathsf{H}_{t,c}(G,\mathfrak{h})$, the graded $G$-character of the module, the Euler–Poincaré pairing, and the composition series polynomials for standard modules. In the global theory, we introduce integral-reflection modules for $\mathsf{H}_{t,c}(G,\mathfrak{h})$ constructed from finite-dimensional $G$-modules. We define and compute the index of a Dirac operator on the integral-reflection module and show that the index is, in a sense, independent of the parameter function $c$. The study of the kernel of these global Dirac operators leads naturally to a notion of dualised generalised Dunkl–Opdam operators.
Activation of Peripheral T Follicular Helper Cells During Acute Dengue Virus Infection
Authors: Haltaufderhyde Kirk , Srikiatkhachorn Anon , Green Sharone , Macareo Louis , Park Sangshin , Kalayanarooj Siripen , Rothman Alan L , Mathew Anuja
Published: June 2018

We investigated the immune response of peripheral T follicular helper cells during acute dengue virus infection in Thai children. We report significant associations between peripheral T follicular helper cell activation and plasmablast activation, secondary infection, and disease.
Providers’ assessment of a novel interactive health information technology in a pediatric intensive care unit
Authors: Asan Onur , Holden Richard J , Flynn Kathryn E , Murkowski Kathy , Scanlon Matthew C
Published: June 2018

Objective

To explore perceptions of critical care providers about a novel collaborative inpatient health information technology (HIT) in a pediatric intensive care unit (PICU) setting.

Methods

This cross-sectional, concurrent mixed methods study was conducted in the PICU of a large midwestern children’s hospital. The technology, the Large Customizable Interactive Monitor (LCIM), is a flat panel touch screen monitor that displays validated patient information from the electronic health record. It does not require a password to login and is available in each patient’s room for viewing and interactive use by physicians, nurses, and families. Quantitative data were collected via self-administered, standardized surveys, and qualitative data via in-person, semistructured interviews between January and April 2015. Data were analyzed using descriptive statistics and inductive thematic analysis.

Results

The qualitative analysis showed positive impacts of the LCIM on providers’ workflow, team interactions, and interactions with families. Providers reported concerns regarding perceived patient information overload and associated anxiety and burden for families. Sixty percent of providers thought that LCIM was useful for their jobs at different levels, and almost 70% of providers reported that LCIM improved information sharing and communication with families. The average overall satisfaction score was 3.4 on a 0 to 6 scale, between “a moderate amount” and “pretty much.”

Discussion and Conclusion

This study provides new insight into collaborative HIT in the inpatient pediatric setting and demonstrates that using such technology has the potential to improve providers’ experiences with families and just-in-time access to EHR information in a format more easily shared with families.
Oral Contraceptive Use and Breast Cancer Risk: Retrospective and Prospective Analyses From a BRCA1 and BRCA2 Mutation Carrier Cohort Study
Authors: Schrijver Lieske H , Olsson Håkan , Phillips Kelly-Anne , Terry Mary Beth , Goldgar David E , Kast Karin , Engel Christoph , Mooij Thea M , Adlard Julian , Barrowdale Daniel , Davidson Rosemarie , Eeles Ros , Ellis Steve , Evans D Gareth , Frost Debra , Izatt Louise , Porteous Mary E , Side Lucy E , Walker Lisa , Berthet Pascaline , Bonadona Valérie , Leroux Dominique , Mouret-Fourme Emmanuelle , Venat-Bouvet Laurence , Buys Saundra S , Southey Melissa C , John Esther M , Chung Wendy K , Daly Mary B , Bane Anita , van Asperen Christi J , Gómez Garcia Encarna B , Mourits Marian J E , van Os Theo A M , Roos-Blom Marie-José , Friedlander Michael L , McLachlan Sue-Anne , Singer Christian F , Tan Yen Y , Foretova Lenka , Navratilova Marie , Gerdes Anne-Marie , Caldes Trinidad , Simard Jacques , Olah Edith , Jakubowska Anna , Arver Brita , Osorio Ana , Noguès Catherine , Andrieu Nadine , Easton Douglas F , van Leeuwen Flora E , Hopper John L , Milne Roger L , Antoniou Antonis C , Rookus Matti A ,   EMBRACE, GENEPSO, BCFR, HEBON, kConFab, and IBCCS
Published: June 2018

Background

For BRCA1 and BRCA2 mutation carriers, the association between oral contraceptive preparation (OCP) use and breast cancer (BC) risk is still unclear.

Methods

Breast camcer risk associations were estimated from OCP data on 6030 BRCA1 and 3809 BRCA2 mutation carriers using age-dependent Cox regression, stratified by study and birth cohort. Prospective, left-truncated retrospective and full-cohort retrospective analyses were performed.

Results

For BRCA1 mutation carriers, OCP use was not associated with BC risk in prospective analyses (hazard ratio [HR] = 1.08, 95% confidence interval [CI] = 0.75 to 1.56), but in the left-truncated and full-cohort retrospective analyses, risks were increased by 26% (95% CI = 6% to 51%) and 39% (95% CI = 23% to 58%), respectively. For BRCA2 mutation carriers, OCP use was associated with BC risk in prospective analyses (HR = 1.75, 95% CI = 1.03 to 2.97), but retrospective analyses were inconsistent (left-truncated: HR = 1.06, 95% CI = 0.85 to 1.33; full cohort: HR = 1.52, 95% CI = 1.28 to 1.81). There was evidence of increasing risk with duration of use, especially before the first full-term pregnancy (BRCA1: both retrospective analyses, P < .001 and P = .001, respectively; BRCA2: full retrospective analysis, P = .002).

Conclusions

Prospective analyses did not show that past use of OCP is associated with an increased BC risk for BRCA1 mutation carriers in young middle-aged women (40–50 years). For BRCA2 mutation carriers, a causal association is also not likely at those ages. Findings between retrospective and prospective analyses were inconsistent and could be due to survival bias or a true association for younger women who were underrepresented in the prospective cohort. Given the uncertain safety of long-term OCP use for BRCA1/2 mutation carriers, indications other than contraception should be avoided and nonhormonal contraceptive methods should be discussed.
Glycosuria amount in response to hyperglycaemia and risk for diabetic kidney disease and related events in Type 1 diabetic patients
Authors: Carpentier Charlyne , Dubois Séverine , Mohammedi Kamel , Belhatem Narimène , Bouhanick Béatrice , Rohmer Vincent , Briet Claire , Bumbu Anisoara , Hadjadj Samy , Roussel Ronan , Potier Louis , Velho Gilberto , Marre Michel
Published: June 2018

Background

Hyperglycaemia impairs tubulo-glomerular feedback. We tested whether variable tubulo-glomerular feedback during hyperglycaemia contributes to renal risk heterogeneity seen in Type 1 diabetes.

Methods

During the period 1990–92, we studied the tubulo-glomerular feedback in Type 1 diabetic patients at high or low renal risk [21 of 54 with glomerular hyperfiltration and/or microalbuminuria against 11 of 55 with normal glomerular filtration rate (GFR) and urinary albumin despite uncontrolled diabetes]. The GFR, effective renal plasma flow, mean arterial pressure and fractional reabsorptions of glucose, osmols, sodium and lithium were measured sequentially during normo- and hyperglycaemia. All patients were followed up until 2016 for incident proteinuria, estimated GFR <60 mL/min/1.73 m2, doubling of serum creatinine, end-stage renal disease or all-cause death.

Results

Glycaemia increased from 6.1 ± 1.3 to 15.1 ± 1.9 mmol/L in both high-risk and low-risk patients. Glycosuria was lower in the high- versus low-risk patients: 0.34 ± 0.25 versus 0.64 ± 0.44 mmol/min (P = 0.03). Both groups displayed similar kidney function during normoglycaemia. Hyperglycaemia increased more importantly GFR and fractional reabsorptions, and pre-glomerular vasodilatation in the high- than in the low-risk patients (all P < 0.05). Over 21 years, 31.5% high- versus 12.7% low-risk patients developed endpoints (adjusted P = 0.006). In a multi-adjusted survival analysis of patients having undergone renal tests, each 0.10 mmol/min glycosuria during hyperglycaemia reduced the outcome risk by 0.72 (95% confidence interval 0.49–0.97, P = 0.03).

Conclusions

Reduced tubulo-glomerular feedback and glycosuria during hyperglycaemia indicate high renal risk for Type 1 diabetic patients. Inter-individual variability in tubulo-glomerular feedback activity determines renal risk in Type 1 diabetes.
Intraoperative Assessment of Cortical Perfusion After Intracranial-To-Intracranial and Extracranial-To-Intracranial Bypass for Complex Cerebral Aneurysms Using Flow 800
Authors: Rennert Robert C , Strickland Ben A , Ravina Kristine , Bakhsheshian Joshua , Fredrickson Vance , Carey Joseph , Russin Jonathan J
Published: June 2018

BACKGROUND

Revascularization strategies for complex cerebral aneurysms are largely based on subjective interpretation of flow demands, or indirect measures of perfusion in at-risk territories. Indocyanine Green -based flow analyses ((ICG-BFA); Flow 800, Carl Zeiss, Oberkochen, Germany) provide a real-time, semiquantitative measure of intraoperative cortical perfusion during cerebral bypass surgery for complex aneurysms.

OBJECTIVE

To determine the utility of intraoperative ICG-BFA for assessing cortical perfusion in at-risk territories during cerebral bypass for complex aneurysms requiring vessel sacrifice.

METHODS

Retrospective analysis of consecutive patients from a prospective, single-institution open cerebrovascular database.

RESULTS

Intraoperative ICG-BFA confirmed adequate cortical perfusion in 2 patients with fusiform posterior circulation aneurysms, treated with a posterior inferior cerebellar artery (PICA)-PICA and occipital artery (OA)-to-third segment of the posterior cerebral artery (P3) bypass with proximal vessel sacrifice, respectively. ICG-BFA was used in a third patient that underwent clip reconstruction/ intracranial-to-intracranial bypass for a large middle cerebral artery (MCA) bifurcation aneurysm requiring sacrifice of the temporal M2 branch. In this case, a frontal M3 to temporal M3 side-to-side anastomosis was created to arborize the MCA tree and allow filling of both M2 territories through a single M2 branch. After aneurysm reconstruction, ICG-BFA identified an inadvertent occlusion of the frontal M2 that left the entire MCA distribution reliant on collateral flow but did not cause a neuromonitoring change. Repeat ICG-BFA after clip re-arrangement demonstrated aneurysm occlusion and equal flow in both frontal and temporal MCA cortical distributions from the arborization.

CONCLUSION

ICG-BFA is a useful adjunct for intraoperative cortical flow assessment during cerebral revascularization for complex aneurysms requiring vessel sacrifice.
Meta-Analysis of the Effects of QoI and DMI Fungicide Combinations on Fusarium Head Blight and Deoxynivalenol in Wheat
Authors: Paul P. A. , Bradley C. A. , Madden L. V. , Lana F. Dalla , Bergstrom G. C. , Dill-Macky R. , Esker P. D. , Wise K. A. , McMullen M. , Grybauskas A. , Kirk W. W. , Milus E. , Ruden K.
Published: June 2018

Field trials were conducted in 17 U.S. states to evaluate the effects of quinone outside inhibitor (QoI) and demethylation inhibitor (DMI) fungicide programs on Fusarium head blight index (IND) and deoxynivalenol (DON) toxin in wheat. Four DMI-only treatments applied at Feekes 10.5.1, five QoI-only treatments applied between Feekes 9 or Feekes 10.5, three QoI+DMI mixtures applied at Feekes 10.5, and three treatments consisting of a QoI at Feekes 9 followed by a DMI at Feekes 10.5.1 were evaluated. Network meta-analytical models were fitted to log-transformed mean IND and DON data and estimated contrasts of log means were used to obtain estimates of mean percent controls relative to the nontreated check as measures of efficacy. Results from the meta-analyses were also used to assess the risk of DON increase in future trials. DMI at Feekes 10.5.1 were the most effective programs against IND and DON and the least likely to increase DON in future trials. QoI-only programs increased mean DON over the nontreated checks and were the most likely to do so in future trials, particularly when applied at Feekes 10.5. The effects of QoI+DMI combinations depended on the active ingredients and whether the two were applied as a mixture at heading or sequentially. Following a Feekes 9 QoI application with a Feekes 10.5.1 application of a DMI reduced the negative effect of the QoI on DON but was not sufficient to achieve the efficacy of the Feekes 10.5.1 DMI-only treatments. Our results suggest that one must be prudent when using QoI treatments under moderate to high risk of FHB, particularly where the QoI is used without an effective DMI applied in combination or in sequence.
Biological and Genomic Characterization of a Novel Tobamovirus Infecting Hoya spp.
Authors: Adkins Scott , D’Elia Tom , Fillmer Kornelia , Pongam Patchara , Baker Carlye A.
Published: June 2018

Foliar symptoms suggestive of virus infection were observed on the ornamental plant hoya (Hoya spp.; commonly known as waxflower) in Florida. An agent that reacted with commercially available tobamovirus detection reagents was mechanically transmitted to Chenopodium quinoa and Nicotiana benthamiana. Rod-shaped particles ∼300 nm in length and typical of tobamoviruses were observed in partially purified virion preparations by electron microscopy. An experimental host range was determined by mechanical inoculation with virions, and systemic infections were observed in plants in the Asclepiadaceae, Apocynaceae, and Solanaceae families. Some species in the Solanaceae and Chenopodiaceae families allowed virus replication only in inoculated leaves, and were thus only local hosts for the virus. Tested plants in the Amaranthaceae, Apiaceae, Brassicaceae, Cucurbitaceae, Fabaceae, and Malvaceae did not support either local or systemic virus infection. The complete genome for the virus was sequenced and shown to have a typical tobamovirus organization. Comparisons of genome nucleotide sequence and individual gene deduced amino acid sequences indicate that it is a novel tobamovirus sharing the highest level of sequence identity with Streptocarpus flower break virus and members of the Brassicaceae-infecting subgroup of tobamoviruses. The virus, for which the name Hoya chlorotic spot virus (HoCSV) is proposed, was detected in multiple hoya plants from different locations in Florida.
Nanostructure of DNA repair foci revealed by superresolution microscopy
Authors: Sisario Dmitri , Memmel Simon , Doose Sören , Neubauer Julia , Zimmermann Heiko , Flentje Michael , Djuzenova Cholpon S. , Sauer Markus , Sukhorukov Vladimir L.
Published: June 2018

Induction of DNA double‐strand breaks (DSBs) by ionizing radiation leads to formation of micrometersized DNA‐repair foci, whose organization on the nanometer‐scale remains unknown because of the diffraction limit (~200 nm) of conventional microscopy. Here, we applied diffraction‐unlimited, direct stochastic optical‐reconstruction microscopy (dSTORM) with a lateral resolution of ~20 nm to analyze the focal nanostructure of the DSB marker histone γH2AX and the DNA‐repair protein kinase (DNA‐PK) in irradiated glioblastoma multiforme cells. Although standard confocal microscopy revealed substantial colocalization of immunostained γH2AX and DNA‐PK, in our dSTORM images, the 2 proteins showed very little (if any) colocalization despite their close spatial proximity. We also found that γH2AX foci consisted of distinct circular subunits (“nanofoci”) with a diameter of ~45 nm, whereas DNA‐PK displayed a diffuse, intrafocal distribution. We conclude that γH2AX nanofoci represent the elementary, structural units of DSB repair foci, that is, individual γH2AX‐containing nucleosomes. dSTORM‐based γH2AX nanofoci counting and distance measurements between nanofoci provided quantitative information on the total amount of chromatin involved in DSB repair as well as on the number and longitudinal distribution of γH2AX‐containing nucleosomes in a chromatin fiber. We thus estimate that a single focus involves between ~0.6 and ~1.1Mbp of chromatin, depending on radiation treatment. Because of their ability to unravel the nanostructure of DSB‐repair foci, dSTORM and related single‐molecule localization nanoscopy methods will likely emerge as powerful tools in biology and medicine to elucidate the effects of DNA damaging agents in cells.—Sisario, D., Memmel, S., Doose, S., Neubauer, J., Zimmermann, H., Flentje, M., Djuzenova, C. S., Sauer, M., Sukhorukov, V. L. Nanostructure of DNA repair foci revealed by superresolution microscopy. FASEB J. 32, 6469–6477 (2018). www.fasebj.org
Identifying and treating traumatic hand and wrist injuries
Authors: Kavin Michelle , Liss Frederic E.
Published: June 2018

Proper identification and management of traumatic hand and wrist injuries is critical to preventing loss of function, nerve damage, joint instability, persistent pain, and delay in indicated surgery. This article uses case studies to help clinicians make accurate diagnoses and treatment plans. Physical examination findings, radiograph results, and treatment plans are reviewed for four traumatic hand and wrist fractures or dislocations.
Arthrodiastasis followed by open reduction associated with pelvic and femoral osteotomies for the treatment of high inveterate congenital hip dislocation
Authors: Gutiérrez Carbonell Pedro
Published: June 2018

Our purpose is to analyze results, following the use of arthrodiastasis for the treatment of inveterate congenital hip dislocations. The study included eight patients. The mean age was 6 years. Three (37.5%) were male patients, and five (62.5%) were female patients. The patients were followed-up for 46 months. Teratologic, neurologic, rheumatic, and syndrome-associated dislocations were excluded. The following scores were used: Harris Hip Score, displacement of femoral head with respect to Hilgenreiner’s line, Acetabular index, Wiberg angle, Reimer’s extrusion index, and leg length discrepancy. Statistical analysis was carried out using Wilcoxon’s test and Fisher’s test. P values less than 0.05 were considered significant. We performed surgical technique in two stages. First, arthrogram and an adductor and a psoas tenotomy through an inguinal approach were performed; two 3.2 mm hydroxiapatite-coated screws were positioned in the supra-acetabular region and femoral shaft, joined using monolateral LRS fixator with a proximal locking T clamp. Distraction began the day after the procedure at a rate of 1 mm/day until restoration of Shenton’s arc. Second, we performedan arthrogram intraoperatively, which included the anterior approach to the hip with open reduction, capsulorrhaphy and Salter osteotomy, and proximal femoral varus derotational osteotomy. Harris Hip Score improved significantly. Acetabular index and Wiberg angle decreased significantly in an average time of 14 months. Reimer’s index showed no difference with respect to a healthy hip. Final leg length discrepancy was 14.9 mm. The complications that occurred were superficial pin tract infections: 25% of patients. We believe that arthrodiastasis, compounded by monolateral external fixation and an adductor and psoas tenotomy, combined with open reduction and pelvic and femoral osteotomies, is an optional tool to resolve the treatment approach to high inveterate congenital dislocation of the hip.
Outpatient and Inpatient Single-level Cervical Total Disc Replacement
Authors: Segal Dale N. , Wilson Jacob M. , Staley Christopher , Yoon S. Tim
Published: June 2018

Study Design.

A retrospective cohort study.

Objective.

The aim of this study was to compare 30-day postoperative outcomes between patients undergoing outpatient and inpatient single-level cervical total disc replacement (TDR) surgery.

Summary of Background Data.

Cervical TDR is a motion-sparing treatment for cervical radiculopathy and myelopathy. It is an alternative to anterior cervical discectomy and fusion (ACDF) with a similar complication rate. Like ACDF, it may be performed in the inpatient or outpatient setting. Efforts to reduce health care costs are driving spine surgery to be performed in the outpatient setting. As cervical TDR surgery continues to gain popularity, the safety of treating patients on an outpatient basis needs to be validated.

Methods.

The National Surgical Quality Improvement Program (NSQIP) database was queried for patients who underwent single-level cervical disc replacement surgery between 2006 and 2015. Complication data including 30-day complications, reoperation rate, readmission rate, and length of stay data were compared between the inpatient and outpatient cohort using univariate analysis.

Results.

There were 531 (34.2%) patients treated as outpatients and 1022 (65.8%) were treated on an inpatient basis. The two groups had similar baseline characteristics. The overall 30-day complication rate was 1.4% for inpatients and 0.6% for outpatients. Reoperation rate was 0.6% for inpatient and 0.4% for outpatients. Readmission rate was 0.9% and 0.8% for inpatient and outpatient, respectively. There were no statistical differences identified in rates of readmission, reoperation, or complication between the inpatient and outpatient cohorts.

Conclusion.

There was no difference between 30-day complications, readmission, and reoperation rates between inpatients and outpatients who underwent a single-level cervical TDR. Furthermore, the overall 30-day complication rates were low. This study supports that single-level cervical TDR can be performed safely in an outpatient setting.

Level of Evidence: 3
US Pediatricians' Attitudes, Beliefs, and Perceived Injunctive Norms About Spanking
Authors: Taylor Catherine A. , Fleckman Julia M. , Scholer Seth J. , Branco Nelson
Published: June 2018

Objective:

To assess United States pediatricians' attitudes, beliefs, and perceived professional injunctive norms regarding spanking.

Method:

A self-administered questionnaire was mailed to a nationwide random sample of 1500 pediatricians in the US, drawn from a database maintained by IMS Health. Four survey mailings were conducted and cash incentives of up to $20 were provided. The response rate was 53% (N = 787).

Results:

Most respondents were members of the American Academy of Pediatrics (85%), had been practicing physicians for 15 years or more (66%), and were white (69%) and female (59%). All US regions were represented. About 3-quarters of pediatricians did not support the use of spanking, and most perceived that their colleagues did not support its use either. Pediatricians who were male, black, and/or sometimes spanked as children had more positive attitudes toward spanking and expected more positive outcomes from spanking than their counterparts. Nearly 80% of pediatricians never or seldom expected positive outcomes from spanking, and a majority (64%) expected negative outcomes some of the time.

Conclusion:

The majority of pediatricians in the US do not support the use of spanking with children and are aware of the empirical evidence linking spanking with increased risk of poor health outcomes for children. Pediatricians are a key, trusted professional source in advising parents about child discipline. These findings suggest that most pediatricians will discourage the use of spanking with children, which over time could reduce its use and associated harms in the population. This is of clinical relevance because, despite strong and consistent evidence of the harms that spanking raises for children, spanking is still broadly accepted and practiced in the US
Concentrated Growth Factor Enhanced Fat Graft Survival: A Comparative Study
Authors: Hu Yun , Jiang Yichen , Wang Muyao , Tian Weidong , Wang Hang
Published: June 2018

BACKGROUND

Concentrated growth factors (CGFs) belong to a new generation biomaterials that concentrate large number of growth factors and CD34+ stem cells in small volume of plasma.

OBJECTIVE

The purpose of this study was to evaluate the impact of the new technique, CGF, on fat graft survival, which compared with platelet-rich plasma (PRP) and platelet-rich fibrin (PRF).

MATERIALS AND METHODS

Nude mice received fat graft were divided into PRP group, PRF group, CGF group, and saline. The grafts were volumetrically and histologically evaluated at 4, 8, and 12 weeks after fat grafting. In vitro growth factor levels in PRP, PRF, and CGF were compared using enzyme-linked immunoassay method. Cell count and real-time polymerase chain reaction were used to evaluate the impact of CGF in medium on human adipose-derived stem cell (hADSC) proliferation and vascular differentiation, respectively.

RESULTS

Fat graft weight was significantly higher in the CGF group than those in the other groups, and histologic evaluation revealed greater vascularity, fewer cysts, and less fibrosis. Adding CGF to the medium maximally promoted hADSC proliferation and expressing vascular endothelial growth factor and PECAM-1.

CONCLUSION

In this preliminary study, CGF treatment improved the survival and quality of fat grafts.
Durability, Behavior, and Tolerability of 5 Hyaluronidase Products
Authors: Casabona Gabriela , Marchese Paula Barreto , Montes José Raúl , Hornfeldt Carl S.
Published: June 2018

BACKGROUND

Hyaluronic acid (HA) dermal fillers are commonly used in cosmetic dermatology. Due to differences in their physical characteristics, HA fillers demonstrate different sensitivity to degradation by hyaluronidase (Hase) because of HA concentration and differences in cross-linking. Similarly, there are differences in the activity of Hase products depending on source and concentration.

OBJECTIVE

The primary objective was to demonstrate the differences in potency and activity of 5 Hase products when used to degrade 5 different HA products using a human in vivo model.

MATERIALS AND METHODS

The study subject was a healthy, consenting adult woman scheduled to undergo abdominoplasty. Skin to be excised was injected with 0.1 to 0.2 mL of each filler (10 injections each) leaving a visible lump. Immediately afterward, the HA lumps were injected with 4 IU of each Hase product every 2 minutes until the HA lumps were no longer visible or palpable. This procedure was repeated after 30 days. Injected tissues were excised after abdominoplasty for histological analysis.

RESULTS

The 5 Hase products displayed a wide range of doses and times required to completely degrade the 5 HA products ranging from <2 to >16 minutes.

CONCLUSION

Cosmetic practitioners should familiarize themselves with differences in HA and Hase products.
Treatment of Cosmetic Tattoos: A Review and Case Analysis
Authors: McIlwee Bridget E. , Alster Tina S.
Published: June 2018

BACKGROUND

Cosmetic tattoos such as eyeliner, brow liner, and lip liner have become increasingly popular in the United States and throughout the world. For a variety of reasons, patients frequently regret their tattoos and request their removal; however, removal is often complicated by the aesthetically sensitive location of these specialized tattoos and the fact that they often contain white metallic compounds that darken on pigment-specific laser irradiation.

OBJECTIVE

To review the clinical use, effectiveness, and safety of an ablative laser technique for cosmetic tattoos.

MATERIALS AND METHODS

A thorough literature review pertaining to laser treatment of cosmetic tattoos and a discussion of illustrative patient cases showcasing the successful use of ablative carbon dioxide (CO2) laser to treat cosmetic tattoos is presented.

RESULTS

Cosmetic eyeliner and lip liner tattoos were significantly improved after CO2 laser vaporization. Side effects were limited to erythema, edema, and serosanguinous drainage. No infection, scarring, nor tattoo ink darkening was observed.

CONCLUSION

Because ablative lasers do not target specific tattoo inks, they do not pose a risk of paradoxical tattoo ink darkening and, thus, can be applied successfully in the treatment of iron oxide– or titanium dioxide–containing cosmetic tattoos.
Mindfulness in a Graduate Nursing Curriculum
Authors: Plummer Carrie , Cloyd Eydie , Doersam Jennifer K. , Dietrich Mary S. , Hande Karen A.
Published: June 2018

This study evaluated a mindfulness-based stress reduction intervention for graduate nursing students. Forty-four participants engaged in 20 weekly, 1.5-hour sessions of mindfulness training. There were no statistically significant effects on participants' stress levels or quality of life, yet there was a statistically significant increase in overall mindfulness (P < .05).
A Novel Inducible Mouse Model of MLL‐ENL‐driven Mixed‐lineage Acute Leukemia
Authors: Stavropoulou Vaia , Almosailleakh Marwa , Royo Hélène , Spetz Jean‐François , Juge Sabine , Brault Laurent , Kopp Patrick , Iacovino Michelina , Kyba Michael , Tzankov Alexandar , Stadler Michael B. , Cazzaniga Gianni , Peters Antoine H.F.M. , Schwaller Juerg
Published: June 2018

Supplemental Digital Content is available in the text
Ruxolitinib for the Treatment of Essential Thrombocythemia
Authors: Gunawan Arief , Harrington Patrick , Garcia‐Curto Natalia , McLornan Donal , Radia Deepti , Harrison Claire
Published: June 2018

Deregulated Janus Kinase 2 (JAK2) activation is central to the pathogenesis of most myeloproliferative neoplasms (MPNs), of which essential thrombocythemia (ET) is the most common entity. Patients with ET are risk‐stratified according to their risk of thrombo‐hemorrhagic complications. High‐risk patients are offered treatments to reduce their platelet count using cytoreductive therapy. The disease course is often long and therapy intolerance is not infrequent. Ruxolitinib, a Janus Kinase (JAK) 1/JAK2 inhibitor, has demonstrated efficacy in patients with both myelofibrosis (MF) and polycythemia vera and is well tolerated. Side effects include predictable cytopenias and an augmented risk of infections. Ruxolitinib has been investigated in a small group of ET patients who were refractory/intolerant to hydroxycarbamide (HC) and demonstrated improvements in both symptoms and splenomegaly. Of note, a proportion of treated patients (13.2%) also had a significant reduction in platelet counts. However, these results require further validation in comparison with conventional therapy. Recently, a randomized‐controlled phase 2 study (MAJIC‐ET) assessed the role of Ruxolitinib in patients refractory or intolerant to HC. This study revealed that Ruxolitinib demonstrated some clinical efficacy but was only superior in terms of symptom control. In clinical practice, some individuals with ET do exhaust all potential treatment options and there may well be a role for Ruxolitinib in such patients or those with a significant symptom burden. However, in the wider context the goal of therapy with the use of JAK inhibitor therapy in ET needs to be defined carefully and we explore this within this timely review article.
Corneal Subbasal Nerve Density and Sensitivity After Pars Plana Vitrectomy Using Contact or Noncontact Wide-Angle Viewing Systems
Authors: Tosi Gian Marco , Bacci Tommaso , Tarantello Antonio , Martone Gianluca , Traversi Claudio , Marigliani Davide , Cevenini Gabriele , Virgili Gianni
Published: June 2018

Purpose:

To assess corneal subbasal nerve density (SBND) and corneal sensitivity (CS) after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) without intraoperative 360-degree laser treatment using contact or noncontact panoramic viewing systems.

Methods:

This is a prospective study of 34 eyes affected by RRD, which underwent PPV using contact (18 eyes) and noncontact (16 eyes) panoramic viewing systems; 12 eyes which underwent scleral buckling, and 17 eyes which underwent cataract surgery. SBND and CS were assessed before surgery and 3 and 6 months postoperatively by in vivo confocal microscopy and Cochet–Bonnet esthesiometry.

Results:

Compared with baseline values, at 6 months, SBND and CS decreased in both contact PPV (SBND preoperative value: 19.1 ± 3.7 mm/mm2; SBND postoperative value: 3.5 ± 1.3 mm/mm2; CS preoperative value: 5.1 ± 0.5 cm; CS postoperative value: 1.5 ± 0.4 cm) and in noncontact PPV groups (SBND preoperative value: 19.5 ± 3.8 mm/mm2; SBND postoperative value: 8.7 ± 2.3 mm/mm2; CS preoperative value: 5.3 ± 0.5 cm; CS postoperative value: 2.5 ± 0.7 cm) (P < 0.001 for all comparisons). SBND reduction was greater in the contact PPV group than in the noncontact PPV group (P < 0.001). By contrast, the scleral buckling and cataract surgery group values were unchanged (P > 0.1 for all comparisons). In multivariate analysis, no significant effect was found for cataract surgery associated with PPV, pseudophakia, surgical time, intraocular pressure, or for laser in horizontal sectors for PPV groups. SBND was highly correlated with CS (r = 0.93).

Conclusions:

A contact viewing system reduces SBND after PPV more than a noncontact system does.
Uncertainty of Acute Stroke Patients: A Cross-sectional Descriptive and Correlational Study
Authors: Ni Chunping , Peng Jing , Wei Yuanyuan , Hua Yan , Ren Xiaoran , Su Xiangni , Shi Ruijie
Published: June 2018

Background: Uncertainty is a chronic and pervasive source of psychological distress for patients and plays an important role in the rehabilitation of stroke survivors. Little is known about the level and correlates of uncertainty among patients in the acute phase of stroke. Purpose: The purposes of this study were to describe the uncertainty of patients in the acute phase of stroke and to explore characteristics of patients associated with that uncertainty. Methods: A cross-sectional descriptive and correlational study was conducted with a convenience sample of 451 consecutive hospitalized acute stroke patients recruited from the neurology department of 2 general hospitals of China. Uncertainty was measured using Chinese versions of Mishel Uncertainty in Illness Scale for Adults on the fourth day of patients’ admission. Results: The patients had moderately high Mishel Uncertainty in Illness Scale for Adults scores (mean [SD], 74.37 [9.22]) in the acute phase of stroke. A total of 95.2% and 2.9% of patients were in moderate and high levels of uncertainty, respectively. The mean (SD) score of ambiguity (3.05 [0.39]) was higher than that of complexity (2.88 [0.52]). Each of the following characteristics was independently associated with greater uncertainty: functional status (P = .000), suffering from other chronic diseases (P = .000), time since the first-ever stroke (P = .000), self-evaluated economic pressure (P = .000), family monthly income (P = .001), educational level (P = .006), and self-evaluated severity of disease (P = .000). Conclusion: Patients experienced persistently, moderately high uncertainty in the acute phase of stroke. Ameliorating uncertainty should be an integral part of the rehabilitation program. Better understanding of uncertainty and its associated characteristics may help nurses identify patients at the highest risk who may benefit from targeted interventions.
Sampling Utility of the Convex Probe Endobronchial Ultrasound Visible Intrapulmonary Lesion
Authors: Almeida Francisco A. , Salam Shameen , Mehta Atul C. , Yuhico Luke , Sarda Yash , Choi Humberto , Cicenia Joseph C. , Gildea Thomas , Machuzak Michael , Mazzone Peter , Oliveira Eduardo , Sethi Sonali , Wang Xiao-Feng , Reynolds Jordan P.
Published: June 2018

Background:

The value of endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA) in the mediastinal staging of lung cancer has been well established. However, data regarding its utility in the diagnosis of intrapulmonary lesions has been sparse. This study assesses the sampling utility of convex probe EBUS-visible intrapulmonary lesions not visualized by the white-light bronchoscopy.

Methods:

A retrospective analysis of EBUS-TBNA of EBUS-visible intrapulmonary lesions was performed between January 2010 and March 2015. Patients with visible endobronchial lesions by white-light bronchoscopy were excluded from analysis.

Results:

Among 108 procedures, the diagnostic yield of EBUS-TBNA for EBUS-visible intrapulmonary lesions was 87%. Following diagnoses were established: lung cancer (73/67.6%), lung metastases (10/9.2%), infection (5/4.6%), lymphoma (1/<1%), sarcoma/spindle cell sarcoma or neoplasm (3/2.8%), unspecified malignancy (1<1%), and hamartoma (1/<1%). EBUS-TBNA was nondiagnostic in 14 (13%); among these, 9 turned out to have benign disease based on additional bronchoscopy samples or other testing and/or follow-up imaging. Five were ultimately diagnosed with a malignant condition: lymphoma (1), epithelioid hemangioendothelioma (1), and non–small cell lung cancer (3). The sensitivity and the negative predicted value of EBUS-TBNA for differentiating malignancy from benign disease was 94.7% and 75%, respectively, while the accuracy for diagnosing the neoplastic disease was 95.3%. There was one major bleeding requiring bronchial artery embolization and 1 pneumothorax requiring chest tube drainage.

Conclusion:

EBUS-TBNA is safe and effective in the diagnosis of EBUS-visible intrapulmonary lesions. It should be considered as the diagnostic test of choice in patients with these lesions undergoing EBUS-TBNA for the staging of suspected lung cancer.
The Direct Oblique Method
Authors: Miyake Kotaro , Morimura Osamu , Inoue Takako , Yoshida Kenya , Nagatomo Izumi , Kijima Takashi , Kumanogoh Atsushi
Published: June 2018

Background:

The purpose of this study was to identify bronchi on computed tomographic (CT) images, manual analysis is more accurate than automatic methods. Nonetheless, manual bronchoscopic navigation is not preferred as it involves mentally reconstructing a route to a bronchial target by interpreting 2-dimensional CT images. Here, we established the direct oblique method (DOM), a form of manual bronchoscopic navigation that does not necessitate mental reconstruction, and compared it with automatic virtual bronchoscopic navigation (VBN).

Methods:

Routes were calculated to 47 identical targets using 2 automatic VBNs (LungPoint and VINCENT-BFsim) and the DOM, using 3 general application CT viewers (Aquarius, Synapse Vincent, and OsiriX). Results of all analyses were compared.

Results:

The DOM drew routes to more targets than the VBNs [94% (the DOM on any viewer) vs. 49% (LungPoint) vs. 62% (VINCENT-BFsim), P<0.0001]. For the 44 targets with the CT-bronchus or CT-artery signs, 100% of the DOM routes led to targets. In the bronchoscopic simulation phase, the DOM covered 100% of the bifurcations identified on CT, whereas some bifurcations were skipped and some bronchial walls appeared partially transparent in the VBNs. Manual analysis identified more bronchi near the targets than the VBNs [32.1±3.4 (manual analysis) vs.18.9±2.1 (LungPoint) vs. 22.9±2.7 (VINCENT-BFsim), mean±SEM, P<0.0001]. The DOM took around 5 minutes on average.

Conclusion:

On the basis of precise manual CT analysis using general application CT viewers, the DOM drew routes leading to more targets and provided better bronchoscopic simulation than the automatic route calculation of the VBNs.
Transbronchial Lung Cryobiopsy in the Diagnosis of Interstitial Lung Disease
Authors: Cho Roy , Zamora Felix , Gibson Heidi , Dincer H. Erhan
Published: June 2018

Background:

Surgical lung biopsy (SLB) is the gold standard to aid diagnosis of interstitial lung disease (ILD). Complication rates are restrictive as routine approach for all patients with ILD. Transbronchial lung cryobiopsy (TBLC) is presumed to be a safe, less invasive alternative to assist multidisciplinary discussions regarding the diagnosis of ILD. Varying practice patterns and lack of consistent guidelines prohibit wide support of this technique. The purpose of this study was to evaluate safety and diagnostic yield of TBLC, with highlight of distinct technical features, in ILD.

Methods:

Retrospective study of patients with ILD on the basis of high-resolution chest computed tomography who underwent TBLC.

Results:

Of 121 TBLC, 40 patients (mean age, 57.2±13 y; 28 men) with ILD were referred for biopsy. Procedures were performed in endoscopy suite (60%) or operating room by using 1.9-mm cryoprobe. Biopsies were performed in 2 lobes with at least 3 to 5 specimens >5 mm in diameter. The average diameter and area of specimens were 5.7±2 mm and 40±2 mm2, respectively. The most common diagnosis was nonspecific interstitial pneumonitis; usual interstitial pneumonia was diagnosed in 1 patient. Of 6 nondiagnostic specimens, 2 underwent SLB with subsequent diagnoses. Final histopathologic diagnostic rate was 85%. Bleeding was the most frequent complication.

Conclusion:

We provided a detailed description of our TLBC technique and highlighted areas of similarity and differences among comparative studies and attest that TBLC is a safe alternative to SLB in the diagnosis of ILD. Our data also indicated the tendency for moderate-to-severe bleeding occurred more in the endoscopy suite.