bluuebunny/crossref_metadata_2025 huggingface dataset:
Managing Menopause by Combining Evidence With Clinical Judgment
Authors: SHUFELT CHRISANDRA , MANSON JOANN
Published: May 2018

In the United States, nearly 10 million women are currently in the menopause transition and 2.25 million women are 51 years of age, which is the average age of menopause. Approximately 75% of these women will experience vasomotor symptoms such as hot flashes and night sweats. Menopause hormone therapy (HT) remains the most effective treatment for menopausal symptoms, but the decision to use HT is complex and requires balancing the benefits and risks for the individual patient. The decision also requires clinical judgment and shared decision making with the patient. In this review, we discuss the current guidelines for HT use, the benefits and risks for the individual patient and a novel algorithm and clinical decision support tool for menopausal symptom management that facilitates shared decision making between clinician and patient.
Multiplex Real-time PCR Detection of Intestinal Protozoa in HIV-infected Children in Malawi
Authors: Huibers Minke H. W. , Moons Peter , Maseko Nelson , Gushu Monfort B. , Iwajomo Oluwadamilola H. , Heyderman Robert S. , Boele van Hensbroek Michael , Brienen Eric A. , van Lieshout Lisette , Calis Job C. J.
Published: May 2018

Background:

Intestinal protozoa are common opportunistic infections in HIV patients. Longitudinal studies on either the clinical relevance or the effect of immune reconstitution by antiretroviral therapy on intestinal protozoan infections in children are lacking however. This study investigates prevalence and clinical relevance of intestinal protozoa in HIV-infected Malawian children before and during their first year of antiretroviral treatment (ART).

Methods:

Stool samples collected at enrolment and during follow-up were tested for nonopportunistic (Giardia lamblia,Dientamoeba fragilis,Entamoeba histolytica) and opportunistic protozoa (Enterocytozoon bieneusi,Encephalitozoonspp.,Cryptosporidiumspp. andCystoisospora belli) using multiplex real-time polymerase chain reaction. Associations between infections and clinical symptoms were evaluated using univariate methods.

Results:

Nonopportunistic and opportunistic protozoa were detected in 40% (14/35) and 46% (16/35) of children at baseline, respectively.E. bieneusiwas the most prevalent protozoa (37%, 13/35) and associated with gastrointestinal complaints (43% in positive (10/13) versus 18% (4/22) inE. bieneusi-negative children,P= 0.001. Body mass index recovery during 12 months of ART was more commonly delayed inE. bieneusi-positive children (+0.29 +standard deviation 0.83) thanE. bieneusi-negative children (+1.03 +standard deviation 1.25;P= 0.05).E. bieneusiwas not detected after 12 months of ART.

Conclusions:

E. bieneusiwas the most prevalent opportunistic intestinal protozoa, present in over a third of study participants before initiation of ART. Although all children clearedE. bieneusiafter 12 months of ART,E. bieneusiwas associated with gastrointestinal complaints and may delay body mass index recovery. Trials to assess effect of treatment ofE. bieneusion nutritional status should be considered in HIV-infected African children.
Seroprevalence of Toxoplasma gondii Infection Among Β-Thalassemia Major Pediatric Population: Implications for Transfusion Transmissible Toxoplasmosis
Authors: El-Tantawy Nora , Darwish Ahmad , Eissa Eman
Published: May 2018

Background:

Children with β-thalassemia major who regularly receive blood transfusion are at risk of developing transfusion-transmitted infection. Toxoplasmosis is a common and a serious parasitic disease with high prevalence and could be transmitted through blood transfusion from healthy asymptomatic donors. However, screening Toxoplasma gondii before blood donation has not been considered. The objective of this study was to determine the prevalence of T. gondii antibodies among thalassemia children undergoing blood transfusion.

Methods:

In a case–control study, serum samples from 211 thalassemia children and 100 control children were investigated for Toxoplasma IgM and IgG using the enzyme-linked immunosorbent assay. Positive serum samples for IgG antibodies to T. gondii were further subjected to IgG avidity enzyme-linked immunosorbent assay.

Results:

The seroprevalence of Toxoplasma infection among thalassemia children was 23.2% and 53.6% for IgM and IgG anti-Toxoplasma antibodies, respectively. Whereas in the control group, the prevalence was 5% and 18% for IgM and IgG anti-Toxoplasma antibodies, respectively. There is a significant statistical difference between thalassemia and control groups regarding the prevalence of toxoplasmosis. From these positive IgG samples, 65.5% have low avidity indicating recent infection while 38.73% have high avidity indicating past infection.

Conclusion:

Due to the high serologic infection rate of toxoplasmosis among thalassemia pediatric population in this study with no existing effective therapies and no available T. gondii vaccine, appropriate strategies are critical for reducing the risk of that infection. Screening of blood for T. gondii antibodies should be considered before transmission to those children especially in countries with a high prevalence of toxoplasmosis.
Modified Exosomes Reduce Apoptosis and Ameliorate Neural Deficits Induced by Traumatic Brain Injury
Authors: Wang Bo , Han Shuangshuang
Published: May 2018

Apoptosis contributes to the pathogenesis of traumatic brain injury (TBI). Engineered exosomes incorporated with therapeutic nuclear acids have been explored for gene therapy for human diseases. The current study sought to investigate the effect of modified exosome-containing plasmids expressing B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X-protein (Bax) short hairpin RNA (shRNA) on apoptosis and neural functions after TBI. C57BL/6J mice were subjected to controlled cortical impact injury and were treated with the modified exosomes. The results showed that modified exosomes attenuated the decrease of myeloid cell leukemia-1 (Mcl-1), X-linked inhibitor of apoptosis protein (XIAP), and Survivin protein levels in the brain and reduced Cytochrome c release from mitochondria to cytosol after TBI. They also attenuated the impairments of miniature excitatory postsynaptic current (mEPSC) and long-term potentiation (LTP) in the hippocampus of TBI mice and improved the motor and cognitive behaviors after TBI. These results suggested that the modified exosomes might reduce apoptosis and ameliorate neural and functional deficits in mouse models of TBI.
Decomposing Medicaid Spending During Health System Reform and ACA Expansion
Authors: Renfro Stephanie , Lindner Stephan , McConnell K. John
Published: May 2018

Background:

Expansion of the Medicaid program is likely to create new budgetary pressures at the state and federal levels, creating a need for greater understanding of how program dollars are allocated and what drives spending growth.

Objective:

To characterize Oregon Medicaid expenditures across diseases and medical conditions, during periods of payment reform and coverage expansion.

Research Design:

Decomposition of changes in Medicaid expenditures using a person-based allocation of spending across 50 diseases/medical conditions. Four indices describe changes in costs per enrolled member, demographic shifts, prevalence of treated disease/condition, and costs per treated member.

Subjects:

Oregon Medicaid beneficiaries during 2011 (N=597,422), 2013 (N=614,858), and 2014 (N=978,237).

Results:

Expenditures on pregnancy/birth and mental conditions accounted for 24% of 2011 spending. Oregon’s 2012 payment reform was associated with reduced spending attributable primarily to decreased prevalence of treated conditions. The 2014 Medicaid expansion was marked by lower pregnancy and mental health expenditures and higher spending on treatment for substance use and heart disease.

Conclusions:

Medicaid spending is concentrated among a small group of medical conditions, not all of which are typically associated with the program. The relative expenditure burdens for some conditions are likely to change with health system reform and enrollment expansions. Decomposition into 4 indices and reporting by disease/condition elucidate variability in drivers of cost growth.
Microbial Metabolism in the Mammalian Gut
Authors: Hall Anne , Versalovic James
Published: May 2018

Human intestinal microbes participate actively at the interface of diet, nutrition, and overall health status. These biodiverse communities of microorganisms have a broader metabolic repertoire compared with their host, and they are able to synthesize and degrade substrates that would be otherwise unavailable. In recent years, we have recognized that healthy microbial communities are important for energy harvest and the regulation of body systems outside the digestive tract. Microbial dysbiosis, however, has been implicated in a number of human disorders, including obesity and inflammation. This dichotomy highlights the need to understand the factors that determine the composition and metabolic output of our resident and transient microbes. Throughout the human lifespan, we know that diet plays a major role in shaping gut microbial communities, as well as directing the types and amounts of metabolites produced. Understanding the factors that affect microbial metabolic output within the host may help identify the roles of microbes in health, as well as new targets for treatment in disease. In this article, we review facets of the assembly and activities of the healthy human intestinal microbiome, as well as ways that the microbiota has been shown to influence the host via metabolism of two dietary macronutrients: carbohydrates and amino acids.
Maltase Has Most Versatile α‐Hydrolytic Activity Among the Mucosal α‐Glucosidases of the Small Intestine
Authors: Lee Byung‐Hoo , Hamaker Bruce R.
Published: May 2018

Complete digestion of the glycemic carbohydrates to glucose takes place through the combined action of the 4 mucosal α‐glucosidases (maltase‐glucoamylase and sucrase‐isomaltase) in the small intestine. Maltase digests α‐1,2‐ and α‐1,3‐disaccharides better than the other α‐glucosidases, and has, as well, the capability to effectively hydrolyze α‐1,4 and α‐1,6 linkages that form the major backbone of a starch molecule. This broad hydrolytic activity on α‐linkages makes it an enzyme that has the most versatile α‐hydrolytic activity among the 4

mucosal α‐glucosidases. The slowly digestible properties of the unusual linkages from this research suggest the development of new glycemic oligosaccharides which will be hydrolyzed slowly, compared to α‐1,4 linkages, for modulating the postprandial glycemic response. In addition, using mammalian mucosal α‐glucosidases is a better fit to characterize carbohydrate digestion properties, compared to fungal amyloglucosidase which is currently applied in in vitro assays.
Metabolic Impacts of Maltase Deficiencies
Authors: Nichols Buford L. , Baker Susan S. , Quezada‐Calvillo Roberto
Published: May 2018

The mucosal maltase enzymes are characterized by an activity that produces glucose from linear glucose polymers, assayed with the disaccharide maltose. The related enzyme isomaltase produces glucose from branched glucose polymers, assayed with palatinose. Maltase and isomaltase activities are part of the 4 disaccharidases assayed from clinical duodenal biopsy homogenates. The reported maltase activities are more difficult to interpret than lactase or sucrase activities because both the sucrase‐isomaltase and maltase‐glucoamylase proteins have overlapping maltase activities. The early work of Dahlqvist identified 4 maltase activities from human small intestinal mucosa. On one peptide, sucrase (maltase Ib) and isomaltase (maltase Ia) activities shared maltase activities but identified the enzymes as sucrase‐isomaltase. On the other peptide, no distinguishing characteristics of the 2 maltase activities (maltases II and III) were detected and the activities identified as maltase‐glucoamylase. The nutritional/clinical importance of small intestinal maltase and isomaltase activities are due to their crucial role in the digestion of food starches to absorbable free glucose. This review focuses on the interpretation of biopsy maltase activities in the context of reported lactase, sucrase, maltase, and palatinase biopsy assay activity patterns. We present a classification of mucosal maltase deficiencies and novel primary maltase deficiency (Ib, II, III) and provide a clarification of the role of maltase activity assayed from clinically obtained duodenal biopsies, as a path toward future clinical and molecular genomic investigations.
The History of Maltose‐active Disaccharidases
Authors: Lentze Michael J.
Published: May 2018

The history of maltose‐active disaccharidases is closely related to the history of the sugar and starch industry. It began in the 19th century, when a shortage of cane sugar occurred in continental Europe, because Napoleon Bonaparte decreed that no goods could be imported from England to the countries he occupied. Other sugar sources had to be found, and it led to the identification of sugar beets as alternative source of sugar by Marggraf in 1774, to the detection of starch hydrolysis by diluted sulfuric acid by Kirchhoff in 1812, and to the starch digestion enzyme, α‐amylase, by Payen in 1833. In the 20th century, Borkström's group in Sweden investigated the absorption of nutrients in human adults by transintubation techniques and found that the luminal concentration of invertase was small compared to that of α‐amylase. They speculated that the major locus of this enzyme activity must be in the intestinal cells. Borkström's coworker, Dahlqvist, investigated the maltose‐active enzymes in pig intestine, and a second group around Semenza studied the maltase‐active enzymes in rabbit intestine. After the first descriptions of congenital sucrase‐isomaltase deficiency in 1960 and 1961, the research on disaccharidases increased. Dahlqvist published the first quantitative method to measure these enzymes. Consecutive research led to the discovery of 4 maltases, which were later identified as 2 complex enzymes: the sucrase‐isomaltase complex and the maltase‐glucoamylase complex. The homology of the 2 enzyme complexes was later determined when the cDNA sequences of the 2 complexes in human intestine were identified.
Clinical Characteristics of Disaccharidase Deficiencies Among Children Undergoing Upper Endoscopy
Authors: Cohen Stanley A. , Oloyede Hannah , Gold Benjamin D. , Mohammed Aminu , Elser Heather E.
Published: May 2018

Objectives:

The epidemiology and clinical significance of disaccharidase deficiencies have not been thoroughly characterized. Recent work suggests at least genetic sucrase‐isomaltase deficiency is more prevalent than previously believed. Because lactase deficiency (LD) is well described, the present study focuses on the clinical characteristics of children with disaccharidase deficiencies determined by esophagogastroduodenoscopy.

Methods:

Endoscopic records were reviewed from patients undergoing esophagogastroduodenoscopies with biopsies assayed for disaccharidase activity performed by 13 pediatric gastroenterologists during 5 years (2010–2014). Presenting symptoms, clinical and histological diagnosis, treatment, disaccharidase results, and demographic variables were obtained from medical and endoscopic records of those with maltase and sucrase deficiency (SD).

Results:

Among 963 patients undergoing intestinal disaccharidase testing, 73 (7.6%) had SD on biopsy (enzyme activity <25 μmol · min−1 · g−1). Thirty‐four (34/73; 47%) had normal duodenal histology and are the focus of this report. Four patients had SD without LD. Pan‐disaccharidase deficiency was observed in 24 patients when maltase and palatinase assays were obtained (n = 646), and 11 had SD + LD when just those 2 enzymes were analyzed (n = 317). Those with SD without LD were younger 4.6 ± 6.1 versus 14.1 ± 3.6 years and uniformly presented with diarrhea. Patients with pan‐disaccharidase deficiency or SD + LD primarily reported abdominal pain (33/35; 94%), diarrhea (16/35; 46%), nausea (14/35; 40%); and poor weight gain/weight loss (10/35; 29%); constipation, flatulence, and bloating were also noted. Maltase deficiency is less common (8/963; 0.8%), presenting with similar symptoms.

Conclusions:

Genetic sucrase‐isomaltase deficiency often occurs together with lactase or pan‐disaccharide deficiency. Disaccharidase deficiency should be considered a potential cause of abdominal pain and/or diarrhea in children and adolescents.
Starch Consumption Patterns in Infants and Young Children
Authors: Quann Erin , Carvalho Ryan
Published: May 2018

Background:

The introduction of starch into an infant's diet is an important milestone in the feeding journey. Intestinal maturity and the presence of digestive enzymes are necessary for the physiologic breakdown of starch and other complementary foods. However, little is known about the consumption patterns of starch containing foods during complementary feeding.

Method:

The 2008 Feeding Infants and Toddlers Study (FITS) is a cross‐sectional 24‐hour dietary intake survey of a nationally representative sample of infants, toddlers, and preschoolers from birth to 48 months of age. We looked at the age‐based prevalence of consumption of starch‐containing foods during complementary feeding.

Results:

We found that about 90% of infants were consuming starch by 6 and 8.9 months, with less than half of infants being exposed to complementary foods from multiple food groups under 6 months. The most common food source of starch was iron‐fortified infant cereals, followed by vegetables and fruits. Rice and oats were the most prevalent cereal types, while sweet potatoes, peas and squash were the most commonly consumed starch‐containing vegetables. Bananas were the leading starch‐containing fruit that was consumed. Around 9 and 11 months, the prevalence of iron‐fortified cereals declined and were replaced with lower iron‐containing ready‐to‐eat cereals. There was also a drop in the prevalence of fruit and vegetable consumption once the infant became a toddler. Most bread products consumed by toddlers were not whole grain, but their cereal choices were often whole grain. Other sources of starch were mixed dishes, which contained grains like bread or pasta combined with other types of foods.

Conclusions:

Starch enters the infant's diet around the time of complementary feeding, though earlier exposure may occur from certain carbohydrate components of infant formula. Most infants are exposed to starch from grains, followed by vegetables and fruits.
Structure and Digestion of Common Complementary Food Starches
Authors: Lin Amy Hui‐Mei
Published: May 2018

Starch is the major source of dietary glucose for rapid development of children. Starches from various crops naturally differ in molecular structures and properties. Cooking, processing, and storage may change their molecular properties and affect their digestibility and functionality. Starch digestion is affected by its susceptibility to α‐amylase and α‐glucosidase (maltase), and the susceptibility is determined by starch granule architecture and glucan structures, as well as the interaction between starch and other food components. Starch is given as a complementary feeding to young children in many cultures, and starch or modified starch, is used in special formulae of infant foods or supplements. Although indigestible starch does not provide much energy, it can benefit colonic health.
Feasibility of a Cognitive-Behavioral and Environmental Intervention for Sleep-Wake Difficulties in Community-Dwelling Cancer Patients Receiving Palliative Care
Authors: Bernatchez Marie Solange , Savard Josée , Savard Marie-Hélène , Aubin Michèle
Published: May 2018

Background

High rates of sleep-wake difficulties have been found in patients with cancer receiving palliative care. Pharmacotherapy is the most frequently used treatment option to manage these difficulties despite numerous adverse effects and the absence of empirical evidence of its efficacy and innocuity in palliative care.

Objective

This pilot study aimed to assess the feasibility and acceptability of a cognitive-behavioral and environmental intervention (CBT-E) to improve insomnia and hypersomnolence in patients with a poor functioning level and to collect preliminary data on its effects.

Methods

Six patients with cancer receiving palliative care (Eastern Cooperative Oncology Group score 2–3), who had insomnia and/or hypersomnolence, received 1 CBT-E individual session at home. They applied the strategies for 3 weeks. Patients completed the Insomnia Severity Index, the Epworth Sleepiness Scale, a daily sleep diary, and a 24-hour actigraphic recording (7 days) at pretreatment and posttreatment, in addition to a semistructured interview (posttreatment).

Results

Participants found strategies easy to apply most of the time, and none was rated as impossible to use because of their health condition. However, their adherence and satisfaction toward CBT-E were highly variable. Results on the effects of CBT-E were heterogeneous, but improvements were observed in patients with a persistent insomnia disorder.

Conclusions

The CBT-E protocol tested among this highly selected sample was fairly well received and suggested positive outcomes in some patients, particularly those with an insomnia complaint alone.

Implications

Efforts should be pursued to adapt CBT-E and develop other nonpharmacological interventions, in order to provide an alternative to pharmacotherapy for sleep-wake difficulties in this population.
Human Immunodeficiency Virus Serodiscordance and Dual Contraceptive Method Use Among Human Immunodeficiency Virus-infected Men and Women in Lilongwe, Malawi
Authors: Gausi Blessings , Chagomerana Maganizo B. , Tang Jennifer H. , Hosseinipour Mina C. , Haddad Lisa B. , Hannock Tweya , Phiri Sam
Published: May 2018

Background

Some human immunodeficiency virus (HIV) serodiscordant couples are faced with the dual challenge of preventing HIV transmission to the uninfected partner and avoiding unintended pregnancy. Therefore, we hypothesized that serodiscordance is associated with dual method use at last sex.

Methods

We analyzed data from a cross-sectional survey of HIV-infected men and women attending 2 ante-retroviral therapy clinics in Lilongwe, Malawi. We used Fisher exact test and Wilcoxon rank sum to assess for associations between serodiscordance, covariates, and dual method use. Multivariable logistic regression was used to estimate the adjusted odds ratio (aOR) and 95% confidence intervals (CI) of dual method use at last sex, comparing serodiscordant to seroconcordant relationships. Separate analyses were conducted for men and women.

Results

We surveyed 253 HIV-infected men, of which 44 (17.4%) were in a known serodiscordant relationship and 63 (24.9%) were using dual methods at last sex. Likewise, among 302 HIV-infected women surveyed, 57 (18.9%) were in a known serodiscordant relationship, and 80 (26.5%) were using dual method at last sex. Serodiscordance was not significantly associated with dual method use at last sex for among HIV-infected men (aOR, 0.62; 95% CI, 0.27–1.44) or women (aOR, 1.21; 95% CI, 0.59–2.47).

Conclusion

Dual method use was low among all HIV-infected individuals, irrespective of their partner's HIV status. Given these findings, we recommend greater efforts to encourage HIV providers to counsel their patients about the importance of dual method use to prevent both unintended pregnancy and sexually transmitted infections.
Reduced intraepidermal nerve fibre density, glial activation, and sensory changes in HIV type-1 Tat-expressing female mice: involvement of Tat during early stages of HIV-associated painful sensory neuropathy
Authors: Wodarski Rachel , Bagdas Deniz , Paris Jason J. , Pheby Tim , Toma Wisam , Xu Ruqiang , Damaj M. Imad , Knapp Pamela E. , Rice Andrew S.C. , Hauser Kurt F.
Published: May 2018

Introduction:

HIV infection is associated with chronic pain states, including sensory neuropathy, which affects greater than 40% of patients.

Objectives and Methods:

To determine the impact of HIV-Tat induction on nociceptive behaviour in female mice conditionally expressing HIV Tat1-86 protein through a doxycycline (DOX)-driven glial fibrillary acidic protein promoter, intraepidermal nerve fibre density and immune cell activation in the dorsal root ganglion (DRG) and spinal cord were assessed by immunohistochemistry. Mice were assessed for mechanical and thermal sensitivity for 9 weeks using von-Frey and Hargreaves tests.

Results:

Intraepidermal nerve fibre density was significantly reduced after 6 weeks of Tat induction, similar to sensory neuropathy seen in clinical HIV infection. Tat induction through DOX caused a significant reduction in paw withdrawal thresholds in a time-dependent manner starting the 4th week after Tat induction. No changes in paw withdrawal latencies were seen in Tat(−) control mice lacking the tat transgene. Although reductions in paw withdrawal thresholds increased throughout the study, no significant change in spontaneous motor activity was observed. Spinal cord (cervical and lumbar), DRG, and hind paw skin were collected at 8 days and 6 weeks after Tat induction. HIV-Tat mRNA expression was significantly increased in lumbar DRG and skin samples 8 days after DOX treatment. Tat induced a significant increase in the number of Iba-1 positive cells at 6 weeks, but not after 8 days, of exposure. No differences in glial fibrillary acidic protein immunoreactivity were observed.

Conclusion:

These results suggest that Tat protein contributes to painful HIV-related sensory neuropathy during the initial stages of the pathogenesis.
Computed Tomography Perfusion Measurements in Renal Lesions Obtained by Bayesian Estimation, Advanced Singular-Value Decomposition Deconvolution, Maximum Slope, and Patlak Models
Authors: Deniffel Dominik , Boutelier Timothé , Labani Aissam , Ohana Mickael , Pfeiffer Daniela , Roy Catherine
Published: May 2018

Objectives

The aims of this study were to evaluate the agreement of computed tomography (CT)-perfusion parameter values of the normal renal cortex and various renal tumors, which were obtained by different mathematical models, and to evaluate their diagnostic accuracy.

Materials and Methods

Perfusion imaging was performed prospectively in 35 patients to analyze 144 regions of interest of the normal renal cortex and 144 regions of interest of renal tumors, including 21 clear-cell renal cell carcinomas (RCC), 6 papillary RCCs, 5 oncocytomas, 1 chromophobe RCC, 1 angiomyolipoma with minimal fat, and 1 tubulocystic RCC. Identical source data were postprocessed and analyzed on 2 commercial software applications with the following implemented mathematical models: maximum slope, Patlak plot, standard singular-value decomposition (SVD), block-circulant SVD, oscillation-limited block-circulant SVD, and Bayesian estimation technique. Results for blood flow (BF), blood volume (BV), and mean transit time (MTT) were recorded. Agreement and correlation between pairs of models and perfusion parameters were assessed. Diagnostic accuracy was evaluated by receiver operating characteristic (ROC) analysis.

Results

Significant differences and poor agreement of BF, BV, and MTT values were noted for most of model comparisons in both the normal renal cortex and different renal tumors. The correlations between most model pairs and perfusion parameters ranged between good and perfect (Spearman ρ = 0.79–1.00), except for BV values obtained by Patlak method (ρ = 0.61–0.72). All mathematical models computed BF and BV values, which differed significantly between clear cell RCCs, papillary RCCs, and oncocytomas, which introduces them as useful diagnostic tests to differentiate between different histologic subgroups (areas under ROC curve, 0.83–0.99). The diagnostic accuracy to discriminate between clear-cell RCCs and the renal cortex was the lowest based on the Patlak plot model (area under ROC curve, 0.76); BF and BV values obtained by other algorithms did not differ significantly in their diagnostic accuracy.

Conclusions

Quantitative perfusion parameters obtained from different mathematical models cannot be used interchangeably. Based on BF and BV estimates, all models are a useful tool in the differential diagnosis of kidney tumors, with the Patlak plot model yielding a significantly lower diagnostic accuracy.
Adrenal Histoplasmosis
Authors: Sanders Vanessa , Donald Joseph , Siegel Barry A.
Published: May 2018

An 89-year-old woman presented with seizure and hyponatremia. CT and MRI demonstrated mass-like enlargement of the adrenal glands and multiple pulmonary nodules. PET/CT performed to evaluate for metastatic disease demonstrated intense 18F-FDG uptake within enlarged adrenal glands. Given mild uptake in the pulmonary nodules, the differential diagnosis for the adrenal uptake included lymphoma, granulomatous infection, and less likely, metastatic lung cancer.
“Hepatic Superscan” in a Patient With Hepatosplenic Alphabeta T-cell Lymphoma
Authors: Liu Entao , Wang Siyun , Lai Peilong , Lian Zhouyang , Wang Shuxia
Published: May 2018

A 36-year-old woman with a 2-week history of fever and markedly elevated lactate dehydrogenase levels. Nonenhanced CT and contrast-enhanced CT showed hepatosplenomegaly, diffusely decreased attenuation of the liver, and homogeneous enhancement in the hepatic and splenic parenchyma. 18F-FDG PET/CT revealed diffuse intense heterogeneous uptake by the liver (like superscan in bone scintigraphy). A liver needle biopsy confirmed the diagnosis of hepatosplenic alphabeta T-cell lymphoma. Subsequently, she received chemotherapy. The follow-up 18F-FDG PET/CT showed decreased 18F-FDG uptake in the liver and spleen.
BRCA2 Mutation as a Possible Cause of Poor Response to 177Lu-PSMA Therapy
Authors: Ahmadzadehfar Hojjat , Gaertner Florian , Lossin Philipp S. , Schwarz Bettina , Essler Markus
Published: May 2018

We present the case of a 66-year-old man with castration-resistant prostate cancer, with an increasing prostate-specific antigen level, and a progressive disease during 177Lu-PSMA radionuclide therapy. Because the patient had a BRCA2 mutation, poly-ADP ribose polymerase inhibitor therapy was started. The patient showed a dramatic subjective and biological response to this therapy with a progression-free survival of 5 months.
BRAFV600E Mutation Does Not Significantly Affect the Efficacy of Radioiodine Therapy in Patients With Papillary Thyroid Carcinoma Without Known Distant Metastases
Authors: Shen Guohua , Kou Ying , Liu Bin , Huang Rui , Kuang Anren
Published: May 2018

Purpose

The BRAF
V600E mutation is the most common and specific oncogenic event in papillary thyroid carcinoma (PTC). However, its role in radioiodine therapy decision making has yet to be established. This study aimed to evaluate the impact of the BRAF
V600E mutation on the clinical response to radioiodine therapy.

Methods

This retrospective study included PTC patients who received total thyroidectomy with lymph node dissection, radioiodine therapy, and thyroid-stimulating hormone suppression between January 2012 and March 2016. Included patients were divided into 2 groups based on the BRAF mutation status. The association between the clinicopathological characteristics and the BRAF
V600E mutation was evaluated. After a median follow-up of 37 months, the clinical outcome between these 2 groups was also compared based on the ongoing risk stratification.

Results

A total of 512 PTC patients without distant metastases were included, with a positive BRAF mutation in 338 patients. No significant association was observed between the BRAF mutation and clinicopathological characteristics, except for sex, tumor size, and extrathyroidal extension. The initial risk stratification between the positive and negative mutation groups revealed no significant difference (P = 0.845). At the end of follow-up, no significant difference regarding the clinical response to radioiodine therapy was demonstrated between these 2 groups for all patients or patients with high recurrence risk (P = 0.586 and P = 0.680, respectively).

Conclusions

The BRAF
V600E mutation status may not impact the clinical response to radioiodine therapy for PTC patients without distant metastases.
Lymph Node With the Highest FDG Uptake Predicts Distant Metastasis-Free Survival in Patients With Locally Advanced Nasopharyngeal Carcinoma
Authors: Cho Hojin , Kim Sung Hoon , Kim Hyunjeong , Koh Yoon Woo , Kim Se-Heon , Choi Eun Chang , Yun Mijin
Published: May 2018

Purpose

Distant failure is a major concern in patients with nasopharyngeal carcinoma. We evaluated whether the metabolic features on 18F-FDG PET/CT can predict distant metastasis-free survival (DMFS) in patients with locally advanced nasopharyngeal carcinoma.

Methods

We retrospectively reviewed 51 patients stage III, IVA, and IVB nasopharyngeal carcinoma who underwent 18F-FDG PET/CT at staging. The SUVmax for the primary site and the lymph nodes with the highest uptake as well as at the farthest station were divided by the SUVmean of the background liver (TLR, NLR-H, and NLR-F, respectively). The prognostic value of clinicopathologic factors and SUV parameters for predicting DMFS were assessed using a Cox proportional hazards model. Differences in DMFS were examined by the Kaplan-Meier method.

Results

In the median follow-up period of 50.4 ± 39.3 months (median ± interquartile range; range, 3.8–130.9), distant metastasis developed in 11 patients (21.6%). In univariate analyses, N stage (N3b) (P = 0.003) and NLR-H >5.70 (P = 0.02) were significant prognostic factors for DMFS, and remained significant in multivariate analysis, whereas TLR (P = 0.18) and NLR-F (P = 0.76) did not. The Kaplan-Meier curves showed significantly poorer DMFS in patients with NLR-H >5.70 than in those with lower NLR-H (≤5.70) (1-year DMFS rate, 84.2% vs 93.5%; P = 0.01).

Conclusions

In addition to anatomical N stage, higher NLR-H on pretreatment 18F-FDG PET/CT is an independent prognostic factor for worse DMFS in patients with locally advanced nasopharyngeal carcinoma.
Reinforcement of Lower Lateral Cartilage Using Sliced Costal Periphery to Reconfigure Nasal Tip in Asian Rhinoplasty
Authors: Wang Lin , Niu Yonggan , Zhang Hui , Li Baokai
Published: May 2018

Background:

Reinforcement of lower lateral crura (LLC) is an imperative prophylaxis against the secondary deformity of alar and nasal tip in Asian rhinoplasty. The common limitation of the existing techniques is loss of nasal tip's mobility to a large degree in exchange for structural stability. In search for a natural and animated postoperative nasal tip, the elasticity and rigidity of coastal periphery was taken into account.

Method:

Two pieces of sliced costal periphery (SCP) were used to reinforce the LLC. One hundred twenty patients who accepted this technique and completed 18-month follow-up were included in this study. They were all females in which 67 patients underwent the primary rhinoplasty, and the remaining 53 patients underwent the revision rhinoplasty. Two pieces of septal extension grafts and 2 strips of SCP were used in all patients. Videos and pictures were taken and analyzed preoperatively and at 18 months postoperatively.

Result:

The videos and pictures showed the pleasing contour and mobility of nasal tip. No complications associated with the LLC occurred. All patients who underwent primary rhinoplasty were pleased about the postoperative contour and mobility of nasal tip. In revision rhinoplasty group, 30 patients (56.6%) who had complained about the stiffness or mobility loss of the nasal tip before became satisfied with the soft and animated nasal tip after the surgery.

Conclusion:

Reinforcement of LLC by SCP is a promising technique to achieve natural and animated nasal tip. Moreover, this technique is helpful to prevent or restore the problems associated with the inherent weak or iatrogenic cripple of LLC in Asians rhinoplasty. Studies with longer follow-up and larger sample should be done to trace the reliability and practicability in the long run.
Management of Severe Cicatricial Entropion With Labial Mucous Membrane Graft in Cicatricial Ocular Surface Disorders
Authors: Osaki Tammy H. , Sant’Anna Ana Estela , Osaki Midori H. , Kikkawa Don O. , Yabumoto Cristina , Yang Patrick , Korn Bobby S.
Published: May 2018

The management of cicatricial entropion represents a therapeutic challenge especially when the underlying causes are progressive cicatricial diseases that affect the ocular surface. The authors aimed to report long-term efficacy of labial mucous membrane graft to manage severe cicatricial entropion of the upper eyelid. This study is a retrospective chart review of patients who underwent tarsotomy associated with labial mucous membrane graft to treat severe cicatricial entropion of the upper eyelid. Surgeries were performed over a 16-year period. Clinical data (age, gender, etiology of the cicatricial entropion, improvement of symptoms, eyelid position, recurrence, complications, and follow-up period) were extracted from these patients’ charts. Etiology of the cicatricial entropion, improvement of symptoms, eyelid position, recurrence, complications, and follow-up period were evaluated. Sixty-three eyelids from 44 patients underwent surgery. Mean follow-up was 48.4 ± 46.1 months (range 6 months to 15 years). Main underlying diagnoses were Stevens–Johnson syndrome (63%), trachoma (19%), chemical injury (8%), and trauma (5%). Forty-three patients (98%) reported improvement of ocular symptoms after the procedure. Complete resolution (restoration of the upper eyelid margin to normal anatomic position with good esthetic appearance) was achieved in 52 eyelids (83%). Recurrence occurred in 7 (11%) eyelids. No postoperative infection, failure of graft survival, or other complications were observed. The use of labial mucous membrane as a posterior lamella graft showed good functional and cosmetic outcomes, long-term stability and low recurrence rates in the treatment of severe cicatricial entropion of the upper eyelid.
Electromyographic Activity of the Masseter and Temporal Muscles in Patients With Nonsyndromic Complete Unilateral Cleft Lip and Palate: 2-Stage Versus 1-Stage Palate Repair
Authors: Sabbag Anelise , Denadai Rafael , Raposo-Amaral Cesar Augusto , Buzzo Celso Luiz , Raposo-Amaral Cassio Eduardo , Nagae Mirian H.
Published: May 2018

Objective:

To assess the electromyographic activity of the masseter and temporal muscles in cleft patients who underwent 1-stage palate repair versus 2-stage palate repair.

Methods:

Thirty-two patients with nonsyndromic complete unilateral cleft lip and palate operated by 2 different protocols for palate repair, 1-stage (group 1, n = 16) versus 2-stage with delayed hard palate closure (group 2, n = 16) were available in the retrospective longitudinal study. Standardized electromyographic records of the masseter and anterior portion of temporal muscles were obtained with 2 repetitions during mastication and rest.

Results:

No statistically significant (all P > 0.05) differences were observed in the electromyographic data between the groups 1 and 2.

Conclusion:

There were similar electromyographic activity of masseter and temporal muscles during mastication and at rest after 1- and 2-stage palate closure.
Can herbivore-induced volatiles protect plants by increasing the herbivores’ susceptibility to natural pathogens?
Authors: Gasmi Laila , Martínez-Solís María , Frattini Ada , Ye Meng , Collado María Carmen , Turlings Ted C.J. , Erb Matthias , Herrero Salvador
Published: May 2018

In response to insect herbivory, plants mobilize various defenses. Defense responses include the release of herbivore-induced plant volatiles (HIPVs) that can serve as signals to alert undamaged tissues and to attract natural enemies of the herbivores. It has also been shown that some HIPVs can have a direct negative impact on herbivore survival, but it is not yet understood by what mechanism. Here we tested the hypothesis that exposure to HIPVs renders insects more susceptible to natural pathogens. Exposing caterpillars of the noctuidSpodoptera exiguato indole and linalool, but not exposure to (Z)-3-hexenyl acetate increased the susceptibility to its nucleopolyhedrovirus (SeMNPV). We also found that exposure to indole, but not exposure to linalool or (Z)-3-hexenyl acetate, increased the pathogenicity ofBacillus thuringiensis. Additional experiments revealed significant changes on gut microbiota composition after forty-eight hours of larval exposure to indole. Overall, these results provide evidences that certain HIPVs can strongly enhance the susceptibility of caterpillars to pathogens, possibly through effects on the insects’ gut microbiota. These findings suggest a novel mechanism by which HIPVs can protect plants from herbivorous insects.
The Valuation of Social Rewards in Schizophrenia
Authors: Catalano Lauren T. , Heerey Erin A. , Gold James M.
Published: May 2018

Social impairment in schizophrenia is often thought to reflect poor social cognition. Here we examine responses to social rewards, an aspect of social functioning that is not featured prominently in the literature. The goal of this experiment was to explore whether people with schizophrenia (1) undervalue social rewards, and (2) whether the undervaluation of social rewards was related to social motivation and pleasure deficits in schizophrenia and decreased social functioning. People with schizophrenia and healthy participants completed a game (Shore & Heerey, 2011) to explore preferences for different types of social (polite and genuine smiles) and nonsocial (monetary) rewards from computerized opponents. Preferences for reward types were quantified for each participant based on choice behavior during the game. Participants also completed a smile discrimination task to assess their ability to discriminate these types of smiles. Analyses revealed that people with schizophrenia (N= 41) treated genuine smiles as significantly less rewarding than did healthy participants (N= 29), despite showing a similar preference for monetary rewards. Interestingly, the undervaluation of social rewards was not related to the ability to discriminate between the smiles. The current findings provide preliminary evidence of reduced social reward valuation among individuals with schizophrenia, which may have implications for behavior in face-to-face social interactions.

General Scientific Summary

Social cognitive deficits are well documented in schizophrenia. However, it is less clear how people with schizophrenia respond to social rewards. Our study yields initial evidence of a deficit in social reward valuation (operationalized as a preference for genuine smiles) despite similar preferences for monetary rewards.
Links between environment, diet, and the hunter-gatherer microbiome
Authors: Fragiadakis Gabriela K. , Smits Samuel A. , Sonnenburg Erica D. , Van Treuren William , Reid Gregor , Knight Rob , Manjurano Alphaxard , Changalucha John , Dominguez-Bello Maria Gloria , Leach Jeff , Sonnenburg Justin L.
Published: May 2018

The study of traditional populations provides a view of human-associated microbes unperturbed by industrialization, as well as a window into the microbiota that co-evolved with humans. Here we discuss our recent work characterizing the microbiota from the Hadza hunter-gatherers of Tanzania. We found seasonal shifts in bacterial taxa, diversity, and carbohydrate utilization by the microbiota. When compared to the microbiota composition from other populations around the world, the Hadza microbiota shares bacterial families with other traditional societies that are rare or absent from microbiotas of industrialized nations. We present additional observations from the Hadza microbiota and their lifestyle and environment, including microbes detected on hands, water, and animal sources, how the microbiota varies with sex and age, and the shortterm effects of introducing agricultural products into the diet. In the context of our previously published findings and of these additional observations, we discuss a path forward for future work.
Bacterial virulence against an oceanic bloom-forming phytoplankter is mediated by algal DMSP
Authors: Barak-Gavish Noa , Frada Miguel José , Lee Peter A. , DiTullio Giacomo R. , Ku Chuan , Malitsky Sergey , Aharoni Asaph , Green Stefan J. , Rotkopf Ron , Kartvelishvily Elena , Sheyn Uri , Schatz Daniella , Vardi Assaf
Published: May 2018

Emiliania huxleyiis a bloom forming microalga that impacts the global sulfur cycle by producing large amounts of dimethylsulfoniopropionate (DMSP) and its volatile metabolic product dimethyl sulfide (DMS). Top-down regulation ofE. huxleyiblooms is attributed to viruses and grazers, however, the possible involvement of algicidal bacteria in bloom demise is still elusive. We isolated from a North AtlanticE. huxleyibloom aRoseobacterstrain,SulfitobacterD7, which exhibited algicidal effects againstE. huxleyiupon co-culturing. Both the alga and the bacterium were found to co-occur during a naturalE. huxleyibloom, therefore establishing this host-pathogen system as an attractive, ecologically relevant model for studying alga-bacterium interaction in the oceans. During interaction,SulfitobacterD7 consumed and metabolized algal DMSP to produce high amounts of methanethiol, an alternative product of DMSP catabolism. We revealed a unique strain-specific response, in whichE. huxleyistrains that exuded higher amounts of DMSP were more susceptible toSulfitobacterD7 infection. Intriguingly, exogenous application of DMSP enhanced bacterial virulence and induced susceptibility in a resistant algal strain to the bacterial pathogen. This DMSP-dependent pathogenicity was highly specific as compared to supplementation of propionate and glycerol. We propose a novel function for DMSP, in addition to its central role in mutualistic interactions, as a mediator of bacterial virulence that may regulateE. huxleyiblooms.
A re-inducible gap gene cascade patterns the anterior-posterior axis of insects in a threshold-free fashion
Authors: Boos Alena , Distler Jutta , Rudolf Heike , Klingler Martin , El-Sherif Ezzat
Published: May 2018

Gap genes mediate the division of the anterior-posterior axis of insects into different fates through regulating downstream hox genes. Decades of tinkering the segmentation gene network of the long-germ fruit flyDrosophila melanogasterled to the conclusion that gap genes are regulated (at least initially) through a threshold-based French Flag model, guided by both anteriorly- and posteriorly-localized morphogen gradients. In this paper, we show that the expression patterns of gap genes in the intermediate-germ beetleTribolium castaneumare mediated by a threshold-free ‘Speed Regulation’ mechanism, in which the speed of a genetic cascade of gap genes is regulated by a posterior gradient of the transcription factor Caudal. We show this by re-inducing the leading gap gene (namely,hunchback) resulting in the re-induction of the gap gene cascade at arbitrary points in time. This demonstrates that the gap gene network is self-regulatory and is primarily under the control of a posterior speed regulator inTriboliumand possibly all insects.
Fast Nonnegative Matrix Factorization and Applications to Pattern Extraction, Deconvolution and Imputation
Authors: Lin Xihui , Boutros Paul C.
Published: May 2018

Nonnegative matrix factorization (NMF) is a technique widely used in various fields, including artificial intelligence (AI), signal processing and bioinformatics. However existing algorithms and R packages cannot be applied to large matrices due to their slow convergence, and cannot handle missing values. In addition, most NMF research focuses only on blind decompositions: decomposition without utilizing prior knowledge. We adapt the idea of sequential coordinate-wise descent to NMF to increase the convergence rate. Our NMF algorithm thus handles missing values naturally and integrates prior knowledge to guide NMF towards a more meaningful decomposition. To support its use, we describe a novel imputation-based method to determine the rank of decomposition. All our algorithms are implemented in the R package NNLM, which is freely available on CRAN.