bluuebunny/crossref_metadata_2025 huggingface dataset:
Is It Time for Entrustable Professional Activities for Residency Program Directors?
Authors: Bing-You Robert G. , Holmboe Eric , Varaklis Kalli , Linder Jo
Published: November 2016

Residency program directors (PDs) play an important role in establishing and leading high-quality graduate medical education programs. However, medical educators have failed to codify the position on a national level, and PDs are often not recognized for the significant role they play. The authors of this Commentary argue that the core entrustable professional activities (EPAs) framework may be a mechanism to further this work and define the roles and responsibilities of the PD position. Based on personal observations as PDs and communications with others in the academic medicine community, the authors used work in competency-based medical education to define a list of potential EPAs for PDs. The benefits of developing these EPAs include being able to define competencies for PDs using a deconstructive process, highlighting the increasingly important role PDs play in leading high-quality graduate medical education programs, using EPAs as a framework to assess PD performance and provide feedback, allowing PDs to focus their professional development efforts on the most important areas for their work, and helping guide the PD recruitment and selection processes.
Gynecologists and human papillomavirus DNA testing: exploring knowledge, attitudes, and practice in Italy
Authors: Caglioti Claudia , Pileggi Claudia , Nobile Carmelo G.A. , Pavia Maria
Published: November 2016

The aim of this survey was to examine the knowledge, attitudes, and behavior of gynecologists in terms of human papillomavirus (HPV) DNA testing as a primary screening tool for cervical cancer. A national cross-sectional web survey was carried out through multistage sampling using an overall sample of 1000 gynecologists. Gynecologists were asked to fill in a self-administered questionnaire exploring their knowledge, attitudes, and practice toward cervical cancer screening and HPV-DNA testing. A total of 582 gynecologists completed the web questionnaire. Of these, 24.5% were uncertain on the higher sensitivity of HPV-DNA compared with the Pap test, whereas 19% were uncertain on the role of the HPV-DNA test as a primary test in women younger than 30 years old and only 44.9% knew that a negative HPV-DNA test allows for an extension of the test interval to 5 years. Most gynecologists showed a definite positive attitude on the role of screening for cervical cancer prevention and were prepared to accept new technologies. The HPV-DNA test was considered highly effective by 86.9%, whereas 94% recommend/perform HPV-DNA tests in women older than 30 years of age; 25.5% performed HPV-DNA as a primary test, followed by a Pap test in those cases that were positive. Only 56.3% recommended/performed HPV-DNA tests 1 year after a positive HPV-DNA test, followed by a negative Pap test, whereas 42.9% recommended colposcopy. Although the use of the HPV-DNA test is very widespread among Italian gynecologists performing cervical cancer screening, there is lack of standardization of practices according to current guidelines.
Socioeconomic status and site-specific cancer incidence, a Bayesian approach in a French Cancer Registries Network study
Authors: Bryere Joséphine , Dejardin Olivier , Launay Ludivine , Colonna Marc , Grosclaude Pascale , Launoy Guy
Published: November 2016

The aim of this study was to identify and compare cancer sites whose incidence is influenced by social deprivation. The study population comprised 189 144 cases of cancer diagnosed between 2006 and 2009, recorded in member registries of the French Network of Cancer Registries. Social environment was assessed at an aggregate level using the European Deprivation Index. The association between incidence and socioeconomic status was assessed by a geographical Bayesian Poisson model enabling a reduction of the overall variability and smoothing of the relative risks by sharing information provided by multiple geographic units. For cancers of the stomach, liver, lips–mouth–pharynx, and lung, a higher incidence in deprived populations was found for both sexes as well as for cancers of the larynx, esophagus, pancreas, and bladder in men and cervical cancer in women. For melanoma, prostate, testis, ovarian, and breast cancer, a higher incidence was observed in affluent populations. The highest relative risks of the lowest social class compared with the highest social class were found for larynx [relative risk (RR)=1.67 (1.43–1.95)], lips–mouth–pharynx [RR=1.89 (1.72–2.07)], and lung cancer [RR=1.59 (1.50–1.68)] in men and for cervix [RR=1.62 (1.40–1.88)] and lips–mouth–pharynx [RR=1.56 (1.30–1.86)] cancer in women. By estimating the burden of social deprivation on cancer incidence throughout France, this study enables us to measure the gains that could be achieved by implementing targeted prevention efforts.
Linear Folliculotropic CD30-Positive Lymphomatoid Drug Reaction
Authors: Chen Yi-Chin , Wu Yu-Hung
Published: November 2016

We report a unique case of probable drug-induced CD30-positive lymphomatoid reaction. A 58-year-old woman presented with bilateral facial eruptions of 3 weeks duration composed of erythematosus papules in a linear distribution. The pathological features demonstrated a dense dermal and follicular infiltrate of many medium- to large-sized atypical CD30-positive lymphoid cells. The rash resolved rapidly after discontinuation of her medication 1 week later and did not recur. This case highlights the importance of clinicopathological correlation.
Bullous Pyoderma Gangrenosum With Subungual Involvement Associated With Ulcerative Colitis
Authors: Aktaş Karabay Ezgi , Aksu Cerman Aslı , Kıvanc Altunay İlknur , Yalçın Özben
Published: November 2016

Pyoderma gangrenosum (PG) is a rare inflammatory and ulcerative skin disease of unknown etiology characterized by neutrophilic infiltration of the dermis, mainly affecting the lower extremities. Bullous PG is a rare variant of this disease, usually associated with hematologic disorders. Here, we report a case of pathergy-positive bullous PG with subungual involvement associated with ulcerative colitis.
Transaortic Edge-To-Edge Repair for Functional Mitral Regurgitation during Aortic Valve Replacement: A 13-Year Experience
Authors: Mihos Christos G. , Larrauri-Reyes Maiteder , Hung Judy , Santana Orlando
Published: November 2016

Objective

The study evaluated the feasibility of a transaortic edge-to-edge mitral valve repair (Alfieri stitch) for moderate or greater (≥2+) functional mitral regurgitation (MR) in high-risk patients undergoing aortic valve replacement.

Methods

We retrospectively evaluated 40 consecutive patients who underwent aortic valve replacement combined with a transaortic edge-to-edge mitral valve repair for 2+ or greater functional MR, between February 2002 and April 2015. The MR was graded semiquantitatively as 0 (trace/none), mild moderate (2+), or moderate to severe (3–4+).

Results

Thirty-two patients had aortic stenosis, and eight had aortic regurgitation. The mean ± standard deviation (SD) age was 77.5 ± 5 years, 34 (85%) were male, and the mean ± SD EuroSCORE II was 14.3% ± 12.9. At a median follow-up of 1 month (interquartile range, 0.75–10), there were significant improvements in preoperative versus postoperative median MR grade (3+ vs 1+, P < 0.001), mean left ventricular ejection fraction (34% vs 41%, P = 0.018), left ventricular end-diastolic diameter (54 vs 49 mm, P = 0.005), and pulmonary artery systolic pressure (49 vs 35 mm Hg, P < 0.001). Persistent 3 to 4+ MR occurred in two patients (5%). In 12 patients with at least 6-month follow-up (mean ± SD, 18 ± 11 months), a sustained improvement in all echocardiographic parameters was observed, with persistent 3 to 4+ MR occurring in one patient (8.3%). Actuarial survival at 1, 3, and 4.5 years was 82% ± 6, 71% ± 8, and 65% ± 10, respectively.

Conclusions

A transaortic edge-to-edge repair for 2+ or greater functional MR can be safely performed during aortic valve replacement and is associated with improvements in MR grade, left ventricular remodeling, and pulmonary hemodynamics.
The Angiovac Device: Understanding the Failures on the Road to Success
Authors: Worku Berhane , Salemi Arash , D'Ayala Marcus D. , Tranbaugh Robert F. , Girardi Leonard N. , Gulkarov Iosif M.
Published: November 2016

Objective

Current percutaneous thromboembolectomy techniques may obviate surgical intervention in high-risk patients with iliocaval thrombus or thrombus of the right side of the heart, but typically require thrombus fragmentation and thrombolysis with associated bleeding and thromboembolic complications. The AngioVac (Angiodynamics, Latham, NY USA) device uses a percutaneous venovenous bypass circuit to aspirate intact thrombus. A review of the literature was performed with regard to the AngioVac device to determine the factors correlating with successful thrombus extraction.

Methods

A literature search was performed with regard to use of the AngioVac device using the PubMed database. A meta-analysis was not performed given the small size and lack of statistical analysis of the individual reports included.

Results

Twenty-three reports describing 57 procedures in 56 patients were analyzed. Indications for thrombectomy included iliocaval thrombus in 53% (30), thrombus of the right side of the heart, in 49% (28), pulmonary embolus in 14% (8), and upper extremity venous/Glenn shunt thrombosis in 7% (4). The complete success rate, defined as removal of all thrombus, was 75% (43), with an 11% (6) partial success rate. In 14% (8) of cases, minimal or no thrombus was retrieved. When analyzed by indication, iliocaval thrombus and thrombus of the right side of the heart demonstrated 87% (26) and 82% (23) complete success rates, respectively. Pulmonary embolus demonstrated a significantly lower success rate at 12.5% [1; (P < .001)]. Complications occurred in 12% (7), including six hematomas and one retroperitoneal bleed.

Conclusions

The AngioVac device offers an excellent alternative to surgical thrombectomy for patients presenting with iliocaval or intracardiac thrombus, with success rates of more than 80%, although it seems that pulmonary emboli are less amenable. Appropriate patient selection can lead to improved outcomes. Larger numbers are needed to make more definite conclusions.
Myocardial Protection and Financial Considerations of Custodiol Cardioplegia in Minimally Invasive and Open Valve Surgery
Authors: Hummel Brian W. , Buss Randall W. , DiGiorgi Paul L. , Laviano Brittany N. , Yaeger Nalani A. , Lucas M. Lee , Comas George M.
Published: November 2016

Objective

Single-dose antegrade crystalloid cardioplegia with Custodiol-HTK (histidine-tryptophan-ketoglutarate) has been used for many years. Its safety and efficacy were established in experimental and clinical studies. It is beneficial in complex valve surgery because it provides a long period of myocardial protection with a single dose. Thus, valve procedures (minimally invasive or open) can be performed with limited interruption. The aim of this study is to compare the use of Custodiol-HTK cardioplegia with traditional blood cardioplegia in patients undergoing minimally invasive and open valve surgery.

Methods

A single-institution, retrospective case-control review was performed on patients who underwent valve surgery in Lee Memorial Health System at either HealthPark Medical Center or Gulf Coast Medical Center from July 1, 2011, through March 7, 2015. A total of 181 valve cases (aortic or mitral) performed using Custodiol-HTK cardioplegia were compared with 181 cases performed with traditional blood cardioplegia. Each group had an equal distribution of minimally invasive and open valve cases. Right chest thoracotomy or partial sternotomy was performed on minimally invasive valve cases. Demographics, perioperative data, clinical outcomes, and financial data were collected and analyzed.

Results

Patient outcomes were superior in the Custodiol-HTK cardioplegia group for blood transfusion, stroke, and hospital readmission within 30 days (P < 0.05). No statistical differences were observed in the other outcomes categories. Hospital charges were reduced on average by $3013 per patient when using Custodiol-HTK cardioplegia.

Conclusions

Use of Custodiol-HTK cardioplegia is safe and cost-effective when compared with traditional repetitive blood cardioplegia in patients undergoing minimally invasive and open valve surgery.
Online Ratings of ASOPRS Surgeons: What Do Your Patients Really Think of You?
Authors: Vu Alexander F. , Espinoza Gabriela M. , Perry Julian D. , Chundury Rao V.
Published: November 2016

Purpose:

To characterize patient evaluations of American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) surgeons on a popular online physician rating website in an effort to determine which factors play a role in determining the likelihood of a patient recommending an ASOPRS surgeon to family and friends.

Methods:

After obtaining approval and access from Healthgrades.com, the website database was searched for 612 U.S.-based ASOPRS members using their name as published on http://www.asoprs.org/ as of May 2015. For each surgeon, the total number of ratings and average ratings were recorded under each category. The evaluator recommendation, defined as the response to the questions of “likelihood of recommending Dr. X to family and friends,” constituted the main outcome measure. Variables from each surgeon were compared using unpaired t tests, with statistical significance set at p < 0.05. Correlations were analyzed using Spearman correlation (r
s), with coefficients of greater than or equal to 0.40 or less than or equal to −0.40 considered significant.

Results:

Five-hundred nineteen members (85%) had at least 1 rating while 222 members (36%) had 10 or more ratings. The mean number of ratings for all rated members was 11.4 (range, 1–77; standard deviation [SD] = 11.1) and mean evaluator recommendation score was 4.16 (range, 1–5; SD = 0.79). There was a strong negative correlation between total wait time and evaluator recommendation score (r
s = −0.409, p < 0.001). The average number of ratings and rating scores for all categories were not significantly different when comparing male with female members. University-employed members had significantly fewer ratings (8.46; range, 1–52; SD = 9.3) compared with other members (11.9; range, 1–77; SD = 11.3) (p < 0.016). There were no differences in any other rating score when comparing those university-employed members with other members.

Conclusion:

Online patient-reported evaluations of ASOPRS surgeons appear high in many categories. Long wait times correlate strongly with lower recommendation scores. Further study is required to determine how online patient reviews correlate to objective outcome measures, and how these reviews affect surgeon selection by patients.
Patient-Centered Medical Home Implementation and Burnout Among VA Primary Care Employees
Authors: Simonetti Joseph A. , Sylling Philip W. , Nelson Karin , Taylor Leslie , Mohr David C. , Curtis Idamay , Schectman Gordon , Fihn Stephan D. , Helfrich Christian D.
Published: November 2016

Burnout is widespread throughout primary care and is associated with negative consequences for providers and patients. The relationship between the patient-centered medical home model and burnout remains unclear. Using survey data from 8135 and 7510 VA primary care employees in 2012 and 2013, respectively, we assessed whether clinic-level medical home implementation was independently associated with burnout prevalence and estimated whether burnout changed among this workforce from 2012 to 2013. Adjusting for differences in respondent and clinic characteristics, we found that burnout was common among primary care employees, increased by 3.9% from 2012 to 2013, and was not associated with the extent of medical home implementation.
Prospective interventional study of tenofovir in pregnancy to prevent vertical transmission of hepatitis B in highly viremic women
Authors: Sellier Pierre O. , Maylin Sarah , Berçot Béatrice , Chopin Dorothée , Lopes Amanda , Simoneau Guy , Evans John , Delcey Véronique , Bénifla Jean-Louis , Simon François , Bergmann Jean-François
Published: November 2016

Background

The risk of vertical transmission of hepatitis B virus (HBV) increases as maternal HBV DNA increase, despite serovaccination to newborns.

Methods

From 1 July 2012 to 1 January 2016, all pregnant women in Lariboisiere Hospital, Paris, France, with HBV DNA of 5 log10 IU/ml and above were administered tenofovir from week 28 of pregnancy until delivery. HBV DNA was measured at months 1, 2 of tenofovir and at delivery. The newborns were serovaccinated, tested for hepatitis B surface antigen, hepatitis B core antibody (HBcAb)±HBV DNA, and hepatitis B surface antibody (HBsAb) when aged 9 months, and then 24 months. This study was registered in
http://www.ClinicalTrials.gov
(NCT02039362).

Results

Thirty-one women gave birth to 37 newborns. Maternal HBV DNA at baseline was 8.23 log10 IU/ml and above in 12 pregnancies. The mean (median) HBV DNA were 4.4±1.2 (4.8), 3.3±1.7 (3.8), and 2.1±1.9 (2.0) log10 IU/ml at months 1, 2 of tenofovir and at delivery, respectively. Twenty-seven newborns were followed up: none of the 19 children aged 9 months or older was positive for hepatitis B surface antigen when aged 9 months; 14 children tested positive for HBcAb (probably transferred maternal antibodies, not found when aged 24 months) and for HBsAb without HBV DNA. Four of the 19 children showed HBsAb without HBcAb, the last being doubtful for HBcAb and HBsAb without HBV DNA. Eight newborns aged less than 9 months were not tested.

Conclusion

Tenofovir from week 28 of pregnancy to highly viremic HBV women plus serovaccination to newborns could prevent chronic and past infection.
Mental health promotion for junior physicians working in emergency medicine: evaluation of a pilot study
Authors: Mache Stefanie , Bernburg Monika , Baresi Lisa , Groneberg David
Published: November 2016

Objectives

Work-related stress is highly prevalent among physicians working in emergency medicine. Mental health promotion interventions offer the chance to strengthen physicians’ health, work ability, and performance. The aim of this study was to implement and evaluate a mental health promotion program for junior physicians working in emergency medicine.

Methods

In total, 70 junior physicians working in emergency medicine were randomized to either the mental health promotion program (n=35) or a waitlist control arm (n=35). The training involved 90-min sessions over a time period of 3 months. The primary outcome was perceived stress. The secondary outcomes included emotional exhaustion, emotion regulation, work engagement, and job satisfaction. Self-report assessments for both groups were scheduled at baseline, after the training, after 12 weeks, and 6 months.

Results

The intervention group showed a highly significant reduction in perceived stress and emotional exhaustion from baseline to all follow-up time points, with no similar effects found in the comparison group. The benefit of the mental health promotion program was also evident in terms of improved emotion regulation skills, job satisfaction, and work engagement. Participating physicians evaluated the training with high scores for design, content, received outcome, and overall satisfaction.

Conclusion

The results suggest that this health promotion program is a promising intervention to strengthen mental health and reduce perceived work stress. It is suitable for implementation as a group training program for junior physicians working in emergency medicine. Comparable interventions should be pursued further as a valuable supportive offer by hospital management.
Severe Hemolytic Anemia Following Intravenous Immunoglobulin in an Infant With Kawasaki Disease
Authors: Tocan Vlad , Inaba Akari , Kurano Tamami , Sonoda Motoshi , Soebijanto Keiji , Nakayama Hideki
Published: November 2016

Severe hemolytic anemia (HA) is an uncommon adverse reaction of intravenous immunoglobulin (IVIg) administration. Previous reports assume that antibodies contained in IVIg preparations are the cause of hemolysis. We report a 10-month-old infant with Kawasaki disease who was treated with high-dose IVIg and developed severe HA. The patient’s Rh blood type was D+C+c+E−e+. He developed anti-C and anti-e antibodies following treatment with IVIg, and, after considering all possible causes of hemolysis, we concluded that this was a case of autoimmune HA induced by immunoglobulin treatment. The hyperinflammatory condition associated with Kawasaki disease may have contributed to the severity of anemia.
Epstein-Barr Virus–associated Mucocutaneous Ulcer in a Patient With T-Cell Acute Lymphoblastic Leukemia: Importance of Accurate Diagnosis and Conservative Management
Authors: Vatsayan Anant , Gupta Ashish , Ahuja Sanjay , Egler Rachel , Beck Rose C. , Matloub Yousif
Published: November 2016

Epstein-Barr virus–associated mucocutaneous ulcer (EBV-MCU) is a recently characterized entity that falls under the spectrum of EBV-lymphoproliferative disorders. First described in 2010 by Dojcinov et al, it is an EBV-driven localized proliferation of B cells, occurring in mucocutaneous tissues including the skin, the oropharynx, and the gastrointestinal tract of immunosuppressed patients in the absence of an intact T-cell repertoire. Typically, it has been described in elderly patients with age-related immunosenescence and patients who are on immunosuppressive therapy. However, only 2 cases have been reported in pediatric, adolescent, and young adult age groups, with all these patients manifesting after solid organ transplant. To the best of our knowledge there are no case reports of EBV-MCU occurring in association with hematologic malignancy. Here, we present a case of EBV-MCU in a young adult patient with T-cell acute lymphoblastic leukemia. Our report serves to promote awareness among clinicians regarding this newly described and extremely rare clinical entity in young immunosuppressed patients. In addition, we highlight the importance of accurate diagnosis to prevent overtreatment of this indolent, often self-resolving disease that has a significant clinicopathologic overlap with other aggressive forms of EBV-lymphoproliferative disorders that require more intensive therapy.
Death Due to Pulmonary Alveolar Proteinosis
Authors: Altaf Emran , Mitchel Erik K. , Berry Chris , Hossain Altaf
Published: November 2016

Presented are 2 cases of death from pulmonary alveolar proteinosis (PAP). Within the past 2 years, there have been 2 cases of rare nonneoplastic lung disease that consists of the filling of the alveoli of the lung by a periodic acid–Schiff stain-positive lipoproteinaceous material. This condition bears a certain resemblance to interstitial lung disease and/or Pneumocystitis jirovecci infection of the lungs. The presented cases were clinically diagnosed as interstitial lung disease. In the first case presented, the decedent was admitted to hospital with diagnosis of pneumonia but died in hospital despite observation and treatment. Autopsy examination revealed that instead of an infection, there was amorphous granular eosinophilic proteinaceous fluid in irregular clumps, with scattered foamy macrophages and cholesterol clefts and cracks in the lung alveoli. The second case was suspected of electrocution. There were no findings pointing to or against the possibility of electrocution, whereas the alveoli and terminal bronchioles were filled with amorphous granular eosinophilic lipoproteinaceous substance. The alveolar structure was well preserved, and the interstitium had no or mild chronic inflammatory cells. In both cases, the lipoproteinaceous material stained deep pink with periodic acid–Schiff stain. The gross and microscopic examination in the second case also signified pulmonary alveolar proteinosis.

The following report describes 2 cases of this uncommon disorder, with cause of death confirmed by postmortem examination.
Atypical Spindle Cell Lipomatous Tumor
Authors: Mariño-Enriquez Adrian , Nascimento Alessandra F. , Ligon Azra H. , Liang Cherwei , Fletcher Christopher D.M.
Published: November 2016

The classification of atypical adipocytic neoplasms with spindle cell features remains challenging. To better define this category of low-grade lipomatous neoplasms, we present herein the clinical, histologic, and immunohistochemical characteristics of a large series of 232 atypical spindle cell lipomatous tumors. The lesions affected 140 males and 92 females, at an average age of 54 years (range, 6 to 87 y), clinically presenting as a persistent or enlarging mass with a median size of 5 cm. The anatomic distribution of the tumors was wide, predominating in the limbs and limb girdles (147 cases, 63%), mainly in the hands and feet (17% and 11%, respectively), with equal distribution between subcutaneous and deeper locations. Microscopic examination revealed a spectrum of histologic appearances. All cases consisted of a poorly marginated proliferation of mildly atypical spindle cells set in a fibrous or myxoid stroma, with a variably prominent admixed adipocytic component showing variation in adipocyte size and scattered nuclear atypia, frequently with univacuolated or multivacuolated lipoblasts. Tumor cellularity and the relative proportion of the different components were very variable. Tumor margins were often ill defined with invasion into surrounding tissues. Two tumors showed morphologic features reminiscent of dedifferentiation. By immunohistochemistry, the neoplastic spindle cells expressed CD34 (64%), S100 protein (40%) and, less frequently, desmin (23%). Expression of Rb was lost in 57% of cases examined. MDM2 and CDK4 were never coexpressed and FISH for MDM2 amplification was consistently negative, highlighting critical biological differences from atypical lipomatous tumor/dedifferentiated liposarcoma. The morphologic differential diagnosis of atypical spindle cell lipomatous tumor is broad, and includes spindle cell lipoma, diffuse neurofibroma, mammary-type myofibroblastoma, dermatofibrosarcoma protuberans, fat-forming solitary fibrous tumor, and morphologically low-grade malignant peripheral nerve sheath tumor. Most patients underwent surgical excision of the primary mass. With a median follow-up of 4 years (range, 1 mo to 20 y), 87% of patients (63/72) were alive with no evidence of recurrence or metastatic disease. Local recurrence of the tumor was observed in 12% of patients (9 out of 72, multiple in 3 of them) at intervals between 6 months and 17 years after resection of the primary tumor. None of the patients developed tumor metastasis or died of disease. Identification of the neoplastic adipocytic component admixed with spindle cells, and recognition of the range of histologic appearances are key for the diagnosis of atypical spindle cell lipomatous tumor. Whereas the risk of metastatic dissemination is minimal, there is a non-negligible risk for local recurrence (13%) which warrants surgical resection with clear margins whenever feasible.
Integration of EEG Into Psychiatric Practice: A Step Toward Precision Medicine for Autism Spectrum Disorder
Authors: Swatzyna Ronald J. , Tarnow Jay D. , Turner Robert P. , Roark Alexandra J. , MacInerney Erin K. , Kozlowski Gerald P.
Published: November 2016

Introduction:

Data from an EEG is not commonly used by psychiatrists to plan treatment and medication. However, EEG abnormalities such as isolated epileptiform discharges are found to be more prevalent in psychiatric patients, particularly those diagnosed with autism spectrum disorder (ASD). Most medications prescribed for ASD lower seizure threshold and increase side effects. Therefore, it may be prudent to order an EEG for ASD cases, especially those categorized as refractory.

Methods:

The data set was obtained from a multidisciplinary practice that treats a wide variety of neuroatypical children and adolescent refractory patients. This study investigated 140 nonepileptic subjects diagnosed with ASD, aged 4 to 25 years. Visual inspection of the EEG was performed to search for paroxysmal, focal, or lateralizing patterns.

Results:

Of the 140 subjects, the EEG data identified 36% with isolated epileptiform discharges. The χ2 analysis found no significant difference between genders among the three age groups. Findings indicated a high prevalence of isolated epileptiform discharges among individuals with ASD.

Conclusions:

Our results find that compared with the healthy population, a large number of patients with ASD have isolated epileptiform discharges despite never having a seizure. Our findings support the use of EEG in children, adolescents, and young adults with ASD, regardless of gender or age. This is particularly true for those who exhibit aggressive behaviors or those who have failed previous medication attempts with stimulants, antidepressants, and/or antipsychotics.
DualPhos: a versatile, chemoselective reagent for two-carbon aldehyde to latent (
E
)-alkenal homologation and application in the total synthesis of phomolide G
Authors: McLeod David , McNulty James
Published: November 2016

Advances on the use of the 2-pinacolacetal-tripropylphosphonium salt DualPhos as a general reagent for the two-carbon aldehyde to alkenal homologation and a chemoselective iron (III) chloride mediated deprotection are described. The strategy allows isolation of the latent alkenal intermediates or direct hydrolysis to (
E
)-alkenals. The robust chemical stability of the latent alkenals is demonstrated in a total synthesis of the macrolactone phomolide G.
The effects of exposure to objective coherence on perceived meaning in life: a preregistered direct replication of Heintzelman, Trent & King (2013)
Authors: Ratner Kaylin , Burrow Anthony L. , Thoemmes Felix
Published: November 2016

Having a sense of meaning in life (MIL) has been acknowledged as a catalyst to psychological flourishing. As such, understanding ways to promote MIL represents a worthy goal for those interested in bolstering positive outcomes. This study sought to replicate the findings of Heintzelman, Trent & King (2013
Psychol. Sci.
24
, 991–998 (
doi:10.1177/0956797612465878
)), who found that MIL could be influenced by external stimulation. Their findings suggest that exposure to coherent stimuli produces significantly higher MIL scores than exposure to incoherent stimuli. Using materials and methodology provided by the corresponding author of the original paper, this study attempted to directly test this manipulation under conditions with increased statistical power. All tests, however, failed to replicate. Possible explanations for these discrepant findings are discussed, and potential future directions for this area of the literature are proposed.
Photophysics of sunscreen molecules in the gas phase: a stepwise approach towards understanding and developing next-generation sunscreens
Authors: Rodrigues Natércia D. N. , Staniforth Michael , Stavros Vasilios G.
Published: November 2016

The relationship between exposure to ultraviolet (UV) radiation and skin cancer urges the need for extra photoprotection, which is presently provided by widespread commercially available sunscreen lotions. Apart from having a large absorption cross section in the UVA and UVB regions of the electromagnetic spectrum, the chemical absorbers in these photoprotective products should also be able to dissipate the excess energy in a safe way, i.e. without releasing photoproducts or inducing any further, harmful, photochemistry. While sunscreens are tested for both their photoprotective capability and dermatological compatibility, phenomena occurring at the molecular level upon absorption of UV radiation are largely overlooked. To date, there is only a limited amount of information regarding the photochemistry and photophysics of these sunscreen molecules. However, a thorough understanding of the intrinsic mechanisms by which popular sunscreen molecular constituents dissipate excess energy has the potential to aid in the design of more efficient, safer sunscreens. In this review, we explore the potential of using gas-phase frequency- and time-resolved spectroscopies in an effort to better understand the photoinduced excited-state dynamics, orphotodynamics, of sunscreen molecules. Complementary computational studies are also briefly discussed. Finally, the future outlook of expanding these gas-phase studies into the solution phase is considered.
Self-locking degree-4 vertex origami structures
Authors: Fang Hongbin , Li Suyi , Wang K. W.
Published: November 2016

A generic degree-4 vertex (4-vertex) origami possesses one continuous degree-of-freedom for rigid folding, and this folding process can be stopped when two of its facets bind together. Such facet-binding will induceself-lockingso that the overall structure stays at a pre-specified configuration without additional locking elements or actuators. Self-locking offers many promising properties, such as programmable deformation ranges and piecewise stiffness jumps, that could significantly advance many adaptive structural systems. However, despite its excellent potential, the origami self-locking features have not been well studied, understood, and used. To advance the state of the art, this research conducts a comprehensive investigation on the principles of achieving and harnessing self-locking in 4-vertex origami structures. Especially, for the first time, this study expands the 4-vertex structure construction from single-component to dual-component designs and investigates their self-locking behaviours. By exploiting various tessellation designs, this research discovers that the dual-component designs offer the origami structures with extraordinary attributes that the single-component structures do not have, which include the existence of flat-folded locking planes, programmable locking points and deformability. Finally, proof-of-concept experiments investigate how self-locking can effectively induce piecewise stiffness jumps. The results of this research provide new scientific knowledge and a systematic framework for the design, analysis and utilization of self-locking origami structures for many potential engineering applications.
Neuronal components of evaluating the human origin of abstract shapes
Authors: Goldberg Hagar , Hart Yuval , Mayo Avraham E , Alon Uri , Malach Rafael
Published: November 2016

Communication through visual symbols is a key aspect of human culture. However, to what extent can people distinguish between human-origin and artificial symbols, and the neuronal mechanisms underlying this process are not clear. Using fMRI we contrasted brain activity during presentation of human-created abstract shapes and random-algorithm created shapes, both sharing similar low level features.

We found that participants correctly identified most shapes ashumanorrandom. The lateral occipital complex (LOC) was the main brain region showing preference to human-made shapes, independently of task. Furthermore, LOC activity was parametrically correlated to beauty and familiarity scores of the shapes (rated following the scan). Finally, a model classifier based only on LOC activity showed human level accuracy at discriminating between human-made and randomly-made shapes.

Our results highlight the sensitivity of the human brain to social and cultural cues, and point to high-order object areas as central nodes underlying this capacity.
Reducing mitochondrial reads in ATAC-seq using CRISPR/Cas9
Authors: Montefiori Lindsey , Hernandez Liana , Zhang Zijie , Gilad Yoav , Ober Carole , Crawford Gregory , Nobrega Marcelo , Sakabe Noboru Jo
Published: November 2016

ATAC-seq is a high-throughput sequencing technique that aims at identifying DNA sequences located in open chromatin. Depending on the cell type, ATAC-seq may yield a high number of mitochondrial sequencing reads (~20-80% of the reads). As the regions of open chromatin of interest are usually located in the nuclear genome, mitochondrial reads are typically discarded from the analysis. To decrease wasted sequencing, we performed targeted cleavage of mitochondrial DNA using CRISPR/Cas9 and 100 mtDNA-specific guide RNAs. We also tested a modified ATAC-seq protocol that does not include detergent in the cell lysis buffer. Both treatments resulted in considerable reduction of mitochondrial reads (1.7 and 3-fold, respectively). The removal of detergent, however, resulted in increased background and fewer peaks identified. The highest number of peaks and highest quality data was obtained by preparing samples with the original ATAC-seq protocol (using detergent) and treating them with anti-mitochondrial guide RNAs and Cas9. This strategy could lead to considerable cost reduction and improved peak calling when performing ATAC-seq on a moderate to large number of samples and in cell types that contain a large amount of mitochondria.
In vivoimaging of coral tissue and skeleton with optical coherence tomography
Authors: Wangpraseurt Daniel , Wentzel Camilla , Jacques Steven L. , Wagner Michael , Kuhl Michael
Published: November 2016

Optical coherence tomography (OCT) is a non-invasive three-dimensional imaging technique with micrometer resolution allowing microstructural characterization of tissuesin vivoand in real time. We present the first application of OCT forin vivoimaging of tissue and skeleton structure of intact living corals spanning a variety of morphologies and tissue thickness. OCT visualized different coral tissue layers (e.g. endoderm vs ectoderm), special structures such as mesenterial filaments and skeletal cavities, as well as mucus release from living corals. We also developed a new approach for non-invasive imaging and quantification of chromatophores containing green fluorescent protein (GFP)-like host pigment granules in coral tissue. The chromatophore system is hyper-reflective and can thus be imaged with good optical contrast in OCT, enabling quantification of chromatophore size, distribution and abundance. Because of its rapid imaging speed, OCT can also be used to quantify coral tissue movement showing that maximal linear contraction velocity was ~120 μm per second upon high light stimulation. Based on OCT imaging of tissue expansion and contraction, we made first estimates of dynamic changes in the coral tissue surface area, which varied by a factor of 2 between the contracted and expanded state of the coralPocillopora damicornis. We conclude that OCT is an excellent novel tool forin vivotomographic imaging of corals that can reveal tissue and skeleton organization as well as quantify dynamic changes in tissue structure and coral surface area non-invasively and at high spatio-temporal resolution.
Raoult’s law revisited: accurately predicting equilibrium relative humidity points for humidity control experiments
Authors: Bowler Michael G. , Bowler David R. , Bowler Matthew W.
Published: November 2016

The humidity surrounding a sample is an important variable in scientific experiments. Biological samples in particular require not just a humid atmosphere but often a relative humidity (RH) that is in equilibrium with a stabilizing solution required to maintain the sample in the same state during measurements. The controlled dehydration of macromolecular crystals can lead to significant increases in crystal order, which often leads to higher diffraction quality. Devices that can accurately control the humidity surrounding crystals on a beamline have led to this technique being increasingly adopted, as experiments become easier and more reproducible. Matching the relative humidity to the mother liquor is the first step to allow the stable mounting of a crystal. In previous work, we measured the equilibrium relative humidity for a range of concentrations of the most commonly used precipitants and showed how this related to Raoult’s law for the equilibrium vapour pressure of water above a solution. However, a discrepancy between measured values and those predicted by theory could not be explained. Here, we have used a more precise humidity control device to determine equilibrium relative humidity points. The new results are in agreement with Raoult’s law. We also present a simple argument in statistical mechanics demonstrating that the saturated vapour pressure of a solvent is proportional to its mole fraction in an ideal solution: Raoult’s Law. The same argument can be extended to the case where solvent and solute molecules are of different size, as is the case with polymers. The results provide a framework for the correct maintenance of the RH surrounding samples.

Synopsis

The equilibrium relative humidity values for a number of the most commonly used precipitants in biological macromolecule crystallisation have been measured using a new humidity control device. A simple argument in statistical mechanics demonstrates that the saturated vapour pressure of a solvent is proportional to its mole fraction in an ideal solution (Raoult’s Law). The same argument can be extended to the case where solvent and solute molecules are of different size.
Mycoplasma Faucium and Breast Cancer
Authors: Mitin V. , Tumanova L. , Botnariuc N.
Published: November 2016

Viruses and bacteria are the cause of a large number of different human diseases. It is believed that some of them may even contribute to the development of cancer. The present work is dedicated to the identification of mycoplasmas in patients with breast cancer. Mycoplasmas may participate in the development of several human diseases including chronic fatigue syndrome, acquired immunodeficiency syndrome, atypical pneumonia, etc. Moreover, there is a reason to believe that mycoplasma can participate in the development of cancer, leukemia and lymphoma.

DNA samples from blood, saliva and tumor tissues of the Oncology Institute of Moldova patients diagnosed with breast cancer were analyzed. Mycoplasma testing was performed using nested PCR method. ForMycoplasma spp. detection, we used primers from the region of the 16S-23S RNA genes. The identification ofMycoplasma faucium,Mycoplasma salivariumandMycoplasma oralewas performed by nested PCR with primers for RNA polymerase beta subunit gene corresponding to mycoplasma.

M.fauciumandM.salivariuswas found in saliva at about 100%, andM.orale at a frequency of about 50%. OnlyM.fauciumwas found with the frequency of about 60% in the tissue of the patients. Moreover, a fairly high rate of detection of mycoplasma is observed both in the cases when primers for RNA polymerase gene and primers for 16S-23S RNA were used.

We foundM.fauciumin tumor tissues of patients diagnosed with breast cancer. It is known that mycoplasmas are able to stimulate the synthesis of certain cytokines, which act as mitogenes on the cell. We assume that M.faucium can stimulate the mitogenes synthesis in breast tissues (e.g., cytokines) which, in turn, stimulate cell division and thus participate in the initiation of breast cancer.
The Impact of Lethal Recessive Alleles on Bottlenecks with Implications for Conservation Genetics
Authors: Campbell R. B.
Published: November 2016

When a bottleneck occurs, lethal recessive alleles from the ancestral population provide a genetic load. The purging of lethal recessive mutations may prolong the bottleneck, or even cause the population to become extinct. But the purging is of short duration, it will be over before near neutral deleterious alleles accumulate. Lethal recessive alleles from the parental population and near neutral deleterious mutations which occur during a bottleneck are temporally separated threats to the survival of a population. Breeding individuals from a large population into a small endangered population will provide the benefit of viable alleles to replace near neutral deleterious alleles but also the cost of lethal recessive mutations from the large population.
Flagellar synchronization is a simple alternative to cell cycle synchronization for ciliary and flagellar studies
Authors: Dutta Soumita , Avasthi Prachee
Published: November 2016

The unicellular green alga,Chlamydomonas reinhardtii, is an ideal model organism for studies of ciliary function and assembly. In assays for biological and biochemical effects of various factors on flagellar structure and function, synchronous culture is advantageous for minimizing variability. Here, we have characterized a method in which 100% synchronization is achieved with respect to flagellar length but not with respect to the cell cycle. The method requires inducing flagellar regeneration by amputation of the entire cell population and limiting regeneration time, which results in a maximally homogeneous distribution of flagellar length at three hours post-amputation. We find that time-limiting new protein synthesis during flagellar synchronization limits variability in the unassembled pool of limiting flagellar protein and variability in flagellar length without scaling the cell volume range. We also find that long and short flagella mutants that regenerate normally require longer and shorter synchronization times, respectively. By minimizing flagellar length variability using a simple method requiring only hours and no changes in media, flagellar synchronization facilitates the detection of small changes in flagellar length resulting from both chemical and genetic perturbations inChlamydomonas. This method increases our ability to probe the basic biology of ciliary size regulation and related disease etiologies.
Cross-laboratory analysis of brain cell type transcriptomes with applications to interpretation of bulk tissue data
Authors: Mancarci B. Ogan , Toker Lilah , Tripathy Shreejoy J , Li Brenna , Rocco Brad , Sibille Etienne , Pavlidis Paul
Published: November 2016

Establishing the molecular diversity of cell types is crucial for the study of the nervous system. We compiled a cross-laboratory database of mouse brain cell type-specific transcriptomes from 36 major cell types from across the mammalian brain using rigorously curated published data from pooled cell type microarray and single cell RNA-sequencing studies. We used these data to identify cell type-specific marker genes, discovering a substantial number of novel markers, many of which we validated using computational and experimental approaches. We further demonstrate that summarized expression of marker gene sets in bulk tissue data can be used to estimate the relative cell type abundance across samples. To facilitate use of this expanding resource, we provide a user-friendly web interface atNeuroexpresso.org.

Significance Statement

Cell type markers are powerful tools in the study of the nervous system that help reveal properties of cell types and acquire additional information from large scale expression experiments. Despite their usefulness in the field, known marker genes for brain cell types are few in number. We present NeuroExpresso, a database of brain cell type specific gene expression profiles, and demonstrate the use of marker genes for acquiring cell type specific information from whole tissue expression. The database will prove itself as a useful resource for researchers aiming to reveal novel properties of the cell types and aid both laboratory and computational scientists to unravel the cell type specific components of brain disorders.