bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined exposure of emotional labor and job insecurity on depressive symptoms among female call-center workers
Authors: Cho Seong-Sik , Kim Hyunjoo , Lee JinWoo , Lim Sinye , Jeong Woo Chul
Published: March 2019

Call-center workers work under unfavorable psychosocial working conditions, including, emotional labor and job insecurity, which might be linked to depressive symptoms.

The purpose of this study was to explore the link between emotional labor and depressive symptoms and to investigate the influence of combined exposure to emotional labor and job insecurity on depressive symptoms.

A health survey was conducted among female call-center workers in Geumcheon-gu (a district in Seoul), South Korea, in November 2012. The short form of the Korean occupational stress scale was used to measure occupational stressors. A questionnaire with 8 items was employed to assess emotional labor. Depressive symptoms were estimated using the Korean Version of the Centre for Epidemiologic Studies Depression Scale (CES-D). The association of emotional labor and occupational stressors with depressive symptoms was assessed using multilevel mixed-effects logistic regression.

Overall, 699 female call-center workers were enrolled into this study. The odds ratios of experiencing depressive symptoms in workers exposed to emotional labor and job insecurity were 5.45 (95% confidence interval [CI]: 3.38–8.80) and 2.37 (95% CI: 0.86–6.50), respectively. When workers were simultaneously exposed to excessive emotional labor and high job insecurity levels, the odds ratio of experiencing depressive symptoms was 10.13 (95% CI: 3.51–29.23). The Relative Excess Risk due to the Interaction (RERI) of job insecurity and emotional labor was 3.30 (95% CI: −5.50 to 12.11); however, this was not statistically significant (P = .46).

Although a causal relationship could not be established due to the cross-sectional study design, the combined effect of emotional labor and job insecurity might have a serious influence on behavioral health among call-center female workers.
Prognositic significance of P-cadherin expression in breast cancer
Authors: Xi Yupeng , Zhang Xiwen , Yang Zizhen , Zhang Xing , Guo Qiujun , Zhang Zhenhua , Chen Shuntai , Zheng Honggang , Hua Baojin
Published: March 2019

Background:

P-cadherin is a calcium-dependent cell–cell adhesion glycoprotein. It has been implicated in invasiveness and metastasis. However, the clinical prognostic value of overexpression of P-cadherin in patients with breast cancer (BC) remains unsettled.

Methods:

A systematic literature search will be performed in all available databases to quantitatively review eligible studies and identify all relevant data, which could be used to detect the relationship between overexpression of P-cadherin and overall survival (OS), disease-free survival (DFS), and clinicopathological parameters. Hazard ratio and 95% confidence intervals (CIs) or P value will be employed as effect measures to estimate the correlation between P-cadherin and the oncologic outcomes including overall survival (OS), disease-free survival (DFS). Odds ratios (ORs) and the 95% CIs will be evaluated for the pooled analysis of the correlation between P-cadherin expression and clinicopathological features. We will use the Review Manager (Revman) 5.3.5 software (Cochrane Community, London, United Kingdom) and STATA 14 software (version 14.0; Stata Corp, College Station, TX) to perform the meta-analysis to calculate the data.

Results:

The review will provide a high-quality synthesis of current evidence of the prognostic role of P-cadherin in BCs. The results will be published in a peer-reviewed journal.

Conclusion:

We hope that the results of this study will provide significant evidence to assess whether the expression of P-cadherin is associated with poor prognosis in patients with BC.

PROSPERO registration number:

This meta-analysis protocol has been registered in the PROSPERO network with registration number: CRD42019119880.
Mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, dialysis adequacy influence all-cause mortality in hemodialysis patients
Authors: Duong Tuyen Van , Wu Pei-Yu , Wong Te-Chih , Chen Hsi-Hsien , Chen Tso-Hsiao , Hsu Yung-Ho , Peng Sheng-Jeng , Kuo Ko-Lin , Liu Hsiang-Chung , Lin En-Tzu , Feng Yi-Wei , Yang Shwu-Huey
Published: March 2019

Hemodialysis patients are at the high risk for morbidity and mortality. Evaluation and management of body composition and biochemical values are important to improve dialysis outcomes. We aimed to examine the effects of the mid-arm circumference, body fat, nutritional and inflammatory biomarkers, blood glucose, and dialysis adequacy on the mortality.

A prospective cohort study was conducted on 375 patients from 7 hospital-based dialysis centers. At baseline between September 2013 and April 2017, we assessed patients’ characteristics using chart review, body composition using the bioelectrical impedance analysis, and biochemical parameters using available laboratory tests. Patients were followed-up for all-cause mortality until April 2018. Kaplan–Meier Curves with Log-rank test, and Cox proportional hazards models were used to analyze the effects of assessed factors on the mortality.

During the median of follow-up time of 1.4 (1.0–3.2) years, 47 (12.5%) patients died. In the multivariate analysis, mid-arm circumference (hazard ratio, HR, 0.90; 95% confidence interval, 95%CI, 0.82–0.99; P = .036), body fat mass (HR, 0.95; 95%CI, 0.91–1.00; P = .031), percent body fat (HR, 0.96; 95%CI, 0.92–0.99; P = .024), serum creatinine (HR, 0.81; 95%CI, 0.68–0.96; P = .015), and eKt/V (HR, 0.07; 95%CI, 0.01–0.33; P = .001) reduced the mortality risk. Inflammation (HR, 2.90; 95%CI, 1.59–5.27; P < .001), hyperglycemia (HR, 2.16; 95%CI, 1.06–4.40; P = .033), and low serum uric acid (HR, 2.22; 95%CI, 1.15–4.31; P = .018) increased the death risk.

In hemodialysis patients, the higher values of the mid-arm circumference, body fat, serum creatinine, uric acid, and dialysis adequacy were associated with lower mortality, whereas, inflammation and hyperglycemia associated with higher mortality.
Anti-cyclic citrullinated peptide antibody is highly associated with rheumatoid factor and radiological defects in rheumatoid arthritis patients
Authors: Sulaiman Farah Nadiah , Wong Kah Keng , Ahmad Wan Aireene Wan , Ghazali Wan Syamimee Wan
Published: March 2019

Rheumatoid arthritis (RA) is a chronic debilitating inflammatory disease affecting mainly the joint, surrounding tissue and other extra-articular structures in the body. RA can lead to destruction of bone and cartilage which may cause severe disability and it is characterized by the presence of serum rheumatoid factor (RF). The anti-cyclic citrullinate peptide (anti-CCP) antibody is another serum biomarker used in RA diagnosis with higher sensitivity and specificity.

In this cross-sectional study with retrospective record review, 159 established RA patients from Hospital Universiti Sains Malaysia (HUSM) were recruited. Enzyme-linked immunosorbent assays (ELISAs) for serum RF and anti-CCP were performed. Our goal was to evaluate the significance of anti-CCP antibody in predicting the disease activity and progression in terms of radiological and extra-articular manifestations upon diagnosis.

Of the 159 RA patients included in this study, mean age was 48.3 years old and majority (n = 134; 84.3%) were female. A total of 83 (52.2%) and 99 (62.3%) patients had anti-CCP antibody and RF, respectively. Mean Disease Activity Score-28 for Rheumatoid Arthritis with erythrocyte sedimentation rate (ESR) (DAS28-ESR) score for all patients was 4.74 (medium and high disease activity). Fifty-eight (36.5%) patients had radiological defects and 49 (30.8%) patients had extra-articular involvement manifested by rheumatoid nodule, pulmonary involvement, and anemia.

In terms of anti-CCP antibody association with clinical and laboratory parameters, a significant co-occurrence of RF and anti-CCP antibody (P = .002) was observed. Anti-CCP antibody was significantly associated with radiological defects in which majority of patients with such defects (n = 40/58; 68.9%) were positive for anti-CCP antibody (P = .001). However, there was no significant difference between mean and classes of disease activity score and extra-articular manifestations between different anti-CCP antibody groups. In addition, extra-articular manifestations were not associated with high disease activity upon RA diagnosis

There was a significant association between anti-CCP antibody positivity and positive RF. Radiological defects were the sole clinical parameter significantly associated with anti-CCP antibody positivity, indicating that patients positive for anti-CCP antibody should be routinely monitored for radiological defects and their onset.
Fibroblast growth factors in control of lipid metabolism: from biological function to clinical application
Authors: Struik Dicky , Dommerholt Marleen B. , Jonker Johan W.
Published: March 2019

Purpose of review

Several members of the fibroblast growth factor (FGF) family have been identified as key regulators of energy metabolism in rodents and nonhuman primates. Translational studies show that their metabolic actions are largely conserved in humans, which led to the development of various FGF-based drugs, including FGF21-mimetics LY2405319, PF-05231023, and pegbelfermin, and the FGF19-mimetic NGM282. Recently, a number of clinical trials have been published that examined the safety and efficacy of these novel therapeutic proteins in the treatment of obesity, type 2 diabetes (T2D), nonalcoholic steatohepatitis (NASH), and cholestatic liver disease. In this review, we discuss the current understanding of FGFs in metabolic regulation and their clinical potential.

Recent findings

FGF21-based drugs induce weight loss and improve dyslipidemia in patients with obesity and T2D, and reduce steatosis in patients with NASH. FGF19-based drugs reduce steatosis in patients with NASH, and ameliorate bile acid-induced liver damage in patients with cholestasis. In contrast to their potent antidiabetic effects in rodents and nonhuman primates, FGF-based drugs do not appear to improve glycemia in humans. In addition, various safety concerns, including elevation of low-density lipoprotein cholesterol, modulation of bone homeostasis, and increased blood pressure, have been reported as well.

Clinical trials with FGF-based drugs report beneficial effects in lipid and bile acid metabolism, with clinical improvements in dyslipidemia, steatosis, weight loss, and liver damage. In contrast, glucose-lowering effects, as observed in preclinical models, are currently lacking.
Rethinking what constitutes a diagnosis in the genomics era: a critical illness perspective
Authors: Lakhani Saquib A. , Pierce Richard
Published: March 2019

Purpose of review

The purpose of this review is to highlight the significant advances in the testing, interpretation, and diagnosis of genetic abnormalities in critically ill children and to emphasize that pediatric intensivists are uniquely positioned to search for genetic diagnoses in these patients.

Recent findings

Ten years following the first clinical diagnosis made through whole exome sequencing, we remain in the dark about the function of roughly 75% of our genes. However, steady advancements in molecular techniques, particularly next-generation sequencing, have spurred a rapid expansion of our understanding of the genetic underpinnings of severe congenital diseases. This has resulted in not only improved clinical diagnostics but also a greater availability of research programs actively investigating rare, undiagnosed diseases. In this background, the scarcity of clinical geneticists compels nongeneticists to familiarize themselves with the types of patients that could benefit from genetic testing, interpretations of test results as well as the available resources for these patients.

When caring for seriously ill children, critical care pediatricians should actively seek the possibility of an underlying genetic cause for their patients’ conditions. This is true even in instances when a child has a descriptive diagnosis without a clear underlying molecular genetic mechanism. By promoting such diagnostics, in both clinical and research settings, pediatric intensivists can advance the care of their patients, improve the quality of information provided to families, and contribute to the knowledge of broad fields in medicine.
Self-Reported Infertility and Associated Pelvic Inflammatory Disease Among Women of Reproductive Age—National Health and Nutrition Examination Survey, United States, 2013–2016
Authors: Anyalechi Gloria Ebelechukwu , Hong Jaeyoung , Kreisel Kristen , Torrone Elizabeth , Boulet Sheree , Gorwitz Rachel , Kirkcaldy Robert D. , Bernstein Kyle
Published: March 2019

Background

Sexually transmitted diseases, including chlamydia and gonorrhea, cause of pelvic inflammatory disease (PID) and infertility. We estimated the prevalence of infertility and infertility health care seeking.

Methods

We analyzed self-reported lifetime infertility and infertility health care-seeking in women aged 18 to 49 years in the 2013 and 2015 National Health and Nutrition Examination Surveys. Weighted prevalence of infertility and infertility health care seeking, prevalence ratios (PRs), and 95% confidence intervals (CIs) were calculated.

Results

Among 2626 eligible women, 13.8% had self-reported infertility (95% CI, 12.3–15.3) with higher prevalence by age: 960, 18 to 29 years (PR, 6.4%; 95% CI, 4.8–8.0); 799, 30 to 39 years (PR, 14.8%; 95% CI, 12.2–17.3); and 867, 40 to 49 years (PR, 20.8%; 95% CI, 17.2–24.4). Non-Hispanic white women (PR, 15.4%; 95% CI, 13.0–17.8; n = 904) and non-Hispanic black women (PR, 12.9%; 95% CI, 10.3–15.5; n = 575) had the highest infertility prevalences. Women reporting PID treatment (n = 122) had higher infertility prevalence (PR, 24.2%; 95% CI, 16.2–32.2) than women without PID treatment (PR, 13.3%; 95% CI, 11.6–15.0; n = 2,485), especially among 18- to 29-year-old women (PR, 3.8; 95% CI, 1.8–8.0). Of 327 women with infertility, 60.9% (95% CI, 56.1–65.8) sought health care. Women without health care insurance sought care less frequently than women with insurance.

Conclusions

In a nationally representative sample, 13.8% of reproductive-age women reported a history of infertility, of whom 40% did not access health care. Self-reported PID was associated with infertility, especially in young women. Annual chlamydia and gonorrhea screening to avert PID may reduce the burden of infertility in the United States.
Sexually Transmitted Disease, Human Immunodeficiency Virus, and Pregnancy Testing Behaviors Among Internet and Mobile Dating Application Users and Nonusers, 2016
Authors: Coor Alexandra , Kachur Rachel , Friedman Allison , Witbart Lauren , Habel Melissa A. , Bernstein Kyle , Hogben Matthew
Published: March 2019

We examined 2016 United States market research to understand the demographics and sexual health testing behaviors of dating app users. Internet/app users were more likely to be young adults, male, nonwhite, of Hispanic ethnicity, and unmarried. Users also reported greater testing for sexually transmitted disease, human immunodeficiency virus, and pregnancy.
Perioperative Therapies—Using Repurposed Drugs to Improve Cancer Surgery Outcomes
Authors: Pantziarka Pan , Bouche Gauthier
Published: March 2019

Aims

Reducing the rate of recurrence after curative-intent surgical resection is an attractive strategy for improving long-term survival in cancer. Perioperative therapies administered in the period immediately prior to, during, or after surgery therefore hold the potential to improve overall survival. Drug repurposing is a source of therapeutic candidates for further clinical investigation. We aimed to identify noncancer drugs with the potential to be repurposed as perioperative therapies.

Methods

The Repurposing Drugs in Oncology repurposing database and PubMed were used for a literature-based search of publications related to perioperative treatment of cancer. Three clinical trials registries were also searched to identify relevant clinical trials with survival endpoints. Both the literature and trial screens were supplemented with additional data known to the authors.

Results

Fifty-two drugs were identified as potential perioperative therapies, with 67% having supporting human data. There are few clinical trials with survival endpoints, mainly in breast and colorectal cancers.

Discussion

The perioperative setting is not as well established as the neoadjuvant and adjuvant settings, making identification of relevant research and clinical trials difficult. Despite the potential benefits of such interventions, there is a need for more well-designed clinical trials, additional research, and biomarkers of response.
Transcriptome Signature Reversion as a Method to Reposition Drugs Against Cancer for Precision Oncology
Authors: Koudijs Karel K. M. , Terwisscha van Scheltinga Anton G. T. , Böhringer Stefan , Schimmel Kirsten J. M. , Guchelaar Henk-Jan
Published: March 2019

Transcriptome signature reversion (TSR) has been hypothesized as a promising method for discovery and use of existing noncancer drugs as potential drugs in the treatment of cancer (i.e., drug repositioning, drug repurposing). The TSR assumes that drugs with the ability to revert the gene expression associated with a diseased state back to its healthy state are potentially therapeutic candidates for that disease. This article reviews methodology of TSR and critically discusses key TSR studies. In addition, potential conceptual and computational improvements of this novel methodology are discussed as well as its current and possible future application in precision oncology trials.
Patient-Centered Outcomes and Key Study Procedure Finalization in the Pilot Feasibility Gout Randomized Trial
Authors: Singh Jasvinder A. , Willig Amanda L. , Darnell Betty , Green Candace , Morgan Sarah , Weiss Rick , Saag Kenneth G. , Cutter Gary , McGwin Gerald
Published: March 2019

Objective

The aim of this study was to report patient-centered outcomes and finalization of key study procedures from a 9-month pilot internet randomized controlled trial of cherry extract versus diet modification.

Methods

We randomized 84 people with physician-confirmed gout in an internet study to cherry extract (n = 41) or dietitian-assisted diet modification for gout (n = 43). All study outcomes were collected via internet and phone calls. We finalized key study procedures. We assessed acceptability and feasibility of the intervention and satisfaction with study website.

Results

Study participant satisfaction with the intervention was high. The intervention was perceived as easy, enjoyable, understandable, and helpful (scores 65–88 for all; higher = better). The amount of time spent for the study was acceptable. Participant satisfaction with website interaction and content was very high; 85% or more were moderately to extremely satisfied. Significantly lower total calories, total carbohydrate, and saturated fat intake were noted at 6 months in the diet modification versus cherry extract group; differences were insignificant at 9 months. Six of the 8 Health Assessment Questionnaire sections/domains improved significantly from baseline to 9 months in cherry extract versus 2 Health Assessment Questionnaire sections/domains in the diet modification group. Key study procedures were finalized for a future trial, including an internet diet assessment tool, gout flare assessment, provider confirmation of gout diagnosis, patient reporting of classification criteria, and centralized laboratory-assisted serum urate testing.

Conclusions

High patient acceptability and feasibility of study/intervention and finalization of key study procedures indicate that hypothesis-testing internet gout trials of cherry extract and/or diet modification can be conducted in the future.
Helical Rim Reconstruction With Chondrocutaneous Hatchet Flap-Z Plasty
Authors: Durğun Mustafa , Baş Soysal
Published: March 2019

Background

Helical rim reconstruction is relatively difficult because of the unique anatomical structure of the ear. The aesthetic and functional characteristics of the ear make such reconstruction even more important. This article presents the newly defined chondrocutaneous hatchet flap-Z plasty (HFZP) method in helical rim defects and evaluates the results.

Methods

This study retrospectively evaluates 14 patients who were operated on using the chondrocutaneous HFZP method after a tumor excision located on the helical rim. The etiologies of the patients were basal cell carcinoma (n = 7), squamous cell carcinoma (n = 2), and actinic keratosis (n = 5). All patients were operated on under local anesthesia. The patients were evaluated regarding age, sex, etiology, defect location, and aesthetic outcomes.

Result

Five patients were female, and 9 were male. The mean age of the patients was 72.2 years. Nine tumors were localized in the upper one-third of the helical rim, and 5 were localized in the middle one-third. The average duration of operation was 24 minutes. The aesthetic results were 11 patients (78.59%) who recovered with excellent outcome, 2 patients (14.2%) with good outcome, and 1 patient(7.1%) with poor outcome. There were no postoperative complications, such as flap necrosis, infection, suture detachment hemorrhage, or hematoma.

Conclusions

The chondrocutaneous HFZP method is a simple, single-stage method that uses local tissues without color mismatch. In addition to the method's geometric gain, there is no removal of healthy skin or cartilage, resulting in minimal decreases in the vertical and horizontal diameters of the ear.
Intraoperatively Detected But Previously Indocyanine Green–Negative Lymphatic Vessels May Have Misprized Potentials and Should Not Be Neglected in Lymphaticovenous Bypass Surgery
Authors: Scaglioni Mario F. , Uyulmaz Semra , Arvanitakis Michael , Lineaweaver William C. , Zhang Feng
Published: March 2019

Introduction

Identification of patent lymphatic vessels without fibrosis and with high flow is difficult but crucial in the preoperative planning of lymphaticovenous anastomosis (LVA). Lymphatic vessels on the operating field cannot always be visualized preoperatively because of the anatomical and physiological characteristics of lymphedema tissue. The purposes of this study were to demonstrate our clinical experience in identifying indocyanine green (ICG)–negative lymphatics intraoperatively and to emphasize the therapeutic potential of performing anastomoses with ICG-negative lymphatics.

Methods

Indocyanine green–positive lymphatic ducts were marked preoperatively in 5 patients with lower extremity lymphedema; moreover, if ICG-negative lymphatics were identified during surgery, they were used for additional LVA thus implementing multiple anastomoses in one surgical setting.

Results

In total, 33 LVAs were performed in 5 patients with lower extremity lymphedema, of which 11 LVAs were implemented with ICG-negative lymphatics. Immediately after the anastomosis, a strong lymphatic drainage could be appreciated in all cases. Six months postoperatively patients reported a subjective decrease in limb circumference and pressure sensation.

Conclusions

We believe that ICG-negative lymphatics found intraoperatively should be evaluated for additional LVAs in order to maximize drainage effect and might provide better outcomes.
Clinical and Molecular Study of ELMO-2–Related Massive Intraosseous Vascular Malformations
Authors: Vargel Ibrahim , Calis Mert , Canter Halil Ibrahim , Cil Barbaros Erhan
Published: March 2019

Massive intraosseous vascular malformations, a relatively rare entity in the vascular malformation spectrum, deserves attention as involving the membranous bones of the craniofacial skeleton and may lead to severe life-threatening hemorrhages and even death. The main aim of this study was to summarize the 25 years of clinical experience with these vascular malformation osseous patients, focus on the molecular and genetic aspect of the clinical entity, and to emphasize the certain challenging conditions in the treatment of these patients. All the patients appeared to be unaffected at birth, whereas initial symptoms occasionally began with painless swelling in the mandible in early childhood. The disease was progressive in behavior especially in the pubertal ages and was specifically involving the maxilla and mandible of the craniofacial skeleton in all the patients. Calvarium and cranial base were the second most common involved regions among these patients (62.5%). Clavicular (50%), costal (25%), and vertebral (25%) involvements were also a significant manifestation of the disease. Tissue samples obtained from the affected individuals and the blood samples from their families were matched, revealing a loss of function mutation in the ELMO-2 gene of chromosome 20 leading to developmental abnormality of the vascular structures via RAC1 signaling and leading to abnormally enlarged vessels in the intraosseus portion of the membranous bone. Immunohistochemical staining revealed positive CD31 and smooth muscle actin staining but negative proliferation and maturity markers such as Ki-67, desmin, h-caldesmon, and myofibroblast-like desmin. The follow-up of 3 of 5 patients ended up with mortality (60%). vascular malformation osseous is intraosseous vascular malformation with aggressive biological behavior associated with ELMO-2 gene mutation. Further studies for obtaining prenatal diagnosis and achievement of gene therapy should take place. As the disease rapidly progresses as the affected individual grows, surgical interventions should be taken into consideration before the initiation of complications.
Pocket Irrigation and Technique During Reconstructive Surgery
Authors: Epps Mathew Thomas , Langsdon Sarah , Pels Taylor K. , Noyes Victoria , Levine David , Thurston Todd E. , Spratt Henry G. , Brzezienski Mark A.
Published: March 2019

Background

Expander-to-implant is the most common breast reconstruction procedure in the United States. Irrigation with triple antibiotic solution (TAS), as described by Adams et al in 2006, has become standard of care to lower bacterial bioburden. However, several alternative solutions have been implemented with the literature lacking a consensus regarding use (Plast Reconstr Surg. 2006;117:30-36).

Objective

We distributed a peer-reviewed survey among a cohort of American Society of Plastic Surgery (ASPS) members to assess pocket irrigation technique during implant-based reconstructive surgery. We then conducted a pilot in vitro study to determine antibacterial efficacy of the most preferred irrigation at preferred dwell times against select bacterial species linked to breast pocket contamination during reconstructive implant-based surgery.

Methods

The survey was distributed a total of 3 times to a random cohort of 2488 ASPS members in January 2018. During in vitro studies, pure cultures of common breast flora were exposed to TAS versus saline control at 1, 2, and 5 minutes in a simulated in vivo cavity. Viable plate counts were used to assess cell viability.

Results

The response rate was above the ASPS survey average at 16% (n = 407). The population reflected a cross-section of practice types and experience levels. Triple antibiotic solution without Betadine was the favored irrigation at 41%, with 73% of its users preferring dwell times of 2 minutes or less. Over 30 distinct breast pocket irrigation solutions were identified. Bacteria added to the in vivo cavity survived a 2-minute dwell time with TAS as follows: 51% Staphylococcus epidermidis, 69% Escherichia coli, 88% Enterococcus faecalis, 88% Pseudomonas aeruginosa, and 98% Acinetobacter baumannii.

Conclusion

Our survey data demonstrate significant variability in practice and lack of consensus among ASPS members regarding antimicrobial irrigation during reconstructive breast surgery. Our in vitro data underscores the importance of relating clinical practices with laboratory studies of microorganisms potentially linked to breast pocket contamination and suggests that TAS requires either dwell times greater than 5 minutes and/or the inclusion of efficacious antimicrobial agents (eg, Betadine). This finding has the potential to impact antimicrobial pocket irrigation and technique during breast reconstruction.
The Impact of Preoperative Negative-Pressure Wound Therapy on Pectoralis Major Muscle Flap Reconstruction for Deep Sternal Wound Infections
Authors: Barbera Federico , Lorenzetti Fulvio , Marsili Ricccardo , Lisa Andrea , Guido Gabriele , Pantaloni Marcello
Published: March 2019

Background

Deep sternal wound infection (DSWI) represents a life-threatening complication following open-heart surgery and pectoralis major muscle flap reconstruction has led to a significant reduction in mortality and morbidity. Negative-pressure wound therapy represented a step forward in DSWI treatment, both as a single procedure or as a preparation for reconstructive surgery.

In the present study, we report our 13 years' experience with sternal reconstruction in order to evaluate the impact of preoperative vacuum-assisted closure (VAC) therapy on reconstructive outcome.

Methods

Seventy-three patients diagnosed with DSWI undergoing pectoralis major muscle flap reconstruction were divided into 2 subgroups: preoperative VAC treatment group (n = 37) and no preoperative VAC (NVAC n = 36). We collected patients' DSWI and reconstructive surgery clinical data, and we analyzed surgical outcome in terms of complication rate, reoperation rate, defects closure times, and intraoperative/30-day and 1-year mortality.

Results

Eighty-three flaps were used, bilateral flaps were used more in the NVAC subgroup (P = 0.005), and operative time was significantly shorter in the VAC subgroup (P < 0.001). Complication rate was 9.6%, with no significant differences between the 2 subgroups (P = 0.723). There was no recurrence of mediastinitis, and all flaps survived. Sternal closure time was significantly lower in the VAC subgroup (P < 0.001). No intraoperative death occurred; 30-day and 1-year mortality were 2.7% and 19.2%, respectively, with no significant difference between the 2 groups (P = 0.596).

Conclusions

Preoperative VAC therapy makes reconstructive surgery easier and faster, even though it has no impact on complication rate and overall success of the reconstruction. Pectoralis major muscle flap represents a reliable solution even if not associated with preoperative VAC.
Assessing the Fisher, Mohler, and Millard Techniques of Cleft Lip Repair Surgery With Eye-Tracking Technology
Authors: Kwong Jeffrey W. , Cai Lawrence Z. , Azad Amee D. , Lorenz H. Peter , Khosla Rohit K. , Lee Gordon K. , Nazerali Rahim S.
Published: March 2019

Background

Cleft lip repair is essential to restoring physiologic function and ensuring social and psychological well-being in children with orofacial clefts. It is important to critically study various techniques to understand the elements of the lip and nasal repair that contribute to favorable results. Here, we use eye-tracking technology to evaluate how viewers analyze images of cleft lips repaired by the Fisher, Millard, or Mohler techniques.

Methods

Thirty viewers were shown 5 images without deformity and 5 images each of unilateral cleft lips repaired by the Fisher, Millard, or Mohler techniques. Viewers assessed the esthetic quality of images on a Likert scale while eye-tracking technology analyzed their gaze patterns.

Results

Of the 3 repair techniques, viewers found Fisher repairs most esthetically pleasing (mean ± standard error, 6.91 ± 0.13). Mohler repairs were next most attractive at (6.47 ± 0.13), followed by Millard repairs at (5.60 ± 0.14). The proportion of time spent in fixed gaze on the nose and upper lip was greatest for Millard repairs (58.3% ± 0.4%) and least for Fisher repairs (51.9% ± 0.5%). Viewers fixated most frequently on the nose and upper lip in Millard repairs (83.2% ± 0.5%) and least frequently in Fisher repairs (75.3% ± 0.5%). When examining the Millard compared with Fisher and Mohler repairs, viewers spent more time and fixations on the ipsilateral lip, nose, and repair scar than on the contralateral lip.

Conclusions

The esthetics of the Fisher repair appear to be favored as measured by Likert scores and gaze data. Eye-tracking technology may be a useful tool to assess outcomes in plastic surgery.
The role of mucins in mucositis
Authors: Thorpe Daniel
Published: March 2019

Purpose of review

Alimentary mucositis is a severe dose limiting side effect of chemotherapy and radiotherapy. Mucin expression and secretion are associated with mucositis. This article aims to review current studies involving mucin and mucositis.

Recent findings

Mucins have been shown to alter mucositis severity and key targets associated with mucositis. First, interventions increasing mucin content has been associated with reduce damage associated with mucositis. Second, mucins have also been shown to protect microbiota from radiation-induced damage. Finally, mucins have also been shown to be involved in lumen epithelial barrier interactions altering signalling for cell proliferation, motility, and the inhibition of apoptosis.

The current studies suggest that mucin expression prior to and during mucositis may be very important in reducing the severity of mucositis and further research into the area is warranted.
Psychometric Evaluation of the Toileting Behaviors: Women’s Elimination Behaviors Scale in a Sample of College Women
Authors: Angelini Kimberly J. , Newman Diane K. , Palmer Mary H.
Published: March 2019

Background

Lower urinary tract symptoms in women including urinary incontinence and overactive bladder are common women’s health conditions with negative financial, health, and quality of life consequences. Certain behaviors are associated with symptom presentation. Identifying and modifying these behaviors could decrease symptom presentation and progression. The Toileting Behaviors: Women’s Elimination Behaviors (TB-WEB) scale is the only known theory-based tool to date designed to assess urinary toileting behaviors in women. It has been validated in middle-aged women, but it has not been validated in a younger population.

Objectives

The purpose of this study was to assess the psychometric properties of the TB-WEB in a sample of college-aged women.

Methods

Surveys were sent to senior-level undergraduates electronically via university email addresses. One hundred ninety-three women responded to the survey. Those who had missing responses on the TB-WEB were excluded from psychometric analyses. Demographic characteristics from those with missing data were not statistically different from those with complete responses.

Results

The total Cronbach α for the 18-item TB-WEB was 0.846, and the 5 previously identified subscales ranged between 0.528 and 0.919. A 5-factor structure was identified, similar to previous testing of the TB-WEB. Higher scores were significantly correlated with frequency of urinary incontinence episodes (r
s= 0.311; P < 0.001).

Conclusions

The validated TB-WEB can be used reliably in a younger sample of women (mean age, 22 years) enrolled in college. It may be useful to identify problematic toileting behaviors and women at risk for having or developing lower urinary tract symptoms.
Subjective Sleep Quality and Excessive Daytime Sleepiness in Hemodialysis Patients Waitlisted for Renal Transplant
Authors: Gencdal Işil Y.
Published: March 2019

Objective:

Sleep disturbances are common in hemodialysis (HD) patients, impeding their daily activities and reducing their overall quality of life. The aim of this study was to investigate sleep quality and excessive daytime sleepiness (EDS) in HD patients waitlisted for renal transplant.

Methods:

The study included 137 patients (84 men and 53 women) undergoing HD three times per week; the mean age was 49.74±12.49 years. I used the Pittsburgh Sleep Quality Index (PSQI) to identify poor sleepers and the Epworth Sleepiness Scale (ESS) to identify those with EDS.

Results:

PSQI scores classified 87 of the 137 patients (63.5%) as poor sleepers, and ESS scores indicated that 47 patients (34.3%) had EDS. Among the 87 poor sleepers, 46% presented with EDS. Among the patients with EDS, 85% were also poor sleepers. Multivariate analysis revealed a positive correlation between the PSQI and ESS scores (P=0.002).

Conclusions:

Poor sleep quality and EDS are quite common among patients receiving HD, but these sleep disturbances often go undiagnosed or untreated. Better awareness and treatment of SDs could improve quality of life for HD patients waitlisted for renal transplant.
Unfolding the Complex Dynamic Interplay Between Attentional Processes and Anxiety: A Commentary on Ghassemzadeh, Rothbart, and Posner
Authors: Heeren Alexandre , Hoebeke Yorgo , Coussement Charlotte
Published: March 2019

Theories about the involvement of attention in feelings of fear and anxiety have been debated in philosophical circles since long before the foundation of experimental psychology and cognitive neuroscience. In this issue, Ghassemzadeh, Rothbart, and Posner (2019) provide a much-needed historical and conceptual review of the relations between attention and anxiety disorders. Throughout their paper, they argue that insights from the study of brain networks of attention offer a particularly viable prospect for best clarifying the complex relations between attentional processes and anxiety. We fully share this view. Moreover, we believe that the computational and conceptual tools of network analysis (also known as graph theory) can enable researchers to move even closer to elucidating the complex dynamic interplay between those phenomena. In this commentary, we explain why and how to use network analysis for this purpose.
variant2literature: full text literature search for genetic variants
Authors: Lin Yin-Hung , Lu Yu-Chen , Chen Ting-Fu , Hsu Jacob Shujui , Lee Ko-Han , Cheng Yi-Wei , Chen Yi-Chieh , Fan Jhih-Sheng , Tu Chien-Ta , Hsu Chen-Ming , Chou Chih-Chen , Chen Pei-Lung , Tu Yi-Chin Ethan , Chen Chien-Yu
Published: March 2019

Motivation

Whole genome sequencing (WGS) by next-generation sequencing produces millions of variants for an individual. The retrieval of biomedical literature for such a large number of genetic variants remains challenging, because in many cases the variants are only present in tables as images, or in the supplementary documents of which the file formats are diverse.

Results

The proposed tool named variant2literature from the TaiGenomics (Toolkits for AI genomics) resolves the problem by incorporating text recognition with image processing. In addition to the adoption of advanced image-based text retrieval, the recall rate of finding the literature containing the variants of interest is further improved by employing the skill of variant normalization. Different variant presentations are transformed into chromosome coordinates (standard VCF format) such that false negatives can be largely avoided. variant2literature is available in two ways. First, a web-based interface is provided to search all the literature in PMC Open Access Subset. Second, the command-line executable can be downloaded such that the users are free to search all the files in a specified directory locally.

Availability

http://variant2literature.taigenomics.com/

Contact

chienyuchen@ntu.edu.tw
Enhancing Boolean networks with continuous logical operators and edge tuning
Authors: Poret Arnaud , Sousa Claudio Monteiro , Boissel Jean-Pierre
Published: March 2019

Due to the scarcity of quantitative details about biological phenomena, quantitative modeling in systems biology can be compromised, especially at the subcellular scale. One way to get around this is qualitative modeling because it requires few to no quantitative information. One of the most popular qualitative modeling approaches is the Boolean network formalism. However, Boolean models allow variables to take only two values, which can be too simplistic in some cases. The present work proposes a modeling approach derived from Boolean networks where continuous logical operators are used and where edges can be tuned. Using continuous logical operators allows variables to be more finely valued while remaining qualitative. To consider that some biological interactions can be slower or weaker than other ones, edge states are also computed in order to modulate in speed and strength the signal they convey. The proposed formalism is illustrated on a toy network coming from the epidermal growth factor receptor signaling pathway. The obtained simulations show that continuous results are produced, thus allowing finer analysis. The simulations also show that modulating the signal conveyed by the edges allows to incorporate knowledge about the interactions they model. The goal is to provide enhancements in the ability of qualitative models to simulate the dynamics of biological networks while limiting the need of quantitative information.
Multiparasitism among Schoolchildren of Akonolinga, Nyong et Mfoumou Division, Centre Region of Cameroon
Authors: Oyono Martin G. , Lehman Leopold G. , Fosso Samuel , Bilong C. F. Bilong
Published: March 2019

In Sub-Saharan Africa, school-age children are the most vulnerable to parasitic infections and are particularly exposed to multi-parasitism and its potential consequences. This study aimed at determining the intensity of multi-parasitism in Nyong et Mfoumou Division and identifying its determinants. A cross-sectional study took place from September 2017 to July 2018 among pupils of five (05) government schools from the Nyong et Mfoumou Division. Stool samples were collected from each child and examined for protozoan cysts, helminth eggs and larva while blood samples were collected for detection of Plasmodium spp and filarial blood stages. In addition, socio-demographic and school environment related information were documented. In total, 416 schoolchildren were recruited; out of which 309 (74.28%) were infected by at least one parasite species. 13 parasite species were found: 03 hemoparasites and 10 intestinal parasites. Plasmodium falciparum was the main hemoparasite (37.26%). Amongst intestinal parasites, Entamoeba coli were the most common among protozoa (29.33%) and Ascaris lumbricoides among helminths (21.39%). The frequency of multi-parasitism was 44.47% and the average species reach was 1.43 ± 0.01 per individual. Four types of multi-parasitism were found (bi-parasitism, tri-parasitism, quadri-parasitism and penta-parasitism); the bi-parasitism (26.68%) was the most common. Significantly statistic associations were found between parasite species such as: Entamoeba coli, Entamoeba histolytica/dispar, Ascaris lumbricoides, Trichirus trichiura and Mansonella perstans and can generally be explained by the same means of transmission. We conclude that the intensity of multiparasitism among schoolchildren in Nyong et Mfoumou Division is high with predominance in rural areas.

Author Summary

Everywhere in Sub-Saharan Africa, school-age children are most vulnerable to parasitic infections, and in higher risk of multiparasitism and its potential consequences. Here, we report results obtained from pupils aged from 4 to 15 years from the Nyong et Mfoumou Division in the Centre Region of Cameroon. Amongst these pupils, 74.28% were infected with one parasite specie at least and 13 parasite species were found in the study area. The highest frequency, 37.26%, was found for Plasmodium falciparum. Entamoeba coli (29.33%) and Ascaris lumbricoides (21.39%) were the most common intestinal protozoa and helminth respectively. The frequency of multiparasitism was 44.47%; 26.68% participants harbored two parasites species concurrently and the maximum number of parasites harbored by one host individual was 5. The risk of multiparasitism was significantly higher for females, schoolchildren aged from 8 to 11 years and those living in rural areas. We conclude that the frequency of multiparasitism is higher in the Nyong et Mfoumou Division. These findings could be helpful in defining and implementing more effective parasitic diseases control strategies.
Transcription-coupled repair and mismatch repair contribute towards preserving genome integrity at mononucleotide repeat tracts
Authors: Georgakopoulos-Soares Ilias , Koh Gene , Jiricny Josef , Hemberg Martin , Nik-Zainal Serena
Published: March 2019

Introductory paragraph

The mechanisms that underpin how insertions or deletions (indels) become fixed in DNA have primarily been ascribed to replication-related and/or double-strand break (DSB)-related processes. We introduce a novel way to evaluate indels, orientating them relative to gene transcription. In so doing, we reveal a number of surprising findings: First, there is a transcriptional strand asymmetry in the distribution of mononucleotide repeat tracts in the reference human genome. Second, there is a strong transcriptional strand asymmetry of indels across 2,575 whole genome sequenced human cancers. We suggest that this is due to the activity of transcription-coupled nucleotide excision repair (TC-NER). Furthermore, TC-NER interacts with mismatch repair (MMR) under physiological conditions to produce strand bias. Finally, we show how insertions and deletions differ in their dependencies on these repair pathways. Our novel analytical approach reveals new insights into the contribution of DNA repair towards indel mutagenesis in human cells.
Leaf shape is a predictor of fruit quality and cultivar performance in tomato
Authors: Rowland Steven D. , Zumstein Kristina , Nakayama Hokuto , Cheng Zizhang , Flores Amber M. , Chitwood Daniel H. , Maloof Julin N. , Sinha Neelima R.
Published: March 2019

Commercial tomato (Solanum lycopersicum) is one of the most widely grown vegetable crops worldwide. Heirloom tomatoes retain extensive genetic diversity and a considerable range of fruit quality and leaf morphological traits.

Here the role of leaf morphology was investigated for its impact on fruit quality. Heirloom cultivars were grown in field conditions and BRIX by Yield (BY) and other traits measured over a fourteen-week period. The complex relationships among these morphological and physiological traits were evaluated using PLS-Path Modeling, and a consensus model developed.

Photosynthesis contributed strongly to vegetative biomass and sugar content of fruits but had a negative impact on yield. Conversely leaf shape, specifically rounder leaves, had a strong positive impact on both fruit sugar content and yield. Cultivars such as Stupice and Glacier, with very round leaves, had the highest performance in both fruit sugar and yield. Our model accurately predicted BY for two commercial cultivars using leaf shape data as input.

This study revealed the importance of leaf shape to fruit quality in tomato, with rounder leaves having significantly improved fruit quality. This correlation was maintained across a range of diverse genetic backgrounds and shows the importance of leaf morphology in tomato crop improvement.