bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of In-Furrow and Early-Season Banded Applications of Fungicides on Incidence of Early Leaf Spot of Peanut
Authors: Culbreath Albert K. , Kemerait Robert C. , Tsai Yun-Ching , Brenneman Timothy B. , Stevenson Katherine L. , Cantonwine Emily G.
Published: July 2018

Field experiments were conducted in Tifton, GA, in 2012-2014 to determine the effect of in-furrow applications of prothioconazole and early-season banded applications of prothioconazole or pyraclostrobin on incidence of early leaf spot (Cercospora arachidicola) of peanut (Arachis hypogaea). In each year, border rows were planted in May as a source of inoculum for plants in the treatment plots. Plots were planted in August or September after epidemics of early leaf spot were severe in the border plots. Fungicide application regimes included two rates (100 and 200 g a.i./ha) of prothioconazole applied in-furrow at planting, and 200 g a.i./ha of prothioconazole or 164 g a.i./ha of pyraclostrobin applied concentrated in a 30-cm band 21 days after planting (DAP). Incidence (percent of leaflets with one or more leaf spot) of early leaf spot was monitored until 54 to 57 days after planting in each year. In all years, disease incidence was below 10% at 28 DAP in plots treated with 200 g a.i./ha of prothioconazole in-furrow compared to over 40% in nontreated plots at the same time. In-furrow applications of 100 g a.i./ha of prothioconazole were less effective, but suppressed leaf spot incidence compared to the control. Banded applications of either fungicide at 21 DAP resulted in a decrease in leaf spot incidence, and prevented increase in leaf spot incidence for 19 days or longer.

Accepted for publication 30 November 2015. Published 3 December 2015.
A Quantitative Disease Severity Rating Scale for Northern Corn Leaf Blight
Authors: Price Trey , Purvis Myra , Pruitt Hunter
Published: July 2018

Northern corn leaf blight (NCLB) is an annual issue for corn producers throughout the United States. Consequently, researchers are constantly evaluating hybrids for resistance and fungicides for efficacy. In most cases, NCLB severity is evaluated by visually estimating the percentage of affected foliage. Perceptions of disease severity are variable among stakeholders; therefore, a rating scale was created using photo analysis software that may be used to increase accuracy of disease severity estimations.

Accepted for publication 15 March 2016. Published 28 March 2016.
Effect of Seed Treatment on Early Season Brown Spot Caused by Septoria glycines of Soybean
Authors: Batzer Jean C. , Kandel Yuba R. , Bradley Carl A. , Chilvers Martin I. , Tenuta Albert U. , Wise Kiersten A. , Hernández Edward , Mueller Daren S.
Published: July 2018

Early season brown spot caused by Septoria glycines was compared in Illinois, Indiana, Iowa, Michigan, and Ontario, Canada, soybean fields planted with differing commercial seed treatments. Seed treatments that included fluopyram significantly reduced brown spot (P < 0.001). A greenhouse mist chamber experiment revealed that fluopyram seed treatment reduced the Area Under Disease Progress Curve of brown spot over a 6-week period (P < 0.001). Brown spot severity was unaffected by plant age at inoculation for the control treatment without fluopyram (P = 0.911); however, severity increased with plant age at inoculation for the fluopyram treatment (P = 0.009). The sensitivity of two S. glycines isolates to fluopyram was assessed by determining the effective concentration required to reduce its colony diameter growth in culture by 50% (EC50). Both isolates had an EC50 of 0.41 μg/ml of fluopyram. These results demonstrate that fluopyram seed treatment is effecttive at controlling early season brown spot in soybean.

Accepted for publication 19 September 2016.
Resolution of inflammation is altered in chronic heart failure and entails a dysfunctional responsiveness of T lymphocytes
Authors: Chiurchiù Valerio , Leuti Alessandro , Saracini Stefano , Fontana Davide , Finamore Panaiotis , Giua Renato , Padovini Lucia , Incalzi Raffaele Antonelli , Maccarrone Mauro
Published: July 2018

Chronic heart failure (CHF) is characterized by an ongoing nonresolving inflammatory status, where T lymphocytes seem critical. It has been recently recognized that transition from acute to chronic inflammation could be caused by defects in resolving inflammation, the resolution of which is mediated by a novel family of ω‐3‐derived specialized proresolving lipid mediators such as resolvins. We analyzed 27 elderly patients with CHF and 23 healthy age‐matched control subjects, and we reported significantly lower levels of D‐series resolvin (RvD)l in plasma of patients with CHF that were associated with a reduced ability of their leukocytes to produce this lipid via its biosynthetic enzyme 15‐lipoxygenase and that correlated with gas exchange dysfunction. Furthermore, when pretreating ex vivo peripheral blood mononuclear cells of patients with CHF with RvD1 or RvD2, we found that neither of them was able to modulate the immune response of CD8+ and CD4+ T cells in terms of proinflammatory cytokine production, namely TNF‐α, IFN‐γ, IL‐17, and IL‐2. Such impaired T‐cell responsiveness in patients with CHF was associated with a significant reduction in mRNA and protein expression of RvD1 receptor GPR32, suggesting a defective signaling in the proresolving pathway. We conclude that patients with CHF show alterations in producing proresolving mediator RvD1 and a failure of adaptive immune cells in responding to the anti‐inflammatory actions of RvDs that may contribute to the progression of chronic inflammation. Thus, the proresolution pathway might be a potential candidate to design better treatments for CHF aimed at reducing T cell‐mediated chronic inflammation.—Chiurchiù, V., Leuti, A., Saracini, S., Fontana, D., Finamore, P., Giua, R., Padovini, L., Incalzi, R. A., Maccarrone, M. Resolution of inflammation is altered in chronic heart failure and entails a dysfunctional responsiveness of T lymphocytes. FASEB J. 33, 909–916 (2019). www.fasebj.org
Identifying and treating patients with synthetic psychoactive drug intoxication
Authors: Brown Gina R. , McLaughlin Krisha , Vaughn Kaitlin
Published: July 2018

Tens of thousands of ED visits each year are related to synthetic psychoactive drug intoxication. Signs, symptoms, and treatment of toxicity with synthetic cathinones, synthetic cannabinoids, or dextromethorphan overlap greatly and can be challenging. This article describes signs and symptoms of psychoactive drug abuse and how to properly manage these symptoms.
Commonwealth Fund Tracks U.S. Health Care Trends
Authors: Stubenrauch James M.
Published: July 2018

Four million lose health coverage and many low-income adults now lack insurance.
Study of U.S. Veterans Links Mild Traumatic Brain Injury to Dementia Risk
Authors: Mechcatie Elizabeth
Published: July 2018

The risk is present even without loss of consciousness.
Overview of Drugs Used to Treat Opioid Use Disorder
Authors: Aschenbrenner Diane S.
Published: July 2018

Medication-assisted treatment for opioid use disorder is likely to be used with more frequency because of the current epidemic of opioid abuse in the United States.

Three drugs are approved to treat opioid use disorder: buprenorphine, methadone, and naltrexone. Understanding the differences between these products will help nurses provide appropriate patient education.
New Maintenance Treatment for Recurrent Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
Authors: Aschenbrenner Diane S.
Published: July 2018

Rucaparib (Rubraca) can now be used as maintenance treatment in patients with recurrent ovarian, fallopian tube, or primary peritoneal cancer that is completely or partially responding to platinum-based chemotherapy.

The most common adverse effects of rucaparib treatment include fatigue, rash, gastrointestinal complaints, hematologic problems, and nasopharyngitis/upper respiratory infection.
Buprenorphine Implant Removal 7 Years Postinsertion: A Case Report
Authors: Frost Michael , Bobb Raymond
Published: July 2018

A long-acting buprenorphine subdermal implant, Probuphine, was approved by the Food and Drug Administration (FDA) in May 2016, for the maintenance treatment of patients with opioid-use disorder. Long-acting implants offer the potential benefits of improved medication adherence, consistent daily dosing, and reduced risk of medication diversion. Sets of 4 implants are typically inserted for a period of 6 months and then removed. Similar technology has been successfully utilized in implantable formulations of birth control medications; however, there is currently little clinical experience involving buprenorphine implants that have remained in the body for extended periods of time. This is a case report involving an early clinical study subject who had been lost to follow-up at the time of the original study because of incarceration. Despite the protracted duration of time since initial implantation, all 4 implants remained easily palpable, and displayed little physical deterioration or tissue infiltration. All implants were able to be removed using the standard explant technique of midline incision and limited tissue dissection. While extending length of treatment beyond the indicated 6-month period is not being espoused, this case demonstrates that although situations may arise where implants may remain in an individual for longer than the intended dosing period, implants may be removed safely despite remaining implanted for longer than intended.
Etomidate and Etomidate Analog Binding and Positive Modulation of γ-Aminobutyric Acid Type A Receptors
Authors: McGrath Megan , Yu Zhiyi , Jayakar Selwyn S. , Ma Celena , Tolia Mansi , Zhou Xiaojuan , Miller Keith W. , Cohen Jonathan B. , Raines Douglas E.
Published: July 2018

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background

Naphthalene-etomidate, an etomidate analog containing a bulky phenyl ring substituent group, possesses very low γ-aminobutyric acid type A (GABAA) receptor efficacy and acts as an anesthetic-selective competitive antagonist. Using etomidate analogs containing phenyl ring substituents groups that range in volume, we tested the hypothesis that this unusual pharmacology is caused by steric hindrance that reduces binding to the receptor’s open state.

Methods

The positive modulatory potencies and efficacies of etomidate and phenyl ring–substituted etomidate analogs were electrophysiology defined in oocyte-expressed α1β3γ2L GABAA receptors. Their binding affinities to the GABAA receptor’s two classes of transmembrane anesthetic binding sites were assessed from their abilities to inhibit receptor labeling by the site-selective photolabels 3[H]azi-etomidate and tritiated R-5-allyl-1-methyl-5-(m-trifluoromethyl-diazirynylphenyl) barbituric acid.

Results

The positive modulatory activities of etomidate and phenyl ring–substituted etomidate analogs progressively decreased with substituent group volume, reflecting significant decreases in both potency (P = 0.005) and efficacy (P < 0.0001). Affinity for the GABAA receptor’s two β+ − α– anesthetic binding sites similarly decreased with substituent group volume (P = 0.003), whereas affinity for the receptor’s α+ – β–/γ+ – β– sites did not (P = 0.804). Introduction of the N265M mutation, which is located at the β+ − α– binding sites and renders GABAA receptors etomidate-insensitive, completely abolished positive modulation by naphthalene-etomidate.

Conclusions

Steric hindrance selectively reduces phenyl ring–substituted etomidate analog binding affinity to the two β+ − α– anesthetic binding sites on the GABAA receptor’s open state, suggesting that the binding pocket where etomidate’s phenyl ring lies becomes smaller as the receptor isomerizes from closed to open.
Assessment of the Impact of Perioral Rejuvenation With Hyaluronic Acid Filler on Projected First Impressions and Mood Perceptions
Authors: Dayan Steven H. , Bacos Jonathan T. , Gandhi Nimit D. , Ho Thuy-Van T. , Kalbag Arjun
Published: July 2018

BACKGROUND

Small-particle hyaluronic acid filler is approved for lip augmentation and correction of perioral rhytides. Treatment with this product may improve facial aesthetics, projected first impression, and self-perception of mood.

OBJECTIVE

To determine the effect of perioral rejuvenation with hyaluronic acid on patient perception of mood and projected first impression.

MATERIALS AND METHODS

Seventeen subjects underwent perioral rejuvenation treatment with small-particle hyaluronic acid filler. Each subject underwent photography and completed 2 surveys measuring self-perception of mood before treatment and after achieving an optimal cosmetic result. Aesthetic improvement with treatment was assessed using the Global Aesthetic Improvement Scale and the Oral Commissure Severity and Perioral Line Severity scales. Seventeen hundred blinded evaluators rated pre-treatment and post-treatment photographs of the subjects using a First Impressions Questionnaire.

RESULTS

Perioral filler treatment significantly improved pre-treatment and post-treatment scores for happiness within the Happiness Measures Scale. This treatment was found to significantly improve projected first impression across all categories.

CONCLUSION

Small-particle hyaluronic acid filler treatment for perioral rejuvenation is an effective method for improving physical appearance as well as first impressions. Larger studies are necessary to verify whether perioral rejuvenation with hyaluronic acid offers enhanced self-perception of mood.
Characteristics of Patients Receiving Treatment Who Deny A Diagnosis Glaucoma or Elevated Intraocular Pressure in the United States
Authors: Lowry Eugene A. , Mansberger Steven L.
Published: July 2018

Purpose:

The purpose of this study was to determine the proportion of patients in the US population who are receiving long-term intraocular pressure (IOP)-lowering medication, but, deny having a diagnosis of glaucoma or elevated IOP.

Materials and Methods:

The National Health and Nutrition Examination Survey (NHANES) is a home-based survey of a cross-sectional, representative, stratified sample of the US population every 2 years. Questions on prescription medication use are asked in every survey cycle, and patients were questioned whether they had ever been diagnosed with glaucoma or elevated IOP in the 2005-2006 and 2007-2008 surveys. During these 2 cycles, there were 7081 participants over age 40 of whom 135 endorse at least one year of topical IOP-lowering medication and were included in the final study.

Results:

A total of 8.8% of Americans taking IOP-lowering medications for at least one year denied a diagnosis of glaucoma or high eye pressure. Patients taking more medications were more likely to endorse their diagnosis.

Conclusions:

Over 150,000 Americans being treated for glaucoma or ocular hypertension may be unaware or deny a glaucoma diagnosis. Improving this awareness may enhance adherence. Patient awareness of their diagnosis is essential to quality care.
Outcome Measurement Instruments for Provoked Vulvodynia: A Systematic Review
Authors: Davenport Rachael B. , Voutier Catherine R. , Veysey Emma C.
Published: July 2018

Objective

The objective of this study was to detail the outcome measurement instruments used in randomized control trials and observational studies investigating therapeutic interventions for provoked vulvodynia.

Materials and Methods

We searched Ovid Medline, Embase, Emcare, and PyschINFO libraries from database inception through April 2017. We included randomized control trials and observational studies of provoked vulvodynia that used instruments to measure the outcome of therapeutic interventions.

Results

A total of 2299 articles were retrieved and 25 were eligible for inclusion in accordance with the selection criteria. The included studies measured 26 different outcomes, using 110 outcome measurement instruments. Patient-reported outcomes were most commonly measured (144/166, 86%), followed by physician-reported outcomes (20/166, 12%). The most commonly measured outcomes were patient-reported psychological impact of disease (27/166, 16%), patient-reported improvement in dyspareunia (25/166, 15%), and patient-reported reduction in pain (24/166, 14%). The Pain Catastrophizing Scale, the Beck Depression Inventory, and the State Trait Anxiety Questionnaire were the most commonly used instruments to measure psychological impact.

The most commonly measured clinician-rated outcome was an improvement in pain (17/166, 10%), which was most frequently assessed by the cotton swab test. Only 34 (31%) outcome measurement instruments were specific to vulvodynia (26/110, 23%) or sexual functioning (8/110, 7%).

Conclusions

There is a wide range of outcome measurement instruments used in provoked vulvodynia studies, resulting in inconsistency of reporting and difficulty in comparing and combining findings for systemic review. There is a pressing need for the development of validated, reliable instruments and consensus on a core outcome set for further research purposes.
Curricular Innovations for Teaching Undergraduate Nursing Students Care of Older Adults
Authors: Gray-Miceli Deanna , Morse Catherine
Published: July 2018

Background

By 2030, 1 in 5 persons will be 65 years or older. To address the health care needs of the burgeoning elderly population, nursing faculty need to use curricular models that are poised to deliver age-appropriate nursing care to the specialized needs of the older adult population.

Problem

The lack of geriatric clinical experiences and clinical faculty who do not have expertise in geriatric nursing assessment create barriers to guide students in learning about care of older adults.

Approach

A new curricular approach to educate prelicensure nursing students about caring for older adults was created, which used 6 types of learning assignments during a 7-week clinical practicum. Students were exposed to interactive learning assignments based on competencies involving interviewing, performance-based assessment, clinical decision making, and problem-based learning.

Outcome

Prelicensure nursing students (n = 124) rated the interactive, performance-based functional evaluation assignment highest for perceived understanding and as the best type of learning experience.
Applying Artificial Intelligence to Identify Physiomarkers Predicting Severe Sepsis in the PICU*
Authors: Kamaleswaran Rishikesan , Akbilgic Oguz , Hallman Madhura A. , West Alina N. , Davis Robert L. , Shah Samir H.
Published: July 2018

Objectives:

We used artificial intelligence to develop a novel algorithm using physiomarkers to predict the onset of severe sepsis in critically ill children.

Design:

Observational cohort study.

Setting:

PICU.

Patients:

Children age between 6 and 18 years old.

Interventions:

None.

Measurements and Main Results:

Continuous minute-by-minute physiologic data were available for a total of 493 critically ill children admitted to a tertiary care PICU over an 8-month period, 20 of whom developed severe sepsis. Using an alert time stamp generated by an electronic screening algorithm as a reference point, we studied up to 24 prior hours of continuous physiologic data. We identified physiomarkers, including sd of heart rate, systolic and diastolic blood pressure, and symbolic transitions probabilities of those variables that discriminated severe sepsis patients from controls (all other patients admitted to the PICU who did not meet severe sepsis criteria). We used logistic regression, random forests, and deep Convolutional Neural Network methods to derive our models. Analysis was performed using data generated in two windows prior to the firing of the electronic screening algorithm, namely, 2–8 and 8–24 hours. When analyzing the physiomarkers present in the 2–8 hours analysis window, logistic regression performed with specificity of 87.4% and sensitivity of 55.0%, random forest performed with 79.6% specificity and 80.0% sensitivity, and the Convolutional Neural Network performed with 83.0% specificity and 75.0% sensitivity. When analyzing physiomarkers from the 8–24 hours window, logistic regression resulted in 77.1% specificity and 39.3% sensitivity, random forest performed with 82.3% specificity and 61.1% sensitivity, whereas the Convolutional Neural Network method achieved 81% specificity and 76% sensitivity.

Conclusions:

Artificial intelligence can be used to predict the onset of severe sepsis using physiomarkers in critically ill children. Further, it may detect severe sepsis as early as 8 hours prior to a real-time electronic severe sepsis screening algorithm.
Efficacy and Safety of Hepatitis B Vaccination in Rheumatoid Arthritis Patients Receiving Disease-Modifying Antirheumatic Drugs and/or Biologics Therapy
Authors: Intongkam Samanan , Samakarnthai Parinya , Pakchotanon Rattapol , Narongroeknawin Pongthorn , Assavatanabodee Paijit , Chaiamnuay Sumapa
Published: July 2018

Objectives

The aims of this study were to assess efficacy and safety of the hepatitis B vaccination in rheumatoid arthritis (RA) patients receiving conventional and/or biological disease-modifying antirheumatic drugs (DMARDs).

Methods

A longitudinal open-label study was conducted. Of 46 RA patients, 33 received only conventional synthetic DMARDs, and 13 received both conventional synthetic DMARDs and biological DMARDs, and 9 healthy age- and sex-matched control subjects were vaccinated with 20 μg recombinant hepatitis B vaccine (EuVax B) at weeks 0, 4, and 24. Hepatitis B surface antibody levels were measured 8 weeks after the last dose of vaccination. Seroprotection was defined as hepatitis B surface antibody level of 10 mIU/mL or greater. Disease Activity Score in 28 Joints scores were recorded at weeks 0, 4, and 32 in 46 RA patients who received hepatitis B vaccination and 47 treatment-matched RA patients who did not receive it. Adverse events were recorded at each visit.

Statistical analyses were performed using SPSS version 16.0.

Results

Seroprotection was lower in the RA patients than in the control subjects (64% vs. 100%, p = 0.045). Patients receiving biological DMARDs and conventional DMARDs had a lower proportion of seroprotection compared with the control group (50% vs. 100% [p = 0.02] and 69.7% vs. 100% [p = 0.09], respectively). Among RA patients, responders were younger than nonresponders with a mean age of 57.5 (SD, 9.0) years and 64.9 (SD, 10.9) years (p = 0.04) and less likely to be treated with rituximab (6.9% vs. 37.5%, p = 0.01). Overall, hepatitis B vaccination was well tolerated. The rate of RA flare was not increased after hepatitis B vaccination.

Conclusions

Patients with RA receiving DMARDs had less humoral response to hepatitis B vaccination as compared with control subjects. Aging and rituximab use were associated with impaired response to hepatitis B vaccination. Hepatitis B vaccination is safe and well tolerated in RA patients.
Practical Guidance on Biosimilars, With a Focus on Latin America
Authors: Azevedo Valderilio Feijó , Babini Alejandra , Caballero-Uribe Carlo V. , Castañeda-Hernández Gilberto , Borlenghi Cecilia , Jones Heather E.
Published: July 2018

Background/Historical Perspective

Availability of biologic disease-modifying antirheumatic drugs (bDMARDs) has improved clinical outcomes in rheumatoid arthritis, but it also increased the cost of treatment. Biosimilars, the regulated copies of biologic products, have a potential to reduce health care costs and expand access to treatment. However, because of a complex development process, biosimilars can be considered only those noninnovator biologics with satisfactory supporting evidence (ranging from structural to clinical), as outlined in the recommendations by the World Health Organization (WHO). In Latin America, a heterogeneous regulatory landscape and nonconsistent approval practices for biosimilars create decision-making challenges for practicing rheumatologists.

Summary of Literature

Most Latin American countries either have adopted or are in the process of adopting guidelines for the approval of biosimilars. However, among several marketed bDMARDs in the region, currently there are only 2 products that could be considered true biosimilars, based on the WHO criteria. The rest can be considered only intended copies, whose safety and efficacy are not fully established. One such product had to be withdrawn from the market because of safety concerns.

Conclusions and Future Directions

Practicing rheumatologists in Latin America need to understand the regulatory situation for biosimilars in their countries. When considering bDMARDs that are not innovator products, clinicians should use only those that have been approved according to the WHO recommendations. For clarification, local health authorities or professional associations should be contacted.
Developing an In-house Interdisciplinary Three-Dimensional Service: Challenges, Benefits, and Innovative Health Care Solutions
Authors: Hatamleh Muhanad M. , Ong Juling , Hatamleh Zaydoon Mohammad , Watson Jason , Huppa Chrisopher
Published: July 2018

Three-dimensional printing (3DP) technologies have been employed in regular medical specialties. They span wide scope of uses, from creating 3D medical models to design and manufacture of Patient-specific implants and guidance devices which help to optimize medical treatments, patient education, and medical training. This article aims to provide an in-depth analysis of factors and aspects to consider when planning to setup a 3D service within a hospital serving various medical specialties. It will also describe challenges that might affect 3D service development and sustainability and describe representative cases that highlight some of the innovative approaches that are possible with 3D technology. Several companies can offer such 3DP service. They are often web based, time consuming, and requiring special call conference arrangements. Conversely, the establishment of in-house specialized hospital-based 3D services reduces the risks to personal information, while facilitating the development of local expertise in this technology. The establishment of a 3D facility requires careful consideration of multiple factors to enable the successful integration with existing services. These can be categorized under: planning, developing and sustaining 3D service; 3D service resources and networking workflow; resources and location; and 3D services quality and regulation management.
Individualized Treatment for Infantile Hemangioma
Authors: Xu Meng-nan , Zhang Min , Xu Yuan , Wang Min , Yuan Si-Ming
Published: July 2018

Infantile hemangioma can grow dramatically or typically locate on the face, which may lead to functional impairment, cosmetically disfiguring and exhibiting complications such as ulceration, bleeding, or infection. Early intervention is necessary. In this study, the authors chose individual treatment for different patients. From January 2012 to December 2016, 185 patients with hemangioma were enrolled into this study. Lesion area ranged from 0.5 cm × 0.5 cm to 9 cm × 12 cm. The initial treatment age ranged from 1 to 7 months with an average age of 3.9 months. Thirty-five children achieved the treatment of Intralesional Compound Betamethasone, 134 children achieved the treatment of oral propranolol, and 16 children achieved the treatment of topical carteolol. In the follow-up, the treatment could be repeated or switched to oral propranolol if the tumor tended to grow again. At the end of follow-up, 89% of the patients’ tumors shrinked or involuted completely, 5 patients switched to oral propranolol. The adverse effects included soft tissue atrophy, moon face, diarrhea, heart rate reduction, and liver enzyme abnormalities. All of the patients recovered in a short period. Early treatment for hemangioma can achieve good results and avoid functional impairment. For different patients, the authors suggest individualized treatment according to the tumors’ size and location.
Persistent Nasal Infantile Hemangioma: A Surgical Treatment Algorithm
Authors: Giugliano Carlos , Reculé Francisca , Guler Kenneth , Gantz José Tomás , Hasbún Trinidad
Published: July 2018

Treatment of infantile hemangioma is usually medical. The nose is one of the most important aesthetic and functional units of the face; therefore, surgical management is preferred in persistent lesions (fibro-fatty tissue component) that do not respond to medical treatment. Herein, the authors analyze the results of surgical nasal hemangioma treatment in their center, a literature review and propose an algorithm for surgical management. A retrospective analysis of 23 persistent nasal hemangioma operated between 1996 and 2014 at our institution was made. The authors recollected the following demographic and clinical data: hemangioma subtype, phase of evolution, affected aesthetic nasal subunit, previous treatment, surgery type, complications and follow-up period. The Strasser scale was chosen for assessment of postoperative photographic results. Surgical treatment was performed. Age average was 6.8 years old (range 2–19). Mixed hemangioma was the most common subtype (83%). Surgery was mainly performed in the involution phase (87%). The most affected aesthetic subunit was nasal tip (44%). All lesions received previous medical treatment. The most common surgical technique was open rhinoplasty approach. Follow-up was an average of 26.6 months. Aesthetic results according to the Strasser method included: 3 excellent scores, 15 good, 5 regular, and none poor. Surgery was performed on patients in order to correct nasal persistent hemangiomas sequel. The nose has serious psychosocial impact and mixed infantile hemangiomas appear to have a higher rate of persistent hemangioma requiring surgery, but further studies are needed. Aesthetic outcome with surgical procedures chosen were acceptable and no complications were reported.
22q11.2 Deletion: Surgical and Speech Outcomes of Patients With Velopharyngeal Insufficiency Treated With a Superiorly Based Pharyngeal Flap as the Primary Surgery
Authors: Álvarez Carvajal Drina C. , Palomares Aguilera Mirta M. , Geldres Meneses María B. , Bravo-Torres Sofía , Giugliano Villarroel Carlos
Published: July 2018

The most frequent palate diagnoses in patients with chromosome 22q11.2 deletion syndrome are a classic submucous cleft, occult, and velopharyngeal insufficiency without cleft, which generates alterations in speech that require surgery. Surgical protocols are controversial owing to syndrome characteristics that make their handling more complex. Pharyngeal flap pharyngoplasty is effective for this type of patient. The objective of this study is to examine the surgical management of velopharyngeal insufficiency in patients with chromosome 22 deletion, using a pharyngeal flap as the primary surgery. The clinical records of patients with chromosome 22 deletion and velopharyngeal insufficiency between 2015 and 2017 were analyzed retrospectively. Eight patients underwent pharyngeal flap pharyngoplasty as a primary surgery, including 1 with velopharyngeal insufficiency without a cleft, 1 with a classic submucous cleft, and 6 with occult submucous cleft. The pre- and postoperative protocol performed by speech therapists and surgeons included clinical evaluation of the oral cavity; perceptual, video recording, and nasometry speech evaluation; and videonasopharyngoscopy. All perceptual parameters and nasometry results significantly changed. Of the cases, 88% achieved a flap with the expected width and height and complete closure of the velopharyngeal sphincter. One patient required flap revision. Four of the 8 patients achieved normal resonance, and 2 of 8 showed mild hypernasality. Using the pharyngeal flap pharyngoplasty as a primary technique to correct velopharyngeal insufficiency in patients with chromosome 22 deletion provides satisfactory outcomes and decreases the number of surgeries. Preoperative planning must be conducted carefully and needs to be individualized to be successful.
Statewide Success of Staged Sacral Neuromodulation for the Treatment of Urinary Complaints in California (2005–2011)
Authors: Dobberfuhl Amy D. , Mahal Amandeep , Dallas Kai B. , Choi Katherine M. , Comiter Craig V. , Elliott Christopher S.
Published: July 2018

Purpose

Sacral neuromodulation (SNS) is approved by the Food and Drug Administration as a third-line treatment for refractory overactive bladder, idiopathic urinary retention, and fecal incontinence. Prior to implantation of an implantable pulse generator, all patients undergo a trial phase to ensure symptom improvement. The published success rates of progression from the test phase to permanent implant vary widely (range, 24% to >90%). We sought to characterize success rates using a statewide registry.

Methods

Using nonpublic data, we identified SNS procedures using the California Office of Statewide Planning and Development ambulatory surgery database from 2005 to 2011. A successful trial was defined as receiving a stage 2 generator implantation after trial lead placement. Multivariable logistic regression was performed to identify factors associated with staged success.

Results

During the study period, 1396 patients underwent a staged SNS procedure, with 962 (69%) subsequently undergoing generator placement. Successful trial rates were 72% for overactive bladder wet, 69% for urgency/frequency, 68% for interstitial cystitis, 67% for neurogenic bladder, and 57% for urinary retention. On multivariate logistic regression, only male sex (odds ratio, 0.51) and urinary retention [odds ratio, 0.54) were significantly associated with lower odds of success, whereas age, race/ethnicity, medical insurance, and placement at an academic or high-volume institution had no association.

Conclusions

The “real world” success rates for staged SNS implantation in California are less than those observed by some academic centers of excellence but better than previously reported for Medicare beneficiaries. Successful trial rates for interstitial cystitis and neurogenic voiding dysfunction are similar to refractory overactive bladder.
Fungal Lumbosacral Osteomyelitis After Robotic-Assisted Laparoscopic Sacrocolpopexy
Authors: Boyd Brittni , Pratt Toya , Mishra Kavita
Published: July 2018

Sacral osteomyelitis is a rare complication after robotic sacrocolpopexy, with previous reports of enteric and skin flora as inciting organisms. We report a patient who presented with severe low back pain and fever 6 weeks after a robotic sacrocolpopexy, who was subsequently diagnosed as having lumbosacral discitis and osteomyelitis with thoracic intervertebral extension. Empiric antibiotic therapy was initially administered. After laparoscopic mesh excision and abdominal wash out, Candida albicans was isolated from the excised mesh. Postoperatively, the patient was treated with a 12-month course of oral fluconazole with significant clinical improvement. To our knowledge, this is the second reported case of fungal osteomyelitis, providing further recommendations for the management of postoperative sacral osteomyelitis using a minimally invasive surgical technique and guidance by a multidisciplinary team.
Interventions for Multilingual Children With Hearing Loss
Authors: Guiberson Mark , Crowe Kathryn
Published: July 2018

The aim of this article was to (1) provide a scoping review of the literature addressing speech, auditory, language, and literacy interventions in multilingual children with hearing loss, and (2) identify future research directions. The search conducted for this scoping review yielded a total of 27 sources describing 58 intervention approaches for a range of grade levels (from preschool age through school age). The majority of interventions were obtained from sources describing children with hearing loss (n = 35), followed by multilingual children (n = 32), multilingual children with additional needs (n = 22), and finally multilingual children with hearing loss (n = 17). The scope of the interventions identified and the strength of intervention recommendations are discussed. This scoping review identified a number of compelling and promising research-based interventions from the best available evidence currently available, and this review confirmed the need for more intervention studies with multilingual children with hearing loss.
Impact of Escalating Literacy Demands on English Learners With Hearing Loss
Authors: Rosa-Lugo Linda I. , Ehren Barbara J.
Published: July 2018

Gainful employment for adults in the United States currently requires high levels of literacy. As challenging as these requirements may be for the workforce at large, for adults who have a hearing loss (HL) and whose first spoken language is not English, the demands are especially problematic. Therefore, it is critical that educators prepare English learner (EL) K-12 students with HL for life beyond school by understanding and addressing the underlying language of curriculum. The authors explore the escalating literacy demands of the workforce and the corresponding spoken and written language demands of more rigorous K-12 curriculum standards. They highlight the specific challenges of EL children and adolescents with HL who are acquiring English as a second spoken language. They make the case for a more robust collaborative approach, involving multiple perspectives, rather than “teamwork,” in addressing the needs of these students across the grades, with intercultural competence as a major component in engaging families as partners.
Providing Interventions That Support Literacy Acquisition in Children With Hearing Loss
Authors: Houston K. Todd , Robertson Lyn , Wray Denise
Published: July 2018

Today, children with hearing loss are often identified at birth, fitted with advanced hearing technology, and enrolled in family-centered early intervention. Most of these children have the opportunity to enter kindergarten or first grade with language competencies that rival their hearing peers. For these children to be successful communicators ready to learn, professionals serving them and their families—such as early interventionists, speech-language pathologists, and early childhood educators—must understand the developmental, communicative, and educational challenges inherent to childhood hearing loss. Likewise, these professionals also must be competent practitioners in the provision of evidence-based interventions that establish the critical foundations for literacy acquisition.
Interdisciplinary Design to Improve Fast Track in the Emergency Department
Authors: Celona Carol Anne , Amaranto Andrew , Ferrer Robin , Wieland Matt , Abrams Stacy , Obusan Farley , LoPuzzo Sharon , Joy Valsamma
Published: July 2018

Delays in medical care will increase risks for patients. For this reason, timeliness of care is a public health priority and the one of the missions for this facility. The goal of this process improvement project was to enhance timeliness of care by restructuring fast track. Door-to-provider time, treat and release time, and the number of patients who left without being seen by a provider were monitored. Nurse practitioners were introduced into advanced practice provider mix and the development of care teams was implemented. The number of fast-track visits increased significantly to a projected 23,710 in 2017, whereas the door-to-provider time decreased to 48 min, treat and release times decreased to 162 min, and the number of patients who left without being seen decreased to 4.7%. Work needs to continue in these areas in to exceed Medicare and Medicaid Services benchmarks.
Learning-based screening of hematologic disorders using quantitative phase imaging of individual red blood cells
Authors: Kim Geon , Jo YoungJu , Cho Hyungjoo , Min Hyun-seok , Park YongKeun
Published: July 2018

We present a rapid and label-free method for hematologic screening for diseases and syndromes, utilizing quantitative phase imaging (QPI) and machine learning. We aim to establish an efficient blood examination framework that does not suffer from the drawbacks of conventional blood assays, which are incapable of profiling single cells or using labeling procedures. Our method involves the synergistic employment of QPI and machine learning. The high-dimensional refractive index information arising from the QPI-based profiling of single red blood cells is processed to screen for diseases and syndromes using machine learning, which can utilize high-dimensional data beyond the human level. Accurate screening for iron-deficiency anemia, reticulocytosis, hereditary spherocytosis, and diabetes mellitus is demonstrated (>99% accuracy) using the proposed method. Furthermore, we highlight the synergy between QPI and machine learning in the proposed method by analyzing the performance of the method.
WEScover: selection of whole exome sequencing vs. gene panel testing
Authors: Alvarez William Jefferson , Lee In-Hee , Hernandez-Ferrer Carles , Mandl Kenneth D. , Kong Sek Won
Published: July 2018

Motivation

Whole exome sequencing (WES) is widely adopted in clinical and research settings. However, there is potential for false negatives due to incomplete breadth and depth of coverage for several exons in clinically implicated genes. In some cases, a targeted gene panel testing may be a dependable option to ascertain true negatives for genomic variants in known phenotype associated genes. We developed a tool for quickly gauging whether all genes of interest would be reliably covered by WES or whether targeted gene panel testing should instead be considered to minimize false negatives in candidate genes.

Results

WEScover is a novel web application that provides an interface for discovering breadth and depth of coverage across population scale WES datasets, searching either by phenotype, by targeted gene panels and by gene(s). Moreover, the application shows metrics from the Genome Aggregation Database to provide gene-centric view on breadth of coverage.

Conclusion

WEScover allows users to efficiently query genes and phenotype for exome coverage of associated exons, and recommends use of panel tests for genes that are potentially not well covered by WES.
The R package Rsubread is easier, faster, cheaper and better for alignment and quantification of RNA sequencing reads
Authors: Liao Yang , Smyth Gordon K. , Shi Wei
Published: July 2018

The first steps in the analysis of RNA sequencing (RNA-seq) data are usually to map the reads to a reference genome and then to count reads by gene, by exon or by exon-exon junction. These two steps are at once the most common and also typically the most expensive computational steps in an RNA-seq analysis. These steps are typically undertaken using Unix command-line or Python software tools, even when downstream analysis is to be undertaken using R.

We present Rsubread, a Bioconductor software package that provides high-performance alignment and counting functions for RNA-seq reads. Rsubread provides the ease-of-use of the R programming environment, creating a matrix of read counts directly as an R object ready for downstream analysis. It has no software dependencies other than R itself. Using SEQC data and simulations, we compare Rsubread to the popular non-R tools TopHat2, STAR and HTSeq. We also compare to counting functions provided in the Bioconductor infrastructure packages. We show that Rsubread is faster, uses less memory and produces read count summaries that more accurately correlate with true values. The results show that users can adopt the R environment for alignment and quantification without suffering any loss of performance.
Mobility in Osteogenesis Imperfecta: A Multicenter North American Study
Authors: Kruger Karen M. , Caudill Angela , Rodriguez Celin Mercedes , Nagamani Sandesh CS , Shapiro Jay R , Steiner Robert D , Bober Michael B , Hart Tracy , Cuthbertson M.S. David , Krischer Jeff , Byers Peter H , Durigova Michaela , Glorieux Francis H , Rauch Frank , Sutton V Reid , Lee Brendan , Rush Eric T , Smith Peter A. , Harris Gerald F.
Published: July 2018

Background

Osteogenesis imperfecta (OI) is a genetic connective tissue disorder characterized by increased bone fragility and recurrent fractures. The phenotypic severity of OI has a significant influence on the ability to walk but little is known about the ambulatory characteristics, strength, or functional abilities in individuals with OI, especially in the more severe forms. To advance clinical research in OI, the Linked Clinical Research Centers, network of clinical centers in North America with significant experience in treating patients with OI, was established in 2009. The purpose of this work was to characterize mobility in OI using standard clinical assessment tools. and determine if any patient characteristics could be used to predict mobility outcomes.

Methods

Data were collected at five clinical sites and included age, gender, ethnicity, height, weight, use of assistive device, and bisphosphonate use and mobility metrics (age at first walk, Gillette Functional Assessment Questionnaire, Functional Mobility Scale, and distance walked in the 6 minute walk test). Linear mixed models were developed to explore the relationships between subject demographics and mobility metrics.

Results

The study identified 491 individuals age 3 and older. In general, the results showed minor limitations in the type I group while the more severe types showed more significant limitations in all mobility metrics analyzed. Height and weight were shown to be the most significant predictors of mobility metrics. Relationships with mobility and bisphosphonates varied with OI type and whether oral or IV was used.

Conclusion

This paper is the most comprehensive report of mobility in individuals with OI to date. These results are vital to understanding the mobility limitations of specific types of OI and beneficial when developing rehabilitation protocols for this population. It is important for physicians, patients, and caregivers to gain insight into severity and classification of the disease and the influence of disease-related characteristics on the prognosis for mobility.
Disentangling the Role of Face Typicality and Affect in Emotional Face Processing: Self-reported and Electrophysiological Evidence
Authors: Pereira Mariana R. , Paiva Tiago O. , Barbosa Fernando , Almeida Pedro R. , Martins Eva C. , Baldeweg Torsten , de Haan Michelle , Ferreira-Santos Fernando
Published: July 2018

Typicality, or averageness, is one of the key features that influences face evaluation, but the role of this property in the perception of facial expressions of emotions is still not fully understood. Typical faces are usually considered more pleasant and trustworthy, and neuroimaging results suggest typicality modulates amygdala and fusiform activation, influencing face perception. At the same time, there is evidence that arousal is a key affective feature that modulates neural reactivity to emotional expressions. In this sense, it remains unclear whether the neural effects of typicality depend on altered perceptions of affect from facial expressions or if the effects of typicality and affect independently modulate face processing. The goal of this work was to dissociate the effects of typicality and affective properties, namely valence and arousal, in electrophysiological responses and self-reported ratings across several facial expressions of emotion. Two ERP components relevant for face processing were measured, the N170 and Vertex Positive Potential (VPP), complemented by subjective ratings of typicality, valence, and arousal, in a sample of 30 healthy young adults (21 female). The results point out to a modulation of the electrophysiological responses by arousal, regardless of the typicality or valence properties of the face. These findings suggest that previous findings of neural responses to typicality may be better explained by accounting for the subjective perception of arousal in facial expressions.