bluuebunny/crossref_metadata_2025 huggingface dataset:
Can We Do More With Less While Building Predictive Models? A Study in Parsimony of Risk Models for Predicting Heart Failure Readmissions
Authors: Mahajan Satish M. , Mahajan Amey , Burman Prabir , Heidenreich Paul
Published: December 2018

Hospital readmission due to heart failure is a topic of concern for patients and hospitals alike: it is both the most frequent and expensive diagnosis for hospitalization. Therefore, accurate prediction of readmission risk while patients are still in the hospital helps to guide appropriate postdischarge interventions. As our understanding of the disease and the volume of electronic health record data both increase, the number of predictors and model-building time for predicting risk grow rapidly. This suggests a need to use methods for reducing the number of predictors without losing predictive performance. We explored and described three such methods and demonstrated their use by applying them to a real-world dataset consisting of 57 variables from health data of 1210 patients from one hospital system. We compared all models generated from predictor reduction methods against the full, 57-predictor model for predicting risk of 30-day readmissions for patients with heart failure. Our predictive performance, measured by the C-statistic, ranged from 0.630 to 0.840, while model-building time ranged from 10 minutes to 10 hours. Our final model achieved a C-statistic (0.832) comparable to the full model (0.840) in the validation cohort while using only 16 predictors and providing a 66-fold improvement in model-building time.
A STROBE compliant observational study on trace elements in patients with ulcerative colitis and their relationship with disease activity
Authors: Poursadegh Farid , Ahadi Mitra , Vosoughinia Hassan , Salehi Maryam , Beheshti Namdar Ali , Farzanehfar Mohammad Reza , Memar Bahram , Ziaolhagh Reza
Published: December 2018

Nutritional deficiencies and malnutrition are considered to be related to ulcerative colitis (UC); however, the association between serum levels of micronutrients and UC is not well known. This study aimed to evaluate the serum levels of micronutrients in UC patients and investigate their association with disease activity.

This cross-sectional study was conducted on UC patients visiting the Department of Gastroenterology at 3 different teaching hospitals between January 2016 and January 2017. UC activity was measured based on Truelove and Witts’ severity index and guidelines for colonoscopy. A healthy gender- and age-matched group was also selected. Serum levels of zinc, copper, selenium, ceruloplasmin, albumin, and total protein were compared between the 2 groups of UC patients and healthy subjects using independent-samples t test. Also, the association between serum levels of micronutrients and UC activity was assessed by using Pearson and Spearman correlation coefficient tests. The data were analyzed by SPSS version 21, considering P ≤.05 as the statistical significance level.

Overall, 112 (54 male and 58 female) individuals with the mean age of 34.6 years were studied in the 2 groups of UC patients (n = 56) and healthy subjects (n = 56). The 2 groups were homogeneous in terms of age, gender, marital status, place of residence, and educational level (P >.05). The serum levels of total protein (6.41 ± 1.1 vs 7.41 ± 0.4 g/dL; P = .0001), albumin (4.72 ± 1.1 vs 5.19 ± 0.28 g/dL; P = .0001), zinc (679 ± 62 vs 1055 ± 156 μg/L; P = .0001), and selenium (81.85 ± 6.4 vs 108.4 ± 12.98 micg/L; P = .0001) were significantly lower in the UC patients. The serum level of copper did not differ significantly between the 2 groups (P = .1).

Considering the simultaneous reduction in nutritional criteria in the UC patient group, malnutrition appears to be a factor affecting micronutrient deficiency in patients with UC.
Myiasis-induced sepsis: a rare case report of Wohlfahrtiimonas chitiniclastica and Ignatzschineria indica bacteremia in the continental United States
Authors: Lysaght Travis B. , Wooster Meghan E. , Jenkins Peter C. , Koniaris Leonidas G.
Published: December 2018

Rationale:

The presentation of sepsis and bacteremia in cutaneous and cavitary myiasis is uncommon. We present a patient, residing in a temperate region of the United States, with myiasis and sepsis from the emerging human pathogens Wohlfahrtiimonas chitiniclastica and Ignatzschineria indica.

Patient concerns:

A 37-year-old male patient with an 8-month history of chronic lymphedema and ulcers of the lower left extremity presented with myiasis of the left foot and leg. The patient was initially seen by his family practitioner many times and was prescribed antibiotics which he could not afford. Debridement of the myiasis was not conducted by the family practitioner due to the belief that the patient's current state of myiasis would effectively debride and eventually heal the chronic ulcers along with multiple antibiotic regimens. Over the 8-month period, the patient developed a progressive, painful, necrotizing infection of his lower left extremity.

Diagnoses:

Physical examination clearly showed myiasis of the patient's lower left extremity, believed to be caused by Lucilia sericata (green bottle fly). Blood cultures revealed the presence of Providencia stuartii, W chitiniclastica, and I indica to be the underlying cause of sepsis and bacteremia.

Interventions:

All visible maggots were extracted, debridement of devitalized tissue was performed, and the leg ulcers were wrapped in pH neutral bleach. The patient was initially treated with a broad-spectrum antibiotic regimen of vancomycin, clindamycin, piperacillin, and tazobactam which, following clinical improvement, was de-escalated to cefepime.

Outcomes:

The fly larvae and maggots were removed from the extremity by scrubbing, pulse lavage, and filing away the callused tissue. Additionally, the patient's sepsis and bacteremia, caused by W chitiniclastica and I indica, were successfully treated through antibiotic intervention. Amputation was avoided.

Lessons:

The use of pulse lavage and chlorhexidine-soaked brushes for the removal of cavitary myiasis is an effective and minimally invasive procedure which does not cause additional damage to surrounding tissue. W chitiniclastica and I indica are emerging bacteria that have known association to parasitic fly myiasis in humans and are capable of causing sepsis and/or bacteremia if not accurately identified and treated promptly.
Comparison of refractive outcomes between femtosecond laser-assisted cataract surgery and conventional cataract surgery
Authors: Whang Woong-Joo , Yoo Young-Sik , Joo Choun-Ki , Yoon Geunyoung
Published: December 2018

The purpose of our study is to compare the predictive accuracy of femtosecond laser-assisted cataract surgery with the results of conventional cataract surgery. This prospective study included 83 eyes from 83 patients who underwent femtosecond laser-assisted cataract surgery and 83 eyes from 83 patients who underwent conventional cataract surgery. Preoperative IOL power calculations were performed with the partical coherence interferometry. Femtosecond laser-assisted capsulotomy was based on 5.2 mm scanned capsule center. Following phacoemulsification, 1-piece IOL was inserted into the capsular bag. Refractive outcome was measured 3 months postoperatively with manual refraction. Predicted refraction was assessed by the Barret-Universal II, Haigis, Hoffer Q, SRK/T, and T2 formulas. We applied optimized IOL constants and retrospectively personalized IOL constants. There was no difference in preoperative demographic data. When the optimized IOL constants were used, the femtosecond laser-assisted group produced significantly lower MAEs in the Barret-Universal II, Hoffer Q, SRK/T, and T2 formulas (P < .05). After the personalization of IOL constants, there were statistical differences in the Barret-Universal II, Hoffer Q (P < .05). The standard deviation of ME and MedAE were also relatively lower with femtosecond laser-assisted group. In conclusion, femtosecond laser-assisted cataract surgery with Catalys femtosecond laser system produced better refractive outcomes than conventional cataract surgery.
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia
Authors: Jin Linfang , Wang Zhiqiang , Qi Xiaowei
Published: December 2018

Rationale:

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare idiopathic disease with only about 100 cases reported in the literature.

Patient concerns:

Here, we presented 4 cases of DIPNECH. Four patients included 2 females and 2 males, aged 54 to 64 years old; 3 had no smoking history and 1 had history of smoking for 30 years. Surgical resection was performed for every patient. Cases 1 and 3 did not receive postoperative chemotherapy or radiotherapy, and case 2 received 4 times of postoperative chemotherapy. Case 4 just finished the operation and after a period of time, he will receive postoperative chemotherapy.

Diagnoses:

Case 1: A 57-year-old female had chest pain, and computer tomography (CT) examination prompted a mass shadow of left lung lower lobe. Case 2: A 64-year-old female had cough and expectoration for more than 1 month. CT examination showed: a lump with diameter of about 2.5 cm and irregular edge was in right lung upper lobe, being largely possibly lung cancer. Case 3: A 54-year-old male, CT examination accidentally found a long strip-shaped nodule in left lung oblique fissure when checkup's, and he had no fever, cough, expectoration, chest tightness, or chest pain. Case 4: A 61-year-old male, checkup's CT examination accidentally found a nodule, fibrosis, bronchiectasis, and secondary infection in the left lower lobe. Combined with pathological morphology and immunohistochemistry, cases 1 and 3 were diagnosed as DIPNECH with multiple carcinoid tumorlet formation and chronic inflammation and bronchiectasis, case 2 was diagnosed as an adenocarcinoma with DIPNECH and multiple carcinoid tumorlet formation, case 4 was diagnosed as an adenocarcinoma with DIPNECH and multiple carcinoid tumorlet formation and chronic inflammation and bronchiectasis.

Interventions:

Surgical resection was performed for every patient. Cases 1 and 3 did not receive postoperative chemotherapy or radiotherapy, and case 2 received 4 times of postoperative chemotherapy. Case 4 just finished the operation and after a period of time, he will receive postoperative chemotherapy.

Outcomes:

Four patients have been followed up and have had good condition.

Lessons:

DIPNECH is often found accidentally in a surgical specimen, is easily missed, and needs careful observation. Immunohistochemistry is necessary to make this diagnosis.
Evaluation of the correlation of vasculogenic mimicry, Notch4, DLL4, and KAI1/CD82 in the prediction of metastasis and prognosis in non-small cell lung cancer
Authors: Wang Yichao , Yang Ruixue , Wang Xiaolin , Ci Hongfei , Zhou Lei , Zhu Bo , Wu Shiwu , Wang Danna
Published: December 2018

Vasculogenic mimicry (VM) is a new blood supply style in tumors and has long been treated as a useful factor in malignant tumor metastasis and prognosis. Notch4 (a marker of Notch signaling pathway receptors), DLL4 (a marker of Notch signaling pathway ligands) and KAI1/CD82 (a suppressor gene of tumor metastasis) are all effective predictive factors for tumor metastasis. In this study, we analyzed correlations among VM, Notch4, DLL4, and KAI1/CD82 in non-small cell lung cancer (NSCLC), and their respective associations with patients’ clinicopathological parameters and survival rate in NSCLC.

Positive rates of VM, Notch4, DLL4, and KAI1/CD82 in 189 whole NSCLC specimens were detected by histochemical and immunohistochemical staining. Moreover, patients’ clinicopathological information was also collected.

Positive rates of VM, Notch4, and DLL4 were significantly higher, and levels of KAI1/CD82 were significantly lower in NSCLC than in normal lung tissues. Positive rates of VM, Notch4, and DLL4 were positively associated with tumor size, lymph node metastasis (LNM), distant metastasis (DM) and tumor-node-metastasis (TNM) stage, and inversely with patients, overall survival (OS) time and positive rate of DLL4 were positively associated with tumor grade. Levels of KAI1/CD82 were negatively associated with tumor size, LNM, DM, and TNM stage. The KAI1/CD82+ subgroup had significantly longer OS time than did the KAI1/CD82- subgroup. In multivariate analysis, high VM, Notch4, DLL4 levels, tumor size, LNM, DM, TNM stage, and low KAI1/CD82 levels were potential to be independent prognostic factors for overall survival time (OST) in NSCLC patients.

VM and the expression of Notch4, DLL4, and KAI1/CD82 represent promising markers for tumor metastasis and prognosis, and maybe potential therapeutic targets for NSCLC.
Sinonasal hemangiopericytoma caused hypophosphatemic osteomalacia
Authors: Li Jing , Huang Yuanyuan , Yang Fuzhou , Zhang Qi , Chen Decai , Wang Qin
Published: December 2018

Rationale:

Tumor-induced osteomalacia (TIO) is a rare, paraneoplastic syndrome featured with fibroblast growth factor 23 (FGF23) secretion primarily by benign mesenchymal tumors and sometimes by malignancies. TIO diagnosis and treatment is often delayed because TIO usually has nonspecific generalized bone pain and weakness, and location of TIO tumor is quite challenging. Very few TIO caused by sinonasal hemangiopericytoma have been reported in the literature.

Patient concerns:

A 40-year-old Chinese woman presented with diffuse bone pain for more than 1 year. Laboratory examination showed hypophosphatemia, hyperphosphaturia, hypocalcemia, an elevated serum alkaline phosphatase (ALP) level and bone-specific ALP level. Imaging studies revealed low bone mineral density (BMD) and multiple pseudofractures at the ribs. F-18 fluorodeoxyglucose positron emission tomography was negative in searching for tumors. Because no tumor was located, the patient was treated with oral phosphate, calcium, and alfacalcidol, and achieved great relief in her symptoms and improvement in BMD. Six years later, the patient had breast cancer surgery and received chemotherapy, and still had hypophosphatemia. During this time, nasopharyngo-fiberscope showed nasal mass in her left nasal cavity. Then she had her nasal polyps removed and surprisingly the serum phosphate became normal.

Diagnoses and interventions:

The patient had the nasal mass resected, and pathological diagnosis of the nasal mass was sinonasal hemangiopericytoma. Immunohistochemical analysis was positive for FGF23. Thus the final diagnosis was osteomalacia induced by sinonasal hemangiopericytoma. Phosphate supplementation and alfacalcidol were discontinued.

Outcomes:

The patient had normal serum phosphate after 6-month follow-up.

Lessons:

By presenting this case, we hope to remind clinicians that in patients with osteomalacia with undetermined reason and intranasal polypoid mass, sinonasal hemangiopericytoma should be suspected.
Prognostic and clinicopathological value of FoxM1 expression in colorectal cancer
Authors: Yao Yizhou , Wang Xuchao , Jiang Linhua , Shao Xinyu , Zhu Xinguo , He Songbing
Published: December 2018

Background:

The study aims to assess the relationship between FoxM1 expression and clinicopathological parameters and prognosis of patients diagnosed with colorectal cancer (CRC) by summarizing the studies included.

Methods:

PubMed, EMBASE, The Cochrane Library and other sources were searched for relative studies. Odds ratio (OR) and confidence interval (CI) were used to assess association between FoxM1 expression and clinical parameters and prognosis of CRC patients.

Results:

Eight studies were included in the final analysis, with 1149 CRC patients. The outcome revealed that expression of FoxM1 was associated with lymph node metastasis (OR = 0.33, 95%CI = 0.19–0.62, P < .001), distant metastasis (OR = 0.35, 95%CI = 0.24–0.46, P < .001) and tumor node metastasis (TNM) stage (OR = 0.45, 95%CI = 0.29–0.72, P < .001). Meanwhile, reduced FoxM1 expression indicated higher 5-year survival rate (OR = 0.38, 95%CI = 0.18–0.78, P = .01). Expression of FoxM1 was also increased obviously in CRC tissues (OR = 13.04, 95%CI = 4.07–41.71, P < .001).

Conclusion:

This pooled analysis indicated that FoxM1 expression related to lymph node metastasis, distant metastasis, TNM stage and poor prognosis of the CRC patients.
Oncologic Safety of Fat Grafting for Autologous Breast Reconstruction in an Animal Model of Residual Breast Cancer
Authors: Silva Mayara M. A. , Kokai Lauren E. , Donnenberg Vera S. , Fine Jeffrey L. , Marra Kacey G. , Donnenberg Albert D. , Neto Miguel Sabino , Rubin J. Peter
Published: December 2018

Background:

Clinical outcomes suggest that postoncologic reconstruction with fat grafting yields cumulative incidence curves of recurrence comparable to those of other breast reconstruction procedures; however, results from experimental research studies suggest that adipose stem cells can stimulate cancer growth. In this study, a novel animal model of residual cancer was developed in mouse mammary pads to test whether lipofilling impacts the probability of locoregional recurrence of breast cancer after breast conserving surgery.

Methods:

Mammary fat pads of female NOD-SCID gamma mice were each injected with MCF-7 cells in Matrigel. Tumors were allowed to engraft for 2 weeks, after which time either sterile saline (n = 20) or human fat graft (n = 20) was injected adjacent to tumor sites. After 8 weeks, tumors were assessed for volume measurement, histologic grade, Ki67 positivity, and metastatic spread.

Results:

Animals receiving lipofilling after tumor cell engraftment had lower tumor volume and mass (p = 0.046 and p = 0.038, respectively). Macroscopic invasion was higher in the saline group. Histologic grade was not significantly different in the two groups (p = 0.17). Ki67 proliferation index was lower in tumors surrounded by fat graft (p = 0.01). No metastatic lesion was identified in any animal.

Conclusions:

Adipose transfer for breast reconstruction performed in the setting of residual breast tumor in a clinically relevant animal model did not increase tumor size, proliferation, histologic grade, or metastatic spread. This study supports the oncologic safety of lipofilling as part of the surgical platform for breast reconstruction after cancer therapy.
Variation in the Treatment of Distal Radius Fractures in the United States: 2010 to 2015
Authors: Huetteman Helen E. , Shauver Melissa J. , Malay Sunitha , Chung Ting-Ting , Chung Kevin C.
Published: December 2018

Background:

It remains unknown whether treatment trends for distal radius fracture have changed in light of value-based care initiatives during recent years. The authors aimed to characterize modern practice patterns for distal radius fracture management.

Methods:

Truven MarketScan databases from 2009 to 2015 were used to extract demographic characteristics, geographic location, and comorbidities for patients receiving treatment for a distal radius fracture. Regression modeling and Joinpoint analysis were used to assess treatment trends and the association of patient factors with treatment provided.

Results:

Among 499,766 eligible encounters, the rate of internal fixation fluctuated around 13 percent. Casting/splinting remained the most frequent treatment across all populations. Treatment trends varied by age; children and adolescents almost exclusively received closed treatment (mean, 97 percent), yet rates of internal fixation increased among adults and elderly patients. Patients aged 55 to 64 years were most likely to undergo internal fixation (OR, 1.89; 95 percent CI, 1.82 to 1.96). Higher median household income also significantly increased odds of receiving internal fixation (p< 0.001). Despite declining rates of external fixation and percutaneous pinning, regional variations among surgical modalities persist.

Conclusions:

The increased use of internal fixation for distal radius fractures may be slowing. Treatment type continues to differ widely across demographic groups, underscoring the need for standardization. In accordance with value-based care initiatives, treatment decisions should be made to combine patient needs with financial implications on the health system. Comparative effectiveness data to derive optimal management strategies are still warranted.
Histopathologic Evaluation of Flexor Tenosynovium in Recurrent Carpal Tunnel Syndrome
Authors: Scott Kelly L. , Conley Christopher R. , Renfree Kevin J.
Published: December 2018

Background:

The authors’ purpose was to evaluate the histopathology of flexor tenosynovium in true, idiopathic recurrent carpal tunnel syndrome for the presence of abnormal inflammatory or pathologic findings that might explain causation or that differ from those previously described for primary, idiopathic carpal tunnel syndrome.

Methods:

Thirty-five patients (19 women and 16 men; mean age, 72 years) underwent open revision carpal tunnel release a mean 13 years (range, 0.5 to 30 years) after primary carpal tunnel release. Recurrence was confirmed by recurrent symptoms, positive provocative tests, and electrodiagnostic testing. All patients underwent tenosynovial biopsy, including Congo red staining for amyloid.

Results:

Histopathologic findings demonstrated noninflammatory, fibrous connective tissue in 31 of 35 patients (89 percent); and mild, chronic inflammation (without granulomas) in four of 35 patients (11 percent). Nine of 35 patients (26 percent) had positive results for amyloid, with a statistically higher incidence in men (p = 0.03) and advanced age (p = 0.02). Subtyping performed in eight of nine amyloid-positive specimens confirmed seven cases of transthyretin-type amyloid typically seen in localized (senile) amyloidosis and one case of light-chain amyloid in a patient who was subsequently diagnosed with myeloma.

Conclusions:

Flexor tenosynovium in patients with recurrent carpal tunnel syndrome does not appear to be substantially different histologically from that previously described in primary idiopathic carpal tunnel syndrome, although a slightly higher prevalence of amyloid was seen in this group (especially older men). No patients have developed systemic amyloidosis. Routine biopsy of tenosynovium in idiopathic, recurrent carpal tunnel syndrome is unnecessary.
Correcting Exorbitism by Monobloc Frontofacial Advancement in Crouzon-Pfeiffer Syndrome: An Age-Specific, Time-Related, Controlled Study
Authors: Way Benjamin L. M. , Khonsari Roman H. , Karunakaran Tharsika , Nysjö Johan , Nyström Ingela , Dunaway David J. , Evans Robert D. , Hayward Richard D. , Britto Jonathan A.
Published: December 2018

Background:

In FGFR2 craniosynostosis, midfacial hypoplasia features oculo-orbital disproportion and symptomatic exorbitism. Clinical consequences may mandate surgery at a young age to prevent globe subluxation, corneal ulceration, and potential loss of vision. Monobloc osteotomy and distraction osteogenesis (monobloc distraction) seek to correct exorbitism. A report of the age-related impact of monobloc osteotomy and distraction osteogenesis on orbital volume, globe volume, and globe protrusion is presented.

Methods:

Computed tomographic scan data from 28 Crouzon-Pfeiffer patients were assessed at preoperative, early postoperative, and 1-year follow-up time points. Orbital volumes, globe volumes, and globe protrusions were measured by manual and semiautomatic segmentation techniques, and these were compared to 40 age-matched controls.

Results:

Crouzon-Pfeiffer syndrome orbital volumes are significantly small, and are significantly overexpanded by distraction to endpoints correcting symptomatic exorbitism. Globe volumes are significantly larger than controls under 5 years, do not independently correlate with globe protrusion, and are unaffected by surgery. Correlation between orbital volume expansion and reduction of globe protrusion is not significant. Age-related variations of postoperative growth potential occur to 1 year postoperatively. The Crouzon-Pfeiffer syndrome FGFR2 orbit exhibits early growth acceleration followed by premature growth arrest at 10 to 14 years.

Conclusions:

Orbital volume expansion by monobloc osteotomy and distraction osteogenesis is not the sole determinant of reduced globe protrusion. Mean volume relapse of the orbit at 1 year is insignificant across the series. Derived Crouzon-Pfeiffer growth curves suggest that “early functional monobloc” in infants occurs on a background of dynamic orbital growth, which remains programmed to a Crouzon-Pfeiffer FGFR2 phenotype and aligns with the incidence of delayed clinical regression and later secondary surgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Respiratory Failure following Abdominal Wall Reconstruction: An Analysis of the Nationwide Inpatient Sample
Authors: Sood Ravi F. , Lipira Angelo B. , Neligan Peter C. , Louie Otway , Wright Andrew S. , Gibran Nicole S.
Published: December 2018

Background:

Patients undergoing abdominal wall reconstruction are at increased risk of postoperative respiratory failure. Understanding the epidemiology of this complication may guide preventive efforts.

Methods:

The authors performed a population-based retrospective cohort study of adults undergoing elective abdominal wall reconstruction (ventral hernia repair with component separation) in the United States from 2004 through 2011 using the Nationwide Inpatient Sample.

Results:

Of 2283 patients undergoing elective abdominal wall reconstruction, 57 percent were women, with a median age of 57 years, median hospital stay of 5 days, and mean total cost of $23,730. Postoperative respiratory failure occurred in 212 patients (9.3 percent), 164 patients (7.2 percent) were discharged to a skilled nursing facility, and 18 patients (0.8 percent) died. On multivariate analysis, age, male sex, congestive heart failure, lung disease, obesity, and obstructive sleep apnea were independently associated with increased risk of respiratory failure. Respiratory failure was associated with significantly increased risk of death and discharge to a skilled nursing facility as well as significantly increased total cost and hospital length of stay.

Conclusions:

Respiratory failure is an uncommon but devastating complication of abdominal wall reconstruction. The authors report clinical risk factors that may facilitate perioperative risk-reduction strategies to improve outcomes of elective abdominal wall reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, III.
Long-Term Assessment of Perioral Rhytide Correction with Erbium:YAG Laser Resurfacing
Authors: Sanniec Kyle , Afrooz Paul N. , Burns A. Jay
Published: December 2018

Background:

Use of nonsurgical skin rejuvenation has grown over the past two decades. This has led to an increase in ablative and nonablative resurfacing devices. Moderate to heavy perioral rhytides require an ablative laser to maximize results. Traditionally, this was performed with carbon dioxide lasers; however, more recently, erbium lasers have been used to target heavy rhytides. The purpose of this study was to assess long-term correction of perioral rhytides with the use of the senior author’s (A.J.B.) erbium laser resurfacing technique.

Methods:

A retrospective review of all patients who underwent perioral erbium laser resurfacing performed by the senior author from 2009 to 2016 with a minimum of 6-month follow-up was performed. Ten blinded nonphysicians and 10 blinded plastic surgeons evaluated the imaging based on a previously established standardized grading sheet, with gradation improvement from 1 to 8. The absolute and percentage improvement were evaluated, along with complications.

Results:

Forty-five patients met inclusion criteria, with an average follow-up of 13 months. A statistically significant score improvement of 2.2 gradations was seen, in addition to a significant improvement (from 56 percent to 66 percent). Both the surgeon and nonphysician groups showed improvement, with no differences between the two groups. There were no cases of hypopigmentation at the 6-month postoperative visit.

Conclusions:

Erbium laser resurfacing is a powerful and safe tool for correcting perioral rhytides. It is effective in isolation or with other facial rejuvenation procedures. Erbium laser resurfacing is a useful adjunct in facial rejuvenation that can deliver exceptional results with few complications when performed within the proper guidelines.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Current Best Peripheral Nerve Transfers for Spinal Cord Injury
Authors: Hill Elspeth J. R. , Fox Ida K.
Published: December 2018

Learning Objectives:

After reviewing this article, the participant should be able to: 1. Understand the anatomy and pathophysiology of spinal cord injury and the resulting upper and lower motor neuron syndromes. 2. Recognize who may benefit from nerve transfers. 3. Understand the role of history, examination, imaging, and electrodiagnostics in the determination of time-sensitive lower motor neuron injury versus non–time-sensitive upper motor neuron injury. 4. Outline the surgical options and perioperative care for those undergoing nerve transfer and the expected outcomes in restoring shoulder, elbow, wrist, and hand function.

This article outlines how to localize and differentiate upper motor neuron from combined upper and lower motor neuron injury patterns in spinal cord injury by means of detailed history, physical examination, imaging, and electrodiagnostic studies to formulate appropriate surgical plans to restore function in this complex population.
Adapting the novel-object recognition task to quantify how much attention rodents allocate to motivationally-salient objects
Authors: Hornoiu Iasmina , Gigg John , Talmi Deborah
Published: December 2018

The allocation of attention can be modulated by the emotional value of a stimulus. In order to understand the biasing influence of emotion on attention allocation further, we require an animal test of how motivational salience modulates attention. In mice, female odour triggers arousal and elicits emotional responses in males. Here, we determined the extent to which objects labelled with female odour modulated the attention of C57BL/6J male mice. Seven experiments were conducted, using a modified version of the spontaneous Novel Object Recognition task. Attention was operationalised as differential exploration time of identical objects that were labelled with either female mouse odour (O+), a non-social odour, almond odour (Oa) or not labelled with any odour (O-). In some experiments we tested trial unique (novel) objects than never carried an odour (X-). We found that when single objects were presented, as well as when two objects were presented simultaneously (so competed with each other for attention), O+ received preferential attention compared to O-. This result was independent of whether O+ was at a novel or familiar location. When compared with Oa at a novel location, O+ at a familiar location attracted more attention. Compared to X-, O+ received more exploration only when placed at a novel location, but attention to O+ and X- was equivalent when they were placed in a familiar location. These results suggest that C57BL/6J male mice weigh up aspects of odour, object novelty and special novelty for motivational salience, and that, in some instances, female odour elicits more attention (object exploration) compared to other olfactory stimuli and visual object novelty. The findings of this study pave the way to using motivationally-significant odours to modulate the cognitive processes that give rise to novel object recognition.
The protective effect of Capheic acid phenyl ester on hepatic ischemia-reperfusion injury in cholestatic rats
Authors: Aslaner Arif , Cakir Tugrul
Published: December 2018

PURPOSE: Caffeic acid phenyl ester (CAPE), which is an active component of propolis, has antioxidant, antiproliferative, immunomodulatory and anti-inflammatory properties and has been used for many years. The protective effect against ischemic reperfusion injury in the cholestatic liver is unknown and it is aimed to determine its effect in this study. MATERIALS AND METHODS: Three groups of 18 Wistar albino rats were divided into cholestasis, control and study groups with bile duct attachment. Intraperitoneal administration of caffeic acid phenyl ester at the dose of 30 mg/kg/ day started 15 days ago and continued until the second operation in the study group. On the seventh day, hepatic ischemia was performed for 30 minutes followed by reperfusion for 60 minutes. Serum, plasma and liver samples were taken. Laboratory analysis, tissue glutathione, malondialdehyde, and myeloperoxidase levels were evaluated. RESULTS: Significant reduction in the level of liver glutathione and a marked increase in malondialdehyde level and myeloperoxidase activity were observed in the cholestatic I / R group. After treatment, all parameters except serum bilirubin levels were reversed. CONCLUSIONS: Intraperitoneal administration of CAPE may improve liver function and may reduce inflammation and oxidative stress in cholestatic I / R injury.
Single-cell multi-omic profiling of chromatin conformation and DNA methylome
Authors: Lee Dong-Sung , Luo Chongyuan , Zhou Jingtian , Chandran Sahaana , Rivkin Angeline , Bartlett Anna , Nery Joseph R. , Fitzpatrick Conor , O’Connor Carolyn , Dixon Jesse R. , Ecker Joseph R.
Published: December 2018

Recent advances in the development of single cell epigenomic assays have facilitated the analysis of gene regulatory landscapes in complex biological systems. Methods for detection of single-cell epigenomic variation such as DNA methylation sequencing and ATAC-seq hold tremendous promise for delineating distinct cell types and identifying their critical cis-regulatory sequences. Emerging evidence has shown that in addition to cis-regulatory sequences, dynamic regulation of 3D chromatin conformation is a critical mechanism for the modulation of gene expression during development and disease. It remains unclear whether single-cell Chromatin Conformation Capture (3C) or Hi-C profiles are suitable for cell type identification and allow the reconstruction of cell-type specific chromatin conformation maps. To address these challenges, we have developed a multi-omic method single-nucleus methyl-3C sequencing (sn-m3C-seq) to profile chromatin conformation and DNA methylation from the same cell. We have shown that bulk m3C-seq and sn-m3C-seq accurately capture chromatin organization information and robustly separate mouse cell types. We have developed a fluorescent-activated nuclei sorting strategy based on DNA content that eliminates nuclei multiplets caused by crosslinking. The sn-m3C-seq method allows high-resolution cell-type classification using two orthogonal types of epigenomic information and the reconstruction of cell-type specific chromatin conformation maps.
Mangrove leaf and root traits and their relation to urbanization
Authors: Branoff Benjamin
Published: December 2018

Root and leaf traits are one means of understanding plant ecophysiological responses to environmental variation and disturbance. In mangroves, both chemical and morphological variations have been recorded in response to changes in inundation, salinity, and nutrient levels. Some have also been noted in urban environments, primarily in response to elevated nutrients and toxic substances. Yet these studies have not attempted to isolate the urban from the non-urban influences on both morphological and chemical traits. This study measured mangrove leaf and root chemical and morphological traits in herbarium samples and in field collected leaves and roots along a quantified urban gradient in three watersheds of Puerto Rico. It then correlated these traits with predictors of surrounding land cover, as well as with metrics of flooding and water chemistry. There were significant lines of evidence leading to an influence of urban sewage and roads on leaf and root traits. Leaf percent nitrogen increased with urbanization and with surface water nitrogen and phosphorus concentrations, but its isotopic content decreased with increasing phosphorus, leading to the hypothesis that both nitrogen and phosphorus are fueling an otherwise co-limited community of mangroves and nitrogen fixing microbes. The most urban site harbored some of the highest metal concentrations, and there was evidence that elevated concentrations primarily influence fine roots. Other morphological traits are more likely explained by both water chemistry and leaf chemistry and should be considered when interpreting the influence of urban landscapes on mangroves. Percent nitrogen in herbarium samples increased at the least urban site, but remained unchanged at the most urban site, reflecting the relative levels of urbanization at the time of the first samples and their subsequent changes. Most metals from herbarium samples decreased or remained unchanged, suggesting regulation and infrastructure have helped to reduce the release of trace metals to the estuaries. Understanding the influence of urbanization in the context of water chemistry and flooding dynamics will aid in the management of these systems as global urbanization continues.
ReALLEN: structural variation discovery in cancer genome by sensitive analysis of single-end reads
Authors: Kanno Ryo , Tanaka Daisuke , Nanamiya Hideaki , Isogai Takao
Published: December 2018

Background

The structural abnormalities in chromosomes are important issues in cancer genomics. Next generation sequencing technologies have big potentials to detect the structural variations precisely and comprehensively. Nevertheless, it is still difficult problem to detect large structural variations from short read sequence data. Major efforts have been achieved with paired-end reads, since discordant pairs directly reflect the existence of large rearrangement. Furthermore, approaches to detect structural variations from single-end reads are still worthwhile challenge because they allow wide choices of sequencing platforms.

Result

We present ReALLEN, a series of tools to detect genomic rearrangement with base-pair resolution from single-end reads provided by next generation sequencing. We examined the performance of ReALLEN using simulated dataset and real dataset sequenced by Ion Torrent systems. In most cases on the simulated dataset, ReALLEN showed nearly 100% precision and better sensitivity than other major tools. Notably, ReALLEN showed stable scores even if it was on some unfavorable conditions, for example, low coverage or small variant size. On the real dataset sequenced by Ion Torrent systems, ReALLEN accurately found an insertional translocation that was crucial for the diagnosis of chronic myeloid leukemia.

Conclusion

ReALLEN is useful to researchers in finding genomic rearrangements. It will contribute to discovery of cancer-specific fusion proteins, precise diagnosis of known types of cancers, and understanding of genetic diseases caused by abnormal chromosomes.
Influence of expected reward on perceptual decision making
Authors: Rakhshan Mohsen , Lee Vivian , Chu Emily , Harris Lauren , Laiks Lillian , Khorsand Peyman , Soltani Alireza
Published: December 2018

Perceptual decision making is influenced by reward expected from alternative options or actions, but the underlying neural mechanisms are currently unknown. More specifically, it is debated whether reward effects are mediated through changes in sensory processing and/or later stages of decision making. To address this question, we conducted two experiments in which human subjects made saccades to what they perceived to be the first or second of two visually identical but asynchronously presented targets, while we manipulated expected reward from correct and incorrect responses on each trial. We found that unequal reward caused similar shifts in target selection (reward bias) between the two experiments. Moreover, observed reward biases were independent of the individual’s sensitivity to sensory signals. These findings suggest that the observed reward effects were determined heuristically via modulation of decision-making processes instead of sensory processing and thus, are more compatible with response bias rather than perceptual bias. To further explain our findings and uncover plausible neural mechanisms, we simulated our experiments with a cortical network model and tested alternative mechanisms for how reward could exert its influence. We found that our observations are more compatible with reward-dependent input to the output layer of the decision circuit. Together, our results suggest that during a temporal judgment task, the influence of reward information on perceptual choice is more compatible with changing later stages of decision making rather than early sensory processing.
Increased hippocampal GABAergic inhibition after long-term high-intensity sound exposure
Authors: Cunha Alexandra Siqueira , de Deus Junia lara , Ceballos Cesar Celis , Leao Ricardo Mauricio
Published: December 2018

Exposure to loud sounds has been related to deleterious mental and systemic effects in addition to auditory maladies. Hippocampal function has been shown to be affected to either high intensity sound exposure or long-term sound deprivation. Hippocampal long-term potentiation (LTP) is inhibited after 10 days of daily exposure to 2 minutes of high-intensity noise (110 dB), in the hippocampi of Wistar rats. He we investigate how the glutamatergic and GABAergic neurotransmission mediated by ionotropic receptors is affected by the same protocol of high intensity sound exposure. We found that while the glutamatergic transmission both by AMPA/kainite and NMDA receptors in the Schaffer-CA1 synapses is largely unaffected by long-term exposure to high intensity sound, the amplitude of the inhibitory GABAergic currents is potentiated, but not the frequency of the both spontaneous and miniature currents. We conclude that GABAergic transmission is potentiated at the post-synaptic level in the hippocampal CA1 pyramidal neurons after a prolonged exposure to short periods of high-intensity sound. This effect could be an important factor for the reduced LTP in the hippocampi of these animals after high intensity sound exposure, and demonstrated that prolonged exposure to high- intensity sound can affect hippocampal inhibitory transmission and consequently its function.
The effect of ocean warming on black sea bass (Centropristis striata) aerobic scope and hypoxia tolerance
Authors: Slesinger Emily , Andres Alyssa , Young Rachael , Seibel Brad , Saba Vincent , Phelan Beth , Rosendale John , Wieczorek Daniel , Saba Grace
Published: December 2018

Over the last decade, ocean temperature in the U.S. Northeast Continental Shelf (U.S. NES) has warmed faster than the global average and is associated with observed distribution changes of the northern stock of black sea bass (Centropristis striata). Mechanistic models based on physiological responses to environmental conditions can improve future habitat suitability projections. We measured maximum, resting metabolic rate, and hypoxia tolerance (Scrit) of the northern adult black sea bass stock to assess performance across the known temperature range of the species. A subset of individuals was held at 30°C for one month (30chronic°C) prior to experiments to test acclimation potential. Absolute aerobic scope (maximum – resting metabolic rate) reached a maximum of 367.21 mgO2 kg−1 hr−1 at 24.4°C while Scrit continued to increase in proportion to resting metabolic rate up to 30°C. The 30chronic°C group had a significant decrease in maximum metabolic rate and absolute aerobic scope but resting metabolic rate or Scrit were not affected. This suggests a decline in performance of oxygen demand processes (e.g. muscle contraction) beyond 24°C despite maintenance of oxygen supply. The Metabolic Index, calculated from Scrit as an estimate of potential aerobic scope, closely matched the measured factorial aerobic scope (maximum / resting metabolic rate) and declined with increasing temperature to a minimum below 3. This may represent a critical value for the species. Temperature in the U.S. NES is projected to increase above 24°C in the southern portion of the northern stock’s range. Therefore, these black sea bass will likely continue to shift north as the ocean continues to warm.
Inflammatory mediators causing cutaneous chronic itch in some diseases via transient receptor potential channel subfamily V member 1 and subfamily A member 1
Authors: Xie Bo , Li Xin‐Yu
Published: December 2018

Chronic itch with an itch–scratch vicious circle is a significant problem in a large amount of diseases. Some of these diseases, such as psoriasis, atopic dermatitis, prurigo nodularis, Sézary syndrome, uremic pruritus, diabetes and jaundice, are common. For a very long time, chronic itch has been a thorny problem with few effective treatments. Because of this, itch researchers and dermatologists seek to find the mechanisms among chronic itch, inflammatory cytokines and neurons. As an immediate area of research focus, we are going to find the peripheral cross‐talk between neurons and skin cells. Two receptors, named transient receptor potential channel vanilloid 1 and transient receptor potential channel ankyrin transmembrane protein 1, have been shown to play important roles in chronic itch. Many advances have been made so far this decade. This review talks about the updated mechanism of itch‐related inflammatory cytokines via transient receptor potential channels in cutaneous chronic itch and corresponding diseases. The search for itch‐related inflammatory mediators and the structure of transient receptor potential channels this decade could deepen our understanding of the mechanism of itch and help us find more treatments of chronic itch in the future.
The Comprehensive Early Drinking History Form: A Novel Measure of Early Alcohol Exposure
Authors: Hartman Jessica D. , Corbin William R. , Chassin Laurie , Doane Leah D.
Published: December 2018

Background

Adolescent and young adult alcohol use is a major public health concern; alcohol is the most widely used substance by teenagers. It is imperative to better understand alcohol use during adolescence and early adulthood given the important changes that occur. Although numerous measures aim to capture alcohol use during this time, no existing measure gathers comprehensive information on alcohol use across these developmental stages. We developed the Comprehensive Early Drinking History Form (CEDHF), which retrospectively gathers drinking information for each year since onset of first regular use, including quantity/frequency of both regular use and periods of heaviest drinking. The CEDHF also collects information on aggregate drinking experiences between age of onset and age of first regular use.

Methods

Using a sample of young adults (ages 21 to 27) from an ongoing longitudinal study, we examined whether the CEDHF predicted both concurrent (N = 303) and future (N = 75) alcohol‐related problems over and above other commonly used alcohol use measures (e.g., age of onset, age of first intoxication, Timeline Follow‐Back) and current alcohol problems.

Results

Controlling for gender, age, and current problems, the CEDHF predicted both concurrent and future alcohol‐related problems over and above these other widely used measures of alcohol exposure.

Conclusions

The CEDHF may be a valuable tool when longitudinal studies are not feasible as it provides more comprehensive information than other widely used measures of early alcohol exposure. Further, this measure can provide detailed information regarding who is at highest risk for future consequences.