bluuebunny/crossref_metadata_2025 huggingface dataset:
Right Ventricular Failure Post-Implantation of Left Ventricular Assist Device: Prevalence, Pathophysiology, and Predictors
Authors: Ali Hyeon-Ju R. , Kiernan Michael S. , Choudhary Gaurav , Levine Daniel J. , Sodha Neel R. , Ehsan Afshin , Yousefzai Rayan
Published: October 2019

Despite advances in left ventricular assist device (LVAD) technology, right ventricular failure (RVF) continues to be a complication after implantation. Most patients undergoing LVAD implantation have underlying right ventricular (RV) dysfunction (either as a result of prolonged LV failure or systemic disorders) that becomes decompensated post-implantation. Additional insults include intra-operative factors or a sudden increase in preload in the setting of increased cardiac output. The current literature estimates post-LVAD RVF from 3.9% to 53% using a diverse set of definitions. A few of the risk factors that have been identified include markers of cardiogenic shock (e.g., dependence on inotropes and Interagency Registry for Mechanically Assisted Circulatory Support profiles) as well as evidence of cardiorenal or cardiohepatic syndromes. Several studies have devised multivariable risk scores; however, their performance has been limited. A new functional assessment of RVF and a novel hepatic marker that describe cholestatic properties of congestive hepatopathy may provide additional predictive value. Furthermore, future studies can help better understand the relationship between pulmonary hypertension and post-LVAD RVF. To achieve our ultimate goal—to prevent and effectively manage RVF post-LVAD—we must start with a better understanding of the risk factors and pathophysiology. Future research on the different etiologies of RVF—ranging from acute post-surgical complication to late-onset RV cardiomyopathy—will help standardize definitions and tailor therapies appropriately.
Biologically Inspired, Open, Helicoid Impeller Design for Mechanical Circulatory Assist
Authors: Park Jiheum , Oki Kristi , Hesselmann Felix , Geirsson Arnar , Kaufmann Tim , Bonde Pramod
Published: October 2019

Rotating impeller actuated by electromagnet has been a key technological innovation which surpassed earlier limitations of pulsatile pumps. Current impeller design, however, is alien to the functional unit of the human circulatory system and remains a potential cause of adverse prothrombotic events such as hemolysis or pump thrombosis by forcing blood cells to pass over a narrow space available within the rapidly alternating blades attached along its central hub, creating fundamentally a nonphysiologic flow, especially for miniaturized percutaneous blood pumps. Here, we present a biologically inspired, open, helicoid (BiO-H) impeller design for a circulatory assist device that has a fundamentally different footprint from the conventional Archimedean screw-based impeller designs by implementing new design features inspired by an avian right atrioventricular valve. Design parameters including an inner diameter, helix height, overall height, helix revolutions/pitch, blade length, blade thickness, introductory blade angle, number of blades, and blade shape were optimized for maximum output volumetric flow rate through the parametric analysis in computational fluid dynamics simulation. BiO-H shows an improved flow path with 2.25-fold less cross-sectional area loss than the conventional impeller designs. BiO-H with a diameter of 15 mm resulted in a maximum flow rate of 25 L/min at 15,000 revolutions per minute in simulation and showed further improved pressure–flow relationship in benchtop experiments. The design shows promise in increasing flow and could serve as a new impeller design for future blood pumps.
Exercise and lifestyle changes in pediatric asthma
Authors: Lu Kim D. , Forno Erick
Published: October 2019

Purpose of review

The purpose of this review is to discuss the most recent studies on lifestyle interventions in pediatric asthma. We include studies on physical activity and exercise, sedentary time, nutrition, behavioral therapy and the role of schools.

Recent findings

Several small studies in children with asthma suggest that exercise interventions can improve aerobic fitness, asthma symptoms or control and quality of life. Existing evidence supports recommending higher intake of fruits and vegetables for asthma risk and control. In contrast, the ‘Western diet’ – high in refined grains, highly processed foods, red meats and fried foods with low intake of fruits and vegetables – has a proinflammatory effect and may alter microbiota composition leading to worse asthma outcomes. Finally, there are opportunities to utilize schools to promote physical activity, though standardization of asthma management in the schools is needed.

Assessing physical activity/fitness levels, sedentary time and nutritional status is important in the management of children with asthma, as they are modifiable factors. Larger rigorous studies evaluating lifestyle interventions are needed to better inform current asthma guidelines as well as to understand the underlying mechanism(s) related to physical activity and diet in asthma.
Lost in transition: biomarkers of remodeling in patients with asthma
Authors: Bahmer Thomas , Sand Jannie Marie Bülow , Weckmann Markus
Published: October 2019

Purpose of review

‘Biomarkers of remodeling’ represent a loose collection of features referring to several biological adaptations of the lung to cope with stressing factors. In addition, remodel-’ing’ infers a dynamic process that would require a spatiotemporal resolution. This review focuses on different aspects of remodeling in pediatric and adult care.

Recent findings

This review will cover aspects of pediatric remodeling, adult remodeling and techniques and procedures to adequately assess remodeling across different age spectra. In pediatrics, the onset and first features of remodeling are discussed and the continuation into adolescence is addressed. For adults, this review addresses predominant features of remodeling throughout the adult life span and whether there are currently interventions available to treat or reverse remodeling.

The term ‘remodeling’ is often referred to via biomarkers that reflect the endstage of a process, although it rather reflects a continuous process starting in childhood and progressing to all age-levels in patients with asthma. Hence, only few biomarkers or surrogates are able to ‘capture’ its spatiotemporal component, and hardly any are ready for routine use in clinical practice. Given the clinical impact of the remodeling processes, new biomarkers are needed to adequately treat patients with asthma and objectively monitor treatment response beyond symptom control and lung function.
Genetic polymorphisms present in IL10, IL23R, NOD2, and ATG16L1 associated with susceptibility to inflammatory bowel disease in Mexican population
Authors: Quiroz-Cruz Sarai , Posada-Reyes Berenice , Alatorre-García Thalia , Del Real-Calzada Carlos Manuel , García-Samper Xóchitl , Escobar-Gutiérrez Alejandro , Vázquez-Chacón Carlos Arturo , Martínez-Guarneros José Armando , Cruz-Rivera Mayra , Vaughan Gilberto , Fonseca-Coronado Salvador
Published: October 2019

Objective:

Ulcerative colitis and Crohn’s disease are the two clinical forms of inflammatory bowel disease (IBD). Diverse studies have shown the association of single nucleotide polymorphism (SNP) in molecules of the immune system and the occurrence of IBD. Here, several SNPs of the immune system with controversial results for their association with UC and CD were evaluated in a Mexican population.

Methods:

SNPs rs1800896, rs3024505 (IL-10); rs11209026 (IL23R); rs2066844, rs2066845 (NOD-2), and rs2241880 (ATG16L1) were assessed in 93 patients with IBD and 200 healthy controls by hybridization probes and quantitative PCR.

Results:

The AG genotype for rs1800896 was associated with an increased risk for both UC and CD (P = 0.005 and P = 0.026, respectively); whereas the AA genotype presents a negative association (P = 0.011 for UC, and 0.0038 for CD). For this SNP, G allele was associated with risk of UC (P = 0–043) but not for CD. For the rs3024505 in IL-10, T allele was associated with UC (P = 0.011). Moreover, this allele was associated with early onset of UC (P = 0.033) and with the use of steroid treatment (P = 0.019). No significant differences for NOD2 (rs2066844T and rs2066845C), IL23R (rs11209026), and ATG16L1 (rs22411880) were found between cases and controls and the homozygous TT genotype for rs2066844 and CC for rs2066845 were not observed.

Conclusion:

Our results show both genotypic and phenotypic associations of IL-10 SNPs with IBD but not with the other immune-related SNPs studied in this Mexican cohort.
A prospective study comparing patient-reported outcomes in Crohn’s disease
Authors: Hoekman Daniël R. , Löwenberg Mark , van den Brink Gijs R. , Ponsioen Cyriel Y. , Benninga Marc A. , D’Haens Geert R.
Published: October 2019

Background

Patient reported outcomes are important in Crohn’s disease. In this prospective cohort, we investigated the performance of the Bristol Stool Form Scale (BSFS) and a visual analog scale (VAS) for abdominal pain as outcome measures in Crohn’s disease.

Methods

Patients with active Crohn’s disease starting glucocorticoids or anti-tumor necrosis factor were included. Before treatment and 10 weeks later we collected: clinical activity [Harvey Bradshaw Index (HBI) and Crohn’s-Disease-Activity-Index (CDAI)], serum C-reactive protein (CRP) and fecal calprotectin, and BSFS (1–7) and a 100-mm VAS based on a 7-day diary. Clinical response was defined as a reduction by at least 3 and at least 100 of HBI and CDAI, respectively. Fecal calprotectin-response and CRP-response were defined as reduction of at least 50%.

Results

Thirty-eight patients completed follow-up. At baseline, BSFS-parameters correlated more strongly with clinical activity (range: r

s
: 0.31–0.74) than with CRP (r

s
: −0.01 to 0.16) and fecal calprotectin (r

s
: 0.14–0.26). VAS scores correlated very weakly to moderately with clinical activity (r

s
: 0.18–0.45), and weakly to moderately with CRP (r

s
: 0.24–0.34) and fecal calprotectin (r

s
: 0.35–0.43). Changes in VAS scores correlated moderately to strongly (r

s
: 0.55–0.71) with changes in clinical activity, and weakly with changes in CRP and fecal calprotectin (r

s
: 0.21–0.35). Changes in BSFS parameters correlated weakly to moderately (r

s
: 0.23–0.53) with changes in clinical activity, and very weakly to weakly (r

s
: 0.01–0.35) with changes in CRP and fecal calprotectin. Responsiveness of VAS and BSFS was moderate to high (Guyatt’s statistic 0.41–2.17) and highly dependent on the definition of response.

Conclusions

The BSFS and a VAS appear to be responsive with moderate-to-strong construct validity to monitor patients with Crohn’s disease.
Patient Characteristics Affect Discharge Status for Opioid-related Infective Endocarditis
Authors: Schuller Kristin A. , Franz Berkeley , Cronin Cory E.
Published: October 2019

Background:

Opioid overdoses have increased dramatically in the last 20 years, but secondary complications, such as infective endocarditis (IE) are also on the rise.

Objective:

The objective of this study was to understand the effect that opioid-related IE has on hospitals across the US and to understand the disposition of patients after treatment for IE, particularly in regard to insurance status and type.

Research Design:

Secondary data analysis of the publicly-available 2015 Nationwide Inpatient Sample (NIS) was used to assess opioid-related IE based on patient and hospital characteristics. Bivariate and logistic regression was calculated to determine significance between the outcome variable (IE) and other covariates.

Subjects:

The 2015 NIS data contained 7,153,989 weighted observations with 5760 (0.02%) incidences of opioid-related IE.

Measures:

The NIS dataset represents a 20% stratified sample of all US hospitalizations across all payors in a given year. Opioid-related IE was the outcome variable measured through ICD-9 and ICD-10 codes, and the independent variables included the patient’s age, sex, primary payer, household income, discharge status, length of stay, and transfer status, and the hospital’s size, ownership, region, and location with teaching status.

Results:

Routine discharge was the top discharge status across all payors, except Medicare. Nearly 26% of self-pay patients were discharged against medical advice. Logistic regression results indicate that patients who are younger, uninsured, have increased condition severity, have longer lengths of stay, and are discharged against medical advice or transferred to a short-term hospital or other health facility experienced significantly higher odds of opioid-related IE admissions as compared with all other admissions. The only significant hospital characteristic was region.

Conclusions:

The fact that patient disposition varied across different payors suggests that hospitals are missing opportunities to engage the most vulnerable patients with IE. Given the long-term care required by this condition, hospitals are well-positioned to participate in interventions to initiate substance abuse treatment and help patients navigate outpatient substance abuse treatment options.
The Perceptions of Professional Leadership Coaches Regarding the Roles and Challenges of Nurse Managers
Authors: Bradley Jennifer M. , Moore Linda Weaver
Published: October 2019

OBJECTIVE

The purpose of this study was to explore professional coaches’ perceptions of nurse managers (NMs) and the NM role.

BACKGROUND

Nurse Managers are often inadequately prepared, developed, and supported in their roles. Professional coaching is a strategy that may prove beneficial to help prepare NMs for their roles.

METHODS

A qualitative design using researcher-participant interviews of 11 professional coaches provided data regarding coaches’ perceptions of NMs and the role development needs.

RESULTS

Coaches reported why they made the decision to coach NMs, why NMs sought coaching services, how the NM experience differed from that of higher level leaders, and what the coaches believed was their most valuable contribution when working with NMs.

CONCLUSION

Findings suggest that coaches can provide needed support to NMs to maximize their role effectiveness and preparedness.
Diagnostic Accuracy of the Partograph Alert and Action Lines to Predict Adverse Birth Outcomes: A Systematic Review
Authors: Bonet M. , Oladapo O. T. , Souza J. P. , Gülmezoglu A. M.
Published: October 2019

(Abstracted from BJOG 2019;126:1524–1533)

Women and their offspring are at heightened risk of morbidity and mortality during childbirth. Tools, such as the partograph, have been used to assist in labor-related decision-making over the last couple of decades.
Gynecology and Oncology Fetal Myofibromatosis: A Challenge for Prenatal Diagnosis Mini Review of the English Literature
Authors: Pekar-Zlotin Marina , Levinsohn-Tavor Orna , Livneh Ayelet , Sher Osnat , Melcer Yaakov , Maymon Ron
Published: October 2019

Importance

Infantile myofibromatosis (IM) is a benign neoplasm with a reported incidence of 1:150,000. The “solitary” type is characterized by a single lesion in the skin, muscle, or bone, whereas the “multicentric” type may also involve the viscera.

Objective

This report describes the prenatal diagnosis of IM and recommendations for future pregnancy follow-up.

Evidence Acquisition

This systematic search of the English literature yielded 8 reports documenting prenatal diagnosis of IM between 1999 and 2018.

Results

Fetal age at diagnosis ranged from 13 to 38 weeks of gestation. Seven cases were diagnosed in the third trimester (30–34 weeks). Five cases were of the “solitary” type, and all successfully underwent surgical removal of the tumor with a good outcome. Three were of the “multicentric” type, and the 1 infant presenting with diffuse disease died several weeks after delivery.

Conclusion and Relevance

The prenatal diagnosis of IM is often not made until the third trimester following a normal second-trimester anomaly scan, likely due to development of this lesion over time. Women should be referred for genetic counseling and consideration of preimplantation genetic diagnosis following the delivery of an affected child with the autosomal recessive form of the disorder and identified causative pathogenic variants.

Target Audience

Obstetricians and gynecologists, family physicians

Learning Objectives

After completing this activity, the reader should be better able to describe this rare benign neoplasm with a reported incidence of 1:150,000; identify infantile myofibromatosis when encounter a third-trimester sonographic finding consistent with soft tissue tumor; and counsel couples regarding future pregnancy risks and recommendations for evaluation and follow-up in a subsequent pregnancy.
Telangiectatic Squamous Cell Carcinoma of Uterine Cervix: A Previously Undescribed Variant of Squamous Cell Carcinoma
Authors: Jha Shilpy , Mitra Subarna , Baisakh Manas R. , Adhya Amit K.
Published: October 2019

Squamous cell carcinoma of the uterine cervix is the second most common malignancy in women worldwide. We describe an unusual telangiectatic variant of squamous cell carcinoma in a 53 yr old woman. The tumor showed the usual morphologic features of a poorly differentiated keratinizing squamous cell carcinoma with >75% tumor area showing cavernous hemangioma like ectatic spaces filled with blood. The blood-filled spaces lacked an endothelial lining as evidenced by negativity for CD31 and CD34. This unusual variant has not been reported previously. Awareness of this entity is necessary for avoiding confusion with vascular tumors such as hemangiomas and angiosarcoma.
Next of Kin Involvement in Regulatory Investigations of Adverse Events That Caused Patient Death: A Process Evaluation (Part I – The Next of Kin’s Perspective)
Authors: Wiig Siri , Haraldseid-Driftland Cecilie , Tvete Zachrisen Rannveig , Hannisdal Einar , Schibevaag Lene
Published: October 2019

Objective

The aim of the study was to explore experiences from the next of kin’s perspective of a new involvement method in the regulatory investigation process of adverse events causing patient death.

Methods

The study design was a qualitative process evaluation of the new involvement method in two Norwegian counties. Next of kin who had lost a close family member in an adverse event were invited to a 2-hour face-to-face meeting with regulatory inspectors to shed light on the event from the next of kin’s perspective. Data collection involved 18 interviews with 29 next of kin who had participated in the meeting and observations (20 hours) of meetings from 2017 to 2018. Data were analyzed using a thematic content analysis.

Results

Next of kin wanted to be involved and had in-depth knowledge about the adverse event and the healthcare system. Their involvement extended beyond sharing information, and some experienced it as having a therapeutic effect and contributing to transparency and trust building. The inspectors’ professional, social, and human skills determined the experiences of the involvement and were key for next of kin’s positive experiences. The meeting was emotionally challenging, and some next of kin found it difficult to understand the regulators’ independent role and suggested improving information given to the next of kin before the meeting.

Conclusions

Although the meeting was emotionally challenging, the next of kin had a positive experience of being involved in the investigation and believed that their information contributed to improving the investigation process.
Breast Cancer Imaging With PET Based Radiopharmaceuticals Other Than 18F-FDG
Authors: Vatsa Rakhee , Singh Shashank Shekhar , Ashwathanarayana Abhiram Gopalajois , Kumar Rajender , Rana Nivedita , Shukla Jaya , Mittal Bhagwant Rai
Published: October 2019

Breast cancer is the most common cancer in women with rising incidence worldwide. 18F-FDG PET/CT imaging has already established itself as a pivotal modality for staging, restating and response assessment in patients with carcinoma breast. The complex biology of this cancer is increasingly being decoded and various molecular targets have been identified and exploited for guiding the treatment at various time points during the course of the disease. We here depict a series of various metabolic and receptor targeting PET radiotracers in breast cancer patients which may help us understand the in vivo biology of this tumor.
A Comparison of Intracranial Volume Growth in Normal Children and Patients With Metopic Craniosynostosis
Authors: Cronin Brendan J. , Brandel Michael G. , McKee Ryan M. , Hashmi Asra , Oviedo Parisa , Buckstaff Taylor , Cahill Gabrielle , Mannix Emily , Reid Chris M. , Lance Samuel , Vinocur Daniel , Meltzer Hal S. , Gosman Amanda A.
Published: October 2019

Background:

The impact of metopic craniosynostosis on intracranial volume (ICV) and ICV growth is unclear. In addition, the relationship between head circumference (HC) and ICV in these patients is not previously described.

Methods:

A retrospective review of 72 patients with metopic craniosynostosis was performed. The ICVs were calculated from manually segmented preoperative computed tomography scans. Magnetic resonance imaging data for 270 healthy children were available. The ICVs were calculated in FreeSurfer.

First, a growth curve for metopic patients was generated and a logarithmic best-fit curve was calculated. Second, the impact of metopic craniosynostosis on ICV relative to healthy controls was assessed using multivariate linear regression. Third, the growth curves for metopic patients and healthy children were compared.

Pearson's correlation was used to measure the association between HC and ICV.

Results:

Mean metopic ICV was significantly lower than normal ICV within the first 3 to 6 months (674.9 versus 813.2 cm3; P = 0.002), 6 to 9 months (646.6 versus 903.9 cm3; P = 0.005), and 9 to 12 months of life (848.0 versus 956.6 cm3; P = 0.038). There was no difference in ICV after 12 months of age (P = 0.916).

The ICV growth in patients with metopic craniosynostosis is defined by a significantly different growth curve than in normal children (P = 0.005).

The ICV and HC were highly correlated across a broad range of ICVs and patient age (r = 0.98, P < 0.001).

Conclusion:

Patients with metopic craniosynostosis have significantly reduced ICVs compared to healthy children, yet greater than normal ICV growth, which allows them to achieve normal volumes by 1 year of age. The HC is a reliable metric for ICV in these patients.
Evaluation of Choline and Acetylcholine Levels in Responders and Nonresponders to Anticholinergic Therapy for Overactive Bladder Syndrome
Authors: Sheyn David , Hijaz Adonis K. , Hazlett Fred E. , El-Nashar Sherif , Mangel Jeffrey M. , Li Xiaolin , Mara Emily , Mahajan Sangeeta T.
Published: October 2019

Objective

This study aimed to determine whether levels of choline (Ch) and acetylcholine (Ach) differ between responders and nonresponders to anticholinergic therapy.

Methods

Patients prescribed an anticholinergic were evaluated using the Overactive Bladder Symptom Score; Medical, Epidemiologic and Social Aspects of Aging and Incontinence Questionnaire; and Incontinence Impact Questionnaire-7. A 1-day voiding diary and a urine sample were collected. After treatment for 12 weeks, the questionnaires were administered and 1-day voiding diary was completed. Levels of Ach and Ch were measured by liquid chromatography with tandem mass spectrometry. Subjects were divided into responders and nonresponders. Wilcoxon rank sum test and Fisher exact test were used to express differences between groups. Spearman ρ correlation coefficient was used to determine the relationship between Ach and Ch and symptom severity, patient demographics, and questionnaire scores.

Results

Thirty-one women were included in the analysis. The treatment response rate was 48.8%. The median age was 67 years (interquartile range, 50–76 years), and median body mass index was 32.3 kg/m2 (27.5–40.6 kg/m2), with 41.2% having an additional complaint of stress incontinence. There were no significant differences in symptom severity or questionnaire scores between groups.

The median Ch and Ach levels were higher in responders (28.6 vs 9.2 μL, P = 0.04) and (83.1 vs 18.7 nL, P = 0.02), respectively. Levels of both Ch and Ach had moderate positive correlations with the Medical, Epidemiologic and Social Aspects of Aging and Incontinence Questionnaire urgency urinary incontinence score (ρ = 0.533 [P = 0.002] and ρ = 0.453 [P = 0.01], respectively).

Conclusion

In women with overactive bladder, urinary Ach and Ch levels are higher in responders to anticholinergic therapy compared with nonresponders.
Physical Activity, Muscle Strength, and Functional Fitness
Authors: Lin Yi-Pei , Yang Yuan-Han , Hsiao Shih-Fen
Published: October 2019

Background:

Muscle strength and fitness are important in supporting an independent lifestyle in the elderly, especially those with Alzheimer disease (AD).

Objectives:

To establish the relationships of physical activity, key muscle strength, and functional fitness on the elderly with and without AD.

Methods:

Twenty AD patients and 20 non-AD elderly were tested for senior functional fitness test, handgrip strength, and muscle strength of elbow flexors and knee extensors. The Physical Activity Scale for the Elderly was also documented.

Results:

Handgrip strength and elbow flexor strength were significantly lower in the AD group, especially in those with mild severity. They also showed worst agility and least amount of physical activity weekly. Handgrip and elbow flexor strength of the AD group also correlated with the Physical Activity Scale for the Elderly.

Conclusions:

Older people with AD appear to engage less in physical activity as the disease progresses. The decline in muscle strength and agility might contribute further to limited physical activity and dependent lifestyle.
Nanotechnology Applications in Transplantation Medicine
Authors: Yao Christine G. , Martins Paulo N.
Published: October 2019

A recent technological advance that shows promise for applications in health care, including transplantation medicine, is the implementation of nanoparticles. Nanoparticles can be composed of a variety of organic or inorganic materials and confer many advantages over conventional treatments available, such as low toxicity, low-effective dosage required, and a high degree of manipulability. Although also used for imaging and diagnostics, nanoparticles’ utility as a drug or genetic delivery system is of particular interest in transplantation medicine. Currently, researchers are exploring options to integrate nanoparticles into both diagnostics and therapy for both grafts ex-situ before transplantation and for patients following transplantation. These studies have demonstrated that nanoparticles can mitigate damage to organs and patients through a large variety of mechanisms—ranging from the induction of cellular genetic changes to the enhancement of immunosuppressive drug delivery. Specifically, with the advent of machine perfusion preservation ex vivo, treatment of the graft became a very attractive approach and nanoparticles have great potential. However, before nanoparticles can be translated into clinical use, their short-term and long-term toxicity must be thoroughly characterized, especially with regards to their interactions with other biological molecules present in the human body.
Liver Retransplantation Associated With Kidney Transplantation for End-stage Liver Graft Disease and Renal Insufficiency: A Morbid Procedure on a Unique Subgroup of Patients
Authors: Cauchy François , Vibert Eric , Cherqui Daniel , Perdigao Fabiano , Sepulveda Ailton , Samuel Didier , Calmus Yvon , Conti Filomena , Adam René , Soubrane Olivier , Scatton Olivier
Published: October 2019

Background.

Chronic renal disease (CKD) jeopardizes the long-term outcomes of liver transplant recipients. In patients with end-stage liver graft disease and CKD, liver retransplantation associated with kidney transplantation (ReLT-KT) might be necessary. Yet, this specific subset of patients remains poorly described.

Methods.

Indications, perioperative characteristics, and short- and long-term outcomes of patients undergoing ReLT-KT at 2 transplantation units from 1994 to 2012 were analyzed. Risk factors for postoperative mortality and long-term survivals were evaluated.

Results.

Among 3060 patients undergoing liver transplantation (LT), 45 (1.5%) underwent ReLT-KT. The proportion of ReLT-KT among LT recipients continuously grew throughout the study period from 0.3% to 2.4% (P < 0.001). Median time from primary LT to ReLT-KT was 151.3 (7.5–282.9) months. The most frequent indications for liver retransplantation were recurrence of the primary liver disease and cholangitis in 15 (33.3%) cases each. CKD was related to calcineurin inhibitors toxicity in 38 (84.4%) cases. Twelve (26.7%) patients died postoperatively. D-MELD (donor age × recipients’ MELD) was associated with postoperative mortality (HR: 8.027; 95% CI: 2.387-18.223; P = 0.026) and optimal cut-off value was 1039 (AUC: 0.801; P = 0.002). Overall 1, 3, and 5 years survivals were 68.8%, 65.9%, and 59.5%, respectively. D-MELD > 1039 was the only factor associated with poor survival (P = 0.021).

Conclusions.

ReLT-KT is a highly morbid increasingly performed procedure. Refinements in the selection of grafts and transplant candidates are required to limit the postoperative mortality of these patients.
Asymmetry of amygdala resting-state functional connectivity in healthy human brain
Authors: Tetereva Alina O. , Balaev Vladislav V. , Kartashov Sergey I. , Ushakov Vadim L. , Ivanitsky Alexey M. , Martynova Olga V.
Published: October 2019

Lateral asymmetry is one of the fundamental properties of the functional anatomy of the human brain. Amygdala (AMYG) asymmetry was also reported in clinical studies of resting-state functional connectivity (rsFC) but rarely in healthy groups. To explore this issue, we investigated the reproducibility of the data on rsFC of the left and right AMYG using functional MRI twice a week in 20 healthy volunteers with mild-to-moderate anxiety. We found a resting-state network of the AMYG, which included regions involved in emotional processing and several other brain areas associated with memory and motor inhibition. The AMYG network was stable in time and within subjects, but the right AMYG had more significant connections with anatomical brain regions. The rsFC values of the right AMYG were also more sustained across the week than the left AMYG rsFC. Subjective ratings of anxiety did not correlate significantly with the patterns of seed-based AMYG connectivity. Our findings indicate that, for healthy subjects, rsFC may differ for the right and left AMYG. Moreover, the AMYG functional connectivity is variable in short-term observations, which may also influence the results of longitude studies.
Protective effects of fusidic acid against sodium nitroprusside-induced apoptosis in C6 glial cells
Authors: Park Euteum , Kim Do Kyung , Kim Chun-Sung , Kim Jae-Sung , Kim Seung , Chun Hong Sung
Published: October 2019

Fusidic acid, a steroidal antibiotic, possesses antimicrobial, antioxidant, and anti-inflammatory properties, but the effect of fusidic acid against neurodegenerative disease-related cell death has not been studied. Here, we investigated the protective effects of fusidic acid on sodium nitroprusside (SNP)-induced toxicity in C6 glial cells. Fusidic acid (5–20 μM) prevented SNP (100 μM)-induced cell death dose dependently, and effectively attenuated SNP-induced generation of nitric oxide (NO), total reactive oxygen species (ROS), and peroxynitrite (ONOO−). Fusidic acid (20 μM) pretreatment significantly suppressed SNP (100 μM)-induced apoptotic events, such as nuclear condensation and caspase-3 activation. In addition, fusidic acid effectively attenuated SNP-induced endoplasmic reticulum (ER) stress markers, such as GRP78, IRE1, ATF6, PERK, XBP1s, eIF2α, CHOP, and caspase-12. A specific adenosine monophosphate-activated protein kinase (AMPK) inhibitor, compound C (10 μM), reversed the preventive effects of fusidic acid against SNP-induced cytotoxicity, CHOP elevation, and caspase-3 activation. These results suggest that fusidic acid can protect C6 glial cells against cytotoxicity, through the regulation of AMPK pathway and apoptotic events.
In Their Own Words
Authors: Goldstine Jimena , Leece Rebecca , Samas Salihu , Zonderland René
Published: October 2019

PURPOSE:

The aim of this study was to identify themes related to barriers and facilitators to the integration of intermittent catheterization (IC) in the daily lives or persons using the form of bladder evacuation.

DESIGN:

Descriptive, qualitative study.

SUBJECTS AND SETTING:

A purposive sample of 25 adults from 5 countries (United States, United Kingdom, Germany, France, and the Netherlands) was assembled. All participants had used IC as their primary method of bladder emptying for at least 1 year and, in that time, had used as least 2 different IC products.

METHODS:

Guided telephone interviews with each participant were conducted by professional staff fluent in each participant's local language as well as trained in qualitative data collection. Interviews were digitally recorded and subsequently transcribed verbatim into English for analysis. We used ATLAS.ti qualitative analysis software (version 7.5.11) to assist with data organization and identification of major themes. Descriptive statistics (eg, mean, standard deviation, or frequency) were used to characterize the sample in terms of sociodemographic and clinical characteristics as collected during the interview.

RESULTS:

Analysis revealed 9 main themes around individuals' lived experiences of IC: initial fear, urinary tract infection, pain/discomfort, independence, choice, community, life quality, resilience, and acceptance.

DISCUSSION:

Our results indicate that IC is perceived as a burden by some, but not all, users. The challenge, and opportunity, is to learn more about what has gone right for those who have adapted and to leverage the clinical, practical, psychological, and social factors that enable individuals to integrate IC into the rhythm of their daily lives.
Motor Function Improvement After Electroconvulsive Therapy in a Parkinson’s Disease Patient With Deep Brain Stimulator
Authors: Volkaerts Liesbeth , Roels Rick , Bouckaert Filip
Published: October 2019

In patients with a deep brain stimulator (DBS), electroconvulsive therapy (ECT) has proven to be a safe and effective treatment option after several medication failures in major depression, especially in the presence of psychotic symptoms. Electroconvulsive therapy has also proven to be effective in the treatment of Parkinson's disease (PD). To date, there have been no reports on the effect of ECT on motor function in PD patients with a functioning DBS. We present the case of a woman with DBS as a treatment for PD, safely treated with ECT for a psychotic depression. Depression severity and motor changes were evaluated on a weekly basis using the Montgomery-Åsberg Depression Rating Scale and the Unified Parkinson's Disease Rating Scale. During the course of ECT, the Montgomery-Åsberg Depression Rating Scale score declined from 34 to 13, and the Unified Parkinson's Disease Rating Scale motor score from 44 to 12 with positive impact on rigidity. Considering the positive impact of ECT on the motor function in our patient, new research should look into ECT as an augmentation strategy in motor dysfunction in patients treated with DBS for PD.
Reconstructing lost BOLD signal in individual participants using deep machine learning
Authors: Yan Yuxiang , Dahmani Louisa , Shen Lunhao , Peng Xiaolong , Wang Danhong , Ren Jianxun , He Changgeng , Jiang Changqing , Gong Chen , Tian Ye , Zhang Jianguo , Guo Yi , Lin Yuanxiang , Wang Meiyun , Li Luming , Hong Bo , Liu Hesheng
Published: October 2019

The blood oxygen level-dependent (BOLD) signal in functional neuroimaging suffers from magnetic susceptibility artifacts and interference from metal implants. The resulting signal loss hampers functional neuroimaging studies and can lead to misinterpretation of findings. Here, we reconstructed compromised BOLD signal using deep machine learning. We trained a deep learning model to learn principles governing BOLD activity in one dataset and reconstructed artificially-compromised regions in another dataset, frame by frame. Strikingly, BOLD time series extracted from reconstructed frames were correlated with the original time series, even though the frames did not independently carry information about BOLD fluctuations through time. Moreover, reconstructed functional connectivity (FC) maps exhibited good correspondence with the original FC maps, indicating that the deep learning model recovered functional relationships among brain regions. We replicated this result in patients whose scans suffered signal loss due to intracortical electrodes. Critically, the reconstructions captured individual-specific information rather than group information learned during training. Deep machine learning thus presents a unique opportunity to reconstruct compromised BOLD signal while capturing features of an individual’s own functional brain organization.
Demographic tradeoffs predict tropical forest dynamics
Authors: Rüger Nadja , Condit Richard , Dent Daisy H. , DeWalt Saara J. , Hubbell Stephen P. , Lichstein Jeremy W. , Lopez Omar R. , Wirth Christian , Farrior Caroline E.
Published: October 2019

Assessing vegetation feedbacks with the climate system and planning sustainable management in tropical forests requires efficient, yet accurate, predictions of the joint dynamics of hundreds of tree species. With increasing information on tropical tree life-histories, our predictive understanding is no longer limited by species data, but by the ability of existing models to make use of it. Using a demographic forest model, we show that the basal area and compositional changes during forest succession in a Neotropical forest can be accurately predicted by representing tropical tree diversity (hundreds of species) with only five functional groups spanning two essential tradeoffs – the growth–survival and stature–recruitment tradeoffs. This data-driven modeling framework substantially improves our ability to predict consequences of anthropogenic impacts on tropical forests.
Gene Expression Networks in the Drosophila Genetic Reference Panel
Authors: Everett Logan J. , Huang Wen , Zhou Shanshan , Carbone Mary Anna , Lyman Richard F. , Arya Gunjan H. , Geisz Matthew S. , Ma Junwu , Morgante Fabio , St. Armour Genevieve , Turlapati Lavanya , Anholt Robert R. H. , Mackay Trudy F. C.
Published: October 2019

A major challenge in modern biology is to understand how naturally occurring variation in DNA sequences affects complex organismal traits through networks of intermediate molecular phenotypes. Here, we performed deep RNA sequencing of 200 Drosophila Genetic Reference Panel inbred lines with complete genome sequences, and mapped expression quantitative trait loci for annotated genes, novel transcribed regions (most of which are long noncoding RNAs), transposable elements and microbial species. We identified host variants that affect expression of transposable elements, independent of their copy number, as well as microbiome composition. We constructed sex-specific expression quantitative trait locus regulatory networks. These networks are enriched for novel transcribed regions and target genes in heterochromatin and euchromatic regions of reduced recombination, and genes regulating transposable element expression. This study provides new insights regarding the role of natural genetic variation in regulating gene expression and generates testable hypotheses for future functional analyses.
A data-driven method for reconstructing and modelling social interactions in moving animal groups
Authors: Escobedo R. , Lecheval V. , Papaspyros V. , Bonnet F. , Mondada F. , Sire C. , Theraulaz G.
Published: October 2019

Group-living organisms that collectively migrate range from cells and bacteria to human crowds, and include swarms of insects, schools of fish and flocks of birds or ungulates. Unveiling the behavioural and cognitive mechanisms by which these groups coordinate their movements is a challenging task. These mechanisms take place at the individual scale and they can be described as a combination of pairwise interactions between individuals and interactions between these individuals and the physical obstacles in the environment. Thanks to the development of novel tracking techniques that provide large and accurate data sets, the main characteristics of individual and collective behavioural patterns can be quantified with an unprecedented level of precision. However, in a large number of works, social interactions are usually described by force map methods that only have a limited capacity of explanation and prediction, being rarely suitable for a direct implementation in a concise and explicit mathematical model. Here, we present a general method to extract the interactions between individuals that are involved in the coordination of collective movements in groups of organisms. We then apply this method to characterize social interactions in two species of shoaling fish, the rummynose tetra (Hemigrammus rhodostomus) and the zebrafish (Danio rerio), which both present a burst-and-coast motion. The detailed quantitative description of microscopic individual-level interactions thus provides predictive models of the emergent dynamics observed at the macroscopic group-level. This method can be applied to a wide range of biological and social systems.
Accounting for diverse evolutionary forces reveals the mosaic nature of selection on genomic regions associated with human preterm birth
Authors: LaBella Abigail L. , Abraham Abin , Pichkar Yakov , Fong Sarah L. , Zhang Ge , Muglia Louis J. , Abbot Patrick , Rokas Antonis , Capra John A.
Published: October 2019

Human pregnancy requires the coordinated function of multiple tissues in both mother and fetus and has evolved in concert with major human adaptations. As a result, pregnancy-associated phenotypes and related disorders are genetically complex and have likely been sculpted by diverse evolutionary forces. However, there is no framework to comprehensively evaluate how these traits evolved or to explore the relationship of evolutionary signatures on trait-associated genetic variants to molecular function. Here we develop an approach to test for signatures of diverse evolutionary forces, including multiple types of selection, and apply it to genomic regions associated with spontaneous preterm birth (sPTB), a complex disorder of global health concern. We find that sPTB-associated regions harbor diverse evolutionary signatures including evolutionary sequence conservation (consistent with the action of negative selection), excess population differentiation (local adaptation), accelerated evolution (positive selection), and balanced polymorphism (balancing selection). Furthermore, these genomic regions show diverse functional characteristics which enables us to use evolutionary and molecular lines of evidence to develop hypotheses about how these genomic regions contribute to sPTB risk. In summary, we introduce an approach for inferring the spectrum of evolutionary forces acting on genomic regions associated with complex disorders. When applied to sPTB-associated genomic regions, this approach both improves our understanding of the potential roles of these regions in pathology and illuminates the mosaic nature of evolutionary forces acting on genomic regions associated with sPTB.
An insulin-stimulated proteolytic mechanism links energy expenditure with glucose uptake
Authors: Habtemichael Estifanos N. , Li Don T. , Camporez João Paulo , Westergaard Xavier O. , Sales Chloe I. , Liu Xinran , López-Giráldez Francesc , DeVries Stephen G. , Li Hanbing , Ruiz Diana M. , Wang Kenny Y. , Sayal Bhavesh S. , Hirabara Sandro , Vatner Daniel F. , Philbrick William , Shulman Gerald I. , Bogan Jonathan S.
Published: October 2019

Mechanisms to coordinately regulate energy expenditure and glucose uptake into muscle and fat cells are not well described. Insulin stimulates glucose uptake in part by causing site-specific endoproteolytic cleavage of TUG, which mobilizes GLUT4 glucose transporters to the cell surface. Here, we show that the TUG C-terminal cleavage product enters the nucleus, binds the transcriptional regulators PGC-1α and PPARγ, and increases oxidative metabolism and thermogenic protein expression. Muscle-specific genetic manipulation of this pathway impacts whole-body energy expenditure, independent of glucose uptake. The PPARγ2 Pro12Ala polymorphism, which reduces diabetes risk, enhances TUG binding. The TUG cleavage product stabilizes PGC-1α and is itself susceptible to an Ate1 arginyltransferase -dependent degradation mechanism; binding of the TUG product confers Ate1-dependent stability upon PGC-1α. We conclude that TUG cleavage coordinates energy expenditure with glucose uptake, that this pathway may contribute to the thermic effect of food, and that its attenuation may be important in obesity.
Distinct patterns of surround modulation in V1 and hMT+
Authors: Er Gorkem , Pamir Zahide , Boyaci Huseyin
Published: October 2019

Modulation of a neuron’s responses by the stimuli presented outside of its classical receptive field is ubiquitous in the visual system. This “surround modulation” mechanism is believed to be critical for efficient processing and leads to many well-known perceptual effects. The details of surround modulation, how-ever, are still not fully understood. One of the open questions is related to the differences in surround modulation mechanisms in different cortical areas, and their interactions. Here we study patterns of surround modulation in primary visual cortex (V1) and middle temporal complex (hMT+) utilizing a well-studied effect in motion perception, where human observers’ ability to discriminate the drift direction of a grating improves as its size gets bigger if the grating has a low contrast, and deteriorates if it has a high contrast. We first replicated the findings in the literature with a behavioral experiment using small and large (1.06 and 8.05 degrees of visual angle) drifting gratings with either low (2%) or high (99%) contrast presented at the periphery. Next, using functional MRI, we found that in V1 with increasing size cortical responses increased at both contrast levels, but they increased more at high contrast. Whereas in hMT+ with increasing size cortical responses remained unchanged at high contrast, and increased at low contrast. These findings show that surround modulation in V1 and hMT+ are distinct. Furthermore these findings provide evidence that the size-contrast interaction in motion perception is likely to originate in hMT+.
A memory-based theory of emotional disorders
Authors: Cohen Rivka T. , Kahana Michael J.
Published: October 2019

Learning and memory play a central role in emotional disorders, particularly in depression and posttraumatic stress disorder. We present a new, transdiagnostic theory of how memory and mood interact in emotional disorders. Drawing upon retrieved-context models of episodic memory, we propose that memories form associations with the contexts in which they are encoded, including emotional valence and arousal. Later, encountering contextual cues retrieves their associated memories, which in turn reactivate the context that was present during encoding. We first show how our retrieved-context model accounts for findings regarding the organization of emotional memories in list-learning experiments. We then show how this model predicts clinical phenomena, including persistent negative mood after chronic stressors, intrusive memories of painful events, and the efficacy of cognitive-behavioral therapies.