bluuebunny/crossref_metadata_2025 huggingface dataset:
The decay of Western liberalism and the Christological alternative
Authors: Wood Benjamin J.
Published: December 2018

Recent election results across the Western world have seen the resurgence of authoritarian and nativist forms of politics. Key shibboleths of liberal democracy have come under fierce attack from burgeoning populist movements. Calls for a return to homogenous national identities and firm lines of cultural belonging increasingly eclipse values of social openness, pluralism and multiculturalism. In such a febrile atmosphere, it might be legitimate to ask, is Western liberalism in a state of decay? And if so, how should Christian communities respond to such a development? Drawing constructively on the work of Karl Barth and E.M Forster, this article argues that the fragmentation of liberal values risks making secular culture less receptive to the distinctive summons of the Christian message. Chiefly imperilled by such disintegration is the pedagogical capacity of political liberalism to sensitise otherwise secular citizens to notions of universal community, which lie at the centre of the Gospel's subversive social imaginary. In a world where ‘nation’ and ‘ethnicity’ are again compelling rivals for the West's civic affections, liberal politics must recover a public creed which grounds the language of liberty in a robust account of community, friendship and care.
Inhibiting antibiotic-resistant Enterobacteriaceae by microbiota-mediated intracellular acidification
Authors: Sorbara Matthew T. , Dubin Krista , Littmann Eric R. , Moody Thomas U. , Fontana Emily , Seok Ruth , Leiner Ingrid M. , Taur Ying , Peled Jonathan U. , van den Brink Marcel R.M. , Litvak Yael , Bäumler Andreas J. , Chaubard Jean-Luc , Pickard Amanda J. , Cross Justin R. , Pamer Eric G.
Published: December 2018

Klebsiella pneumoniae, Escherichia coli, and other members of the Enterobacteriaceae family are common human pathogens that have acquired broad antibiotic resistance, rendering infection by some strains virtually untreatable. Enterobacteriaceae are intestinal residents, but generally represent <1% of the adult colonic microbiota. Antibiotic-mediated destruction of the microbiota enables Enterobacteriaceae to expand to high densities in the colon, markedly increasing the risk of bloodstream invasion, sepsis, and death. Here, we demonstrate that an antibiotic-naive microbiota suppresses growth of antibiotic-resistant clinical isolates of Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis by acidifying the proximal colon and triggering short chain fatty acid (SCFA)–mediated intracellular acidification. High concentrations of SCFAs and the acidic environment counter the competitive edge that O2 and NO3 respiration confer upon Enterobacteriaceae during expansion. Reestablishment of a microbiota that produces SCFAs enhances clearance of Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis from the intestinal lumen and represents a potential therapeutic approach to enhance clearance of antibiotic-resistant pathogens.
Integration of accessibility data from structure probing into RNA–RNA interaction prediction
Authors: Miladi Milad , Montaseri Soheila , Backofen Rolf , Raden Martin
Published: December 2018

Experimental structure probing data has been shown to improve thermodynamics-based RNA secondary structure prediction. To this end, chemical reactivity information (as provided e.g. by SHAPE) is incorporated, which encodes whether or not individual nucleotides are involved in intra-molecular structure. Since inter-molecular RNA–RNA interactions are often confined to unpaired RNA regions, SHAPE data is even more promising to improve interaction prediction. Here, we show how such experimental data can be incorporated seamlessly into accessibility-based RNA–RNA interaction prediction approaches, as implemented in IntaRNA. This is possible via the computation and use of unpaired probabilities that incorporate the structure probing information. We show that experimental SHAPE data can significantly improve RNA–RNA interaction prediction. We evaluate our approach by investigating interactions of a spliceosomal U1 snRNA transcript with its target splice sites. When SHAPE data is incorporated, known target sites are predicted with increased precision and specificity.

Availability and implementation

https://github.com/BackofenLab/IntaRNA

Supplementary information

Supplementary data are available at Bioinformatics online.
TriPOINT: a software tool to prioritize important genes in pathways and their non-coding regulators
Authors: Thibodeau Asa , Shin Dong-Guk
Published: December 2018

Current approaches for pathway analyses focus on representing gene expression levels on graph representations of pathways and conducting pathway enrichment among differentially expressed genes. However, gene expression levels by themselves do not reflect the overall picture as non-coding factors play an important role to regulate gene expression. To incorporate these non-coding factors into pathway analyses and to systematically prioritize genes in a pathway we introduce a new software: Triangulation of Perturbation Origins and Identification of Non-Coding Targets. Triangulation of Perturbation Origins and Identification of Non-Coding Targets is a pathway analysis tool, implemented in Java that identifies the significance of a gene under a condition (e.g. a disease phenotype) by studying graph representations of pathways, analyzing upstream and downstream gene interactions and integrating non-coding regions that may be regulating gene expression levels.

Availability and implementation

The TriPOINT open source software is freely available at https://github.uconn.edu/ajt06004/TriPOINT under the GPL v3.0 license.

Supplementary information

Supplementary data are available at Bioinformatics online.
Cardiovascular risk is associated with a transmural gradient of myocardial oxygenation during adenosine infusion
Authors: Luu Judy M , Schmidt Anna , Flewitt Jacqueline , Mikami Yoko , ter Keurs Henk , Friedrich Matthias G
Published: December 2018

Aims

In patients with coronary artery disease (CAD), a transmural gradient of myocardial perfusion has been repeatedly observed, with the subendocardial layer showing more pronounced perfusion deficits. Oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR) allows for monitoring transmural changes of myocardial oxygenation in vivo. We hypothesized that OS-CMR could help identify a transmural oxygenation gradient as a disease marker in patients at risk for CAD.

Methods and results

We assessed 34 patients with known CAD and 28 subjects with coronary risk factors but no evidence of significant CAD. Results were compared with 11 healthy volunteers. OS-CMR was performed at 1.5 T, applying a T2*-weighted cine steady state free precession sequence at baseline and during infusion of adenosine. A reader blinded to patient data quantified the relative change of myocardial oxygenation in OS-CMR, defined by the change of signal intensity (ΔSI%) between baseline and during adenosine infusion in the entire myocardium, the subepicardial layer, and the subendocardial layer. SI changes were homogenous throughout the myocardium in healthy subjects, whereas both, patients with risk factors only and patients with CAD, had a significantly smaller ΔSI% in the subendocardial layer than in the subendocardial layer. Both patient groups had an overall decreased ΔSI% across all layers when compared with healthy subjects (P < 0.05).

Conclusion

Even in the absence of overt CAD, cardiovascular risk factors are associated with a transmural gradient of the myocardial oxygenation response to adenosine as assessed by OS-CMR. An inducible transmural oxygenation gradient may serve as a non-invasive marker for cardiovascular risk.
Quantification of epicardial adipose tissue in patients undergoing hybrid ablation for atrial fibrillation
Authors: Vroomen Mindy , Olsthoorn Jules R , Maesen Bart , L’Espoir Vladimir , La Meir Mark , Das Marco , Maessen Jos G , Crijns Harry J G M , Verheule Sander , Pison Laurent
Published: December 2018

OBJECTIVES

Epicardial adipose tissue volume (EAT-V) has been linked to atrial fibrillation (AF) recurrences after catheter ablation. We retrospectively studied the association between atrial EAT-V and outcome after hybrid AF ablation (epicardial surgical and endocardial catheter ablation).

METHODS

On preoperative cardiac computed tomography angiography scans, the left atrium and right atrium were manually delineated using the open source ImageJ. With custom-made automated software, the number of pixels in the regions of interest on each slice was calculated. On the basis of the Hounsfield units, pixel size and slice thickness, EAT-V was computed and normalized in relation to the body surface area (BSA) and the myocardial tissue volume.

RESULTS

Eighty-five patients were included. Left atrial and right atrial EAT-V normalized to BSA were not significantly different between paroxysmal and persistent AF [0.84 (0.51–1.50) vs 0.81 (0.57–1.18), 1.74 (1.02–2.56) vs 1.55 (1.26–2.18), all P = 0.9], neither between the acute conduction block and no acute conduction block in the epicardial box lesion [0.92 (0.55–1.39) vs 0.72 (0.55–1.24), P = 0.5, right atrium not applicable], nor between the sinus rhythm and arrhythmia recurrence after 12 months [0.88 (0.55–1.48) vs 0.63 (0.47–1.10), 1.61 (1.11–2.50) vs 1.55 (1.20–2.20), all P > 0.1]. Left atrial EAT-V normalized to myocardial tissue volume was not different between the groups.

CONCLUSIONS

This study could neither confirm that EAT-V was predictive of recurrence of supraventricular arrhythmias in patients undergoing a hybrid AF ablation, nor that EAT-V was different between patients with paroxysmal AF and persistent and long-standing persistent AF. This suggests that EAT-V might not affect the outcome in surgical ablation procedures and therefore should not influence preoperative or intraoperative decision-making.
On Cyclic Descents for Tableaux
Authors: Adin Ron M , Reiner Victor , Roichman Yuval
Published: December 2018

The notion of descent set, for permutations as well as for standard Young tableaux (SYT), is classical. Cellini introduced a natural notion of cyclic descent set for permutations, and Rhoades introduced such a notion for SYT—but only for rectangular shapes. In this work we define cyclic extensions of descent sets in a general context and prove existence and essential uniqueness for SYT of almost all shapes. The proof applies nonnegativity properties of Postnikov’s toric Schur polynomials, providing a new interpretation of certain Gromov–Witten invariants.
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data
Authors: Durojaiye Ashimiyu B , Levin Scott , Toerper Matthew , Kharrazi Hadi , Lehmann Harold P , Gurses Ayse P
Published: December 2018

Objectives

The study sought to identify collaborative electronic health record (EHR) usage patterns for pediatric trauma patients and determine how the usage patterns are related to patient outcomes.

Materials and Methods

A process mining–based network analysis was applied to EHR metadata and trauma registry data for a cohort of pediatric trauma patients with minor injuries at a Level I pediatric trauma center. The EHR metadata were processed into an event log that was segmented based on gaps in the temporal continuity of events. A usage pattern was constructed for each encounter by creating edges among functional roles that were captured within the same event log segment. These patterns were classified into groups using graph kernel and unsupervised spectral clustering methods. Demographics, clinical and network characteristics, and emergency department (ED) length of stay (LOS) of the groups were compared.

Results

Three distinct usage patterns that differed by network density were discovered: fully connected (clique), partially connected, and disconnected (isolated). Compared with the fully connected pattern, encounters with the partially connected pattern had an adjusted median ED LOS that was significantly longer (242.6 [95% confidence interval, 236.9–246.0] minutes vs 295.2 [95% confidence, 289.2–297.8] minutes), more frequently seen among day shift and weekday arrivals, and involved otolaryngology, ophthalmology services, and child life specialists.

Discussion

The clique-like usage pattern was associated with decreased ED LOS for the study cohort, suggesting greater degree of collaboration resulted in shorter stay.

Conclusions

Further investigation to understand and address causal factors can lead to improvement in multidisciplinary collaboration.
Long-Term Safety and Efficacy of Dolutegravir in Treatment-Experienced Adolescents With Human Immunodeficiency Virus Infection: Results of the IMPAACT P1093 Study
Authors: Viani Rolando M , Ruel Theodore , Alvero Carmelita , Fenton Terry , Acosta Edward P , Hazra Rohan , Townley Ellen , Palumbo Paul , Buchanan Ann M , Vavro Cindy , Singh Rajendra , Graham Bobbie , Anthony Patricia , George Kathleen , Wiznia Andrew ,   The P1093 Study Team, Heckman Barbara , Popson Stephanie , Sise Thucuma , Hergott Katelyn , Myers Kathryn , Rodriguez Carina A , Emmanuel Patricia J , Casey Denise , Wara Diane , Tilton Nicole , Aziz Mariam , McNichols Maureen , Logan Latania , Sirisanthana Virat , Aurpibul Linda , Kosachunhanan Nataporn , Jensen Jennifer , Williams Ruth , Qureshi Tarannum , Dobroszycki Joanna , Huh Heesun , Reinoso Francisco , Rana Sohail , Houston Patricia , Mengistab Mulu , Burchett Sandra K , Karthas Nancy , Kneut Catherine
Published: December 2018

Background

P1093 is an ongoing phase I/II multicenter open-label study of dolutegravir plus an optimized background regimen in age-defined pediatric cohorts; here we report the long-term safety and virologic efficacy outcomes for the oldest cohort.

Methods

The study enrolled human immunodeficiency virus type 1 (HIV-1)–infected treatment-experienced adolescents aged 12 to <18 years, with an HIV-1 RNA level ≥1000 copies/mL . Cumulative safety and HIV-1 RNA outcomes were assessed once the last enrolled participant reached 144 weeks of follow-up.

Results

Among 23 adolescents enrolled, 16 remained in the study at least 144 weeks; the median follow-up was 153 weeks (range, 55–193 weeks). Dolutegravir was well tolerated, with grade 3 clinical adverse events in 5 participants, grade 3 laboratory abnormalities in 3, and grade 4 laboratory abnormalities in 1; none of the adverse events or abnormalities were judged to be treatment related. In an-intent-to-treat analysis, an HIV-1 RNA level <400 copies/mL at week 144 was achieved in 43% (10 of 23 participants; 95% confidence interval, 23.2%–65.5%); in addition, 35% (8 of 23; 16.4%–57.3%) had an HIV-1 RNA level <50 copies/mL. Nine participants (39%) discontinued study treatment before 144 weeks, but none because of adverse events or drug intolerance. All participants with sustained virologic control had excellent adherence; most who experienced virologic failure had adherence levels <90%. HIV-1 genotypic drug resistance testing was available at time of failure from 6 participants; 1 had evolution in integrase resistance with E138T, S147G, and R263K mutations at week 192 and phenotypic dolutegravir resistance of a 5.1-fold change.

Conclusions

Dolutegravir plus an optimized background regimen seemed safe, well tolerated, and efficacious in this cohort of treatment-experienced HIV-1-infected adolescents. Adherence remains problematic in this population.

Clinical Trials Registration

NCT01302847.
Galaxy formation in the Planck Millennium: the atomic hydrogen content of dark matter haloes
Authors: Baugh C M , Gonzalez-Perez Violeta , Lagos Claudia D P , Lacey Cedric G , Helly John C , Jenkins Adrian , Frenk Carlos S , Benson Andrew J , Bower Richard G , Cole Shaun
Published: December 2018

We present recalibrations of the galform semi-analytical model of galaxy formation in a new N-body simulation with the Planck cosmology. The Planck Millennium simulation uses more than 128 billion particles to resolve the matter distribution in a cube of 800 Mpc on a side, which contains more than 77 million dark matter haloes with mass greater than 2.12 × 109 h−1 M⊙ at this day. Only minor changes to a very small number of model parameters are required in the recalibration. We present predictions for the atomic hydrogen content (H i) of dark matter haloes, which is a key input into the calculation of the H i intensity mapping signal expected from the large-scale structure of the Universe. We find that the H i mass–halo mass relation displays a clear break at the halo mass above which AGN heating suppresses gas cooling, ≈3 × 1011h−1 M⊙. Below this halo mass, the H i content of haloes is dominated by the central galaxy; above this mass it is the combined H i content of satellites that prevails. We find that the H i mass–halo mass relation changes little with redshift up to $z$ = 3. The bias of H i sources shows a scale dependence that gets more pronounced with increasing redshift.
Effects of increasing copper from tri-basic copper chloride or a copper-methionine chelate on growth performance of nursery pigs1,2
Authors: Carpenter Corey B , Woodworth Jason C , DeRouchey Joel M , Tokach Mike D , Goodband Robert D , Dritz Steve S , Wu Fangzhou , Usry James L
Published: December 2018

A total of 2,117 pigs were used in two 35-d growth experiments to determine the effects of increasing added Cu from tri-basic copper chloride (TBCC) or a Cu-methionine chelate (Cu-chelate) on nursery pig growth performance. In experiment 1, 1,452 pigs (350 barrows [DNA 200 × 400; initially 5.9 ± 0.17 kg] in group 1 and 1,102 pigs [PIC 1050 × 280; initially 6.0 ± 0.26 kg] in group 2) were weaned at approximately 21 d of age. In experiment 2, 665 pigs (350 barrows, DNA 200 × 400; initially 6.4 ± 0.19 kg, in group 3 and 315 pigs, DNA 241 × 600; initially 5.2 ± 0.49 kg, in group 4) were weaned at approximately 21 d of age. Pigs in groups 1, 2, and 3 were fed a common starter diet for 7 d and pigs in group 4 were fed a common diet for 5 d after weaning before starting experiments. On d 0 of each experiment, pens of pigs were blocked by body weight (BW) and assigned to 1 of 7 dietary treatments. Treatments were arranged as a 2 × 3 factorial plus one control diet, with main effects of Cu source (TBCC vs. Cu-chelate) and level. Copper levels were 50, 100, or 150 mg/kg in experiment 1 and 75, 150, or 225 mg/kg in experiment 2. Diets were corn-soybean meal-based and fed in meal form in two phases (d 0 to 14 and 14 to 35). In experiment 1 from d 0 to 35, there was a Cu source × level interaction (linear, P < 0.05) for average daily gain (ADG) and d 35 BW where the magnitude of improvement with increasing Cu was greater in pigs fed Cu-chelate compared to those fed TBCC. Increasing added Cu increased (linear, P < 0.01) average daily feed intake (ADFI) and gain:feed (G:F). Although Cu source did not influence G:F, pigs fed Cu from Cu-chelate had greater (P ≤ 0.01) ADG and ADFI than those fed Cu from TBCC. In experiment 2, from d 0 to 35, there were no evidence for Cu source × level interactions. Increasing Cu increased (linear, P < 0.05) ADG and final BW. The increase in ADG combined with unaffected ADFI resulted in marginally increased G:F (linear, P = 0.052). In summary, these results suggest that increasing dietary Cu from TBCC or a Cu-chelate improved overall ADG, and d 35 BW in nursery pigs and Cu source has potential to influence nursery pig performance.
Biomechanical Investigation of an Integrated 2-Screw Cephalomedullary Nail Versus a Sliding Hip Screw in Unstable Intertrochanteric Fractures
Authors: Santoni Brandon G. , Diaz Miguel A. , Stoops T. Kyle , Lannon Sean , Ali Ashley , Sanders Roy W.
Published: December 2018

Objective:

To compare the efficacy of 2 intertrochanteric (IT) fracture fixation devices in conferring mechanical stability to unstable IT femur fractures.

Methods:

Nine pairs of cadaveric female femurs with a groupwise average bone quality indicative of osteopenia were used. An unstable IT fracture without calcar support (OTA/AO 31-A2) was created and stabilized with either a sliding hip screw and side plate (SHS) or a cephalomedullary nail using an integrated dual-screw fixation [InterTAN (ITN)]. Constructs were evaluated under stepwise and increasing cyclic loading up to 50,000 cycles (1500 N) or by failure in a test model that may best simulate hip joint contact forces at heel strike. Number of cycles to failure, failure load, and femoral head rotation about the screw axis were compared between groups.

Results:

The average number of cycles in the ITN group was greater compared with that in the SHS group (48,383 vs. 31,403 cycles, P = 0.046). Similarly, the average maximum load survived by the ITN group was greater than that of the SHS group (1456 vs. 1113 N, P = 0.046). The number of constructs that survived up to the maximum applied load of 1500 N was greater in the ITN group (8/9, 89%) when compared with that of the SHS constructs (3/9, 33%) (P = 0.049). Finally, the ITN group conferred greater rotational control of the femoral head compared with the SHS constructs (1.5 vs. 5.5 degrees, P = 0.018), and reduced the amount of varus collapse (11.1 vs. 31.1 degrees, P = 0.038).

Conclusions:

The integrated dual-screw construct appeared to confer significantly greater fracture stability compared with a sliding hip screw and side plate using a worst-case model that simulates heel strike during gait. Study data provide biomechanical evidence that the ITN device may provide more stability and rotational resistance than a sliding hip screw in the elderly female patient population with an unstable IT fracture and compromised bone quality.
Symmetry Matching of the Medial Acetabular Surface—A Quantitative Analysis in View of Patient-Specific Implants
Authors: Osterhoff Georg , Petersik Andreas , Sprengel Kai , Pape Hans-Christoph
Published: December 2018

Objective:

To quantify intrapelvic surface symmetry in reference to a preshaped suprapectineal acetabular implant.

Methods:

In this cross-sectional study, an anatomically preshaped acetabular fracture implant was fitted on 3D surface models of 516 pelvises from a preexisting bone database using a software tool for automated implant fitting (SOMA, Stryker Orthopaedic Modeling and Analytics) of a CAD model of the implant. The distances between bone and the reference implant were measured at 2310 reference points for each hemipelvis.

Results:

The average distance between the left hemipelvis and the plate was 1.98 mm (median, 10% percentile: 1.45, 90% percentile: 2.78) and 2.0 mm (median, 10% percentile: 1.45, 90% percentile: 2.92) between the right hemipelvis and the plate. There was no significant difference between the 2 hemipelvises (median absolute pairwise delta: 0.25 mm; 10% percentile: 0.04, 90% percentile: 0.82; Wilcoxon, P = 0.064).

Conclusions:

With regard to the periacetabular surface of the inner pelvis, the pelvis can be considered sufficiently symmetric for using the mirrored contralateral hemipelvis as a template for patient-specific implants in acetabular fracture fixation.
The Financial Impact of the Affordable Care Act on a Level-1 Orthopedic Trauma Service
Authors: Beck Chad J. , Shelton Trevor J. , Wisner David H. , Wolinsky Philip R.
Published: December 2018

Objectives:

To determine the impact of the Affordable Care Act (ACA) on professional fees and proportion of payer type for an orthopedic trauma service at a level-1 trauma center.

Methods:

We analyzed professional fee data and payer mix for the 18 months before and after implementation of the ACA. Data were collected for inpatients (IP) and outpatients (OP). We corrected for changes in patient volume between the 2-time periods by calculating average values per patient.

Results:

Post ACA, we treated a higher percentage of patients with Medicaid and had a reduction in the percentage of uninsured/county payers. Collections for IPs decreased $75.49/patient and OPs decreased $0.10/patient. Our collection rate decreased 6% for IPs and 5% for OPs. In particular, Medicaid collections decreased by $180/IP, and $4/OP, and Medicare decreased by $61/IP and increased $5/OP post ACA, whereas contract collections increased by $140/IP and $20/OP. The changes in our own institution's insurance were mixed with decreases of $514/IP for partial risk and $735/IP for full-risk insurance and increases of $1/OP for partial risk, and $35/OP for full-risk insurance.

Conclusions:

Post ACA, we saw less patients, primarily in the OP setting. This shift was accompanied by a significant decrease in our collection rate; specifically, a decrease in the amount we collected per Medicaid patient—the category of payer that increased post ACA. The ACA did allow more uninsured patients access to medical care but was associated with lower IP and OP reimbursements.
Percutaneous Vertebral Augmentation for Vertebral Compression Fractures
Authors: Rabei Rana , Patel Ketan , Ginsburg Michael , Patel Mikin V. , Turba Ulku C. , Arslan Bulent , Ahmed Osman
Published: December 2018

Study Design.

Retrospective analysis of Medicare data

Objective.

To analyze trends of vertebral augmentation in the elderly Medicare population in the context of evolving evidence and varied medical society opinions.

Summary of Background Data.

Percutaneous vertebral augmentation offers a minimally invasive therapy for vertebral compression fractures. Numerous trials have been published on this topic with mixed results. The impact of these studies and societal recommendations on physician practice patterns is not well understood.

Methods.

The Centers for Medicare and Medicaid Services annual Medicare Physician Supplier Procedure Summary database was examined for kyphoplasty and vertebroplasty procedures from 2005 through 2015. Top provider specialties were determined based on annual procedural volume, and grouped into the three broad categories of radiology, surgery, and anesthesia/pain medicine. Data entries were independently analyzed by provider type, site of service, submitted charges, and reimbursement rates for interventions during the study period.

Results.

Between 2005 and 2015 total annual claims for vertebral augmentation procedures in the Medicare population increased from 108.11% (37,133–77,276) peaking in 2008 and declining by 15.56% in 2009. Radiology is the largest provider of vertebral augmentation by specialty with declining market shares from 71% in 2005 to 43% in 2015. The frequency of vertebroplasty declined by 61.7% (35,409–13,478) from 2005 to 2015 with reduction in Medicare reimbursement. Annual volume of kyphoplasty grew by 18.3% (48,725–57,646) with significant increase in reimbursement for office-based procedures ($728.50/yr, P < 0.001, R
2 = 0.69).

Conclusion.

The annual volume of vertebral augmentation declined in 2009 following two negative trials on vertebroplasty. Although these publications had a persistent negative impact on practice of vertebroplasty, the overall frequency of vertebral augmentation in the Medicare population has not changed significantly between 2005 and 2015. Instead, there has been a significant shift in provider practice patterns in favor of kyphoplasty in increasingly outpatient and office-based settings.

Level of Evidence: 3
Vaginal estrogen use and chronic disease risk in the Nurses’ Health Study
Authors: Bhupathiraju Shilpa N. , Grodstein Francine , Stampfer Meir J. , Willett Walter C. , Crandall Carolyn J. , Shifren Jan L. , Manson JoAnn E.
Published: December 2018

Objective:

To examine the associations between vaginal estrogen use and multiple health outcomes including cardiovascular disease (total myocardial infarction, stroke, and pulmonary embolism/deep vein thrombosis), cancer (total invasive, breast, endometrial, ovarian, and colorectal cancer), and hip fracture.

Methods:

We included postmenopausal women from the Nurses’ Health Study (1982-2012) who were not current users of systemic hormone therapy at the start of the study or during follow-up. Vaginal estrogen use was self-reported on the biennial questionnaires. Information on incident health outcomes were self-reported and confirmed by medical records. We used Cox proportional hazards regression to model the multivariable adjusted hazard ratios and the 95% confidence intervals for vaginal estrogen use and multiple health outcomes.

Results:

Over 18 years of follow-up, after adjusting for covariates, risks for cardiovascular disease, cancer, and hip fracture were not different between users and nonusers of vaginal estrogen. No statistically significant increase in risk of any health outcome was observed with vaginal estrogen use. In sensitivity analyses, when we examined associations by hysterectomy status, the stratified results were generally similar to those for the total cohort.

Conclusions:

Vaginal estrogen use was not associated with a higher risk of cardiovascular disease or cancer. Our findings lend support to the safety of vaginal estrogen use, a highly effective treatment for genitourinary syndrome of menopause.
Surgical Therapy of Temporal Triggered Migraine Headache
Authors: Bertozzi Nicolò , Simonacci Francesco , Lago GianLuigi , Bordin Chiara , Raposio Edoardo
Published: December 2018

Background:

The auriculotemporal and zygomaticotemporal nerves are the 2 primary trigger points in the temporal area of migraine headache. Different surgical approaches are described in literature, either open or endoscopic ones.

Methods:

We described and delineated the currently adopted strategies to treat temporal trigger points in migraine headache. Furthermore, we reported our personal experience in the field.

Results:

Regardless of the type of approach, outcomes observed were similar and ranged from 89% to 67% elimination / >50% reduction rates. All procedures are minimally invasive and only minor complications are reported, with an incidence ranging from 1% to 5%.

Conclusions:

Just like upper limb compressive neuropathies, migraine headache is believed to be caused by chronic compression of peripheral nerves (ie, the terminal branches of trigeminal nerve) caused by surrounding structures (eg, muscles, vessels, and fascial bands) the removal of which eventually results in improvement or elimination of migraine attacks. Particular attention should be paid to the close nerve/artery relationship often described in anatomical studies and clinical reports.
CUTICULAR DRUSEN
Authors: Sakurada Yoichi , Parikh Ravi , Gal-Or Orly , Balaratnasingam Chandrakumar , Leong Belinda C.S. , Tanaka Koji , Cherepanoff Svetlana , Spaide Richard F. , Freund K. Bailey , Yannuzzi Lawrence A.
Published: December 2018

Purpose:

Cuticular drusen (CD) have been associated with manifestations of age-related macular degeneration such as atrophy and neovascularization in the macula. In this study, eyes with CD were followed and investigated for the estimated 5-year risk of progression to sequelae of age-related macular degeneration such as geographic atrophy (GA) and macular neovascularization (MNV).

Methods:

A consecutive series of patients with CD were followed for the development of GA and MNV. Whenever possible, they were also studied retrospectively. The patients with CD were categorized into three phenotypic groups. Phenotype 1: eyes had concentrated, densely populated CD in the macular and paramacular area, Phenotype 2: eyes showed scattered CD in the posterior fundus, and Phenotype 3: involved eyes with CD mixed with large drusen (>200 µm). The 5-year incidence of progression was then estimated using a Kaplan–Meier estimator.

Results:

A total of 63 eyes from 38 patients (35 women with a mean age at presentation of 58.9 ± 14.2 years) were studied and followed for a mean of 40 ± 18 months. Thirteen patients had single eyes with GA (84.5%; 11/13) or MNV (15.5%; 2/13) in one eye at presentation and were subsequently excluded. Geographic atrophy developed in 19.0% (12/63) of eyes and MNV in 4.8% (3/63) of eyes. The cumulative estimated 5-year risk of GA and MNV was 28.4% and 8.7%, respectively. The estimated 5-year incidence of MNV or GA was 12.6%, 50.0%, and 51.6% in Phenotype 1, Phenotype 2, and Phenotype 3, respectively (P = 0.0015, log-rank test). No difference in risk was found in the development of GA or MNV (P = 0.11) between the subgroup of patients presenting with GA or MNV in their fellow eye and those with both eyes included.

Conclusion:

When patients with CD are followed longitudinally, there was a significant risk of progression to GA or MNV for Phenotype 2 and Phenotype 3. Patients with CD are commonly first diagnosed in the fifth decade of life, and there is a female predominance. Clinicians should use multimodal imaging to detect and be aware of the risk of progression to manifestations of GA and MNV. These risks of GA and MNV suggest that patients with CD may be part of the overall spectrum of age-related macular degeneration.
A Randomized Trial to Evaluate the Effect of Toric Versus Spherical Contact Lenses on Vision and Eyestrain
Authors: Berntsen David A. , Cox Stephanie M. , Bickle Katherine M. , Mathew Jessica H. , Powell Daniel R. , Seidman Scott H. , Little Borm Kim , Lorenz Kathrine Osborn , Nichols Jason J.
Published: December 2018

Objectives:

To compare the effect of toric versus spherical soft contact lenses on objective measures of visual performance using visual acuity and electromyography of the orbicularis oculi muscle.

Methods:

Current soft contact lens wearers with −0.75 to −1.75 D astigmatism in each eye were binocularly fitted with toric (1-Day ACUVUE MOIST for astigmatism) and spherical (1-Day ACUVUE MOIST) contact lenses in random order. After each fitting and at 1-week follow-up, high- and low-contrast visual acuities were measured. Electromyography was used to objectively evaluate eyestrain. Linear mixed models were used to assess differences between toric and spherical contact lenses.

Results:

The mean age (±SD) of the 60 participants was 27.5±5.0 years, spherical refractive error was −3.68±2.01 D, and cylinder was −1.28±0.36 D. High- and low-contrast visual acuities with toric lenses were better than with spherical lenses at both fitting (toric high-contrast: −0.065±0.078 and low-contrast: 0.133±0.103 vs. spherical high-contrast: 0.001±0.104 and low-contrast: 0.224±0.107) and follow-up (toric high-contrast: −0.083±0.087 and low-contrast: 0.108±0.107 vs. spherical high-contrast: −0.015±0.095 and low-contrast: 0.211±0.104) (all P<0.0001). Electromyography-measured eyestrain was less with toric versus spherical contact lenses at fitting (least-square ratio of toric over spherical=0.72; P=0.0019) but not at follow-up (ratio=0.86; P=0.11).

Conclusion:

These results suggest that toric contact lenses provided improved objective measures of vision in a low-to-moderate astigmatic population.
Interpreting Neurologic Outcomes in a Changing Trial Design Landscape: An Analysis of HeartWare Left Ventricular Assist Device Using a Hybrid Intention to Treat Population
Authors: Mahr Claudius , Thinh Pham Duc , Mokadam Nahush A. , Silvestry Scott C. , Cowger Jennifer , Kiernan Michael S. , D’alessandro David A. , Coglianese Erin E. , Faraz Masood Muhammad , Kormos Robert L. , Jacoski Mary V. , Teuteberg Jeffrey J.
Published: December 2018

Randomized controlled trials can provide optimal clinical evidence to assess the benefits of new devices, and it is these data that often shape device usage in real-world practice. However, individual clinical trial results sometimes appear discordant for the same device, and alternative devices are sometimes not employed in similar patient populations. To make sound evidence-based decisions, clinicians routinely rely on cross-trial comparisons from different trials of similar but not identical patient populations to assess competing technology when head-to-head randomized comparisons are unavailable.
Renal transplantation and predisposition to opportunistic infections
Authors: Dandamudi Raja , Smith Jodi , Dharnidharka Vikas R.
Published: December 2018

Purpose of review

Infections represent a significant source of morbidity and mortality after kidney transplantation in children. We review recent advances in epidemiology, assessment, prevention and treatment for several different infections.

Recent findings

Infections, such as bacterial urinary tract infection or opportunistic viral infection remain common, may be increasing and represent a large proportion of hospitalization. Extended antiviral agent use reduces the incidence of cytomegalovirus disease but its efficacy to reduce Epstein–Barr virus disease remains controversial. Human herpesvirus-6 and hepatitis E virus represent new infections to keep in mind. Ureteral stenting increases the rate of early UTI. Several new vaccines are now available, but rates of complete vaccination pretransplant are low.

Infections remain a critical posttransplant issue associated with significant medical burdens. Emerging data on associated risk factors, assessment of and treatment for infections provide clinicians with new knowledge.
Symptoms of Feeding Problems in Preterm‐born Children at 6 Months to 7 Years Old
Authors: Park Jinhee , Thoyre Suzanne M. , Pados Britt F. , Gregas Matt
Published: December 2018

Objectives:

Describe symptoms of feeding problems in children born very preterm (<32 weeks gestation) and moderate to late preterm (32–37 weeks gestation) compared to children born full‐term; explore the contribution of medical risk factors to problematic feeding symptoms.

Methods:

The sample included 57 very preterm, 199 moderate to late preterm, and 979 full‐term born children ages 6 months to 7 years. Symptoms of feeding problems were assessed using the Pediatric Eating Assessment Tool and compared between groups after accounting for the child's age and/or sex. With the sample of preterm children, we further analyzed 11 medical factors as potential risk factors affecting a child's feeding symptoms: feeding problems in early infancy and conditions of oxygen requirement past 40 weeks of postmenstrual age, congenital heart disease, structural anomaly, genetic disorder, cerebral palsy, developmental delay, speech‐language delay, sensory processing disorder, vision impairment, or symptoms of gastroesophageal reflux.

Results:

Compared to children born full‐term, both very preterm and moderate to late preterm born children had significantly higher scores on the Pediatric Eating Assessment Tool total scale and all 4 subscales. More severe symptoms were noted in very preterm children, particularly in the areas of Physiologic Symptoms and Selective/Restrictive Eating. Among preterm children, all 11 medical factors were found to be associated significantly with increased symptoms of feeding problems.

Conclusion:

Compared to children born full‐term, preterm born children demonstrated greater symptoms of feeding problems regardless of their current age, suggesting children born preterm may require more careful monitoring of feeding throughout childhood.
Quantifying Burn Injury–Related Disability and Quality of Life in the Developing World
Authors: McMahon Heather A. , Ndem Idorenyin , Gampper Lauren , Gampper Thomas J. , DeGeorge Brent R.
Published: December 2018

Background

Untreated or undertreated burns are commonly encountered by plastic surgeons on medical trips in India and represent a major cause of disability. We sought to utilize validated patient-reported outcomes instruments to identify the patient population with the greatest burn-related disability in order to appropriately allocate plastic surgery resources to those in greatest need.

Methods

The Quick Disability of the Arm, Shoulder, and Hand, RAND 36-Item Short Form Health Survey, and Burn-Specific Health Scale–Revised, Brief, and Adapted questionnaires were administered via an interpreter during a plastic surgery trip to Jharkhand, India, in January 2018. Demographics, comorbidities, and burn-specific history were recorded.

Results

Twenty-eight postburn patients were surveyed (mean age, 17.0 ± 9.2 years; male:female ratio, 1:2.5). Mean time from injury was 4.74 years. No patient had received formal, primary burn care. Mechanism of injury: flame (39%), oil (32%), scalding water (14%), and other (14%). Fifty-four percent were extremity burns; 25%, facial; and 18%, neck burns. The Burn-Specific Health Scale–Revised, Brief, and Adapted demonstrated that the most significantly impacted domains for all patients were body image and skin sensitivity, with more than 80% of patients complaining of issues with skin sensitivity. In addition, children (aged <18 years) had diminished body image domain scores. RAND SF-36 scores were lowest in the energy (73.1 ± 25.0) and general health (76.5 ± 13.8) domains, and females with extremity burns demonstrated statistically significant decreases in their physical limitation domain scores (85.9 ± 17.3, P < 0.05). Females with extremity burns also had statistically significant lower scores in the energy domain (64.09 ± 25.75) as compared with their male counterparts with extremity burns (100 ± 0, P = 0.045). In general, females scored lower than did males in multiple domains, and those results reached statistical significance in the energy (65.9 ± 24.6 vs 93.6 ± 10.9), emotional (77.2 ± 21.5 vs 95.4 ± 11.2), and general health domains (71.1 ± 11.9 vs 90.0 ± 7.5) with P < 0.05. Children demonstrated significantly diminished scores in the emotional (75.5 ± 24.6) and general health (79.1 ± 11.8) domains.

Conclusion

These data demonstrate the significant impact on quality of life that untreated burns have in this population. Male and female children with extremity burns and adult women with extremity burns were most significantly affected in multiple domains. Consequently, children and adult women with extremity burns appear to be the patient cohort with the greatest opportunity to impact their quality of life. These data may be utilized to improve patient triage and resource allocation for future surgical trips but could also be of significant benefit to internal health agencies and ministries for the same purpose.
Language Disorders in Huntington Disease: A Systematic Literature Review
Authors: Gagnon Maude , Barrette Jasmine , Macoir Joël
Published: December 2018

Objective:

A systematic review examining the presence and nature of language disorders associated with Huntington disease (HD).

Background:

HD is characterized by gradual motor dysfunction, psychiatric problems, and cognitive decline. Communication abilities in HD may be affected not only by dysarthria but also by language impairment. However, the nature and type of this impairment is not well defined.

Methods:

We searched the PubMed and PsycINFO databases and selected studies on the basis of the original language of the article, peer-review status, and specificity of the results regarding language and communication disorders.

Results:

Thirty-one articles meeting the selection criteria were selected for this review. According to most of the studies, individuals with HD present with primary deficits of language. However, a few authors suggested that language deficits in HD result from nonlinguistic impairments, or that language abilities are largely preserved. More specifically, studies showed that HD is associated with difficulties in producing and understanding sentences and discourse, processing semantic representations of object and action concepts, retrieving lexical forms of nouns, and applying morphological and syntactic rules. There is some disagreement regarding whether HD affects reading abilities, sentence production, semantic processing, and application of morphological rules in verb conjugation.

Conclusions:

Although people with HD present with language impairment, further studies are needed to identify their functional origin. Clinical studies are also needed to determine the impact of such impairments on an individual’s functional communication in daily living and to chart the progression of the impairments over the course of the disease.
The heparin-binding proteome in normal pancreas and murine experimental acute pancreatitis
Authors: Nunes Quentin M. , Su Dunhao , Brownridge Philip J. , Simpson Deborah M. , Sun Changye , Li Yong , Bui Thao P. , Zhang Xiaoying , Huang Wei , Rigden Daniel J. , Beynon Robert J. , Sutton Robert , Fernig David G.
Published: December 2018

Acute pancreatitis (AP) is acute inflammation of the pancreas, mainly caused by gallstones and alcohol, driven by changes in communication between cells. Heparin-binding proteins (HBPs) play a central role in health and diseases. Therefore, we used heparin affinity proteomics to identify extracellular HBPs in pancreas and plasma of normal mice and in a caerulein mouse model of AP. Many new extracellular HBPs (360) were discovered in the pancreas, taking the total number of HBPs known to 786. Extracellular pancreas HBPs form highly interconnected protein-protein interaction networks in both normal pancreas (NP) and AP. Thus, HBPs represent an important set of extracellular proteins with significant regulatory potential in the pancreas. HBPs in NP are associated with biological functions such as molecular transport and cellular movement that underlie pancreatic homeostasis. However, in AP HBPs are associated with additional inflammatory processes such as acute phase response signalling, complement activation and mitochondrial dysfunction, which has a central role in the development of AP. Plasma HBPs in AP included known AP biomarkers such as serum amyloid A, as well as emerging targets such as histone H2A. Other HBPs such as alpha 2-HS glycoprotein (AHSG) and histidine-rich glycoprotein (HRG) need further investigation for potential applications in the management of AP. Pancreas HBPs are extracellular and so easily accessible and are potential drug targets in AP, whereas plasma HBPs represent potential biomarkers for AP. Thus, their identification paves the way to determine which HBPs may have potential applications in the management of AP.
Strong and lasting impacts of past global warming on baleen whale and prey abundance
Authors: Cabrera Andrea A. , Schall Elena , Bérubé Martine , Bachmann Lutz , Berrow Simon , Best Peter B. , Clapham Phillip J. , Cunha Haydée A. , Rosa Luciano Dalla , Dias Carolina , Findlay Kenneth P. , Haug Tore , Heide-Jørgensen Mads Peter , Kovacs Kit M. , Landry Scott , Larsen Finn , Lopes Xênia Moreira , Lydersen Christian , Mattila David K. , Oosting Tom , Pace Richard M. , Papetti Chiara , Paspati Angeliki , Pastene Luis A. , Prieto Rui , Ramp Christian , Robbins Jooke , Ryan Conor , Sears Richard , Secchi Eduardo R. , Silva Monica A. , Víkingsson Gísli , Wiig Øystein , Øien Nils , Palsbøll Per J.
Published: December 2018

The demography of baleen whales and their prey during the past 30 thousand years was assessed to understand the effects of past rapid global warming on marine ecosystems. Mitochondrial and genome-wide DNA sequence variation in eight baleen whale and seven prey species revealed strong, ocean-wide demographic changes that were correlated with changes in global temperatures and regional oceanographic conditions. In the Southern Ocean baleen whale and prey abundance increased exponentially and in apparent synchrony, whereas changes in abundance varied among species in the more heterogeneous North Atlantic Ocean. The estimated changes in whale abundance correlated with increases in the abundance of prey likely driven by reductions in sea-ice cover and an overall increase in primary production. However, the specific regional oceanographic environment, trophic interactions and species ecology also appeared to play an important role. Somewhat surprisingly the abundance of baleen whales and prey continued to increase for several thousand years after global temperatures stabilized. These findings warn of the potential for dramatic, long-term effects of current climate changes on the marine ecosystem.

One Sentence Summary

The effects of past global warming on marine ecosystems were drastic, system-wide and long-lasting.