bluuebunny/crossref_metadata_2025 huggingface dataset:
A comprehensive survey of models for dissecting local ancestry deconvolution in human genome
Authors: Geza Ephifania , Mugo Jacquiline , Mulder Nicola J , Wonkam Ambroise , Chimusa Emile R , Mazandu Gaston K
Published: May 2018

Over the past decade, studies of admixed populations have increasingly gained interest in both medical and population genetics. These studies have so far shed light on the patterns of genetic variation throughout modern human evolution and have improved our understanding of the demographics and adaptive processes of human populations. To date, there exist about 20 methods or tools to deconvolve local ancestry. These methods have merits and drawbacks in estimating local ancestry in multiway admixed populations. In this article, we survey existing ancestry deconvolution methods, with special emphasis on multiway admixture, and compare these methods based on simulation results reported by different studies, computational approaches used, including mathematical and statistical models, and biological challenges related to each method. This should orient users on the choice of an appropriate method or tool for given population admixture characteristics and update researchers on current advances, challenges and opportunities behind existing ancestry deconvolution methods.
MRMAssayDB: an integrated resource for validated targeted proteomics assays
Authors: Bhowmick Pallab , Mohammed Yassene , Borchers Christoph H
Published: May 2018

Motivation

Multiple Reaction Monitoring (MRM)-based targeted proteomics is increasingly being used to study the molecular basis of disease. When combined with an internal standard, MRM allows absolute quantification of proteins in virtually any type of sample but the development and validation of an MRM assay for a specific protein is laborious. Therefore, several public repositories now host targeted proteomics MRM assays, including NCI’s Clinical Proteomic Tumor Analysis Consortium assay portals, PeptideAtlas SRM Experiment Library, SRMAtlas, PanoramaWeb and PeptideTracker, with all of which contain different levels of information.

Results

Here we present MRMAssayDB, a web-based application that integrates these repositories into a single resource. MRMAssayDB maps and links the targeted assays, annotates the proteins with information from UniProtKB, KEGG pathways and Gene Ontologies, and provides several visualization options on the peptide and protein level. Currently MRMAssayDB contains >168K assays covering more than 34K proteins from 63 organisms; >13.5K of these proteins are present in >2.3K KEGG biological pathways corresponding to >300 master pathways, and mapping to >13K GO biological processes. MRMAssayDB allows comprehensive searches for a targeted-proteomics assay depending on the user’s interests, by using target-protein name or accession number, or using annotations such as subcellular localization, biological pathway, or disease or drug associations. The user can see how many data repositories include a specific peptide assay, and the commonly used transitions for each peptide in all empirical data from the repositories.

Availability and implementation

http://mrmassaydb.proteincentre.com

Supplementary information

Supplementary data are available at Bioinformatics online.
Detection and Isolation of Clostridium difficile Asymptomatic Carriers During Clostridium difficile Infection Outbreaks: An Exploratory Study
Authors: Paquet-Bolduc Bianka , Gervais Philippe , Roussy Jean-Francois , Trottier Sylvie , Oughton Matthew , Brukner Ivan , Longtin Jean , Loo Vivian G , Dascal Andre , Longtin Yves
Published: May 2018

During 4 Clostridium difficile infection outbreaks, unit-wide screening of 114 patients led to detection and isolation of 15 (13%) C. difficile asymptomatic carriers. Carriage prevalence varied between outbreaks, from 0% to 29% (P = .004). Isolating carriers was not associated with significantly shorter outbreak durations, compared with historical controls.
Population genomic data reveal genes related to important traits of quail
Authors: Wu Yan , Zhang Yaolei , Hou Zhuocheng , Fan Guangyi , Pi Jinsong , Sun Shuai , Chen Jiang , Liu Huaqiao , Du Xiao , Shen Jie , Hu Gang , Chen Wenbin , Pan Ailuan , Yin Pingping , Chen Xiaoli , Pu Yuejin , Zhang He , Liang Zhenhua , Jian Jianbo , Zhang Hao , Wu Bin , Sun Jing , Chen Jianwei , Tao Hu , Yang Ting , Xiao Hongwei , Yang Huan , Zheng Chuanwei , Bai Mingzhou , Fang Xiaodong , Burt David W , Wang Wen , Li Qingyi , Xu Xun , Li Chengfeng , Yang Huanming , Wang Jian , Yang Ning , Liu Xin , Du Jinping
Published: May 2018

Background

Japanese quail (Coturnix japonica), a recently domesticated poultry species, is important not only as an agricultural product, but also as a model bird species for genetic research. However, most of the biological questions concerning genomics, phylogenetics, and genetics of some important economic traits have not been answered. It is thus necessary to complete a high-quality genome sequence as well as a series of comparative genomics, evolution, and functional studies.

Results

Here, we present a quail genome assembly spanning 1.04 Gb with 86.63% of sequences anchored to 30 chromosomes (28 autosomes and 2 sex chromosomes Z/W). Our genomic data have resolved the long-term debate of phylogeny among Perdicinae (Japanese quail), Meleagridinae (turkey), and Phasianinae (chicken). Comparative genomics and functional genomic data found that four candidate genes involved in early maturation had experienced positive selection, and one of them encodes follicle stimulating hormone beta (FSHβ), which is correlated with different FSHβ levels in quail and chicken. We re-sequenced 31 quails (10 wild, 11 egg-type, and 10 meat-type) and identified 18 and 26 candidate selective sweep regions in the egg-type and meat-type lines, respectively. That only one of them is shared between egg-type and meat-type lines suggests that they were subject to an independent selection. We also detected a haplotype on chromosome Z, which was closely linked with maroon/yellow plumage in quail using population resequencing and a genome-wide association study. This haplotype block will be useful for quail breeding programs.

Conclusions

This study provided a high-quality quail reference genome, identified quail-specific genes, and resolved quail phylogeny. We have identified genes related to quail early maturation and a marker for plumage color, which is significant for quail breeding. These results will facilitate biological discovery in quails and help us elucidate the evolutionary processes within the Phasianidae family.
Illuminating the CJEU’s Blind Spot of Intersectional Discrimination in Parris v Trinity College Dublin
Authors: Atrey Shreya
Published: May 2018

The Court of Justice of the European Union decided its first ever discrimination claim argued explicitly on two grounds—sexual orientation and age—on 24 November 2016. It found that no discrimination could exist on both grounds where no discrimination existed on the grounds considered separately. With this, the Court rejected the possibility of recognising discrimination based on two grounds combined together and thus the relevance of intersectionality in European Union (EU) discrimination law. This note critiques the decision in Parris v Trinity College Dublin not only for disregarding intersectional discrimination but also for its weak single-ground analysis. In particular, the note argues that the Court failed: (i) to appreciate the normative basis of intersectionality—as creating unique patterns of disadvantage based on a combination of grounds—and how it transpires in practice; and (ii) in the alternative, to apply the Employment Directive 2000/78 correctly to claims of sexual orientation and age discrimination and in the light of its discrimination jurisprudence. The failure in Parris thus signifies a lost opportunity for the Court to address complex forms of structural inequality in EU law.
Genome-wide association analysis identifies a meningioma risk locus at 11p15.5
Authors: Claus Elizabeth B , Cornish Alex J , Broderick Peter , Schildkraut Joellen M , Dobbins Sara E , Holroyd Amy , Calvocoressi Lisa , Lu Lingeng , Hansen Helen M , Smirnov Ivan , Walsh Kyle M , Schramm Johannes , Hoffmann Per , Nöthen Markus M , Jöckel Karl-Heinz , Swerdlow Anthony , Larsen Signe Benzon , Johansen Christoffer , Simon Matthias , Bondy Melissa , Wrensch Margaret , Houlston Richard S , Wiemels Joseph L
Published: May 2018

Background

Meningiomas are adult brain tumors originating in the meningeal coverings of the brain and spinal cord, with significant heritable basis. Genome-wide association studies (GWAS) have previously identified only a single risk locus for meningioma, at 10p12.31.

Methods

To identify a susceptibility locus for meningioma, we conducted a meta-analysis of 2 GWAS, imputed using a merged reference panel from the 1000 Genomes Project and UK10K data, with validation in 2 independent sample series totaling 2138 cases and 12081 controls.

Results

We identified a new susceptibility locus for meningioma at 11p15.5 (rs2686876, odds ratio = 1.44, P = 9.86 × 10–9). A number of genes localize to the region of linkage disequilibrium encompassing rs2686876, including RIC8A, which plays a central role in the development of neural crest-derived structures, such as the meninges.

Conclusions

This finding advances our understanding of the genetic basis of meningioma development and provides additional support for a polygenic model of meningioma.
Posterior Reversible Encephalopathy Syndrome as a Complication of Induced Hypertension in Subarachnoid Hemorrhage: A Case-Control Study
Authors: Allen Michelle L , Kulik Tobias , Keyrouz Salah G , Dhar Rajat
Published: May 2018

BACKGROUND

Induced hypertension (IH) remains the mainstay of medical management for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH). However, raising blood pressure above normal levels may be associated with systemic and neurological complications, of which posterior reversible encephalopathy syndrome (PRES) has been increasingly recognized.

OBJECTIVE

To ascertain the frequency and predisposing factors for PRES during IH therapy.

METHODS

We identified 68 patients treated with IH from 345 SAH patients over a 3-yr period. PRES was diagnosed based on clinical suspicion, confirmed by imaging. We extracted additional data on IH, including baseline and highest target mean arterial pressure (MAP), comparing PRES to IH-treated controls.

RESULTS

Five patients were diagnosed with PRES at median 6.6 d (range 1-8 d) from vasopressor initiation. All presented with lethargy, 3 had new focal deficits, and 1 had a seizure. Although baseline MAP (prior to DCI) did not differ between cases and controls, both MAP immediately prior to IH (112 vs 90) and highest MAP targeted were greater (140 vs 120 mm Hg, both P < .01). Magnitude of MAP elevation was greater (54 vs 34 above baseline, P = .004) while degree of IH was not (37 vs 38 above pre-IH MAP). All 4 surviving PRES patients had complete resolution with IH discontinuation.

CONCLUSION

PRES was diagnosed in 7% of SAH patients undergoing IH therapy, most often when MAP was raised well above baseline to levels that exceed traditional autoregulatory thresholds. High suspicion for this reversible disorder appears warranted in the face of unexplained neurological deterioration during aggressive IH.
CE: Original Research: Understanding the Hospital Experience of Older Adults with Hearing Impairment
Authors: Funk Amy , Garcia Christina , Mullen Tiara
Published: May 2018

Background: Older hospitalized adults with hearing impairment are vulnerable to adverse outcomes. These patients are at risk for being labeled confused, experiencing a loss of control, experiencing heightened fear and anxiety, and misunderstanding the plan of care.

Objective: This qualitative study sought to assess the hospital experience of older adults with hearing impairment in order to formulate suggestions for improving nursing care.

Methods: Open-ended interviews were conducted with eight participants, ages 70 to 95 years, who were identified as having a hearing impairment and were admitted as inpatients to a midwestern medical center.

Results: Through data analysis, three common themes emerged: health care communication difficulties, passivity and vulnerability, and frustration with family.

Conclusions: Nurses will benefit from having a deeper understanding of the hospital experience of this vulnerable population. Efforts to address their needs can be accomplished through the following nursing actions: assess, accommodate, educate, empower, and advocate.
Hypertension management options
Authors: Scordo Kristine Anne
Published: May 2018

The new hypertension guideline lowers the definition of high BP to 130/80 mm Hg. This means that millions of adults will now be diagnosed with hypertension and that many of those taking antihypertensive drugs are not at goal. The challenge is to communicate the change, the strength of evidence behind the change, and the options available to patients. Healthcare providers must be knowledgeable of the new guideline and must be ready to meet this challenge.
Antipsychotic use in older adults
Authors: Pathak Sushila , Duff Elsie
Published: May 2018

Due to the physiologic changes of aging, managing behavioral issues and antipsychotic use is associated with adverse reactions that are more complex in older adults than in younger adults. Therefore, appropriate prescribing and evaluating the need to continue antipsychotics are necessary to enhance optimum patient outcomes. This article discusses best practice recommendations for NPs in Canada to help ensure safe use of antipsychotic medications in the older adult population.
Effects of Additional Low-Pass–Filtered Speech on Listening Effort for Noise-Band–Vocoded Speech in Quiet and in Noise
Authors: Pals Carina , Sarampalis Anastasios , van Dijk Mart , Başkent Deniz
Published: May 2018

Objectives:

Residual acoustic hearing in electric–acoustic stimulation (EAS) can benefit cochlear implant (CI) users in increased sound quality, speech intelligibility, and improved tolerance to noise. The goal of this study was to investigate whether the low-pass–filtered acoustic speech in simulated EAS can provide the additional benefit of reducing listening effort for the spectrotemporally degraded signal of noise-band–vocoded speech.

Design:

Listening effort was investigated using a dual-task paradigm as a behavioral measure, and the NASA Task Load indeX as a subjective self-report measure. The primary task of the dual-task paradigm was identification of sentences presented in three experiments at three fixed intelligibility levels: at near-ceiling, 50%, and 79% intelligibility, achieved by manipulating the presence and level of speech-shaped noise in the background. Listening effort for the primary intelligibility task was reflected in the performance on the secondary, visual response time task. Experimental speech processing conditions included monaural or binaural vocoder, with added low-pass–filtered speech (to simulate EAS) or without (to simulate CI).

Results:

In Experiment 1, in quiet with intelligibility near-ceiling, additional low-pass–filtered speech reduced listening effort compared with binaural vocoder, in line with our expectations, although not compared with monaural vocoder. In Experiments 2 and 3, for speech in noise, added low-pass–filtered speech allowed the desired intelligibility levels to be reached at less favorable speech-to-noise ratios, as expected. It is interesting that this came without the cost of increased listening effort usually associated with poor speech-to-noise ratios; at 50% intelligibility, even a reduction in listening effort on top of the increased tolerance to noise was observed. The NASA Task Load indeX did not capture these differences.

Conclusions:

The dual-task results provide partial evidence for a potential decrease in listening effort as a result of adding low-frequency acoustic speech to noise-band–vocoded speech. Whether these findings translate to CI users with residual acoustic hearing will need to be addressed in future research because the quality and frequency range of low-frequency acoustic sound available to listeners with hearing loss may differ from our idealized simulations, and additional factors, such as advanced age and varying etiology, may also play a role.
The Barrow Biomimetic Spine
Authors: Bohl Michael A. , Mooney Michael A. , Repp Garrett J. , Nakaji Peter , Chang Steve W. , Turner Jay D. , Kakarla U. Kumar
Published: May 2018

Study Design.

Objective and subjective fluoroscopic assessments of a new synthetic spine model.

Objective.

The aim of this study was to analyze the fluoroscopic performance and fidelity to human tissue of a new synthetic spine model.

Summary of Background Data.

The Barrow Biomimetic Spine project aims to develop a 3-dimensional (3D) printed, synthetic spine model that will one day replace cadaveric tissue in spine biomechanical research. A crucial component to any biomimetic spine model is that it performs similarly to cadaveric tissue on standard diagnostic imaging modalities.

Methods.

Numerous L5 vertebral bodies (VBs) were 3D printed with variable shell thicknesses and internal densities, and fluoroscopic images were taken of these models to measure cortical thickness and gray-scale density. An L3-L5 spinal segment was then printed, and fluoroscopic films were obtained at variable C-arm angles. Three spine surgeons subjectively scored these images for human fidelity. Pedicle screws were then placed into the L3-L5 segment to demonstrate successful or breached placement. Standard anteroposterior (AP) and lateral films were taken, and three spine surgeons were tested and scored on correctly identifying screw placement.

Results.

Cortical thickness and gray-scale density testing demonstrated an upward trend with increases in relevant print settings. Subjective scoring demonstrated nearly perfect fidelity for the L3-L5 model. Surgeon identification of screw placement on the AP and lateral fluoroscopic views also demonstrated nearly perfect fidelity.

Conclusion.

This study is the first to demonstrate that 3D-printed VB and segmental spine models accurately mimic human tissue on C-arm fluoroscopy, not only in respect to their anatomical appearance in standard views but also in their response to surgical manipulation and the variations in C-arm angle that commonly occur in the operating room. As such, these spine models have the potential to serve as an excellent platform for future research and surgical education programs.

Level of Evidence: N/A
Predicting Factors at Skeletal Maturity for Curve Progression and Low Back Pain in Adult Patients Treated Nonoperatively for Adolescent Idiopathic Scoliosis With Thoracolumbar/Lumbar Curves
Authors: Ohashi Masayuki , Watanabe Kei , Hirano Toru , Hasegawa Kazuhiro , Katsumi Keiichi , Shoji Hirokazu , Mizouchi Tatsuki , Endo Naoto
Published: May 2018

Study Design.

A retrospective, long-term follow-up study.

Objective.

We aimed to clarify the predicting factors at skeletal maturity for future curve progression and low back pain (LBP) in adolescent idiopathic scoliosis (AIS) with thoracolumbar/lumbar (TL/L) curve.

Summary of Background Data.

TL/L curves are likely to progress after skeletal maturity and cause LBP.

Methods.

Of 147 patients treated nonoperatively for AIS with TL/L curve, 56 (55 females; average age at the time of survey, 39.5 ± 7.1 years; average follow-up duration after maturity, 24.9 ± 6.9 years) completed questionnaires, including the visual analogue scale (VAS) for LBP and Oswestry disability index (ODI). Forty-nine patients underwent a radiological examination, and 48 underwent lumbar magnetic resonance imaging (MRI).

Results.

The mean Cobb angle of the TL/L curve increased from 37.3° ± 7.5° to 47.8° ± 12.6° (0.41° ± 0.39° per year). The factors at skeletal maturity that were associated with the annual progression of the TL/L curve included a cranially located apical vertebra, and great apical vertebral translation and L3 tilt. In addition, the VAS for LBP was positively correlated with L4 tilt, and the ODI was positively correlated with L4 tilt and apical vertebral rotation. Multivariate analyses and receiver-operating characteristic curves demonstrated that L3 tilt at skeletal maturity independently predicted a curve progression ≥0.5° per year (odds ratio [OR], 1.17), while L4 tilt at skeletal maturity independently predicted a VAS ≥3 cm (OR, 1.20) and ODI ≥21% (OR, 1.25) in adulthood, with a cutoff value of approximately 16° for each factor. Moreover, lumbar disc degeneration on MRI was associated with L4 tilt at skeletal maturity and LBP in adulthood.

Conclusion.

Great L3 and L4 tilt at skeletal maturity, especially those >16°, are predictors of future curve progression and LBP in adulthood, respectively. For adolescent patients with these risk factors, periodic follow-ups into adulthood should be considered.

Level of Evidence: 4
Maternal Prepregnancy Weight Status and Adolescent Eating Disorder Behaviors
Authors: Micali Nadia , Daniel Rhian M. , Ploubidis George B. , De Stavola Bianca L.
Published: May 2018

Background:

Maternal characteristics and childhood growth have been identified as risk factors for eating disorders. Most studies to date have been unable to investigate these factors prospectively while accounting for their interdependencies. We address this by investigating whether the association of maternal prepregnancy body mass index (ppBMI) with adolescent eating disorder behaviors can be explained by childhood growth and/or a concurrent environmental pathway captured by maternal eating habits.

Methods:

We analyzed data from girls participating in the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective UK cohort. The study had information on parentally and self-reported eating disorder behaviors at age 13/14 years (n = 3,529), maternal ppBMI and eating habits at age 8, child’s birth weight, BMI from age 7 to 12, pubertal development at 11, and relevant confounders. We quantified contributions of childhood growth and concomitant maternal eating habits to the association of maternal ppBMI with eating disorder behaviors in terms of interventional disparity effects for multiple mediators.

Results:

Maternal prepregnancy underweight was negatively associated with eating disorder behaviors (−0.18; 95% confidence interval: −0.29, −0.06), whereas overweight/obesity had the opposite relationship (0.25; 0.18, 0.32). Both were nearly fully explained by childhood growth.

Conclusions:

Although maternal ppBMI is associated with developing eating disorders, its role needs to be understood in the context of childhood factors, in particular childhood growth. The relatively small size of the remaining associations, once growth factors are hypothetically equalized across levels of maternal ppBMI, suggests that childhood growth is a potential area for prevention.
Corneal Irregular Astigmatism and Curvature Changes After Small Incision Lenticule Extraction: Three-Year Follow-Up
Authors: Sideroudi Haris , Lazaridis Apostolos , Messerschmidt-Roth Anke , Labiris Georgios , Kozobolis Vassilios , Sekundo Walter
Published: May 2018

Purpose:

To evaluate the long-term changes in anterior and posterior corneal irregular astigmatism and curvatures after small incision lenticule extraction (SMILE).

Methods:

Fifty eyes of 28 patients underwent SMILE for myopic astigmatism. All procedures were performed using the VisuMax® femtosecond laser. A Scheimpflug camera was used for preoperative and 3-year postoperative tomography. Anterior and posterior corneal Fourier parameters (spherical component, regular astigmatism, asymmetry, and irregularity) and curvature data were evaluated and compared within 2 subgroups according to the magnitude of the refractive correction (low myopia group: spherical equivalent (SEQ) ≥ −6 D; high myopia group: (SEQ) < −6 D). Associations between all studied parameters were examined.

Results:

Three years postoperatively, an increase in anterior corneal curvatures and Fourier parameters was detected and the results were strongly correlated with the preoperative SEQ, lenticule thickness, and volume. At the posterior cornea, the flattest radius, corneal astigmatism, spherical component, regular astigmatism, and irregularity decreased only in the high myopia group. A correlation was found between changes in posterior astigmatism and changes in anterior radii (R = 0.349, P = 0.014), SEQ (R = 0.396, P = 0.0049), and lenticule thickness (R = −0.414, P = 0.0031). Moreover, changes in posterior corneal irregularity correlated with the changes in anterior and posterior radii (R = −0.3, P = 0.034, and R = 0.449, P = 0.0012, respectively), changes in preoperative SEQ (R = 0.284, P = 0.0477), and lenticule thickness (R = −0.311, P = 0.0298).

Conclusions:

Three years after SMILE, there was a reduction of posterior astigmatism in high refractive corrections. This could result in undercorrection in high refractive treatments. Total irregularities increased despite the compensatory effect of the posterior corneal surface.
Changes in Ocular Hypotensive Drug Usage for Glaucoma Treatment After Cataract Surgery: A Nationwide Population-based Study in Taiwan
Authors: Chang Pei-Yao , Wang Jiun-Yi , Chang Shu-Wen , Chang Yu-Chia
Published: May 2018

Purpose:

The aims of this study were to observe the changes in the demand for prescriptions of ocular hypertensive drug (OHD) after cataract surgery, to investigate patterns of change in the required OHD amount in open-angle glaucoma (OAG) and angle-closure glaucoma (ACG) cases, and to determine the associated factors related to the change.

Materials and Methods:

This population-based cohort study using the Taiwan National Health Insurance Research Database enrolled patients with glaucoma who underwent bilateral cataract surgeries within 2 years between 2001 and 2012. The major dependent variables were the total amounts of OHDs prescribed within 1 year before the first cataract surgery and 1 year after the second cataract surgery. We compared the overall change in the required OHD amount before and after cataract surgery and further explored potential factors affecting the change.

Results:

Among the 440 patients, there were more cases of ACG than OAG (68.6% vs. 31.4%). The total OHD amount prescribed reduced significantly after cataract surgery in patients with OAG (median, from 12 to 6 bottles before and after the surgery, P<0.0001) and ACG (median, from 10 to 3 bottles, P<0.0001), and the reduction was sustained for 5 years. The reduction was significantly larger in patients with ACG and higher demand for OHD (P=0.0157). Among the OAG cases, the reduction was significantly larger in patients who were female individuals (P=0.0138), treated in clinics (P=0.0305), and exhibited high demand for OHD (P=0.0282).

Conclusions:

The prescriptions of OHDs by glaucoma patients reduced considerably after cataract surgery. Although the reduction proportion of the demand for OHD after cataract surgery was significantly larger in patients with ACG than in those with OAG, the reduction was sustained for 5 years in both types of glaucoma.
Applicability of ISNT Rule Using BMO-MRW to Differentiate Between Healthy and Glaucomatous Eyes
Authors: Park Do Young , Lee Eun Jung , Han Jong Chul , Kee Changwon
Published: May 2018

Purpose:

We evaluated the applicability of the ISNT rule using Bruch’s membrane opening minimum rim width (BMO-MRW) in healthy eyes and eyes with normal tension glaucoma (NTG).

Materials and Methods:

In total, 124 healthy eyes and 136 NTG eyes were analyzed. Using 2-dimensional disc photographs, neuroretinal rim (NRR) thickness was measured at the superior, inferior, nasal, and temporal sides of the optic disc. Using spectral domain-optical coherence tomography, BMO-MRW was measured at the same regions. We compared the applicability of the ISNT rule in healthy and NTG eyes between these 2 methods. If the NRR was not clearly distinguished on disc photographs, the eye was classified into the “indistinguishable NRR” group and we only tested applicability of the ISNT rule using BMO-MRW.

Results:

The specificity of “violation of the ISNT rule” for the diagnosis of glaucoma was higher when BMO-MRW was used (66.3%) than using disc photographs (42.2%), whereas the sensitivity did not show a significant difference between the 2 methods (91.7% vs. 86.5%). Compared with eyes with distinguishable NRR (179 eyes), eyes with indistinguishable NRR (81 eyes) had higher axial length, more negative refractive error, and higher tilt ratio (P<0.001). The diagnostic ability of “violation of ISNT rule” using BMO-MRW was not significantly different between eyes with indistinguishable NRR and those with distinguishable NRR (P>0.05).

Conclusions:

Application of the ISNT rule using BMO-MRW shows superiority in distinguishing between healthy and glaucomatous optic discs compared with disc photographs. The ISNT rule can be applied using BMO-MRW even when NRR is indistinguishable on disc photographs, such as in myopic tilted discs.
The Efficacy of Deep Sclerectomy on Posture-induced Intraocular Pressure Changes
Authors: Aragno Vittoria , Labbé Antoine , Brion Frédérique , Baudouin Christophe , Hamard Pascale
Published: May 2018

Purpose:

The purpose of this study was to evaluate the efficacy of nonpenetrating deep sclerectomy (NPDS) on posture-induced intraocular pressure (IOP) changes in open-angle glaucoma (OAG).

Materials and Methods:

Twenty-five eyes of 25 patients with OAG that underwent NPDS were included in this study. IOP was measured with the IcarePro (ICP) tonometer in the sitting, supine, dependent lateral decubitus position (DLDP), and nondependent lateral decubitus position (NDLDP) before surgery, and at 1 and 3 months after surgery.

Results:

The mean baseline IOP measured in the sitting position was 20.5±8.4 mm Hg with Goldmann applanation tonometry and 19.6±6.5 mm Hg with ICP. At 1 and 3 months after NPDS, mean IOP decreased significantly in each position (P<0.001). At each time point, mean IOP was higher in all lying positions than in the sitting position (P<0.001) and higher in the DLDP than in the supine and NDLDP positions (P<0.001 and P=0.001). Posture-induced IOP changes between the sitting and supine position, DLDP, and NDLDP, respectively, were significantly reduced by 77% (P=0.009), 60% (P=0.001), and 82% (P=0.01) at 1 month and by 79% (P=0.004), 70% (P<0.001), and 79% (P<0.001) at 3 months after surgery. The IOP fluctuation reduction was significantly inferior when considering sitting-DLDP than other postural changes.

Conclusions:

NPDS is effective in lowering the mean IOP in all body positions and also the postural IOP fluctuations. The mean IOP in the DLDP remained higher than in the other body positions. This posture should be avoided in patients with asymmetric OAG.
Linezolid-containing Treatment Regimens for Tuberculosis in Children
Authors: Prieto Luis M. , Santiago Begoña , del Rosal Teresa , Carazo Begoña , Jiménez Ana B. , Pérez-Gorricho Beatriz , Rubio Felipe , Tagarro Alfredo , Blázquez-Gamero Daniel , Moreno-Pérez David , Mellado María J. , Baquero-Artigao Fernando
Published: May 2018

Background:

In recent years, there is an increasing interest in the use of linezolid for the treatment of tuberculosis (TB).

Methods:

Patients less than 18 years of age who received linezolid within the Spanish Pediatric TB Network from 2001 to 2016 were retrospectively included. Treatment characteristics, adverse events (AEs) and outcomes were analyzed.

Results:

Fifteen children were included (53% male) with a median age of 3.6 years [interquartile range (IQR): 1.6–6.2]. Median follow-up was 54 months (IQR: 38–76). The reasons for linezolid use were drug-resistant TB in 8 (53%) patients, drug-induced liver injury in 5 (33%) patients and chronic liver disease in 2 (13%) patients. Four children (26%) were on immunosuppressive therapy when TB was diagnosed. Five children (33%) were diagnosed with extrapulmonary TB. The median duration of linezolid treatment was 13 months (IQR: 7.5–17). Nine patients had 13 linezolid-related AEs. Hematologic toxicity was observed in 8 patients (53%) and gastrointestinal intolerance in 3 patients (20%). In 2 patients, linezolid dose was reduced, and in 2 patients, linezolid was discontinued because of AEs. A 2-year-old girl went back to her country of birth and was lost to follow-up. No relapses were observed among the other 14 patients (93%).

Conclusions:

Linezolid may be considered when treating children with drug-resistant TB but also in the cases of patients with chronic liver disease or drug-induced liver injury. However, AEs should be closely monitored. Further studies are needed to determine the optimum dosage and the optimal duration of linezolid treatment in children.
Zika Virus–Associated Guillain-Barré Syndrome in a Returning US Traveler
Authors: Beattie Jason , Parajuli Sunita , Sanger Matthew , Lee Gregory , Pleninger Perrin , Crowley George , Kwon Sophia , Murthy Vivek , Manko Jeffrey A. , Caplan Arthur , Dufort Elizabeth , Pastula Daniel M. , Nolan Anna
Published: May 2018

Zika virus (ZIKV) infection has been associated with Guillain-Barré syndrome (GBS). Roughly 60% of people in countries such as the United States live in areas at risk of seasonal spread of ZIKV. Zika virus belongs to a class of diseases that is not typically seen in hospital settings across the United States and Europe. We describe the case presentation, management, and treatment of ZIKV infection complicated by GBS. A 64-year-old woman with recent travel to the Dominican Republic presented with rash followed by an acute, ascending polyneuropathy consistent with GBS. She was confirmed to have an acute ZIKV infection by detection of ZIKV nucleic acid by reverse transcription–polymerase chain reaction. She met Brighton Collaboration criteria level 1 evidence for GBS. She received 2 courses of intravenous immunoglobulin and slowly improved, but still had weakness at discharge. More research is needed to identify the pathophysiology behind ZIKV-associated GBS and its optimal treatment. Prevention is fundamental to limiting infection and spread of ZIKV.
Genetic characteristics of patients with congenital hyperinsulinism
Authors: Vajravelu Mary Ellen , De León Diva D.
Published: May 2018

Purpose of review

Congenital hyperinsulinism is the most common cause of persistent hypoglycemia in infants and children. Early and appropriate recognition and treatment of hypoglycemia is vital to minimize neurocognitive impairment.

Recent findings

There are at least 11 known monogenic forms of hyperinsulinism and several associated syndromes. Molecular diagnosis allows for prediction of the effectiveness of diazoxide and the likelihood of focal hyperinsulinism. Inactivating mutations in the genes encoding the ATP-sensitive potassium channel (KATP hyperinsulinism) account for 60% of all identifiable mutations, including 85% of diazoxide-unresponsive cases. Syndromes or disorders associated with hyperinsulinism include Beckwith−Wiedemann syndrome, Kabuki syndrome, Turner syndrome, and congenital disorders of glycosylation. Although focal hyperinsulinism can be cured by resection of the lesion, therapeutic options for nonfocal hyperinsulinism remain limited and include diazoxide, octreotide, long-acting somatostatin analogs, and near-total pancreatectomy. Although sirolimus has been reported to improve glycemic control in infants with diazoxide-unresponsive hyperinsulinism, the extent of improvement has been limited, and significant adverse events have been reported.

Identification of the cause of congenital hyperinsulinism helps guide management decisions. Use of therapies with limited benefit and significant potential risks should be avoided.
Age Differences in the Coping Strategies of Patients With Colorectal Cancer
Authors: Kang Youngmi , Son Heesook
Published: May 2018

Background

Colon and/or rectum cancer (CRC) patients use various strategies to cope with their condition, and these can vary between age groups.

Objectives

The aims of this study were to investigate differences between psychosocial/spiritual variables and coping strategies in CRC patients of different age groups (younger vs older) and to identify the predictors of coping for both age groups.

Methods

A cross-sectional descriptive study was conducted at 3 outpatient clinics in Korea. The Hospital Anxiety and Depression Scale, Social Support Scale, and Self-Transcendence Scale were used to measure psychosocial and spiritual variables; the Mini-Mental Adjustment to Cancer Scale was used to assess cancer-specific coping strategies.

Results

Both younger and older patients who were psychologically distressed used more maladaptive coping. Individuals who received less social support from healthcare providers used more maladaptive coping strategies. For younger patients, self-transcendence was the only significant predictor of both adaptive and maladaptive coping strategies; for older patients, Hospital Anxiety and Depression Scale score was the only significant predictor of maladaptive coping.

Conclusion

Differences in psychological distress, social support, and self-transcendence due to age are important protective or risk factors for the use of coping strategies among CRC patients.

Implications for Practice

Considering our findings, we encourage healthcare professionals to be aware of patients' coping strategies and take them into account when planning age-specific interventions related to coping, before hospital discharge.
Toradol following Breast Surgery: Is There an Increased Risk of Hematoma?
Authors: Nguyen Brittany N. , Barta Ruth J. , Stewart Christine E. , Heinrich Cherrie A.
Published: May 2018

Background:

Ketorolac tromethamine (Toradol), a nonsteroidal antiinflammatory drug, is used with increased frequency given its success in postoperative pain control and the subsequent decreased need for narcotics. Its use has been limited in plastic surgery for fear of postoperative bleeding and hematoma formation. In this study of breast surgery patients, the authors investigated whether ketorolac increased the risk of postoperative hematoma formation.

Methods:

After obtaining institutional review board approval, the authors retrospectively reviewed the records of patients undergoing breast surgery from January of 2012 through December of 2014. The authors compared the incidence of postoperative hematomas in patients who did, versus those who did not, receive ketorolac postoperatively.

Results:

For the entire cohort, the overall hematoma rate was 2.8 percent. Of the patients who received ketorolac, the rate was 3.5 percent; of those who did not, the rate was 2.5 percent. Of the breast reduction patients, the rate was 4 percent in those who received ketorolac versus 3.2 percent in those who did not. Of the breast reconstruction patients, the rate was 4 percent in those who received ketorolac versus 3.2 percent in those who did not.

Conclusions:

Recently, the high rates of prescribing postoperative narcotics have received increased attention. Aside from the risk of increased availability of narcotics in the community, the side effects can delay patient recovery. Ketorolac is controversial for postoperative pain control because of the potential risk of bleeding, but in the authors’ 3-year retrospective study, it was not associated with an increased risk of hematoma formation.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Quality of Surgical Outcomes Reporting in Plastic Surgery: A 15-Year Analysis of Complication Data
Authors: Parikh Rajiv P. , Sharma Ketan , Qureshi Ali A. , Franco Michael J. , Myckatyn Terence M.
Published: May 2018

Background:

Postoperative complication data are integral to assessing patient outcomes and identifying areas for improving quality in surgical care. Accurate appraisal of surgical techniques requires consistency and reliability in complication data reporting. The purpose of this study was to analyze the quality of complication reporting in plastic surgery.

Methods:

The authors critically reviewed the literature from January 1, 2000, to December 31, 2014, to identify articles reporting surgical outcomes after three index procedures: autologous breast reconstruction, prosthetic breast reconstruction, and reduction mammaplasty. Studies were extracted from the journals Plastic and Reconstructive Surgery and Annals of Plastic Surgery. Two authors independently analyzed data using a modification of established criteria for complication reporting that incorporates 10 critical elements.

Results:

Two hundred ninety-six articles reporting outcomes for 299,819 procedures in 249,942 patients were analyzed. Of the 10 reporting criteria, no articles met all criteria, fewer than 1 percent met nine, 16 percent met seven to eight, 43 percent met five to six, 35 percent met three to four, and 6 percent met one to two (mean, five criteria met). Commonly underreported criteria included complication definitions (37 percent of articles reported), aesthetic or patient-reported outcome (28 percent), and complication severity (16 percent). Only 46 studies (16 percent) reported complication severity, with 15 different definitions of what constituted a “major” complication. Risk factors for complications were absent in 37 percent of articles.

Conclusions:

Inconsistency in reporting complications in the plastic surgery literature confounds the comparison of surgical outcomes. The use of standard guidelines to accurately, efficiently, and reproducibly report complication data is essential for quality assurance and improvement.
The Functional Anatomy of the Superficial Fat Compartments of the Face: A Detailed Imaging Study
Authors: Schenck Thilo L. , Koban Konstantin C. , Schlattau Alexander , Frank Konstantin , Sykes Jonathan M. , Targosinski Stefan , Erlbacher Katharina , Cotofana Sebastian
Published: May 2018

Background:

The superficial (subcutaneous) facial fat compartments contribute to the signs of facial aging, but a comprehensive anatomical description of their location and their functional behavior during the application of soft-tissue fillers remains elusive.

Methods:

The authors investigated 30 fresh frozen cephalic specimens from 13 male and 17 female Caucasian body donors (age, 78.3 ± 14.2 years; body mass index, 23.1 ± 5.3 kg/m2). Upright-position, contrast-enhanced computed tomographic scanning, and additional magnetic resonance imaging were performed. Three-dimensional reconstruction–based measures were conducted to evaluate the position of the applied contrast agent in each compartment separately. Successive anatomical dissections were performed to confirm the imaging findings.

Results:

Positive correlations were detected between the amounts of injected material and the inferior displacement for the superficial nasolabial (rp = 0.92, p = 0.003), middle cheek (rp = 0.70, p = 0.05), and jowl (rp = 0.92, p = 0.03) compartments but not for the medial cheek (rp = 0.20, p = 0.75), lateral cheek (rp = 0.15, p = 0.75), or the superior (rp = −0.32, p = 0.41) or inferior superficial temporal compartment (rp = −0.52, p = 0.29).

Conclusion:

This study confirms the presence of distinct subcutaneous fat compartments and provides evidence for an individual behavior when soft-tissue fillers are applied: inferior displacement of the superficial nasolabial, middle cheek, and jowl compartments, in contrast to an increase in volume without displacement (i.e., an increase in projection) of the medial cheek, lateral cheek, and both superficial temporal compartments.
Outcomes of Sphincter Pharyngoplasty in the Cleft Population
Authors: Grover Ritwik , Barnett Addison , Rampazzo Antonio , Papay Frank , Gharb Bahar Bassiri
Published: May 2018

Introduction:

Sphincter pharyngoplasty (SP) is becoming increasingly popular for correction of velopharyngeal insufficiency (VPI) after cleft palate repair because of high success rate, low incidence of postoperative obstructive sleep apnea (OSA), and ease of revision in case of failure. This study is a meta-analysis of SP outcomes, reasons for failure, and revision strategies.

Methods:

A comprehensive review of the literature on SP outcomes was conducted. Sphincter pharyngoplasty failure was defined as persistent hypernasality, incomplete velopharyngeal port (VP) closure on instrumental evaluation with concomitant VPI, or nonresolving hyponasality and/or OSA persisting >3 months after surgery. Two-tailed paired Student t test was used to compare outcomes between syndromic versus nonsyndromic patients and preoperative versus postoperative OSA rates.

Results:

Forty-four publications evaluating 2402 patients were included. Overall SP success rate was 78.4% (77.3% in nonsyndromic vs 84.8% in syndromic patients, P = 0.11). Overall primary revision rate was 17.8% (20% in nonsyndromic vs 15.4% in syndromic patients P = 0.97). Most failures (89.5%) manifested as persistent VPI with continued hypernasality requiring revision, whereas 10.5% of failures manifested as obstructive symptoms and/or severe hyponasality requiring revision. Causal factors of SP failure were the following: large central port (62.8%), dehiscence (15.5%), tight port (12.1%), and low-inset (9.7%). Primary revision success rate was 75.6%. Obstructive sleep apnea rates increased from 5.1% to 18.4% (P = 0.02).

Conclusions:

This study suggests that SP can resolve VPI in 78.4% of patients, which can be increased to 94.7% after one revision. Most failures are technique-dependent; therefore, there could be significant ground for improvement of outcomes.
Posterior Lamellar Reconstruction of the Lower Eyelid With a Gingivoalveolar Mucosal Graft
Authors: Baltu Yahya
Published: May 2018

The anterior and posterior lamellae should be simultaneously reconstructed to repair the upper and lower eyelid's full thickness defects after resection of a malignant tumor. The author described a gingivoalveolar mucosal graft for posterior lamellar reconstruction of the lower eyelid. Between November 2014 and September 2017, 11 patients (6 women, 5 men; mean age 62.7 years) with 13 posterior lamellar defect of lower eyelid underwent reconstruction with gingivoalveolar mucosal graft. The defects ranged from 10 x 8 mm to 20 x 10 mm. For 11 lower eyelid defects, the anterior lamellar defect was previously reconstructed with an appropriate local flap. The remaining 2 defects were repaired with graft only. The mean follow-up period was 15.3 months. The pathologic diagnoses were squamous cell carcinoma for 8 lower eyelid lesions and basal cell carcinoma for the remaining 5 lower eyelid lesions. No case of necrosis and infection was observed in any flap or graft. Also, there was not observed ectropion or lid laxity at lower eyelids. However, redness developed in 1 eye, but healed in 1 week. Donor areas completely improved with secondary healing with no any complication. Gingivoalveolar mucosal graft is a reliable and easy accessible choice for posterior lamellar reconstruction of eyelid defects. While the gingival mucosal part provides a stable and tight structural support for marginal palpebral area, the alveolar part occupies the conjunctival side without causing corneal irritation.