bluuebunny/crossref_metadata_2025 huggingface dataset:
Pectoralis Major Median Myotomy: The Median Cut
Authors: Borenstein Amiram , Abrahami Yoav
Published: January 2020

Dual-plane breast augmentation offers the advantages of a subpectoral implant location with the ability to expand its use to glandular ptotic and constricted lower pole breasts. Alas, high implant position or very loose breast tissue can lead to a notorious breast shape known as the “waterfall deformity.” To prevent many of these undesired deformities, the authors introduce a novel pectoralis major median myotomy they call the “median cut.” From all of the dual-plane breast augmentations that were performed by the two authors between the years 2011 and 2017, a total of 605 included a median cut to resolve an apparent waterfall deformity. Without this procedure, a shift to subglandular augmentation would have been performed. The authors strongly believe that the median cut is a powerful and effective way to avoid intraoperative waterfall deformities and to have more women benefit from a submuscular approach.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
An Objective, Quantitative, Dynamic Assessment of Hyaluronic Acid Fillers That Adapt to Facial Movement
Authors: Percec Ivona , Bertucci Vince , Solish Nowell , Wagner Ted , Nogueira Alessandra , Mashburn Jay
Published: January 2020

Background:

Objective dynamic assessments are central to the evaluation of facial rejuvenation treatments. This study used three-dimensional digital stereophotogrammetry to generate a quantitative dynamic assessment of facial strain and hyaluronic acid filler efficacy.

Methods:

Thirty women (aged 41 to 65 years) with moderate to severe bilateral nasolabial folds and marionette lines received Restylane Refyne, Restylane Defyne, or both, and were compared to a “younger” untreated group (n = 20; aged 25 to 35 years). Three-dimensional videos were collected at baseline and at day 42. Dynamic strain was analyzed at the marionette lines and nasolabial folds as subjects went from a neutral position through a series of facial expressions.

Results:

Baseline nasolabial folds and marionette lines showed statistically significant (p ≤ 0.05) differences in the level of stretch between younger and older untreated subjects, with higher stretch profiles observed in the older cohort. In the older cohort, filler treatment reduced peak strain (stretch) in the nasolabial folds and marionette lines compared with baseline across all tested expressions, resembling the youthful strain profile of the younger untreated control group. Treatment was well tolerated.

Conclusions:

Quantitative dynamic strain analysis is an innovative method for evaluating the dynamic face following dermal fillers and provides objective evidence that such treatment results in stretch levels resembling a younger phenotype in areas prone to the effects of facial aging. The strain reduction following filler treatment objectively conveys a dermal tightening effect, likely secondary to the volumization of treated areas. Additional studies will refine the technology and associated procedures to optimize quantitative dynamic strain analysis for treatment planning and patient outcome optimization.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
The Roles of Podoplanin-Positive/Podoplanin-Negative Cells from Adipose-Derived Stem Cells in Lymphatic Regeneration
Authors: Dai Tingting , Jiang Zhaohua , Cui Chunxiao , Sun Yiyu , Lu Bolun , Li Haibo , Cao Weigang , Chen Bin , Li Shengli , Guo Lifei
Published: January 2020

Background:

Secondary lymphedema is a refractory disease, for which adipose-derived stem cells have shown some therapeutic potential. However, the mechanism of this action remains poorly understood.

Methods:

The authors identified podoplanin-expressing adipose-derived stem cells, which allowed them to divide adipose-derived stem cells into podoplanin-positive and podoplanin-negative groups that they characterized in vitro. The authors then used a mouse hindlimb model for lymphedema to trace the fate of podoplanin-positive, podoplanin-negative, and unsorted adipose-derived stem cells in vivo.

Results:

When induced in culture, podoplanin-positive cells were noted to up-regulate the expression of lymphatic endothelial cell markers, including LYVE-1, and assumed a cobblestone morphology. In addition, a substantial increase in lymphangiogenic cytokines was detected in the podoplanin-positive supernatant. The above findings were largely absent from the podoplanin-negative and unsorted groups. In the mouse model, the implanted cells relieved the limb lymphedema by promoting lymphangiogenesis, with the podoplanin-positive group showing the most significant effect. Immunocolocalization further revealed that the podoplanin-positive cells incorporated into lymphatic vessels were positive for LYVE-1.

Conclusions:

These data demonstrated that actions by means of both paracrine and differentiation pathways were involved in the adipose-derived stem cell–mediated therapeutic effects. The podoplanin-positive cells possessed lymphatic paracrine and differentiation abilities and may represent lymphatic endothelial cell precursor cells. The podoplanin-negative cells, which constitute a considerable proportion of the adipose-derived stem cells, may play an important paracrine role by secreting mesenchymal stem cell–related factors.
The Broad Application of Prepectoral Direct-to-Implant Breast Reconstruction with Acellular Dermal Matrix Drape and Fluorescent Imaging in a Community Setting
Authors: Bilezikian Jordan A. , Tenzel Paul L. , Bebb Gregory G. , Kays Charles R.
Published: January 2020

Background:

Much has been written regarding the new paradigm of prepectoral direct-to-implant reconstruction, but patient selection continues to be unclear. Prepectoral direct-to-implant (PDTI) reconstruction with acellular dermal matrix drape and fluorescent imaging (ADFI) was offered to all patients.

Methods:

The PDTI with ADFI protocol is (1) fluorescent imaging following mastectomy, (2) acellular dermal matrix prepectoral drape construction, (3) direct-to-implant placement beneath drape, and (4) repeated fluorescent imaging with implant in place.

Results:

Patient ages ranged from 29 to 82 years, and body mass index ranged from 19 to 48 kg/m2. Implant size ranged from 240 to 800 cc. Two hundred thirty breasts in 131 patients were reconstructed with the PDTI with ADFI protocol between October of 2016 and June of 2018; 32 patients underwent unilateral and 99 underwent bilateral reconstruction. Twelve breasts (5 percent) received postmastectomy radiation therapy after reconstruction. Ten patients (8 percent) had previous lumpectomy and radiation therapy, with local recurrence, and underwent completion mastectomy and PDTI reconstruction with ADFI. Fifteen patients and 22 breasts (9 percent) had subpectoral reconstructions converted to PDTI with ADFI. Ten infections (4 percent) required explantation. Eight breasts (4 percent) were reconstructed with tissue expanders because of poor vascular flow. Seven breasts (3 percent) in five patients received minor cosmetic revision.

Conclusions:

SPY fluorescent imaging and expanded use of acellular dermal matrices has created an environment where PDTI reconstruction can be successful in nearly all postmastectomy patients. Tissue expansion/two-stage reconstruction has evolved to a default approach when vascular supply to skin flaps is compromised. PDTI reconstruction with ADFI has resulted in zero necroses of skin flaps, patients rarely undergoing revisions, fewer office visits, and quicker return to preoperative lifestyles.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Expression of CD40 Ligand on T Cells and Soluble CD40 Ligand in Children With Kawasaki Disease
Authors: Jindal Ankur Kumar , Rawat Amit , Goel Shubham , Shandilya Jitendra , Saikia Biman , Minz Ranjana W. , Singh Surjit
Published: January 2020

Background/Objective

This study was done to examine the role of CD40 ligand (CD40L) in children with Kawasaki disease (KD). There is paucity of literature on this aspect of KD.

Methods

This was a case-control study of patients with KD diagnosed at the Allergy Immunology Unit, Postgraduate Institute of Medical Education and Research, Chandigarh, India. CD40L expression on activated CD3+ T cells was measured using flow cytometry, and soluble CD40L (sCD40L) was measured using enzyme-linked immunosorbent assay.

Results

We included 14 children with KD, 14 healthy controls, and 12 febrile controls for the purpose of this study. Mean percentage CD40L expression was higher in patients with KD (before administration of intravenous immunoglobulin [IVIg]) as compared with normal and febrile controls. This difference was statistically significant when compared with normal control (p = 0.00; confidence interval [CI], 8.92–20.30), but was not statistically significant when compared with febrile controls (p = 0.138; CI, −3.50 to 22.08). CD40L expression decreased after giving IVIg, but the difference was not statistically significant (p = 0.073; CI, −1.04 to 19.73). Mean sCD40L values increased significantly after giving IVIg (when repeated after a median period of 11 days; p = 0.001; CI, −0.77 to −0.29). There was no statistically significant difference between mean sCD40L in patients with KD (before giving IVIg) as compared with normal and febrile controls (p = 0.42; CI, −1.11 to −0.51 and p = 0.641; CI, −0.37 to 0.57, respectively).

Conclusions

CD40L may have important role in the pathogenesis of KD. However, these results need to be validated in larger multicenter studies.
The Visual Analogue Scale Versus Numerical Rating Scale in Measuring Pain Severity and Predicting Disability in Low Back Pain
Authors: Shafshak Tarek Saad , Elnemr Rehab
Published: January 2020

Background

Low back pain (LBP) is a public health problem that requires accurate assessment for proper management and predicting prognosis.

Objective

This study aims to assess the agreement between visual analogue scale (VAS) and numeric rating scale (NRS) in measuring LBP severity, and investigate their ability in predicting disability.

Methods

A cross-sectional study was performed on 100 patients with chronic LBP. Pain severity assessment was performed using VAS, NRS, and pain severity scores of the Brief Pain Inventory (BPI). Disability assessment was done by BPI-Pain interference and Modified Oswestry Disability Index (MODI).

Results

There was a significant positive correlation between VAS and NRS (r = 0.92, p < 0.001) with high agreement between both as detected by Bland-Altman method (mean difference = 0.33). Moreover, there was significant (p < 0.001) positive correlation between disability scores and either VAS (r = 0.92 with BPI pain interference; r = 0.75 with MODI) or NRS (r = 0.95 with BPI pain interference; r = 0.68 with MODI). By using receiver operating characteristic curve, a score of 6 in VAS or NRS can predict severe disability, whereas VAS score higher than 4 and NRS score higher than 3 can predict moderate disability.

Conclusions

Visual analogue scale and NRS appeared reliable in assessing LBP severity with no significant difference between them. Moreover, either VAS or NRS scores can predict disability of patients with LBP.
Impact of Software Parameter Settings on Image Quality of Virtual Grid Processed Radiography Images
Authors: Gossye Tim , Smeets Peter V. , Achten Eric , Bacher Klaus
Published: January 2020

Objectives

Mobile radiography systems are commonly used in the intensive care unit. The use of a physical antiscatter grid with these systems is uncommon because of drawbacks. In 2015, Virtual Grid (Fujifilm, Tokyo, Japan) became available for chest and abdomen examinations. In this study, we compared image quality (IQ) with a contrast-detail phantom (CDRAD 2.0; Artinis Medical Systems, Zetten, the Netherlands) of digital radiographs acquired without any grid (gridless) with those corrected for scatter by either software (SW)-based scatter correction (Virtual Grid) or a physical grid (grid). Furthermore, we determined the optimal Virtual Grid settings that lead to the best contrast-detail IQ score (inverse IQ figure).

Materials and Methods

Images were obtained with a cassette spot film device with an inserted portable flat-panel detector (Fujifilm, Tokyo, Japan). The CDRAD phantom was sandwiched between polymethylmethacrylate (PMMA) with total thicknesses of 12, 16, 21, and 26 cm to simulate patient attenuation and scatter. Tube voltages of 81, 90, 109, and 125 kVp were used to make the radiographs. In total, 12 different Virtual Grid settings (grid ratio, line pairs (lp)/cm, and type of interstitial material) were applied for every phantom thickness and tube voltage.

Results

An average increase of 32% in IQ was obtained when Virtual Grid images with a SW grid ratio 10:1 were compared with gridless images (P < 0.001). Increasing the SW grid ratio to 20:1 resulted in a further increased IQ. With a phantom thickness of 12 cm PMMA, Virtual Grid outperformed the removable physical grid presented in the cassette spot film device. The linear mixed-effects model showed that IQ is mainly affected by PMMA, tube voltage, and the SW grid ratio.

Conclusions

Virtual Grid improves images obtained without physical grid for a wide range of experimental conditions. Despite the different possible settings of the Virtual Grid SW, the most important parameter affecting IQ is the SW grid ratio.
Intense FAPI Uptake in Inflammation May Mask the Tumor Activity of Pancreatic Cancer in 68Ga-FAPI PET/CT
Authors: Luo Yaping , Pan Qingqing , Zhang Wen , Li Fang
Published: January 2020

Contrast CT revealed diffuse enlargement of the pancreas with a suspicious lesion in the uncinate process in a 57-year-old man who presented with jaundice. 18F-FDG PET/CT showed increased radioactivity in the enlarged pancreas with a nodular lesion with even higher uptake in the uncinate process. To differentiate autoimmune pancreatitis and pancreatic cancer, 68Ga-FAPI PET/CT was performed. It revealed intense 68Ga-FAPI uptake in the pancreas, but the FDG-avid lesion in the uncinate process was not shown. The patient was finally diagnosed with pancreatic cancer with tumor-induced pancreatitis with endoscopic ultrasonography–guided biopsy.
A Rare Presentation of Melanoma as a Retroperitoneal Mass Seen on FDG PET
Authors: Yao Yutang , Liu Wusong , Zuo Zhuo , Cheng Zhuzhong
Published: January 2020

A 55-year-old woman presented with intermittent fatigue and abdominal pain. Ultrasound and CT scan showed a large heterogeneous mass in the retroperitoneum, suggestive of malignancy. 18F-FDG PET/CT was performed for staging. PET/CT images showed a hypermetabolic retroperitoneal mass. Endoscopy revealed a mass infiltrating the duodenum. Eventually, the mass was pathologically proved to be malignant melanoma. Further extensive clinical, radiological, and endoscopic investigations proved the retroperitoneum to be the primary site.
Anaplastic Large Cell Lymphoma Involving 7 Different Organs in a Pediatric Patient Demonstrated by FDG PET/CT
Authors: Zhang Mingyu , Yang Xu , Wang Wei , Yang Jigang
Published: January 2020

An 11-year-old girl presented with vomiting, abdominal pain, nausea, and scleral icterus for 7 days. FDG PET/CT demonstrated multiple FDG-avid lesions in muscle, bone, kidney, pancreas, ovary, lymph nodes, and central nervous system. Biopsy from the lesion in the muscle of the right upper arm demonstrated ALK-positive anaplastic large cell lymphoma. The present case highlights the advantage of FDG PET/CT in better staging pediatric patients with anaplastic large cell lymphoma.
Freestyle Perforator Puzzle Flap for Posterior Trunk Reconstruction
Authors: Maruccia Michele , Di Taranto Giuseppe , Schonauer Fabrizio , D'Andrea Francesco , Losco Luigi , Ribuffo Diego , Chen Hung-Chi , Cigna Emanuele
Published: January 2020

Background

Closure of extensive defects of posterior trunk can be challenging for reconstructive surgeons owing to the need of a large bulk of well-vascularized tissue to resurface the skin and the exposed hardware and to fill the dead spaces. We hypothesized that elevating multiple perforators flaps in various patterns would allow for reconstruction of large posterior trunk defects with tension-free primary closure and minimal donor site morbidity.

Patients and Methods

Between January 2013 and December 2016, 23 patients with large posterior trunk defects underwent reconstruction with a multiple freestyle perforator flaps approach. We experimented a freestyle perforator-based reconstruction, which consists of designing a sequence of flaps, able to adequately fit the defects, allowing for tensionless primary closure.

Results

The average age of patients was 60.2 years (range, 18–80 years). A total number of 62 perforator flaps was performed, with an average of 2.6 flaps per patient. We were able to successfully cover defects up to 27 × 29 cm. A single perforator was used in 58 flaps, whereas more than 1 perforator was applied in 4 flaps. In all cases, the donor sites were closed primarily, and patients healed uneventfully. Six patients underwent radiotherapy after surgery, but no complication occurred.

Conclusions

In this series of extensive defects of the posterior trunk, a tension-free closure was achieved by distributing the tension to multiple freestyle perforator flaps, supplying sufficient volume of tissue and reliable vascularization. This approach can be a valid tool in facing reconstruction of large and complicated defects of the posterior trunk.
Novel Three-Dimensional Coordinate System to Analyze Alveolar Molding Effects of Pre-Surgical Nasoalveolar Molding on Infants With Non-Syndromic Unilateral Cleft Lip and Palate
Authors: Zheng Jie , He Hong , Kuang Wenying , Yuan Wenjun
Published: January 2020

The aim of this study is to establish a stable 3-dimensional (3D) coordinate system for investigating the alveolar molding effects of pre-surgical nasoalveolar molding (PNAM) on non-syndromic unilateral cleft lip and palate (UCLP) patients, basing on the Frankfort Horizontal (FH) plane.

Twenty-one non-syndromic UCLP neonates who sought medical advice in the department of Orthodontics, from 2016.5 to 2017.10 were enrolled in the present study. All neonates were subjected to PNAM before the cleft lip repair. The treatment duration was 75.76 days. Silicone rubber models were obtained and scanned using a 3D laser scanner pre- and post-PNAM treatment. A 3D coordinate system based on the FH reference plane was built utilizing Rhino3D software to record the landmark 3D coordinates, to measure the distance, angle, and length variables. The Paired Student's t test and the Pearson correlation coefficient were used to calculate reproducibility and reliability of the landmark localization for repeated measurements. Changes of the measurement variables were analyzed by the Paired Student's t test.

This study revealed a high reproducibility and reliability for most of the landmarks. By the end of PNAM treatment, the cleft gap was reduced with the malformation of alveolar segments aligned normally and the anterior points of both alveolar segments were rotated to the cleft side.

Utilizing the FH plane to set up a rigorous and stable 3D system is meaningful. PNAM therapy is effective in reducing the severity of the maxillary deformity not only on the non-cleft side, but also on the cleft side.
The Effect of Buccal Fat Pad Graft in the Palatoplasty and the Risk Factor of Postoperative Palatal Fistula
Authors: Kim Jwa-Young , Kim Seong-Gon , Park Young-Wook , Hwang Dae Seok , Paeng Jun-Young , Seok Hyun
Published: January 2020

Purpose:

The aim of this study was to evaluate the effect of buccal fat pad (BFP) in the palatoplasty and to investigate the risk factors associated with postoperative palatal fistula formation.

Materials and Methods:

Sixty-five cleft palate patients were enrolled for this study. Clinical data regarding sex, age, type of cleft, surgical technique, the ratio of cleft width, and BFP graft were collected. The ratio of cleft width was measured and calculated using preoperative clinical photographs. In 36 patients, the BFP was harvested and grafted on the cleft palate to prevent palatal fistula formation. The patients were followed up, the incidence of fistula formation was investigated, and the risk factors related with the fistula were evaluated.

Results:

Four patients had postoperative palatal fistula and were not BFP grafted during operation. The BFP graft and ratio of cleft width are significant factors in palatal fistula formation (P = .035, .003). There was a significant difference in the ratio of cleft width between the normal and fistula groups (P = .006). In the logistic regression analysis, there was significant association between high ratio of cleft width and palatal fistula formation in the no BFP group (odds ratio; 11.15, P = .036).

Conclusions:

The ratio of cleft width and BFP graft was a significant factor in palatal fistula formation. The BFP graft is a reliable procedure to prevent palatal fistula formation and increase the success of palatoplasty.
Application of Disposable Multifunctional Drainage Tube-Assisted Irrigation in Patients With Severe Multi-Space Infections in Oral and Maxillofacial Head and Neck Regions
Authors: Dai Tianguo , Cheng Jinqiang , Ran Hongbing , Xu Bo , Liu Yingkai , Qiu Yinxiu
Published: January 2020

Purpose:

To compare the clinical efficacy of disposable multifunctional drainage tube (DMDT)-assisted irrigation with the traditional abscess incision rubber drainage technique in patients with severe multi-space infections in oral and maxillofacial head and neck regions.

Patients and Methods:

The data of 74 patients with severe multi-space infections in oral and maxillofacial head and neck regions, who were admitted to the Department of Oral and Maxillofacial Surgery, Central Hospital of Panzhihua City, Sichuan Province, China, between January 2015 and January 2019, were retrospectively studied. According to the treatment method, the patients were divided into 2 groups: the DMDT-assisted irrigation group and the abscess incision rubber drainage group. Cure rate, complications, length of hospitalization, days of antimicrobial use, cost of antimicrobial drugs, total hospitalization cost, number of dressing changes, and patient pain during dressing changes were compared between the 2 groups.

Results:

Of the 74 patients, 38 were treated with the DMDT-assisted irrigation, and 36 with the traditional abscess incision rubber drainage. Compared with the traditional treatment group, the total hospitalization cost of the DMDT-assisted irrigation group is not much different (P = 0.72), but the patients in the DMDT-assisted irrigation group have higher cure rate, fewer complications, less antibiotics cost, shorter hospitalization length and fewer dressing changes than the control group (P < 0.05).

Conclusions:

The DMDT-assisted irrigation technique not only improves the cure rate, reduces complications, shortens hospitalization, reduces the use of antibiotics, and alleviates patient pain during dressing changes, but also improves clinical and therapeutic efficacy by reducing the number of dressing changes.
Discriminant Analysis of the Patient-Specific Functional Scale in Discerning Between Loss of Physical Function Categories in Community-Dwelling Older Adults
Authors: Taylor J. David , Mathis Ruth Ann
Published: January 2020

Previous research indicates that the Patient-Specific Functional Scale (PSFS) is a reliable and valid measure of loss of physical function in community-dwelling older adults. However, the ability of the PSFS to classify community-dwelling older adults into categories of loss of physical function has not been investigated. The purpose of this study was to investigate the ability of the PSFS to discern between different categories of physical function loss in community-dwelling older adults. Thirty-one community-dwelling older adults (mean age = 81.1 years; SD = 8.3) completed a set of physical function questionnaires: the PSFS, the Lower Extremity Functional Scale (LEFS), and the Activities-specific Balance Confidence (ABC) scale. Study participants also completed the Short Physical Performance Battery (SPPB). Scores on the PSFS, LEFS, ABC scale, and SPPB were divided into loss of physical function categories (mild, moderate, severe, and very severe). Discriminant analysis was used to determine the ability of the PSFS to discern between the different categories of loss of physical function. The canonical correlation between the eigenvalues and classifications for the LEFS, ABC scale, and SPPB was 0.85 (P < .001), 0.72 (P < .001), and 0.40 (P = .18), respectively. The findings of this investigation indicate that the PSFS has predictive ability to classify community-dwelling older adults into categories of loss of physical function, based on LEFS and ABC scale classifications, which could be important for purposes such as evaluation, screening, and measuring clinically important differences in loss of physical function.
Patient Travel Distance and Post Lung Transplant Survival in the United States: A Cohort Study
Authors: Tsuang Wayne M. , Arrigain Susana , Lopez Rocio , Snair Megan , Budev Marie , Schold Jesse D.
Published: January 2020

Background.

In response to a longstanding Federal mandate to minimize the role of geography in access to transplant in the United States, we assessed whether patient travel distance was associated with lung transplant outcomes. We focused on the posttransplant time period, when the majority of patient visits to a transplant center occur.

Methods.

We present a cohort study of lung transplants in the United States between January 1, 2006, and May 31, 2017. Travel distance was measured from the patient’s permanent home zip code to the transplant center using SAS URL access to GoogleMaps. We leveraged data from the US Census, US Department of Agriculture, and the Economic Innovations Group to assess socioeconomic status. Multivariable Cox models were used to assess graft survival.

Results.

We included 18 128 patients who met the inclusion criteria. Median distance was 69.6 miles. Among patients who traveled >60 miles to reach a transplant center, 41.8% bypassed a closer center and sought care at a more distant center. Patients traveling longer distances sought care at centers with a higher annual transplant volume. In the adjusted Cox Model, patients who traveled >360 miles had a slightly higher risk for posttransplant graft failure than patients traveling ≤60 miles (hazard ratio 1.09; 95% CI, 1.01-1.18), and a higher risk for treated acute rejection (hazard ratio, 1.63; 95% CI, 1.43-1.86).

Conclusions

Travel distance was significantly associated with post lung transplant survival. However, this effect was relatively modest. Patient travel distance is an important component of access to lung transplant care.
HOUSES Index as an Innovative Socioeconomic Measure Predicts Graft Failure Among Kidney Transplant Recipients
Authors: Stevens Maria A. , Beebe Timothy J. , Wi Chung-II , Taler Sandra J. , St. Sauver Jennifer L. , Juhn Young J.
Published: January 2020

Background.

Despite extensive evaluation processes to determine candidacy for kidney transplantation, variability in graft failure exists. The role of patient socioeconomic status (SES) in transplantation outcomes is poorly understood because of limitations of conventional SES measures.

Methods.

This population-based retrospective cohort study assessed whether a validated objective and individual-level housing-based SES index (HOUSES) would serve as a predictive tool for graft failure in patients (n = 181) who received a kidney transplant in Olmsted County, MN (January 1, 1998 to December 8, 2016). Associations were assessed between HOUSES (quartiles: Q1 [lowest] to Q4 [highest]) and graft failure until last follow-up date (December 31, 2016) using Cox proportional hazards. The mean age (SD) was 46.1 (17.2) years, 109 (60.2%) were male, 113 (62.4%) received a living kidney donor transplant, and 40 (22.1%) had a graft failure event.

Results.

Compared with Q1, patients with higher HOUSES (Q2–Q4) had significantly lower graft failure rates (adjusted hazard ratio, 0.47; 95% confidence interval, 0.24-0.92; P < 0.029), controlling for age, sex, race, previous kidney transplantation, and donor type.

Conclusions.

Although criteria for kidney transplant recipients are selective, patients with higher HOUSES had lower graft failure rates. Thus, HOUSES may enable transplantation programs to identify a target group for improving kidney transplantation outcomes.
Comparing Emotional Adjustment of Living-donor and Deceased-donor Kidney Transplant Patients
Authors: Lai Yousheng Lester , Neo Hui Ling Michelle , Vathsala Anantharaman , Griva Konstadina
Published: January 2020

Background.

Kidney transplantation is regarded as the best treatment option for patients with end-stage renal disease. However, living-donor recipients (LDRs) and deceased-donor recipients (DDRs) still face challenges in transplant-specific emotional adjustment post-transplantation. Research distinguishing emotional adjustment between transplant groups has been limited to Western settings, with little attention given to Asian populations. As such, documenting and comparing the emotional adjustment of LDRs and DDRs in an ethnically diverse Asian setting in Singapore and identifying factors associated with emotional adjustment are of interest.

Methods.

One hundred eighty-two kidney transplant patients (106 LDRs and 76 DDRs) completed measures of generic distress (Depression, Anxiety, Stress Scale-21) and transplantation-specific emotional and behavioral outcomes (Transplant Effects Questionnaire).

Results.

LDRs were significantly younger (P = 0.019) and had higher education levels (P = 0.007), higher personal income (P < 0.001), shorter dialysis vintage (P < .001), and higher estimated glomerular filtration rates (eGFRs) (P = 0.002) compared with DDRs. Generic symptoms of depression and stress were very low; however, 29.2% of LDRs and 19.7% of DDRs experienced moderate to severe symptoms of anxiety. Similarly, 83.0% of LDRs and 72.4% of DDRs reported high levels of transplant-specific worry. Multivariate models showed younger patients expressing greater generic distress, and transplant-specific worry (P < 0.01), despite higher eGFRs (P < 0.05). ANCOVA controlling for casemix differences showed that LDRs experienced higher feelings of guilt (P = 0.004) and greater willingness to disclosure (P = 0.041).

Conclusions.

Clinicians should be vigilant of younger kidney transplant patients who have greater risk of poorer emotional adjustment. Future interventions should target alleviating anxiety and transplant-specific worry.
Laboratory methods supporting measles surveillance in Queensland, Australia, 2010–2017
Authors: McMahon Jamie L. , Northill Judith A. , Finger Mitchell , Lyon Michael , Lambert Stephen B. , Mackay Ian M.
Published: January 2020

Purpose. Australia was officially recognised as having eliminated endemic measles transmission in 2014. Maintaining laboratory support for surveillance of vaccine-preventable diseases, such as measles, is an essential component of reaching and maintaining transmission-free status.

Methodology. Real-time and conventional PCR-based tools were used to detect, differentiate from measles vaccine virus (MeVV), and sequence fragments of measles viruses (MeV) identified from specimens collected in Queensland. Specimens were mostly from travellers who had visited or returned to Queensland from international or interstate sites or been in contact with a case from either group.

Results. Between 2010 and 2017, 13 678 specimens were tested in our laboratory using real-time RT-PCR (RT-rPCR), identifying 533 positives. Most specimens were swabs (70.98 %) and urines (25.56 %). A MeVV RT-rPCR was used on request and identified 154 instances of MeVV. MeV-positive extracts were genotyped as required. Genotypes identified among sequenced specimens included B3, D4, D8, D9, G3, and H1 as well as members of clade A as expected from the detection of MeV among virus introductions due to global travel and vaccination.

Conclusion. We describe the workflow employed and results from our laboratory between 2010 and 2017 for the sensitive detection of MeV infection, supporting high-quality surveillance to ensure the maintenance of Australia’s measles-free status.
Psychrobacillus glaciei sp. nov., a psychrotolerant species isolated from an Antarctic iceberg
Authors: Choi Jun Young , Lee Pyung Cheon
Published: January 2020

We performed taxonomic studies on a psychrotolerant strain, designated PB01T, isolated from an Antarctic iceberg. The cells of strain PB01T were Gram-stain-positive, strictly aerobic, white–yellow and rod-shaped. The results of 16S rRNA gene sequence analysis revealed that strain PB01T was closely related to

Psychrobacillus psychrodurans

DSM 11713T (99.19 % similarity),

Psychrobacillus psychrotolerans

DSM 11706T (98.91 %) and

Psychrobacillus insolitus

DSM 5T (98.85 %). Despite high 16S rRNA gene sequence similarity, the degrees of DNA–DNA relatedness between strain PB01T and its three closest phylogenetic neighbours were 62.4±7.3 % for

P. psychrodurans

DSM 11713T, 61.1±5.4 % for

P. psychrotolerans

DSM 11706T and 56.1±6.9 % for

P. insolitus

DSM 5T. The predominant cellular fatty acids were anteiso-C15 : 0, iso-C15 : 0 and C16 : 1ω7с-OH. Menaquinone-8 was the major respiratory quinone, and phosphatidylethanolamine was the major polar lipid. The DNA G+C content of strain PB01T calculated from the complete genome sequence was 36.0 mol%. Based on the phenotypic, chemotaxonomic, genomic and phylogenetic data obtained in the present study, we conclude that strain PB01T represents a novel species of the genus

Psychrobacillus

, for which we propose the name Psychrobacillus glaciei sp. nov. The type strain is PB01T (=CECT 9792T=KCTC 43041T).
Description of Paenibacillus tepidiphilus sp. nov., isolated from a tepid spring
Authors: Narsing Rao Manik Prabhu , Dong Zhou-Yan , Kan Yu , Dong Lei , Li Shuai , Xiao Min , Kang Ying Qian , Zhang Kun , Li Wen-Jun
Published: January 2020

China is a hotspot for hot springs and during microbial diversity analysis of Tengchong hot spring, Yunnan province, south-west PR China, two strains designated SYSU G01001T and SY-13 were isolated. SYSU G01001T and SY-13 were Gram-stain-positive, motile and spore-forming. Colonies were white, circular, raised and punctiform. SYSU G01001T and SY-13 grew at pH 6.0–9.0 (optimum pH 8.0) and at 23–37 °C (optimum 28 °C). The 16S rRNA gene sequence similarity between SYSU G01001T and SY-13 was 99.6 % but these strains shared low sequence similarity with

Paenibacillus azotifigens

(97.5 %) indicating that they represented a novel species. On the basis of the results, SYSU G01001T was selected for further investigations and SY-13 was considered to represent a second strain of the species. The cell wall peptidoglycan of SYSU G01001T was meso-2,6-diaminopimelic acid and MK-7 was the only respiratory quinone. The polar lipids were diphosphatidylglycerol (DPG), phosphatidylglycerol (PG), phosphatidylethanolamine (PE), two unidentified aminolipids (AL), two unidentified amino phospholipids (APL), an unidentified phospholipid (PL) and an unidentified polar lipid (L). The G+C content of the genomic DNA was 53.9 mol%. The average nucleotide identity (ANIb and ANIm) values between SYSU G01001T and

Paenibacillus azotifigens

LMG 29963T were below the cut-off level (95–96 %) recommended as the average nucleotide identity (ANI) criterion for interspecies identity. On the basis of the above results strain SYSU G01001T represents a novel species of the genus

Paenibacillus

, for which the name Paenibacillus tepidiphilus sp. nov. is proposed. The type strain is SYSU G01001T (=KCTC 33952T=CGMCC 1.13870T).
Genomic alterations and abnormal expression of APE2 in multiple cancers
Authors: Jensen Katherine A. , Shi Xinghua , Yan Shan
Published: January 2020

Although APE2 plays essential roles in base excision repair and ATR-Chk1 DNA damage response (DDR) pathways, it remains unknown how the APE2 gene is altered in the human genome and whether APE2 is differentially expressed in cancer patients. Here, we report multiple-cancer analyses of APE2 genomic alterations and mRNA expression from cancer patients using available data from The Cancer Genome Atlas (TCGA). We observe that APE2 genomic alterations occur at ~17% frequency in 14 cancer types (n= 21,769). Most frequent somatic mutations of APE2 appear in uterus (2.89%) and skin (2.47%) tumor samples. Furthermore, APE2 expression is upregulated in tumor tissue compared with matched non-malignant tissue across 5 cancer types including kidney, breast, lung, liver, and uterine cancers, but not in prostate cancer. We also examine the mRNA expression of 13 other DNA repair and DDR genes from matched samples for 6 cancer types. We show that APE2 mRNA expression is positively correlated with PCNA, APE1, XRCC1, PARP1, Chk1, and Chk2 across these 6 tumor tissue types; however, groupings of other DNA repair and DDR genes are correlated with APE2 with different patterns in different cancer types. Taken together, this study demonstrates alterations and abnormal expression of APE2 from multiple cancers.
Temporal Trends in Vaping Use: Demographic Diversity and Healthcare Utilization Outcomes
Authors: Nguyen Trevor , Nikova Teodora , Luong Eric , Bottling Patrick , Henglin Mir , Kim Elizabeth H. , Rader Florian , Danovitch Itai , Weinberg Aaron , Cheng Susan , Ebinger Joseph
Published: January 2020

BACKGROUND

Use of electronic cigarettes (e-cigarettes) has increased substantially in recent years. Marketed as a safer alternative to conventional tobacco cigarettes, the safety profile of e-cigarettes is now being questioned. Importantly, the clinical consequences of e-cigarette use remain poorly characterized.

METHODS

Using data from the electronic health record (EHR), we identified a cohort of e-cigarette users and never-smokers in the region of central Los Angeles. Using information extracted from the EHR, we assessed temporal trends in the demographic characteristics of e-cigarette users, including race/ethnicity and location of residence. We also used data on urgent medical visits (i.e. emergency department encounters and hospital admissions) occurring during the study period (January 2014 to January 2020) and employed a negative binomial regression model to compare healthcare utilization rates between e-cigarette users and never-smokers.

RESULTS

We identified a total of 698 e-cigarette users, in addition to 999 never-smokers, with demographic, clinical, and outcomes data available over the duration of the study period. From the beginning to the end of the study period, e-cigarette use increased across all race/ethnicity groups and across all geographic regions of residence. Notably, e-cigarette users experienced a 4.96 higher rate of urgent medical visits when compared to never-smokers evaluated over the same study period.

CONCLUSION

E-cigarettes use continues to expand, with evidence of racial/ethnic as well as geographic variation in uptake. Use of e-cigarette devices is associated with substantially higher rates of urgent healthcare utilization. These findings highlight the need for a more granular understanding of e-cigarette use and enhanced attention to the diversity as well as breadth of the population affected by this burgeoning health crisis.
Normative reference values of the handgrip strength for the Portuguese workers
Authors: Bernardes Sarah Fernandes , Assunção Ana , Fujão Carlos , Carnide Filomena
Published: January 2020

Aim

This study aims to identify the normative values of handgrip strength for Portuguese workers in the automotive industry.

Methods

About 1225 employees were invited to participate in the study. The final sample consisted of 656 employees in the assembly area. The handgrip strength was measured in kilograms (kg) using the Jamar digital dynamometer. Two measurements were performed in both hands, totaling four measurements. For the present study, the maximum value was recorded regardless of the hand.

Results

showed the peak mean values of handgrip strength in the group of women was 34 kg in the age group of 35-39 years, and the group of men the peak mean was 52 kg in the age group of 25-34 years. The most pronounced decline in the female group appears in the age of 30-34 years with 30 kg and the men group the decline occurs of 2kg below the peak force, in the age group between the 40-57 years. This study used a cut-off at 2 SD below by the sex-specific peak mean.

Conclusion

Normative values can help delineate the career path of workers because they portray risk values according to age, height, and gender. And they can also help in adjusting the morphological and strength characteristics of the worker with the task to be performed, as an example of work above head level.

Key Messages

The handgrip strength is a general indicator of muscle strength, in addition to being closely related to cardiovascular and nutritional diseases. Also, this measure is one of the keys to defining sarcopenia.

One of the main findings of the study was found in the group of women aged 30-34 years, with a significant decline in handgrip strength compared to other age groups. Furthermore, the present study, established for the first time, normative values for the handgrip strength of Portuguese workers in the automotive industry.

The handgrip strength decline is a crucial predictor of frailty syndrome, and sarcopenia can be checked by the occupational medicine department, individually, by the risk threshold outcomes presents in this study. Also, it is possible to design the conditions work processes associated with the predictive values of HG2 and HG5 and the implementation of the workers’ clinical surveillance system through periodic tests of handgrip strength.
Coordination and assembly of protein complexes encoded across mitochondrial and nuclear genomes is assisted by CLPP2 inArabidopsis thaliana
Authors: Petereit Jakob , Duncan Owen , Murcha Monika W , Fenske Ricarda , Cincu Emilia , Cahn Jonathan , Pružinská Adriana , Ivanova Aneta , Kollipara Laxmikanth , Wortelkamp Stefanie , Sickmann Albert , Lee Jiwon , Lister Ryan , Millar A Harvey , Huang Shaobai
Published: January 2020

Protein homeostasis in eukaryotic organelles and their progenitor prokaryotes is regulated by a series of proteases including the caseinolytic protease (CLPP). CLPP has essential roles in chloroplast biogenesis and maintenance, but the significance of the plant mitochondrial CLPP remains unknown and factors that aid coordination of nuclear and mitochondrial encoded subunits for complex assembly in mitochondria await discovery. We generated knock-out lines of the single gene for the mitochondrial CLP protease subunit,CLPP2,inArabidopsis thaliana. Mutants had higher abundance of transcripts from mitochondrial genes encoding OXPHOS protein complexes, while transcripts for nuclear genes encoding other subunits of the same complexes showed no change in abundance. In contrast, the protein abundance of specific nuclear-encoded subunits in OXPHOS complexes I and V increased in CLPP2 knockouts, without accumulation of mitochondrial-encoded counterparts in the same complex. Protein complexes mainly or entirely encoded in the nucleus were unaffected. Analysis of protein import, assembly and function of Complex I revealed that while function was retained, protein homeostasis was disrupted through decreased assembly, leading to accumulation of soluble subcomplexes of nuclear-encoded subunits. Therefore, CLPP2 contributes to the mitochondrial protein degradation network through supporting coordination and assembly of protein complexes encoded across mitochondrial and nuclear genomes.

One sentence summary

CLPP contributes to the mitochondrial protein degradation network through supporting coordination and assembly of protein complexes encoded across mitochondrial and nuclear genomes.
The lonely fish is not a loner fish: whole-brain mapping reveals abnormal activity in socially isolated zebrafish
Authors: Tunbak Hande , Vazquez-Prada Mireya , Ryan Thomas , Kampff Adam R. , Dreosti Elena
Published: January 2020

The zebrafish is used to assess the impact of social isolation on behaviour and brain function. As in humans and other social species, early social deprivation reduces social preference in juvenile zebrafish. Whole-brain functional maps of anti-social isolated fish were distinct from anti-social fish found in the normal population. These isolation-induced activity changes revealed profound disruption of neural activity in brain areas linked to social behaviour, such as the preoptic area and hypothalamus. Several of these affected regions are modulated by serotonin, and we found that social preference in isolated fish could be rescued by acutely reducing serotonin levels.
Wnt signaling determines body axis polarity in regeneratingHydratissue
Authors: Wang Rui , Steele Robert E. , Collins Eva-Maria S.
Published: January 2020

How an animal establishes its body axis is a fundamental question in developmental biology. The freshwater cnidarianHydrais an attractive model for studying axis formation because it is radially symmetric, with a single oral-aboral axis. It was recently proposed that the orientation of the new body axis in a regeneratingHydrais determined by the oral-aboral orientation of the actin-myosin contractile processes (myonemes) in the parent animal’s outer epithelial layer. However, because the myonemes are not known to possess polarity, it remained unclear how the oral-aboral polarity of the axis would be defined. As Wnt signaling is known to maintain axis polarity inHydraand bilaterians, we hypothesized that it plays a role in axis specification in excisedHydratissue pieces. We tested this hypothesis using pharmacological perturbations and novel grafting experiments to set Wnt-derived signals and myoneme orientation perpendicular to each other to determine which controls axis formation. Our results demonstrate that Wnt signaling is the dominant encoder of axis information, in line with its highly conserved role in anterior-posterior patterning.
The entorhinal cortical alvear pathway differentially excites interneuron subtypes in hippocampal CA1
Authors: Bell Karen A. , Delong Rayne , Goswamee Priyodarshan , McQuiston A. Rory
Published: January 2020

The entorhinal cortex alvear pathway is a major excitatory input to hippocampal CA1, yet nothing is known about its physiological impact. We investigated the alvear pathway projection and innervation of neurons in CA1 using optogenetics and whole cell patch clamp methods in transgenic mouse brain slices. Using this approach, we show that the medial entorhinal cortical alvear inputs onto both CA1 pyramidal cells and stratum oriens interneurons were monosynaptic, had low release probability, and were mediated by AMPA receptors. Optogenetic theta burst stimulation was unable to elicit suprathreshold activation of CA1 pyramidal neurons but was capable of activating CA1 stratum oriens interneurons. CA1 stratum oriens interneuron subtypes were not equally affected. Higher burst action potential frequencies were observed in parvalbumin-expressing interneurons relative to vasoactive-intestinal peptide-expressing or a subset of oriens lacunosum-moleculare interneurons. Furthermore, alvear excitatory synaptic responses were observed in greater than 70% of PV and VIP interneurons and less than 20% of O-LM cells. Finally, greater than 50% of theta burst-driven inhibitory postsynaptic current amplitudes in CA1 PCs were inhibited by optogenetic suppression of PV interneurons. Therefore, our data suggest that the alvear pathway primarily affects hippocampal CA1 function through feedforward inhibition of select interneuron subtypes.