bluuebunny/crossref_metadata_2025 huggingface dataset:
The Political Economy of Program Enforcement: Evidence from Brazil
Authors: Brollo Fernanda , Kaufmann Katja , La Ferrara Eliana
Published: June 2019

Do politicians manipulate the enforcement of conditional welfare programs to influence electoral outcomes? We study the Bolsa Familia Program (BFP) in Brazil, which provides a monthly stipend to poor families conditional on school attendance. Repeated failure to comply with this requirement results in increasing penalties. First, we exploit random variation in the timing when beneficiaries learn about penalties for noncompliance around the 2008 municipal elections. We find that the vote share of candidates aligned with the president is lower in zip codes where more beneficiaries received penalties shortly before (as opposed to shortly after) the elections. Second, we show that politicians strategically manipulate enforcement. Using a regression discontinuity design, we find weaker enforcement before elections in municipalities where mayors from the presidential coalition can run for reelection. We provide evidence that manipulation occurs through misreporting school attendance, particularly in municipalities with a higher fraction of students in schools with politically connected principals.
Analogues of the fundamental and secondary theorems of selection, assuming a log-normal distribution of expected fitness
Authors: Morrissey Michael B , Bonnet Timothée
Published: June 2019

It is increasingly common for studies of evolution in natural populations to infer the quantitative genetic basis of fitness (e.g., the additive genetic variance for relative fitness), and of relationships between traits and fitness (e.g., the additive genetic covariance of traits with relative fitness). There is a certain amount of tension between the theory that justifies estimating these quantities, and methodological considerations relevant to their empirical estimation. In particular, the additive genetic variances and covariances involving relative fitness are justified by the fundamental and secondary theorems of selection, which pertain to relative fitness on the scale that it is expressed. However, naturally-occurring fitness distributions lend themselves to analysis with generalized linear mixed models (GLMMs), which conduct analysis on a different scale, typically on the scale of the logarithm of expected values, from which fitness is expressed. This note presents relations between evolutionary change in traits, and the rate of adaptation in fitness, and log quantitative genetic parameters of fitness, potentially reducing the discord between theoretical and methodological considerations to the operationalization of the secondary and fundamental theorems of selection.
Damselfly (Odonata: Calopterygidae) Population Decline in an Urbanizing Watershed
Authors: Córdoba-Aguilar Alex , Rocha-Ortega Maya
Published: June 2019

Reduction of terrestrial vegetation and degradation of water quality are among the factors driving insect population decline in growing cities. In this study, we investigated the extent of habitat deterioration, behavioral and physiological responses, and fitness of a damselfly [Hetaerina americana (F.)] population in a semitropical region in central Mexico. The study population was located in a riverine area that crosses a small urban area (Tehuixtla city). We related two habitat variables (tree/shrub covered area and numbers of wastewater outlets) to presumable damselfly responses (larval and adult abundance, duration of adults exposed directly to sunlight, lipid content and muscle mass, and egg survival) over the years 2002 and 2016. We detected a reduction in terrestrial vegetation cover, an increase in wastewater outlets, and a decrease in larval and adult abundance. Adults were more exposed to sunlight in 2016 than in 2002 and showed a reduced lipid content and muscle mass in 2016. Egg survival also decreased. Although correlative, these results suggest impairment of damselfly condition (via lipid and muscle reduction) and fitness as urbanization increases.
Boundaries of eliminated heterochromatin of Tetrahymena are positioned by the DNA-binding protein Ltl1
Authors: Jaspan Vita N , Taye Marta E , Carle Christine M , Chung Joyce J , Chalker Douglas L
Published: June 2019

During differentiation of the Tetrahymena thermophila somatic nucleus, its germline-derived DNA undergoes extensive reorganization including the removal of ∼50 Mb from thousands of loci called internal eliminated sequences (IESs). IES-associated chromatin is methylated on lysines 9 and 27 of histone H3, marking newly formed heterochromatin for elimination. To ensure that this reorganized genome maintains essential coding and regulatory sequences, the boundaries of IESs must be accurately defined. In this study, we show that the developmentally expressed protein encoded by Lia3-Like 1 (LTL1) (Ttherm_00499370) is necessary to direct the excision boundaries of particular IESs. In ΔLTL1 cells, boundaries of eliminated loci are aberrant and heterogeneous. The IESs regulated by Ltl1 are distinct from those regulated by the guanine-quadruplex binding Lia3 protein. Ltl1 has a general affinity for double stranded DNA (Kd ∼ 350 nM) and binds specifically to a 50 bp A+T rich sequence flanking each side of the D IES (Kd ∼ 43 nM). Together these data reveal that Ltl1 and Lia3 control different subsets of IESs and that their mechanisms for flanking sequence recognition are distinct.
Integrative construction of regulatory region networks in 127 human reference epigenomes by matrix factorization
Authors: Liu Dianbo , Davila-Velderrain Jose , Zhang Zhizhuo , Kellis Manolis
Published: June 2019

Despite large experimental and computational efforts aiming to dissect the mechanisms underlying disease risk, mapping cis-regulatory elements to target genes remains a challenge. Here, we introduce a matrix factorization framework to integrate physical and functional interaction data of genomic segments. The framework was used to predict a regulatory network of chromatin interaction edges linking more than 20 000 promoters and 1.8 million enhancers across 127 human reference epigenomes, including edges that are present in any of the input datasets. Our network integrates functional evidence of correlated activity patterns from epigenomic data and physical evidence of chromatin interactions. An important contribution of this work is the representation of heterogeneous data with different qualities as networks. We show that the unbiased integration of independent data sources suggestive of regulatory interactions produces meaningful associations supported by existing functional and physical evidence, correlating with expected independent biological features.
The nucleosome position-encoding WW/SS sequence pattern is depleted in mammalian genes relative to other eukaryotes
Authors: Wright Gregory M , Cui Feng
Published: June 2019

Nucleosomal DNA sequences generally follow a well-known pattern with ∼10-bp periodic WW (where W is A or T) dinucleotides that oscillate in phase with each other and out of phase with SS (where S is G or C) dinucleotides. However, nucleosomes with other DNA patterns have not been systematically analyzed. Here, we focus on an opposite pattern, namely anti-WW/SS pattern, in which WW dinucleotides preferentially occur at DNA sites that bend into major grooves and SS (where S is G or C) dinucleotides are often found at sites that bend into minor grooves. Nucleosomes with the anti-WW/SS pattern are widespread and exhibit a species- and context-specific distribution in eukaryotic genomes. Unlike non-mammals (yeast, nematode and fly), there is a positive correlation between the enrichment of anti-WW/SS nucleosomes and RNA Pol II transcriptional levels in mammals (mouse and human). Interestingly, such enrichment is not due to underlying DNA sequence. In addition, chromatin remodeling complexes have an impact on the abundance but not on the distribution of anti-WW/SS nucleosomes in yeast. Our data reveal distinct roles of cis- and trans-acting factors in the rotational positioning of nucleosomes between non-mammals and mammals. Implications of the anti-WW/SS sequence pattern for RNA Pol II transcription are discussed.
A novel histone H4 variant H4G regulates rDNA transcription in breast cancer
Authors: Long Mengping , Sun Xulun , Shi Wenjin , Yanru An , Leung Sophia T C , Ding Dongbo , Cheema Manjinder S , MacPherson Nicol , Nelson Christopher J , Ausio Juan , Yan Yan , Ishibashi Toyotaka
Published: June 2019

Histone variants, present in various cell types and tissues, are known to exhibit different functions. For example, histone H3.3 and H2A.Z are both involved in gene expression regulation, whereas H2A.X is a specific variant that responds to DNA double-strand breaks. In this study, we characterized H4G, a novel hominidae-specific histone H4 variant. We found that H4G is expressed in a variety of human cell lines and exhibit tumor-stage dependent overexpression in tissues from breast cancer patients. We found that H4G localized primarily to the nucleoli of the cell nucleus. This localization was controlled by the interaction of the alpha-helix 3 of the histone fold motif with a histone chaperone, nucleophosmin 1. In addition, we found that modulating H4G expression affects rRNA expression levels, protein synthesis rates and cell-cycle progression. Our data suggest that H4G expression alters nucleolar chromatin in a way that enhances rDNA transcription in breast cancer tissues.
Association between dietary zinc intake and abdominal aortic calcification in US adults
Authors: Chen Wei , Eisenberg Ruth , Mowrey Wenzhu B , Wylie-Rosett Judith , Abramowitz Matthew K , Bushinsky David A , Melamed Michal L
Published: June 2019

Background

In animal studies, zinc supplementation inhibited phosphate-induced arterial calcification. We tested the hypothesis that higher intake of dietary zinc was associated with lower abdominal aortic calcification (AAC) among adults in the USA. We also explored the associations of AAC with supplemental zinc intake, total zinc intake and serum zinc level.

Methods

We performed cross-sectional analyses of 2535 participants from the National Health and Nutrition Examination Survey 2013–14. Dietary and supplemental zinc intakes were obtained from two 24-h dietary recall interviews. Total zinc intake was the sum of dietary and supplemental zinc. AAC was measured using dual-energy X-ray absorptiometry in adults ≥40 years of age and quantified using the Kauppila score system. AAC scores were categorized into three groups: no AAC (AAC = 0, reference group), mild–moderate (AAC >0–≤6) and severe AAC (AAC >6).

Results

Dietary zinc intake (mean ± SE) was 10.5 ± 0.1 mg/day; 28% had AAC (20% mild–moderate and 8% severe), 17% had diabetes mellitus and 51% had hypertension. Higher intake of dietary zinc was associated with lower odds of having severe AAC. Per 1 mg/day higher intake of dietary zinc, the odds of having severe AAC were 8% lower [adjusted odds ratio 0.92 (95% confidence interval 0.86–0.98), P = 0.01] compared with those without AAC, after adjusting for demographics, comorbidities and laboratory measurements. Supplemental zinc intake, total zinc intake and serum zinc level were not associated with AAC.

Conclusions

Higher intake of dietary zinc was independently associated with lower odds of having severe AAC among noninstitutionalized US adults.
Imaging the kidney: from light to super-resolution microscopy
Authors: Angelotti Maria Lucia , Antonelli Giulia , Conte Carolina , Romagnani Paola
Published: June 2019

The important achievements in kidney physiological and pathophysiological mechanisms can largely be ascribed to progress in the technology of microscopy. Much of what we know about the architecture of the kidney is based on the fundamental descriptions of anatomic microscopists using light microscopy and later by ultrastructural analysis provided by electron microscopy. These two techniques were used for the first classification systems of kidney diseases and for their constant updates. More recently, a series of novel imaging techniques added the analysis in further dimensions of time and space. Confocal microscopy allowed us to sequentially visualize optical sections along the z-axis and the availability of specific analysis software provided a three-dimensional rendering of thicker tissue specimens. Multiphoton microscopy permitted us to simultaneously investigate kidney function and structure in real time. Fluorescence-lifetime imaging microscopy allowed to study the spatial distribution of metabolites. Super-resolution microscopy increased sensitivity and resolution up to nanoscale levels. With cryo-electron microscopy, researchers could visualize the individual biomolecules at atomic levels directly in the tissues and understand their interaction at subcellular levels. Finally, matrix-assisted laser desorption/ionization imaging mass spectrometry permitted the measuring of hundreds of different molecules at the same time on tissue sections at high resolution. This review provides an overview of available kidney imaging strategies, with a focus on the possible impact of the most recent technical improvements.
Meta-analysis of the Smoker’s Paradox in Acute Ischemic Stroke Patients Receiving Intravenous Thrombolysis or Endovascular Treatment
Authors: Zhang Peng , Guo Zhen-Ni , Sun Xin , Zhao Yingkai , Yang Yi
Published: June 2019

Introduction

The existence of the smoker’s paradox is controversial and potential mechanisms have not been explained. We aimed to explore the association between cigarette smoking and functional outcome at 3 months in patients with acute ischemic stroke who were treated with intravenous thrombolysis (IVT) or endovascular treatment (EVT).

Methods

This meta-analysis was conducted in accordance with the PRISMA guidelines. Studies exploring the association between smoking and good functional outcome (modified Rankin Scale score ≤ 2) following IVT or EVT were searched via the databases of PubMed, Embase, and the Cochrane Library from inception to August 8, 2018. Information on the characteristics of included studies was independently extracted by two investigators. Data were pooled using a random-effects or fixed-effects meta-analysis according to the heterogeneity of included studies.

Results

Among 20 identified studies, 15 reported functional outcomes following IVT, and five reported functional outcomes following EVT. Unadjusted analyses showed that smoking increased the odds of good functional outcomes with a pooled odds ratio (OR) of 1.48 (95% confidence interval [CI]: 1.36–1.60) after IVT and 2.10 (95% CI: 1.47–3.20) after EVT. Of IVT studies, only eight reported outcomes adjusted for covariates and none of the EVT studies reported adjusted outcomes. After adjustment, the relation between smoking and good functional outcome following IVT lost statistical significance (OR 1.14 [95% CI: 0.81–1.59]).

Conclusion

Our meta-analysis suggested that smoking was not associated with good functional outcome (mRS ≤ 2) at 3 months in patients with acute ischemic stroke who were treated with intravenous thrombolysis.

Implications

The existence of the smoker’s paradox is controversial. A previous letter by Plas et al. published in 2013 reported a positive result for the association between smoking and good functional outcome at 3 months in acute ischemic stroke patients who received intravenous thrombolysis (IVT). However, a major limitation of their meta-analysis was that the process of data synthesis was based on unadjusted data. Therefore, we conducted this meta-analysis to investigate the association based on adjusted data and a larger sample size. Our meta-analysis suggested that smoking was not associated with good functional outcome after adjusting for covariates.
Postural Control and Interceptive Skills in Children With Autism Spectrum Disorder
Authors: Chen Li-Chiou , Su Wan-Chun , Ho Tzu-Lin , Lu Lu , Tsai Wen-Che , Chiu Yen-Nan , Jeng Suh-Fang
Published: June 2019

Background

Increasing evidence shows common motor deficits associated with autism spectrum disorder (ASD) that can relate to impaired planning and control processes of the sensorimotor system. Catching is a fundamental motor skill that requires coordination between vision, posture, and arm movements. Although postural control and ball catching have been shown to be impaired in children with ASD, previous studies have not investigated how these components are integrated.

Objective

The objective of this study was to investigate the sensorimotor control of arm movements and postural adjustments during ball catching in children with and without ASD.

Design

This study employed a cross-sectional design.

Methods

Fifteen children with ASD (mean [SD] age = 8.8 [1.2] years; 12 boys) and 15 age- and sex-matched typically developing children participated in this study. Children were asked to catch a ball rolling down a ramp in 6 test conditions in which visual inputs and ramp direction were manipulated to provide different sensory conditions and postural demands.

Results

Compared with their typically developing peers, children with ASD had increased difficulties catching balls, especially those from lateral directions. They less often used visual information to plan for catching motion, demonstrated fewer and delayed anticipatory postural adjustments, and exhibited increased corrective control.

Limitations

The sample excluded children with intellectual disability and attention deficit and hyperactivity disorders that might reduce the generalizability to the whole ASD population.

Conclusions

Our results suggest that motor difficulties present in children with ASD can result from compromised sensorimotor integration in planning and control of movements.
The Formalization of Banking Supervision in Japan and Sweden
Authors: HOTORI Eiji , WENDSCHLAG Mikael
Published: June 2019

This study examines the formalization of banking supervision in Japan and Sweden that occurred in the decades around 1900. Using an incremental change approach, we examine the respective cases along three dimensions: (a) the legal framework, (b) the banking supervisory agency, and (c) bank supervisory activities. Through this comparative analysis, we find several similarities and differences. The most important similarity we find is that financial crises—generally considered to be a primary driver of major regulatory and supervisory reforms—did not play a main role in the formalization of supervision in either Japan or Sweden. Rather, formalization was an incremental change process closely linked to the organic development of the banking sector, the general public’s increasing exposure to the banks as deposit holders and borrowers, and the increased need for professionalization of the banking sector. This finding suggests that our approach is applicable to any country where the formalization of supervision took place without being prompted by a specific event such as a financial crisis.
The Influence of Professionals’ Empathy on Parents’ Anxiety in Cases of Juvenile Criminology
Authors: Rocha Juliana , Carvalho Irene Palmares
Published: June 2019

In situations of juvenile delinquency, abuse, or neglect, determination of child custody relies on interviews with parents. This study aims to examine the effects of the interviewer’s empathy on parents’ anxiety, and to explore how parents experience these situations. A measure of anxiety was applied to 41 parents under evaluation for child custody before and after the assessment interview. Professionals’ empathy was rated by both parents and professionals after each appointment. Parents participated in semistructured interviews. Data were analyzed through statistical and content analyses. The decrease in anxiety was significantly greater for parents who perceived professionals as “perfect” than for parents who perceived professionals as “less than perfect” in empathy. Parents’ and professionals’ empathy scores correlated positively, but the association between professionals’ self-rated empathy and parents’ anxiety was nonsignificant. Reactions to the justice system’s intervention emerging in the semistructured interviews were “unjustifiable intrusion,” “disconcerting information,” and “reality confirmation.” Each associated differently with parents’ expectations for the assessment interview (respectively, that the process be over quickly, that it be over successfully, and that help start quickly). Our results support the important effects, from parents’ perspectives, of empathy in assessment interviews in the context of juvenile criminology.
A Novel MicroRNA Signature for Cholestatic Drugs in Human Hepatocytes and Its Translation into Novel Circulating Biomarkers for Drug-Induced Liver Injury Patients
Authors: López-Riera Mireia , Conde Isabel , Castell José V , Jover Ramiro
Published: June 2019

Drug-induced liver injury (DILI) diagnosis and classification (hepatocellular, cholestatic, and mixed) relies on traditional clinical biomarkers (eg ALT and ALP), despite limitations such as extrahepatic interferences, narrow dynamic ranges, and low mechanistic value. microRNAs may be very useful for complementing traditional DILI biomarkers but most studies in this direction have considered only paracetamol poisoning. Thus the value of microRNAs (miRNAs) as biomarkers for idiosyncratic DILI has not yet been demonstrated. In this study, we first examined the effect of model cholestatic drugs on the human hepatocyte miRNome by RNAseq and RT-qPCR. Results demonstrated that chlorpromazine, cyclosporin A, and ANIT induced (miR-21-3p, -21-5p, -22-3p, -27a-5p, -1260b, -34a-5p, and -98-5p) and repressed (-122-5p, -192-5p, -30c-5p, -424-5p, and -16-5p) specific miRNAs in sandwich-cultured upcyte hepatocytes. However, no common signature was found for cholestatic drugs. Next we investigated the levels of these miRNA in human serum and found that most were also significantly altered in cholestatic/mixed DILI patients upon hospital/ambulatory admission. However, miR-122-5p, -192-5p, -34a-5p, and -22-3p demonstrated a much more significant induction in patients with hepatocellular DILI, thus revealing better specificity for hepatocellular damage. Time-course analyses demonstrated that -1260b and -146 had a very similar profile to ALP, but with wider dynamic ranges, while -16-5p and -451a showed a negative correlation. Conversely, -122-5p and -192-5p correlated with ALT but with wider dynamic ranges and faster recoveries. Finally, the 122/451a and 122/16 ratios showed excellent prediction performances in both the study [area under the receiver operating characteristic curve (AUROC) >0.93] and the validation cohort (AUROC > 0.82), and can, therefore, be postulated for the first time as circulating miRNA biomarkers for idiosyncratic DILI.
Genetic Divergence and Diversity in Himalayan Puccinia striiformis Populations from Bhutan, Nepal, and Pakistan
Authors: Khan Muhammad Rameez , Rehman Zia-ur , Nazir Sidra Noreen , Tshewang Sangay , Baidya Suraj , Hodson David , Imtiaz Muhammad , Ali Sajid
Published: June 2019

The western Himalayan region in Pakistan has been shown to be the center of diversity of Puccinia striiformis; however, little is known about its genetic relations with the eastern part of the Himalayas. We studied the genetic structure of P. striiformis from Nepal (35 isolates) and Bhutan (31 isolates) in comparison with 81 Pakistani samples collected during 2015 and 2016, through microsatellite genotyping. Genetic analyses revealed a recombinant and highly diverse population structure in Pakistan, Bhutan, and Nepal. A high level of genotypic diversity (>0.90) was observed for the three countries of Pakistan (0.96), Bhutan (0.96), and Nepal (0.91) with the detection of 108 distinct multilocus genotypes (MLGs) in the overall population; 59 for Pakistan, 27 for Bhutan, and 26 for Nepal. Mean number of alleles per locus and gene diversity were higher in Nepal (3.19 and 0.458, respectively) than Bhutan (3.12 and 0.458, respectively). A nonsignificant difference between the observed and the expected heterozygosity in all populations further confirmed the recombinant structure. A clear population subdivision between the Himalayan region of Nepal, Bhutan, and Pakistan was evident, as revealed by FST values (ranging between 0.111 to 0.198), discriminant analysis of principal components, and resampling of MLGs. Limited gene flow could be present between Nepal and Bhutan, while the population from Pakistan was clearly distinct, and no divergence was present between two populations from Pakistan (Bajaur and Malakand). The overall high diversity and recombination signature suggested the potential role of recombination in the eastern Himalayan region (Nepal and Bhutan), which needs to be considered during host resistance deployment and in the context of aerial dispersal of the pathogen. Further surveillance should be made in the Himalayan region for disease management in the region and in the context of worldwide invasions.

[Formula: see text] Copyright © 2019 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Population Structure ofColletotrichum tanacetiin Australian Pyrethrum Reveals High Evolutionary Potential
Authors: Lelwala Ruvini V. , Scott Jason B. , Ades Peter K. , Taylor Paul W. J.
Published: June 2019

Colletotrichum tanaceti, the causal agent of anthracnose, is an emerging pathogen of commercially grown pyrethrum (Tanacetum cinerariifolium) in Australia. A microsatellite marker library was developed to understand the spatio-genetic structure over three sampled years and across two regions where pyrethrum is cultivated in Australia. Results indicated that C. tanaceti was highly diverse with a mixed reproductive mode; comprising both sexual and clonal reproduction. Sexual reproduction of C. tanaceti was more prevalent in Tasmania than in Victoria. Little differentiation was observed among field populations likely due to isolation by colonization but most of the genetic variation was occurring within populations. C. tanaceti was likely to have had a long-distance gene and genotype flow among distant populations within a state and between states. Anthropogenic transmission of propagules and wind dispersal of ascospores are the most probable mechanisms of long-distance dispersal of C. tanaceti. Evaluation of putative population histories suggested that C. tanaceti most likely originated in Tasmania and expanded from an unidentified host onto pyrethrum. Victoria was later invaded by the Tasmanian population. With the mixed mode of reproduction and possible long-distance gene flow, C. tanaceti is likely to have a high evolutionary potential and thereby has ability to adapt to management practices in the future.
Advanced Paternal Age, Infertility, and Reproductive Risks: A Review of the Literature
Authors: Brandt Justin S. , Cruz Ithier Mayra A. , Rosen Todd , Ashkinadze Elena
Published: June 2019

(Abstracted from Prenat Diagn 2019;39:81–87)

Advanced paternal age (APA) is associated with infertility and other reproductive risks. Studies looking at APA and outcomes have used different paternal age cutoffs, which has complicated systematic evaluations of reproductive risk associated with paternal aging.
The Frequency of Intrapartum Caesarean Section Use With the WHO Partograph Versus Zhang’s Guideline in the Labour Progression Study (LaPS): A Multicentre, Cluster-Randomised Controlled Trial
Authors: Bernitz Stine , Dalbye Rebecka , Zhang Jun , Eggebø Torbjørn M. , Frøslie Kathrine F. , Olsen Inge Christoffer , Blix Ellen , Øian Pål
Published: June 2019

(Abstracted from Lancet 2019;393:340–348)

The rate of cesarean sections is increasing worldwide and is a great concern because of its association with adverse outcomes for mothers and babies, the more than 50% risk for a subsequent cesarean section, and the increase in costs of labor care. Assessment and identification of labor progression and prolonged labor, denoted as true labor dystocia and often caused by inadequate contractions or obstructed labor, have profound effects on labor management and intrapartum cesarean section (ICS) use, because labor dystocia is the main indication for an ICS.
Prothrombin Complex Concentrate-induced Disseminated Intravascular Coagulation Can Be Prevented by Coadministering Antithrombin in a Porcine Trauma Model
Authors: Grottke Oliver , Honickel Markus , Braunschweig Till , Reichel Anne , Schöchl Herbert , Rossaint Rolf
Published: June 2019

Editor’s Perspective

What We Already Know about This Topic

What this Article Tells Us That Is New

Background

The risk of thromboembolic complications with prothrombin complex concentrates (PCCs) appears low when used for reversal of vitamin K antagonists but might be different in other indications (e.g., trauma). A difference in risk could arise from the plasma ratio of pro- versus anticoagulant proteins. This study used a porcine trauma model to investigate combined treatment with PCC and antithrombin. The hypothesis was that antithrombin can modulate prothrombotic effects and prevent adverse events of PCC.

Methods

Nine treatment groups (n = 7 per group) were included: control (placebo), PCC (50 IU/kg), PCC plus antithrombin (three groups, with antithrombin doses of 12.5, 25, or 50 IU/kg), fibrinogen concentrate (100 mg/kg) plus PCC, fibrinogen concentrate plus PCC plus antithrombin dose of 50 IU/kg, tranexamic acid (15 mg/kg) plus fibrinogen concentrate plus PCC, and tranexamic acid plus fibrinogen concentrate plus PCC plus antithrombin dose of 50 IU/kg. In each group, bilateral femur fractures and thorax contusion were followed 60 min later by blunt liver injury. Study treatment was then administered, and animals were subsequently observed for 210 min.

Results

Total blood loss (mean ± SD) was statistically significantly lower in all three PCC plus antithrombin groups (PCC plus antithrombin dose of 50 IU/kg, 672 ± 63 ml; PCC plus antithrombin dose of 25 IU/kg, 535 ± 72 ml; and PCC plus antithrombin dose of 12.5 IU/kg, 538 ± 50 ml) than in the PCC group (907 ± 132 ml), which in turn had statistically significantly reduced bleeding versus the control group (1,671 ± 409 ml). Signs of disseminated intravascular coagulation were apparent with PCC monotherapy, and early deaths occurred with fibrinogen concentrate plus PCC, attributable to pulmonary emboli. Antithrombin was protective against both of these effects: signs of disseminated intravascular coagulation were absent from the PCC plus antithrombin groups, and there were no early deaths in the group with fibrinogen concentrate plus PCC plus antithrombin dose of 50 IU/kg.

Conclusions

According to this trauma model, 50 IU/kg PCC increases the risk of disseminated intravascular coagulation and other thromboembolic complications, most notably when coadministered with fibrinogen concentrate. The addition of antithrombin appears to reduce this risk.
Nonossifying Fibromas: A Computed Tomography–based Criteria to Predict Fracture Risk
Authors: Goldin Amanda N. , Muzykewicz David A. , Mubarak Scott J.
Published: June 2019

Background:

Nonossifying fibroma (NOF) is the most common benign osseous lesion in children; however, our understanding of which lesions progress to a fracture remains unclear. In this study, we seek to formulate a classification system for NOFs to assess for fracture risk and determine what this classification system tells us regarding fracture risk of the distal tibia and distal femur NOFs.

Methods:

Charts were retrospectively reviewed for patients with NOFs. A 4-point criteria was created and used to calculate fracture risk for distal tibia and distal femur NOFs. The analysis included incidence, specificity, and sensitivity.

Results:

One point was given for each of the following findings on computed tomography (CT) scan: (1) >50% width on coronal view; (2) >50% width on sagittal view; (3) any cortical breach; (4) lack of a neocortex. In total, 34 patients with NOFs of the distal tibia had CT scans, of which 14 fractured. Zero with a 0- or 1-point score fractured, 2 with a 2-point score fractured (20%), 4 with a 3-point score fractured (44%), and 8 with a 4-point score fractured (100%). Sensitivities of 1-, 2-, 3-, and 4-point scores were 100%, 100%, 85.7%, and 57.1%, respectively, and specificities were 71.4%, 71.4%, 80%, and 100%, respectively. A total of 41 patients with NOFs of the distal femur had CT scans, of which 5 fractured. Zero with a 0-point score fractured, 1 with a 1-point score fractured (4%), 0 with a 2-point score fractured, 1 with a 3-point score fractured (20%), and 3 with a 4-point score fractured (100%). Sensitivities of 1-, 2-, 3-, and 4-point scores were 100%, 80%, 80%, and 60%, respectively; and specificities were 60%, 87.8%, 90%, and 100%, respectively.

Conclusions:

Our 4-point CT criteria is easy to apply and identifies patients at high risk of fracture, helping surgeons make decisions regarding treatment.

Level of Evidence:

Level IV—prognostic study.
Is It Growth or Natural History? Increasing Spinal Deformity After Sanders Stage 7 in Females With AIS
Authors: Grothaus Olivia , Molina Domingo , Jacobs Cale , Talwalkar Vishwas , Iwinski Henry , Muchow Ryan
Published: June 2019

Background:

Accurate prognosis and treatment decisions in adolescent idiopathic scoliosis (AIS) demand a reliable radiographic marker of growth cessation. Specifically, Sanders Stage 7 (SS7) is a useful marker of spine growth cessation in females and is proposed as a bracing endpoint. The purpose of this study was to determine the amount of curve progression noted in female individuals with AIS after achieving SS7. We hypothesize that a subset of patients continues to progress at a greater rate than the natural history at SS7.

Methods:

This retrospective review included female patients with AIS treated at a single institution from May 2008 to 2018. Patients required a hand radiograph demonstrating SS7 and concurrent spine radiograph measuring <50 degrees, plus 2-year follow-up spine radiograph. Curve types were categorized by the modified Lenke Classification. Risser grade, menarche, height, weight, and bracing data were collected. Progression was defined as an increase of the main curve ≥5 degrees. Comparison between groups was analyzed using independent t tests and χ2 or Fisher exact tests as appropriate. Binary logistic regressions were used to construct a model predictive of progressing beyond 50 degrees or undergoing surgery.

Results:

A total of 89 patients met inclusion criteria, average main curve magnitude 33 degrees (SD 9) at SS7 and 38 degrees (SD 11) at 2-year follow-up. Forty-five (51%) patients progressed ≥5 degrees and 17 (19%) progressed at least 10 degrees. Seventy patients had curves <40 degrees at SS7 and 22 (31%) progressed to >40 degrees at 2 years. Eleven (12%) patients progressed to >50 degrees or had surgery at 2-year follow-up. Receiver operating characteristic curve analysis identified a threshold of 39.5 degrees curvature at SS7 associated with progression to >50 degrees or surgery (area under the curve=0.94, P<0.001, sensitivity=100%, specificity=87%). Patients with initial curves >40 degrees did have additional height gained (2.1 cm; SD 1.5), but this was not different than those <40 degrees, P>0.05. In addition, no other variables had statistically significant association with those that progressed (P>0.05).

Conclusions:

A curve >40 degrees at SS7 is at high risk for progressing to a curve measuring >50 degrees or requiring surgery. Those with curves below this threshold still have potential to make clinically significant progression after skeletal maturity. Follow-up of patients beyond SS7 is essential for curves measuring >40 degrees. Reaching SS7 with a curve <50 degrees may not be the endpoint for curve progression, even if predictive of the end of spinal growth.

Level of Evidence:

Level III—retrospective research study.
In Degenerative Spondylolisthesis, Unilateral Laminotomy for Bilateral Decompression Leads to Less Reoperations at 5 Years When Compared to Posterior Decompression With Instrumented Fusion
Authors: Kuo Calvin C. , Merchant Maqdooda , Kardile Mayur P. , Yacob Alem , Majid Kamran , Bains Ravinder S.
Published: June 2019

Study Design.

Multicenter retrospective cohort study.

Objective.

The aim of this study was to compare reoperation rates at 5-year follow-up of unilateral laminotomy for bilateral decompression (ULBD) versus posterior decompression with instrumented fusion (Fusion) for patients with low-grade degenerative spondylolisthesis (DS) with lumbar spinal stenosis (LSS) in a multicenter database.

Summary of Background Data.

Controversy exists regarding whether fusion should be used to augment decompression surgery in patients with LSS with DS. For years, the standard has been fusion with standard laminectomy to prevent postoperative instability. However, this strategy is not supported by Level 1 evidence. Instability and reoperations may be reduced or prevented using less invasive decompression techniques.

Methods.

We identified 164 patients with DS and LSS who underwent ULBD between January 2007 and December 2011 in a multicenter database. These patients were propensity score-matched on age, sex, race, and smoking status with patients who underwent Fusion (n = 437). Each patient required a minimum of 5-year follow-up. The primary outcome was 5-year reoperation. Secondary outcome measures included postoperative complication rates, blood loss during surgery, and length of stay. Logistic regression models were used to estimate the odds ratio of the 5-year reoperation rate between the two surgical groups.

Results.

The reoperation rate at 5-year follow-up was 10.4% in the ULBD group and 17.2% in the Fusion group. ULBD reoperations were more frequent at the index surgical level; Fusion reoperations were more common at an adjacent level. The two types of operations had similar postoperative complication rates, and both groups tended to have fusion reoperations.

Conclusion.

For patients with stable DS and LSS, ULBD is a viable, durable option compared to fusion with decreased blood loss and length stay, as well as a lower reoperation rate at 5-year follow-up. Further prospective studies are required to determine the optimal clinical scenario for ULBD in the setting of DS.

Level of Evidence: 3
A Congregation Transition of Care Program Using Faith Community Nurses and Volunteer Faith-Based Nurses
Authors: Strait Lee Ann , Fitzgerald Elizabeth , Zurmehly Joyce , Overcash Janine
Published: June 2019

Transition of Care Models can reduce the 30-day hospital readmission rate up to 67% by offering coordination and continuity of care. The purpose of this project was to evaluate a Congregation Transition of Care (CTOC) program in faith-based communities with the use of a faith community nurse and volunteer faith-based registered nurses. Descriptive statistics were used to describe findings, revealing a CTOC program can be effective in reducing 30-day readmissions in the faith community.
Triclosan and Female Reproductive Health
Authors: Zhu Wenting , Zhou Wei , Huo Xiaona , Zhao Shasha , Gan Yuexin , Wang Bin , Cheng Weiwei , Ouyang Fengxiu , Wang Weiye , Tian Ying , Zhang Jun
Published: June 2019

Background:

Triclosan (2,4,4′-trichloro-2′-hydroxy-diphenyl ether) is widely used in personal care and household products. Previous in vitro and in vivo studies showed that triclosan may affect female reproductive health. However, evidence from human studies is scarce.

Objectives:

To assess the potential effects of triclosan on women’s reproductive health.

Methods:

A prospective cohort study recruited 1,182 couples who planned to conceive and presented to preconception care clinics for physical examination in Shanghai, China, between 2013 and 2015. These couples were then prospectively followed every 2 months for 12 months. Triclosan was quantified in preconception urine samples at enrollment. The outcomes of interest included menstruation and fecundity. Normal menstruation was defined as a woman who had normal cycle duration between 21 and 35 days, duration of menstrual bleeding between 3 and 7 days, and self-reported normal amount of menstrual bleeding.

Results:

A total of 698 women were included in the analysis on the association between triclosan and menstruation. Compared with low triclosan levels, high triclosan levels were associated with increased risks of abnormal menstruation [adjusted odds ratio (OR) = 1.47; 95% confidence interval = 1.05, 2.06] and prolonged menstrual cycle (OR = 2.08; 95% confidence interval = 1.00, 2.31). In the analysis on the association between triclosan and fecundability, 648 women were included. Compared with the lowest tertile of triclosan level (<1.1 ng/mL), the highest level (>4.5 ng/mL) was associated with a 23% of reduction in fecundability and there tended to be a dose–response pattern.

Conclusion:

Our findings suggest that triclosan may affect menstruation and reduce female fecundity.
Effects of Short-term Exposure to Ambient Particulate Matter on the Lung Function of School Children in Dhaka, Bangladesh
Authors: Tasmin Saira , Ng Chris Fook Sheng , Stickley Andrew , Md Nasiruddin , Saroar Golam , Yasumoto Shinya , Watanabe Chiho
Published: June 2019

Background:

Ambient particulate pollution may adversely affect children’s lung function. However, evidence on this association remains scarce in Asia despite this region having the greatest burden of disease due to air pollution.

Objectives:

To investigate the effect of short-term exposure to ambient particulate matter (PM) on the lung function of school children in Dhaka city, Bangladesh. The possible seasonal modification of this association was also examined.

Methods:

A panel of 315 school children who were 9–16 years of age were recruited from three schools in and around Dhaka. Lung function was assessed using a spirometry test during the cool and warm seasons in 2013, yielding six measurements per child. Daily PM data were retrieved from nearby air monitoring stations. Linear mixed effects models were used to examine associations. Seasonal modification was examined by stratification.

Results:

An inverse association was observed for the lung function parameters with PM2.5; peak expiratory flow (PEF) and forced expiratory volume within 1 second (FEV1) decreased with increasing PM2.5. The percent deviation from the personal median was −4.19% [95% confidence interval (CI): −5.72, −2.66] for PEF and −2.05% (95% CI: −2.92, −1.18) for FEV1 for a 20 µg/m3 increase in PM2.5 on the previous day. Results for PM10 were less consistent. The estimated effects of PM on lung functions were generally greater in the warm season.

Conclusions:

Short-term exposure to PM is associated with worse lung function in children living in highly polluted settings, with the strength of these adverse PM effects varying by season.
Long-term Exposure to Low Air Pollutant Concentrations and the Relationship with All-Cause Mortality and Stroke in Older Men
Authors: Dirgawati Mila , Hinwood Andrea , Nedkoff Lee , Hankey Graeme J. , Yeap Bu B. , Flicker Leon , Nieuwenhuijsen Mark , Brunekreef Bert , Heyworth Jane
Published: June 2019

Background:

Long-term air pollution exposure has been associated with increased risk of mortality and stroke. Less is known about the risk at lower concentrations. The association of long-term exposure to PM2.5, PM2.5 absorbance, NO2, and NOx with all-cause mortality and stroke was investigated in a cohort of men aged ≥ 65 years who lived in metropolitan Perth, Western Australia.

Methods:

Land use regression models were used to estimate long-term exposure to air pollutants at participant’s home address (n = 11,627) over 16 years. Different metrics of exposure were assigned: baseline; year before the outcome event; and average exposure across follow-up period. The Mortality Register and Hospital Morbidity Data from the Western Australia Data Linkage System were used to ascertain mortality and stroke cases. Hazard ratios (HRs) and 95% confidence intervals were estimated using Cox proportional hazard models, adjusting for age, smoking, education, and body mass index for all-cause mortality. For fatal and hospitalized stroke, the models included variables controlled for all-cause mortality plus hypertension.

Results:

Fifty-four percent of all-participants died, 3% suffered a fatal stroke, and 14% were hospitalized stroke cases. PM2.5 absorbance increased the risk of all-cause mortality with adjusted HR of 1.12 (1.02–1.23) for baseline and average exposures, and 1.14 (1.02–1.24) for past-year exposure. There were no associations between PM2.5 absorbance, NO2, and NOx and stroke outcomes. However, PM2.5 was associated with reduced risks of fatal stroke.

Conclusion:

Long-term exposure to PM2.5 absorbance was associated with all-cause mortality among older men exposed to low concentrations; and exposure to PM2.5 was associated with reduced risk of fatal stroke.
Association Between Long-term Exposure to PM2.5 and Incidence of Type 2 Diabetes in Taiwan
Authors: Li Chia-Ying , Wu Chih-Da , Pan Wen-Chi , Chen Yi-Chen , Su Huey-Jen
Published: June 2019

Background:

Long-term exposure to fine particulate matter (PM with an aerodynamic diameter ≤2.5 µm; PM2.5) contributes to an elevated incidence of type 2 diabetes (T2D) in North America and Europe, but there is limited empirical evidence for Asian countries. This study determined the association between and the exposure-response relationship for PM2.5and the incidence of T2D in Taiwan.

Methods:

This retrospective cohort study was conducted for the years 2001–2012. Health information, including age, sex, health insurance premium, type of occupation, medication, and disease status, was retrieved from the Longitudinal Health Insurance Database 2000. Monitoring data for PM2.5came from the Environmental Protection Administration of Taiwan, and Land-use Regression modeling was used to approximate participants’ long-term exposure to PM2.5. Cox proportional hazards models with a generalized estimating equation to account for the correlation within the locations of the medical facilities were used to estimate the association between exposure to PM2.5and the incidence of T2D, adjusting for the potential confounders. We also examined effect modification of sex, age, hyperlipidemia, and National Health Insurance premium for the association.

Results:

Forty-eight thousand six hundred eleven new cases of diabetes were identified among 505,151 eligible participants, with the median follow-up of 12 years. Positive associations were identified between long-term exposure to PM2.5exposure and the incidence of T2D. An increase of 10 μg/m3PM2.5was associated with an 11.0% increase in the risk of contracting diabetes (95% confidence interval = 8.0%, 13.0%). The results show that there is an almost linear relationship between exposure to PM2.5and the incidence of T2D. Sex, age, hyperlipidemia, and National Health Insurance premium acted as effect modifiers of the association between diabetes incidence and levels of PM2.5exposure in Taiwan.

Conclusions:

In the population in Taiwan, long-term exposure to PM2.5increases the risk of incidence of T2D by 11%. This effect is more pronounced in elderly male patients who exhibit hyperlipidemia and in individuals who have a lower insurance health insurance premium.
Glomus Tumor Originating from a Digital Nerve
Authors: Shinohara Takaaki , Hirata Hitoshi
Published: June 2019

Glomus tumors are relatively rare benign neoplasms that most commonly occur in the hand. They arise from the normal glomus body, which is an arteriovenous shunt related to thermoregulation. Glomus tumors in nerves are an extremely rare occurrence, as normal glomus bodies have not been found in nerves. We describe the case of a 30-year-old woman with a glomus tumor originating from a digital nerve that required excision along with a nerve segment. In this case, because the tumor was inseparable from both fascicles of the nerve, a segment of the ulnar digital nerve was resected with the tumor. After tumor resection, direct nerve repair was performed and the patient showed favorable outcomes.