bluuebunny/crossref_metadata_2025 huggingface dataset:
OPTICAL COHERENCE TOMOGRAPHY PREDICTORS OF SHORT-TERM VISUAL ACUITY IN EYES WITH MACULAR EDEMA SECONDARY TO RETINAL VEIN OCCLUSION TREATED WITH INTRAVITREAL CONBERCEPT
Authors: Tang Fusheng , Qin Xiuhong , Lu Jianmin , Song Peng , Li Mingshu , Ma Xiang
Published: January 2019

Purpose:

To identify the spectral domain optical coherence tomography predictors of visual prognosis in retinal vein occlusion macular edema after intravitreal conbercept injection.

Methods:

Retrospective cohort study of 63 treatment-naive retinal vein occlusion macular edema eyes received pro re nata intravitreal conbercept with at least 3 months of follow-up. The best-corrected visual acuity (BCVA) and optical coherence tomography scans were recorded at baseline, 1 month, and 3 months after starting therapy. On spectral domain optical coherence tomography, the following lesions in the 1-mm-wide retinal area centered on the fovea: disorganization of the retinal inner layer extent, cysts, hyperreflective foci, microaneurysms, external limiting membrane or ellipsoid zone disruption, foveal bulge, and foveal depression were evaluated by masked graders. Regression analysis was used to determine independent predictors of BCVA at 1- and 3-month follow-up.

Results:

The thicker central subfield thickness, greater extent of external limiting membrane disruption, and presence of hyperreflective foci >20 at baseline were correlated with the worse baseline BCVA (all P < 0.05). The greater extent of external limiting membrane disruption and presence of hyperreflective foci >20 at baseline were associated with poorer BCVA during follow-up (all P < 0.05). The central subfield thickness and extent of ellipsoid zone disruption at baseline and their changes over time were correlated with the 3-month BCVA improvement (all P < 0.05). Furthermore, changes in the ellipsoid zone disruption extent or central subfield thickness after 1 month identified eyes with a high likelihood of subsequent BCVA improvement or decline.

Conclusion:

The external limiting membrane status and hyperreflective foci >20 at baseline could be good predictors for short-term visual outcome, whereas the central subfield thickness and ellipsoid zone status at baseline and their changes over time may predict visual improvement in patients with retinal vein occlusion macular edema after intravitreal conbercept injection.
Genetic pathway analysis reveals a major role for extracellular matrix organization in inflammatory and neuropathic pain
Authors: Parisien Marc , Samoshkin Alexander , Tansley Shannon N. , Piltonen Marjo H. , Martin Loren J. , El-Hachem Nehme , Dagostino Concetta , Allegri Massimo , Mogil Jeffrey S. , Khoutorsky Arkady , Diatchenko Luda
Published: January 2019

Chronic pain is a debilitating and poorly treated condition whose underlying mechanisms are poorly understood. Nerve injury and inflammation cause alterations in gene expression in tissues associated with pain processing, supporting molecular and cellular mechanisms that maintain painful states. However, it is not known whether transcriptome changes can be used to reconstruct a molecular pathophysiology of pain. In the current study, we identify molecular pathways contributing to chronic pain states through the analysis of global changes in the transcriptome of dorsal root ganglia, spinal cord, brain, and blood in mouse assays of nerve injury– and inflammation-induced pain. Comparative analyses of differentially expressed genes identified substantial similarities between 2 animal pain assays and with human low-back pain. Furthermore, the extracellular matrix (ECM) organization has been found the most commonly regulated pathway across all tested tissues in the 2 animal assays. Examination of human genome-wide association study data sets revealed an overrepresentation of differentially expressed genes within the ECM organization pathway in single nucleotide polymorphisms most strongly associated with human back pain. In summary, our comprehensive transcriptomics analysis in mouse and human identified ECM organization as a central molecular pathway in the development of chronic pain.
A Student-Led, Multifaceted Intervention to Decrease Unnecessary Folate Ordering in the Inpatient Setting
Authors: Goetz Celine , Di Capua John , Lee Irene , Mei Rena , Narula Sukrit , Zarrin Sarah , Poeran Jashvant , Cho Hyung J.
Published: January 2019

To reduce unnecessary laboratory testing, a three-phase intervention was designed by students to decrease serum folate laboratory testing in the inpatient setting. These included an educational phase, a personalized feedback phase, and the uncoupling of orders in the electronic medical record. Average monthly serum folate ordering decreased by 87% over the course of the intervention, from 98.4 orders per month at baseline to 12.7 per month in the last phase of the intervention. In the segmented regression analysis, joint ordering of folate and vitamin B12 significantly decreased during the intervention (∆slope = −4.22 tests/month, p = .0089), whereas single ordering of vitamin B12 significantly increased (∆slope = +5.6 tests/month; p < .001). Our intervention was successful in modifying ordering patterns to decrease testing for a deficiency that is rare in the U.S. population.
Elevations in High-Sensitive Cardiac Troponin T and N-Terminal Prohormone Brain Natriuretic Peptide Levels in the Serum Can Predict the Development of Anthracycline-Induced Cardiomyopathy
Authors: Bisoc Alina , Ciurescu Daniel , Rădoi Mariana , Tântu Monica M. , Rogozea Liliana , Sweidan Alexander J. , Bota Daniela A.
Published: January 2019

Background:

Anthracyclines remain the cornerstone of the treatment in many cancers including lymphomas, leukemia and sarcomas, and breast cancer. The cardiomyopathy that develops from anthracyclines can lead to heart failure and decreased survival. Multiple mechanisms are involved in the pathophysiology of anthracycline-induced heart failure.

Study Question:

We hypothesize that anthracycline-induced cardiac (AIC) pathology can be monitored using a panel of blood biomarkers including high-sensitive cardiac troponin T (hs-cTnT) for myocyte necrosis and N-terminal prohormone brain natriuretic peptide (NT-proBNP) for parietal stress.

Study Design:

A prospective, institutionally approved study recruited all patients with cancer scheduled to start anthracycline chemotherapy in the Transylvania University cancer clinics.

Measures and Outcomes:

Transthoracic 2D echocardiography and the measurements of NT-proBNP and hs-cTnT plasma levels were performed at the beginning of the study and 3 months and 6 months after anthracycline treatment initiation.

Results:

The plasma levels of hs-cTnT at 3 months (rho = 0.439, P = 0.0001) and 6 months (rho = 0.490, P = 0.0001) are correlated with AIC occurrence. For a cutoff value of hs-cTnT at 3 months > 0.008 ng/mL, we obtained 66.7% sensitivity and 67.9% specificity for developing AIC at 6 months, with a 54.5% positive predictive value and a 87.8% negative predictive value. The NT-proBNP serum levels at 3 months (rho = 0.495, P = 0.0001) and 6 months (rho = 0.638, P = 0.0001) are correlated with an AIC diagnosis at 6 months. For a cutoff value of NT-proBNP at 3 months >118.5 pg/mL, we obtained 80% sensitivity and 79.2% specificity for evolution to AIC at 6 months, with 52.2% positive predictive value and 93.3% negative predictive value.

Conclusions:

In anthracycline-treated cancer patients, the increase in plasma levels of NT-proBNP and of hs-cTnT can predict the development of anthracycline-induced cardiomyopathy. Early identification of at-risk patients will potentially allow for targeted dose reductions and will diminish the number of patients developing cardiac pathology.
Subclinical coronary atherosclerosis and cardiovascular risk stratification in heterozygous familial hypercholesterolemia patients undergoing statin treatment
Authors: Miname Marcio H. , Bittencourt Marcio S. , Nasir Khurram , Santos Raul D.
Published: January 2019

Purpose of review

To discuss the heterogeneity of atherosclerotic cardiovascular disease (ASCVD) risk in heterozygous familial hypercholesterolemia and evidence and limitations of clinical risk scores and subclinical coronary atherosclerosis (SCA) imaging to evaluate risk.

Recent findings

Risk evaluation in contemporary familial hypercholesterolemia cohorts needs to consider the cause of the familial hypercholesterolemia phenotype, for example the presence of autosomal molecular defects that impart a greater ASCVD risk than in polygenic hypercholesterolemia, prospective follow-up and the impact of statin treatment. As atherosclerosis is multifactorial, clinical scores like the Montreal familial hypercholesterolemia score and SAFEHEART risk equation have been proposed to stratify ASCVD in statin-treated, molecularly defined familial hypercholesterolemia individuals. However, these scores need further validation. SCA distribution in familial hypercholesterolemia individuals undergoing conventional lipid-lowering treatment is heterogeneous, with 45–50% of individuals not presenting any coronary artery calcification (CAC). One study suggests that the absence of CAC associates with no ASCVD events in asymptomatic familial hypercholesterolemia individuals undergoing statin therapy despite elevated residual LDL-cholesterol levels. In contrast, the presence of CAC was independently associated with ASCVD events.

ASCVD risk is heterogeneous in statin-treated familial hypercholesterolemia individuals. Further studies are necessary to determine how risk stratification, especially with SCA detection, impacts on prescription of proprotein convertase subtilisin kexin type 9 inhibitors within a cost-constrained environment.
Cost-Effectiveness of Accelerated HIV Response Scenarios in Côte d'Ivoire
Authors: Maheu-Giroux Mathieu , Diabaté Souleymane , Boily Marie-Claude , Jean-Paul Nedjéda , Vesga Juan F. , Baral Stefan , Abo Kouamé , Wognin Venance , Diouf Daouda , Alary Michel
Published: January 2019

Background:

Despite Côte d'Ivoire epidemic being labeled as “generalized,” key populations (KPs) are important to overall transmission. Using a dynamic model of HIV transmission, we previously estimated the impact of several treatment-as-prevention strategies that reached—or missed—the UNAIDS 90-90-90 targets in different populations groups, including KP and clients of female sex workers (CFSWs). To inform program planning and resources allocation, we assessed the cost-effectiveness of these scenarios.

Methods:

Costing was performed from the provider's perspective. Unit costs were obtained from the Ivorian Programme national de lutte contre le Sida (USD 2015) and discounted at 3%. Net incremental cost-effectiveness ratios (ICER) per adult HIV infection prevented and per disability-adjusted life-years (DALY) averted were estimated over 2015–2030.

Results:

The 3 most cost-effective and affordable scenarios were the ones that projected current programmatic trends [ICER = $210; 90% uncertainty interval (90% UI): $150–$300], attaining the 90-90-90 objectives among KP and CFSW (ICER = $220; 90% UI: $80–$510), and among KP only (ICER = $290; 90% UI: $90–$660). The least cost-effective scenario was the one that reached the UNAIDS 90-90-90 target accompanied by a 25% point drop in condom use in KP (ICER = $710; 90% UI: $450–$1270). In comparison, the UNAIDS scenario had a net ICER of $570 (90% UI: $390–$900) per DALY averted.

Conclusions:

According to commonly used thresholds, accelerating the HIV response can be considered very cost-effective for all scenarios. However, when balancing epidemiological impact, cost-effectiveness, and affordability, scenarios that sustain both high condom use and rates of viral suppression among KP and CFSW seem most promising in Côte d'Ivoire.
Drivers of HIV Infection Among Cisgender and Transgender Female Sex Worker Populations in Baltimore City: Results From the SAPPHIRE Study
Authors: Sherman Susan G. , Park Ju Nyeong , Galai Noya , Allen Sean T. , Huettner Steve S. , Silberzahn Bradley E. , Decker Michele R. , Poteat Tonia C. , Footer Katherine H.A.
Published: January 2019

Objective:

To determine and compare risk factors for HIV infection among cisgender female sex workers (CFSWs) and transgender female sex workers (TFSWs).

Design:

Baseline data from a cohort study (SAPPHIRE) of street-based CFSW and TFSW in Baltimore, MD.

Methods:

Women were queried about individual (eg, drug use), interpersonal (eg, sexual abuse), and structural (eg, housing) risk factors and questioned on their sex work risk environment. Women were tested for HIV/sexually transmitted infections. We used logistic regression to identify key risk factors for prevalent HIV in each population.

Results:

We recruited 262 CFSW and 62 TFSW between 2016 and 2017. Compared with TFSW, CFSW were more likely to be white (66% vs. 0%), recently homeless (62% vs. 23%, P < 0.001), regularly gone to sleep hungry (54% vs. 16%, P < 0.001), and to inject drugs (71% vs. 4%, P < 0.001). HIV prevalence was 8 times greater in TFSW than in CFSW (40% vs. 5%, P < 0.001). All participants reported high rates of lifetime physical and sexual violence. Cocaine injection [adjusted odds ratio (aOR) = 3.65, 95% confidence interval (CI): 1.12 to 11.88], food insecurity (aOR = 1.92, 95% CI: 1.22 to 3.04), and >5 years in sex work (aOR = 5.40, 95% CI: 2.10 to 13.90) were independently associated with HIV among CFSW. Childhood sexual abuse (aOR = 4.56, 95% CI: 1.20 to 17.32), being in sex work due to lack of opportunities (aOR = 4.81, 95% CI: 1.29 to 17.90), and >5 years in sex work (aOR = 5.62, 95% CI: 1.44 to 21.85) were independently associated with HIV among TFSW.

Conclusions:

Although distinct, both populations share a history of extensive childhood abuse and later life structural vulnerability, which drive their engagement in street-based sex work and their HIV risk profiles.
New antibiotics for community-acquired pneumonia
Authors: Kollef Marin H. , Betthauser Kevin D.
Published: January 2019

Purpose of review

This review provides the rationale for the development of new antibiotics to treat community-acquired pneumonia (CAP). It also provides an overview of the new antibiotics targeting CAP that have recently received approval by the regulatory agencies, and those antibiotics that are in the development pipeline.

Recent findings

CAP is one of the most common reasons for hospitalization and carries a significant morbidity and risk of mortality. Increasing antibiotic resistance amongst the common bacterial pathogens associated with CAP, especially staphylococci and Streptococcus pneumoniae, has made the empiric treatment of this infection increasingly problematic. Moreover, failure of initial empiric therapy to cover the causative agents associated with CAP can be associated with worse clinical outcomes. There have been several antibiotics newly approved or in development for the treatment of CAP. These agents include delafloxacin, omadacycline, lefamulin, solithromycin, nemonoxacin, and ceftaroline. Their major advantages include activity against methicillin-resistant Staphylococcus aureus and macrolide-resistant Strep. pneumoniae.

CAP continues to be an important infection because of its impact on patient outcomes especially in the elderly and immunocompromised hosts. The availability of new antibiotics offers an opportunity for enhanced empiric treatment of the antibiotic-resistant bacterial pathogens associated with CAP.
Understanding Symptoms of Muscle Tightness, Weakness, and Rigidity From a Nursing Perspective
Authors: Bhimani Rozina H. , Soomar Daanish
Published: January 2019

Purpose

This study examined the nature of muscle tightness from nurses' perspectives and explored how the symptoms of muscle tightness are communicated, managed, and differentiated from other conditions, such as muscle rigidity and muscle weakness.

Design

An exploratory, descriptive qualitative design was used.

Methods

Eight rehabilitation nurses described lexicons, care strategies, and communication for muscle tightness, weakness, and rigidity.

Findings

Nurses used conflicting terms to describe muscle tightness, weakness, and rigidity. They identified medications and range of motion as the best strategies to manage muscle conditions. Nurses approach care holistically and do not differentiate care strategies that are based only on a symptoms lens.

Conclusions

Nurses were unable to clearly differentiate between muscle tightness and rigidity.

Clinical Relevance

Nurses influence patients' choice of vocabulary; therefore, they must use simple but precise terminologies to educate their patients. Miscommunication between nurses and patients can lead to errors, which can have negative consequences.
The Impact of Resident Postgraduate Year Involvement in Body-Contouring and Breast Reduction Procedures
Authors: Malyar Masoud , Peymani Abbas , Johnson Anna Rose , Chen Austin D. , Van Der Hulst René R. W. J. , Lin Samuel J.
Published: January 2019

Background

Given the rising popularity in body-contouring procedures (BCPs) in the United States, it is important to assess the currently unknown association between resident involvement and postoperative complications. As such, the aim of this study was to evaluate the impact of resident involvement on outcomes in BCPs using a large national database.

Methods

A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database was performed (2006–2012) to identify patients undergoing BCPs, using relevant Current Procedural Terminology codes. Outcome measures included postoperative complications, hospital length of stay, and operation time.

Multivariate regression models were used to assess the impact of resident involvement and resident experience on outcomes.

Results

A total of 9638 cases were identified, of which 3311 involved resident participation.

Resident involvement was associated with significantly higher rates of complications (7.8% vs 4.4%; P = 0.003) and longer operation times (180.7 vs 171.9 minutes; P = 0.005). For each year increase of resident postgraduate year, there was a significant decrease in odds of complications (odds ratio, 0.906; P = 0.013) and operative time (−2.7 minutes; P = 0.001).

Conclusions

Resident involvement in BCPs was associated with an increased rate of overall complications in a large, national database. However, the clinical significance of these outcomes may be debated. Increased postgraduate year experience as a surgical resident was inversely associated with overall complications. Guided resident autonomy and earlier exposure to BCPs could lead to an optimization of clinical outcomes and resident education.
Repair of Sacral and Ischial Region Defects With Lateral Sacral Artery Perforator Flaps
Authors: Durgun Mustafa , Bas Soysal
Published: January 2019

Background

Reconstructive choices for the defects of the sacral and ischial regions include various steps of the reconstructive ladder from primary closure to free flaps. This study aimed to present repair of sacral and ischial region defects with lateral sacral artery perforator (LSAP) flaps.

Methods

We enrolled a total of 18 patients with sacral and ischial region defects reconstructed with LSAP flaps in the study between September 2014 and October 2015. The patients were evaluated in terms of age, sex, neurological situation, etiology, defect size, defect region, flap size, perforator number, and postoperative complications.

Results

No patient had hematoma, seroma, and complications of the donor area. In the postoperative period, 2 patients were observed to have short-term complications (11.1%) including a partial flap loss (5.5%) due to distal venous failure (flap survival rate, 95%) and a wound site infection (5.5%). Duration of follow-up of the patients ranged between 26 and 38 months. Recurrence was observed from long-term complications of 4 patients' pressure sores (22%).

Conclusions

The LSAP flap has not been frequently described in the literature. We believe that LSAP flap is a flap of choice that should be considered preferably for sacral and ischial defects, which can be reliably elevated over pedicles and has short surgery duration and low surgical morbidity.
Autologous Breast Reconstruction With a Delay Procedure of the Deep Inferior Epigastric Artery Perforator Flap Because of Venous Congestion of the Flap on Pedicle
Authors: Hillberg Nadine S. , van Mulken Tom J. M. , Meesters-Caberg Marleen A. J. , Piatkowski Andrzej , Keuter Xavier A. H. , Hommes Juliette , van der Hulst René R. W.
Published: January 2019

The deep inferior epigastric artery perforator (DIEP) flap is one of the most used free flaps for the reconstruction of the breast after a mastectomy. Despite careful selection of the patients and preoperative imaging, difficulties in vascularization of the flap can occur in some cases. Although multiple vascular connections (bipedicled, turbocharged, or stacked) can be made in selected cases, there can still be venous congestion before the flap is transferred.

Between 2016 and 2018, 4 cases in our series of 281 patients experienced such problems. Three of 4 patients had undergone preoperative imaging of the perforators by a magnetic resonance angiography or computed tomography angiography, in which a good perforator was seen. All 4 patients had a venous problem of blood circulation in the flap intraoperatively. The flaps were left to rest to decide on its venous status. Without improvement after this period of 20 to 30 minutes, the surgeons decided to withhold the translocation of the flap to the chest wall and sutured the flap back into the donor side. The final anastomosis of the DIEP flap occurred on average 8 days after the prefabrication. The translocation of the DIEP flap to the chest in this second operation went uncomplicated in all cases. Postoperatively, all patients had adequate arterial inflow and venous outflow of the flap. There were no postoperative complications.

In case a DIEP flap shows venous problems before translocation, a delay procedure can be applied. In this way, the vascularization of the flap can be improved, and the translocation of the DIEP flap in a second operation can be successfully performed.
Graciloplasty for Anal Incontinence—Is Electrical Stimulation Necessary?
Authors: Gohil Amish Jayantilal , Gupta Ashish Kumar , Jesudason Mark Ranjan , Nayak Sukria
Published: January 2019

Introduction

Anal incontinence brings lot of social embarrassment, mental distress, dignity loss, anxiety, low confidence, and eventually a low self-esteem with a restricted social life to the affected person. Surgical repair is the mainstay of treatment for anal incontinence. However, some patients need additional procedures such as gluteoplasty, graciloplasty (adynamic and dynamic), artificial bowel sphincter, and sacral nerve stimulation, which help to reinforce or augment the anal sphincter.

Methods

A retrospective analysis of 17 patients who underwent adynamic graciloplasty for reconstruction of anal sphincter from January 2008 to December 2017 was done. Demographic profile, fecal incontinence scores (Wexner score and KAMM score), and anal manometric findings were recorded pregraciloplasty and postgraciloplasty.

Results

Of the total 17 patients, 9 were males and 8 were females. Satisfactory continence was achieved in 13 patients out of 17 (76.47%). Continence was defined as satisfactory for patients having a postoperative Wexner score of 2 or less and KAMM score of 4 or less. It was considered to be poor if the Wexner score was greater than 6 and KAMM score was greater than 8 in the follow-up period or if the stoma was not reversed.

Conclusions

Unstimulated or adynamic graciloplasty is a relatively safe procedure, has a short learning curve, is affordable, and avoids the additional implant-related complications. We feel that the unstimulated graciloplasty still has a significant role in the management of anal incontinence.
Gluteal Flaps Revisited
Authors: Myers Paige L. , Krasniak Peter J. , Day Serena J. , Bossert Ronald P.
Published: January 2019

Background

Abdominoperineal resection is the treatment for many anorectal malignancies. The laparotomy approach allows for harvest of the rectus abdominis muscle for perineal reconstruction. However, with increasing numbers of robotic abdominoperineal resections being performed, the morbidity associated with a laparotomy incision is avoided. We describe a modification of the previous technique of advancing bilateral fasciocutaneous gluteal flaps into the pelvic cavity for reconstruction. This operation is performed expeditiously in the prone position. The patient is spared a large anterior deficit but reaps the benefits of a robust reconstruction with minimal morbidity.

Methods

A retrospective chart review was performed from July 2012 to February 2018 of our institution's electronic record database. All patients who underwent modified V-Y gluteal fasciocutaneous flaps for perineal defects were included. Patient demographics, comorbidities, and adjunctive therapies as well as outcomes and complications were analyzed.

Results

A total of 31 patients (51 flaps) were identified with 100% flap survival. The total number of patients with minor complications was 42%, consisting of 4 surgical site infections (13%), 13 cases of dehiscence (42%), and 2 cases requiring return to the operating room for abscess drainage (6%). Importantly, dehiscence was defined as any wound separation, regardless of size, with an average of only 3.8 cm2. All healed with conservative management. After foregoing bolstering with synthetic mesh, the complication rate decreased from 67% to 37% (odds ratio, 3.4; P = 0.11).

Conclusions

This modified technique of bilateral fasciocutaneous gluteal V-Y advancement flaps for perineal wound control is a safe and effective method of reconstructing defects.
The Effect of Chyle Fat Injection on Human Hypertrophic Scars in an Animal Model
Authors: Chen Junnan , Lai Linying , Ma Kui , Xu Xiao , Huang Zhenya , Zhou Guiwen , Zhou Yunchao , Liang Liming , Chen Minliang
Published: January 2019

Background

Chyle fat transplantation has shown positive effects on preexisting human hypertrophic scars (HSs) in a nude mouse HS graft model.

Methods

Hypertrophic scar fragments were obtained from 5 surgically treated burn patients and implanted into the backs of nude mice in 3 groups: group A, control; group B, triamcinolone; and group C, chyle fat. The specimens were implanted after the corresponding intralesional injection in each group, and the mice were observed for 4 weeks. In total, 18 mice and 72 scar specimens were studied. After 4 weeks, the HSs were removed from the mice. Then, the scar weights, histology, and decorin staining were assessed to evaluate the therapeutic efficacy.

Results

An obviously significant difference was observed in the HS weight reduction between groups A and C (P < 0.01), and a significant difference in the HS weight reduction was observed between groups A and B (P < 0.05). However, there was no significant difference between groups B and C. The treatment groups (groups B and C) showed strong decorin staining. Furthermore, the decorin staining was much stronger in group C than in group B (P < 0.05). Significant differences in extracellular matrix deposition were observed among the 3 groups, as determined by Masson trichrome staining. Both groups B and C showed significant therapeutic efficacy compared with group A, and group C exhibited a significant therapeutic effect compared with group B (P < 0.05).

Conclusions

This study indicates that chyle fat grafting is beneficial for treating HSs.
EEG in WNV Neuroinvasive Disease
Authors: Parsons Angela M. , Grill Marie F. , Feyissa Anteneh M. , Britton Jeffrey , Hocker Sara , Crepeau Amy
Published: January 2019

Purpose:

Neuroinvasive West Nile virus (WNV) is rare, occurring in less than 1% of those infected, and may manifest as meningitis, encephalitis, and/or acute flaccid paralysis. Patients may present initially with nonspecific symptoms including fevers. Although rare, neuroinvasive WNV is associated with significant morbidity and mortality. The mainstay of treatment is supportive care. Electroencephalography (EEG) allows for identification of nonconvulsive status epilepticus and other epileptiform and nonepileptiform patterns suggestive of underlying cognitive dysfunction. Our aim was to describe specific EEG patterns observed in WNV neuroinvasive disease.

Methods:

A retrospective chart review was conducted. West Nile virus was confirmed with serum and/or cerebrospinal fluid markers. Patients with a history of abnormal EEG were excluded. Electroencephalography reports were classified into categories based on the presence of epileptiform activity, focal slowing, generalized periodic discharges with triphasic morphology, and frontally predominant generalized rhythmic delta activity.

Results:

In our cohort of 34 patients, 60% of focal EEG abnormalities were anterior-predominant, seen as epileptiform discharges, focal slowing, or frontally predominant generalized rhythmic delta activity. Nonepileptiform EEG patterns included nonspecific slowing and generalized periodic discharges with triphasic morphology. Two patients had electrographic seizures, one arising from the frontocentral head region.

Conclusions:

EEGs are important in the evaluation of WNV infection to rule out seizures or alternative causes of encephalopathy, and because of the risk of nonconvulsive seizures or status epilepticus in encephalitis. Although an anterior predominance of EEG abnormalities was seen in our cohort, this most likely is more correlative to encephalopathy than WNV itself. Although a specific correlative EEG pattern may not accompany all cases of WNV neuroinvasive disease, WNV should be considered as a possible etiology in patients presenting with an encephalitic or meningitic syndrome in the presence of abnormal EEG findings including encephalopathic patterns, particularly those with anterior predominant EEG changes.
Gametophyte niche differences among sympatric tree ferns
Authors: Brock James M. R. , Burns Bruce R. , Perry George L. W. , Lee William G.
Published: January 2019

Forest community assembly is usually framed in terms of sporophyte dynamics; however, the recruitment and maintenance of fern populations, frequently influential in forest composition and structure, are initially determined by gametophytes. Sporophytes of three
Cyathea
tree fern species show habitat partitioning along gradients of phosphorus and light; we asked whether gametophyte niche differences parallel this pattern. To compare niche characteristics among taxa we compared growth rates to a size threshold (≥3 mm) of gametophytes under controlled conditions using a multi-factorial, multi-level (3 × 4) experiment, varying irradiance (5.4 ± 4.4; 59.1 ± 44.3; 107 ± 74.1 µmol m
−2
s
−1
) and orthophosphate concentrations (5, 10, 20, 40 mg kg
−1
). Gametophytes of the pioneer species
C. medullaris
developed to the size threshold across a broad range of phosphate and irradiance treatments (more than 20% of gametophytes in ≥ 7 of the 12 treatments), peaking at 20 mg kg
−1
P and 60 µmol m
−2
s
−1
irradiance. The growth rates of the forest understorey species
C. dealbata
and
C. smithii
also peaked at 60 µmol m
−2
s
−1
but varied across treatments, suggesting niche differentiation along irradiance and orthophosphate gradients. Our analysis suggests that gametophyte development is strategically aligned to the ecological habits of sporophytes and that forest community assembly is likely strongly influenced by the independent gametophyte life-stage.
The revolution of crossdating in marine palaeoecology and palaeoclimatology
Authors: Black Bryan A. , Andersson Carin , Butler Paul G. , Carroll Michael L. , DeLong Kristine L. , Reynolds David J. , Schöne Bernd R. , Scourse James , van der Sleen Peter , Wanamaker Alan D. , Witbaard Rob
Published: January 2019

Over the past century, the dendrochronology technique of crossdating has been widely used to generate a global network of tree-ring chronologies that serves as a leading indicator of environmental variability and change. Only recently, however, has this same approach been applied to growth increments in calcified structures of bivalves, fish and corals in the world's oceans. As in trees, these crossdated marine chronologies are well replicated, annually resolved and absolutely dated, providing uninterrupted multi-decadal to millennial histories of ocean palaeoclimatic and palaeoecological processes. Moreover, they span an extensive geographical range, multiple trophic levels, habitats and functional types, and can be readily integrated with observational physical or biological records. Increment width is the most commonly measured parameter and reflects growth or productivity, though isotopic and elemental composition capture complementary aspects of environmental variability. As such, crossdated marine chronologies constitute powerful observational templates to establish climate–biology relationships, test hypotheses of ecosystem functioning, conduct multi-proxy reconstructions, provide constraints for numerical climate models, and evaluate the precise timing and nature of ocean–atmosphere interactions. These ‘present–past–future’ perspectives provide new insights into the mechanisms and feedbacks between the atmosphere and marine systems while providing indicators relevant to ecosystem-based approaches of fisheries management.
Measures of oxidative state are primarily driven by extrinsic factors in a long-distance migrant
Authors: Bodey Thomas W. , Cleasby Ian R. , Blount Jonathan D. , Vigfusdottir Freydis , Mackie Kerry , Bearhop Stuart
Published: January 2019

Oxidative stress is a likely consequence of hard physical exertion and thus a potential mediator of life-history trade-offs in migratory animals. However, little is known about the relative importance of intrinsic and extrinsic stressors on the oxidative state of individuals in wild populations. We quantified the relationships between air temperature, sex, body condition and three markers of oxidative state (malondialdehyde, superoxide dismutase and total antioxidant capacity) across hundreds of individuals of a long-distance migrant (the brent goose
Branta bernicla hrota
) during wintering and spring staging. We found that air temperature and migratory stage were the strongest predictors of oxidative state. This emphasizes the importance of extrinsic factors in regulating the oxidative state of migrating birds, with differential effects across the migration. The significance of abiotic effects demonstrates an additional mechanism by which changing climates may affect migratory costs.
Estimation in emerging epidemics: biases and remedies
Authors: Britton Tom , Scalia Tomba Gianpaolo
Published: January 2019

When analysing new emerging infectious disease outbreaks, one typically has observational data over a limited period of time and several parameters to estimate, such as growth rate, the basic reproduction numberR0, the case fatality rate and distributions of serial intervals, generation times, latency and incubation times and times between onset of symptoms, notification, death and recovery/discharge. These parameters form the basis for predicting a future outbreak, planning preventive measures and monitoring the progress of the disease outbreak. We study inference problems during the emerging phase of an outbreak, and point out potential sources of bias, with emphasis on: contact tracing backwards in time, replacing generation times by serial intervals, multiple potential infectors and censoring effects amplified by exponential growth. These biases directly affect the estimation of, for example, the generation time distribution and the case fatality rate, but can then propagate to other estimates such asR0and growth rate. We propose methods to remove or at least reduce bias using statistical modelling. We illustrate the theory by numerical examples and simulations.
Probabilistic analytical modelling of predator–prey interactions in fishes
Authors: Free Brian A. , McHenry Matthew J. , Paley Derek A.
Published: January 2019

Predation is a fundamental interaction between species, yet it is largely unclear what tactics are successful for the survival or capture of prey. One challenge in this area comes with how to test theoretical ideas about strategy with experimental measurements of features such as speed, flush distance and escape angles. Tactics may be articulated with an analytical model that predicts the motion of predator or prey as they interact. However, it may be difficult to recognize how the predictions of such models relate to behavioural measurements that are inherently variable. Here, we present an alternative approach for modelling predator–prey interactions that uses deterministic dynamics, yet incorporates experimental kinematic measurements of natural variation to predict the outcome of biological events. This technique, called probabilistic analytical modelling (PAM), is illustrated by the interactions between predator and prey fish in two case studies that draw on recent experiments. In the first case, we use PAM to model the tactics of predatory bluefish (Pomatomus saltatrix) as they prey upon smaller fish (Fundulus heteroclitus). We find that bluefish perform deviated pure pursuit with a variable pursuit angle that is suboptimal for the time to capture. In the second case, we model the escape tactics of zebrafish larvae (Danio rerio) when approached by adult predators of the same species. Our model successfully predicts the measured patterns of survivorship using measured probability density functions as parameters. As these results demonstrate, PAM is a data-driven modelling approach that can be predictive, offers analytical transparency, and does not require numerical simulations of system dynamics. Though predator–prey interactions demonstrate the use of this technique, PAM is not limited to studying biological systems and has broad utility that may be applied towards understanding a wide variety of natural and engineered dynamical systems where data-driven modelling is beneficial.
The diverse small proteins called odorant-binding proteins
Authors: Sun Jennifer S. , Xiao Shuke , Carlson John R.
Published: January 2019

The term ‘odorant-binding proteins (Obps)’ is used to refer to a large family of insect proteins that are exceptional in their number, abundance and diversity. The name derives from the expression of many family members in the olfactory system of insects and their ability to bind odorants
in vitro.
However, an increasing body of evidence reveals a much broader role for this family of proteins. Recent results also provoke interesting questions about their mechanisms of action, both within and outside the olfactory system. Here we describe the identification of the first Obps and some cardinal properties of these proteins. We then consider their function, discussing both the prevailing orthodoxy and the increasing grounds for heterodox views. We then examine these proteins from a broader perspective and consider some intriguing questions in need of answers.
Trace fossils associated with Burgess Shale non-biomineralized carapaces: bringing taphonomic and ecological controls into focus
Authors: Mángano M. Gabriela , Hawkes Christopher David , Caron Jean-Bernard
Published: January 2019

The association of trace fossils and non-biomineralized carapaces has been reported from Cambrian Lagerstätten worldwide, but the abundance, ichnodiversity, taphonomy and ecological significance of such associations have yet to be fully investigated. Two main end-member hypotheses are explored based on the study of a relatively wide variety of trace fossils preserved associated to
Tuzoia
carapaces from the middle Cambrian Burgess Shale in British Columbia. In the ecological
Tuzoia
garden hypothesis, the bacterially enriched surface of carapaces provides opportunities for intricate ecologic interactions among trophic levels. In the taphonomic shielding hypothesis, the trace fossil–carapace association results from preferential preservation of traces as controlled by compaction independent of any association in life. In an attempt to better understand the role of the carapace as a medium for preservation of trace fossils and to evaluate the effects of mechanical stress related to burial, a numerical model was developed. Results indicate that the carapace can shield underlying sediment from mechanical stress for a finite time, differentially protecting trace fossils during the initial phase of burial and compaction. However, this taphonomic model alone fails to fully explain relatively high-density assemblages displaying a diversity of structures spatially confined within the perimeter of carapaces or branching patterns recording re-visitation.
A continuous model of physiological prion aggregation suggests a role for Orb2 in gating long-term synaptic information
Authors: Sanguanini Michele , Cattaneo Antonino
Published: January 2019

The regulation of mRNA translation at the level of the synapse is believed to be fundamental in memory and learning at the cellular level. The family of cytoplasmic polyadenylation element binding (CPEB) proteins emerged as an important RNA-binding protein family during development and in adult neurons.DrosophilaOrb2 (homologue of mouse CPEB3 protein and of the neural isoform ofAplysiaCPEB) has been found to be involved in the translation of plasticity-dependent mRNAs and has been associated with long-term memory. Orb2 protein presents two main isoforms, Orb2A and Orb2B, which form an activity-induced amyloid-like functional aggregate, thought to be the translation-inducing state of the RNA-binding protein. Here we present a first two-states continuous differential model for Orb2A–Orb2B aggregation. This model provides new working hypotheses for studying the role of prion-like CPEB proteins in long-term synaptic plasticity. Moreover, this model can be used as a first step to integrate translation- and protein aggregation-dependent phenomena in synaptic facilitation rules.
Remarkable problem-solving ability of unicellular amoeboid organism and its mechanism
Authors: Zhu Liping , Kim Song-Ju , Hara Masahiko , Aono Masashi
Published: January 2019

Choosing a better move correctly and quickly is a fundamental skill of living organisms that corresponds to solving a computationally demanding problem. A unicellular plasmodium ofPhysarum polycephalumsearches for a solution to the travelling salesman problem (TSP) by changing its shape to minimize the risk of being exposed to aversive light stimuli. In our previous studies, we reported the results on the eight-city TSP solution. In this study, we show that the time taken by plasmodium to find a reasonably high-quality TSP solution grows linearly as the problem size increases from four to eight. Interestingly, the quality of the solution does not degrade despite the explosive expansion of the search space. Formulating a computational model, we show that the linear-time solution can be achieved if the intrinsic dynamics could allocate intracellular resources to grow the plasmodium terminals with a constant rate, even while responding to the stimuli. These results may lead to the development of novel analogue computers enabling approximate solutions of complex optimization problems in linear time.
Does truth matter to voters? The effects of correcting political misinformation in an Australian sample
Authors: Aird Michael J. , Ecker Ullrich K. H. , Swire Briony , Berinsky Adam J. , Lewandowsky Stephan
Published: January 2019

In the ‘post-truth era’, political fact-checking has become an issue of considerable significance. A recent study in the context of the 2016 US election found that fact-checks of statements by Donald Trump changed participants' beliefs about those statements—regardless of whether participants supported Trump—but not their feelings towards Trump or voting intentions. However, the study balanced corrections of inaccurate statements with an equal number of affirmations of accurate statements. Therefore, the null effect of fact-checks on participants’ voting intentions and feelings may have arisen because of this artificially created balance. Moreover, Trump's statements were not contrasted with statements from an opposing politician, and Trump's perceived veracity was not measured. The present study (N= 370) examined the issue further, manipulating the ratio of corrections to affirmations, and using Australian politicians (and Australian participants) from both sides of the political spectrum. We hypothesized that fact-checks would correct beliefs and that fact-checks would affect voters’ support (i.e. voting intentions, feelings and perceptions of veracity), but only when corrections outnumbered affirmations. Both hypotheses were supported, suggesting that a politician's veracity does sometimes matter to voters. The effects of fact-checking were similar on both sides of the political spectrum, suggesting little motivated reasoning in the processing of fact-checks.
A yeast metabolome-based model for an ecotoxicological approach in the management of lignocellulosic ethanol stillage
Authors: Roscini Luca , Favaro Lorenzo , Corte Laura , Cagnin Lorenzo , Colabella Claudia , Basaglia Marina , Cardinali Gianluigi , Casella Sergio
Published: January 2019

Lignocellulosic bioethanol production results in huge amounts of stillage, a potentially polluting by-product. Stillage, rich in heavy metals and, mainly, inhibitors, requires specific toxicity studies to be adequately managed. To this purpose, we applied an FTIR ecotoxicological bioassay to evaluate the toxicity of lignocellulosic stillage. Two weak acids and furans, most frequently found in lignocellulosic stillage, have been tested in different mixtures against three
Saccharomyces cerevisiae
strains. The metabolomic reaction of the test microbes and the mortality induced at various levels of inhibitor concentration showed that the strains are representative of three different types of response. Furthermore, the relationship between concentrations and FTIR synthetic stress indexes has been studied, with the aim of defining a model able to predict the concentrations of inhibitors in stillage, resulting in an optimized predictive model for all the strains. This approach represents a promising tool to support the ecotoxicological management of lignocellulosic stillage.
Production of bioadsorbent from phosphoric acid pretreated palm kernel shell and coconut shell by two-stage continuous physical activation via N
2
and air
Authors: Lee Chuan Li , H'ng Paik San , Paridah Md Tahir , Chin Kit Ling , Rashid Umer , Maminski Mariusz , Go Wen Ze , Nazrin Raja Ahamd Raja , Rosli Siti Nurul Asyikin , Khoo Pui San
Published: January 2019

In the present study, agricultural biomass—palm kernel shell (PKS) and coconut shell (CS)—was used to produce high porosity bioadsorbent using two-stage continuous physical activation method with different gas carrier (air and N
2
) in each stage. The activation temperature was set constant at 600, 700, 800 or 900°C for both activation stages with the heating rate of 3°C min
−1
. Two parameters, the gas carrier and activation temperature, were determined as the significant factors on the adsorption properties of bioadsorbent. BET, SEM, FTIR, TGA, CHNS/O and ash content were used to elucidate the developed bioadsorbent prepared from PKS and CS and its capacity towards the adsorption of methylene blue and iodine. The novel process of two-stage continuous physical activation method was able to expose mesopores and micropores that were previously covered/clogged in nature, and simultaneously create new pores. The synthesized bioadsorbents showed that the surface area (PKS: 456.47 m
2
g
−1
, CS: 479.17 m
2
g
−1
), pore size (PKS: 0.63 nm, CS: 0.62 nm) and pore volume (PKS: 0.13 cm
3
g
−1
, CS: 0.15 cm
3
g
−1
) were significantly higher than that of non-treated bioadsorbent. The surface morphology of the raw materials and synthesized bioadsorbent were accessed by SEM. Furthermore, the novel process meets the recent industrial adsorbent requirements such as low activation temperature, high fixed carbon content, high yield, high adsorption properties and high surface area, which are the key factors for large-scale production of bioadsorbent and its usage.