bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Silicone Hydrogel and Hydrogel Daily Disposable Contact Lenses
Authors: Diec Jennie , Tilia Daniel , Thomas Varghese
Published: January 2017

Objective:

To compare subjective, objective and safety performance of silicone hydrogel (SiHy) daily disposable (DD) with hydrogel (Hy) DD contact lenses.

Method:

Retrospective analysis on approximately 40 participants (Px) each in 5 trials. Lenses grouped into SiHy (delefilcon A, somofilcon A, narafilcon A) and Hy (omafilcon A, nelfilcon A). Participants attended follow-up visits at baseline, 2 weeks, 1 and 3 months. Subjective ratings (1–10 scale), adverse events (percentage of Px), physiological variables (0–4 scale), and wearing time were collected at each visit and compared between groups.

Result:

Trials enrolled 201 Px totally. No differences in age, sex, and lens wear experience were found between SiHy and Hy groups (P≥0.09). There was greater increase in limbal redness from baseline in Hy group (0.18±0.38 vs. 0.02±0.47, P<0.001), whereas conjunctival staining and indentation were less in Hy group (P<0.001). No differences in comfortable wearing time were found between groups (P=0.41), and comfort at insertion, during day, and end of day was also no different (P≥0.71). Incidence of corneal infiltrative events (SiHy vs. Hy: 6.7% vs. 2.5%; P=0.32) and mechanical adverse events (SiHy vs. Hy: 0.0% vs. 0.0%; P=1.00) were no different.

Conclusion:

Though some statistical significance was found between the groups, these differences were within measurement error. Neither material types showed superiority in comfort, and adverse event rates were low with both material types. These findings suggest that choice of material is a patient and practitioner preference; however, for patients at risk of hypoxia-related complications, SiHy materials should be considered.
Traditional Sternotomy versus Minimally Invasive Aortic Valve Replacement in Patients Stratified by Ejection Fraction
Authors: Nguyen Tom C. , Thourani Vinod H. , Pham Justin Q. , Zhao Yelin , Terwelp Matthew D. , Balan Prakash , Ocazionez Daniel , Loghin Catalin , Smalling Richard W. , Estrera Anthony L. , Lamelas Joseph
Published: January 2017

Objective

Low ejection fraction (EF < 40%) portends adverse outcomes in patients undergoing valvular heart surgery. The role of traditional median sternotomy aortic valve replacement (SAVR) compared with minimally invasive aortic valve replacement (MIAVR) in this cohort remains incompletely understood.

Methods

A multi-institutional retrospective review of 1503 patients who underwent SAVR (n = 815) and MIAVR via right anterior thoracotomy (n = 688) from 2011 to 2014 was performed. Patients were stratified into two groups: EF of less than 40% and EF of 40% or more. In each EF group, SAVR and MIAVR patients were propensity matched by age, sex, body mass index, race, diabetes, hypertension, dyslipidemia, dialysis, cerebrovascular disease, cardiovascular disease, cerebro-vascular accident, peripheral vascular disease, last creatinine level, EF, previous MI and cardiogenic shock, and the Society for Thoracic Surgeons (STS) score.

Results

Among patients with an EF of 40% or more (377 pairs), patients who underwent MIAVR compared with SAVR had decreased intensive care unit hours (56.8% vs 84.6%, P < 0.001), postoperative length of stay (7.1 vs 7.9 days, P = 0.04), incidence of atrial fibrillation (18.8% vs 38.7%, P < 0.001), bleeding (0.8% vs 3.2%, P = 0.04), and a trend toward decreased 30-day mortality (0.3% vs 1.3%, P = 0.22). The STS scores were largely equivalent in patients undergoing MIAVR compared with SAVR (2.4% vs 2.6%, P = 0.09). In patients with an EF of less than 40% (35 pairs), there was no difference in intensive care unit hours (69% vs 72.6%, P = 0.80), postoperative length of stay (10.3 vs 7.2 days, P = 0.13), 30-day mortality (3.8% vs 0.8%, P = 0.50), or the STS score (3.3% vs 3.2%, P = 0.68).

Conclusions

Minimally invasive aortic valve replacement in patients with preserved EF was associated with improved short-term outcomes compared with SAVR. In patients with left ventricular dysfunction, short-term outcomes between MIAVR and SAVR are largely equivalent.
Breast Milk Is a Potential Vehicle for Human Papillomavirus Transmission to Oral Mucosa of the Spouse
Authors: Louvanto Karolina , Sarkola Marja , Rintala Marjut , Syrjänen Kari , Grenman Seija , Syrjänen Stina
Published: January 2017

Background:

Human papillomavirus (HPV) DNA has been detected in breast milk, but its origin has remained obscure. The aim of the study was to analyze the prevalence and persistence of HPV in breast milk in the Finnish Family HPV cohort study. The association of breast milk HPV positivity with the family members’ oral HPV status was evaluated.

Methods:

We included 308 families to the study where the mother was breast feeding her offspring. Mothers collected the milk samples manually at day 3, and at months 2, 6 and 12. Cervical and/or oral samples were collected from all family members. HPV testing was performed using nested polymerase chain reaction and Luminex-based Multimetrix kit.

Results:

Breast milk HPV DNA was found in 10.1% (31/308), 20.1% (39/194) and 28.8% (17/59) of samples at day 3, months 2 and 6, respectively. The following HPV genotypes were detected: 6, 16, 18, 33, 45, 53, 56, 59, 66 and 82. Breast milk HPV persisted among 5.5% (9/164) of the lactating mothers. No significant associations were detected between the persistent breast milk HPV and the offspring’s oral incident HPV infection. Breast milk HPV positivity showed a strong association with the fathers’ oral HPV positivity at baseline, as well as at 6- and 12-month follow-up visits, with odds ratio (OR) = 3.24 [95% confidence interval (CI): 1.04–10.12], OR = 6.34 (95% CI: 1.84–21.89) and OR = 14.25 (95% CI: 1.16–174.80), respectively.

Conclusions:

HPV in breast milk is prevalent among the lactating mothers and HPV can also persist in breast milk. The breast milk is a potential vehicle for HPV transmission to oral mucosa of the spouse but not of the offspring.
Vemurafenib (BRAF Inhibitor) Therapy for Orbital Erdheim-Chester Disease
Authors: Gupta Adit , Yeganeh Amir , Rootman Daniel , Goldberg Robert
Published: January 2017

Erdheim-Chester disease is a rare xanthogranulomatous systemic disease, which involves the orbit in some cases. Through this case report, the authors review the treatment modalities used in orbital Erdheim-Chester disease and explore a newer modality of treatment. Cases of orbital Erdheim-Chester disease were identified in the literature utilizing a PubMed search and all the treatment modalities were reviewed. The response to treatment of orbital Erdheim-Chester disease has been poor with the various medical and surgical treatment modalities used in the past. The authors report the use of BRAF inhibitor with a remarkable response in our case.
Primidone inhibits TRPM3 and attenuates thermal nociception in vivo
Authors: Krügel Ute , Straub Isabelle , Beckmann Holger , Schaefer Michael
Published: January 2017

The melastatin-related transient receptor potential (TRP) channel TRPM3 is a nonselective cation channel expressed in nociceptive neurons and activated by heat. Because TRPM3-deficient mice show inflammatory thermal hyperalgesia, pharmacological inhibition of TRPM3 may exert antinociceptive properties. Fluorometric Ca2+ influx assays and a compound library containing approved or clinically tested drugs were used to identify TRPM3 inhibitors. Biophysical properties of channel inhibition were assessed using electrophysiological methods. The nonsteroidal anti-inflammatory drug diclofenac, the tetracyclic antidepressant maprotiline, and the anticonvulsant primidone were identified as highly efficient TRPM3 blockers with half-maximal inhibition at 0.6 to 6 μM and marked specificity for TRPM3. Most prominently, primidone was biologically active to suppress TRPM3 activation by pregnenolone sulfate (PregS) and heat at concentrations markedly lower than plasma concentrations commonly used in antiepileptic therapy. Primidone blocked PregS-induced Ca2+
i influx through TRPM3 by allosteric modulation and reversibly inhibited atypical inwardly rectifying TRPM3 currents induced by coapplication of PregS and clotrimazole. In vivo, analgesic effects of low doses of primidone were demonstrated in mice, applying PregS- and heat-induced pain models, including inflammatory hyperalgesia. Thus, applying the approved drug at concentrations that are lower than those needed to induce anticonvulsive effects offers a shortcut for studying physiological and pathophysiological roles of TRPM3 in vivo.
Making the most of hypomethylating agents in myelodysplastic syndromes
Authors: Bhatt Geetika , Blum William
Published: January 2017

Purpose of review

Hypomethylating agents (HMA) are the preferred therapy for patients with higher risk myelodysplastic syndromes (MDS) and an alternative therapeutic strategy for older patients with acute myeloid leukemia. These agents have improved both survival and quality of life, but results overall remain poor. The purpose of this review is to highlight recent developments in clinical research with HMA in MDS/acute myeloid leukemia over the last year.

Recent findings

Combination of HMA with B-cell lymphoma-2 inhibitors, hedgehog inhibitors, and a variety of other agents are underway, as are further studies with reformulated HMA that have more favorable pharmacokinetics (including oral bioavailability). HMA may also be promising in maintenance therapy after allogeneic transplantation. Generally speaking, testing new agents in randomized studies after ‘HMA failure,’ however, may be suboptimal for assessing efficacy.

No clear ‘winner’ as a combination partner with HMA or novel formulation of HMA has yet emerged. We concur with growing trends to test novel agents early in the drug development timeline, including the frontline treatment setting in combination with HMA, to bring new agents to Food and Drug Administration approval more quickly. HMA are standard in name only, clinical research should be the standard of care.
The Effects of Attention Problems on Psychosocial Functioning in Childhood Brain Tumor Survivors: A 2-Year Postcraniospinal Irradiation Follow-up
Authors: Oh Yunhye , Seo Hyunjung , Sung Ki Woong , Joung Yoo Sook
Published: January 2017

Objective:

To examine the psychosocial outcomes and impact of attention problems in survivors of pediatric brain tumor.

Study Design:

The survivors’ cognitive functioning was measured using the Wechsler Intelligence Scale for Children. The Child Behavior Checklist-Attention Problems scale was used to screen for attention problems, and participants were classified as having attention problems (n=15) or normal attention (n=36). Psychosocial functioning was examined with the Korean Personality Rating scale for Children (K-PRC) at precraniospinal radiation and at 2-year follow-up.

Results:

The attention problem group showed significantly higher depression and externalizing symptoms (delinquency, hyperactivity) and more significant impairment in family relationships than did the normal attention group at baseline. At follow-up, the attention problem group demonstrated significantly more delinquency and impaired family and social relationships. With the K-PRC scores, except for the somatization, social relationship subscale, there were significant differences between groups, but not in terms of treatment by time interaction or within time. At follow-up, multiple linear regressions showed that age at diagnosis significantly predicted K-PRC somatization (B=−1.7, P=0.004) and social relationships (B=−1.7, P=0.004), baseline full-scale intelligence quotient predicted K-PRC depression (B=−0.4, P=0.032) and somatization (B=−0.3, P=0.015), and attention problems at baseline predicted K-PRC depression (B=−15.2, P=0.036) and social relationships (B=−11.6, P=0.016).

Conclusion:

Pediatric brain tumor survivors, in particular, patients with attention problems, had worse psychosocial functioning at baseline and follow-up. Attention problems at baseline need to be carefully evaluated in assessing psychosocial functioning of pediatric brain tumor survivors.
Vocal Cord Palsy in Children With Cancer: A 10-Year Analysis of UK Pediatric Intensive Care Admissions
Authors: Capsomidis Anna , Hall Andrew , Daya Hamid , Round Jonathan , Lancaster Donna , Bate Jessica
Published: January 2017

Vocal cord palsy (VCP) is a rare but potentially life-threatening complication in children with cancer. This study reviews UK Intensive Care admissions for children with cancer and VCP using data obtained from the Pediatric Intensive Care Audit Network (PICANet) database. 26 children with cancer and VCP were admitted to intensive care from 2002 to 2012. The majority of admissions (23/26) required respiratory intervention (17 invasive ventilation, 8 noninvasive ventilation, and 5 tracheostomy). VCP should be considered early in children with cancer who present with signs of upper airway obstruction, especially in those receiving vinca-alkaloids as VCP is likely to be reversible.
Evaluating Excessive Burden of Depression on Health Status and Health Care Utilization Among Patients With Hypertension in a Nationally Representative Sample From the Medial Expenditure Panel Survey (MEPS 2012)
Authors: Shao Hui , Mohammed Mir Umer , Thomas Nick , Babazadeh Saleh , Yang Shuang , Shi Qian , Shi Lizheng
Published: January 2017

Depression and hypertension frequently present together in clinical practice. Evaluating the interaction between depression and hypertension would help stakeholders better understand the value of depression prevention in primary care. This retrospective study aimed to evaluate the excessive burden of depression on overall health and on health care utilization expenditure among hypertensive patients. A total of 7019 hypertensive patients (ICD-9-CM: 401) were identified from the 2012 Medical Expenditure Panel Survey (MEPS 2012) data, of which 936 patients had depression (ICD-9-CM: 311). Hypertension with depression was associated with worse health status (physical component score, −3.97 [17.9% reduction]; mental component score, −9.14 [9% reduction]), higher utilization of health care services (outpatient visits, 6.4 [63.8% higher]; nights of hospitalization, 0.9 [100% higher]; medication prescription, 22.6 [76.8% higher]), and higher health care expenditures (inpatient, $1953.2 [72% higher]; prescription drugs, $1995.5 [82% higher]).
A Course-Based Approach to the Doctor of Nursing Practice Project
Authors: Fitzgerald Cynthia , Purath Janet , Van Son Catherine , Duvall Darryl , Eddy Linda
Published: January 2017

We describe a course-based approach to the doctor of nursing practice project in which students work in groups of 8 to 12 with a faculty member to complete individual final projects that require a minimum of 360 practicum hours in 3-semester-long courses. Project teams include agency or community-based mentors. Project findings are disseminated through written and oral reports. This approach preserves faculty resources and provides students with mentoring, opportunities for reflection, and time for project development.
Deconstructing Clinical Workflow
Authors: Booth Richard G. , Sinclair Barbara , Strudwick Gillian , Brennan Laura , Morgan Lisa , Collings Stephanie , Johnston Jessica , Loggie Brittany , Tong James , Singh Chantal
Published: January 2017

The purpose of this quality improvement project was to better understand how to teach medication administration underpinned by an electronic medication administration record (eMAR) system used in simulated, prelicensure nursing education. Methods included a workflow and integration analysis and a detailed process mapping of both an oral and a sublingual medication administration. Procedural and curriculum development considerations related to medication administration using eMAR technology are presented for nurse educators.
Evaluation and Management of Female Victims of Sexual Assault
Authors: Vrees Roxanne A.
Published: January 2017

Sexual assault is characterized by any sexual contact or behavior that occurs without explicit consent. Classifications vary based on the status of the perpetrator’s relationship to the victim (eg, stranger, acquaintance) and characteristics of the victim herself (eg, child, elder adult, mentally disabled adult). Regardless of the classification, sexual assault is a significant individual as well as public health issue affecting women of all ages. While the majority of sexual assault cases are not initially reported to law enforcement, the best available data suggest the lifetime prevalence of sexual assault in the United States is approximately 20% among adult women. With such a significant proportion of women affected by sexual assault, women’s health care providers in both ambulatory and emergency care settings play key roles in the evaluation, management, and advocacy of these victims. Establishing standard protocols based on state laws and on victim-centered practices to avoid revictimization of the patient is critical.

The primary goals of care include the assessment and treatment of physical injuries, psychological assessment and support, pregnancy assessment and prevention, and therapy for prevention of sexually transmitted infections. In addition, evidentiary collection is a critical component of the sexual assault evaluation and subsequent legal proceedings.

This report focuses specifically on the immediate evaluation and management of adult female victims of sexual assault. Best practices include the utility of the Sexual Assault Nurse Examiner and Sexual Assault Forensic Examiner programs, as well as standardized treatment protocols.

Target Audience

Obstetricians and gynecologists, family physicians.

Learning Objective

After completing this activity, the learner should be better able to (1) be familiar with the clinical and forensic components of the initial evaluation of a female victim of sexual assault; (2) provide counseling and treatment for pregnancy prevention, sexually transmitted infections, and human immunodeficiency virus following a sexual assault; (3) discuss the immediate and long-term sequelae following sexual assault; and (4) identify available local resources for sexual assault victims.
Electrographic Seizures in Children and Neonates Undergoing Extracorporeal Membrane Oxygenation
Authors: Lin Jainn-Jim , Banwell Brenda L. , Berg Robert A. , Dlugos Dennis J. , Ichord Rebecca N. , Kilbaugh Todd J. , Kirsch Roxanne E. , Kirschen Matthew P. , Licht Daniel J. , Massey Shavonne L. , Naim Maryam Y. , Rintoul Natalie E. , Topjian Alexis A. , Abend Nicholas S.
Published: January 2017

Objective:

We aimed to determine the prevalence and risk factors for electrographic seizures in neonates and children requiring extracorporeal membrane oxygenation support.

Design:

Prospective quality improvement project.

Setting:

Quaternary care pediatric institution.

Patients:

Consistent with American Clinical Neurophysiology Society electroencephalographic monitoring recommendations, neonates and children requiring extracorporeal membrane oxygenation support underwent clinically indicated electroencephalographic monitoring.

Interventions:

We performed a 2-year quality improvement study from July 2013 to June 2015 evaluating electrographic seizure prevalence and risk factors.

Main Results:

Ninety-nine of 112 patients (88%) requiring extracorporeal membrane oxygenation support underwent electroencephalographic monitoring. Electrographic seizures occurred in 18 patients (18%), of whom 11 patients (61%) had electrographic status epilepticus and 15 patients (83%) had exclusively electrographic-only seizures. Electrographic seizures were more common in patients with low cardiac output syndrome (p = 0.03). Patients with electrographic seizures were more likely to die prior to discharge (72% vs 30%; p = 0.01) and have unfavorable outcomes (54% vs 17%; p = 0.004) than those without electrographic seizures.

Conclusions:

Electrographic seizures occurred in 18% of neonates and children requiring extracorporeal membrane oxygenation support, often constituted electrographic status epilepticus, and were often electrographic-only thereby requiring electroencephalographic monitoring for identification. Low cardiac output syndrome was associated with an increased risk for electrographic seizures. Electrographic seizures were associated with higher mortality and unfavorable outcomes. Further investigation is needed to determine whether electrographic seizures identification and management improves outcomes.
Evaluating the Necessity of Antibiotics in the Treatment of Acute Epididymitis in Pediatric Patients
Authors: Cristoforo Thomas A.
Published: January 2017

Objectives

This literature review and data analysis aims to evaluate the percentage of pediatric patients with acute epididymitis found to have bacterial etiology and the percentage of patients in these studies that were treated with antibiotic therapy versus conservative therapy.

Methods

A search of EBSCO through January 13, 2016, using the key words epididymitis or epididymo-orchitis and child, children, or pediatric, identified 542 potential studies.

Twenty-seven retrospective studies met the inclusion criteria, containing patients aged 21 years or younger with acute epididymitis or epididymoorchitis. The number and age of patients, urine cultures and urinalysis results, number of patients treated with antibiotics, and incidence were extracted.

Results

A total of 1496 patients with acute epididymitis were identified. A urinalysis was obtained for 1124 patients, and 190 (16.9%) were positive. Aurine culturewas obtained for 670 patients, and 100 (14.9%) were positive. Fourteen studies addressed antibiotic administration wherein 652 patients were with acute epididymitis and 554 (85%) received antibiotics.

Of 502 patients with urinalysis results, urine culture results, and antibiotic treatment rates, 54 (10.8%) were positive for a bacterial source. Antibiotics were administered to 410 (81.7%) of these 502 patients.

Conclusions

Practitioners should consider only prescribing antibiotics to patients with acute epididymitis if there is an abnormal urinalysis or urine culture.
Comparison of Resource Utilization and Length of Hospitalization Between Overweight and Healthy-Weight Pediatric Trauma Patients Presenting to a Pediatric Emergency Department With Moderate to Severe Injury
Authors: Romano Theresa , Koutroulis Ioannis , Weiner Evan , Little Anthony , Singh Sabina
Published: January 2017

Objectives

Our study aimed to compare overweight and healthy-weight pediatric trauma patient outcomes, specifically with respect to hospital length of stay and resource utilization. We hypothesized that overweight pediatric trauma patients would have increased hospital length of stay and radiographic study use compared with their healthy-weight counterparts.

Methods

This was a prospective, observational, cohort study of pediatric trauma patients aged 2 to 19 years presenting to an urban pediatric emergency department over a period of 1 year. Using measured height and weight values, body mass index (BMI) for age was calculated and plotted on the Centers for Disease Control and Prevention BMI-for-age growth charts. Patients were followed up throughout their hospitalization, and the following items were recorded: trauma alert level, mechanism of injury, age, sex, race, Glasgow Coma Scale score, total number of days in hospital, total number of intensive care unit days, total number of radiographs obtained, total number of computed tomography scans obtained, and mechanism of injury.

Results

Our study population included 109 subjects. The mean age of the subjects was 9.7 years. The number of patients meeting the definition of obese (BMI for age ≥95%) was 15, or 14% of the total study population. There was no significant difference between the overweight cohort and the healthy-weight cohort found among any of the variables recorded and analyzed.

Conclusions

Although there are many chronic conditions in children associated with obesity, in the case of trauma, it does not seem to be a strong concern. A continued focus on preventing and reversing childhood obesity for other physical and mental health outcomes may be more important.
Computed Tomography in Cystic Fibrosis: Combining Low-Dose Techniques and Iterative Reconstruction
Authors: Kahn Johannes , Kaul David , Grupp Ulrich , Böning Georg , Renz Diane , Staab Doris , Schreiter Vera , Streitparth Florian
Published: January 2017

Objective

The aim of the study was to evaluate the impact of iterative reconstruction (IR) and low-kilovolt technique on dose reduction and image quality of chest computed tomography scans obtained in patients with cystic fibrosis (CF).

Methods

A total of 124 CF patients were examined; group A (n = 63) was examined with a dose reduction protocol using IR and group B (n = 61) with a standard protocol using filtered back projection. Further subgroups with tube voltage modulations were established. Quantitative and qualitative image quality was assessed.

Results

The radiation dose in groups with comparable image quality was approximately 40% lower using IR compared with filtered back projection. The IR protocol combined with 80-kV tube voltage showed adequate image quality with a mean effective dose of only 0.47 mSv.

Conclusions

Iterative reconstruction helps extensively reduce radiation dose by improving image quality. It permits the use of low-kilovolt protocols without significantly degrading image reading ability in the monitoring of the predominantly young patients with CF.
Prevalence and Severity of Depression and Anxiety in Patients With Systemic Sclerosis
Authors: Faezi Seyedeh Tahereh , Paragomi Pedram , Shahali Ashraf , Akhlaghkhah Maryam , Akbarian Mahmood , Akhlaghi Maassoomeh , Kheirandish Masoumeh , Gharibdoost Farhad
Published: January 2017

Background

Systemic sclerosis (SSc) is a chronic multisystem connective tissue disorder with detrimental impact on quality of life. Patients with SSc face emotional distress and frequently meet criteria for a psychiatric disorder. However, the pattern of psychiatric manifestations may vary according to socioethnic background.

Objectives

We investigated the prevalence of depressive and anxiety symptoms and examined their association with sociodemographic and clinical factors in Iranian SSc patients.

Methods

Depressive and anxiety symptoms were evaluated by Beck Depression Inventory and Cattell questionnaire in 114 SSc patients. The associations between sociodemographic and clinical factors and depressive/anxiety symptoms were examined via multivariate analysis.

Results

The prevalence of depressive symptoms was 68.4%. There was a significant association between depressive symptoms and pulmonary and gastrointestinal manifestations. Also, diffuse SSc patients were more prone to depressive symptoms. Mean Rodnan scores were significantly higher in patients with depressive symptoms in comparison with subjects with no depressive symptoms. The prevalence of anxiety symptoms was 23.6%. Anxiety symptoms were not associated with demographic characteristics, SSc subtype, disease duration, Rodnan score, other clinical features, and previous history of depression in the patients or their family. The coincidence of anxiety and depression was 82.8%.

Conclusions

Depressive and anxiety symptoms are prevalent among Iranian SSc population. The depressive symptoms showed correlation with pulmonary and gastrointestinal involvement, as well as diffuse SSc subtype.
Metal Artifact Reduction in X-ray Computed Tomography Using Computer-Aided Design Data of Implants as Prior Information
Authors: Ruth Veikko , Kolditz Daniel , Steiding Christian , Kalender Willi A.
Published: January 2017

Objectives

The performance of metal artifact reduction (MAR) methods in x-ray computed tomography (CT) suffers from incorrect identification of metallic implants in the artifact-affected volumetric images. The aim of this study was to investigate potential improvements of state-of-the-art MAR methods by using prior information on geometry and material of the implant.

Materials and Methods

The influence of a novel prior knowledge–based segmentation (PS) compared with threshold-based segmentation (TS) on 2 MAR methods (linear interpolation [LI] and normalized-MAR [NORMAR]) was investigated. The segmentation is the initial step of both MAR methods. Prior knowledge–based segmentation uses 3-dimensional registered computer-aided design (CAD) data as prior knowledge to estimate the correct position and orientation of the metallic objects. Threshold-based segmentation uses an adaptive threshold to identify metal. Subsequently, for LI and NORMAR, the selected voxels are projected into the raw data domain to mark metal areas. Attenuation values in these areas are replaced by different interpolation schemes followed by a second reconstruction. Finally, the previously selected metal voxels are replaced by the metal voxels determined by PS or TS in the initial reconstruction. First, we investigated in an elaborate phantom study if the knowledge of the exact implant shape extracted from the CAD data provided by the manufacturer of the implant can improve the MAR result. Second, the leg of a human cadaver was scanned using a clinical CT system before and after the implantation of an artificial knee joint. The results were compared regarding segmentation accuracy, CT number accuracy, and the restoration of distorted structures.

Results

The use of PS improved the efficacy of LI and NORMAR compared with TS. Artifacts caused by insufficient segmentation were reduced, and additional information was made available within the projection data. The estimation of the implant shape was more exact and not dependent on a threshold value. Consequently, the visibility of structures was improved when comparing the new approach to the standard method. This was further confirmed by improved CT value accuracy and reduced image noise.

Conclusions

The PS approach based on prior implant information provides image quality which is superior to TS-based MAR, especially when the shape of the metallic implant is complex. The new approach can be useful for improving MAR methods and dose calculations within radiation therapy based on the MAR corrected CT images.
Perspectives of Patients, Caregivers and Researchers on Research Priorities in Donation and Transplantation in Canada: A Pilot Workshop
Authors: Allard Julie , Durand Céline , Anthony Samantha J. , Dumez Vincent , Hartell David , Hébert Marie-Josée , West Lori J. , Wright Linda , Fortin Marie-Chantal
Published: January 2017

Background

It is vitally important to seek input from key stakeholders to increase the quality and relevance of health-related research and accelerate its adoption into practice. Patients and caregivers have rarely been involved in setting research priorities in the transplantation and donation field. The objectives of this explorative study are: (i) to discuss research priorities within the Canadian National Transplant Research Program during a priority-setting exercise with patients, caregivers, organ donors and researchers and (ii) to compare the identified priorities with research published in 2 prestigious transplantation journals.

Methods

A pilot workshop attended by 10 patients and caregivers and 5 researchers was held in Montréal (Quebec, Canada) in August 2014 to identify research priorities. Priorities were identified using a thematic analysis of the workshop transcription conducted by multiple coders. These priorities were compared with the topics of research articles published in 2 major transplantation journals between 2012 and 2014.

Results

The themes of the 10 research priorities identified by study participants were related to different research domains: social, cultural, and environmental health factors (4); biomedical or clinical (4); and research about health systems and services (2). 26.7% of the research articles published were related to the identified priorities. Thirteen percent looked at ways to improve graft survival and 8.5% looked at the development of tolerance, 2 priorities identified by participants. Fewer than 5% examined the other 8 research priorities identified as important by workshop participants.

Conclusions

This is the first study reporting patients' and researchers' priorities in the field of transplantation and donation in Canada. There is a discrepancy between topics that key stakeholders find important and research published in 2 major transplantation journals. The research priorities identified during our initial workshop will be validated through a national survey and workshop.
5 Years Experience With Drug Eluting and Bare Metal Stents as Primary Intervention in Transplant Renal Artery Stenosis
Authors: Estrada Chelsea C. , Musani Muzammil , Darras Frank , Suh Heesuck , Abate Mersema T. , Mani Anil , Nord Edward P.
Published: January 2017

Background

Transplant renal artery stenosis (TRAS) is a common vascular complication after kidney transplantation and is associated with refractory hypertension, volume overload, and graft injury or loss. This article describes 5-year outcomes of endovascular intervention for TRAS with bare metal and drug eluting stents (DES).

Methods

We investigated, as a prospective cohort study, patient and graft outcomes after the targeted use of DES for vessel diameter less than 5 mm and bare metal stents (BMS) for vessel diameter greater than 5 mm as the primary management for TRAS.

Results

From March 2008 to November 2014, 57 patients were stented for hemodynamically significant TRAS; 29 received DES, 26 received BMS, and 2 patients received both stent types. They were followed up for a mean of 35.1 ± 22.8 months; a subset of these patients who all received DES were followed up for 61.7 ± 17.5 months. Mean serum creatinine declined from 2.87 ± 1.5 mg/dL at the time of intervention to 1.98 ± 0.76 mg/dL (P < 0.001) at one month follow-up and was 1.96 ±0.92 mg/dL (P < 0.001) at 35.1 ± 22.8 months. Mean systolic blood pressure declined from 159.05 ± 19.68 mm Hg at time of intervention to 135.65 ± 15.10 mm Hg (P < 0.001) at most recent visit. Clinically driven restenosis requiring repeat revascularization occurred in 15.7% of patients.

Conclusions

Primary stenting with DES and BMS is both successful in the initial treatment of TRAS and also produced an immediate and long-term reduction in serum creatinine and systolic blood pressure.
Co-option of bacteriophage lysozyme genes by bivalve genomes
Authors: Ren Qian , Wang Chunyang , Jin Min , Lan Jiangfeng , Ye Ting , Hui Kaimin , Tan Jingmin , Wang Zheng , Wyckoff Gerald J. , Wang Wen , Han Guan-Zhu
Published: January 2017

Eukaryotes have occasionally acquired genetic material through horizontal gene transfer (HGT). However, little is known about the evolutionary and functional significance of such acquisitions. Lysozymes are ubiquitous enzymes that degrade bacterial cell walls. Here, we provide evidence that two subclasses of bivalves (Heterodonta and Palaeoheterodonta) acquired a lysozyme gene via HGT, building on earlier findings. Phylogenetic analyses place the bivalve lysozyme genes within the clade of bacteriophage lysozyme genes, indicating that the bivalves acquired the phage-type lysozyme genes from bacteriophages, either directly or through intermediate hosts. These bivalve lysozyme genes underwent dramatic structural changes after their co-option, including intron gain and fusion with other genes. Moreover, evidence suggests that recurrent gene duplication occurred in the bivalve lysozyme genes. Finally, we show the co-opted lysozymes exhibit a capacity for antibacterial action, potentially augmenting the immune function of related bivalves. This represents an intriguing evolutionary strategy in the eukaryote–microbe arms race, in which the genetic materials of bacteriophages are co-opted by eukaryotes, and then used by eukaryotes to combat bacteria, using a shared weapon against a common enemy.
T-type Ca
2+
channels are required for enhanced sympathetic axon growth by TNFα reverse signalling
Authors: Kisiswa Lilian , Erice Clara , Ferron Laurent , Wyatt Sean , Osório Catarina , Dolphin Annette C. , Davies Alun M.
Published: January 2017

Tumour necrosis factor receptor 1 (TNFR1)-activated TNFα reverse signalling, in which membrane-integrated TNFα functions as a receptor for TNFR1, enhances axon growth from developing sympathetic neurons and plays a crucial role in establishing sympathetic innervation. Here, we have investigated the link between TNFα reverse signalling and axon growth in cultured sympathetic neurons. TNFR1-activated TNFα reverse signalling promotes Ca
2+
influx, and highly selective T-type Ca
2+
channel inhibitors, but not pharmacological inhibitors of L-type, N-type and P/Q-type Ca
2+
channels, prevented enhanced axon growth. T-type Ca
2+
channel-specific inhibitors eliminated Ca
2+
spikes promoted by TNFα reverse signalling in axons and prevented enhanced axon growth when applied locally to axons, but not when applied to cell somata. Blocking action potential generation did not affect the effect of TNFα reverse signalling on axon growth, suggesting that propagated action potentials are not required for enhanced axon growth. TNFα reverse signalling enhanced protein kinase C (PKC) activation, and pharmacological inhibition of PKC prevented the axon growth response. These results suggest that TNFα reverse signalling promotes opening of T-type Ca
2+
channels along sympathetic axons, which is required for enhanced axon growth.
Correlations between axial stiffness and microstructure of a species of bamboo
Authors: Mannan Sayyad , Paul Knox J. , Basu Sumit
Published: January 2017

Bamboo is a ubiquitous monocotyledonous flowering plant and is a member of the true grass familyPoaceae. In many parts of the world, it is widely used as a structural material especially in scaffolding and buildings. In spite of its wide use, there is no accepted methodology for standardizing a species of bamboo for a particular structural purpose. The task of developing structure–property correlations is complicated by the fact that bamboo is a hierarchical material whose structure at the nanoscopic level is not very well explored. However, we show that as far as stiffness is concerned, it is possible to obtain reliable estimates of important structural properties like the axial modulus from the knowledge of certain key elements of the microstructure. Stiffness of bamboo depends most sensitively on the size and arrangement of the fibre sheaths surrounding the vascular bundles and the arrangement of crystalline cellulose microfibrils in their secondary cell walls. For the species of bamboo studied in this work, we have quantitatively determined the radial gradation that the arrangement of fibres renders to the structure. The arrangement of the fibres gives bamboo a radially graded property variation across its cross section.
A Bayesian bird's eye view of ‘Replications of important results in social psychology’
Authors: Marsman Maarten , Schönbrodt Felix D. , Morey Richard D. , Yao Yuling , Gelman Andrew , Wagenmakers Eric-Jan
Published: January 2017

We applied three Bayesian methods to reanalyse the preregistered contributions to theSocial Psychologyspecial issue ‘Replications of Important Results in Social Psychology’ (Nosek & Lakens. 2014 Registered reports: a method to increase the credibility of published results.Soc. Psychol.45, 137–141. (doi:10.1027/1864-9335/a000192)). First, individual-experiment Bayesian parameter estimation revealed that for directed effect size measures, only three out of 44 central 95% credible intervals did not overlap with zero and fell in the expected direction. For undirected effect size measures, only four out of 59 credible intervals contained values greater than0.10(10% of variance explained) and only 19 intervals contained values larger than0.05. Second, a Bayesian random-effects meta-analysis for all 38t-tests showed that only one out of the 38 hierarchically estimated credible intervals did not overlap with zero and fell in the expected direction. Third, a Bayes factor hypothesis test was used to quantify the evidence for the null hypothesis against a default one-sided alternative. Only seven out of 60 Bayes factors indicated non-anecdotal support in favour of the alternative hypothesis (BF10>3), whereas 51 Bayes factors indicated at least some support for the null hypothesis. We hope that future analyses of replication success will embrace a more inclusive statistical approach by adopting a wider range of complementary techniques.
Characterization of recruitment through tandem running in an Indian queenless antDiacamma indicum
Authors: Kaur Rajbir , Joseph Joby , Anoop Karunakaran , Sumana Annagiri
Published: January 2017

Tandem running is a primitive recruitment method employed by many ant genera. This study characterizes this behaviour during the recruitment of colony mates to a new nest in an Indian antDiacamma indicum. Tandem leaders who have knowledge of the new nest lead a single follower at a time, to the destination by maintaining physical contact. In order to characterize tandem running, we captured and analysed 621 invitations, 217 paths and 226 termination events. Remarkably, not a single colony member was lost. While invitations were stereotypic in behaviour, termination was not. Analysis of speed revealed that the average transport speed was 4.2 cm s−1. Coupled adult-brood transport was slower than other transports but was more efficient than individual trips. Comparing tandem running with other popular recruitment methods in ants allows us to postulate that even though tandem running is primitive it is probably just another means to achieve the same end.
Eye and head movements are complementary in visual selection
Authors: Solman Grayden J. F. , Foulsham Tom , Kingstone Alan
Published: January 2017

In the natural environment, visual selection is accomplished by a system of nested effectors, moving the head and body within space and the eyes within the visual field. However, it is not yet known if the principles of selection for these different effectors are the same or different. We used a novel gaze-contingent display in which an asymmetric window of visibility (a horizontal or vertical slot) was yoked to either head or eye position. Participants showed highly systematic changes in behaviour, revealing clear differences in the principles underlying selection by eye and head. Eye movements were more likely to move in the direction of visible information—horizontally when viewing with a horizontal slot, and vertically with a vertical slot. Head movements showed the opposite and complementary pattern, moving to reveal new information (e.g. vertically with a horizontal slot and vice versa). These results are consistent with a nested system in which the head favours exploration of unknown regions, while the eye exploits what can be seen with finer-scale saccades.
Methylation of
avpr1a
in the cortex of wild prairie voles: effects of CpG position and polymorphism
Authors: Okhovat M. , Maguire S. M. , Phelps S. M.
Published: January 2017

DNA methylation can cause stable changes in neuronal gene expression, but we know little about its role in individual differences in the wild. In this study, we focus on the vasopressin 1a receptor (
avpr1a
), a gene extensively implicated in vertebrate social behaviour, and explore natural variation in DNA methylation, genetic polymorphism and neuronal gene expression among 30 wild prairie voles (
Microtus ochrogaster
). Examination of CpG density across 8 kb of the locus revealed two distinct CpG islands overlapping promoter and first exon, characterized by few CpG polymorphisms. We used a targeted bisulfite sequencing approach to measure DNA methylation across approximately 3 kb of
avpr1a
in the retrosplenial cortex, a brain region implicated in male space use and sexual fidelity. We find dramatic variation in methylation across the
avrp1a
locus, with pronounced diversity near the exon–intron boundary and in a genetically variable putative enhancer within the intron. Among our wild voles, differences in cortical
avpr1a
expression correlate with DNA methylation in this putative enhancer, but not with the methylation status of the promoter. We also find an unusually high number of polymorphic CpG sites (polyCpGs) in this focal enhancer. One polyCpG within this enhancer (polyCpG 2170) may drive variation in expression either by disrupting transcription factor binding motifs or by changing local DNA methylation and chromatin silencing. Our results contradict some assumptions made within behavioural epigenetics, but are remarkably concordant with genome-wide studies of gene regulation.
A method for detecting characteristic patterns in social interactions with an application to handover interactions
Authors: Bode Nikolai W. F. , Sutton Andrew , Lacey Lindsey , Fennell John G. , Leonards Ute
Published: January 2017

Social interactions are a defining behavioural trait of social animals. Discovering characteristic patterns in the display of such behaviour is one of the fundamental endeavours in behavioural biology and psychology, as this promises to facilitate the general understanding, classification, prediction and even automation of social interactions. We present a novel approach to study characteristic patterns, including both sequential and synchronous actions in social interactions. The key concept in our analysis is to represent social interactions as sequences of behavioural states and to focus on changes in behavioural states shown by individuals rather than on the duration for which they are displayed. We extend techniques from data mining and bioinformatics to detect frequent patterns in these sequences and to assess how these patterns vary across individuals or changes in interaction tasks. To illustrate our approach and to demonstrate its potential, we apply it to novel data on a simple physical interaction, where one person hands a cup to another person. Our findings advance the understanding of handover interactions, a benchmark scenario for social interactions. More generally, we suggest that our approach permits a general perspective for studying social interactions.
Detecting and characterizing high-frequency oscillations in epilepsy: a case study of big data analysis
Authors: Huang Liang , Ni Xuan , Ditto William L. , Spano Mark , Carney Paul R. , Lai Ying-Cheng
Published: January 2017

We develop a framework to uncover and analyse dynamical anomalies from massive, nonlinear and non-stationary time series data. The framework consists of three steps: preprocessing of massive datasets to eliminate erroneous data segments, application of the empirical mode decomposition and Hilbert transform paradigm to obtain the fundamental components embedded in the time series at distinct time scales, and statistical/scaling analysis of the components. As a case study, we apply our framework to detecting and characterizing high-frequency oscillations (HFOs) from a big database of rat electroencephalogram recordings. We find a striking phenomenon: HFOs exhibit on–off intermittency that can be quantified by algebraic scaling laws. Our framework can be generalized to big data-related problems in other fields such as large-scale sensor data and seismic data analysis.