bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative metabolomics of Japanese Black cattle beef and other meats using gas chromatography–mass spectrometry
Authors: Ueda Shuji , Iwamoto Eiji , Kato Yoshiki , Shinohara Masakazu , Shirai Yasuhito , Yamanoue Minoru
Published: October 2018

Progress in metabolomic analysis now allows the evaluation of food quality. This study aims to identify the metabolites in meat from livestock using a metabolomic approach. Using gas chromatography–mass spectrometry (GC/MS), many metabolites were reproducibly detected in meats, and distinct differences between livestock species (cattle, pigs, and chickens) were indicated. A comparison of metabolites between tissues types (muscle, intramuscular fat, and intermuscular fat) in marbled beef of Japanese Black cattle revealed that most metabolites are abundant in the muscle tissue. Several metabolites (medium-chain fatty acids, etc.) involved in triacylglycerol synthesis were uniquely detected in fat tissue. Additionally, the results of multivariate analysis suggest that GC/MS analysis of metabolites can distinguish between cattle breeds. These results provide useful information for the analysis of meat quality using GC/MS-based metabolomic analysis.

ABBREVIATIONS: GC/MS: gas chromatography-mass spectrometry; NMR: nuclear magnetic resonance; MS: mass spectrometry; IS: 2-isopropylmalic acid; MSTFA: N-Methyl-N-trimethylsilyltrifluoroacetamide; CV: coefficient of variation; TBS: Tris-buffered saline; MHC: myosin fast type; PCA: principal component analysis; OPLS-DA: orthogonal partial least-squares discriminant analysis; O2PLS: two-way orthogonal partial least-squares
Polycomb complexes in normal and malignant hematopoiesis
Authors: Di Carlo Valerio , Mocavini Ivano , Di Croce Luciano
Published: October 2018

Epigenetic mechanisms are crucial for sustaining cell type–specific transcription programs. Among the distinct factors, Polycomb group (PcG) proteins are major negative regulators of gene expression in mammals. These proteins play key roles in regulating the proliferation, self-renewal, and differentiation of stem cells. During hematopoietic differentiation, many PcG proteins are fundamental for proper lineage commitment, as highlighted by the fact that a lack of distinct PcG proteins results in embryonic lethality accompanied by differentiation biases. Correspondingly, proteins of these complexes are frequently dysregulated in hematological diseases. In this review, we present an overview of the role of PcG proteins in normal and malignant hematopoiesis, focusing on the compositional complexity of PcG complexes, and we briefly discuss the ongoing clinical trials for drugs targeting these factors.
SeeVis—3D space-time cube rendering for visualization of microfluidics image data
Authors: Hattab Georges , Nattkemper Tim W
Published: October 2018

Motivation

Live cell imaging plays a pivotal role in understanding cell growth. Yet, there is a lack of visualization alternatives for quick qualitative characterization of colonies.

Results

SeeVis is a Python workflow for automated and qualitative visualization of time-lapse microscopy data. It automatically pre-processes the movie frames, finds particles, traces their trajectories and visualizes them in a space-time cube offering three different color mappings to highlight different features. It supports the user in developing a mental model for the data. SeeVis completes these steps in 1.15 s/frame and creates a visualization with a selected color mapping.

Availability and implementation

https://github.com/ghattab/seevis/

Supplementary information

Supplementary data are available at Bioinformatics online.
Ofsted and Children’s Services: What Performance Indicators and Other Factors Are Associated with Better Inspection Results?
Authors: Wilkins David , Antonopoulou Vivi
Published: October 2018

‘Failing’ an inspection of The Office for Standards in Education, Children’s Services and Skills (Ofsted) has severe consequences on a local authority. Senior managers may lose their jobs and the workforce as a whole can be destabilised. In extreme cases, central government can decide whether the authority is no longer capable of running children’s services. On the other hand, receiving positive Ofsted judgements often brings with it a national reputation for excellence. This study reports the findings of an analysis of key performance indicators, expenditure and deprivation in relation to Ofsted inspections for eighty-seven local authorities in England undertaken between 2014 and 2016. Our aim was to examine the association between these factors and Ofsted judgements. Our findings suggest that for most of the factors we considered, there is no clear pattern of better or worse performance between local authorities with different Ofsted ratings. However, ‘good and outstanding’ authorities tend to outperform other authorities in relation to some procedural variables. By itself, the level of local authority deprivation was most clearly associated with the Ofsted rating, and expenditure was associated with the authority’s level of deprivation but not their Ofsted judgement. Comparisons are made with the concept of ‘value-added’ performance in relation to schools.
A Hybrid Decentralized Coordinated Approach for Multi-Robot Exploration Task
Authors: Mohamed Khalil , El Shenawy Ayman , Harb Hany
Published: October 2018

Exploring the environment using multi-robot systems is a fundamental process that most automated applications depend on. This paper presents a hybrid decentralized task assignment approach based on Partially Observable Semi-Markov Decision Processes called HDec-POSMDPs, which are general models for multi-robot coordination and exploration problems in which robots can make their own decisions according to its local data with limited communication between the robot team. In this paper, a variety of multi-robot exploration algorithms and their comparison have been tackled. These algorithms, which have been taken into consideration, are dependent on different parameters. Collectively, there are five metrics maximize the total exploration percentage, minimize overall mission time, reduce the number of hops in the networked robots, reduce the energy consumed by each robot and minimize the number of turns in the path from the start pose cells to the target cells. Therefore, a team of identical mobile robots is used to perform coordination and exploration process in an unknown cell-based environment. The performance of the task depends on the strategy of coordination among the robots involved in the team. Therefore, the proposed approach is implemented, tested and evaluated in MRESim computer simulator, and its performance is compared with different coordinated exploration strategies for different environments and different team sizes. The experimental results demonstrate a good performance of the proposed approach compared to the four existing approaches.
Change in the North Sea ecosystem from the 1970s to the 2010s: great skua diets reflect changing forage fish, seabirds, and fisheries
Authors: Church Gabriella E , Furness Robert W , Tyler Glen , Gilbert Lucy , Votier Stephen C
Published: October 2018

Understanding anthropogenic impacts are crucial to maintain marine ecosystem health. The North Sea has changed in recent decades, largely due to commercial fishing and climate change. Seabirds can act as useful indicators of these changes. By analyzing n = 20 013 pellets and n = 24 993 otoliths regurgitated by great skuas Stercorarius skua in northern Scotland over five decades from the 1970s to the 2010s (in 36 years 1973–2017), we reveal how the diet of this top predator has changed alongside the changing North Sea ecosystem. Sandeels Ammodytes spp. were the most common dietary item during the 1970s, but became virtually absent from the 1980s onward. Discarded whitefish dominated skua diets from the 1980s to the present day, despite long-term declines in North Sea discard production. However, the discarded fish eaten by great skuas has become smaller and the species composition changed. Skua pellets only rarely contained avian prey in the 1970s but this increased during the 1980s, and fluctuated between 10% and 20% from the 1990s to 2010s. There have also been changes in the avian prey in the diet—black-legged kittiwakes Rissa tridactyla generally being replaced by auks Alcid spp. and northern fulmars Fulmarus glacialis. The Shetland marine ecosystem has experienced steep declines in sandeel stocks and in seabirds that feed on them. Great skuas have been able to prey switch to respond to this change, supported by abundant discards, enabling them to maintain a favourable population status while other seabird species have declined.
Inpatient portal clusters: identifying user groups based on portal features
Authors: Fareed Naleef , Walker Daniel , Sieck Cynthia J , Taylor Robert , Scarborough Seth , Huerta Timothy R , McAlearney Ann Scheck
Published: October 2018

Objective

Conduct a cluster analysis of inpatient portal (IPP) users from an academic medical center to improve understanding of who uses these portals and how.

Methods

We used 18 months of data from audit log files, which recorded IPP user actions, of 2815 patient admissions. A hierarchical clustering algorithm was executed to group patient admissions on the basis of proportion of use for each of 10 IPP features. Post-hoc analyses were conducted to further understand IPP use.

Results

Five cluster solutions were developed for the study sample. Our taxonomy included users with high levels of accessing features that were linked to reviewing schedules, results, tutorials, and ordering food. Patients tended to stay within their clusters over multiple admissions, and the clusters had differences based on patient and clinical characteristics.

Discussion

Distinct groups of users exist among IPP users, suggesting that training on IPP use to enhance patient engagement could be tailored to patients. More exploration is also needed to understand why certain features were not used across all clusters.

Conclusions

It is important to understand the specifics about how patients use IPPs to help them better engage with their healthcare. Our taxonomy enabled characterization of 5 groups of IPP users who demonstrated distinct preferences. These results may inform targeted improvements to IPP tools, could provide insights to improve patient training around portal use, and may help care team members effectively engage patients in the use of IPPs. We also discuss the implications of our findings for future research.
Implementation of a Pragmatic Biomarker-Driven Algorithm to Guide Antibiotic Use in the Pediatric Intensive Care Unit: the Optimizing Antibiotic Strategies in Sepsis (OASIS) II Study
Authors: Downes Kevin J , Fitzgerald Julie C , Schriver Emily , Boge Craig L K , Russo Michael E , Weiss Scott L , Balamuth Fran , Kubis Sherri E , Tolomeo Pam , Bilker Warren B , Han Jennifer H , Lautenbach Ebbing , Coffin Susan E , Gerber Jeffrey S
Published: October 2018

Background

Biomarkers can facilitate safe antibiotic discontinuation in critically ill patients without bacterial infection.

Methods

We tested the ability of a biomarker-based algorithm to reduce excess antibiotic administration in patients with systemic inflammatory response syndrome (SIRS) without bacterial infections (uninfected) in our pediatric intensive care unit (PICU). The algorithm suggested that PICU clinicians stop antibiotics if (1) C-reactive protein <4 mg/dL and procalcitonin <1 ng/mL at SIRS onset and (2) no evidence of bacterial infection by exam/testing by 48 hours. We evaluated excess broad-spectrum antibiotic use, defined as administration on days 3–9 after SIRS onset in uninfected children. Incidence rate ratios (IRRs) compared unadjusted excess length of therapy (LOT) in the 34 months before (Period 1) and 12 months after (Period 2) implementation of this algorithm, stratified by biomarker values. Segmented linear regression evaluated excess LOT among all uninfected episodes over time and between the periods.

Results

We identified 457 eligible SIRS episodes without bacterial infection, 333 in Period 1 and 124 in Period 2. When both biomarkers were below the algorithm’s cut-points (n = 48 Period 1, n = 31 Period 2), unadjusted excess LOT was lower in Period 2 (IRR, 0.53; 95% confidence interval, 0.30–0.93). Among all 457 uninfected episodes, there were no significant differences in LOT (coefficient 0.9, P = .99) between the periods on segmented regression.

Conclusions

Implementation of a biomarker-based algorithm did not decrease overall antibiotic exposure among all uninfected patients in our PICU, although exposures were reduced in the subset of SIRS episodes where biomarkers were low.
Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Use of Stereotactic Radiosurgery in the Treatment of Adults With Metastatic Brain Tumors
Authors: Graber Jerome J , Cobbs Charles S , Olson Jeffrey J
Published: October 2018

TARGET POPULATION

These recommendations apply to adult patients with new or recurrent solitary or multiple brain metastases from solid tumors as detailed in each section.

QUESTION 1

Should patients with newly diagnosed metastatic brain tumors undergo stereotactic radiosurgery (SRS) compared with other treatment modalities?

RECOMMENDATIONS

Level 3: SRS is recommended as an alternative to surgical resection in solitary metastases when surgical resection is likely to induce new neurological deficits, and tumor volume and location are not likely to be associated with radiation-induced injury to surrounding structures.

Level 3: SRS should be considered as a valid adjunctive therapy to supportive palliative care for some patients with brain metastases when it might be reasonably expected to relieve focal symptoms and improve functional quality of life in the short term if this is consistent with the overall goals of the patient.

QUESTION 2

What is the role of SRS after open surgical resection of brain metastasis?

RECOMMENDATION

Level 3: After open surgical resection of a solitary brain metastasis, SRS should be used to decrease local recurrence rates.

QUESTION 3

What is the role of SRS alone in the management of patients with 1 to 4 brain metastases?

RECOMMENDATIONS

Level 3: For patients with solitary brain metastasis, SRS should be given to decrease the risk of local progression.

Level 3: For patients with 2 to 4 brain metastases, SRS is recommended for local tumor control, instead of whole brain radiotherapy, when their cumulative volume is < 7 mL.

QUESTION 4

What is the role of SRS alone in the management of patients with more than 4 brain metastases?

RECOMMENDATION

Level 3: The use of stereotactic radiosurgery alone is recommended to improve median overall survival for patients with more than 4 metastases having a cumulative volume < 7 mL. The full guideline can be found at: https://www.cns.org/guidelines/guidelines-treatment-adults-metastatic-brain-tumors/chapter_4
Procedural Variables Influencing Stereotactic Accuracy and Efficiency in Deep Brain Stimulation Surgery
Authors: Mirzadeh Zaman , Chen Tsinsue , Chapple Kristina M , Lambert Margaret , Karis John P , Dhall Rohit , Ponce Francisco A
Published: October 2018

BACKGROUND

Deep brain stimulation (DBS) is well-established, evidence-based therapy for Parkinson disease, essential tremor, and primary dystonia. Clinical outcome studies have recently shown that “asleep” DBS lead placement, performed using intraoperative imaging with stereotactic accuracy as the surgical endpoint, has motor outcomes comparable to traditional “awake” DBS using microelectrode recording (MER), but with shorter case times and improved speech fluency.

OBJECTIVE

To identify procedural variables in DBS surgery associated with improved surgical efficiency and stereotactic accuracy.

METHODS

Retrospective review of 323 cases with 546 leads placed (August 2011-October 2014). In 52% (n = 168) of cases, patients were asleep under general anesthesia without MER. Multivariate regression identified independent predictors of reduced surgery time and improved stereotactic accuracy.

RESULTS

MER was an independent contributor to increased procedure time (+44 min; P = .03). Stereotactic accuracy was better in asleep patients. Accuracy was improved with frame-based stereotaxy at head of bed 0° vs frameless stereotaxy at head of bed 30°. Improved accuracy was also associated with shorter procedures (r = 0.17; P = .049). Vector errors were evenly distributed around the planned target for the globus pallidus internus, but directionally skewed for the subthalamic (medial-posterior) and ventral intermediate nuclei (medial-anterior).

CONCLUSION

Distinct procedural variables in DBS surgery are associated with reduced case times and improved stereotactic accuracy.
Optimum frequency of Faraday tomography to explore the intergalactic magnetic field in filaments of galaxies
Authors: Akahori Takuya , Ideguchi Shinsuke , Aoki Takahiro , Takefuji Kazuhiro , Ujihara Hideki , Takahashi Keitaro
Published: October 2018

Faraday tomography is thought to be a powerful tool to explore the cosmic magnetic field. Broadband radio polarimetric data are essential to ensuring the quality of Faraday tomography, but such data are not easy to obtain because of radio frequency interferences. In this paper, we investigate optimum frequency coverage of Faraday tomography so as to explore the Faraday rotation measure (RM) due to the intergalactic magnetic field (IGMF) in filaments of galaxies. We adopt a simple model of the IGMF and estimate confidence intervals of the model parameters using the Fisher information matrix. We find that meaningful constraints on RM due to the IGMF are available with data at multiple narrowbands which are scattered over the ultra-high frequency (UHF, 300–3000 MHz). The optimum frequency depends on the Faraday thickness of the Milky Way foreground. These results are obtained for a wide brightness range of the background source including fast radio bursts. We discuss the relation between the polarized-intensity spectrum and the optimum frequency.
Intravenous vs Oral Acetaminophen for Analgesia After Cesarean Delivery: A Randomized Trial
Authors: Wilson Sylvia H , Wolf Bethany J , Robinson Stefanie M , Nelson Cecil , Hebbar Latha
Published: October 2018

Objective

Examination of postoperative analgesia with intravenous and oral acetaminophen.

Design

Prospective, three-arm, nonblinded, randomized clinical trial.

Setting

A single academic medical center.

Subjects

Parturients scheduled for elective cesarean delivery.

Methods

This trial randomized 141 parturients to receive intravenous acetaminophen (1 g every eight hours, three doses), oral acetaminophen (1 g every eight hours, three doses), or no acetaminophen. All patients received a standardized neuraxial anesthetic with intrathecal opioids and scheduled postoperative ketorolac. The primary outcome, 24-hour opioid consumption, was evaluated using the Kruskal-Wallace test and Tukey-Kramer adjustment for multiple comparisons. Secondary outcomes included 48-hour opioid consumption, first opioid rescue, pain scores, patient satisfaction, times to ambulation and discharge, and side effects.

Results

Over 18 months, 141 parturients with similar demographic variables completed the study. Median (interquartile range) opioid consumption in intravenous morphine milligram equivalents at 24 hours was 0 (5), 0 (7), and 5 (7) for the intravenous, oral, and no groups, respectively, and differed between groups (global P = 0.017). Opioid consumption and other secondary outcomes did not differ between the intravenous vs oral or oral vs no groups. Opioid consumption was reduced at 24 hours with intravenous vs no acetaminophen (P = 0.015). Patients receiving no acetaminophen had 5.8 times the odds of consuming opioids (P = 0.036), consumed 40% more opioids controlling for time (P = 0.041), and had higher pain scores with ambulation (P = 0.004) compared with the intravenous group.

Conclusions

Intravenous acetaminophen did not reduce 24-hour opioid consumption or other outcomes compared with oral acetaminophen. Intravenous acetaminophen did decrease opioid consumption and pain scores compared with no acetaminophen.
THE COMPARISON OF THE EXTERNAL DOSE RATE MEASUREMENT OF CHILDREN AND ADOLESCENT PATIENTS WITH ADULT PATIENTS TREATED WITH RADIOIODINE THERAPY
Authors: Edis Nurcan , Tamam Muge Oner
Published: October 2018

The aim of this study is to evaluate the radiation safety of caregiving people contacting the child and adolescent patients with thyroid cancer who received radioactive iodine-131 (RIT) treatment by comparison with external dose rate measurements of adult patients according to their administered activities and days of hospitalization. We retrospectively evaluated external dose rate measurement of 158 children and adolescent patients and 158 adult patients. During the RIT, the hospitalization time were grouped as 2, 3 and 4 d, and the administered activities as <3700, 3700 and >3700 MBq. The values of external dose rate measurements of children and adolescents were statistically significantly higher than the adult group. Different approaches in radiation safety rules are required for children and adolescents. In terms of radiation safety, we suggest that more specific regulations for family members and caregivers should be established and informed.
A Meta-analysis of Immune Parameters, Variability, and Assessment of Modal Distribution in Psychosis and Test of the Immune Subgroup Hypothesis
Authors: Pillinger Toby , Osimo Emanuele F , Brugger Stefan , Mondelli Valeria , McCutcheon Robert A , Howes Oliver D
Published: October 2018

Immune parameters are elevated in psychosis, but it is unclear whether alterations are homogenous across patients or heterogeneity exists, consistent with the hypothesis that immune alterations are specific to a subgroup of patients. To address this, we examine whether antipsychotic-naïve first-episode psychosis patients exhibit greater variability in blood cytokines, C-reactive protein, and white cell counts compared with controls, and if group mean differences persist after adjusting for skewed data and potential confounds. Databases were searched for studies reporting levels of peripheral immune parameters. Means and variances were extracted and analyzed using multivariate meta-analysis of mean and variability of differences. Outcomes were (1) variability in patients relative to controls, indexed by variability ratio (VR) and coefficient of variation ratio (CVR); (2) mean differences indexed by Hedges g; (3) Modal distribution of raw immune parameter data using Hartigan’s unimodality dip test. Thirty-five studies reporting on 1263 patients and 1470 controls were included. Variability of interleukin-6 (IL6) (VR = 0.19), tumor necrosis factor-α (TNFα) (VR = 0.36), interleukin-1β (VR = 0.35), interleukin-4 (VR = 0.55), and interleukin-8 (VR = 0.28) was reduced in patients. Results persisted for IL6 and IL8 after mean-scaling. Ninety-four percent and one hundred percent of raw data were unimodally distributed in psychosis and controls, respectively. Mean levels of IL6 (g = 0.62), TNFα (g = 0.56), interferon-γ (IFNγ) (g = 0.32), transforming growth factor-β (g = 0.53), and interleukin-17 (IL17) (g = 0.48) were elevated in psychosis. Sensitivity analyses indicated this is unlikely explained by confounders for IL6, IFNγ, and IL17. These findings show elevated cytokines in psychosis after accounting for confounds, and that the hypothesis of an immune subgroup is not supported by the variability or modal distribution.
Cognitive Effects of Perioperative Pregabalin
Authors: Myhre Marianne , Jacobsen Henrik Børsting , Andersson Stein , Stubhaug Audun
Published: October 2018

EDITOR’S PERSPECTIVE

What We Already Know about This Topic

Perioperative administration of pregabalin has been associated with decreased postoperative pain and opioid requirements

What This Article Tells Us That Is New

This secondary analysis of data demonstrating that perioperative administration of pregabalin was associated with a reduction in opioid requirements and incisional hyperalgesia suggests that these benefits may be compromised by an increased risk of developing impaired postoperative cognitive performance

Background

Pregabalin has shown opioid sparing and analgesic effects in the early postoperative period; however, perioperative effects on cognition have not been studied. A randomized, parallel group, placebo-controlled investigation in 80 donor nephrectomy patients was previously performed that evaluated the analgesic, opioid-sparing, and antihyperalgesic effects of pregabalin. This article describes a secondary exploratory analysis that tested the hypothesis that pregabalin would impair cognitive function compared to placebo.

Methods

Eighty patients scheduled for donor nephrectomy participated in this randomized, placebo-controlled study. Pregabalin (150 mg twice daily, n = 40) or placebo (n = 40) was administered on the day of surgery and the first postoperative day, in addition to a pain regimen consisting of opioids, steroids, local anesthetics, and acetaminophen. Specific cognitive tests measuring inhibition, sustained attention, psychomotor speed, visual memory, and strategy were performed at baseline, 24 h, and 3 to 5 days after surgery, using tests from the Cambridge Neuropsychological Test Automated Battery.

Results

In the spatial working memory within errors test, the number of errors increased with pregabalin compared to placebo 24 h after surgery; median (25th, 75th percentile) values were 1 (0, 6) versus 0 (0, 1; rate ratio [95% CI], 3.20 [1.55 to 6.62]; P = 0.002). Furthermore, pregabalin significantly increased the number of errors in the stop-signal task stop-go test compared with placebo; median (25th, 75th percentile) values were 3 (1, 6) versus 1 (0, 2; rate ratio, 2.14 [1.13 to 4.07]; P = 0.020). There were no significant differences between groups in the paired associated learning, reaction time, rapid visual processing, or spatial working memory strategy tests.

Conclusions

Perioperative pregabalin significantly negatively affected subdomains of executive functioning, including inhibition, and working memory compared to placebo, whereas psychomotor speed was not changed.
Data and Lifelong Learning Protocol: Understanding Cultural Barriers and Facilitators to Using Clinical Performance Data to Support Continuing Professional Development
Authors: Wiljer David , Tavares Walter , Mylopoulos Maria , Campbell Craig , Charow Rebecca , Davis Dave , Okrainec Allan , Silver Ivan , Sockalingam Sanjeev
Published: October 2018

Continuing professional development (CPD) can support delivery of high-quality care, but may not be optimized until we can understand cultural barriers and facilitators, especially as innovations emerge. Lifelong learning (LLL), linked with quality improvement, competence, and professionalism, is a core competency in medical education. The purpose of this study is to examine cultural factors (individual, organizational, and systemic) that influence CPD and specifically the use of clinical data to inform LLL and CPD activities. This mixed-method study will examine the perceptions of two learner groups (psychiatrists and general surgeons) in three phases: (1) a survey to understand the relationship between data-informed learning and orientation to LLL; (2) semistructured interviews using purposive and maximum variation sampling techniques to identify individual-, organizational-, and system-level barriers and facilitators to engaging in data-informed LLL to support practice change; and (3) a document analysis of legislation, policies, and procedures related to the access and the use of clinical data for performance improvement in CPD. We obtained research ethics approval from the University Health Network in Toronto, Ontario, Canada. By exploring two distinct learner groups, we will identify contextual features that may inform what educators should consider when conceptualizing and designing CPD activities and what initial actions need to be taken before CPD activities can be optimized. This study will lead to the development of a framework reflective of barriers and facilitators that can be implemented when planning to use data in CPD activities to support data adoption for LLL.
Evaluation of Aqueous Endocan and Endostatin Levels in Patients With Pseudoexfoliation Syndrome
Authors: Yağci Ramazan , Dervişoğullari Serdar , Güler Emre , Totan Yüksel , Hepşen İbrahim F.
Published: October 2018

Purpose:

The purpose of the present study was to evaluate the aqueous humor endocan and endostatin levels in patients with pseudoexfoliation (PEX) syndrome and to compare the results with healthy individuals.

Materials and Methods:

Twenty nine cataract patients with PEX syndrome (PEX group) and 32 cataract patients without PEX syndrome (control group) were enrolled in the study. Endocan and endostatin were measured in the aqueous humor of the PEX and control groups by enzyme-linked immunosorbent assay.

Results:

There was no difference between the PEX and control groups in terms of age (P=0.721) and sex (P=0.902). The aqueous levels of endocan in patients with PEX (26.39±5.80 pg/mL) was significantly higher than in the control group (11.42±2.44 pg/mL) (P=0.039). The aqueous levels of endostatin was 12.00±1.35 ng/mL in the PEX group and 14.22±3.31 ng/mL in the control group, however, the difference was not statistically significant (P=0.41).

Conclusions:

The findings of the present study could suggest that the increased levels of aqueous endocan may be related to pathogenesis of PEX. However, levels of aqueous endostatin did not show any significant difference in PEX.
Higher Body Mass Index Adversely Affects Knee Function After Anterior Cruciate Ligament Reconstruction in Individuals Who Are Recreationally Active
Authors: Harput Gulcan , Guney-Deniz Hande , Ozer Hamza , Baltaci Gul , Mattacola Carl
Published: October 2018

Objective:

Our aim was to investigate the effect of body mass index (BMI) levels on quadriceps and hamstring strength and functional outcomes up to 6 months after anterior cruciate ligament reconstruction (ACLR) with hamstring tendon autograft (HTG).

Design:

Prospective, controlled study.

Setting:

University clinical laboratory.

Patients:

Ninety-one participants who had undergone unilateral ACLR with HTG were divided into 2 groups according to their BMI. The participants whose BMI were between 18.5 and 24.9 kg/m2 were included in group 1 (n = 50, age: 27.2 ± 6.7 years, BMI: 22.3 ± 1.6 kg/m2) and those whose BMI > 24.9 kg/m2 were included in group 2 (n = 41, age: 30.2 ± 6.9 years, BMI: 28.0 ± 2.4 kg/m2).

Interventions:

Quadriceps and hamstring strength, functional performance including hop, jump, and balance performance, and IKDC score.

Main Outcome Measures:

Maximum voluntary isometric contraction of the quadriceps and hamstring muscles and the body mass were measured at 1, 3, and 6 months after surgery. Absolute peak torques and normalized peak torques to body weight for both limbs were recorded. Functional outcomes were evaluated at 6 months after surgery.

Results:

Normalized quadriceps strength improvement was lower in group 2 when compared with group 1 (F
(2,178) = 6.23, P = 0.003). Group 2 also demonstrated lower scores in functional performance (P < 0.05). Normalized hamstring and absolute quadriceps and hamstring strength improvement was not affected by higher BMI level (P > 0.05).

Conclusions:

Higher BMI levels adversely affect quadriceps strength capacity and performance in patients who have undergone ACLR with HTG. Clinicians should consider BMI levels of patients when assessing and targeting muscle recovery because it could negatively affect the success of the ACLR rehabilitation.
Do Normative Composite Scores on the Functional Movement Screen Differ Across High School, Collegiate, and Professional Athletes? A Critical Review
Authors: Pollen Travis R. , Keitt Frazier , Trojian Thomas H.
Published: October 2018

Objective:

The Functional Movement Screen (FMS) is a battery of 7 unloaded tests designed to rate human movement competency. Injury rates vary across the different level of a sport. The purpose of this critical review was to determine whether normative FMS composite scores differ across high school, collegiate, and professional athletic populations and to determine whether normative composite scores correlate with rates of severe injury across different collegiate sports.

Data Sources:

PubMed, Web of Science, and EBSCO databases from inception to September 2017 with the following syntax: “functional movement screen*” OR “movement screen*”. Additional records were identified by citation tracking and hand search of articles.

Study Selection:

A total of 708 records identified, of which 36 were included. Studies were included if they reported a FMS composite score for one of the groups.

Data Extraction:

Two reviewers (T.R.P. and F.K.) screened records for the author and year; sample size; study design; sport(s); number, age, and sex of participants; testing conditions; methodological quality; and mean or median composite score(s).

Data Synthesis:

Normative FMS composite scores were invariant to level of play, with 61% of reported scores falling between 14 and 16, despite injury rates increasing by level of play. Scores for high school, college, and professional athletes were 14.1, 14.8, and 15.7, respectively. There was a significant positive relationship between composite scores and rate of severe injury in college sports (r(11) = 0.66, P = 0.014).

Conclusions:

Our findings potentially undermine the FMS's predictive validity. Although the FMS may have other applications, this critical review provides further evidence against the composite score for injury prediction in competitive athletes.
Performance of Endobronchial Ultrasound Elastography in the Differentiation of Malignant and Benign Mediastinal Lymph Nodes
Authors: Fournier Clément , Dhalluin Xavier , Wallyn Frederic , Machuron François , Bouchindhomme Brigitte , Copin Marie C. , Valentin Victor
Published: October 2018

Background:

Little data exists regarding the performance of elastography in EBUS-TBNA. The aim of the study was to evaluate the elastography score proposed and previously published by Izumo, in particular its capacity to perfectly identify benign lymph node, and to discriminate malignant ones.

Methods:

This study included patients undergoing EBUS-TBNA for mediastinal lymph nodes (LN). Before LN needle aspiration, an elastography was performed which allowed a color elastogram to be superimposed on the ultrasound image. Three blinded assessors classified these elastograms into 3 types using the score published by Izumo: type 1 (predominantly not blue), type 2 (partially blue, partially not blue), or type 3 (predominantly blue). These types were then compared with pathology results.

Results:

A total of 217 LN (114 patients) were analyzed: histologic findings identified 97 benign LN (44.7% of the lymph nodes) and 120 malignant LN (55.3%). There were 44 elastographies (20.2%) that were classified as type 1, 90 elastographies (41.5%) classified as type 2, and 83 elastographies (38.3%) classified as type 3. Considering type 1 as benign and type 3 as malignant, sensitivity, specificity, positive predictive value, and negative predictive value were respectively 87.0%, 68.0% , 80.0% , and 77.0%. Ten (23%) of the 44 lymph nodes with a type 1 elastogram were malignant.

Conclusion:

Elastography does not preclude performing TBNA of the lymph nodes. It does not preclude EBUS-TBNA when a type 1 elastogram pattern is found. All lymph nodes visualized should be sampled by EBUS-TBNA, regardless of elastography pattern.
Introducing the “ChOLE” Classification and Its Comparison to the EAONO/JOS Consensus Classification for Cholesteatoma Staging
Authors: Linder Thomas E. , Shah Shankar , Martha Aline Silveira , Röösli Christof , Emmett Susan D.
Published: October 2018

Many previous attempts have been made to classify or categorize cholesteatomas. Recently, the European Academy of Otology and Neurotology and the Japanese Otological Society proposed a classification system based primarily on extension and complications. The European Academy of Otology and Neurotology/Japanese Otological Society consensus statement makes an effort to standardize reporting of surgical techniques. Internet-based multicenter studies are facilitated by increasing connectivity, but a mutually-agreed framework for reporting is necessary for results to be comparable across sites. New technologies compete with established standardized surgical approaches and need to be validated. It is definitively the right time to find a consensus on how to record and report surgical findings in cholesteatoma surgery. To stimulate this interesting discussion, we propose a ChOLE-classification system, which is based on the differentiation into extension (Ch), status of the ossicular chain at the end of surgery (O), complications (L), and degree of pneumatization and ventilation (E). A numeric rule is used to stage these cholesteatomas from I–III.
Predictive Potential of Eyelids and Tear Film in Determining Symptoms in Contact Lens Wearers
Authors: Siddireddy Jaya Sowjanya , Tan Jacqueline , Vijay Ajay Kumar , Willcox Mark
Published: October 2018

SIGNIFICANCE

Early diagnosis of clinical markers of contact lens discomfort can help clinicians set realistic expectations and monitor and provide prophylactic management for contact lens wearers.

PURPOSE

The purpose of this study was to evaluate the potential of eyelid- and tear film–related clinical markers to be used as predictive factors for diagnosing discomfort in contact lens wearers.

METHODS

A cross-sectional study was performed on 30 contact lens wearers (6 male, 24 female) with median age of 23 years (range, 18 to 41 years). Eyelid signs and tear film characteristics were evaluated during a single visit, and subjects completed the Contact Lens Dry Eye Questionnaire to evaluate ocular discomfort. Area under the curve (AUC) statistics and sensitivity and specificity values from receiver operating characteristic curves were analyzed to evaluate the predictive potential of clinical signs in discriminating symptoms of contact lens discomfort.

RESULTS

The presence of foam at meibomian gland orifices (AUC, 0.944; P < .05; sensitivity >0.7), meibomian gland secretion volume (AUC, 0.935; P < .05; sensitivity >0.7), quality (AUC, 0.969; P < .05; sensitivity >0.7), and expressibility (AUC, 0.933; P < .05; sensitivity >0.7) were significant and strong predictors of discomfort in lens wear. Tear evaporation rates with (AUC, 0.779; P < .05; sensitivity >0.7) or without contact lenses (AUC, 0.788; P < .05; sensitivity >0.7), palpebral conjunctival roughness (AUC, 0.859; P < .05; sensitivity >0.7), palpebral conjunctival staining (AUC, 0.817; P < .05; sensitivity >0.7), palpebral conjunctival hyperemia (AUC, 0.746; P < .05; sensitivity >0.7), meibomian gland orifice capping (AUC, 0.873; P < .05; sensitivity >0.7), pouting (AUC, 0.891; P < .05; sensitivity >0.7), and lid-parallel conjunctival folds (AUC, 0.770; P < .05; sensitivity >0.7) were other acceptable discriminators of symptoms of discomfort during contact lens wear. An equation was developed to identify symptomatic from asymptomatic lens wearers based on the significant predictors: Symptom discriminant function score = 3.378 (meibomian gland secretion grade) + 0.224 (meibomian gland morphology grade) + 0.61 (tear evaporation rate without contact lenses) + 0.439 (lid-parallel conjunctival folds grade) − 0.346 (palpebral conjunctival health grade) − 4.625.

CONCLUSIONS

This study demonstrated that clinical signs related to meibomian gland secretions and morphology, tear evaporation, lid-parallel conjunctival folds, and palpebral conjunctival health may successfully predict symptoms of discomfort in contact lens wearers.
Cornea Full-field Displacement and Strain Measurement in Vivo Using Three-dimensional Digital Image Correlation
Authors: Zhang Xueyong , Wang Qing , Wang Like , Xiao Hong , Zhang Daming , Liao Rongfeng , Zheng Yongping
Published: October 2018

SIGNIFICANCE

Corneal biomechanics are becoming increasingly important for clinical evaluation and diagnosis, such as in refractive surgery, glaucoma, and keratoconus. We developed and used a new technique to measure the full-field displacement and strain of the cornea under elevated intraocular pressure in vivo.

PURPOSE

In this study, we propose a three-dimensional digital image correlation method for the determination of corneal biomechanical properties.

METHODS

Corneal deformation change on the rabbit eyeball was investigated under different inflation conditions with intraocular pressure levels of 2.3, 3.3, 5.3, and 6.9 kPa in vivo.

RESULTS

The proposed method was able to measure the displacement of the corneal surface and to construct real-time full-field three-dimensional deformation vector fields and strain mapping. The results show that the strain distribution is not uniform on the corneal surface at each intraocular pressure level. Compression strains, rather than extensile strains, are dominant at the corneal apex region.

CONCLUSIONS

This technique has the potential to be used as an assistive tool for the determination of corneal biomechanical properties in ophthalmologic investigations.
Case Report: Penetrating Corneal Injury Under an Intact Laser-assisted in Situ Keratomileusis Flap
Authors: Maki Sarah , Hou Joshua H.
Published: October 2018

SIGNIFICANCE

As the prevalence of post–laser-assisted in situ keratomileusis (LASIK) patients rises, recognition of possible traumatic complications and their management in this population becomes increasingly relevant. Penetrating injuries and intraocular foreign bodies are possible in post-LASIK corneas despite an intact anterior corneal surface. However, with prompt recognition and treatment, excellent visual recovery can be achieved.

PURPOSE

The purpose of this study was to report an interesting case of a penetrating foreign body through an intact LASIK flap.

CASE REPORT

A 48-year-old man presented to an outside provider with right eye pain after his eye was struck by a tree branch. His ocular history was notable for uncomplicated LASIK surgery 4 years before presentation. On initial examination, the patient was diagnosed as having a small corneal abrasion and hyphema. Despite appropriate therapy, his eye continued to subjectively and objectively worsen. Follow-up examination after the injury was notable for a new dense hypopyon. Because of concern for secondary infection, the patient was referred urgently for further evaluation. Upon referral, the patient was noted to have a dense, fibrinous mass located inferiorly in the anterior chamber. Although the cornea was edematous temporally with deep folds, the anterior corneal surface appeared intact without evidence of laceration or flap displacement. Concern for endophthalmitis prompted anterior chamber washout, where a large vegetative foreign body was recovered despite an intact anterior corneal surface and LASIK. Post-operative anterior-segment optical coherence tomography after resolution of the corneal edema confirmed the presence of a well-aligned penetrating tract through the posterior stromal bed underneath the LASIK flap. Epithelial ingrowth that developed within the post-operative period further affirmed the initial tract of the penetrating foreign body.

CONCLUSIONS

This case illustrates a novel complication after trauma in a post-LASIK patient, describes possible management, and underscores the care that must be taken when assessing patients with a history of LASIK surgery.
No evidence of widespread mechanical pressure hyperalgesia after experimentally induced central sensitization through skin nociceptors
Authors: Cayrol Timothée , Pitance Laurent , Roussel Nathalie , Mouraux André , van den Broeke Emanuel N.
Published: October 2018

Introduction:

An increasing number of clinical studies involving a range of chronic pain conditions report widespread mechanical pressure pain hypersensitivity, which is commonly interpreted as resulting from central sensitization (CS). Secondary hyperalgesia (increased pinprick sensitivity surrounding the site of injury) is considered to be a manifestation of CS. However, it has not been rigorously tested whether CS induced by peripheral nociceptive input involves widespread mechanical pressure pain hypersensitivity.

Objectives:

The aim of this study was to assess whether high-frequency electrical stimulation (HFS), which induces a robust secondary hyperalgesia, also induces a widespread decrease of pressure pain thresholds (PPTs).

Methods:

We measured PPTs bilaterally on the temples (temporalis muscles), on the legs (tibialis anterior muscles), and on the ventral forearm (flexor carpi radialis muscles) before, 20 minutes after, and 45 minutes after applying HFS on the ventral forearm of sixteen healthy young volunteers. To evaluate the presence of secondary hyperalgesia, mechanical pinprick sensitivity was assessed on the skin surrounding the site where HFS was applied and also on the contralateral arm.

Results:

HFS induced a significant increase in mechanical pinprick sensitivity on the HFS-treated arm. However, HFS did not decrease PPTs neither in the area of increased pinprick sensitivity nor at more distant sites.

Conclusion:

This study provides no evidence for the hypothesis that CS, induced after intense activation of skin nociceptors, involves a widespread decrease of PPTs.
Iodine Quantification Using Dual-Energy Computed Tomography for Differentiating Thymic Tumors
Authors: Yan Wei-Qiang , Xin Yong-Kang , Jing Yong , Li Gang-Feng , Wang Shu-Mei , Rong Wei-Cheng , Xiao Gang , Lei Xue-Bin , Li Bo , Hu Yu-Chuan , Cui Guang-Bin
Published: October 2018

Purpose

The aim of the study was to explore the efficacy of iodine quantification with dual-energy computed tomography (DECT) in differentiating thymoma, thymic carcinoma, and thymic lymphoma.

Materials and Methods

Fifty-seven patients with pathologically confirmed low-risk thymoma (n = 16), high-risk thymoma (n = 15), thymic carcinoma (n = 14), and thymic lymphoma (n = 12) underwent chest contrast-enhanced DECT scan were enrolled in this study. Tumor DECT parameters including iodine-related Hounsfield unit (IHU), iodine concentration (IC), mixed HU (MHU), and iodine ratio in dual phase, slope of energy spectral HU curve (λ), and virtual noncontrast (VNC) were compared for differences among 4 groups by one-way analysis of variance. Receiver operating characteristic curve was used to determine the efficacy for differentiating the low-risk thymoma from other thymic tumor by defined parameters.

Results

According to quantitative analysis, dual-phase IHU, IC, and MHU values in patients with low-risk thymoma were significantly increased compared with patients with high-risk thymoma, thymic carcinoma, and thymic lymphoma (P < 0.05/4).The venous phase IHU value yielded the highest performance with area under the curve of 0.893, 75.0% sensitivity, and 89.7% specificity for differentiating the low-risk thymomas from high-risk thymomas or thymic carcinoma at the cutoff value of 34.3 HU. When differentiating low-risk thymomas from thymic lymphoma, the venous phase IC value obtained the highest diagnostic efficacy with the area under the curve of 0.969, and sensitivity, specificity, and cutoff value were 87.5%, 100.0%, and 1.25 mg/mL, respectively.

Conclusions

Iodine quantification with DECT may be useful for differentiating the low-risk thymomas from other thymic tumors.