bluuebunny/crossref_metadata_2025 huggingface dataset:
The Non-Lantibiotic Bacteriocin Garvicin Q Targets Man-PTS in a Broad Spectrum of Sensitive Bacterial Genera
Authors: Tymoszewska Aleksandra , Diep Dzung B. , Wirtek Paulina , Aleksandrzak-Piekarczyk Tamara
Published: August 2017

Mannose phosphotransferase system (Man-PTS) is the main mannose permease in bacteria but it is also a known receptor for subclass IIa bacteriocins (pediocin-like group) as well as subclass IId lactococcin A (LcnA) and lactococcin B (LcnB) (LcnA-like group). Subclass IIa bacteriocins exhibit a strong activity against Listeria spp. but they are not against Lactococcus spp. In contrast, the LcnA-like bacteriocins act only against Lactococcus lactis strains. Garvicin Q (GarQ) is a subclass IId bacteriocin with minor similarity to LcnA-like bacteriocins and a relatively broad antimicrobial spectrum including, among others, Listeria and Lactococcus spp. To identify the GarQ receptor, we obtained GarQ-resistant mutants of Lactococcus garvieae IBB3403 and L. lactis IL1403 and sequenced their genomes that revealed mutations in genes encoding the membrane-bound Man-PTS IIC or IID subunits encoded by ptnCD in L. lactis and manCD in L. garvieae. This is the first time that a bacteriocin outside the pediocin- and LcnA-like groups is shown to target Man-PTS. The interaction between GarQ and Man-PTS may occur through a new binding pattern involving specific amino acids highly conserved among the GarQ-sensitive bacterial species located in the N-terminal part and extracellular loops of subunit IID and in transmembrane region of IIC.
Effect of hydrogen passivation on the decoupling of graphene on SiC(0001) substrate: First-principles calculations
Authors: Liu Kang , Yan Pinglan , Li Jin , He Chaoyu , Ouyang Tao , Zhang Chunxiao , Tang Chao , Zhong Jianxin
Published: August 2017

Intercalation of hydrogen is important for understanding the decoupling of graphene from SiC(0001) substrate. Employing first-principles calculations, we have systematically studied the decoupling of graphene from SiC surface by H atoms intercalation from graphene boundary. It is found the passivation of H atoms on both graphene edge and SiC substrate is the key factor of the decoupling process. Passivation of graphene edge can weaken the interaction between graphene boundary and the substrate, which reduced the energy barrier significantly for H diffusion into the graphene-SiC interface. As more and more H atoms diffuse into the interface and saturate the Si dangling bonds around the boundary, graphene will detach from substrate. Furthermore, the energy barriers in these processes are relatively low, indicating that these processes can occur under the experimental temperature.
Auditory verbal hallucinations related to altered long-range synchrony of gamma-band oscillations
Authors: Steinmann Saskia , Leicht Gregor , Andreou Christina , Polomac Nenad , Mulert Christoph
Published: August 2017

Our understanding of the neural correlates of auditory-verbal-hallucinations (AVH) has substantially increased during the last few years, but is far from sufficient. One current hypothesis, the interhemispheric miscommunication theory, is based on findings from fMRI, DTI and EEG, but there is only limited evidence so far concerning underlying functional coupling mechanisms. Here we report a 64-channel EEG study using lagged phase synchronization analysis and eLORETA source estimation to examine the functional connectivity between bilateral auditory cortices in the gamma-band in 26 schizophrenia patients (13 with and 13 without AVH) and 26 matched healthy controls (HC) while performing a dichotic listening task. We found a significantly reduced right-ear-advantage (REA) in AVH but not in non-AVH patients compared to HC. The major finding was significantly stronger gamma-band connectivity between bilateral auditory cortices during conscious perception of left (versus right) ear syllables in patients with AVH compared to HC and patients without AVH. A significant positive correlation was found between this connectivity alteration and the AVH symptom score in schizophrenia patients. These findings provide further support for the interhemispheric miscommunication hypothesis of AVH pathophysiology by indicating that aberrant gamma-band coupling between auditory cortices is related to the emergence of AVH in schizophrenia.
A unique thermo-induced gel-to-gel transition in a pH-sensitive small-molecule hydrogel
Authors: Xie Hongtao , Asad Ayoubi Mehran , Lu Wensheng , Wang Jide , Huang Jianbin , Wang Wei
Published: August 2017

For a hydrogel based on a zwitterionic dendritic surfactant, we report an apparently unprecedented reversible temperature-induced gel-to-gel phase transition below the melting point of its alkyl chains, where the supramolecular self-assembly of surfactant molecules underwent a dramatic transformation from low-temperature surfactant bilayers to high-temperature entangled surfactant worm-like micelles.
Microfluidic synthesis of α-ketoesters via oxidative coupling of acetophenones with alcohols under metal-free conditions
Authors: Guo Shiyu , Dai Zhongxue , Hua Jiawei , Yang Zhao , Fang Zheng , Guo Kai
Published: August 2017

An efficient and novel method for the synthesis of α-ketoesters has been developed via oxidative coupling of acetophenones with alcohols under TBHP/I2/DBU conditions in a microfluidic chip reactor, which has a wide substrate scope, uses a lower dosage of iodine and affords higher product yields in only a few seconds.
High efficiency quasi 2D lead bromide perovskite solar cells using various barrier molecules
Authors: Cohen Bat-El , Wierzbowska Malgorzata , Etgar Lioz
Published: August 2017

A power conversion efficiency of 9.5% and an open circuit voltage of more than 1.4 V were achieved for bromide-based quasi 2D perovskite solar cells.
Nitrogen and oxygen co-doped 3D nanoporous duct-like graphene@carbon nano-cage hybrid films for high-performance multi-style supercapacitors
Authors: Qin Kaiqiang , Wang Liping , Wang Ning , Li Jiajun , Zhao Naiqin , Shi Chunsheng , He Chunnian , He Fang , Ma Liying , Liu Enzuo
Published: August 2017

A flexible high-quality nitrogen and oxygen co-doped 3D nanoporous duct-like graphene@carbon nano-cages (NO-3DG@CNCs) film shows excellent electrochemical performances in aqueous-system, ionic-system and lithium-ion capacitors.
Tuneable plasmonic gold dendrimer nanochains for sensitive disease detection
Authors: Ruiz-Sanchez Antonio J. , Parolo Claudio , Miller Benjamin S. , Gray Eleanor R. , Schlegel Kristina , McKendry Rachel A.
Published: August 2017

We report the development of a tuneable plasmonic nanochain immunoassay with increased sensitivity over traditional monodisperse nanoparticle lateral flow tests.
Zwitterion-coated ultrasmall iron oxide nanoparticles for enhanced T1-weighted magnetic resonance imaging applications
Authors: Ma Dan , Chen Jingwen , Luo Yu , Wang Han , Shi Xiangyang
Published: August 2017

Zwitterion l-cysteine-coated ultrasmall iron oxide nanoparticles can be obtained for enhanced blood pool and tumor MR imaging.
Bottom-up nanoarchitectures of semiconductor nano-building blocks obtained via a controllable in situ SEM-FIB thermal soldering method
Authors: Zhang Xuan , Zheng Xiujun , Zhang Hong , Zhang Junli , Fu Jiecai , Zhang Qiang , Peng Chaoyi , Bai Feiming , Zhang Xixiang , Peng Yong
Published: August 2017

Nanoscale semiconductor building blocks can be controllably soldered together via a novel in situ SEM-FIB thermal soldering technique.
Surface-related properties of perovskite CH3NH3PbI3thin films by aerosol-assisted chemical vapour deposition
Authors: Afzaal M. , Salhi B. , Al-Ahmed A. , Yates H. M. , Hakeem A. S.
Published: August 2017

Surface-related properties of methylammonium lead iodide thin films by AACVD are reported and discussed.
Dialect Variation of Copula and Auxiliary Verb BE: African American English–Speaking Children With and Without Gullah/Geechee Heritage
Authors: Berry Jessica R. , Oetting Janna B.
Published: August 2017

Purpose

We compared copula and auxiliary verb BE use by African American English–speaking children with and without a creole heritage, using Gullah/Geechee as the creole criterion, to determine if differences exist, the nature of the differences, and the impact of the differences on interpretations of ability.

Method

Data came from 38 children, aged 5 to 6 years (19 with Gullah/Geechee and 19 without Gullah/Geechee heritage). All were developing language typically, with groups matched on gender, maternal education, and, when possible, test scores. The children's productions of BE were elicited using a screener, probes, and language samples.

Results

Although many similarities were documented, the 2 groups' BE systems differed in 3 ways: use of unique forms (i.e.,də), unique use of shared forms (i.e., BEEN), and rates of use of shared forms (e.g.,am, is, was/were, wasforwere). Although most noticeable in the language samples, differences surfaced across tasks and showed the potential to affect interpretations of ability.

Conclusions

Dialect variation that is tied to children's creole heritage exists, involves 3 types of variation, and potentially affects interpretations of ability. Effects of a heritage language and different types of variation should be considered in research and clinical endeavors with African American English–speaking children.
Do the Hard Things First: A Randomized Controlled Trial Testing the Effects of Exemplar Selection on Generalization Following Therapy for Grammatical Morphology
Authors: Van Horne Amanda Jean Owen , Fey Marc , Curran Maura
Published: August 2017

Purpose

Complexity-based approaches to treatment have been gaining popularity in domains such as phonology and aphasia but have not yet been tested in child morphological acquisition. In this study, we examined whether beginning treatment with easier-to-inflect (easy first) or harder-to-inflect (hard first) verbs led to greater progress in the production of regular past-tense
–ed
by children with developmental language disorder.

Method

Eighteen children with developmental language disorder (ages 4–10) participated in a randomized controlled trial (easy first,
N
= 10, hard first,
N
= 8). Verbs were selected on the basis of frequency, phonological complexity, and telicity (i.e., the completedness of the event). Progress was measured by the duration of therapy, number of verb lists trained to criterion, and pre/post gains in accuracy for trained and untrained verbs on structured probes.

Results

The hard-first group made greater gains in accuracy on both trained and untrained verbs but did not have fewer therapy visits or train to criterion on more verb lists than the easy-first group. Treatment fidelity, average recasts per session, and verbs learned did not differ across conditions.

Conclusion

When targeting grammatical morphemes, it may be most efficient for clinicians to select harder rather than easier exemplars of the target.
Changes in surgical team performance and safety climate attitudes following expansion of perioperative services: a repeated-measures study
Authors: Gillespie Brigid M. , Harbeck Emma , Kang Evelyn , Steel Catherine , Fairweather Nicole , Chaboyer Wendy
Published: August 2017

Objective
The aim of the present study was to describe process changes in surgical team performance and team members’ attitudes to safety culture following hospital relocation and expansion of perioperative services.

Methods
The study was a naturalistic study using structured observations and surveys to assess non-technical skills (NTS; i.e. communication, teamwork, situational awareness, decision making and leadership) in surgery. This interrupted time series design used mixed-linear regression models to examine the effect of phase (before and after hospital relocation) on surgical teams’ NTS and their processes that may affect performance. Differences in self-reported teamwork and safety climate attitudes were also examined.

Results
In all, 186 procedures (100 before and 81 after hospital relocation) were observed across teams working in general, paediatric, orthopaedic and thoracic surgeries. Interobserver agreement ranged from 86% to 95%. An effect of phase was found, indicating that there were significant improvements after relocation in the use of NTS by the teams observed (P=0.020; 95% confidence interval 1.9–4.7).

Conclusions
The improvements seen in surgical teams’ NTS performance and safety culture attitudes may be related to the move to a new state-of-the-art perioperative department.

What is known about the topic?
Patient safety in surgery relies on optimal team performance, underpinned by effective NTS.

What does this paper add?
The NTS of surgical teams may be improved through ergonomic innovations that promote teams’ shared mental models.

What are the implications for practitioners?
Effective multidisciplinary teamwork relies on a combination of NTS and ergonomic factors, which inherently contribute to team performance and safety climate attitudes.
Reconstituted IMPDH polymers accommodate both catalytically active and inactive conformations
Authors: Anthony Sajitha A. , Burrell Anika L. , Johnson Matthew C. , Duong-Ly Krisna C. , Kuo Yin-Ming , Simonet Jacqueline C. , Michener Peter , Andrews Andrew , Kollman Justin M. , Peterson Jeffrey R.
Published: August 2017

Several metabolic enzymes undergo reversible polymerization into macromolecular assemblies. The function of these assemblies is often unclear, but in some cases they regulate enzyme activity and metabolic homeostasis. The guanine nucleotide biosynthetic enzyme inosine monophosphate dehydrogenase (IMPDH) forms octamers that polymerize into helical chains. In mammalian cells, IMPDH filaments can associate into micron-length assemblies. Polymerization and enzyme activity are regulated in part by binding of purine nucleotides to an allosteric regulatory domain. ATP promotes octamer polymerization, whereas guanosine triphosphate (GTP) promotes a compact, inactive conformation whose ability to polymerize is unknown. Also unclear is whether polymerization directly alters IMPDH catalytic activity. To address this, we identified point mutants of human IMPDH2 that either prevent or promote polymerization. Unexpectedly, we found that polymerized and nonassembled forms of recombinant IMPDH have comparable catalytic activity, substrate affinity, and GTP sensitivity and validated this finding in cells. Electron microscopy revealed that substrates and allosteric nucleotides shift the equilibrium between active and inactive conformations in both the octamer and the filament. Unlike other metabolic filaments, which selectively stabilize active or inactive conformations, recombinant IMPDH filaments accommodate multiple states. These conformational states are finely tuned by substrate availability and purine balance, while polymerization may allow cooperative transitions between states.
Cross-sectional and Prospective Correlates of Recovery Expectancies in the Rehabilitation of Whiplash Injury
Authors: Elphinston Rachel A. , Thibault Pascal , Carriere Junie S. , Rainville Pierre , Sullivan Michael J.L.
Published: August 2017

Objectives:

Investigations have shown that expectancies are significant prognostic indicators of recovery outcomes following whiplash injury. However, little is currently known about the determinants of recovery expectancies following whiplash injury. The purpose of the present study was to examine the cross-sectional and prospective correlates of recovery expectancies in individuals admitted to a rehabilitation program for whiplash injury.

Materials and Methods:

Participants (N=96) completed measures of recovery expectancies, psychosocial variables, symptom severity, symptom duration, and disability at time 0 (admission) and time 1 (discharge).

Results:

Consistent with previous research, more positive recovery expectancies at time 0 were related to reductions in pain at time 1 (r=−0.33, P<0.01). Scores on measures of pain catastrophizing, fear of movement and reinjury, and depression were significantly correlated with recovery expectancies. Pain severity, duration of work disability, and neck range of motion were not significantly correlated with recovery expectancies. Over the course of treatment, 40% of the sample showed moderate to large changes (an increase of ≥20%) in recovery expectancies, there were small changes (<20%) in 30% of the sample, and negative changes in 20% of the sample. A hierarchical regression showed that decreases in fear of movement and reinjury (β=−0.25, P<0.05) and pain catastrophizing (β=−0.23, P<0.05) were associated with increases in recovery expectancies through the course of treatment.

Conclusions:

The discussion addresses the processes linking pain-related psychosocial factors to recovery expectancies and makes recommendations for interventions that might be effective in increasing recovery expectancies.
Increased Pain Sensitivity in Accident-related Chronic Pain Patients With Comorbid Posttraumatic Stress
Authors: Vaegter Henrik B. , Andersen Tonny E. , Harvold Mathea , Andersen Per G. , Graven-Nielsen Thomas
Published: August 2017

Objectives:

Posttraumatic stress disorder (PTSD) is prevalent in chronic pain, and associated with increased pain, hyperalgesia, and psychological distress. This study aimed to investigate antinociceptive and pronociceptive pain mechanisms, pain intensity, and psychological distress (depression, anxiety, pain catastrophizing, and fear of movement) in patients with accident-related chronic spinal pain with (N=44) and without (N=64) comorbid PTSD characteristics.

Materials and Methods:

Cuff algometry was performed on lower legs to assess pressure pain threshold (cPPT), tolerance (cPTT), temporal summation of pain (increase in pain scores to 10 repeated stimulations), and conditioning pain modulation (increase in cPPT during cuff pain conditioning on the contralateral leg). Warmth detection threshold and heat pain threshold at the hand were also assessed. Clinical pain intensity (numerical rating scale), psychological distress, and PTSD symptomatology (ICD-11) were assessed with questionnaires. Mediation analyses were performed to investigate possible psychological mediators in the associations between PTSD and pain (intensity and mechanisms).

Results:

Patients with PTSD demonstrated increased pain intensity, and psychological distress as well as reduced warmth detection threshold and cPTT compared with patients without PTSD (P<0.05). No significant differences in cPPT, heat pain threshold, temporal summation of pain, and conditioning pain modulation were found. The association between PTSD and pain intensity was mediated by pain catastrophizing, and fear of movement mediated the association with cPTT.

Discussion:

The association between PTSD and pain intensity is in accordance with the mutual-maintenance and fear-avoidance models. Future studies should investigate changes in pain intensity and mechanisms after treatment targeting comorbid PTSD in chronic pain patients.
Guided growth for angular correction in children: a comparison of two tension band plate designs
Authors: Kadhim Muayad , Gauthier Luke , Logan Karl , El-Hawary Ron , Orlik Benjamin
Published: August 2017

This retrospective cohort study examined 20 patients (48 physes), 11 boys and nine girls, who were treated with hinge-plate or eight-plate. The mean age of the patients at surgery was 11.9±2.6 years. The mean follow-up duration was 13±2.7 months. The radiographic measurement of both distal femoral and proximal tibial deformity showed significant correction, with no difference between the hinge-plate and the eight-plate. Both screw divergence angle and the hinge angle showed significant changes at the last follow-up. The deformity correction of the distal femoral physis was quicker than the proximal tibial physis. The rate of mechanical femoral–tibial angle correction was 0.97°/month if both femoral and tibial physes were treated. Level of evidence: III.
Guided Growth: Novel Applications in the Hip, Knee, and Ankle
Authors: Bouchard Maryse
Published: August 2017

Hemiepiphyseodesis for angular deformities in the growing child is effective and avoids the complications of osteotomies and gradual correction with external fixation. This article reviews applications of screw hemiepiphyseodesis for coronal and sagittal plane deformities in the lower extremity. Indications, technical pearls, and pitfalls are discussed.
State of the Art: Amputation and Prosthetics
Authors: Westberry David E.
Published: August 2017

Amputation is not a defeat or failure of treatment, but an effective management strategy for certain conditions in the pediatric population. The principles of management, especially in the pediatric population, have not changed. Current surgical strategies focus on providing an optimal residual limb for prosthetic fitting. New technology provides improvement in the design and fabrication of prosthetic devices.
Optimizing Aesthetic Outcomes in Delayed Breast Reconstruction
Authors: Dec Wojciech
Published: August 2017

Background:

The need to restore both the missing breast volume and breast surface area makes achieving excellent aesthetic outcomes in delayed breast reconstruction especially challenging. Autologous breast reconstruction can be used to achieve both goals. The aim of this study was to identify surgical maneuvers that can optimize aesthetic outcomes in delayed breast reconstruction.

Methods:

This is a retrospective review of operative and clinical records of all patients who underwent unilateral or bilateral delayed breast reconstruction with autologous tissue between April 2014 and January 2017. Three groups of delayed breast reconstruction patients were identified based on patient characteristics.

Results:

A total of 26 flaps were successfully performed in 17 patients. Key surgical maneuvers for achieving aesthetically optimal results were identified. A statistically significant difference for volume requirements was identified in cases where a delayed breast reconstruction and a contralateral immediate breast reconstruction were performed simultaneously.

Conclusions:

Optimal aesthetic results can be achieved with: (1) restoration of breast skin envelope with tissue expansion when possible, (2) optimal positioning of a small skin paddle to be later incorporated entirely into a nipple areola reconstruction when adequate breast skin surface area is present, (3) limiting the reconstructed breast mound to 2 skin tones when large area skin resurfacing is required, (4) increasing breast volume by deepithelializing, not discarding, the inferior mastectomy flap skin, (5) eccentric division of abdominal flaps when an immediate and delayed bilateral breast reconstructions are performed simultaneously; and (6) performing second-stage breast reconstruction revisions and fat grafting.
THE NATURAL HISTORY OF FULL-FIELD STIMULUS THRESHOLD DECLINE IN CHOROIDEREMIA
Authors: Dimopoulos Ioannis S. , Freund Paul R. , Knowles JACOB A. , MacDonald Ian M.
Published: August 2017

Purpose:

To evaluate full-field sensitivity thresholds (FSTs) across a wide range of choroideremia (CHM) disease stages and to determine their applicability as functional endpoints for CHM clinical trials.

Methods:

Thirty CHM subjects (60 eyes) and 50 healthy controls (50 eyes) underwent FST testing under dark-adapted conditions to determine rod- and cone-mediated FSTs. Central retinal structure and function were assessed using fundus autofluorescence and microperimetry. Correlation and regression analyses were performed to compare FST responses with the residual area of retinal pigment epithelium in the peri- and parafoveal regions, as well as the mean and highest macular microperimetry sensitivity.

Results:

All patients with CHM had a baseline of 18 dB elevation in dark-adapted rod FSTs, including the least affected individuals. Further FST sensitivity loss was exponentially associated with decrease in the area of residual peri- and parafoveal retinal pigment epithelium, with precipitous loss of sensitivity noted for fundus autofluorescence areas less than 5 mm2. Cone FSTs were comparable with controls, except for advanced stages of CHM. Full-field sensitivity threshold responses showed high correlation with both mean and highest macular microperimetry thresholds (P < 0.001). In some cases of absent macular fundus autofluorescence, the peripheral retina could contribute to detectable rod FST responses but with severely diminished cone-driven responses.

Conclusion:

Full-field sensitivity threshold testing demonstrated a baseline level of rod dysfunction in CHM present in all rod photoreceptors. Further decline in FST responses correlated strongly with the extent of central retina structural and functional loss. Full-field sensitivity threshold allowed quantification of residual rod function in peripheral islands of vision, which cannot be reliably achieved with other conventional tests. As such, the FST can serve as a complimentary tool to guide patient selection and expand the eligibility criteria for current and future CHM clinical trials.
ATYPICAL FORM OF RETINOPATHY OF PREMATURITY WITH SEVERE FIBROVASCULAR PROLIFERATION IN THE OPTIC DISK REGION
Authors: Yokoi Tadashi , Katagiri Satoshi , Hiraoka Miina , Nakayama Yuri , Hosono Katsuhiro , Hotta Yoshihiro , Nishina Sachiko , Azuma Noriyuki
Published: August 2017

Purpose:

To describe severe fibrovascular proliferation that developed in the optic disk region in an atypical form of retinopathy of prematurity (ROP).

Methods:

Retrospective observational case reports.

Results:

Four patients (8 eyes) with ROP were included. Three patients were born very prematurely (24–25 weeks of gestational age; weight, 500–1,000 grams); 1 patient was born at 33 weeks of gestational age. Among all eight eyes of four patients who received prompt ROP screening and underwent laser photocoagulation, six eyes had atypical and severe fibrovascular proliferation mainly in the optic disk region; the other two eyes, including one eye with classic ROP and one eye with aggressive posterior ROP, did not have the atypical form. All eight eyes had a total to partial retinal detachment. Among the six eyes with the atypical form, early vitreous surgery with lensectomy was possible in three eyes; only late vitreous surgery with lensectomy was possible in two eyes; one eye was inoperable. Three eyes had a partial or complete reattachment, whereas three eyes had a total retinal detachment. Among the six eyes with atypical fibrovascular proliferation, only two eyes obtained light perception vision.

Conclusion:

An atypical and severe form of ROP, in which fibrovascular proliferation grew mainly from the optic disk region, needs further investigation for treatment in addition to laser photocoagulation and vitreous surgery.
THE EXPANDING CLINICAL SPECTRUM OF CHOROIDAL EXCAVATION IN MACULAR DYSTROPHIES
Authors: Battaglia Parodi Maurizio , Casalino Giuseppe , Iacono Pierluigi , Introini Ugo , Adamyan Tatevik , Bandello Francesco
Published: August 2017

Purpose:

To assess the prevalence and the clinical course of focal choroidal excavation (FCE) in patients affected by macular dystrophies.

Methods:

Prospective case series. All the patients underwent a complete ophthalmologic examination, including best-corrected visual acuity and spectral domain optical coherence tomography. The presence of choroidal neovascularization (CNV) was assessed on the basis of the leakage detected on fluorescein angiography.

Results:

A total of 162 eyes from 81 patients with macular dystrophy were included in the study. FCE was diagnosed in seven eyes (4.3% of the eyes), including four eyes with Best vitelliform dystrophy, two eyes with pattern dystrophy associated with pseudoxanthoma elasticum, and one case of Stargardt disease. In eyes with FCE and macular dystrophy, the mean best-corrected visual acuity was 0.4 ± 0.1 logarithm of the minimum angle of resolution (approximately corresponding to 20/50 Snellen equivalent) at baseline and was stable to 0.41 ± 0.1 logarithm of the minimum angle of resolution (approximately corresponding to 20/50 Snellen equivalent) at the final visit. In four of these seven eyes, FCE was associated with a subfoveal CNV. The CNV was managed with one intravitreal anti–vascular endothelial growth factor injection, achieving the complete anatomical stabilization of the CNV and recovery of the best-corrected visual acuity.

Conclusion:

Focal choroidal excavation can be infrequently encountered in patients with macular dystrophies. The presence of CNV may complicate FCE in these patients, and anti–vascular endothelial growth factor seems to be an effective treatment with no progression of FCE over time.
Is a surgical CURE in the future for colorectal cancer liver metastasis?
Authors: Little Kristen
Published: August 2017

This review was constructed to evaluate the current advancements in the surgical management of colorectal cancer liver metastases. A shift from the classic conservative and palliative management of such cases has begun with transitions toward surgical management. This shift is due to multiple compounding factors of which many are being studied and presented individually. By combing these factors together, this review provides guidance on the most significant preoperative prognostic factors and suggests future treatment goals for these patients. A progressive conversion from conservative to surgical management also presents ethical implications to be considered. This review may direct future research on surgical resection of colorectal cancer liver metastases and provide advantageous information on the value of preoperative prognostic factors and the role of surgical intervention in this patient population.
A Systematic Review of Patient-Reported Outcomes for Surgically Amenable Epiphora
Authors: Schulz Christopher B. , Kennedy Alasdair , Rogers Simon
Published: August 2017

Purpose:

In evaluating epiphora and its management, the bottom line for all stakeholders is whether an intervention confers any real benefit on quality of life. A review was conducted to identify and appraise patient-reported outcome measures (PROMs) in surgically amenable epiphora.

Methods:

A systematic search was conducted of studies relating to surgical intervention for epiphora. Patient-reported outcome measures were identified and assessed against standard criteria.

Results:

Of 30,544 identified articles, 227 were eligible for data extraction. Of these, 69% reported a PROM as the primary outcome. PROMs identified included single-item symptom scores (48% of primary outcome PROMs), single-item reports of improvement (30%), the Glasgow Benefit Inventory (3%), Lacrimal Symptom Questionnaire (0.5%), Nasolacrimal Duct Obstruction Symptom Score (0.5%), Ocular Surface Disease Index (0.5%), Visual Function Questionnaire-25, the Short Form-36 Health Survey, and 3 other symptom scores. None were developed through consultation with the target population, and there was inadequate testing of content validity. The strengths and limitations of each PROM are presented, with regard to interpretation, responsiveness, reliability, and validity.

Discussion:

The importance of robust and psychometrically sound PROMs is essential if the under-reporting of quality of life improvement in patients treated for epiphora is to change. Recommendations for the use of each identified PROM are discussed.

Conclusions:

Several PROMs have been used in the recent literature to evaluate patients undergoing surgery to treat epiphora. Assessed against standard criteria, no PROM has proven to be both psychometrically robust and clinically meaningful for use in this population. Future PROM development should be guided by this standard framework.
Cerebral white matter structure is disrupted in Gulf War Veterans with chronic musculoskeletal pain
Authors: Van Riper Stephanie M. , Alexander Andrew L. , Koltyn Kelli F. , Stegner Aaron J. , Ellingson Laura D. , Destiche Daniel J. , Dougherty Ryan J. , Lindheimer Jacob B. , Cook Dane B.
Published: August 2017

Chronic musculoskeletal pain (CMP) affects ∼25% of the 700,000 Veterans deployed during the Persian Gulf War (1990-1991). The cause of their pain is unknown, and there are no efficacious treatments. A small body of literature suggests that brain abnormalities exist in Gulf War Veterans (GVs), yet relationships between brain abnormalities and disease symptoms remain largely unexplored. Our purpose was to compare white matter (WM) integrity between GVCMP and matched, healthy Veteran controls (GVCO) and investigate relationships between cerebral WM integrity and symptoms. Thirty GVCMP and 31 controls completed magnetic resonance imaging with diffusion tensor imaging. Tract-based spatial statistics estimated WM fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity over the whole brain (P < 0.05) and were corrected using threshold-free cluster enhancement. GVCMP had greater pain symptoms and mood disturbance and lower quality of life and physical function compared with GVCO (P < 0.05). GVCMP had lower WM integrity across several brain regions implicated in chronic pain (P < 0.05) including the middle and inferior frontal gyrus, corpus callosum, corona radiata, precentral gyrus, external capsule, and posterior thalamic radiation. For GVCMP, WM integrity was associated with pain and mood symptoms in widespread brain areas that were found to be different between groups (P < 0.05). Results indicate widespread WM microstructure disruption across brain regions implicated in pain processing and modulation in chronic pain. The observed relationships between WM microstructure and symptoms encourage the testing of treatments designed to improve the brain health of affected Veterans.
Cannabis-Induced Acute Pancreatitis
Authors: Barkin Jodie A. , Nemeth Zsuzsanna , Saluja Ashok K. , Barkin Jamie S.
Published: August 2017

Objectives

Cannabis is the most frequently consumed illicit drug in the world, with higher prevalence under the age of 35 years. Cannabis was first reported as a possible cause of acute pancreatitis (AP) in 2004. The aim of this systematic review is to examine cannabis use as an etiology of AP.

Methods

A search using PubMed/Medline, Embase, Scopus, and Cochrane was performed without language or year limitations to May 1, 2016. Search terms were “Cannabis” and “Acute Pancreatitis” with all permutations. The search yielded 239 results. Acute pancreatitis was defined by meeting 2 of 3 Revised Atlanta Classification criteria. Cannabis-induced AP was defined by preceding use of cannabis and exclusion of common causes of AP when reported. Sixteen papers met inclusion criteria dating from 2004 to 2016.

Results

There were 26 cases of cannabis-induced AP (23/26 men; 24/26 under the age of 35 y). Acute pancreatitis correlated with increased cannabis use in 18 patients. Recurrent AP related temporally to cannabis use was reported in 15 of 26. There are 13 reports of no further AP episodes after cannabis cessation.

Conclusions

Cannabis is a possible risk factor for AP and recurrent AP, occurring primarily in young patients under the age of 35 years. Toxicology screens should be considered in all patients with idiopathic AP.
Local and Systemic Expression of Immunomodulatory Factors in Chronic Pancreatitis
Authors: Komar Hannah M. , Hart Phil A. , Cruz-Monserrate Zobeida , Conwell Darwin L. , Lesinski Gregory B.
Published: August 2017

Inflammatory and fibrotic events that drive chronic pancreatitis (CP) are likely orchestrated via signaling of soluble cytokines and chemokines systemically and within the pancreas. However, a comprehensive summary of the expression of such factors during CP has not been reported to date. This information is important given continued interest in targeting cytokines that influence CP pathogenesis. Reported data on the expression change of soluble immunomodulatory factors in human CP patients were identified via a literature search using a single search term. Thirty-one articles meeting the prespecified inclusion criteria were identified to generate a compiled data summary. Compiled data demonstrated up-regulation of several factors in the blood or pancreas microenvironment of CP patients. Nine factors were elevated in both compartments, including fractalkine, IFN-γ, interleukin 1β, IL-6, IL-8, macrophage inhibitory cytokine 1, neutrophil gelatinase–associated lipocalin, transforming growth factor β, and tumor necrosis factor α. Most up-regulated factors could be classified into one of several functional groups, including inflammation, chemotaxis, angiogenesis, bone remodeling, extracellular matrix remodeling, and pain. After further validation, these factors may be used as biomarkers for disease diagnosis and identification of comorbidities, or as potential therapeutic targets.
Epstein Barr Virus Infection Can be a Secondary Event in B-Cell Lymphomas: A Review of 338 Cases and a Novel Finding of Zonal EBER+ Tumor Cells Showing Features of Progression From Underlying EBV-negative Lymphoma
Authors: Miller Ira J.
Published: August 2017

Cases of B-cell lymphoma over an 8-year interval with diagnosis of EBER positivity were retrieved from archives and reviewed for classification and pattern of Epstein Barr Virus (EBV) expression. Of 46 cases that were EBV early RNA (EBER)+ by in situ hybridization staining, 7 had nonuniform staining among the neoplastic cells. Four of those cases showed a uniform admixture of EBER+ and EBER− tumor cells, compatible with the prevailing theory of episomal EBV loss with cell replication. Three cases of lymphomas showed a partial and zonal pattern and other features suggest that EBV infection occurred after the lymphoma was already established. In case 1, an EBV-negative follicular lymphoma and an EBV+ diffuse large B-cell lymphoma (DLBCL) of activated B cell type were contiguous in a lymph node. Both components showed a BCL2 translocation by fluorescence in situ hybridization. In case 2, a DLBCL of germinal center type in an human immunodeficiency virus positive patient contained clusters of EBR+ lymphoma cells with Reed-Sternberg morphology and shift to an activated B-cell immunophenotype. In case 3, an ulcerated and perforated DLBCL in the stomach showed a superficial swath of EBER+ tumor cells accompanied by a relative absence of reactive T cells. In all 3 cases the tumor cells in EBER+ areas expressed latent membrane protein-1 and showed strong CD30 positivity. All 3 patients were treated with chemotherapy are currently in remission. Heterogenous EBER positivity has been reported previously in DLBCLs, attributed to loss of the episomal viral DNA from a subset of fully transformed tumor cells. Previously reported cases did not include description of zonation of EBV or phenotypic differences correlating with the presence of EBV. The cases reported here suggest that in a subset of EBV+ DLBCLs, EBV infection may not be the “first hit.”
Pathologic Prognostic Factors of Pineal Parenchymal Tumor of Intermediate Differentiation
Authors: Chatterjee Debajyoti , Lath Khushboo , Singla Navneet , Kumar Narendra , Radotra Bishan D.
Published: August 2017

Introduction:

Pineal parenchymal tumor of intermediate differentiation (PPTID) is an uncommon tumor of the pineal gland. Although this behaves as a grade II/III tumor, the exact clinical behavior is not well known. There is no well-established pathologic factor that can predict the behavior of PPTID.

Aim and Objective:

The aim of this study was to determine the pathologic prognostic factors in PPTID.

Materials and Methods:

All PPTID cases diagnosed between 2006 and 2016 were analyzed retrospectively. Immunohistochemistry for synaptophysin, neurofilament protein (NFP), glial fibrillar acid protein, NeuN, and Ki-67 were performed in all cases. Cases were classified arbitrarily into low grade (mitosis <4/10 hpf and Ki-67 <5%) and high grade (mitosis ≥4/10 hpf and Ki-67 ≥5%). Clinical details including follow-up information were retrieved from the patients’ files.

Results:

A total of 16 patients (6 low grade and 10 high grade) were included in this study. The age ranged from 2 to 55 years (average, 28.2) with a mild male preponderance (male:female, 1.67:1). All cases showed strong and diffuse positivity for synaptophysin. Focal NFP positivity was seen in 2 low-grade and 3 high-grade tumors. Only 2 cases showed focal NeuN positivity. Average Ki-67 index was 1.7% and 12.6% in low-grade and high-grade tumors, respectively. All patients with low-grade tumor were alive without recurrence. Among the patients with high-grade tumors, 2 had local recurrence, 1 had spinal metastasis, and 3 patients died.

Conclusion:

Mitosis and Ki-67 proliferation index are the most important pathologic prognostic factors in PPTID. NFP expression does not carry any prognostic significance.
Subclinical Rhythmic EEG Discharge of Adult (SREDA) in a Child With Generalized Epilepsy and Literature Review of SREDA in Children
Authors: Goeden Marcie , Bansal Lalit R.
Published: August 2017

Subclinical rhythmic discharges of adult (SREDA) is a rare benign EEG variant in adults and is of unknown clinical significance. Its occurrence in children is extremely rare. In review of the literature, it has been described in only four children. We present a case of a 10-year-old female with generalized idiopathic childhood absence epilepsy who is noted to have SREDA in three subsequent EEGs performed across a 25-month span. She had no clinical change with these discharges and it was believed to be a benign variant. Including our patient, three of four children with SREDA presented with generalized epilepsy leading to the conclusion that, although rare, SREDA is more common in children presenting with generalized epilepsy.
Spatial protein analysis in developing tissues: a sampling-based image processing approach
Authors: Leonavicius Karolis , Royer Christophe , Miranda Antonio , Tyser Richard , Kip Anne-Marie , Srinivas Shankar
Published: August 2017

Advances in fluorescence microscopy approaches have made it relatively easy to generate multi-dimensional image volumes and have highlighted the need for flexible image analysis tools for the extraction of quantitative information from such data. Here we demonstrate that by focusing on simplified feature-based nuclear segmentation and probabilistic cytoplasmic detection we can create a tool that is able to extract geometry based information from diverse mammalian tissue images. Our open-source image analysis platform, called ‘SilentMark’ can cope with noisy images and with crowded fields of cells to quantify signal intensity in different cellular compartments. Additionally, it provides tissue geometry related information, which allows one to quantify protein distribution with respect to marked regions of interest. The lightweight SilentMark algorithms have the advantage of not requiring multiple processors and graphics cards and can be run even with just several hundred MB of memory. This makes it possible to use the method as a web application, effectively eliminating setup hurdles and compatibility issues with operating systems. We test this platform on mouse pre-implantation embryos, embryonic stem cell derived embryoid bodies and mouse embryonic heart and relate protein localisation to tissue geometry.
Natural Language Processing for Classification of Acute, Communicable Findings on Unstructured Head CT Reports: Comparison of Neural Network and Non-Neural Machine Learning Techniques
Authors: Chokshi Falgun H. , Shin Bonggun , Lee Timothy , Lemmon Andrew , Necessary Sean , Choi Jinho D.
Published: August 2017

Background and Purpose

To evaluate the accuracy of non-neural and neural network models to classify five categories (classes) of acute and communicable findings on unstructured head computed tomography (CT) reports.

Materials and Methods

Three radiologists annotated 1,400 head CT reports for language indicating the presence or absence of acute communicable findings (hemorrhage, stroke, hydrocephalus, and mass effect). This set was used to train, develop, and evaluate a non-neural classifier, support vector machine (SVM), in comparisons to two neural network models using convolutional neural networks (CNN) and neural attention model (NAM) Inter-rater agreement was computed using kappa statistics. Accuracy, receiver operated curves, and area under the curve were calculated and tabulated. P-values < 0.05 was significant and 95% confidence intervals were computed.

Results

Radiologist agreement was 86-94% and Cohen’s kappa was 0.667-0.762 (substantial agreement). Accuracies of the CNN and NAM (range 0.90-0.94) were higher than SVM (range 0.88-0.92). NAM showed relatively equal accuracy with CNN for three classes, severity, mass effect, and hydrocephalus, higher accuracy for the acute bleed class, and lower accuracy for the acute stroke class. AUCs of all methods for all classes were above 0.92.

Conclusions

Neural network models (CNN & NAM) generally had higher accuracies compared to the non-neural models (SVM) and have a range of accuracies that comparable to the inter-annotator agreement of three neuroradiologists.

The NAM method adds ability to hold the algorithm accountable for its classification via heat map generation, thereby adding an auditing feature to this neural network.

Abbreviations

NLP

Natural Language Processing

CNN

Convolutional Neural Network

NAM

Neural Attention Model

HER

Electronic Health Record
TF2Network: predicting transcription factor regulators and gene regulatory networks in Arabidopsis using publicly available binding site information
Authors: Kulkarni Shubhada R. , Vaneechoutte Dries , Velde Jan Van de , Vandepoele Klaas
Published: August 2017

A gene regulatory network (GRN) is a collection of regulatory interactions between transcription factors (TFs) and their target genes. GRNs control different biological processes and have been instrumental to understand the organization and complexity of gene regulation. Although various experimental methods have been used to map GRNs inArabidopsis thaliana, their limited throughput combined with the large number of TFs makes that for many genes our knowledge about regulating TFs is incomplete. We introduce TF2Network, a tool that exploits the vast amount of TF binding site information and enables the delineation of GRNs by detecting potential regulators for a set of co-expressed or functionally related genes. Validation using two experimental benchmarks reveals that TF2Network predicts the correct regulator in 75-92% of the test sets. Furthermore, our tool is robust to noise in the input gene sets, has a low false discovery rate, and shows a better performance to recover correct regulators compared to other plant tools. TF2Network is accessible through a web interface where GRNs are interactively visualized and annotated with various types of experimental functional information. TF2Network was used to perform systematic functional and regulatory gene annotations, identifying new TFs involved in circadian rhythm and stress response.
Note on the power law of forgetting
Authors: Kahana Michael J. , Adler Mark
Published: August 2017

Power functions (e.g.,f(t) =at−b) describe the relationships among many variables observed in nature. One example of this is the power law of forgetting: The decline in memory performance with time or intervening events is well fit by a power function. This simple functional relationship accounts for a great deal of accumulated data. In this note, we consider a simple yet general memory model in which all items decay monotonically in strength, but at different rates. To translate between continuous changes in strength and actual memory for events we assume a simple strength threshold for remembering. We prove a limit theorem for this model: as time grows large and memories decay, the empirical forgetting function approaches a power function under very general conditions. Power forgetting emerges for almost any monotonically decreasing strength function (including linear and exponential cases). We also illustrate by way of simulations that the power function provides an excellent fit to the entire time-course of the forgetting function, not just its limiting behavior.