bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced Recovery Pathway in Microvascular Autologous Tissue-Based Breast Reconstruction: Should It Become the Standard of Care?
Authors: Kaoutzanis Christodoulos , Ganesh Kumar Nishant , O’Neill Dillon , Wormer Blair , Winocour Julian , Layliev John , McEvoy Matthew , King Adam , Braun Stephane A. , Higdon K. Kye 
Published: February 2018

Background:
Enhanced recovery pathway programs have demonstrated improved perioperative care and shorter length of hospital stay in several surgical disciplines. The purpose of this study was to compare outcomes of patients undergoing autologous tissue–based breast reconstruction before and after the implementation of an enhanced recovery pathway program.

Methods:
The authors retrospectively reviewed consecutive patients who underwent autologous tissue–based breast reconstruction performed by two surgeons before and after the implementation of the enhanced recovery pathway at a university center over a 3-year period. Patient demographics, perioperative data, and 45-day postoperative outcomes were compared between the traditional standard of care (pre–enhanced recovery pathway) and enhanced recovery pathway patients. Multivariate logistic regression was performed to identify risk factors for length of hospital stay. Cost analysis was performed.

Results:
Between April of 2014 and January of 2017, 100 consecutive women were identified, with 50 women in each group. Both groups had similar demographics, comorbidities, and reconstruction types. Postoperatively, the enhanced recovery pathway cohort used significantly less opiate and more acetaminophen compared with the traditional standard of care cohort. Median length of stay was shorter in the enhanced recovery pathway cohort, which resulted in an extrapolated $279,258 savings from freeing up inpatient beds and increase in overall contribution margins of $189,342. Participation in an enhanced recovery pathway program and lower total morphine-equivalent use were independent predictors for decreased length of hospital stay. Overall 45-day major complication rates, partial flap loss rates, emergency room visits, hospital readmissions, and unplanned reoperations were similar between the two groups.

Conclusion:
Enhanced recovery pathway program implementation should be considered as the standard approach for perioperative care in autologous tissue–based breast reconstruction because it does not affect morbidity and is associated with accelerated recovery with reduced postoperative opiate use and decreased length of hospital stay, leading to downstream health care cost savings.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Unusual Case of Diffuse Penile Metastasis of Prostate Cancer on 68Ga PSMA PET/CT Imaging and 177Lu PSMA Posttherapy Scintigraphy
Authors: Vadi Shelvin Kumar , Kumar Rajender , Mittal Bhagwant Rai , Parihar Ashwin Singh , Singh Shrawan Kumar 
Published: February 2018

Abstract
An 85-year-old man with prostate cancer for metastatic workup underwent 68Gallium Prostate-Specific Membrane Antigen (68Ga-PSMA) PET/CT (68Ga-PSMA PET/CT), which revealed unusual tracer uptake in the shaft and glans of penis as well as multiple systemic metastases in liver, skeletal, and lymph nodes. The penile lesion was proved to be metastatic adenocarcinoma from prostate on fine needle aspiration cytology. The patient underwent 177Lutetium (177Lu)-labeled PSMA radioligand therapy, which also revealed diffuse tracer uptake in the penile shaft as well as other metastatic sites.
Is There Any Potential of FDG PET/CT in Monitoring Disease Activity in Familial Hemophagocytic Lymphohistiocytosis?
Authors: Tang YongXiang , Tan HongPei , Hu Shuo 
Published: February 2018

Abstract
FDG PET/CT was performed in a 30-year-old woman to detect the source of fever of unknown origin. The images showed widespread abnormal activity, consistent with lymphoma. However, lymph node biopsy revealed only inflammation, and a diagnosis of familial hemophagocytic lymphohistiocytosis was eventually made after familial hemophagocytic lymphohistiocytosis–specific gene was detected. After proper therapy, a follow-up FDG PET/CT examination 2 months later showed resolution of most of the previously seen lesions.
Active Bone Marrow With Focal FDG Accumulation Mimicking Bone Metastasis With a Case of Early Esophageal Cancer
Authors: Okuyama Chio , Sasaki Naomi , Nishimura Motoki , Matsushima Shigenori , Yoshimatsu Rika 
Published: February 2018

Abstract
A 68-year-old man underwent 18F-FDG PET/CT for the staging of esophageal carcinoma discovered by a medical checkup. Increased focal accumulation in some vertebrae, right humerus, and right femoral bone was noted on FDG-PET, whereas CT showed relatively high attenuation, and MRI showed hypointense lesions on T1- and T2-weighted imaging. A bone biopsy revealed mildly hypercellular bone marrow in the thoracic spine with FDG accumulation and markedly hypocellular bone marrow in the pelvic bone without an increased uptake. 111InCl scintigraphy showed a similar distribution and confirmed the diagnosis of bone marrow reconversion.
Amyloid PET Positivity in Different Primary Progressive Aphasia Phenotypes
Authors: Beaufils Emilie , Vercouillie Johnny , Vierron Emilie , Cottier Jean-Philippe , Camus Vincent , Mondon Karl , Guilloteau Denis , Hommet Caroline , Ribeiro Maria Joao 
Published: February 2018

Purpose
Primary progressive aphasia (PPA) is a neurological syndrome in which language functions become progressively impaired with relative sparing of memory and other instrumental functions. The pathologic causes of PPA are heterogeneous, but studies suggest that logopenic PPA (LPA) is underpinned by Alzheimer disease (AD) pathology in a high proportion of cases. The purposes of this descriptive and retrospective study were to characterize 18F-florbetapir PET imaging in a group of patients with a clinical syndrome of PPA, to determine the value of clinical characterization based on language phenotype in predicting the underlying pathology of PPA with 18F-florbetapir, and to quantify amyloid load in PPA subjects classified as “positive” 18F-florbetapir scans. Then, we compare the quantification and distribution of 18F-florbetapir uptake with those of typical, predominantly amnestic AD patients.

Methods
We conducted a PET study with 18F-florbetapir in a cohort of 12 right-handed patients diagnosed with PPA: 3 patients with semantic-variant PPA, 5 with nonfluent PPA, 1 with LPA, and 3 unclassifiable patients. We evaluated amyloid deposition between APP groups and 11 patients with typical amnestic AD.

Results
Among the 12 patients with PPA syndrome, 8 (66.7%) were considered as amyloid positive. One of the 3 patients with semantic-variant PPA was 18F-florbetapir positive. In contrast, 4 of the 5 nonfluent-variant PPA, 2 of the 3 unclassifiable cases and the single patient with LPA were 18F-florbetapir positive. A significantly higher 18F-florbetapir uptake was observed in PPA 18F-florbetapir–positive patients compared with typical AD patients. This difference was observed in all regions of interest, except in posterior cingulate and temporal cortex.

Conclusions
These results suggest that 18F-florbetapir PET may be useful in a routine clinical procedure to improve the reliability of identifying AD pathology in patients with PPA syndrome, with different clinical subtypes of the PPA syndrome.
Key Components of the Safe Surgical Ward
Authors: Hassen Yasmin A. M. , Johnston Maximilian J. , Singh Pritam , Pucher Philip H. , Darzi Ara 
Published: February 2018

Objective:
The aim of this study was to prioritize key factors contributing to safety on the surgical ward

Background:
There is a variation in the quality and safety of postoperative care between institutions. These variations may be attributed to a combination of process-related issues and structural factors. The aim of this study is to reach a consensus, by means of Delphi methodology, on the most influential of these components that may determine safety in this environment.

Methods:
The Delphi questionnaire was delivered via an online questionnaire platform. The panel were blinded. An international panel of safety experts, both clinical and nonclinical, and safety advocates participated. Individuals were selected according to their expertise and extent of involvement in patient safety research, regulation, or patient advocacy.

Results:
Experts in patient safety from the UK, Europe, North America, and Australia participated. The panel identified the response to a deteriorating patient and the care of outlier patients as error-prone processes. Prioritized structural factors included organizational and environmental considerations such as use of temporary staff, out-of-hours reduction in services, ward cleanliness, and features of layout. The latter includes dedicated areas for medication preparation and adequate space around the patient for care delivery. Potential quality markers for safe care that achieved the highest consensus include leadership, visibility between patients and nurses, and nursing team skill mix and staffing levels.

Conclusion:
International consensus was achieved for a number of factors across process-related and structural themes that may influence safety in the postoperative environment. These should be championed and prioritized for future improvements in patient safety at the ward-level.
Improved Glucose Tolerance in a Kidney Transplant Recipient With Type 2 Diabetes Mellitus After Switching From Tacrolimus To Belatacept: A Case Report and Review of Potential Mechanisms
Authors: de Graav Gretchen N. , van der Zwan Marieke , Baan Carla C. , Janssen Joop A.M.J.L. , Hesselink Dennis A. 
Published: February 2018

Abstract
The introduction of immunosuppressant belatacept, an inhibitor of the CD28-80/86 pathway, has improved 1-year outcomes in kidney transplant recipients with preexistent diabetes mellitus and has also reduced the risk of posttransplant diabetes mellitus. So far, no studies have compared a tacrolimus-based with a belatacept-based immunosuppressive regimen with regard to improving glucose tolerance after kidney transplantation. Here, we present the case of a 54-year-old man with type 2 diabetes mellitus who was converted from belatacept to tacrolimus 1 year after a successful kidney transplantation. Thereafter, he quickly developed severe hyperglycemia, and administration of insulin was needed to improve metabolic control. Six months after this episode, he was converted back to belatacept because of nausea, diarrhea, and hyperglycemia. After switching back to belatacept and within 4 days after stopping tacrolimus glucose tolerance improved and insulin therapy could be discontinued. Although belatacept is considered less diabetogenic than tacrolimus, the rapid improvement of glucose tolerance after switching to belatacept is remarkable. In this article, the potential mechanisms of this observation are discussed.
Emerging targets for reprograming the immune response to promote repair and recovery of function after spinal cord injury
Authors: Brennan Faith H. , Popovich Phillip G. 
Published: February 2018

Purpose of review
In adult mammals, a traumatic spinal cord injury (SCI) elicits a chronic unregulated neuroinflammatory response accompanied by seemingly paradoxical suppression of systemic immunity. These SCI-induced changes in immune function contribute to poor neurological outcomes and enhanced morbidity or mortality. Nonspecific anti-inflammatory or proinflammatory therapies are ineffective and can even worsen outcomes. Therefore, recent experimental SCI research has advanced the understanding of how neuroimmune cross-talk contributes to spinal cord and systemic pathology.

Recent findings
It is now appreciated that the immune response caused by injury to the brain or spinal cord encompasses heterogeneous elements that can drive events on the spectrum between exacerbating pathology and promoting tissue repair, within the spinal cord and throughout the body. Recent novel discoveries regarding the role and regulation of soluble factors, monocytes/macrophages, microRNAs, lymphocytes and systemic immune function are highlighted in this review.

Summary
A more nuanced understanding of how the immune system responds and reacts to nervous system injury will present an array of novel therapeutic opportunities for clinical SCI and other forms of neurotrauma.
Mechanisms for lesion localization in neuromyelitis optica spectrum disorders
Authors: Bradl Monika , Reindl Markus , Lassmann Hans 
Published: February 2018

Purpose of review
Neuromyelitis optica spectrum disorders (NMOSD) are severe inflammatory diseases of the central nervous system (CNS), with the presence of aquaporin 4 (AQP4)-specific serum antibodies in the vast majority of patients, and with the presence of myelin oligodendrocyte glycoprotein (MOG)-specific antibodies in approximately 40% of all AQP4-antibody negative NMOSD patients. Despite differences in antigen recognition, the preferred sites of lesions are similar in both groups of patients: They localize to the spinal cord and to the anterior visual pathway including retina, optic nerves, chiasm, and optic tracts, and – to lesser extent – also to certain predilection sites in the brain.

Recent findings
The involvement of T cells in the formation of NMOSD lesions has been challenged for quite some time. However, several recent findings demonstrate the key role of T cells for lesion formation and localization. Studies on the evolution of lesions in the spinal cord of NMOSD patients revealed a striking similarity of early NMOSD lesions with those observed in corresponding T-cell-induced animal models, both in lesion formation and in lesion localization. Studies on retinal abnormalities in NMOSD patients and corresponding animals revealed the importance of T cells for the very early stages of retinal lesions which eventually culminate in damage to Müller cells and to the retinal nerve fiber layer. Finally, a study on cerebrospinal fluid (CSF) barrier pathology demonstrated that NMOSD immunopathology extends beyond perivascular astrocytic foot processes to include the pia, the ependyma, and the choroid plexus, and that diffusion of antibodies from the CSF could further influence lesion formation in NMOSD patients.

Summary
The pathological changes observed in AQP4-antibody positive and MOG-antibody positive NMOSD patients are strikingly similar to those found in corresponding animal models, and many mechanisms which determine lesion localization in experimental animals seem to closely reflect the human situation.
Online incidental statistical learning of audiovisual word sequences in adults: a registered report
Authors: Kuppuraj Sengottuvel , Duta Mihaela , Thompson Paul , Bishop Dorothy 
Published: February 2018

Statistical learning has been proposed as a key mechanism in language learning. Our main goal was to examine whether adults are capable of simultaneously extracting statistical dependencies in a task where stimuli include a range of structures amenable to statistical learning within a single paradigm. We devised an online statistical learning task using real word auditory–picture sequences that vary in two dimensions: (i) predictability and (ii) adjacency of dependent elements. This task was followed by an offline recall task to probe learning of each sequence type. We registered three hypotheses with specific predictions. First, adults would extract regular patterns from continuous stream (effect of grammaticality). Second, within grammatical conditions, they would show differential speeding up for each condition as a factor of statistical complexity of the condition and exposure. Third, our novel approach to measure online statistical learning would be reliable in showing individual differences in statistical learning ability. Further, we explored the relation between statistical learning and a measure of verbal short-term memory (STM). Forty-two participants were tested and retested after an interval of at least 3 days on our novel statistical learning task. We analysed the reaction time data using a novel regression discontinuity approach. Consistent with prediction, participants showed a grammaticality effect, agreeing with the predicted order of difficulty for learning different statistical structures. Furthermore, a learning index from the task showed acceptable test–retest reliability (
r
= 0.67). However, STM did not correlate with statistical learning. We discuss the findings noting the benefits of online measures in tracking the learning process.
Genome-wide analysis of adolescent psychotic experiences shows genetic overlap with psychiatric disorders
Authors: Pain Oliver , Dudbridge Frank , Cardno Alastair G. , Freeman Daniel , Lu Yi , Lundstrom Sebastian , Lichtenstein Paul , Ronald Angelica 
Published: February 2018

AbstractThis study aimed to test for overlap in genetic influences between psychotic experience traits shown by adolescents in the community, and clinically-recognized psychiatric disorders in adulthood, specifically schizophrenia, bipolar disorder, and major depression. The full spectra of psychotic experience domains, both in terms of their severity and type (positive, cognitive, and negative), were assessed using self- and parent-ratings in three European community samples aged 15-19 years (Final N incl. siblings = 6,297-10,098). A mega-genome-wide association study (mega-GWAS) for each psychotic experience domain was performed. SNP-heritability of each psychotic experience domain was estimated using genomic-relatedness-based restricted maximum-likelihood (GREML) and linkage disequilibrium-(LD-) score regression. Genetic overlap between specific psychotic experience domains and schizophrenia, bipolar disorder, and major depression was assessed using polygenic risk scoring (PRS) and LD-score regression. GREML returned SNP-heritability estimates of 3-9% for psychotic experience trait domains, with higher estimates for less skewed traits (Anhedonia, Cognitive Disorganization) than for more skewed traits (Paranoia and Hallucinations, Parent-rated Negative Symptoms). Mega-GWAS analysis identified one genome-wide significant association for Anhedonia within IDO2 but which did not replicate in an independent sample. PRS analysis revealed that the schizophrenia PRS significantly predicted all adolescent psychotic experience trait domains (Paranoia and Hallucinations only in non-zero scorers). The major depression PRS significantly predicted Anhedonia and Parent-rated Negative Symptoms in adolescence. Psychotic experiences during adolescence in the community show additive genetic effects and partly share genetic influences with clinically-recognized psychiatric disorders, specifically schizophrenia and major depression.
Targeting TrkB with a brain-derived neurotrophic factor mimetic promotes myelin repair in the brain
Authors: Fletcher Jessica L , Wood Rhiannon J , Nguyen Jacqueline , Norman Eleanor ML , Jun Christine MK , Prawdiuk Alexa R , Biemond Melissa , Nguyen Huynh TH , Northfield Susan E , Hughes Richard A , Gonsalvez David G , Xiao Junhua , Murray Simon S 
Published: February 2018

AbstractMethods to promote myelin regeneration in response to central myelin loss are essential to prevent the progression of clinical disability in demyelinating diseases. The neurotrophin brain-derived neurotrophic factor (BDNF) is known to promote myelination during development via oligodendrocyte expressed TrkB receptors. Here, we use a structural mimetic of BDNF to promote myelin regeneration in a preclinical mouse model of central demyelination. We show that selective targeting of TrkB with the BDNF-mimetic enhances remyelination, increasing oligodendrocyte differentiation, the frequency of myelinated axons, and myelin sheath thickness after a demyelinating insult. Treatment with exogenous BDNF exerted an attenuated effect, increasing myelin sheath thickness only. Further, following conditional deletion of TrkB from pre-myelinating oligodendrocytes, we show the effects of the BDNF-mimetic on oligodendrocyte differentiation and remyelination are lost, indicating these are dependent on oligodendrocyte expression of TrkB. Overall, these studies demonstrate that targeting oligodendrocyte TrkB promotes in vivo remyelination in the brain.
Microtubule-associated protein IQ67 DOMAIN5 regulates interdigitation of leaf pavement cells inArabidopsis thaliana
Authors: Mitra Dipannita , Kumari Pratibha , Quegwer Jakob , Klemm Sandra , Möeller Birgit , Poeschl Yvonne , Pflug Paul , Stamm Gina , Abel Steffen , Bürstenbinder Katharina 
Published: February 2018

AbstractPlant microtubules form a highly dynamic intracellular network with important roles for regulating cell division, cell proliferation and cell morphology. Its organization and dynamics are coordinated by various microtubule-associated proteins (MAPs) that integrate environmental and developmental stimuli to fine-tune and adjust cytoskeletal arrays. IQ67 DOMAIN (IQD) proteins recently emerged as a class of plant-specific MAPs with largely unknown functions. Here, using a reverse genetics approach, we characterize Arabidopsis IQD5 in terms of its expression domains, subcellular localization and biological functions. We show thatIQD5is expressed mostly in vegetative tissues, where it localizes to cortical microtubule arrays. Our phenotypic analysis ofiqd5loss-of-function lines reveals functions of IQD5 in pavement cell (PC) shape morphogenesis, as indicated by reduced interdigitation of neighboring cells in the leaf epidermis ofiqd5mutants. Histochemical analysis of cell wall composition further suggests reduced rates of cellulose deposition in anticlinal cell walls, which correlate with reduced asymmetric expansion. Lastly, we provide evidence for IQD5-dependent recruitment of calmodulin calcium sensors to cortical microtubule arrays. Our work thus identifies IQD5 as a novel player in PC shape regulation, and, for the first time, links calcium signaling to developmental processes that regulate multi-polar growth in PCs.HighlightMicrotubule-localized Arabidopsis IQ67 DOMAIN5 regulates pavement cell morphogenesis in the leaf epidermis and links calcium-calmodulin signaling to lobe initiation and asymmetric expansion during early phases of interdigitated cell growth.
Highly efficient CRISPR/Cas9-mediated tissue specific mutagenesis inDrosophila
Authors: Poe Amy R. , Wang Bei , Sapar Maria L. , Ji Hui , Li Kailyn , Onabajo Tireniolu , Fazliyeva Rushaniya , Gibbs Mary , Qiu Yue , Hu Yuzhao , Han Chun 
Published: February 2018

ABSTRACTTissue-specific loss-of-function (LOF) analysis is an essential approach for characterizing gene function. Here we describe an efficientCRISPR-mediatedtissue-restrictedmutagenesis (CRISPR-TRiM) method for ablating gene function inDrosophila. This binary system consists of a tissue-specific Cas9 and a ubiquitously expressed multi-guide RNA (gRNA) transgene. To facilitate the construction of these components, we developed convenient tools for generating and evaluating enhancer-driven Cas9 lines, identified a multi-gRNA design that is highly efficient in mutagenizing somatic cells, and established an assay for testing the efficiency of multi-gRNAs in creating double-stranded breaks. We found that excision of genomic DNA induced by two gRNAs is infrequent in somatic cells, while indels more reliably cause tissue-specific LOF. Furthermore, we show that enhancer-driven Cas9 is less cytotoxic yet results in more complete gene removal than Gal4-driven Cas9 in larval neurons. Finally, we demonstrate that CRISPR-TRiM efficiently unmasks redundant gene functions in neuronal morphogenesis. Importantly, two Cas9 transgenes that turn on with different timings in the neuronal lineage revealed the extent to which gene products persist in cells after tissue-specific gene knockout. These CRISRPR tools can be applied to analyze tissue-specific gene function in many biological processes.