bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infantile hemangiomas: what have we learned from propranolol?
Authors: Hagen Rachael , Ghareeb Erica , Jalali Omid , Zinn Zachary 
Published: May 2018

Purpose of review
Infantile hemangiomas are the most common vascular tumor of infancy. Treatment of infantile hemangiomas was revolutionized when propranolol, a nonselective β-blocker, was reported to be effective therapy. In this review, we highlight the lessons learned using propranolol to treat infantile hemangiomas. We also describe the ongoing effort to understand the mechanism of action of propranolol.

Recent findings
Although the pathogenesis of infantile hemangiomas is not fully understood, maternal hypoxic stress and embolization of placental tissue are suggested to be critical components in their development. The mechanism of action of propranolol remains unclear, however various molecular mechanisms are detailed in this review. Propranolol treatment remains a well tolerated therapy, with low risk of adverse events or long-term neurocognitive effects. Dosing recommendations and optimal treatment duration vary among studies, and should be altered in patients with certain medical conditions such as Posterior fossa anomalies, Hemangioma, Arterial lesions, Cardiac abnormalities/coarctation of the aorta, Eye anomalies (PHACE) syndrome.

Summary
Propranolol is a well tolerated and effective treatment for infantile hemangiomas. The efficacy of propranolol for infantile hemangiomas is clear, however questions pertaining to mechanism of action, pretreatment risk stratification, and optimal dosing remain unanswered. The guidelines for managing infantile hemangiomas with propranolol will continue to adapt as research catches up to clinical experience.
Nonsuicidal self-injury in adolescents: current developments to help inform assessment and treatment
Authors: Pluhar Emily , Lois Rebecca H. , Burton Elvin Thomaseo 
Published: May 2018

Purpose of review
This review summarizes the recent literature examining nonsuicidal self-injury (NSSI) in adolescents, with a particular focus on how primary care pediatricians (PCPs) might assess and intervene as a common first point of contact. This NSSI review is timely and relevant, given the prevalence rates among adolescents, as well as its link to suicidal behaviors.

Recent findings
NSSI is most prevalent among adolescents, with lifetime prevalence rates between 17 and 60%. With evidence that the most common age of onset is between 12 and 14 years, evaluating NSSI is a challenging yet necessary aspect of a comprehensive adolescent medical examination. The function of NSSI behaviors may have implications for effective treatment and should be included in assessment. The majority of research has indicated that NSSI serves an emotion regulation function, in that the behavior results in a decrease in intensity of adverse emotional states in the absence of more effective coping strategies.

Summary
Considering the prevalence of self-injury among adolescents, the likelihood that PCPs will encounter NSSI in their practice is quite high. Given that more than 50% of youth do not receive needed mental health services, it is critical that PCPs assess for NSSI and intervene accordingly.
Validating the Changes to Self-identity After Total Laryngectomy
Authors: Bickford Jane , Coveney John , Baker Janet , Hersh Deborah 
Published: May 2018

Background
A total laryngectomy often prolongs life but results in long-term disablement, disfigurement, and complex care needs. Current clinical practice addresses the surgical options, procedures, and immediate recovery. Less support is available longer-term despite significant changes to aspects of personhood and ongoing medical needs.

Objective
The aim of this study was to explore the experience of living with and/or supporting individuals with a laryngectomy at least 1 year after surgery.

Methods
Constructivist grounded theory methods and symbolic interactionism were used to guide collection and analysis of interview data from 28 participants (12 individuals with a laryngectomy, 9 primary supporters, and 7 health professionals).

Results
The phenomena of “validating the altered self after total laryngectomy” highlighted how individuals, postlaryngectomy, navigate and negotiate interactions due to the disruption of their self-expression, related competencies, and roles. Several reframing patterns representing validation of the self emerged from the narratives. They were as follows: destabilized, resigned, resolute, and transformed. The data describe the influence of the processes of developing competence and building resilience, combined with contextual factors, for example, timing and turning points; being supported; and personal factors on these reframing patterns.

Conclusion
The findings further our understanding of the long-term subjective experience of identity change after laryngectomy and call attention to the persisting need for psychosocial support.

Implications for Practice
This research provides important evidence for evaluating and strengthening the continuum of services (specialist to community) and supporting social participation, regardless of communication method, and for competency training for all involved to optimize person-centered practices.
Symptoms, Psychosocial Factors, and Health-Related Quality of Life in Patients With Neuroendocrine Tumors
Authors: Haugland Trude , DeVon Holli A. 
Published: May 2018

Background
Understanding the influence of psychosocial factors and symptoms on health-related quality of life (HRQoL) might help researchers develop interventions to optimize HRQoL in patients with neuroendocrine tumors (NETs).

Objective
The aim of this study was to characterize available evidence on symptoms, psychosocial factors, and HRQoL in patients with NET.

Methods
For this integrative literature review, the literature search was guided by the methodology proposed by Whittemore and Knafl. MEDLINE, CINAHL, PubMed, PsychINFO, and Google Scholar were searched for articles exploring symptoms, psychosocial factors, and HRQoL in patients living with gastrointestinal NETs.

Results
Combining keywords yielded 37 articles after removing 2 duplicates. Twenty-three articles were removed because they did not meet inclusion criteria. Two articles had a qualitative design. The final review included 15 studies. Geographically diverse studies indicate that patients with NET experience fatigue, nausea/vomiting, pain, dyspnea, and sleep disturbance. Anxiety, higher depression, and stress negatively influenced HRQoL. More social support, self-efficacy, and optimism were associated with better HRQoL. Findings from the qualitative studies emphasize that NET-related symptoms and adverse effects of the treatment influence the patients' HRQoL.

Conclusion
This review identified fatigue, nausea/vomiting, pain, dyspnea, and sleep disturbance as the most important symptoms. The most frequently reported psychosocial factors were anxiety and depression, which influenced HRQoL negatively. Social support and self-efficacy had a positive impact on HRQoL.

Implications for Practice
Researchers and clinicians must understand the importance of psychosocial factors and symptoms associated with HRQoL to develop targeted interventions to optimize HRQoL in patients with NET.
Periauricular Purse-String Reinforced with SMAS plication and Malaria Fat Pad Elevation for Mid-and Lower Facial Rejuvenation
Authors: Wang Rongrong , Yang Jie , Guo Ke , Zhong Aimei , Tong Jing , Xiong Lingyun , Sun Jiaming 
Published: May 2018

Background
Facial aging is a complex process influencing every layer of the facial structure. Most accepted surgical techniques for facial rejuvenation involve certain manipulation of the superficial musculoaponeurotic system (SMAS). Out of these SMAS-based techniques, SMAS plication or suspension provides excellent outcomes with shorter convalescence and fewer potential complications. Herein, we would like to present our own technique combining SMAS plication, periauricular purse-string, and malar fat pad elevation technique for mid and lower facelift.

Methods
Through a classical periauricular and temporal incision, a periauricular permanent purse-string suture was woven into the SMAS to suspend sagging soft tissue of the mid and lower face after superficial undermining, then plication of inner and outer SMAS of the purse-string loop was performed to further secure suspension, and at last the malar fat pad was elevated for midface rejuvenation. The shape of the loop varies with patients' age; for younger patients, the loop is more vertical, and for older patients, the loop is more horizontal. Patient-reported outcomes were described using the FACE-Q questionnaire.

Results
From January 2010 to June 2015, a total of 138 patients were treated with this technique by a same surgeon. Follow-up duration ranged from 1 to 6 years. Preoperative and postoperative photographs were recorded and analyzed. The complications rates were low, and satisfaction rates were high. Patients felt that they appeared 7.3 years younger than their actual age on average and were most satisfied with the appearance of their lower face and jawline.

Conclusions
Periauricular purse-string reinforced with SMAS plication and malar fat pad elevation technique produces esthetically pleasing outcomes, besides being simple, safe, and personalized.
The Soleus Muscle Flap
Authors: Song Ping , Pu Lee L. Q. 
Published: May 2018

Abstract
Lower extremity reconstruction often poses several challenges for the reconstructive surgeon. Because of limited local tissue options, patients who sustain extensive middle to distal third tibia fractures used to be at higher risk of limb loss without adequate soft tissue coverage. The traditional principle of reconstructing middle and distal third leg wounds with free tissue transfer is being challenged by advances in understanding of local muscle flap anatomy and surgical techniques to improve the efficacy of local flaps. In this article, we examine contemporary considerations, developed by the authors, for the appropriate indications of free tissue transfer versus use of local flaps such as the soleus muscle flap. We review the versatility and reliability of the soleus muscle as a local muscle option once the technique is mastered on how to safely and effectively design and execute this flap. We highlight the importance of an algorithmic approach to soft-tissue reconstruction of the lower extremity based on the best surgical option for the patient. This includes factors such as medical history, appropriate surgical candidacy, as well as the size and mechanism of injury to decide the most viable option for lower extremity reconstruction. We show that the medial hemisoleus muscle flap is a reliable local option, both by itself or in conjunction with other local flaps, to reconstruct less extensive wounds in the middle to distal third of the leg. Ultimately, such a local muscle flap must be mastered by the reconstructive surgeon to augment his or her armamentarium to provide a well-rounded reconstructive plan in managing the soft-tissue wound, while minimizing donor-site morbidity and potentially be more cost-effective in nature.
Fatal Case of Metformin-Associated Lactic Acidosis Associated With Temporary Ileostomy
Authors: Tirelli Flavio , Biondi Alberto , Persiani Roberto 
Published: May 2018

BACKGROUND:
Metformin is considered a first choice for oral treatment of patients with type 2 diabetes in the absence of contraindications. Colorectal cancer is the second most frequent cancer among the general population; low anterior resections and temporary diverting ileostomies are commonly performed in this population. As the incidence of type 2 diabetes increases, the use of metformin in patients with both type 2 diabetes and an ileostomy will most likely increase as well.

CASE:
We present the case of a patient affected by colorectal cancer who developed a severe metformin-associated lactic acidosis (MALA) after creation of a temporary ileostomy to protect a low colorectal anastomosis. High-volume output from his ileostomy led to significant fluid loss and electrolyte imbalance, his condition was complicated by MALA, resulting in death.

CONCLUSION:
The population of ileostomy patients who also have type 2 diabetic and taking metformin is at risk for MALA. High stomal output can lead to dehydration, with a loss of fluids and electrolytes and metformin could aggravate this condition, potentiating the risk of MALA.
The variability of amino acids sequences in hepatitis B virus
Authors: Cao Jianhao , Luo Shuhong , Xiong Yuanyan 
Published: May 2018

AbstractHepatitis B virus (HBV) is an important human pathogen belonging to theHepadnaviridaefamily,Orthohepadnavirusgenus. It infects over 240 million people globally. The reverse transcription during its genome replication leads to low fidelity DNA synthesis, which is the source of variability in the viral proteins. To investigate the variability quantitatively, we retrieved amino acid sequences of 5167 records of all available HBV genotypes (A-J) from the Genbank database. The amino acid sequences encoded by the open reading frames (ORF) S/C/P/X in the HBV genome were extracted and subjected to alignment respectively. We analyzed the variability of the lengths and the sequences of proteins as well as the frequencies of amino acids. Our study comprehensively characterized of the variability and conservation of HBV at the level of amino acids, especially for the structural proteins, hepatitis B surface antigens (HBsAg), to find out the potential sites critical for virus assembly and immune recognition. Interestingly, the preS1/S2 domains in HBsAg were variable at some positions of amino acid residues, which provides a potential mechanism of immune-escape for HBV, while the preS2 and S domains were conserved in the lengths of protein sequences. In the S domain, the cysteine residues and the secondary structures of the alpha-helix and beta-sheet were likely critical for the stable folding of the protein structure. The preC domain and C-terminal domain (CTD) of the core protein are highly conserved. And the polymerases HBpol and the HBx were highly variable at the amino acid level.
Toxicity of TiO2, SiO2, ZnO, CuO, Au and Ag engineered nanoparticles on hatching and early nauplii of Artemia sp.
Authors: Rohit R , Murthy Ch. Lakshmi N , Idris Mohammed M , Singh Shashi 
Published: May 2018

AbstractThe potential of environmental release enhances with increased commercial applications of the nanomaterials. A simple and efficient test to estimate the acute toxicity of nanoparticles is carried out in this work using Artemia species and their hatching rate. We have tested six different engineered nanoparticles (silver, gold, copper oxide, zinc oxide, titanium dioxide and silicon nanoparticles) and three soluble salts (CuSO4, ZnSO4 and AgNO3) on Artemia sp. The physiochemical properties of the nanoparticles involved in this study are estimated and their properties in normal water and marine water were analyzed. Hydrated and bleached Artemia cysts were allowed to hatch in continuously aerated, filtered sterile salt water containing nanoparticles; hatching of viable nauplii vs total hatchlings were recorded. In parallel, Standard Artemia toxicity test was conducted on the nauplii monitoring the viability. A comparison of results obtained in both experiments is discussed. The toxicity of the nanoparticles was compared and the order of toxicity is estimated as Ag>CuO>ZnO>Au>TiO2>SiO2.
MTAP loss correlates with an immunosuppressive profile in GBM and its substrate MTA stimulates alternative macrophage polarization
Authors: Hansen Landon J. , Yang Rui , Woroniecka Karolina , Chen Lee , Yan Hai , He Yiping 
Published: May 2018

ABSTRACTGlioblastoma (GBM) is a lethal brain cancer known for its potent immunosuppressive effects. Loss ofMethylthioadenosine Phosphorylase(MTAP) expression, via gene deletion or epigenetic silencing, is one of the most common alterations in GBM. Here, we show that MTAP loss in GBM cells is correlated with differential expression of immune regulatory genes. In silico analysis of gene expression profiles in GBM samples revealed that lowMTAPexpression is correlated with reduced proportions of γδT cells, fewer activated CD4 cells, and an increased proportion of M2 macrophages. Using in vitro macrophage models, we found that methylthioadenosine (MTA), the metabolite that accumulates as a result of MTAP loss in GBM cells, promotes the immunosuppressive alternative activation (M2) of macrophages. We show that this effect of MTA on macrophages is independent of IL4/IL3 signaling, is mediated by the adenosine A2Breceptor, and can be pharmacologically reversed. This study suggests that MTAP loss in GBM cells contributes to the immunosuppressive microenvironment, and thatMTAPstatus should be a factor for consideration in understanding GBM immune states and devising immunotherapy-based approaches for treatingMTAP-null GBM.
Relative value perception in an insect: positive and negative incentive contrasts in ants
Authors: Wendt Stephanie , Strunk Kim S. , Heinze Juergen , Roider Andreas , Czaczkes Tomer J. 
Published: May 2018

AbstractHumans tend to value things not on their absolute values, but relative to reference points such as former experience or expectations. People rate the quality of a new salary relative to their previous salary and the salaries of their peers, instead of appreciating its absolute value. Here, we demonstrate a similar effect in an insect: ants, which had previously experienced a low quality food source, showed higher acceptance of medium quality food (e.g. 0.1M then 0.5M; positive contrast) than if they had received the medium food all along (e.g. 0.5M then 0.5M; control), and vice versa for high expectations. Further experiments demonstrate that these contrast effects arise from cognitive rather than mere sensory or pre-cognitive perceptual causes. Pheromone deposition also correlates with perceived reward value, and ants showed successive contrasts in their pheromone deposition. Relative value perception can therefore be expected to have strong effects not only on individual behaviour, but also on collective decision-making. Contrast effects were also social: the quality of food received from other ants affected the perceived value of food found later. Value judgement is a key element in decision making, and thus relative value perception will strongly influence how animals interact with their environment.
Genome Functional Annotation across Species using Deep Convolutional Neural Networks
Authors: Khodabandelou Ghazaleh , Routhier Etienne , Mozziconacci Julien 
Published: May 2018

ABSTRACTDeep neural network application is today a skyrocketing field in many disciplinary domains. In genomics the development of deep neural networks is expected to revolutionize current practice. Several approaches relying on convolutional neural networks have been developed to associate short genomic sequences with a functional role such as promoters, enhancers or protein binding sites along genomes. These approaches rely on the generation of sequences batches with known annotations for learning purpose. While they show good performance to predict annotations from a test subset of these batches, they usually perform poorly when applied genome-wide.In this study, we address this issue and propose an optimal strategy to train convolutional neural networks for this specific application. We use as a case study transcription start sites and show that a model trained on one organism can be used to predict transcription start sites in a different specie. This cross-species application of convolutional neural networks trained with genomic sequence data provides a new technique to annotate any genome from previously existing annotations in related species. It also provides a way to determine whether the sequence patterns recognized by chromatin associated proteins in different species are conserved or not.
Metagenomic analysis suggests broad metabolic potential in extracellular symbionts of the bivalveThyasiracf.gouldi
Authors: McCuaig Bonita , Peña-Castillo Lourdes , Dufour Suzanne C. 
Published: May 2018

AbstractNext-generation sequencing has opened new avenues for studying metabolic capabilities of bacteria that cannot be cultured. Here, we provide a metagenomic description of a chemoautotrophic gammaproteobacterial symbiont associated withThyasiracf.gouldi, a sediment-dwelling bivalve from the family Thyasiridae. Symbionts of thyasirids differ from those of other bivalves by being located outside rather than inside gill epithelial cells, and recent work suggests that they are capable of living freely in the environment. TheT. cf.gouldisymbiont genome shows no signs of genomic reduction and contains many genes that would only be useful outside the host, including flagellar and chemotaxis genes. The thyasirid symbiont may be capable of sulfur oxidation via both the sulfur oxidation and dissimilatory sulfate reduction pathways, as observed in other bivalve symbionts. In addition, genes for hydrogen oxidation and dissimilatory nitrate reduction were found, suggesting varied metabolic capabilities under a range of redox conditions. The genes of the tricarboxylic acid cycle are also present, along with membrane bound sugar importer channels, suggesting that the bacteria may be mixotrophic. In this study, we have generated the first thyasirid symbiont genomic resources and lay the groundwork for further research in tracking the changes required for life as a bivalve symbiont.
Laboratory Validation of a Clinical Metagenomic Sequencing Assay for Pathogen Detection in Cerebrospinal Fluid
Authors: Miller S , Naccache SN , Samayoa E , Messacar K , Arevalo S , Federman S , Stryke D , Pham E , Fung B , Bolosky WJ , Ingebrigtsen D , Lorizio W , Paff SM , Leake JA , Pesano R , DeBiasi RL , Dominguez SR , Chiu CY 
Published: May 2018

ABSTRACTMetagenomic next-generation sequencing (mNGS) for pan-pathogen detection has been successfully tested in proof-of-concept case studies in patients with acute illness of unknown etiology, but to date has been largely confined to research settings. Here we developed and validated an mNGS assay for diagnosis of infectious causes of meningitis and encephalitis from cerebrospinal fluid (CSF) in a licensed clinical laboratory. A clinical bioinformatics pipeline, SURPI+, was developed to rapidly analyze mNGS data, automatically report detected pathogens, and provide a graphical user interface for evaluating and interpreting results. We established quality metrics, threshold values, and limits of detection of between 0.16 – 313 genomic copies or colony forming units per milliliter for each representative organism type. Gross hemolysis and excess host nucleic acid reduced assay sensitivity; however, a spiked phage used as an internal control was a reliable indicator of sensitivity loss. Diagnostic test accuracy was evaluated by blinded mNGS testing of 95 patient samples, revealing 73% sensitivity and 99% specificity compared to original clinical test results, with 81% positive percent agreement and 99% negative percent agreement after discrepancy analysis. Subsequent mNGS challenge testing of 20 positive CSF samples prospectively collected from a cohort of pediatric patients hospitalized with meningitis, myelitis, and/or encephalitis showed 92% sensitivity and 96% specificity relative to conventional microbiological testing of CSF in identifying the causative pathogen. These results demonstrate the analytic performance of a laboratory-validated mNGS assay for pan-pathogen detection, to be used clinically for diagnosis of neurological infections from CSF.