bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hormonal control of seasonal color change in female spiny-footed lizards: an observational and experimental approach
Authors: Fresnillo Belén , Belliure Josabel , Gil Diego , Cuervo José J 
Published: March 2019

AbstractBreeding coloration of females often signals aspects of their reproductive status, suggesting a link between color and sex steroid hormones. In this study, we examined the relationships between 2 sex steroid hormones (progesterone and β-estradiol) and reproductive coloration in female spiny-footed lizards Acanthodactylus erythrurus. We first explored natural variation in female plasma hormone levels and coloration during their reproductive cycle. β-estradiol was negatively related to brightness and positively related to red saturation, whereas progesterone was not significantly related to coloration. After identifying key relationships, plasma hormone concentrations were manipulated by creating 3 experimental female groups (β-estradiol-treated, progesterone-treated, and control), and the effects on coloration were monitored. β-estradiol-treated females, in which there was a rise in both β-estradiol and progesterone levels, lost their red coloration earlier than females in the other 2 experimental groups, whereas progesterone treatment had no significant effect on female coloration. Our results suggest that high levels of either β-estradiol alone or β-estradiol together with progesterone trigger the loss of red coloration in female spiny-footed lizards, and that progesterone alone does not affect coloration. We hypothesize that changes in female breeding color might be regulated by β-estradiol in species in which conspicuous coloration is displayed before ovulation, and by progesterone in species in which this color is displayed during gravidity.
Mucosal and Systemic Immune Profiles Differ During Early and Late Phases of the Disease in Patients With Active Ulcerative Colitis
Authors: Mavroudis Georgios , Magnusson Maria K , Isaksson Stefan , Sundin Johanna , Simrén Magnus , Öhman Lena , Strid Hans 
Published: March 2019

AbstractBackground and AimsAlterations in the immunopathogenesis in ulcerative colitis [UC] during the disease course have been proposed. We therefore aimed to determine mucosal and systemic immune profiles in individual patients at the time of diagnosis [early disease] and after 10 years [late disease].MethodsPatients with UC provided serum and mucosal biopsies during a flare in early and in late disease. Serum samples were analysed using the Olink Proseek Inflammation panel. mRNA gene expression of biopsies was analysed using the Qiagen RT2 Profiler PCR Arrays Antibacterial response and T Helper Cell Differentiation.ResultsOrthogonal projections to latent structures discriminant analyses [OPLS-DA] demonstrated that the profile of 15 serum proteins discriminated in early and late disease [R2 = 0.84, Q2 = 0.65] in 15 UC patients. Eight of these proteins were differently expressed between the groups [Q <0.05]. Further, OPLS-DA of the mRNA profiles in biopsies strongly discriminated early and late disease with high predictability [R2 = 0.96, Q2 = 0.89]; 42 genes were differently expressed at the two time points [Q <0.05]. Finally, principal component analysis showed that T helper [Th] 1- and Th2-related genes were associated with early disease and late disease, respectively, and hierarchical cluster analysis was able to cluster patients with early from late disease with only minor overlap.ConclusionsMucosal and systemic immune profiles differ between early and late disease in patients with active UC, with a transition from a Th1- to a Th2-driven disease in the intestine. Improved understanding of the variation in immunopathogenesis during the disease course in UC is important to guide individualised treatment decision making.
Timeliness of Human Immunodeficiency Virus Diagnosis and Antiretroviral Treatment Initiation in the Era of Universal Testing and Treatment
Authors: Robertson McKaylee M , Braunstein Sarah L , Hoover Donald R , Li Sheng , Nash Denis 
Published: March 2019

Abstract

Background
We describe the timing of human immunodeficiency virus (HIV) diagnosis and antiretroviral treatment (ART) initiation after implementation of universal testing and treatment policies in New York City (NYC).

Methods
Using NYC population-based HIV registry data for persons with HIV diagnosed from 2012 through 2015 and followed up through June 2017, we examined trends in the proportion with diagnosis soon after HIV infection (ie, with CD4 cell count ≥500/μL or with acute HIV infection) and used Kaplan-Meier plots and proportional hazards regression to examine the timing of ART initiation after diagnosis.

Results
Among 9987 NYC residents with HIV diagnosed from 2012 to 2015, diagnosis was early in 35%, and 87% started ART by June 2017. The annual proportion of persons with early diagnosis did not increase appreciably (35% in 2012 vs 37% in 2015; P = .08). By 6 months after diagnosis, 62%, 67%, 72% and 77% of persons with HIV diagnosed in 2012, 2013, 2014, or 2015, respectively, had started ART, with median (interquartile range) times to ART initiation of 3.34 (1.34–12.75), 2.62 (1.28–10.13), 2.16 (1.15–7.11), and 2.03 (1.11–5.61) months, respectively.

Conclusions
Although recommendations for ART initiation on diagnosis are increasingly being implemented, the findings of the current study suggest that immediate treatment initiation is not universal. Continued efforts are needed to expand and better target HIV testing to promote earlier diagnosis.
Plasmodium falciparum (Haemosporodia: Plasmodiidae) and O’nyong-nyong Virus Development in a Transgenic Anopheles gambiae (Diptera: Culicidae) Strain
Authors: Mumford John D , Long Carole A , Weaver Scott C , Miura Katzutoyo , Wang Eryu , Rotenberry Rachel , Dotson Ellen M , Benedict Mark Q 
Published: March 2019

Abstract
Transgenic Anopheles gambiae Giles (Diptera: Culicidae) mosquitoes have been developed that confer sexual sterility on males that carry a transgene encoding a protein which cuts ribosomal DNA. A relevant risk concern with transgenic mosquitoes is that their capacity to transmit known pathogens could be greater than the unmodified form. In this study, the ability to develop two human pathogens in these transgenic mosquitoes carrying a homing endonuclease which is expressed in the testes was compared with its nontransgenic siblings. Infections were performed with Plasmodium falciparum (Welch) and o’nyong-nyong virus (ONNV) and the results between the transgenic and nontransgenic sibling females were compared. There was no difference observed with ONNV isolate SG650 in intrathoracic infections or the 50% oral infectious dose measured at 14 d postinfection or in mean body titers. Some significant differences were observed for leg titers at the medium and highest doses for those individuals in which virus titer could be detected. No consistent difference was observed between the transgenic and nontransgenic comparator females in their ability to develop P. falciparum NF54 strain parasites. This particular transgene caused no significant effect in the ability of mosquitoes to become infected by these two pathogens in this genetic background. These results are discussed in the context of risk to human health if these transgenic individuals were present in the environment.
Insights into BRCA Cancer Predisposition from Integrated Germline and Somatic Analyses in 7632 Cancers
Authors: Yost Shawn , Ruark Elise , Alexandrov Ludmil B , Rahman Nazneen 
Published: March 2019

Abstract

Background
It is often assumed any cancer in a germline BRCA1 or BRCA2 (collectively termed BRCA) mutation carrier was caused by that mutation. It is also often assumed the occurrence of breast or ovarian cancer in an individual with a variant of uncertain significance (VUS) suggests the VUS is pathogenic. These assumptions have profound management implications for cancer patients and healthy individuals.

Methods
We compared the frequency of BRCA mutations, allele loss, and Signature 3 in 7632 individuals with 28 cancers and 1000 population controls. Because only increased frequency was the focus of the study, all statistical tests were one-sided.

Results
Individuals with breast or ovarian cancer had increased germline BRCA pathogenic mutation frequencies compared to controls (P = 1.0x10−10 and P = 1.4x10−34, respectively). There was no increase in other cancer types. Wild-type allele loss and Signature 3 were statistically significantly higher in breast and ovarian cancers with BRCA mutations compared with other cancers with BRCA mutations (P = 5.1x10−10 and P = 3.7x10−9) and cancers without BRCA mutations (P = 2.8x10−53 and P = 1.0x10−134). There was no difference between non-breast and non-ovarian cancers with BRCA mutations and cancers without BRCA mutations. Allele loss and Signature 3 were statistically significantly higher in breast and ovarian cancers in individuals with BRCA pathogenic mutations compared to those with VUS (P = 3.8x10−17 and P = 1.6x10−8) or benign variants (P = 1.2x10−28 and P = 2.2x10−10). There was no difference between individuals with BRCA VUS and those with benign variants.

Conclusions
These data show that non-breast and non-ovarian cancers in individuals with germline BRCA pathogenic mutations are often not causally related to the mutation and that BRCA VUS are highly unlikely to be pathogenic. These results should reduce inappropriate management of germline BRCA information.
Hyaluronate gel injection for rectum dose reduction in gynecologic high-dose-rate brachytherapy: initial Japanese experience
Authors: Kashihara Tairo , Murakami Naoya , Tselis Nikolaos , Kobayashi Kazuma , Tsuchida Keisuke , Shima Satoshi , Masui Koji , Yoshida Ken , Takahashi Kana , Inaba Koji , Umezawa Rei , Igaki Hiroshi , Ito Yoshinori , Kato Tomoyasu , Uno Takashi , Itami Jun 
Published: March 2019

Abstract
Perirectal hyaluronate gel injection (HGI) appears to be a promising technique for healthy tissue dose sparing in pelvic radiotherapy. In this analysis, we report our initial experience of HGI in gynecologic brachytherapy, focusing on its safety and effectiveness for dose reduction to the rectum. Between July 2013 and May 2014, 36 patients received HGI for primary/salvage gynecologic brachytherapy. Dosimetric effect analysis was based on pre- and post-HGI computed tomography dataset registration with corresponding dose–volume histogram evaluation. The maximum dose to the most exposed 0.1 cm3 (D0.1cm3) and 2.0 cm3 (D2.0cm3) were used as index values for rectum and bladder dose evaluation. The dose indexes for target volume (TV) coverage were TV D90/V100. In all cases, HGI was well tolerated, with no acute or late adverse events documented at a median follow-up of 220 days (range, 18–1046 days). Rectum D2.0cm3 and D0.1cm3 were significantly decreased by HGI (P < 0.001 and P = 0.003, respectively), with no significant impact on dosimetric parameters of bladder and TV coverage. Factors correlating negatively with the dosimetric effect of HGI were an increasing number of interstitial catheters (P = 0.003) as well as Lcranial100% (P = 0.014) and Lcranial80% (P = 0.001) [i.e. the length from the anal verge to the most cranial point at which the 100% and 80% isodose lines, respectively, crossed the rectum]. The concept of HGI for gynecologic brachytherapy is plausible, and our initial experience indicates it to be an effective technique for rectal dose reduction in radiotherapy of intrapelvic tumours.
An Automated Method for Direct Antiglobulin Testing and the Resulting Amount of Phototherapy Used at a Large Academic Medical Center
Authors: Fei Fei , Marques Marisa B , Staley Elizabeth M , Williams Lance A 
Published: March 2019

ABSTRACTObjectiveTo evaluate how clinical practice was affected by the change in direct antiglobulin testing (DAT) methodologies and subsequent stronger reported DAT results at our large academic medical center.MethodWe retrospectively reviewed DAT results of umbilical cord blood from infants with blood type A or B born to mothers with antibody-negative type O blood, based on records kept at the University of Alabama at Birmingham (UAB) Hospital, a 1400-bed academic medical center.ResultsWe randomly chose 50 neonates with positive DAT results who had been tested using the tube method and 50 whose testing had used the gel method. Although 86% of results with the tube method were positive microscopically, 52% and 40% of the DAT results with the gel method were 1+ and 2+ positive, respectively. Further, we observed an increase in the number of neonates treated with phototherapy who had been tested using the gel method.ConclusionWe report that DATs performed using the gel method had increased DAT strength compared with tube testing, which led to increased use of phototherapy by our clinical colleagues.
Pediatric Intracavernous Sinus Lesions: A Single Institutional Surgical Case Series and Review of the Literature
Authors: Hoshide Reid , Rennert Robert C , Calayag Mark , Gonda David , Meltzer Hal , Crawford John R , Levy Michael L 
Published: March 2019

Abstract

BACKGROUND
Pediatric intracavernous sinus tumors are exceedingly rare and thus poorly characterized. Their neurosurgical management is challenging and diagnostic, and management guidelines are limited.

OBJECTIVE
To report our institutional experience with the surgical resection of pediatric intracavernous sinus tumors. We also compare and contrast our results with the 14 cases of pediatric intracavernous sinus lesions in the current literature.

METHODS
A retrospective descriptive analysis of consecutive pediatric patients (ages 0-18 yr) presenting to our institution with a diagnosis of an intracavernous sinus lesion was performed. From January 2012 to January 2017, 5 cases were identified. Eleven patients with secondary invasion of the cavernous sinus (2 meningiomas, 7 pituitary adenomas) or dermoid tumors involving the cavernous sinus (2) were not included in our review.

RESULTS
Surgical resection via a frontotemporal orbitozygomatic approach was performed in all cases by a single senior neurosurgeon (M.L.). There were no perioperative or postoperative complications attributable to the surgery or approach. Four of 5 patients remained neurologically stable throughout the perioperative and postoperative period. The fifth patient had a complete resolution of their cranial neuropathies postoperatively. A pathological diagnosis that guided long-term management was obtained in all cases.

CONCLUSION
Neurosurgical management of pediatric cavernous sinus lesions can be safely performed and critically guide future therapies. Surgeon familiarity with cavernous sinus and skull-base anatomy is critical to the successful management of these patients. The benefits of surgery should be balanced against the potential complications and need for a tissue diagnosis in children. The senior author had a significant experience with cavernous sinus approaches in adults prior to initiating use of the approach in the pediatric population.
Worker Power and Class Polarization in Intra-Year Work Hour Volatility
Authors: LaBriola Joe , Schneider Daniel 
Published: March 2019

AbstractPrecarious work, which has become more prevalent in the United States in recent decades, is disproportionately experienced by workers of lower socio-economic classes, and research suggests that the erosion of worker power has contributed to this class polarization in precarity. One dimension of precarious work of growing interest to scholars and policymakers is instability faced by workers in the amount and regularity of their work hours. However, we know little about the magnitude of month-to-month or week-to-week (intra-year) volatility in hours worked, the extent of class-based polarization in this measure of job quality, and whether worker power moderates this polarization. In this paper, we make novel use of the panel nature of the nationally-representative Current Population Survey (CPS) to estimate intra-year volatility in the actual hours respondents report working in the previous week across four consecutive survey months. Using this new measure, we then show that, net of demographic characteristics and controls for occupation and industry, low-wage workers experience disproportionately greater work hour volatility. Finally, we find evidence that reductions in marketplace bargaining power—as measured by higher state-level unemployment rates—increase wage- and education-based polarization in work hour volatility, while increases in associational power—as measured by union coverage—reduce wage-based polarization in work hour volatility.
Beyond the United States Medical Licensing Examination Score: Assessing Competence for Entering Residency
Authors: Radabaugh Carrie L. , Hawkins Richard E. , Welcher Catherine M. , Mejicano George C. , Aparicio Alejandro , Kirk Lynne M. , Skochelak Susan E. 
Published: March 2019

Assessments of physician learners during the transition from undergraduate to graduate medical education generate information that may inform their learning and improvement needs, determine readiness to move along the medical education continuum, and predict success in their residency programs. To achieve a constructive transition for the learner, residency program, and patients, high-quality assessments should provide meaningful information regarding applicant characteristics, academic achievement, and competence that lead to a suitable match between the learner and the residency program’s culture and focus.
The authors discuss alternative assessment models that may correlate with resident physician clinical performance and patient care outcomes. Currently, passing the United States Medical Licensing Examination Step examinations provides one element of reliable assessment data that could inform judgments about a learner’s likelihood for success in residency. Yet, learner capabilities in areas beyond those traditionally valued in future physicians, such as life experiences, community engagement, language skills, and leadership attributes, are not afforded the same level of influence when candidate selections are made.
While promising new methods of screening and assessment—such as objective structured clinical examinations, holistic assessments, and competency-based assessments—have attracted increased attention in the medical education community, currently they may be expensive, be less psychometrically sound, lack a national comparison group, or be complicated to administer. Future research and experimentation are needed to establish measures that can best meet the needs of programs, faculty, staff, students, and, more importantly, patients.
Effect of Serious Adverse Events on Health-related Quality of Life Measures Following Surgery for Adult Symptomatic Lumbar Scoliosis
Authors: Smith Justin S. , Shaffrey Christopher I. , Kelly Michael P. , Yanik Elizabeth L. , Lurie Jon D. , Baldus Christine R. , Edwards Charles , Glassman Steven D. , Lenke Lawrence G. , Boachie-Adjei Oheneba , Buchowski Jacob M. , Carreon Leah Y. , Crawford Charles H. , Errico Thomas J. , Lewis Stephen J. , Koski Tyler , Parent Stefan , Kim Han Jo , Ames Christopher P. , Bess Shay , Schwab Frank J. , Bridwell Keith H. 
Published: March 2019

Study Design.
Secondary analysis of prospective multicenter cohort.

Objective.
To assess effect of serious adverse events (SAEs) on 2- and 4-year patient-reported outcomes measures (PROMs) in patients surgically treated for adult symptomatic lumbar scoliosis (ASLS).

Summary of Background Data.
Operative treatment for ASLS can improve health-related quality of life, but has high rates of SAEs. How these SAEs effect health-related quality of life remain unclear.

Methods.
The ASLS study assessed operative versus nonoperative ASLS treatment, with randomized and observational arms. Patients were 40- to 80-years-old with ASLS, defined as lumbar coronal Cobb ≥30° and Oswestry Disability Index (ODI) ≥20 or Scoliosis Research Society-22 (SRS-22) ≤4.0 in pain, function, and/or self-image domains. SRS-22 subscore and ODI were compared between operative patients with and without a related SAE and nonoperative patients using an as-treated analysis combining randomized and observational cohorts.

Results.
Two hundred eighty-six patients were enrolled, and 2- and 4-year follow-up rates were 90% and 81%, respectively, although at the time of data extraction not all patients were eligible for 4-year follow-up. A total of 97 SAEs were reported among 173 operatively treated patients. The most common were implant failure/pseudarthrosis (n = 25), proximal junctional kyphosis/failure (n = 10), and minor motor deficit (n = 8). At 2 years patients with an SAE improved less than those without an SAE based on SRS-22 (0.52 vs. 0.79, P = 0.004) and ODI (−11.59 vs. −17.34, P = 0.021). These differences were maintained at 4-years for both SRS-22 (0.51 vs. 0.86, P = 0.001) and ODI (−10.73 vs. −16.69, P = 0.012). Despite this effect, patients sustaining an operative SAE had greater PROM improvement than nonoperative patients (P<0.001).

Conclusion.
Patients affected by SAEs following surgery for ASLS had significantly less improvement of PROMs at 2- and 4-year follow-ups versus those without an SAE. Regardless of SAE occurrence, operatively treated patients had significantly greater improvement in PROMs than those treated nonoperatively.

Level of Evidence: 2
PHQ-9 Score Predicts Postoperative Outcomes Following Minimally Invasive Transforaminal Lumbar Interbody Fusion
Authors: Patel Dil V. , Yoo Joon S. , Khechen Benjamin , Haws Brittany E. , Block Andrew M. , Lamoutte Eric H. , Karmarkar Sailee S. , Singh Kern 
Published: March 2019

Study Design:
This was a retrospective cohort study.

Objective:
This study evaluates if an association exists between preoperative depression and postoperative outcomes following minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Summary of Background Data:
Few studies have quantified preoperative depression symptoms using Patient Health Questionnaire-9 (PHQ-9) to predict postoperative outcomes after lumbar fusion, especially MIS TLIF.

Methods:
A surgical database of patients undergoing primary, single-level MIS TLIF was retrospectively reviewed. Patients were stratified by predefined preoperative PHQ-9 scores: no depression (<5), mild depression (5–9), and moderate to severe depression (≥10). Inpatient pain scores and narcotics use were recorded. Oswestry Disability Index, Veterans RAND-12 Mental Component Score and Physical Component Score, and Visual Analog Scale (VAS) back and leg pain scores were collected preoperatively and at 6-week, 12-week, and 6-month follow-up. One-way analysis of variance and χ2 analysis determined if an association existed between PHQ-9 subgroups and baseline characteristics or perioperative outcomes. Multivariate linear regression assessed for an association between PHQ-9 and postoperative patient-reported outcomes.

Results:
In total, 94 patients were included. Patients with higher PHQ-9 scores were younger, obese, and carried workers’ compensation insurance. Higher PHQ-9 scores were associated with worse preoperative Oswestry Disability Index, Veterans RAND-12 Mental Component Score and Physical Component Score, and VAS back and leg pain scores. Patients with higher PHQ-9 reported greater inpatient VAS pain scores on postoperative day 0 and 1 and demonstrated greater hourly narcotics consumption on postoperative day 0. Furthermore, higher PHQ-9 scores exhibited less improvement in all patient-reported outcomes.

Conclusions:
Patients with severe depression symptoms reported greater pain, increased narcotics consumption, and less clinical improvement after MIS TLIF. Therefore, patients with greater PHQ-9 scores should be monitored more closely and may benefit from additional counseling with regard to postoperative outcomes to better manage pain control and expectations of recovery.