Journal of Oral Rehabilitation, EarlyView.
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Πέμπτη 24 Μαΐου 2018
Effect of dietary counselling with prosthetic restoration on fruit and vegetable intake in partially dentate patients: A prospective study
The rational design of multiple molecular module-based assemblies for simultaneously improving rice yield and grain quality
Source:Journal of Genetics and Genomics
Author(s): Kun Wu, Xiaopeng Xu, Nan Zhong, Haixiang Huang, Jianping Yu, Yafeng Ye, Yuejin Wu, Xiangdong Fu
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Control of flowering and inflorescence architecture in tomato by synergistic interactions between ALOG transcription factors
Source:Journal of Genetics and Genomics
Author(s): Xiaozhen Huang, Lingli Tang, Yuan Yu, Justin Dalrymple, Zachary B. Lippman, Cao Xu
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Is blaCTX-M-1 Riding the Same Plasmid Among Horses in Sweden and France?
Microbial Drug Resistance, Ahead of Print.
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Association of Colistin-Resistant KPC Clonal Strains with Subsequent Infections and Colonization and Biofilm Production
Microbial Drug Resistance, Ahead of Print.
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Limited Mutation-Rate Variation Within the Paramecium aurelia Species Complex
Mutation is one of the most fundamental evolutionary forces. Studying variation in the mutation rate within and among closely-related species can help reveal mechanisms of genome divergence, but such variation is unstudied in the vast majority of organisms. Previous studies on ciliated protozoa have found extremely low mutation rates. In this study, using mutation-accumulation techniques combined with deep whole-genome sequencing, we explore the germline base-substitution mutation-rate variation of three cryptic species in the Paramecium aurelia species complex-P. biaurelia, P. sexaurelia, and P. tetraurelia. We find that there is extremely limited variation of the mutation rate and spectrum in the three species and confirm the extremely low mutation rate of ciliates.
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A High Quality Genome for Mus spicilegus, a Close Relative of House Mice with Unique Social and Ecological Adaptations
Genomic data for the closest relatives of house mice (Mus musculus species complex) are surprisingly limited. Here, we present the first complete genome for a behaviorally and ecologically unique member of the sister clade to house mice, the mound-building mouse, Mus spicilegus. Using read cloud sequencing and de novo assembly we produced a 2.50 Gbp genome with a scaffold N50 of 2.27 Mbp. We constructed >25 000 gene models, of which the majority had high homology to other Mus species. To evaluate the utility of the M. spicilegus genome for behavioral and ecological genomics, we extracted 196 vomeronasal receptor (VR) sequences from our genome and analyzed phylogenetic relationships between M. spicilegus VRs and orthologs from M. musculus and the Algerian mouse, M. spretus. While most M. spicilegus VRs clustered with orthologs in M. musculus and M. spretus, 10 VRs with evidence of rapid divergence in M. spicilegus are strong candidate modulators of species-specific chemical communication. A high quality assembly and genome for M. spicilegus will help to resolve discordant ancestry patterns in house mouse genomes, and will provide an essential foundation for genetic dissection of phenotypes that distinguish commensal from non-commensal species, and the social and ecological characteristics that make M. spicilegus unique.
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The Aspergillus nidulans Pyruvate Dehydrogenase Kinases Are Essential To Integrate Carbon Source Metabolism
The pyruvate dehydrogenase complex (PDH), that converts pyruvate to acetyl-coA, is regulated by pyruvate dehydrogenase kinases (PDHK) and phosphatases (PDHP) that have been shown to be important for morphology, pathogenicity and carbon source utilisation in different fungal species. The aim of this study was to investigate the role played by the three PDHKs PkpA, PkpB and PkpC in carbon source utilisation in the reference filamentous fungus Aspergillus nidulans, in order to unravel regulatory mechanisms which could prove useful for fungal biotechnological and biomedical applications. PkpA and PkpB were shown to be mitochondrial whereas PkpC localised to the mitochondria in a carbon source-dependent manner. Only PkpA was shown to regulate PDH activity. In the presence of glucose, deletion of pkpA and pkpC resulted in reduced glucose utilisation, which affected carbon catabolite repression (CCR) and hydrolytic enzyme secretion, due to de-regulated glycolysis and TCA cycle enzyme activities. Furthermore, PkpC was shown to be required for the correct metabolic utilisation of cellulose and acetate. PkpC negatively regulated the activity of the glyoxylate cycle enzyme isocitrate lyase (ICL), required for acetate metabolism. In summary, this study identified PDHKs important for the regulation of central carbon metabolism in the presence of different carbon sources, with effects on the secretion of biotechnologically important enzymes and carbon source-related growth. This work demonstrates how central carbon metabolism can affect a variety of fungal traits and lays a basis for further investigation into these characteristics with potential interest for different applications.
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Phenotypic Data from Inbred Parents Can Improve Genomic Prediction in Pearl Millet Hybrids
Background: Pearl millet is a non-model grain and fodder crop adapted to extremely hot and dry environments globally. In India, a great deal of public and private sectors' investment has focused on developing pearl millet single cross hybrids based on the cytoplasmic-genetic male sterility (CMS) system, while in Africa most pearl millet production relies on open pollinated varieties. Pearl millet lines were phenotyped for both the inbred parents and hybrids stage. Many breeding efforts focus on phenotypic selection of inbred parents to generate improved parental lines and hybrids. This study evaluated two genotyping techniques and four genomic selection schemes in pearl millet. Results: Despite the fact that 6x more sequencing data were generated per sample for RAD-seq than for tGBS, tGBS yielded more than 2x as many informative SNPs (defined as those having MAF > 0.05) than RAD-seq. A genomic prediction scheme utilizing only data from hybrids generated prediction accuracies (median) ranging from 0.73-0.74 (1000-grain weight), 0.87-0.89 (days to flowering time), 0.48-0.51 (grain yield) and 0.72-0.73 (plant height). For traits with little to no heterosis, hybrid only and hybrid/inbred prediction schemes performed almost equivalently. For traits with significant mid-parent heterosis, the direct inclusion of phenotypic data from inbred lines significantly (p<0.05) reduced prediction accuracy when all lines were analyzed together. However, when inbreds and hybrid trait values were both scored relative to the mean trait values for the respective populations, the inclusion of inbred phenotypic datasets moderately improved genomic predictions of the hybrid genomic estimated breeding values. Conclusion: Here we show that modern approaches to genotyping by sequencing can enable genomic selection in pearl millet. While historical pearl millet breeding records include a wealth of phenotypic data from inbred lines, we demonstrate that the naive incorporation of this data into a hybrid breeding program can reduce prediction accuracy, while controlling for the effects of heterosis per se allowed inbred genotype and trait data to improve the accuracy of genomic estimated breeding values for pearl millet hybrids.
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Genome-Wide Analysis of Multidrug and Toxic Compound Extrusion (MATE) Family in Diploid Cotton, G. raimondii and G. arboreum and Its Expression Analysis Under Salt, Cadmium and Drought Stress
The extrusion of toxins and substances at cellular level is a vital survival life process in plants under abiotic stress. The multidrug and toxic compound extrusion (MATE) gene family is largely involved in the exportation of toxins and other substrates. We undertook to carry out the genome-wide analysis of MATE gene families in Gossypium raimondii and Gossypium arboreum and assessed their expression levels under salt, cadmium and drought stresses. We identified 70 and 68 MATE genes in G. raimondii and G. arboreum respectively. Majority of the genes were predicted to be localized within the plasma membrane with a few being distributed in other cell parts. Based on phylogenetic analysis, the genes were subdivided into three subfamilies designated as M1, M2 and M3. Closely related members shared similar gene structures, thus were highly conserved in nature and found to have evolved majorly through purifying selection. The genes were distributed in all the chromosomes. Twenty-nine gene duplication events were detected, with segmental type being the dominant. GO annotation revealed the link to salt, drought and cadmium stresses. The genes exhibited differential expression, with GrMATE18, GrMATE34, GaMATE41 and GaMATE51 were significantly up regulated under drought, salt and cadmium stress, and possibly could be the candidate genes. The results of this study provide the very first information on the genome wide and functional characterization of MATE genes in diploid cotton. The results therefore would be important for breeders in the development of more stress tolerant cotton genotypes.
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Genomic Selection for Late Blight and Common Scab Resistance in Tetraploid Potato (Solanum tuberosum)
Potato (Solanum tuberosum) is a staple food crop and is considered one of the main sources of carbohydrates worldwide. Late blight (Phytophthora infestans) and common scab (Streptomyces scabies) are two of the primary production constraints faced by potato farming. Previous studies have identified a few resistance genes for both late blight and common scab; however, these genes explain only a limited fraction of the heritability of these diseases. Genomic selection has been demonstrated to be an effective methodology for breeding value prediction in many major crops (e.g., maize and wheat). However, the technology has received little attention in potato breeding. We present the first genomic selection study involving late blight and common scab in tetraploid potato. Our data involves 4,110 Single Nucleotide Polymorphisms (SNPs) genetic markers and field evaluations for 1,763 late blight phenotypes collected in seven years and 3,885 common scab phenotypes in nine years. We report moderately high genomic heritability estimates (0.46±0.04 and 0.45±0.017, for late blight and common scab, respectively). The extent of genotype-by-year interaction was high for late blight and low for common scab. Our assessment of prediction accuracy demonstrates the applicability of genomic prediction for tetraploid potato breeding. For both traits, we found that more than 90% of the genetic variance could be captured with an additive model. For common scab, the highest prediction accuracy was achieved using an additive model. For late blight, small but statistically significant gains in prediction accuracy were achieved using a model that accounted for both additive and dominance effects. Using whole-genome regression models we identified SNPs located in previously reported hotspots regions for late blight, on genes associated with systemic disease resistance responses, and a new locus located in a WRKY transcription factor for common scab.
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Reply to the Letter to the Editor regarding “The 5-year cost-effectiveness of anterior cervical discectomy and fusion or cervical disc replacement: a Markov analysis”
The authors appreciate the Letter to the Editor regarding our recently published article entitled, "The 5-year cost-effectiveness of two-level anterior cervical discectomy and fusion or cervical disc replacement: a Markov analysis" [1]. The writers of the letter raise several interesting points that warrant further discussion.
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Misinterpreted Markov analysis
In a recent article, Overley et al. [1] used a Markov analysis to report on the 5-year cost-effectiveness of two-level anterior cervical discectomy and fusion (ACDF) versus cervical disc replacement (CDR) as treatment to cervical degenerative disc disease (DDD). I will not challenge the numerical results as presented, but rather the three main conclusions derived from the results. One cherry-picks a willingness-to-pay (WTP) threshold, one misunderstands the underlying data, and the third misrepresents a statistical procedure.
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Electrical impedance imaging of human muscle at the microscopic scale using a multi-electrode needle device: A simulation study
Developments in imaging techniques over the past two decades have enhanced the diagnosis and evaluation of muscle disorders. Two of the most commonly used imaging modalities, magnetic resonance imaging (MRI) and ultrasound (US), have received increasing attention in both clinical neuromuscular clinical care and research (Mercuri et al., 2007; Pillen et al., 2008). MRI has shown versatility due to its ability to assist in disease diagnosis, as a biomarker of disease progression, and as a tool to assess metabolic alterations (Kuo and Carrino, 2007; Andreassen et al., 2009; Ekstrand et al., 2012).
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Stimulation frequency of magnetic seizure therapy contributes to the adequacy of seizures
Magnetic seizure therapy (MST) is currently under research as an alternative treatment approach to electroconvulsive therapy (ECT) in treatment-resistant depression (TRD). Compared to ECT́s electrical stimulation, MST uses strong magnetic stimulation for seizure induction under anesthesia. MST is associated with a reduced passage of induced current through specific brain regions probably included in cognitive side effects by ECT (Deng et al., 2011). Currently, the optimal stimulation parameters of MST to induce seizure are far away from clinical routine.
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Incidence of cancer (other than gastric cancer) in pernicious anaemia: A systematic review with meta-analysis
Pernicious anaemia (PA) is associated with increased gastric cancer risk, but the evidence is conflicting regarding the associated risk of other cancers.
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Vitamin D Prescribing Practices in Primary Care Pediatrics: Underpinnings From the Health Belief Model and Use of Web-Based Delphi Technique for Instrument Validity
Vitamin D deficiency and insufficiency is a pandemic problem in children and adolescents in the United States. The problem may be aggravated by the inconsistent implementation of current clinical practice guidelines for vitamin D management by pediatric primary care providers. This study examines the relationship between primary care providers' prescribing vitamin D to children ages 1 through 18 years and their practice actions and knowledge. A descriptive correlation design was used. Participants were recruited from a purposive sample of pediatricians and pediatric nurse practitioners through an online invitation to participate in a survey.
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EMS Week 2018: Top tweets from chiefs, departments and field personnel
EMS industry members demonstrated what it means to be "Stronger Together" by motivating each other through social media
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10 ways first responders are being honored around the U.S.
From memorial statues to challenge coins, first responders are feeling the love from states around the country
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'EMS Strong' celebrates the bonds that encourage, inspire EMS providers
EMS1 leaders reflect on the fitting theme of EMS Week 2018, and how their colleagues have furthered their own careers and contributions to the field
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Combined Effects and Cross-Interactions of Different Antibiotics and Polypeptides in Salmonella bredeney
Microbial Drug Resistance, Ahead of Print.
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Frozen White-Leg Shrimp (Litopenaeus vannamei) in Korean Markets as a Source of Aeromonas spp. Harboring Antibiotic and Heavy Metal Resistance Genes
Microbial Drug Resistance, Ahead of Print.
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Prediction of Central Neuropathic Pain in Spinal Cord Injury Based on EEG Classifier
Source:Clinical Neurophysiology
Author(s): Aleksandra Vuckovic, Vicente Jose Ferrer Gallardo, Mohammed Jarjees, Mathew Fraser, Mariel Purcell
ObjectivesTo create a classifier based on electroencephalography (EEG) to identify spinal cord injured (SCI) participants at risk of developing central neuropathic pain (CNP) by comparing them with patients who had already developed pain and with able bodied controls.MethodsMultichannel EEG was recorded in the relaxed eyes opened and eyes closed states in 10 able bodied participants and 31 subacute SCI participants (11 with CNP, 10 without NPand 10 who later developed pain within 6 months of the EEG recording). Up to nine EEG band power features were classified using linear and non-linear classifiers.ResultsThree classifiers (artificial neural networks ANN, support vector machine SVM and linear discriminant analysis LDA) achieved similar average performances, higher than 85% on a full set of features identifying patients at risk of developing pain and achieved comparably high performance classifying between other groups. With only 10 channels, LDA and ANN achieved 86% and 83% accuracy respectively, identifying patients at risk of developing CNP.ConclusionTransferable learning classifier can detect patients at risk of developing CNP. EEG markers of pain appear before its physical symptoms. Simple and complex classifiers have comparable performance.SignificanceIdentify patients to receive prophylaxic treatment of CNP.
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Pacing Decision Making in Sport and the Effects of Interpersonal Competition: A Critical Review
Abstract
An athlete's pacing strategy is widely recognised as an essential determinant for performance during individual events. Previous research focussed on the importance of internal bodily state feedback, revealed optimal pacing strategies in time-trial exercise, and explored concepts such as teleoanticipation and template formation. Recently, human–environment interactions have additionally been emphasized as a crucial determinant for pacing, yet how they affect pacing is not well understood. Therefore, this literature review focussed on exploring one of the most important human–environment interactions in sport competitions: the interaction among competitors. The existing literature regarding the regulation of exercise intensity and the effect of competition on pacing and performance is critically reviewed in this paper. The PubMed, CINAHL and Web of Science electronic databases were searched for studies about pacing in sports and (interpersonal) competition between January 2000 to October 2017, using the following combination of terms: (1) Sports AND (2) Pacing, resulting in 75 included papers. The behaviour of opponents was shown to be an essential determinant in the regulation of exercise intensity, based on both observational (N = 59) and experimental (N = 16) studies. However, adjustment in the pacing response related to other competitors appears to depend on the competitive situation and the current internal state of the athlete. The findings of this review emphasize the importance of what is happening around the athlete for the outcome of the decision-making process involved in pacing, and highlight the necessity to incorporate human–environment interactions into models that attempt to explain the regulation of exercise intensity in sports and exercise.
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Celebrating EMS Week 2018
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Celebrating EMS Week 2018
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Celebrating EMS Week 2018
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Positive Identification feature available in Elite for EMS
LAKEVILLE, Minn. — ImageTrend, Inc. announced the availability of a feature for Positive Identification of EMS personnel for the handling of controlled substances. This function employs a list of challenge questions that can be randomly generated at time of signature when documenting a controlled substance within a patient care report to verify the identity of the logged in medic. "A completely ...
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Paramedic, 83, hopes to return to work after hip heals
Veteran paramedic David Blackstone recently had hip surgery, but he hopes to return to the EMS industry when he is back on his feet
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EMS: So much more than lights and sirens
Celebrating those who spend their days and nights helping others when they need help the most during EMS Week 2018
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An Autonomous Programmable Actuator and Shape Reconfigurable Structures Using Bistability and Shape Memory Polymers
3D Printing and Additive Manufacturing, Ahead of Print.
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Celebrating EMS Week 2018
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Absence of complications after endoscopic mucosal biopsy
Digestive Diseases
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HBsAg-negative and anti-HBc-positive in eosinophilic granulomatosis with polyangiitis: A retrospective pilot study
Rheumatology International
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Profiles of patients who use marijuana for inflammatory bowel disease
Digestive Diseases and Sciences
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Acid?suppressive drugs and risk of kidney disease: A systematic review and meta?analysis
Journal of Gastroenterology and Hepatology
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Increased long-term dietary fiber intake is associated with decreased risk of fecal incontinence in older women
Gastroenterology
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Comparison of clinical outcome of hepatic arterial infusion chemotherapy and sorafenib for advanced hepatocellular carcinoma according to macrovascular invasion and transcatheter arterial chemoembolization refractory status
Journal of Gastroenterology and Hepatology
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Lower sustained diphtheria and pertussis antibody concentrations in inflammatory bowel disease patients
Digestive Diseases and Sciences
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Clinical and genetic risk factors for decreased bone mineral density in Japanese patients with inflammatory bowel disease
Journal of Gastroenterology and Hepatology
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Robotic vs conventional laparoscopic gastrectomy for gastric cancer: A retrospective cohort study
International Journal of Surgery
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Respiratory Synkinesis seen in the biceps brachii muscle resulting from meningitis 20 years prior
No abstract available
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Endovascular thrombectomy in acute ischemic stroke: new treatment guide
Purpose of review Recent randomized clinical trials (RCTs) have demonstrated strong efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) from large vessel occlusions (LVO). SIESTA, AnSTROKE, GOLIATH showed no deleterious effects of general anesthesia on patient outcome after EVT compared with conscious sedation. DAWN and DEFUSE 3 are extending the time window for EVT up to 24 h in carefully selected patients. This review discusses the current literature on the rapidly expanding subject of endovascular stroke therapy and optimal anesthetic management. Recent findings Recent retrospective studies of RCT data sets show that general anesthesia is associated with negative clinical outcome in AIS patients undergoing EVT when compared with sedation. Two of the possible mechanisms of this finding are systolic hypotension and hypocapnia. SIESTA, AnSTROKE, GOLIATH showed no difference in short-term clinical outcome between EVT patients treated with general anesthesia versus conscious sedation. DAWN and DEFUSE 3 demonstrated improved functional outcomes after EVT in those treated up to 24 h after selection with perfusion imaging, increasing the number of patients eligible for EVT. Summary Effective reperfusion with stent retriever technology, careful patient selection using perfusion imaging, and careful use of anesthetic technique affect outcome. Correspondence to Apolonia E. Abramowicz, MD, Department of Anesthesiology, Westchester Medical Center, New York Medical College, 100 Woods Road, Macy Pavilion Room 2391, Valhalla, NY 10595, USA. Tel: +1 914 493 7692; e-mail: elisabeth.abramowicz@gmail.com Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Emerging evidence for antidepressant actions of anesthetic agents
Purpose of review After decades without substantial advances, multiple novel antidepressants show promise against treatment-resistant depression. Interestingly, many of these are anesthetics. The purpose of this review is to discuss the evidence for the antidepressant effects of ketamine, nitrous oxide, isoflurane and propofol and to consider potential clinical, administrative and research implications for anesthesiologists. Recent findings Ketamine has acute, transient antidepressant and antisuicidal effects. Nitrous oxide has also shown antidepressant efficacy. There are converging preclinical and clinical data that isoflurane (and perhaps propofol), dosed to burst suppression, has relatively rapid, robust and durable antidepressant effects and lacks the adverse effects associated with electroconvulsive therapy (ECT). Summary Several anesthetics show promise as novel antidepressants. Ketamine is the most well studied. Anesthetic-induced burst-suppression may provide an alternative to ECT that lacks adverse cognitive effects. Further study is necessary to better understand how these drugs work and how they might be used as effective antidepressant therapy. Correspondence to Scott C. Tadler, Associate Professor, Department of Anesthesiology, Adjunct Associate Professor, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84132, USA. Tel: +801 581 6393; e-mail: scott.tadler@hsc.utah.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Advances in pharmacokinetic modeling: target controlled infusions in the obese
Purpose of review The use of conventional pharmacokinetic parameters sets 'models' derived from nonobese patients has proven inadequate to administer intravenous anesthetics in the obese population and is commonly associated with higher than anticipated plasma propofol concentrations when used with target (plasma or effect site) controlled infusion pumps. In this review we will describe recent modeling strategies to characterize the disposition of intravenous anesthetics in the obese patient and will show clinically relevant aspects of new model's performance in the obese population. Recent findings Because clearance of a drug increases in a nonlinear manner with weight, nonlinear relationships better scale infusion rates between lean and obese individuals. Allometric concepts have been successfully used to describe size-related nonlinear changes in clearances. Other nonlinear scaling options include the use of descriptors such as body surface area, lean body weight, fat-free mass, and normal fat mass. Newer pharmacokinetic models, determined from obese patient data, have been developed for propofol and remifentanil using allometric concepts and comprehensive size descriptors. Summary Pharmacokinetic models to perform target-controlled infusion in the obese population should incorporate descriptors that reflect with greater precision the influence of body composition in volumes and clearances of each drug. It is our hope that commercially available pumps will soon incorporate these new models to improve the performance of this technique in the obese population. Correspondence to Luis I. Cortínez, Associate Professor, Pontificia Universidad Católica de Chile Santiago, Chile. Tel: +56(2)6382933; fax: +56(2)6327620; e-mail: licorti@med.puc.cl Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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An overview of the cannabinoid type 2 receptor system and its therapeutic potential
Purpose of review This narrative review summarizes recent insights into the role of the cannabinoid type 2 (CB2) receptor as potential therapeutic target in neuropathic pain and neurodegenerative conditions. Recent findings The cannabinoid system continues to receive attention as a therapeutic target. The CB2 receptor is primarily expressed on glial cells only when there is active inflammation and appears to be devoid of undesired psychotropic effects or addiction liability. The CB2 receptor has been shown to have potential as a therapeutic target in models of diseases with limited or no currently approved therapies, such as neuropathic pain and neurodegenerative conditions such as Alzheimer's disease. Summary The functional involvement of CB2 receptor in neuropathic pain and other neuroinflammatory diseases highlights the potential therapeutic role of drugs acting at the CB2 receptor. Correspondence to Mohamed Naguib, MB, BCh, MSc, FCARCSI, MD, Department of General Anesthesia, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave. - NE6–306, Cleveland, OH 44195, USA. Tel: +1 216 444 6328; fax: +1 216 636-2043; e-mail: naguibm@ccf.org Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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New horizons in anesthetic clinical pharmacology, patient outcomes and perioperative neuromonitoring
No abstract available
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Leveraging epigenomics and contactomics data to investigate SNP pairs in GWAS
Abstract
Although Genome Wide Association Studies (GWAS) have led to many valuable insights into the genetic bases of common diseases over the past decade, the issue of missing heritability has surfaced, as the discovered main effect genetic variants found to date do not account for much of a trait's predicted genetic component. We present a workflow, integrating epigenomics and topologically associating domain data, aimed at discovering trait-associated SNP pairs from GWAS where neither SNP achieved independent genome-wide significance. Each analyzed SNP pair consists of one SNP in a putative active enhancer and another SNP in a putative physically interacting gene promoter in a trait-relevant tissue. As a proof-of-principle case study, we used this approach to identify focused collections of SNP pairs that we analyzed in three independent Type 2 diabetes (T2D) GWAS. This approach led us to discover 35 significant SNP pairs, encompassing both novel signals and signals for which we have found orthogonal support from other sources. Nine of these pairs are consistent with eQTL results, two are consistent with our own capture C experiments, and seven involve signals supported by recent T2D literature.
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Informing Federal Policy on Firearm Restrictions for Veterans with Fiduciaries: Risk Indicators in the Post-Deployment Mental Health Study
Abstract
This article examines the public safety rationale for a federal policy of prohibiting gun sales to veterans with psychiatric disabilities who are assigned a fiduciary to manage their benefits from the Department of Veterans Affairs. The policy was evaluated using data on 3200 post-deployment veterans from the Iraq and Afghanistan war era. Three proxy measures of fiduciary need—based on intellectual disability, drug abuse, or acute psychopathology—were associated in bivariate analysis with interpersonal violence and suicidality. In multivariate analysis, statistical significance remained only for the measure based on acute psychopathology. Implications for reforms to the fiduciary firearm restriction policy are discussed.
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Erector Spinae Plane Block Versus Retrolaminar Block: A Magnetic Resonance Imaging and Anatomical Study
Background and Objectives The erector spinae plane (ESP) and retrolaminar blocks are ultrasound-guided techniques for thoracoabdominal wall analgesia involving injection into the musculofascial plane between the paraspinal back muscles and underlying thoracic vertebrae. The ESP block targets the tips of the transverse processes, whereas the retrolaminar block targets the laminae. We investigated if there were differences in injectate spread between the 2 techniques that would have implications for their clinical effect. Methods The blocks were performed in 3 fresh cadavers. The ESP and retrolaminar blocks were performed on opposite sides of each cadaver at the T5 vertebral level. Twenty milliliters of a radiocontrast dye mixture was injected in each block, and injectate spread was assessed by magnetic resonance imaging and anatomical dissection. Results Both blocks exhibited spread to the epidural and neural foraminal spaces over 2 to 5 levels. The ESP block produced additional spread to intercostal spaces over 5 to 9 levels and was associated with a greater extent of craniocaudal spread along the paraspinal muscles. Conclusions The clinical effect of ESP and retrolaminar blocks can be explained by epidural and neural foraminal spread of local anesthetic. The ESP block produces additional intercostal spread, which may contribute to more extensive analgesia. The implications of these cadaveric observations require confirmation in clinical studies. Accepted for publication January 28, 2018. Address correspondence to: Ki Jinn Chin, FRCPC, Department of Anesthesia, Toronto Western Hospital, McL 2-405, 399 Bathurst St, Toronto, Ontario, Canada M5T 2S8 (e-mail: gasgenie@gmail.com). The authors have no sources of funding to declare for this article. The authors declare no conflict of interest. Copyright © 2018 by American Society of Regional Anesthesia and Pain Medicine.
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Use of Serratus Plane Block for Repair of Coarctation of Aorta: A Report of 3 Cases
Objectives The practice of regional anesthesia techniques (thoracic, epidural, paravertebral) in pediatric cardiac surgery enhances perioperative outcomes such as improved perioperative analgesia, decreased stress response, early extubation, and shortened hospital stay. However, these blocks can be technically challenging and can be associated with unacceptable failure rate and complications in infants. For these reasons, regional anesthesia is sometimes avoided in pediatric cardiac surgery. We describe the simple and effective serratus plane block for thoracotomy analgesia in 2 neonates and a child. Case Report We present 3 pediatric patients, each of whom was having coarctation repair and received an ultrasound-guided serratus plane block for thoracotomy analgesia. The patients were 3 days, 14 days, and 4 years old, weighing from 1.9 to 16 kg. The serratus plane block was performed prior to surgical incision. The block was technically simple compared with thoracic epidural or paravertebral block. All patients were extubated immediately after completion of surgery. Apart from the induction dose of fentanyl (2 μg/kg), no further opioids were required intraoperatively. Postoperative opioid requirements as well as duration of intensive care and hospital stay were lower than recent averages (for the same demographic and procedure) in our hospital. Conclusions We propose that the serratus plane block is a simple procedure that provides good perioperative analgesia for infant thoracotomy, potentially facilitating early extubation and a shorter hospital stay. Accepted for publication January 15, 2018. Address correspondence to: Abhijit Biswas, MBBS, MSc, FCARCSI, EDRA, Department of Anesthesia and Perioperative Medicine, London Health Science Centre, 339 Windermere Rd, London, Ontario, Canada N6A 5A5 (e-mail: avijitbsws@yahoo.com). This work is attributed to the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. Funding was provided by the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. The authors declare no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.rapm.org). Copyright © 2018 by American Society of Regional Anesthesia and Pain Medicine.
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Major Laparoscopic Intraperitoneal Surgery Performed With Combined Bilateral Subcostal Transversus Abdominal Plane Block and Celiac Plexus Block, Intravenous Sedation Without Tracheal Intubation: A Feasibility Study of 3 Cases
Objectives Major abdominal surgery usually requires general anesthesia with tracheal intubation and may be supplemented with neuraxial anesthesia to provide intraoperative and postoperative pain relief. Attempts at using only neuraxial anesthesia for major abdominal surgery have often been shown to be poorly effective. This report demonstrates that laparoscopic colonic surgical procedures can be performed with ultrasound-guided blocks (bilateral transversus abdominal plane block and celiac plexus block) and intravenous sedation, while avoiding general or neuraxial anesthesia. Case Report We report our preliminary experience in 3 patients (all American Society of Anesthesiologists physical status III) who underwent laparoscopic colonic surgery without general anesthesia. Intraoperative visceral analgesia was provided by single-injection ultrasound anterior celiac plexus block to which was added a bilateral subcostal transversus abdominal plane block to obtain parietal analgesia. Light intravenous sedation was added. Surgical exposure was satisfactory, and no patient complained of any symptom during the procedure. No adverse effect was recorded. Postoperative pain was minimal, and recovery was enhanced with mobilization and walking within hours after surgery. Patient satisfaction was excellent. Conclusions To date, celiac plexus block has been used almost exclusively to relieve pancreatic cancer pain. This is the first report in which it is shown that major intra-abdominal surgery can be performed almost exclusively with regional anesthesia while avoiding adverse effects and problems associated with either general or neuraxial anesthesia. In addition, prolonged postoperative pain relief facilitated early recovery. Accepted for publication January 15, 2018. Address correspondence to: Dan Benhamou, MD, Département d'Anesthésie Réanimation, Hôpital Bicêtre Université Paris-Sud, 78 Rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex, France (e-mail: dan.benhamou@aphp.fr). The work should be attributed to Private Hospital Eure et Loir, Mainvilliers, France. The work was managed with hospital funds only. The authors declare no conflict of interest. Authors Contributions: A.T. provided anesthesia to the patients, collected data, and wrote the first draft. M.B. performed the surgical procedure and participated in writing the manuscript. P.J.Z. participated in writing the manuscript. D.B. participated in writing the manuscript and coordinated manuscript preparation and submission. Copyright © 2018 by American Society of Regional Anesthesia and Pain Medicine.
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Inter-ray variation in metatarsal strength properties in humans and African apes: Implications for inferring bipedal biomechanics in the Olduvai Hominid 8 foot
Source:Journal of Human Evolution
Author(s): Biren A. Patel, Tea Jashashvili, Stephanie H. Bui, Kristian J. Carlson, Nicole L. Griffin, Ian J. Wallace, Caley M. Orr, Randall L. Susman
When measured as a ratio of mean midshaft diameter to bone length, the OH 8 fossil hominin foot exhibits a metatarsal (Mt) robusticity pattern of 1 > 5 > 3 > 4 > 2, which differs from the widely perceived "common" modern human pattern (1 > 5 > 4 > 3 > 2); African apes generally exhibit a third pattern (1 > 2 > 3 > 4 > 5). Largely because of the relative ranking of Mt2 and Mt5, OH 8 metatarsals structurally resemble the pattern exhibited by bipedal humans more than the pattern of quadrupedal and climbing African apes. Considering only these three phenotypes, however, discounts the potentially important functional implications of variation in modern human (and African ape) metatarsal robusticity patterns, suggesting that they are not useful for interpreting the specific biomechanics of a bipedal gait in fossils (i.e., whether it was modern human-like or not). Using computed tomography scans to quantify metatarsal midshaft cross-sectional geometry in a large sample of Homo (n=130), Gorilla (n=44) and Pan (n=80), we documented greater variation in metatarsal robusticity patterns than previously recognized in all three groups. While apes consistently show a 1 > 2 > 3 > 4 > 5 pattern in our larger sample, there does not appear to be a similarly precise single "common" human pattern. Rather, human metatarsals converge towards a 1 > 4/5 > 2/3 pattern, where metatarsals 4 and 5, and metatarsals 2 and 3, often "flip" positions relative to each other depending on the variable examined. After reassessing what a "common" human pattern could be based on a larger sample, the previously described OH 8 pattern of 1 > 5 > 3 > 4 > 2 is only observed in some humans (<6%) and almost never in apes (<0.5%). Although this suggests an overall greater similarity to (some) humans than to any ape in loading of the foot, the relatively rare frequency of these humans in our sample underscores potential differences in loading experienced by the medial and lateral columns of the OH 8 foot compared to modern humans.
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The Child and Adolescent Services Assessment: Interrater Reliability and Predictors of Rater Disagreement
Abstract
The current study evaluated the interrater reliability of the Child and Adolescent Services Assessment (CASA), a widely used structured interview measuring pediatric mental health service use. Interviews (N = 72) were randomly selected from a pediatric effectiveness trial, and audio was coded by an independent rater. Regressions were employed to identify predictors of rater disagreement. Interrater reliability was high for items (> 94%) and summary metrics (ICC > .79) across service sectors. Predictors of disagreement varied by domain; significant predictors indexed higher clinical severity or social disadvantage. Results support the CASA as a reliable and robust assessment of pediatric service use, but administrators should be alert when assessing vulnerable populations.
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Piepkorn type of osteochondrodysplasia: Defining the severe end of FLNB‐related skeletal disorders in three fetuses and a 106‐year‐old exhibit
American Journal of Medical Genetics Part A, EarlyView.
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