Extensions of the Rosner-Colditz breast cancer prediction model to include older women and type-specific predicted risk.

Purpose: A breast cancer risk prediction rule previously developed by Rosner and Colditz has reasonable predictive ability. We developed a re-fitted version of this model, based on more than twice as many cases now including women up to age 85, and further extended it to a model that distinguished risk factor prediction of tumors with different estrogen/progesterone receptor status.

Methods: We compared the calibration and discriminatory ability of the original, the re-fitted, and the type-specific models.

Sepsis and septic shock.

For more than two decades, sepsis was defined as a microbial infection that produces fever (or hypothermia), tachycardia, tachypnoea and blood leukocyte changes. Sepsis is now increasingly being considered a dysregulated systemic inflammatory and immune response to microbial invasion that produces organ injury for which mortality rates are declining to 15-25%. Septic shock remains defined as sepsis with hyperlactataemia and concurrent hypotension requiring vasopressor therapy, with in-hospital mortality rates approaching 30-50%.

Penile Replantation: A Retrospective Analysis of Outcomes and Complications.

 Penile replantation is an uncommonly performed procedure, which can alleviate physical and psychosocial sequelae of penile amputation. This study critically appraises the current literature on penile replantation.  A comprehensive literature search of the Medline, PubMed, and Google Scholar databases was conducted with multiple search terms related to penile replantation.

HLA compatibility assessment and management of highly sensitized patients under the new kidney allocation system (KAS): A 2016 status report from twelve HLA laboratories across the U.S.

Twelve HLA laboratories were surveyed to assess the methods and operational issues involved to define highly sensitized patients and to assess HLA compatibility under the new kidney allocation system (KAS) in the U.S. All laboratories used single antigen bead assays both pre- and post-KAS to define both broad and allele-specific HLA antibodies.

Prenatal DHA supplementation and infant attention.

Background: Results of randomized trials on the effects of prenatal docosahexaenoic acid (DHA) on infant cognition are mixed, but most trials have used global standardized outcomes, which may not be sensitive to effects of DHA on specific cognitive domains.

Methods: Women were randomized to 600 mg/d DHA or a placebo for the last two trimesters of pregnancy. Infants of these mothers were then followed on tests of visual habituation at 4, 6, and 9 mo of age.

Early School Adjustment and Educational Attainment.

Although school attainment is a cumulative process combining mastery of both academic and behavioral skills, most studies have offered only a piecemeal view of the associations between middle childhood capacities and subsequent schooling outcomes. Using a 20-year longitudinal dataset, this study estimates the association between children's academic skills, anti-social behaviors and attention problems, all averaged across middle childhood, and their long-term educational outcomes. After adjusting for family and individual background measures, we find that high average levels of math and reading achievement, and low average levels of anti-social behavior problems, are positively associated with later attainment.

Educational Exposure to Transgender Patient Care in Plastic Surgery Training.

Background: Gender dysphoria is estimated to occur in up to 0.9 percent of the U.S.

Breast cancer screening using tomosynthesis in combination with digital mammography compared to digital mammography alone: a cohort study within the PROSPR consortium.

Digital breast tomosynthesis (DBT) is emerging as the new standard of care for breast cancer screening based on improved cancer detection coupled with reductions in recall compared to screening with digital mammography (DM) alone. However, many prior studies lack follow-up data to assess false negatives examinations. The purpose of this study is to assess if DBT is associated with improved screening outcomes based on follow-up data from tumor registries or pathology.

Electromagnetic navigation transthoracic needle aspiration for the diagnosis of pulmonary nodules: a safety and feasibility pilot study.

Background: Pulmonary nodules remain a diagnostic challenge for physicians. Minimally invasive biopsy methods include bronchoscopy and CT guided transthoracic needle aspiration (TTNA). A novel electromagnetic guidance transthoracic needle aspiration (ETTNA) procedure which can be combined with navigational bronchoscopy (NB) and endobronchial ultrasound (EBUS) in a single setting has become available.

Quantitative autism symptom patterns recapitulate differential mechanisms of genetic transmission in single and multiple incidence families.

Background: Previous studies have demonstrated aggregation of autistic traits in undiagnosed family members of children with autism spectrum disorder (ASD), which has significant implications for ASD risk in their offspring. This study capitalizes upon a large, quantitatively characterized clinical-epidemiologic family sample to establish the extent to which family transmission pattern and sex modulate ASD trait aggregation.

Methods: Data were analyzed from 5515 siblings (2657 non-ASD and 2858 ASD) included in the Interactive Autism Network.

Technical Note: Simulation of 4DCT tumor motion measurement errors.

Purpose: To determine if and by how much the commercial 4DCT protocols under- and overestimate tumor breathing motion.

Methods: 1D simulations were conducted that modeled a 16-slice CT scanner and tumors moving proportionally to breathing amplitude. External breathing surrogate traces of at least 5-min duration for 50 patients were used.

The "hierarchical" Scratch Collapse Test for identifying multilevel ulnar nerve compression.

Background: The Scratch Collapse Test (SCT) is used to assist in the clinical evaluation of patients with ulnar nerve compression. The purpose of this study is to introduce the hierarchical SCT as a physical examination tool for identifying multilevel nerve compression in patients with cubital tunnel syndrome.

Methods: A prospective cohort study (2010-2011) was conducted of patients referred with primary cubital tunnel syndrome.

The Supercharge End-to-Side Anterior Interosseous-to-Ulnar Motor Nerve Transfer for Restoring Intrinsic Function: Clinical Experience.

Background: The authors reviewed their initial clinical experience with the supercharge end-to-side anterior interosseous-to-ulnar motor nerve transfer and refined their indications for this technique.

Methods: A retrospective cohort study was performed of all patients undergoing the supercharge end-to-side procedure from 2009 to 2012. Preoperative and intraoperative data were reviewed.

LAG3 expression in active Mycobacterium tuberculosis infections.

Mycobacterium tuberculosis (MTB) is a highly successful pathogen because of its ability to persist in human lungs for long periods of time. MTB modulates several aspects of the host immune response. Lymphocyte-activation gene 3 (LAG3) is a protein with a high affinity for the CD4 receptor and is expressed mainly by regulatory T cells with immunomodulatory functions.

Analysis of longitudinal quality-of-life data in high-risk operable patients with lung cancer: results from the ACOSOG Z4032 (Alliance) multicenter randomized trial.

Background: Prior studies have suggested that low baseline quality-of-life (QOL) scores predict worse survival in patients undergoing lung cancer surgery. However, these studies involved average-risk patients undergoing lobectomy. We report QOL results from a multicenter trial, American College of Surgeons Oncology Group Z4032, which randomized high-risk operable patients to sublobar resection (SR), or SR with brachytherapy, and included longitudinal QOL assessments.

Correlation of pelvic magnetic resonance imaging diagnosis with pathology for indeterminate adnexal masses.

Objectives: The aim of this study was to determine the accuracy of pelvic magnetic resonance imaging (MRI) diagnoses compared with the final pathology diagnoses for a series of women with indeterminate adnexal masses.

Materials And Methods: We performed a retrospective cohort study of women who underwent pelvic MRI with a diagnosis of an adnexal mass between June 2009 and 2010 after indeterminate ultrasound at our tertiary care institution. Chart abstraction was performed for demographic information and radiologic interpretations (benign or malignant) and favored a specific histologic subtype on MRI reports.

Proteinuria is associated with neurocognitive impairment in antiretroviral therapy treated HIV-infected individuals.

Background: Proteinuria is a marker of vascular dysfunction that predicted increased cardiovascular mortality and is associated with neurocognitive impairment (NCI) in population-based studies. We examined associations between proteinuria and HIV-associated NCI.

Methods: Multivariable logistic regression was used to examine associations between NCI at the first neurocognitive assessment (baseline) and simultaneous, clinically significant proteinuria [as random spot urine protein-to-creatinine ratios (UP/Cr) ≥200 mg/g] in a prospective multicenter observational cohort study.

Impact of brachytherapy on local recurrence rates after sublobar resection: results from ACOSOG Z4032 (Alliance), a phase III randomized trial for high-risk operable non-small-cell lung cancer.

Purpose: A major concern with sublobar resection (SR) for non-small-cell lung cancer (NSCLC) is high local recurrence (LR). Adjuvant brachytherapy may reduce LR This multicenter randomized trial compares SR to SR with brachytherapy (SRB).

Patients And Methods: High-risk operable patients with NSCLC ≤ 3 cm were randomly assigned to SR or SRB.

Novel role for carbamoyl phosphate synthetase 2 in cranial sensory circuit formation.

In zebrafish, cranial sensory circuits form by 4 days post-fertilization. We used a forward genetic screen to identify genes involved in the formation of these circuits. In one mutant allele, sl23, axons arising from the epibranchial sensory ganglia do not form their stereotypical terminal fields in the hindbrain.

A review of cutaneous toxicities from targeted therapies in the treatment of colorectal cancers.

Currently there are three targeted therapies approved for the treatment of colorectal cancers. These include the epidermal growth factor receptor (EGFR) inhibitors, cetuximab and panitumumab, and the multikinase inhibitor regorafenib. It is important to understand and recognize the common presentations of cutaneous toxicity that result from these agents to effectively manage symptoms and prevent premature discontinuation of anticancer treatment.

Median to radial nerve transfers for restoration of wrist, finger, and thumb extension.

Radial nerve injury results in loss of wrist, finger, and thumb extension. Traditionally, radial nerve palsies that fail to recover spontaneously have been reconstructed with tendon transfers or nerve grafts. Nerve transfers are a novel approach to the surgical management of Sunderland grade IV and V radial nerve injuries.

Effect of electrical field stimulation on dorsal root ganglion neuronal function.

Objectives: Neural stimulation may provide analgesia for a variety of painful conditions. Activation of primary sensory neurons, which underlies pain relief by spinal cord stimulation, also may be achieved by stimulation at the level of the dorsal root ganglion (DRG). The DRG also is a site of pain pathogenesis, particularly in neuropathic pain.

Modeling of topology-dependent neural network plasticity induced by activity-dependent electrical stimulation.

Activity-dependent electrical stimulation can induce cerebrocortical reorganization by activating brain areas using stimulation derived from the statistics of neural or muscular activity. Due to the nature of synaptic plasticity, network topology is likely to influence the effectiveness of this type of neuromodulation, yet its effect under different network topologies is unclear. To address this issue, we simulated small-scale three-neuron networks to explore topology-dependent network plasticity.