bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Computed Tomographic Analysis of Spheno-Occipital Synchondrosis Ossification for Age Estimation in a Sample of Egyptians
Authors: Sobh Zahraa Khalifa , Mohamed Ahmed Samir 
Published: December 2020

Abstract
The aim of the present work was to create statistically quantified age estimation standards based on spheno-occipital synchondrosis (SOS) fusion state as visualized in computed tomography in Egyptians. The study included 208 Egyptians between the ages of 5 and 30 years (117 male and 90 female participants). Spheno-occipital synchondrosis was visualized in a midsagittal view in a neutral head position. Degree of ossification of SOS was assessed using a 4-stage system. Interobserver agreement and intraobserver agreement were almost perfect with Cohen κ values of 0.863 and 0.983, respectively. The mean ages of complete fusion (stage 3) were 20.36 ± 3.11 and 20.94 ± 4.06 years in male and female participants, respectively. Nonfusion (stage 0) was observed up to 15 and 13 years in male and female participants, respectively. Complete fusion occurred as early as 15 and 13 years in male and female participants, respectively. All subjects with nonfused SOS were minors (<18 years). A total of 87.9% of male participants and 85.3% of female participants with completely fused SOS were legally adults (≥18 years). Significant regression models were formulated to predict age from SOS fusion stage (adjusted R
2 = 0.779 for male participants and 0.780 for female participants). Regression models predicted that male and female participants 18 years or older with 96.30% and 95.59% accuracy, respectively.
Left Carotid Artery Thrombosis Due to Thromboangiitis Obliterans
Authors: Bourgeau Melanie E. , Key Phillip G. , Chou Jesse , Prahlow Joseph A. 
Published: December 2020

Abstract
Thromboangiitis obliterans (TAO, Buerger disease) is a segmental, non-atherosclerotic vasculitis that causes occlusion of the small and medium sized vessels of the distal extremities. In rare cases, it can affect vessels in the gastrointestinal, cerebrovascular, coronary, and renal systems. The etiology of thromboangiitis obliterans is unknown, but there is a strong association with smoking in the development and the progression of the disease. We present the case of a 42-year-old homeless female smoker, who was found dead outdoors. Although originally suspected to be a possible trauma-related death, autopsy revealed a thrombus in her left carotid artery, which caused an acute cerebral infarction. It was concluded that thromboangiitis obliterans, likely precipitated by smoking, was the cause of the thrombosis and subsequent death.
Postmortem Diagnosis of Clostridium Without Culture Confirmation
Authors: Jackson McKenzie , Kemp Walter L. 
Published: December 2020

Abstract
We report 3 individuals with clostridial sepsis, 2 culture-confirmed and 1 assumed based on historical information and autopsy findings. Case 1: a 46-year-old man with history of colon cancer status postcolectomy was found unresponsive and rapidly developed decompositional changes. At autopsy, within 1 day of his death, he had marked gaseous distention of the scrotum and palpable crepitance from the eyes to the feet, with bullae formation in the suprapubic region and left thigh. Postmortem culture of bullae fluid grew Clostridium septicum. Case 2: a 63-year-old woman with history of non-Hodgkin's lymphoma who was identified to have Clostridium perfringens by hospital cultures. Autopsy was performed the day after death. The skin had a generalized red-tan discoloration. The liver had large gas pockets in the parenchyma. Microscopic examination revealed bacterial rods. Other than diverticulosis and mild coronary artery atherosclerosis, no other disease process was identified. Case 3: a 34-year-old man was found dead in his apartment, which was 68°F, just under 1 day after having last been known alive. He was cooled before autopsy and autopsied less than 24 hours after being found. He had fixed anterior lividity, an abdomen that was distended by gas formation, and a scrotum that was distended by gas formation. There was no green discoloration of the abdomen. Glomerular capillaries contained bacterial rods with terminal spores. Because no other cause was identified, the cause of death was certified as probable clostridial sepsis.
Disseminated Herpes Simplex Virus in an Immunocompetent Patient Without Presence of Epidermal or Mucosal Lesions
Authors: Marshall Cody , Khatoon Nazia , Lynch Edward 
Published: December 2020

Abstract
Herpes simplex virus (HSV) is a disease usually characterized by lesions within the epidermis or mucosa of children and adults. However, this infection can also cause complications to many systems of the body, including the peripheral and central nervous system, respiratory system, and hepatobiliary system. In this case, we present a 43-year-old man with a history of substance abuse, who presented with fever, cough, and headache, and within days, progressed into fulminant hepatitis and hypoxic failure. Bacterial and fungal cultures were negative, as well as the workup for human immunodeficiency virus. However, the presence of HSV was detected in a bronchial lavage culture after the patients had expired. This result, along with the findings at autopsy, including viral cytopathic effect in the lung and liver, which were confirmed with immunohistochemical stains for HSV, strongly suggest that the cause of death is from disseminated herpes virus infection with hepatitis and viral pneumonitis. This disseminated infection occurred in an immunocompetent host without any evidence of mucocutaneous lesions.
Cardiovascular Effects of Transcranial Direct Current Stimulation and Bimanual Training in Children With Cerebral Palsy
Authors: Keller-Ross Manda L. , Chantigian Daniel P. , Nemanich Samuel , Gillick Bernadette T. 
Published: December 2020

Purpose:
To determine the influence of combined transcranial direct current stimulation (tDCS) to the motor cortex (M1) and bimanual training on cardiovascular function in children with cerebral palsy (CP).

Methods:
Mean arterial pressure (MAP), heart rate (HR), and HR variability (HRV) were measured immediately before and after 20 minutes of cathodal tDCS to contralesional M1 and bimanual training on days 1, 6, and 10 of a 10-day trial in 8 participants (5 females, 7-19 years).

Results:
Baseline MAP and HR were similar across days (93 ± 10 mm Hg and 90 ± 10 bpm, P > .05). MAP was similar from baseline to postintervention across all 3 days. Systolic pressure, diastolic pressure, nor HR significantly changed. HRV was not influenced by the 10-day intervention.

Conclusions:
Combined cathodal tDCS to M1 and bimanual training does not influence autonomic and cardiovascular function in children with CP due to perinatal stroke.
Designing Exercise to Improve Bone Health Among Individuals With Cerebral Palsy
Authors: Gannotti Mary E. , Liquori Brianna M. , Thorpe Deborah E. , Fuchs Robyn K. 
Published: December 2020

Purpose:
Individuals with cerebral palsy (CP), ambulatory or not, have less bone strength and density than their peers. Aging individuals with CP are at a higher risk for nontraumatic fractures, progressive deformity, pain, and spinal stenosis. Critical periods for skeletal formation are during prepuberty and adolescence. Applying mechanostat theory to exercise design for individuals with CP may be beneficial.

Methods:
Principles of mechanostat theory, particularly the osteogenic index, is applied to guide the design of exercise programs based on varying levels of physical capacity.

Results:
Recommendations are made for optimizing dosing of a variety of interventions for improving bone health among individuals with CP based on mechanostat theory with specific type, number of repetitions, and frequency.

Conclusions:
Researchers and clinicians are called to action to consider the role of exercise throughout the lifespan for all individuals with CP, regardless of level of severity.
Lack of Abdominal Stability and Control as a Possible Contributor to Rectus Femoris Avulsion Fracture in the Adolescent Soccer Player: A Case Report
Authors: Lasky-McFarlin Chelsea , Thomas Mae , Newman Jennifer , Thorpe Deborah 
Published: December 2020

Purpose:
To describe evaluation and physical therapy treatment for an athlete who is male and 13 years old with healing bilateral rectus femoris avulsion fractures.

Summary of Key Points:
Fractures of the anterior inferior iliac spine may be linked to poor abdominal stability in soccer athletes who are male and an adolescent. The development and use of an abdominal stability screening tool could be an efficient and effective way to determine fracture risk and guide prevention programs.

Conclusions and Recommendations for Clinical Practice:
Following 8 weeks of conservative physical therapy treatment, the athlete met all goals and returned to pain-free soccer activities without residual impairments. Four months following discharge, he reported full participation in soccer competition without complications. This case illustrates that abdominal weakness is a potential risk factor for anterior inferior iliac spine avulsion fracture. Screening for abdominal weakness and incorporating preventative programs into training regimens is recommended to prevent anterior inferior iliac spine injuries in this population.
Development and Validation of a Syndrome Definition to Identify Suspected Nonfatal Heroin-Involved Overdoses Treated in Emergency Departments
Authors: Scholl Lawrence , Liu Stephen , Vivolo-Kantor Alana , Board Amy , Stein Zachary , Roehler Douglas R. , McGlone Londell , Hoots Brooke E. , Mustaquim Desiree , Smith Herschel 
Published: December 2020

Context:
The Centers for Disease Control and Prevention (CDC) works closely with states and local jurisdictions that are leveraging data from syndromic surveillance systems to identify meaningful changes in overdose trends. CDC developed a suspected nonfatal heroin overdose syndrome definition for use with emergency department (ED) data to help monitor trends at the national, state, and local levels.

Objective:
This study assesses the percentage of true-positive unintentional and undetermined intent heroin-involved overdose (UUHOD) captured by this definition.

Design/Setting:
CDC applied the UUHOD definition to ED data available in CDC's National Syndromic Surveillance Program (NSSP). Data were analyzed from 18 states that shared access to their syndromic data in NSSP with the CDC overdose morbidity team. Data were analyzed using queries and manual reviews to identify heroin overdose diagnosis codes and text describing chief complaint reasons for ED visits.

Measures:
The percentage of true-positive UUHOD was calculated as the number of true-positives divided by the number of total visits captured by the syndrome definition.

Results:
In total, 99 617 heroin overdose visits were identified by the syndrome definition. Among 95 323 visits identified as acute heroin-involved overdoses, based on reviews of chief complaint text and diagnosis codes, 967 (1.0%) were classified as possible intentional drug overdoses. Among all 99 617 visits, 94 356 (94.7%) were classified as true-positive UUHOD; 2226 (2.2%) and 3035 (3.0%) were classified as “no” and “maybe” UUHOD, respectively.

Conclusion:
Analysis of the CDC heroin overdose syndrome definition determined that nearly all visits were captured accurately for patients presenting to the ED for a suspected acute UUHOD. This definition will continue to be valuable for ongoing heroin overdose surveillance and epidemiologic analysis of heroin overdose patterns. CDC will evaluate possible definition refinements as new products and terms for heroin overdose emerge.
Negative-Pressure Wound Therapy With Instillation: A Tool in the Multidisciplinary Approach to Limb Function Preservation
Authors: Kim Paul J. , Attinger Christopher E. 
Published: December 2020

Summary:
The multidisciplinary approach to lower extremity function preservation is well established and is globally considered the standard of care. Every member of the team contributes their unique skills and knowledge to patient care. The effective integration of negative-pressure wound therapy with instillation (NPWTi) has fundamentally changed the approach to the infected or contaminated wound. Initially, in conjunction with excisional debridement, NPWTi has demonstrated its utility of expediting wound bed preparation for closure or coverage. With the introduction of a novel foam design, the effectiveness has increased and provided an option in cases where surgical intervention is not available or recommended. The successful implementation and continued monitoring of NPWTi provides an efficient tool to expedite ultimate wound healing and involves all members of the team.
Twins, Telomeres, and Aging—in Space!
Authors: Luxton Jared J. , Bailey Susan M. 
Published: December 2020

Background:
The landmark National Aeronautics and Space Administration Twins Study represented an integrated effort to launch human space life science research into the modern age of molecular- and “omics”-based studies. As part of the first One-Year Mission aboard the International Space Station, identical twin astronauts Scott and Mark Kelly were the subjects of this “out of this world” research opportunity. Telomeres, the natural ends of chromosomes that shorten with cell division and a host of lifestyle factors and stresses, are key molecular determinants of aging and aging trajectories.

Methods:
We proposed that telomere length dynamics (changes over time) represent a particularly relevant and integrative biomarker for astronauts, as they reflect the combined experiences and environmental exposures encountered during spaceflight. Telomere length (quantitative polymerase chain reaction and telomere fluorescence in situ hybridization) and telomerase activity (quantitative polymerase chain reaction -telomere repeat amplification protocol) were longitudinally assessed in the space- and earth-bound twins. Chromosome aberrations (directional genomic hybridization), signatures of radiation exposure, were also evaluated.

Results:
The twins had relatively similar telomere lengths before spaceflight, and the earth-bound twins’ telomeres remained relatively stable over the course of the study. Surprisingly, the space twins’ telomeres were longer during spaceflight, and upon return to Earth shortened rapidly, resulting in many more short telomeres after spaceflight than before. Chromosomal signatures of space radiation exposure were also elevated during spaceflight, and increased inversion frequencies persisted after spaceflight, suggestive of ongoing genome instability.

Conclusion:
Although the definitive mechanisms underlying such dramatic spaceflight-associated shifts in telomere length remain unclear, improved maintenance of telomere length has important implications for aging science and improving healthspan for those on Earth, as well.
Inflammasome Activation in Pollution-Induced Skin Conditions
Authors: Ferrara Francesca , Prieux Roxane , Woodby Brittany , Valacchi Giuseppe 
Published: December 2020

Summary:Exposure to air pollutants has been now associated with detrimental effects on a variety of organs, including the heart, lungs, GI tract, and brain. However, recently it has become clear that pollutant exposure can also promote the development/exacerbation of a variety of skin conditions, including premature aging, psoriasis, acne, and atopic dermatitis. Although the molecular mechanisms by which pollutant exposure results in these cutaneous pathological manifestations, it has been noticed that an inflammatory status is a common denominator of all those skin conditions. For this reason, recently, the activation of a cytosolic multiprotein complex involved in inflammatory responses (the inflammasome) that could promote the maturation of proinflammatory cytokines interleukin-1β and interleukin-18 has been hypothesized to play a key role in pollution-induced skin damage. In this review, we summarize and propose the cutaneous inflammasome as a novel target of pollutant exposure and the eventual usage of inflammasome inhibitor as new technologies to counteract pollution-induced skin damage. Possibly, the ability to inhibit the inflammasome activation could prevent cutaneous inflammaging and ameliorate the health and appearance of the skin.
Targeting Alternative Splicing for Reversal of Cellular Senescence in the Context of Aesthetic Aging
Authors: Bramwell Laura R. , Harries Lorna W. 
Published: December 2020

Summary:
Cellular senescence is a state of stable cell cycle arrest that has increasingly been linked with cellular, tissue, and organismal aging; targeted removal of senescent cells brings healthspan and lifespan benefits in animal models. Newly emerging approaches to specifically ablate or rejuvenate senescent cells are now the subject of intense study to explore their utility to provide novel treatments for the aesthetic signs and diseases of aging in humans. Here, we discuss different strategies that are being trialed in vitro, and more recently in vivo, for the targeted removal or reversal of senescent cells. Finally, we describe the evidence for a newly emerging molecular mechanism that may underpin senescence; dysregulation of alternative splicing. We will explore the potential of restoring splicing regulation as a novel “senotherapeutic” approach and discuss strategies by which this could be integrated into the established portfolio of skin aging therapeutics.
Temporal Variation of the Facial Skin Microbiome: A 2-Year Longitudinal Study in Healthy Adults
Authors: Hillebrand Greg G. , Dimitriu Pedro , Malik Kausar , Park Yulia , Qu Di , Mohn William W. , Kong Rong 
Published: December 2020

Background:
The human skin microbiome is highly personalized, depending on, for example, body site, age, gender, and lifestyle factors. The temporal stability of an individual’s skin microbiome—its resiliency and robustness over months and years—is also a personalized feature of the microbiome. The authors measured the temporal stability of the facial skin microbiome in a large cohort of subjects. In addition to measuring microbiome dynamics, they tracked facial skin condition using noninvasive, objective imaging and biophysical measures to identify significant facial features associated with temporal changes in microbiome diversity and composition.

Methods:
The authors used 16S ribosomal RNA amplicon sequencing to track cheek and forehead skin microbiome diversity and composition annually over a 2-year period (2017–2019) in 115 healthy adult men and women. Skin metadata included facial features, such as wrinkles, hyperpigmentation, porphyrins, and skin color tone, as well as biophysical parameters for stratum corneum barrier function, pH, hydration, and elasticity.

Results:
Across the subject population, the facial skin microbiome composition and diversity were relatively stable, showing minor variation over the 2-year period. However, for some subjects, composition, diversity, and relative abundance of specific organisms showed substantial changes from one year to the next, and these changes were associated with changes in stratum corneum barrier function and follicular porphyrins.

Conclusions:
For healthy people, facial skin microbiome diversity and composition are relatively stable from year to year. Tracking the temporal changes in the microbiome along with skin phenotypic changes allows for a deeper understanding of the skin microbiome’s role in health and disease. These results should be helpful in the design of longer-term intervention trials with microbiome-based skin care treatments.
The Effect of Intraoperative Radiotherapy on Healing and Complications After Sacrectomy and Immediate Reconstruction
Authors: Lasso Jose M. , Pinilla Carmen , Vasquez Wenceslao , Asencio JM 
Published: December 2020

Introduction
Sacropelvic resection is the treatment of choice for pelvic bone tumors and can be associated with intraoperative electron radiotherapy (IOERT) to optimize local control of the disease. Reconstruction with flaps also is essential to avoid pelvic complications. There is scarcity of publications evaluating outcomes of reconstructive procedures associated with IOERT.

Methods
A prospective study in 53 patients between 2005 and 2018 was performed. Thirty-four patients received IOERT (group I [GI]) and 19 did not (GII). We examined demographic characteristics, tumor pathology, type of resection and volume of surgical specimen, timing of surgery, IOERT doses, postoperative stay, and complications. We used it for reconstruction rectus abdominis, gluteal, omental and gracilis, superior gluteal artery perforator flap, and free flaps.

Results
Colonic adenocarcinoma and chordoma were the most frequent tumors. The median (interquartile range) IOERT dose was 1250 (1000–1250) cGy; operating time was 10.15 (8.6–14.0) hours versus 6.0 (5.0–13.0) hours, hospital stay was 37 (21.2–63.0) days versus 26.0 (12.0–60.0) days, and volume of surgical specimen was 480.5 (88.7–1488.0) mL versus 400 (220.0–6700.0) mL in GI and GII, respectively. Operating time was significantly longer in GI (P < 0.03). There were significant positive correlations between operating time, hospital stay, and volume of surgical specimen. Main complications were exudative wounds (50% vs 31.5%), wound dehiscence (41.1% vs 31.5%), and seroma (29.4% vs 26.3%) in GI and GII, respectively. Complications were similar to previous studies with or without radiotherapy.

Conclusions
Under a reconstructive approach, IOERT did not harm flap survival nor increased pelvic complications when compared with similar cases without IOERT.
Repair of Pediatric Split Earlobe Deformity With Anterior Straight-Line Closure and Posterior Z-Plasty
Authors: Tilt Alexandra , Malphrus Elizabeth , Mantilla-Rivas Esperanza , Manrique Monica , Rogers Gary F. , Oh Albert K. 
Published: December 2020

Background
Split earlobe deformity typically results from earring-related trauma or, less commonly, from congenital malformation. Several surgical approaches to repair the earlobe have been described, with the goals of reconstructing normal contour of the earlobe, avoiding notching of the free margin, and minimizing scar visibility.

Methods
The authors reviewed 26 consecutive patients who underwent earlobe reconstruction using the senior author's novel technique, which involves anterior straight-line closure paired with a posterior Z-plasty. Baseline demographic characteristics, etiology of split earlobe, follow-up, outcomes, and rate of complications were analyzed.

Results
The median age at surgical repair was 8.04 (interquartile range, 4.53–12.84) years. Most patients had acquired split earlobe deformity secondary to trauma. Median follow-up was 86.5 (interquartile range, 29–385.5) days. Only 4 patients had less than satisfactory results, 3 having residual contour abnormality and 1 noting earlobe asymmetry. None of these patients desired revision. No keloid formation, dehiscence, or other postoperative complications were reported.

Conclusions
The authors describe a novel and effective surgical technique that successfully reconstructs split earlobe deformity. This technique minimizes visible scarring with an anterior straight-line repair combined with posterior Z-plasty to avoid notching.