bluuebunny/crossref_metadata_2025_split huggingface dataset:
Persistent cloaca: persistence of the challenge
Authors: AbouZeid Amr Abdelhamid , Radwan Ahmed Bassiouny , Eldebeiky Mohamed , Hay Sameh Abdel 
Published: January 2020

Abstract
Background
Persistent cloaca or cloacal anomalies represent a special category of anorectal anomalies affecting the female sex with a reported incidence of about one in 25,000 live birth.
The study included 34 cases of cloaca that were managed at our unit between 2003 through 2017. We retrospectively reviewed patients’ records that included clinical presentation, investigations, operative data, and follow-up notes.
Anatomically, we stratified cloaca into three types according to the level of urogenital confluence. A low confluence (type 1) was defined by being at or below the level of the lower border of pubic symphysis with a short common channel (11 cases). A high confluence (type 3) was defined by being at or above the level of the upper border of pubic symphysis (9 cases). Between the low and high types, we defined an intermediate type (type 2) where the urogenital confluence was behind the mid-portion of pubic symphysis (14 cases).

Results
Renal anomalies were common association: solitary kidney in seven, pelvic kidney in two, and urinary tract dilatation (hydroureteronephrosis) in 12 cases. At follow-up, chronic renal insufficiency was detected in seven cases
The prognosis for urinary continence was excellent in low confluence (type 1) cloaca. On the other hand, urinary incontinence was common among type 3 (high confluence) cloaca (62.5%).

Conclusion
Renal anomalies represent a common association with cloaca and a major cause of morbidity. Efforts should be directed to preserve renal function during the initial management, and to preserve the continence potential following the definitive repair.

Level of evidence
This is a case series with no comparison group (level IV).
Outcome of management of gastroschisis: comparison of improvised surgical silo and extended right hemicolectomy
Authors: Okoro Philemon E. , Ngaikedi Charles 
Published: January 2020

AbstractBackgroundGastroschisis is onea of the major abdominal wall defects encountered commonly in pediatric surgery. Whereas complete reduction and abdominal closure is achieved easily sometimes, a daunting situation arises when the eviscerated bowel loops and other viscera cannot be returned immediately into the abdominal cavity. This situation is a major contributor to the outcome of the treatment of gastroschisis in our region. In our efforts to improve our outcome, we have adopted the technique of extended right hemicolectomy for cases where complete reduction and primary abdominal wall closure is otherwise not possible. This study compared the management outcome of gastroschisis using our improvised silo, and performing an extended right hemicolectomy.ResultsThirty-nine cases were analyzed. Simple closure could not be achieved in 28 cases. In the absence of standard silos, improvised ones were constructed from the amniotic membrane (3 cases), urine bag (4 cases), and latex gloves (9 cases) giving a total of 16 cases managed with silos. Extended right hemicolectomy was performed in 12 cases.ConclusionsGiven the peculiarities of circumstances in our region regarding human and material resources in the care of gastroschisis patients, an extended right hemicolectomy, to make it possible to close the abdomen primarily in gastroschisis is a more viable option than the use of improvised silo.Trial registrationThis trial was approved by the Ethical Committee of the University of Port Harcourt Teaching Hospital, Nigeria. Reference Number: UPTH/ADM/90/S.II/VOL XI/835. Registered 3 May 2013.
Evaluation of Adolescents’ and Young Adults’ Attitudes Toward Participation in Cancer Clinical Trials
Authors: Lewin Jeremy , Bell Jennifer A. H. , Wang Kate , Forcina Victoria , Tam Seline , Srikanthan Amirrtha , Lin Yu-Chung , Taback Nathan , Mitchell Laura , Gupta Abha A. 
Published: January 2020

PURPOSE: Participation in cancer clinical trials (CCTs) for adolescents and young adults (AYAs) remains the lowest of any patient group with cancer. Little is known about the personal barriers to AYA accrual. The aim of this study was to explore AYA attitudes that influence CCT participation. METHODS: A mixed-methods approach was used. AYAs and non-AYAs (≥ 40 years) completed the Cancer Treatment subscale of the Attitudes Toward Cancer Trials Scales and 9 supplementary questions formed from interview analysis. Differences between AYA and non-AYA cohorts were analyzed using the Mann-Whitney U test, and logistic regression models were constructed to evaluate the effect of demographics on perceptions of CCTs. RESULTS: Surveys were distributed to 61 AYAs (median age, 29 years; range, 17-39 years) and 74 non-AYAs (median age, 55 years; range, 40-88 years). Compared with non-AYAs, AYAs perceived CCTs to be unsafe/more difficult (Personal Barrier/Safety domain; P = .01). There were no differences based on age in other domains. AYAs were also more concerned with CCT interference in their long-term goals ( P = .04). Multivariable ordered logistic regression identified increased personal barriers in the Personal Barrier/Safety domain for AYAs ( P = .01), in patients with English as a second language (ESL; P < .01), and in patients previously not offered a clinical trial ( P = .03). Long-term goals were identified as a barrier in particular tumor types ( P = .01) and in patients with ESL ( P < .01), with a trend identified in AYAs ( P = .12). CONCLUSION: Age-related differences in attitudes toward CCTs suggest that tailored approaches to CCT accrual are warranted. Patient-centered delivery of information regarding CCTs, particularly in patients with ESL and who are trial naïve, may improve accrual.
Thigh Muscle Fat Infiltration Is Associated With Impaired Physical Performance Despite Remission in Cushing’s Syndrome
Authors: Martel-Duguech Luciana , Alonso-Jiménez Alicia , Bascuñana Helena , Díaz-Manera Jordi , Llauger Jaume , Nuñez-Peralta Claudia , Biagetti Betina , Montesinos Paula , Webb Susan M , Valassi Elena 
Published: January 2020

AbstractContextMuscle weakness is common in patients with Cushing’s syndrome (CS) and may persist after the resolution of hypercortisolism. Intramuscular fatty infiltration has been associated with the deterioration of muscle performance in several conditions.ObjectivesTo quantify the degree of fatty infiltration in the thigh muscles of “cured” CS patients and evaluate the relationship between intramuscular fatty infiltration and physical performance.DesignThis was a cross-sectional study.SettingTertiary referral center.PatientsThirty-six women with CS in remission, and 36 controls matched for age, BMI, menopausal status, and level of physical activity.Main Outcome MeasuresWe analyzed the percentage fat fraction (FF) of the thigh muscles in the anterior, posterior, and combined anterior and posterior compartments using MRI and 2-point Dixon sequence. We assessed muscle function and strength using the following tests: gait speed (GS), timed up and go (TUG), 30-second chair stand, and hand grip strength.ResultsFat fraction in all the compartments analyzed was increased in patients as compared with controls. The performance on TUG, 30-second chair stand, and GS was more impaired in CS patients versus controls. In patients, greater FF was negatively associated with performance on functional tests. Fat fraction in the combined anterior and posterior compartments predicted performance on TUG (ß 0.626, P &lt; 0.000) and GS (ß -0.461, P = 0.007), after adjusting for age, BMI, menopausal status, and muscle mass.ConclusionsThigh muscle fatty infiltration is increased in “cured” CS patients and is associated with poorer muscle performance. Future studies are needed to establish therapeutic strategies to improve muscle weakness in these patients.
Myeloid-Derived Growth Factor Promotes Intestinal Glucagon-Like Peptide-1 Production in Male Mice With Type 2 Diabetes
Authors: Wang Li , Li Yixiang , Guo Bei , Zhang Jiajia , Zhu Biao , Li Huan , Ding Yan , Meng Biying , Zhao Hui , Xiang Lin , Dong Jing , Liu Min , Zhang Junxia , Xiang Lingwei , Xiang Guangda 
Published: January 2020

Abstract
Myeloid-derived growth factor (MYDGF), which is produced by bone marrow–derived cells, mediates cardiac repair following myocardial infarction by inhibiting cardiac myocyte apoptosis to subsequently reduce the infarct size. However, the function of MYDGF in the incretin system of diabetes is still unknown. Here, loss-of-function and gain-of-function experiments in mice revealed that MYDGF maintains glucose homeostasis by inducing glucagon-like peptide-1 (GLP-1) production and secretion and that it improves glucose tolerance and lipid metabolism. Treatment with recombinant MYDGF increased the secretion and production of GLP-1 in STC-1 cells in vitro. Mechanistically, the positive effects of MYDGF are potentially attributable to the activation of protein kinase A/glycogen synthase kinase 3β/β-catenin (PKA/GSK-3β/β-catenin) and mitogen-activated protein kinase (MAPK) kinases/extracellular regulated protein kinase (MEK/ERK) pathways. Based on these findings, MYDGF promotes the secretion and production of GLP-1 in intestinal L-cells and potentially represents a potential therapeutic medication target for type 2 diabetes.
Microbial Reconstitution Reverses Early Female Puberty Induced by Maternal High-fat Diet During Lactation
Authors: Wang Mengjie , Zhang Youjie , Miller David , Rehman Naveen O , Cheng Xi , Yeo Ji-Youn , Joe Bina , Hill Jennifer W 
Published: January 2020

Abstract
Recent work shows that gut microbial dysbiosis contributes to the risk of obesity in children whose mothers consume a high-fat diet (HFD) during both gestation and lactation or during gestation alone. Obesity predisposes children to developing precocious puberty. However, to date, no study has examined how maternal HFD (MHFD) during lactation regulates the gut microbiota (GM), pubertal timing, and fertility of offspring. Here, we found that MHFD during lactation markedly altered the GM of offspring. The pups developed juvenile obesity, early puberty, irregular estrous cycles, and signs of disrupted glucose metabolism. Remarkably, permitting coprophagia between MHFD and maternal normal chow offspring successfully reversed the GM changes as well as early puberty and insulin insensitivity. Our data suggest that microbial reconstitution may prevent or treat early puberty associated with insulin resistance.
Analysis of 1478 Cases of Hypospadias Repair: The Incidence of Requiring Repeated Anesthetic Exposure as Well as Exploration of the Involvement of Trainees on Case Duration
Authors: Adler Adam C. , Chandrakantan Arvind , Sawires Youstina , Lee Andrew D. , Hart Margaret , Koh Chester J. , Janzen Nicolette K. , Austin Paul F. , Andropoulos Dean B. 
Published: January 2020

BACKGROUND:
Recently, there has been significant focus on the effects of anesthesia on the developing brain. Concern is heightened in children <3 years of age requiring lengthy and/or multiple anesthetics. Hypospadias correction is common in otherwise healthy children and may require both lengthy and repeated anesthetics. At academic centers, many of these cases are performed with the assistance of anesthesia and surgical trainees. We sought to identify both the incidence of these children undergoing additional anesthetics before age 3 as well as to understand the effect of trainees on duration of surgery and anesthesia and thus anesthetic exposure (AE), specifically focusing on those cases >3 hours.

METHODS:
We analyzed all cases of hypospadias repair from December 2011 through December 2018 at Texas Children’s Hospital. In all, 1326 patients undergoing isolated hypospadias repair were analyzed for anesthesia time, surgical time, provider types involved, AE, caudal block, and additional AE related/unrelated to hypospadias.

RESULTS:
For the primary aim, a total of 1573 anesthetics were performed in children <3 years of age, including 1241 hypospadias repairs of which 1104 (89%) were completed with <3 hours of AE. For patients with <3 hours of AE, 86.1% had a single surgical intervention for hypospadias. Of patients <3 years of age, 17.3% required additional nonrelated surgeries. There was no difference in anesthesia time in cases performed solely by anesthesia attendings versus those performed with trainees/assistance (16.8 vs 16.8 minutes; P = .98). With regard to surgery, cases performed with surgical trainees were of longer duration than those performed solely by surgical attendings (83.5 vs 98.3 minutes; P < .001). Performance of surgery solely by attending surgeon resulted in a reduced total AE in minimal alveolar concentration (MAC) hours when compared to procedures done with trainees (1.92 vs 2.18; P < .001). Finally, comparison of patients undergoing initial correction of hypospadias with subsequent revisions revealed a longer time (117.7 vs 132.2 minutes; P < .001) and AE during the primary stage.

CONCLUSIONS:
The majority of children with hypospadias were repaired within a single AE. In general, most children did not require repeated AE before age 3. While presence of nonattending surgeons was associated with an increase in AE, this might at least partially be due to differences in case complexity. Moreover, the increase is likely not clinically significant. While it is critical to maintain a training environment, attempts to minimize AE are crucial. This information facilitates parental consent, particularly with regard to anesthesia duration and the need for additional anesthetics in hypospadias and nonhypospadias surgeries.
HCT116 colorectal liver metastases exacerbate muscle wasting in a mouse model for the study of colorectal cancer cachexia
Authors: Huot Joshua R. , Novinger Leah J. , Pin Fabrizio , Bonetto Andrea 
Published: January 2020

ABSTRACT
Colorectal cancer (CRC) is often accompanied by formation of liver metastases (LM) and skeletal muscle wasting, i.e. cachexia. Despite affecting the majority of CRC patients, cachexia remains underserved, understudied and uncured. Animal models for the study of CRC-induced cachexia, in particular models containing LM, are sparse; therefore, we aimed to characterize two new models of CRC cachexia. Male NSG mice were injected subcutaneously (HCT116) or intrasplenically (mHCT116) with human HCT116 CRC tumor cells to disseminate LM, whereas experimental controls received saline (n=5-8/group). Tumor growth was accompanied by loss of skeletal muscle mass (HCT116: −20%; mHCT116: −31%; quadriceps muscle) and strength (HCT116: −20%; mHCT116: −27%), with worsened loss of skeletal muscle mass in mHCT116 compared with HCT116 (gastrocnemius: −19%; tibialis anterior: −22%; quadriceps: −21%). Molecular analyses revealed elevated protein ubiquitination in HCT116, whereas mHCT116 also displayed elevated Murf1 and atrogin-1 expression, along with reduced mitochondrial proteins PGC1α, OPA1, mitofusin 2 and cytochrome C. Further, elevated IL6 levels were found in the blood of mHCT116 hosts, which was associated with higher phosphorylation of STAT3 in skeletal muscle. To clarify whether STAT3 was a main player in muscle wasting in this model, HCT116 cells were co-cultured with C2C12 myotubes. Marked myotube atrophy (–53%) was observed, along with elevated phospho-STAT3 levels (+149%). Conversely, inhibition of STAT3 signaling by means of a JAK/STAT3 inhibitor was sufficient to rescue myotube atrophy induced by HCT116 cells (+55%). Overall, our results indicate that the formation of LM exacerbates cachectic phenotype and associated skeletal muscle molecular alterations in HCT116 tumor hosts.
Exertion-Related Illness: The Critical Roles of Leadership and Followership
Authors: O'Connor Francis G. , Grunberg Neil E. , Harp Jacob B. , Duster Patricia A. 
Published: January 2020

Abstract
Exertion-related illness (ERI), despite aggressive efforts with both prevention and emergency action planning, continues to be a considerable threat to both athletes and warfighters. Numerous case reports and series have served to elucidate risk factors, which have in turn become the focus of prevention strategies. While this approach has assisted in mitigating athlete risk, recent institutional guidance has identified the need for greater protection of athletes by accountability of training programs and the recognition of periods of distinct athlete vulnerability. These recommendations, in addition to observations from lessons learned from the aforementioned cluster reports of ERI, have a strong call-out for the role of leadership as both a culprit for injury and a potential mechanism for prevention. This commentary introduces a leader-follower framework and explores this model in the evolution of ERI and offers recommendations as to how we move forward toward making progress in prevention.
Evaluation and Management of Sports-Related Eye Injuries
Authors: Toldi James P. , Thomas Justin L. 
Published: January 2020

Abstract
Ocular injuries occur at a high rate in the United States and are a common complaint in the emergency department (ED). The CDC estimates that the annual rate for all-cause ocular injuries presenting to the ED is approximately 37.6 per 10,000 (1). The personal impact of ocular injury is an obvious one which necessitates urgent evaluation and possibly emergent ophthalmologic evaluation for vision preserving intervention. Specific sports and recreational activities increase the risk of injury; these include sports involving projectiles (i.e., target shooting, racquet sports, hockey pucks, lacrosse) as well as combat sports (i.e., martial arts, boxing, wrestling). Sideline physicians should be aware of the sports setting and be prepared for ocular injuries with the proper sideline equipment. Prompt recognition, management, and referral can lead to decreased morbidity in this select population.
Tibial Acceleration during Running Is Higher in Field Testing Than Indoor Testing
Authors: MILNER CLARE E. , HAWKINS JILLIAN L. , AUBOL KEVIN G. 
Published: January 2020

ABSTRACT
Tibial acceleration is frequently measured in runners, and recent advances in wireless technology have led to field studies measuring tibial acceleration outside the laboratory. However, it is unknown whether laboratory and field measures of tibial acceleration differ within runners. In addition, the relationship between peak axial acceleration and the more recent measure peak resultant tibial acceleration has not been determined.

Purpose
This study aimed to determine whether laboratory and field measures of tibial acceleration are comparable, and whether peak axial and peak resultant tibial acceleration are interchangeable.

Methods
Nineteen healthy rearfoot striking runners between 18 and 45 yr of age participated. A precision accelerometer was aligned with the vertical axis of the distal tibia and firmly attached. Data were collected in the following conditions during running at 3.0 m·s−1 ± 5%: traditional overground laboratory gait analysis contacting force plates, treadmill, outdoor grass, and outdoor sidewalk. Acceleration data were filtered and normalized to gravity. Peaks for variables of interest were extracted from the first 40% of stride for 10 trials per condition. Differences among conditions were determined.

Results
Peak positive acceleration was lower in laboratory and treadmill compared with grass and sidewalk conditions. However, laboratory and treadmill were similar in magnitude, as were grass and sidewalk. Peak resultant acceleration was consistently higher than peak axial acceleration, with the same pattern among conditions. Laboratory acceleration measures explained at best only half of the variance in the field conditions and did not explain the variance for grass.

Conclusion
Tibial impact acceleration magnitude is influenced by testing procedures in runners. These findings support measuring tibial impact acceleration in the field to determine new metrics associated with injury.
The Multidimensional Battery of Prosody Perception (MBOPP)
Authors: Jasmin Kyle , Dick Frederic , Tierney Adam Taylor 
Published: January 2020

Prosody can be defined as the rhythm and intonation patterns spanning words, phrases and sentences. Accurate perception of prosody is an important component of many aspects of language processing, such as parsing grammatical structures, recognizing words, and determining where emphasis may be placed. Prosody perception is important for language acquisition and can be impaired in language-related developmental disorders. However, existing assessments of prosodic perception suffer from some shortcomings. These include being unsuitable for use with typically developing adults due to ceiling effects, or failing to allow the investigator to distinguish the unique contributions of individual acoustic features such as pitch and temporal cues. Here we present the Multi-Dimensional Battery of Prosody Perception (MBOPP), a novel tool for the assessment of prosody perception. It consists of two subtests: Linguistic Focus, which measures the ability to hear emphasis or sentential stress, and Phrase Boundaries, which measures the ability to hear where in a compound sentence one phrase ends, and another begins. Perception of individual acoustic dimensions (Pitch and Time) can be examined separately, and test difficulty can be precisely calibrated by the experimenter because stimuli were created using a continuous voice morph space. We present validation analyses from a sample of 57 individuals and discuss how the battery might be deployed to examine perception of prosody in various populations.
Causal claims about correlations reduced in press releases following academic study of health news
Authors: Bratton Luke , Adams Rachel C. , Challenger Aimée , Boivin Jacky , Bott Lewis , Chambers Christopher D. , Sumner Petroc 
Published: January 2020

Background: Exaggerations in health news were previously found to strongly associate with similar exaggerations in press releases. Moreover such exaggerations did not appear to attract more news. Here we assess whether press release practice changed after these reported findings; simply drawing attention to the issue may be insufficient for practical change, given the challenges of media environments. Methods: We assessed whether rates of causal over-statement in press releases based on correlational data were lower following a seminal paper on the topic, compared to an equivalent baseline period in the preceding year. Results: We found that over-statements in press releases reduced from 28% (95% confidence interval = 16% to 45%) in 2014 to 13% (95% confidence interval = 6% to 25%) in 2015. A corresponding numerical reduction in exaggerations in news was not significant. The association between over-statements in news and press releases remained strong. Conclusions: Press release over-statements were less frequent following publication of Sumner et al. (2014), indicating that press release practice is malleable. However, this is correlational evidence and the reduction may be due to other factors.