bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fluoroscopic Marker–Based Guidance System Improves Gamma Lag Screw Placement During Nailing of Intertrochanteric Fractures: A Randomized Controlled Trial
Authors: Weidert Simon , Sommer Fabian , Suero Eduardo M. , Becker Christopher A. , Pieske Oliver , Greiner Axel , Kammerlander Christian , Böcker Wolfgang , Grote Stefan 
Published: November 2019

Objectives:
To determine whether a fluoroscopy-based navigation system would improve tip-apex distance (TAD) compared with the conventional technique.

Design:
Randomized controlled trial.

Setting:
Level 1 trauma center.

Patients:
A total of 161 patients were screened for inclusion in the study. After meeting inclusion and exclusion criteria, 31 patients were randomized (n = 18 navigated vs. n = 13 control group), with the patient blinded to the result.

Intervention:
Fluoroscopy-based navigated guidance of lag screw length and position.

Main Outcome Measures:
Average TAD and the proportion of TAD over 25 mm.

Results:
TAD was lower in the navigated group compared with the control group (mean = 17.5 vs. 24.2 mm; P = 0.0018). No navigated cases exceeded the 25 mm TAD threshold, compared with 39% of conventional cases (P = 0.0076). Navigation resulted in fewer drilling attempts compared with the conventional technique (median = 1 vs. 4 attempts; P < 0.0001). We detected no significant differences in operation time or total number of fluoroscopic images (P > 0.05).

Conclusions:
Fluoroscopy-based computer navigated Gamma nailing for intertrochanteric fractures improved TAD and reduced the number of drilling attempts without increasing operation time compared with the conventional fluoroscopy-guided technique in a teaching hospital setting.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Prevalence of Osteoporosis in Patients Undergoing Lumbar Fusion for Lumbar Degenerative Diseases
Authors: Zou Da , Jiang Shuai , Zhou Siyu , Sun Zhuoran , Zhong Woquan , Du Guohong , Li Weishi 
Published: November 2019

Study Design.
Retrospective analysis.

Objective.
To investigate the prevalence of osteoporosis (OP) in patients undergoing lumbar fusion for lumbar degenerative diseases (LDD).

Summary of Background Data.
OP is related to many complications after lumbar fusion for patients with LDD. There are sparse data on the prevalence of OP among this specific population. Moreover, LDD can falsely elevate the bone mineral density measured by dual energy x-ray absorptiometry (DXA), leading to unreliable diagnostic results. Computed tomography (CT) Hounsfield unit (HU) values can help identify osteoporotic patients undetected by DXA.

Methods.
A total of 479 patients aged≥50 years undergoing lumbar fusion for LDD were reviewed. The diagnosis of OP using DXA was based on World Health Organization criterion. The criterion for OP diagnosed on CT scan was the L1-HU value≤110.

Results.
The prevalence of OP diagnosed on lumbar DXA, hip DXA, and both was 32.4%, 19.6%, 39.7%, respectively. The females had higher prevalence of OP diagnosed on DXA (spine and hip) than males (48.9% vs. 27.1%, P < 0.001). In females but not males, the prevalence of OP significantly increased with age (females, 50–59: 28.0%, 60–69: 58.1%, ≥70: 78.8%, P < 0.001). Patients having primary diagnosis of degenerative lumbar scoliosis had the higher prevalence of OP than the rest patients (56.5% vs. 36.8%, P = 0.002). Among the 324 patients diagnosed with non-OP by lumbar DXA, the prevalence of OP diagnosed on CT scan was 25.9%, it increased with age and was also highest in patients with degenerative lumbar scoliosis.

Conclusion.
OP was quite common among patients aged≥50 years undergoing lumbar fusion for LDD, especially for females aged≥60 years or patients having degenerative lumbar scoliosis. Older patients or patients having degenerative lumbar scoliosis are more likely to have unreliable lumbar T-scores. Measurements of HU values can help identify more osteoporotic patients in this population.

Level of Evidence: 3
Increasing Numbers of Staphylococcal Scalded Skin Syndrome Cases Caused by ST121 in Houston, Texas
Authors: Hultén Kristina G. , Kok Melissa , King Kathryn E. , Lamberth Linda B. , Kaplan Sheldon L. 
Published: November 2019

Background:
The molecular epidemiology of Staphylococcus aureus strains causing staphylococcal scalded skin syndrome (SSSS) in the United States has not been described. We analyzed patient and S. aureus isolate characteristics associated with SSSS in children at Texas Children’s Hospital.

Methods:
Patients with SSSS were identified by ICD9/10 codes and available S. aureus isolates were identified from an ongoing S. aureus surveillance study. Medical records were reviewed for 58 patients with available S. aureus isolates. Isolate analyses included PCR for agr group, pvl (lukSF-PV), tst, eta and etb, pulsed-field gel electrophoresis, multi-locus sequence typing and antimicrobial susceptibilities.

Results:
Cases of SSSS increased from 2.3/10,000 admissions in 2008 to 52.6/10,000 admissions in 2017 (P < 0.0001). The 58 study cases (57 methicillin-susceptible S. aureus, 1 MRSA) with isolates were from 2013 to 2017. The majority (88%) of isolates was of clonal cluster (CC) 121, agr group IV, pvl
−, tst
− and carried eta and/or etb and 26% were clindamycin resistant. Twelve ST121 isolates had high level resistance to mupirocin. Patients were treated with standard supportive care plus systemic antibiotics [clindamycin alone or in combination with another antibiotic (n = 44)]. One patient had a recurrent SSSS and one patient was transferred to a burn unit on day 3.

Conclusions:
Cases of SSSS are increasing at our hospital. Most S. aureus strains isolated were of one CC, CC121 and carried eta and etb. Supportive care plus clindamycin was effective treatment. We speculate that CC121 was recently introduced to our region and is responsible for the increasing numbers of SSSS cases observed at Texas Children’s Hospital.
Daily Dengue Severity Score to Assess Severe Manifestations
Authors: Tangnararatchakit Kanchana , Chuansumrit Ampaiwan , Watcharakuldilok Piangor , Apiwattanakul Nopporn , Lertbunrian Rojjanee , Keatkla Jiraporn , Yoksan Sutee 
Published: November 2019

Background:
The study aimed to develop dengue severity score to assess severe manifestations among hospitalized patients with dengue infection.

Method:
Children and adolescents with serologically confirmed dengue infection admitted at Ramathibodi Hospital from 2004 to 2018 and treated by an expert multidisciplinary team were recruited. Medical records were retrospectively reviewed and 14 items, related to clinical parameters and managements during hospitalization, were obtained daily as dengue severity score.

Results:
A total of 191 patients with a mean age of 10.7 years from 2004 to 2013 were recruited. They were classified as dengue fever (35), dengue hemorrhagic fever (DHF) I (53), II (50), III (37) and IV (16). The analysis of 593 daily records revealed the range of daily severity score among patients with DHF grades III (10–20) and IV (31–47) were significantly higher than those of other groups (dengue fever, 5–13; DHF I, 2–10; DHF II, 6–11) with P-values of 0.0001. Using a validity test, a total daily score of ≥12 was an assessment tool for dengue shock syndrome with sensitivity, 86% and specificity, 84%. An additional 51 hospitalized patients with DHF grades II, III and IV with similar ages from 2014 to 2018 were recruited. The number of patients with severe manifestations, having daily score of ≥12, was significantly higher than those without severe manifestations starting from Day −3 to Day +1 of illness.

Conclusions:
Daily dengue severity score of ≥12 was an accurate assessment tool for severe manifestations.
Selective modulation of tonic aversive qualities of neuropathic pain by morphine in the central nucleus of the amygdala requires endogenous opioid signaling in the anterior cingulate cortex
Authors: Navratilova Edita , Nation Kelsey , Remeniuk Bethany , Neugebauer Volker , Bannister Kirsty , Dickenson Anthony H. , Porreca Frank 
Published: November 2019

Abstract
The amygdala is a key subcortical region believed to contribute to emotional components of pain. As opioid receptors are found in both the central (CeA) and basolateral (BLA) nuclei of the amygdala, we investigated the effects of morphine microinjection on evoked pain responses, pain-motivated behaviors, dopamine release in the nucleus accumbens (NAc), and descending modulation in rats with left-side spinal nerve ligation (SNL). Morphine administered into the right or left CeA had no effect on nerve injury–induced tactile allodynia or mechanical hyperalgesia. Right, but not left, CeA morphine produced conditioned place preference (CPP) and increased extracellular dopamine in the NAc selectively in SNL rats, suggesting relief of aversive qualities of ongoing pain. In SNL rats, CPP and NAc dopamine release following right CeA morphine was abolished by blocking mu opioid receptor signaling in the rostral anterior cingulate cortex (rACC). Right CeA morphine also significantly restored SNL-induced loss of the diffuse noxious inhibitory controls, a spino-bulbo-spinal pain modulatory mechanism, termed conditioned pain modulation in humans. Microinjection of morphine into the BLA had no effects on evoked behaviors and did not produce CPP in nerve-injured rats. These findings demonstrate that the amygdalar action of morphine is specific to the right CeA contralateral to the side of injury and results in enhancement of net descending inhibition. In addition, engagement of mu opioid receptors in the right CeA modulates affective qualities of ongoing pain through endogenous opioid neurotransmission within the rACC, revealing opioid-dependent functional connections from the CeA to the rACC.
Use of Myoelectric Limb Orthoses for Elbow Flexion in Patients with Brachial Plexus Injury: A Case Series
Authors: Anderson Gregory R. , Beahrs Taylor R. , Kircher Michelle F. , Shin Alexander Y. 
Published: November 2019

ABSTRACT

Introduction
Myoelectric limb orthoses (MLOs) are powered devices that assist with specific motions in patients with neuromuscular deficits or inadequate motor power. MLOs enable patients to self-initiate and control movements using their own muscle signals. While these devices have been used for patients that have sustained neurologic deficits from cerebrovascular accidents, their use in traumatic adult brachial plexus injuries is novel.

Materials and Methods
This case series presents three patients with traumatic brachial plexus injuries treated with MLOs to improve elbow flexion after inadequate recovery. The MLO was used as both a rehabilitation device and a functional device.

Results/Conclusions
MLOs demonstrate potential for improving patient clinical outcomes and satisfaction after brachial plexus injuries with incomplete recovery or inadequate function after surgical intervention.
Effect of semaglutide on coronary atherosclerosis progression in patients with type II diabetes: rationale and design of the semaglutide treatment on coronary progression trial
Authors: Hamal Sajad , Cherukuri Lavanya , Shaikh Kashif , Kinninger April , Doshi Jay , Birudaraju Divya , Budoff Matthew J. 
Published: November 2019

Background:
Cardiovascular morbidity and mortality are a major burden in patients with type 2 diabetic mellitus. In a landmark study, semaglutide (an injectable glucagon like peptide-1 receptor agonist) has been shown to significantly reduce cardiovascular events, however, the mechanism of benefit is still unknown. The primary hypothesis of our current study is to assess the effect of semaglutide to reduce progression of noncalcified coronary atherosclerotic plaque volume as measured by serial coronary CTA as compared to placebo in persons with diabetes over 1 year.

Methods:
One hundred forty patients will be enrolled after signing informed consent and followed up for 12 months and with a phone call 30 days after medical discontinuation. All the participants will undergo coronary artery calcium scoring and coronary computed tomography angiography at our center at baseline and 12 months. Eligible participants will be randomly assigned to semaglutide 2 mg/1.5 ml (1.34 mg/ml) prefilled pen for subcutaneous (SC) injection or placebo 1.5 ml, pen-injector for SC injection in a 1:1 fashion as add-on to their standard of care.

Results:
As of July 2019, the study was approximately 30% enrolled with an estimated enrollment completion by first quarter of 2020 and end of study by first quarter 2021. Thirty patients were enrolled as of 23 July 2019. Preliminary data of demographics and clinical characteristics were summarized.

Conclusion:
Our current study will provide important imaging-derived data that may add relevance to the clinically derived outcomes from liraglutide effect and action in diabetes: evaluation of cardiovascular outcome results and semaglutide and cardiovascular outcomes in patients with type 2 diabetic mellitus 6 trials.
Can training induce inflammatory control in asthma, or is it symptom control only?
Authors: Pitzner-Fabricius Anders , Toennesen Louise Lindhardt , Backer Vibeke 
Published: November 2019

Purpose of review
Exercise has shown to reduce asthma symptoms; however, the underlying mechanism for this improvement remains unclear. Improvement in inflammatory control could be the reason for this reduction in symptoms. This review discusses recent studies evaluating the effect of exercise on inflammatory control in patients with asthma.

Recent findings
New studies support that exercise is well tolerated and feasible regardless of intensity. Exercise seems to improve systemic low-grade inflammation, but consistency lacks when it comes to reduction in airway inflammation.

Summary
Physical exercise as an adjuvant therapy leads to improvement in asthma symptoms and asthma-related quality of life and should be recommended for all patients with asthma.
Spirituality in heart failure: a review of the literature from 2014 to 2019 to identify spiritual care needs and spiritual interventions
Authors: Ross Linda , Miles Jackie 
Published: November 2019

Purpose of review
The burden of heart failure is significant and its management is complex. Current evidence confirms a high level of spiritual distress and a strong desire for spiritual support, which is endorsed by healthcare policy, yet spiritual support is rarely provided for this patient group. There is a need to identify how spiritual support might be meaningfully included within holistic heart failure multidisciplinary care and how its effectiveness might be demonstrated.

Recent findings
A literature review was undertaken to identify recent evidence (2014–2019) of the spiritual care needs of heart failure patients/carers and the nature and effectiveness of spiritual interventions in heart failure care.

Summary
Taken as a whole, studies exploring heart failure patients’/carers’ needs reflected the broad spectrum of spirituality as defined by international consensus, however, some studies focused on only some aspects of spirituality and on advanced disease. All studies were limited. No single spiritual intervention was identified as effective in enhancing quality of life in patients with heart failure. Life review and relaxation/meditation appeared ineffective. Interventions, which included elements of ‘talking’ about spiritual matters, ‘spiritual coping’ and those involving a holistic person-centred team approach to care of which spiritual care was an aspect, are worth investigating further in well designed randomized controlled trials.
Relation between Methylenetetrahydrofolate Reductase C677T and A1298C Polymorphisms and Migraine Susceptibility
Authors: Rai Vandana , Kumar Pradeep 
Published: November 2019

AbstractMigraine is a neurological disorder which impairs the patient’s quality of life. Several association studies investigating the association between MTHFR gene C677T and A1298C polymorphisms and susceptibility to migraine were published. But the results were conflicting, so authors performed a meta-analysis of published case control studies. Four databases were searched for suitable studies up to December, 2018. Odds ratios (OR) with 95% confidence intervals (CI) was calculated adopting additive, homozygote, co-dominant, dominant, and recessive genetic models.Results of MTHFR C677T polymorphism studies meta-analysis showed significant association with migraine risk using allele contrast, homozygote, dominant and recessive genetic models (T vs. C: OR = 1.18, 95%CI = 1.00-1.26, p= 0.05; TT vs. CC: OR = 1.24, 95%CI = 1.0-1.5, p= 0.04; CT vs. CC: OR = 1.08, 95%CI = 0.97-1.07, p= 0.25; TT+CT vs. CC: OR = 1.15, 95%CI = 1.0-1.29, p= 0.04; TT vs. CT +CC: OR = 1.97, 95%CI = 1.28-3.42, p= 0.002). However, results of MTHFR A1298 polymorphism studies meta-analysis did not show any association with migraine. Subgroup analysis based on ethnicity and migraine types i. e migraine with aura (MA) and without aura (MO) were also performed. Results of present meta-analysis indicate overall association between MTHFR C677T polymorphism with migraine in total 24 studies, in Asian population and in MA cases but did not show any association with Caucasian population and MO cases.
Deep functional synthesis: a machine learning approach to gene functional enrichment
Authors: Wang Sheng , Ma Jianzhu , Fong Samson , Rensi Stefano , Han Jiawei , Peng Jian , Pratt Dexter , Altman Russ B. , Ideker Trey 
Published: November 2019

ABSTRACTGene functional enrichment is a mainstay of genomics, but it relies on manually curated databases of gene functions that are incomplete and unaware of the biological context. Here we present an alternative machine learning approach, Deep Functional Synthesis (DeepSyn), which moves beyond gene function databases to dynamically infer the functions of a gene set from its associated network of literature and data, conditioned on the disease and drug context of the current experiment. Using a knowledge graph with 3,048,803 associations between genes, diseases, drugs, and functions, DeepSyn obtained accurate performance (range 0.74 AUC to 0.96 AUC) on a variety of biological applications including drug target identification, gene set functional enrichment, and disease gene prediction.AvailabilityThe DeepSyn codebase is available on GitHub at http://github.com/wangshenguiuc/DeepSyn/ under an open source distribution license.
Reanalysis of Alzheimer’s Brain Sequencing Data Reveals Absence of Purported HHV6A and HHV7
Authors: Chorlton Samuel D. 
Published: November 2019

AbstractReadhead et al. recently reported in Neuron the detection and association of Human Herpesviruses 6A (HHV6A) and 7 (HHV7) with Alzheimer’s disease by shotgun sequencing. I was skeptical of the specificity of their modified Viromescan bioinformatics method and subsequent analysis for numerous reasons. In their supplementary data, they report the detection of Variola virus, the etiological agent of the eradicated disease smallpox, in 97.5% of their Mount Sinai Brain Bank dataset. I reanlyzed Readhead et al’s data using highly sensitive and specific alternative methods and find no HHV7 reads in their samples; HHV6A reads were found in only 2 out of their top 15 samples sorted by reported HHV6A abundance. Finally, I recreate Readhead et al’s modified Viromescan method and identify reasons for its low specificity.
Decoding the genomic basis of osteoarthritis
Authors: Steinberg Julia , Southam Lorraine , Butterfield Natalie C , Roumeliotis Theodoros I , Fontalis Andreas , Clark Matthew J , Jayasuriya Raveen L , Swift Diane , Shah Karan M , Curry Katherine F , Brooks Roger A , McCaskie Andrew W , Lelliott Christopher J. , Choudhary Jyoti S , Bassett JH Duncan , Williams Graham R , Wilkinson J Mark , Zeggini Eleftheria 
Published: November 2019

AbstractOsteoarthritis causes pain and functional disability for a quarter of a billion people worldwide, with no disease-stratifying tools nor modifying therapy. Here, we use primary cartilage and synovium from osteoarthritis patients to construct a molecular quantitative trait locus map of gene expression and protein abundance. By integrating data across omics levels, we identify likely effector genes for osteoarthritis-associated genetic signals. We detect pronounced molecular differences between macroscopically intact and highly degenerated cartilage. We identify molecularly-defined patient subgroups that correlate with clinical characteristics, stratifying patients on the basis of their molecular profile. We construct and validate a 7-gene classifier that reproducibly distinguishes between these disease subtypes, and identify potentially actionable compounds for disease modification and drug repurposing.
Attenuation of epigenetic regulator SMARCA4 and ERK-ETS signaling suppresses aging-related dopaminergic degeneration
Authors: Sun Ling , Zhang Jie , Chen Wenfeng , Chen Yun , Zhang Xiaohui , Yang Mingjuan , Xiao Min , Ma Fujun , Yao Yizhou , Ye Meina , Zhang Zhenkun , Chen Kai , Chen Fei , Ren Yujun , Ni Shiwei , Zhang Xi , Yan Zhangming , Sun Zhi-Rong , Zhou Hai-Meng , Yang Hongqin , Xie Shusen , Haque M Emdadul , Huang Kun , Yang Yufeng 
Published: November 2019

ABSTRACTParkinson’s disease (PD) is a complex disease with high heterogeneity. How complex interactions of genetic, environmental factors and aging jointly contribute to dopaminergic degeneration in PD is largely unclear. Here, we applied frequent gene co-expression analysis on human patient substantia nigra-specific microarray datasets to identify potential novel disease-related genes. In vivo Drosophila studies validated two of 32 candidate genes, a chromatin remodeling factor SMARCA4 and a biliverdin reductase BLVRA. Inhibition of SMARCA4 was able to prevent dopaminergic degeneration not only caused by overexpression of BLVRA but also in four most common Drosophila PD models. Mechanistically, aberrant SMARCA4 and BLVRA converged on elevated ERK-ETS activity, attenuation of which by either genetic or pharmacological manipulation effectively suppressed dopaminergic degeneration in vivo. Drug inhibition of MEK/ERK also mitigated mitochondrial defects in PD gene-deficient human cells. Our findings underscore the important role of epigenetic regulators and implicate a common signaling axis for therapeutic intervention in a broad range of aging-related disorders including PD.
Maximum likelihood estimation of natural selection and allele age from time series data of allele frequencies
Authors: He Zhangyi , Dai Xiaoyang , Beaumont Mark , Yu Feng 
Published: November 2019

AbstractTemporally spaced genetic data allow for more accurate inference of population genetic parameters and hypothesis testing on the recent action of natural selection. In this work, we develop a novel likelihood-based method for jointly estimating selection coefficient and allele age from time series data of allele frequencies. Our approach is based on a hidden Markov model where the underlying process is a Wright-Fisher diffusion conditioned to survive until the time of the most recent sample. This formulation circumvents the assumption required in existing methods that the allele is created by mutation at a certain low frequency. We calculate the likelihood by numerically solving the resulting Kolmogorov backward equation backwards in time while re-weighting the solution with the emission probabilities of the observation at each sampling time point. This procedure reduces the two-dimensional numerical search for the maximum of the likelihood surface for both the selection coefficient and the allele age to a one-dimensional search over the selection coefficient only. We illustrate through extensive simulations that our method can produce accurate estimates of the selection coefficient and the allele age under both constant and non-constant demographic histories. We apply our approach to re-analyse ancient DNA data associated with horse base coat colours. We find that ignoring demographic histories or grouping raw samples can significantly bias the inference results.