bluuebunny/crossref_metadata_2025_split huggingface dataset:
N-Acetyl-L-Cysteine Reduces Fibrosis and Improves Muscle Function After Acute Compartment Syndrome Injury
Authors: Yosef Benyam , Zhou Yu , Mouschouris Kathryn , Poteracki James , Soker Shay , Criswell Tracy 
Published: February 2020

ABSTRACT

Introduction
Upon injury, skeletal muscle undergoes a multiphase process beginning with degeneration of the damaged tissue, which is accompanied by inflammation and finally regeneration. One consequence of an injured microenvironment is excessive production of reactive oxygen species, which results in attenuated regeneration and recovery of function ultimately leading to fibrosis and disability. The objective of this research was to test the potential of the antioxidant, N-Acetyl-L-Cysteine (NAC), as a mediator of reactive oxygen species damage that results from traumatic muscle injury in order to support repair and regeneration of wounded muscle tissue and improve function recovery.

Materials and Methods
Adult female Lewis rats were subjected to compartment syndrome injury as previously published by our group. Rats received intramuscular injections of NAC or vehicle at 24, 48, and 72 hours postinjury. Muscle function, tissue fibrosis, and the expression of myogenic and angiogenic markers were measured.

Results
Muscle function was significantly improved, and tissue fibrosis was significantly decreased in NAC-treated muscles.

Conclusions
These results suggest that NAC treatment of skeletal muscle after injury may be a viable option for the prevention of long-term fibrosis and scar formation, facilitating recovery of muscle function.
Proteomic Analysis of Inflammatory Biomarkers Associated With Breast Cancer Recurrence
Authors: Bera Alakesh , Russ Eric , Srinivasan Muthu , Eidelman Ofer , Eklund Michael , Hueman Matthew , Pollard Harvey B , Hu Hai , Shriver Craig D , Srivastava Meera 
Published: February 2020

ABSTRACTIntroductionBreast cancer is the most frequent cancer detected for women, and while our ability to treat breast cancer has improved substantially over the years, recurrence remains a major obstacle. Standard screening for new and recurrent breast cancer involves clinical breast imaging. However, there is no clinically approved noninvasive body fluid test for the early detection of recurrent breast cancer. Materials and Method: In this study, we analyzed serum samples from both recurrent and nonrecurrent breast cancer patients by different proteomics methods to identify biomarkers in patients with recurrence of disease.ResultsComparative data analysis identified several histone deacetylase (HDAC) proteins, which were found at significantly higher levels in the serum of recurrent breast cancer patients: HDAC9 (C-term) (P = 0.0035), HDAC5 (C-term) (P = 0.013), small ubiquitin-like modifier 1 (N-term) (P = 0.017), embryonic stem cell-expressed Ras (inter) (P = 0.018), and HDAC7 (C-term) (P = 0.020). Chronic inflammation plays a critical role in the development of the breast cancer recurrence, and we identified several proinflammatory cytokines that were present at elevated levels only in recurrent breast cancer patient serum.ConclusionsOur data indicated that the epigenetic regulation of inflammatory processes plays a critical role in breast cancer recurrence. The identified proteins could lay the groundwork for the development of a serum-based breast cancer recurrence assay.
Ultrasound Evaluation of the Peroneal Tendons in an Asymptomatic Elite Military Population: A Prospective Cohort Study
Authors: Martin Kevin , Wake Jeffrey , Van Buren J Preston 
Published: February 2020

ABSTRACT

Introduction
The purpose of this study was to identify the location of the peroneal tendons in relationship to the fibular groove in an asymptomatic population of elite U.S. Military Service members.

Materials and Methods
The peroneal tendons of 41 active duty U.S. Army Rangers were examined. Subjects were placed in a lateral recumbent position with the ankle in a resting neutral position to visualize the tendon in a retromalleolar short-axis view. Maximum active ankle eversion followed by gravity inversion was facilitated while the ultrasound probe was maintained in its original position. Distance from the fibrous lateral ridge of the retromalleolar groove to the anterior aspect of the peroneal brevis was measured in the short axis in neutral, eversion, and inversion.

Results
The mean sagittal distance and standard deviation was 0.48 ± 0.9 mm. No subjects demonstrated greater than 1 mm difference between positions, and no dislocations were identified. Side-to-side difference and dominant vs nondominant differences were not statistically significant.

Conclusion
The study demonstrates that the distance between the peroneal brevis and the lateral fibular ridge is consistent throughout extremes of motion. These results further the understanding of peroneal tendon function under dynamic examination. Our findings also establish side-to-side consistency prompting a bilateral examination to help identify abnormal pathology.
Traumatic Brain Injuries: Unreported and Untreated in an Army Population
Authors: Escolas Sandra M , Luton Margie , Ferdosi Hamid , Chavez Bianca D , Engel Scot D 
Published: February 2020

ABSTRACT

Introduction
In 2008, it was reported that 19.5% of service members previously deployed experienced a mild traumatic brain injury (mTBI). Fifty-seven percent of those did not seek medical care. It was suggested that concerns with seeking care involved confidentiality and career issues. Objective: This study addressed mTBI history, medical treatment history, and stigmas associated with mTBI/concussion.

Materials and Methods
An anonymous questionnaire was developed. Data collection occurred throughout March 2018 in conjunction with Brain Injury Awareness Month activities.

Results
All 5,174 volunteers were Army; 86% male; 87% were between 18 and 34 years old; 89% had &lt;14 years in the military; 35% had a combat deployment; and 10% reported having one or more mTBIs in their military careers. Of the Soldiers who reported a concussion, 52% sought medical care. Of those not seeking care, 64% reported they did not think the injury required care, followed by 18% fearing negative impact on their career. Twenty-eight percent who experienced an mTBI versus 11% who have not reported that there is a stigma associated with an mTBI.

Conclusions
Soldiers sometimes failed to report their suspected concussions and did not seek medical care. Educational efforts may increase reporting of and medical screening for potentially concussive events. Future research to determine the ramifications of unreported and untreated mTBIs/concussions is recommended.
Hand Surgeon Perspectives on Upper Extremity Allograft: A Survey of the American Society for Surgery of the Hand
Authors: Archual Anthony J , Lee Andy C H , DeGeorge Brent R 
Published: February 2020

ABSTRACT

Introduction
Allograft tissue products have widespread applications across surgical specialties, but little data exist about surgeon attitudes toward the use of these products in the upper extremity.

Methods
Using a web-based survey, we sought to investigate the use of and feelings toward allograft products among hand surgeons. A short questionnaire was distributed to all active members of American Society for Surgery of the Hand as of October 2015 (N = 2,578). Demographic and practice setting information was collected. Additionally, questions concerning the use of human allograft tissue products of various types including bone, skin, and soft tissues were asked.

Results
Of 2,578 American Society for Surgery of the Hand members, 406 hand surgeons (15.8%) responded to the survey. A large majority (92%) reported having used allograft products in the upper extremity. Orthopedic-trained surgeons were more likely to have used bone and tendon allograft, whereas plastic and general surgery-trained surgeons were more likely to have used nerve and dermis allograft. Reduced donor site morbidity and complication rates were factors motivating surgeons to use allograft tissue.

Conclusions
In spite of variation with respect to their use, allograft tissue products are popular and interest in new products, especially to improve flexor tendon pulley reconstruction, is high.
Assessing Surgical Task Load and Performance: A Comparison of Simulation and Maritime Operation
Authors: Spitzer Holly V , Hoang Tuan , Pierce Eric , Franciose Reginald J , Pena Matthew , Shattuck Nita L , Bass Cameron R , Blankenship Jeffrey , Juliano Michael , Lindemann Cameron B , Springer Hayden A , LaPorta Anthony J 
Published: February 2020

ABSTRACTIntroductionThis study examined the effects of simulated and actual vessel motion at high seas on task load and surgical performance.MethodsThis project was performed in phases. Phase I was a feasibility study. Phase II utilized a motion base simulator to replicate vessel motion. Phase III was conducted aboard the U.S. Naval Ship Brunswick. After performing surgical tasks on a surgical simulation mannequin, participants completed the Surgical Task Load Index (TLX) designed to collect workload data. Simulated surgeries were evaluated by subject matter experts.ResultsTLX scores were higher in Phase III than Phase II, particularly at higher sea states. Surgical performance was not significantly different between Phase II (84%) and Phase III (89%). Simulated motions were comparable in both phases.ConclusionsSimulated motion was not associated with a significant difference in surgical performance or deck motion, suggesting that this simulator replicates the conditions experienced during surgery at sea on the U.S. Naval Ship Brunswick. However, Surgical TLX scores were dramatically different between the two phases, suggesting increased workload at sea, which may be the result of time at sea, the stress of travel, or other factors. Surgical performance was not affected by sea state in either phase.
Comparison of Three Devices to Measure Pressure for Acute Compartment Syndrome
Authors: Merle Geraldine , Comeau-Gauthier Marianne , Tayari Vahid , Kezzo Mohamad Nizar , Kasem Chrouk , Al-Kabraiti Faisal , Laverdiere Carl , Xereas George , Harvey Edward J 
Published: February 2020

Abstract
Introduction: Acute compartment syndrome (ACS) is a well-recognized and common emergency. Undiagnosed ACS leads to muscle necrosis, limb contracture, intractable pain, and may even result in amputation. Methods: Three devices (Synthes, Stryker, and MY01) were compared in a pre-clinical rat abdominal compartment syndrome simulation. Simultaneous measurements of intracompartmental pressures allowed concurrent comparison among all devices. Results: Large variations from the reference values are seen with the Synthes and Stryker devices. Variances are large in these two devices even under ideal conditions. The MY01 device was the truest indicator of reference pressure in this ACS model (over 600% more accurate). Conclusions: The MY01 device was the most accurate device in tracking pressure changes in this rat model of abdominal compartment syndrome.
Diffusion Tensor Tractrography Visualizes Partial Nerve Laceration Severity as Early as 1 Week After Surgical Repair in a Rat Model Ex Vivo
Authors: Farinas Angel F , Manzanera Esteve Isaac V , Pollins Alonda C , Cardwell Nancy L , Does Mark D , Dortch Richard D , Thayer Wesley P 
Published: February 2020

Abstract
Background: Previous studies in our laboratory have demonstrated that a magnetic resonance imaging method called diffusion tensor imaging (DTI) can differentiate between crush and complete transection peripheral nerve injuries in a rat model ex vivo. DTI measures the directionally dependent effect of tissue barriers on the random diffusion of water molecules. In ordered tissues such as nerves, this information can be used to reconstruct the primary direction of diffusion along fiber tracts, which may provide information on fiber tract continuity after nerve injury and surgical repair. Methods: Sprague-Dawley rats were treated with different degrees of partial transection of the sciatic nerve followed by immediate repair and euthanized after 1 week of recovery. Nerves were then harvested, fixed, and scanned with a 7 Tesla magnetic resonance imaging to obtain DTIand fiber tractography in each sample. Additional behavioral (sciatic function index, foot fault asymmetry) and histological (Toluidine blue staining) assessments were performed for validation. Results: Tractography yielded a visual representation of the degree of injury that correlated with behavioral and histological evaluations. Conclusions: DTI tractography is a noninvasive tool that can yield a visual representation of a partial nerve transection as early as 1 week after surgical repair.
The Prehospital Evaluation and Care of Moderate/Severe TBI in the Austere Environment
Authors: Gurney Jennifer M , Loos Paul E , Prins Mayumi , Van Wyck David W , McCafferty Randall R , Marion Donald W 
Published: February 2020

AbstractIncreased resource constraints secondary to a smaller medical footprint, prolonged evacuation times, or overwhelming casualty volumes all increase the challenges of effective management of traumatic brain injury (TBI) in the austere environment. Prehospital providers are responsible for the battlefield recognition and initial management of TBI. As such, targeted education is critical to efficient injury recognition, promoting both provider readiness and improved patient outcomes. When austere conditions limit or prevent definitive treatment, a comprehensive understanding of TBI pathophysiology can help inform acute care and enhance prevention of secondary brain injury. Field deployable, noninvasive TBI assessment and monitoring devices are urgently needed and are currently undergoing clinical evaluation. Evidence shows that the assessment, monitoring, and treatment in the first few hours and days after injury should focus on the preservation of cerebral perfusion and oxygenation. For cases where medical management is inadequate (eg, evidence of an enlarging intracranial hematoma), guidelines have been developed for the performance of cranial surgery by nonneurosurgeons. TBI management in the austere environment will continue to be a challenge, but research focused on improving evidence-based monitoring and therapeutic interventions can help to mitigate some of these challenges and improve patient outcomes.
Analysis of Casualties That Underwent Airway Management Before Reaching Role 2 Facilities in the Afghanistan Conflict 2008–2014
Authors: Hudson Ian L , Blackburn Megan B , Staudt Amanda M , Ryan Kathy L , Mann-Salinas Elizabeth A 
Published: February 2020

AbstractIntroductionAirway compromise is the second leading cause of potentially survivable death on the battlefield. The purpose of this study was to better understand wartime prehospital airway patients.Materials and MethodsThe Role 2 Database (R2D) was retrospectively reviewed for adult patients injured in Afghanistan between February 2008 and September 2014. Of primary interest were prehospital airway interventions and mortality. Prehospital combat mortality index (CMI-PH), hemodynamic interventions, injury mechanism, and demographic data were also included in various statistical analyses.ResultsA total of 12,780 trauma patients were recorded in the R2D of whom 890 (7.0%) received prehospital airway intervention. Airway intervention was more common in patients who ultimately died (25.3% vs. 5.6%); however, no statistical association was found in a multivariable logistic regression model (OR 1.28, 95% CI 0.98–1.68). Compared with U.S. military personnel, other military patients were more likely to receive airway intervention after adjusting for CMI-PH (OR 1.33, 95% CI 1.07–1.64).ConclusionsIn the R2D, airway intervention was associated with increased odds of mortality, although this was not statistically significant. Other patients had higher odds of undergoing an airway intervention than U.S. military. Awareness of these findings will facilitate training and equipment for future management of prehospital/prolonged field care airway interventions.
Evidence of Pathogen-Induced Immunogenetic Selection across the Large Geographic Range of a Wild Seabird
Authors: Levy Hila , Fiddaman Steven R , Vianna Juliana A , Noll Daly , Clucas Gemma V , Sidhu Jasmine K H , Polito Michael J , Bost Charles A , Phillips Richard A , Crofts Sarah , Miller Gary D , Pistorius Pierre , Bonnadonna Francesco , Le Bohec Céline , Barbosa Andrés , Trathan Phil , Raya Rey Andrea , Frantz Laurent A F , Hart Tom , Smith Adrian L 
Published: February 2020

AbstractOver evolutionary time, pathogen challenge shapes the immune phenotype of the host to better respond to an incipient threat. The extent and direction of this selection pressure depend on the local pathogen composition, which is in turn determined by biotic and abiotic features of the environment. However, little is known about adaptation to local pathogen threats in wild animals. The Gentoo penguin (Pygoscelis papua) is a species complex that lends itself to the study of immune adaptation because of its circumpolar distribution over a large latitudinal range, with little or no admixture between different clades. In this study, we examine the diversity in a key family of innate immune genes—the Toll-like receptors (TLRs)—across the range of the Gentoo penguin. The three TLRs that we investigated present varying levels of diversity, with TLR4 and TLR5 greatly exceeding the diversity of TLR7. We present evidence of positive selection in TLR4 and TLR5, which points to pathogen-driven adaptation to the local pathogen milieu. Finally, we demonstrate that two positively selected cosegregating sites in TLR5 are sufficient to alter the responsiveness of the receptor to its bacterial ligand, flagellin. Taken together, these results suggest that Gentoo penguins have experienced distinct pathogen-driven selection pressures in different environments, which may be important given the role of the Gentoo penguin as a sentinel species in some of the world’s most rapidly changing environments.
Evaluation of Renal Safety Between Imipenem/Relebactam and Colistin Plus Imipenem in Patients With Imipenem-Nonsusceptible Bacterial Infections in the Randomized, Phase 3 RESTORE-IMI 1 Study
Authors: Brown Michelle L , Motsch Johann , Kaye Keith S , File Thomas M , Boucher Helen W , Vendetti Neika , Aggrey Angela , Joeng Hee-Koung , Tipping Robert W , Du Jiejun , DePestel Daryl D , Butterton Joan R , Paschke Amanda 
Published: February 2020

AbstractBackgroundIn the randomized controlled RESTORE-IMI 1 clinical trial (NCT02452047), imipenem/cilastatin (IMI) with relebactam (IMI/REL) was as effective as colistin plus IMI for the treatment of imipenem-nonsusceptible gram-negative infections. Differences in nephrotoxicity were observed between treatment arms. As there is no standard definition of nephrotoxicity used in clinical trials, we conducted analyses to further understand the renal safety profile of both treatments.MethodsNephrotoxicity was retrospectively evaluated using 2 acute kidney injury assessment criteria (Kidney Disease Improving Global Outcomes [KDIGO] and Risk, Injury, Failure, Loss, and End-stage Kidney Disease [RIFLE]). Additional outcomes included time to onset of protocol-defined nephrotoxicity and incidence of renal adverse events.ResultsOf 47 participants receiving treatment, 45 had sufficient data to assess nephrotoxicity (IMI/REL, n = 29; colistin plus IMI, n = 16). By KDIGO criteria, no participants in the IMI/REL but 31.3% in the colistin plus IMI group experienced stage 3 acute kidney injury. No IMI/REL-treated participants experienced renal failure by RIFLE criteria, vs 25.0% for colistin plus IMI. Overall, the time to onset of nephrotoxicity varied considerably (2–22 days). Fewer renal adverse events (12.9% vs 37.5%), including discontinuations due to drug-related renal adverse events (0% vs 12.5%), were observed in the IMI/REL group compared with the colistin plus IMI group, respectively.ConclusionsOur analyses confirm the findings of a preplanned end point and provide further evidence that IMI/REL had a more favorable renal safety profile than colistin-based therapy in patients with serious, imipenem-nonsusceptible gram-negative bacterial infections.ClinicalTrials.gov IdentifierNCT02452047.
Parental Separation during Childhood and Adult Children’s Wealth
Authors: Lersch Philipp M , Baxter Janeen 
Published: February 2020

AbstractThis study examines the association between parental separations during childhood and economic wealth of adult children. We provide a new test of this relationship and address two unresolved debates in the literature concerning (1) the pathways linking parental separation and adult children’s wealth and (2) the relevance of the timing of exposure. We use data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey on 16,652 individuals and estimate mixed effects models after matching to predict adult children’s wealth. We find that parental separation is associated with about 46 percent less net wealth for adult children. The negative association is limited to adult children who experienced parental divorce before age 15. The association does not differ between children who experienced parental divorce before age 6 and between age 6 and 14. We identify reduced education and earning capacities, unstable family structures among adult children and less future-oriented time preferences as likely mechanisms through which parental separation influences adult children’s wealth.
Angioedema without urticaria: novel findings which must be measured in clinical setting
Authors: Veronez Camila Lopes , Grumach Anete Sevciovic 
Published: February 2020

Purpose of reviewAngioedema without urticaria is composed of an increasing subtype's variety and presents a challenging diagnosis. This review summarizes the subtypes recently described and subsequent new findings helpful within their classification.Recent findingsNew methods to measure cleaved high molecular weight kininogen and activated plasma kallikrein have emerged as potential biochemical tests to identify bradykinin-mediated angioedema. Three new subtypes of hereditary angioedema (HAE) with normal C1 inhibitor were described in the past two years: HAE due to mutation in plasminogen gene, in kininogen gene, and in angiopoietin-1 gene; implicating the fibrinolytic and contact systems, and the regulation of vasculature, respectively. The understanding of some mechanisms in angioedema has been improved, compatible to the dominant-negative for some C1 inhibitor variants; furthermore, the increased activation of truncated F12 mutants by plasma kallikrein; and the diminished binding of angiopoietin-1 to its receptor.SummaryThe validation of biomarkers for the contact system activation could be beneficial in differentiating bradykinin – from histaminergic-mediated angioedema. Currently, the available laboratorial tests are still somewhat restricted to the evaluation of the complement activation and the mediators of nonhistaminergic and nonbradykinin-mediated angioedema remain to be identified.