bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trajectory analysis of sleep maintenance problems in midlife women before and after surgical menopause: the Study of Women's Health Across the Nation (SWAN)
Authors: Kravitz Howard M. , Matthews Karen A. , Joffe Hadine , Bromberger Joyce T. , Hall Martica H. , Ruppert Kristine , Janssen Imke 
Published: January 2020

Abstract

Objective:
Investigate temporal patterns of sleep maintenance problems in women who became surgically menopausal (hysterectomy with bilateral oophorectomy) before their final menstrual period and examine whether presurgery trajectories of sleep maintenance problems are related to problems staying asleep postsurgery.

Methods:
Longitudinal analysis of sleep self-reports collected every 1 to 2 years from 1996 to 2013 from 176 surgically menopausal women in the Study of Women's Health Across the Nation, a seven-site community-based, multiethnic/multiracial, cohort study. Median follow-up was 15.3 years (4.2 years presurgery, 10.2 years postsurgery). Group-based trajectory modeling was used to identify patterns of problems staying asleep, and the presurgery trajectories were used to predict similar postsurgery sleep problems.

Results:
Four trajectory patterns of sleep maintenance problems were identified: low (33.5% of women), moderate (33.0%), increasing during presurgery (19.9%), and high (13.6%). One-fifth of women reported a presurgery increase in these problems. Postsurgically, problems staying asleep remained associated with similar levels of presurgical problems, even after adjusting for postsurgical early morning awakening, frequent vasomotor symptoms, and bodily pain score (βlow = −1.716, βmoderate = −1.144, βincreasing = −0.957, βhigh = −1.021; all P values <0.01).

Conclusions:
Sleep maintenance problems were relatively stable across time postsurgery. These data are remarkably consistent with our trajectory results across the natural menopause, suggesting that presurgical assessment of sleep concerns could help guide women's expectations postsurgically. Although reassuring that sleep complaints do not worsen postsurgically for most surgically menopausal women, referral to a sleep specialist should be considered if sleep symptoms persist or worsen after surgery.
Use of an Imaging Spectrometer for Characterization of a Cesium Dosimeter Calibration Facility
Authors: Champion Roger J. , Golduber Robert M. , Kearfott Kimberlee J. 
Published: January 2020

Abstract
Past investigations into the characterization of a space-constrained 137Cs dosimetry calibration facility did not provide detailed positional measurements of gamma ray spectra. In this paper, a commercially available Compton imaging system, or imaging spectrometer, was used to accomplish this. This resulted in both spectral information and point of origin information for the measured gamma rays. The relationship between measured spectra and position was explored relative to a dosimetry phantom. The Compton equation was found to accurately describe the relationship for positions associated with larger scattering angles and was found to be less reliable for those associated with smaller angles.
Characterization of Primary Human Dermal Fibroblasts to Ensure for Instance EMF Exposure Experiments under Comparable Cell Culture Condition
Authors: Franchini Valeria , Müller Thomas , Haupt Julian M. , Ostheim Patrick , Majewski Matthaeus , Lista Florigio , Port Matthias , Abend Michael 
Published: January 2020

Abstract
HDFa (human dermal fibroblasts) are used as cellular models for EMF exposure. To ensure reproducible in vitro experiments, comparable proliferation and differentiation cell conditions must exist, and different donors, passage numbers, culture time, and growth media must be considered. In this study, the authors cultured fibroblasts in DMEM or 106 medium. Growth curves, vitality, morphology, and gene expression of genes coding for proliferation (PCNA, CDKN2A, CDKN1A, SFN), differentiation (PDGFRA, TGM2, ACTA2, PDPN, NTN1, MGP, PPP1R14), and SFN target genes (TP63, MMP1, MMP3) were examined in both media and passage numbers 3–4, 5-6 and >6. At passages 3–4, proliferating cells can be observed in both media. While cells cultured in DMEM proliferate over the passages, from passage 5, cells in 106 medium persisted around the seeded number. TGM2 down-regulation over all passages in both media and cells morphology suggest papillary-type fibroblasts. Downregulation of SFN (negative regulator of mitotic translation and cell differentiation) coincided with proliferating fibroblasts over all examined conditions. Downstream SFN target genes in proliferating cells appeared upregulated (TP63) and downregulated (MMP1/MMP3), suggestive for a status characterized by increased stemnesses (upregulated TP63) and wound healing capacity (downregulated MMP1, MMP3). Resting cells (SFN control values) were associated with control values of TP63 and MMP1/MMP3 expression, suggesting a reduced stemness and wound healing capacity. In conclusion, a set of markers related to proliferation (SFN), differentiation (TGM2), stemnesses (TP63), and wound healing (MMP1/MMP3) allow a culture characterization so that cells under two different conditions can be exposed, thus enabling reproducible EMF experiments or experiments with other exposures.
Relationship of the Perme ICU Mobility Score and Medical Research Council Sum Score With Discharge Destination for Patients in 5 Different Intensive Care Units
Authors: Perme Christiane , Schwing Terrence , deGuzman Kirsten , Arnold Catherine , Stawarz-Gugala Agata , Paranilam Jaya , Estrada Cecilia , Lapnawan Jenny , Mondkar Rajashree , Ragsdale Judith 
Published: January 2020

Background:
Measurement tools are increasingly used to quantify impairments in mobility and muscle strength of patients in the intensive care unit (ICU), yet little evidence exists to support the relationship between measurement tools and discharge destination.

Objective:
The aim of this study is to investigate whether a relationship between the Perme ICU Mobility Score (Perme Score) and the Medical Research Council Sum Score (MRC-SS) exists between either of these 2 measurement tools and discharge destination for patients in the ICU.

Design:
The Perme Score and the MRC-SS were performed on patients during the initial physical therapy (PT) evaluation in 5 different ICUs. Data were analyzed to determine whether a relationship exists between either of these scores and discharge destination.

Methods:
Data were collected on 250 patients in 5 ICUs during the initial PT evaluation.

Results:
Patients in the ICU with a higher Perme Score or MRC-SS at the time of PT evaluation were discharged home whereas those with lower scores required postacute care placement.

Conclusion:
The results from this study demonstrate the potential use of the Perme Score or the MRC-SS as standardized measurement tools to assist physical therapists in providing discharge recommendations in the ICU.
Knowledge of the Human Papillomavirus by Social Stratification Factors
Authors: Fernández-Feito Ana , Lana Alberto , Parás Bravo Paula , Pellico López Amada , Paz-Zulueta María 
Published: January 2020

Background
Social determinants of health explain most health inequities. Intermediate determinants dictate differences in the exposure and vulnerability of people based on social stratification. Vulnerable women (lower education level, older age, uninsured, etc.) have lower adherence to recommended Pap smear screening guidelines. However, a gap remains concerning the effect of social determinants on human papillomavirus (HPV) infection.

Objectives
The aim of this study was to analyze the association between the level of knowledge about HPV infection and HPV vaccines with education level and residential setting among a sample of Spanish women.

Methods
A cross-sectional study at six primary care centers (Cantabria, Spain) was performed. All women >21 years consecutively attended by midwives for routine follow-up were invited to participate during the study period (2015–2016) until a convenience sample was recruited. Participants completed an anonymous questionnaire addressing sociodemographic variables (age, education level, and residential setting) and the level of knowledge regarding HPV infection, including general knowledge about infection and knowledge about the HPV vaccine. Associations between education level (primary, secondary, and university) and residential setting (urban, semiurban, and rural) with the level of knowledge of HPV infection and HPV vaccine were calculated using adjusted logistic regressions. Dose–response associations were estimated based on p-trend.

Results
Compared to university women, a lower education level was associated with limited or no knowledge of either HPV infection or the HPV vaccine. Women living in rural areas poorly identified “promiscuity” as a risk factor of HPV infection and “the use of condoms” as a protective factor. Moreover, living in rural areas was associated with limited or no knowledge of HPV infection and HPV vaccine. There were significant dose–response trends; those who were more educated and living in more urban areas had more knowledge about either HPV infection or the vaccine.

Discussion
In our sample, the level of knowledge of HPV infection and HPV vaccine was high. However, vulnerable women, defined by a lower education level and living in rural areas, presented a greater lack of knowledge regarding HPV infection and the HPV vaccine.
Weight Gain and Blood Pressure in Toddlers Born Very Preterm
Authors: Rodriguez Jeannie , Adams-Chapman Ira , Affuso Olivia , Azuero Andres , Downs Charles A. , Turner-Henson Anne , Rice Marti 
Published: January 2020

Background
Preterm birth is a risk factor for elevated blood pressure in childhood and the development of hypertension and cardiometabolic disease in adulthood; however, mechanisms for the development of both are poorly understood. Rapid weight gain early in childhood may serve as a driver directly and indirectly through cortisol levels found to be elevated in early childhood in individuals born preterm.

Objectives
The objective of this pilot study was to examine the effect sizes of the relationships between weight gain and blood pressure in toddlers born very preterm. A secondary aim was to note any mediating effect of cortisol on the relationships between weight gain and blood pressure.

Methods
A cross-sectional design with a convenience sample of 36 toddlers who were born very preterm was used to examine the relationships between postnatal weight gain, cortisol, and blood pressure at follow-up.

Results
Many of the participants experienced rapid weight gain in the first 12 months of life. Mean systolic and diastolic readings were 94 and 56.6, respectively. Diastolic blood pressure readings were obtained from 23 participants, and the majority were elevated. Weight gain was associated with diastolic blood pressure with a medium effect size. A mediating role with cortisol was not supported.

Discussion
Although findings need to be validated in a larger sample, the blood pressure elevations in this sample were alarming. If readings continue to amplify as these children age, the fact that elevations are already present during the toddler period could indicate more significant cardiovascular disease in adulthood for this population. Rapid weight gain in early life may be a driver for elevated blood pressure even during early childhood in individuals born preterm.
An Intraoperative Salvage After Transection of the Greater Palatine Artery During Cleft Palate Repair: A Case for Buccal Fat and Buccal Myomucosal Flaps
Authors: Ayyash Ali M. , Anstadt Erin E. , Dvoracek Lucas A. , Marji Fady P. , Lee Jonathan Y. , Losee Joseph E. , Goldstein Jesse A. 
Published: January 2020

Abstract
Recently, several adjunctive procedures have gained traction to aid cleft surgeons in repairing especially challenging palatal clefts. Buccal fat flaps and buccal myomucosal flaps have demonstrated particular utility in reinforcing thin palatal flaps or tissue deficits. Although their use has not been widely accepted, they may be particularly helpful in the setting of significant scarring or vascular compromise. Here the authors describe the case of an intraoperative salvage using bilateral buccal fat flaps and a right buccal myomucosal flap after transection of the right Greater Palatine artery (GPA) during palatoplasty on a 14-month old female with Pierre Robin Sequence and a wide Veau II cleft palate. For this operative salvage, bilateral buccal fat flaps were used to reinforce the hard-soft palate junction and a 4 cm × 2 cm flap of the right-sided buccal mucosa and buccinator muscle was inset along the majority of the right-sided soft and posterior hard palate. At 2 years follow-up, the patient had no significant complications and was doing well with healthy-appearing palatal tissue and age-appropriate speech.
Orbit in a Box: A Simplified Technique for Patient-Specific Virtually Planned Orbital Floor Reconstruction
Authors: Menzel Christoph Lothar , Hammacher Andreas , Lommen Julian , Schorn Lara Katharina Franziska , Handschel Jörg , Holtmann Henrik 
Published: January 2020

Purpose:
Possibilities for the reconstruction of orbital floor fractures have been extensive for years with regard to materials, methods and differential indications and are inconsistent worldwide. With the spread of CAD/CAM techniques, new and mostly time-consuming possibilities for orbital floor reconstructions have been added.

Methods:
The simple and time-efficient CT-to-patient-specific implant workflow presented here shows that a “form-box” can be created from a patient's computer tomography data set using planning software and a 3D printer. The box is then used to form a patient-specific implant for orbital floor reconstruction: here polydioxanone foil was used, for which stable thermoplastic deformability has been demonstrated for 3D reconstructions.

Results:
Patient-specific thermoplastic shaping of polydioxanone is feasible in a theoretical clinical setting, though its thermoplastic shaping is not yet certified for clinical use. However, a flexible adaptation of the “form-box” design to other materials is possible by setting a single planning parameter.

Conclusions:
The simple structure of the box and its straightforward planning/fabrication process with widely available low-cost materials offer the possibility that a surgeon without a 3D specialist can produce a “form-box” for next day surgery if needed.
Pediatric-Specific Midfacial Fracture Patterns and Management: Pediatric Versus Adult Patients
Authors: Fujisawa Kou , Suzuki Ayumi , Yamakawa Tomomi , Onishi Fumio , Minabe Toshiharu 
Published: January 2020

Purpose:
The purpose of this study was to compare the midfacial fracture patterns and management approaches between pediatric and adult patients.

Methods:
We retrospectively analyzed 164 pediatric patients (<16 years old) and 564 nongeriatric adult patients (16 to 65 years old) with midfacial fractures at a single institution between 2011 and 2016. The location of the fractures, along with the etiology and management of the midfacial fractures, were compared.

Results:
Significantly greater proportions of pediatric versus adult patients had sports-related injuries (P < 0.001) and sustained nasal fractures (P < 0.001). On the other hand, significantly greater proportions of adult versus pediatric patients were injured in falls, traffic accidents, or assaults (P = 0.004, P < 0.001, and P = 0.002) and sustained maxillary or zygomatic fractures (P = 0.039 and P < 0.001). Bivariate logistic regression analyses revealed that the risks of nasal, maxillary, and zygomatic fractures were significantly related to age status after adjusting for etiology (P < 0.001, P = 0.045, and P < 0.001). In contrast, the risks of hospitalization and surgical treatment were significantly associated with etiology, but not with age status (P = 0.290 and P = 0.847).

Conclusion:
These data suggest that the age-related structure and composition of the facial skeleton affect the pediatric-specific fracture patterns independent of the etiology. The comparisons in this study may serve as a guide for the management of pediatric midfacial fractures.
Treatment of the Patient With Crouzon Syndrome With Orthognathic Surgery
Authors: Sancar Bahadir , Tanisik Burakhan Hakan 
Published: January 2020

Abstract
Crouzon syndrome is a genetic disease that is transferred by autosomal dominant inheritance. Patients with this syndrome have craniosynostosis, hypertelorism, orbital proptosis, mid-face hypoplasia, mandibular prognathism, and concave facial profile. A number of surgical treatments are used to improve facial contours, and to correct dental and maxillary relationships. Orthognathic surgery is routinely used in the treatment of these patients. We present a female patient with Crouzon syndrome treated with Le Fort I and bilateral sagittal split osteotomy. Previously, surgically assisted rapid maxillary expansion (SARME) surgery was performed to the patient by separating the pterygomaxillary junction under general anesthesia. Down fracture was performed during the Le Fort I osteotomy without the need to separate the pterygomaxillary junction again. The facial appearance was improved with bilateral sagittal split osteotomy, and skeletal malocclusion between the jaws was treated.
Surgical Protocol for a Safe Lateral Nasal Wall Osteotomy
Authors: Suzen Muazzez , Temiz Mustafa , Demirel Oguzhan , Uckan Sina 
Published: January 2020

Purpose:
The purpose of this study was to define the anatomy and anatomic variations of the lateral nasal wall area to identify safe access points, determine the optimum osteotomy line for Le Fort I osteotomies, and define a surgical protocol.

Materials and Methods:
The angulations and widths of 160 lateral nasal walls and the distances of the greater palatine canal were measured on axial images from coronal sections 5 mm over the deepest point of the nasal base.

Results:
The average angle between the anterior lateral nasal wall and the medial maxillary sinus wall was 160 degrees in females and 165.67 degrees in males for the right and 155.90 degrees in females and 163.22 degrees in males for the left side. Statistically significant differences were found in the lengths, angulations, and widths of the lateral nasal walls between females and males.

Conclusion:
This study described the mean angulations and linear distances between anatomic structures of the lateral nasal wall and it defines the “Medipol protocol” for a safe osteotomy.
Adolescent Polypharmacy and Serotonin Syndrome
Authors: Davis Chemar R. , Hernandez Michael , Stock Saundra 
Published: January 2020

Objectives
The objective of this study was to present a case and review serotonin syndrome and the risk of occurrence in children and adolescents on multiple psychotropic medications.

Methods
The clinical history of a patient in the University of South Florida's child and adolescent psychiatry clinic is presented. Literature review on serotonin syndrome, attention-deficit/hyperactivity disorder (ADHD), and psychostimulants was conducted through PubMed.

Results/Discussion
We have presented a case of possible serotonin-related abnormal movements in an adolescent girl prescribed stimulants and multiple serotonergic medications. Serotonin syndrome may be precipitated through drug interactions that increase serum levels of psychotropic medications. Patients with ADHD often have comorbid psychiatric illness requiring treatment with medication. Amphetamine salts are an often-overlooked agent that potentiates serotonin through monoamine oxidase inhibitor (MAO) inhibition and neurotransmitter release. Children and adolescents on multiple psychotropic medications should be closely monitored for the triad of altered mental status, neuromuscular abnormalities, and autonomic hyperactivity.

Conclusions
Patients with ADHD often have comorbid psychiatric illness and are treated with multiple psychotropic medications. Given the effects of drug-drug interactions and the serotonergic effects of psychostimulants, clinicians should remain vigilant for the triad of altered mental status, neuromuscular abnormalities, and autonomic hyperactivity seen in serotonin syndrome.
Coma Reversal After Intravenous Lipid Emulsion Therapy in a Trazodone-Poisoned Patient
Authors: Warnant Alexandra , Gerard Ludovic , Haufroid Vincent , Hantson Philippe 
Published: January 2020

Abstract
A 77-year-old woman developed a deep coma (Glasgow Coma Scale score at 3/15) after a trazodone overdose (maximal ingested dose, 4500 mg), and orotracheal intubation was required for mechanical ventilation. In addition, she presented sinus bradycardia (<40/min) with QTc prolongation, whereas arterial blood pressure was preserved. The administration of intravenous lipid emulsion (1.5 mL/kg as a bolus followed by a continuous infusion of 0.5 mL/kg per minute for 30 minutes) resulted in a rapid improvement of her neurological condition, with a Glasgow Coma Scale score rising from 3 to 10/15 at the end of intravenous lipid emulsion infusion. A significant increase in heart rate (from 39 to 54/min) was also observed. The treatment was well tolerated, and the patient did not experience ventricular dysrhythmias. In addition, the patient was found to have a reduced metabolic activity related to cytochrome P450 2D6 polymorphism.
Ares-GT: design of guide RNAs targeting multiple genes for CRISPR-Cas experiments
Authors: Minguet Eugenio G. 
Published: January 2020

ABSTRACTMotivationThere is a lack of tools to design guide RNA for CRISPR genome editing of gene families and usually good candidate sgRNAs are tagged with low scores precisely because they match several locations in the genome, thus time-consuming manual evaluation of targets is required. Moreover, online tools are limited to a restricted list of reference genome and lack the flexibility to incorporate unpublished genomes or contemplate genomes of populations with allelic variants.ResultsTo address these issues, I have developed the ARES-GT, a local command line tool in Python software. ARES-GT allows the selection of candidate sgRNAs that match multiple input query sequences, in addition of candidate sgRNAs that specifically match each query sequence. It also contemplates the use of unmapped contigs apart from complete genomes thus allowing the use of any genome provided by user and being able to handle intraspecies allelic variability and individual polymorphisms.AvailabilityARES-GT is available at GitHub (https://github.com/eugomin/ARES-GT.git).