bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osteosynthesis Using the Anatomical Plate With Grasping Arms for Unstable Distal Clavicle Fractures: A Technical Trick and Clinical Experience
Authors: Furuhata Ryogo , Takahashi Masaaki , Matsumura Noboru , Morioka Hideo 
Published: March 2021

Summary:
Plate fixation is an established method of treating distal clavicle fractures. However, it is often difficult to maintain the reduction of distal fragments with conventional plates, especially in cases where the distal fragments are small or comminuted. This study aimed to introduce a technical trick and clinical experience of osteosynthesis using an anatomical nonlocking plate with grasping arms (SCORPION NEO plate) for unstable distal clavicle fractures. During fixation, distal fragments are grasped by the plate arms and fixed with 2 screws. We retrospectively reviewed 41 patients who underwent osteosynthesis for unstable distal clavicle fractures (Neer type 2 and 5) using a SCORPION NEO plate. Patients were divided into 2 groups: type unstable 1, where the trapezoid ligament adhered to a distal fragment, and type unstable II (UII), where the trapezoid ligament adhered to a third fragment detached from a distal fragment. Although delayed union, plate loosening, plate-related pain, infection, and stiffness were observed in 2 (4.9%), 2 (4.9%), 3 (7.3%), 1 (2.4%), and 1 patient (2.4%), respectively; all fractures united at the time of final follow-up. Operating time for the UII group was significantly longer than that for the UI group. There were no significant differences between the 2 groups in postoperative complications and coracoclavicular distance ratios at the time of bone union. Our results demonstrated that osteosynthesis with the anatomical plate with grasping arms could be a viable option in the treatment of unstable distal clavicle fractures, especially in cases where distal fragments are not contiguous with the trapezoid ligament.
Surgical Site Complications in Open Pronation-Abduction Ankle Fracture–Dislocations With Medial Tension Failure Wounds
Authors: Martin Case W. , Ryan James C. , Bullock Travis S. , Cabot John H. , Makhani Ahmed A. , Griffin Leah P. , Zelle Boris A. 
Published: March 2021

Objectives:
To examine the incidence of surgical site complications associated with pronation-abduction ankle fracture–dislocations with an open medial tension wound.

Design:
Retrospective case series.

Setting:
Accredited Level-1 trauma center.

Patients/Participants:
Forty-eight open pronation-abduction ankle fracture–dislocations with medial tension failure wounds treated at our institution from 2014 to 2016.

Intervention:
Immediate irrigation and debridement along with surgical stabilization of open ankle fracture–dislocation.

Main Outcome Measures:
The primary outcome measure was deep surgical site infection. Secondary outcome measures included other surgical site complications and adverse radiographic events.

Results:
A total of 5 patients (10.4%) developed a deep surgical site infection requiring additional surgical debridement. One of the patients with a deep surgical site infection required a below-knee amputation as a result of sepsis. Adverse radiographic outcomes included 3 fibular nonunions (6.3%), 3 implant failures related to syndesmotic fixations (6.3%), one periimplant fracture (2.1%), and postoperative collapse of the tibial plafond in 3 patients (6.3%).

Conclusions:
Open pronation-abduction ankle fracture–dislocations with medial tension failure wounds remain a challenging and potentially devastating injury. Our study suggests that with appropriate surgical debridement, early stabilization, and primary wound closure, acceptable outcomes with a relatively low risk of surgical site complications can be achieved.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Acute Compartment Syndrome in Type IIIB Open Tibial Shaft Fractures Using a 2-Stage Orthoplastic Approach
Authors: Al-Hourani Khalid , Stoddart Michael , Pearce Oliver , Riddick Andrew , Khan Umraz , Kelly Michael B. 
Published: March 2021

Objective:
To determine the rate of acute compartment syndrome (ACS) in a series of patients with Gustilo–Anderson type IIIB open tibial shaft fractures that were treated using a specific 2-stage orthoplastic protocol.

Design:
Consecutive cohort study.

Patients/Participants:
Ninety-three (n = 93) consecutive patients with a type IIIB open tibial shaft fracture (OTA/AO-42) treated using a 2-stage orthoplastic approach, between August 2015 and January 2018. After exclusions, 83 (n = 83) were eligible for analysis.

Intervention:
Colloid resuscitation and 2-stage orthoplastic reconstruction of type IIIB open tibial shaft fracture. Stage 1 consists of “3-vessel view” early debridement and temporary internal fixation, with stage 2 consisting of a single-stage fix and flap.

Main Outcome Measurements:
Rate of ACS. Secondary outcomes included early/late sequelae of missed ACS, deep infection, arterial injury, nonunion, and flap failure.

Results:
Eighty-three (n = 83) patients were included for analysis. The median age was 45.4 years [interquartile range (IQR) 35] with a median follow-up of 1.6 years (IQR 0.8). The median number of operations was 2.0 (IQR 4). For the primary outcome, there were a total of 0 (0/83) patients who required fasciotomy or developed early/late clinical sequelae of missed ACS. Six (6/83, 7.2%) patients developed deep infection, 18 patients (18/83, 21.7%) experienced nonischemic arterial injury, 5 patients (5/83, 6.0%) experienced nonunion, with 4 patients (4/83, 4.8%) experiencing flap failure. Diabetes was the only variable associated with deep infection (P = 0.025) and nonunion (P < 0.001).

Conclusions:
Patients with type IIIB open tibial shaft fractures treated with colloid resuscitation and a 2-stage orthoplastic protocol, which includes early “3-vessel view” exposure and debridement, do not appear to develop ACS. Furthermore, no sequelae of missed compartment syndrome was observed at final follow-up.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Microbiological Evaluation of Opened Saline Bottles for Scleral Lens Use and Hygiene Habits of Scleral Lens Patients
Authors: Jeong Moon , Lee Karen L. , She Rosemary C. , Chiu Gloria B. 
Published: March 2021

SIGNIFICANCE
Scleral lenses have become a widely used treatment option for patients with irregular corneas and ocular surface disease. Successful wear entails use of a nonpreserved saline solution to fill the lens before application on the eye.

PURPOSE
The purposes of this study were to evaluate solution from opened bottles of multidose preservative-free saline for microbiological growth and to better understand study participant hygiene habits while handling these bottles for scleral lens wear.

METHODS
Eligible study participants in this single-center prospective study were patients who routinely used multidose preservative-free saline solution for scleral lens rinsing and filling. Study participants completed a 12-question survey regarding their scleral lens hygiene habits and donated their opened multidose preservative-free saline bottle (PuriLens Plus; The Lifestyle Company, Inc., Freehold, NJ), which was processed for bacterial and fungal cultures.

RESULTS
Thirty-five participants (19 males, 16 females) with ages ranging from 6 to 81 years (mean, 47.9 years) were included. Indications for scleral lens wear included those with irregular corneas and ocular surface disease. The overall rate of microbial contamination among saline samples was 62.9% (n = 22). Twenty-one different microorganisms were identified. The survey responses did not differ significantly (P > .05) for any of the questions with regard to likelihood of positive culture. There were no significant age or sex differences between participants with positive or negative culture results. No significant differences were found between isolation of specific microorganisms and any of the survey responses.

CONCLUSIONS
This study suggests that off-label multidose preservative-free saline commonly used to rinse and fill scleral lenses before application on the eye may become contaminated with microorganisms once the bottle has been opened. Eye care practitioners and scleral lens patients should be aware of these potential contaminations and prioritize lens, hand, and environmental hygiene to minimize the risk of ocular complications.
Gas-Permeable Contact Lenses and Water Exposure: Practices and Perceptions
Authors: Steele Kelsy R. , Wagner Heidi , Lai Nicky , Zimmerman Aaron B. 
Published: March 2021

SIGNIFICANCE
This study provides insight into the current recommendations, clinical behaviors, and risk assessments of eye care professionals on the topic of rigid contact lens exposure to tap water. This knowledge may motivate professional organizations to develop initiatives to educate eye care professionals on the dangers of contact lens exposure to water.

PURPOSE
The purpose of this study was to investigate the practice patterns and risk perceptions of eye care professionals regarding gas-permeable contact lens exposure to tap water.

METHODS
A branched-logic survey was started by 320 clinicians, vision scientists, and industry personnel and was fully completed by 272 participants. The survey queried participants about their current practices, recommendations, and perceptions of risk regarding exposure of gas-permeable contact lenses to tap water.

RESULTS
Of those who prescribe gas-permeable contact lenses, 57.4% reported rinsing lenses with tap water, whereas only 32.7% reported engaging in this same behavior in front of patients. Of those who reported never rinsing lenses with tap water, 85.6% indicated that rinsing lenses with water increases infection risk, whereas 52.1% of those who rinse lenses with water reported the same perceived risk (P < .001). Of all participants, 60% indicated that wearing contact lenses while showering increases infection risk, and 50.2% of all participants advised patients to avoid this behavior.

CONCLUSIONS
A discrepancy exists between perceptions of risk concerning exposure of contact lenses to water and both clinical practices and patient education provided by professionals.
Barriers and Facilitators to Obtaining Eyeglasses for Vulnerable Patients in a Michigan Free Clinic
Authors: Killeen Olivia J. , Cho Juno , Newman-Casey Paula Anne , Kana Lulia , Woodward Maria A. 
Published: March 2021

SIGNIFICANCE
Uncorrected refractive error is the main cause of visual impairment globally. Understanding barriers and facilitators underserved individuals face in obtaining eyeglasses will help address high rates of uncorrected refractive error.

PURPOSE
The purpose of this study was to understand the barriers and facilitators to obtaining eyeglasses among low-income patients in Michigan.

METHODS
Participants older than 18 years with hyperopia, myopia, or presbyopia and without active eye disease, severe mental illness, or cognitive impairment at Hope Clinic, Ypsilanti, Michigan, were included in this study. The participants answered a sociodemographic survey and underwent autorefraction and an interview. Interviews were audiorecorded, transcribed, and analyzed by two investigators.

RESULTS
Interviews were completed by 43 participants, and 30 participants' interviews were analyzed. The mean ± standard deviation age of 30 participants was 55 ± 12 years, 70% were female, 57% were African American, 40% had high school diploma or less, 57% earned less than U.S. $25,000 per year, 93% had worn glasses previously, and 87% had some medical insurance. Uncorrected visual acuity was logMAR 0.73 ± 0.61; best-corrected visual acuity was logMAR 0.16 ± 0.21. Thematic saturation was reached after 25 transcripts. Top barriers to using eyeglasses were cost (312 mentions, 29 participants), negative experiences with eyeglasses (263, 29), and limited access to eye care (175, 27). Top facilitators were positive experiences with glasses (230, 29), easy access to eyeglasses (143, 27), and availability of transportation (65, 27). Most participants (97%, 29) reported being negatively impacted by uncorrected refractive error. Most (97%, 29) were skeptical about obtaining eyeglasses online because of possible prescription problems.

CONCLUSIONS
Key barriers to correcting uncorrected refractive error in our community span across multiple health domains but are predominately rooted in external factors such as cost and access to vision care. Online eyeglasses may address access issues, but many participants were uncomfortable or unable to obtain glasses online.
Contact Lens Adaption in Neophytes
Authors: Pucker Andrew D. , Steele Kelsy , Rueff Erin , Franklin Quentin X. , McClure Kate , Savla Keyur , Walline Jeffrey J. 
Published: March 2021

SIGNIFICANCE
Clinicians commonly either recommend patients begin contact lens (CL) wear full time or suggest that patients should gradually increase their wear times during the first few days of wear. This study found no differences between these two wear schedules, suggesting that patient preference may be the best schedule.

PURPOSE
The purpose of this study was to determine if there are any clinical differences in neophyte, 2-week, reusable soft CL wearers who were randomized to either a full-time or a gradually increasing wear time schedule.

METHODS
This was an investigator-masked, three-visit, randomized, clinical trial. Participants were randomized to wear their CLs full time starting on the first day or gradually starting with 2 hours of wear on the first day and increasing wear by 2 hours each day until 8 hours or more of wear per day was achieved. Symptoms (Ocular Surface Disease Index and visual analog scale) and ocular surface signs (tear breakup time, extent of corneal staining, and Schirmer test I) were evaluated at each visit.

RESULTS
A total of 25 participants were randomized, with 21 participants completing at least 1 week of follow-up. Completed participants had a mean ± standard deviation age of 23.5 ± 3.0 years, and 48% were female. No significant between-group differences were found when comparing the full-time and gradual wear time schedule groups at 2 weeks (all, P > .32): Ocular Surface Disease Index (10.8 ± 8.5 vs. 16.3 ± 18.8), visual analog scale (89.0 ± 9.7 vs. 81.8 ± 18.7), tear breakup time (11.7 ± 7.0 vs. 9.8 ± 2.7), extent of corneal staining (0.0 ± 0.1 vs. 0.3 ± 0.5), or Schirmer test I (15.9 ± 8.8 vs. 21.2 ± 12.5).

CONCLUSIONS
No between-group differences were found for any metric evaluated, which suggests that the best wear schedule may be the one that best suits the neophyte CL wearer's lifestyle.
Cryptic transmission of SARS-CoV-2 and the first COVID-19 wave in Europe and the United States
Authors: Davis Jessica T. , Chinazzi Matteo , Perra Nicola , Mu Kunpeng , Piontti Ana Pastore y , Ajelli Marco , Dean Natalie E. , Gioannini Corrado , Litvinova Maria , Merler Stefano , Rossi Luca , Sun Kaiyuan , Xiong Xinyue , Halloran M. Elizabeth , Longini Ira M. , Viboud Cécile , Vespignani Alessandro 
Published: March 2021

AbstractGiven the narrowness of the initial testing criteria, the SARS-CoV-2 virus spread through cryptic transmission in January and February, setting the stage for the epidemic wave experienced in March and April, 2020. We use a global metapopulation epidemic model to provide a mechanistic understanding of the global dynamic underlying the establishment of the COVID-19 pandemic in Europe and the United States (US). The model is calibrated on international case introductions at the early stage of the pandemic. We find that widespread community transmission of SARS-CoV-2 was likely in several areas of Europe and the US by January 2020, and estimate that by early March, only 1 − 3 in 100 SARS-CoV-2 infections were detected by surveillance systems. Modeling results indicate international travel as the key driver of the introduction of SARS-CoV-2 with possible importation and transmission events as early as December, 2019. We characterize the resulting heterogeneous spatio-temporal spread of SARS-CoV-2 and the burden of the first COVID-19 wave (February-July 2020). We estimate infection attack rates ranging from 0.78%-15.2% in the US and 0.19%-13.2% in Europe. The spatial modeling of SARS-CoV-2 introductions and spreading provides insights into the design of innovative, model-driven surveillance systems and preparedness plans that have a broader initial capacity and indication for testing.
Characterization of transcript enrichment and detection bias in single-nuclei RNA-seq for mapping of distinct human adipocyte lineages
Authors: Gupta Anushka , Shamsi Farnaz , Altemos Nicolas , Dorlhiac Gabriel F. , Cypess Aaron M. , White Andrew P. , Patti Mary Elizabeth , Tseng Yu-Hua , Streets Aaron 
Published: March 2021

ABSTRACTSingle-cell RNA-sequencing (scRNA-seq) enables molecular characterization of complex biological tissues at high resolution. The requirement of single-cell extraction, however, makes it challenging for profiling tissues such as adipose tissue where collection of intact single adipocytes is complicated by their fragile nature. For such tissues, single-nuclei extraction is often much more efficient and therefore single-nuclei RNA-sequencing (snRNA-seq) presents an alternative to scRNA-seq. However, nuclear transcripts represent only a fraction of the transcriptome in a single cell, with snRNA-seq marked with inherent transcript enrichment and detection biases. Therefore, snRNA-seq may be inadequate for mapping important transcriptional signatures in adipose tissue. In this study, we compare the transcriptomic landscape of single nuclei isolated from preadipocytes and mature adipocytes across human white and brown adipocyte lineages, with whole-cell transcriptome. We demonstrate that snRNA-seq is capable of identifying the broad cell types present in scRNA-seq at all states of adipogenesis. However, we also explore how and why the nuclear transcriptome is biased and limited, and how it can be advantageous. We robustly characterize the enrichment of nuclear-localized transcripts and adipogenic regulatory lncRNAs in snRNA-seq, while also providing a detailed understanding for the preferential detection of long genes upon using this technique. To remove such technical detection biases, we propose a normalization strategy for a more accurate comparison of nuclear and cellular data. Finally, we demonstrate successful integration of scRNA-seq and snRNA-seq datasets with existing bioinformatic tools. Overall, our results illustrate the applicability of snRNA-seq for characterization of cellular diversity in the adipose tissue.
Histological analysis of implantation embryos in large Japanese field mouse (Apodemus speciosus) and estimation of developmental stage
Authors: Imai Hiroyuki , Kano Kiyoshi , Kusakabe Ken Takeshi 
Published: March 2021

AbstractThe large Japanese field mice (Apodemus speciosus) are small rodent specie endemic to Japan. The genetic characteristics ofA. speciosusis different chromosome numbers within one species. Furthermore,A. speciosusis used for research in radiation and genetics. In this present study, a pregnantA. speciosuswas obtained, and histochemical analysis of the implanted embryos was performed and compared with developmental stages of the mouse. Although there were some differences, the structures of the implanted embryos including the primitive streak and placenta ofA. speciosuswere similar to that of the mouse. Our study will be important report in the construction of a developmental atlas ofA. speciosus.
Duox generated reactive oxygen species activate ATR/Chk1 to induce G2 arrest in Drosophila tracheoblasts
Authors: Kizhedathu Amrutha , Chhajed Piyush , Yeramala Lahari , Basu Deblina Sain , Mukherjee Tina , Vinothkumar Kutti R. , Guha Arjun 
Published: March 2021

ABSTRACTProgenitors of the thoracic tracheal system of adult Drosophila (tracheoblasts) arrest in G2 during larval life and rekindle a mitotic program subsequently. G2 arrest is dependent on ATR-dependent phosphorylation of Chk1 that is actuated in the absence of detectable DNA damage. We are interested in the mechanisms that activate ATR/Chk1 (Kizhedathu et al., 2018, 2020). Here we report that levels of reactive oxygen species (ROS) are high in arrested tracheoblasts and decrease upon mitotic re-entry. High ROS is dependent on expression of Duox, an H2O2 generating-Dual Oxidase. ROS quenching by overexpression of Superoxide Dismutase 1, or by knockdown of Duox, abolishes Chk1 phosphorylation and results in precocious proliferation. Tracheae deficient in Duox, or deficient in both Duox and regulators of DNA damage-dependent ATR/Chk1 activation (Claspin/ATRIP/TOPBP1), can induce phosphorylation of Chk1 in response to micromolar concentrations of H2O2 in minutes. The findings presented reveal that H2O2 activates ATR/Chk1 in tracheoblasts by a non-canonical, potentially direct, mechanism.
Mitogenomic analyses provide further evidence for multiple miniaturization events during the evolution of Seychelles caecilian amphibians
Authors: Gwilt Annie J. , Streicher Jeffrey W. , Maddock Simon T. 
Published: March 2021

AbstractWhole mitochondrial genomes have been helpful in estimating phylogenetic relationships in many organismal groups, including caecilian amphibians. Despite the increasing ease of obtaining mitochondrial genome sequences from high-throughput sequencing, several species of caecilian lack this important molecular resource. As part of a targeted-sequence capture project of nuclear ultraconserved elements for a small but substantially diverse radiation of caecilian amphibians found on the granitic Seychelles, we examined off-target sequences to determine if we captured enough mitochondrial fragments to reconstruct mitogenomes. We reconstructed (near-)complete mitogenomes for six of the eight species of Seychelles caecilians and completed 14 independent phylogenetic analyses (Bayesian inference and maximum likelihood) on different mitochondrial datasets assembled using different alignment techniques. As with other studies, we were unable to fully resolve internal phylogenetic relationships of the group. However, we found strong support in most analyses that a recently described miniaturized species,Hypogeophis pti, and another similarly-sized miniaturized species,H. brevisare not sister taxa. Our study suggests that miniature species of caecilians likely evolved at least twice on the Seychelles and highlights the need to revise genus-level taxonomy of Seychelles caecilians while providing further evidence that off-target sequences often contain enough mitochondrial fragments to reconstruct mitogenomes.
Base editing using CRISPR/Cas9 inDrosophila
Authors: Marr Elizabeth , Potter Christopher J. 
Published: March 2021

AbstractCas9 and a guide RNA function to target specific genomic loci for generation of a double stranded break. Catalytic dead versions of Cas9 (dCas9) no longer cause double stranded breaks and instead can serve as molecular scaffolds to target additional enzymatic proteins to specific genomic loci. To generate mutations in selected genomic residues, dCas9 can be used for genomic base editing by fusing a cytidine deaminase to induce C>T (or G>A) mutations at targeted sites. Here, we test base editing inDrosophilaby expressing a transgenicDrosophilabase editor (DBE2, based on the mammalian BE2) which consists of a fusion protein of cytidine deaminase, dCas9, and uracil glycosylase inhibitor. We utilized transgenic lines expressing gRNAs along with pan-tissue expression of theDrosophilaBase Editor (Actin5C-DBE2) and found high rates of base editing at multiple targeted loci in the 20 bp target sequence. Highest rates of conversion of C>T were found in positions 3-9 of the gRNA targeted site, with conversion reaching nearly 100% of targeted DNA is somatic tissues. The simultaneous use of two gRNA targeting a genomic region spaced ∼50 bps apart led to mutations between the two gRNA targets, implicating a method to broaden the available sites accessible to targeting. These results indicate base editing is efficient inDrosophila, and could be used to induce point mutations at select loci.