bluuebunny/crossref_metadata_2025_split huggingface dataset:
Theoretical search for heterogeneously architected 2D structures
Authors: Yang Weizhu , Liu Qingchang , Gao Zongzhan , Yue Zhufeng , Xu Baoxing 
Published: July 2018

Significance
The bottom-up assembly of deterministic structures by lattice cell structures for surpassing properties of individual components or their sums by orders of magnitude is of critical importance in materials by design. Here, we present a theoretical strategy in the search and design of heterogeneously architected 2D structures (HASs) by assembling arbitrarily shaped basic lattice structures and demonstrate that an extremely broad range of mechanical properties can be achieved. This strategy allows designing HASs through interface properties of close relevance to assembly patterns and bonding connections between basic lattice structures. Studies using extensive numerical experiments validate the robust, reliable, and lucrative strategy of searching and designing HASs and offer quantitative guidance in the discovery of emerging 2D superstructures.
Bacillus subtilis highly efficient protein expression systems that are chromosomally integrated and controllable by glucose and rhamnose
Authors: Hirooka Kazutake , Tamano Ayaka 
Published: July 2018

ABSTRACT
To achieve rhamnose-inducible efficient protein expression in Bacillus subtilis, we assembled the strong promoters of B. subtilis cdd and ylbP genes and the regulatory region (PrhaEW) of B. subtilis rhaEWRBMA operon, whose transcription is induced by rhamnose and repressed by glucose, to produce various hybrid constructs. These constructs were evaluated using B. subtilis strains carrying a fusion of each construct to the gene encoding a mutated green fluorescent protein in the chromosome. When these strains were cultivated in the presence of glucose or rhamnose, the strain carrying a fusion of a partial PrhaEW region, lacking the intrinsic Shine-Dalgarno (SD) sequence, and the ylbP SD sequence most strictly controlled the promoter activity depending on sugar species. Moreover, the strain carrying a fusion of the cdd core promoter and the ylbP SD sequence showed the highest promoter activity when it was cultivated in the presence of glucose until the late stationary phase.
Abbreviations: RNAP: RNA polymerase; cre: catabolite-responsive element; SD: Shine-Dalgarno; PAGE: polyacrylamide gel electrophoresis; GFP: green fluorescent protein; OD600: optical density at 600 nm; LB: Luria-Bertani; a.u.: arbitrary unit; SDS: sodium dodecyl sulfate.
Clinical Manifestations and Bacterial Genomic Analysis of Group A Streptococcus Strains That Cause Pediatric Toxic Shock Syndrome
Authors: Deniskin Roman , Shah Brittany , Muñoz Flor M , Flores Anthony R 
Published: July 2018

Abstract
We report here 18 cases of pediatric group A streptococcal toxic shock syndrome, associated clinical findings, and bacterial molecular genetic characteristics discovered through whole-genome sequencing. This comparative whole-genome sequencing revealed unique gene content (speK) and polymorphisms (dpiB) in emm87 group A Streptococcus, the relative contributions of which, in combination with the host response, in the development of streptococcal toxic shock syndrome remain to be elucidated.
The clinical implication of monoclonal gammopathies: monoclonal gammopathy of undetermined significance and of renal significance
Authors: Batko Krzysztof , Malyszko Jolanta , Jurczyszyn Artur , Vesole David H , Gertz Morie A , Leleu Xavier , Suska Anna , Krzanowski Marcin , Sułowicz Władysław , Malyszko Jacek S , Krzanowska Katarzyna 
Published: July 2018

AbstractMonoclonal gammopathy of renal significance (MGRS) has introduced a new perspective to several well-known disease entities impacting nephrology, haematology and pathology. Given the constantly changing disease spectrum of these entities, it is clinically imperative to establish diagnostic and treatment pathways supported by evidence-based medicine. MGRS is a disease of the kidney, secondary to plasma cell clonal proliferation or immune dysfunction, requiring therapeutic intervention to eradicate the offending clone. To fully understand the disease(s), it is prerequisite to determine the significance of the findings. The diagnostic work up should be extensive due to the wide heterogeneity of clinical presentation, ultimately necessitating kidney biopsy. Particular patient profiles such as AL amyloidosis, which may be diagnosed through biopsies of other tissues/organs, may be an exception. Treatment decisions should be formulated by multi-disciplinary consensus: nephrologists, haematologists and pathologists. The ultimate goal in managing MGRS is eradication of the offending plasma cell clone which requires targeted chemotherapy and, in eligible cases, haematopoietic stem cell transplantation. We present a review of diagnostic procedures, treatment options and advances in the last few years in the management of MGRS in an effort to acquaint specialists with this new face of several older diseases.
Government Policy Experiments and Informed Consent
Authors: MacKay Douglas , Chakrabarti Averi 
Published: July 2018

Abstract
Governments are increasingly making use of field experiments to evaluate policy interventions in the spheres of education, public health and welfare. However, the research ethics literature is largely focused on the clinical context, leaving investigators, institutional review boards and government agencies with few resources to draw on to address the ethical questions they face regarding such experiments. In this article, we aim to help address this problem, investigating the conditions under which informed consent is required for ethical policy research conducted or authorized by government. We argue that investigators need not secure participants' informed consent when conducting government policy experiments if: (i) the government institution conducting or authorizing the experiment possesses a right to rule over the spheres of policy targeted by the research; and (ii) data collection does not involve the violation of participants' autonomy rights.
Unplanned Immediate Return to Operating Room After Spine Surgery
Authors: Chen Dennis Q. , Shimer Adam L. , Li Xudong , Hassanzadeh Hamid , Shen Francis H. , Singla Anuj 
Published: July 2018

Study Design.
Retrospective analysis; single center data.

Objective.
The purpose of this study is to look at the utility and relevance of immediate postoperative radiographs in providing vital information leading to immediate revision after spine surgery.

Summary of Background Data.
Immediate postoperative radiographs are routinely obtained in the recovery room after spine surgery to verify the level, alignment of the spine, implant position, and the adequacy of the procedure. However, with the ability to utilize intraoperative fluoroscopy imaging for the same purpose, the requirement for immediate postoperative radiographs needs to be validated. The purpose of this study is to look at the utility and relevance of these postoperative radiographs in providing critical information that may warrant immediate intervention.

Methods.
Retrospective analysis of all spine surgeries (elective and emergent), performed at a single center from 2011 to 2016, was done and cases returning to operating room within 48 hours were identified. Indication of immediate revision was reviewed and utility of immediate postoperative radiographs in guiding immediate revision was analyzed.

Results.
A total of 1804 elective and urgent spinal surgeries were performed by seven surgeons. Twenty-two patients returned to operating room within 48 hours of their index procedures. Of these 22 cases, only two patients were noted to have positive findings on recovery room radiographs. The findings of suboptimal spinal alignment or failed instrumentation led to the immediate revision in both cases. Both cases involved instrumentation at cervicothoracic region and intraoperative imaging provided only limited visualization.

Conclusion.
Routine recovery room radiographs played a role in the decision to emergently return to the operating room in 0.10% (2/1804) cases at our institution. The potential benefit of immediate recovery room radiographs after spine surgery should be weighed against the added healthcare cost and patient discomfort associated with obtaining these radiographs routinely. Imaging may be delayed to a more elective time without any significant risk in majority of spine cases.

Level of Evidence: 3
Simultaneous Determination of Cefalexin, Cefazolin, Flucloxacillin, and Probenecid by Liquid Chromatography–Tandem Mass Spectrometry for Total and Unbound Concentrations in Human Plasma
Authors: Zhang Mei , Moore Grant A. , Chin Paul K. L. , Everts Richard , Begg Evan J. 
Published: July 2018

Background:
Pharmacokinetic studies and therapeutic drug monitoring of antibiotics require a simple, rapid, and reliable analytical method for monitoring the concentrations in plasma, including unbound concentrations for highly protein-bound drugs. The aim of the current work was to develop and validate a liquid chromatography–tandem mass spectrometry method for the simultaneous determination of total and unbound concentrations of 3 widely used β-lactam antibiotics (cefalexin, cefazolin, and flucloxacillin) and the often coadministered drug probenecid in human plasma, suitable for pharmacokinetic studies and for routine use in ordinary, busy hospital laboratories.

Methods:
Unbound drug was separated from bound drug by ultrafiltration. A simple 1-step protein precipitation was used for sample preparation. Cefalexin, cefazolin, flucloxacillin, probenecid, and their corresponding isotopically labeled internal standards were then resolved on a C18 (2) column. All the compounds were detected using electrospray ionization in the positive mode.

Results:
Standard curves were linear for all compounds over the concentration range of 0.2–100 mg/L (r > 0.99) for total drug in plasma and 0.01–10 mg/L (r > 0.99) for unbound drug in plasma ultrafiltrate. For both total and unbound drugs, bias was <±10%, and intra- and interday coefficients of variation (imprecision) were <10%. The limit of quantification was 0.2 mg/L for total plasma concentrations and 0.01 mg/L for plasma ultrafiltrate concentrations of all drugs.

Conclusions:
The method has proven to be simple, rapid, robust, and reliable and is currently being used in clinical pharmacokinetic studies and in the routine clinical service to enhance the effective use of the β-lactam antibiotics.
Changes in carotid artery intima-media thickness 3 years after cessation of menopausal hormone therapy: follow-up from the Kronos Early Estrogen Prevention Study
Authors: Miller Virginia M. , Hodis Howard N. , Lahr Brian D. , Bailey Kent R. , Jayachandran Muthuvel 
Published: July 2018

AbstractObjective:Little is known regarding the progression of preclinical atherosclerosis upon cessation of menopausal hormone therapy (MHT). This study evaluated changes in carotid artery intima-media thickness (CIMT) in a subgroup of participants during 4 years and 3 years after the Kronos Early Estrogen Prevention Study (KEEPS).Methods:Of the women enrolled in KEEPS at Mayo Clinic (n = 118), a subset (n = 76) agreed to participate in this follow-up study. KEEPS MHT assignments were placebo (PBO),n = 33; transdermal 17β-estradiol (tE2),n = 23; and oral conjugated equine estrogens group (oCEE),n = 20. CIMT was measured by B-mode ultrasonography. Longitudinal analysis of CIMT was performed using all available data from pre-, on-, and post-treatment periods.Results:At 7 years, median age of participants was 60.2 years; median time since menopause was 8.5 years. The mean difference in rates of increase was significantly greater over the post- than on-treatment period within the oCEE group (0.010 [0.002-0.017] mm/y), but not within the PBO (0.006 [−0.001 to 0.012] mm/y;P = 0.072)or tE2(0.002 [−0.005 to 0.010] mm/y;P = 0.312) groups. There were, however, no significant treatment differences in the linear trends over those intervals (P = 0.524).Conclusions:Cessation of MHT at the lower doses and formulations used in KEEPS did not appear to alter the trajectory of CIMT over a 3-year follow-up period. CIMT, however, increased in all groups over the entire 7-year timeframe as expected with age and timing of menopause possibly key contributors.
FIXATION STATUS AFTER RESOLUTION OF MACULAR EDEMA ASSOCIATED WITH BRANCH RETINAL VEIN OCCLUSION
Authors: Kogo Takahiro , Muraoka Yuki , Ooto Sotaro , Suzuma Kiyoshi , Murakami Tomoaki , Iida Yuto , Iida-Miwa Yuko , Ghashut Rima , Miyata Manabu , Tsujikawa Akitaka 
Published: July 2018

Purpose:
To evaluate fixation status of eyes with branch retinal vein occlusion (BRVO) and to investigate its association with other clinical parameters.

Methods:
This study included 57 consecutive eyes with BRVO after resolution of macular edema. Fixation status was determined by microperimetry. Defect length of the foveal ellipsoid zone band was measured by optical coherence tomography, and retinal perfusion status was assessed by optical coherence tomography angiography.

Results:
In microperimetry, the mean fixation rate around the gravitational center of all fixation points (defined as the fixation center) was found to be 79.8 ± 18.9%, which was significantly associated with defect length of the foveal ellipsoid zone band (P < 0.001) and distance between the foveal and fixation centers (P = 0.012). The integrity of the ellipsoid zone band at the fixation center was intact in 55 eyes (96.5%). Fixation centers were located within and outside the foveal avascular zone in 33 (57.9%) and 24 (42.1%) eyes, respectively; among the latter eyes, all fixation centers were perfused. Downward deviation of fixation points was rare, despite variations in the occluded area; there was a significant difference in distribution of deviation between eyes with superotemporal and inferotemporal BRVO (P < 0.001).

Conclusion:
In eyes with BRVO, fixation status was strongly associated with visual acuity, morphologic damage, and retinal perfusion status both in the foveal area and at the fixation center after resolution of macular edema. This information regarding fixation status could facilitate vision management in patients with BRVO.
A Case Series and Literature Review: Isolated Traumatic First Rib Fracture in Athletes
Authors: Marcussen Britt , Negaard Matthew , Hosey Robert G. , Smoot Milton Kyle 
Published: July 2018

Objective:
To present a case series of 14 isolated traumatic first rib fractures sustained in sport and review the literature on clinical presentation, mechanism of injury, diagnosis, and management of sport-related traumatic first rib fractures.

Design:
We compiled a series of isolated traumatic first rib fractures seen in 2 Division 1–associated sports medicine clinics. We also performed a literature search for additional publications of isolated traumatic first rib fractures in sport.

Setting:
Patients in our case series were all evaluated and treated at 2 tertiary care center sports medicine clinics.

Patients:
Patients were those who sustained isolated traumatic first rib fracture during sport.

Interventions:
None.

Main Outcome Measures:
None.

Results:
None.

Conclusions:
Traumatic fracture of the first rib in sport is certainly not a common diagnosis, but it is likely more widespread than sports medicine providers realize. Considering the diagnosis of first rib fracture for athletes with shoulder pain after trauma is essential for identifying this injury. Although more study is likely needed to make definitive recommendations on treatment and return to play protocols, the case series and literature review presented suggests that rehabilitation and return to play when the patient is asymptomatic may be appropriate care.
Interposition Vein Grafting in Head and Neck Free Flap Reconstruction
Authors: Maricevich Marco , Lin Lawrence O. , Liu Jun , Chang Edward I. , Hanasono Matthew M. 
Published: July 2018

Background:Many surgeons are hesitant to use interposition vein grafting in head and neck microvascular free flap surgery because of concerns for elevated risk of flap loss.Methods:The authors conducted a review of patients who underwent head and neck free flap reconstruction between 2005 and 2015. The effect of vein grafts on flap compromise and flap loss was analyzed using univariate and multivariate models.Results:A total of 3240 free flaps were performed. Vein grafts were used in 241 flaps (7.4 percent). The free flap compromise rate was 14.5 percent with vein grafts and 3.4 percent without vein grafts (p< 0.001). The free flap loss rate was 6.4 percent with vein grafts and 1.1 percent without vein grafts (p< 0.001). Radiation therapy, chemotherapy, prior neck dissection, prior free flap, osteoradionecrosis, and multiple free flap surgery were more frequent within the vein graft group (allp< 0.001). Despite this, vein grafting was associated with an increased risk of flap compromise (adjusted OR, 4.8; 95 percent CI, 3.2 to 7.3;p< 0.001) and flap loss (adjusted OR, 5.5; 95 percent CI, 3.0 to 10.2;p< 0.001) on multivariable analysis. Individual review of each flap loss within the vein graft group identified no cases of thrombosis caused by anastomotic technical errors, arguing against the requirement of an additional anastomosis as a cause for loss of vein-grafted free flaps.Conclusions:An increased risk of free flap compromise and loss is associated with use of vein grafts. However, a 93.4 percent success rate was still achieved in notably more challenging cases where vein grafting was deemed necessary taking into consideration the pertinent risks and benefits.CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, III.
Magnetic Resonance Arthrographic Demonstration of Association of Superior Labrum Anterior and Posterior Lesions With Extended Anterior Labral Tears
Authors: Ogul Hayri , Ayyildiz Veysel , Pirimoglu Berhan , Polat Gokhan , Tuncer Kutsi , Kose Mehmet , Kantarci Mecit 
Published: July 2018

Objective
The objective of this study was to evaluate retrospectively the full extent of anterior labral tear and associated other labral tears on magnetic resonance arthrographic images in patients with anterior shoulder instability.

Materials and Methods
One hundred ten magnetic resonance arthrography images with anterior labral tear were retrieved from the database of the Radiology Department. Two skeletal radiologists, one with 15 years of experience and the other with 5 years of experience analyzed the images in random order. Approval for the study was granted by the Ethics Committee. Statistical analyses were performed using SPSS software.

Results
The most common localization of the labral lesions was at the anterior-inferior part of the glenoid labrum (22.7%). The anterior labral tears were commonly associate with superior labrum anterior and posterior (SLAP) lesions (45%). The most common type of SLAP lesion was type V (23.6%). Superior Labrum Anterior and Posterior type V lesion was more often detected in patients with Bankart lesion (27.7%, P = 0.043).

Conclusions
Isolated anterior labral tears are less than expected. In majority of the cases, a distinct tear at a different site of the labrum accompanies the anterior labral tear. Massive anterior labral tears are mostly seen together with SLAP lesions.
Metal Artifact Reduction Computed Tomography of Arthroplasty Implants
Authors: Khodarahmi Iman , Haroun Reham R. , Lee Moses , Fung George S.K. , Fuld Matthew K. , Schon Lew C , Fishman Elliot K. , Fritz Jan 
Published: July 2018

Objective
The aim of this study was to compare the effects of combined virtual monoenergetic extrapolation (VME) of dual-energy computed tomography data and iterative metal artifact reduction (iMAR) at higher photon energies on low- and high-density metal artifacts and overall image quality of the ankle arthroplasty implants with iMAR, weighted filtered back projection (WFBP), and WFBP-based VME.

Materials and Methods
Total ankle arthroplasty implants in 6 human cadaver ankles served as surrogates for arthroplasty implants. All specimens underwent computed tomography with a 2 × 192-slice dual-source computed tomography scanner at tube voltages of 80 and tin-filtered 150 kVp to produce mixed 120 kVp equivalent polychromatic and virtual monoenergetic extrapolated images at 150 and 190 keV (VME 150 and VME 190, respectively). By implementing the WFBP and iMAR reconstruction algorithms on polychromatic, VME 150 and VME 190 data, 6 image datasets were created: WFBP-Polychromatic, iMAR-Polychromatic, WFBP-VME 150, WFBP-VME 190, iMAR-VME 150, and iMAR-VME 190. High-density and low-density artifacts were separately quantified with a threshold-based computer algorithm. After anonymization and randomization, 2 observers independently ranked the datasets for overall image quality. Repeated measures analysis of variance, Friedman, and Cohen weighted κ tests were applied for statistical analysis. A conservative P value of less than 0.001 was considered statistically significant.

Results
iMAR-VME 190 keV and iMAR-VME 150 keV created the least amount of high-density artifacts (all P < 0.001), whereas iMAR-Polychromatic was the most effective method to mitigate low-density streaks (P < 0.001). For low- and high-density artifacts, polychromatic iMAR acquisition was superior to WFBP-VME 150 keV and WFBP-VME 190 keV (all P < 0.001). On sharp kernel reconstructions, readers ranked the overall image quality of iMAR-Polychromatic images highest (all P < 0.001). Similarly, on soft tissue kernel reconstructions, readers ranked iMAR-Polychromatic images highest with a statistically significant difference over other techniques (all P < 0.001), except for iMAR-VME 150 keV (P = 0.356).

Conclusions
In computed tomography imaging of ankle arthroplasty implants, iMAR reconstruction results in fewer metal artifacts and better image quality than WFBP reconstruction for both polychromatic and virtual monoenergetic data. The combination of iMAR and VME at higher photon energies results in mixed effects on implant-induced metal artifacts, including decreased high-density and increased low-density artifacts, which in combination does not improve image quality over iMAR reconstruction of the polychromatic data. Our results suggest that, for ankle arthroplasty implants, the highest image quality is obtained by iMAR reconstruction of the polychromatic data without the need to implement VME at high-energy levels.
Oral Myiasis in a Patient With HIV Manifestations and Neurologic Toxoplasmosis Treated by Ivermectin
Authors: Pires Willian Ricardo , Puttini Igor de Oliveira , Oliva André Hergesel de , Jacob Ricardo Garcia Mureb , Figueira Heldo Cesar , Sonoda Celso Koogi , Faverani Leonardo Perez , Souza Francisley Ávila , Garcia Júnior Idelmo Rangel 
Published: July 2018

Abstract
Myiasis has been defined as a pathologic condition where dipterous larvae are lodged in mammalian hosts causing an infestation, which feeds on living or dead tissue for at least a certain period inside the host and develops itself as parasites. In humans, the most commonly affected sites are the nose, eyes, skin wounds, sinuses, lungs, ears, gut, gall bladder, vagina, nasal cavities, and rarely the mouth because the oral tissues are rarely exposed to the external environment. The etiology of oral myiasis is usually related to local factors such as poor oral hygiene, periodontal disease and labial incompetence, and systemic factors such as neurologic deficits.