bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genome-Scale Characterization of Toxicity-Induced Metabolic Alterations in Primary Hepatocytes
Authors: Rawls Kristopher D , Blais Edik M , Dougherty Bonnie V , Vinnakota Kalyan C , Pannala Venkat R , Wallqvist Anders , Kolling Glynis L , Papin Jason A 
Published: September 2019

AbstractContext-specific GEnome-scale metabolic Network REconstructions (GENREs) provide a means to understand cellular metabolism at a deeper level of physiological detail. Here, we use transcriptomics data from chemically-exposed rat hepatocytes to constrain a GENRE of rat hepatocyte metabolism and predict biomarkers of liver toxicity using the Transcriptionally Inferred Metabolic Biomarker Response algorithm. We profiled alterations in cellular hepatocyte metabolism following in vitro exposure to four toxicants (acetaminophen, carbon tetrachloride, 2,3,7,8-tetrachlorodibenzodioxin, and trichloroethylene) for six hour. TIMBR predictions were compared with paired fresh and spent media metabolomics data from the same exposure conditions. Agreement between computational model predictions and experimental data led to the identification of specific metabolites and thus metabolic pathways associated with toxicant exposure. Here, we identified changes in the TCA metabolites citrate and alpha-ketoglutarate along with changes in carbohydrate metabolism and interruptions in ATP production and the TCA Cycle. Where predictions and experimental data disagreed, we identified testable hypotheses to reconcile differences between the model predictions and experimental data. The presented pipeline for using paired transcriptomics and metabolomics data provides a framework for interrogating multiple omics datasets to generate mechanistic insight of metabolic changes associated with toxicological responses.
Gestational Exposure to Bisphenol A and Bisphenol S Leads to Fetal Skeletal Muscle Hypertrophy Independent of Sex
Authors: Jing Jiongjie , Pu Yong , Gingrich Jeremy , Veiga-Lopez Almudena 
Published: September 2019

Abstract
Gestational exposure to bisphenol A (BPA) can lead to offspring insulin resistance. However, despite the role that the skeletal muscle plays in glucose homeostasis, it remains unknown whether gestational exposure to BPA, or its analog bisphenol S (BPS), impairs skeletal muscle development. We hypothesized that gestational exposure to BPA or BPS will impair fetal muscle development and lead to muscle-specific insulin resistance. To test this, pregnant sheep (n = 7–8/group) were exposed to BPA or BPS from gestational day (GD) 30 to 100. At GD120, fetal skeletal muscle was harvested to evaluate fiber size, fiber type, and gene and protein expression related to myogenesis, fiber size, fiber type, and inflammation. Fetal primary myoblasts were isolated to evaluate proliferation and differentiation. In fetal skeletal muscle, myofibers were larger in BPA and BPS groups in both females and males. BPA females had higher MYH1 (reflective of type-IIX fast glycolytic fibers), whereas BPS females had higher MYH2 and MYH7, and higher myogenic regulatory factors (Myf5, MyoG, MyoD, and MRF4) mRNA expression. No differences were observed in males. Myoblast proliferation was not altered in gestationally BPA- or BPS-exposed myoblasts, but upon differentiation, area and diameter of myotubes were larger independent of sex. Females had larger myofibers and myotubes than males in all treatment groups. In conclusion, gestational exposure to BPA or BPS does not result in insulin resistance in fetal myoblasts but leads to fetal fiber hypertrophy in skeletal muscle independent of sex and alters fiber type distribution in a sex-specific manner.
Clinical Features of Pediatric Complex Regional Pain Syndrome
Authors: Mesaroli Giulia , Ruskin Danielle , Campbell Fiona , Kronenberg Sefi , Klein Sara , Hundert Amos , Stinson Jennifer 
Published: September 2019

Objectives:
Complex regional pain syndrome (CRPS) is a painful condition of a limb characterized by a constellation of symptoms. Little is known about the clinical features of pediatric CRPS, with fewer than a dozen studies published to date. The aim of this study was to explore the clinical course of pediatric CRPS, with emphasis on clinical features and disease outcomes. A secondary aim was to discern differences in clinical features of pediatric CRPS with and without related movement disorders, and between children who had a favorable and unfavorable outcome.

Materials and Methods:
We carried out a retrospective chart review of children with CRPS who presented to a pediatric Chronic Pain Clinic in Canada over a 5-year period (2012 to 2016).

Results:
The study identified 59 children with CRPS (mean age: 12.7±2.5; 74.6% female; 72.9% lower extremity). In total, 87% (n=48) of children experienced complete resolution or significant improvement of CRPS, with a relapse rate of 15%. Overall, 25% (n=15) had a CRPS-related movement disorder. There were no differences in the clinical features of pediatric CRPS with or without related movement disorders. Children who experienced a favorable outcome had a significantly shorter symptom duration at the initial visit in comparison with children who experienced an unfavorable outcome.

Discussion:
In this cohort, pediatric CRPS was most common in girls around the age of 12, usually in the lower extremity, and most experienced a favorable outcome. Further research is needed to better understand the prognosis and relapse rate of pediatric CRPS.
Management of Gustilo-Anderson Type II and IIIA Open Long Bone Fractures in Children: Which Wounds Require a Second Washout?
Authors: Wang Kemble K. , Rademacher Emily S. , Miller Patricia E. , Lins Laura , Jordan Eric , May Collin , Glotzbecker Michael P. , Hedequist Daniel J. , Shore Benjamin J. 
Published: September 2019

Introduction:
Timing of wound closure in pediatric Gustilo-Anderson grade II and IIIA open long bone fracture remain controversial. Our aims are (1) to determine the proportion of patients with these fractures whose wounds can be treated with early primary wound closure (EPWC); (2) to compare the complication rates between EPWC and delayed wound closure (DWC); and (3) to determine factors associated with higher likelihood of undergoing DWC.

Patients and Methods:
At a level-1 pediatric trauma center, 96 patients (younger than 18 y) who sustained Gustilo-Anderson grade II and IIIA open long bone fractures (humerus, radius, ulnar, femur, or tibia) within a 10-year period (2006-2016) were included for this study. Decision for EPWC versus DWC was at the discretion of the attending surgeon at time of initial surgery. Data collection was via retrospective review of charts and radiographs. Particular attention was paid to the incidence of return to operating room rate, nonunion, compartment syndrome, and infection. Median follow-up duration was 7.5 months (interquartile range: 3.6 to 25.3 mo). All patients were followed-up at least until bony union.

Results:
Overall, 81% of patients (78/96) underwent EPWC. Of the grade II fractures, 86% underwent EPWC. Four patients (5%) in the EPWC group and 1 patient (6%) in the DWC group had at least 1 complication. When controlling for mechanism of injury, Gustilo-Anderson fracture type and age, there was no difference in rate of complications between the EPWC and the DWC groups. Grade IIIA fractures and being involved in a motor vehicle accident were factors associated with a higher likelihood of undergoing DWC.

Conclusion:
The majority of grade II and IIIA pediatric long bone fractures may be safely treatable with EPWC without additional washouts. Future prospective research is required to further define the subgroups that can benefit from DWC.

Level of Evidence:
Level IV—therapeutic, case cohort study.
Incidence of Fusion Across Total Disc Replacement With Heterotopic Ossification
Authors: Chin Kingsley R. , Pencle Fabio J.R. , Mustafa Luai S. , Mustafa Moawiah S. , Quijada Kathleen A. , Seale Jason A. 
Published: September 2019

Study Design:
This is a level III retrospective study.

Objective:
The authors aim to review the outcomes and complications of ball and socket total disk replacements (TDRs).

Summary of Background Data:
TDR is a motion-preserving technique that closely reproduces physiologic kinematics of the cervical spine. However, heterotopic ossification and spontaneous fusion after implantation of the total cervical disk have been reported in several studies to decrease the range of motion postulated by in vitro and in vivo biomechanical studies.

Methods:
The medical records of 117 consecutive patients undergoing cervical TDR over a 5-year period with Mobi-C, Prodisc-C, Prestige LP, and Secure-C implants were followed. Outcomes assessed included Visual Analogue Scale neck and arm and Neck Disability Index scores. The radiographic assessment looked at heterotopic ossification leading to fusion and complication rates.

Results:
Of the 117 patients that underwent TDR, 56% were male with the group’s mean age being 46.2±10.3 years and body mass index of 18.9±13.6 kg/m2. The longest follow-up was 5 years with Prodisc-C group, with overall fusion noted in 16% of patients. One patient was also noted to have fusion which was not seen radiographically but noted intraoperatively for adjacent segment disease. There has been no demonstrable radiographic fusion seen in the Prestige LP group, however, the follow-up has only been 12–24 months for this group.

Conclusion:
In this study, we have demonstrated radiographic fusion anterior to the ball and socket TDR as well as the uncovertebral joint. We postulate that with the use of a mobile core disk there is an increased potential for fusion leading to a nonfunctional disk replacement.
Defining Instability in Degenerative Spondylolisthesis
Authors: Spina Nicholas , Schoutens Carlijn , Martin Brook I. , Brodke Darrel S. , Lawrence Brandon , Spiker William Ryan 
Published: September 2019

Study Design:
Surgeon survey.

Objective:
To examine factors influencing surgeons’ definition of instability in grade 1 degenerative spondylolisthesis (DS) and assess treatment preferences for both stable and unstable DS.

Summary of Background Data:
DS treatment options are broadly classified as decompression with or without fusion. In surgical decision-making, “instability” is frequently considered as a key factor. However, no consensus on the definition of instability exists.

Methods:
A survey was conducted to ascertain the minimum amounts of static translation, dynamic translation, and angulation change that surgeons considered significant for determining instability. The importance of other clinical and radiographic features were also assessed, and respondents’ standard treatment for stable and unstable DS.

Results:
Out of 226 respondents, 99% deemed dynamic translation moderately to extremely influential for determining instability, whereas only 55% found static translation as important. The most prevalent cut-off values for dynamic (57%) and static translation (32%) were at least 2–4 mm and for angulation change at least 10–15 degrees (43%). Facet angulation was considered moderately to extremely important to determine instability by 69% of the surgeons, disk height by 67%, patient age by 64%, severity of stenosis by 55%, severity of back pain by 50%, patient-reported function by 49%, pelvic incidence by 47%, and severity of neurogenic claudication by 42%.
Decompression with fusion was the preferred treatment method for unstable DS in 99% of the respondents. For stable DS, 40% would still perform fusion, whereas 60% preferred treatment with decompression-alone. Those who preferred fusion for stable DS reported significantly lower thresholds for static (P<0.001) and dynamic translation (P=0.004) for their determination of instability.

Conclusions:
Clear consensus regarding the definition of instability does not exist. Dynamic translation is the most agreed-upon parameter of influence. Treatment preferences vary for stable DS, but for unstable cases there is broad consensus to perform fusion.

Level of Evidence:
Level II.
Incidence, Risk Factors, and Trends of Motor Peripheral Nerve Injury After Colorectal Surgery: Analysis of the National Surgical Quality Improvement Program Database
Authors: Al-Temimi Mohammed H. , Chandrasekaran Bindupriya , Phelan Michael J. , Pigazzi Alessio , Mills Steven D. , Stamos Michael J. , Carmichael Joseph C. 
Published: September 2019

BACKGROUND:
Motor peripheral nerve injury is a rare but serious event after colorectal surgery, and a nationwide study of this complication is lacking.

OBJECTIVE:
The purpose of this study was to report the incidence, trends, and risk factors of motor peripheral nerve injury during colorectal surgery.

DESIGN:
The National Surgical Quality Improvement Program database was surveyed for motor peripheral nerve injury complicating colorectal procedures. Risk factors for this complication were identified using logistic regression analysis.

SETTINGS:
The study used a national database.

PATIENTS:
Patients undergoing colorectal resection between 2005 and 2013 were included.

MAIN OUTCOME MEASURES:
The incidence, trends, and risk factors for motor peripheral nerve injury complicating colorectal procedures were measured.

RESULTS:
We identified 186,936 colorectal cases, of which 50,470 (27%) were performed laparoscopically. Motor peripheral nerve injury occurred in 122 patients (0.065%). Injury rates declined over the study period, from 0.025% in 2006 to <0.010% in 2013 (p < 0.001). Patients with motor peripheral nerve injury were younger (mean ± SD; 54.02 ± 15.41 y vs 61.56 ± 15.95 y; p < 0.001), more likely to be obese (BMI ≥30; 43% vs 31%; p = 0.003), and more likely to have received radiotherapy (12.3% vs 4.7%; p < 0.001). Nerve injury was also associated with longer operative times (277.16 ± 169.79 min vs 176.69 ± 104.80 min; p < 0.001) and was less likely to be associated with laparoscopy (p = 0.043). Multivariate analysis revealed that increasing operative time was associated with nerve injury (OR = 1.04 (95% CI, 1.03–1.04)), whereas increasing age was associated with a protective effect (OR = 0.80 (95% CI, 0.71–0.90)).

LIMITATIONS:
This study was limited by its retrospective nature.

CONCLUSIONS:
Motor peripheral nerve injury during colorectal procedures is uncommon (0.065%), and its rate declined significantly over the study period. Prolonged operative time is the strongest predictor of motor peripheral nerve injury during colorectal procedures. Instituting and documenting measures to prevent nerve injury is imperative; however, special attention to this complication is necessary when surgeons contemplate long colorectal procedures.
Quality of Life and Functional Outcome After Transanal Abdominal Transanal Proctectomy for Low Rectal Cancer
Authors: Marks John H. , Salem Jean F. , Valsdottir Elsa B. , Yarandi Shadi S. , Marks Gerald J. 
Published: September 2019

BACKGROUND:
Transanal abdominal transanal proctectomy is a sphincter-preserving procedure designed to avoid colostomy in patients with cancer in the distal third of the rectum. Oncologic outcomes of this procedure have been established. However, data regarding patient satisfaction and quality of life are scant.

OBJECTIVE:
The purpose of this study was to evaluate the quality of life and functional outcomes of patients after transanal abdominal transanal proctectomy.

DESIGN:
This is a cross-sectional study.

SETTINGS:
The study was conducted at a tertiary referral colorectal center.

PATIENTS:
Patients who underwent transanal abdominal transanal proctectomy were included and surveyed using the Fecal Incontinence Quality of Life Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, the Quality of Life Questionnaire CR38 module, and a questionnaire designed by the authors to assess satisfaction with quality of life.

MAIN OUTCOME MEASURES:
Quality of life, functional outcomes, and patient satisfaction were measured and compared by age, tumor level, and stage of the disease.

RESULTS:
A total of 133 surveys were mailed, and 90 patients responded and were included in the study. Patient quality of life was not significantly different after surgery. Patients with more proximal tumors had better lifestyle, physical, and emotional scores. Older patients performed better on multiple levels, including coping, emotional, body image, future perspective, and digestive. Stage of disease had no impact on quality of life. Compared with reference values, patients who underwent transanal abdominal transanal proctectomy performed better on most of the components. All of patients preferred transanal abdominal transanal proctectomy over having a stoma based on their current anal sphincter function, and >97% of patients preferred transanal abdominal transanal proctectomy based on their current quality of life, sexual function, and level of activities.

LIMITATIONS:
This study is limited by the lack of a comparison group and a potential selection bias.

CONCLUSIONS:
Satisfaction with quality of life and functional outcomes is high after transanal abdominal transanal proctectomy. Older patients and those with more proximal tumors performed better. This patient population clearly preferred a sphincter-preserving option for treatment of their rectal cancer.
Effect of Topical Garlic on Wound Healing and Scarring: A Clinical Trial
Authors: Alhashim Minhal , Lombardo Jamie 
Published: September 2019

BACKGROUND
Historically, garlic containing compounds have been used on wounds to improve healing and ward off infection. Researchers have tested many of these ancient ointments, discovering that garlic is a common ingredient in those that are effective.

OBJECTIVE
To determine the efficacy of topical garlic on surgical wounds compared with Vaseline by analysis of visual analog scales and digital photograph analysis.

MATERIALS AND METHODS
Seventeen patients with 2 skin excisions applied a 30% garlic ointment to one surgical wound and Vaseline to the other surgical wound twice daily. They were followed up at 2 weeks and 4 weeks post-op. Digital photographs were taken of the sites, and wound visual analog scales were filled out by the patient and the physician.

RESULTS
Patients and the onsite physician stated the garlic site healed better in 59% and 65% of the wounds, respectively, at 2 weeks. At 4 weeks, the patients and the onsite physician stated the garlic site healed better in 76% and 88% of wounds, respectively. Digital photograph analysis revealed less erythema at the garlic sites (p-value = .02).

CONCLUSION
Surgical wounds treated with 30% garlic ointment healed with more cosmetically appealing scars than the Vaseline-treated sites.
Quarter-Descemet Membrane Endothelial Keratoplasty: One- to Two-Year Clinical Outcomes
Authors: Birbal Rénuka S. , Ni Dhubhghaill Sorcha , Baydoun Lamis , Ham Lisanne , Bourgonje Vincent J.A. , Dapena Isabel , Oellerich Silke , Melles Gerrit R. J. 
Published: September 2019

Purpose:
To report clinical outcomes of the first Quarter-Descemet membrane endothelial keratoplasty (Quarter-DMEK) case series performed for central Fuchs endothelial corneal dystrophy.

Methods:
This is a prospective, interventional case series analyzing the clinical outcomes of 19 eyes of 19 patients with central Fuchs endothelial corneal dystrophy, that is, with guttae predominantly in the 6- to 7-mm optical zone, who underwent unilateral Quarter-DMEK at a tertiary referral center. Main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD), and postoperative complications. Included eyes had up to 2 years of postoperative follow-up.

Results:
At 6 months postoperatively, all eyes reached a BCVA of ≥20/40 (≥0.5): 18 of 19 eyes (95%) with ≥20/25 (≥0.8) and 9 of 19 eyes (42%) with ≥20/20 (≥1.0). Thereafter, BCVA remained stable up to 2 years postoperatively. The mean donor ECD decreased from 2842 ± 139 cells/mm2 (n = 19) before implantation to 913 ± 434 cells/mm2 (−68%) at 6 months (n = 19), 869 ± 313 cells/mm2 (−70%) at 12 months (n = 18), and 758 ± 225 cells/mm2 (−74%) at 24 months (n = 13) after Quarter-DMEK. Visually significant graft detachment requiring rebubbling occurred in 8 of 19 eyes (42%).

Conclusions:
Quarter-DMEK surgery yields visual outcomes similar to those of conventional DMEK and may potentially quadruple the availability of endothelial grafts. Further modifications of the graft preparation and the surgical technique may improve clinical outcomes in terms of lower ECD decrease and fewer graft detachments.
Modified Sutureless and Glue-Free Method Versus Conventional Sutures for Conjunctival Autograft Fixation in Primary Pterygium Surgery: A Randomized Controlled Trial
Authors: Yan Bin , Peng Li , Peng Hanhan , Zhou Shu , Chen Baihua 
Published: September 2019

Purpose:
To compare the advantages and disadvantages of a modified sutureless and glue-free method with those of conventional sutures for conjunctival autograft fixation in pterygium surgery.

Methods:
A prospective randomized controlled study was performed on 73 eyes with primary nasal pterygium. After pterygium excision, the bare sclera was covered with a limbal conjunctival autograft, which was fixed using a modified sutureless and glue-free method in group 1 (39 eyes) and sutures in group 2 (34 eyes). The main outcome measures were operative time, autograft stability, postoperative discomfort, autograft thickness, pterygium recurrence, and complications.

Results:
The mean operative time was significantly shorter in group 1 (11.9 ± 1.3 minutes) than in group 2 (24.3 ± 6.1 minutes, P < 0.0001). On day 2 postsurgery, the average conjunctival autograft thickness was significantly higher in group 1 (861 ± 340 μm) than in group 2 (577 ± 287 μm, P = 0.034). Subsequently, conjunctival autograft thickness gradually decreased, with no significant difference between groups after 1 week. There were no significant differences in postoperative discomfort between groups, except for a greater foreign body sensation on day 2 and an itching sensation in 1 week in group 2 compared with group 1. Autograft side displacement occurred in 4 patients (10.3%) in group 1; 2 of these 4 developed a granuloma. There was 1 recurrence (2.9%) in group 2.

Conclusions:
The modified sutureless and glue-free limbal conjunctival autograft fixation method might be effective and efficient for primary pterygium surgery, with potentially decreased recurrence and postoperative discomfort.