bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polycyclic Aromatic Hydrocarbons Can Trigger Hepatocyte Release of Extracellular Vesicles by Various Mechanisms of Action Depending on Their Affinity for the Aryl Hydrocarbon Receptor
Authors: van Meteren Nettie , Lagadic-Gossmann Dominique , Chevanne Martine , Gallais Isabelle , Gobart Dimitri , Burel Agnès , Bucher Simon , Grova Nathalie , Fromenty Bernard , Appenzeller Brice M R , Chevance Soizic , Gauffre Fabienne , Le Ferrec Eric , Sergent Odile 
Published: July 2019

Abstract
Extracellular vesicles (EVs) are membrane-enclosed nanostructures released by cells into the extracellular environment. As major actors of physiological intercellular communication, they have been shown to be pathogenic mediators of several liver diseases. Extracellular vesicles also appear to be potential actors of drug-induced liver injury but nothing is known concerning environmental pollutants. We aimed to study the impact of polycyclic aromatic hydrocarbons (PAHs), major contaminants, on hepatocyte-derived EV production, with a special focus on hepatocyte death. Three PAHs were selected, based on their presence in food and their affinity for the aryl hydrocarbon receptor (AhR): benzo[a]pyrene (BP), dibenzo[a,h]anthracene (DBA), and pyrene (PYR). Treatment of primary rat and WIF-B9 hepatocytes by all 3 PAHs increased the release of EVs, mainly comprised of exosomes, in parallel with modifying exosome protein marker expression and inducing apoptosis. Moreover, PAH treatment of rodents for 3 months also led to increased EV levels in plasma. The EV release involved CYP metabolism and the activation of the transcription factor, the AhR, for BP and DBA and another transcription factor, the constitutive androstane receptor, for PYR. Furthermore, all PAHs increased cholesterol levels in EVs but only BP and DBA were able to reduce the cholesterol content of total cell membranes. All cholesterol changes very likely participated in the increase in EV release and cell death. Finally, we studied changes in cell membrane fluidity caused by BP and DBA due to cholesterol depletion. Our data showed increased cell membrane fluidity, which contributed to hepatocyte EV release and cell death.
Presence of a Sexual Population of Puccinia graminis f. sp. tritici in Georgia Provides a Hotspot for Genotypic and Phenotypic Diversity
Authors: Olivera Pablo D. , Sikharulidze Zoya , Dumbadze Rusudan , Szabo Les J. , Newcomb Maria , Natsarishvili Ketino , Rouse Matthew N. , Luster Douglas G. , Jin Yue 
Published: July 2019

Wheat stem rust, caused by Puccinia graminis f. sp. tritici, is a re-emerging disease exemplified by recent epidemics caused by new virulent races. Understanding the sources and origins of genetic variations in the pathogen populations globally can facilitate the development of better strategies in disease management. We analyzed 68 wheat stem rust samples collected between 2013 and 2015 from Georgia where stem rust incidences are frequent and the alternate host, common barberry, is present. A total of 116 single-pustule isolates were derived and evaluated on stem rust differential lines to determine the virulence phenotypes and 23 races were identified, many of which were detected for the first time. Unique virulence combinations including, Sr22+Sr24 and Sr13b+Sr35+Sr37 were detected. These virulence combinations pose new challenges to breeding programs because many of these genes are used in breeding for resistance to the Ug99 race group. Sixty-one isolates were genotyped using a custom single-nucleotide polymorphism chip and 17 genotypes were identified. The 2013 isolates contained 11 multilocus genotypes compared with isolates of 2014 and 2015, with five and three genotypes, respectively. The higher levels of virulence and genotypic diversity observed in the 2013 samples strongly indicated that sexual recombination occurs in the Georgian P. graminis f. sp. tritici population, and that the Caucasus region of Eurasia may be an important source of new races. [Formula: see text] Copyright © 2019 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
The role of component-resolved diagnosis in Hymenoptera venom allergy
Authors: Bilò Maria B. , Ollert Markus , Blank Simon 
Published: July 2019

Purpose of review
Component-resolved diagnostics (CRD) is a new tool aiming at detecting IgE-mediated sensitizations against individual, relevant allergens. Here, we discuss recent literature on molecular diagnosis in the field of Hymenoptera venom allergy (HVA) as well as CRD strengths and weaknesses.

Recent findings
CRD, using single molecules or panels of allergens, may discriminate between primary sensitization and cross-reactivity in patients with double/multiple positivity in diagnostic tests with whole extracts, allowing the specialist to choose the most suitable venom for specific immunotherapy (VIT), avoiding unnecessary VIT and reducing the risk of side effects. Future availability of the cross-reactive recombinant pairs of allergens of different species may further increase the diagnostic performance. CRD may be useful in patients with negative allergy tests and a proven history of a previous systemic reaction, including those with mast cell disorders, who could benefit from VIT. In honeybee venom allergy, different sensitization profiles have been identified, which could be associated with a greater risk of VIT failure or treatment side effects.

Summary
CRD is undoubtedly an innovative diagnostic method that leads to a more precise definition of the sensitization profile of the HVA patient. Together with a better knowledge of the molecular composition of different venom extracts, CRD may contribute to optimize patient-tailored therapy.
Emerging indications for hyperbaric oxygen
Authors: Bennett Michael H. , Mitchell Simon J. 
Published: July 2019

Purpose of review
To identify and discuss emerging trends in the therapeutic use of hyperbaric oxygen.

Recent findings
There has been a maturing of the clinical evidence to support the treatment of sudden hearing loss, a wide range of problematic chronic wound states and the prevention and treatment of end-organ damage associated with diabetes mellitus. On the other hand, the controversy continues concerning the use of hyperbaric oxygen therapy (HBOT) to treat sequelae of mild traumatic brain injury. HBOT remains poorly understood by many medical practitioners despite more than 50 years of clinical practice. Pharmacological actions arise from increased pressures of oxygen in the blood and tissues. Most therapeutic mechanisms identified are not the simple result of the reoxygenation of hypoxic tissue, but specific effects on immunological and metabolic pathways by this highly reactive element. HBOT remains controversial despite biological plausibility and a solid clinical evidence base in several disease states.

Summary
Multiple proposals for new indications for HBOT continue to emerge. Although many of these will likely prove of limited clinical importance, some show significant promise. Responsible practitioners remain acutely aware of the need for high-quality clinical evidence before introducing emerging indications into routine practice.
Opioid Consumption Patterns After Lumbar Microdiscectomy or Decompression
Authors: Lovecchio Francis , Premkumar Ajay , Stepan Jeffrey G. , Mejia Dianna , Stein Daniel , Patel Dil V. , Lafage Virginie , Derman Peter , Khechen Benjamin , Iyer Sravisht , Lebl Darren , Qureshi Sheeraz , Huang Russel , Singh Kern , Albert Todd J. 
Published: July 2019

Study Design.
Prospective observational study

Objective.
The aim of this study was to record daily opioid use and pain levels after 1-level lumbar decompression or microdiscectomy.

Summary of Background Data.
The standardization of opioid-prescribing practices through guidelines can decrease the risk of misuse and lower the number of pills available for diversion in this high-risk patient population. However, there is a paucity of quantitative data on the “minimum necessary amount” of opioid appropriate for post-discharge prescriptions.

Methods.
At two institutions between September 2017 and 2018, we prospectively enrolled 85 consecutive adult patients who underwent one-level lumbar decompression or microdiscectomy. Patients with a history of opioid dependence were excluded. Daily opioid consumption and pain scores were collected using an automated text-messaging-based platform for 6 weeks or until consumption ceased. Refills during the study period were monitored. Patients were asked for the number of pills left over and the method of disposal. Opioid use was converted to oral morphine equivalents (OMEs). Results are also reported in terms of “pills” (oxycodone 5 mg equivalents) to facilitate clinical applications. Risk factors were compared between patients in the top and bottom half of opioid consumption.

Results.
Total opioid consumption ranged from 0 to 118 pills, with a median consumption of 32 pills (236.3 OME). Seventy-five percent of patients consumed ≤57 pills (431.3 OME). Mean Numeric Rating Scale pain scores declined steadily over the first 2 weeks. By postoperative day 7 half of the study population had ceased taking opioids altogether. Only 22.4% of patients finished their initial prescription, and only 9.4% of patients obtained a refill.

Conclusion.
These data may be used to formulate evidence-based opioid prescription guidelines, establish benchmarks, and identify patients at the higher end of the opioid use spectrum.

Level of Evidence: 2
A Rare Spinal Injury
Authors: Bayram Serkan , Akgül Turgut , Özmen Emre , Şar Cüneyt 
Published: July 2019

Study Design.
Case report.

Objective.
We present a 18-year-old male patient with gunshot injury through right scapular region with the bullet ending up and causing a fracture in the odontoid process.

Summary of Background Data.
Odontoid fracture owing to gunshot wound is an extremely rare injury.

Methods.
An 18-year-old male patient was brought to the emergency department with gunshot injury. x-Ray imaging showed retained bullet in the odontoid process. Computed tomography scan showed fracture of the odontoid and body of scapula consistent with the trajectory of the bullet. Owing to a normal neurological examination, conservative follow-up was decided and given a Philadelphia collar.

Results.
At 2 years’ follow-up, patient demonstrated limited axial rotation and flexion/extension. However, no pain and neurologic problem were observed.

Conclusion.
Odontoid fracture owing to gunshot wound can be treated conservatively; emergency or elective surgical intervention was not necessary. In the follow-up, patient did not demonstrate any signs of neurological impairment or infection.

Level of Evidence: 5
Syndromic Scoliosis: National Trends in Surgical Management and Inpatient Hospital Outcomes
Authors: Chung Andrew S. , Renfree Sean , Lockwood Donovan B. , Karlen Judson , Belthur Mohan 
Published: July 2019

Study Design.
Retrospective cohort study.

Objective.
Evaluate the trends in management and inpatient outcomes in patients with syndromic scoliosis undergoing spinal deformity correction.

Summary of Background Data.
Syndromic scoliosis (SS) refers to scoliosis that is most commonly associated with systemic disease including Ehler Danhlos syndrome (EDS), Marfan syndrome (MF), Down syndrome (DS), Achondroplasia (AP), and Prader-Willi syndrome (PWS). Limited data exist evaluating hospital outcomes in patients with SS undergoing spinal deformity correction.

Methods.
The Kids’ Inpatient Database (KIDS) was queried from 2001 to 2012 to identify all pediatric patients with scoliosis undergoing spinal fusion. These patients were then sub-divided into two cohorts: (1) patients with idiopathic scoliosis (IS) and (2) patients with syndromic scoliosis. Trends in surgical management, and postoperative morbidity and mortality were assessed. Length of stay and total hospital charges were additionally analyzed. A sub-analysis to characterize outcomes in each syndrome was also performed.

Results.
An estimated 1071 patients with SS were identified and compared with 24,989 pediatric patients with IS. MF (36.8%), Down syndrome (16.0%), and PWS (14.9%) were the most common diagnoses among patients with SS. Between 2001 and 2012, there was a significant decline in the number of anterior procedures performed in both cohorts. Conversely, the number of posterior based procedures increased. SS was associated with increased major complications (2.7% compared with 1.0% in IS; P < 0.001) and minor complication rates (41.0% compared with 28.5% in IS; P < 0.001). Patients with AP incurred the highest rate of major complications (10.7%), minor complications (60.8%), and intraoperative durotomies (6.1%). Total hospital charges increased significantly over the 12-year span.

Conclusion.
Trends in management of syndromic scoliosis have paralleled that of idiopathic scoliosis. Syndromic scoliosis is associated with increased risks with surgical deformity correction. Further prospective studies are warranted to evaluate the reasons for these differences.

Level of Evidence: 3
Mesenchymal Stem Cell Homing Into Intervertebral Discs Enhances the Tie2-positive Progenitor Cell Population, Prevents Cell Death, and Induces a Proliferative Response
Authors: Wangler Sebastian , Peroglio Marianna , Menzel Ursula , Benneker Lorin M. , Haglund Lisbet , Sakai Daisuke , Alini Mauro , Grad Sibylle 
Published: July 2019

Study Design.
Experimental study with human mesenchymal stem cells (MSCs) and intervertebral disc (IVD) tissue samples.

Objective.
This study aimed to characterize the effect of MSC homing on the Tie2-positive IVD progenitor cell population, IVD cell survival, and proliferation.

Summary of Background Data.
Homing of human MSCs has been described as potential alternative to MSC injection, aiming to enhance the regenerative capacity of the IVD. IVD cells expressing Tie2 (also known as CD202b or Angiopoietin-1 receptor TEK tyrosine kinase) represent a progenitor cell population with discogenic differentiation potential. However, the fraction of Tie2-positive progenitor cells decreases with aging and degree of IVD degeneration, resulting in a potential loss of the IVD's regenerative capacity.

Methods.
Human MSCs, isolated from vertebral bone marrow aspirates, were labeled and seeded onto the endplate of bovine IVDs and human IVD tissue. Following MSC migration for 5 days, IVD cells were isolated by tissue digestion. The fractions of Tie2-positive, dead, apoptotic, and proliferative IVD cells were evaluated by flow cytometry and compared to untreated IVDs. For human IVDs, 3 groups were investigated: nondegenerated (organ donors), IVDs of patients suffering from spinal trauma, and degenerative IVD tissue samples.

Results.
MSC homing enhanced the fraction of Tie2-positive IVD cells in bovine and human IVD samples. Furthermore, a proliferative response and lower fraction of dead cells were observed after MSC homing in both bovine and human IVD tissues.

Conclusion.
Our findings indicate that MSC homing enhances the survival and regenerative capability of IVD cells, which may be mediated by intercellular communication. MSC homing could represent a potential treatment strategy to prevent the onset of the degenerative cascade in IVDs at risk such as IVDs adjacent to a fused segment or IVDs after herniation.

Level of Evidence: N/A
Bladder Scans and Postvoid Residual Volume Measurement Improve Diagnostic Accuracy of Cauda Equina Syndrome
Authors: Venkatesan Muralidharan , Nasto Luigi , Tsegaye Magnum , Grevitt Michael 
Published: July 2019

Study Design.
A prospective, observational cohort study.

Objective.
The aim of this study was to determine the role of pre and postvoid bladder scan in predicting cauda equina syndrome (CES). The thesis was that bladder scanning [specifically postvoid residual (PVR) volume] would have higher diagnostic accuracy than physical examination alone.

Summary of Background Data.
CES is an ill-defined condition with a spectrum of presenting symptoms. There is neither a combination of clinical symptoms and/or signs that reliably predicts cauda equina compression nor single defining clinical criterion that has 100% predictive value to confirm or exclude CES.

Methods.
Patients with suspected CES admitted over a 6-month period at a single institution were prospectively assessed by physical examination (including digital rectal examination and pin prick perianal sensation) and bladder ultrasound scanning (recording pre- and PVR volume). These results were compared with the subsequent magnetic resonance imaging (MRI) scans and those patients who had emergent surgery for CES.

Results.
Ninety-two patients were included in the study (52 women) with a mean age of 44.9 years.
An MRI scan demonstrating causing compression of the cauda equina was present in only 18% (17/92).
The sensitivity of anal tone to predict CES was 52.9%. Peri-anal numbness (either unilateral or bilateral) had sensitivity of 82.3% and negative predictive value of 92%.
For nonoperated group (without CES), mean PVR was 199 mL (95% confidence interval ± 59 mL). On the basis of receiver operating curves, the optimal bladder volume cut-off for predicting CES was ≥200 mL for PVR volume. A PVR of <200 mL gave CES probability of 3.6%. If >200 mL, then the probability of having CES is 43% (P < 0.000003). A PVR <200 mL had a negative predictive value of 97%.

Conclusion.
Bladder scanning was a useful adjunct in the diagnosis of CES. It had a better negative predictive value than physical examination.

Level of Evidence: 3
Reciprocal Change in Sagittal Profiles After Adolescent Idiopathic Scoliosis Surgery With Segmental Pedicle Screw Construct
Authors: Shimizu Takayoshi , Cerpa Meghan , Lehman Ronald A. , Sielatycki John Alex , Pongmanee Suthipas , Lenke Lawrence G. 
Published: July 2019

Study Design.
Retrospective cohort.

Objective.
This radiographic analysis using a full-body x-ray evaluated the ways in which the sagittal profiles of the unfused spinal segments, pelvic, and lower extremities spontaneously change after adolescent idiopathic scoliosis (AIS) surgery with segmental pedicle screw constructs.

Summary of Background Data.
Reciprocal lordotic changes in unfused spinal segments after corrective surgery for AIS have been reported. However, a full-body analysis has not been studied.

Methods.
The sagittal profiles of 51 (age ≤18) patients with AIS undergoing corrective surgery with segmental pedicle screw constructs were investigated. Patients were divided into two groups: group T; selective thoracic fusion and group L; fusion to the low lumbar spine. They were further subcategorized according to preoperative thoracic kyphosis (TK: T5–12): hypokyphotic (TK <20°) and normohyperkyphotic (TK >20°) groups. The postoperative change in the sagittal parameters and the correlation between the instrumented thoracic alignment change (ΔT2−12) and reciprocal changes of unfused segments were analyzed.

Results.
At baseline, the entire cohort had a relatively hypokyphotic thoracic spine (TK: 25.5° ± 13.7°), low T1 slope (13.6° ± 7.7°), and kyphotic cervical spine (C2–7 lordosis: 7.7° ± 13.1°). The lower extremities were in neutral alignment overall. Postoperatively, the cervical alignment changed significantly lordotic (average −13.4° increased lordosis) after the adequate preservation of TK (average 17.8° increased kyphosis) in the hypokyphotic group T. Linear correlations were observed between ΔT2–12 and spontaneous reciprocal changes in C2–7 lordosis, lumbar lordosis, and knee flexion angle in group T.

Conclusion.
The sagittal profiles of patients with AIS can significantly change after adequate restoration of TK which averaged 17.8°, particularly in the cervical spine. Lordotic reciprocal change in the cervical spine as well as increase in lumbar lordosis can occur in a linear correlation after adequate restoration of TK. There were no significant changes that occurred in the pelvis or lower extremities after AIS corrective surgery.

Level of Evidence: 4
Predicting the Natural Course of Hemivertebra in Early Childhood
Authors: Chang Sam Yeol , Nam Yunjin , Lee Jeongik , Lee Na-Kyoung , Chang Bong-Soon , Lee Choon-Ki , Kim Hyoungmin 
Published: July 2019

Study Design.
A retrospective cohort, radiographic study.

Objective.
The aim of this study was to compare the progression of scoliosis owing to single hemivertebra (HV) during early childhood, according to the anteroposterior discordance obtained from the three-dimensional computed tomography (3D-CT) studies.

Summary of Background Data.
Previous studies have utilized 3D-CT for the classification of congenital spinal deformities and have introduced the concept of two types of deformity: unison and discordant anomalies. However, there have been no further studies on the clinical significance of these discordant deformities, especially in the identification of deformities that will progress and require an operation.

Methods.
We retrospectively analyzed 97 cases of single HV with thoracolumbar scoliosis, diagnosed in children before the age of 3 years and followed up past the age of 6 years. The segmentation of the anterior and posterior components, and anteroposterior discordance of the HV were evaluated using 3D-CT images. Coronal segmental curve angle (SCA) and balance were measured using whole spine plain radiographs.

Results.
Using 3D-CT, 41 (42.3%) cases of unison HV and 56 (57.7%) discordant HV were identified. Unison HV comprised 21 (21.6%) cases of fully segmented (FS) unison HV and 20 (20.6%) cases of semi-segmented unison HV with corresponding anterior and posterior segmentation. Fifty-six cases of discordant HV were further classified into 4 different types. In the 86 patients who were followed without operation between the ages of 3 and 6 years, the average progression of SCA was significantly larger in FS unison HV (one-way analysis of variance, P < 0.001). Ten of 86 (11.6%) patients showed a coronal imbalance at the age of 6 years, but the proportion of patients with coronal imbalance was not significantly different among the deformity types.

Conclusion.
Anteroposterior discordance on 3D analysis is a useful indicator for the progression of congenital scoliosis due to single HV in early childhood.

Level of Evidence: 4