bluuebunny/crossref_metadata_2025_split huggingface dataset:
A nucleotide-dependent oligomerization of the Escherichia coli replication initiator DnaA requires residue His136 for remodeling of the chromosomal origin
Authors: Saxena Rahul , Stanley Christopher B , Kumar Pankaj , Cuneo Matthew J , Patil Digvijay , Jha Jyoti , Weiss Kevin L , Chattoraj Dhruba K , Crooke Elliott 
Published: October 2019

AbstractEscherichia coli replication initiator protein DnaA binds ATP with high affinity but the amount of ATP required to initiate replication greatly exceeds the amount required for binding. Previously, we showed that ATP-DnaA, not ADP-DnaA, undergoes a conformational change at the higher nucleotide concentration, which allows DnaA oligomerization at the replication origin but the association state remains unclear. Here, we used Small Angle X-ray Scattering (SAXS) to investigate oligomerization of DnaA in solution. Whereas ADP-DnaA was predominantly monomeric, AMP–PNP–DnaA (a non-hydrolysable ATP-analog bound-DnaA) was oligomeric, primarily dimeric. Functional studies using DnaA mutants revealed that DnaA(H136Q) is defective in initiating replication in vivo. The mutant retains high-affinity ATP binding, but was defective in producing replication-competent initiation complexes. Docking of ATP on a structure of E. coli DnaA, modeled upon the crystallographic structure of Aquifex aeolicus DnaA, predicts a hydrogen bond between ATP and imidazole ring of His136, which is disrupted when Gln is present at position 136. SAXS performed on AMP–PNP–DnaA (H136Q) indicates that the protein has lost its ability to form oligomers. These results show the importance of high ATP in DnaA oligomerization and its dependence on the His136 residue.
Final Results of the Prospective Multicenter Excimer Laser-Assisted High-Flow Bypass Study on the Treatment of Giant Anterior Circulation Aneurysms
Authors: van der Zwan Albert , Vajkoczy Peter , Amin-Hanjani Sepideh , Charbel Fady T , Welch Babu , Tymianski Michael , Kivipelto Leena , van Thoor Sander , Chakraborty Shamik , O’Donnell Devon , Langer David J 
Published: October 2019

Abstract

BACKGROUND
Both conventional bypass utilizing temporary recipient vessel occlusion and the excimer laser-assisted nonocclusive anastomosis (ELANA) bypass technique are possible strategies in the treatment of giant aneurysms. These treatments have only been studied in single institutional retrospective studies. The potential advantage of the ELANA technique is the absence of temporary occlusion of major arteries, decreasing the risk of intraoperative ischemia.

OBJECTIVE
To investigate the risks and potential benefits of high-flow bypass surgery for giant and complex aneurysms of the anterior cerebral circulation. In addition, the effectiveness of the ELANA bypass procedure in the treatment of these aneurysms is determined.

METHODS
A total of 37 patients were included in 8 vascular neurosurgical centers in the United States, Canada, and Europe. A 30-d postoperative bypass follow-up was studied by using digital subtraction angiography and/or magnetic resonance angiography and computed tomography angiography to assess patency as well as by clinical monitoring in all patients.

RESULTS
In 35 patients, an ELANA high-flow bypass was performed and the aneurysm treated. Four patients had remaining neurological deficits after 30 d caused by stroke (11.4%). These strokes were not related to the ELANA anastomosis device.

CONCLUSION
This study does not prove that the ELANA technique has an advantage over conventional bypass techniques, but it appears to be an acceptable alternative to conventional transplanted high-flow bypass in this very-difficult-to-treat patient group, especially in select patients whom cannot be bypassed using conventional means in which temporary occlusion is considered to be not recommended.
Influence of fatty acid desaturase (FADS) genotype on maternal and child polyunsaturated fatty acids (PUFA) status and child health outcomes: a systematic review
Authors: Conway Marie C , McSorley Emeir M , Mulhern Maria S , Strain J J , van Wijngaarden Edwin , Yeates Alison J 
Published: October 2019

Abstract

Context
Polyunsaturated fatty acids (PUFA) are important during pregnancy for fetal development and child health outcomes. The fatty acid desaturase (FADS) genes also influence PUFA status, with the FADS genes controlling how much product (eg, arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid) is metabolized from the precursor molecules linoleic acid and α-linolenic acid.

Objective
The current review discusses the influence of FADS genotype on PUFA status of pregnant women, breast milk, and children, and also how FADS may influence child health outcomes.

Data sources
The Ovid Medline, Scopus, Embase, Cochrane Library, CINAHL Plus, PubMed and Web of Science databases were searched from their inception to September 2018.

Data extraction
Eligible studies reported FADS genotype and blood concentrations of PUFA during pregnancy, in childhood, breast milk concentrations of PUFA or child health outcomes.

Data analysis
In pregnant and lactating women, minor allele carriers have higher concentrations of linoleic acid and α-linolenic acid, and lower concentrations of arachidonic acid, in blood and breast milk, respectively. In children, FADS genotype influences PUFA status in the same manner and may impact child outcomes such as cognition and allergies; however, the direction of effects for the evidence to date is not consistent.

Conclusion
Further studies are needed to further investigate associations between FADS and outcomes, as well as the diet-gene interaction.
The Spark That Still Shines: John Calvin on Conscience and Natural Law
Authors: Lee Constance Y 
Published: October 2019

Abstract
John Calvin (1509–64), a central figure in Reformed theology, is perhaps best known for his bleak doctrine of total human depravity. This dismal view of human reason has commonly overshadowed his statement that ‘some sparks still shine’. This article proposes that Calvin’s account of conscience, by conserving an illuminated space in human nature, makes possible a formal doctrine of natural law. Calvin enlists the interconnectedness between the knowledge of God and human reason to frame his anthropology. According to this, human reason was originally created to perfectly access knowledge of God but after the Fall, can only attain imperfect access. Within this broader framework, by adopting a dialectic of dual perspectives, Calvin maintains that, however fallen, human nature still partially reflects the Imago Dei as first intended. As through a glass darkly, this divine image is reflected in human conscience endowing it with sufficient knowledge for moral discernment. Calvin’s emphasis on ‘common grace’ in the preservation of this knowledge allows him to simultaneously maintain human ignorance and their universal accountability to objective norms. In this way, Calvin’s account of conscience enables him to hold both apparent extremes in tension: the immanent fallibility of human beings with the external normative standards they ought to pursue.
Analgesic Effects of Directed Repetitive Transcranial Magnetic Stimulation in Acute Neuropathic Pain After Spinal Cord Injury
Authors: Zhao Chen-Guang , Sun Wei , Ju Fen , Wang Hong , Sun Xiao-Long , Mou Xiang , Yuan Hua 
Published: October 2019

Abstract

Objectives
Central neuropathic pain (CNP) often appears following spinal cord injury (SCI), but current treatments are not always successful. In this study, we evaluated the analgesic effects of repetitive transcranial magnetic stimulation (rTMS) applied over the hand area of the motor cortex in patients with acute CNP after SCI.

Methods
A total of 48 patients with complete or incomplete SCI and acute CNP participated in this study and were randomized to receive either rTMS (10 Hz, 1,500 stimuli; N = 24) or a sham intervention (N = 24) for three weeks. The numeric rating scale (NRS) and Short-Form McGill Pain Questionnaire-2 (Chinese Edition; SF-MPQ-2-CN) were analyzed to assess the degree of pain. Brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were collected to explore expression influenced by rTMS. Motor-evoked potential (MEP) latency and maximal amplitude were measured to determine neurophysiological changes. The assessments were carried out at baseline (T0), three days (T1), one week (T2), two weeks (T3), and three weeks (T4) after onset of treatment.

Results
The analysis showed significant treatment–time interactions for the quality and intensity of pain, as measured by NRS (P &lt; 0.001, η2 = 0.441) and SF-MPQ-2 (P &lt; 0.001, η2 = 0.590). Compared with the sham group, the NRS and SF-MPQ2-CN scores were significantly lower on the third day (P &lt; 0.001, Cohen’s d = 1.135; P = 0.006, Cohen’s d = 0.616) and after one week (P &lt; 0.001, Cohen’s d = 0.846; P = 0.012, Cohen’s d = 0.557) of treatment. In addition, the serum levels of BDNF and NGF were significantly higher in the treated group after three weeks (P = 0.015, Cohen’s d = 0.539; P = 0.009, Cohen’s d = 0.580), and the MEP amplitude increased by 109.59% (P = 0.033, Cohen’s d = 0.464).

Conclusions
These findings indicate that 10 Hz rTMS over the hand area of the motor cortex could alleviate acute CNP in the early phase of SCI and could enhance MEP parameters and modulate BDNF and NGF secretion.
Prevalence of severe childhood obesity in Wales UK
Authors: Beynon Claire , Bailey Linda 
Published: October 2019

AbstractBackgroundIn Wales, approximately one in eight children is obese (aged 4–5 years). The aim of this prevalence study was to examine the trends in severe childhood obesity and investigate any relationship with socioeconomic deprivation.MethodsData for all children included as part of the Wales Childhood Measurement Programme (2013/14–2017/18) were utilized. Data on the number who had a body mass index above the 99.6th centile indicating severe obesity were calculated over time by sex and in relation to deprivation.ResultsOf the 162 208 children measured between 2013/14 and 2017/18 (mean age 5.06 years, standard deviation 0.35 years), the overall prevalence of severe obesity was 3.1% (95% confidence interval [CI] 3.0–3.2%). This varies from 1.9% (95% CI 1.7–2.1%) in the least deprived areas to 3.9% (95% CI 3.7–4.0%) in the most deprived areas. Boys have higher prevalence of severe obesity than girls: 3.6% (95% CI 3.4–3.9%) of boys (n = 598) and 3.0% (95% CI 2.7–3.2%) of girls (n = 467) were categorized as severely obese in reception year in Wales in 2017/18. Prevalence has increased over time but this is not statistically significant.ConclusionThis study found significantly higher levels of severe obesity in areas of socioeconomic deprivation. Levels of severe obesity were significantly higher in boys than in girls.
Do Corporate Governance Ratings Change Investor Expectations? Evidence from Announcements by Institutional Shareholder Services*
Authors: Guest Paul M , Nerino Marco 
Published: October 2019

Abstract
This paper examines empirically the announcement effect of commercial corporate governance ratings on share returns. Rating downgrades by Institutional Shareholder Services (ISS) are associated with negative returns of –1.14% over a 3-day announcement window. The returns are highly correlated with the proprietary analysis of ISS and are decreasing in agency costs, consistent with ratings providing independent information on underlying corporate governance quality. We thus show that the influence and impact of ISS extends beyond proxy recommendations and subsequent voting outcomes. Our findings contrast with the insignificant price impact of Daines, Gow, and Larcker (2010), whose analysis we replicate and successfully reconcile to ours by pooling upgrades and downgrades together.
Lumbar hernia after iliac crest bone harvest
Authors: Pastore Anthony , Sobel Jonathan E. 
Published: October 2019

ABSTRACT
A lumbar hernia is a rare occurrence, with about 300 cases reported in the literature since the first publication by Garengeot in 1731. Incisional lumbar hernias are defined as secondary acquired hernias that can develop after surgeries such as nephrectomies or aortic aneurysm repairs. Harvesting bone from the iliac crest also has been identified as a cause of incisional lumbar hernias, occurring after about 0.5% of these procedures. This article discusses a patient presenting with flank pain years after an iliac crest bone harvest as well as a brief review of the pathogenesis and history of lumbar hernias.
Can pimavanserin help patients with Parkinson disease psychosis?
Authors: de la Cruz Jennifer , Canal Clinton 
Published: October 2019

ABSTRACT
Pimavanserin is a first-in-class selective serotonin 5-HT2A receptor inverse agonist approved for the treatment of Parkinson disease psychosis. This article discusses pimavanserin's mechanism of action, which patients are appropriate candidates for therapy, adverse reactions, and appropriate dosing.
Clinical utility of next-generation sequencing in precision oncology
Authors: Hux Anna , Lewis Amanda , Sachwitz Drew , Gregory Tanya 
Published: October 2019

ABSTRACT
The Precision Medicine Initiative (PMI) aims to change the way diseases are diagnosed and treated by taking into account a patient's genome, lifestyle, and environment. This type of research also uncovers potential biomarkers that can lead to the development of novel targeted therapies. Next-generation sequencing (NGS) is a new technology that facilitates collection of this genetic information by processing large amounts of DNA in an efficient and cost-effective way. NGS is particularly useful in oncology and has already begun to transform cancer management.
Recognizing, diagnosing, and treating pediatric generalized anxiety disorder
Authors: Panganiban Marinela , Yeow Michelle , Zugibe Kaitlyn , Geisler Sheryl L. 
Published: October 2019

ABSTRACT
Generalized anxiety disorder (GAD), characterized by excessive worry or apprehension, can lead to significant distress or impairment in patients' social or occupational function but commonly is overlooked by primary care providers. GAD and other anxiety disorders are among the most common mental health disorders affecting children. Without treatment, children with GAD are at higher risk for academic underperformance, substance abuse, other mental health disorders, and poor outcomes in adulthood. This article reviews screening and assessment for GAD in children and pharmacologic and nonpharmacologic recommendations for management.
Paroxysmal laryngospasm
Authors: Holley David , Mendez Anthony , Donald Carrlene 
Published: October 2019

ABSTRACT
Paroxysmal laryngospasm is an episodic event, resulting in complete closure of the larynx caused by hypersensitization of laryngeal tissue and protective laryngeal reflexes. This condition most often occurs secondary to laryngopharyngeal reflux. Prognosis generally is good after treatment is initiated; however, often because of a misunderstanding of the clinical course and potential causes, patients with paroxysmal laryngospasm can go untreated. This article describes paroxysmal laryngospasm, similarly presenting diseases, and treatment strategies.
An unusual case of bilateral anterior opercular syndrome from a neuro-rehabilitation perspective
Authors: Eventide Chad , Nair Ajoy , Tai Yen F. , Timms Katie , Lichtblau Nicole 
Published: October 2019

ABSTRACT
Bilateral anterior opercular syndrome, also known as Foix-Chavany-Marie syndrome, is relatively rare and is characterized by inability of voluntary activation of facial, lingual, pharyngeal, and masticatory muscles with preserved automatic and reflex movements such as smiling and yawning. The syndrome is caused by bilateral lesions of the anterior opercula and results in severe impairments with speech and swallowing. This article describes a patient with bilateral anterior opercular syndrome secondary to embolic strokes and how neuro-rehabilitation improved symptoms.
Progression of a Buschke-Lowenstein tumor into invasive squamous cell carcinoma
Authors: Fai Emmanuel K. , Bhutta Habib A. , Ali Kashif 
Published: October 2019

ABSTRACT
Buschke-Lowenstein tumors primarily are slow-growing giant condylomata accuminata of the anogenital region. They are locally destructive with a low rate of metastasis. Sexually transmitted oncogenic human papillomavirus type 6 and 11 are the greatest risk factors for Buschke-Lowenstein tumors or verrucous carcinomas, a type of squamous cell cancer. Grossly, the tumor appears as a large fungating, erythematous, cauliflower-like mass. Radical surgical excision of the tumor is the treatment of choice and close follow-up for recurrence is essential. The use of radiation or chemotherapy as adjunct treatments is controversial. This case report describes a patient with this rare condition.
Does rivaroxaban have a role in treating patients with PAD?
Authors: Thomas Rebekah 
Published: October 2019

ABSTRACT
Peripheral arterial disease can cause devastating health outcomes, and few therapies are available to treat this condition. Results of a secondary analysis of the COMPASS trial suggest benefit with the use of rivaroxaban 2.5 mg twice daily plus aspirin 100 mg daily. This treatment regimen could change the standard pharmacotherapeutic management practice for many patients with peripheral arterial disease.
Mechanisms of Failure Following Simulated Repetitive Lifting
Authors: Amin Dhara B. , Tavakoli Javad , Freeman Brian J.C. , Costi John J. 
Published: October 2019

Study Design.
A biomechanical analysis correlating internal disc strains and tissue damage during simulated repetitive lifting.

Objective.
To understand the failure modes during simulated safe and unsafe repetitive lifting.

Summary of Background Data.
Repetitive lifting has been shown to lead to lumbar disc herniation (LDH). In vitro studies have developed a qualitative understanding of the effect of repetitive loading on LDH. However, no studies have measured internal disc strains and subsequently correlated these with disc damage.

Methods.
Thirty human cadaver lumbar functional spinal units were subjected to an equivalent of 1 year of simulated repetitive lifting under safe and unsafe levels of compression, in combination with flexion (13–15°), and right axial rotation (2°) for 20,000 cycles or until failure. Safe or unsafe lifting were applied as a compressive load to mimic holding a 20 kg weight either close to, or at arm's length, from the body, respectively. Maximum shear strains (MSS) were measured, and disc damage scores were determined in nine regions from axial post-test magnetic resonance imaging (MRI) and macroscopic images.

Results.
Twenty percent of specimens in the safe lifting group failed before 20,000 cycles due to endplate failure, compared with 67% in the unsafe group. Over half of the specimens in the safe lifting group failed via either disc protrusion or LDH, compared with only 20% via protrusion in the unsafe group. Significant positive correlations were found between MRI and macroscopic damage scores in all regions (r
s > 0.385, P < 0.049). A significant positive correlation was observed in the left lateral region for MSS versus macroscopic damage score (r
s = 0.486, P < 0.037) and MSS versus failure mode (r
s = 0.724, P = 0.018, only specimens with disc failure). Pfirrmann Grade 3 discs were strongly associated with subsequent LDH (P = 0.003).

Conclusion.
Increased shear strains were observed in the contralateral side to the applied rotation as disc injury progressed from protrusion to LDH. Larger compressive loads applied to simulate unsafe lifting led to frequent early failure of the endplate, however, smaller compressive loads at similar flexion angles applied under safe lifting led to more loading cycles before failure, where the site of failure was more likely to be the disc. Our study demonstrated that unsafe lifting leads to greater risk of injury compared with safe lifting, and LDH and disc protrusion were more common in the posterior/posterolateral regions.

Level of Evidence: N/A
MRI Bone Marrow Edema Signal Intensity
Authors: Sims Kevin , Kountouris Alex , Stegeman James R. , Rotstein Andrew H. , Beakley David , Saw Anna E. , Cook Jill L. 
Published: October 2019

Study Design.
Comparative reliability and prospective validity.

Objective.
First, to evaluate the reliability of four methods of assessing magnetic resonance imaging (MRI) bone marrow edema (BMO) of the posterior vertebral arch of the lumbar vertebrae of elite junior fast bowlers. Second, to evaluate the validity of the most reliable method for the early detection of lumbar bone stress injury.

Summary of Background Data.
MRI has demonstrated utility in identifying BMO in lumbar vertebrae. Methods to grade the severity of BMO may provide valuable insight to inform clinical management, particularly in elite athletes where detection of early-stage bone stress may prevent progression to more severe and costly bone stress injury.

Methods.
Sixty-five male elite junior fast bowlers had repeat MRI scans during a cricket season. A subset of 19 bowlers’ images were reassessed by experienced musculoskeletal radiologists to determine intra- and inter-rater reliability. All images were aligned with independent medical records of lower back symptoms and diagnosed bone stress injuries to establish the relationship of BMO and lumbar bone stress injury.

Results.
Clinical detection of abnormal BMO, whether the pars region of the vertebra was considered in its entirety or subdivided into regions, had fair-to-moderate inter-rater reliability, and fair-to-almost perfect intra-rater reliability. Measurement of BMO signal intensity using an imaging software tool had excellent intra-rater and inter-rater reliability (ICC = 0.848, 0.837). BMO signal intensity was positively associated with subsequent LBSI (P < 0.001), and differentiated between asymptomatic and symptomatic bowlers (P < 0.001).

Conclusion.
Measurement of BMO signal intensity using an imaging software tool proved a reliable and valid measure of the severity of lumbar bone stress injury in elite junior fast bowlers.

Level of Evidence: 2