bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distal Radius Fracture
Authors: Jiang Sharon , Berger Jack M. , Nicholson Luke 
Published: May 2019

Abstract
This chapter discusses distal radius fractures, which are one of the most commonly encountered orthopedic injuries and cause significant pain in both the nonoperative and operative setting. Regional anesthesia, administered commonly in the form of brachial plexus blocks, provides for reliable analgesia during closed reduction, operative fixation, and the postoperative period. Complications related to distal radius fractures include carpal tunnel syndrome, compartment syndrome, symptomatic malunion, persistent wrist pain, and complex regional pain syndrome (CRPS). Following distal radius fracture management, follow-up is warranted for the development of CRPS, for which a variety of pharmacologic and interventional therapies may be considered.
Total Knee Arthroplasty
Authors: Chokshi Rishi , Elkassabany Nabil 
Published: May 2019

Abstract
This chapter reviews key concepts regarding acute pain management in patients undergoing total knee arthroplasty (TKA). Patients presenting to TKA often have multiple relevant comorbidities that may complicate perioperative pain management. Furthermore, the pain resulting from this procedure is particularly challenging to address with otherwise common systemic analgesics, necessitating more advanced interventions that consider both pain intensity alongside patient function and rehabilitation. Many intraoperative anesthetic management decisions carry important implications for both early and longer-term postoperative function and pain management in this patient population. This chapter will provide a broad, case-based, evidence-supported review of modern approaches to enhanced recovery after surgery (ERAS) principles for patients presenting for total knee arthroplasty.
Total Hip Arthroplasty
Authors: Rose Sydney E. , Gonzalez-Sotomayor Julio A. 
Published: May 2019

Abstract
This chapter discusses the goals, procedure, and potential outcomes of total hip arthroplasty (THA). Patients may be candidates for a THA when they have severe arthritis of their hip(s) (degeneration of cartilage covering the ends of the bones creating the hip joint). Arthritic hip pain is often progressive and gets worse as the cartilage continues to deteriorate. Typically, at the time a patient seeks hip arthroplasty, his or her quality of life has become very compromised. In a total hip arthroplasty, damaged bone and cartilage of the hip joint are removed and replaced with prosthetic components. THA can be performed under neuraxial anesthesia (spinal or epidural) or general anesthesia or a combination of both.
Ankle Arthrodesis
Authors: Berlin Jill , Halaszynski Thomas 
Published: May 2019

Abstract
This chapter discusses ankle arthrodesis (i.e., ankle fusion) surgery, the goal of which is to relieve pain and maintain or improve patient function. Candidates for ankle arthrodesis are those in whom more conservative treatments have failed and also those with severe ankle arthritis (degeneration of the cartilage covering the ends of the bones that form the ankle). The bones that form the ankle joint include the tibia, fibula, and talus. Pain can be made worse with movement of the ankle. To reduce pain is to take bones of the ankle and fuse them into one bone (to eliminate ankle motion).
Thoracic Surgery in the Elderly Patient
Authors: Donnelly Melanie , Wilson Elizabeth 
Published: May 2019

Abstract
Pain management in elderly patients poses unique challenges due to altered physiology (such as chronic renal insufficiency) and altered pharmacodynamics that make them more sensitive. Elderly patients undergoing thoracic surgery generally benefit from analgesic techniques that reduce the use of opioids and rely more on regional and neuraxial analgesic techniques using local anesthetics. In this chapter we provide an overview of the challenges of managing acute pain in the aged, discuss the benefits of using multimodal non-opioid analgesics in preventing chronic post-thoracotomy pain, and review the different regional and neuraxial analgesic techniques (i.e. paravertebral blocks, epidural analgesia) that can positively affect outcomes in the elderly after thoracic surgery.
Open Abdominal Aortic Aneurysm Repair
Authors: Cobb Danielle , Dangler Lori , Robinson Albert 
Published: May 2019

Abstract
This chapter describes the significant challenge that open repair of abdominal aortic aneurysms poses for acute pain medicine physicians. In particular, acute pain medicine physicians must have a solid understanding of ischemic pain mechanisms and temporizing analgesic strategies. Epidural analgesia is often optimal for postoperative pain control, but risks must be weighed in the setting of commonly used anticoagulants in this population. Patient-controlled opioid-based analgesia is an option; an advantage of its use is that the patient typically spends less time in pain and tends to use less medication than when medication is given according to a set schedule. However, it is characterized by numerous concerns related to safety and adverse events; if the PCA device is not programmed properly, it can result in the under- or overdosing of narcotics.
Complex Regional Pain Syndrome
Authors: Hanling Steven R. , Fowler Ian M. , Phillips C. Ryan 
Published: May 2019

Abstract
Complex regional pain syndrome (CRPS) is a chronic pain condition that typically occurs after injury to a limb or directly to a nerve. Progression of the disease can result in multiple debilitating symptoms including pain disproportionate to the inciting event. The Budapest criteria cateforize the constellation of signs and symptoms of CRPS (sensory, vasomotor, sudomotor/edema, and motor/trophic changes) and are used to diagnose the syndrome. Treatments include rehabilitation (physical and occupation therapy), multimodal pain medication (medications that target neuropathic pain such as antidepressants, membrane stabilizers, and ion channel blockers), interventional treatments (sympathetic blocks, infusion catheters, neuromodulation), and psychological therapy.
Hip Fracture
Authors: Arias Franchesca , Price Catherine C. , Gadsden Jeffrey C. 
Published: May 2019

Abstract
This chapter discusses hip fracture, which is a significant public health problem associated with substantial morbidity and mortality. Pain with hip fracture is often severe but despite this is frequently undertreated in the elderly population. Untreated pain not only is inhumane but also is a significant risk factor for delirium in this population that is already at increased risk due to age-related cognitive decline. Hip fracture patients benefit from early intervention with regional analgesic techniques such as femoral or fascia iliaca block, as well as a scheduled regimen of nonopioid analgesics such as acetaminophen and nonsteroidal anti-inflammatory medications. While opioids are known to contribute to risk for delirium, pain itself is a much stronger risk factor, and when nonopioid options are exhausted, opioids should be carefully considered. Continuous nerve block techniques provide opportunities for extended pain relief, which is associated with improved recovery profile, greater satisfaction, and a decreased risk for complications.
Inguinal Hernia Repair in a Neonate
Authors: Franklin Andrew D. , Kynes J. Matthew 
Published: May 2019

Abstract
This chapter describes inguinal hernia repair in the neonatal infant, which is one of the most commonly performed pediatric surgeries on an ambulatory basis. However, as many patients were born prematurely, a variety of analgesic concerns exist such as comorbid chronic lung disease or the concurrent risk of postoperative apnea depending on age at presentation. Additionally as acute pain in the neonatal population is often underappreciated and may have a lasting impact, numerous analgesic modalities should be considered. Intraoperatively, while general anesthesia is an option, numerous regional anesthetic techniques are available that may minimize the use of sedating agents. Both neuraxial (epidural, spinal, caudal injection) and peripheral (ilioinguinal/iliohypogastric blockade, paravertebral blockade, or transversus abdominis plane blockade) are available as analgesic modalities and in some scenarios surgical modalities. With the use of any of these modalities, complications such as nerve damage, failed block, and local anesthetic toxicity may occur. Following surgery, some neonates may require further monitoring for apneic events. Upon discharge, non-opioid analgesia including acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) if age permits should be emphasized.
Pediatric Orthopedic Surgery
Authors: Boretskty Karen 
Published: May 2019

Abstract
This chapter discusses the importance of using a comprehensive multimodal approach to analgesia following pediatric orthopedic surgery. Prior to opioid use, nonopioid adjuncts such as acetaminophen and short-course nonsteroidal anti-inflammatory use is preferred. Because breakthrough pain is common, targeted opioid therapy is often appropriate, and dosing guidelines are described in the chapter. Codeine is not recommended in the pediatric population. Following surgery, the use of peripheral regional anesthesia and perineural infusions has been shown to provide superior analgesia and opioid-sparing characteristics. While compartment syndrome is a concern in the pediatric population, few data exist to suggest peripheral regional anesthesia delays diagnosis. Pediatric patients with the appropriate amount of support may be discharged home with a perineural catheter. Additional postdischarge nonopioid analgesics should be encouraged, and a short course of opioid therapy may be provided if needed.
Pediatric Tonsillectomy
Authors: Franklin Andrew 
Published: May 2019

Abstract
Pediatric tonsillectomy and adenotonsillectomy are two of the most common surgical procedures performed on children. Tonsillectomy is a painful procedure and strategies to provide adequate analgesia are often complicated by opioid related adverse effects, particularly when the child has coexisting obstructive sleep apnea, obesity, or congenital disorders. A safe and effective multimodal analgesic plan for post-tonsillectomy pain may include adjuncts such as acetaminophen, ibuprofen, dexamethasone, and/or dexmedetomidine to reduce overall opioid usage during the perioperative period. The goal of perioperative analgesia after tonsillectomy is not necessarily to provide a pain-free state, but rather to preserve adequate respiratory function and provide enough analgesia to promote enteral hydration and adequate nutrition during the first few days following surgery, as most children recover quite rapidly from this surgical procedure.
Hypertension
Authors: Zweiker Robert , Perl Sabine 
Published: May 2019

Abstract
Hypertension has a major impact on cardiovascular and overall morbidity and mortality of patients. In most cases, the condition is caused by polygenetic predisposition and environmental lifestyle factors. General practitioners and other health-care providers should seek to screen for high blood pressure (BP) in all adults. Public knowledge about the disease can also help to detect previously unknown hypertension. First-degree family members of hypertensive patients deserve special attention because of the hereditary nature of the disease. Most measurements are made as in-office BP readings (&gt;140/&gt;90mmHg), which should be confirmed by out-of-office BP measurements in order to uncover white-coat effects. The basis for treatment decisions is ideally a calculation of the overall cardiovascular risk. Treatment of hypertension consists of both non-pharmacological lifestyle changes and pharmacological therapy. Several classes of antihypertensive drugs are available. The choice of medication is mainly dependent on compelling indications, as their main effect is BP lowering per se. From a hypertensiologist’s view, renin–angiotensin system inhibition seems an appropriate first choice of treatment for younger patients, whereas the elderly benefit more from calcium channel blockers and diuretics. Nevertheless, therapy based on the combination of 2–3 drugs is preferable in most cases.
Pulmonary hypertension
Authors: Tonkin James , Ryan Kate , Madden Brendan 
Published: May 2019

Abstract
Pulmonary hypertension is characterized by a mean pulmonary artery pressure greater than 25mmHg at rest. Pulmonary hypertension is divided into groups 1 to 5, according to the underlying cause. Group 1 diseases are characterized by plexogenic pulmonary arteriopathy, which occurs through nitric oxide, endothelin, and prostacyclin pathways. Investigations for diagnosis include echocardiography, computed tomography pulmonary angiography, and right heart catheterization. Treatment options for group 1 pulmonary hypertension include phosphodiesterase-5 inhibitors, endothelin receptor antagonists, prostacyclin analogues, and novel therapies such as selexipag and riociguat. However, chronic thromboembolic pulmonary hypertension is often treated surgically with pulmonary thromboendarterectomy.
Characterization of the pleiotropic LysR-type transcription regulator LeuO of Escherichia coli
Authors: Fragel Susann M , Montada Anna , Heermann Ralf , Baumann Ulrich , Schacherl Magdalena , Schnetz Karin 
Published: May 2019

AbstractLeuO is a pleiotropic LysR-type transcriptional regulator (LTTR) and co-regulator of the abundant nucleoid-associated repressor protein H-NS in Gammaproteobacteria. As other LTTRs, LeuO is a tetramer that is formed by dimerization of the N-terminal DNA-binding domain (DBD) and C-terminal effector-binding domain (EBD). To characterize the Escherichia coli LeuO protein, we screened for LeuO mutants that activate the cas (CRISPR-associated/Cascade) promoter more effectively than wild-type LeuO. This yielded nine mutants carrying amino acid substitutions in the dimerization interface of the regulatory EBD, as shown by solving the EBD’s crystal structure. Superimposing of the crystal structures of LeuO-EBD and LeuO-S120D-EBD suggests that the Ser120 to Asp substitution triggers a structural change that is related to effector-induced structural changes of LTTRs. Corresponding functional analyses demonstrated that LeuO-S120D has a higher DNA-binding affinity than wild-type LeuO. Further, a palindromic DNA-binding core-site and a consensus sequence were identified by DNase I footprinting with LeuO-S120D as well as with the dimeric DBD. The data suggest that LeuO-S120D mimics an effector-induced form of LeuO regulating a distinct set of target loci. In general, constitutive mutants and determining the DNA-binding specificity of the DBD-dimer are feasible approaches to characterize LTTRs of unknown function.
Superior Cerebellar Artery Aneurysms Causing Facial Pain: A Comprehensive Review
Authors: Ros de San Pedro Javier 
Published: May 2019

Abstract

BACKGROUND
Trigeminal neuralgia caused by superior cerebellar artery aneurysms (TGN-SCAAs) is a rare event without previous analysis.

OBJECTIVE
To describe the features of TGN-SCAA based on 8 cases (7 from literature +1 illustrative case).

METHODS
All cases were thoroughly studied with gathering of their epidemiological, radiological, clinical, therapeutic, and outcome data.

RESULTS
The mean age at diagnosis was 61 yr. Gender distribution showed a female predominance (M: F = 2:6). Side distribution had a left dominance (75%). The aneurysms mean size was 15.4 mm (range: 5-27). All 5 proximal SCAAs (SCA-Basilar junction) presented a lateral-posterior projection, while all 3 distal SCAAs (s2 segment) had variable projections but constant direct trigeminal nerve (TN) contact. No hemorrhage occurred. TGN was the clinical onset in all 8 cases. The most frequent pain distribution was V1-2-3 (n = 3), followed by V1-2 (n = 1) and V1 alone (n = 1). Proximal SCAAs caused TGN through direct TN compression (n = 1), third nerve compression (n = 1), cavernous sinus compression (n = 1), or a combination thereof (n = 2). However, all distal SCAAs caused TGN by direct TN compression (n = 3). Two different treatment options were used: clipping (n = 4) and coiling (n = 4). The post-treatment Barrow Neurological Institute score for pain control was I in all cases (100%). The mRS score was 0 in 75% of cases.

CONCLUSION
TGN-SCAAs are infrequent lesions, characterized by large size, variable TGN mechanisms depending on their anatomic location, and mostly affecting the first and second trigeminal divisions. Both SCAA clipping and coiling were used equally, providing good neurological and pain relief results.
Feeding ecology of early life stages of striped bass (Morone saxatilis) along an estuarine salinity-turbidity gradient, St. Lawrence Estuary, Canada
Authors: Vanalderweireldt L , Sirois P , Mingelbier M , Winkler G 
Published: May 2019

Abstract
After being extirpated from the St. Lawrence River in the 1960s, striped bass (Morone saxatilis) were reintroduced to the estuary in 2002 and by 2008, they were naturally reproducing. To document the habitat use and feeding ecology of this reintroduced population, we examined the gut contents of 333 larvae and juveniles. Samples were collected in four estuarine habitats in 2014: the upstream freshwater section (UP), the oligohaline (O-ETM) and the mesohaline (M-ETM) estuarine turbidity maximum zones, and the downstream polyhaline section (DOWN). In June, pelagic larvae developed in the UP and the O-ETM, feeding mainly on copepods such as Eurytemora affinis. The O-ETM exhibited better suitable feeding conditions compared to the UP, likely due to the presence of Bosmina sp. as a primary prey. After July, striped bass shifted to larger prey items, consuming mainly dipteran pupa in upstream littoral habitats and gammarids and mysids in downstream habitats. In the early summer, the UP provided a high-quality nursery habitat and as the season progressed, the smallest juveniles dispersed downstream and improved their feeding success by exploiting a new feeding niche. This observation suggests that being distributed throughout the estuary may increase the potential survival of striped bass early life stages.
The Importance of Political Knowledge for Effective Citizenship
Authors: Kleinberg Mona S , Lau Richard R 
Published: May 2019

Abstract
General political knowledge is a central variable in American politics research. Individuals with high political knowledge exhibit behaviors that are consequential to a well-functioning democracy, including holding more stable political opinions, exhibiting greater ideological constraint, knowing more about political candidates, and being more likely to vote correctly. In this paper, we examine whether the internet revolution, enabling citizens to look up anything at any time, has changed the relative importance of political knowledge in American politics. We show that important generational differences exist between Americans raised during the broadcast era and Americans raised with the presence and accessibility of the internet. Internet access can be a substitute for political knowledge stored in long-term memory, particularly among this younger generation, who may be relying on the internet to store knowledge for them.
Toxicoproteomic Analysis of Poly(ADP-Ribose)-Associated Proteins Induced by Oxidative Stress in Human Proximal Tubule Cells
Authors: Islas-Robles Argel , Yedlapudi Deepthi , Lau Serrine S , Monks Terrence J 
Published: May 2019

Abstract
2,3,5-Tris-(glutathion-S-yl)hydroquinone (TGHQ) is a nephrotoxic and nephrocarcinogenic metabolite of hydroquinone. TGHQ generates reactive oxygen species (ROS), causing DNA-strand breaks, hyperactivation of PARP-1, increases in intracellular calcium ([Ca2+]i), and cell death. PARP-1 catalyzes the attachment of ADP-ribose polymers (PAR) to target proteins. In human kidney proximal tubule cells, ROS-mediated PARP-1 hyperactivation and elevations in [Ca2+]i are reciprocally coupled. The molecular mechanism of this interaction is unclear. The aim of the present study was to identify ROS-induced PAR-associated proteins to further understand their potential role in cell death. PAR-associated proteins were enriched by immunoprecipitation, identified by LC-MS/MS, and relative abundance was obtained by spectral counting. A total of 356 proteins were PAR-modified following TGHQ treatment. A total of 13 proteins exhibited gene ontology annotations related to calcium. Among these proteins, the general transcription factor II-I (TFII-I) is directly involved in the modulation of [Ca2+]i. TFII-I binding to phospholipase C (PLC) leads to calcium influx via the TRPC3 channel. However, inhibition of TRPC3 or PLC had no effect on TGHQ-mediated cell death, suggesting that their loss of function may be necessary but insufficient to cause cell death. Nevertheless, TGHQ promoted a time-dependent translocation of TFII-I from the nucleus to the cytosol concomitant with a decrease in tyrosine phosphorylation in α/β-TFII-I. Therefore it is likely that ROS have an important impact on the function of TFII-I, such as regulation of transcription, and DNA translesion synthesis. Our data also shed light on PAR-mediated signaling during oxidative stress, and contributes to the development of strategies to prevent PAR-dependent cell death.
Understanding Retirement Requires Getting Inside People’s Stories: A Call for More Qualitative Research
Authors: Amabile Teresa M 
Published: May 2019

AbstractQuantitative research, using surveys and archival data, has contributed much to the field’s understanding of the retirement transition, the factors influencing it, and its consequences. In this commentary, I argue that, in order to move to a deeper understanding of retirement decisions, retirement processes, and retirement experiences, researchers must add rigorous qualitative studies to their portfolios. Only by asking open-ended questions of people approaching, moving through, or living in retirement can we illuminate deeper psychological issues such as identity maintenance and change, the reconstruction of life narratives and structures, the reciprocal influence of relationships on individual decisions and experiences, and the confrontation of existential questions about the meaning of one’s life.