bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anatomy of the Superficial Fascia System of the Breast: A Comprehensive Theory of Breast Fascial Anatomy
Authors: Rehnke Robert D. , Groening Rachel M. , Van Buskirk Eric R. , Clarke John M. 
Published: October 2018

Background:
It has been two centuries since Petrus Camper identified superficial fascia and over 175 years since Sir Astley Cooper wrote his book on the anatomy of the breast. In the 1990s, Ted Lockwood taught us the importance of the superficial fascia layers in body contouring procedures he pioneered. These descriptions, however, fail to explain the three-dimensional fascial system in the breast. The authors set out to discover and describe a theory of superficial fascia structures responsible for breast shape.

Methods:
The nature of the superficial fascia system that surrounds the breast and its attachments to the chest were studied in 12 cadaver breast dissections and in clinical cases of both cosmetic and reconstructive breast procedures.

Results:
The authors found a three-dimensional, closed system of fascia and fat surrounding the corpus mammae, which attaches to the skin by means of specialized vertical cutaneous ligaments, or Cooper ligaments, and which attaches to the chest wall by means of a three-dimensional zone of adherence at the breast’s periphery.

Conclusions:
The breast is shaped by a three-dimensional, fibrofatty fascial system. Two layers of this system surround the corpus mammae and fuse together around it, and anchor it to the chest wall in a structure we have called the circummammary ligament.
Clinical, Economic, and Organizational Impact of the Clinical Pharmacist in an Orthopedic and Trauma Surgery Department
Authors: Renaudin Pierre , Coste Annabelle , Audurier Yohan , Berbis Julie , Canovas François , Jalabert Anne , Castet-Nicolas Audrey , Mercier Gregoire , Villiet Maxime , Dagneaux Louis , Breuker Cyril 
Published: October 2018

Aim
The aim of this study was to evaluate the clinical, economic, and organizational impact of clinical pharmacist services added to an adult orthopedic and trauma surgery unit in a university hospital.

Methods
This was a prospective, observational study performed from January to February 2017. All pharmacists’ interventions were documented, and their clinical, economic, and organizational impact and the probability of adverse drug events (ADEs) were assessed using the clinical, economic and organizational scale three-dimensional scale. An expert panel composed of three clinical pharmacists, one surgeon and one anesthetist classified the pharmacist intervention. The potential clinical impact was determined through a consensus by the expert panel. Cost avoidance was calculated for serious ADEs with a major impact by avoiding an additional cost of €4912 per event and taking into account the probability of ADE occurrence.

Results
The pharmacists performed 1014 interventions for 28 days with a 95.3% acceptance rate by prescribers. Thirty-nine interventions were rated to have a major clinical impact (3.8%). The organizational impact was estimated favorable for 856 (84.4%) pharmacist interventions. Cost avoidance was estimated at €24,364, and the indirect costs benefit was estimated at €11,864 during the study. The cost-benefit ratio of the clinical pharmacist intervention was €1.94 in savings for every €1 invested.

Conclusions
Clinical pharmacist services in an orthopedic and trauma surgery department have the potential to improve patient outcomes and avoid healthcare costs. Furthermore, the presence of a pharmacist in surgical units allows for communication between the unit and the pharmacy, which produces better fluidity and improves the quality of care.
The Las Vegas mass shooting: An analysis of blood component administration and blood bank donations
Authors: Lozada M. James , Cai Stephanie , Li Marissa , Davidson Stephanie Lynne , Nix Justin , Ramsey Glenn 
Published: October 2018

BACKGROUND
The deadliest mass shooting in modern United States history occurred on October 1, 2017, in Las Vegas, killing 58 and overwhelming hospitals with more than 600 injured. The scope of the tragedy offers insight into medical demands, which may help guide preparedness for future mass shooting incidents.

METHODS
Retrospective, deidentified, health care institution–provided data from all hospitals and blood banks providing care to Las Vegas shooting victims were gathered. Study authors independently reviewed all data and cross-referenced it for verification. Main outcomes and measures include the number of victims requiring hospital and intensive care admission, the amount and types of blood components transfused during the first 24 hours, and the amount of blood donated to local blood banks following the Las Vegas mass shooting.

RESULTS
Two hundred twenty patients required hospital admission, 68 of them to critical care. Nearly 500 blood components were transfused during the first 24 hours in a red blood cell–to–plasma–to–platelet ratio of 1:0.54:0.81. Public citizens donated almost 800 units of blood immediately after the shooting; greater than 17% of this donated blood went unused.

CONCLUSIONS
The amount of blood components transfused per patient admitted was similar in magnitude to other mass casualty events, and available blood supply met patient demand. The public call for blood donors was not necessary to meet immediate demand and led to resource waste. Preparation for future mass shooting incidents should include training the community in hemorrhage control, encouraging routine blood donation, and avoiding public calls for blood donation unless approved by local blood suppliers.

LEVEL OF EVIDENCE
Therapeutic study, level V.
Feeding the disparities: the geography and trends of breastfeeding in the United States
Authors: Garnier Romain , Bento Ana I. , Rohani Pejman , Omer Saad B. , Bansal Shweta 
Published: October 2018

AbstractThere is scientific consensus on the importance of breastfeeding for the present and future health of newborns, in high- and low-income settings alike. In the United States, improving breast milk access is a public health priority but analysis of secular trends are largely lacking. Here, we used data from the National Immunization Survey of the CDC, collected between 2003 and 2016, to illustrate the temporal trends and the spatial heterogeneity in breastfeeding. We also considered the effect sizes of two key determinants of breastfeeding rates. We show that, while access to breast milk both at birth and at 6 months old has steadily increased over the past decade, large spatial disparities still remain at the state level. We also find that, since 2009, the proportion of households below the poverty level has become the strongest predictor of breastfeeding rates. We argue that, because variations in breastfeeding rates are associated with socio-economic factors, public health policies advocating for breastfeeding are still needed in particular in underserved communities. This is key to reducing longer term health disparities in the U.S., and more generally in high-income countries.
Bidirectional effects of anxiety and anorexia nervosa: A Mendelian randomization study
Authors: Lloyd E Caitlin , Sallis Hannah , Verplanken Bas , Haase Anne M , Munafò Marcus R 
Published: October 2018

AbstractObjectivesTo assess bidirectional effects of anxiety and anorexia nervosa (AN) phenotypes. Design Two-sample Mendelian randomization.SettingGenome-wide association study (GWAS) summary statistics from the Psychiatric Genomics Consortium (PGC), analysis of the UK Biobank sample, and Anxiety Neuro Genetics Study (ANGST) consortium.ParticipantsEuropean descent participants from the PGC (n = 14,477), UK Biobank (n = 348,219), and ANGST consortium (n = 17,310, and n = 18,186).Main outcome measuresAN diagnosis, worry, anxiety disorder pathology (case-control and quantitative phenotypes).ResultsWe found evidence of a moderate genetic correlation between worry and AN (Rg = 0.36, SE = 0.05, p < 0.001), and the Mendelian randomization analysis supported a causal influence of worry on AN (OR = 2.14, 95% CI: 1.18 to 3.90, p = 0.01). There was no clear evidence for a causal effect of AN on worry in this study (B = −0.01, 95% CI: −0.03 to 0.02, p = 0.55). There was no robust evidence for a causal influence of anxiety disorders on AN (for case-control anxiety disorder phenotype: OR = 1.02, 95% CI: 0.69, 1.50, p = 0.922; for quantitative anxiety disorder phenotype: OR = 4.26, 95% CI: 0.49, 36.69, p = 0.187). There was no robust evidence for a causal effect of AN on anxiety disorders (for case control anxiety disorder phenotype: OR = 1.00, 95% CI: 0.72, 1.38, p = 0.981; for quantitative anxiety disorder phenotype: B = 0.01, 95% CI: −0.06, 0.6=09, p = 0,761). AN and anxiety disorder phenotypes were not genetically correlated (for case-control anxiety disorder phenotype: Rg = 0.10, se = 0.17, p = .56; for quantitative anxiety disorder phenotype: Rg = 0.12, SE = 0.17, p = 0.47).ConclusionsFindings support a role for worry in AN development, highlighting a potential target of future AN prevention efforts. Mechanisms underlying the association should be a focus of future investigation. The relatively small sample sizes of anxiety disorder and AN GWASs may have limited power to detect causal effects; these associations should be studied further.
Risk aversion in macaques in a freely moving patch-leaving foraging task
Authors: Eisenreich B. R , Hayden Benjamin Y. 
Published: October 2018

ABSTRACTAnimals, including humans, are risk-averse in most contexts. A major exception is the rhesus macaque (Macaca mulatta), which is robustly risk-seeking. Macaques‘ unique preferences may reflect their unique evolutionary history. Alternatively, they may derive from elements of task design associated with the demands of physiological recording, the source of nearly all macaque risk preference data. To disambiguate these possibilities we assessed macaques’ risk attitudes in a somewhat more naturalistic environment: subjects foraged at four feeding stations in a large enclosure. Stations (i.e. patches) provided either stochastically or non-stochastically depleting rewards. Subjects’ patch residence times were longer at safe than at risky stations, indicating a preference for safe options. This preference was not attributable to a win-stay-lose-shift heuristic. These findings highlight the lability of risk attitudes in macaques and support the hypothesis that observed differences between macaques and other species are ephemeral, not evolved.
Global biogeography of Tetragnatha spiders reveals multiple colonization of the Caribbean
Authors: Čandek Klemen , Agnarsson Ingi , Binford Greta J. , Kuntner Matjaž 
Published: October 2018

AbstractOrganismal variation in dispersal ability can directly affect levels of gene flow amongst populations, therefore importantly shaping species distributions and species richness patterns. The intermediate dispersal model of biogeography (IDM) predicts that in island systems, species diversity of those lineages with an intermediate dispersal potential is the highest. We broadly test this prediction, focusing on ‘four-jawed spiders’ (genus Tetragnatha) of the Caribbean archipelago. First, we report on original sampling of this globally distributed genus with numerous widespread as well as endemic species. We then reconstruct multiple Tetragnatha phylogenies from roughly 300 individuals delineated into 54 putative species. Our results support the monophyly of the four-jawed spiders but reject the monophyly of those lineages that reach the Caribbean, where we find low levels of endemism yet high diversity within Tetragnatha. The chronogram detects a potential early overwater colonization of the Caribbean, and in combination with reconstructed biogeographic history, refutes the possibility of ancient vicariant origins of Caribbean Tetragnatha as well as the GAARlandia land-bridge scenario. Instead, biogeographic results hypothesize multiple colonization events to, and from the Caribbean since mid-Eocene to late-Miocene. Tetragnatha seems unique among the arachnids explored so far in comprising some species that are excellent dispersers, and others that are not, perhaps having secondarily lost this dispersal propensity. A direct test of the IDM would require consideration of three categories of dispersers. However, four-jawed spiders do not fit one of these three a priori definitions, but rather represent a more complex combination of attributes of a ‘dynamic disperser’.
The Ca2+-activated Cl− current ensures robust and reliable signal amplification in vertebrate olfactory receptor neurons
Authors: Reisert Johannes , Reingruber Jürgen 
Published: October 2018

AbstractActivation of most primary sensory neurons results in transduction currents that are carried by cations. One notable exception is the vertebrate olfactory receptor neuron (ORN), where the transduction current is carried largely by the anion Cl−. However, it remains unclear why ORNs use an anionic current for signal amplification. We have sought to provide clarification on this topic by studying the so far neglected dynamics of Na+, Ca2+, K+ and Cl− in the small space of olfactory cilia during an odorant response. Using computational modeling and simulations we compared the outcomes of signal amplification based on either Cl− or Na+ currents. We found that amplification produced by Na+ influx instead of a Cl− efflux is problematic due to several reasons: First, the Na+ current amplitude varies greatly depending on mucosal ion concentration changes. Second, a Na+ current leads to a large increase in the ciliary Na+ concentration during an odorant response. This increase inhibits and even reverses Ca2+ clearance by Na+/Ca2+/K+ exchange, which is essential for response termination. Finally, a Na+ current increases the ciliary osmotic pressure, which could cause swelling to damage the cilia. By contrast, a transduction pathway based on Cl− efflux circumvents these problems and renders the odorant response robust and reliable.
Activation of SEDS-PBP cell wall synthases by an essential regulator of bacterial division
Authors: Lariviere Patrick J. , Mahone Christopher R. , Santiago-Collazo Gustavo , Howell Matthew , Daitch Allison K. , Zeinert Rilee , Chien Peter , Brown Pamela J. B. , Goley Erin D. 
Published: October 2018

AbstractBacterial growth and division require insertion of new peptidoglycan (PG) into the existing cell wall by PG synthase enzymes. Emerging evidence suggests that many PG synthases require activation to function, however it is unclear how activation of division-specific PG synthases occurs. The FtsZ cytoskeleton has been implicated as a regulator of PG synthesis during division, but the mechanisms through which it acts are unknown. Here we show that FzlA, an essential regulator of constriction inCaulobacter crescentus, links FtsZ to PG synthesis to promote division. We find that hyperactive mutants of the PG synthases FtsW and FtsI specifically renderfzlA, but not other division genes, non-essential. However, FzlA is still required to maintain proper constriction rate and efficiency in a hyperactive PG synthase background. Intriguingly, loss offzlAin the presence of hyperactivated FtsWI causes cells to rotate about the division plane during constriction and sensitizes cells to cell wall-specific antibiotics. We demonstrate that FzlA-dependent signaling to division-specific PG synthesis is conserved in another α-proteobacterium,Agrobacterium tumefaciens.These data establish that FzlA links FtsZ to cell wall remodeling, serving both to activate and spatially orient PG synthesis during division. Overall, our findings support the paradigm that activation of SEDS-PBP PG synthases is a broadly conserved requirement for bacterial morphogenesis.
Efficiency of island homing by sea turtles under multimodal navigating strategies
Authors: Painter K. J. , Plochocka A. Z. 
Published: October 2018

AbstractA dot in the vastness of the Atlantic, Ascension Island remains a lifelong goal for the green sea turtles that hatched there, returning as adults every three or four years to nest. This navigating puzzle was brought to the scientific community’s attention by Charles Darwin and remains a topic of considerable speculation. Various cues have been suggested, with orientation to geomagnetic field elements and following odour plumes to their island source among the most compelling. Via a comprehensivein silicoinvestigation we test the hypothesis that multimodal cue following, in which turtles utilise multiple guidance cues, is the most effective strategy. Specifically, we combine agent-based and continuous-level modelling to simulate displaced virtual turtles as they attempt to return to the island. Our analysis shows how population homing efficiency improves as the number of utilised cues is increased, even under “extreme” scenarios where the overall strength of navigating information decreases. Beyond the paradigm case of green turtles returning to Ascension Island, we believe this could commonly apply throughout animal navigation.
Bacterial contribution to genesis of the novel germ line determinantoskar
Authors: Blondel Leo , Jones Tamsin E. M. , Extavour Cassandra G. 
Published: October 2018

AbstractNew cellular functions and developmental processes can evolve by modifying existing genes or creating novel genes. Novel genes can arise not only via duplication or mutation but also by acquiring foreign DNA, also called horizontal gene transfer (HGT). Here we show that HGT likely contributed to the creation of a novel gene indispensable for reproduction in some insects. Long considered a novel gene with unknown origin,oskarhas evolved to fulfil a crucial role in insect germ cell formation. Our analysis of over 100 insect Oskar sequences suggests that Oskar arose de novoviafusion of eukaryotic and prokaryotic sequences. This work shows that highly unusual gene origin processes can give rise to novel genes that can facilitate evolution of novel developmental mechanisms.One Sentence SummaryOur research shows that gene origin processes often considered highly unusual, including HGT and de novo coding region evolution, can give rise to novel genes that can both participate in pre-existing gene regulatory networks, and also facilitate the evolution of novel developmental mechanisms.
3-D navigation – A core driver of brain plasticity in video game interventions
Authors: Kühn Simone , Becker Maxi , Gallinat Jürgen 
Published: October 2018

AbstractRecent evidence has repeatedly shown that 3D platform video game training leads to substantial brain structural plasticity in hippocampus, prefrontal cortex and cerebellum. However, a great disadvantage of using complex video game interventions is the difficulty to attribute the observed effects to specific game mechanics.In order to address this caveat, we conducted a longitudinal training study in which 40 participants were randomly assigned to train with a 3D platformer game or a 2D platformer game. The main difference between the two games lies within their affordance for spatial exploration. After a training phase of two months, we observed extended brain structural increases in the 3D in comparison to the 2D condition in bilateral prefrontal areas, hippocampus/ entorhinal cortex as well as precuneus and the temporal lobe. In the reverse contrast an increase in bilateral caudate nucleus was observed.The results demonstrate a crucial role of 3D spatial navigation for widespread brain plasticity effects within a two-months training setup. Given the vast complexity of video games, spatial navigation seems to play an outstanding role in structural plasticity. Since prefrontal, temporal and hippocampal volume deficits are prominent risk factors for several psychiatric disorders, daily navigation habits (outdoor movement, using GPS devices etc.) have to be considered in future mental disorders prevention research.
Subcortical theta oscillations alternate with high amplitude neocortical population within synchronized states
Authors: Krull Erin Munro , Sakata Shuzo , Toyoizumi Taro 
Published: October 2018

AbstractSynchronized states are marked by large-amplitude low-frequency oscillations in the cortex. These states can be seen during quiet waking or slow-wave sleep. Within synchronized states, previous studies have noted a plethora of different types of activity, including delta oscillations (0.5-4 Hz) and slow oscillations (<1 Hz) in the cortex and large- and small-irregular activity in the hippocampus. However, it is not still fully characterized how neural populations contribute to the synchronized state. Here we apply independent component analysis (ICA) to parse which populations are involved in different kinds of cortical activity, and find two populations that alternate throughout synchronized states. One population broadly affects cortical deep layers, and is associated with larger amplitude slower cortical activity. The other population exhibits theta-frequency oscillations that are not easily observed in raw field potential recordings. These theta oscillations apparently come from below the cortex, suggesting hippocampal origin, and are associated with smaller amplitude faster cortical activity. Relative involvement of these two alternating populations may indicate different modes of operation within synchronized states.
Genetic Association of Arterial Stiffness Index with Blood Pressure and Coronary Artery Disease
Authors: Zekavat Seyedeh M. , Haas Mary , Aragam Krishna , Emdin Connor , Khera Amit V. , Klarin Derek , Zhao Hongyu , Natarajan Pradeep 
Published: October 2018

AbstractBackgroundArterial stiffness index (ASI) is independently associated with blood pressure and coronary artery disease (CAD) in epidemiologic studies. However, it is unknown whether these associations represent causal relationships.ObjectivesHere, we assess whether genetic predisposition to increased ASI is associated with elevated blood pressure and CAD risk.MethodsGenome-wide association analysis (GWAS) of finger photoplethysmography-derived ASI was performed in 131,686 participants from the UK Biobank. Across UK Biobank participants not in the ASI GWAS, a 6-variant ASI polygenic risk score was calculated. The ASI polygenic score was associated with systolic and diastolic blood pressures (SBP, DBP, N=208,897), and with incident CAD over 10 years follow-up (N=223,061; 7,534 cases). The lack of CAD association observed was replicated among 184,305 participants (60,810 cases) from the Coronary Artery Disease Genetics Consortium (CARDIOGRAMplusC4D).ResultsWe replicated prior reports of the epidemiologic association of ASI with SBP (Beta 0.55mmHg, [95% CI, 0.45–0.65],P=5.77×10−24), DBP (Beta 1.05mmHg, [95% CI, 0.99–1.11],P=7.27×10−272), and incident CAD (HR 1.08 [95% CI, 1.04–1.11],P=1.5×10−6) in multivariable models. While each SD increase in genetic predisposition to elevated ASI was highly associated with SBP (Beta 4.63 mmHg [95% CI, 2.1–7.2];P=3.37×10−4), and DBP (Beta 2.61 mmHg [95% CI, 1.2–4.0];P=2.85×10−4), no association was observed with incident CAD in UK Biobank (HR 1.12 [95% CI, 0.55–2.3];P=0.75), or with prevalent CAD in CARDIOGRAMplusC4D (OR 0.56 [95% CI, 0.26–1.24];P=0.15).ConclusionsA genetic predisposition to higher ASI was associated with elevated blood pressure but not with increased risk of developing CAD.Condensed AbstractArterial stiffness index (ASI) is proposed by some as a surrogate of blood pressure and coronary artery disease (CAD) risk based on epidemiologic analyses. We tested whether genetic predisposition to increased ASI is associated with elevated blood pressure and CAD risk to assess whether these represent causal relationships. We find that a genetic predisposition to higher ASI is associated with elevated systolic (Beta 4.63 mmHg [95% CI, 2.1–7.2]) and diastolic blood pressures (Beta 2.61 mmHg [95% CI, 1.2–4.0]) in the UK Biobank, but not associated with incident CAD in the UK Biobank (P=0.75) or with prevalent CAD in CARDIOGRAMplusC4D (P=0.15). These data support a causal relationship of ASI with blood pressure but do not support the notion that ASI is a suitable surrogate for CAD risk.