bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scratch Modeling of Paint Coated Sheet Metal for Multi-Stage Deep Drawing Process
Authors: Kim J , Yoon J W , Lee B , Kim J , Park J 
Published: September 2018

Abstract
The scratch phenomenon of paint coated sheet metal in multi-stage deep drawing has been investigated. The tensile tests at a quasi-static strain rate of sheet metals coated with two different types of paint were conducted along the rolling, diagonal, and transverse directions of the sheet metal in order to consider strain hardening and anisotropy. It has been found that the types of paint are negligible for plasticity behavior. Finite element simulations of the multi-stage deep drawing process was performed using the obtained material properties and the simulation results were compared with the actual testing. Through the simulation results, three approaches, which include the contact pressure, the accumulated slip distance, and the accumulated friction work were implemented to investigate the scratch phenomenon and they were compared for the scratched and non-scratched regions. It was found that the accumulated slip distance at the scratched region was larger than that of the non-scratched region with a good correlation from experimental observation, whereas either the contact pressure or accumulated friction work approach did not predict the experiments. Therefore, it is concluded that the accumulated slip distance is a good method to identify the scratch on the paint coated sheet metal during deep drawing process.
Safe Gluteal Fat Graft Avoiding a Vascular or Nervous Injury: An Anatomical Study in Cadavers
Authors: Alvarez-Alvarez Filiberto Alejandro , González-Gutiérrez Hiram O , Ploneda-Valencia César Felipe 
Published: September 2018

Abstract

Background
Fat grafting for gluteal augmentation is one of the most popular aesthetic surgery procedures. It has an associated mortality to fat embolism of 0.2%.

Objectives
The authors of this study sought to describe which technique for synthetic graft application was least likely to cause a fat embolism.

Methods
Ten fresh bodies were obtained and 4 groups arranged with 5 buttocks each randomly assigned. Group 1 was infiltrated through the upper medial intergluteal sulcus (upper medial intergluteal sulcus) with an angulation of −30°, −10°, and 0°. Group 2 was infiltrated through the middle lower gluteal sulcus with an angulation of −30°, 0°, and +15°. Group 3 was infiltrated through a peritrochanteric (PT) access at the level of the femur head at 0° and +10° and in the middle of the buttock at the level of the posterior superior iliac crest at −30° toward the trochanter (lateral direction). Group 4 was infiltrated in the same manner as group 1 without −30°. A complication occurred when the graft was in contact with the vascular or nervous bundle, within the gluteus medius muscle, or both.

Results
Group 1 had 3 buttocks with a complication (UMIGS −30°). Group 2 had complications in all the injection techniques. Group 3 had 5 buttocks with a complication (PT at 0°). Group 4 had no complications.

Conclusions
The injection of the fat graft through the UMIGS at 0° and 10° angles, and through the middle of the buttock at the level of posterior superior iliac crest a −30° angle, reaches the surface needed for gluteal augmentation. The group 2 techniques should be avoided because they have a high risk of complication.
Dietary Patterns and Self-reported Incident Disability in Older Adults
Authors: Agarwal Puja , Wang Yamin , Buchman Aron S , Bennett David A , Morris Martha C 
Published: September 2018

Abstract

Background or Objectives
Disability in older adults is associated with low quality of life and higher mortality. Diet may be a potentially important public health strategy for disability prevention in aging. We examined the relations of the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean–DASH Intervention for Neurodegenerative Delay (MIND) diets to functional disability in the Rush Memory and Aging Project.

Methods
A total of 809 participants (mean age = 80.7 ± 7.2 years, 74% female) without functional disability at baseline were followed for an average of 5.3 years. Standardized measures for self-reported disability including, activities of daily living ADL), instrumental ADL, and mobility disability were assessed annually. The diet scores were computed based on a validated food frequency questionnaire administered at baseline.

Results
In Cox proportional hazards models adjusted for age, sex, education, smoking, physical activity, and total calories, the second (hazard ratio = 0.75, 95% CI: 0.60–0.95) and third tertiles (hazard ratio = 0.67, 95% CI: 0.53–0.86) of MIND diet scores had lower rates of ADL disability compared to the lowest tertile (p for trend = .001), whereas only the third tertiles of the Mediterranean (hazard ratio = 0.73, 95% CI: 0.57–0.94) and DASH (hazard ratio = 0.75, 95% CI: 0.59–0.95) diets were significantly associated with ADL disability. Instrumental ADL disability was inversely and linearly associated with the MIND diet score only (p for trend = .04). Mobility disability was associated with the MIND (p for trend = .02), Mediterranean (p for trend = .05) and DASH (p for trend = .02) diet scores.

Conclusion
These findings are encouraging that diet may be an effective strategy for the prevention of functional disability in older adults.
Mismatch Repair Protein Loss as a Prognostic and Predictive Biomarker in Breast Cancers Regardless of Microsatellite Instability
Authors: Fusco Nicola , Lopez Gianluca , Corti Chiara , Pesenti Chiara , Colapietro Patrizia , Ercoli Giulia , Gaudioso Gabriella , Faversani Alice , Gambini Donatella , Michelotti Anna , Despini Luca , Blundo Concetta , Vaira Valentina , Miozzo Monica , Ferrero Stefano , Bosari Silvano 
Published: September 2018

Abstract

Background
Breast cancers that harbor mismatch-repair (MMR) deficiency and/or microsatellite instability (MSI) might be sensitive to immune checkpoint blockade, but there are currently no specific guidelines for assessing MMR status in breast cancer. Here, we sought to define the clinical value of MMR immunohistochemistry (IHC) and MSI analysis in breast cancers.

Methods
We subjected 444 breast cancers to MMR IHC and MSI analysis. Cases were classified as MMR-proficient (pMMR), MMR-deficient (dMMR), and MMR-heterogeneous (hMMR) based on the loss of immunoreactivity; MSI was defined by instability in the five indicators recommended by the National Cancer Institute for endometrial and colorectal cancers. Correlation of MMR status with patients’ survival was assessed using the Kaplan-Meier estimator. Statistical tests were two-sided.

Results
Loss of MMR proteins was homogeneous (dMMR) in 75 patients (17%) and heterogeneous (hMMR) in 55 (12%). Among luminal breast cancers, there were similar frequencies of dMMR and hMMR tumors. Overall, the rate of discrepancy between IHC and MSI analysis was high (91%). Women with Luminal B-like dMMR carcinomas (n = 44) showed shorter overall survival (median = 77 months, range = 0–115 months) than those with pMMR (n = 205) or hMMR (n = 35) tumors (median = 84 months, range = 0–127 months) (P = .008). On the contrary, patients with estrogen receptor-negative breast cancers treated with chemotherapy lived longer in cases of dMMR (n = 9) than pMMR (n = 33) or hMMR (n = 7) tumors, with 87 months of median survival (range = 73–123 months) for the former compared with 79 months (range = 8–113 months) for the latter two categories (P < .001).

Conclusions
Immunohistochemistry and MSI are not interchangeable tests in breast carcinomas. MMR protein loss is a more common event than MSI and shows intra-tumor heterogeneity. MMR IHC allows the identification of clinically relevant subclasses of breast cancer patients, provided that multiple areas of the tumor are analyzed.
Carbapenem-Nonsusceptible Gram-Negative Pathogens in ICU and Non-ICU Settings in US Hospitals in 2017: A Multicenter Study
Authors: McCann Eilish , Srinivasan Arjun , DeRyke C Andrew , Ye Gang , DePestel Daryl D , Murray John , Gupta Vikas 
Published: September 2018

Abstract

Background
Infections caused by Gram-negative pathogens resistant to carbapenems have limited treatment options and are associated with increased morbidity and mortality. We evaluated the rates, infection sources, and pathogen types associated with carbapenem-nonsusceptible (Carb-NS) Gram-negative isolates in intensive care unit (ICU) and non-ICU settings in a large US hospital database.

Methods
We conducted a retrospective cross-sectional analysis of carbapenem susceptibility of all nonduplicate isolates of Gram-negative pathogens collected from January 1, 2017, to December 31, 2017, at 358 US hospitals in the BD Insights Research Database. Carb-NS isolates included all pathogens reported at the institutional level as intermediate or resistant.

Results
Of 312 075 nonduplicate Gram-negative isolates, 10 698 (3.4%) were Carb-NS. Respiratory samples were the most frequent source of Carb-NS isolates (35.2%); skin/wound accounted for 23.6%. Pseudomonas aeruginosa was the most common Carb-NS pathogen (58.5% of isolates), and about 30% were Enterobacteriaceae. The highest rates of Carb-NS were found in Acinetobacter spp. (35.6%) and P. aeruginosa (14.6%). The rate of Carb-NS was significantly higher in ICU (5.4%) vs non-ICU settings (2.7%; P &lt; .0001 in univariate analysis). This difference remained significant in multivariable analysis after adjusting for infection and hospital characteristics (odds ratio, 1.35; 95% confidence interval, 1.17–1.56; P &lt; .0001).

Conclusions
Infections caused by Carb-NS isolates pose a significant clinical problem across different sources of infection, species of pathogen, and hospital settings. Widespread infection prevention and antimicrobial stewardship initiatives, in combination with new treatment options, may be required to reduce the burden of carbapenem resistance in health care settings.
Combined Keratoplasty, Pars Plana Vitrectomy, and Flanged Intrascleral Intraocular Lens Fixation to Restore Vision in Complex Eyes With Coexisting Anterior and Posterior Segment Problems
Authors: Yokogawa Hideaki , Kobayashi Akira , Okuda Tetsuhiko , Mori Natsuko , Masaki Toshinori , Sugiyama Kazuhisa 
Published: September 2018

Purpose:
To restore vision in complex eyes with coexisting anterior and posterior segment problems, combined corneal transplantation (penetrating keratoplasty [PK] or Descemet-stripping automated endothelial keratoplasty [DSAEK]), pars plana vitrectomy (PPV), and/or flanged intrascleral intraocular lens (IOL) fixation, designated vitreocorneal surgery are performed. In this study, we evaluated the usefulness of vitreocorneal surgery for eyes with complex comorbidities.

Methods:
Thirteen consecutive eyes in 13 patients with coexisting corneal pathology (ie, corneal scarring, bullous keratoplasty, corneal laceration) and posterior segment pathology (ie, aphakia without capsular support, retinal detachment, intravitreal foreign body) underwent vitreocorneal surgery. Visual outcomes, intraoperative and postoperative complications, and additional surgery were retrospectively evaluated.

Results:
Vitreocorneal surgery included PK + PPV + intrascleral IOL fixation (n = 5), PK + PPV (n = 3), PK + intrascleral IOL fixation (n = 1), DSAEK + intrascleral IOL fixation (n = 1), and DSAEK + PPV + intrascleral IOL fixation (n = 3). An intraoperative Eckardt temporary keratoprosthesis use enabled safe PPV. No vitreoretinal/IOL complications occurred. One eye required repeat DSAEK to repair endothelial graft detachment and inversion. In 3 eyes, secondary glaucoma was subsequently treated by glaucoma drainage device implantation through the pars plana. Mean best spectacle-corrected visual acuity (logMAR) improved from 1.8 ± 0.9 preoperatively to 1.1 ± 0.6 at 11.2 ± 14.6 months postoperatively (P = 0.002). Postoperative refraction was −0.68 ± 2.56 D (spherical equivalent).

Conclusions:
PK or DSAEK with PPV and/or flanged intrascleral IOL fixation is useful for complex eyes with coexisting anterior and posterior segment problems.
Development and Functional Modulation of Regulatory T Cells by Transcription Factors and Epigenetics
Authors: Ito Minako , Iizuka-Koga Mana , Ando Makoto , Yoshimura Akihiko 
Published: September 2018

Abstract:
Regulatory T cells (Tregs) are essential for the maintenance of immune homeostasis. Studies of Treg are not only necessary for understanding the mechanism of immune homeostasis but also extremely useful for the development of treatments of various immune diseases. Forkhead box P3 (Foxp3) was identified as the master gene responsible for the immune-suppressing activity of Tregs. The promoter region and several intronic enhancers, designated conserved noncoding sequence (CNS) 0, 1, 2, and 3, at the Foxp3 gene locus have important roles in Foxp3 expression and Treg development. We demonstrated that transcription factors Nr4a and Smad2/3 are required for development of thymic Tregs and induced Tregs, respectively. In addition to transcription factors, Treg-specific DNA demethylation has been shown to be important for Treg stability. In particular, DNA demethylation of CNS2 was implicated in Treg stability, and members of the ten-eleven translocation family of demethylation factors were recently demonstrated to have important roles in 5′-C-phosphate-G-3′ demethylation at CNS2. This article summarizes recent findings regarding the roles of transcription factors and epigenetic modifications in the differentiation, maintenance, and function of Tregs. This review will facilitate clinical application of Tregs to diseases in the field of ophthalmology, including uveitis and age-related macular degeneration.
The Evolving Story of Pterygium
Authors: Young Alvin L. , Cao Di , Chu Wai Kit , Ng Tsz Kin , Yip Yolanda W.Y. , Jhanji Vishal , Pang Chi Pui 
Published: September 2018

Abstract:
Pterygium is a fibrovascular subepithelial growth of degenerative tissue over the limbus. It is a common condition worldwide that is especially prevalent in tropical countries within the “pterygium belt.” Its exact etiology remains to be elucidated; however, it is strongly associated with exposure to ultraviolet light. The high expression levels of tumor protein p53 (TP53) observed in laboratory studies of pterygium seem to contradict the fast-growing nature of its clinical behavior, and TP53 mutations have been suggested. We demonstrated that mouse double minute 2 (MDM2), a TP53-binding protein, contributes to the inhibition of TP53 activity in human pterygium. Thus, disruption of the MDM2-TP53 interaction should attenuate human pterygium cell growth. For primary pterygium, treatment is relatively straightforward and involves surgical excision. To minimize the risk of recurrence, many adjunctive therapies are adopted, including antimetabolites, such as mitomycin C and 5-fluorouracil, amniotic membrane, different variations on conjunctival and/or limbal conjunctival grafts, and other medications such as anti-vascular endothelial growth factor. In the future, MDM2 antagonists may help further lower the recurrence rates after the treatment of pterygium.
Post-Laser In Situ Keratomileusis Epithelial Ingrowth: Treatment, Recurrence, and Long-Term Results
Authors: Yesilirmak Nilufer , Chhadva Priyanka , Cabot Florence , Galor Anat , Yoo Sonia H. 
Published: September 2018

Purpose:
To study outcomes after surgical removal of epithelial ingrowth (EI) in post-laser in situ keratomileusis patients, specifically comparing visual results and recurrence rates between 2 different EI management techniques.

Methods:
In this retrospective chart review of 67 eyes of 54 patients who underwent surgical treatment for EI after laser in situ keratomileusis between July 1999 and July 2014 at the Bascom Palmer Eye Institute, Miami, FL, surgical techniques, recurrence rates, visual acuity (VA), and refractive error were assessed.

Results:
Of the 67 eyes, 56 eyes (83.6%) had flap lift + scraping alone, and 11 eyes (16.4%) had flap lift + scraping + suturing. After mean follow-up of 2.5 years, 11 of 56 eyes (19.6%) treated with flap lift + scraping alone had EI recurrence, whereas no eyes treated with flap lift + scraping + suturing had EI recurrence. VA results and refractive errors were better in eyes treated with lift + scraping alone compared with lift + scraping + suturing at 1 month. In the 67 eyes with 1-year follow-up, VA and refractive errors improved from preoperative values and were comparable between groups.

Conclusions:
Scraping alone provides significantly better initial visual outcomes but higher EI recurrence rates compared with scrape–suturing. Long-term visual outcomes are comparable between 2 techniques.
Necrosis of the Glabella After Injection With Hyaluronic Acid Into the Forehead
Authors: Han Jingjian , He Yanzi , Liu Kuikui , Yang Qinghua 
Published: September 2018

Abstract
Skin necrosis is a rare but severe potential complication after injection of hyaluronic acid (HA). Based on the understanding of the causes and mechanisms of this complication, many precautions have been proposed. Still, this adverse reaction happened from time to time. Here, the authors present a patient with glabellar skin necrosis following an injection into the forehead using HA filler. Although not uncommon, this patient might suggest an alternative cause or mechanism of tissue necrosis following HA injection besides intravascular injection or extravascular compression directly by HA filler. Further study is needed to examine other possible causes in order to eliminate this risk.
Complex Orbital Fractures: Three-Dimensional Planning and Combined Surgical Approach
Authors: Mici Elidon , Calvo Alessandro , Cicciù Marco , Cervino Gabriele , Belli Evaristo 
Published: September 2018

Abstract
Nowadays the development of diagnostic imaging, surgical techniques, alloplastic materials, and surgical instruments has made possible a more accurate management of orbital fractures. The aim of the present study was the management of orbital fractures and the solution of particular cases. The use of high-resolution computed tomography makes possible to gain a better understanding of the complex orbit anatomical structure. Also endoscopy is a valid alternative for medial orbital wall fractures treatment. It gives high control of the fracture site and its reduction. When this technology is combined with 3-dimensional (3D) reformatted images, it allows us to reconstruct more accurately the orbital defects. The authors present their experience in complex orbital fractures treated with the aim of the 3D navigation using a preformed orbital titanium plate. Endosopical approach was used to control plate positioning.
Comparison of Musculocutaneous and Fasciocutaneous Free Flaps for the Reconstruction of the Extensive Composite Scalp and Cranium Defects
Authors: Uzun Hakan , Bitik Ozan , Ersoy Umut Sinan , Bilginer Burçak , Aksu Ali Emre 
Published: September 2018

Abstract
Composite scalp and cranium defects, which require microsurgical reconstruction, result from tumor resection, radiation, trauma, severe burn injuries, and rarely vasculitic disorders. In the current study, the authors aim to compare the outcomes of the fasciocutaneous flaps and musculocutaneous free flaps used for the reconstruction of extensive composite scalp and cranium defects. From 2010 to 2017, 21 patients who underwent composite scalp and cranium defect reconstruction with a free flap were retrospectively identified. Eighteen patients had squamous cell carcinoma, 2 patients had meningioma, and 1 patient had Ewing sarcoma. Thirteen musculocutaneous free flaps including latissimus dorsi and vertical rectus abdominis flaps and 9 free fasciocutaneous flaps including radial forearm and anterolateral thigh flaps were used. Only 1 flap loss was encountered. No neurologic impairment in postoperative period was reported. The mean length of stay in the hospital, the duration of surgery, and total volume of blood transfusion for the fasciocutaneous flap group were significantly shorter than those for musculocutaneous flap group. No flap atrophy was reported in fasciocutaneous flap group. Reconstruction of the composite scalp and cranium defects with fasciocutaneous free flaps allows shorter hospitalization, less blood transfusion and less flap atrophy than those of musculocutaneous flaps. To this respect, their usage should be prioritized in such challenging patients.
A non-canonical JAGGED1 signal to JAK2 mediates osteoblast commitment in cranial neural crest cells
Authors: Kamalakar Archana , Oh Melissa S. , Stephenson Yvonne C. , Ballestas-Naissir Samir A. , Davis Michael E. , Willett Nick J. , Drissi Hicham M. , Goudy Steven L. 
Published: September 2018

AbstractDuring craniofacial development, cranial neural crest (CNC) cells migrate into the developing face and form bone through intramembranous ossification. Loss of JAGGED1 (JAG1) signaling in the CNC cells is associated with maxillary hypoplasia or maxillary bone deficiency (MBD) in mice and recapitulates the MBD seen in humans with Alagille syndrome. JAGGED1, a membrane-bound NOTCH ligand, is required for normal craniofacial development, andJagged1mutations in humans are known to cause Alagille Syndrome, which is associated with cardiac, biliary, and bone phenotypes and these children experience increased bony fractures. Previously, we demonstrated deficient maxillary osteogenesis inWnt1-cre;Jagged1f/f(Jag1CKO) mice by conditional deletion ofJagged1in maxillary CNC cells. In this study, we investigated the JAG1 signaling pathways in a CNC cell line. Treatment with JAG1 induced osteoblast differentiation and maturation markers,Runx2andOcn, respectively, Alkaline Phosphatase (ALP) production, as well as classic NOTCH1 targets,Hes1andHey1.While JAG1-inducedHes1andHey1expression levels were predictably decreased after DAPT (NOTCH inhibitor) treatment, JAG1-inducedRunx2andOcnlevels were surprisingly constant in the presence of DAPT, indicating that JAG1 effects in the CNC cells are independent of the canonical NOTCH pathway. JAG1 treatment of CNC cells increased Janus Kinase 2 (JAK2) phosphorylation, which was refractory to DAPT treatment, highlighting the importance of the non-canonical NOTCH pathway during CNC cells osteoblast commitment. Pharmacologic inhibition of JAK2 phosphorylation, with and without DAPT treatment, upon JAG1 induction reduced ALP production and,Runx2andOcngene expression. Collectively, these data suggest that JAK2 is an essential component downstream of a non-canonical JAG1-NOTCH1 pathway through which JAG1 stimulates expression of osteoblast-specific gene targets in CNC cells that contribute to osteoblast differentiation and bone mineralization.