bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival following Self-Inflicted Gunshots to the Face
Authors: Elegbede Adekunle , Wasicek Philip J. , Mermulla Sara , Dunlow Ryan , Rasko Yvonne M. , Aarabi Bizhan , Liang Fan , Grant Michael P. , Nam Arthur J. 
Published: July 2019

Background:
Self-inflicted gunshot wounds involving the face are highly morbid. However, there is a paucity of objective estimates of mortality. This study aims to provide prognostic guidance to clinicians that encounter this uncommon injury.

Methods:
A retrospective review of patients presenting to R Adams Cowley Shock Trauma Center (a Level I trauma center) with self-inflicted gunshot wounds to the face from 2007 to 2016. Isolated gunshot wounds to the calvaria or neck were excluded. The data were analyzed to determine predictors of survival.

Results:
Of the 69 patients that met inclusion criteria, 90 percent were male and 80 percent were Caucasian, with an age range of 21 to 85 years. The most frequently seen injury patterns showed submental (57 percent), intraoral (22 percent), and temporal (12 percent) entry sites. Fewer than half (41 percent) of the cohort sustained penetrative brain injury. Overall, there were 18 deaths (overall mortality, 26 percent), 17 of which were secondary to brain injury. Independent predictors of death included penetrative brain injury (OR, 17; p < 0.0001) and age. Mortality was 17 percent among patients younger than 65 years, compared with 73 percent for those aged 65 years or older (p = 0.0001). Gastrostomy placement was independently associated with 25 percent reduction in length of hospitalization (p = 0.0003).

Conclusions:
Despite tremendous morbidity, the overwhelming majority of patients who present with facial self-inflicted gunshot wounds will survive, especially if they are young and have no penetrative brain injury. These findings should help guide clinical decisions for this devastating injury.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Treating Craniofacial Dysostoses with Hypertelorism by Monobloc Facial Bipartition Distraction: Surgical and Educational Videos
Authors: Raposo-Amaral Cassio Eduardo , Denadai Rafael , Ghizoni Enrico , Raposo-Amaral Cesar Augusto 
Published: July 2019

Summary:
Simultaneously advancing and medializing the orbital segments in a stable bone bloc constitutes a major advancement in craniofacial surgery. Monobloc bipartition enables destigmatization of the syndromic face by correcting the abnormal orbital axis and interorbital distance. The authors stratified this complex surgical approach into five major steps to facilitate a holistic understanding of the surgical sequence. The rationale for latency and activation periods and the advantages and disadvantages of this technique are described.
A Smart Sensing Cannula for Fat Grafting
Authors: Turer David M. , Qaium Ehsan B. , Lawrence April M. , Clark William W. , Rubin J. Peter 
Published: July 2019

Summary:
Gluteal fat grafting has been highlighted as a significant safety issue in plastic surgery, with a mortality rate as high as one in 3000 cases. Injury to the gluteal veins resulting in fat emboli has been identified as the cause of these mortalities. The gluteal veins lie deep to the gluteal musculature in the buttocks, and it has been suggested that avoiding intramuscular injection of fat may prevent these complications. The authors present a novel injection cannula design that uses impedance sensing to determine the location of the cannula tip. Specifically, the system can determine when the tip of the cannula leaves the subcutaneous plane and enters muscle. The use of this system may prevent inadvertent injury to the gluteal veins and subsequent embolic complications.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Female Genital and Vaginal Plastic Surgery: An Overview
Authors: Placik Otto J. , Devgan Lara L. 
Published: July 2019

Learning Objectives:
After studying this article and viewing the video, the participant should be able to: 1. Accurately describe the relevant aesthetic anatomy and terminology for common female genital plastic surgery procedures. 2. Have knowledge of the different surgical options to address common aesthetic concerns and their risks, alternatives, and benefits. 3. List the potential risks, alternatives, and benefits of commonly performed female genital aesthetic interventions. 4. Be aware of the entity of female genital mutilation and differentiation from female genital cosmetic surgery.

Summary:
This CME activity is intended to provide a brief 3500-word overview of female genital cosmetic surgery. The focus is primarily on elective vulvovaginal procedures, avoiding posttrauma reconstruction or gender-confirmation surgery. The goal is to present content with the best available and independent unbiased scientific research. Given this relatively new field, data with a high level of evidence are limited. Entities that may be commonly encountered in a plastic surgery practice are reviewed. The physician must be comfortable with the anatomy, terminology, diagnosis, and treatment options. Familiarity with requested interventions and aesthetic goals is encouraged.
Influence of Biological Parameters Assessed in [18F]FDG PET/CT on Overall Survival in Cervical Cancer Patients
Authors: Cegla Paulina , Burchardt Ewa , Roszak Andrzej , Czepczynski Rafal , Kubiak Anna , Cholewinski Witold 
Published: July 2019

Aim
The aim of this study was to estimate the influence of biological parameters assessed in [18F]FDG PET/CT on overall survival (OS) in cervical cancer patients.

Methods
Retrospective analysis was performed on a group of 371 patients with newly diagnosed and histologically confirmed cervical cancer. PET biological parameters in primary tumor including SUVmax, SUVmean, total lesion glycolysis (TLG), metabolic tumor volume (MTV), heterogeneity, and parameters referring both to primary tumor and metastatic lesions: SUVtotal, TLGtotal, and MTVtotal, were analyzed.

Results
Based on PET/CT results, 3 subgroups were identified: cervical only—with disease limited only to the cervix (38%), +regional nodes—where increased glucose accumulation in addition to the cervical area was also observed in regional lymph nodes (36%), and +distal metastases—where PET scan showed a disseminated disease (26%). Depending on the stage of the disease, in the cervical-only group, 5-year survival rate was 86%; in the +regional nodes group, it was 80%; whereas in the +distal metastases group, 5-year survival rate was only 55%. However, based on Cox regression model, significant influence on OS was found only in heterogeneity of primary tumor; more inhomogeneous tumors suggest worse prognosis (0.25 ± 0.04 vs 0.16 ± 0.09, P < 0.001), SUVtotal (76.6 ± 130.1 vs 45.4 ± 73.4, P = 0.002), and MTVtotal (79.03 ± 88.27 vs 63.00 ± 83.80 cm3, P = 0.03). For heterogeneity, cutoff point suggesting worse prognosis was 0.18; for SUVtotal, 52.3; and for MTVtotal, 66.55 cm3.

Conclusions
Stage of disease assessed in [18F]FDG PET/CT significantly influences survival rate in patients with cervical cancer. SUVtotal, MTVtotal, and heterogeneity of primary tumor are independent prognostic factors on OS in cervical cancer patients.
68Ga-DOTATATE PET/CT in Focal Fatty Sparing of the Liver
Authors: Hod Nir , Levin Daniel , Anconina Reut , Taragin Benjamin H. , Dudnik Julia , Lantsberg Sophie 
Published: July 2019

Abstract

68Ga-DOTATATE imaging is commonly used for the detection of metastatic disease in neuroendocrine tumors. We present a case of a 69-year-old woman postsurgery for lung carcinoid tumor in which sequential follow-up 68Ga-DOTATATE PET/CT studies identified focal hepatic uptake that was presumed to represent a liver metastasis. However, correlative imaging with MRI revealed a focal fatty sparing of the liver composed of benign hepatic parenchyma at that area accompanied with diffuse liver steatosis in the background of the “pseudolesion.” This report demonstrates a potential “false-positive” hepatic finding that can strikingly mimic a metastasis in neuroendocrine tumor imaging.
The Use of Random Forests to Classify Amyloid Brain PET
Authors: Zukotynski Katherine , Gaudet Vincent , Kuo Phillip H. , Adamo Sabrina , Goubran Maged , Scott Christopher , Bocti Christian , Borrie Michael , Chertkow Howard , Frayne Richard , Hsiung Robin , Laforce Robert , Noseworthy Michael D. , Prato Frank S. , Sahlas Demetrios J. , Smith Eric E. , Sossi Vesna , Thiel Alexander , Soucy Jean-Paul , Tardif Jean-Claude , Black Sandra E. 
Published: July 2019

Purpose
To evaluate random forests (RFs) as a supervised machine learning algorithm to classify amyloid brain PET as positive or negative for amyloid deposition and identify key regions of interest for stratification.

Methods
The data set included 57 baseline 18F-florbetapir (Amyvid; Lilly, Indianapolis, IN) brain PET scans in participants with severe white matter disease, presenting with either transient ischemic attack/lacunar stroke or mild cognitive impairment from early Alzheimer disease, enrolled in a multicenter prospective observational trial. Scans were processed using the MINC toolkit to generate SUV ratios, normalized to cerebellar gray matter, and clinically read by 2 nuclear medicine physicians with interpretation based on consensus (35 negative, 22 positive). SUV ratio data and clinical reads were used for supervised training of an RF classifier programmed in MATLAB.

Results
A 10,000-tree RF, each tree using 15 randomly selected cases and 20 randomly selected features (SUV ratio per region of interest), with 37 cases for training and 20 cases for testing, had sensitivity = 86% (95% confidence interval [CI], 42%–100%), specificity = 92% (CI, 64%–100%), and classification accuracy = 90% (CI, 68%–99%). The most common features at the root node (key regions for stratification) were (1) left posterior cingulate (1039 trees), (2) left middle frontal gyrus (1038 trees), (3) left precuneus (857 trees), (4) right anterior cingulate gyrus (655 trees), and (5) right posterior cingulate (588 trees).

Conclusions
Random forests can classify brain PET as positive or negative for amyloid deposition and suggest key clinically relevant, regional features for classification.
Reassessment of the Need for an Oxygen Carrier for the Treatment of Traumatic Hemorrhage When Blood is not an Option
Authors: Pusateri Anthony E. , Glassberg Elon , Weiskopf Richard B. 
Published: July 2019

ABSTRACT
Approximately 10 years ago, the development of hemoglobin-based oxygen carriers (HBOCs) was largely stalled after two large phase 3 clinical trials failed to achieve licensure primarily because the safety profile was viewed as unsatisfactory when HBOCs were compared with red cells. Concerns were also raised that HBOCs, as a class, had inherent toxicities. Since then, clinical experience with HBOCs in expanded access programs and under licensure in South Africa has demonstrated that HBOCs can be used safely and effectively. In recent years, clinical studies have demonstrated that prehospital blood transfusion improves survival in severely injured patients with hemorrhage, especially when transport times are longer than 20 to 30 min. Yet, logistical constraints still limit use of blood products in the prehospital setting. As the urgent need for oxygen-carrying capacity for trauma patients for whom red cells are not available is becoming much more apparent, it is imperative that we reexamine the possibility of using HBOCs when red blood cell transfusion is not an option.
Mitigating Racial and Sex Disparities in Access to Living Donor Kidney Transplantation
Authors: Mustian Margaux N. , Kumar Vineeta , Stegner Katie , Mompoint-Williams Darnell , Hanaway Michael , Deierhoi Mark H. , Young Carlton , Orandi Babak J. , Anderson Douglas , MacLennan Paul A. , Reed Rhiannon D. , Shelton Brittany A. , Eckhoff Devin , Locke Jayme E. 
Published: July 2019

Objective:
In this study, we sought to assess likelihood of living donor kidney transplantation (LDKT) within a single-center kidney transplant waitlist, by race and sex, after implementation of an incompatible program.

Summary Background Data:
Disparities in access to LDKT exist among minority women and may be partially explained by antigen sensitization secondary to prior pregnancies, transplants, or blood transfusions, creating difficulty finding compatible matches. To address these and other obstacles, an incompatible LDKT program, incorporating desensitization and kidney paired donation, was created at our institution.

Methods:
A retrospective cohort study was performed among our kidney transplant waitlist candidates (n = 8895). Multivariable Cox regression was utilized, comparing likelihood of LDKT before (era 1: 01/2007–01/2013) and after (era 2: 01/2013–11/2018) implementation of the incompatible program. Candidates were stratified by race [white vs minority (nonwhite)], sex, and breadth of sensitization.

Results:
Program implementation resulted in the nation's longest single-center kidney chain, and likelihood of LDKT increased by 70% for whites [adjusted hazard ratio (aHR) 1.70; 95% confidence interval (CI), 1.46–1.99] and more than 100% for minorities (aHR 2.05; 95% CI, 1.60–2.62). Improvement in access to LDKT was greatest among sensitized minority women [calculated panel reactive antibody (cPRA) 11%–49%: aHR 4.79; 95% CI, 2.27–10.11; cPRA 50%–100%: aHR 4.09; 95% CI, 1.89–8.82].

Conclusions:
Implementation of an incompatible program, and the resulting nation's longest single-center kidney chain, mitigated disparities in access to LDKT among minorities, specifically sensitized women. Extrapolation of this success on a national level may further serve these vulnerable populations.
Rapid leaf trait response to growing-season meteorology inVitis:Implications for leaf physiognomic paleoclimate reconstructions
Authors: Baumgartner Aly , Donahoo Michaela , Chitwood Daniel H. , Peppe Daniel J. 
Published: July 2019

ABSTRACTPREMISE OF THE STUDYThe size and shape (physiognomy) of woody, dicotyledonous angiosperm leaves are correlated with climate and these relationships have been used to develop. proxies. These proxies assume that leaf morphology plastically responds to meteorological conditions and that leaf traits change isometrically through development.METHODSWe used Digital Leaf Physiognomy (DiLP) to measure leaf characters of multipleVitisspecies from the USDA Germplasm Repository in Geneva, NY from the 2012-2013 and 2014-2015 growing seasons. These growing seasons had different temperature and precipitation.KEY RESULTSWe found three primary results: (1) there were predictable significant differences in leaf characters in leaves of different developmental stages along the vine, (2) there were significant differences in leaf characters in leaves of the same developmental stage between the growing seasons, and (3) there were significant differences in leaf characters between growing seasons.CONCLUSIONSWe found thatVitisleaf shape had the strongest relationship with growing season meteorological conditions in taxa growing in their native range. In addition, leaves have variable phenotypic plasticity along the vine. We interpret that the meteorological signal was strongest in those leaves that have completed allometric expansion. This is significant for leaf physiognomic-paleoclimate proxies because these leaves are most likely to be preserved in leaf litter and reflect the type of leaves included in paleoclimate reconstructions. We found that leaf development does have the potential to be a confounding factor, but it is unlikely to exert a significant influence on analysis due to differential preservation potential.
Thermodynamic and Kinetic Characterization of Protein Conformational Dynamics within a Riemannian Diffusion Formalism
Authors: Goolsby Curtis , Fakharzadeh Ashkan , Moradi Mahmoud 
Published: July 2019

AbstractWe have formulated a Riemannian framework for describing the geometry of collective variable spaces of biomolecules within the context of collective variable based molecular dynamics simulations. The formalism provides a theoretical framework to develop enhanced sampling techniques, path-finding algorithms, and transition rate estimators consistent with a Riemannian treatment of the collective variable space, where the quantities of interest such as the potential of the mean force, minimum free energy path, the diffusion constant, and the transition rate remain invariant under coordinate transformation due to the Riemannian treatment of the collective variable space. Specific algorithms within this framework are discussed such as the Riemannian umbrella sampling, the Riemannian string method, and a Riemannian-Bayesian estimator of free energy and diffusion constant, which can be used to estimate the transition rate along a minimum free energy path.
What threatens Brazilian endangered species and how they are Red-Listed
Authors: Bernard Enrico , de Barros Fernanda Silva , Felix Vitória Edna Fernandes , Lacher Thomas E. 
Published: July 2019

AbstractBrazil is a continental-sized megadiverse country with high rates of habitat loss and degradation. Part of the Brazilian biodiversity – including endemic species – is recognized as threatened. By following the IUCN standards, we review the classification of all the 1172 endangered species in Brazil, analyzing differences among categories and groups. Based on a subsample of all 464 terrestrial vertebrates we identified 1036 records of threats affecting them. Criterion B was the most used (56% overall; 70% for CR species; 75% for EN), mainly related to reductions in their habitat area, extent and/or quality due to deforestation. Data on population declines (criterion A), number of reproductive individuals (criterion C), and population sizes (criterion D) are available for only a small fraction of the Brazilian fauna. Criterion E (probability of extinction in the wild) was used for only one species. Birds and mammals had the highest diversity of used criteria, while marine fish the lowest (90% related to declining populations). Two out of three of the 464 vertebrate species analyzed were negatively impacted by agribusiness. Other major threats are hunting, urban sprawl, rural settlements, and the construction of hydroelectric dams. Birds and mammals experience more co-occurrence of threats. Some threats are clearly underestimated in Brazil: climate change was indicated for only 2% species analyzed, but included no birds or amphibians. The main threats identified are linked to the patterns of economic development in Brazil and the current political and economic context points to a worrisome conservation scenario in the near future.
Microtubule Disruption does not Impair Learning in the Unicellular Organism Paramecium: Implications for Information Processing in Microtubules
Authors: Alipour A. , Hatam G. , Seradj H. 
Published: July 2019

AbstractInformation processing in microtubules is an open question that has not been properly addressed yet. It was suggested that microtubules could store and process information in the nervous system or even support consciousness. The unicellular organism,Paramecium caudatum, that has a microtubular structure but does not have a neuron or neural network, shows intelligent behaviors such as associative learning. This may suggest that the microtubules are involved in intelligent behavior, information storage or information processing in paramecium. To test this hypothesis, we have utilized a paramecium learning task in which the organism associates brightness in its swimming medium with attractive cathodal shocks to study the role of microtubules in paramecium learning. We used an antimicrotubular agent (parbendazole) and disrupted microtubular dynamics in paramecium to see if microtubules are an integral part of information storage and processing in paramecium’s learning process. We observed that a partial allosteric modulator of GABA (midazolam) could disrupt the learning process in paramecium, but the antimicrotubular agent could not. Therefore, our results suggest that microtubules are probably not vital for the learning behavior inP. caudatum. Consequently, our results call for a further revisitation of the microtubular information processing hypothesis.
Brain-age in midlife is associated with accelerated biological aging and cognitive decline in a longitudinal birth-cohort
Authors: Elliott Maxwell L. , Belsky Daniel W. , Knodt Annchen R. , Ireland David , Melzer Tracy R. , Poulton Richie , Ramrakha Sandhya , Caspi Avshalom , Moffitt Terrie E. , Hariri Ahmad R. 
Published: July 2019

AbstractAn individual’s brain-age is the difference between chronological age and age predicted from machine-learning models of brain-imaging data. Brain-age has been proposed as a biomarker of age-related deterioration of the brain. Having an older brain-age has been linked to Alzheimer’s, dementia and mortality. However, these findings are largely based on cross-sectional associations which can confuse age differences with cohort differences. To illuminate the validity of brain-age a biomarker of accelerated brain aging, a study is needed of a large cohort all born the same year who nevertheless vary on brain-age. In a population-representative 1972-73 birth cohort we measured brain-age at age 45, as well as the pace of biological aging and cognitive decline in longitudinal data from childhood to midlife (N=869). In this cohort, all chronological age 45 years, brain-age was measured reliably (ICC=.81) and ranged from 24 to 72 years. Those with older midlife brain-ages tended to have poorer cognitive function in both adulthood and childhood, as well as impaired brain health at age 3. Furthermore, those with older brain-ages had an accelerated pace of biological aging, older facial appearance and early signs of cognitive decline from childhood to midlife. These findings help to validate brain-age as a potential surrogate biomarker for midlife intervention studies that seek to measure treatment response to dementia-prevention efforts in midlife. However, the findings also caution against the assumption that brain-age scores represent only age-related deterioration of the brain as they may also index central nervous system variation present since childhood.
Allicin regulates energy homeostasis through brown adipose tissue
Authors: Zhang Chuanhai , He Xiaoyun , Sheng Yao , Xu Jia , Yang Cui , Zheng Shujuan , Liu Junyu , Li Haoyu , Ge Jianbing , Yang Minglan , Zhai Baiqiang , Xu Wentao , Luo Yunbo , Huang Kunlun 
Published: July 2019

AbstractBackground/objectives:Disorder of energy homeostasis can lead to a variety of metabolic diseases, especially obesity. Brown adipose tissue (BAT) is a promising potential therapeutic target for the treatment of obesity and related metabolic diseases. Allicin, a main bioactive ingredient in garlic, has multiple biology and pharmacological function. However, the role of Allicin, in the regulation of metabolic organ, especially the role of activation of BAT, has not been well studied. Here, we analyzed the role of Allicin in whole-body metabolism and the activation of BAT.Results:Allicin had a significant effect in inhibiting body weight gain, decreasing adiposity, maintaining glucose homeostasis, improving insulin resistance, and ameliorating hepatic steatosis in diet-introduced obesity (DIO) mice. Then we find that Allicin can strongly activate brown adipose tissue (BAT). The activation of brown adipocyte treated with Allicin was also confirmed in mouse primary brown adipocytes.Conclusion:Allicin can ameliorate obesity through activating brown adipose tissue. Our findings provide a promising therapeutic approach for the treatment of obesity and metabolic disorders.