bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent Myalgia since Early Infancy—Misleading Clinical Course in a Child with Carnitine Palmitoyltransferase-II Deficiency
Authors: Arélin Maria , Zierz Stephan , Ceglarek Uta , Heinemann Mitja , Beblo Skadi , Merkenschlager Andreas 
Published: September 2019

AbstractMetabolic myopathies are heterogeneous hereditary diseases affecting skeletal muscle energy supply. Symptoms usually comprise pain, cramps, hypotonia, weakness, and myoglobinuria.We present a boy with recurrent myalgia and weakness after some minutes of exercise or during febrile infections since early infancy. First laboratory workup at the age of 9 years showed no abnormalities, apart from a slightly elevated creatine kinase. After exclusion of common structural and metabolic myopathies, next generation sequencing panel (4 years after the initial diagnostic metabolic workup) revealed two potentially pathogenic missense mutations in the CPT2 gene (c.149C > A (p.P50H) and c.1459G > A (p.E487K)).Our case underscores the clinical variability of muscle carnitine palmitoyltransferase II (CPT II) deficiency and illustrates a pitfall of diagnostic algorithms for metabolic myopathies. Myalgia following exercise of a few minutes duration would have argued for a carbohydrate and against a fatty acid metabolic defect. However, CPT II deficiency is the most common disorder of muscle fatty acid metabolism and should be considered even in atypical scenarios. Analyses of plasma acyl carnitine profile during acute metabolic crises may help to unmask biochemical markers which are often overlooked in dried-blood analyses.
Treatment of Colocutaneous Fistula in the Left Thigh
Authors: Huda Tanweerul , Pandya Bharati 
Published: September 2019

Abstract
Aim There are few publications on the surgical management of a colocutaneous fistula in the thigh. Here, we describe a patient who presented with a 2-year history of fecal fistula in the left thigh, following a history of drainage of a psoas abscess. This is followed by a discussion of appropriate treatment modalities for this type of fistula.
Methods To determine the appropriate treatment for our patient with chronic fistula, we thoroughly reviewed the relevant literature in an Internet-based search and selected a staged operative approach for our patient.
Results Using a staged surgical procedure, we were able to resolve the colocutaneous fistula without the occurrence of comorbidities.
Conclusion Substantial morbidity is associated with the presence of colocutaneous fistulas. The best possible approach is prevention of its occurrence, but this is not always feasible. Measures for management of an acute fistula differ from those in patients with chronic fistula. Medical management can be more effective in acute cases, while chronic cases require surgical management. We used a staged surgical method with a few risks for our patient and he is in good health 1 year after treatment.
Totally Laparoscopic Resection of an Extremely Giant Hepatic Hemangioma
Authors: Veerankutty Fadl H. , Rather Shiraz Ahmad , Yeldho Varghese , Zacharia Bincy M. , TU Shabeer Ali , B. Venugopal 
Published: September 2019

AbstractRisk of massive intraoperative hemorrhage and the difficulty to control it makes the laparoscopic treatment of giant hepatic hemangiomas (GH) a challenge for minimally invasive hepatobiliary surgeons. Symptomatic GHs of more than 20 cm (extremely giant hepatic hemangiomas) are typically treated with an open resection. There is a paucity of literature on laparoscopic resection of extremely giant hepatic hemangiomas. We describe (with video), here, the technical nuances of pure laparoscopic resection of an extremely giant hepatic hemangioma using modified port positions and the anterior approach.
Aesthetic Breast Surgery: What Do the Measurements Reveal?
Authors: Bolletta Elisa , Mcgoldrick Ciara , Hall-Findlay Elizabeth 
Published: September 2019

Abstract

Background
Do plastic surgeons really know what happens to the breast after surgery? We often think that we do, but we have very few measurements to show whether we are on the right track.

Objectives
Only when the surgeon can predict the changes can she or he achieve consistent outcomes. Measurements lead to understanding; understanding what the measurements show allows us to refine our approach.

Methods
Consecutive patients in 4 categories were analyzed: breast reduction, mastopexy, augmentation, and mastopexy-augmentation. All procedures were performed by a single surgeon and all measurements were performed by the same surgeon. A standard measuring tape was utilized, and data were collected immediately preoperatively and at each follow-up visit. Only those patients with preoperative and complete 1-year postoperative measurements were included in this review. The parameters measured were clavicle to upper breast border (UBB), UBB to nipple, suprasternal notch (SSN) to nipple, SSN to inframammary fold (IMF), and chest midline to nipple.

Results
The changes were consistent. The borders of the breast footprint were expanded with the addition of an implant (UBB and IMF) and reduced with the removal of parenchyma (IMF). The existing SSN to nipple position was stretched when volume was added to the breast mound and it remained unchanged from the preoperatively marked position in a breast reduction.

Conclusions
Although measurements are not necessary to achieve good aesthetic results in breast surgery, surgeons should understand what the measurements show and what happens to the different breast parameters.

Level of Evidence: 3
Long-Living Budding Yeast Cell Subpopulation Induced by Ethanol/Acetate and Respiration
Authors: Kwon Young-Yon , Kim Seung-Soo , Lee Han-Jun , Sheen Seo-Hyeong , Kim Kyoung Heon , Lee Cheol-Koo 
Published: September 2019

Abstract
Budding yeast generate heterogeneous cells that can be separated into two distinctive cell types: short-living low-density and long-living high-density (HD) cells by density gradient centrifugation. We found that ethanol and acetate induce formation of HD cells, and mitochondrial respiration is required. From their transcriptomes and metabolomes, we found upregulated differentially expressed genes in HD cells involved in the RGT2/RGT1 glucose sensing pathway and its downstream genes encoding hexose transporters. For HD cells, we determined an abundance of various carbon sources including glucose, lactate, pyruvate, trehalose, mannitol, mannose, and galactose. Other upregulated differentially expressed genes in HD cells were involved in the TORC1–SCH9 signaling pathway and its downstream genes involved in cytoplasmic translation. We also measured an abundance of free amino acids in HD cells including valine, proline, isoleucine, and glutamine. These characteristics of the HD cell transcriptome and metabolome may be important conditions for maintaining a long-living phenotype.
Shorter Telomere Length in Carriers of APOE-ε4 and High Plasma Concentration of Glucose, Glyoxal and Other Advanced Glycation End Products (AGEs)
Authors: Dhillon Varinderpal S , Deo Permal , Chua Ann , Thomas Phil , Fenech Michael 
Published: September 2019

Abstract
Apolipoprotein-ε4 (APOE-ε4)—common variant is a major genetic risk factor for cognitive decline and Alzheimer's disease (AD). An accelerated rate of biological aging could contribute to this increased risk. Glycation of serum proteins due to excessive glucose and reactive oxygen species leads to the formation of advanced glycation end products (AGEs)—a risk factor for diabetes and AD, and decline in motor functioning in elderly adults. Aim of present study was to investigate impact of APOE-ε4 allele containing genotype and accumulation of AGEs in plasma on telomere length (TL). Results showed that TL is significantly shorter in APOE-ε4 carriers compared with non-APOE-ε4 carriers (p = .0003). Higher plasma glucose level was associated with shorter TL irrespective of APOE-ε4 allele containing genotype (r = −.26; p = .0004). With regard to AGEs, higher plasma glyoxal and fluorescent AGEs concentrations were inversely related to TL (r = −.16; p = .03; r = −.28; p = .0001), however, plasma Nε-(carboxymethyl)lysine levels didn't correlate with TL (r = −.04; p = .57). Results support the hypotheses that APOE-ε4 carriers have shorter telomeres than noncarriers and telomere erosion is increased with higher concentration of glucose, fluorescent AGEs, and glyoxal.
Against Sovereignty in Cyberspace
Authors: Mueller Milton L 
Published: September 2019

AbstractIn discussing the historical origins of sovereignty, Jens Bartelson (2018, 510) wrote, “Making sense of sovereignty . . . entails making sense of its component terms—supreme authority and territory—and how these terms were forged together into a concept.” The question of sovereignty in cyberspace, however, inverts this historical “forging together,” as territoriality and authority are sundered in cyberspace. This paper argues that attempts to apply sovereignty to cyberspace governance are inappropriate to the domain. It develops a technically grounded definition of “cyberspace” and examines its characteristics as a distinct domain for action, conflict, and governance, while clarifying its relationship to territoriality. It reviews the literature on cyberspace and sovereignty since the early 1990s, showing the emergence of explicitly pro-sovereigntist ideas and practices in the last ten years. The cyber-sovereignty debate is linked to IR research on the historical emergence of sovereignty, demonstrating how technologies routinely change the basis of international order and challenging the presumption that territorial sovereignty is a stable and uniform principle of international organization that can be presumptively applied to the internet. The paper also links the conceptual debate over cyber-sovereignty to the real-world geopolitical struggle over the governance of the internet, showing how different conceptions of sovereignty serve the interests of different powers, notably the United States, Russia, and China. The paper explores the relevance of an alternative governance model for cyberspace based on the global commons concept. It refutes the arguments made against that model and then explains what difference it might make to governance if we conceive of cyberspace in that way.
Institutional Habitus, State identity, and China's Ministry of Foreign Affairs
Authors: Loh Dylan M H 
Published: September 2019

AbstractForeign ministries play a critical role in international relations and are the main interface of diplomacy. Yet, in international relations scholarship, foreign ministries are relatively neglected as an object of scholarly analysis and feature very little around discussions of state's agency and identity. Using China's Ministry of Foreign Affairs (MOFA) as a foil, I suggest that foreign ministries develop dispositions, perceive the social world around them, and react to the world from these orientations. The implication of this, then, are that foreign ministries are contributive to a state's identity and “actorness.” In that way, I develop the concept of institutional habitus to understand China's MOFA and the ways in which this habitus is sustained and performed through MOFA's physical artefacts and its agents. This rendering of habitus responds to sociology's invitation to extend Bourdieu-inspired analysis toward organizations and organizational change and, more broadly, complements existing theorization of state identity by showcasing an important but omitted source of identity: the foreign ministry. I argue that China's MOFA's organizational habitus manifests and preserves itself through three means: first, through the iterative reinscription of institutional memory and invocation of history; second, through displays of fealty; and third, in organizational and personal self-regulation, discipline, and taciturnity.
Feedlot performance and biological responses to coated and non-coated steroidal implants containing trenbolone acetate and estradiol benzoate in finishing beef steers123
Authors: Smith Zachary K , Kim Jongkyoo , Johnson Bradley J 
Published: September 2019

Abstract
Predominately Angus steers (n = 24; initial BW = 435 ± 28.3 kg) were used to evaluate non-coated (NC) and coated implants (CI) containing equal amounts of trenbolone acetate (TBA; 200 mg) and estradiol benzoate (EB; 28 mg) in finishing steers on sera metabolite responses, gene expression, and immunohistochemical analyses of the Longissimus muscle (LM). Performance data were analyzed as a randomized complete block design, and all other data were analyzed as repeated measures for a completely randomized design. Treatments were no implant (NI), NC (Synovex-PLUS; Zoetis, Parsippany, NJ), and CI (Synovex-One Feedlot) implant. There were 2 pen replicates per treatment (n = 4 steers/pen). LM biopsies, blood, and BW were collected before feeding on days 0, 14, 28, 56, 84, 112, and 133, with final BW being captured on day 140. Genes of interest were determined by RT-qPCR using two housekeeping genes. Sera was analyzed for estradiol-17β (E2),17β-trenbolone (TbOH), insulin-like growth factor 1 (IGF-I), NEFA, and urea-N (SUN). An α of 0.10 determined significance for performance and sera data; α of 0.05 was used for gene and histology data. No performance differences (P ≥ 0.10) were detected. An implant × day interaction (P ≤ 0.10) for E2, IGF-I, and SUN was detected; implants elevated (P ≤ 0.10) E2, 17β-TbOH, and IGF-I; and decreased SUN across day of the study, meaning sera metabolites are not altered with time on feed. An implant × day interaction was detected for myogenic factor 5 (MYF-5) positive cells and proportions of MHCIIX. In LM, CI had greater (P < 0.10) IGF-I in LM over NI. CI increased (P < 0.05) G protein-coupled estrogen receptor 1 (GPER1) expression, as well as, GPER1 semi-quantitative scores over NI and NC. An implant × day interaction (P ≤ 0.05) for estrogen and androgen receptor-positive nuclei was detected; implants had increased (P ≤ 0.05) estrogen and androgen receptor-positive nuclei compared to NI. CIs increase genes associated with muscle tissue growth.
Association study reveals Th17, Treg, and Th2 loci related to resistance to Haemonchus contortus in Florida Native sheep1
Authors: Estrada-Reyes Zaira Magdalena , Rae Owen , Postley Carol , Jiménez Medrano Myriam Berenice , Leal Gutiérrez Joel David , Mateescu Raluca Georgiana 
Published: September 2019

Abstract
The aim of this study was to identify for the first time single nucleotide polymorphisms (SNPs) associated with Haemonchus contortus resistance in Florida Native sheep, using a targeted sequencing approach. One hundred and fifty-three lambs were evaluated in this study. At the start of the trial, phenotypic records for fecal egg count (FEC), FAMACHA score, body condition score (BCS), and weight were recorded and deworming of sheep with levamisole (18 mg/kg of body weight) was performed. Ten days post-deworming (baseline) and 28 d post-baseline, a full hematogram of each sheep was obtained and FEC, FAMACHA score, BCS, and weight were assessed. Average daily gain was calculated at the end of the trial. Out of 153 animals, 100 sheep were selected for genotyping using a targeted sequencing approach. Targeted sequencing panel included 100 candidate genes for immune response against H. contortus. SNPs were discarded if call rate &lt;95% and minor allele frequency ≤0.05. A mixed model was used to analyze the response variables and included the identity by state matrix to control for population structure. A contemporary group (age, group, and sex) was included as fixed effect. Bonferroni correction was used to control for multiple testing. Eighteen SNPs on chromosomes 1, 2, 3, 4, 6, 7, 11, 15, 18, 20, 24, and 26 were significant for different traits. Our results suggest that loci related to Th17, Treg, and Th2 responses play an important role in the expression of resistant phenotypes. Several genes including ITGA4, MUC15, TLR3, PCDH7, CFI, CXCL10, TNF, CCL26, STAT3, GPX2, IL2RB, and STAT6 were identified as potential markers for resistance to natural H. contortus exposure. This is the first study that evaluates potential genetic markers for H. contortus resistance in Florida Native sheep.
Sedation and Analgesia for Adult Outpatient Burn Dressing Change: A Survey of American Burn Association Centers
Authors: Voss Jordan K , Lozenski Jeanette , Hansen Jennifer K , Salerno Shannon , Lackamp Aaron , Parks Jennifer , Bhavsar Dhaval , Kovac Anthony L 
Published: September 2019

Abstract
The management of pain and sedation during burn dressing change is challenging. Previous reviews and studies have identified wide variability in such practices in hospitalized burn patients. This survey-based study aimed to determine the most commonly utilized sedation and analgesia practices in adult burn patients treated in the outpatient setting. The goal was to identify opportunities for improvement and to assist burn centers in optimizing sedation procedures. A 23-question survey was sent to members of the American Burn Association. Nonpharmacological interventions including music, television, games, and virtual reality were used by 68% of survey respondents. Eighty-one percent reported premedicating with oral opioids, 32% with intravenous opioids, and 45% with anxiolytics. Fifty-nine percentage of respondents indicated that the initial medication regimen for outpatient dressing changes consisted of the patient's existing oral pain medications. Forty-three percent indicated that there were no additional options if this regimen provided inadequate analgesia. Fifty-six percentage of respondents felt that pain during dressing change was adequately controlled 75% to 100% of the time, and 32% felt it was adequately controlled 50% to 75% of the time. Nitrous oxide was used by 8%. Anesthesia providers and an acute pain service are available in a minority of cases (13.7% and 28%, respectively) and are rarely consulted. Procedural burn pain remains significantly undertreated in the outpatient setting and the approach to treatment is variable among burn centers in the United States. Such variation likely represents an opportunity for identifying and implementing optimal practices and developing guidelines for burn pain management in the outpatient setting.
Utility of MolecuLight i:X for Managing Bacterial Burden in Pediatric Burns
Authors: Farhan Nawras , Jeffery Steven 
Published: September 2019

AbstractPediatric burn injuries are vulnerable to severe complications, most often infection, making prompt and precise diagnosis of bacterial bioburden vital to preventing detrimental consequences and optimizing patients’ outcomes. Currently, burn wounds are assessed for infection via examining the clinical signs and symptoms of infection, which can be confirmed by swab culture analysis. While the former approach is subjective and experience-dependant, the latter technique is susceptible to missing subsurface, biofilm-associated colonization, and any peripheral bacterial burden, and also delays confirmation by up to 5 days. The MolecuLight i:X is a handheld, noncontact fluorescence imaging device, which can reveal real-time information about clinically significant levels of bacteria and their biodistribution in surface and subsurface burn wound tissues. We conducted a single-center observational study to assess the device efficacy in identifying critical bacterial levels in pediatric burn wounds and to test the children’s compliance and the overall feasibility of the device integration into the current diagnostic practice. Ten patients with 16 wounds were recruited and assessed for the presence or absence of clinical signs and symptoms of infection and the presence or absence of bacterial fluorescence on images, with swabs taken to confirm findings. Results demonstrate the device’s ability to visualize clinically significant bacterial burden and to localize distribution of pathogens. All clinicians agreed on the high compliance with the device and high feasibility of incorporating the device into routine wound assessments. The results of this study may pave the way toward including bacterial fluorescence imaging into the standard diagnostic algorithm for pediatric burn population.
Promoter Methylation Status in Pro-opiomelanocortin Does Not Contribute to Dyspigmentation in Hypertrophic Scar
Authors: Carney Bonnie C , Dougherty Ryan D , Moffatt Lauren T , Simbulan-Rosenthal Cynthia M , Shupp Jeffrey W , Rosenthal Dean S 
Published: September 2019

Abstract
Burn injuries frequently result in hypertrophic scars (HTSs), specifically when excision and grafting are delayed due to limited resources or patient complications. In patient populations with dark baseline pigmentation, one symptom of HTS that often occurs is dyspigmentation. The mechanism behind dyspigmentation has not been explored, and, as such, prevention and treatment strategies for this morbidity are lacking. The mechanism by which cells make pigment is controlled at the apex of the pathway by pro-opiomelanocortin (POMC), which is cleaved to its products alpha-melanocyte-stimulating hormone (α-MSH) and adrenocorticotropin hormone (ACTH). α-MSH and ACTH secreted by keratinocytes bind to melanocortin 1 receptor (MC1R), expressed on melanocytes, to initiate melanogenesis. POMC protein expression is upregulated in hyperpigmented scar compared to hypopigmented scar by an unknown mechanism in a Duroc pig model of HTS. POMC RNA levels, as well as the POMC gene promoter methylation status were investigated as a possible mechanism. DNA was isolated from biopsies obtained from distinct areas of hyper- or hypopigmented scar and normal skin. DNA was bisulfite-converted, and amplified using two sets of primers to observe methylation patterns in two different CpG islands near the POMC promoter. Amplicons were then sequenced and methylation patterns were evaluated. POMC gene expression was significantly downregulated in hypopigmented scar compared to normal skin, consistent with previously reported protein expression levels. There were significant changes in methylation of the POMC promoter; however, none that would account for the development of hyper- or hypopigmentation. Future work will focus on other areas of POMC transcriptional regulation.
Domestically Acquired Seoul Virus Causing Hemophagocytic Lymphohistiocytosis—Washington, DC, 2018
Authors: Shastri Bhagyashree , Kofman Aaron , Hennenfent Andrew , Klena John D , Nicol Stuart , Graziano James C , Morales-Betoulle Maria , Cannon Deborah , Maradiaga Agueda , Tran Anthony , Ramdeen Sheena K 
Published: September 2019

Abstract
Seoul orthohantavirus (SEOV) infections, uncommonly reported in the United States, often result in mild illness. We report a case of hemophagocytic lymphohistiocytosis secondary to SEOV infection that was domestically acquired in Washington, DC.