bluuebunny/crossref_metadata_2025_split huggingface dataset:
Framework for the Creation of Ethical and Professional Social Media Content
Authors: Schoenbrunner Anna , Gosman Amanda , Bajaj Anureet K. 
Published: April 2019

Background:
Social media are powerful tools that allow users to communicate directly with an online community. Plastic surgeons were early adopters of social media, recognizing their educational and marketing potential. With the use of social media comes ethical and legal concerns. The lack of professional society policies on social media use has led to calls for the American Society of Plastic Surgeons to establish guidelines regarding the use of social media in medical practice. The authors propose a framework for the creation of ethical and professional social media content.

Methods:
The authors reviewed the updated American Society of Plastic Surgeons Code of Ethics, current professional organization codes of ethics and social media guidelines, recently published articles, and legal documents pertaining to social media use in medical practice.

Results:
The updated American Society of Plastic Surgeons Code of Ethics provides adequate guidance for the professional use of social media in plastic surgery practice. The authors drew on the American Society of Plastic Surgeons Code of Ethics along with existing professional society guidelines to develop a framework for the professional and ethical creation of social media content. The authors also propose a sample informed consent form for social media use.

Conclusions:
Social media are powerful tools that will continue to transform the practice of plastic surgery and medicine at large. Plastic surgeons must uphold values of professionalism and ethics when using social media to protect patients and maintain the high professional standards of the specialty.
The Effect of Bimaxillary Surgery on the Airway Morphology in Class III Patients: Taking Into Account the Head Posture During Walking
Authors: Kiliç Banu , Amuk Nisa Gül , Hacioğlu Zeynep , Demirbaş Ahmet Emin 
Published: April 2019

Objectives:
To assess changes in head and neck posture, airway, hyoid, tongue, and soft palate in skeletal class III individuals whose cephalograms were taken using dynamic natural head positioning method with an inclinometer.

Materials and Methods:
This study was conducted on 20 class III patients operated with double jaw surgery. Natural head positions were determined before and 6 months after the surgery. Craniocervical, pharyngeal airway, tongue, and hyoid positions were measured. In the analysis of the data, paired t test, independent sample t test and correlation tests were used.

Results:
There was a statistically significant change in the craniocervical measurements with the operation and the head position was further extended (P < 0.05). Significant changes were observed in the soft palate angles upon surgery (P < 0.026) and the increase in oropharyngeal airway area was statistically significant (P < 0.001). There was a statistically significant increase in tongue length (TL) and distance from vertical reference plane to tongue tip (TTi/VRP) measurements (P < 0.001 and P < 0.012, respectively). There was a statistically significant decrease in distance from horizontal reference plane to tongue tip (TTi/HRP) and tongue dorsum (TD/HRP) measurements (P < 0.033 and P < 0.003, respectively). The only significant change among the hyoid bone position-related measurements was distance between hyoidale and epiglottis (P < 0.013).

Conclusions:
Hyoid bone location, tongue measurements, and posterior pharyngeal airway were found to be related to each other and they have been found to be effective on the head and neck posture. Head position will be affected by possible surgical alternatives.
LPS-Induced Hypotension in Pregnancy: The Effect of Progesterone Supplementation
Authors: Zöllner Julia , Howe Laura G. , Edey Lydia F. , O’Dea Kieran P. , Takata Masao , Leiper James , Johnson Mark R. 
Published: April 2019

ABSTRACT
Our previous work has shown that pregnancy exacerbates the hypotensive response to both infection and lipopolysaccharide (LPS). The high levels of progesterone (P4) associated with pregnancy have been suggested to be responsible for the pregnancy-induced changes in the cardiovascular response to infection. Here, we test the hypothesis that P4 supplementation exacerbates the hypotensive response of the maternal cardiovascular to LPS.
Female CD1 mice had radiotelemetry probes implanted to measure hemodynamic function noninvasively and were time-mated. From day 14 of pregnancy, mice received either 10 mg of P4 or vehicle alone per day and on day 16, intraperitoneal LPS (10 μg of serotype 0111:B4) was injected. In two identically treated cohorts of mice, tissue and serum (for RNA, protein studies) were collected at 6 and 12 h.
Administration of LPS resulted in a fall in blood pressure in vehicle treated, but not P4 supplemented mice. This occurred with similar changes in the circulating levels of cytokines, vasoactive factors and in both circulating and tissue inflammatory cell numbers, but with reduced left ventricular expression of cytokines in P4-supplemented mice. However, left ventricular expression of markers of cardiac dysfunction and apoptosis were similar.
This study demonstrates that P4 supplementation prevented LPS-induced hypotension in pregnant mice in association with reduced myocardial inflammatory cytokine gene expression. These observations suggest that rather than being detrimental, P4 supplementation has a protective effect on the maternal cardiovascular response to sepsis.
Norepinephrine vs Vasopressin: Which Vasopressor Should Be Discontinued First in Septic Shock? A Meta-Analysis
Authors: Wu Zongsheng , Zhang Shi , Xu Jingyuan , Xie Jianfeng , Huang Lili , Huang Yingzi , Yang Yi , Qiu Haibo 
Published: April 2019

ABSTRACT

Background:
Patients with septic shock in whom norepinephrine (NE) infusion alone is insufficient to raise blood pressure require the concomitant administration of vasopressin (VP). However, current guidelines do not advise clinicians as to which vasoactive agent to discontinue first once the patient's septic shock begins to resolve. Moreover, there is controversial data guiding clinicians on how to discontinue vasopressors for septic shock patients who are receiving a combination therapy of NE and VP.

Methods:
The PubMed, EMBASE, and Cochrane Central Register databases were searched from the database inception until October 18, 2018. Studies were limited to adult patients with septic shock who received concomitant NE and VP treatment, that included different orders of vasopressor discontinuation. The primary outcome was the incidence of hypotension. Overall mortality, ICU mortality, and length of stay (LOS) in the ICU were secondary outcomes. Sensitivity and subgroup analyses as well as trial sequential analysis were performed.

Results:
One prospective randomized controlled trial and seven retrospective cohort studies were included in present meta-analysis. Compared with discontinuing VP first, the incidence of hypotension was significantly lower when NE was discontinued first (odds ratio, OR 0.3, 95% confidence interval, CI 0.10 to 0.86, P = 0.02; I
2 = 91%). No significant difference was detected in either overall mortality (OR 1.28, 95% CI 0.77 to 2.10, P = 0.34) or ICU mortality (OR 0.99, 95% CI 0.74 to 1.34, P = 0.96) between these two groups. Furthermore, ICU LOS was also evaluated in five studies, and no statistical significance was observed between the two groups with different orders in weaning vasopressors (mean difference 1.35, 95% CI −2.05 to 4.74, P = 0.44). The subgroup analyses suggested a significant association between hypotension and the practice of discontinuing VP first specifically in patients with a low usage rate of corticosteroids (odds ratio, OR 0.18, 95% confidence interval, CI 0.04 to 0.78, P = 0.02). The trial sequential analysis indicated a lack of sufficient evidence to draw conclusions from the current results (required information size  = 11 821).

Conclusions:
In adults with septic shock treated with concomitant VP and NE therapy, discontinuing VP first may lead to a higher incidence of hypotension but is not associated with mortality or ICU LOS. Further prospective studies with larger sample sizes are warranted.
The Prognostic Value of Prehospital Blood Lactate Levels to Predict Early Mortality in Acute Cardiovascular Disease
Authors: Martín-Rodríguez Francisco , López-Izquierdo Raúl , Castro Villamor Miguel A. , del Pozo Vegas Carlos , Delgado Benito María del Pilar , Martínez Caballero Carmen M. , Priego Martínez Vicente , Martín Conty José Luis , Mayo-Iscar Agustín , Sánchez-Soberón Irene , Baez Gemma Pastor 
Published: April 2019

ABSTRACT

Introduction:
The knowledge of the prognostic value of prehospital lactate (PLA) is limited. Our objective was to evaluate the predictive capacity of PLA to predict early mortality (within 48 h) from the index event in acute cardiovascular disease (ACVD).

Methods:
Prospective, longitudinal, multicenter, observational study in patients, attended by advanced life support units, transferred to the emergency department of their reference hospital and diagnosed with ACVD. We collected demographic, physiological, clinical, analytical variables, main cardiological diagnosis, and data on hospital admission and early mortality. The main outcome variable was mortality from any cause within 2 days.

Results:
Between March 1, 2018 and January 31, 2019, a total of 492 patients were included in our study. Early mortality after the index event within the first 48 h affected 27 patients (5.5%). The most frequent cause of care demand was chest pain with 223 cases (45.3%). The predictive power of PLA to discriminate mortality at 2 days obtained an area under the curve of 0.911 (95% confidence interval [CI]: 0.83–0.98, P < 0.001). A value equal or superior to 4.3 mmol/L globally attained a sensitivity of 92.6% (95% CI, 76.6–97.9) with a specificity of 82.8% (95% CI, 79.1–86.0), with a positive predictive value of 23.8 (16.7–32.8) and a negative predictive value of 99.5 (98.1–99.9).

Conclusion:
PLA represents a prognostic biomarker with excellent predictive capacity for ACVD. Prehospital Emergency Services (PhEMS) should incorporate this test routinely in their usual procedures.
Trauma-Induced Long-Term Alterations of Human T Cells and Monocytes—Results of an Explorative, Cross-Sectional Study
Authors: Ruhrmann Sophie , Schneck Emmanuel , Markmann Melanie , Zink Jan , Zajonz Thomas Simon , Arens Christoph , Uhle Florian , Sander Michael , Koch Christian 
Published: April 2019

ABSTRACT

Background:
Major trauma leads to complex immune reactions, known to result in a transient immunodeficiency. The long-term consequences of severe trauma on immune function and regulation as well as its clinical impact remain unclear.

Methods:
Six months (ranging from −12 to +5 days) after a major trauma event, 12 former trauma patients (Injury Severity Score ≥ 16) and 12 healthy volunteers were enrolled. The current clinical status and infection history since discharge were assessed by a standardized questionnaire. Immune cell subsets (cluster of differentiation (CD)4+, CD8+, CD14+), cell surface receptor expression (programmed cell death protein 1 (PD-1), B- and T-lymphocyte attenuator (BTLA), cytotoxic T-lymphocyte-associated protein 4, toll-like receptor (TLR)-2, -4, and -5, Dectin-1, programmed death ligand 1 (PD-1L)), and human leucocyte antigen D-related receptor (HLA-DR)-expression were quantified by flow cytometry. Cytokine secretion (IL-2, -4, -6, -10, and 17A, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ) was assessed after stimulation of whole blood with LPS-, α-CD3/28, or zymosan.

Results:
Analysis of surface receptors on T cells revealed a significant elevation of PD-1 expression on CD4+ T cells, whereas BTLA expression on CD4+ and CD8+ T cells was significantly suppressed in the trauma cohort. Monocytes showed a significantly reduced expression of TLR-2 and -4 as well as a reduced proportion of TLR-4 monocytes. HLA-DR receptor density revealed no significant changes between both cohorts. LPS-induced IL-6 and TNF-α secretion showed non-significant trends toward reduced values. No differences regarding clinical apparent infections could be detected.

Conclusions:
Six months following major trauma, changes of cell surface receptors on CD4+ and CD8+ T cells as well as on CD14+ monocytes were present, hinting toward an immunosuppressive phenotype. Following major trauma, although IL-6 and TNF-α release after stimulation were reduced, they did not reach statistical significance. Overall, further studies are necessary to evaluate the clinical implications of these findings.

Trial registration:
DRKS00009876, Internet Portal of the German Clinical Trials Register (DRKS), registration date 11.08.2016, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00009876.
Bariatric Surgery is Associated With Reduced Risk of Breast Cancer in Both Premenopausal and Postmenopausal Women
Authors: Feigelson Heather Spencer , Caan Bette , Weinmann Sheila , Leonard Anthony C. , Powers J. David , Yenumula Panduranga R. , Arterburn David E. , Koebnick Corinna , Altaye Mekibib , Schauer Daniel P. 
Published: April 2019

Objective:
This retrospective cohort study examined whether bariatric surgery is associated with reduced risk of breast cancer among pre- and postmenopausal women.

Background:
Obesity is associated with increased risk of breast cancer, but the impact of weight loss on breast cancer risk has been difficult to quantify.

Methods:
The cohort included obese (body mass index ≥35 kg/m2) patients enrolled in an integrated health care delivery system between 2005 and 2012 (with follow-up through 2014). Female bariatric surgery patients (N = 17,998) were matched on body mass index, age, study site, and comorbidity index to 53,889 women with no bariatric surgery. Kaplan–Meier curves and Cox proportional hazards models were used to examine incident breast cancer up to 10 years after bariatric surgery. Pre- and postmenopausal women were examined separately, and further classified by estrogen receptor (ER) status.

Results:
The analysis included 301 premenopausal and 399 postmenopausal breast cancer cases. In multivariable adjusted models, bariatric surgery was associated with a reduced risk of both premenopausal (HR = 0.72, 95% CI, 0.54–0.94) and postmenopausal (HR = 0.55, 95% CI, 0.42–0.72) breast cancer. Among premenopausal women, the effect of bariatric surgery was more pronounced among ER-negative cases (HR = 0.36, 95% CI, 0.16–0.79). Among postmenopausal women, the effect was more pronounced in ER-positive cases (HR = 0.52, 95% CI, 0.39–0.70).

Conclusions:
Bariatric surgery was associated with a reduced risk of breast cancer among severely obese women. These findings have significant public health relevance because the prevalence of obesity continues to rise, and few modifiable breast cancer risk factors have been identified, especially for premenopausal women.
Ankle2, A Target of Zika Virus, Controls Asymmetric Cell Division of Neuroblasts and Uncovers a Novel Microcephaly Pathway
Authors: Link N. , Chung H. , Jolly A. , Withers M. , Tepe B. , Arenkiel B.R. , Shah P.S. , Krogan N.J. , Aydin H. , Geckinli B.B. , Tos T. , Isikay S. , Tuysuz B. , Mochida G.H. , Thomas A.X. , Clark R.D. , Mirzaa G.M. , Lupski J.R. , Bellen H.J. 
Published: April 2019

ABSTRACTNeuroblasts in flies divide asymmetrically by establishing polarity, distributing cell fate determinants asymmetrically, and positioning their spindle for cell division. The apical complex contains aPKC, Bazooka (Par3), and Par6, and its activity depends on L(2)gl. We show that Ankle2 interacts with L(2)gl and affects aPKC. Reducing Ankle2 levels disrupts ER and nuclear envelope morphology, releasing the kinase Ballchen/VRK1 into the cytosol. These defects are associated with reduced phosphorylation of aPKC, disruption of Par complex localization, and spindle alignment defects. Importantly, removal of one copy ofballchen/VRK1orl(2)glsuppresses the loss ofAnkle2and restores viability and brain size. The Zika virus NS4A protein interacts withDrosophilaAnkle2 and VRK1 in dividing neuroblasts. Human mutational studies implicate this neural cell division pathway in microcephaly and motor neuron disease. In summary, NS4A, ANKLE2, VRK1 and LLGL1 define a novel pathway that impinges on asymmetric determinants of neural stem cell division.
A revised model for promoter competition based on multi-way chromatin interactions
Authors: Oudelaar A. Marieke , Harrold Caroline L. , Hanssen Lars L. P. , Telenius Jelena M. , Higgs Douglas R. , Hughes Jim R. 
Published: April 2019

AbstractSpecific communication between gene promoters and enhancers is critical for accurate regulation of gene expression. However, it remains unclear how specific interactions between multiple regulatory elements and genes contained within a single chromatin domain are coordinated. Recent technological advances allow for the investigation of multi-way chromatin interactions at single alleles in individual nuclei. This can provide insights into how multiple regulatory elements cooperate or compete for transcriptional activation. We have used these techniques in a mouse model in which the α-globin domain is extended to include several additional genes. This allows us to determine how the interactions of the α-globin super-enhancer are distributed between multiple promoters in a single domain. Our data show that gene promoters do not form mutually exclusive interactions with the super-enhancer, but all interact simultaneously in a single complex. These finding show that promoters within the same domain do not structurally compete for interactions with enhancers, but form a regulatory hub structure, consistent with the recent model of transcriptional activation in phase-separated nuclear condensates.
Coupling Metastasis to pH-Sensing GPR68 Using a Novel Small Molecule Inhibitor
Authors: Williams Charles H. , Neitzel Leif R. , Karki Pratap , Keyser Brittany D. , Thayer Timothy E. , Wells Quinn S. , Perry James A , Birukova Anna A. , Birukov Konstantin G. , Hong Charles C. 
Published: April 2019

AbstractAn acidic milieu is a hallmark of the glycolytic metabolism that occurs in cancerous cells. The acidic environment is known to promote cancer progression, but the underlying signaling and cell biological underpinnings of these phenomena are not well understood. Here, we describe ogremorphin, a first-in-class small-molecule inhibitor of GPR68, an extracellular proton-sensing and mechanosensing G protein–coupled receptor. Ogremorphin was discovered in a chemical genetic zebrafish screen for its ability to perturb neural crest development, which shares basic cell behaviors of migration and invasion with cancer metastasis. Ogremorphin also inhibited migration and invasive behavior of neural crest–derived human melanoma cellsin vitro. Furthermore, in phenome-wide association studies (PheWAS), we identified an aberrantly activated variant of GPR68, which is associated with cancer metastasisin vivoand promotes invasive phenotypes of cancer cellsin vitro. Thus, extracellular proton-sensing GPR68 signaling promotes cell migration and invasion during embryonic development and may do likewise in cancer progression.
Dissecting the cellular specificity of smoking effects and reconstructing lineages in the human airway epithelium
Authors: Goldfarbmuren Katherine C. , Jackson Nathan D. , Sajuthi Satria P. , Dyjack Nathan , Li Katie S. , Rios Cydney L. , Plender Elizabeth G. , Montgomery Michael T. , Everman Jamie L. , Vladar Eszter K. , Seibold Max A. 
Published: April 2019

AbstractCigarette smoke first interacts with the lung through the cellularly diverse airway epithelium and goes on to drive development of most chronic lung diseases. Here, through single cell RNA-sequencing analysis of the tracheal epithelium from smokers and nonsmokers, we generated a comprehensive atlas of epithelial cell types and states, connected these into lineages, and defined cell-specific responses to smoking. Our analysis inferred multi-state lineages that develop into surface mucus secretory and ciliated cells and contrasted these to the unique lineage and specialization of submucosal gland (SMG) cells. Our analysis also suggests a lineage relationship between tuft, pulmonary neuroendocrine, and the newly discovered CFTR-rich ionocyte cells. Our smoking analysis found that all cell types, including protected stem and SMG populations, are affected by smoking, through both pan-epithelial smoking response networks and hundreds of cell type-specific response genes, redefining the penetrance and cellular specificity of smoking effects on the human airway epithelium.
Segregated neural explants exhibit co-oriented, asymmetric, neurite outgrowth
Authors: Pettigrew David B. , Dobson Curtis B. , Isaacson Lori G. , Leuthardt Eric , Lilley Heather , Suidan Georgette , Crutcher Keith A. 
Published: April 2019

AbstractExplants of embryonic chick sympathetic and sensory ganglia were found to exhibit asymmetric radial outgrowth of neurites under standard culture conditions with or without exogenous Nerve Growth Factor [NGF]. Opposing sides of an explant exhibited: a] differences in neurite length and, b] differences in terminal morphology. Strikingly, this asymmetry exhibited co-orientation among segregated, neighboring explants. The underlying mechanism[s] of the asymmetry and its co-orientation have not been discovered but appears to depend on cell clustering because dissociated sympathetic neurons do not exhibit co-orientation whereas re-aggregated clusters of cells do. This emergent behavior may be similar to the community effect described in other cell types. If a similar phenomenon exists in the embryo, or in maturity, it may contribute to the establishment of proper orientation of neurite outgrowth during development and/or injury-induced neuronal plasticity.
Hoarding of international reserves: It's a neighbourly day in Asia
Authors: Cheung Yin‐Wong , Qian Xingwang , Remolona Eli 
Published: April 2019

AbstractTo explain why Asian countries seem to have been hoarding international reserves, especially since the 1997 crisis, we consider various regional neighbourhood effects. One such effect is that of “catching up with the Joneses”. We revisit that effect by analysing several refinements of it. We also consider the fear of the kind of contagion that the crisis‐hit countries saw in 1997. Finally, we look at the possibility of a regional financial cycle, in which the conditions that led to the crisis might have been correlated across countries. We find that refining the Joneses effect to take account of trade links strengthens its power to explain the build‐up of reserves. We also observe that a country that finds itself more vulnerable than its regional neighbours would tend to accumulate more reserves. Finally, we find that a common regional factor related to current‐account balances spurs further reserve accumulation. Contrary to previous analyses, our results suggest that only a couple of Asian countries have been holding excessive reserves. Some were actually holding less reserves than would be optimal in the presence of neighbourhood effects.