bluuebunny/crossref_metadata_2025_split huggingface dataset:
Porcine Acellular Peritoneal Matrix in Immediate Breast Reconstruction: A Multicenter, Prospective, Single-Arm Trial
Authors: Simpson Andrew M. , Higdon Kent K. , Kilgo Matthew S. , Tepper Donna G. , Alizadeh Kaveh , Glat Paul M. , Agarwal Jayant P. 
Published: December 2018

Background:
Use of biological implants such as acellular dermal matrices in tissue expander breast reconstruction is a common adjunct to submuscular implant placement. There is a paucity of published prospective studies involving acellular matrices. The authors sought to evaluate a porcine-derived acellular peritoneal matrix product for immediate breast reconstruction.

Methods:
A prospective, single-arm trial was designed to analyze safety and outcomes of immediate tissue expander–based breast reconstruction with a novel porcine-derived acellular peritoneal matrix surgical mesh implant. Twenty-five patients were enrolled in this industry-sponsored trial. Patient demographics, surgical information, complications, histologic characteristics, and satisfaction (assessed by means of the BREAST-Q questionnaire) were evaluated.

Results:
Twenty-five patients (44 breasts) underwent mastectomy with immediate breast reconstruction using tissue expanders with acellular peritoneal matrix. Sixteen reconstructed breasts experienced at least one complication (36 percent). Seroma and hematoma occurred in one of 44 (2.3 percent) and two of 44 breasts (4.6 percent), respectively. Wound dehiscence occurred in four of 44 breasts (9.1 percent). Three subjects experienced reconstruction failure resulting in expander and/or acellular peritoneal matrix removal (6.8 percent); all failures were preceded by wound dehiscence. Histologic analysis showed cellular infiltration and product resorption. Results of the BREAST-Q demonstrated a level of postoperative patient satisfaction consistent with results in the available literature.

Conclusions:
Prepared porcine-derived acellular peritoneal matrix is a safe adjunct in immediate two-stage tissue expander-based breast reconstruction. Further studies are required to determine efficacy compared to current commercially available acellular matrices.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
The Use of Tumescent Technique in Mastectomy and Related Complications: A Meta-Analysis
Authors: Siotos Charalampos , Aston Jeffrey W. , Euhus David M. , Seal Stella M. , Manahan Michele A. , Rosson Gedge D. 
Published: December 2018

Background:
Postoperative skin necrosis in surgical patients is costly to hospitals and health care providers. Tumescent dissection technique is commonly used in mastectomy and immediate breast reconstruction, as it helps reduce blood loss; however, it may increase the risk of mastectomy skin flap necrosis. In this context, the authors have conducted a systematic review of the literature to perform a meta-analysis of the relationship between tumescent technique in mastectomy with or without breast reconstruction and complication rates.

Methods:
The authors screened the PubMed (1966 to 2016), Scopus (2004 to 2016), Embase (1966 to 2016), and Web of Science (1964 to 2016) databases for relevant articles through March 30, 2017. The authors included studies on the use of tumescent technique in the context of mastectomy with or without immediate breast reconstruction. The primary outcome the authors evaluated was the rate of skin flap necrosis; the secondary outcomes were the rates of breast hematomas and infections. Because of the heterogeneity of the studies, the authors performed a meta-analysis using the random effects model.

Results:
After screening, the authors evaluated five studies including 3982 mastectomies. Mastectomies performed under the preoperative application of tumescent solution had statistically higher rates of skin flap necrosis overall (p = 0.03) and major (p < 0.01) and minor skin necrosis (p = 0.03). However, the rates of hematoma and infection were not correlated with the use of tumescent technique.

Conclusions:
The authors’ systematic review of the literature provides a better understanding of the consequences of the application of tumescent technique in mastectomy. The authors’ findings suggest that tumescent technique may increase the risk of skin necrosis in mastectomy with or without breast reconstruction.
Vascularity of the Proximal Fibula and Its Implications in Vascularized Epiphyseal Transfer: An Anatomical and High-Resolution Computed Tomographic Angiography Study
Authors: Morsy Mohamed , Sur Yoo Joon , Akdag Osman , Sabbagh M. Diya , Suchyta Marissa A. , El-Gammal Tarek A. , Lachman Nirusha , Moran Steven L. 
Published: December 2018

Background:
Various vascular pedicles have been used to supply the proximal fibula for vascularized epiphyseal transfer. The optimal pedicle has, however, not been agreed on. This study aimed to describe the detailed vascular anatomy of the proximal fibula to assist the surgeon in choosing the optimal pedicle.

Methods:
Twenty-eight lower extremities were injected with latex or a mixture of latex and barium sulfate. Vessels supplying the proximal fibula were identified and dissected, and the course, diameter, anatomical relations, length, and branches were documented. In the barium group, high-resolution computed tomographic scanning was conducted before dissection. In seven specimens, branches of the deep peroneal nerve to the tibialis anterior muscle were carefully preserved, and their relation to the proximal fibular vascularity was noted.

Results:
An anastomotic vascular network supplied the proximal fibula. This was formed superiorly by branches of the inferior lateral genicular artery, and inferiorly by branches of the anterior tibial artery, the most important of which were the first and second recurrent epiphyseal arteries. One or more deep peroneal nerve branches passed deep to the first recurrent epiphyseal artery in all specimens examined. In five specimens, all of the branches were superficial to the second recurrent epiphyseal artery, whereas two had branches deep to it.

Conclusions:
The proximal fibula can be transferred using the inferior lateral genicular or anterior tibial artery because of the existing anastomosis. Factors including length of pedicle, potential for nerve injury, and diaphyseal portion to be harvested should be considered in the pedicle choice.
Targeted Muscle Reinnervation Technique in Below-Knee Amputation
Authors: Bowen J. Byers , Ruter Daniel , Wee Corinne , West Julie , Valerio Ian L. 
Published: December 2018

Summary:
Approximately 25 percent of major limb amputees will develop chronic localized symptomatic neuromas and phantom limb pain in the residual limb. A method to treat and possibly prevent these pain symptoms is targeted reinnervation. Previous studies prove that targeted reinnervation successfully treats and, in some cases, resolves peripheral neuropathy and phantom limb pain in patients who have undergone previous amputation (i.e., secondary targeted reinnervation). This article seeks to share the authors’ clinical indications and surgical technique for targeted muscle reinnervation in below-knee amputation, a surgical description currently absent from our literature. Targeted reinnervation for the below-knee amputee has been performed on 22 patients at the authors’ institution. Each patient has been followed on an outpatient basis for 1 year to evaluate symptoms of neuroma or phantom limb pain, patient satisfaction, and functionality. All subjects have denied neuroma pain following amputation. The majority of subjects reported phantom pain at 1 month. However, at 3 months, all patients reported resolution of this pain. Dumanian et al. first noted the improvement of symptomatic neuroma and phantom limb pain in patients undergoing targeted reinnervation to provide intuitive control of upper limb prostheses. These findings have been substantiated by multiple previous studies at various amputation levels. This study extends the success of targeted muscle reinnervation to below-knee amputations and provides a description for this technique.
Toward the Bionic Face: A Novel Neuroprosthetic Device Paradigm for Facial Reanimation Consisting of Neural Blockade and Functional Electrical Stimulation
Authors: Jowett Nate , Kearney Robert E. , Knox Christopher J. , Hadlock Tessa A. 
Published: December 2018

Background:
Facial palsy is a devastating condition potentially amenable to rehabilitation by functional electrical stimulation. Herein, a novel paradigm for unilateral facial reanimation using an implantable neuroprosthetic device is proposed and its feasibility demonstrated in a live rodent model. The paradigm comprises use of healthy-side electromyographic activity as control inputs to a system whose outputs are neural stimuli to effect symmetric facial displacements. The vexing issue of suppressing undesirable activity resulting from aberrant neural regeneration (synkinesis) or nerve transfer procedures is addressed using proximal neural blockade.

Methods:
Epimysial and nerve cuff electrode arrays were implanted in the faces of Wistar rats. Stimuli were delivered to evoke blinks and whisks of various durations and amplitudes. The dynamic relation between electromyographic signals and facial displacements was modeled, and model predictions were compared against measured displacements. Optimal parameters to achieve facial nerve blockade by means of high-frequency alternating current were determined, and the safety of continuous delivery was assessed.

Results:
Electrode implantation was well tolerated. Blinks and whisks of tunable amplitudes and durations were evoked by controlled variation of neural stimuli parameters. Facial displacements predicted from electromyographic input modelling matched those observed with a variance-accounted-for exceeding 96 percent. Effective and reversible facial nerve blockade in awake behaving animals was achieved, without detrimental effect noted from long-term continual use.

Conclusions:
Proof-of-principle of rehabilitation of hemifacial palsy by means of a neuroprosthetic device has been demonstrated. The use of proximal neural blockade coupled with distal functional electrical stimulation may have relevance to rehabilitation of other peripheral motor nerve deficits.
Finesse in Face Lifting: The Role of Facial Fat Compartment Augmentation in Facial Rejuvenation
Authors: Rohrich Rod J. , Afrooz Paul N. 
Published: December 2018

Summary:
Much of facial aging can be attributed to volume deflation and tissue laxity. Successful surgical rejuvenation can be achieved through volume restoration with autologous fat grafting of the facial fat compartments. In conjunction with volume restoration, correction of tissue laxity and recontouring of the face and neck can be achieved. Current strategies for surgical correction of the face and neck involve superficial musculoaponeurotic system manipulation, medial platysma plication, and lateral platysma tightening through the lateral platysma window. These combined techniques facilitate optimal results in facial rejuvenation.
Early-Life Home Environment and Obesity in a Mexican American Birth Cohort: The CHAMACOS Study
Authors: Tindula Gwen , Gunier Robert B. , Deardorff Julianna , Nabaglo Kelly , Hubbard Alan , Huen Karen , Eskenazi Brenda , Holland Nina 
Published: December 2018

ABSTRACT

Objective
Little is known about the impact of the home environment on biomarkers of obesity, such as adipokines, in children. In this study, we examined the relationship of maternal depressive symptoms and potentially protective social factors, including maternal support and the home learning environment, with body mass index and adipokines.

Methods
Data were obtained from 326 Mexican American participants from the Center for the Health Assessment of Mothers and Children of Salinas cohort. Plasma adipokine levels were assessed in 326 children by enzyme-linked immunoassay at birth or ages 5, 9, or 14 years. Maternal depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale when children were 1, 3.5, 7, and 9 years old; social support was assessed by the Duke-University of North Carolina Questionnaire at ages 1 and 5 years; and home learning environment by the Home Observation for the Measurement of the Environment (HOME) at ages of 6 months and 1, 2, 3.5, 7, 9, and 10.5 years.

Results
Age was significantly associated with adiponectin (B = −5.0, SE = 0.2) and leptin (B = 0.01, SE = 0.003) levels. Individual time point analyses identified significant positive associations of HOME scores in childhood with adiponectin at ages 9 years (HOME score; age 3.5 years: B = 0.9, p = .04) and 14 years (HOME score; age 7 years: B = 0.6, p = .02, age 9 years: B = 0.6, p = .05, age 10.5 years: B = 0.5, p = .04). We observed significant relationships of maternal depressive symptoms at age 9 years with adiponectin and body mass index z-score at age 14 years (B = −0.2, p = .003 and B = 0.02, p = .002, resp.), which were confirmed in longitudinal models.

Conclusions
This study adds new evidence that adverse and protective aspects of the home environment could lead to altered obesity status in children.
Nonconvulsive Status Epilepticus: Validating the Salzburg Criteria Against an Expert EEG Examiner
Authors: Krogstad Martin H. , Høgenhaven Hans , Beier Christoph P. , Krøigård Thomas 
Published: December 2018

Purpose:
Rapid and correct diagnosis of nonconvulsive status epilepticus (NCSE) is crucial for optimal treatment. However, electroencephalographic diagnosis can be challenging. Salzburg Consensus Criteria (SCC) have been proposed to facilitate correct diagnosis, but their validity needs to be further established.

Methods:
We retrospectively reanalyzed the first EEG in adult patients (n = 284) referred under the suspicion of NCSE at our institution in 2014. Nonconvulsive status epilepticus or possible NCSE was diagnosed according to the SCC by an examiner specifically trained in SCC and was compared with the original diagnosis made by an expert EEG examiner, which in this context served as the reference standard, to assess the validity of the criteria. Furthermore, the clinical outcome for patients not diagnosed using SCC (false-negatives) was examined.

Results:
Nonconvulsive status epilepticus or possible NCSE was diagnosed in 40 patients by the inexperienced reader using the SCC, blinded to other clinical data, and in 47 patients by the experienced reader, not blinded to the clinical data, who did not use SCC. There were eight false-negatives, one false-positive, 39 true-positives, and 236 true-negatives. Concordance between SCC and the reference standard was high (k = 0.88 [95% confidence interval, 0.80 to 0.96]). Four of the eight false-negatives suffered from anoxic encephalopathy. The remainder had a history of epilepsy and returned to preictal functional state.

Conclusions:
The SCC for NCSE implemented by an inexperienced EEG reader, blinded to all other data, yielded results highly concordant with the evaluation of EEG by an experienced reader. False-negative diagnoses were associated with postictal states or anoxic encephalopathy.
Genome-wide association study identifies common genetic risk factors for alcohol, heroin and methamphetamine dependence
Authors: Sun Yan , Chang Suhua , Liu Zhen , Zhang Libo , Wang Fan , Yue Weihua , Sun Hongqiang , Ni Zhaojun , Chang Xiangwen , Zhang Yibin , Chen Yang , Lu Lin , Shi Jie 
Published: December 2018

AbstractBackgroundCommon molecular and cellular foundations underlie different types of substance dependence (SD). However direct evidence for common genetic factors of SD is lacking. Here we aimed to identify specific genetic variants that are shared between alcoholism, heroin and methamphetamine dependence.MethodsWe first conducted a combined case-control genome-wide association analysis (GWAS) of 521 alcoholic, 1,026 heroin and 1,749 methamphetamine patients and 2,859 healthy controls. We then replicated the significant loci using an independent cohort (146 alcoholic, 1,045 heroin, 763 methamphetamine and 1,904 controls). Second, we examined the genetic effects of these identified SNPs on gene expression, addiction characteristics and brain images (gray and white matter). Furthermore, we investigated the effects of these genetic variants on addiction behaviors using self-administration rat models.ResultsWe identified and validated four genome-wide significant loci in the combined cohorts in the discovery stage: ADH1B rs1229984 (P=6.45×10−10), ANKS1B rs2133896 (P=4.09×10−8), AGBL4 rs147247472 (P=4.30×10−8) and CTNNA2 rs10196867 (P=4.67×10−8). Association results for each dependence group showed that ADH1B rs1229984 was only associated with alcoholism, while the other three loci were associated with heroin, methamphetamine addiction and alcoholism respectively. Variants that were strongly linked to rs2133896 affected ANKS1B gene expression, heroin use frequency and interacted with heroin dependence to affect gray matter of the left calcarine and white matter of the right superior longitudinal fasciculus. In addition, the reduced anks1b expression in the ventral tegmental area increased addiction vulnerability for heroin and methamphetamine in self-administration rat models.ConclusionOur findings revealed several novel genome-wide significant SNPs and genes that synchronously affected the vulnerability and phenotypes for alcoholism, heroin and MA dependence. These findings could shed light on the root cause and the generalized vulnerability for SD.
Inhibition of mitochondrial permeability transition by deletion of the ANT family and CypD
Authors: Karch Jason , Bround Michael J. , Khalil Hadi , Sargent Michelle A. , Latchman Nadina , Terada Naohiro , Peixoto Pablo M. , Molkentin Jeffery D. 
Published: December 2018

AbstractThe mitochondrial permeability transition pore (MPTP) has resisted molecular identification for decades. The original model of the MPTP had the adenine nucleotide translocator (ANT) as the inner membrane pore-forming component. Indeed, reconstitution experiments showed that recombinant or purified ANT generates MPTP-like pores in lipid bilayers. This model was challenged when mitochondria from Ant1/2 double null mouse liver still showed MPTP activity. Because mice contain and express 3 Ant genes, here we reinvestigated the genetic basis for the ANTs as comprising the MPTP. Liver mitochondria from Ant1, Ant2, and Ant4 deficient mice were highly refractory to Ca2+-induced MPT, and when also given cyclosporine A, MPT was completely inhibited. Moreover, liver mitochondria from mice with quadruple deletion of Ant1, Ant2, Ant4 and Ppif (cyclophilin D, target of CsA) lacked Ca2+-induced MPT. Finally, inner membrane patch clamping in mitochondria from Ant1, Ant2 and Ant4 triple null mouse embryonic fibroblasts (MEFs) showed a loss of MPT-like pores. Our findings suggest a new model of MPT consisting of two distinct molecular components, one of which is the ANTs and the other of which is unknown but requires CypD.One Sentence SummaryGenetic deletion of Ant1/2/4 and Ppif in mice fully inhibits the mitochondrial permeability transition pore
Fire, grazing and climate shape plant–grasshopper interactions in a tallgrass prairie
Authors: Welti Ellen A. R. , Qiu Fan , Tetreault Hannah M. , Ungerer Mark , Blair John , Joern Anthony 
Published: December 2018

AbstractSpecies interactions are integral to ecological community function, and the structure of species interactions has repercussions for the consequences of species extinctions. Few studies have examined the role of environmental factors in controlling species interaction networks across time.We examined variation in plant–grasshopper network structural properties in response to three major grassland drivers: periodic fire, ungulate grazing and climate.We sequenced a plant barcoding gene from extracted grasshopper gut contents to characterize diets of 26 grasshopper species. Resulting grasshopper species’ diets were combined with long‐term plant and grasshopper surveys to assemble plant–grasshopper networks across 13–19 years for six watersheds subjected to varying fire and grazing treatments.Network modularity, generality and predicted grasshopper community robustness to plant species loss all increased in grazed watersheds. Temperature decreased predicted grasshopper community robustness to plant species loss.Grasshopper communities were found to be vulnerable to climatic warming due to host plant loss. However, intermediate disturbance from ungulate grazers may maintain grasshopper diversity and buffer community robustness to species loss. Our results suggest that climate and disturbance shape the structure of ecological interaction networks and thus have many indirect effects on species persistence though direct effects on interaction partners.Aplain language summaryis available for this article.
A guide to modelling priorities for managing land‐based impacts on coastal ecosystems
Authors: Brown Christopher J. , Jupiter Stacy D. , Albert Simon , Anthony Kenneth R. N. , Hamilton Richard J. , Fredston‐Hermann Alexa , Halpern Benjamin S. , Lin Hsien‐Yung , Maina Joseph , Mangubhai Sangeeta , Mumby Peter J. , Possingham Hugh P. , Saunders Megan I. , Tulloch Vivitskaia J. D. , Wenger Amelia , Klein Carissa J. 
Published: December 2018

Abstract

Pollution from land‐based run‐off threatens coastal ecosystems and the services they provide, detrimentally affecting the livelihoods of millions people on the world's coasts. Planning for linkages among terrestrial, freshwater and marine ecosystems can help managers mitigate the impacts of land‐use change on water quality and coastal ecosystem services.

We examine the approaches used for land‐sea planning, with particular focus on the models currently used to estimate the impacts of land‐use change on water quality and fisheries. Our findings could also be applied to other ecosystem services. This Review encompasses modelling of: large scale drivers of land‐use change; local activities that cause such change; run‐off, dispersal and transformation of pollutants in the coastal ocean; ecological responses to pollutants; socio‐economic responses to ecological change; and finally, the design of a planning response.

We find that there is a disconnect between the dynamical models that can be used to link land to sea processes and the simple tools that are typically used to inform planning. This disconnect may weaken the robustness of plans to manage dynamic processes. Land‐sea planning is highly interdisciplinary, making the development of effective plans a challenge for small teams of managers and decision makers.

Synthesis and applications. We propose some guiding principles for where and how dynamic land‐sea connections can most effectively be built into planning tools. Tools that can capture pertinent processes are needed, but they must be simple enough to be implemented in regions with limited resources for collecting data, developing models and developing integrated land‐sea plans.