bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anabolic actions of Notch on mature bone
Authors: Liu Peng , Ping Yilin , Ma Meng , Zhang Demao , Liu Connie , Zaidi Samir , Gao Song , Ji Yaoting , Lou Feng , Yu Fanyuan , Lu Ping , Stachnik Agnes , Bai Mingru , Wei Chengguo , Zhang Liaoran , Wang Ke , Chen Rong , New Maria I. , Rowe David W. , Yuen Tony , Sun Li , Zaidi Mone 
Published: March 2016

Significance
Notch is a critical regulator of skeletal development, but its role in remodeling of the adult skeleton is unclear. Using genetically modified mice, we show that Notch stimulates skeletal mineralization by bone-building osteoblasts. Thus, overexpression of the Notch intracellular domain in mice results in an increase in bone mass, prevents bone loss following ovariectomy and during aging, and promotes fracture healing. Notch is therefore a potential therapeutic target for conditions of bone loss, including osteoporosis.
Myofibroblasts are distinguished from activated skin fibroblasts by the expression of AOC3 and other associated markers
Authors: Hsia Lin-ting , Ashley Neil , Ouaret Djamila , Wang Lai Mun , Wilding Jennifer , Bodmer Walter F. 
Published: March 2016

SignificanceMyofibroblasts surround the epithelial cells of the crypts that form the surface of the gut. They play an important role in controlling the normal epithelium and influence the development of colorectal and other epithelial cancers. The definition of myofibroblasts previously depended almost entirely on the expression of smooth muscle actin. We identified the surface enzyme AOC3 (amine oxidase, copper containing 3) as a new marker of myofibroblasts and as a result have discovered additional highly distinctive markers for myofibroblasts, including the transcription factor NKX2-3. The discovery of these new markers should greatly enhance the proper definition of myofibroblasts and related cell types and thus should contribute to the improved treatment of the many diseases, including cancer, that involve these cell types.
Influence of solid state fermentation by Trichoderma spp. on solubility, phenolic content, antioxidant, and antimicrobial activities of commercial turmeric
Authors: Mohamed Saleh A , Saleh Rashad M , Kabli Saleh A , Al-Garni Saleh M 
Published: March 2016

Abstract
The influence of solid state fermentation (SSF) by Trichoderma spp. on the solubility, total phenolic content, antioxidant, and antibacterial activities of turmeric was determined and compared with unfermented turmeric. The solubility of turmeric was monitored by increase in its phenolic content. The total phenolic content of turmeric extracted by 80% methanol and water after SSF by six species of Trichoderma spp. increased significantly from 2.5 to 11.3–23.3 and from 0.5 to 13.5–20.4 GAE/g DW, respectively. The antioxidant activities of fermented turmeric were enhanced using 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2′-azino-bis (3-ethylbenzo-thiazoline-6-sulfonic acid) (ABTS), and ferric ion-reducing antioxidant power (FRAP) assays. The antibacterial activity of fermented turmeric against human-pathogenic bacteria Escherichia coli, Streptococcus agalactiae, Staphylococcus aureus, Entreococcus faecalis, Methicillin-Resistant S. aureus, Klebsiella pneumonia, and Pseudomonas aeruginosae showed a broad spectrum inhibitory effect. In conclusion, the results indicated the potentials of using fermented turmeric as natural antioxidant and antimicrobial material for food applications.
The preventive effect of fish oil on abdominal aortic aneurysm development
Authors: Kugo Hirona , Zaima Nobuhiro , Mouri Youhei , Tanaka Hiroki , Yanagimoto Kenichi , Urano Tetsumei , Unno Naoki , Moriyama Tatsuya 
Published: March 2016

Abstract
Abdominal aortic aneurysm (AAA) is a vascular disease involving gradual dilation of the abdominal aorta and high rupture-related mortality rates. AAA is histologically characterized by oxidative stress, chronic inflammation, and extracellular matrix degradation in the vascular wall. We previously demonstrated that aortic hypoperfusion could cause the vascular inflammation and AAA formation. However, the preventive method for hypoperfusion-induced AAA remains unknown. In this study, we evaluated the effect of fish oil on AAA development using a hypoperfusion-induced AAA animal model. Dilation of the abdominal aorta in the fish oil administration group was smaller than in the control group. Collagen destruction and oxidative stress were suppressed in the fish oil administration group than in the control group. These results suggested that fish oil could prevent the development of AAA induced by hypoperfusion.
Difference in the action mechanism of radon inhalation and radon hot spring water drinking in suppression of hyperuricemia in mice
Authors: Etani Reo , Kataoka Takahiro , Kanzaki Norie , Sakoda Akihiro , Tanaka Hiroshi , Ishimori Yuu , Mitsunobu Fumihiro , Yamaoka Kiyonori 
Published: March 2016

Abstract
Although radon therapy is indicated for hyperuricemia, the underlying mechanisms of action have not yet been elucidated in detail. Therefore, we herein examined the inhibitory effects of radon inhalation and hot spring water drinking on potassium oxonate (PO)–induced hyperuricemia in mice. Mice inhaled radon at a concentration of 2000 Bq/m 3 for 24 h or were given hot spring water for 2 weeks. Mice were then administrated PO at a dose of 500 mg/kg. The results obtained showed that serum uric acid levels were significantly increased by the administration of PO. Radon inhalation or hot spring water drinking significantly inhibited elevations in serum uric acid levels through the suppression of xanthine oxidase activity in the liver. Radon inhalation activated anti-oxidative functions in the liver and kidney. These results suggest that radon inhalation inhibits PO-induced hyperuricemia by activating anti-oxidative functions, while hot spring water drinking may suppress PO-induced elevations in serum uric acid levels through the pharmacological effects of the chemical compositions dissolved in it.
Becoming blind in one eye
Authors: Dobson Ruth , Giovannoni Gavin 
Published: March 2016

Abstract
This case describes a young woman initially presenting with symptoms suggestive of optic neuritis. She later develops transverse myelitis, and a diagnosis of neuromyelitis optica (NMO; Devic’s disease) is made following investigation. The clinical features and investigative findings associated with NMO are discussed, and are related to the underlying pathology. Differential diagnoses for both optic neuropathy and transverse myelitis are given in the accompanying tables. Treatment options for both acute relapses and long-term immunosuppression are given.
Seeing double
Authors: Shah Anish N. , Riordan-Eva Paul 
Published: March 2016

Abstract
This case provides a thorough exploration of the nuances of assessing, investigating, and treating patients with idiopathic intracranial hypertension (IIH). It starts by considering a patient presenting with raised intracranial pressure in the context of a recent external ear infection and a sixth cranial nerve paresis, who wishes to become pregnant during her subsequent treatment. It explores in detail the steps required to exclude secondary causes of intracranial hypertension before labelling the condition IIH. It discusses the complexities of managing IIH in pregnancy, and describes common neuro-ophthalmologic diagnostic tests that are normally performed in eye clinics including perimetry, Hess charts for ocular motility, and the detection, imaging, and monitoring of optic disc oedema. Finally, it reviews the evidence for current medical and surgical treatments for IIH including weight loss, various medications, optic nerve sheath fenestration, cerebrospinal fluid diversion procedures, transverse sinus stenting, and bariatric surgery.
Getting your head out of a spin
Authors: Kaski Diego , Bronstein Adolfo M. 
Published: March 2016

Abstract
This case describes a patient with acute vertigo and discusses the differential diagnoses to consider, with a specific focus on the common presentations including benign paroxysmal positional vertigo (BPPV), vestibular neuritis, vestibular migraine, and posterior circulation stroke. We highlight the importance of obtaining a clear description of what the patient means by the terms ‘dizziness’ or ‘vertigo’ to narrow the differential diagnosis (e.g. vestibular versus, for example, postural hypotension, anaemia, syncope, or anxiety). We describe and illustrate important clinical manoeuvres, including the Dix-Hallpike manoeuvre for the diagnosis of BPPV and the head impulse test to explore the integrity of the vestibulo-ocular reflex (VOR). Finally, one of the greatest challenges for clinicians dealing with acute dizziness is the differentiation between peripheral and central causes of vertigo. We provide a practical framework to address this issue.
A painful oculomotor nerve palsy
Authors: Siva Vino , Papadopoulos Marios C. , Walsh Daniel C. 
Published: March 2016

Abstract
This case presents the case of a posterior communicating artery (PCom) aneurysm manifesting as a pupil-sparing oculomotor nerve palsy. In addition to the clinical presentation, it reviews the role and timing of different investigative tools in the diagnosis and management of subarachnoid haemorrhage (CT, lumbar puncture, angiography, transcranial Doppler ultrasound). The case discusses the neurological sequelae of aneurysmal subarachnoid haemorrhage, paying particular attention to the diagnosis and management of delayed cerebral ischaemia. It highlights the multifaceted approach needed in managing such patients, with peri-operative medical care playing a pivotal role in preserving neurological function. It also reviews the evidence surrounding the treatment of incidental cerebral aneurysms.
A complex sleep disorder
Authors: Winston Joel S. , Eriksson Sofia H. 
Published: March 2016

Abstract
The apparent simplicity of sleep belies enormous neurobiological complexity. Clinical complaints about sleep difficulties must be tackled with a careful history and may require specialist investigation. Here we discuss the challenging case of a 42-year-old woman referred with a two-year history of sleep-related problems that had proved difficult to treat in primary care. Appropriate investigation led to the diagnosis of narcolepsy with cataplexy and rapid eye movement (REM) sleep behaviour disorder. Adequate control of the sleep disorders proved difficult despite trials of multiple medication regimes. The underlying neurophysiology of these conditions is discussed together with a summary of current approaches to treatment. Critically, the presence of two diagnoses renders treatment substantially more complicated, and it is proposed that improved understanding of the neurobiology of sleep will lead to more rational and successful treatment of sleep disorders.
Symptoms come and go but the lesions get bigger
Authors: Paling David , Chard Declan 
Published: March 2016

Abstract
This case describes the case of a young woman with a relapsing and remitting neurological disorder but with features atypical of multiple sclerosis, including prominent cognitive features during relapses, large lesions on MRI, and continuing expansion of lesions despite treatment. We outline her clinical journey, including complications of an early lumbar puncture, through to a brain biopsy which was able to confirm her diagnosis. We then discuss the rationale for our eventual choice of treatment and discuss monitoring for the development of progressive multifocal leucoencephalopathy. Finally, we discuss her likely future prognosis based upon case series of patients with similar clinical features.
Symptoms falling on deaf ears
Authors: Chinthapalli Krishna , Warner Graham 
Published: March 2016

Abstract
This case describes the case of a person with unexplained bilateral sensorineural deafness, intracranial calcification, and a sensory peripheral neuropathy. She was found to have maternally inherited diabetes and deafness (MIDD), a mitochondrial disease. The discussion reviews mitochondrial diseases, which may present at any age with symptoms varying from ataxia to seizures. An overview of mitochondrial genetics and the currently described spectrum of mitochondrial diseases is given, before the diagnostic algorithms, investigations, and potential complications are discussed. Interpretation of common test findings is also discussed, particularly audiograms and intracranial calcification. The case is aimed at medical trainees, especially in neurology, cardiology, or clinical genetics.
Difficulty breathing and moving
Authors: Spillane Jennifer , Kullmann Dimitri M. 
Published: March 2016

Abstract
This case describes a patient who presented with neuromuscular weakness culminating in respiratory failure and admission to the ICU. He was subsequently diagnosed with Lambert-Eaton myasthenic syndrome (LEMS), a rare autoimmune disease that presents with skeletal muscle weakness and autonomic dysfunction. Approximately 50 per cent of cases of LEMS are paraneoplastic; most frequently it is associated with a small-cell lung cancer. The diagnosis of LEMS is based on characteristic neurophysiological findings of small compound muscle action potential amplitudes that increase following maximal exercise or high-frequency stimulation, a process known as facilitation. In addition, approximately 85 per cent of patients have antibodies to voltage-gated calcium channels detectable on serology The treatment of LEMS depends on the presence of an underlying malignancy. If a tumour is present, treatment must be directed towards this. 3, 4-Diaminopyridine may provide symptomatic relief in both tumour and non-tumour LEMS and immunmodulatory therapy may also be required.
Paroxysmal sensory and motor events
Authors: Paterson Ross W. , Sztriha Laszlo K. 
Published: March 2016

Abstract
This case discusses the clinical approach to the patient with paroxysmal sensory and motor events. Transient ischaemic attacks (TIAs) are a common cause of paroxysmal neurological events, yet up to 60 per cent of patients referred to the TIA clinic have an alternative final diagnosis. This case illustrates the importance of history-tak ing, imaging, and other paraclinical investigations for accurately assessing and managing the TIA patient whilst exploring a comprehensive range of alternative diagnostic possibilities including epilepsy and amyloid spells.
Does Increased Experience with Tissue Oximetry Monitoring in Microsurgical Breast Reconstruction Lead to Decreased Flap Loss? The Learning Effect
Authors: Koolen Pieter G. L. , Vargas Christina R. , Ho Olivia A. , Ibrahim Ahmed M. S. , Ricci Joseph A. , Tobias Adam M. , Winters Hay A. H. , Lin Samuel J. , Lee Bernard T. 
Published: March 2016

Background:
Early studies have shown that near-infrared monitoring with tissue oximetry shows promise in providing earlier detection of free flap vascular compromise. However, large-scale clinical evaluation of this technology on flap outcome has not previously been established. This study examines the effect of tissue oximetry on flap reexploration rates and salvage over a 10-year period. The learning curve for this new technology is also assessed.

Methods:
A retrospective review was performed of prospectively maintained data on all microsurgical breast reconstructions performed at an academic institution from 2004 to 2014. Patients were divided into two separate cohorts—standard clinical monitoring and standard clinical monitoring plus tissue oximetry—and rates of reexploration and flap salvage were compared. Subgroup analysis (tertiles) was performed to assess outcomes with increasing experience.

Results:
A total of 380 flaps (36.2 percent) received standard clinical monitoring, and 670 flaps (63.8 percent) received additional tissue oximetry monitoring. The rate of flap salvage before implementation of tissue oximetry monitoring was 57.7 percent and increased to 96.6 percent (p < 0.001). The number of complete flap losses decreased from 11 (2.9 percent) to one (0.1 percent) with the use of tissue oximetry (p < 0.001). Subgroup analysis demonstrated significantly fewer reexplorations in the third tertile.

Conclusions:
Inclusion of continuous tissue oximetry in the postoperative monitoring protocol of microsurgical breast reconstruction is associated with significantly improved salvage rates and fewer flap losses. Furthermore, learning curve assessment demonstrates that use of tissue oximetry can decrease the rate of reexploration over time.
Seroma in Prosthetic Breast Reconstruction
Authors: Jordan Sumanas W. , Khavanin Nima , Kim John Y. S. 
Published: March 2016

Background:
Seroma, as a complication of prosthetic breast reconstruction, results in patient distress, increased office visits, undesirable aesthetic outcomes, and—importantly—may escalate to infection and frank prosthesis loss. Herein, the authors review the pathophysiology and risk factors and attempt to collate published practices for avoidance and management of seroma.

Methods:
A systematic literature review was performed using MEDLINE, Web of Science, Embase, and Cochrane Library for studies published between 2000 and January of 2015. Random-effects meta-analysis was used to estimate the overall pooled incidence of seroma and to examine the effect of drain number and acellular dermal matrix use.

Results:
Seventy-two relevant primary articles and three systematic reviews were identified. Fifty-one citations met inclusion criteria, including two randomized controlled trials. The overall pooled incidence was 5.4 percent (95 percent CI, 4.1 to 6.7 percent). Obesity, acellular dermal matrix, and preoperative irradiation were cited risk factors. Pooled relative risk for acellular dermal matrix was 1.83 (95 percent CI, 1.28 to 2.62). Drain practices were collated from 34 articles.

Conclusions:
Seromas following prosthetic breast reconstruction are complicated by the hypovascular, proinflammatory milieu of the mastectomy skin flap, the geometrically complex dead space, and the presence of a foreign body with potential contamination and biofilm. There is reasonable evidence to suggest that these factors contribute to a progression of seroma to infection and prosthesis loss. These findings have motivated this summary article on current practice guidelines and strategies to prevent and treat seromas.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.
What Is the Best Way to Measure Surgical Quality? Comparing the American College of Surgeons National Surgical Quality Improvement Program versus Traditional Morbidity and Mortality Conferences
Authors: Zhang Jacques X. , Song Diana , Bedford Julie , Bucevska Marija , Courtemanche Douglas J. , Arneja Jugpal S. 
Published: March 2016

Background:
Morbidity and mortality conferences have played a traditional role in tracking complications. Recently, the American College of Surgeons National Surgical Quality Improvement Program Pediatrics (ACS NSQIP-P) has gained popularity as a risk-adjusted means of addressing quality assurance. The purpose of this article is to report an analysis of the two methodologies used within pediatric plastic surgery to determine the best way to manage quality.

Methods:
ACS NSQIP-P and morbidity and mortality data were extracted for 2012 and 2013 at a quaternary care institution. Overall complication rates were compared statistically, segregated by type and severity, followed by a subset comparison of ACS NSQIP-P-eligible cases only. Concordance and discordance rates between the two methodologies were determined.

Results:
One thousand two hundred sixty-one operations were performed in the study period. Only 51.4 percent of cases were ACS NSQIP-P eligible. The overall complication rates of ACS NSQIP-P (6.62 percent) and morbidity and mortality conferences (6.11 percent) were similar (p = 0.662). Comparing for only ACS NSQIP-P–eligible cases also yielded a similar rate (6.62 percent versus 5.71 percent; p = 0.503). Although different complications are tracked, the concordance rate for morbidity and mortality and ACS NSQIP-P was 35.1 percent and 32.5 percent, respectively.

Conclusions:
The ACS NSQIP-P database is able to accurately track complication rates similarly to morbidity and mortality conferences, although it samples only half of all procedures. Although both systems offer value, limitations exist, such as differences in definitions and purpose. Because of the rigor of the ACS NSQIP-P, we recommend that it be expanded to include currently excluded cases and an extension of the study interval.
Are Passive Physical Modalities Effective for the Management of Common Soft Tissue Injuries of the Elbow?
Authors: Dion Sarah , Wong Jessica J. , Côté Pierre , Yu Hainan , Sutton Deborah , Randhawa Kristi , Southerst Danielle , Varatharajan Sharanya , Stern Paula J. , Nordin Margareta , Chung Chadwick , D’Angelo Kevin , Dresser Jocelyn , Brown Courtney , Menta Roger , Ammendolia Carlo , Shearer Heather M. , Stupar Maja , Ameis Arthur , Mior Silvano , Carroll Linda J. , Jacobs Craig , Taylor-Vaisey Anne 
Published: March 2016

Objective:
To evaluate the effectiveness of passive physical modalities for the management of soft tissue injuries of the elbow.

Methods:
We systematically searched MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials from 1990 to 2015. Studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. We included studies with a low risk of bias in our best evidence synthesis.

Results:
We screened 6618 articles; 21 were eligible for critical appraisal and 9 (reporting on 8 randomized controlled trials) had a low risk of bias. All randomized controlled trials with a low risk of bias focused on lateral epicondylitis. We found that adding transcutaneous electrical nerve stimulation to primary care does not improve the outcome of patients with lateral epicondylitis. We found inconclusive evidence for the effectiveness of: (1) an elbow brace for managing lateral epicondylitis of variable duration; and (2) shockwave therapy or low-level laser therapy for persistent lateral epicondylitis.

Discussion:
Our review suggests that transcutaneous electrical nerve stimulation provides no added benefit to patients with lateral epicondylitis. The effectiveness of an elbow brace, shockwave therapy, or low-level laser therapy for the treatment of lateral epicondylitis is inconclusive. We found little evidence to inform the use of passive physical modalities for the management of elbow soft tissue injuries.