bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Factors for Permanent Work Disability in Patients With Rheumatoid Arthritis Who Received Combination Therapy of Conventional Synthetic Disease-Modifying Antirheumatic Drugs
Authors: Vazquez-Villegas M. Luisa , Gamez-Nava Jorge I. , Celis Alfredo , Sanchez-Mosco Dalia , de la Cerda-Trujillo Liliana F. , Murillo-Vazquez Jessica D. , Saldaña-Cruz A. Miriam , Alcaraz-Lopez Miriam F. , Diaz-Rizo Valeria , Alvarez-Nemegyei Jose , Cardiel Mario H. , Gonzalez-Lopez Laura 
Published: September 2017

Background
There is limited information about the factors related with the development of long-term permanent work disability (PWD) in rheumatoid arthritis (RA) treated with a combination of conventional synthetic disease-modifying antirheumatic drugs (cs-DMARDs).

Objective
The aim of this study was to evaluate incidence and factors associated with the development of PWD in RA treated with combination therapy using conventional synthetic cs-DMARDs.

Methods
We assessed in multivariate models the effect of clinical and demographic factors in the development of PWD in a long-term retrospective cohort of 180 workers with RA who were treated with a combination of cs-DMARDs.

Results
Incidence rates of PWD were 2.2% at 1 year, 7.7% at 5 years, 24.9% at 10 years, 34.9% at 15 years, and 45% at 20 years. In the adjusted Cox regression analysis, factors associated with PWD development were the first failure with combination of cs-DMARDs (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.05–5.46; P = 0.03), poor functioning at time of cohort onset (HR, 2.2; 95% CI, 1.05–4.70; P = 0.03), and requirement for joint replacement (HR, 3.3; 95% CI, 1.28–8.79; P = 0.01).

Conclusions
Around 25% of workers with combination therapy with cs-DMARDs developed PWD in 10 years following the diagnosis of RA. Some factors increase the risk of disability. Permanent work disability generates a relevant society burden and increases health care costs. Therefore, indicators predicting failure of combination therapies with cs-DMARDs might provide clinicians of useful tools for modifying treatments avoiding the disease progression.
Non contrast, Pseudo-Continuous Arterial Spin Labeling and Accelerated 3-Dimensional Radial Acquisition Intracranial 3-Dimensional Magnetic Resonance Angiography for the Detection and Classification of Intracranial Arteriovenous Shunts
Authors: Schubert Tilman , Clark Zachary , Sandoval-Garcia Carolina , Zea Ryan , Wieben Oliver , Wu Huimin , Turski Patrick A. , Johnson Kevin M. 
Published: September 2017

Objectives
The aim of this study was to assess the sensitivity and specificity of pseudo-continuous arterial spin labeling (PCASL) magnetic resonance angiography (MRA) with 3-dimensional (3D) radial acquisition for the detection of intracranial arteriovenous (AV) shunts.

Materials and Methods
A total of 32 patients who underwent PCASL-MRA, clinical magnetic resonance imaging (MRI)/MRA exam, and digital subtraction angiography (DSA) were included in this retrospective analysis. Twelve patients presented with AV shunts. Among these were 8 patients with AV malformations (AVM) and 4 patients with AV fistulas (AVF). The clinical MRI/MRA included 3D time-of-flight MRA in all cases and time-resolved, contrast-enhanced MRA in 9 cases (6 cases with AV shunting). Research MRI and clinical MRI were independently evaluated by 2 neuroradiologists blinded to patient history. A third radiologist evaluated DSA imaging. A diagnostic confidence score was used for the presence of abnormalities associated with AV shunting (1–5). The AVMs were characterized using the Spetzler-Martin scale, whereas AVFs were characterized using the Borden classification. κ Statistics were applied to assess intermodality agreement.

Results
Compared with clinical MRA, noncontrast PCASL-MRA with 3D radial acquisition yielded excellent sensitivity and specificity for the detection of intracranial AV shunts (reader 1: 100%/100%, clinical MRA: 91.7%, 94.4%; reader 2: 91.7%/100%, clinical MRA: 91.7%/100%). Diagnostic confidence was 4.8/4.66 with PCASL-MRA and 4.25/4.66 with clinical MRA. For AVM characterization with PCASL-MRA, intermodality agreement with DSA showed κ values of 0.43 and 0.6 for readers 1 and 2, respectively. For AVF characterization, intermodality agreement showed κ values of 0.56 for both readers.

Conclusion
Noncontrast PCASL-MRA with 3D radial acquisition is a potential tool for the detection and characterization of intracranial AV shunts with a sensitivity and specificity equivalent or higher than routine clinical MRA.
Fractures of the Nasal Bones: Is External Splinting Really Warranted?
Authors: Schoinohoriti Ourania , Igoumenakis Dimosthenis , Rallis George 
Published: September 2017

Background:
It has been advocated that reduction of nasal bone fractures should be followed by internal packing and/or external splinting. Despite the ample literature concerning the advantages and limitations of various splint types, the necessity and effectiveness of external splinting has not been well documented.

Objective:
To present the authors’ experience and review the literature on treatment of nasal bone fractures, focusing on the indications and effectiveness of external splinting following closed reduction.

Study Design:
Retrospective analysis and literature review.

Patients and Methods:
Medical records of all patients, treated at the Department of Oral and Maxillofacial Surgery of the “KAT” General Hospital of Attica between January 2010 and December 2016 for facial trauma including nasal bone fractures, were retrospectively reviewed. Patient demographic data, fracture type, applied treatment, complications, and final outcome were registered.

Results:
A total of 77 patients (58 males; 19 females) were included in the study. The age range was 18 to 65 years (mean, 37.8). Closed reduction without external splinting was performed in 63 patients and open reduction with internal fixation in 6; 8 severely comminuted fractures were treated with closed reduction and external splinting. The mean follow-up was 4.8 months. All severely comminuted fractures presented complications.

Conclusions:
External splinting following closed reduction of nasal bone fractures should not be used routinely but only in selected patients with severe comminution. Since the pertinent literature is inconclusive on the indications and effectiveness of external splinting, randomized controlled studies are warranted to fully elucidate the issue.
Multiple (Concomitant) Traumatic Pseudoaneurysms of the Superficial Temporal Artery
Authors: Gurkanlar Doga , Fahrioğlu Sevda Lafci 
Published: September 2017

Abstract
The authors present a case with a 22-year-old man suffering from a 2 pseudoaneurysms at the temporal region following trauma. The second pseudoaneurysm was diagnosed through an astute use of digital subtraction angiography along with ultrasound to the right external carotid artery which was preferred due to the presence of a vascular pathology at the region of the trauma. During surgery, the distal and proximal ends of both aneurysms were ligated and resected. The concomitant pseudoaneurysms and the use of digital subtraction angiography should be kept in mind in such trauma patients to prevent additional surgical interventions.
Evaluating the traditional day and night shift in an acute care surgery fellowship: Is the swing shift a better choice?
Authors: Chestovich Paul J. , McNicoll Christopher F. , Ingalls Nichole K. , Kuhls Deborah A. , Fraser Douglas R. , Morrissey Shawna L. , Fildes John J. 
Published: September 2017

BACKGROUND
Fellowship trainees in acute care surgery require experience in the management of complex and operative trauma cases. Trauma center staffing usually follows standard 12-hour or 24-hour shifts, with resident and fellow trainees following a similar schedule. Although trauma admissions can be generally unpredictable, we analyzed temporal trends of trauma patient arrival times to determine the best time frame to maximize trainee experience during each day.

METHODS
We reviewed 10 years (2007–2016) of trauma registry data for blunt and penetrating trauma activations. Hourly volumetric trends were observed, and three specific events were chosen for detailed analysis: (1) trauma activation with Injury Severity Score (ISS) greater than 15, (2) laparotomy for trauma, and (3) thoracotomy for trauma. A retrospective shift log was created, which included day (7:00 am to 7:00 pm), night (7:00 pm to 7:00 am), and swing (noon to midnight) shifts. A swing shift was chosen because it captures the peak volume for all three events. Means and 95% confidence intervals were calculated, and comparisons were made between shifts using the Wilcoxon matched-pairs signed rank test with Bonferroni correction, and p less than 0.05 considered significant.

RESULTS
During the 10-year study period, 28,287 patients were treated at our trauma center. This included the evaluation and management of 7,874 patients with ISS greater than 15, performance of 1,766 laparotomies, and 392 thoracotomies for trauma. Swing shift was superior to both day and night shifts for ISS greater than 15 (p < 0.001). Both swing and night shifts were superior to day shift for laparotomies (p < 0.001). Swing shift was superior to both day shift (p < 0.001) and night shift (p = 0.031). Shifts with the highest yield of ISS greater than 15, laparotomies, and thoracotomies include night and swing shifts on Fridays and Saturdays.

CONCLUSION
Projected experience of acute care surgery fellows in managing complex trauma patients increases with the integration of swing shifts into the schedule. Daily trauma volume follows a temporal pattern which, when used correctly, can increase trainee exposure to complex and operative trauma cases. We encourage other centers to analyze their volume and adjust trainee schedules accordingly to maximize their educational experience.

Level of Evidence
Therapeutic study, level IV.
The “mortality ascent”: Hourly risk of death for hemodynamically unstable trauma patients at Level II versus Level I trauma centers
Authors: Herrera-Escobar Juan Pablo , Rios-Diaz Arturo J. , Zogg Cheryl K. , Wolf Lindsey L. , Harlow Alyssa , Schneider Eric B. , Cooper Zara , Ordonez Carlos Alberto , Salim Ali , Haider Adil H. 
Published: September 2017

BACKGROUND
Severely injured trauma patients have higher in-hospital mortality at Level II versus Level I trauma centers (TCs). To better understand these differences, we sought to determine if there were any periods during which hemodynamically unstable trauma patients are at higher risk of death at Level II versus Level I TCs within the first 24 hours postadmission.

STUDY DESIGN
Trauma patients aged 18 years to 64 years, with Injury Severity Score of 15 or greater, systolic blood pressure less than 90 mm Hg at admission, and treated at Level II or Level I TCs, were identified using the 2007 to 2012 National Trauma Data Bank. Burn patients, transfers, and patients dead on arrival were excluded. Log-binomial regression models, adjusted for patient- and hospital-level confounders, were used to compare mortality at Level II versus Level I TCs over the first 24 hours postadmission.

RESULTS
Of 13,846 hemodynamically unstable patients, 4,212 (30.4%) were treated at 149 Level II TCs, and 9,634 (69.6%) at 116 Level I TCs. Within the first 24 hours, 3,059 (22.1%) patients died. In risk-adjusted models, mortality risk was significantly elevated at Level II versus Level I TCs during the 24 hours postadmission (relative risk, 1.08; 95% confidence interval, 1.01–1.16). Hourly mortality risk was significantly different between Level II and Level I TCs during 4 hours to 7 hours postadmission, with a maximal difference at 7 hours (relative risk, 1.70; 95% confidence interval, 1.23–2.36) and comparable mortality risk beyond 7 hours postadmission.

CONCLUSION
The 4-hour to 7-hour time window postadmission is critical for hemodynamically unstable trauma patients. Variations in available treatment modalities may account for higher relative mortality at Level II TCs during this time. Further investigation to elucidate specific risk factors for mortality during this period may lead to reductions in in-hospital mortality among hemodynamically unstable trauma patients.

Level of Evidence
Therapeutic/care management, level IV.
A Follow-up Study of Electroconvulsive Therapy in Children and Adolescents
Authors: Mitchell Shanti , Hassan Ehmer , Ghaziuddin Neera 
Published: September 2017

Objectives
Electroconvulsive therapy (ECT) is an effective and a safe treatment for several severe psychiatric disorders across the age span. However, its use remains controversial and highly stigmatized especially among patients under 18 years. In this study, we examined current symptoms, attitudes, perception, and functioning of patients treated with ECT when they were less than 18 years old.

Methods
Participants had received ECT before age 18, between 1989 and 2015, at a tertiary medical center. Institutional review board–approval was obtained, and study documents (cover letter, consent, self-ratings scales for depression, anxiety, global functioning, and suicidality) were mailed.

Results
Based on self-rated depression, 59.1% (13/22) participants indicated mild or no depression; 65% (13/20) reported mild or no anxiety; the majority, 84.3% (16/19) perceived ECT as having improved their overall illness; and 27.3% (6/22) among the respondents reported no clinical impairment on a global functioning scale, whereas 72.7% (16/22) reported significant or severe impairment. Despite reports of ongoing impaired global functioning among some participants, adequate academic performance (83.3%, 5/6) and mild or no suicidality (78.3%, 18/23) were endorsed by the majority reported.

Conclusions
The majority of participants who had received ECT before age 18 years reported mild or absence of depression and anxiety on self-rated follow-up measures after treatment with ECT. Most notably, the majority reported absence of suicidality and adequate academic performance. A number of respondents, however, continued to endorse global impairment, which may be a reflection of their baseline severe illness, which had warranted treatment with ECT.
Loss of generalist plant species and functional diversity decreases the robustness of a seed dispersal network
Authors: Bastazini Vinicius A. G. , Debastiani Vanderlei J. , Azambuja Bethânia O. , Guimarães Paulo R. , Pillar Valério D. 
Published: September 2017

SummaryUnderstanding cascading effects of species loss has become a major challenge for ecologists. Traditionally, the robustness of ecological networks has been evaluated based on simulation studies where primary extinctions occur at random or as a function of species specialization, ignoring other important biological factors. Here, we estimate the robustness of a seed dispersal network from a grassland–forest mosaic in southern Brazil, simulating distinct scenarios of woody plant species extinction, including scenarios where species are eliminated based on their evolutionary and functional distinctiveness. Our results suggest that the network is more robust when species are eliminated based on their evolutionary uniqueness, followed by random extinctions, the extinction of the most specialist species, functional distinctiveness and, at last, when the most generalist species are sequentially eliminated. Our results provide important information for grassland–forest mosaic management, as they indicate that loss of generalist species and functional diversity makes the system more likely to collapse.
Leaf shedding as a bacterial defense in Arabidopsis cauline leaves
Authors: Patharkar O. Rahul , Gassmann Walter , Walker John C. 
Published: September 2017

AbstractPlants utilize an innate immune system to protect themselves from disease. While many molecular components of plant innate immunity resemble the innate immunity of animals, plants also have evolved a number of truly unique defense mechanisms, particularly at the physiological level. Plant’s flexible developmental program allows them the unique ability to simply produce new organs as needed, affording them the ability to replace damaged organs. Here we develop a system to study pathogen-triggered leaf abscission in Arabidopsis. Cauline leaves infected with the bacterial pathogenPseudomonas syringaeabscise as part of the defense mechanism.Pseudomonas syringaelacking a functional type III secretion system fail to elicit an abscission response, suggesting that the abscission response is a novel form of immunity triggered by effectors.HAESA/HAESA-like 2, INFLORESCENCE DEFICIENT IN ABSCISSION, andNEVERSHEDare all required for pathogen-triggered abscission to occur. Additionallyphytoalexin deficient 4, enhanced disease susceptibility 1, salicylic acid induction deficient 2, andsenescence-associated gene 101plants with mutations in genes necessary for bacterial defense and salicylic acid signaling, and NahG transgenic plants with low levels of salicylic acid fail to abscise cauline leaves normally. Bacteria that physically contact abscission zones trigger a strong abscission response; however, long distance signals are also sent from distal infected tissue to the abscission zone, alerting the abscission zone of looming danger. We propose a threshold model regulating cauline leaf defense where minor infections are handled by limiting bacterial growth, but when an infection is deemed out of control, cauline leaves are shed. Together with previous results our findings suggest that salicylic acid may regulate both pathogen‐ and drought-triggered leaf abscission.Author SummaryPlants have a flexible development program that determine their form. We describe an organ level defense response in Arabidopsis to bacterial attack where plants simply shed heavily infected leaves. The genetics regulating this defense mechanism are comprised of both classical defense genes and floral organ abscission genes working together. Long distance signals are transmitted from infected areas to abscission zones which activate the abscission receptor. Salicylic acid, a defense hormone, signaling is necessary for cauline leaf abscission.
Sequences enriched in Alu repeats drive nuclear localization of long RNAs in human cells
Authors: Lubelsky Yoav , Ulitsky Igor 
Published: September 2017

AbstractLong noncoding RNAs (lncRNAs) are emerging as key players in multiple cellular pathways, but their modes of action, and how those are dictated by sequence remain elusive. While lncRNAs share most molecular properties with mRNAs, they are more likely to be enriched in the nucleus, a feature that is likely to be crucial for function of many lncRNAs, but whose molecular underpinnings remain largely unclear. In order identify elements that can force nuclear localization we screened libraries of short fragments tiled across nuclear RNAs, which were cloned into the untranslated regions of an efficiently exported mRNA. The screen identified a short sequence derived from Alu elements and found in many mRNAs and lncRNAs that increases nuclear accumulation and reduces overall expression levels. Measurements of the contribution of individual bases and short motifs to the element functionality identified a combination of RCCTCCC motifs that are bound by the abundant nuclear protein HNRNPK. Increased HNRNPK binding and C-rich motifs are predictive of substantial nuclear enrichment in both lncRNAs and mRNAs, and this mechanism is conserved across species. Our results thus detail a novel pathway for regulation of RNA accumulation and subcellular localization that has been co-opted to regulate the fate of transcripts that integrated Alu elements.
Evolution and Engineering of Allosteric Regulation in Protein Kinases
Authors: Pincus David , Pandey Jai P. , Creixell Pau , Resnekov Orna , Reynolds Kimberly A. 
Published: September 2017

ABSTRACTAllosteric regulation – the control of protein function by sites far from the active site – is a common feature of proteins that enables dynamic cellular responses. Reversible modifications such as phosphorylation are well suited to mediate such regulatory dynamics, yet the evolution of new allosteric regulation demands explanation. To understand this, we mutationally scanned the surface of a prototypical kinase to identify readily evolvable phosphorylation sites. The data reveal a set of spatially distributed “hotspots” that coevolve with the active site and preferentially modulate kinase activity. By engineering simple consensus phosphorylation sites at these hotspots we successfully rewiredin vivocell signaling. Beyond synthetic biology, the hotspots are frequently used by the diversity of natural allosteric regulatory mechanisms in the kinase family and exploited in human disease.ONE SENTENCE SUMMARYCell signaling is easily rewired by introducing new phosphoregulation at latent allosteric surface sites.
Post-fireQuercus albafitness in a stressed plant community
Authors: Milla Kevin 
Published: September 2017

AbstractPrescribed burns are widely used for managing North American deciduous forests due to their ability to positively affect plant community structure and composition. This study examines the effects of neighboring herbaceous plants on the recruitment ofQuercus alba(white oak) seedlings in fire-managed parts of Shawnee National Forest (Illinois, USA). Herbs were clipped to induce plant community stress and relative growth rates (RGRs) of planted white oak seedlings were assessed to determine if a competitive or facilitative dynamic is present. In addition to RGR, we observed the mycorrhizal network via fungal colonization in mesh bags to quantify belowground activity for our experimental plots. Our results supported fire’s positive effects on tree recruitment and herbaceous growth. Clipping combined with fire management decreased RGR. This finding suggests that a facilitative dynamic is at play and herbaceous neighbors help white oak seedlings persist due to protection from environmental stressors (p = 0.017). Soil moisture played a large role in promoting tree fitness on each of our sites. Lower hyphal biomass was observed in areas where herbs were clipped. We further speculate that the stress caused by clipping may have suspended or eliminated the need for mycorrhizae to form, possibly due to herb mortality. Knowing how herbs and trees interact will lead to purposeful forest community planning especially in fire-managed forests where herbs are likely to dominate post-prescribed burn.