bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sarcopenia in Children With End‐Stage Liver Disease
Authors: Lurz Eberhard , Patel Hiten , Frimpong Richard G. , Ricciuto Amanda , Kehar Mohit , Wales Paul W. , Towbin Alexander J. , Chavhan Govind B. , Kamath Binita M. , Ng Vicky L. 
Published: October 2017

ABSTRACTBackground:Sarcopenia, reflected by decreased psoas muscle surface area (PMSA), has been identified as a novel and independent predictor of wait‐list mortality and outcomes in adult liver transplantation (LT). We hypothesized that children with end‐stage liver disease (ESLD) would have smaller PMSA than healthy controls.Methods:Computer tomography images of children (ages 0 to 18 years) listed for LT in 2015 and a control group comprised 2:1 age‐ and gender‐matched healthy pediatric trauma victims were reviewed. PMSA was determined at 2 intervertebral disc (L3/4; L4/5) levels. A subset of images was reviewed by 2 radiologists to determine interrater correlation.Results:A total of 23 children with ESLD were included, and the most prevalent diagnosis was biliary atresia (61%). On both lumbar levels, median PMSA was significantly smaller in ESLD subjects compared with the 46 healthy controls (L4/5; median total PMSA (tPMSA) 407 mm2 (interquartile range 339–537) versus controls 513 mm2 (interquartile range 437–672); P = 0.004), independent of participants’ weight z scores (r = 0.01; P = 0.95). Excellent interrater correlation was seen (intraclass correlation 0.99).Conclusions:In this retrospective pilot study, PMSA was significantly lower in children with ESLD compared with healthy age‐ and gender‐matched controls. Because this finding was independent of growth in ESLD subjects, PMSA may represent a novel objective nutritional biomarker in children with advanced liver disease.
Is There a Continuum of Risk for Sexually Transmitted Infections Among African American Women?
Authors: Harbison Hanne S. , Austin Erika L. , Hook Edward W. , Muzny Christina A. 
Published: October 2017

Abstract
This study compared sexual risk behaviors and sexually transmitted infection prevalence among African American women who have sex with women, women who have sex with men with a single male partner, women who have sex with men with 4 or more male partners, and women who have sex with women and men at a sexually transmitted disease clinic. The results suggest that, despite differences in prevalence, there was not a clear continuum of sexually transmitted infection risk among African American women in the study; all women were at risk.
Pediatric Obstructive Sleep Apnea: Consensus, Controversy, and Craniofacial Considerations
Authors: Garg Ravi K. , Afifi Ahmed M. , Garland Catharine B. , Sanchez Ruston , Mount Delora L. 
Published: October 2017

Summary:
Pediatric obstructive sleep apnea, characterized by partial or complete obstruction of the upper airway during sleep, is associated with multiple adverse neurodevelopmental and cardiometabolic consequences. It is common in healthy children and occurs with a higher incidence among infants and children with craniofacial anomalies. Although soft-tissue hypertrophy is the most common cause, interplay between soft tissue and bone structure in children with craniofacial differences may also contribute to upper airway obstruction. Snoring and work of breathing are poor predictors of obstructive sleep apnea, and the gold standard for diagnosis is overnight polysomnography. Most healthy children respond favorably to adenotonsillectomy as first-line treatment, but 20 percent of children have obstructive sleep apnea refractory to adenotonsillectomy and may benefit from positive airway pressure, medical therapy, orthodontics, craniofacial surgery, or combined interventions. For children with impairment of facial skeletal growth or craniofacial anomalies, rapid maxillary expansion, midface distraction, and mandibular distraction have all been demonstrated to have therapeutic value and may significantly improve a child’s respiratory status. This Special Topic article reviews current theories regarding the underlying pathophysiology of pediatric sleep apnea, summarizes standards for diagnosis and management, and discusses treatments in need of further investigation, including orthodontic and craniofacial interventions. To provide an overview of the spectrum of disease and treatment options available, a deliberately broad approach is taken that incorporates data for both healthy children and children with craniofacial anomalies.
Resurfacing Capitate Pyrocarbon Implant versus Proximal Row Carpectomy Alone: A Comparative Study to Evaluate the Role of Capitate Prosthetic Resurfacing in Advanced Carpal Collapse
Authors: Giacalone Francesco , di Summa Pietro G. , Fenoglio Alessandro , Sard Arman , Dutto Elisa , Ferrero Matteo , Bertolini Maddalena , Garcia-Elias Marc 
Published: October 2017

Background:
The Resurfacing Capitate Pyrocarbon Implant associated with proximal row carpectomy has been used to treat symptomatic advanced carpal collapse, widening the indications of proximal row carpectomy to patients with capitate head arthritis. The authors retrospectively compared their case series of implant versus carpectomy alone, analyzing whether prosthetic implant outcomes could be similar to those of proximal row carpectomy even with a higher stage of osteoarthritis.

Methods:
Fifty-seven patients who underwent surgery for wrist osteoarthritis (minimum follow-up, 2 years) were selected retrospectively. Twenty-five patients (scapholunate advanced collapse/scaphoid nonunion advanced collapse stage III to IV and Kienböck disease stage IV) underwent proximal row carpectomy plus Resurfacing Capitate Pyrocarbon Implant (group A); 32 patients (scapholunate advanced collapse/scaphoid nonunion advanced collapse stage I to II and Kienböck disease stage III) underwent carpectomy alone (group B). Mean follow-up was 33 months. Patients were evaluated clinically and radiographically. Patient-Rated Wrist Evaluation and Disabilities of the Arm, Shoulder, and Hand questionnaire scores were assessed.

Results:
Group A showed consistent pain relief (visual analogue scale score of 2), while preserving wrist mobility (flexion, 27 degrees; extension, 33 degrees) and grip strength (54 percent compared with the contralateral side). Average Disabilities of the Arm, Shoulder, and Hand questionnaire score was 20, and average Patient-Rated Wrist Evaluation score was 28. No statistically significant difference was observed between groups for all outcomes, except for better extension (p < 0.05) in group B.

Conclusions:
Even starting from a higher grade of osteoarthritis, Resurfacing Capitate Pyrocarbon Implant plus proximal row carpectomy showed satisfying results, compared with those obtained with just carpectomy. Data show that indications for proximal row carpectomy can be widened by using the implant, without worsening outcomes. The implant could be a useful alternative to more aggressive salvage procedures in case of capitate head and lunate fossa osteoarthritis involvement.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Orthognathic Surgery Has a Significant Effect on Perceived Personality Traits and Emotional Expressions
Authors: Mazzaferro Daniel M. , Wes Ari M. , Naran Sanjay , Pearl Rebecca , Bartlett Scott P. , Taylor Jesse A. 
Published: October 2017

Background:
The effects of orthognathic surgery go beyond objective cephalometric correction of facial and dental disproportion and malocclusion, respectively. The authors hypothesized that there is tangible improvement following surgery that alters publicly perceived personality traits and emotions.

Methods:
The authors used Amazon.com’s Mechanical Turk (MTurk), a crowdsourcing tool, to determine how preoperative and postoperative images of orthognathic surgery patients were perceived on six personality traits and six emotional expressions based on posteroanterior and lateral photographs. Blinded respondents provided demographic information and were randomly assigned to one of two sets of 20 photographs (10 subjects before and after surgery).

Results:
Data on 20 orthognathic surgery patients were collected from 476 individuals. The majority of participants were female (52.6 percent), 18 to 39 years old (67.9 percent), Caucasian (76.6 percent), had some college or technical training or graduated college (72.7 percent), and had an annual income between $20,000 and $99,999 (74.6 percent). A paired t test analysis found that subjects were perceived significantly more favorably after orthognathic surgery in 12 countenance categories: more dominant, trustworthy, friendly, intelligent, attractive, and happy; and also less threatening, angry, surprised, sad, afraid, and disgusted (p < 0.05). Raters with the highest annual income perceived a greater magnitude of dominance after surgery than those earning less (p < 0.001).

Conclusions:
There is significant improvement in the countenance of patients after orthognathic surgery, with both perceived personality traits and emotions deemed more favorable. Additional work is needed to better understand the physiologic underpinnings of such findings. Crowdsourcing technology offers a unique opportunity for surgeons to gather data regarding laypeople’s perceptions of surgical outcomes in areas such as orthognathic surgery.
Not All Gustilo Type IIIB Fractures Are Created Equal: Arterial Injury Impacts Limb Salvage Outcomes
Authors: Stranix John T. , Lee Z-Hye , Jacoby Adam , Anzai Lavinia , Avraham Tomer , Thanik Vishal D. , Saadeh Pierre B. , Levine Jamie P. 
Published: October 2017

Background:
Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors’ experience, however, the presence of arterial injury appears to negatively impact microsurgical outcomes.

Methods:
In a retrospective review of 806 lower extremity reconstructions between 1979 and 2016, 361 soft-tissue flaps performed for Gustilo type IIIB/C coverage met inclusion criteria. Patient demographics, flap characteristics, and outcomes were analyzed.

Results:
Most patients suffered type IIIB [n = 332 (91.9 percent)] injuries; 29 (8.0 percent) had type IIIC injuries. Preoperative angiography [n = 243 (67.3 percent)] demonstrated arterial injury in 126 (51.8 percent); 27 arterial injuries were identified intraoperatively; and the overall incidence was 153 of 361 (42.4 percent). Complications occurred in 143 flaps (39.6 percent) and included 37 partial losses (10.2 percent) and 31 total losses (8.6 percent). Injured recipient arteries [n = 62 (17.2 percent)] had more complications (p = 0.004); specifically, increased take-backs (p = 0.009). Decreasing vessel runoff increased the risk of complications (p = 0.025), take-backs (p = 0.007), and total flap failures (p = 0.024) accordingly. Specifically, among grade IIIB injuries, controlling for age, sex, time since injury, and vein number, single-vessel runoff was associated with higher rates of complications (relative risk, 3.07; p = 0.012), take-backs (relative risk, 3.43; p = 0.013), and total flap failures (relative risk, 4.80; p = 0.010) compared with three-vessel runoff.

Conclusions:
Arterial injury was common among Gustilo type IIIB patients and correlated with increased reconstructive complications. Nonischemic arterial injury appears to negatively impact reconstructive outcomes and should be accounted for when considering free tissue transfer for lower extremity salvage. The authors propose a 3-2-1 modification of the Gustilo type IIIB classification to incorporate degree of arterial injury, as it appears to add prognostic value and certainly influences the reconstructive plan.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, IV.
Evidence-Based Clinical Practice Guideline: Autologous Breast Reconstruction with DIEP or Pedicled TRAM Abdominal Flaps
Authors: Lee Bernard T. , Agarwal Jayant P. , Ascherman Jeffrey A. , Caterson Stephanie A. , Gray Diedra D. , Hollenbeck Scott T. , Khan Seema A. , Loeding Lauren D. , Mahabir Raman C. , Miller Archibald S. , Perdikis Galen , Schwartz Jaime S. , Sieling Beth A. , Thoma Achilles , Wolfman Judith A. , Wright Jean L. 
Published: October 2017

Summary:
The American Society of Plastic Surgeons commissioned a multistakeholder Work Group to develop recommendations for autologous breast reconstruction with abdominal flaps. A systematic literature review was performed and a stringent appraisal process was used to rate the quality of relevant scientific research. The Work Group assigned to draft this guideline was unable to find evidence of superiority of one technique over the other (deep inferior epigastric perforator versus pedicled transverse rectus abdominis musculocutaneous flap) in autologous tissue reconstruction of the breast after mastectomy. Presently, based on the evidence reported here, the Work Group recommends that surgeons contemplating breast reconstruction on their next patient consider the following: the patient’s preferences and risk factors, the setting in which the surgeon works (academic versus community practice), resources available, the evidence shown in this guideline, and, equally important, the surgeon’s technical expertise. Although theoretical superiority of one technique may exist, this remains to be reported in the literature, and future methodologically robust studies are needed.
Orthognathic Surgery and Rhinoplasty to Address Nasomaxillary Hypoplasia
Authors: Veeramani Anamika , Sawh Raj , Steinbacher Derek M. 
Published: October 2017

Summary:
The treatment of nasomaxillary hypoplasia is challenging. The phenotype of Binder “syndrome” includes the following: midfacial hypoplasia, class III malocclusion, small or absent anterior nasal spine, flattened nose, horizontal nostrils, short columella, acute nasolabial angle, and a flat frontonasal angle. A staged approach is used, with orthognathic surgery to achieve vertical maxillary length and sagittal advancement, followed by rhinoplasty aimed to increase nasal tip projection, rotation, and columellar length. This article details the diagnosis and treatment of nasomaxillary hypoplasia, demonstrating the senior author’s (D.M.S.) preferred approach and technical steps.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Effect of Compound 21, a Selective Angiotensin II Type 2 Receptor Agonist, in a Murine Xenograft Model of Dupuytren Disease
Authors: Chisholm Jessica , Gareau Alison J. , Byun Stephanie , Paletz Justin L. , Tang David , Williams Jason , LeVatte Terry , Bezuhly Michael 
Published: October 2017

Background:
Although surgical excision and intralesional collagenase injection are mainstays in Dupuytren disease treatment, no effective medical therapy exists for recurrent disease. Compound 21, a selective agonist of the angiotensin II type 2 receptor, has been shown to protect against fibrosis in models of myocardial infarction and stroke. The authors investigated the potential use of compound 21 in the treatment of Dupuytren disease.

Methods:
Human dermal fibroblasts were treated in vitro with compound 21 and assessed for viability using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, migration by means of scratch assay, and profibrotic gene transcription by means of quantitative reverse transcription polymerase chain reaction. Compound 21 effects in vivo were assessed using a xenograft model. Dupuytren disease cord specimens from patients undergoing open partial fasciectomy were divided into two segments. Segments were implanted under the dorsal skin of nude mouse pairs. Beginning on day 5, one mouse from each pair received daily intraperitoneal injections of compound 21 (10 μg/kg/day), and the other received vehicle. On day 10, segments were explanted and submitted for immunohistochemistry.

Results:
Human dermal fibroblasts treated with compound 21 displayed decreased migration and decreased gene expression of connective tissue growth factor, fibroblast specific protein-1, transforming growth factor-β1, Smad3, and Smad4. Dupuytren disease segments from compound 21–treated mice demonstrated significantly reduced alpha-smooth muscle actin and Ki67 staining, with increased density of CD31+ staining vessels.

Conclusions:
Compound 21 significantly decreases expression of profibrotic genes and decreases myofibroblast proliferation as indicated by reduced Ki67 and alpha-smooth muscle actin expression. These findings support compound 21 as a potential novel treatment modality for Dupuytren disease.
An Unexpected and Less Recognized Altered Distribution on Bone Scintigraphy; Possibility of 99mTc-Dextrose Complex as a Cause
Authors: Qutbi Mohsen , Shafiei Babak , Khoshbakht Sepideh , Asadi Ali , Neshandar Asli Isa 
Published: October 2017

Abstract
Optimal performance of diagnostic tests and correct interpretation depend on multiple factors, one of which is proper radiopharmaceutical preparation. Unwanted impurities result in altered distribution of radiopharmaceuticals and then poor-quality or uninterpretable studies. Therefore, following the reconstitution steps according to standard and validated protocols by the technologist is mandatory. Here, we present 2 cases with unexpected and less recognized distribution of 99mTc–methylene diphosphonate on bone scintigraphy.
A Case of Anaplastic Oligodendroglioma With Extensive Extraneural Metastases Imaged With FDG PET
Authors: Ambinder Emily B. , Rowe Steven P. 
Published: October 2017

Abstract
A 28-year-old man with history of anaplastic oligodendroglimoma in the left frontal lobe presented with worsening right leg weakness 2 months after surgical resection. MRI of the brain and spine demonstrated a new mass in the left parietal lobe, as well as extraneural osseous metastases. FDG PET scan subsequently showed widespread extraneural metastatic disease. Extraneural metastases from primary brain tumors are a rare occurrence, although anaplastic oligodendroglioma has a propensity for spreading in such a manner. FDG PET can effectively stage patients with extraneural metastases from anaplastic oligodendroglioma by detecting metastatic disease in sites such as the skeleton and liver.
Intracardiac Metastases Detected by 18F-FSPG PET/CT
Authors: Magarik Meaghan A. , Walker Ronald C. , Gilbert Jill , Manning H. Charles , Massion Pierre P. 
Published: October 2017

Abstract
PET/CT imaging is frequently used for cancer diagnosis and restaging as metabolically active cells, including cancer, utilize glucose for proliferation. 18F-FDG is the most commonly utilized radiopharmaceutical in PET/CT imaging. Limitations of 18F-FDG imaging include intense physiologic uptake in benign tissues such as the brain and myocardium. We present a case of non–small cell lung cancer with myocardial and pericardial metastases obscured by physiologic 18F-FDG cardiac uptake but detected with the investigational PET radiotracer (4S)-4-(3-18F-fluoropropyl)-l-glutamate (18F-FSPG), which targets a pathway associated with glutathione biosynthesis. This case demonstrates the added value of 18F-FSPG PET/CT imaging.
The Call and the Challenge of Pediatric Resuscitation and Simulation Research in Low-Resource Settings
Authors: Rule Amy R.L. , Tabangin Meredith , Cheruiyot David , Mueri Priscilla , Kamath-Rayne Beena D. 
Published: October 2017

Summary Statement
The greatest burden of younger than 5 years mortality is in low- and middle-income nations where education resources are often few. The World Health Organization recommends scale-up of simulation in these settings, but it has been poorly studied. Although there has been an increase of contextualized resuscitation simulation programs designed for these settings, sustaining clinical outcomes and provider skill retention have remained research gaps. Our team designed a study to evaluate skill retention after an initial Helping Babies Breathe training at a rural Kenya referral hospital between randomized learner groups receiving supervised mock codes with debriefing versus just-in-time training with a peer. Although we saw sustained skills retention and some clinical improvements, we were unable to answer our research question because of numerous challenges, mainly that hospital leadership preferred the implementation of 1 arm of the study over another because of lack of protected education time and resources, eliminating differences between randomized study groups. Further challenges included lack of familiarity with simulation and debriefing and lack of protected educational resources and time, cultural differences in giving feedback, undeveloped systems for documentation, and high acuity and clinical volume. Our experience teaches many important lessons in how best to implement and study simulation in low-resource settings. Best practices include long-term partnerships, flexibility, community and staff engagement, mixed methodologies including community-based participatory methods, and careful attention to educational and research capacity building.
Entrained audiovisual speech integration implemented by two independent computational mechanisms: Redundancy in left posterior superior temporal gyrus and Synergy in left motor cortex
Authors: Park Hyojin , Ince Robin A. A. , Schyns Philippe G. , Thut Gregor , Gross Joachim 
Published: October 2017

AbstractInformation integration is fundamental to many aspects of human behavior, and yet its neural mechanism remains to be understood. For example, during face-to-face communication we know that the brain integrates the auditory and visual inputs but we do not yet understand where and how such integration mechanisms support speech comprehension. Here we show that two independent mechanisms forge audiovisual representations for speech comprehension in different brain regions. With a novel information theoretic measure, we found that theta (3-7 Hz) oscillations in the posterior superior temporal gyrus/sulcus (pSTG/S) code speech information that is common (i.e. redundant) to the auditory and visual inputs whereas the same oscillations in left motor and inferior temporal cortex code synergistic information between the same inputs. Importantly, redundant coding in the left pSTG/S and synergistic coding in the left motor cortex predict behavior - i.e. speech comprehension performance. Our findings therefore demonstrate that processes classically described as integration effectively reflect independent mechanisms that occur in different brain regions to support audiovisual speech comprehension.
Data Science Issues in Understanding Protein-RNA Interactions
Authors: Chakrabarti Anob M. , Haberman Nejc , Praznik Arne , Luscombe Nicholas M. , Ule Jernej 
Published: October 2017

AbstractAn interplay of experimental and computational methods is required to achieve a comprehensive understanding of protein-RNA interactions. Crosslinking and immunoprecipitation (CLIP) identifies endogenous interactions by sequencing RNA fragments that co-purify with a selected RBP under stringent conditions. Here we focus on approaches for the analysis of resulting data and appraise the methods for peak calling, visualisation, analysis and computational modelling of protein-RNA binding sites. We advocate a combined assessment of cDNA complexity and specificity for data quality control. Moreover, we demonstrate the value of analysing sequence motif enrichment in peaks assigned from CLIP data, and of visualising RNA maps, which examine the positional distribution of peaks around regulated landmarks in transcripts. We use these to assess how variations in CLIP data quality, and in different peak calling methods, affect the insights into regulatory mechanisms. We conclude by discussing future opportunities for the computational analysis of protein-RNA interaction experiments.