bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vertical Profunda Artery Perforator Flap for Plantar Foot Wound Closure: A New Application
Authors: Alfonso Allyson R. , Mayo James L. , Sharma Vishal K. , Allen Robert J. , Chiu Ernest S. 
Published: January 2018

ABSTRACT

BACKGROUND:
Plantar foot reconstruction requires special consideration of both form and function. There are several fasciocutaneous flap options, each with indications and reservations.

CASE STUDY:
This case presents a new application of the vertical profunda artery perforator flap for definitive closure of a neuropathic foot ulcer in a young woman with spina bifida. The postoperative course was uneventful, and the flap survived completely. The surgical and donor sites were without wound recurrence at 5-month follow-up.

DISCUSSION:
Understanding the variability of foot flap options is important because of unique cases such as the one presented where the wound was caused by specific and less commonly observed foot anatomy. The specific choice to use the vertical profunda artery perforator flap for this patient and her neuropathic wound type was made based on its excellent flexibility, durability, and donor site appeal.

CONCLUSIONS:
The vertical profunda artery perforator flap has adequate surface area and bulk and a favorable pedicle length and caliber, can be thinned, and leaves a donor scar in a less conspicuous area than other popular free flaps for lower-extremity reconstruction. For these reasons, it should be considered a first-line therapy for free flap coverage of selected foot wounds.
Diagnostic and Therapeutic Ultrasound on Venous and Arterial Ulcers: A Focused Review
Authors: Kavros Steven J. , Coronado Robert 
Published: January 2018

ABSTRACTGENERAL PURPOSE:To provide information about the use of ultrasound for diagnostic and therapeutic treatment of venous and arterial ulcers.TARGET AUDIENCE:This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.LEARNING OBJECTIVES/OUTCOMES:After completing this continuing education activity, you should be able to:OBJECTIVE:To review the diagnostic and therapeutic use of ultrasound on venous and arterial ulcers.METHODS:PubMed was searched for peer-reviewed articles using the search terms “ultrasound for venous ulcers” and “ultrasound for arterial ulcers.” The search yielded 282 articles on ultrasound for venous ulcers and 455 articles for ultrasound on arterial ulcers. Data from 36 articles were selected and included after abstract review.RESULTS:Ultrasound is an established diagnostic modality for venous and arterial disease and is indicated for wound debridement. Recent evidence continues to support its superiority over standard of care in healing venous ulcers, but findings conflict in terms of the effectiveness of low-frequency ultrasound over high-frequency ultrasound. There are currently no standardized treatment protocols for ultrasound.CONCLUSIONS:Diagnostic ultrasound is used to assess venous and arterial disease and guide appropriate treatment for ulcers. Therapeutic low-frequency ultrasound is used to debride the wound bed, as an adjunctive topical wound treatment with standard of care, and to guide the application of other advanced therapies to chronic wounds. Better trial designs and consistent data are needed to support the effectiveness of ultrasound therapy on venous and arterial ulcers.
Developing a Mobile App for Prevention and Treatment of Pressure Injuries
Authors: Salomé Geraldo Magela , Ferreira Lydia Masako 
Published: January 2018

ABSTRACT

OBJECTIVE:
This descriptive study describes the planning and development of a mobile application (app) for prevention and treatment of pressure injuries for use by providers in a university research center. The app delineates risk factors for pressure injury development, provides an evaluation of the wound, recommends wound cleansing procedures, performs pressure injury staging, and recommends treatment interventions.

METHODS:
A mobile app was developed using a contextualized instructional design, which involves a constructivist proposal and planning, developing, and applying specific didactic situations, thus incorporating mechanisms that favor contextualization. A literature search was conducted to identify relevant studies for the construction of the mobile app. The development process involved the selection of app tools, definition of the navigation structure, and planning of the environment configuration. The environment for downloading the app software on the Internet and installing it on the mobile device was created.

MAIN RESULTS:
The literature search yielded 18 articles, 2 books, and 1 master’s degree thesis. A mobile app was created with an easy-to-use graphic interface. The app stores the patient’s demographic characteristics and provides an evaluation of his/her wound, a list of risk factors for pressure injury development, wound cleansing procedures, and treatment interventions.

CONCLUSIONS:
The developed app may be useful in clinical practice, helping to prevent pressure injuries and promote select nursing interventions for the treatment of patients with pressure injury.
Interdisciplinary Team Evaluation: An Effective Method for the Diagnostic Assessment of Autism Spectrum Disorder
Authors: Gerdts Jennifer , Mancini James , Fox Emily , Rhoads Candace , Ward Tracey , Easley Erin , Bernier Raphael A. 
Published: January 2018

ABSTRACT:

Objective:
The objective of this research is to assess the feasibility of an interdisciplinary team diagnostic assessment model for autism spectrum disorder (ASD).

Method:
Medical records from 366 patients evaluated for ASD at the Seattle Children's Autism Center (SCAC) were reviewed. ASD diagnostic outcomes, provider satisfaction, engagement in follow-up care, billed time, and reimbursement amounts were compared in patients evaluated through an interdisciplinary team approach (n = 91) with those seen in multidisciplinary evaluations led by either a psychologist (n = 165) or a physician (n = 110).

Results:
Diagnostic determination was made in 90% of patients evaluated through the interdisciplinary team model in a single day. Rates of ASD diagnosis were similar across the 3 tracks, ranging from 61% to 72%. Demographic characteristics did not impact the likelihood of ASD diagnosis. Rates of patient follow-up care and provider satisfaction were significantly higher in interdisciplinary versus multidisciplinary teams. Interdisciplinary team evaluations billed 1.8 fewer hours yet generated more net hourly clinic income compared with psychology-led multidisciplinary evaluations.

Conclusion:
An interdisciplinary team approach, focusing on ruling-in or ruling-out ASD, was sufficient to determine ASD diagnosis in most patients seen at the SCAC Interdisciplinary teams generated more clinic income and decreased the time spent in evaluation compared with a psychology-led approach. They did so while maintaining consistency in diagnostic rates, demonstrating increased provider satisfaction and an increased likelihood of engagement in follow-up care.
Validation of Biomarkers for Early Detection of Pancreatic Cancer
Authors: Young Matthew R. , Wagner Paul D. , Ghosh Sharmistha , Rinaudo Jo Ann , Baker Stuart G. , Zaret Kenneth S. , Goggins Michael , Srivastava Sudhir 
Published: January 2018

Abstract
Pancreatic cancer is the third leading cause of cancer death in the United States, and the 5-year relative survival for patients diagnosed with pancreatic cancer is less than 10%. Early intervention is the key to a better survival outcome. Currently, there are no biomarkers that can reliably detect pancreatic cancer at an early stage or identify precursors that are destined to progress to malignancy. The National Cancer Institute in partnership with the Kenner Family Research Fund and the Pancreatic Cancer Action Network convened a Data Jamboree on Biomarkers workshop on December 5, 2016, to discuss and evaluate existing or newly developed biomarkers and imaging methods for early detection of pancreatic cancer. The primary goal of this workshop was to determine if there are any promising biomarkers for early detection of pancreatic cancer that are ready for clinical validation. The Alliance of Pancreatic Cancer Consortia for Biomarkers for Early Detection, formed under the auspices of this workshop, will provide the common platform and the resources necessary for validation. Although none of the biomarkers evaluated seemed ready for a large-scale biomarker validation trial, a number of them had sufficiently high sensitivity and specificity to warrant additional research, especially if combined with other biomarkers to form a panel.
HIV Coinfection Among Persons Diagnosed As Having Sexually Transmitted Diseases, San Francisco, 2007 to 2014
Authors: Chen Miao-Jung , Scheer Susan , Nguyen Trang Q. , Kohn Robert P. , Schwarcz Sandra K. 
Published: January 2018

Background
Early syphilis, gonorrhea, and chlamydia but not HIV infections have increased in San Francisco, primarily among men.

Methods
We linked records of persons reported with early syphilis, gonorrhea, and chlamydia to records of persons reported with HIV to measure the proportion and characteristics of San Francisco residents with HIV-sexually transmitted disease (STD) coinfection between 2007 and 2014. We measured trends in HIV coinfection separately for men and women for each STD.

Results
From 2007 to 2014, of the 5745 early syphilis, 18,037 gonorrhea, and 37,224 chlamydia diagnoses that were reported, 66%, 28%, and 15%, respectively, were among persons coinfected with HIV. Men accounted for most persons with early syphilis, gonorrhea, and chlamydia HIV coinfection. For early syphilis and HIV coinfection, among men who have sex with men (MSM), Latinos were more likely and Asian/Pacific Islanders were less likely to have HIV coinfection compared with whites. Older age at diagnosis and history of an STD were both also significantly associated with early syphilis and HIV coinfection. Transgender persons, older ages, Latino MSM compared with white MSM, and those with a history of STD were more likely to have HIV coinfection, whereas Asian/Pacific Islander MSM were less likely to have HIV coinfection for both gonorrhea and chlamydia,

Conclusions
Our findings highlight the high burden of HIV-STD coinfection in San Francisco. To maintain the current declines in HIV incidence and turn the curve in rising STD incidence, there is an urgent need for collaborative HIV and STD prevention and control efforts.
Posttraumatic Stress in Children After Injury
Authors: Hildenbrand Aimee K. , Kassam-Adams Nancy , Barakat Lamia P. , Kohser Kristen L. , Ciesla Jeffrey A. , Delahanty Douglas L. , Fein Joel A. , Ragsdale Lindsay B. , Marsac Meghan L. 
Published: January 2018

Objectives
After injury, many children experience posttraumatic stress symptoms (PTSS) that negatively impact recovery. Acute pain and PTSS share neurobiological pathways, and acute dosage of morphine has been linked to reduced PTSS in naturalistic studies. However, the complex interactions between pain, morphine and other opioid use, and PTSS have yet to be investigated in robust pediatric samples.
This prospective, longitudinal study examined relationships between acute pain, opioid medications, and PTSS after pediatric injury.

Methods
Ninety-six children aged 8 to 13 years (mean = 10.60, SD = 1.71), hospitalized for unintentional injury, completed assessments at baseline (T1) and 12 weeks (T2) later. Pain ratings and opioid administration data were obtained via chart review.

Results
Structural equation modeling revealed that worst pain endorsed during hospitalization was positively associated with concurrent and later PTSS when controlling for evidence-based risk factors (ie, age, sex, prior trauma history, traumatic appraisals of injury event, heart rate). Neither opioid medications overall nor morphine specifically (milligram/kilogram/day) administered during hospitalization mediated the relationship between pain and T2 PTSS.

Conclusions
Pain during hospitalization may increase susceptibility for persistent PTSS above and beyond the influence of other empirical risk factors. Findings suggest that pain assessment may be a useful addition to pediatric PTSS screening tools and highlight the need for additional research on pharmacological secondary prevention approaches. Given that inadequate pain control and persistent PTSS each hinder recovery and long-term functioning, better understanding of interactions between acute pain and PTSS after injury is essential for improving screening, prevention, and early intervention efforts.
Fluid Removal With Ultrasound Guided Protocol Improves the Efficacy and Safety of Dehydration in Post-Resuscitated Critically Ill Patients: A Quasi-Experimental, Before and After Study
Authors: Wang Luhao , Qiu Chunfang , Guan Xiangdong , Chen Minying , Chen Juan , Si Xiang , Du Zhicheng , Liu Yanqiu , Ouyang Bin 
Published: January 2018

ABSTRACT
Fluid overload is associated with increased morbidity and mortality in critically ill patients. However, researches rarely study the precise start or end point of fluid removal and no protocol was developed to control the fluid removal process. We hypothesized that individualized fluid removal with ultrasound-guided protocol could improve the efficacy and safety of fluid removal in post-resuscitated critically ill patients. A quasi-experimental, before and after trial was conducted to identify the benefits of ultrasound-guided fluid removal. Fluid removal was performed either following the doctor's experience in Control group, or abiding the ultrasound guided protocol in Ultrasound group. The study end points were the start time, end time, length of fluid removal, and the complications related to fluid removal. A total of 85 subjects were finally analyzed in this study. The fluid removal was started earlier, completed quicker and ended earlier (21.0 ± 14.6 h vs. 35.1 ± 26.5 h, 49.8 ± 32.6 vs. 93.0 ± 42.8 h, 69.0 ± 32.2 h vs. 126.4 ± 52.5 h, P < 0.05) in Ultrasound group than in Control. The subjects had more daily negative fluid balance and urine output (−990.4 ± 636.1 mL vs. −723.6 ± 549.5 mL, 2425.8 ± 886.7 mL vs. 1560.7 ± 1125.3 mL, P < 0.05) in Ultrasound group. The time of lung B-lines to reduce to zero was shorter and B-line at the end point was less (49.5 ± 36.6 h vs. 75.6 ± 58.8 h, 0[1] vs. 0[0], P < 0.05) in Ultrasound group. The length of intensive care unit stay in shock subgroup had a tendency to shorten (96.1 ± 61.5 h vs. 174.6 ± 132.0 h, P > 0.05) in Ultrasound group. We concluded that fluid removal with individualized ultrasound-guided protocol improves the efficacy and safety of dehydration in critically ill patients.
Political Ideology, Confidence in Science, and Participation in Alzheimer Disease Research Studies
Authors: Gabel Matthew , Gooblar Jonathan , Roe Catherine M. , Selsor Natalie J. , Morris John C. 
Published: January 2018

Background:
Americans’ confidence in science varies based on their political ideology. This ideological divide has potentially important effects on citizens’ engagement with and participation in clinical studies of Alzheimer disease (AD).

Methods:
A probability sample of 1583 Americans was surveyed about their willingness to participate in longitudinal AD research and about their political attitudes. These survey results were compared with a survey of 382 participants in a longitudinal AD study at the Knight Alzheimer Disease Research Center.

Results:
Among Americans, more conservative ideology decreases willingness to participate in a hypothetical longitudinal cohort study of AD both directly and through its negative effect on confidence in science. The Knight Alzheimer Disease Research Center study participants expressed more liberal ideology and greater confidence in science than Americans in general. Of the survey respondents opposed to participation, over a quarter changed to neutral or positive if the study returned their research results to them.

Conclusions and Relevance:
Clinical studies of AD are likely biased toward participants who are more liberal and have higher confidence in science than the general population. This recruitment bias may be reduced by lowering the trust demanded of participants through measures such as returning research results to participants.
Methionine coordinates a hierarchically organized anabolic program enabling proliferation
Authors: Walvekar Adhish S. , Srinivasan Rajalakshmi , Gupta Ritu , Laxman Sunil 
Published: January 2018

AbstractMethionine availability during overall amino acid limitation metabolically reprograms cells to support proliferation, the underlying basis for which remains unclear. Here, we construct the organization of this methionine mediated anabolic program, using yeast. Combining comparative transcriptome analysis, biochemical and metabolic flux based approaches, we discover that methionine rewires overall metabolic outputs by increasing the activity of three key regulatory nodes. These are: the pentose phosphate pathway coupled with reductive biosynthesis, and overall transamination capacity, including the synthesis of glutamate/glutamine. These provides the cofactors or substrates that enhance subsequent rate-limiting reactions in the synthesis of costly amino acids, and nucleotides, which are also induced in a methionine dependent manner. This thereby results in a biochemical cascade establishing an overall anabolic program. For this methionine mediated anabolic program leading to proliferation, cells co-opt a “starvation stress response” regulator, Gcn4p. Collectively, our data suggest a hierarchical metabolic framework explaining how methionine mediates an anabolic switch.
Human CCL3L1 copy number variation, gene expression, and the role of the CCL3L1-CCR5 axis in lung function
Authors: Adewoye Adeolu B , Shrine Nick , Odenthal-Hesse Linda , Welsh Samantha , Malarstig Anders , Jelinsky Scott , Kilty Iain , Tobin Martin D , Hollox Edward J , Wain Louise V 
Published: January 2018

AbstractThe CCL3L1-CCR5 signaling axis is important in a number of inflammatory responses, including macrophage function, and T-cell-dependent immune responses. Small molecule CCR5 antagonists exist, including the approved antiretroviral drug maraviroc, and therapeutic monoclonal antibodies are in development. Repositioning of drugs and targets into new disease areas can accelerate the availability of new therapies and substantially reduce costs. As it has been shown that drug targets with genetic evidence supporting their involvement in the disease are more likely to be successful in clinical development, using genetic association studies to identify new target repurposing opportunities could be fruitful. Here we investigate the potential of perturbation of the CCL3L1-CCR5 axis as treatment for respiratory disease. Europeans typically carry between 0 and 5 copies of CCL3L1 and this multi-allelic variation is not detected by widely used genome-wide single nucleotide polymorphism studies. We directly measured the complex structural variation of CCL3L1 using the Paralogue Ratio Test (PRT) and imputed (with validation) CCR5del32 genotypes in 5,000 individuals from UK Biobank, selected from the extremes of the lung function distribution, and analysed DNA and RNAseq data for CCL3L1 from the 1000 Genomes Project. We confirmed the gene dosage effect of CCL3L1 copy number on CCL3L1 mRNA expression levels. We found no evidence for association of CCL3L1 copy number or CCR5del32 genotype with lung function suggesting that repositioning CCR5 antagonists is unlikely to be successful for the treatment of airflow obstruction.
Transcription-dependent DNA methylation at the imprintedZrsr1-DMR
Authors: Joh Keiichiro 
Published: January 2018

AbstractZrsr1is a paternally expressed imprinted gene located in the first intron ofCommd1, and theZrsr1promoter resides in a differentially methylated region (DMR) that is maternally methylated in the oocyte. However, a mechanism for the establishment of the methylation has remained obscure.Commd1is transcribed in the opposite direction toZrsr1with predominant maternal expression, especially in the adult brain. In this study, we foundCommed1transcribed through the DMR in the growing oocyte.Zrsr1-DMR methylation was abolished by the prevention ofCommd1transcription. This result indicated that methylation at theZrsr1-DMR was transcription-dependent.
Mutations inBcl9andPygogenes cause congenital heart defects by tissue-specific perturbation of Wnt/β-catenin signaling
Authors: Cantù Claudio , Felker Anastasia , Zimmerli Dario , Chiavacci Elena , Cabello Elena María , Kirchgeorg Lucia , Valenta Tomas , Hausmann George , Ripoll Jorge , Vilain Natalie , Aguet Michel , Basler Konrad , Mosimann Christian 
Published: January 2018

AbstractGenetic alterations in humanBCL9genes have repeatedly been found in congenital heart disease (CHD) with as-of-yet unclear causality. BCL9 proteins and their Pygopus (Pygo) co-factors can participate in canonical Wnt signaling via binding to β-catenin. Nonetheless, their contributions to vertebrate heart development remain uncharted. Here, combining zebrafish and mouse genetics, we document tissue-specific functions in canonical Wnt signaling for BCL9 and Pygo proteins during heart development. In a CRISPR-Cas9-based genotype-phenotype association screen, we uncovered that zebrafish mutants forbcl9andpygogenes largely retain β-catenin activity, yet develop cardiac malformations. In mouse, both systemic and lineage-specific loss of the Pygo-BCL9-β-catenin complex caused heart defects with outflow tract malformations, aberrant cardiac septation and valve formation, and compact myocardium hypoplasia. Mechanistically, these phenotypes coincide with transcriptional deregulation during heart patterning, and Pygo2 associates with β-catenin atcis-regulatory regions of cardiac genes. Taken together, our results establish BCL9 and Pygo as tissue-specific β-catenin co-factors during vertebrate heart development. Our results further implicate alterations inBCL9andBCL9Lin human CHDs as possibly causative.
Locally coordinated synaptic plasticity shapes cell-wide plasticity of visual cortex neurons in vivo
Authors: El-Boustani Sami , P K Ip Jacque , Breton-Provencher Vincent , Okuno Hiroyuki , Bito Haruhiko , Sur Mriganka 
Published: January 2018

AbstractPlasticity of cortical responses involves activity-dependent changes at synapses, but the manner in which different forms of synaptic plasticity act together to create functional changes in neuronal responses remains unknown. Here we show that spike-timing induced receptive field plasticity of individual visual cortex neurons in vivo is anchored by increases in synaptic strength of identified spines, and is accompanied by a novel decrease in the strength of adjacent spines on a slower time scale. The locally coordinated potentiation and depression of spines involves prominent AMPA receptor redistribution via targeted expression of the immediate early gene Arc. Similar changes accompany recovery of eye-specific responses following monocular deprivation. These findings demonstrate that Hebbian strengthening of activated synapses and heterosynaptic weakening of adjacent synapses, in dendrites with heterogeneous synaptic inputs, co-operatively orchestrate cell-wide plasticity of functional neuronal responses.One Sentence SummaryArc-mediated local synaptic plasticity regulates reorganization of synaptic responses on dendritic stretches to mediate functional plasticity of neuronal responses in vivo.