bluuebunny/crossref_metadata_2025_split huggingface dataset:
Operative versus nonoperative management of pediatric type 1 open forearm fractures: a retrospective review
Authors: Goss David A. , Mundy Andrew , Beebe Allan C. , Klingele Kevin E. , Balch Samora Julie , Samora Walter P. 
Published: October 2017

Background:
Considerable debate exists regarding the management of type 1 open forearm fractures in the pediatric population. The purpose of this study was to compare outcomes of nonoperative with operative treatment, and specifically to determine if there are differences in infection rates and complications.

Methods:
We retrospectively reviewed 155 consecutive type 1 open fractures treated at a single large pediatric hospital from 1995-2013. Inclusion criteria were patients younger than 18 yr of age with type 1 open forearm fractures with a minimum of 6 mo follow-up. Exclusion criteria were patients with type 2 or 3 injuries, inadequate documentation, and less than 6 mo follow-up.

Results:
From 1995-2013, 19,455 fractures of the forearm were treated. We identified 185 type 1 open fractures, 30 of which were excluded for inadequate follow-up or documentation. One hundred and nineteen patients were managed nonoperatively, and 36 patients were managed operatively with a mean age of 8.8 and 11.2 yr, respectively. There was a 0% infection rate in the nonoperative group. One patient in the operative group developed an infected nonunion. Initial sagittal deformity for the operative and nonoperative groups was 18.8 and 24.7 degrees. Residual deformity at final follow-up was significantly higher in the nonoperative group in both sagittal (P=0.031) and coronal (P=0.017) planes, although all patients fell within accepted parameters. Other than infection rate, there were no differences in complications between the two groups. The overall infection rate was 0.65%, with a 0% infection rate in the nonoperative group. Operations were performed more frequently in older children.

Conclusions:
Our results indicate that nonoperative management of type 1 open fractures in the pediatric population can be safe and effective.
What did we learn from ‘omics’ studies in osteoarthritis
Authors: Ruiz-Romero Cristina , Rego-Perez Ignacio , Blanco Francisco J. 
Published: October 2017

Purpose of review
‘Omics’ technologies developed for the massive analysis of the major biologically relevant molecules (genes, proteins, metabolites) have been applied to the study of osteoarthritis (OA) for more than a decade.

Recent findings
‘Omics’ studies have undoubtedly contributed to increase the knowledge on pathogenic processes related with OA and have provided hundreds to thousands of molecules that might have a putative biomarker utility for this disease.

Summary
This review describes the most recent ‘omics’ studies in OA research, their conclusions, and discuss those remaining challenges. Still many validation studies must be performed in large and well-characterized cohorts for the translation of the findings from ‘omics’ strategies to clinical applications. The development of tools for the intelligent integration of ‘omics’ data with clinical and imaging information is also mandatory to take full profit of the work that has been already performed.
Magnetic Resonance Neurography of the Lumbosacral Plexus in Failed Back Surgery Syndrome
Authors: Dessouky Riham , Khaleel Mohammed , Khalifa Dalia N. , Tantawy Hazim I. , Chhabra Avneesh 
Published: October 2017

Study Design.
Retrospective clinical case series.

Objective.
To study the role of magnetic resonance neurography (MRN) of the lumbosacral plexus in management of patients with failed back surgery syndrome (FBSS).

Summary of Background Data.
FBSS is one of the major problems in health care, affecting up to 40% of patients after spine surgery. To date, no imaging modality has been used to effectively classify nerve compression, because nerve injuries are challenging to detect on conventional lumbar spine magnetic resonance imaging (MRI). To our knowledge, no previous studies have addressed the use of MRN in FBSS or compared it to lumbar spine MRI.

Methods.
From 203 consecutive 3 T MRN studies of lumbosacral plexus in 1 year, 12% (25/203) presented as FBSS. Demographic data, number of previous lumbar MRIs and their findings, MRN findings, interval between MRI and MRN, pre-and post-MRN diagnosis, pain levels, and treatments were recorded. Changes in diagnosis, treatment, and outcomes after MRN were determined.

Results.
The final sample of 25 patients had a mean age 62 ± 15 and male to female ratio 1:1.08. Approximately 88% (22/25) had previous lumbar MRI, of which 27% had 3 or more. Most common imaging findings were neuroforaminal stenosis 22.6% (7/31) on MRI and neuropathy 22.9% (19/83) on MRN. Mean interval between MRI and MRN was 13.9 ± 28.3 months. Lumbar MRIs were inconclusive in 36% (8/22). MRN detected 63% (52/83) more findings and changed the diagnosis and treatment in 12% and 48% of FBSS cases, respectively. Favorable outcomes were recorded in 40% to 67% of patients following MRN-guided treatments.

Conclusion.
FBSS is a complex problem and MRN of lumbosacral plexus impacts its management by better directing source of symptoms.

Level of Evidence: 4
Effects of Hyperoxia During Resuscitation From Hemorrhagic Shock in Swine With Preexisting Coronary Artery Disease
Authors: Hartmann Clair , Loconte Maurizio , Antonucci Elena , Holzhauser Michael , Hölle Tobias , Katzsch David , Merz Tamara , McCook Oscar , Wachter Ulrich , Vogt Josef A. , Hoffmann Andrea , Wepler Martin , Gröger Michael , Matejovic Martin , Calzia Enrico , Georgieff Michael , Asfar Pierre , Radermacher Peter , Nussbaum Benedikt L. 
Published: October 2017

Objectives:
Investigation of the effects of hyperoxia during resuscitation from hemorrhagic shock in swine with preexisting coronary artery disease.

Design:
Prospective, controlled, randomized trial.

Setting:
University animal research laboratory.

Subjects:
Nineteen hypercholesterolemic pigs with preexisting coronary artery disease.

Interventions:
Anesthetized, mechanically ventilated, and surgically instrumented pigs underwent 3 hours of hemorrhagic shock (removal of 30% of the calculated blood volume and subsequent titration of mean arterial blood pressure ≈40 mm Hg). Postshock resuscitation (48 hr) comprised retransfusion of shed blood, crystalloids (balanced electrolyte solution), and norepinephrine support. Pigs were randomly assigned to “control” (Fio
2 0.3, adjusted for arterial oxygen saturation ≥ 90%) and “hyperoxia” (Fio
2 1.0 for 24 hr) groups.

Measurements and Main Results:
Before, at the end of shock and every 12 hours of resuscitation, datasets comprising hemodynamics, calorimetry, blood gases, cytokines, and cardiac and renal function were recorded. Postmortem, organs were sampled for immunohistochemistry, western blotting, and mitochondrial high-resolution respirometry. Survival rates were 50% and 89% in the control and hyperoxia groups, respectively (p = 0.077). Apart from higher relaxation constant τ at 24 hours, hyperoxia did not affect cardiac function. However, troponin values were lower (2.2 [0.9–6.2] vs 6.9 [4.8–9.8] ng/mL; p < 0.05) at the end of the experiment. Furthermore, hyperoxia decreased cardiac 3-nitrotyrosine formation and increased inducible nitric oxide synthase expression. Plasma creatinine values were lower in the hyperoxia group during resuscitation coinciding with significantly improved renal mitochondrial respiratory capacity and lower 3-nitrotyrosine formation.

Conclusions:
Hyperoxia during resuscitation from hemorrhagic shock in swine with preexisting coronary artery disease reduced renal dysfunction and cardiac injury, potentially resulting in improved survival, most likely due to increased mitochondrial respiratory capacity and decreased oxidative and nitrosative stress. Compared with our previous study, the present results suggest a higher benefit of hyperoxia in comorbid swine due to an increased susceptibility to hemorrhagic shock.
An update on the status of molecular testing for the indeterminate thyroid nodule and risk stratification of differentiated thyroid cancer
Authors: Nicholson Kristina J. , Yip Linwah 
Published: October 2017

Purpose of review
Correct identification of malignancy in cytologically indeterminate thyroid nodules is a diagnostic challenge, leading to potentially unnecessary surgery in patients for whom final histology is benign. Similarly, many patients with differentiated thyroid cancer (DTC) undergo aggressive surgical management of tumors, which may ultimately have low-risk histologic features. Use of molecular testing strategies can aid in both the diagnosis of indeterminate thyroid nodules and preoperative risk stratification of DTC.

Recent findings
Validation studies of both the Afirma Gene Expression Classifier and Thyroseq Next-Generation Sequencing panel are ongoing. Both tests can be used to help rule out malignancy in indeterminate thyroid nodules. Recent additions to available molecular testing for indeterminate thyroid nodules include the Rosetta microRNA classifier and the augmentation of the ThyGenX gene panel with a microRNA reflex test (ThyraMIR). Mutational analysis of DTC shows that mutation in TERT alone, and in combination with other mutations, portends advanced disease.

Summary
Currently available molecular testing modalities are useful for ruling out malignancy in indeterminate thyroid nodules; however, longer-term follow-up studies are needed to confirm that test-negative nodules are truly benign. Analysis of specific gene mutations helps identify aggressive disease to guide prognostication and management, but further study is needed.
Ab Interno Gel Implant for the Treatment of Glaucoma Patients With or Without Prior Glaucoma Surgery: 1-Year Results
Authors: Hengerer Fritz H. , Kohnen Thomas , Mueller Michael , Conrad-Hengerer Ina 
Published: October 2017

Purpose:
The purpose of this study is to evaluate IOP lowering effects and complication management of an ab interno gel implant for the treatment of patients refractory to antiglaucoma medication or glaucoma surgery.

Methods:
Retrospective analysis of the medical records of 242 consecutive eyes of 146 patients with uncontrolled intraocular pressure (IOP) despite maximum tolerated medical therapy or prior surgical intervention that underwent XEN45 implantation (as sole procedure or in combination with cataract surgery) between March 2014 and June 2015. Data included IOP, number of glaucoma medications, the need for additional surgery, needling, and complications.

Results:
During the study period, mean IOP had decreased by 54.1% from 32.19 (±9.1) mm Hg to 14.24 (±4.0) mm Hg (P=0.00; Wilcoxon test). The number of antiglaucoma medications had decreased from a mean of 3.13±1.0 to 0.3±0.7 (P=0.00; Wilcoxon test). Needling was required between week 1 and months 3 in 27.7% of all eyes to enhance the outflow. Hypotony (IOP<6 mm Hg) was observed in 9 eyes (4.0%) at 1 month but normalized in all eyes at 12 months postoperatively. Two eyes experienced hypotony requiring the refill of the anterior chamber.

Conclusions:
Our data indicate that the XEN45 gel implant has a favorable safety profile and is an effective treatment option for controlling IOP in glaucoma patients with unregulated IOP despite IOP lowering medical therapy or prior surgical intervention. It offers an effective approach, both as sole procedure and in combination with cataract surgery.
Helmet Use and Risk-Taking Behavior Among Skiers and Snowboarders
Authors: Willick Stuart E. , Wagner Graham , Ericson Don , Josten George , Teramoto Masaru , Davis Jeremy 
Published: October 2017

Objective:
To characterize factors associated with helmet use and risk-taking behavior among recreational skiers and snowboarders.

Design:
Observational study.

Setting:
Large, western United States mountain resort.

Participants:
1285 male and female recreational skiers and snowboarders were interviewed during a single winter ski season.

Independent Variables:
Helmet use, demographic, and sport-related characteristics.

Main Outcome Measures:
Brief sensation seeking scale (BSSS) as a measure of risk-taking behavior and self-reported risk compensation.

Results:
Of the respondents (N = 1285), 17.5%, 12.5%, and 70.0% reported that they never, sometimes, and always wore a helmet, respectively. Multiple linear regression analysis showed that individuals reporting sometimes wearing a helmet had significantly higher BSSS scores than those reporting never wearing a helmet (P = 0.031) or always wearing it (P = 0.018). Male gender, younger age, snowboarding, higher perceived sport ability, more days per year skiing or snowboarding, and more time spent in the terrain park were significantly associated with higher BSSS scores (P < 0.05). Logistic regression analysis focusing on subgroups of respondents who reported either sometimes or always wearing a helmet indicated that the odds of taking more risks when wearing a helmet for inconsistent helmet users was 75% higher than the odds for those who reported always wearing a helmet (P = 0.06).

Conclusions:
Inconsistent helmet users have characteristics of risk-taking behavior and risk compensation. Male gender, younger age, snowboarding, higher perceived sport ability, and more time spent on the mountain and in the terrain park are also important determinants of risk-taking behavior.
Risk of Cervical Intra-epithelial Neoplasia and Invasive Cancer of the Cervix in DES Daughters
Authors: Verloop J. , van Leeuwen F. E. , Helmerhorst Th. J. M. , de Kok I. M. C. M. , van Erp E. J. M. , van Boven H. H. , Rookus M. A. 
Published: October 2017

(Abstracted from Gynecol Oncol 2017;144:305–311)
Several million pregnant women worldwide received diethylstilbestrol (DES) from the late 1940s to the early 1970s to prevent miscarriages and other pregnancy complications. Women exposed to DES in utero have an increased risk of clear cell adenocarcinoma (CCA) of the vagina and cervix; their risk of non–CCA-invasive cervical cancer remains unclear.
Non-opioid Pain Management in Benign Minimally Invasive Hysterectomy: A Systematic Review
Authors: Blanton Emily , Lamvu Georgine , Patanwala Insiyyah , Barron Kenneth I. , Witzeman Kathryn , Tu Frank F. , As-Sanie Sawsan 
Published: October 2017

(Abstracted from Am J Obstet Gynecol 2017;216(6):557–567)
A national survey found that more than 70% of postsurgical patients experience moderate to extreme pain after discharge, and nearly 28% of these have severe to extreme pain. A minimally invasive hysterectomy is typically associated with less postoperative pain than a laparotomy approach.
Surgical Pain After Transobturator and Retropubic Midurethral Sling Placement
Authors: Thomas Tonya N. , Siff Lauren N. , Jelovsek J. Eric , Barber Matthew 
Published: October 2017

(Abstracted from Obstet Gynecol 2017;130:118–125)
A safe and effective surgical treatment for stress urinary incontinence is the midurethral sling. There are 2 surgical approaches: retropubic and transobturator.
Total Pregnancy Loss After Chorionic Villus Sampling and Amniocentesis: A Cohort Study
Authors: Bakker M. , Birnie E. , Robles de Medina P. , Sollie K. M. , Pajkrt E. , Bilardo C. M. 
Published: October 2017

(Abstracted from Ultrasound Obstet Gynecol 2017;49:599–606)
Invasive prenatal procedures such as chorionic villus sampling (CVS) and amniocentesis are often assessed based on their procedure-related fetal loss rate (FLR), which is defined as the total FLR minus the spontaneous FLR. Spontaneous FLR is determined based on the maternal risk profile, whereas procedure-related risk depends on operator experience, technical difficulties, and instruments utilized.
Molecular structure of human KATP in complex with ATP and ADP
Authors: Lee Kenneth Pak Kin , Chen Jue , MacKinnon Roderick 
Published: October 2017

ABSTRACTIn many excitable cells KATP channels respond to intracellular adenosine nucleotides: ATP inhibits while ADP activates. We present two structures of the human pancreatic KATP channel, containing the ABC transporter SUR1 and the inward-rectifier K+channel Kir6.2, in the presence of Mg2+and nucleotides. These structures, referred to as quatrefoil and propeller forms, were determined by single-particle cryo-EM at 3.9 Å and 5.6 Å, respectively. In both forms ATP occupies the inhibitory site in Kir6.2. The nucleotide-binding domains of SUR1 are dimerized with Mg2+-ATP in the degenerate site and Mg2+-ADP in the consensus site. A lasso extension forms an interface between SUR1 and Kir6.2 adjacent to the ATP site in the propeller form, and is disrupted in the quatrefoil form. These structures support the role of SUR1 as an ADP sensor and highlight the lasso extension as a key regulatory element in ADP’s ability to override ATP inhibition.
Potential forMethanosarcinato contribute to uranium reduction during acetate-promoted groundwater bioremediation
Authors: Holmes Dawn E , Orelana Roberto , Giloteaux Ludovic , Wang Li-Ying , Shrestha Pravin , Williams Kenneth , Lovley Derek R , Rotaru Amelia-Elena 
Published: October 2017

AbstractPrevious studies ofin situbioremediation of uranium-contaminated groundwater with acetate injections have focused on the role ofGeobacterspecies in U(VI) reduction because of a lack of other abundant known U(VI)-reducing microorganisms. Monitoring the levels of methyl CoM reductase subunit A (mcrA) transcripts during an acetate-injection field experiment demonstrated that acetoclastic methanogens from the genusMethanosarcinawere enriched after 40 days of acetate amendment. The increased abundance ofMethanosarcinacorresponded with an accumulation of methane in the groundwater. An enrichment culture dominated by aMethanosarcinaspecies with the sameMethanosarcina mcrAsequence that predominated in the field experiment could effectively convert acetate to methane. In order to determine whetherMethanosarcinaspecies could be participating in U(VI) reduction in the subsurface, cell suspensions ofM. barkeriwere incubated in the presence of U(VI) with acetate provided as the electron donor. U(VI) was reduced by metabolically activeM. barkericells, however, no U(VI) reduction was observed in inactive controls. These results demonstrate thatMethanosarcinaspecies could play an important role in the long-term bioremediation of uranium-contaminated aquifers after depletion of Fe(III) oxides limits the growth ofGeobacterspecies. The results also suggest thatMethanosarcinahave the potential to influence uranium geochemistry in a diversity of anaerobic sedimentary environments.
The Effect of Targeted Vaccination Against Mycobacterium Avium ssp. Paratuberculosis (MAP) in a Multiple Sclerosis Mouse Model: Implications for Causation
Authors: Warmoth Michael R. 
Published: October 2017

Epidemiologic evidence relating to the causation of Multiple Sclerosis, based upon twin concordance studies, implicates both genetic and environmental contributions. The HLA-DRB1/ HLA-A haplotype confers a 23 fold increase in MS prevalence above its baseline of 1 per 1,000 persons. Epigenetic factors, such as an aberrant response to Epstein Barr Virus (EBV) and Vitamin D deficiency can increase that risk 36 and 2 fold respectively. Evidence of an association between elevated MAP antibodies and Multiple Sclerosis has been reported.A prospective randomized controlled trial was performed in SJL mice exposed to the myelin-related oligopeptide PLP139-151; a relapsing-remitting Experimental Autoimmune Encephalitis (EAE) model. 100 mice were randomized into five groups of 20. Group 1-Unimmunized prior to disease induction. Group 2-Immunized twice with a 74 kDa fusion protein vaccine against MAP; delivered 28 days and 7 days prior to disease induction. Group 3- 1 dose of 74 kDa vaccine 10 days post-disease induction. Group 4- Attenuated whole cell MAP vaccine (ΔSigH) 28 days prior to disease induction. Group 5- ΔSigH vaccine 10 days post disease induction.Disability was quantified using a EAE disability scoring reference ranging from 0 to 5.Significant decreases in peak disability were seen in the bimodal peaks of this relapsing-remitting model 38% (p<0.006) and 40% (p<0.001). ΔsigH immunized mice lost half as much weight as controls post disease induction. The results suggest that environmental MAP antigen exposure may play an etiologic role in the development of EAE.
Two SecA/SecY Systems with Distinct Roles in the Ecological Adaptations of Bacteria
Authors: Jiang Xiaowei , Fares Mario A. 
Published: October 2017

AbstractBacteria interact with their environment through the secretion of a specific set of proteins (known as secretome) through various secretion systems. Molecular modifications of these secretion systems may lead to the emergence of new bacterial-environment interactions, although this remains unexplored. In this study we investigate the possible link between molecular and functional changes in secretion proteins and the ecological diversity of bacteria. We studied functional modifications in secretion proteins by identifying events of functional evolutionary divergence—that is, changes at the molecular level that have driven changes of protein’s function. We present data supporting that these functional diversifications occurred in essential secretion proteins in bacteria. In particular, functional divergence of the two most important secretion proteins SecA and SecY in pathogenic bacteria suggests that molecular changes at these proteins are responsible for their adaptations to the host. Functional divergence has mainly occurred at protein domains involved in ATP hydrolysis in SecA and membrane pore formation in SecY. This divergence is stronger in pathogenic bacteria for protein copies resulting from the duplication of SecA/SecY, known as SecA2/SecY2. In concert with these results, we find that the secretome of bacteria with the strongest functional divergence is enriched for proteins specialized in the interaction with specific environments. We unravel evolutionary signatures that link mutations at secretion proteins to the ecological diversification of bacteria.
Enzyme Intermediates Captured “on-the-fly” by Mix-and-Inject Serial Crystallography
Authors: Olmos Jose , Pandey Suraj , Martin-Garcia Jose M. , Calvey George , Katz Andrea , Knoska Juraj , Kupitz Christopher , Hunter Mark S. , Liang Mengning , Oberthuer Dominik , Yefanov Oleksandr , Wiedorn Max , Heyman Michael , Holl Mark , Pande Kanupriya , Barty Anton , Miller Mitchell D. , Stern Stephan , Roy-Chowdhury Shatabdi , Coe Jesse , Nagaratnam Nirupa , Zook James , Verburgt Jacob , Norwood Tyler , Poudyal Ishwor , Xu David , Koglin Jason , Seaberg Matt , Zhao Yun , Bajt Saša , Grant Thomas , Mariani Valerio , Nelson Garrett , Subramanian Ganesh , Bae Euiyoung , Fromme Raimund , Fung Russel , Schwander Peter , Frank Matthias , White Thomas , Weierstall Uwe , Zatsepin Nadia , Spence John , Fromme Petra , Chapman Henry N. , Pollack Lois , Tremblay Lee , Ourmazd Abbas , Phillips George N. , Schmidt Marius 
Published: October 2017

Ever since the first atomic structure of an enzyme was solved, the discovery of the mechanism and dynamics of reactions catalyzed by biomolecules has been the key goal for the understanding of the molecular processes that drive life on earth. Despite a large number of successful methods for trapping reaction intermediates, the direct observation of an ongoing reaction has been possible only in rare and exceptional cases. Here, we demonstrate a general method for capturing enzyme catalysis ‘in-action’ by ‘mix-and-inject serial crystallography’. Specifically, we follow the catalytic reaction of theMycobacterium tuberculosisα-lactamase with the 3rdgeneration antibiotic ceftriaxone by time-resolved serial femtosecond crystallography. The results reveal, in near atomic detail, antibiotic cleavage and inactivation on the millisecond to second time scales including the crossover from transition state kinetics to steady-state kinetics.SynopsisAn enzymatically catalyzed reaction is initiated by diffusion based mixing of substrate and followed at runtime by time-resolved serial crystallography using a free electron laser.