bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moduli Spaces of Representations of Special Biserial Algebras
Authors: Carroll Andrew T , Chindris Calin , Kinser Ryan , Weyman Jerzy 
Published: February 2018

Abstract
We show that the irreducible components of any moduli space of semistable representations of a special biserial algebra are always isomorphic to products of projective spaces of various dimensions. This is done by showing that irreducible components of varieties of representations of special biserial algebras are isomorphic to irreducible components of products of varieties of circular complexes and therefore normal, allowing us to apply recent results of the second and third authors on moduli spaces.
Clinical Surveillance and Evaluation of Suspected Ebola Cases in a Vaccine Trial During an Ebola Epidemic: The Sierra Leone Trial to Introduce a Vaccine Against Ebola
Authors: Conteh Muhammad-Abbas , Goldstein Susan T , Wurie Haja R , Gidudu Jane , Lisk Durodami Radcliffe , Carter Rosalind J , Seward Jane F , Hampton Lee M , Wang David , Andersen Lauren E , Arvay Melissa , Schrag Stephanie J , Dawson Peter , Fombah Augustin E , Petrie Carey R , Feikin Daniel R , Russell James B W , Lindblad Robert , Kargbo S A S , Samai Mohamed , Mahon Barbara E 
Published: February 2018

Abstract
The Sierra Leone Trial to Introduce a Vaccine Against Ebola (STRIVE), an Ebola vaccine trial conducted during the 2014–2016 Ebola epidemic, coordinated with the Sierra Leone national response to identify Ebola cases among trial participants. The early symptoms of Ebola are similar to common vaccine reactions, so it was important to differentiate these to avoid unnecessary referral to an Ebola facility and an increased risk of Ebola exposure. STRIVE developed a modified version of the national case definition and case management algorithm to distinguish between symptoms associated with both Ebola and vaccination with the candidate Ebola vaccine (rVSV∆G-ZEBOV-GP) from those typically associated only with Ebola. For participants who presented ≤48 hours after vaccination, we used the more stringent modified case definition to trigger referral for Ebola evaluation. Participants whose symptoms did not meet case definitions could also be referred to an Ebola facility, based on clinical judgment. No Ebola cases were diagnosed among the 8651 STRIVE participants. Fifty participants were evaluated for Ebola, of whom 34 (68%) were tested after vaccination; 22 deceased participants, all of whom underwent postmortem Ebola testing, as required during the Ebola epidemic, and had negative test results, were excluded from analysis. Seven of 34 participants (21%) had symptom onset ≤48 hours after vaccination, of whom 3 met the modified case definition. The most common diagnosis among those evaluated for Ebola was malaria. STRIVE demonstrates the feasibility of conducting Ebola surveillance among persons vaccinated with rVSV-ZEBOV during an Ebola epidemic and introduces a modified case definition and case management algorithm to distinguish vaccine reactions from early symptoms of Ebola that may be useful for reducing unnecessary Ebola evaluations among persons vaccinated during Ebola outbreaks.

Clinical Trials Registration
ClinicalTrials.gov [NCT02378753] and Pan African Clinical Trials Registry [PACTR201502001037220].
Probiotic treatment during neonatal age provides optimal protection against experimental asthma through the modulation of microbiota and T cells
Authors: Nunes Caroline Fraga , Nogueira Jeane S , Vianna Pedro Henrique Oliveira , Ciambarella Bianca Torres , Rodrigues Patrícia Machado , Miranda Karla Rodrigues , Lobo Leandro Araújo , Domingues Regina Maria Cavalcanti Pillotto , Busch Mileane , Atella Georgia Correa , Vale André Macedo , Bellio Maria , Nóbrega Alberto , Canto Fábio B , Fucs Rita 
Published: February 2018

AbstractThe incidence of allergic diseases, which increased to epidemic proportions in developed countries over the last few decades, has been correlated with altered gut microbiota colonization. Although probiotics may play a critical role in the restoration of gut homeostasis, their efficiency in the control of allergy is controversial. Here, we aimed to investigate the effects of probiotic treatment initiated at neonatal or adult ages on the suppression of experimental ovalbumin (OVA)-induced asthma. Neonatal or adult mice were orally treated with probiotic bacteria and subjected to OVA-induced allergy. Asthma-like symptoms, microbiota composition and frequencies of the total CD4+ T lymphocytes and CD4+Foxp3+ regulatory T (Treg) cells were evaluated in both groups. Probiotic administration to neonates, but not to adults, was necessary and sufficient for the absolute prevention of experimental allergen-induced sensitization. The neonatally acquired tolerance, transferrable to probiotic-untreated adult recipients by splenic cells from tolerant donors, was associated with modulation of gut bacterial composition, augmented levels of cecum butyrate and selective accumulation of Treg cells in the airways. Our findings reveal that a cross-talk between a healthy microbiota and qualitative features inherent to neonatal T cells, especially in the Treg cell subset, might support the beneficial effect of perinatal exposure to probiotic bacteria on the development of long-term tolerance to allergens.
CD28 co-stimulation is dispensable for the steady state homeostasis of intestinal regulatory T cells
Authors: Wakamatsu Ei , Omori Hiroki , Tabata Yuki , Akieda Yuki , Watanabe Shiho , Ogawa Shuhei , Abe Ryo 
Published: February 2018

Abstract
It is well-established that CD28 co-stimulation is required for the development and the proliferation of thymus-derived regulatory T cells (tTregs). Meanwhile, the role of CD28 co-stimulation in the homeostasis of peripherally derived Tregs (pTregs) remains unclear. To clarify this issue, we analyzed Tregs in small and large intestines (SI and LI), the principle sites of pTreg development. Interestingly, and different from in the thymus, Tregs were abundant in the intestines of CD28−/− mice, and most of them were phenotypically pTregs. We showed that CD28−/− naive T cells differentiated into pTregs in the LI after oral exposure to antigens and that CD28−/− pTregs in the LI had the same highly proliferative activity as CD28+/− cells. CD28−/− pTregs acquired these Treg-specific features at transcriptional and epigenetics levels. On the other hand, some immune suppressive molecules were down-regulated in CD28−/− pTregs. Correspondingly, the suppressive activity of CD28−/− pTregs was weaker than CD28+/+ cells. These results indicate that the homeostasis of pTregs in the intestines is maintained even in the absence of CD28, whereas CD28 is required for the maximal suppressive activity of intestinal pTregs.
Neck Remnants and the Risk of Aneurysm Rupture After Endovascular Treatment With Coiling or Stent-Assisted Coiling: Much Ado About Nothing?
Authors: Munich Stephan A , Cress Marshall C , Rangel-Castilla Leonardo , Sonig Ashish , Ogilvy Christopher S , Lanzino Giuseppe , Petr Ondra , Mocco J , Morone Peter J , Snyder Kenneth V , Hopkins L Nelson , Siddiqui Adnan H , Levy Elad I 
Published: February 2018

Abstract

BACKGROUND
Neck remnants are not uncommon after endovascular treatment of cerebral aneurysms. Critics of endovascular treatments for cerebral aneurysms cite neck remnants as evidence in favor of microsurgical clipping. However, studies have failed to evaluate the true clinical significance of aneurysm neck remnants following endovascular therapies.

OBJECTIVE
To assess the clinical significance of residual aneurysm necks and to determine the rate of subsequent rupture following coiling or stent-assisted coiling of cerebral aneurysms.

METHODS
We retrospectively reviewed the records of 1292 aneurysm cases that underwent endovascular treatment at 4 institutions. Aneurysms treated by primary coiling or stent-assisted coiling were included in the study; those treated by flow diversion were excluded Aneurysms with residual filling (i.e., Raymond–Roy Occlusion Classification II, neck remnant; or III, residual aneurysm filling) were assessed for their risk of subsequent rupture.

RESULTS
A total of 626 aneurysms were identified as having residual filling immediately posttreatment. Of these, 13 aneurysms (2.1%) ruptured during the follow-up period (mean 7.3 mo; range 1-84 mo). Eleven of the 13 (84.6%) were ruptured at presentation. Rupture at presentation, the size of the aneurysm, and the increasing age of the patient were predictive of posttreatment rupture.

CONCLUSION
We found that unruptured aneurysms with residual necks following endovascular treatment posed a very low risk of rupture (0.6%). However, patients presenting with ruptured aneurysms had a higher risk of rerupture from a neck remnant (3.4%). These results highlight the importance of achieving complete angiographic occlusion of ruptured aneurysms.
Orthopaedic Trauma Association Annual Meeting Program Committee: Analysis of Impact of Committee Size and Review Process on Abstract Acceptance
Authors: O'Hara Nathan N. , Slobogean Gerard P. , Zhan Min , Gardner Michael J. , McKee Michael D. , Moore Sharon M. , Higgins Thomas F. , O'Toole Robert V. ,   the Orthopaedic Trauma Association Program Committee
Published: February 2018

Objective:
To evaluate whether scientific abstracts selected for podium presentation at the Orthopaedic Trauma Association (OTA) Annual Meeting differ based on the program committee size and/or the proportion of abstracts each committee member evaluates.

Methods:
Abstract scores from the Orthopaedic Trauma Association program committee from 2010 through 2016 were obtained. All members (range, 8–9) reviewed each clinical abstract (range, 506–778) each year in a blinded fashion. The 90 top-scoring abstracts were considered “accepted” for this study. To determine the effect of reducing the committee size, all possible combinations of reviewers for each possible committee size were modeled. To determine the effect of reducing the number of abstracts each member reviewed, we used Monte Carlo simulation with 100 cycles to generate possible combinations of 1–9 reviewers for each abstract. Mean percent agreement with the actual selection was the primary outcome.

Results:
The mean percent agreement progressively declined from 90.2% with 1 less committee member to 56.7% with only a single reviewer. For each reduction in the number of committee members, 4.4% agreement was lost. If all committee members were retained but the number of reviewers per abstract was reduced from 8 to 1, the mean percent agreement declined from 88.8% to 43.0%. Each reduction in reviewers per abstract reduced the mean percent agreement 6.3%.

Conclusion:
The findings inform program committees striving to balance the trade-off between an acceptable reduction in agreement, given a reduction in the program committee size or the proportion of abstracts each committee member evaluates.
Biomechanical Comparison of 3 Inferiorly Directed Versus 3 Superiorly Directed Locking Screws on Stability in a 3-Part Proximal Humerus Fracture Model
Authors: Donohue David M. , Santoni Brandon G. , Stoops T. Kyle , Tanner Gregory , Diaz Miguel A. , Mighell Mark 
Published: February 2018

Objective:
To quantify the stability of 3 points of inferiorly directed versus 3 points of superiorly directed locking screw fixation compared with the full contingent of 6 points of locked screw fixation in the treatment of a 3-part proximal humerus fracture.

Methods:
A standardized 3-part fracture was created in 10 matched pairs (experimental groups) and 10 nonmatched humeri (control group). Osteosynthesis was performed using 3 locking screws in the superior hemisphere of the humeral head (suspension), 3 locking screws in the inferior hemisphere (buttress), or the full complement of 6 locking screws (control). Specimens were tested in varus cantilever bending (7.5 Nm) to 10,000 cycles or failure. Construct survival (%) and the cycles to failure were compared.

Results:
Seven of 10 controls survived the 10,000-cycle runout (70%: 8193 average cycles to failure). No experimental constructs survived the 10,000-cycle runout. Suspension and buttress screw groups failed an average of 331 and 516 cycles, respectively (P = 1.00). The average number of cycles to failure and the number of humeri surviving the 10,000-cycle runout were greater in the control group than in the experimental groups (P ≤ 0.006).

Conclusion:
Data support the use of a full contingent of 6 points of locking screw fixation over 3 superior or 3 inferior points of fixation in the treatment of a 3-part proximal humerus fracture with a locking construct. No biomechanical advantage to the 3 buttress or 3 suspension screws used in isolation was observed.
Minimizing Leg Length Discrepancy After Intramedullary Nailing of Comminuted Femoral Shaft Fractures: A Quality Improvement Initiative Using the Scout Computed Tomography Scanogram
Authors: Gheraibeh Petra , Vaidya Rahul , Hudson Ian , Meehan Robert , Tonnos Frederick , Sethi Anil 
Published: February 2018

Objectives:
To prevent leg length discrepancy (LLD) after locked femoral nailing in patients with comminuted femoral shaft fractures.

Design:
Prospective consecutive case series aimed at quality improvement.

Setting:
Level 1 Trauma Center

Patients:
Ninety-eight consecutive patients with a comminuted femoral shaft fracture underwent statically locked intramedullary nailing, with a focused attempt at minimizing LLD during surgery.

Intervention:
A computed tomography scanogram of both legs was performed on postoperative day 1 to assess for residual LLD. Patients were offered the option to have LLD >1.5 cm corrected before discharge.

Main Outcome Measure:
LLD >1.5 cm.

Results:
Twenty-one patients (21.4%) were found to have an LLD >1.5 cm. An LLD >1.5 cm occurred in 10/55 (18%) antegrade nail patients and 11/43 (26%) retrograde nail patients (P = 0.27). No difference was noted based on the mechanism of injury, surgeon training and OTA/AO type B versus C injury. Ninety of 98 patients left with <1.5 cm LLD, 13/21 had a correction all to ≤0.6 cm, and 8 decided to accept the LLD and declined early correction.

Conclusions:
No patient left the hospital with an LLD >1.5 cm after locked intramedullary nailing for a comminuted femoral shaft fracture without being informed and the option of early correction. We recommend using a full-length computed tomography scanogram after IM nailing of comminuted femur fractures to prevent iatrogenic LLD.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Impact of Psychiatric Illness on Outcomes After Operatively Managed Tibial Plateau Fractures (OTA-41)
Authors: Kugelman David , Qatu Abdullah , Haglin Jack , Konda Sanjit , Egol Kenneth 
Published: February 2018

Objectives:
To assess the role self-reported treatment for a psychiatric diagnosis may play in long-term functional outcomes after operatively managed tibial plateau fractures.

Design:
Prospective cohort study.

Setting:
Academic medical center.

Patients:
Over an 11-year period, patients were screened and identified on presentation to the emergency department or in the clinical office for inclusion in an IRB-approved registry. A total of 245 patients were included in the study. Twenty-one patients reported treatment for a psychiatric diagnosis.

Intervention:
Surgical repair of tibial plateau fractures.

Main Outcome Measure:
Patients were divided into 2 cohorts; 1 cohort being those who self-reported receiving treatment of a psychiatric diagnosis (PI); the other group being those who did not self-report receiving treatment of a psychiatric diagnosis (NPI). Three-month, 6-month, and long-term outcomes (mean = 18 months) were evaluated using the Short Musculoskeletal Function Assessment (SMFA), pain scores, and postoperative complications (infection, VTE, nonunion, and necessity for secondary operations).

Results:
Pain scores were higher in patients who self-reported receiving treatment for a psychiatric diagnosis (P = 0.012). Long-term functional outcomes as measured by the SFMA were demonstrated to be worse in patients who self-reported treatment for a psychiatric diagnosis (P = 0.034). No differences existed between groups in regards to postoperative complications. Multiple linear regression analysis revealed that being treated for diagnosis of a mental health illness was an independent predictor of worse functional outcomes at long-term follow-up [B = 8.874, 95% confidence interval (CI) = 0.354–17.394, P = 0.041].

Conclusions:
Mental health plays a crucial role in long-term outcomes after operative fixation of tibial plateau fractures. Patients who have been diagnosed with a mental health illness have significantly worse outcomes at long-term follow-up.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Efficacy of a Structured Exercise Program for Improving Functional Capacity and Quality of Life in Patients With Stage 3 and 4 Sarcoidosis
Authors: Naz Ilknur , Ozalevli Sevgi , Ozkan Serir , Sahin Hulya 
Published: February 2018

Purpose:
This study investigated the effects of an exercise program on functional capacity and quality of life in patients with stage 3 and stage 4 sarcoidosis.

Methods:
Eighteen patients with stage 3 and 4 sarcoidosis were recruited; 9 received 12 wk of supervised exercise training and 9 received usual care. Patients underwent the following evaluations at baseline and follow-up: 6-min walk test, maximal inspiratory and expiratory pressure tests, back and leg dynamometer test, modified Medical Research Council Dyspnea Scale, Fatigue Severity Scale, St George Respiratory Questionnaire, Short Form-36 Quality of Life Questionnaire, Hospital Anxiety and Depression Questionnaire, body plethysmography, carbon monoxide diffusing capacity test, and blood gas analysis.

Results:
The median (interquartile range) increase in 6-min walk distance in the intervention group was 40 (31-62) m. Improvement in functional capacity; perception of dyspnea; fatigue; anxiety; peripheral and inspiratory muscle strength; partial arterial oxygen pressure; arterial oxygen saturation; and the symptom, activity, and total scores of the St George Respiratory Questionnaire were significantly greater in the intervention group than in the usual care group at follow-up (P < .05).

Conclusions:
Exercise training improves functional capacity, muscle strength, dyspnea, quality of life, anxiety, fatigue, and oxygenation in patients with stage 3 and stage 4 sarcoidosis. Standard treatment of patients with late-stage sarcoidosis should integrate exercise training and pulmonary rehabilitation.
IMPACT OF INNER LIMITING MEMBRANE PEELING ON VISUAL RECOVERY AFTER VITRECTOMY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT INVOLVING THE FOVEA
Authors: Garweg Justus G. , Deiss Mario , Pfister Isabel B. , Gerhardt Christin 
Published: February 2018

Purpose:
To assess the impact of inner limiting membrane peeling during vitrectomy for macula-involving retinal detachment on best-corrected visual acuity (VA).

Methods:
Retrospective analysis of 89 eyes with primary macula-involving retinal detachment, which was undergoing vitrectomy, endolaser, retinotomy, endodrainage, and SF6 tamponade. Membrane-blue-assisted membrane peeling had been performed in 61 of the eyes (Group 1) but not in the other 28 (Group 2), which served as controls.

Results:
Age, lens status, and incidence of proliferative vitreoretinopathy 26.2% versus 39.3%; P = 0.23 in the 2 groups were comparable. The preoperative visual acuity (Early Treatment Diabetic Retinopathy Study letters) was 25.7 ± 27.9 in Group 1 and 28.8 ± 29.9 in Group 2 (P = 0.47). After surgery, these rose from 62.3 ± 30.5 (Group 1) and 34.2 ± 35.8 (Group 2) after 1 week (P = 0.090), through 83.1 ± 8.0 and 57.2 ± 32.4 at 1 month (P = 0.0005), to 92.1 ± 4.5 and 74.4 ± 23.1 Early Treatment Diabetic Retinopathy Study letters after 6 months (P = 0.0005). More than 6-month incidences of proliferative vitreoretinopathy (13.1% vs. 28.6%; P = 0.13) were similar, whereas the redetachment rate (9.8% vs. 32.1%; P = 0.014), the incidence of secondary epiretinal membranes (1.6% vs. 35.7%; P = 0.0005), and the revitrectomy rate were lower in group 1 (9.8% vs. 53.6%; P = 0.0005).

Conclusion:
Inner limiting membrane peeling during vitrectomy for macula-involving retinal detachment may substantially contribute to the visual recovery, reducing the incidence of secondary epiretinal membrane formation.
Supraciliary Implant Placement and Postoperative Suprachoroidal Hemorrhage After Nonpenetrating Deep Sclerectomy
Authors: Rebolleda Gema , Martínez Compadre Alberto , Navero J.M. , Antón Alfonso 
Published: February 2018

Purpose:
The purpose if this study was to evaluate the clinical characteristics and risk factors of 3 eyes (3 patients), with primary open-angle glaucoma (POAG), in whom a postoperative suprachoroidal hemorrhage (SCH) occurred after a previous nonpenetrating deep sclerectomy (NPDS) augmented with a supraciliary nonabsorbable implant placement.

Methods and Surgical Technique:
This is a report of 3 eyes of the 3 patients who underwent NPDS in 3 different centers, by 3 experienced surgeons, and were the only ones to develop postoperative SCH in the last 18 years. All were operated with a one-third thickness outer scleral flap measuring 5×5 mm2 dissected until it reached 1 to 2 mm into the clear cornea. Mitomycin C (MMC, 0.02%) was applied for 1 minute and an inner scleral flap measuring 4×4 mm2 was dissected leaving only 10% of scleral thickness below. Then, the inner wall of Schlemm canal was removed. A supraciliary implant, T-flux (Carl Zeiss Meditec, Zeiss, Spain) in case 2 and Esnoper (AJL Ophthalmics SA, Miñano, Spain) in cases 1 and 3, was placed through a full-thickness escleral incission 2 mm behind the scleral spur.

Results:
Three eyes with uncontrolled primary open-angle glaucoma had a delayed SCH after an uneventful NPDS. Time lapse from filtering surgery to the SCH ranged from 12 hours in case number 1, to 3 weeks in case 3. Several risk factors for DSH were present, but the only common clinical feature for all of them, was the nonabsorbable implant that was placed in the supraciliary space. A Hema implant (Esnoper) was used in 2 eyes (cases 1 and 3), and T-flux, was implanted in the case 2. Case 1 required vitreoretinal surgery and had poor visual outcome, but cases 2 and 3 recovered with conservative treatment.

Conclusions:
Although taking the potential bias arising from the nature of the current cases report into consideration, supraciliary placement of the implant in NPDS could be a risk factor for SCH. Consequently, it seems reasonable to avoid it, especially in the presence of other best recognized factors.