bluuebunny/crossref_metadata_2025_split huggingface dataset:
Buttock Reconstruction in Sarcoma Surgery: An Esthetic Sigmoidplasty Closure for Large Circular Defects Using Double Opposing Skin Flaps
Authors: Nel Corné P.G. , Daya Mahendra 
Published: October 2016

Background:
Large defects arising from extirpation surgery of buttock sarcomas requiring adjuvant radiotherapy are best closed with flap surgery. The traditional solutions are derived from an approach to pressure sores, which were designed for the ischial, sacral, or trochanteric areas, and have now been adapted for true buttock defects. This invariably destroys the esthetics of the buttock. We describe a novel technique of sigmoidplasty, which preserves most of the esthetic features.

Methods:
We report on a retrospective review of 11 consecutive buttock sarcomas managed at our institution between 2009 and 2014, focusing on those for which the described reconstruction method was used (N = 5).

Results:
The immediate outcome was very good. In 1 patient, partial loss of 1 of the flaps and the management thereof resulted in a minor contour deformity. In general, the buttock volume was significantly decreased but the shape was preserved. This was obtained without secondary donor defect and with minimal contour irregularity. Long-term follow-up remained pleasing, and all patients were satisfied with the outcomes.

Conclusions:
The described technique of buttock defect closure satisfies the oncoplastic principles of tumor surgery with the added benefit of superior esthetics. We suggest that it is a versatile adjunct to the reconstructive surgeon’s armamentarium for buttock reconstruction after sarcoma excision, particularly when the gluteal artery perforator systems are unavailable.
Peony-Glycyrrhiza Decoction for Antipsychotic-Related Hyperprolactinemia in Women With Schizophrenia
Authors: Man Sui Cheung , Li Xian-Bin , Wang Huai-Hai , Yuan Hai-Ning , Wang Hua-Ning , Zhang Rui-Guo , Tan Qing-Rong , Wong Hei Kiu , McAlonan Grainne M. , Wang Chuan-Yue , Zhang Zhang-Jin 
Published: October 2016

Objectives
An herbal preparation called peony-glycyrrhiza decoction (PGD) may have the potential in reducing antipsychotic-related hyperprolactinemia (hyperPRL). This double-blind, randomized placebo-controlled study aimed to reevaluate the efficacy of PGD against antipsychotic-related hyperPRL.

Methods
Ninety-nine schizophrenic women who were under antipsychotic therapy and had symptomatic hyperPRL were randomly assigned to additional treatment with placebo (n = 50) or PGD (n = 49, 45 g/d) for 16 weeks. The severity of hyperPRL, psychosis, and abnormal involuntary movements was assessed at baseline and weeks 8 and 16 using standard instruments including the Prolactin Related Adverse Event Questionnaire. Blood levels of prolactin (PRL) and related pituitary and sex hormones were measured at the same time points.

Results
Peony-glycyrrhiza decoction treatment produced a significantly greater reduction of the Prolactin Related Adverse Event Questionnaire score at weeks 8 and 16 and a greater improvement on abnormal involuntary movements at end point compared with placebo, without altering the severity of psychosis. The group treated with PGD showed significantly higher proportion of having overall improvement on hyperPRL symptoms (χ2 = 4.010, P = 0.045) and menstrual resumption (χ2 = 4.549, P = 0.033) at week 8 than placebo. Serum PRL levels were similar in the 2 groups.

Conclusions
Peony-glycyrrhiza decoction is effective in reducing antipsychotic-related hyperPRL and abnormal involuntary movement symptoms, but no reduction in blood PRL concentrations was observed. The underlying mechanisms of PGD's effects need further investigation (trial registration of NCT01852331 at www.clinicaltrials.gov).
Rib fractures in trauma patients: does operative fixation improve outcome?
Authors: Majak Peter , Næss Pål A. 
Published: October 2016

Purpose of review
Renewed interest in surgical fixation of rib fractures has emerged. However, conservative treatment is still preferred at most surgical departments. We wanted to evaluate whether operative treatment of rib fractures may benefit severely injured patients.

Recent findings
Several studies report a reduction in mechanical ventilation time, ICU length of stay (LOS), hospital LOS, pneumonia, need for tracheostomy, pain and costs in operatively treated patients with multiple rib fractures compared with patients treated nonoperatively. Although patient selection and timing of the operation seem crucial for successful outcome, no consensus exists. Mortality reduction has only been shown in a few studies. Most studies are retrospective cohort and case–control studies. Only four randomized control trials exist.

Summary
Conservative treatment, consisting of respiratory assistance and pain control, is still the treatment of choice in the vast majority of patients with multiple rib fractures. In selected patients, operative fixation of fractured ribs within 72 h postinjury may lead to better outcome. More randomized control trials are needed to further determine who benefits from surgical fixation of rib fractures.
Extraintestinal Manifestations of Celiac Disease
Authors: Jericho Hilary , Sansotta Naire , Guandalini Stefano 
Published: October 2016

ABSTRACTObjective:The aim of the study was to evaluate the effectiveness of the gluten‐free diet (GFD) on extraintestinal symptoms in pediatric and adult celiac populations at the University of Chicago.Methods:We conducted a retrospective chart review of the University of Chicago Celiac Center clinic charts from January 2002 to October 2014. Demographics, serologic testing, intestinal biopsies, and extraintestinal symptoms at presentation, 12, 24, and >24 months were recorded. Extraintestinal symptoms included abnormal liver enzymes, arthralgia/arthritis, dermatitis herpetiformis, alopecia, fatigue, headache, anemia, stomatitis, myalgias, psychiatric disorders, rashes, seizures, neuropathy, short stature, delayed puberty, osteoporosis, and infertility.Results:A total of 737 patients with biopsy‐confirmed celiac disease or skin biopsy–confirmed dermatitis herpetiformis were included. Patients lost to follow‐up, or with insufficient data were excluded leaving 328 patients (157 pediatrics younger than 18 years). For pediatrics, the female to male ratio was 2:1 and the mean age at diagnosis was 8.9 years. For adults, 4:1 and 40.6 years old. Extraintestinal symptom rates were similar in children (60%) and adults (62%). Short stature (33%), fatigue (28%), and headache (20%) were most common in children. Iron deficiency anemia (48%), fatigue (37%), and headache/psychiatric disorders (24%) were common in adults. Children had faster/higher rates of symptom resolution compared with adults. Twenty‐eight percent of children with unresolved short stature on a GFD were found to have other comorbidities.Conclusions:Children and adults with celiac disease have similar rates of extraintestinal manifestations. In children short stature, fatigue, and headache were most common, whereas anemia, fatigue, and headache/psychiatric disorders were most common in adults. Children on a strict GFD showed faster and higher rates of symptom resolution as compared to adults. Unresponsive children with short stature must be assessed for comorbidities.
Prevalence of Malnutrition and Feeding Difficulties in Children With Esophageal Atresia
Authors: Menzies Jessica , Hughes Jennifer , Leach Steven , Belessis Yvonne , Krishnan Usha 
Published: October 2016

ABSTRACTObjectives:Growth and feeding problems have been described in children with esophageal atresia (EA). Ongoing gastrointestinal and respiratory complications such as Gastroesophageal reflux disease, esophageal dysmotility, strictures, and respiratory infections may contribute. The aim of the study was to document the prevalence of malnutrition and feeding difficulties and examine predictive factors, which may influence feeding and growth in children attending a multidisciplinary EA clinic in Sydney, Australia.Methods:A retrospective review of 75 children, ages 0 to 16 years, who attended a multidisciplinary EA clinic between 2011 and 2014. Data on demographics, comorbidities, nutrition, and mealtime behaviors were collected from their initial clinic appointment. Factors that may affect on growth and mealtime behaviors were identified and analyzed.Results:Nine percent of children were malnourished and 9% were stunted. Infants, children with prior fundoplication, at risk of aspiration, or those who had surgery in the first year of life additional to EA repair were significantly more likely to be malnourished (P < 0.05). Fifty‐four percent of children required texture modification at their meals, with parental concern being the most common reason. Younger children were less likely to be eating age‐appropriate textures (P = 0.04) which improved after 5 years of age.Conclusions:Poor growth and inability to manage age‐appropriate textures are often present in children with EA, particularly in the younger years. This highlights the need for early intervention in a specialist multidisciplinary EA clinic in which dietetics and speech pathology are available.
Spermatorrhea and Loss of Libido Induced by Topiramate: First Case Report and Review of Literature
Authors: Wu Mengqian , Hao Nanya , Zhou Dong 
Published: October 2016

Background
Topiramate (TPM) is a broad-spectrum antiepileptic drug used for a variety of clinical conditions, including migraine prophylaxis and mood disorders. Spermatorrhea accompanied by loss of libido severely lowers quality of life for men, but had never been reported as a possible adverse effect of TPM.

Case Presentation
Here, we present a case of a 39-year-old Chinese man who was diagnosed with partial epilepsy and treated with TPM (100 mg/d). Eleven days after initiating TPM treatment, he began to experience spermatorrhea every 2 to 3 days, accompanied by loss of libido, lack of energy, lassitude, irascibility, weakness, poor appetite, frequent urination, and nocturia. The symptoms continued for 2 months. After withdrawal of TPM, symptoms disappeared and did not recur.

Conclusions
This is the first case report of TPM-induced spermatorrhea and loss of libido in China. Spermatorrhea and loss of libido are probably rare adverse effects of TPM treatment. When these symptoms occur in a patient taking TPM, the possibility that they are adverse effects to this drug should be considered, and switching the patient to a different drug may be a good option. The underlying mechanism by which TPM induces spermatorrhea may be related to increased serotonin level, and loss of libido may be related to changes in serotonin and hormone levels.
Kinetics and identities of extracellular peptidases in subsurface sediments of the White Oak River Estuary, NC
Authors: Steen Andrew D. , Kevorkian Richard T. , Bird Jordan T. , Dombrowski Nina , Baker Brett J. , Hagen Shane M. , Mulligan Katherine H. , Schmidt Jenna M. , Webber Austen T. , Royalty Taylor , Alperin Marc J. 
Published: October 2016

AbstractAnoxic subsurface sediments contain communities of heterotrophic microorganisms that metabolize organic carbon at extraordinarily slow rates. In order to assess the mechanisms by which subsurface microorganisms access detrital sedimentary organic matter, we measured kinetics of a range of extracellular peptidases in anoxic sediments of the White Oak River estuary, NC. Nine distinct peptidase substrates were enzymatically hydrolyzed at all depths. Potential peptidase activities (Vmax) decreased with increasing sediment depth, althoughVmaxexpressed on a per cell basis was approximately the same at all depths. Half-saturation constants (Km) decreased with depth, indicating peptidases that functioned more efficiently at low substrate concentrations. Potential activities of extracellular peptidases acting on molecules that are enriched in degraded organic matter (D-phenylalanine and L-ornithine) increased relative to enzymes that act on L-phenylalanine, further suggesting microbial community adaptation to access degraded organic matter. Nineteen classes of predicted, exported peptidases were identified in genomic data from the same site, of which genes for class C25 (gingipain-like) peptidases represented more than 40% at each depth. Methionine aminopeptidases, zinc carboxypeptidases, and class S24-like peptidases, which are involved in single-stranded DNA repair, were also abundant. These results suggest a subsurface heterotrophic microbial community that primarily accesses low-quality detrital organic matter via a diverse suite of well-adapted extracellular enzymes.ImportanceBurial of organic carbon in marine and estuarine sediments represents a long-term sink for atmospheric carbon dioxide. Globally, ∼40% of organic carbon burial occurs in anoxic estuaries and deltaic systems. However, the ultimate controls on the amount of organic matter that is buried in sediments, versus oxidized into CO2, are poorly constrained. Here we used a combination of enzyme assays and metagenomic analysis to identify how subsurface microbial communities catalyze the first step of proteinaceous organic carbon degradation. Our results show that microbial communities in deeper sediments are adapted to access molecules characteristic of degraded organic matter, suggesting that those heterotrophs are adapted to life in the subsurface.
Linking structure and activity in nonlinear spiking networks
Authors: Ocker Gabriel Koch , Josić Krešimir , Shea-Brown Eric , Buice Michael A. 
Published: October 2016

AbstractRecent experimental advances are producing an avalanche of data on both neural connectivity and neural activity. To take full advantage of these two emerging datasets we need a framework that links them, revealing how collective neural activity arises from the structure of neural connectivity and intrinsic neural dynamics. This problem ofstructure-driven activityhas drawn major interest in computational neuroscience. Existing methods for relating activity and architecture in spiking networks rely on linearizing activity around a central operating point and thus fail to capture the nonlinear responses of individual neurons that are the hallmark of neural information processing. Here, we overcome this limitation and present a new relationship between connectivity and activity in networks of nonlinear spiking neurons by developing a diagrammatic fluctuation expansion based on statistical field theory. We explicitly show how recurrent network structure produces pairwise and higher-order correlated activity, and how nonlinearities impact the networks' spiking activity. Our findings open new avenues to investigating how single-neuron nonlinearities—including those of different cell types—combine with connectivity to shape population activity and function.
Degenerate time-dependent network dynamics anticipate seizures in human epileptic brain
Authors: Tauste Campo Adrià , Principe Alessandro , Ley Miguel , Rocamora Rodrigo , Deco Gustavo 
Published: October 2016

AbstractEpileptic seizures are known to follow specific changes in brain dynamics. While some algorithms can nowadays robustly detect these changes, a clear understanding of the mechanism by which these alterations occur and generate seizures is still lacking. Here, we provide cross-validated evidence that such changes are initiated by an alteration of physiological network state dynamics. Specifically, our analysis of long intracranial EEG recordings from a group of 10 patients identifies a critical phase of a few hours in which time-dependent network states become less variable (“degenerate”) and is followed by a global functional connectivity reduction before seizure onset. This critical phase is characterized by an abnormal occurrence of highly correlated network instances and is shown to particularly affect the activity of resection regions in patients with validated postsurgical outcome. Our approach characterizes pre-seizure networks dynamics as a cascade of two sequential events providing new insights into seizure prediction and control.
SIRVs: Spike-In RNA Variants as External Isoform Controls in RNA-Sequencing
Authors: Paul Lukas , Kubala Petra , Horner Gudrun , Ante Michael , Holländer Igor , Alexander Seitz , Reda Torsten 
Published: October 2016

AbstractSpike-In RNA variants (SIRVs) enable for the first time the validation of RNA sequencing workflows using external isoform transcript controls. 69 transcripts, derived from seven human model genes, cover the eukaryotic transcriptome complexity of start- and end-site variations, alternative splicing, overlapping genes, and antisense transcription in a condensed format. Reference RNA samples were spiked with SIRV mixes, sequenced, and exemplarily four data evaluation pipelines were challenged to account for biases introduced by the RNA-Seq workflow. The deviations of the respective isoform quantifications from the known inputs allow to determine the comparability of sequencing experiments and to extrapolate to which degree alterations in an RNA-Seq workflow affect gene expression measurements. The SIRVs as external isoform controls are an important gauge for inter-experimental comparability and a modular spike-in contribution to clear the way for diagnostic RNA-Seq applications.
Bryophyte traits explain climate‐warming effects on tree seedling establishment
Authors: Lett Signe , Nilsson Marie‐Charlotte , Wardle David A. , Dorrepaal Ellen 
Published: October 2016

SummaryAbove the alpine tree line, bryophytes cover much of the tundra soil surface in dense, often monospecific carpets. Therefore, when climate warming enables tree seedling establishment above the tree line, interaction with the bryophyte layer is inevitable. Bryophytes are known to modify their environment in various ways. However, little is known about to which extent and by which mechanisms bryophytes affect the response of tree seedlings to climate warming.We aimed to assess and understand the importance of bryophyte species identity and traits for tree seedling performance at tree line temperatures and their response to warmer conditions. Seedlings of two common, tree line‐forming tree species (Betula pubescensandPinus sylvestris) were planted into intact cushions of eight common tundra bryophyte species and bryophyte‐free soil and grown for 18 weeks at current (7·0 °C) and near‐future (30–50 years; 9·2 °C) tree line average growing‐season temperatures. Seedling performance (biomass increase and N‐uptake) was measured and related to bryophyte species identity and traits indicative of their impact on the environment.Tree seedlings performed equally well or better in the presence of bryophytes than in bryophyte‐free soil, which contrasts to their usually negative effects in milder climates. In addition, seedling performance and their response to higher temperatures depended on bryophyte species and seedlings of both species grew largest in the pan‐boreal and subarctic bryophyteHylocomium splendens. However,B. pubescensseedlings showed much stronger responses to higher temperatures when grown in bryophytes than in bryophyte‐free soil, while the opposite was true forP. sylvestrisseedlings. ForB. pubescens, but not forP. sylvestris, available organic nitrogen of the bryophyte species was the trait that best predicted seedling responses to higher temperatures, likely because these seedlings had increased N‐demands.Synthesis. Climatically driven changes in bryophyte species distribution may not only have knock‐on effects on vascular plant establishment, but temperature effects on seedling performance are themselves moderated by bryophytes in a species‐specific way. Bryophyte traits can serve as a useful tool for understanding and predicting these complex interactions.
Rapid transgenerational effects in Knautia arvensis in response to plant community diversity
Authors: Rottstock Tanja , Kummer Volker , Fischer Markus , Joshi Jasmin 
Published: October 2016

Summary

Plant species persistence in natural communities requires coping with biotic and abiotic challenges. These challenges also depend on plant community composition and diversity. Over time, biodiversity effects have been shown to be strengthened via increasing species complementarity in mixtures. Little is known, however, whether differences in community diversity and composition induce rapid transgenerational phenotypic adaptive differentiation during community assembly. We expect altered plant–plant and other biotic interactions (mutualists or antagonists) in high vs. low diverse communities to affect immediate within‐ and between‐species trait differentiations due to competition for light and nutrients.

Three years after the initiation of a large‐scale, long‐term biodiversity experiment in Jena, Germany, we tested for effects of varying experimental plant community diversity (1–60 plant species; one to four plant functional groups) and composition (with or without legumes and/or grasses) on phenotypic differentiation and variation of the tall herb Knautia arvensis. We measured reproduction at different diversity levels in the Jena Experiment (residents hereafter) and, in an additional common garden experiment without competition, recorded subsequent offspring performance (i.e. growth, reproductive success and susceptibility to powdery mildew) to test for differentiation in phenotypic expression and variability.

We observed phenotypic differences among diversity levels with reduced fecundity of K. arvensis residents in more diverse communities. In the next generation grown under common garden conditions, offspring from high‐diversity plots showed reduced growth (i.e. height) and lower reproduction (i.e. fewer infructescences), but increased phenotypic trait variability (e.g. in leaf width and powdery mildew presence) and also tended to be less susceptible to powdery mildew infection.

Community composition also affected Knautia parents and offspring. In the presence of legumes, resident plants produced more seeds (increased fecundity); however, germination rate of those seeds was reduced at an early seedling stage (reduced fertility).

Synthesis. We conclude that rapid transgenerational effects of community diversity and composition on both mean and variation of phenotypic traits among offspring exist. In addition to heritable variation, environmentally induced epigenetic and/or maternal processes matter for early plant community assembly and may also determine future species coexistence and community stability.
Acts of Solidarity: Crossing and Reiterating Israeli–Palestinian Frontiers
Authors: Koensler Alexander 
Published: October 2016

AbstractIn academic and public discourse on the Zionist–Palestinian conflict, there still prevails a ‘methodological nationalism’ based on a separatist imagination overshadowing the existence and role of Israeli–Palestinian forms of communality and solidarity. This article analyses micro‐political practices that cross existing frontiers, both within Israel and between the occupied Palestinian territories and Israel. Through recent conceptualizations of ‘acts’, I read these ethnographic episodes in their intentional and performative dimension. What is the role of these ‘acts’? What are their effects, both on participants and the wider public? Through two interconnected cases, different functions of acts are explored. The first case relates to encounters between Israelis and Palestinians in the embattled city of Hebron in the occupied Palestinian territories; the second investigates moments during a Gandhi‐inspired peace march at the ‘internal’ frontier of the Israeli Negev desert. The ethnographic perspective reveals what lies behind and beneath the acts, going beyond the conflict's obvious structures of power. Acts function primarily as a valve of catharsis for the participants themselves, both overcoming and reproducing hegemonic discursive elements of the conflict. Paradoxically, acts of solidarity are often crucial in shaping public knowledge about the conflict in more sectarian terms.