bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diurnal heat stress reduces pig intestinal integrity and increases endotoxin translocation
Authors: Gabler Nicholas K , Koltes Dawn , Schaumberger Simone , Murugesan G Raj , Reisinger Nicole 
Published: January 2018

Abstract
Heat stress negatively affects performance and intestinal integrity of pigs. The objective of this study was to characterize the effects of diurnal heat stress (dHS) on nursery-grower pig performance, intestinal integrity, and lipopolysaccharide (LPS) translocation. Forty-eight nursery-grower gilts, individually penned, were randomly assigned to two treatments. Twenty-four pigs were then exposed to dHS for 3 d, 6 h at 38°C and 18 h at 32°C, at 40–60% humidity. The remaining pigs were maintained under thermal neutral (TN) conditions. Changes in pig rectal temperatures (Tr), respiration rates (RR), performance, and blood parameters were evaluated. Additionally, ex vivo ileum integrity was assessed with the Ussing chamber by measuring transepithelial resistance (TER), and 4 kDa fluorescein isothiocyanate (FITC)–dextran (FD4) and FITC–LPS mucosal to serosal flux. As expected, dHS increased pig Tr and RR (P &lt; 0.05) and reduced pig performance (P &lt; 0.05) on the 3-d period. Compared with TN, ileum TER (P = 0.04), FITC–LPS (P &lt; 0.001), and FD4 (P = 0.011) permeability were significantly increased due to dHS. Compared with TN pigs, dHS increased serum endotoxin by 150% (P = 0.031). Altogether, 3-d dHS significantly reduced pig performance and intestinal integrity and increased blood endotoxin concentrations.
Beyond the Double Helix: Reading and Writing the Histone Code
Authors: Allis C. David 
Published: January 2018

The human genome is estimated to contain 30,000 – 40,000 unique genes; the DNA sequence and chromosomal location of all these genes are becoming widely known. A central challenge facing the biomedical community is how to derive medically‐valuable knowledge about the function of these genes from the now‐available DNA sequence data. Though every gene exists within every cell in the human body, only a small percentage of genes are activated in any given cell. To manage this genetic information efficiently, nature has evolved a sophisticated system that facilitates access to specific genes. This system relies on a DNA‐histone protein complex called chromatin to efficiently package the genetic information that exists within each cell. This packaging system makes certain genes more readily accessible to transcription factors and other machinery that must engage our genetic template. Chromatin modifications, and the regulation of the enzymes responsible for adding or subtracting them, are poised to take center stage in the study of cancer in the current post‐genomic or epigenomic era. Moreover, the implications of chromatin and its modification are beginning to gain appreciation in clinical oncology. The identification of altered DNA methylation and histone acetylase activity in a range of human cancers, coupled with the use of HDAC inhibitors in the treatment of leukemia, make a compelling argument. It is clear that the regulatory signals provided by chromatin modifications will revolutionize our view of cancer as new models of “epigenetic carcinogenesis” are advanced. We favor the view that there exists an epigenetic indexing system for our genome, or a “histone or epigenetic code,” that represents a fundamental regulatory mechanism that acts outside of the DNA itself. We predict that this “code” impacts on most, if not all, chromatin‐templated processes with far‐reaching consequences for cell fate decisions and for normal and pathological development.Most of our current research is centered on chromatin and its regulation though post‐translational modification of histone (and non‐histone) proteins. That said, other mechanisms such as the existence of DNA methylation and of small non‐coding RNAs are also likely, if not certainly, involved. How epigenetic states, “ON” or “OFF”, are inherited from one generation to the next is a central question that we, and others, are currently addressing.
Making and Breaking Ubiquitin
Authors: Muir Thomas W , McGinty Robert , Pratt Matt , Chatterjee Champak , Schwartz Edmund 
Published: January 2018

A complex interplay between DNA, histones, and chromatin associated proteins coordinates the structure and function of the eukaryotic genome. To help accomplish this task, extensive posttranslational modifications of the core histone proteins have evolved. One of the less elucidated modifications, monoubiquitylation of H2B (uH2B), has been implicated in transcription elongation and histone methylation of H3 K4 and K79. Characterization of the role of uH2B in these processes requires the isolation or generation of homogenously ubiquitylated H2B. To this end, we have developed a traceless semisynthetic strategy to generate uH2B. We employ two expressed protein ligation (EPL) reactions and two methods for ligation site removal to synthesize native uH2B. The resulting uH2B was reconstituted into core histone octamers and nucleosome arrays were then generated for biochemical characterization.Controlling protein function through posttranslational manipulations has emerged as an attractive complimentary technology to existing genetic systems. We have developed a new posttranslational, small molecule‐mediated, technology for the manipulation of protein function. This system, termed SURF (Split‐Ubiquitin for the Rescue of Function), places the complementation of ubiquitin under the control of a small molecule. Before complementation a protein of interest is targeted for destruction by the proteasome through the introduction of an N‐terminal degron. Small molecule induced dimerization results in ubiquitin complementation and folding followed by cleavage of the protein of interest, thereby releasing it from the degron and rescuing its function. This system has been successfully applied to activate several classes of proteins in living cells. This general strategy should allow for inducible rescue of a variety of proteins in such a way that their native structure and function are maintained.
Long-term Outcome of Small, Incidentally Detected Rectal Neuroendocrine Tumors Removed by Simple Excisional Biopsy Compared With the Advanced Endoscopic Resection During Screening Colonoscopy
Authors: Kwak Min-Sun , Chung Su Jin , Yang Jong In , Im Jong Pil , Park Min Jung , Lee Cheol , Kim Joo Sung 
Published: January 2018

BACKGROUND:
Incidental, small rectal neuroendocrine tumors during colonoscopy screening are sometimes removed using biopsy forceps. Few studies have examined the clinical course of rectal neuroendocrine tumors removed by simple excisional biopsy.

OBJECTIVE:
We investigated the long-term outcome of rectal neuroendocrine tumors removed by simple excisional biopsy compared with standard endoscopic resection.

DESIGN:
This was a cohort study.

SETTINGS:
This study was performed at a healthcare center in Korea.

PATIENTS:
We enrolled patients with rectal neuroendocrine tumors detected during a screening colonoscopy between 2003 and 2015.

MAIN OUTCOME MEASURES:
The clinical characteristics and long-term outcomes (overall survival and disease-free survival) of small neuroendocrine tumors <10 mm were compared between the simple excisional biopsy group and advanced endoscopic resection group.

RESULTS:
In total, 166 patients were diagnosed with rectal neuroendocrine tumors (≤5 mm, n = 100; 6–9 mm, n = 50; 10–19 mm, n = 15; ≥20 mm, n = 1). Among the 150 patients with neuroendocrine tumors <10 mm, follow-up endoscopy was performed on 99 (59.6%). All of the tumors were confined to the mucosa or submucosa. Thirty-one and 68 patients were included in the simple excisional biopsy and advanced endoscopic resection groups. The overall follow-up duration was 6.5 years (range, 1.0–12.8 y). Neither overall nor disease-related death occurred. Two patients exhibited local recurrence (6.5%, at 8 and 11 y) in the simple excisional biopsy group and 1 patient (1.5%, at 7 y) in the advanced endoscopic resection group, resulting in no significant difference (p = 0.37). All of the recurrences were diagnosed >5 years from initial diagnosis and successfully treated endoscopically.

LIMITATIONS:
More long-term data should be warranted.

CONCLUSIONS:
The long-term outcome of small rectal neuroendocrine tumors <10 mm removed by simple excisional biopsy was excellent. Neither overall survival nor disease-free survival significantly differed between the simple excisional biopsy group and the advanced endoscopic resection group. Thus, simple excisional biopsy and long-term follow-up can be cautiously applied for small rectal neuroendocrine tumors in clinical practice. See Video Abstract at http://links.lww.com/DCR/A406.
Incidence and Long-term Implications of Prepouch Ileitis: An Observational Study
Authors: Segal Jonathan P. , McLaughlin Simon D. , Faiz Omar D. , Hart Ailsa L. , Clark Susan K. 
Published: January 2018

BACKGROUND:
Restorative proctocolectomy is the procedure of choice in patients with ulcerative colitis refractory to medical therapy. Prepouch ileitis is characterized by mucosal inflammation immediately proximal to the pouch. Prepouch ileitis is uncommon, and long-term follow-up data are lacking.

OBJECTIVE:
The aim of this study is to report the long-term outcomes of prepouch ileitis.

DESIGN:
We followed up a cohort of patients with prepouch ileitis that was originally described in 2009. Patients were followed up until the last recorded clinic attendance or at the point of pouch failure. Follow-up data collected included stool frequency, endoscopic findings, treatment, and overall pouch function.

SETTING:
We accessed a prospectively maintained database at our institution between January 2009 and January 2017.

PATIENTS:
Three of the 34 patients originally described in 2009 were lost to follow-up; we reanalyzed data on the remaining 31.

MAIN OUTCOME MEASURE:
The rate of pouch failure was defined as the need for ileostomy or pouch revision.

RESULTS:
All 31 patients had coexisting pouchitis at index diagnosis of prepouch ileitis. The median length of follow-up from the index pouchoscopy was 98 (range, 27–143) months. Seven (23%) patients who had an index pouchoscopy with prepouch ileitis went on to pouch failure, which is significantly higher than expected (p = 0.03). Five (71%) of these patients had chronic pouchitis, and 2 (29%) had small-bowel obstruction due to prepouch stricture. Two patients had evidence that would support possible Crohn’s disease at long-term follow-up.

LIMITATIONS:
This was a retrospective analysis. Because of the nature of the study, there was some missing information that may have influenced the results. Our study is further limited by small patient numbers.

CONCLUSIONS:
Prepouch ileitis is associated with a significantly increased risk of pouch failure compared with the overall reported literature for restorative proctocolectomy. Prepouch ileitis does not appear to be strongly predictive of Crohn’s disease at long-term follow-up. See Video Abstract at http://links.lww.com/DCR/A480.
Identifying Glaucomatous Damage to the Macula
Authors: Alluwimi Muhammed S. , Swanson William H. , King Brett J. 
Published: January 2018

SIGNIFICANCE
Measurements of the macula have been increasingly used to diagnose and manage patients with glaucoma. Asymmetry analysis was clinically introduced to assess damage to the macular ganglion cells in patients with glaucoma, but its effectiveness is limited by high normal between-subject variability.

PURPOSE
We aimed to reduce the high normal between-subject variability and improve the potential of asymmetry analysis to identify glaucomatous damage to the macula.

METHODS
Twenty patients with glaucoma (aged 57 to 85 years) and 30 age-similar control subjects (aged 53 to 89 years) were recruited from a longitudinal glaucoma study. Participants were imaged with the Spectralis OCT using the posterior pole protocol; measurements of the averaged retinal thickness and ganglion cell layer (GCL) thickness were obtained. We established three zones per hemifield within the central ±9°, based on the lowest between-subject variability that we previously found and the course of retinal nerve fiber layer projections. The criteria for flagging abnormality were at least two contiguous zones when P < 5% or one zone when P < 1% with two-tailed tests.

RESULTS
Between-subject variability of the asymmetry analysis for both retinal and GCL thicknesses remained lower than that of the average thickness across each zone in control subjects (F > 2.52, P < .01). Asymmetry analysis of retinal and GCL thicknesses flagged 16 and 18 of 20 patients, respectively.

CONCLUSIONS
Between-subject variability was reduced in control subjects using the three zones; our criteria identified glaucomatous damage to the macula in most of the patients. We used high-density B-scans to confirm the patterns of the glaucomatous damage we found in this study.
Results for Water-drinking Test, before and after Laser Iridotomy, in Primary Angle-closure Suspects
Authors: Razeghinejad M. Reza , Karampour Parisa , Masoumpour Masoumeh Beigom , Tajbakhsh Zahra , Nowroozzadeh M. Hossein 
Published: January 2018

SIGNIFICANCE
Intraocular pressure and ocular biometric changes were similar before and after laser iridotomy in response to the water-drinking test in a cohort of patients at risk of angle closure. The water-drinking test does not seem to be a good provocative test to determine which eyes would benefit from a laser iridotomy. Our data call into question the preoperative predictive value of this test.

PURPOSE
The aim of this study was to evaluate the effect of water-drinking test on intraocular pressure and ocular biometric parameters, before and after laser peripheral iridotomy, in patients with an occludable angle.

METHODS
Twenty-seven patients, who met the inclusion criteria and had at least 180 degrees of iridotrabecular apposition, underwent a complete eye examination followed by the measurement of ocular biometric (using LenStar LS-900; Haag-Streit AG, Koeniz, Switzerland) and anterior chamber parameters (using Pentacam HR; Oculus Optikgerate GmbH, Wetzlar, Germany). All the measurements were repeated 30 minutes after the water-drinking test. Two weeks after laser peripheral iridotomy, all the measurements were repeated both before and after the water-drinking test.

RESULTS
The mean ± SD of the age of the participants was 57 ± 9 years, and 23 (85.2%) were male. Intraocular pressure increased after the water-drinking test in both pre–laser peripheral iridotomy (17.0 vs. 19.3 mmHg, P < .001) and post–laser peripheral iridotomy (15.6 vs. 18.6 mmHg, P < .001) conditions. The thickness values of central cornea increased slightly after the water-drinking test in pre–laser peripheral iridotomy (535 vs. 538 μm, P = .001) compared with post–laser peripheral iridotomy (532 vs. 536 μm, P = .003). The water-drinking test had no significant effect on other biometric or anterior chamber parameters, before or after laser peripheral iridotomy.

CONCLUSIONS
The water-drinking test increased intraocular pressure, both before and after laser peripheral iridotomy. Laser peripheral iridotomy had no significant effect on the amount of intraocular pressure change after the water-drinking test. The water-drinking test has no effect on other biometric or anterior chamber parameters.
Comparison of Scleral Tono-Pen Intraocular Pressure Measurements with Goldmann Applanation Tonometry
Authors: Badakere Swathi Vallabh , Choudhari Nikhil S. , Rao Harsha L. , Chary C. Raghava , Garudadri Chandra Sekhar , Senthil Sirisha 
Published: January 2018

SIGNIFICANCEMeasuring the intraocular pressure (IOP) on the sclera can be an alternative to conventional corneal measurement in eyes with scarred corneas. However, these measurements have to be evaluated prior in normal eyes. Our study aimed to evaluate scleral IOP using Tono-Pen and compared it with corneal Goldmann applanation measurements.PURPOSEThe aim of this study was to evaluate the ability of limbal and scleral Tono-Pen IOP readings to predict central corneal Goldmann applanation tonometry (GAT) readings in eyes with normal corneas.METHODSIn a cross-sectional study, 115 eyes of 115 patients attending a tertiary eye care center underwent GAT on the central cornea followed by Tono-Pen readings at the central cornea, at the limbus, and at the sclera. Bland-Altman plots were used to determine the agreement between different methods of IOP measurement.RESULTSThe median IOP (interquartile range) by GAT performed on the central cornea was 18 (16, 24) mmHg, and the IOP ranged from 10 to 54 mmHg. The median IOPs (interquartile range) by Tono-Pen obtained at central cornea, limbus, and sclera were 16 (13, 23), 23 (17, 28), and 33 (27, 44) mmHg, respectively. The Pearson correlation coefficient and the 95% limits of agreement between GAT readings and Tono-Pen readings at the central cornea were 0.9 (P< .001) and −4.9 to 8.74 mmHg, respectively. The correlation coefficient between GAT readings and Tono-Pen readings at the limbus and GAT readings and Tono-Pen readings at the sclera was 0.46 (P< .001) and 0.23 (P= .01), respectively. The 95% limits of agreement between these pairs of readings were −20.55 to 13.66 and −44.02 to 13.37 mmHg, respectively.CONCLUSIONSThis study showed limited ability of Tono-Pen readings obtained at the limbus and sclera to predict the central corneal GAT IOP readings in eyes with normal corneas at various IOP ranges.
Direct-to-Implant Breast Reconstruction in Women Older than 65 Years: A Retrospective Analysis of Complication Rate and Overall Outcomes
Authors: Knackstedt Rebecca , Gatherwright James , Moreira Andrea 
Published: January 2018

Background:
Half of all cancers occur in women older than 65 years, yet only 4 to 14 percent of these women undergo reconstruction. Most studies on reconstruction in the elderly have focused on tissue expander/implant or autologous reconstruction. A direct-to-implant approach theoretically reduces the number of operations and postoperative visits, but has yet to be investigated in the elderly.

Methods:
Institutional review board approval was granted for a retrospective chart review for patients who underwent direct-to-implant reconstruction from 2012 to 2015 with any staff in the authors’ department. A control cohort of patients who underwent tissue expander/implant-based reconstruction from the same period was analyzed.

Results:
Direct-to-implant reconstruction was performed in 24 breasts in 19 patients with at least 30-day follow-up and in 17 breasts in 14 patients with at least 1-year follow-up. A control group analysis of tissue expander/implant patients was performed for 109 breasts in 88 patients. The tissue expander/implant group was significantly younger (p = 0.001), with a lower body mass index (p = 0.004). There was no difference in the rate of seroma, hematoma, infection, necrosis, or failed reconstruction. Direct-to-implant patients had significantly reduced numbers of drain days (p < 0.001), length of stay (p = 0.05 and p = 0.039), readmissions (p = 0.03 and 0.03), extra hospital days (p = 0.05 and p = 0.045), and postoperative visits (p < 0.001).

Conclusions:
Direct-to-implant breast reconstruction in the elderly yields similar complication and failure rates compared to tissue expander/implant reconstruction. However, direct-to-implant reconstruction patients had a reduced number of drain days and fewer readmissions, hospital stays, and postoperative visits. Direct-to-implant reconstruction is a powerful tool to use in elderly women with appropriate breast shape and ptosis.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
The Comparison of Strattice and SurgiMend in Acellular Dermal Matrix–Assisted, Implant-Based Immediate Breast Reconstruction
Authors: Mazari Fayyaz A. K. , Wattoo Ghulam M. , Kazzazi Nazar H. , Kolar Kadappa M. , Olubowale Olumuyiwa O. , Rogers Clare E. , Azmy Iman A. 
Published: January 2018

Background:
Strattice (porcine derivative) and SurgiMend (bovine derivative) are the two most common acellular dermal matrices used in breast reconstruction in the United Kingdom. This retrospective study compared clinical outcomes in immediate implant-based breast reconstruction patients.

Methods:
The study, conducted across three hospitals, included all patients who underwent immediate implant-based breast reconstruction using Strattice and SurgiMend. The primary outcome measure was implant loss rate. Secondary outcome measures included acellular dermal matrix loss rate, seroma formation, and minor and major complication rates. Intergroup comparison was performed.

Results:
Eighty-two patients (Strattice, n = 45; SurgiMend, n = 37) underwent 97 immediate implant-based breast reconstructions (Strattice, n = 54; SurgiMend, n = 43). There were no differences between groups for age, comorbidities, specimen weight, or implant volume. Drains were used in all Strattice and 36 (84 percent) SurgiMend cases. The implant loss rate was higher for Strattice (n = 10, 20 percent) compared with SurgiMend (n = 3, 7 percent) but failed to reach statistical significance (chi-square test, p = 0.077). The acellular dermal matrix loss rate was significantly higher (Fisher’s exact test, p = 0.014) in the Strattice group (n = 7, 14 percent), with no acellular dermal matrix loss with SurgiMend. The reoperation rate was also significantly higher (chi-square test, p = 0.002) in the Strattice group (n = 17, 33 percent, versus n = 3, 7 percent). The incidence of red breast was significantly higher (chi-square test, p = 0.022) in the SurgiMend group (n = 9, 21 percent, versus n = 3, 6 percent). Seroma, wound problems, and infection rates were similar.

Conclusions:
Clinical outcomes, including implant loss, acellular dermal matrix loss, and reoperation rates, are significantly better when using SurgiMend in immediate implant-based breast reconstruction compared with Strattice. An appropriately powered randomized trial is needed to provide further information.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.