bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of an “Internal Fixator Technique” to Stabilize Pathologic Fractures Developing Secondary to Osteomyelitis
Authors: Yildirim Azad , Kapukaya Ahmet , Atiç Ramazan , Mertsoy Yilmaz , Yiğit Şehmus , Çaçan Mehmet A. , Alemdar Celil 
Published: August 2015

Background:
There is no consensus on the materials and the techniques to use in fixing pathologic fractures secondary to osteomyelitis. This study reports the results of the fixation of pathologic fractures secondary to osteomyelitis using the “internal fixator technique.”

Methods:
The internal fixator technique was performed on 11 children and adolescents with fractures secondary to osteomyelitis between 2003 and 2010. A retrospective chart review was conducted to record the following: age, sex, the anatomic region of infection, the time delay from symptom onset to fracture, the classification of chronic osteomyelitis, the Cierny-Mader classification, the causative organism, surgeries, the length of hospitalization, the location and the pattern of fracture, the duration of infection, the length of follow-up, and complications.

Results:
The patients included 7 male and 4 female patients with a mean age of 8.7 (range, 6 to 13) years. Pathologic fractures were as follows: 7 femur and 4 tibia. Nine of them were in the metaphysis and 2 others were located in the diaphysis. The time delay from symptom onset to fracture was 3.36 (1 to 9) months. The anatomic region of infection was the diaphysis in 2 cases and the metaphysis in 9 cases. Fractures patterns were short oblique and transverse. The length of hospitalization was a mean of 7 days. The duration of infection ranged from 1 to 12 (mean, 4.38) months. The mean duration of follow-up was 57.09 (range, 36 to 73) months from the initial presentation. Only 2 patients developed shortening, for which no additional intervention was performed.

Conclusions:
This case series demonstrates that the “internal fixator technique” is an acceptable alternative to the management of pathologic fractures of the femur or the tibia in children and adolescents with unresolved acute and chronic osteomyelitis. Infections were resolved in all cases and fractures were sufficiently stabilized to allow union with a low complication rate.

Level of Evidence:
Level IV—therapeutic.
The Fate of DDH Hips Showing Cartilaginous or Fibrous Tissue-filled Joint Spaces Following Primary Reduction
Authors: Kim Hui Taek , Lee Tae Hoon , Ahn Tae Young , Jang Jae Hoon 
Published: August 2015

Background:
Because the use of magnetic resonance imaging is still not universal for the patients with developmental dysplasia of the hip patients, orthopaedists do not generally distinguish widened joint spaces which are “empty” after primary treatment (and therefore still reducible), from those which are filled and much more difficult to treat. To date no studies have focused on the latter hips. We treated and observed the outcomes for 19 hips which showed filled joint spaces after primary treatment.

Methods:
We retrospectively reviewed 19 cases of developmental dysplasia of the hip: (1) who showed a widened joint space on radiographs after primary treatment; and (2) whose magnetic resonance imaging showed that the widened joint space was accompanied by acetabular cartilage hypertrophy and/or was filled with fibrous tissues. All patients were over 1 year old at the time of primary reduction (reduction was closed in 4 patients, open in 6, and open with pelvic osteotomy in 9). Thirteen patients received at least 1 secondary treatment. Final results were classified using a modified Severin classification.

Results:
Final outcomes were satisfactory in 10 (52.6%) and unsatisfactory in 9 (47.4%). The widened joint spaces gradually filled with bone, resulting in a shallow acetabulum in the patients with unsatisfactory results. Of 9 patients who underwent combined pelvic osteotomy at the time of primary reduction, results were satisfactory in 6 (66.7%), whereas all patients who had only closed or open primary reduction had unsatisfactory results.

Conclusions:
Combined pelvic osteotomy at the time of primary reduction is advisable in hips with widened joint spaces. However, hips with filled joint spaces after primary treatment often have unsatisfactory results even after additional pelvic and/or femoral osteotomy.

Level of Evidence:
Level IV—prognostic study.
Reliable Change Estimates for Assessing Recovery From Concussion Using the ANAM4 TBI-MIL
Authors: Haran F. J. , Alphonso Aimee L. , Creason Alia , Campbell Justin S. , Johnson Dagny , Young Emily , Tsao Jack W. 
Published: August 2015

Objective:
To establish the reliable change parameters for the Automated Neuropsychological Assessment Metrics (ANAM) using a healthy normative sample of active duty service members (SMs) and apply the parameters to sample of recently deployed SMs.

Methods:
Postdeployment neurocognitive performance was compared in 1893 US Marines with high rates of combat exposure during deployment. Of the sample, 289 SMs had data for 2 predeployment assessments and were used as a normative subsample and 502 SMs had data for predeployment and postdeployment assessments and were used as a deployed subsample. On the basis of self-report, the deployed subsample were further classified as concussed (n = 238) or as nonconcussed controls (n = 264). Reliable change parameters were estimated from the normative sample and applied data for both deployed groups. Postdeployment performance was quantified using a general linear model (2 group × 2 time) multivariate analysis of variance with repeated measures.

Results:
Both deployed groups demonstrated a pattern of meaningful decreases in performance over time.

Conclusions:
Information from this effort, specifically the reliable change parameters and the base rates of reliable decline, can be used to assist with the identification of postdeployment cognitive issues.
Self-Reported Traumatic Brain Injury, Health and Rate of Chronic Multisymptom Illness in Veterans From the 1990-1991 Gulf War
Authors: Yee Megan K. , Seichepine Daniel R. , Janulewicz Patricia A. , Sullivan Kimberly A. , Proctor Susan P. , Krengel Maxine H. 
Published: August 2015

Background:
Traumatic brain injury (TBI) was not considered to be common in the 1990-1991 Gulf War (GW). Therefore, the relationship between TBI and chronic health symptoms experienced by GW veterans is unknown. Health symptoms reported by veterans deployed more recently to this region (Operations Enduring and Iraqi Freedom) are similar to those of GW veterans and have been primarily attributed to TBI.

Objective:
To examine the relationships among self-reported TBI, health symptoms, chronic multisymptom illness (CMI), and health-related quality of life among GW veterans.

Participants:
Participants included 1 274 GW veterans from the Devens Cohort Study, 156 of whom self-reported a history of TBI (12.2% of the sample).

Design:
Cross-sectional retrospective analysis of existing survey data.

Main Measures:
A 52-item health symptom checklist and the RAND 36-Item Health short Form Survey.

Results:
Self-reported TBI in GW Veterans is related to increased rates of health symptoms, CMI, and poorer health-related quality of life.

Conclusions:
Gulf War veterans' self-reported exposure to TBI is related to increased rates of chronic health symptoms and CMI, which interfere with everyday activities of daily living.
Evidence-Based Practice for the Use of Internal Strategies as a Memory Compensation Technique After Brain Injury: A Systematic Review
Authors: O'Neil-Pirozzi Therese M. , Kennedy Mary R.T. , Sohlberg McKay M. 
Published: August 2015

Objective:
To complete a systematic review of internal memory strategy use with people who have brain injury and provide practitioners with information that will impact their clinical work.

Methods:
A systematic literature search to identify published intervention studies that evaluated an internal memory strategy or technique to improve memory function of individuals with brain injury. Relevant data from reviewed articles were coded using 4 clinical questions targeting participants, interventions, research methods, and outcomes.

Results:
A comprehensive search identified 130 study citations and abstracts. Forty-six met inclusion/exclusion criteria and were systematically reviewed. Visual imagery was most frequently studied, in isolation or in combination with other internal strategies. Despite significant variability in research methods and outcomes across studies, the evidence provides impetus for use of internal memory strategies with individuals following brain injury.

Conclusions:
Individuals with traumatic brain injury may benefit from internal memory strategy use, and clinicians should consider internal memory strategy instruction as part of intervention plans. Further research needs to better delineate influences on intervention candidacy and outcomes.
Application of Thyroid Imaging Reporting and Data System in the Ultrasound Assessment of Thyroid Nodules According to Physician Experience
Authors: Ko Su Yeon , Kim Eun-Kyung , Moon Hee Jung , Yoon Jung Hyun , Kim Ha Yan , Kwak Jin Young 
Published: August 2015

Objective
The aim of this study was to investigate and compare the diagnostic performances of the Thyroid Imaging Reporting and Data System (TIRADS) in differentiating benign and malignant thyroid nodules according to the level of physician experience.

Materials and Methods
From March to October 2013, 1102 patients with 1128 thyroid nodules who underwent initial ultrasound-guided fine needle aspiration were included in this study. Thyroid nodules were categorized according to TIRADS. Diagnostic performances of ultrasound were compared according to performer experience using the χ2 test or Fisher exact test.

Results
Of 1128 thyroid nodules, 281 were malignant, and 847 were benign. The risk of malignancy of each TIRADS category by the experienced and less experienced physicians were as follows: category 3 (0.9% vs 0%), category 4a (3.5% vs 1.3%), category 4b (7.3% vs 12.1%), category 4c (67.5% vs 44.9%), and category 5 (97.7% vs 76.5%). Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 99.1%, 35.9%, 52.5%, 35.5%, and 99.1%, respectively, for experienced physicians and 100%, 20.9%, 37.6%, 35.2%, and 100%, respectively, for less experienced physicians. Specificity, accuracy, and positive predictive value were statistically higher for experienced physicians than those for less experienced physicians (P < 0.001, 0.001, and 0.004). There was a significant difference in areas under the curve between the 2 groups (P < 0.001).

Conclusions
In conclusion, the diagnostic performance of the stratification of malignancy risk according to TIRADS categories was comparable between the experienced and less experienced physician groups. The application of TIRADS is reproducible, and it was easy to predict the probability of thyroid malignancy in both the experienced and less experienced physician groups.
Formation of Chromosomal Domains in Interphase by Loop Extrusion
Authors: Fudenberg Geoffrey , Imakaev Maxim , Lu Carolyn , Goloborodko Anton , Abdennur Nezar , Mirny Leonid A. 
Published: August 2015

SummaryTopologically Associating Domains (TADs) are fundamental structural and functional building blocks of human interphase chromosomes, yet mechanisms of TAD formation remain unknown. Here we propose that loop extrusion underlies TAD formation. In this process, cis-acting loop-extruding factors, likely cohesins, form progressively larger loops, but stall at TAD boundaries due to interactions with boundary proteins, including CTCF. Using polymer simulations, we show that this model can produce TADs as determined by our analyses of Hi-C data. Contrary to typical illustrations, each TAD consists of multiple dynamically formed loops, rather than a single static loop. Our model explains diverse experimental observations, including the preferential orientation of CTCF motifs, enrichments of architectural proteins at TAD boundaries, and boundary deletion experiments, and makes specific predictions for depletion of CTCF versus cohesin. The emerging picture is that TADs arise from actively forming, growing, and dissociating loops, presenting a framework for understanding interphase chromosomal organization.
An integrative model of leukocyte genomics and organ dysfunction in heart failure patients requiring mechanical circulatory support
Authors: Wisniewski Nicholas , Bondar Galyna , Rau Christoph , Chittoor Jay , Chang Eleanor , Esmaeili Azadeh , Deng Mario 
Published: August 2015

AbstractBackgroundThe implantation of mechanical circulatory support (MCS) devices in heart failure patients is associated with a systemic inflammatory response, potentially leading to death from multiple organ dysfunction syndrome. Previous studies point to the involvement of many mechanisms, but an integrative hypothesis does not yet exist. Using time-dependent whole-genome mRNA expression in circulating leukocytes, we constructed a systems-model to improve mechanistic understanding and prediction of adverse outcomes.MethodsWe sampled peripheral blood mononuclear cells from 22 consecutive patients undergoing MCS surgery, at 5 timepoints: day -1 preoperative, and days 1, 3, 5, and 8 postoperative. Phenotyping was performed using 12 clinical parameters, 2 organ dysfunction scoring systems, and survival outcomes. We constructed a systems-representation using weighted gene co-expression network analysis, and annotated eigengenes using gene ontology, pathway, and transcription factor binding site enrichment analyses. Genes and eigengenes were mapped to the clinical phenotype using a linear mixed-effect model, with Cox models also fit at each timepoint to survival outcomes. Finally, we selected top genes associated with survival across all timepoints, and trained a penalized Cox model, based on day -1 data, to predict mortality risk thereafter.ResultsWe inferred a 19-module network, in which most module eigengenes correlated with at least one aspect of the clinical phenotype. We observed a response to surgery orchestrated into stages: first, activation of the innate immune response, followed by anti-inflammation, and finally reparative processes such as mitosis, coagulation, and apoptosis. Eigengenes related to red blood cell production and extracellular matrix degradation became predictors of survival late in the timecourse, consistent with organ failure due to disseminated coagulopathy. Our final predictive model consisted of 10 genes:IL2RA,HSPA7, AFAP1, SYNJ2, LOC653406, GAPDHP35, MGC12916, ZRSR2, and two currently unidentified genes, warranting further investigation.ConclusionOur model provides an integrative representation of leukocyte biology during the systemic inflammatory response following MCS device implantation. It demonstrates consistency with previous hypotheses, identifying a number of known mechanisms. At the same time, it suggests novel hypotheses about time-specific targets.
Gene flow mediates the role of sex chromosome meiotic drive during complex speciation
Authors: Meiklejohn Colin D. , Landeen Emily L. , Gordon Kathleen E. , Rzatkiewicz Thomas , Kingan Sarah B. , Geneva Anthony J. , Vedanayagam Jeffrey P. , Muirhead Christina A. , Garrigan Daniel , Stern David L. , Presgraves Daven C. 
Published: August 2015

ABSTRACTDuring speciation, sex chromosomes often accumulate interspecific genetic incompatibilities faster than the rest of the genome. The drive theory posits that sex chromosomes are susceptible to recurrent bouts of meiotic drive and suppression, causing the evolutionary build-up of divergent cryptic sex-linked drive systems and, incidentally, genetic incompatibilities. To assess the role of drive during speciation, we combine high-resolution genetic mapping of X-linked hybrid male sterility with population genomics analyses of divergence and recent gene flow between the fruitfly species,Drosophila mauritianaandD. simulans. Our findings reveal a high density of genetic incompatibilities and a corresponding dearth of gene flow on the X chromosome. Surprisingly, we find that, rather than contributing to interspecific divergence, a known drive element has recently migrated between species, caused a strong reduction in local divergence, and undermined the evolution of hybrid sterility. Gene flow can therefore mediate the effects of selfish genetic elements during speciation.
Conserved Functions of the MATE Transporter BIG EMBRYO1 in Regulation of Lateral Organ Size and Initiation Rate
Authors: Suzuki Masaharu , Sato Yutaka , Wu Shan , Kang Byung-Ho , McCarty Donald R. 
Published: August 2015

AbstractGenetic networks that determine rates of organ initiation and organ size are key regulators of plant architecture. Whereas several genes that influence the timing of lateral organ initiation have been identified, the regulatory pathways in which these genes operate are poorly understood. Here, we identify a class of genes implicated in regulation of the lateral organ initiation rate. Loss-of-function mutations in the MATE transporter encoded by maize (Zea mays) Big embryo 1 (Bige1) cause accelerated leaf and root initiation as well as enlargement of the embryo scutellum. BIGE1 is localized to trans-Golgi, indicating a possible role in secretion of a signaling molecule. Interestingly, phenotypes of bige1 bear striking similarity to cyp78a mutants identified in diverse plant species. We show that a CYP78A gene is upregulated in bige1 mutant embryos, suggesting a role for BIGE1 in feedback regulation of a CYP78A pathway. We demonstrate that accelerated leaf formation and early flowering phenotypes conditioned by mutants of Arabidopsis thaliana BIGE1 orthologs are complemented by maize Bige1, showing that the BIGE1 transporter has a conserved function in regulation of lateral organ initiation in plants. We propose that BIGE1 is required for transport of an intermediate or product associated with the CYP78A pathway.
The Transcriptional Coregulator LEUNIG_HOMOLOG Inhibits Light-Dependent Seed Germination in Arabidopsis
Authors: Lee Nayoung , Park Jeongmoo , Kim Keunhwa , Choi Giltsu 
Published: August 2015

AbstractPHYTOCHROME-INTERACTING FACTOR1 (PIF1) is a basic helix-loop-helix transcription factor that inhibits light-dependent seed germination in Arabidopsis thaliana. However, it remains unclear whether PIF1 requires other factors to regulate its direct targets. Here, we demonstrate that LEUNIG_HOMOLOG (LUH), a Groucho family transcriptional corepressor, binds to PIF1 and coregulates its targets. Not only are the transcriptional profiles of the luh and pif1 mutants remarkably similar, more than 80% of the seeds of both genotypes germinate in the dark. We show by chromatin immunoprecipitation that LUH binds a subset of PIF1 targets in a partially PIF1-dependent manner. Unexpectedly, we found LUH binds and coregulates not only PIF1-activated targets but also PIF1-repressed targets. Together, our results indicate LUH functions with PIF1 as a transcriptional coregulator to inhibit seed germination.
Discourse analysis and the study of educational leadership
Authors: Anderson Gary , Mungal Angus Shiva 
Published: August 2015

Purpose– The purpose of this paper is to provide an overview of the current and past work using discourse analysis in the field of educational administration and of discourse analysis as a methodology.Design/methodology/approach– Authors reviewed research in educational leadership that uses discourse analysis as a methodology.Findings– While discourse analysis has been used in the field, little work has been done that explores “leadership” as a discourse practice.Originality/value– Increased use of discourse analysis in the field might unearth the ways principals and superintendents are creators of discourse and mediators of the discourses of others.
Interpreting Injury Mechanisms of Blunt Force Trauma from Butterfly Fracture Formation
Authors: Reber Samantha L. , Simmons Tal 
Published: August 2015

AbstractAccording to biomechanics of fracture production during blunt impact, tubular bones are subject to compressive (impact site) and tensile (opposite impact site) forces; this causes bones to break in tension before compression, producing Y‐shaped fracture patterns with breakaway (butterfly) fragments. In current forensic models, the side of the bone exhibiting the breakaway fragment is designated the impact side, with initial breakage occurring opposite. Fracture production and patterning of blunt impacts to 255 sheep femora were analyzed. Contra the existing model, only 60% of complete butterfly fractures exhibited impact side breakaway fragments. Although fractures initiated on the tension, nonimpact side, butterfly fragments formed on either compression or tension sides. Using newly defined breakaway fragment shape criteria, impact side was estimated with 98% accuracy for both complete and partial butterfly fractures. Furthermore, the results suggest that the impact site is the located on one of the Y‐fracture's arms, not the butterfly fragment's center, as previously modeled.
Very serious and non‐ignorable problem: Crisis in emergency medical response in catastrophic event
Authors: Shen Weifeng , Jiang Libing , Zhang Mao , Ma Yuefeng , Jiang Guanyu , He Xiaojun 
Published: August 2015

AbstractThe crisis of medical response caused by catastrophic events might significantly affect emergency response, and might even initiate more serious social crisis. Therefore, early identification and timely blocking the formation of crisis in the early phase after a major disaster will improve the efficiency of medical response in a major disaster and avoid serious consequences. In the present paper, we described the emergency strategy to crisis management of medical response after a major disaster. Major catastrophic events often lead to various crises, including excess demand, the crisis of response in barrier and the structural crisis in response. The corresponding emergency response strategies include: (i) shunt of catastrophic medical surge; (ii) scalability of medical surge capacity; (iii) matching of the structural elements of response; (iv) maintaining the functions of support system for medical response and maximising the operation of the integrated response system; and (v) selection of appropriate care ‘standard’ in extreme situations of overload of disaster medical surge. In conclusion, under the impact of a major catastrophic event, medical response is often complex and the medical surge beyond the conventional response capacity and it is easy to be in crisis. In addition to the current consensus of disaster response, three additional aspects should be considered. First, all relevant society forces led by the government and military should be linkages. Second, a powerful medical response system must be based on a strong support system. Third, countermeasures of medical surge should be applied flexibly to the special and specific disaster environment, to promote the effective medical response force.
Diagnostics and Discovery in Viral Central Nervous System Infections
Authors: Lipkin Walter Ian , Hornig Mady 
Published: August 2015

AbstractThe range of viruses implicated in central nervous system disease continues to grow with globalization of travel and trade, emergence and reemergence of zoonoses and investments in discovery science. Diagnosis of viral central nervous system infections is challenging in that brain tissue, where the pathogen concentration is likely to be highest, is not readily obtained and sensitive methods for molecular and serological detection of infection are not available in most clinical microbiology laboratories. Here we review these challenges and discuss how they may be addressed using advances in molecular, proteomic and immunological methods.