bluuebunny/crossref_metadata_2025_split huggingface dataset:
RETINAL LEAKAGE INDEX DYNAMICS ON ULTRA-WIDEFIELD FLUORESCEIN ANGIOGRAPHY IN EYES TREATED WITH INTRAVITREAL AFLIBERCEPT FOR PROLIFERATIVE DIABETIC RETINOPATHY IN THE RECOVERY STUDY
Authors: Babiuch Amy S. , Wykoff Charles C. , Srivastava Sunil K. , Talcott Katherine , Zhou Brenda , Hach Jenna , Hu Ming , Reese Jamie L. , Ehlers Justis P. 
Published: January 2020

Purpose:
Characterization of leakage indices on ultra-widefield fluorescein angiography in proliferative diabetic retinopathy treated with intravitreal aflibercept.

Methods:
Prospective study enrolling subjects for treatment of proliferative diabetic retinopathy randomized 1:1 to receive 2-mg intravitreal aflibercept every 4 weeks (2q4) or every 12 weeks (2q12). Ultra-widefield fluorescein angiography images obtained at baseline, 24, and 48 weeks were analyzed using a semiautomated leakage segmentation platform. Panretinal and zonal leakage indices were calculated.

Results:
Forty eyes of 40 subjects were included, and mean age was 48 ± 12.1 years. Mean number of injections was 11 ± 1.7 in the 2q4 arm and 4 ± 0.4 in the 2q12 arm. Median baseline leakage index in the 2q4 and 2q12 groups was 5.1% and 4.3%, respectively (P = 0.28). At 24 and 48 weeks, the 2q4 group significantly improved to 1.1% (−79%, P < 0.0001). At Week 24, the 2q12 group demonstrated nonsignificant improvement (3.4%; −21%, P = 0.47); by Week 48, improvement was significant (1.4%; −68%, P = 0.02). The 2q4 group resulted in lower leakage index compared with the 2q12 group at 24 weeks (1.1% vs. 3.4%, respectively; P = 0.008), but by 48 weeks, leakage index was similar between both groups (1.1% vs. 1.4%, respectively; P = 0.34).

Conclusion:
Proliferative diabetic retinopathy treated with intravitreal aflibercept demonstrated significant leakage index reductions at 1 year. Monthly dosing provided more rapid reduction in leakage index compared with quarterly dosing.

Trial Registration:
RECOVERY study (NCT02863354); https://clinicaltrials.gov/ct2/show/NCT02863354.
PROGRESSION OF ABCA4-RELATED RETINOPATHY
Authors: Müller Philipp L. , Pfau Maximilian , Treis Tim , Pascual-Camps Isabel , Birtel Johannes , Lindner Moritz , Herrmann Philipp , Holz Frank G. 
Published: January 2020

Purpose:
To investigate the prognostic value of demographic, functional, genetic, and imaging parameters on retinal pigment epithelium atrophy progression secondary to ABCA4-related retinopathy.

Methods:
Patients with retinal pigment epithelium atrophy secondary to ABCA4-related retinopathy were examined longitudinally with fundus autofluorescence imaging. Lesion area, perimeter, circularity, caliper diameters, and focality of areas with definitely decreased autofluorescence were determined. A model was used to predict the lesion enlargement rate based on baseline variables. Sample size calculations were performed to model the power in a simulated interventional study.

Results:
Sixty-eight eyes of 37 patients (age range, 14–78 years) with a follow-up time of 10 to 100 months were included. The mean annual progression of retinal pigment epithelium atrophy was 0.89 mm2. The number of atrophic areas, the retina-wide functional impairment, and the age-of-onset category constituted significant predictors for future retinal pigment epithelium atrophy growth, explaining 25.7% of the variability. By extension of a simulated study length and/or specific patient preselection based on these baseline characteristics, the required sample size could significantly be reduced.

Conclusion:
Trial design based on specific shape-descriptive factors and patients' baseline characteristics and the adaption of the trial duration may provide potential benefits in required cohort size and absolute number of visits.
The dichotomous role of epiregulin in pain
Authors: Verma Vivek , Khoury Samar , Parisien Marc , Cho Chulmin , Maixner William , Martin Loren J. , Diatchenko Luda 
Published: January 2020

AbstractIt has recently been shown that epidermal growth factor receptor (EGFR) contributes to the pathogenesis of pain. We scanned genetic markers within genes coding for receptors of the EGFR family (EGFR, ERBB2, ERBB3, and ERBB4) and their ligands (AREG, BTC, EGF, EPGN, EREG, HBEGF, MUC4, NRG1, NRG2, NRG3, NRG4, and TGFA) for association with self-reported pain intensity in patients with chronic facial pain who participated in the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) cohort. We found that only epiregulin(EREG)was associated with pain. The strongest effect was observed for a minor allele at rs6836436 inEREG, which was associated with lower chronic pain intensity. However, the same allele was associated with higher facial pain intensity among cases with recent onset of facial pain. Similar trends were observed in an independent cohort of UK Biobank (UKB) where the minor allele at rs6836436 was associated with a higher number of acute pain sites but a lower number of chronic pain sites. Expression quantitative trait loci analyses established rs6836436 as a loss-of-function variant of EREG. Finally, we investigated the functional role of EREG using mouse models of chronic and acute pain. Injecting mice with an EREG monoclonal antibody reversed established mechanosensitivity in the complete Freund's adjuvant and spared nerve injury models of chronic pain. However, the EREG monoclonal antibody prolonged allodynia when administered during the development of complete Freund's adjuvant–induced mechanosensitivity and enhanced pain behavior in the capsaicin model of acute pain.
Cochlear Implant Mapping Through Telemedicine—A Feasibility Study
Authors: Luryi Alexander L. , Tower Jacob I. , Preston Jessica , Burkland Adam , Trueheart Cyndi E. , Hildrew Douglas M. 
Published: January 2020

Objective:
Access to postoperative aural rehabilitation limits cochlear implant (CI) penetration to the candidate population. The purpose of this study was to evaluate the effectiveness of remote CI programming and aural rehabilitation via telehealth.

Study Design and Setting:
Retrospective study of one cochlear implant center.

Patients and Intervention:
Patients undergoing cochlear implantation from 2015 to 2018 undergoing remote programming as part of routine audiologic follow up.

Main Outcome Measures:
AzBio scores, impedances, comfort and threshold levels, and responses to the International Outcome Inventory for Hearing Aids questionnaire modified for CIs (IOI-CI).

Results:
A total of 22 CIs in 20 patients were included during the study period. Threshold, comfort, and impedance levels were readily obtained via telehealth and were not significantly different between telehealth and live sessions. AzBio scores and warble tone pure tone averages were also similar and acceptable in both session modalities. Based on IOI-CI scores, patients were very satisfied with their hearing outcomes.

Conclusions:
Using telemedicine, reliable measurements were readily obtained and hearing outcomes after remote programming were comparable to those expected after in-person programming sessions. Patients were overall satisfied with their remote programming sessions. Telehealth is a cost-effective and safe way to deliver post-CI audiologic care, particularly to patients with limited mobility or those in remote locations.
Deconstructing the Reconstruction: Evaluation of Process and Efficiency in Deep Inferior Epigastric Perforator Flaps
Authors: Haddock Nicholas T. , Teotia Sumeet S. 
Published: January 2020

Background:
With advances in technology and technique, the goal of microvascular breast reconstruction has transitioned from flap success to minimizing complications and maximizing aesthetic outcome and efficiency. In an effort to evaluate efficiency, the authors implemented a rigorous process analysis in their practice to evaluate deep inferior epigastric perforator (DIEP) flap breast reconstruction.

Methods:
A prospective implementation of process analysis was instituted on 147 DIEP flaps. The eight critical maneuvers for a DIEP flap are (1) skin to perforator identification, (2) perforator decision making, (3) perforator dissection, (4) pedicle dissection, (5) flap harvest, (6) preparation for microsurgery, (7) venous anastomosis, and (8) arterial anastomosis. Surgeons with variable experiences (faculty, faculty with senior resident/fellow, and supervised chief resident) used these eight steps to perform DIEP flap reconstruction. The outcomes and time of each maneuver were tracked.

Results:
The total flap harvest time among the three groups was 54.8 minutes for faculty surgeons, 98.3 minutes for senior resident/fellow working with faculty, and 178.8 minutes for supervised chief resident (p < 0.001). The largest difference was seen in perforator dissection. Increasing the number of perforators resulted in longer flap harvest times. Perforator location did not have an impact on times, but harvesting multiple rows took longer for less experienced surgeons. Body mass index and flap weight did not have an impact on time.

Conclusions:
The authors share their experience using process analysis for DIEP flap reconstruction. They defined eight critical maneuvers to maximize efficiency and safety. By communicating efficient processes and integrating them into the workflow of a given operation, surgeons can continue to improve throughout the arc of their careers.
Brachioplasty Refinements
Authors: Rohrich Rod J. , Mohan Raja , Durand Paul D. 
Published: January 2020

Summary:
With a growing massive weight loss population, upper arm contouring continues to rise in popularity. Refinements in technique, such as modification of skin excision patterns and the adjunct use of liposuction, have allowed for safe and reproducible results. This article helps to understand the evolution of upper arm contouring and provides an update on the limited-incision medial brachioplasty. Details of preoperative markings and operative technique are clearly illustrated in the video included.
Ultrafast Brain Magnetic Resonance Imaging in Acute Neurological Emergencies
Authors: Kazmierczak Philipp M. , Dührsen Max , Forbrig Robert , Patzig Maximilian , Klein Matthias , Pomschar Andreas , Kunz Wolfgang G. , Puhr-Westerheide Daniel , Ricke Jens , Solyanik Olga , Cyran Clemens C. 
Published: January 2020

Objectives
The aim of this study was to investigate diagnostic accuracy and impact on patient management of an ultrafast (4:33 minutes/5 sequences) brain magnetic resonance imaging (MRI) protocol for the detection of intracranial pathologies in acute neurological emergencies.

Materials and Methods
Four hundred forty-nine consecutive emergency patients with acute nontraumatic neurological symptoms were evaluated for this institutional review board–approved prospective single-center trial. Sixty patients (30 female, 30 male; mean age, 61 years) with negative head CT were included and underwent emergency brain MRI at 3 T subsequent to CT. MRI included the ultrafast protocol (ultrafast-MRI; sag T1 GRE, ax T2 TSE, ax T2 TSE Flair, ax T2* EPI-GRE, ax DWI SS-EPI; TA, 5 minutes) and an equivalent standard-length protocol (TA, 15 minutes) as reference standard. Two blinded board-certified neuroradiologists independently analyzed the MRI with regard to image quality (1, nondiagnostic; 2, substantial artifacts; 3, satisfactory; 4, minor artifacts; 5, no artifacts) and intracranial pathologies. Sensitivity and specificity for the detection of intracranial pathologies were calculated accordingly.

Results
Ninety-three additional intracranial lesions (acute ischemia, n = 21; intracranial hemorrhage/microbleeds, n = 27; edema, n = 2; white matter lesion, n = 38; chronic infarction, n = 3; others, n = 2) were detected by ultrafast-MRI, whereas 101 additional intracranial lesions were detected by the standard-length protocol (acute ischemia, n = 24; intracranial hemorrhage/microbleeds, n = 32; edema, n = 2; white matter lesion, n = 38; chronic infarction, n = 3; others, n = 2). Image quality was equivalent to the standard-length protocol. Ultrafast-MRI demonstrated high diagnostic accuracy (sensitivity, 0.939 [0.881–0.972]; specificity, 1.000 [0.895–1.000]) for the detection of intracranial pathologies. MRI led to a change in patient management in 10% compared with the initial CT.

Conclusions
Ultrafast-MRI enables time-optimized diagnostic workup in acute neurological emergencies at high sensitivity and specificity compared with a standard-length protocol, with direct impact on patient management. Ultrafast MRI protocols are a powerful tool in the emergency setting and may be implemented on various scanner types based on the optimization of individual acquisition parameters.
Is Rural Plastic Surgery Feasible and Important?
Authors: Meaike Jesse D. , Cantwell Sean , Mills Andrew , Singh Kuldeep , Moran Steven L. 
Published: January 2020

Background
There is little written about the scope of rural plastic surgery within the United States. Approximately 25 million people do not have immediate access to a plastic surgeon. Most areas are designated as rural, and this lack of specialty care can result in suboptimal care. Physicians are more likely to move to a rural area if they have prior life experience with rural areas, but exposure to rural plastic surgery in residency training is scarce. We attempted to examine the practice characteristics of rural plastic surgeons within the United States to (a) to better define the average rural plastic surgery practice and (b) to highlight the broad scope of practice of the rural plastic surgeon to educate both hospital administrators and our physician colleagues of the impact and benefit a plastic surgeon can have on a health system.

Methods
A survey was e-mailed to surgeons identified as rural plastic surgeons who practiced in communities with fewer than 50,000 people not located in a metropolitan area. Thirty-four surgeons were identified and 12 responded to the survey.

Results
Respondents on average were 56 years old and had practiced for 14.3 years. At the time of the survey, 33% practiced in a hospital-employed group practice, and 33% operated in a hospital that is part of a health system. Seventy-five percent did not complete fellowship training, but 67% believed that fellowship training would be beneficial to someone interested in rural plastic surgery. Seventy-five percent recommended hand surgery as the most beneficial fellowship. Eighty-three percent had prior experiences with rural surgery before starting their practice. Average case volume ranged from 150 to more than 1000 cases per year and spanned the spectrum of plastic surgery. Potential barriers to practicing rural plastic surgery included call responsibility and facility limitations.

Conclusions
A career in rural plastic surgery offers great variety encompassing the spectrum of plastic surgery. Most agreed that hand fellowship would be the most beneficial fellowship. Most had prior experience with rural surgery before seeking a career in rural plastic surgery, highlighting the importance of increasing awareness of these opportunities.
Risk of Complications in Primary Versus Revision-Type Cranioplasty
Authors: Shay Tamir , Belzberg Micah , Asemota Anthony O. , Mitchell Kerry-Ann , Wolff Amir , Santiago Gabriel F. , Huang Judy , Brem Henry , Gordon Chad R. 
Published: January 2020

Introduction:
Cranioplasty (CP) is a multifaceted procedure in a heterogenous patient population, with a high risk for complication. However, no previous large-scale studies have compared outcomes in primary (ie, first attempt) CP versus revision CP (ie, following previous attempts). The authors, therefore, analyzed long-term outcomes of 506 consecutive primary and revision CPs, performed by a single surgeon.

Methods:
All CPs performed between 2012 and 2019 were analyzed under IRB protocol approval. Surgeries were categorized as either primary (no previous CP; n = 279) or revision CP (at least one previous CP; n = 227). Complications were defined as either major or minor. Subgroup analyses investigated whether or not CP complication risk directly correlated with the number of previous neuro-cranial surgeries and/or CP attempts.

Results:
The primary CP group experienced a major complication rate of 9% (26/279). In comparison, the revision CP group demonstrated a major complication rate of 32% (73/227). For the revision CP group, the rate of major complications rose with each additional surgery, from 4% (1 prior surgery) to 17% (2 prior surgeries) to 39% (3–4 prior surgeries) to 47% (≥5 prior surgeries).

Conclusion:
In a review of 506 consecutive cases, patients undergoing revision CP had a 3-fold increase in incidence of major complications, as compared to those undergoing primary CP. These results provide critical insight into overall CP risk stratification and may guide preoperative risk-benefit discussions. Furthermore, these findings may support a center-of-excellence care model, particularly for those patients with a history of previous neuro-cranial surgeries and/or CP attempts.
Low light levels increase avoidance behaviour of diurnal fish species: Implications for road culverts
Authors: Keep John K. , Watson Jabin R. , Cramp Rebecca L. , Jones Matthew J. , Gordos Matthew A. , Ward Patrick , Franklin Craig E. 
Published: January 2020

AbstractInadequately designed culverts are known to pose hydraulic barriers to fish passage, but they may also be behavioural barriers if they adversely affect light levels within them. To test this, we performed a choice experiment and quantified the amount of time individuals of four Australian fish species spent in darkened and illuminated areas of an experimental swimming fume. Behavioural responses were reflective of the species’ diel activity patterns; diurnal species preferred illuminated regions, while nocturnal species preferred the darkened region. We then determined a threshold light level of only ~100-200 lux (c.f. midday sunlight ~100,000 lux) was required to overcome the behavioural barrier in ~ 70% of the diurnal fish tested. Placing these threshold values into field context, 100% of culverts sampled recorded inadequate light levels. Attention is required to better understand the impacts of low light levels in culverts on fish passage and to prioritise restoration.
Increased antibiotic susceptibility inNeisseria gonorrhoeaethrough adaptation to the cervical environment
Authors: Ma Kevin C , Mortimer Tatum D , Hicks Allison L , Wheeler Nicole E , Sánchez-Busó Leonor , Golparian Daniel , Taiaroa George , Rubin Daniel HF , Wang Yi , Williamson Deborah A , Unemo Magnus , Harris Simon R , Grad Yonatan H 
Published: January 2020

AbstractNeisseria gonorrhoeaeis an urgent public health threat due to rapidly increasing incidence and antibiotic resistance. In contrast with the trend of increasing resistance, clinical isolates that have reverted to susceptibility regularly appear, prompting questions about which pressures compete with antibiotics to shape gonococcal evolution. Here, we used genome-wide association on the largest collection ofN. gonorrhoeaeisolates to date (n=4852) to identify loss-of-function (LOF) mutations in the efflux pumpmtrCDEoperon as a mechanism of increased antibiotic susceptibility and demonstrate that these mutations are overrepresented in cervical isolates relative to urethral isolates (odds ratio (OR) = 3.74, 95% CI [1.98-6.70]). In support of a model in which pump expression incurs a fitness cost in this niche, cervical isolates were also enriched relative to urethral isolates in LOF mutations in themtrCDEactivatormtrA(OR = 8.60, 95% CI [4.96-14.57]) and infarA,a subunit of the FarAB efflux pump (OR = 6.25, 95% CI [3.90-9.83]). In total, approximately 2 in 5 cervical isolates (42.6%) contained a LOF mutation in either the efflux pump componentsmtrCorfarAor the activatormtrA.Our findings extend beyondN. gonorrhoeaeto otherNeisseria:mtrCLOF mutations are rare (<1%) in the primarily nasopharyngeal-colonizingN. meningitidisin a collection of 14,798 genomes but enriched in a heterosexual urethritis-associated lineage (8.6%, p = 9.90×10−5), indicating that efflux pump downregulation contributes broadly to the adaptation of pathogenicNeisseriato the female urogenital tract. Overall, our findings highlight the impact of integrating microbial population genomics with host metadata and demonstrate how host environmental pressures can lead to increased antibiotic susceptibility.
Silencing ofTaCKX1mediates expression of otherTaCKXgenes to increase grain yield in wheat
Authors: Jabłoński Bartosz , Ogonowska Hanna , Szala Karolina , Bajguz Andrzej , Orczyk Wacław , Nadolska-Orczyk Anna 
Published: January 2020

AbstractTaCKXfamily genes influence development of wheat plants by specific regulation of cytokinin content in different organs. However, their detailed role is not known. TheTaCKX1, highly and specifically expressed in developing spikes and in seedling roots, was silenced by RNAi-mediated gene silencing viaAgrobacteriumand the effect of silencing was investigated in 7 DAP spikes of T1and T2generations. Various levels ofTaCKX1silencing in both generations influence different models of co-expression with otherTaCKXgenes and parameters of yield-related traits. Only a high level of silencing in T2resulted in strong down-regulation ofTaCKX11 (3), up-regulation ofTaCKX2.1,2.2,5and9(10), and a high yielding phenotype. This phenotype is characterised by higher spike number, grain number and grain yield, as well as slightly higher mass of seedling roots, but lower thousand grain weight (TGW) and slightly lower spike length. Content of most of cytokinin forms in 7 DAP spikes of silenced T2lines increased from 40 to 76% compared to the non-silenced control. The CKs cross talk with other phytohormones.Each of the tested yield-related traits is regulated by various up- or down-regulatedTaCKXgenes and phytohormones. Unexpectedly, increased expression ofTaCKX2.1in silent forTaCKX1T2plants up-regulated trans- and cis-zeatin and trans-zeatin glucosides, determining lower TGW and chlorophyll content in flag leaves but higher grain yield. The coordinated effect ofTaCKX1silencing on expression of otherTaCKXgenes, phytohormone levels in 7 DAP spikes and yield-related traits in silenced T2lines is presented.One-sentence summaryDifferent levels ofTaCKX1silencing influence various models of coordinated expression ofTaCKXgenes and phytohormone levels in 7 DAP spikes, as well as yield parameters.