bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Bowel Injury in Hysterectomy for Benign Indications
Authors: Zhu Cici R. , Mallick Ranjeeta , Singh Sukhbir S. , Auer Rebecca , Solnik Jonathon , Choudhry Abdul Jamil , Chen Innie 
Published: September 2020

OBJECTIVE:
To estimate the incidence and risk factors for bowel injury in women undergoing hysterectomy for benign indications.

METHODS:
A retrospective cohort study was conducted among women undergoing hysterectomy for benign indications from 2012 to 2016 at institutes participating in the American College of Surgeons National Surgical Quality Improvement Program, including both inpatient and outpatient settings. Bowel injury was identified using Current Procedural Terminology codes as patients who underwent bowel repair at the time of hysterectomy or postoperatively within 30 days. Multivariate logistic regression models were used to control for patient clinical factors and perioperative factors.

RESULTS:
Bowel injury occurred in 610 of 155,557 (0.39%) included women. After bivariate analysis, factors associated with bowel injury included age, race, body mass index, American Society of Anesthesiologists classification, increased operative time, surgical approach, type of hysterectomy, lysis of adhesions, and operative indication. After adjusting for potential confounders, bowel injury was found associated with older age, surgical indication of endometriosis, and abdominal surgical approach. Compared with the surgical indication of endometriosis (n=63/10,625), the surgical indications of menstrual disorder (odds ratio [OR] 0.33, 95% CI 0.23–0.47; adjusted odds ratio [aOR] 0.33, 95% CI 0.23–0.48; n=67/34,168), uterine leiomyomas (OR 0.80, 95% CI 0.61–1.05; aOR 0.44, 95% CI 0.33–0.59; n=243/51,232), and genital prolapse (OR 0.30, 95% CI 0.20–0.45; aOR 0.41, 95% CI 0.25–0.67; n=36/20,384) were each associated with lower odds of bowel injury. Compared with the vaginal approach to hysterectomy (n=27/27,434), the abdominal approach was found to have significantly increased odds of bowel injury (OR 10.80, 95% CI 7.31–15.95; aOR 10.49 95% CI 6.42–17.12; n=401/38,106); the laparoscopic approach had smaller but significantly increased odds (OR 2.06, 95% CI 1.37–3.08; aOR 2.03 95% CI 1.24–3.34; n=182/90,017) as well.

CONCLUSION:
Increased risk of bowel injury is associated with endometriosis and the abdominal surgical approach to hysterectomy. These findings have implications for the surgical care of women with benign uterine disease.
COMBINED PNEUMATIC AND ENZYMATIC VITREOLYSIS FOR SEVERE CASES OF VITREOMACULAR TRACTION
Authors: Yu Gina , Seto Brendan K. , Yamada Keiko , Zeng Ke , Arroyo Jorge G. 
Published: September 2020

Purpose:
To evaluate the efficacy of combined pneumatic and enzymatic vitreolysis for treatment of severe cases of vitreomacular traction (VMT).

Methods:
We analyzed a retrospective, consecutive series of five patients diagnosed with severe VMT refractory to pneumatic vitreolysis who then received an additional ocriplasmin injection while their gas bubble from pneumatic vitreolysis was still present between February 2015 and February 2019. Vitreomacular traction release was confirmed using spectral-domain optical coherence tomography.

Results:
Four of the five patients treated with combined pneumatic and enzymatic vitreolysis achieved VMT release by Day 28, and all cases eventually achieved complete VMT release. In addition to having VMT refractory to pneumatic vitreolysis, patient characteristics included broad adhesion diameter (>1,500 µm, n = 1), presence of epiretinal membrane (n = 2), age >65 years (n = 4), and pseudophakia (n = 1). The visual acuity improved by three or more lines at 6 months in both of the patients with initial vision worse than 20/50 on an Early Treatment Diabetic Retinopathy Study chart but not in those whose vision was already fairly good (i.e., visual acuity >20/60). None of the patients experienced the following complications after receiving this combined treatment: retinal tears or detachments, vitreous floaters, and ellipsoid zone changes.

Conclusion:
Sequential, combined pneumatic and enzymatic vitreolysis resulted in VMT release in all 5 cases (4 cases by 28 days) and may be a potentially useful alternative to surgical intervention for refractory VMT cases.
TOXOPLASMOSIS RETINOCHOROIDITIS MASQUERADING AS ENDOGENOUS ENDOPHTHALMITIS IN A CASE OF CONGENITAL LONG QT SYNDROME
Authors: Adam Christopher R. , Abrams Gary W. 
Published: September 2020

Purpose:
To describe the diagnostic and treatment challenges of a case of presumed acquired macula-involving toxoplasmosis retinochoroiditis.

Methods:
Case report of a woman with congenital long QT syndrome presenting with retinochoroiditis after undergoing a cardiac procedure. Laboratory analysis, ocular fluid biopsy, and multimodal imaging were obtained.

Results:
Ophthalmic examination was significant for decreased vision and a macula-involving chorioretinal lesion concerning for endogenous endophthalmitis. Multimodal imaging showed a focal, full-thickness necrotizing process associated with vitritis, retinal edema, and choroidal thickening. Analysis of peripheral blood revealed elevated serum toxoplasma Immunoglobulin G titers. Blood cultures and a transesophageal echocardiogram were negative for endocarditis. Aqueous and vitreous specimens were negative for an infectious polymerase chain reaction panel, including toxoplasmosis and negative bacterial and fungal cultures. A diagnosis of presumed acquired toxoplasmosis retinochoroiditis was made and treated with a combination of oral and intravitreal antiparasitic medications resulting in healing of the retinochoroiditis.

Conclusion:
To the authors' knowledge, this is the first reported case of acquired toxoplasmosis retinochoroiditis in an immunocompetent patient with congenital long QT syndrome masquerading as endogenous endophthalmitis. The association of congenital long QT syndrome and a recent cardiac procedure with a risk for endogenous endophthalmitis complicated the diagnosis, clinical course, and treatment options. Our case emphasizes the importance of a thorough patient history, comprehensive clinical examination, and supportive multimodal imaging that were used to characterize the infectious process and guide empirical treatment. In addition, laboratory analysis, comanagement with other specialists, and evaluating the response to antitoxoplasma therapy were all instrumental in the eventual diagnosis and treatment of ocular toxoplasmosis in this atypical case.
Ab Interno Canaloplasty in Open-angle Glaucoma Patients Combined With In Vivo Trypan Blue Aqueous Venography
Authors: Docherty Gavin , Waldner Derek , Schlenker Matt , Crichton Andrew , Ford Bryce , Ahmed Iqbal I.K. , Gooi Patrick 
Published: September 2020

Purpose:
To demonstrate canalogram patterns observed when trypan blue tracer is combined with oculoviscoelastic device during ab interno canaloplasty, and discuss surgical results and potential implications for diagnosis, prognosis, and treatment.

Methods:
This is a retrospective small case series study.

Results:
The authors performed this procedure on 5 patients with informed consent with 4 to 18 months of follow-up. All procedures have been complication free. The average preoperative intraocular pressure was 16.4 mm Hg with an average number of topical glaucoma medications being equal to 3.6. Postoperatively, the average intraocular pressure for the group was reduced to 13 mm Hg with a concurrent drop in the average number of topical medications used equaling 1.8.

Conclusions:
Currently, there are limited practical options to evaluate the patency of the aqueous outflow system in our patients. The primary purpose of this paper is to describe canalogram patterns observed during ab interno canaloplasty with trypan blue. This technique may allow us to further our understanding of the aqueous outflow system and its role in the underlying pathophysiology of glaucoma. Further research is required to evaluate the prognostic and diagnostic significance of this technique.
The Effect of Tube Ligature on the Safety and Efficacy of Ahmed Glaucoma Valve Surgery
Authors: Al Owaifeer Adi M. , Alobaida Ibrahim , Alrefaie Shaimaa , Malik Rizwan , Aljadaan Ibrahim 
Published: September 2020

Precis:
In this matched case-control study, ligature of the Ahmed glaucoma valve (AGV) was associated with a reduction in the rate of postoperative complications without affecting the surgical success rate or the visual outcome following the procedure.

Purpose:
The purpose of this study was to compare the safety and efficacy of AGV surgery with and without tube ligation.

Materials and Methods:
This was a retrospective, matched case-control study. A review was performed of patients who underwent AGV surgery with tube ligation between June 2015 and December 2017 (ligated AGV group). Cases were matched with controls who underwent AGV surgery without tube ligation (nonligated AGV group). Data were compared on postoperative intraocular pressure (IOP), the number of glaucoma medications, surgical success rates, complications, and vision.

Results:
There were 49 eyes in the ligated AGV group, and 98 eyes in the nonligated AGV group. Baseline characteristics were similar between groups except for the number of glaucoma medications (3.72±0.55 in the ligated AGV group vs. 3.92±0.92 in the nonligated AGV group; P<0.01). At 18 months, IOP was 16.7±6.3 mm Hg in the ligated AGV group and 17.3±8.0 mm Hg in the nonligated AGV group (P=0.76). In addition, the mean number of glaucoma medications was 2.38±1.10 in the ligated AGV group and 1.68±1.51 in the nonligated AGV group (P=0.56). The overall success rate at 12 months was similar between groups (P=0.84). The overall rate of complications was statistically lower in the ligated AGV group (28.6%) compared with the nonligated AGV group (73.5%) (P<0.01). The mean change in logarithm of the minimum angle of resolution acuity was similar between groups (P=0.50).

Conclusion:
Tube ligation in AGV surgery may be an effective measure that reduces the rate of postoperative complications without affecting the success rate or visual outcomes of the surgery.
Perception Gaps of Disclosure of Patient Safety Incidents Between Nurses and the General Public in Korea
Authors: Choi Eun Young , Pyo Jeehee , Lee Won , Jang Seung Gyeong , Park Young-Kwon , Ock Minsu , Lee Haeyoung 
Published: September 2020

Objectives
This study aimed to explore nurses’ perceptions regarding disclosure of patient safety incidents.

Methods
An anonymous online survey was conducted, and results were compared with those of the general public using the same questionnaire in a previous study.

Results
Among 689 nurses, 96.8% of nurses felt major errors should be disclosed to patients or their caregivers, but only 67.5% felt disclosure of medical errors should be mandatory. In addition, 58.5% of nurses were concerned that disclose will increase the incidence of medical lawsuits. More than two-thirds of nurses felt such discloses will reduce feelings of guilt associated with a patient safety incident. Only 51.1% of nurses, but 93.3% of the public, felt near misses should be disclosed to patients.

Conclusions
Nurses generally had a positive attitude toward disclosure of patient safety incidents, but they preferred it less than the general public. To reduce this gap, legal and nonlegal measures will need to be implemented. Furthermore, it is necessary to continue monitoring the gap by regularly assessing perceptions of disclosure of patient safety incidents among health care professionals and the general public.
Plasma resuscitation with adjunctive peritoneal resuscitation reduces ischemia-induced intestinal barrier breakdown following hemorrhagic shock
Authors: Schucht Jessica E. , Matheson Paul J. , Harbrecht Brian G. , Bond Logan , Ashkettle Graham R. , Smith Jason W. 
Published: September 2020

INTRODUCTION
Hemorrhagic shock (HS) and resuscitation (RES) cause ischemia-induced intestinal permeability due to intestinal barrier breakdown, damage to the endothelium, and tight junction (TJ) complex disruption between enterocytes. The effect of hemostatic RES with blood products on this phenomenon is unknown. Previously, we showed that fresh frozen plasma (FFP) RES, with or without directed peritoneal resuscitation (DPR) improved blood flow and alleviated organ injury and enterocyte damage following HS/RES. We hypothesized that FFP might decrease TJ injury and attenuate ischemia-induced intestinal permeability following HS/RES.

METHODS
Sprague-Dawley rats were randomly assigned to groups (n = 8): sham; crystalloid resuscitation (CR) (HS of 40% mean arterial pressure for 60 minutes) and CR (shed blood plus two volumes of CR); CR and DPR (intraperitoneal 2.5% peritoneal dialysis fluid); FFP (shed blood plus one volume of FFP); and FFP and DPR (intraperitoneal dialysis fluid plus two volumes of FFP). Fluorescein isothiocyanate–dextran (molecular weight, 4 kDa; FD4) was instilled into the gastrointestinal tract before hemorrhage; FD4 was measured by UV spectrometry at various time points. Plasma syndecan-1 and ileum tissue TJ proteins were measured using enzyme-linked immunosorbent assay. Immunofluorescence was used to visualize claudin-4 concentrations at 4 hours following HS/RES.

RESULTS
Following HS, FFP attenuated FD4 leak across the intestine at all time points compared with CR and DPR alone. This response was significantly improved with the adjunctive DPR at 3 and 4 hours post-RES (p < 0.05). Resuscitation with FFP-DPR increased intestinal tissue concentrations of TJ proteins and decreased plasma syndecan-1. Immunofluorescence demonstrated decreased mobilization of claudin-4 in both FFP and FFP-DPR groups.

CONCLUSION
Fresh frozen plasma–based RES improves intestinal TJ and endothelial integrity. The addition of DPR can further stabilize TJs and attenuate intestinal permeability. Combination therapy with DPR and FFP to mitigate intestinal barrier breakdown following shock could be a novel method of reducing ischemia-induced intestinal permeability and systemic inflammation after trauma.

LEVEL OF EVIDENCE
Prognostic/Epidemiologic, Level III.
The transcriptional and splicing changes caused by hybridization can be globally recovered by genome doubling during allopolyploidization
Authors: Qin Jinxia , Mo Ruirui , Li Hongxia , Ni Zhongfu , Sun Qixin , Liu Zhenshan 
Published: September 2020

AbstractAllopolyploidization, which involves hybridization and genome doubling, is a key driving force in higher plant evolution. The transcriptome reprogramming that accompanies allopolyploidization can cause extensive phenotypic variations, and thus confers allopolyploids higher evolutionary potential than their diploid progenitors. Despite many studies, little is known about the interplay between hybridization and genome doubling in transcriptome reprogramming during allopolyploidization. Here, we performed genome-wide analyses of gene expression and splicing changes during allopolyploidization in wheat and brassica lineages. Our results indicated that both hybridization and genome doubling can induce genome-wide transcriptional and splicing changes. Notably, the gene transcriptional and splicing changes caused by hybridization can be largely recovered to parental levels by genome doubling in allopolyploids. Since transcriptome reprogramming is an important contributor to heterosis, our results revealed that only part of the heterosis in hybrids can be fixed in allopolyploids through genome doubling. Therefore, our findings update the current understanding of the permanent fixation of heterosis in hybrids through genome doubling. In addition, our results indicated that a large proportion of the transcriptome reprogramming in interspecific hybrids was not caused by the merging of two parental genomes, providing novel insights into the mechanism of heterosis.
Playing with peers: Exploring peer support mechanisms of a type 2 diabetes-specific board game
Authors: Lindgreen Pil , Stenov Vibeke , Willaing Ingrid , Basballe Henning Grubb , Joensen Lene Eide 
Published: September 2020

ABSTRACTAimTo explore specific mechanisms of a board game aiming to facilitate peer support among people with type 2 diabetes.DesignQualitative observational study including game tests in group-based diabetes education programs and focus groups exploring experiences among people with type 2 diabetes playing the game.MethodsThe game was tested with 77 people with type 2 diabetes in March-July 2019. Data from audio recordings of game tests and focus groups were analysed using interpretive description.ResultsSix mechanisms facilitated peer support among people with type 2 diabetes: 1) entering a safe space of normality created by emotional in-game mirroring; 2) mutual in-game acknowledgment of out-of-game efforts; 3) forming relationships through in-game humor; 4) health care professionals using game rules to support group dialogues of interest to people with type 2 diabetes; 5) being inspired by in-game exchange of tips and tricks; and 6) co-players guiding each other during the game. Peer support was inhibited by the mechanism of game rules obstructing group dialogues.ConclusionThe board game effectively facilitated peer support through playfulness and humor and helped players form relationships. Additionally, the game established a framework for players to share and listen to each other’s diabetes-specific experiences, promoting a sense of normality and cohesiveness. This process depended on facilitating educators’ flexibility to balance the rules of the game with its aim of creating peer support.ImpactThe study provides detailed knowledge on specific board game mechanisms facilitating peer support among people with type 2 diabetes participating in diabetes education programs.The game was an effective tool to facilitate emotional and practical peer support by encouraging players to share and acknowledge each other’s diabetes experiences.Peer support is promoted through the game by creating a sense of normality and belonging among people with type 2 diabetes.
Copy number variant detection with low-coverage whole-genome sequencing is a viable alternative to the traditional array-CGH
Authors: Kucharík Marcel , Budiš Jaroslav , Hýblová Michaela , Minárik Gabriel , Szemes Tomáš 
Published: September 2020

AbstractCopy number variations (CNVs) are a type of structural variants involving alterations in the number of copies of specific regions of DNA, which can either be deleted or duplicated. CNVs contribute substantially to normal population variability; however, abnormal CNVs cause numerous genetic disorders. Nowadays, several methods for CNV detection are used, from the conventional cytogenetic analysis through microarray-based methods (aCGH) to next-generation sequencing (NGS). We present GenomeScreen – NGS-based CNV detection method for lowcoverage whole-genome sequencing. We determined the theoretical limits of its accuracy and confirmed it with extensive in-silico study and real patient samples with known genotypes. Theoretically, at least 6M uniquely mapped reads are required to detect CNV with a length of 100 kilobases (kb) or more with high confidence (Z-score > 7). In practice, the in-silico analysis showed the requirement of at least 8M to obtain >99% accuracy (for 100 kb deviations). We compared GenomeScreen with one of the currently used aCGH methods in diagnostic laboratories, which has a 200 kb mean resolution. GenomeScreen and aCGH both detected 59 deviations, GenomeScreen furthermore detected 134 other (usually) smaller variations. The performance of the proposed GenemoScreen tool is comparable or superior to the aCGH regarding accuracy, turnaround time, and cost-effectiveness, presenting a reasonable benefit particularly in a prenatal diagnosis setting.
Age-structured SIR model and resource growth dynamics: A preliminary COVID-19 study
Authors: Babajanyan S. G. , Cheong Kang Hao 
Published: September 2020

AbstractIn this paper, we discuss three different response strategies to a disease outbreak and their economic implications in an age-structured population. We have utilized the classical age structured SIR-model, thus assuming that recovered people will not be infected again. Available resource dynamics is governed by the well-known logistic growth model, in which the reproduction coefficient depends on the disease outbreak spreading dynamics. We further investigate the feedback interaction of the disease spread dynamics and resource growth dynamics with the premise that the quality of treatment depends on the current economic situation. The very inclusion of mortality rates and economic considerations in the same model may be incongruous under certain positions, but in this model, we take a ‘realpolitik’ approach by exploring all of these factors together as it is done in reality.
Optimal Control and Cost-effectiveness Analysis of an HPV-Chlamydia Trachomatis co-infection model
Authors: Omame A. , Nnanna C. U. , Inyama S. C. 
Published: September 2020

AbstractIn this work, a co-infection model for human papillomavirus (HPV) and Chlamydia trachomatis with cost-effectiveness optimal control analysis is developed and analyzed. The disease-free equilibrium of the co-infection model is shown not to be globally asymptotically stable, when the associated reproduction number is less unity. It is proven that the model undergoes the phenomenon of backward bifurcation when the associated reproduction number is less than unity. It is also shown that HPV re-infection (εp ≠ 0) induced the phenomenon of backward bifurcation. Numerical simulations of the optimal control model showed that: (i) focusing on HPV intervention strategy alone (HPV prevention and screening), in the absence of Chlamydia trachomatis control, leads to a positive population level impact on the total number of individuals singly infected with Chlamydia trachomatis, (ii) Concentrating on Chlamydia trachomatis intervention controls alone (Chlamydia trachomatis prevention and treatment), in the absence of HPV intervention strategies, a positive population level impact is observed on the total number of individuals singly infected with HPV. Moreover, the strategy that combines and implements HPV and Chlamydia trachomatis prevention controls is the most cost-effective of all the control strategies in combating the co-infections of HPV and Chlamydia trachomatis.