bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Outcomes of Glaucoma Drainage Implant Surgery With or Without Prior Failed Trabeculectomy
Authors: Dawson Emily F. , Rosenberg Nicole C. , Meyer Alissa M. , Culpepper Brady E. , Bolch Charlotte A. , Wilson Mary K. , Nguyen Phuong T. , Rodgers Cooper D. , Smith Ryan J. , Blake Charles R. , Sherwood Mark B. 
Published: April 2021

Precis:
A comparison of 186 glaucoma patients with mixed diagnoses who underwent nonvalved glaucoma drainage device (GDD) implant surgery showed similar long-term intraocular pressure (IOP), medication, and visual acuity (VA) outcomes between those with prior failed trabeculectomy surgery versus those without.

Purpose:
The purpose of this study was to evaluate whether prior failed trabeculectomy adversely affects the outcome of glaucoma tube surgery.

Patients and Methods:
A total of 186 eyes of 186 patients who underwent a nonvalved GDD implant surgery by a single surgeon between 1996 and 2015 at a University practice were included. Patients were of mixed diagnoses and over 18 years old. Before the GDD surgery, 65 had a previous failed glaucoma filtering surgery and 121 had no prior glaucoma surgery. Demographic information, preoperative and postoperative IOP, medication, VA, and complications were collected from chart review.

Results:
No significant difference was noted in mean IOP and mean medication use (13.0 and 12.6 mm Hg on 2.0 and 1.7 medication classes at 5 y postoperatively, respectively), mean VA and change in VA from baseline, or numbers of complications (P>0.05), between eyes that had a prior failed filtration surgery and those that had not. Kaplan-Meier plots for failure over 5 years using a lower limit of <5 mm Hg and an upper limit of ≥18, ≥15, or ≥12 mm Hg did not show a significant difference between groups. Subanalyses were performed to examine only primary glaucoma eyes and results were similar. Further group subanalyses comparing those with baseline IOP ≥25 or <25 mm Hg, age 65 and above or below 65 years and those specifically with Baerveldt 350 mm2 implants also did not show significant differences.

Conclusion:
Prior failed filtration surgery does not appear to affect the outcome of future GDD surgery.
Increased rebleeding and mortality in patients with gastrointestinal bleeding treated with anticoagulant drugs compared to antiplatelet drugs
Authors: Hosni Mohammad , Rahal Mahmoud , Tamim Hani , Daniel Fady , Al Hashash Jana , Sharara Ala I. , Soweid Assaad , Shaib Yasser H. , Mourad Fadi H. , Wehbeh Antonios N. , Rockey Don C. , Barada Kassem 
Published: April 2021

Background/Aim
We determined the effect of antiplatelet and anticoagulant agents on rebleeding and mortality in patients with gastrointestinal bleeding.

Methods
This was a prospective study of patients admitted with gastrointestinal bleeding between 2013 and 2018. Outcomes were compared among patients on antiplatelet agents only, anticoagulant drugs only, combination therapy, and none. The association between mortality, rebleeding, and type of antithrombotic medication on admission and discharge was determined using multivariate analysis.

Results
A total of 509 patients were followed up for a median of 19 months. End of follow-up rebleeding and mortality rates were 19.4% and 23.0%, respectively. Independent predictors of mortality were age [hazard ratio (HR) = 1.025 per year increase, P = 0.002], higher Charlson Comorbidity Index (HR = 1.4, P < 0.0001), severe bleeding (HR = 2.1, P < 0.0001), and being on anticoagulants (HR = 2.3, P = 0.002). Being on antiplatelets was protective against rebleeding (HR = 0.6, P = 0.047). Those on anticoagulants were more likely to die (HR = 2.5, P < 0.0001) and to rebleed (HR = 2.1, P = 0.01) than those on antiplatelets. Antithrombotic drug discontinuation upon discharge was associated with increased mortality in patients with cardiovascular disease.

Conclusion
In gastrointestinal bleeding, rebleeding and mortality were associated with being on anticoagulant drugs, while being on antiplatelet agents was protective against rebleeding. Discontinuation of antithrombotics upon discharge increased the risk of death. The findings inform risk stratification and decisions regarding continuation or discontinuation of antithrombotics.
A population-based US study of hepatitis C diagnosis rate
Authors: Yeo Yee Hui , Kam Leslie Y. , Le Michael H. , Jeong Donghak , Dang Nolan , Henry Linda , Cheung Ramsey , Nguyen Mindie H. 
Published: April 2021

Background
Underdiagnosis of HCV infection may hinder the obtainment of 2030 elimination goal.

Objective
To estimate the pre-DAA HCV diagnosis rate to inform future public health effort.

Methods
Data were obtained from three nationwide databases (Truven Health MarketScan Research Database 2007–2014, US Census Bureau 2012–2016 and NHANES 2007–2014). HCV diagnosis was defined with either one inpatient or two outpatient HCV International Classification of Disease 9 codes, providing the number of patients with diagnosed HCV (Truven). US Census Bureau data were used for age- and sex-standardization. We derived the total (diagnosed and undiagnosed) HCV infection using the NHANES database. To determine the rate and number of undiagnosed HCV, we subtracted diagnosed HCV burden (Truven) from the total HCV burden (NHANES).

Results
Of the 198 073 302 privately insured Americans, 1.49% (2 951 490 persons) had HCV infection. However, only 362 672 (12.29%) persons were diagnosed with HCV, leaving 2 588 818 (87.71%) undiagnosed. About two-third (68.04%) and one-third (33.04%) of diagnosed HCV patients had HCV RNA or genotype tests overall, with even lower rates for the ≥65 age group, respectively.

Conclusion
In the pre-DAA era, only 12% of insured Americans with HCV were diagnosed. While this grim statistic is expected to rise, much more effort is needed to enhance the HCV care cascade.
Application of machine-learning techniques in classification of HIV medical care status for people living with HIV in South Carolina
Authors: Olatosi Bankole , Sun Xiaowen , Chen Shujie , Zhang Jiajia , Liang Chen , Weissman Sharon , Li Xiaoming 
Published: April 2021

Objectives:
Ending the HIV epidemic requires innovative use of data for intelligent decision-making from surveillance through treatment. This study sought to examine the usefulness of using linked integrated PLWH health data to predict PLWH's future HIV care status and compare the performance of machine-learning methods for predicting future HIV care status for SC PLWH.

Design:
We employed supervised machine learning for its ability to predict PLWH's future care status by synthesizing and learning from PLWH's existing health data. This method is appropriate for the nature of integrated PLWH data because of its high volume and dimensionality.

Methods:
A data set of 8888 distinct PLWH's health records were retrieved from an integrated PLWH data repository. We experimented and scored seven representative machine-learning models including Bayesian Network, Automated Neural Network, Support Vector Machine, Logistic Regression, LASSO, Decision Trees and Random Forest to best predict PLWH's care status. We further identified principal factors that can predict the retention-in-care based on the champion model.

Results:
Bayesian Network (F = 0.87, AUC = 0.94, precision = 0.87, recall = 0.86) was the best predictive model, followed by Random Forest (F = 0.78, AUC = 0.81, precision = 0.72, recall = 0.85), Decision Tree (F = 0.76, AUC = 0.75, precision = 0.70, recall = 0.82) and Neural Network (cluster) (F = 0.75, AUC = 0.71, precision = 0.69, recall = 0.81).

Conclusion:
These algorithmic applications of Bayesian Networks and other machine-learning algorithms hold promise for predicting future HIV care status at the individual level. Prediction of future care patterns for SC PLWH can help optimize health service resources for effective interventions. Predictions can also help improve retention across the HIV continuum.
Estimating the influence of Twitter on pre-exposure prophylaxis use and HIV testing as a function of rates of men who have sex with men in the United States
Authors: Chan Man-pui Sally , Morales Alex , Zlotorzynska Maria , Sullivan Patrick , Sanchez Travis , Zhai Chengxiang , Albarracín Dolores 
Published: April 2021

Objective(s):
Acceptance of pre-exposure prophylaxis (PrEP) and testing for HIV is likely to vary as a function of the norms and communications within a geographic area. This study examined associations involving county tweets, in person communications, and HIV prevention and testing in regions with higher (vs. lower) estimated rates of men who have sex with men (MSM).

Design and Methods:
Ecological analyses examined (a) tweets about HIV (i.e. tweet rates per 100 000 county population and topic probabilities in 1959 US counties); (b) individual-level survey data about HIV prevention and testing and communications about PrEP and HIV (N = 30 675 participants); and (c) estimated county-level MSM rates (per 1 000 adult men).

Results:
In counties with higher rates of MSM, tweet rates were directly associated with PrEP use and HIV testing (rs = .06, BF10 > 10). Topics correlated with PrEP use (rs = −0.06 to 0.07, BF10 > 10) and HIV testing (rs = −0.05 to 0.05, BF10 > 10). Mediation analyses showed that hearing about and discussing PrEP mediated the relations between tweet rates and PrEP use (b

i

∗ = 0.01–0.05, BF10 > 100) and between topics and PrEP use (b

i

∗ = −0.04– 0.05, BF10 > 10). Moreover, hearing about PrEP was associated with PrEP use, which was in turn associated with tweet rates (b

i

∗ = 0.01, BF10 > 100) and topics (b

i

∗ = −0.03 – 0.01, BF10 > 10).

Conclusions:
Rates of MSM appear to lead to HIV tweets in a region, in person communications about PrEP, and, ultimately, actual PrEP use. Also, as more men hear about PrEP, they may use PrEP more and may tweet about HIV.
Testicular microvascular flow is altered in Klinefelter syndrome and predicts circulating testosterone
Authors: Carlomagno Francesco , Pozza Carlotta , Tenuta Marta , Pofi Riccardo , Tarani Luigi , Sesti Franz , Minnetti Marianna , Gianfrilli Daniele , Isidori Andrea M. 
Published: April 2021

ABSTRACTContextExperimental studies on Klinefelter syndrome (KS) reported increased intratesticular testosterone (T) levels coexisting with reduced circulating levels. Abnormalities in testicular microcirculation have been claimed; however, no studies investigated in vivo testicular blood flow dynamics in humans with KS.ObjectiveTo analyze the testicular microcirculation in KS by contrast-enhanced ultrasonography (CEUS) and correlate vascular parameters with endocrine function.Design and SettingProspective study. University Settings.Patients51 testicular scans, 17 testes from 10 T-naïve subjects with KS and 34 testes from age-matched eugonadal men (CNT) who underwent CEUS for incidental nonpalpable testicular lesions.Main OutcomesCEUS kinetic parameters.ResultsCEUS revealed slower testicular perfusion kinetics in subjects with KS than in age-matched CNT. Specifically, the wash-in time (Tin, p = 0.008), mean transit time (MTT, p = 0.008), time to peak (TTP, p < 0.001), and washout time (Tout 50%, p = 0.008) were all prolonged. Faster testicular blood flow was associated with higher total T levels. Principal component analysis and multiple linear regression analyses confirmed the findings, and supported a role for reduced venous blood flow as independent predictor of total T levels.ConclusionsTesticular venous blood flow is altered in KS and independently predicts T peripheral release.
The effect of population mobility restrictive measures on the incidence of SARS-CoV-2 infection in the early phase of the pandemic
Authors: Modelli de Andrade Luis Gustavo , Ferreira Gustavo Fernandes , Tedesco-Silva Helio 
Published: April 2021

AbstractBackgroundThis analysis aims to assess the association between population restrictive measures and the cumulative number of confirmed COVID-19 cases in the early phase of pandemic.MethodsWe compared mobility data extracted from the Mobility Reports provided by Google with the cumulative number of confirmed cases of COVID-19 of 15 countries provided by John Hopkins University. We compered the number of confirmed COVID-19 cases before and after the peak effect (PE) of population mobility restrictions in each country, defined as the highest percent reduction in mobility measurements.ResultsTime to PE of population mobility restrictions ranged between 16 and 45 days after the report of the index COVID-19 confirmed case in each country. The most frequent reductions in activities were retail & recreation, parks, and transit & stations, ranging from 30% to 90%. Despite this variability in PE among the countries, the predicted smooth effect after the PE of population mobility restrictions was observed in almost all countries.ConclusionsThese data suggest that the reduction in mobility was associated with a decrease in the cumulative total number of COVI-19 cases in each country, underscoring that the use of widely available real-time surveillance data might be a valuable resource during this pandemic.
Effect of remedial teaching on academic performance of poorly performing students in Pharmacology
Authors: Modi Sophia B , Bindulatha Nair R , Libu GK 
Published: April 2021

AbstractPurposeSignificant learning difficulties requiring remediation has been observed to be experienced by many medical trainees. Research with regard to individualized remedial teaching based on pedagogical diagnosis is a strong need of the time. The objectives of this study were to assess the effect of remedial teaching in improving academic performance among poorly performing students in Pharmacology and to assess factors that could affect academic performance.MethodThe study was conducted in 2019. Academically poor performing students (< 50 % marks in Pharmacology first sessional exam) were selected after getting informed consent. After obtaining baseline information andStudy skills self-assessment inventoryinformation from all students, academically poor performing students (53 students) were identified and they were randomized into two groups. One group (26 students) received academic support alone. The second group (27 students) received academic support, sessions on study skills, stress-coping strategies and counselling regarding their academic and non-academic problems.ResultsThe improvement in test scores among all participants of remedial sessions was statistically significant. Mean pre-test marks 5.27 ± 3.6 post test 14.63 ± 1.24 and the difference is statistically significant. Though apparently high 10.02 ± 3.25 Vs. 8.59 ± 3.55, the post intervention gain in scores is not statistically significant between Academic support + special package group Vs. Academic support alone group (P value 0.16)ConclusionTailored or individualised remediation measures can greatly enhance the academic performance of undergraduate medical students and help them make satisfactory progress on the course.
Ultra-fast, high throughput and inexpensive detection of SARS-CoV-2 seroconversion
Authors: Conzentino Marcelo S. , Santos Tatielle P. C. , Selim Khaled A. , Wagner Berenike , Alford Janette T. , Deobald Nelli , Paula Nigela. M. , Rego Fabiane G. M. , Zanette Dalila L. , Aoki Mateus N. , Nardin Jeanine M. , Huergo Maria C.C. , Reis Rodrigo A. , Huergo Luciano F. 
Published: April 2021

ABSTRACTA technique allowing high throughput, fast and low-cost quantitative analysis of human IgG antibodies reacting to SARS-CoV-2 antigens will be required to understand the levels of protecting antibodies in the population raised in response to infections and/or to immunization. We described previously a fast, simple, and inexpensive Ni2+magnetic bead immunoassay which allowed detection of human antibodies reacting against the SARS-CoV-2 nucleocapsid protein using a minimal amount of serum or blood. A major drawback of the previously described system was that it only processed 12 samples simultaneously. Here we describe a manually operating inexpensive 96 well plate magnetic extraction / homogenization process which allows high throughput analysis delivering results of 96 samples in chromogenic format in 12 minutes or in fluorescent ultrafast format which takes only 7 minutes. We also show that His tag antigen purification can be performed on the fly while loading antigens to the Ni2+magnetic beads in a process which takes only 12 min reducing the pre analytical time and cost. Finally, we show that the magnetic bead immunoassay is antigen flexible and can be performed using either Nucleocapsid, Spike or Spike RBD. The method performed with low inter and intra assay variability using different antigens and detection modes and was able to deliver >99.5% specificity and >95% sensitivity for a cohort of 203 pre pandemic and 63 COVID-19 positive samples.
SARS-CoV-2 transmission dynamics in Belarus revealed by genomic and incidence data analysis
Authors: Nemira Alina , Adeniyi Ayotomiwa Ezekiel , Gasich Elena L. , Bulda Kirill Y. , Valentovich Leonid N. , Krasko Anatoly G. , Glebova Olga , Kirpich Alexander , Skums Pavel 
Published: April 2021

AbstractSince the emergence of COVID-19, a series of non-pharmaceutical interventions (NPIs) has been implemented by governments and public health authorities world-wide to control and curb the ongoing pandemic spread. From that perspective, Belarus is one of a few countries with a relatively modern healthcare system, where much narrower NPIs have been put in place. Given the uniqueness of this Belarusian experience, the understanding its COVID-19 epidemiological dynamics is essential not only for the local assessment, but also for a better insight into the impact of different NPI strategies globally. In this work, we integrate genomic epidemiology and surveillance methods to investigate the emergence and spread of SARS-CoV-2 in the country. The observed Belarusian SARS-CoV-2 genetic diversity originated from at least eighteen separate introductions, at least five of which resulted in on-going domestic transmissions. The introduction sources represent a wide variety of regions, although the proportion of regional virus introductions and exports from/to geographical neighbors appears to be higher than for other European countries. Phylodynamic analysis indicates a moderate reduction in the effective reproductive number ℛe after the introduction of limited NPIs, with the reduction magnitude generally being lower than for countries with large-scale NPIs. On the other hand, the estimate of the Belarusian ℛe at the early epidemic stage is comparable with this number for the neighboring ex-USSR country of Ukraine, where much broader NPIs have been implemented. The actual number of cases by the end of May, 2020 was predicted to be 2-9 times higher than the detected number of cases.
Mortality reduction in ICU-admitted COVID-19 patients in Suriname after treatment with convalescent plasma acquired via gravity filtration
Authors: Bihariesingh-Sanchit R. , Bansie R. , Fröberg J. , Ramdhani N. , Mangroo R. , Bustamente D. , Diaz E. , Thakoer I. , Vreden S. , Choudhry Z. , Jansen Klomp W. , Diavatopoulos D.A. , Nierich A. 
Published: April 2021

AbstractBackgroundAlthough convalescent plasma (CP) treatment is a potential therapeutic option for patients with COVID-19, there is a paucity of data from studies in low-resource settings. The efficacy and safety of CP therapy in intensive care unit (ICU) patients with COVID-19 in Suriname was evaluated. A novel gravity-based filtration method was used to obtain CP. The design was an open-label, multi-centre, non-randomized prospective clinical trial performed in two hospitals in Suriname, from June 2020, to December 2020. A pre-planned interim analysis is reported in 78 PCR-confirmed COVID-19 patients admitted to the ICU with severe or life-threatening symptoms. CP in combination with standard treatment (n = 28) was compared to standard treatment alone (control) (n = 50), stratified by disease severity. The primary endpoint was 28-day ICU mortality. Secondary (exploratory) endpoints were changes two days after treatment initiation in pulmonary oxygen exchange capacity (PF ratio) and chest x-ray (CXR) score.FindingsThe median age of patients was 52 years with 43 [55.1%] being male. Twenty-eight day mortality occurred in 18% (5/28) of the CP group vs 36% (18/50) of the control group. Survival probability was significantly higher in the CP group compared to the control group with standard care (P=0.027). When stratifying into disease severity, the survival probability was the lowest for the control group with life-threatening disease (P=0.0051). CP treatment of severe COVID-19 resulted in a higher probability of survival, with a hazard ratio (HR) of 0.22 (95% CI, 0.074-0.067), correcting for age, the presence of diabetes and COVID-19 severity. Age significantly increased the mortality risk (HR, 1.08 [95%CI, 1.022-1.14]; P = 0.006). In the severe group, CP resulted in an improved CXR score (P =0.0013) and increase in PF ratio (P = 0.011) as compared to standard therapy. The gravity-based plasmapheresis method used for CP production was well-tolerated and no adverse events were observed in the donors.InterpretationAmong patients with severe or life-threatening COVID-19, CP therapy in combination with standard treatment resulted in 78% reduction of 28-day ICU mortality (HR = 0.22) compared to standard treatment alone. Both CXR-score and PF ratio changes represent indicators of treatment effect of CP after two days and can easily be implemented in low-resource settings. The novel CP production method was effective and represents a practical solution for low- and middle income countries (LMICs) to produce CP locally. Although interpretation is limited by the non-randomized design of the trial, these results offer a potential route for broader implementation of CP treatment in LMICs.FundingThis study was funded by the Academic Hospital Paramaribo, without additional third-party funding.