bluuebunny/crossref_metadata_2025_split huggingface dataset:
Catheter-Directed Thrombolytic Therapy in the Management of Massive Pulmonary Embolism in Pregnancy
Authors: Gowda Niraj , Nwabuobi Chinedu K. , Louis Judette M. 
Published: October 2019

BACKGROUND:
Pulmonary embolism is one of the most common causes of maternal mortality and can be classified into low-risk, submassive, and massive. Three treatment options exist for massive pulmonary embolism in nonpregnant patients: thrombolysis, percutaneous catheter-based embolectomy, or surgical embolectomy; however, there is limited evidence to guide management of pulmonary embolism in pregnancy.

CASE:
We present a case of massive pulmonary embolism in pregnancy. Our patient presented with pulmonary embolism with biomarker and imaging evidence of right heart strain. She developed hypotension and an increased oxygen requirement and was subsequently treated with ultrasound-assisted catheter-directed thrombolysis. She was discharged on low-molecular-weight heparin and had a normal spontaneous vaginal delivery at 39 weeks of gestation.

CONCLUSIONS:
Catheter-directed thrombolysis is preferred to systemic thrombolytic therapy in pregnant patients with massive pulmonary embolism requiring thrombus removal.
Patient Reported Outcomes: The Foundation of Value
Authors: Tatman Lauren MacCormick , Obremskey William T. 
Published: October 2019

Summary:
As we transition from volume-based to value-based health care, orthopedic surgeons must understand the role of outcomes in measuring value. Patient-reported outcomes (PROs) offer a number of advantages in orthopedic trauma compared with traditional clinical and radiographic results while also being an important indicator of the patient's perception of their condition. Patient-Reported Outcomes Measurement Information System, developed and funded by the National Institutes of Health, has a number of features that make PRO date collection less burdensome for providers and patients. Patient-specific factors, including comorbidities, mental health, social support, and preinjury function need to be accounted for in our assessment, because all of these factors have demonstrated an impact on outcomes. Orthopedic surgeons should be aware of how they can transition their practice in an era of value-based health care in a manner that will benefit their patients and provide insight into their own clinical practice. Prospective collection of PROs is no longer limited to academic surgeons conducting research, and all orthopedic surgeons should consider incorporating PROs into their daily clinical practice. Orthopedic surgeons must maintain an active role in the development of policies and reimbursement models to advocate for and serve our patients.
Orthopaedic Trauma in Low‐resource Settings: Measuring Value
Authors: Ali Syed H. , Albright Patrick , Morshed Saam , Gosselin Richard A. , Shearer David W. 
Published: October 2019

Summary:
There is increasing recognition of both the impact and value of trauma care in low- and middle-income countries (LMICs). However, data supporting the value of musculoskeletal trauma care specifically are lacking. This review discusses methods of economic analysis relevant to low-resource settings and provides a review of cost studies related to orthopaedic trauma care in these settings. In general, microcosting methods are preferred in LMICs because of the lack of databases with aggregate cost data. It is important that studies use a societal perspective that includes the indirect costs of treatment in addition to direct costs of medical care. Cost-effectiveness studies most commonly report cost per disability-adjusted life year, particularly in LMICs, but quality-adjusted life years are an acceptable alternative that is based on more empiric data. There are solid economic data supporting potential cost savings and improved outcomes with intramedullary nailing for femoral shaft fractures. Trauma care hospitals and educational initiatives have also been found to be highly cost-effective. However, very little data exist to support other interventions in orthopaedic trauma. Orthopaedic surgeons should strive to understand these methodologies and support the conduct of rigorous economic analysis to better establish the value of musculoskeletal trauma care in LMICs.
Pattern-Specific Loss of Desmoplakin I and II Immunoreactivity in Erythema Multiforme and its Variants: A Possible Aid in Histologic Diagnosis
Authors: Forrester Vernon J. , Tran Benjamin , Hein Stephanie C. , Wick Mark R. 
Published: October 2019

Abstract:
Erythema multiforme (EM), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) comprise a family of mucocutaneous diseases associated with significant morbidity and mortality. Previous studies have confirmed the presence of autoantibodies to desmoplakin (Dp) I and II in patients with EM, SJS, and TEN. Truncated Dp production leads to characteristic changes visible on light microscopy: perinuclear clumping of keratin filaments and dyskeratotic keratinocyte. Based on these observations, the question arises as to whether a loss of Dp immunoreactivity in skin biopsies could serve as a diagnostic marker of EM, SJS, and TEN. This study analyzed Dp immunostaining patterns in 20 patients with EM or SJS/TEN. To assess the specificity of this approach, Dp immunostaining was also performed on specimens from patients with 5 potential histologic mimics of EM, SJS, and TEN. All of the samples from patients with EM, SJS, and TEN demonstrated absent or markedly diminished staining for Dp. A χ2 test demonstrated a statistically significant difference between the staining patterns in EM, SJS, and TEN and each of the other diagnostic groups that were investigated. This is the first report demonstrating statistically significant specificity of Dp staining patterns in EM/SJS/TEN as compared with other interface dermatitides.
Perianal Tuberculosis: Lessons Learned in 57 Patients From 743 Samples of Histopathology and Polymerase Chain Reaction and a Systematic Review of Literature
Authors: Garg Pankaj , Garg Mahak , Das B. R. , Khadapkar Rashmi , Menon Geetha R. 
Published: October 2019

BACKGROUND:
Few data are published on perianal tuberculosis.

OBJECTIVE:
This study aimed to determine the best method to diagnose tuberculosis in patients with fistula-in-ano and to conduct a systematic review to determine the incidence and characteristics of tuberculosis fistula-in-ano.

DATA SOURCES:
The prospective study data and existing literature were derived from PubMed, Google scholar, and Scopus

STUDY SELECTION:
Prospective analysis of patients with tuberculous fistula-in-ano treated between 2014 and 2018 was conducted, and a systematic review of studies describing ≥3 patients with tuberculosis fistula-in-ano was completed.

INTERVENTION:
Testing of tuberculosis was performed by histopathology or polymerase chain reaction of tissue or pus from the fistula tract.

MAIN OUTCOME MEASURES:
The primary outcomes measured were the detection rate of various tests to detect tuberculosis in fistula-in-ano and the prevalence rate of tuberculosis in simple versus complex fistulas.

RESULTS:
In 637 samples (410 patients) tested, tuberculosis was detected in 49 samples (43 patients). Additional samples (n = 106) sent in patients with a high index of suspicion tested positive in 14 more patients. Thus, overall, 63 samples tested positive in 57 patients (total: 743 samples in 410 patients were tested). Tuberculosis was detected in 2 of 181 patients (1.1%) in tissue (histopathology), in 28 of 341 patients (8.2%) in tissue (polymerase chain reaction), and in 19 of 115 patients (16.5%) in pus (polymerase chain reaction) samples. To detect tuberculosis, tissue (polymerase chain reaction) was significantly better than tissue (histopathology) (28/341 vs 2/181, p < 0.00001) and pus (polymerase chain reaction) was significantly better than tissue (polymerase chain reaction) (19/115 vs 28/341, p < 0.0009). Tuberculosis was significantly more common in complex fistulas than in simple fistulas (20.3% vs 7.2%, p = 0.0002). The systematic review (n = 199) highlighted that tubercular fistulas are more common in recurrent and complex fistulas and in tuberculosis endemic regions.

LIMITATIONS:
The true sensitivity and specificity of each testing modality could not be determined because not all patients with tuberculosis fistula-in-ano were tested by every diagnostic modality studied.

CONCLUSIONS:
The tuberculosis detection rate of polymerase chain reaction was significantly higher than histopathology. Among polymerase chain reaction, pus had higher detection rate than tissue. Tuberculosis was associated with more complex and recurrent fistulas.
Using Digital Phenotyping to Accurately Detect Depression Severity
Authors: Jacobson Nicholas C. , Weingarden Hilary , Wilhelm Sabine 
Published: October 2019

Abstract
Development of digital biomarkers holds promise for enabling scalable, time-sensitive, and cost-effective strategies to monitor symptom severity among those with major depressive disorder (MDD). The current study examined the use of passive movement and light data from wearable devices to assess depression severity in 15 patients with MDD. Using over 1 week of movement data, we were able to significantly assess depression severity with high precision for self-reported (r = 0.855; 95% confidence interval [CI], 0.610–0.950; p = 4.95 × 10−5) and clinician-rated (r = 0.604; 95% CI, 0.133–0.894; p = 0.017) symptom severity. Pending replication, the present data suggest that the use of passive wearable sensors to inform healthcare decisions holds considerable promise.
Changes in β-Catenin Expression in the Anterior Vaginal Wall Tissues of Women With Pelvic Organ Prolapse: A Potential Pathophysiological Mechanism
Authors: Gong Runqi , Ji Yuting , Zhao Ying , Xia Zhijun 
Published: October 2019

Objectives
The purpose of this study was to investigate the expression of β-catenin in the lamina propria of the anterior vaginal wall of women with pelvic organ prolapse (POP) compared with the expression in the controls.

Methods
Anterior vaginal wall tissues were obtained from women undergoing POP surgery for stage 3 or greater POP (POP group, n = 30; age, 58 ± 7.839 years), with a menopause rate of 70%, and from women without POP undergoing hysterectomy for benign indications (control group, n = 30; age, 54.7 ± 7.173 years), with a menopause rate of 50%. Hematoxylin and eosin staining and Masson trichrome staining were performed on anterior vaginal wall sections. β-Catenin, p-β-catenin, glycogen synthase kinase 3β (GSK3β), p-GSK3β, collagen I, collagen III, MMP2, MMP9, TIMP2, caspase 3, proliferating cell nuclear antigen, and cyclin D1 were evaluated using immunohistochemical analysis. Lamina propria tissues were obtained for Western blot analyses.

Results
Hematoxylin and eosin staining and Masson trichrome staining showed that the collagen fibers were more disorganized and fragmented in the POP group than in the control group. In the POP samples, β-catenin (mean density, POP vs control, 0.43 ± 0.13 vs 0.58 ± 0.16), p-GSK3β, collagen I, collagen III, proliferating cell nuclear antigen, and cyclin D1 were downregulated in the lamina propria, whereas in the control group, p-β-catenin, TIMP2, and caspase 3 were downregulated (P < 0.05 for all). GSK3β was not different between the 2 groups (P > 0.05).

Conclusion
We demonstrated that decreased β-catenin may play an important role in the onset of POP by affecting collagen anabolism.
Peer-Centered Versus Standard Physician-Centered Video Counseling for Midurethral Sling Surgery: A Randomized Controlled Trial
Authors: Krantz Tessa E. , Rogers Rebecca G. , Petersen Timothy R. , Dunivan Gena C. , White Amanda B. , Madsen Annetta M. , Jeppson Peter C. , Ninivaggio Cara S. , Cichowski Sara B. , Komesu Yuko M. 
Published: October 2019

Objectives
Peer counseling may improve upon provider counseling and enhance patient preparedness for midurethral sling (MUS) surgery. We aimed to compare the impact of peer-centered versus standard preoperative video counseling by assessing patient preparedness for MUS surgery.

Methods
Women undergoing MUS were randomized to view either a peer-centered (PEER) or standard physician preoperative counseling video (PHYS). The PEER video featured a woman who had undergone MUS surgery and included the standard risks and benefits as well as additional information identified in prior work as important to patients. The PHYS video featured a surgeon discussing risks and benefits. Patients viewed either video at their preoperative visit and completed the Patient Preparedness Questionnaire (PPQ), Surgical Decision Satisfaction, Decisional Regret Scale, and the Urogenital Distress Inventory Short Form. Patients then underwent standard in-person surgeon counseling. Sessions were timed and compared with historical timed sessions. Our primary outcome was between-group differences in 6-week postoperative PPQ scores.

Results
Patient Preparedness Questionnaire scores did not differ between groups (postoperative PPQ scores: median [interquartile range], 95 [84, 100] vs 92 [80, 100]; P=0.50). The PEER group reported higher decisional regret (15 [0, 28.75] vs 0 [0, 10], P=0.02) and less symptom improvement on Urogenital Distress Inventory Short Form change scores compared with the PHYS group (47.2 [37.2, 62.5] vs 36.1 [16.5, 50], P=0.03); secondary outcomes were not different between groups. In-person counseling times decreased after watching either video compared with the institution’s historical standard (8:27 minutes [08:56, 17:14] vs 11:34 minutes [5:22, 13:07]; P < 0.005).

Conclusion
Patient preparedness did not differ between groups. Decision regret did not differ between groups once adjusted for urinary symptoms.
Engaging Women in Pelvic Floor Disorders Research Using the Internet
Authors: Pandya Lopa K. , Hundley Andrew F. , Hudson Catherine O. , Nekkanti Silpa , Escobar Smith Pamela , Lynch Courtney D. 
Published: October 2019

Objectives
The objective of this study were (1) to assess the feasibility of using online platforms as recruitment tools for pelvic floor disorder studies and (2) to compare the prevalence of symptoms of incontinence and care-seeking behavior by online platform to previously published prevalence estimates.

Methods
We conducted a cross-sectional study among women to assess the prevalence of incontinence symptoms, level of bother, and care-seeking behavior. Participants were recruited through Facebook ads, ResearchMatch, or Reddit. The effectiveness of Facebook ads was assessed using the click through rate and an overall completion rate (number of completes over number of times an ad was shown). A nontargeted ad was posted to a Reddit thread in which research opportunities are advertised. For ResearchMatch, investigators sent a recruitment email. Effectiveness of this method was assessed by observing how many women completed the survey compared with the number of women who received it.

Results
Among the 7361 women who initiated the questionnaire, 6650 (90%) completed it. A majority of participants were recruited through ResearchMatch. Online platforms were successful in recruiting women across a wide age range (ages, 18–93 years). The overall prevalence of incontinence was 46.1% with women 45 years and older having the highest prevalence (64.6%). Common reasons for not seeking care included “not bothersome enough,” “other health problems,” and “being unsure about treatment.”

Conclusions
Internet-based recruitment was found to be feasible. The prevalence of incontinence was higher than has been reported in other population-based samples. Significant barriers to care exist, and further studies should focus on educational strategies.
Identification of the lymphangioleiomyomatosis cell and its uterine origin
Authors: Guo Minzhe , Yu Jane J. , Perl Anne Karina , Wikenheiser-Brokamp Kathryn A. , Riccetti Matt , Zhang Erik Y. , Sudha Parvathi , Adam Mike , Potter Andrew , Kopras Elizabeth J. , Giannikou Krinio , Potter S Steven , Sherman Sue , Hammes Stephen R. , Kwiatkowski David J. , Whitsett Jeffrey A. , McCormack Francis X. , Xu Yan 
Published: October 2019

SUMMARYLymphangioleiomyomatosis (LAM) is a metastasizing neoplasm of reproductive age women that causes cystic lung remodeling and progressive respiratory failure. The source of LAM cells that invade the lung and the reasons that LAM targets women have remained elusive. We employed single cell and single nuclei RNA sequencing on LAM lesions within explanted LAM lungs, known to contain smooth muscle like cells bearing mTOR activating mutations in TSC1 or TSC2, and identified a unique population of cells that were readily distinguished from those of endogenous lung cells. LAMCOREcells shared closest transcriptomic similarity to normal uterus and neural crest. Immunofluorescence microscopy demonstrated the expression of LAMCOREcell signature genes within LAM lesions in both lung and uterus. Serum aptamer proteomics and ELISA identified biomarkers predicted to be secreted by LAMCOREcells. Single cell transcriptomics strongly supports a uterine neural crest origin of LAMCOREcells; providing insights into disease pathogenesis and informing future treatment strategies for LAM.SIGNIFICANCEPresent study identified a novel population of LAMCOREcells, which is likely originated from uterine neural crest; identified novel LAM cell-specific secretome proteins that hold promise as potential biomarkers and therapeutic targets. Advancing the understanding of LAM pathogenesis and metastasis model may yield broader insights into the biology of cancer.
The Impact of Glyphosate-Based Herbicides and Their Components on Daphnia Magna
Authors: Duan Katherine , Kish Alexander , Kish Leanna , Faletra Peter , Salmon Kelly 
Published: October 2019

AbstractRecent studies suggest glyphosate-based herbicides (GBHs) are more harmful to animals than suggested by the EPA and industry-funded studies. Both glyphosate and the only known “other” ingredient in GBHs, polyethoxylated tallow amine (POEA), have been implicated as safety hazards. In this study, we investigated the effects of the commercial GBHs Roundup®, Rodeo® and the two known GBH ingredients, POEA and glyphosate, on the survival and heart rates of Daphnia magna. D. magna were exposed to the retail herbicide mixture and the individual components dissolved in water to mimic possible environmental exposure. When exposed to Roundup® and Rodeo®, D. magna survival and heart rates declined following a dose-response pattern. A commercial formulation of Roundup® containing 98% unlisted ingredients had the greatest effect on heart and survival rates, followed by two formulations of Rodeo with 4.62% unlisted ingredients and 1.72% unlisted ingredients, respectively. The Rodeo® formulation with 1.72% unlisted ingredients had an equal concentration of glyphosate as the Roundup® formulation, suggesting that the negative effects of GBHs are influenced by the unlisted ingredients. Although differences in survival rates were not observed between controls and glyphosate groups, groups exposed to glyphosate alone generally showed a significant (p<0.05) effect on D. magna heart rates. Heart rates following POEA exposure were consistently and, in most cases, significantly (p<0.05) lower than controls. POEA caused a decrease in survival rate for all concentrations, but followed a dose-response pattern only in the three highest concentrations. A Mock-GBH, made with POEA and glyphosate, significantly (p<0.05) lowered heart rates at some higher concentrations, with no dose-response pattern. The Mock-GBH negatively affected survival rates at approximately the same level as POEA alone. The heart rate data suggest that there are undisclosed ingredients in Roundup® and Rodeo® other than POEA and glyphosate that negatively affect D. magna since glyphosate and POEA combined yielded less pronounced negative responses than the full GBH products.
The Future of OA: A large-scale analysis projecting Open Access publication and readership
Authors: Piwowar Heather , Priem Jason , Orr Richard 
Published: October 2019

SummaryUnderstanding the growth of open access (OA) is important for deciding funder policy, subscription allocation, and infrastructure planning.This study analyses the number of papers available as OA over time. The models includes both OA embargo data and the relative growth rates of different OA types over time, based on the OA status of 70 million journal articles published between 1950 and 2019.The study also looks at article usage data, analyzing the proportion of views to OA articles vs views to articles which are closed access. Signal processing techniques are used to model how these viewership patterns change over time. Viewership data is based on 2.8 million uses of the Unpaywall browser extension in July 2019.We found that Green, Gold, and Hybrid papers receive more views than their Closed or Bronze counterparts, particularly Green papers made available within a year of publication. We also found that the proportion of Green, Gold, and Hybrid articles is growing most quickly.In 2019:
31% of all journal articles are available as OA52% of article views are to OA articlesGiven existing trends, we estimate that by 2025:
44% of all journal articles will be available as OA70% of article views will be to OA articlesThe declining relevance of closed access articles is likely to change the landscape of scholarly communication in the years to come.
Percent of views, by OA type:
Percent of papers, by OA type:
An NMDA-R mediated short-term memory resistant to anesthesia in adult Danio rerio
Authors: Rajan Gokul , Joseph Joby 
Published: October 2019

ABSTRACTMemory in animals is labile in the early phase post-training. Memory in the early phase has been shown to be disrupted by treatments such as electroconvulsive shock or cold-shock (Quinn and Dudai, 1976). Using hypothermic shock and other pharmacological interventions, the various underlying memory pathways in Drosophila can be identified as an immediate short-lasting anesthesia sensitive memory and a delayed anesthesia resistant memory which is followed by a more stable protein synthesis dependent long-term memory (Margulies et al., 2005). In another ectothermic animal, Danio rerio, a popular vertebrate model, we ask if such a memory component exists which is sensitive to hypothermic disruption. To test this, we developed a fear conditioning assay with a green light at the bottom of the tank as the conditioned stimulus (CS) and electric shock as the unconditioned stimulus (US). We also standardized a cold anesthesia protocol in adult zebrafish to induce stage V anesthesia. The learning/memory was found to be NMDA-R mediated. Cold anesthesia as well as tricaine mediated anesthesia did not significantly affect the early-acting memory trace induced by a fear-conditioning protocol in adult zebrafish. We suggest future directions to tease out the underlying memory components in the early phase of memory in zebrafish.