bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of 2 Novel Sustained-release Drug Release Systems on Bleb Fibrosis: An In Vivo Trabeculectomy Study in a Rabbit Model
Authors: Swann Forrest B. , Singh Sujata , Blake Diane , John Vijay , Le Crystal , Fullerton Mitchell , Margo Curtis , Zhang Ze , Muddasani Nishika , Wall Jennifer , Satija Celine , Greenberg Erin , Mancera Norberto , Zurakowski David , Ayyala Ramesh S. 
Published: February 2019

Precis:
Rabbit model studies suggested better morphology blebs with equal intraocular pressure (IOP) efficacy as a standard mitomycin C (MMC) trabeculectomy using a novel slow-release drug delivery antifibrotic system delivering small quantities of MMC and 5-fluorouracil (5-FU).

Purpose:
To evaluate 2 different concentrations of biodegradable poly(lactic-co-glycolic acid) (PLGA) system with 5-FU and MMC (ElutiGLASS) for their ability to reduce fibrosis and compare the results with standard trabeculectomy with MMC in a rabbit model.

Materials and Methods:
New Zealand albino rabbits (19) were divided into 3 groups (A, B, C) and standard trabeculectomy operation was performed in the right eye of each rabbit.
Group (A) had trabeculectomy with MMC (0.4 mg/mL) applied using a Weck cell sponge; (B) trabeculectomy with slow-release ElutiGLASS (0.23 mg, 5-FU/0.33 μg MMC released over 23 to 30 d); (C) trabeculectomy with rapid release ElutiGLASS (0.45 mg of 5-FU/0.65 μg MMC, released over 5 to 7 d). The rabbits were followed for 3 months before euthanasia.

Results:
Bleb morphology, vascularity, and fibrosis were less pronounced in groups B and C when compared with group A at 3 months. Group B appears to have a lower and more diffuse bleb appearance compared with the other 2 groups with honeycomb appearance on both clinical examination and ultrasound biomicroscopy imaging with higher percentage of maintained bleb space (83%), less fibrosis than group A while maintaining the same low inflammation score as the other 2 groups on histology. At 3 months, the PLGA polymer had completely disappeared in all rabbits. There were no statistical differences in the degree of IOP reduction or histologic inflammation, among the 3 groups.

Conclusions:
We successfully created a sustained-release antifibrotic drug delivery system that delivered known dosage of the drugs at doses that are significantly lower than the current standard, and resulted in less fibrosis while maintaining a healthy bleb and equal reduction of IOP.

Translational Relevance:
These results are supportive of the antifibrotic effect of the slow-release drug delivery system used in conjunction with trabeculectomy, thus paving the way for human pilot studies to improve and simplify existing surgical techniques for filtering surgeries in glaucoma.
The Louisiana Wellness Centers Program for HIV/STD Prevention Among Gay and Bisexual Men and Transgender Persons
Authors: Burgess Samuel , Beltrami John , Kearns Laura , Gruber DeAnn 
Published: February 2019

Context:
During the conduct of the described demonstration project (2012-2015), the Centers for Disease Control and Prevention funding standard for HIV testing was 1.0% newly diagnosed positivity in non-health care settings. For linkage to HIV medical care, the National HIV/AIDS Strategy goal was 85%, and the funding standard was 80% (the Centers for Disease Control and Prevention and National HIV/AIDS Strategy had no other quantified goals/standards relevant to the project).

Objective:
To determine aggregate quantitative results of HIV/STD testing and engagement in HIV care.

Design:
Information sources used for this case study analysis included the Louisiana Department of Health funding application, progress and final reports submitted to the Centers for Disease Control and Prevention, and records of communications between these agencies.

Setting:
Six community-based Wellness Centers throughout Louisiana.

Participants:
Gay and bisexual men and transgender persons.

Main Outcome Measures:
New HIV/STD diagnoses from testing, linkage to HIV care, and reengagement in HIV medical care.

Results:
The percentage of persons who were newly diagnosed with HIV was 1.4% (44/3214). Of the newly diagnosed persons, 91% (40/44) were linked to HIV medical care. Of persons who were identified as out of care, 83% (5/6) were reengaged in HIV medical care. STD testing results showed that 9.0% (294/3251) of the syphilis tests were positive, and 8.3% (803/9719) of the chlamydia/gonorrhea tests were positive. The pharyngeal chlamydia/gonorrhea positivity was 7.6% (256/3375); the rectal chlamydia/gonorrhea positivity was 13% (374/2948); and the urine chlamydia/gonorrhea positivity was 5.1% (173/3396).

Conclusions:
The demonstration project was successful. The results were used to discontinue funding for a less effective HIV screening program, continue demonstration project activities with other funds, and make policy changes so that extragenital screening for chlamydia/gonorrhea is now the standard at Louisiana clinics that serve gay and bisexual men and transgender persons.
Hyaluronic Acid–Povidone-Iodine Compound Facilitates Diabetic Wound Healing in a Streptozotocin-Induced Diabetes Rodent Model
Authors: Chen Rong-Fu , Wang Chun-Ting , Chen Yu-Hua , Chien Ching-Ming , Lin Sin-Daw , Lai Chung-Sheng , Wang Ching-Jen , Kuo Yur-Ren 
Published: February 2019

Background:
This study investigated whether a hyaluronic acid–povidone-iodine compound can enhance diabetic wound healing.

Methods:
A dorsal skin defect (6 × 5 cm) in a streptozotocin-induced diabetes rodent model was used. Seventy male Wistar rats were divided into seven groups: I, normal control; II, diabetic control, no treatment; III, diabetic rats, lower molecular weight (100 kDa) hyaluronic acid; IV, rats, higher molecular weight (1000 kDa) hyaluronic acid; V, rats, 0.1% povidone-iodine; VI, rats, lower molecular weight hyaluronic acid plus povidone-iodine; and VII, rats, higher molecular weight hyaluronic acid plus povidone-iodine. Histologic examination was performed with hematoxylin and eosin staining. CD45, Ki-67, prolyl 4-hydroxylase, and vascular endothelial growth factor were evaluated with immunohistochemical staining.

Results:
Compared with the control, higher molecular weight hyaluronic acid plus povidone-iodine–treated rats had significantly reduced wound area (p < 0.001). Higher molecular weight hyaluronic acid plus povidone-iodine increased wound healing time when compared with higher molecular weight hyaluronic acid, povidone-iodine, or lower molecular weight hyaluronic acid plus povidone-iodine. Histology revealed significantly increased neovessels and suppressed inflammatory response in the higher molecular weight hyaluronic acid plus povidone-iodine group when compared with the control group. Immunohistochemical staining revealed significantly increased Ki67, prolyl 4-hydroxylase, and vascular endothelial growth factor expression, and suppressed CD45 expression in the higher molecular weight hyaluronic acid plus povidone-iodine group when compared with the other groups.

Conclusion:
Higher molecular weight hyaluronic acid plus povidone-iodine complex dressing significantly facilitated diabetic wound healing via increasing neovascularization and tissue regeneration and suppressing a proinflammatory response.
Reshaping the Oversized Waist through Oblique Flankplasty with Lipoabdominoplasty
Authors: Hurwitz Dennis J. , Beidas Omar , Wright Lauren 
Published: February 2019

Background:
Designed in response to the failure of circumferential lower body lifts to deepen waists, oblique flankplasty with lipoabdominoplasty aesthetically reshapes not only the waist, but also the hips, buttocks, and upper lateral thighs with minimal morbidity.

Methods:
The oblique flankplasty with lipoabdominoplasty technique was standardized, with 5 of 56 cases presented. Operative records on the lower torso from March of 2000 to January of 2018 yielded 30 initial oblique flankplasty with lipoabdominoplasty cases and hundreds of lower body lifts. A subset of randomly selected lower body lift and flank liposuction operations yielded 91 cases. Through SurveyMonkey, the authors and 16 unbiased observers graded flank and global deformity using the Pittsburgh Rating and novel posterior trunk aesthetics scales.

Results:
The oblique flankplasty with lipoabdominoplasty deepened and smoothly transitioned waists. Medial rotation of the lateral buttocks over the posterior iliac spine retained lateral fullness and established hip prominence. Central buttock laxity was corrected without intergluteal cleft lengthening. The immediate result persisted, satisfying high patient expectations. There were three minor complications and three nonexcisional revisions, with no unscheduled hospital admissions. The mean flank deformity for all cases was 1.93 was by chi-square analysis, which was significantly more than 0.88 for postoperative deformity (p < 0.001). Subgroup analysis of each procedure group showed a significant reduction in deformity. Comparing flankplasty with lower body lift, oblique flankplasty with lipoabdominoplasty had slightly greater flank deformity and far greater reduction in deformity and overall aesthetic improvement.

Conclusions:
For grade 2 and 3 flank deformities, oblique flankplasty with lipoabdominoplasty provides a tighter skinned lower torso with gender-appropriate curvatures, including a deeper and more smoothly transitioned waist than lower body lift, leading to uniform patient satisfaction. There was minimal secondary deformity or complications.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Maintaining Updated Patient’s Medication Records: Introduction of an Order-on-Behalf Service by Pharmacists
Authors: Chen Chunliang , Hie Szu Liang , Ng Ai Shing 
Published: February 2019

Introduction
Accurate medication records are integral to healthcare, especially for obstetrics and gynecology and pediatric patients. When pharmacists perform verbal interventions with prescribers, these were often not updated in the patients’ medication records. To address this issue, the order-on-behalf (OOB) service by pharmacists was implemented in late November 2015, with the aim of providing timely updates of patients’ medication records. The impact of service will be evaluated in this article.

Methods
The OOB records from December 2015 to April 2017 were collected and reviewed. Details collected include patient type, date performed, date of prescription, and details of interventions. Respective pharmacists who entered the orders were approached for further clarifications, where required. This was a process improvement project exempted from review.

Results
A total of 1501 entries (824 for women, 677 for children) were reviewed. Top three medication-related problems identified were inappropriate dosage regimen (845), improper drug selection (185), and therapeutic substitution (226). The most commonly implicated drugs were hormones (28%) and antibiotics (18%) for obstetrics and gynecology–related entries and antibiotics (27%) and antiepileptic drugs (6%) for pediatric-related entries.

Conclusions
The OOB service has updated many patients’ medication records. Having updated records enhances patient safety because it provides the most accurate information for the prescribers at the next patient visit. Review of OOB data identified the most common types of medication-related problems, as well as the patient subtypes involved. This provides a platform for future work to be performed on system optimizations to improve patient safety.
Evaluation of Opioid Prescriptions After Urogynecologic Surgery Within a Large Health Care Organization: How Much Are We Prescribing?
Authors: Buono Kristen , Brueseke Taylor , Wu Jun , Whitcomb Emily 
Published: February 2019

Objectives
Data regarding postoperative opioid prescriptions for patients undergoing urogynecologic surgery are sparse. Our objective was to quantify surgeon prescribing patterns for patients undergoing surgery for pelvic organ prolapse or stress urinary incontinence.

Methods
Patients who underwent surgery for pelvic organ prolapse or SUI within a large health care maintenance organization were identified by procedural codes within the electronic medical record. Medical records were reviewed for demographic and clinical data. Our primary objective was to describe initial postoperative morphine milligram equivalent (MME) dosages for patients undergoing various urogynecologic surgeries. Secondary objectives were to evaluate rates of postoperative non-opioid analgesic prescriptions, presence of additional postoperative opioid prescriptions within 90 days of surgery, and to characterize prescribing patterns of surgeons from different specialties.

Results
We evaluated 855 patients undergoing 7 urogynecologic surgeries. There was wide variation in the quantity of MME prescribed to patients undergoing different urogynecologic surgeries, and the mean MME ranged from 137.6 mg after a colpocleisis to 214.1 mg after a laparoscopic uterosacral ligament suspension. Less than two thirds of patients received a postoperative nonsteroidal anti-inflammatory drug (NSAID) prescription, and rates of NSAID prescriptions varied widely between surgeons from different specialties. Thirty-nine (4.6%) patients received an additional postoperative opioid prescription specifically for the indication of persistent postoperative pain.

Conclusions
There is wide variation in the range of MME prescribed postoperatively to patients undergoing common urogynecologic surgeries. Less than two thirds of patients received a postoperative NSAID prescription, which was found to be independently associated with a higher postoperative opioid prescription dose.
Rigidity for sticky discs
Authors: Connelly Robert , Gortler Steven J. , Theran Louis 
Published: February 2019

We study the combinatorial and rigidity properties of disc packings with generic radii. We show that a packing of
n
discs in the plane with generic radii cannot have more than 2
n
− 3 pairs of discs in contact. The allowed motions of a packing preserve the disjointness of the disc interiors and tangency between pairs already in contact (modelling a collection of sticky discs). We show that if a packing has generic radii, then the allowed motions are all rigid body motions if and only if the packing has exactly 2
n
− 3 contacts. Our approach is to study the space of packings with a fixed contact graph. The main technical step is to show that this space is a smooth manifold, which is done via a connection to the Cauchy–Alexandrov stress lemma. Our methods also apply to jamming problems, in which contacts are allowed to break during a motion. We give a simple proof of a finite variant of a recent result of Connelly
et al.
(Connelly
et al
. 2018 (
http://arxiv.org/abs/1702.08442
)) on the number of contacts in a jammed packing of discs with generic radii.
AutoCryoPicker: An Unsupervised Learning Approach for Fully Automated Single Particle Picking in Cryo-EM Images
Authors: Al-Azzawi Adil , Ouadou Anes , Tanner John J. , Cheng Jianlin 
Published: February 2019

AbstractBackgroundAn important task of macromolecular structure determination by cryo-electron microscopy (cryo-EM) is the identification of single particles in micrographs (particle picking). Currently, particle picking is laborious, time consuming, and potentially biased due to the need of human intervention to initialize the particle picking. The results typically include many false positives and negatives. Adjusting the parameters to eliminate false positives often excludes true particles in certain orientations. The supervised machine learning (e.g. deep learning) methods for particle picking often need a large training dataset, which requires extensive manual annotation. Other reference-dependent methods rely on low-resolution templates for particle detection, matching and picking, and therefore, are not fully automated. These issues motivate us to develop a fully automated, unbiased framework for particle picking.ResultsWe design a fully automated, unsupervised approach for single particle picking in cryo-EM micrographs. Our approach consists of three stages: image preprocessing, particle clustering, and particle picking. The image preprocessing is based on image averaging, normalization, cryo-EM image contrast enhancement correction (CEC), histogram equalization, restoration, adaptive histogram equalization, guided image filtering, and morphological operations significantly improves the quality of original cryo-EM images. Our particle clustering method is based on an intensity distribution model which is much faster and more accurate than traditional K-means and Fuzzy C-Means (FCM) algorithms for single particle clustering. Our particle picking method, based on image cleaning and shape detection with a modified Circular Hough Transform algorithm, effectively detects the shape and the center of each particle and creates a bounding box encapsulating the particles.ConclusionsAutoCryoPicker can automatically and effectively recognizes particle-like objects from in noisy cryo-EM micrographs without the need of labeled training data and human intervention and therefore is a useful tool for cryo-EM protein structure determination.
Instability of the pseudoautosomal boundary in house mice
Authors: Morgan Andrew P , Bell Timothy A , Crowley James J , de Villena Fernando Pardo-Manuel 
Published: February 2019

AbstractFaithful segregation of homologous chromosomes at meiosis requires pairing and recombination. In taxa with dimorphic sex chromosomes, pairing between them in the heterogametic sex is limited to a narrow interval of residual sequence homology known as the pseudoautosomal region (PAR). Failure to form the obligate crossover in the PAR is associated with male infertility in house mice (Mus musculus) and humans. Yet despite this apparent functional constraint, the boundary and organization of the PAR is highly variable in mammals, and even between subspecies of mice. Here we estimate the genetic map in a previously-documented expansion of the PAR in the Mus musculus castaneus subspecies and show that the local recombination rate is 100-fold higher than the autosomal background. We identify an independent shift in the PAR boundary in the Mus musculus musculus subspecies and show that it involves a complex rearrangement but still recombines in heterozygous males. Finally, we demonstrate pervasive copy-number variation at the PAR boundary in wild populations of M. m. domesticus, M. m. musculus and M. m. castaneus. Our results suggest that the intensity of recombination activity in the PAR, coupled with relatively weak constraints on its sequence, permit the generation and maintenance in the population of unusual levels of polymorphism of unknown functional significance.
fragilityindex: An R Package for Statistical Fragility Estimates in Biomedicine
Authors: Johnson Kipp W. , Rappaport Eli , Shameer Khader , Glicksberg Benjamin S. , Dudley Joel T. 
Published: February 2019

AbstractPoor reproducibility is a growing crisis in biomedical research. The fragility index was introduced as a convenient measure to estimate how fragile statistical results in clinical trials are to small perturbations in event outcome counts. There is currently no freely available R package to produce this calculation. Furthermore, the original definition of the method is applicable only to 2x2 contingency tables.As such, we developed an R package to calculate fragility index. We have also extended the concept of a statistical fragility index to two of the most commonly used methods in clinical research, survival analysis via weighted log-rank tests and logistic regression, and implemented these technique sin this R package. We describe example applications of these methods to existing publically available datasets. This R package is freely available under the AGPL license on CRAN (https://cran.r-project.org/web/packages/fragilityindex/index.html). The most recent versions may be downloaded and installed via Github (https://github.com/kippjohnson/fragilityindex).
RanGTP regulates cilium formation and ciliary trafficking of a kinesin-II subunit independent of its nuclear functions
Authors: Huang Shengping , Avasthi Prachee 
Published: February 2019

AbstractKinesin is part of the microtubule (MT)-binding motor protein superfamily, which exerts crucial functions in cell division and intracellular transport in different organelles. The heterotrimeric kinesin-II, consisting of the kinesin like protein KIF3A/3B heterodimer and kinesin-associated protein KAP3, is highly conserved across species between the green algaChlamydomonasand humans. It plays diverse roles in cargo transport including anterograde (base to tip) trafficking in cilium. However, the molecular determinants mediating trafficking of heterotrimeric kinesin-II itself is poorly understood. Using the unicellular eukaryoteChlamydomonasand mammalian cells, we show that RanGTP regulates ciliary trafficking of KAP3. We found the armadillo repeat region 6-9 (ARM6-9) of KAP3, required for its nuclear translocation, is sufficient for its targeting to the ciliary base. Given that KAP3 is essential for cilia formation and the emerging roles of RanGTP/importin β in ciliary protein targeting, we further investigate the effect of RanGTP in cilium length regulation in these two different systems. We demonstrate that precise control of RanGTP levels, revealed by different Ran mutants, is crucial for cilium formation and maintenance. Most importantly, we were able to segregate RanGTP regulation of ciliary protein incorporation from of its nuclear roles. Our work provides important support for the model that nuclear import mechanisms have been coopted for independent roles in ciliary import.
Postpartum trend in blood pressure and renal function in women with severe preeclampsia and eclampsia: A prospective cohort-study at Mulago hospital, Kampala, Uganda
Authors: Muteke Kasereka , Beyeza Jolly , Musaba Milton W , Wandabwa Julius , Kiondo Paul 
Published: February 2019

AbstractBackgroundPreeclampsia/Eclampsia is a multisystem disorder of pregnancy with kidney involvement. Our objective was to assess the postpartum trend in blood pressure, renal function and proteinuria and, to investigate their predictors in Ugandan women with severe preeclampsia and eclampsia.MethodsThis was a prospective cohort study that involved 97 women with severe preeclampsia and Eclampsia, conducted at Mulago National referral hospital from August 2017 to April 2018. The clinical and laboratory variables were collected from the women on day1, 7, 21 and day 42 after delivery. Kaplan-Meier Survival analysis, Cox-proportional Regression and Log-Rank tests were used to compare the baseline and the follow-up variables with changes in blood pressure, renal function and urine protein.ResultsMost women (93.8%) recovered from hypertension within 6 weeks of childbirth with the mean time to resolution of 2.49 weeks (95% CI: 2.13-2.82). About 81% of the women recovered their renal function and the mean time to recovery was 24.54 days (95% CI: 20.14-28.95). Proteinuria resolved in approximately 84% of the women and the mean time resolution of urine protein of 32.85 days (95% CI: 30.31-35.39). Having multiple pregnancy versus a singleton pregnancy was associated with persistence of hypertension six weeks after child birth (P-value = 0.013).ConclusionIn this study, the blood pressure and renal function of most women with severe preeclampsia and eclampsia normalized within six weeks after childbirth. A special interdisciplinary follow up for patients with preeclampsia/eclampsia by an obstetrician and physician is needed in the postpartum period to reduce the maternal morbidity and mortality associated with this condition in our community.