bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Optical Coherence Tomography Angiography Peripapillary Vessel Density and Lamina Cribrosa Depth
Authors: Eah Kyu Sang , Shin Joong Won , Sung Kyung Rim 
Published: February 2019

Précis:
Peripapillary vessel density (pVD) assessed by optical coherence tomography angiography (OCT-A) has poor global and regional correlations with lamina cribrosa depth (LCD), except for the inferotemporal area.

Purpose:
To investigate the global and regional relationship between the pVD assessed by OCT-A and LCD assessed by enhanced depth imaging spectral-domain optical coherence tomography (SD-OCT).

Methods:
A total of 38 eyes of 38 healthy subjects and 38 eyes of 38 glaucoma patients were included. Peripapillary microvasculature and lamina cribrosa were imaged by OCT-A and enhanced depth imaging SD-OCT, respectively. The pVD and LCD were measured at temporal, superotemporal, superonasal, nasal, inferonasal, and inferotemporal sectors. Global and regional correlations between pVD and LCD were evaluated in all subjects.

Results:
The pVD (59.0±2.6 vs. 54.4±5.4%) and LCD (318.5±76.4 vs. 404.6±92.5 μm) were significantly different between healthy and glaucoma subjects. The average pVD assessed by OCT-A was not significantly correlated with average LCD assessed by SD-OCT (r=−0.160, P=0.167). Regional correlation between pVD and LCD was statistically significant only in the inferotemporal sector (r=−0.301 and P=0.008). In the linear regression analysis, reduced pVD was independently associated with decreased visual field mean deviation and peripapillary retinal nerve fiber layer thickness but not with increased LCD.

Conclusions:
Global and regional correlations between pVD and LCD were poor except for the inferotemporal sector. This finding suggests that peripapillary microvascular impairment may not result directly from posterior lamina cribrosa displacement.
Risk Factors for Glaucoma Drainage Device Exposure in a Middle-Eastern Population
Authors: Al-Beishri Ali S. , Malik Rizwan , Freidi Alia , Ahmad Sameer 
Published: February 2019

Précis:
In this case-control study, female sex, and older age were risk factors for tube exposure; risk was related to the number of prior ocular surgeries and scleral patch graft (compared with pericardial graft) was found to protect against exposure.

Purpose:
Identification of potential risk factors for glaucoma drainage device (GDD) exposure may help to prevent this potentially blinding complication. The purpose of this study was to evaluate the possible risk factors for GDD exposure in a tertiary eye care center in the Middle-East.

Methods:
A retrospective case-control study was undertaken for a 7-year period (2008 to 2015 inclusive). All patients who presented with a GDD incident exposure were identified and were compared with a similar number of controls (without exposure) identified during the same period. Demographic factors, past ocular history, treatment, and surgical technique were recorded for both groups. Bivariate and multivariable analyses were used to identify possible risk factors for tube exposure.

Results:
A total of 836 patients underwent GDD surgery during this time period and 53 patients were identified with exposure, giving a cumulative incident exposure rate of 6.3% (0.9% per year). Bivariate analysis showed that the median age of cases (51 years) was similar to controls (53 years) (P=0.95), while there was a greater proportion of women with exposure (49%) compared with the control group (28%) with a statistically significant difference (P=0.028). The number of previous surgeries (3.77±2.1) was significantly higher (P=0.018) in the exposure group (4.25±2.0) compared with controls (3.3±2.0). With each unit increase in the number of previous surgeries, the odds of exposure significantly increased by 1.29 (95% confidence interval, 1.05-1.57). In the multivariable regression, female sex (P=0.006) and older age (P=0.025) were significant risk factors and use of a scleral patch (P=0.02) graft potentially protective.

Conclusions:
Previous surgery, female sex, and older age are potential risk factors identified in our study. The use of scleral patch graft is potentially protective against GDD extrusion. Further study is needed to elucidate the reasons for these causative and protective factors.
State Health Officials: Backgrounds and Qualifications
Authors: Yeager Valerie A. , Menachemi Nir , Jacinto Corey M. , Chapple-McGruder Theresa , Danielson Elizabeth C. , Halverson Paul K. 
Published: February 2019

Context:
State health officials (SHOs), the executive and administrative leaders of state public health, play a key role in policy development, must be versed in the relevant/current evidence, and provide expertise about health issues to the legislature and the governor.

Objective:
To provide an empirical examination of SHO backgrounds and qualifications over time.

Design, Setting, and Participants:
Cross-sectional survey of current/former SHOs.

Main Outcome Measures:
State health official educational backgrounds; public health experience; previous employment setting.

Results:
Two-thirds of respondents (64.6%) reported having a medical degree, approximately half (48.3%) a formal public health degree, and almost one-quarter (21.8%) a management degree. The majority had governmental public health experience at some prior point in their career (70.0%). Almost two-thirds worked in governmental public health immediately before becoming an SHO. The proportion that was female increased significantly by decade from 5.6% in the 1970s/80s to 46.4% in the 2010s (P = .02).

Conclusions:
The main finding from this study shows that more than two-thirds of SHOs have had governmental public health experience at some point in their career. This is not a new trend as there were no statistical differences in public health experience by decade. More than half of the SHOs were appointed to the role directly from governmental public health, indicating that their public health experience is timely and likely germane to their appointment as SHO. Findings also indicate improvements in gender diversity among one of the most influential leadership roles in governmental public health whereas significant changes in racial and ethnic diversity were not identified. Women are increasingly being appointed as SHOs, indicating increasing gender diversity in this influential position. Given that governmental public health employees are predominantly women, there is still room for gender equity improvements in executive leadership roles. This is coupled with the need for further racial and ethnic diversity improvements as well.
Cost of Responding to the 2017 University of Washington Mumps Outbreak: A Prospective Analysis
Authors: Pike Jamison , Schwartz Sheryl , Kay Meagan , Perez-Osorio Ailyn , Marin Mona , Jenkins Mark , Routh Janell , Duchin Jeff , DeBolt Chas , Zhou Fangjun 
Published: February 2019

Objectives:
To estimate costs of labor and materials by the University of Washington (UW) and state and local public health departments (PHDs) to respond to the February to June 2017 UW mumps outbreak, where 42 cases were identified among students (primarily sorority and fraternity members), staff, and associated community members.

Design:
We applied standard cost analysis methodology using a combined public health and university perspective to examine the cost of responding to the outbreak.

Setting:
UW's Seattle campus encompasses 703 acres with approximately 32 000 undergraduate students. Nearly 15% of the undergraduate population are members of fraternities or sororities. Housing for the fraternities and sororities is adjacent to the UW campus and consists of 50 houses.

Participants:
During the outbreak, customized costing tools based on relevant staff or faculty positions and activities were provided to the UW and Public Health–Seattle & King County, populated by each person participating in the outbreak response, and then collected and analyzed. Laboratory hours and material costs were collected from the Washington Department of Health and the Minnesota Department of Health.

Main Outcome Measure:
Labor and material costs provided by the UW and PHDs during the outbreak were collected and categorized by payer and activity.

Results:
Total costs to the UW and PHDs in responding to the outbreak were $282 762 ($6692 per case). Of these, the UW spent $160 064, while PHDs spent $122 098. Labor accounted for 77% of total outbreak costs, and UW response planning and coordination accounted for the largest amount of labor costs ($75 493) overall.

Conclusions:
Given the current university and public health department budget constraints, the response to the outbreak amounted to a significant use of resources. Labor was the largest driver of costs for the outbreak response; UW labor costs—related to campus response planning and coordination—dominated the total economic burden from public health and university perspectives.
Effect of Mature Adipocyte-Derived Dedifferentiated Fat Cells on Formation of Basement Membrane after Cultured Epithelial Autograft on Artificial Dermis
Authors: Soejima Kazutaka , Kashimura Tsutomu , Kazama Tomohiko , Matsumoto Taro , Nakazawa Hiroaki 
Published: February 2019

Background:Artificial dermis is an important option for preparing full-thickness wounds for cultured epithelial autografting. Long-term fragility after cultured epithelial autografting remains a problem, probably because of the lack of basement membrane proteins. The authors hypothesized that treating artificial dermis with mesenchymal stem cells would promote basement membrane protein production. The authors tested this using dedifferentiated fat cells in a porcine experimental model.Methods:This study used four male crossbred (Landrace, Large White, and Duroc) swine. Cultured epithelium and dedifferentiated fat cells were prepared from skin and subcutaneous fat tissue harvested from the cervical region. Full-thickness open dorsal wounds were created and treated with artificial dermis to prepare a graft bed for cultured epithelial autograft. Two groups were established: the control group (artificial dermis treated with 0.5 ml of normal saline solution applied to the wounds) and the dedifferentiated fat group (artificial dermis treated with 0.5 × 105dedifferentiated fat cells suspended in 0.5 ml of normal saline solution sprayed onto the wounds). On postoperative day 10, the prepared cultured epithelium was grafted onto the generated dermis-like tissue. Fourteen days later, tissue specimens were harvested and evaluated histologically.Results:Light microscopy of hematoxylin and eosin–stained sections revealed the beginning of rete ridge formation in the dedifferentiated fat group. Synthesis of both collagen IV and laminin-5 was significantly enhanced in the dedifferentiated fat group. Transmission electron microscopy revealed a nearly mature basement membrane, including anchoring fibrils in the dedifferentiated fat group.Conclusion:Combined use of artificial dermis and dedifferentiated fat cells promotes post–cultured epithelial autograft production and deposition of basement membrane proteins at the dermal-epidermal junction and basement membrane development, including anchoring fibrils.
Predictive Factors of Duration of Continuous Renal Replacement Therapy in Acute Kidney Injury Survivors
Authors: Baek Seung Don , Kang Jae-Young , Shin Seulgi , Park Hyang-Sook , Kim Mi-Soon , Kim So Mi , Lee Eun Kyoung , Chang Jai Won 
Published: February 2019

ABSTRACT
The factors influencing continuous renal replacement therapy (CRRT) duration for critically ill patients with acute kidney injury (AKI) are unclear. Therefore, we investigated the clinical factors that could influence the duration of CRRT for AKI survivors. In this retrospective observational study, the medical records of all hospital survivors who required CRRT for AKI in intensive care units were analyzed. The CRRT duration (median, 6 days) was categorized as short-duration CRRT (≤ 6 days, n = 65) and long-duration CRRT (> 6 days, n = 59), according to the median CRRT duration. A urine output of less than 0.5 mL/kg/h (adjusted odds ratio [OR], 3.4; P = 0.010), mechanical ventilation use (adjusted OR, 7.9; P = 0.001), and extracorporeal membrane oxygenation (ECMO) use (adjusted OR, 6.5; P = 0.010) were independent predictors of long-duration CRRT, whereas serum creatinine and neutrophil gelatinase-associated lipocalin were not significant predictors. A clinical model demonstrated a good discriminatory ability to predict long-duration CRRT (area under the curve, 0.84; 95% confidence interval, 0.76–0.90). The urine output immediately before CRRT initiation and factors associated with disease severity significantly affected the duration of CRRT. Simultaneously considering the urine output, mechanical ventilation use, and ECMO use predicted CRRT duration in AKI survivors.
Mechanical Circulatory Support in Refractory Vasodilatory Septic Shock: a Randomized Controlled Porcine Study
Authors: Chvojka Jiri , Martinkova Vendula , Benes Jan , Valesova Lenka , Danihel Vojech , Nalos Lukas , Matejovic Martin 
Published: February 2019

ABSTRACT
As controversy persists regarding the benefits of mechanical circulatory support in septic shock with a predominantly vasoplegic phenotype, preclinical studies may provide a useful alternative to fill the actual knowledge gap. Here, we investigated the physiologic responses to venoarterial extracorporeal membrane oxygenation therapy (VA-ECMO) in a clinically relevant porcine peritonitis-induced model of refractory vasodilatory septic shock. In 12 anesthetized, mechanically ventilated, and instrumented domestic pigs, septic shock was induced by intraperitoneally inoculating autologous feces. After reaching the threshold for refractory vasodilatory shock (norepinephrine dose ≥1 μg/kg/min), the pigs were randomized into the conservative treatment group (control) or the VA-ECMO group (target flow 100 mL/kg/min). The time to develop refractory vasodilatory shock was similar in both groups (18.8 h in the ECMO group, 18.1 h in the control group). There was no difference between the groups in terms of time to death measured from the point of reaching the predefined vasopressor threshold (7.1 h for the ECMO group, 7.9 h for the control group). The initiation of ECMO resulted in a markedly increased fluid and vasopressor support. Although treatment with ECMO compromised neither renal nor carotid blood flow initially, both progressively decreased later during the experiment. The pattern of sepsis-induced multiorgan injury, alterations in energy metabolism, and the systemic inflammatory response were remarkably similar between both groups. In conclusion, the application of VA-ECMO in this model of peritonitis-induced refractory vasodilatory septic shock aggravated hemodynamic deterioration. Our findings contribute to increasing equipoise with respect to the clinical utility of VA-ECMO in refractory vasodilatory shock.
Desire for Continued Pessary Use Among Women of Hispanic and Non-Hispanic Ethnic Backgrounds for Pelvic Floor Disorders
Authors: Gupta Ankita , Cox Carol , Dunivan Gena C. , Gaskins Jeremy T. , Rogers Rebecca G. , Iglesia Cheryl B. , Meriwether Kate V. 
Published: February 2019

Objective
This study aimed to describe the association between patient ethnicity/race and desire to continue using a pessary for the treatment of pelvic floor disorders.

Methods
We performed a secondary analysis of a randomized trial among women presenting for pessary fitting. The primary outcome was the desire to continue using a pessary at 3 months. Bacterial vaginosis by Nugent score and vaginal symptoms (discharge, itching, pain, sores) were also evaluated. Logistic or multiple linear regression was performed with correction for body mass index, education level, parity, Charlson Comorbidity Index, and randomization to TrimoSan gel.

Results
One hundred fourteen women (41 Hispanic and 73 non-Hispanic) were eligible for this analysis. Women self-identified as white (65/114; 57%), Hispanic (41/114, 36%), Asian (3/114; 2.6%), Native American (4/114; 3.5%), and “other” (1/114, 0.9%) race, with no self-identified African American women (0/114) meeting the inclusion criteria. No significant difference in desire to continue pessary use was found between Hispanic and non-Hispanic women (58.5% vs 63%; P = 0.69; corrected odds ratio [cOR], 1.11; 95% confidence interval [CI], 0.43–2.90) or across races (P = 0.89). Hispanic women had significantly higher risk of bacterial vaginosis (34% vs 16%; P = 0.04; cOR, 2.91; 95% CI, 1.01–8.39), higher Nugent scores (5.4 ± 2.3 vs 4.3 ± 2.3; P = 0.02; corrected coefficient, 1.10; 95% CI, 0.10–2.10), and more vaginal pain (17.1% vs 2.8%; P = 0.01; cOR, 9.14; 95% CI, 1.37–61.17) at 3 months.

Conclusions
Despite increased vaginal pain and vaginal microbiome disturbances in Hispanic women using a pessary, no significant differences in the desire to continue using the pessary existed.
Anatomical Outcomes Based on Suturing Technique During Vaginal Mesh Attachment in Robotic Sacrocolpopexy
Authors: Bazzi Ali A. , Osmundsen Blake C. , Hagglund Karen H. , Aslam Muhammad Faisal 
Published: February 2019

Objectives
In this study, we assessed the difference in anatomical outcomes using the barbed, self-anchoring, delayed absorbable suture when compared with the traditional knot-tying interrupted suture technique during vaginal mesh attachment in robotic sacrocolpopexy. In addition, we compared the rates of mesh erosion with the 2 techniques.

Methods
This is a retrospective cohort study of 131 women who underwent minimally invasive robotic sacrocolpopexy at 2 sites. There were 65 subjects at site 1 (barbed, self-anchoring, delayed absorbable suture) and 66 from site 2 (traditional knot-tying technique). The primary outcome was anatomical success (measured by all Pelvic Organ Prolapse Quantification System points <0 postsurgery) in the barbed suture technique at site 1 compared with the traditional knot-tying technique at site 2. The secondary outcome was mesh erosion rates at these sites.

Results
In the barbed suture group, performed at site 1, 98% (n = 59/60) had postoperative success at the 3-month follow-up period compared with 62% (n = 40/65) in the traditional knot-tying group at site 2 during the 12-month postoperative follow-up (P < 0.0001). During this time period, 2% (n = 1) in the barbed suture group and 8% (n = 5) in the traditional knot-tying group experienced sacrocolpopexy mesh erosion (P = 0.208).

Conclusions
Our results indicate that the barbed, self-anchoring, delayed absorbable suture is associated with less anatomical failures compared with traditional knot tying. The use of barbed suture is a safe technique and can be adopted in place of the traditional knot-tying technique. We also found less mesh erosion in the barbed suture group.
The Quality of Health Information Available on the Internet for Patients With Fecal Incontinence
Authors: Kadam-Halani Priyanka K. , Lee Daniel D. , Sammel Mary D. , Arya Lily A. , Andy Uduak U. 
Published: February 2019

Objective
The aim of this study was to assess the quality of information available through the Internet for a variety of search terms for fecal incontinence (FI).

Methods
Using the Google search engine, searches were performed for 4 terms: “bowel control problem,” “accidental bowel leakage,” “fecal incontinence,” and “leaking stool.” The DISCERN quality analysis tool and JAMA benchmark criteria were implemented by 2 independent reviewers to evaluate the first 20 search results for each term. To determine if 1 term provided higher-quality information, mean DISCERN and JAMA criteria scores as well as Web site category were compared using analysis of variance and Pearson χ2 tests.

Results
Mean DISCERN scores for all terms fell in the middle range of possible scores. DISCERN questions addressing risks of treatment options, effects of treatment on quality of life, and gaps in knowledge/differences in expert opinion had the lowest scores across all search terms (range of scores, 1.1–1.7/5). JAMA criteria on authorship and attribution were most frequently missing on average in 48 of 80 and 42 of 80 Web sites, respectively. There were significant differences in mean DISCERN scores among the terms, with “fecal incontinence” yielding the highest mean score. The term “accidental bowel leakage” yielded the highest number of marketing Web sites, whereas “leaking stool” had the highest proportion of social Web sites.

Conclusions
The quality of available information about FI on the Internet is variable, and key components are often missing. The term “fecal incontinence” yielded the highest quality information of all search terms.
Willingness of Women With Pelvic Floor Disorders to Use Mobile Technology to Communicate With Their Health Care Providers
Authors: Lee Daniel D. , Arya Lily A. , Andy Uduak U. , Sammel Mary D. , Harvie Heidi S. 
Published: February 2019

Objectives
The aim of this study was to assess willingness of women with pelvic floor disorders to adopt nontraditional mobile communication methods with health care providers.

Methods
This is a cross-sectional study of women with pelvic floor disorders. Women completed a survey regarding what technology they owned, how they utilized it, and their willingness to use technology to communicate with providers.

Results
Overall mobile technology ownership was high; however, older women were significantly less likely to own a smartphone (75%) compared with younger (100%) and middle-aged women (98%; P < 0.01). On univariable analysis, factors significantly associated with willingness to use mobile technology were age (P < 0.01) and education status (P < 0.01). A relationship between travel distance to the clinic and willingness to adopt various mobile technologies was not noted. On multivariable analysis, after controlling for education and travel distance to clinic, older women remained significantly less likely to express willingness to use various technologies: video-conference technology (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.95–0.99), text messaging (OR, 0.94; 95% CI, 0.91–0.97), Internet-based patient portal (OR, 0.96; 95% CI, 0.94–0.98), and e-mail (OR, 0.94; 95% CI, 0.91–0.98). However, almost 50% of older women and greater than 65% of middle-aged women expressed willingness to adopt technologies for health care communication.

Conclusions
Age-related differences exist in the ownership, utilization, and willingness to communicate with medical providers through mobile technology. However, the majority of women across all age-groups, irrespective of travel distance, are willing to adopt alternative mobile technologies to communicate with their health care providers.