bluuebunny/crossref_metadata_2025_split huggingface dataset:
System Factors Affecting Intraoperative Risk and Resilience
Authors: Kolodzey Lauren , Trbovich Patricia , Kashfi Arash , Grantcharov Teodor P. 
Published: April 2019

Objective:
To identify and categorize system factors in complex laparoscopic surgery that have the potential to either threaten patient safety or support system resilience.

Background:
The operating room is a uniquely complex sociotechnical work system wherein surgical successes prevail despite pervasive safety threats. Holistically characterizing intraoperative factors that thus support system resilience in addition to those that threaten patient safety using contextual methodologies is critical for optimizing surgical safety overall.

Method:
In this prospective descriptive interdisciplinary study, 19 audio/video recordings of complex laparoscopic general surgical procedures were directly observed and transcribed. Using a qualitative systems-based approach, intraoperative human factors with the potential to impact patient safety, either as a safety threat or as a support for resilience, were identified. Adverse events were further assessed for shared threats and supports. Data collection was guided by the Systems Engineering Initiative for Patient Safety 2.0 work system model.

Results:
A total of 1083 relevant observations were made over 39.8 hours of operative time, enabling the identification of 79 distinct safety threats and 67 resilience supports within the surgical system. Safety threats associated with the physical environment, tasks, organization, and equipment were prevalent and observed in equal measure, whereas supports for resilience were predominantly attributed to clinician behaviors, including proactive team management and skills coaching. Two subclinical adverse events were identified; shared safety threats included suboptimal technology design, whereas shared resilience supports included calm clinician behavior and redundant intraoperative resourcing.

Conclusions:
Safety threats and resilience supports were found to be systematic in the surgical setting. Identified safety threats should be prioritized for remediation, and clinician behaviors that contribute to fostering resilience should be valued and protected.
A Minimally Invasive Technique for the 1-Stage Treatment of Complex Pelvic Floor Diseases: Laparoscopic-Pelvic Organ Prolapse Suspension
Authors: Boccasanta Paolo , Venturi Marco , Agradi Sergio , Vergani Contardo , Calabrò Giuseppe , Missaglia Claudio , Bordoni Luca , Longo Antonio 
Published: April 2019

Objective
The aim of this prospective study was to assess the safety and effectiveness of a new single laparoscopic operation devised to relieve obstructed defecation, gynecologic and urinary symptoms in a large series of female patients with multiorgan pelvic prolapse.

Methods
We submitted 384 female patients to laparoscopic pelvic organ prolapse suspension operation, a new technique based on suspension of the middle pelvic compartment, by using a polypropylene mesh and followed up 368 of them, with defecography performed 12 months after surgery and a standardized protocol.

Results
The 368 patients were followed-up for 36.3 (±4.4) months, Recurrence rate was 4.9% for obstructed defecation syndrome and 3.3% for stress urinary incontinence. Complication rate was 2.9%. The mean period of daily activity resumption was 16.3 days (±4.8 days). Anorectal and urogynecologic symptoms and scores significantly improved after the operation (P < 0.001), with no worsening of anal continence. Incidence of postoperative fecal urgency was 0%. Postoperative defecography showed a significant (P < 0.001) improvement of all parameters in 315 patients (82%). Short Form 36 Health Survey score significantly improved after the operation (P < 0.01). An excellent/good overall Satisfaction Index was reported by 78.0% of patients.

Conclusions
In our experience the Laparoscopic-Pelvic Organ Prolapse Suspension seems to be safe and effective as a 1-stage treatment of associated pelvic floor diseases. Randomized studies with an appropriate control group and longer follow-up are now needed to assess the effectiveness of this promising technique.
The Relationship Between Hypoadiponectinemia and Cardiovascular Events in Liver Transplant Recipients
Authors: Siddiqui Mohammad Bilal , Patel Samarth , Arshad Tamoore , Lee Emily , Albhaisi Somaya , Driscoll Carolyn , Wolver Susan , Reichman Trevor , Bhati Chandra , Siddiqui Mohammad Shadab 
Published: April 2019

Background.
Cardiovascular disease (CVD) is an important cause of morbidity and mortality after liver transplantation (LT). Serum adiponectin levels inversely correlate with CVD-related outcomes, but the relationship between hypoadiponectinemia and CVD after LT is unknown. Thus, the aim of the present study was to prospectively evaluate this relationship in LT recipients (LTR).

Methods.
LTR were prospectively enrolled (N = 130) between January 1, 2012, and January 1, 2014. Baseline adiponectin levels were drawn at enrollment and patients were followed for CVD events. Hypoadiponectinemia was defined as serum adiponectin <10 µg/mL. The primary endpoint was a composite CVD outcome consisting of myocardial infarction, angina, need for coronary revascularization, stroke, or cardiac death.

Results.
The mean age was 58 ± 11 years and prevalence of obesity, diabetes, and dyslipidemia was 40%, 35%, and 40%, respectively. A total of 20 CVD events were noted, after median follow up of 45 months. Hypoadiponectinemia was significantly associated with future risk of CVD events (hazard ratio, 3.519; 95% confidence interval, 1.180-10.499, P = 0.024). This association was independent of traditional CVD risk factors including age, gender, obesity, hypertension, diabetes, and choice of immunosuppression.

Conclusions.
Hypoadiponectinemia is a strong independent predictor of future cardiovascular events in LTR, which can be incorporated in clinical practice to assess CVD risk assessment after LT.
Delayed Bleeding of the Transplant Duodenum After Simultaneous Kidney-pancreas Transplantation: Case Series
Authors: Van Mellaert Anke , Gillard Pieter , Jochmans Ina , Demedts Ingrid , Sagaert Xavier , Naesens Maarten , Monbaliu Diethard , Kuypers Dirk , Pirenne Jacques , Sprangers Ben 
Published: April 2019

Background.
In simultaneous pancreas-kidney (SPK) transplant recipients, the majority of complications described in the literature, are early postoperative complications. However, there is growing attention for late complications associated with SPK transplantation.

Methods.
In this case series, we present 3 cases, 2 enterically and 1 bladder-derived SPK transplant patients, with anastomotic hemorrhage of the donor duodenum as a very late complication, >10 years after transplantation (11, 22, and 18 y later, respectively).

Results.
In our center, 122 SPK transplantations have been performed between January 1992 and June 2018. The 3 cases reported here are the only patients in our cohort presenting with delayed anastomotic hemorrhage of the donor duodenum (2.5%). In the first 2 patients, reintervention with reconstruction of the anastomosis was performed. A congestive and friable mucosa was seen, and the resection specimen showed enlarged and congestive submucosal veins in both patients. There was no recurrence of bleeding after reintervention. In the third patient, enteric derivation was not possible because of the extremely fragile intestinal tissue perioperatively, and a conservative approach was taken. As possible precipitating factors are concerned, all 3 of our patients were taking low-dose aspirin and/or clopidogrel as secondary cardiovascular prevention.

Conclusions.
Bleeding of the transplanted donor duodenum can present as a late complication, several years after SPK transplantation. The development of enlarged, congestive submucosal veins could play a role in these late bleedings, and antiplatelet therapy could be a precipitating factor. Further research is necessary to investigate the pathophysiology, the prevalence, optimal treatment, and the consequent influence on mortality, morbidity, and graft loss after SPK transplantation.
Serostatus Testing & Dengue Vaccine Cost-Benefit Thresholds
Authors: Pearson Carl A. B. , Clifford Samuel , Abbas Kaja M. , Flasche Stefan , Hladish Thomas J. 
Published: April 2019

The World Health Organisation currently recommends pre-screening for past infection prior to administration of the only licensed dengue vaccine, CYD-TDV. Using a bounding analysis, we show that despite additional testing costs, this approach can improve the economic viability of CYD-TDV: effective testing reduces unnecessary vaccination costs while increasing the health benefit for vaccine recipients. When testing is cheap enough, those trends outweigh additional screening costs and make test-then-vaccinate strategies net-beneficial in many settings.We derived these results using a general approach for determining price thresholds for testing and vaccination, as well as indicating optimal start and end ages of routine test-then-vaccinate programs. This approach only requires age-specific seroprevalence and a cost estimate for second infections. We demonstrate this approach across settings commonly used to evaluate CYD-TDV economics, and highlight implications of our simple model for more detailed studies. We found trends showing test-then-vaccinate strategies are generally more beneficial starting at younger ages, and that in some settings multiple years of testing can be more beneficial than only testing once, despite increased investment in testing.
Creating a neuroprosthesis for active tactile exploration of textures
Authors: O’Doherty Joseph E. , Shokur Solaiman , Medina Leonel E. , Lebedev Mikhail A. , Nicolelis Miguel A. L. 
Published: April 2019

AbstractIntracortical microstimulation (ICMS) of the primary somatosensory cortex (S1) can produce percepts that mimic somatic sensation and thus has potential as an approach to sensorize prosthetic limbs. However, it is not known whether ICMS could recreate active texture exploration—the ability to infer information about object texture by using one’s fingertips to scan a surface. Here we show that ICMS of S1 can convey information about the spatial frequencies of invisible virtual gratings through a process of active tactile exploration. Two rhesus monkeys scanned pairs of visually identical screen objects with the fingertip of a hand avatar, controlled via a joystick and later via a brain-machine interface, to find the one with denser virtual gratings. The gratings consisted of evenly spaced ridges that were signaled through ICMS pulses generated when the avatar’s fingertip crossed each ridge. The monkeys learned to interpret these ICMS patterns evoked by the interplay of their voluntary movements and the virtual textures of each object. Discrimination accuracy across a range of grating densities followed Weber’s law of just-noticeable differences (JND), a finding that matches normal cutaneous sensation. Moreover, one monkey developed an active scanning strategy where avatar velocity was integrated with the ICMS pulses to interpret the texture information. We propose that this approach could equip upper-limb neuroprostheses with direct access to texture features acquired during active exploration of natural objects.
Correlates of resting and exertional dyspnea among older adults with obstructive lung disease: a cross-sectional analysis of the Canadian Longitudinal Study on Aging
Authors: Good Joshua , Stickland Michael K , Dogra Shilpa 
Published: April 2019

IntroductionIn patients with chronic obstructive pulmonary disease (COPD), the perception of dyspnea is related to quality of life, and is a better predictor of mortality than the severity of airway obstruction. The purpose of the current study was to use population-level data from the Canadian Longitudinal Study on Aging (CLSA) to identify potential correlates of dyspnea in adults with obstructive lung disease.MethodsData from participants with a self-reported obstructive lung disease (asthma or COPD) were used for analysis (n=2,854). Four outcome variables were assessed: self-reported dyspnea at 1) rest, 2) walking on a flat surface, 3) walking uphill/climbing stairs, 4) following strenuous activity. Potential sociodemographic, health, and health behaviour correlates were entered in to logistic regression models.ResultsHigher body fat percentage, and worse forced expiratory volume in one second were associated with higher odds of reporting dyspnea. Females with an anxiety disorder (OR=1.91, CI: 1.29, 2.83) and males with a mood disorder (OR=2.67, CI: 1.53, 4.68) reported higher odds of experiencing dyspnea walking on a flat surface, independent of lung function and other correlates. Dyspnea while walking uphill/climbing stairs was associated with a slower timed up and go time in females (e.g. OR=1.18, CI: 1.10) and males (OR=1.19, CI: 1.09, 1.30).ConclusionsIn addition to traditional predictors such as lung function and body composition, we found that anxiety and mood disorders, as well as functional fitness were correlates of dyspnea. Further research is needed to understand whether targeting these correlates leads to improvements in perceptions of dyspnea.
The rs6505162 C>A polymorphism in themiRNA-423gene exhibits a protective element of coronary artery in a southern Chinese population with Kawasaki disease
Authors: Li Jiawen , Wang Jinxin , Su Xiaoping , Jiang Zhiyong , Rong Xing , Gu Xueping , Qiu Huixian , Zeng Lanlan , Zheng Hao , Gu Xiaoqiong , Chu Maoping 
Published: April 2019

AbstractBackgroundManifesting as acute rash, fever and vasculitis, belonging to autoimmune syndrome, Kawasaki disease(KD) is prone to occur in infants and young children. Males and females is affected by KD at a ratio of 1.4 to 1.7: 1. KD is known to own many common clinical manifestations and complications, like coronary artery lesion(CAL) and coronary artery aneurysm(CAA). Polymorphisms of the rs6505162 locus in themiRNA-423gene are associated with enhancive susceptibility to coronary artery disease and the alterations of the four cytokines IL-4., IL-10, IL-21, IL-22 in the early stages of diabetes. However, no researcher has reported whether rs6505162 is related to KD susceptibility or no. Therefore, we carried out the trial concentrating on the connection betweenmiRNA-423rs6505162 C>A polymorphism and KD susceptibility.MethodsTo obtain the genotypes of rs6505162inobjects enrolled by 532 KD children and 623 control, we applied Taqman real-time PCR and all statistical analyses was carried out by SAS.ResultsThe comparison between all cases and all controls hinted that the rs6505162C>A polymorphism has no relationship with KD susceptibility. Nevertheless, a subgroup analysis revealed that the CA/AA genotypes of rs6505162 could reduce the occurrence of CAA (Adjusted age and gender odds ratio=1.30, 95%CI=1.02-1.67,P=0.037) and CAL (Adjusted OR=1.56, 95%CI=1.19-2.03,P=0.001)in KD patients.ConclusionOur final results stated clearly thatmiRNA-423rs6505162 polymorphism appears to be a protective element of CAL and CAA in southern Chinese suffers with KD.
Comparison of prokaryotic communities among fields exhibiting different disinfestation effects by anaerobic soil disinfestation
Authors: Lee Chol Gyu , Iida Toshiya , Matsuda Eriko , Yoshida Kayo , Kawabe Masato , Maeda Masayuki , Muramoto Yasunori , Watanabe Hideki , Otani Yoko , Nakaho Kazhiro , Ohkuma Moriya 
Published: April 2019

AbstractAnaerobic soil disinfestation (ASD) is a chemical-independent fumigation method used for reducing the abundance of pathogens at soil depths of <40 cm. However, its disinfestation efficiency is unstable under field conditions. The microbial community reflects the soil environment and is a good indicator of soil health. Therefore, soil with a good disinfestation efficiency may have a unique microbial community. The aim of the present study was to compare the prokaryotic communities among soils obtained from 17 geographically different greenhouses that experienced tomato bacterial wilt but exhibited different disinfestation efficiencies after ASD treatment with the same substrate. In the present study, soil prokaryotic communities in the field, which indicate difference in disinfestation effects after ASD treatment among several fields, were compared using next-generation sequencing. The prokaryotic communities in the fields showing different disinfestation effects were roughly separated into sampling fields. The relative abundances of Betaproteobacteria and Clostridia were significantly increased in well-disinfested fields. Overall, 25 operational taxonomic units (OTUs) were specifically increased in various well-disinfested soils and 18 OTUs belonged to phylogenetically diversified Clostridia. Other OTUs belonged to aerobic bacteria and were not previously detected in sample collected from ASD-treated fields. The results showed that the changes to the prokaryotic communities did not affect ASD efficiency, whereas changes in the abundance of specific microbes in the community were related to disinfestation.
Assessing Confidence in the Results of Network Meta-Analysis (Cinema)
Authors: Nikolakopoulou Adriani , Higgins Julian PT , Papakonstantinou Theodore , Chaimani Anna , Del Giovane Cinzia , Egger Matthias , Salanti Georgia 
Published: April 2019

AbstractEvaluation of the credibility of results from a meta-analysis has become an intrinsic part of the evidence synthesis process. We present a methodological framework to evaluate Confidence In the results from Network Meta-Analysis (CINeMA) when multiple interventions are compared. CINeMA considers six domains and we outline the methods used to form judgements about within-study bias, across-studies bias, indirectness, imprecision, heterogeneity and incoherence. Key to judgements about within-study bias and indirectness is the percentage contribution matrix, which shows how much information each study contributes to the results from network meta-analysis. The use of contribution matrix allows the semi-automation of the process, implemented in a freely available web application (cinema.ispm.ch). In evaluating imprecision, heterogeneity and inconsistency we consider the impact of these components of variability in forming clinical decisions. Via three examples, we show that CINeMA improves transparency and avoids the selective use of evidence when forming judgements, thus limiting subjectivity in the process. CINeMA is easy to apply even in large and complicated networks, like a network involving 18 different antidepressant drugs.
Mitochondrial dysfunction and autophagy responses to skeletal muscle stress
Authors: Nichenko Anna S. , Southern W. Michael , Qualls Anita E. , Flemington Alexandra B. , Mercer Grant H. , Yin Amelia , Yin Hang , Call Jarrod A. 
Published: April 2019

AbstractAutophagy plays an important role in mitochondrial maintenance, yet many details of skeletal muscle autophagic activity are unresolved in the context of muscle stress and/or damage. Skeletal muscles from mice were stressed either by fatiguing contractions, eccentric contraction-induced injury (ECCI), or freeze injury (FI) to establish a timeline of mitochondrial function and autophagy induction after different forms of muscle stress. Only FI was sufficient to elicit a reduction in mitochondrial function (−88%, p=0.006), yet both ECCI and FI resulted in greater autophagy-related protein content (28-fold, p≤0.008) suggesting a tunable autophagic response. Muscles from another cohort of mice were used to determine specific forms of autophagy, i.e., flux and mitochondrial-specific, in response to muscle damage. Mitochondrial-specific autophagy was evident by accumulation of autophagy-related proteins in mitochondrial-enriched muscle fractions following FI (37-fold, p=0.017); however, autophagy flux, assessed by LC3II accumulation with the lysosomal inhibitor chloroquine, was insignificant suggesting a physiological bottleneck in the clearance of dysfunctional organelles following FI. Ulk1 muscle-specific knockout (Ulk1 MKO) mice were used to determine if autophagy is necessary for the recovery of mitochondrial function after muscle damage. Ulk1 MKO mice were weaker (−12%, p=0.012) and demonstrated altered satellite cell dynamics (e.g., proliferation) during muscle regeneration after FI compared to littermate control mice, but determination of autophagy necessity for the recovery of mitochondrial function was inconclusive. This study concludes that autophagy is a tunable cellular response to muscle damaging stress and may influence muscle fiber regeneration through interaction with satellite cells.Key Points SummaryMuscle contractility dysfunction is well characterized after many different types of muscle stress however, the timing and magnitude of mitochondrial dysfunction and autophagy induction after different types of muscle stress is largely unknown.In this study we found that only traumatic freeze injury causes mitochondria dysfunction compared to fatigue contractions and eccentric contraction-induced injury, and that the autophagic response to muscle stress scales to the magnitude of muscle damage, i.e., freeze vs. eccentric contraction-induced injury.We determined that total autophagy-related protein content has a greater response to muscle fiber damage compared to autophagy flux likely reflecting a bottleneck of autophagosomes awaiting degradation following muscle injury.Using a skeletal gmuscle-specific autophagy knockout mouse (Ulk1), we found that muscle contractility and satellite cell activity might be influenced by cellular events within the adult muscle fiber following muscle damage.
Detection of Ovarian Cancer Using Samples Sourced from the Vaginal Microenvironment
Authors: Galey Melissa M. , Young Alexandria N. , Petukhova Valentina Z. , Wang Mingxun , Wang Jian , Burdette Joanna E. , Sanchez Laura M. 
Published: April 2019

AbstractMass spectrometry (MS) offers high levels of specificity and sensitivity in clinical applications, and we have previously been able to demonstrate that matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) MS is capable of distinguishing two-component biological mixtures at low limits of detection. Ovarian cancer is notoriously difficult to detect due to the lack of any screening methods for early detection. By sampling a local microenvironment, such as the vaginal fluids, a MS based method is presented that was capable of monitoring disease progression from vaginally collected, local samples from tumor bearing mice. A murine xenograft model of high grade serous ovarian carcinoma (HGSOC) was used for this study and vaginal lavages were obtained from mice on a weekly basis throughout disease progression and subjected to our MALDI-TOF MS workflow followed by statistical analyses. Proteins in the 4-20 kDa region of the mass spectrum could consistently be measured to yield a fingerprint that correlated with disease progression over time. These fingerprints were found to be statistically stable across all mice with the protein fingerprint converging towards the end point of the study. MALDI-TOF MS serves as a unique analytical technique for measuring a sampled vaginal microenvironment in a specific and sensitive manner for the detection of HGSOC in a murine model.
New β-Lactamase Inhibitors Nacubactam and Zidebactam Improve the In Vitro Activity of β-Lactam Antibiotics Against Mycobacterium abscessus Complex Clinical Isolates
Authors: Kaushik Amit , Ammerman Nicole C. , Parrish Nicole M. , Nuermberger Eric L. 
Published: April 2019

AbstractThe new diazabicyclooctane-based β-lactamase inhibitors avibactam and relebactam improve the in vitro activity of β-lactam antibiotics against Mycobacterium abscessus complex (MABC). Here, we evaluated the in vitro activity of two newer diazabicyclooctane-based β-lactamase inhibitors in clinical development, nacubactam and zidebactam, with β-lactams against clinical isolates of MABC. Both inhibitors lowered the MICs of their partner β-lactams, meropenem (eight-fold) and cefepime (two-fold), and those of other β-lactams, similar to prior results with avibactam and relebactam.