bluuebunny/crossref_metadata_2025_split huggingface dataset:
DISEASE CLASSIFICATION OF MACULAR OPTICAL COHERENCE TOMOGRAPHY SCANS USING DEEP LEARNING SOFTWARE
Authors: Bhatia Kanwal K. , Graham Mark S. , Terry Louise , Wood Ashley , Tranos Paris , Trikha Sameer , Jaccard Nicolas 
Published: October 2019

Purpose:
To evaluate Pegasus optical coherence tomography (OCT), a clinical decision support software for the identification of features of retinal disease from macula OCT scans, across heterogenous populations involving varying patient demographics, device manufacturers, acquisition sites, and operators.

Methods:
Five thousand five hundred and eighty-eight normal and anomalous macular OCT volumes (162,721 B-scans), acquired at independent centers in five countries, were processed using the software. Results were evaluated against ground truth provided by the data set owners.

Results:
Pegasus-OCT performed with areas under the curve of the receiver operating characteristic of at least 98% for all data sets in the detection of general macular anomalies. For scans of sufficient quality, the areas under the curve of the receiver operating characteristic for general age-related macular degeneration and diabetic macular edema detection were found to be at least 99% and 98%, respectively.

Conclusion:
The ability of a clinical decision support system to cater for different populations is key to its adoption. Pegasus-OCT was shown to be able to detect age-related macular degeneration, diabetic macular edema, and general anomalies in OCT volumes acquired across multiple independent sites with high performance. Its use thus offers substantial promise, with the potential to alleviate the burden of growing demand in eye care services caused by retinal disease.
COMPARISON OF PROJECTION-RESOLVED OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY-BASED METRICS FOR THE EARLY DETECTION OF RETINAL MICROVASCULAR IMPAIRMENTS IN DIABETES MELLITUS
Authors: Zhu Tie Pei , Li En Hui , Li Jin Yu , Dai Xi Zhe , Zhang Hui Na , Chen Bin Bin , Ye Pan Pan , Su Zhao An , Ye Juan 
Published: October 2019

Purpose:
To determine the ability of nonperfusion, vessel density, and morphologic measurements using projection-resolved optical coherence tomography angiography to detect early retinal microvasculature impairments in diabetes mellitus.

Methods:
A retrospective review was performed on Type 2 diabetes mellitus patients with no diabetic retinopathy (DR) or mild nonproliferative DR and age-matched controls imaged with optical coherence tomography angiography. Foveal avascular zone-related metrics and extrafoveal avascular area were measured in optical coherence tomography angiography images. Vessel density and fractal dimension were calculated with and without a skeletonization process. The vessel diameter index and vessel tortuosity were computed. The area under the receiver operating characteristic curve (AUC) estimated diagnostic performances.

Results:
Dilated capillary diameter was observed in the deep capillary plexus in the diabetic groups. Vessel density and fractal dimension of skeletonized deep capillary plexus significantly and progressively decreased in the no DR and mild nonproliferative DR groups compared with controls. Superficial extrafoveal avascular area, vessel density, and fractal dimension of the skeletonized deep capillary plexus had the highest diagnostic performance to differentiate mild nonproliferative DR from control eyes, with AUCs of 0.885, 0.876, and 0.876, respectively.

Conclusion:
Vessel density and fractal dimension from the skeletonized deep capillary network may be the most sensitive for detecting early retinal capillary loss in diabetes mellitus.
FLAT IRREGULAR PIGMENT EPITHELIUM DETACHMENT IN CENTRAL SEROUS CHORIORETINOPATHY
Authors: Hwang Hyeseong , Kim Jin YOUNG , Kim Kyung TAE , Chae Ju BYUNG , Kim Dong YOON 
Published: October 2019

Purpose:
To investigate the differences in natural course, intravitreal bevacizumab injection (IVB) responsiveness, and optical coherence tomography angiography findings according to the type of pigment epithelial detachment (PED) in patients with central serous chorioretinopathy (CSC).

Methods:
A retrospective review of angiographically proven CSC patients was conducted. Pigment epithelium detachment was classified as flat irregular or focal. To identify the natural course of CSC, we had observed whether subretinal fluid was improved without any treatment until symptom duration was >3 months. When CSC symptom duration was >3 months, IVB injection was performed. Symptom duration, central subfield thickness, subfoveal choroidal thickness, presence of subretinal fluid, natural course, optical coherence tomography angiography findings, and IVB responsiveness were compared between the PED types.

Results:
One hundred eyes were included (64 flat irregular PED vs. 34 focal PED). Flat irregular PED had a longer symptom duration than focal PED (7.20 ± 11.52 vs. 3.69 ± 3.98 months, P = 0.03). In untreated cases, the rate of complete resolution of subretinal fluid was significantly lower in flat irregular PED than in focal PED (34.78% vs. 65.22%, P = 0.017). In contrast to the natural course, responsiveness to IVB was significantly better in flat irregular PED (72.41% vs. 31.58%, P = 0.005). Optical coherence tomography angiography revealed more CNV in flat irregular PED (42.90% vs. 10.00%, P = 0.014). Subfoveal choroidal thickness in flat irregular PED was significantly thicker.

Conclusion:
In CSC patients with flat irregular PED, the natural course was poor, but treatment response to IVB was favorable. Flat irregular PED patients showed longer symptom duration and thicker subfoveal choroidal thickness than those with focal PED. Optical coherence tomography angiography revealed more choroidal neovascularization in flat irregular PED. These findings suggest that CSC with flat irregular PED could be considered a form of pachychoroid neovasculopathy.
MITOGEN-ACTIVATED PROTEIN INHIBITORS: FULL-FIELD ELECTRORETINOGRAM DEMONSTRATING GENERALIZED RETINAL DYSFUNCTION
Authors: van Lint Michel , Ebraert Herlinde , Van Aken Elisabeth H. 
Published: October 2019

Purpose:
To report a patient with generalized retinal toxicity to mitogen-activated protein inhibitors.

Methods:
Retrospective case report.

Results:
Full-field electroretinogram findings indicate a generalized toxicity to the use of the mitogen-activated protein inhibitor trametinib. There was an improved response and resolution of serous detachments after decreasing the dose.

Conclusion:
Mitogen-activated protein inhibitors may affect global retinal function, as opposed to the serous detachments that are concentrated in the posterior pole. This may be of importance in further understanding the underlying pathologic mechanisms.
Nurse practitioners and barriers to diabetic foot treatment
Authors: Anderson Michelle , Arvidson Cathy 
Published: October 2019

ABSTRACT

Background:
Even with full practice authority, nurse practitioners (NPs) face limitations in care and treatment options. An example of this is current federal law prohibiting NPs from ordering diabetic shoes.

Purpose:
This study reviewed the background of this problem, potential impacts on patient health and NP practice, and viable solutions for consideration.

Methods:
This was a descriptive study of NPs in a northwestern state with full practice authority. An anonymous online survey was used. There were 54 total NP respondents.

Results:
The potential negative patient outcomes associated with restricted NP ability to prescribe diabetic footwear were supported through the literature review and the survey, including increased foot complications and acuity, translating to increased costs. Of the NPs queried, 80% felt inability to prescribe diabetic footwear was limiting to their practice, and 92% felt this affected patient outcomes. Federal legislative changes with support of bipartisan bills allowing NPs to prescribe diabetic footwear could facilitate timeliness and access to care while reducing costs.

Implications for practice:
Legislation affecting NP scope of practice is an important issue with implications related to patient outcomes. Nurse practitioners should continue to support legislation at the federal level to pass bills allowing for NPs to certify orders for diabetic shoes.
Immediate Breast Reconstruction in The Netherlands and the United States: A Proof-of-Concept to Internationally Compare Quality of Care Using Cancer Registry Data
Authors: Kamali Parisa , van Bommel Annelotte , Becherer Babette , Cooter Rodney , Mureau Marc A. M. , Pusic Andrea , Siesling Sabine , van der Hulst René R. J. W. , Lin Samuel J. , Rakhorst Hinne 
Published: October 2019

Background:
Studies based on large-volume databases have made significant contributions to research on breast cancer surgery. To date, no comparison between large-volume databases has been made internationally. This is the first proof-of-concept study exploring the feasibility of combining two existing operational databases of The Netherlands and the United States, focusing on breast cancer care and immediate breast reconstruction specifically.313/291

Methods:
The National Breast Cancer Organization The Netherlands Breast Cancer Audit (NBCA) (2011 to 2015) and the U.S. Surveillance, Epidemiology, and End Results (SEER) database (2010 to 2013) were compared on structure and content. Data variables were grouped into general, treatment-specific, cancer-specific, and follow-up variables and were matched. As proof-of-concept, mastectomy and immediate breast reconstruction rates in patients diagnosed with invasive breast cancer or ductal carcinoma in situ were analyzed.

Results:
The NBCA included 115 variables and SEER included 112. The NBCA included significantly more treatment-specific variables (n = 46 versus 6), whereas the SEER database included more cancer-specific variables (n = 74 versus 26). In patients diagnosed with breast cancer or ductal carcinoma in situ, immediate breast reconstruction was performed in 19.3 percent and 24.0 percent of the breast cancer cohort and 44.0 percent and 35.3 percent of the ductal carcinoma in situ cohort in the NBCA and SEER, respectively. Immediate breast reconstruction rates increased significantly over time in both data sets.

Conclusions:
This study provides a first overview of available registry data on breast cancer care in The Netherlands and the United States, and revealed limited data on treatment in the United States. Comparison of treatment patterns of immediate breast reconstruction showed interesting differences. The authors advocate the urgency for an international database with alignment of (treatment) variables to improve quality of breast cancer care for patients across the globe.
Abdominoplasty in the Overweight and Obese Population: Outcomes and Patient Satisfaction
Authors: Hammond Dennis C. , Chandler Ashley R. , Baca Marissa E. , Li Yu Kit , Lynn Jeremy V. 
Published: October 2019

Background:
Abdominoplasty is a safe, efficacious body contouring procedure commonly performed on patients after massive weight loss or pregnancy, or because of general aging. However, complication rates and patient satisfaction levels remain largely unexplored for the overweight and obese patient population. The purpose of this study was twofold: to determine the complication rate and to gauge the psychological impact of abdominoplasty in the overweight or obese patient.

Methods:
A retrospective review was conducted of consecutive overweight and obese patients undergoing abdominoplasty or panniculectomy over a 12-year period from January of 2004 to December of 2016. Patient medical records were reviewed to identify patient demographics and comorbidities, operative details, and postoperative course. A patient survey was used to assess satisfaction, personal experience with complications, and the recovery process.

Results:
Forty-six total patients underwent abdominoplasty or panniculectomy during the 12-year period and met the criterion of body mass index greater than or equal to 25 kg/m2. The average patient body mass index was 32.0 kg/m2, with the majority of the patients categorized as overweight. The average abdominal resection weight was 4834.9 g. Major complications, defined as complications requiring return to the operating room, occurred in four patients (8.7 percent). Minor complications, defined as complications that could be handled in an office setting, occurred in 18 patients (39.1 percent). Thirty-six patients (78.3 percent) responded to the survey. The overwhelming majority of patients who responded to the survey [n = 35 (97.2 percent)] stated that they were satisfied with the final outcome and would choose to have the procedure again.

Conclusion:
Abdominoplasty and panniculectomy in overweight and obese patients are associated with an elevated complication rate, yet patient satisfaction is overwhelmingly high, suggesting the viability of body contouring procedures in this patient population.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
A Prospective, Multicenter, Randomized, Evaluator-Blinded, Split-Hand Study to Evaluate the Effectiveness and Safety of Large-Gel-Particle Hyaluronic Acid with Lidocaine for the Correction of Volume Deficits in the Dorsal Hand
Authors: Moradi Amir , Allen Shawn , Bank David , Marmur Ellen , Fagien Steven , Glaser Dee Anna , Maguire Courtney , Cohen Joel L. 
Published: October 2019

Background:
Hand rejuvenation has become increasingly popular, but there are few reports published on the use of hyaluronic acid gels for correction of volume deficits in the dorsal hand.

Methods:
This study evaluated the efficacy and safety of large-gel-particle hyaluronic acid with lidocaine, a 20-mg/ml hyaluronic acid gel with 0.3% lidocaine, compared to no treatment for the correction of volume deficits in the dorsal hand. This was a prospective, multicenter, split-hand study in 90 subjects who received treatment with product in one hand. The primary efficacy endpoint was based on a 1 point of improvement with treatment versus no treatment according to the Merz Hand Grading Scale at week 12. Other assessments included Central Independent Photographic Reviewers evaluations of hand photographs, Global Aesthetic Improvement Scale, subject satisfaction, and safety.

Results:
The mean injection volume was 2.1 ml at the first treatment. Subjects demonstrated significantly higher response rates with treatment compared to no treatment at week 12 (85.9 percent versus 21.2 percent) and at weeks 16, 20, and 24 (p < 0.0001). Photographic Reviewers assessments showed consistently greater improvements in the treated hands compared with the untreated hands from week 12 to week 24. Most subjects and investigators (≥92.8 percent) reported improvements in Global Aesthetic Improvement Scale score across all time points with treatment. Treatment-related adverse events were reported in seven subjects (7.9 percent). Most of these were mild, and none were serious.

Conclusion:
Hyaluronic acid with lidocaine is safe, effective, and well tolerated for the correction of volume deficits in the dorsal hand.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
International and Geographic Trends in Gender Authorship within Plastic Surgery
Authors: Bucknor Alexandra , Peymani Abbas , Kamali Parisa , Epstein Sherise , Chen Austin D. , Bletsis Patrick , Chattha Anmol , Mathijssen Irene , Rakhorst Hinne , Lin Samuel J. 
Published: October 2019

Background:
Professional advancement in academic plastic surgery may depend on scholarly activity. The authors evaluate gender-based publishing characteristics in three international plastic surgery journals.

Methods:
A retrospective review of all articles published in 2016 in the following journals was undertaken: Plastic and Reconstructive Surgery, Journal of Plastic, Reconstructive and Aesthetic Surgery, European Journal of Plastic Surgery, Annals of Surgery, and New England Journal of Medicine. Data were collected on lead author gender (first or senior author) and differences in author gender proportions, by journal, by article topic, and by geographic location were evaluated.

Results:
Overall, 2610 articles were retrieved: 34.1 percent were from plastic surgery journals, 12.8 percent were from the Annals of Surgery, and 53.1 percent were from the New England Journal of Medicine. There was a lower proportion of female lead authors among plastic surgery journals compared with the Annals of Surgery and the New England Journal of Medicine (31 percent versus 39 percent versus 39 percent; p = 0.001). There were no differences in female lead author geographic location in the Annals of Surgery or the New England Journal of Medicine; within the plastic surgery journals, there were differences (p = 0.005), including a lower proportion arising from East Asia (15 percent) and a higher proportion arising from Canada (48 percent). Within plastic surgery, Plastic and Reconstructive Surgery had the lowest proportion of female lead author (p < 0.001). The proportion of female lead author varied by article topic (p < 0.001) and was notably higher in breast (45.6 percent) and lower in head and neck/craniofacial-orientated articles (25.0 percent).

Conclusions:
There are gender disparities in three mainstream plastic surgery journals—Plastic and Reconstructive Surgery, the Journal of Plastic, Reconstructive and Aesthetic Surgery, the European Journal of Plastic Surgery—and there are lower proportions of lead female authorship compared with the Annals of Surgery and the New England Journal of Medicine. Further research should focus on understanding any geographic disparities that may exist.
Management of Pilonidal Sinus Disease with the Aesthetically Shaped Parasacral Perforator Flap: Multicenter Evaluation of 228 Patients
Authors: Chaput Benoit , Herlin Christian , Jacques Jérémie , Berthier Charline , Meresse Thomas , Bekara Farid , Sinna Raphael , Boissière Florian , Bertheuil Nicolas , Grolleau Jean-Louis 
Published: October 2019

Background:
The management of pilonidal sinus disease is still not standardized. Currently, the two main procedures are a lay-open excision procedure with secondary healing or coverage with local flaps. The authors present their experience with a one-stage excision-coverage with an innovative parasacral artery perforator flap propeller designed to respect the aesthetic unity of the buttocks.

Methods:
Study patients were managed with this procedure in the Toulouse, Montpellier, and Rennes university hospitals between 2012 and 2018. Data were collected on clinical and surgical details, immediate and late postoperative complications, and long-term recurrence. Aesthetic satisfaction was evaluated with a self-evaluation questionnaire.

Results:
The authors operated on 228 consecutive patients for pilonidal sinus disease with an aesthetically shaped parasacral artery perforator flap. The median patient age was 23.5 years, the median operative time was 46 minutes, the median flap length was 9.3 cm (range, 6.5 to 14 cm), and the median flap width was 4.1 cm (range, 4 to 6.5 cm). There were five distal necroses but no complete flap necrosis. There were six postoperative hematomas, 11 infections, and 18 wound dehiscences. The median follow-up period was 27.9 months. Median hospital length of stay was 4.2 days. Three recurrences of pilonidal sinus disease and six instances of hidradenitis suppurativa were detected. Approximately 82 percent of the women and more than 85 percent of the men were “satisfied” or “very satisfied” with the aesthetic outcome, without significant differences between the sexes (p = 0.901).

Conclusions:
The aesthetically shaped parasacral artery perforator flap combines very satisfactory results regarding recurrence and postoperative recovery with cosmetic outcome. This procedure is technically more demanding than other flap procedures, although it is accessible to numerous surgeons as the first-line treatment for pilonidal sinus disease after initial learning.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Fourteen Years After Delayed Replantation of an Avulsed Permanent Tooth: Clinical Features and Outcomes
Authors: Lou Qun , Zhu Yaqin , Wang Xudong 
Published: October 2019

Abstract
This article reports a clinical case of a boy who underwent an avulsion of the upper right central incisor at 8 years old. The avulsed tooth was kept in the socket for 11 years after replantation. The clinical and radiographic findings after 14 years revealed a complete root resorption, but alveolar bone volume is adequate for future implantation from the recent tomography scans view, even in labial area where alveolar bone morphology is poor.
Choosing Your Battles: Which Resistance Genes Warrant Global Action?
Authors: Zhang An-Ni , Li Li-Guan , Yin Xiaole , Dai Chengzhen L , Groussin Mathieu , Poyet Mathilde , Topp Edward , Gillings Michael R , Hanage William P , Tiedje James M , Alm Eric J , Zhang Tong 
Published: October 2019

AbstractThe increasing accumulation of antibiotic resistance genes (ARGs) in pathogens poses a severe threat to the treatment of bacterial infections. However, not all ARGs do not pose the same threats to human health. Here, we present a framework to rank the risk of ARGs based on three factors: “anthropogenic enrichment”, “mobility”, and “host pathogenicity”. The framework is informed by all available bacterial genomes (55,000), plasmids (16,000), integrons (3,000), and 850 metagenomes covering diverse global eco-habitats. The framework prioritizes 3% of all known ARGs in Rank I (the most at risk of dissemination amongst pathogens) and 0.3% of ARGs in Rank II (high potential emergence of new resistance in pathogens). We further validated the framework using a list of 38 ARG families previously identified as high risk by the World Health Organization and published literature, and found that 36 of them were properly identified as top risk (Rank I) in our approach. Furthermore, we identified 43 unreported Rank I ARG families that should be prioritized for public health interventions. Within the same gene family, homologous genes pose different risks, host range, and ecological distributions, indicating the need for high resolution surveillance into their sequence variants. Finally, to help strategize the policy interventions, we studied the impact of industrialization on high risk ARGs in 1,120 human gut microbiome metagenomes of 36 diverse global populations. Our findings suggest that current policies on controlling the clinical antimicrobial consumptions could effectively control Rank I, while greater antibiotic stewardship in veterinary settings could help control Rank II. Overall, our framework offered a straightforward evaluation of the risk posed by ARGs, and prioritized a shortlist of current and emerging threats for global action to fight ARGs.