bluuebunny/crossref_metadata_2025_split huggingface dataset:
Importance of Individual Elements for Perineal Protection in Childbirth: An Interventional, Prospective Trial
Authors: Rasmussen Ole , Yding Annika , Lauszus Finn , Andersen Charlotte , Anhøj Jacob , Boris Jane 
Published: October 2018

Objective To analyze the association between each element of a hands-on intervention in childbirth and the incidence of obstetric anal sphincter injuries (OASIS).
Study Design We conducted a prospective, interventional quality improvement project and implemented a care bundle with five elements at an obstetric department in Denmark with 3,000 deliveries annually. We aimed at reducing the incidence of OASIS. In the preintervention period, 355 vaginally delivering nulliparous women were included. Similarly, 1,622 nulliparous women were included in the intervention period. The association of each element with the outcome was estimated using a regression analysis.
Results The incidence of OASIS went down from 7.0 to 3.4% among nulliparous women delivering vaginally (p = 0.003; relative risk = 0.48; 95% confidence interval [CI]: 0.30–0.76). Number needed to treat was 28. Logistic regression analysis showed that using hand on the head of the child significantly reduced the risk of OASIS (odds ratio = 0.28; 95% CI: 0.14–0.58).
Conclusion Using a quality improvement framework, we documented the individual elements of the intervention. Hand on the infant's head reduced the risk of OASIS.
Laparoscopic Ventral Mesh Rectopexy: Functional Outcomes after Surgery
Authors: Ahmad Nasir , Stefan Samuel , Adukia Vidhi , Naqvi Syed , Khan Jim 
Published: October 2018

Aims Rectal prolapse is a debilitating and unpleasant condition adversely affecting the quality of life. Laparoscopic ventral mesh rectopexy (LVMR) is recognized as one of the treatment options. The aim of this study was to evaluate the functional outcomes after a standardized LVMR.
Methods A cohort of patients who underwent LVMR from 2011 to 2015 were contacted and asked to fill questionnaires about their symptoms before and after the surgery. Three questionnaires based on measurement of Wexner fecal incontinence (WFI), obstructive defecation syndrome (ODS), and Birmingham Bowel and Urinary Symptom (BBUS) scores were used to assess the changes in postoperative functional outcomes. Some additional questions were also added to further assess bowel dysfunction.
Results There were 58 female patients with a mean age of 62.74 ± 15.20 (26–86) years in this cohort. About 70% of the patients participated in the study and returned the filled questionnaires. There was a significant overall improvement across all three scores (WFI: p = 0.001, ODS: p = 0.001, and BBUS: p = 0.001). Some individual components in the scoring systems did not improve to patient's satisfaction. No perioperative complication or conversion to an open procedure was reported in this study. Three recurrences were seen in the redo cases.
Conclusion LVMR is a promising way of dealing with rectal prolapse. A careful patient selection, appropriate preoperative workup, and a meticulous surgical technique undoubtedly transform the postoperative outcomes.
Besonderheiten des Kniegelenkersatzes beim Rheumatiker
Authors: Gaulke R. 
Published: October 2018

ZusammenfassungDurch die zunehmende Spezialisierung in der operativen Versorgung der Erkrankungen des Bewegungsapparates besteht die Gefahr, dass Patienten mit Systemerkrankungen auf die biomechanischen Defizite des zu behandelnden Gelenkes reduziert werden. Insbesondere die Endoprothetik an Knie- und Hüftgelenk hat durch die Zertifizierung von sogenannten Endoprothesenzentren mit Hauptoperateuren, die nahezu ausschließlich Kniebzw. Hüft-Endoprothesen implantieren, zu einer starken Gewichtung der Operationstechnik im Hinblick auf biomechanische Erfordernisse geführt. Bedauerlicherweise treten die Nebenerkrankungen, die den Verlauf nach der Implantation einer Endoprothese maßgeblich beeinflussen können, hierbei häufig in den Hintergrund. Die stetige Markteinführung neuer Immunsuppressiva mit unterschiedlichen Halbwertszeiten erfordert jedoch dringend, dass bei der Implantation einer Endoprothese die Medikation entsprechend pausiert werden muss, um das Infektionsrisiko so gering wie möglich zu halten. Daneben bestehen beim Rheumatiker besondere Risikofaktoren fernab des zu operierenden Gelenkes, welche unter Umständen zu letalen Komplikationen führen können.
Discs large 1 controls daughter-cell polarity after cytokinesis in vertebrate morphogenesis
Authors: Li Yuwei , Junge Jason A. , Arnesano Cosimo , Gross Garrett G. , Miner Jeffrey H. , Moats Rex , Roberts Richard W. , Arnold Don B. , Fraser Scott E. 
Published: October 2018

Significance
An integrative approach is presented for studying cell biology in vivo, assessing protein dynamics and cell behavior, and offering in situ analyses of cytokinesis, daughter-cell polarity, and stereotyped tissue morphogenesis. Tagging endogenous Discs Large 1 (Dlg1) in cartilage using intrabody technology permits in situ 3D time-lapse imaging and reveals Dlg1 enrichment at the midbody during cytokinesis. Functional significance is tested by disrupting Dlg1 multimerization and its midbody localization by using an ablating intrabody, DLGE3. Building on prior work on Dlg1 in epithelia, our work reveals that Dlg1 propagates cell polarity in proliferative mesenchymal tissues and suggests that multiple mechanisms act in concert at distinct phases of the cell cycle to transmit and maintain cell polarity.
KDM3A histone demethylase functions as an essential factor for activation of JAK2−STAT3 signaling pathway
Authors: Kim Hyunkyung , Kim Dongha , Choi Seon Ah , Kim Chang Rok , Oh Se Kyu , Pyo Ki Eun , Kim Joomyung , Lee Seung-Hoon , Yoon Jong-Bok , Zhang Yi , Baek Sung Hee 
Published: October 2018

Significance
An aberrant covalent histone modification which drives dysregulation of transcriptional program is related to human diseases such as cancer. Thus, identifying signaling pathways modulating transcription factors and epigenetic enzymes are coming into view as attractive therapeutic targets. In this study, we provide evidence that KDM3A is tyrosine-phosphorylated by JAK2, and tyrosine-phosphorylated KDM3A acts as a coactivator for STAT3, thereby exerting increased cancer cell growth and motility. We propose that JAK2-dependent tyrosine phosphorylation of KDM3A could be a potential therapeutic target for epigenetic control of oncogenic effect governed by JAK2−STAT3 signaling pathway.
Study on optimization of low carbon renewal system for residential area
Authors: Zhao G C , Yu X F , Fan J S 
Published: October 2018

Abstract
Global climate change has been an impending cosmopolitan issue. As the basic part of the city, urban residential area is the basic space for the use of sustainable ideas to promote the construction of low carbon city. Along with urban expansion, social polarization and significant change of social space in China, the decline tendency of central city become significantly faster. Faced with the double test between climate change and residential area recession, traditional renewal methods no longer meet the needs of urban sustainable development. The urban renewal modes need a major transformation, and Low carbon renewal is an effective way not only to slow down the decline of residential areas but also promote sustainable development of the city. To put forward an analysis and optimization methods for low carbon renewal, we proposed a low carbon renewal system from six aspects: layout planning, road and traffic, architecture planning and design, environment engineering, municipal engineering and construction management. Moreover, we used Analytic Network Process (ANP) to analyse the internal feedback of the system. At last, the optimization process of residential low carbon renewal was proposed.
A New Mechanism of Resistance of Human Immunodeficiency Virus Type 2 to Integrase Inhibitors: A 5-Amino-Acid Insertion in the Integrase C-Terminal Domain
Authors: Le Hingrat Quentin , Collin Gilles , Lê Minh , Peytavin Gilles , Visseaux Benoit , Bertine Mélanie , Tubiana Roland , Karmochkine Marina , Valin Nadia , Collin Fidéline , Lemaignen Adrien , Bernard Louis , Damond Florence , Matheron Sophie , Descamps Diane , Charpentier Charlotte ,   French National Agency for Research on AIDS and Viral Hepatitis (ANRS) CO5 HIV-2 Cohort
Published: October 2018

AbstractBackgroundIntegrase strand transfer inhibitors (INSTIs) are crucial for the treatment of human immunodeficiency virus (HIV) type 2 infection, due to limited available therapeutic options. Recently, bictegravir has been approved for HIV-1, but no data are currently available for HIV-2.MethodsWe assessed the phenotypic susceptibility of 12 HIV-2 clinical isolates, obtained from 2 antiretroviral-naive and 10 antiretroviral-experienced patients, to 5 INSTIs (bictegravir, cabotegravir, dolutegravir, elvitegravir, and raltegravir) at the virological failure of an INSTI-based regimen. The 50% inhibitory concentrations (IC50s) were determined. Phenotypic inhibitory quotients were determined using trough INSTI plasma concentrations.ResultsWild-type viruses were susceptible to the 5 INSTIs, with IC50s in the nanomolar range. Bictegravir had a lower IC50 than the other INSTIs on those HIV-2 isolates bearing major, resistance-associated mutations (codons 143, 148, and 155). We identified a new resistance profile—a 5–amino-acid insertion at codon 231 of the HIV-2 integrase (231INS)—in 6 patients at the virological failure of a raltegravir-based regimen. Those patients had adequate raltegravir concentrations, but harbored multiresistant viruses with low genotypic susceptibility scores (median = 1.5). This insertion rendered isolates highly resistant to raltegravir and elvitegravir, and moderately resistant to dolutegravir and cabotegravir. Regarding bictegravir, 2 isolates remained susceptible and 2 had a slight increase in IC50 (3- to 5-fold change).ConclusionsOur results confirm the potency of INSTI on HIV-2 clinical isolates with wild-type integrase. In addition, we identified a new resistance pathway, 231INS, selected in antiretroviral-experienced patients with multiresistant HIV-2 viruses. This highlights the need of close follow-up of those patients initiating an INSTI-based regimen.
A sentiment analysis system for social media using machine learning techniques: Social enablement
Authors: Rani Sujata , Kumar Parteek 
Published: October 2018

Abstract
In this article, an innovative approach to perform the sentiment analysis (SA) has been presented. The proposed system handles the issues of Romanized or abbreviated text and spelling variations in the text to perform the sentiment analysis. The training data set of 3,000 movie reviews and tweets has been manually labeled by native speakers of Hindi in three classes, i.e. positive, negative, and neutral. The system uses WEKA (Waikato Environment for Knowledge Analysis) tool to convert these string data into numerical matrices and applies three machine learning techniques, i.e. Naive Bayes (NB), J48, and support vector machine (SVM). The proposed system has been tested on 100 movie reviews and tweets, and it has been observed that SVM has performed best in comparison to other classifiers, and it has an accuracy of 68% for movie reviews and 82% in case of tweets. The results of the proposed system are very promising and can be used in emerging applications like SA of product reviews and social media analysis. Additionally, the proposed system can be used in other cultural/social benefits like predicting/fighting human riots.
Beyond biomarkers: How enhanced CT imaging can improve the diagnostic-driven management of invasive mould disease
Authors: Stanzani Marta , Sassi Claudia , Battista Giuseppe , Lewis Russell E 
Published: October 2018

AbstractCT imaging remains an essential diagnostic test for identification, staging and management of invasive mould infection (IMI) in patients with hematological malignancies. Yet the limited specificity of standard CT imaging can drive excessive antifungal use in patients, especially when more definitive diagnosis cannot be established through microbiology or invasive diagnostic procedures. CT pulmonary angiography (CTPA) is a complimentary, non-invasive approach to standard CT that allows for direct visualization of pulmonary arteries inside infiltrates for signs of angioinvasion, vessel destruction and vessel occlusion. Experience from several centers that are using CTPA as part of a standard diagnostic protocol for IMI suggests that a positive vessel occlusion sign (VOS) is the most sensitive and a specific sign of IMI in both neutropenic and non-neutropenic patients. CTPA is particularly useful in patients who develop suspected breakthrough IMI during antifungal prophylaxis because, unlike serum and/or BAL galactomannan and polymerase chain reaction (PCR) testing, the sensitivity is not reduced by antifungal therapy. A negative VOS may also largely rule-out the presence of IMI, supporting earlier discontinuation of empirical therapy. Future imaging protocols for IMI in patients with hematological malignancies will likely replace standard chest X-rays in favor of early low radiation dose CT exams for screening, with characterization of the lesions by CTPA and routine follow-up using functional/metabolic imaging such as 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (FDG-PET/CT) to assess treatment response. Hence, enhanced CT imaging techniques can improve the diagnostic-driven management of IMI management in high-risk patients with hematological malignancies.
Reaching rural veterans: a new mechanism to connect rural, low-income US Veterans with resources and improve food security
Authors: Wright B N , MacDermid Wadsworth S , Wellnitz A , Eicher-Miller H A 
Published: October 2018

AbstractBackgroundRural, low-income US veterans face additional barriers to accessing food and resources compared to urban veterans. Based on both social-ecological and cultural competence approaches, the Reaching Rural Veterans (RRV) pilot intervention built on the existing infrastructure of food pantries to improve food security and connect rural, low-income veterans with resources. This article describes the process of implementing and evaluating RRV.MethodsFive rural food pantries within each of two states, Indiana and Kentucky, received training in cultural competence and held monthly outreach events where food and services were offered to veterans. Veteran adult participants completed an assessment at baseline and 3-month follow-up that measured food security using the US Household Food Security Survey Module and self-reported resource enrollment. Repeated measures logistic regression models evaluated the odds of improving food security and resource enrollment from baseline to follow-up (significance P &lt; 0.05).ResultsRRV recruited 234 participants; 53% completed the follow-up assessment. At follow-up, the odds of household (P = 0.009) and adult (P = 0.01) food security increased, as did enrollment in one or more of the following resources: Temporary Assistance for Needy Families, Supplemental Security Income, General Assistance or Assistance from the Township Trustee (P = 0.005).ConclusionsRRV yielded promising preliminary results of improved food security and resource use.
Correlation between Empirical Antibiotic Therapy and Bone Culture Results in Patients with Osteomyelitis
Authors: Tardáguila-García Aroa , Lázaro-Martínez José Luis , Sanz-Corbalán Irene , García-Álvarez Yolanda , Álvaro-Afonso Francisco Javier , García-Morales Esther 
Published: October 2018

ABSTRACT

OBJECTIVE:
To analyze the correlation between empirical antibiotic therapies prescribed in primary care centers by general practitioners and the microbiology results of bone culture in patients with diabetic foot–related osteomyelitis.

METHODS:
This observational study involved 80 patients with diabetic foot ulcers and clinically suspected osteomyelitis. The patients were taking antibiotics prescribed by general practitioners to treat diabetic foot infections. Bone samples were taken from every patient for microbiology analysis in a specialized diabetic foot unit.

MAIN OUTCOME MEASURE:
The sensitivity of the bone cultures to antibiotics was compared with the patient’s previous antibiotic therapy, and antibiotic and bacterial resistance were analyzed.

MAIN RESULTS:
The bone cultures from only 16 patients (22.3%) showed sensitivity to the antibiotics that the patient had been prescribed. Fifty-six patients (77.8%) displayed bacterial resistance to the antibiotic that they were taking.

CONCLUSIONS:
Awareness and implementation of international antibiotic stewardship guidelines are poor in primary care centers. It is important to establish strategies that foster a better understanding of treatment management standards and ensure the proper implementation of guidelines.
Drug updates and approvals
Authors: Mospan Cortney , Mospan Geoffrey , Byland Emily , Whitaker William Blake , Xiong Linda , Dunlap Jordan , Canupp Katherine 
Published: October 2018

Abstract:
In 2018, the FDA approved several new drugs for use in primary care. This article highlights the following new drugs: bictegravir, emtricitabine, and tenofovir alafenamide (Biktarvy); doxylamine succinate and pyridoxine hydrochloride (Bonjesta); erenumab-aooe (Aimovig); lofexidine hydrochloride (Lucemyra); tezacaftor and ivacaftor (Symdeko); and tildrakizumab-asmn (Ilumya).
Increased Hip Intracapsular Pressure Decreases Perfusion of the Capital Femoral Epiphysis in a Skeletally Immature Porcine Model
Authors: Upasani Vidyadhar V. , Badrinath Raghav , Farnsworth Christine L. , Jeffords Megan E. , Hallare Jericho A. , Ahmed Syed I. , Schrader Tim 
Published: October 2018

Background:
Increased intracapsular hip pressure is thought to be one of the possible etiologies of femoral head avascular necrosis after intra-articular proximal femoral fractures or acute slipped capital femoral epiphysis. The purpose of this study was to evaluate the relationship between intra-articular hip pressure (IAP) and epiphyseal perfusion pressure (EPP), and its dependency on skeletal maturity using a porcine model.

Methods:
Seven female Yorkshire-hybrid pigs were used to study the direct relationship between IAP and EPP. A needle inserted into the capsule provided both IAP monitoring and saline infiltration until IAP was above mean arterial pressure (MAP). Video simultaneously documented IAP, EPP, MAP. Parameters for all trials in each hip were averaged and compared between the 2 age groups. Significance was P<0.05.

Results:
Four young hips (in pigs 10.3±1.0 wk, 27.4±2.0 kg) and 5 older hips (21.1±0.1 wk, 89.4±7.1 kg) were studied. There was no significant difference in the MAP (50.0±11.8 and 55.5±7.0 mm Hg respectively, P=0.411) between the 2 age groups. In the older hips, biphasic EPP persisted despite increasing IAP to an average of 177 mm Hg over MAP. In the young pigs, the biphasic EPP waveform ceased with increased IAP to an average of 28 mm Hg over MAP. Biphasic waveforms returned once IAP fell to an average of 5 mm Hg over MAP.

Conclusions:
Increased IAP resulted in tamponade of epiphyseal perfusion in the young, but not in the older hips. An intact physis may preclude intraosseous metaphyseal vessels from penetrating the epiphysis, leaving it vulnerable to retinacular artery tamponade.

Clinical Relevance:
The IAP and EPP relationship has direct clinical practice implications. Hip capsulotomy and decompression in young patients with intra-articular proximal femoral fractures and increased intracapsular pressure may decrease avascular necrosis risk.
Risk Factors for Cerebrospinal Fluid Leak Following Anterior Cervical Discectomy and Fusion
Authors: Kapadia Bhaveen H. , Decker Samuel I. , Boylan Matthew R. , Shah Neil V. , Paulino Carl B. 
Published: October 2018

Study Design/Setting:
This was a retrospective cohort study.

Purpose:
The purpose of this study was to examine the association between postoperative cerebrospinal fluid (CSF) leak and anterior cervical discectomy and fusion (ACDF). Specifically, we evaluated: (1) demographic risk factors; (2) comorbid risk factors; (3) indications for surgery; and (4) lengths of stay.

Summary of Background Data:
CSF leak is a rare but serious complication of ACDF. Currently, there is a paucity of literature describing the risk factors for CSF leak following ACDF.

Methods:
The Nationwide Inpatient Sample was used to identify all patients who underwent cervical fusion using the anterior approach with excision of intervertebral disc between 1998 and 2010. Patients who had a diagnosis of ossification of the posterior longitudinal ligament in the cervical region were excluded. All patients who had a CSF leak were identified. Demographics and comorbidities were compared via χ2 analysis, and logistic regression to calculate the odds of having a CSF leak.

Results:
Of the 1,261,140 patients identified, 3048 patients (0.24%) had a postoperative CSF leak. Patients who were between the ages of 55 and 69 years (P=0.038) and 70 years or older (P=0.001) were at an increased risk of CSF leak compared with patients who were aged 40–54 years. Non-white race (P=0.021), obesity, (P<0.001) and hypertension (P=0.025) were associated with an increased risk of CSF leak, but diabetes (P=0.966) and hyperlipidemia (P=0.226) were not. Herniated disc diagnosis was associated with decreased risk of CSF leak (P=0.032), but cervical spondylosis with myelopathy patients had an increased risk (P<0.001). Patients with CSF leak had a mean length of stay of 6.0 days compared with 2.1 days among controls.

Conclusions:
Surgical candidates who are older and non-white should be counseled of their increased risk for CSF leak in preoperative planning. Patients who are obese and have hypertension may benefit from medical optimization before surgery.

Level of Evidence:
Level III.
Relationship Between Midface Volume Deficits and the Appearance of Tear Troughs and Nasolabial Folds
Authors: Glaser Dee Anna , Lambros Val , Kolodziejczyk Julia , Magyar Andrew , Dorries Kathleen , Gallagher Conor J. 
Published: October 2018

BACKGROUND
Understanding interrelationships among aging facial features is important in facial aesthetics as a global treatment approach becomes standard.

OBJECTIVE
Examine empirical relationships between midface volume deficit and severity of tear troughs (TTs) and nasolabial folds (NLFs) in women and men of different racial/ethnic groups.

METHODS
A web-based study was administered to health panel members (aged 18–75 years). Participants compared their midface volume, TTs, and NLFs against photonumeric scales depicting degrees of severity. Linear regressions were conducted to assess the relationship of midface volume on severity of TTs and NLFs, controlling for demographic factors.

RESULTS
Of 4,086 participants (80.0% female), 3,553 had complete data. Increasing severity of midface volume deficit was associated with increasing severity of TTs and NLFs in both sexes (all p < .001). Race/ethnicity was associated with differences in severity in all 3 facial areas, although specific differences between races/ethnicities varied for women and men. Progression rates of severity differed between racial/ethnic groups. Correlations between midface volume deficit, TTs, and NLFs were positive and significant (all p < .001).

CONCLUSION
Midface volume deficit was associated with severity of TT deformity and NLFs after controlling for age and other demographic variables.