bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPLICATED CONGENITAL RETINOSCHISIS
Authors: Savoie Brian T. , Ferrone Philip J. 
Published: September 2016

Purpose:
To describe the treatment and natural history of a patient with complicated congenital retinoschisis.

Methods:
A retrospective case report. A 10-month-old boy with congenital retinoschisis presented with tractional retinal detachments and foveal schisis in both eyes.

Results:
On presentation, vision was decreased in both eyes with presumed amblyopia of the left eye. Funduscopic examination revealed bilateral foveal schisis and tractional retinal detachment involving the macula. Follow-up examination revealed superior retinal dragging and peripheral ischemia on fluorescein angiogram in both eyes. Nine months after presentation, combined rhegmatogenous and tractional retinal detachment developed in the right eye and was treated by scleral buckle. After vitrectomy for nonclearing vitreous hemorrhage in the left eye, a combined rhegmatogenous and tractional retinal detachment developed. Vitrectomy and lensectomy with silicone oil was performed. At 6 years of follow-up, both retinas were attached and foveal schisis had resolved.

Conclusion:
Sight threatening complications of congenital retinoschisis include retinal detachment and vitreous hemorrhage. Vitrectomy and/or scleral buckling may prevent progression of vision loss and promote resolution of schisis.
Assessment of National CLAS Standards in Rural and Urban Local Health Departments in Kentucky
Authors: Gómez María L. , Charnigo Richard , Harris Torrie T. , Williams John C. , Pfeifle William 
Published: September 2016

Context:
Findings from the Centers for Disease Control and Prevention suggest that addressing persistent health disparities based on race and ethnicity must become a national priority. The field of cultural and linguistic competency has gained national attention by improving access to and quality of health care, patient-provider communication, health outcomes, and health equity for minority groups and other vulnerable or special needs populations.

Objectives:
(1) To measure how local health departments (LHDs) in Kentucky comply with the National Standards for Culturally and Linguistically Appropriate Services (CLAS); and (2) to provide policy recommendation based on the findings. This study is the first to assess a statewide public health system under the lens of CLAS.

Design:
Analysis of cross-sectional survey.

Setting:
Electronic surveys administered to LHD administrators in Kentucky.

Participants:
Public health directors, nurse leaders, and program managers.

Main Outcome Measure:
Levels of compliance with various CLAS standards were examined for rural and urban counties using a novel scoring method.

Results:
A total of 159 LHD administrators received the survey. Response rate was 67% (106 participants). Rural and urban LHDs achieved moderate compliance on domains of plans and policies, quality monitoring and improvement for needs assessment, management information systems for clients, and staff training and development. Both geographic groups exhibited lesser compliance on domains of organizational governance, culturally inclusive health care environment for educational materials, and diversity of personnel recruitment.

Conclusion:
County and district LHDs in Kentucky have implemented activities and policies that comply with CLAS standards at levels that vary by domain. Areas requiring particular attention include organizational governance, culturally inclusive health care environment for educational materials, and diversity of personnel. Improvements in these areas may help LHDs better meet the needs of vulnerable populations, racial and ethnic minorities, and special needs groups. CLAS practices may allow organizations to adhere to national public health accreditation standards.
Multivariate classification of pain-evoked brain activity in temporomandibular disorder
Authors: Harper Daniel E. , Shah Yash , Ichesco Eric , Gerstner Geoffrey E. , Peltier Scott J. 
Published: September 2016

Abstract

Introduction: Central nervous system factors are now understood to be important in the etiology of temporomandibular disorders (TMD), but knowledge concerning objective markers of central pathophysiology in TMD is lacking. Multivariate analysis techniques like support vector machines (SVMs) could generate important discoveries regarding the expression of pain centralization in TMD. Support vector machines can recognize patterns in “training” data and subsequently classify or predict new “test” data.

Objectives: We set out to detect the presence and location of experimental pressure pain and determine clinical status by applying SVMs to pain-evoked brain activity.

Methods: Functional magnetic resonance imaging was used to record brain activity evoked by subjectively equated noxious temporalis pressures in patients with TMD and controls. First, we trained an SVM to recognize when the evoked pain stimulus was on or off based on each individual's pain-evoked blood–oxygen–level–dependent (BOLD) signals. Next, an SVM was trained to distinguish between the BOLD response to temporalis-evoked pain vs thumb-evoked pain. Finally, an SVM attempted to determine clinical status based on temporalis-evoked BOLD.

Results: The on-versus-off accuracy in controls and patients was 83.3% and 85.1%, respectively, both significantly better than chance (ie, 50%). Accurate determination of experimental pain location was possible in patients with TMD (75%), but not in healthy subjects (55%). The determination of clinical status with temporalis-evoked BOLD (60%) failed to reach statistical significance.

Conclusion: The SVM accurately detected the presence of noxious temporalis pressure in patients with TMD despite the stimulus being colocalized with their ongoing clinical pain. The SVM's ability to determine the location of noxious pressure only in patients with TMD reveals somatotopic-dependent differences in central pain processing that could reflect regional variations in pain valuation.
Microsurgery Workout: A Novel Simulation Training Curriculum Based on Nonliving Models
Authors: Rodriguez Jose R. , Yañez Ricardo , Cifuentes Ignacio , Varas Julian , Dagnino Bruno 
Published: September 2016

Background:
Currently, there are no valid training programs based solely on nonliving models. The authors aimed to develop and validate a microsurgery training program based on nonliving models and assess the transfer of skills to a live rat model.

Methods:
Postgraduate year–3 general surgery residents were assessed in a 17-session program, performing arterial and venous end-to-end anastomosis on ex vivo chicken models. Procedures were recorded and rated by two blinded experts using validated global and specific scales (objective structured assessment of technical skills) and a validated checklist. Operating times and patency rates were assessed. Hand-motion analysis was used to measure economy of movements. After training, residents performed an arterial and venous end-to-end anastomosis on live rats. Results were compared to six experienced surgeons in the same models. Values of p < 0.05 were considered statistically significant.

Results:
Learning curves were achieved. Ten residents improved their median global and specific objective structured assessment of technical skills scores for artery [10 (range, 8 to 10) versus 28 (range, 27 to 29), p < 0.05; and 8 (range, 7 to 9) versus 28 (range, 27 to 28), p < 0.05] and vein [8 (range, 8 to 11) versus 28 (range, 27 to 28), p < 0.05; and 8 (range, 7 to 9) versus 28 (range, 27 to 29), p < 0.05]. Checklist scores also improved for both procedures (p < 0.05). Trainees were slower and less efficient than experienced surgeons (p < 0.05). In the living rat, patency rates at 30 minutes were 100 percent and 50 percent for artery and vein, respectively.

Conclusions:
Significant acquisition of microsurgical skills was achieved by trainees to a level similar to that of experienced surgeons. Acquired skills were transferred to a more complex live model.
Obstructive Sleep Apnea in Adults: The Role of Upper Airway and Facial Skeletal Surgery
Authors: Garg Ravi K. , Afifi Ahmed M. , Sanchez Ruston , King Timothy W. 
Published: September 2016

Summary:
Obstructive sleep apnea represents a large burden of disease to the general population and may compromise patient quality of life; workplace and automotive safety; and metabolic, cardiovascular, and neurocognitive health. The disease is characterized by repetitive cycles of upper airway collapse resulting from a lack of pharyngeal airway structural support and loss of muscle tone among upper airway dilators. Polysomnography serves as the gold standard for diagnosis of obstructive sleep apnea and the apnea-hypopnea index is the most commonly used metric for quantifying disease severity. Conservative treatments include lifestyle modification, continuous positive airway pressure treatment, and dental appliance therapy. Surgical treatment options include pharyngeal and facial skeletal surgery. Maxillomandibular advancement has been shown to be the most effective surgical approach for multilevel expansion of the upper airway and may significantly reduce an obstructive sleep apnea patient’s apnea-hypopnea index. Patient age, obesity, and the degree of maxillary advancement may be key factors contributing to treatment success.
Reducing Decisional Conflict and Enhancing Satisfaction with Information among Women Considering Breast Reconstruction following Mastectomy: Results from the BRECONDA Randomized Controlled Trial
Authors: Sherman Kerry A. , Shaw Laura-Kate E. , Winch Caleb J. , Harcourt Diana , Boyages John , Cameron Linda D. , Brown Paul , Lam Thomas , Elder Elisabeth , French James , Spillane Andrew 
Published: September 2016

Background:Deciding whether or not to have breast reconstruction following breast cancer diagnosis is a complex decision process. This randomized controlled trial assessed the impact of an online decision aid [Breast RECONstruction Decision Aid (BRECONDA)] on breast reconstruction decision-making.Methods:Women (n= 222) diagnosed with breast cancer or ductal carcinoma in situ, and eligible for reconstruction following mastectomy, completed an online baseline questionnaire. They were then assigned randomly to receive either standard online information about breast reconstruction (control) or standard information plus access to BRECONDA (intervention). Participants then completed questionnaires at 1 and 6 months after randomization. The primary outcome was participants’ decisional conflict 1 month after exposure to the intervention. Secondary outcomes included decisional conflict at 6 months, satisfaction with information at 1 and 6 months, and 6-month decisional regret.Results:Linear mixed-model analyses revealed that 1-month decisional conflict was significantly lower in the intervention group (27.18) compared with the control group (35.5). This difference was also sustained at the 6-month follow-up. Intervention participants reported greater satisfaction with information at 1- and 6-month follow-up, and there was a nonsignificant trend for lower decisional regret in the intervention group at 6-month follow-up. Intervention participants’ ratings for BRECONDA demonstrated high user acceptability and overall satisfaction.Conclusions:Women who accessed BRECONDA benefited by experiencing significantly less decisional conflict and being more satisfied with information regarding the reconstruction decisional process than women receiving standard care alone. These findings support the efficacy of BRECONDA in helping women to arrive at their breast reconstruction decision.
Primary Total Laparoscopic Sigmoid Vaginoplasty in Transgender Women with Penoscrotal Hypoplasia: A Prospective Cohort Study of Surgical Outcomes and Follow-Up of 42 Patients
Authors: Bouman Mark-Bram , van der Sluis Wouter B. , Buncamper Marlon E. , Özer Müjde , Mullender Margriet G. , Meijerink Wilhelmus J. H. J. 
Published: September 2016

Background:
In young transgender women previously treated with puberty-suppressing hormones, penoscrotal hypoplasia can make penoscrotal inversion vaginoplasty unfeasible. The aim of this study was to prospectively assess surgical outcomes and follow-up of total laparoscopic sigmoid vaginoplasty as primary reconstruction in a cohort of transgender women with penoscrotal hypoplasia.

Methods:
Baseline demographics, surgical characteristics, and intraoperative and postoperative complications of all performed total laparoscopic sigmoid vaginoplasty procedures were prospectively recorded.

Results:
From November of 2007 to July of 2015, 42 transgender women underwent total laparoscopic sigmoid vaginoplasty as primary vaginal reconstruction. The mean age at the time of surgery was 21.1 ± 4.7 years. Mean follow-up time was 3.2 ± 2.1 years. The mean operative duration was 210 ± 44 minutes. There were no conversions to laparotomy. One rectal perforation was recognized during surgery and immediately oversewn without long-term consequences. The mean length of hospitalization was 5.7 ± 1.1 days. One patient died as a result of an extended-spectrum beta-lactamase–positive necrotizing fasciitis leading to septic shock, with multiorgan failure. Direct postoperative complications that needed laparoscopic reoperation occurred in three cases (7.1 percent). In seven cases (17.1 percent), long-term complications needed a secondary correction. After 1 year, all patients had a functional neovagina with a mean depth of 16.3 ± 1.5 cm.

Conclusions:
Total laparoscopic sigmoid vaginoplasty seems to have a similar complication rate as other types of elective laparoscopic colorectal surgery. Primary total laparoscopic sigmoid vaginoplasty is a feasible gender-confirming surgical technique with good functional outcomes for transgender women with penoscrotal hypoplasia.

CLINICAL QUESTIO/LEVEL OF EVIDENCE:
Therapeutic, IV.
Advancements and Refinement in Facial Neuromodulators
Authors: Kordestani Reza , Small Kevin H. , Rohrich Rod J. 
Published: September 2016

Summary:
The use of neuromodulators has increased by approximately 748 percent from 2000 to 2014 and has become an integral adjunct for facial rejuvenation. Knowledge of facial anatomy, accurate facial analysis, and familiarity with neurotoxin characteristics will minimize complications and optimize results. Current U.S. Food and Drug Administration–approved neurotoxins in the United States include onabotulinumtoxin A (Botox), abobotulinumtoxin A (Dysport), and incobotulinumtoxin A (Xeomin). The dosage and effect of these products are not interchangeable, so practitioners should master the utility and response of one product before trying the other products. All products have equivalent success in appropriately trained hands; the senior author (R.J.R.) favors no particular neurotoxin. This article provides a stepwise approach to treat dynamic facial rhytides with neuromodulators, including indications, facial analysis, preparation and injection technique, post-procedure care, and complications.
Fossil clam shells reveal unintended carbon cycling consequences of Colorado River management
Authors: Smith Jansen A. , Auerbach Daniel A. , Flessa Karl W. , Flecker Alexander S. , Dietl Gregory P. 
Published: September 2016

Water management that alters riverine ecosystem processes has strongly influenced deltas and the people who depend on them, but a full accounting of the trade-offs is still emerging. Using palaeoecological data, we document a surprising biogeochemical consequence of water management in the Colorado River basin. Complete allocation and consumptive use of the river's flow has altered the downstream estuarine ecosystem, including the abundance and composition of the mollusc community, an important component in estuarine carbon cycling. In particular, population declines in the endemic Colorado delta clam,
Mulinia coloradoensis
, from 50--125 individuals m
−2
in the pre-dam era to three individuals m
−2
today, have likely resulted in a reduction, on the order of 5900–15 000 t C yr
−1
(4.1–10.6 mol C m
−2
yr
−1
), in the net carbon emissions associated with molluscs. Although this reduction is large within the estuarine system, it is small in comparison with annual global carbon emissions. Nonetheless, this finding highlights the need for further research into the effects of dams, diversions and reservoirs on the biogeochemistry of deltas and estuaries worldwide, underscoring a present need for integrated water and carbon planning.
Human Endometrial Stromal Cells Are Highly Permissive To Productive Infection by Zika Virus
Authors: Pagani Isabel , Ghezzi Silvia , Ulisse Adele , Rubio Alicia , Turrini Filippo , Garavaglia Elisabetta , Candiani Massimo , Castilletti Concetta , Ippolito Giuseppe , Poli Guido , Broccoli Vania , Panina-Bordignon Paola , Vicenzi Elisa 
Published: September 2016

ABSTRACTZika virus (ZIKV) is a recently re-emerged flavivirus transmitted to humans by mosquito bites but also from mother to fetus and by sexual intercourse. We here show for the first time that primary human endometrial stromal cells (HESC) are highly permissive to ZIKV infection and support itsin vitroreplication. ZIKV envelope expression was detected in the endoplasmic reticulum whereas double-stranded viral RNA colocalized with vimentin filaments to the perinuclear region. ZIKV productive infection also occurred in the human T-HESC cell line with the induction of interferon-β (IFN-β) and of IFN-stimulated genes. Notably,in vitrodecidualization of T-HESC with cyclic AMP and progesterone upregulated the cell surface expression of the ZIKV entry co-receptor AXL and boosted ZIKV replication byca.100-fold. Thus, endometrial stromal cells, particularly if decidualized, likely represent a crucial cell target of sexual virus transmission and a relevant source of ZIKV spreading to placental trophoblasts during pregnancy.AUTHOR SUMMARYInfection by Zika virus (ZIKV), a flavivirus transmitted to humans by mosquito bites, has recently emerged as an important cause of neurological lesions in the fetal brain as women who become infected by ZIKV during pregnancy can transmit the virus to their fetus. In addition, routes of ZIKV transmission independent of mosquito bites have been also identified and include sexual transmission from both infected men and women to their partners, an aspect bearing great societal implications for ZIKV spread. These observations highlight the importance of the female reproductive tract in the establishment and/or spreading of the infection. In this regard, the endometrium is a highly dynamic tissue undergoing major histological changes during the menstrual cycle under the coordinated action of sexual hormones. In particular, progesterone drives the differentiation of human endometrial stromal cells towards decidualization, a process that is critical for fetal trophoblast invasion and placenta formation. We here report for the first time that both primary and immortalized human endometrial stromal cells are highly permissive to ZIKV infection and replication, particularly whenin vitrodecidualized by progesterone, suggesting that these cells could significantly contribute to vertical ZIKV transmission in utero during pregnancy but also to horizontal transmission by the sexual route.
Nanopore DNA Sequencing and Genome Assembly on the International Space Station
Authors: Castro-Wallace Sarah L. , Chiu Charles Y. , John Kristen K. , Stahl Sarah E. , Rubins Kathleen H. , McIntyre Alexa B. R. , Dworkin Jason P. , Lupisella Mark L. , Smith David J , Botkin Douglas J. , Stephenson Timothy A. , Juul Sissel , Turner Daniel J. , Izquierdo Fernando , Federman Scot , Stryke Doug , Somasekar Sneha , Alexander Noah , Yu Guixia , Mason Christopher E. , Burton Aaron S 
Published: September 2016

AbstractThe emergence of nanopore-based sequencers greatly expands the reach of sequencing into low-resource field environments, enablingin situmolecular analysis. In this work, we evaluated the performance of the MinION DNA sequencer (Oxford Nanopore Technologies) in-flight on the International Space Station (ISS), and benchmarked its performance off-Earth against the MinION, Illumina MiSeq, and PacBio RS II sequencing platforms in terrestrial laboratories. Samples contained mixtures of genomic DNA extracted from lambda bacteriophage,Escherichia coli(strain K12) andMus musculus(BALB/c). The in-flight sequencing experiments generated more than 80,000 total reads with mean 2D accuracies of 85 – 90%, mean 1D accuracies of 75 – 80%, and median read lengths of approximately 6,000 bases. We were able to construct directed assemblies of the ~4.7 MbE. coligenome, ~48.5 kb lambda genome, and a representativeM. musculussequence (the ~16.3 kb mitochondrial genome), at 100%, 100%, and 96.7% pairwise identity, respectively, andde novoassemblies of the lambda andE. coligenomes generated solely from nanopore reads yielded 100% and 99.8% genome coverage, respectively, at 100% and 98.5% pairwise identity. Across all surveyed metrics (base quality, throughput, stays/base, skips/base), no observable decrease in MinION performance was observed while sequencing DNA in space. Simulated runs of in-flight nanopore data using an automated bioinformatic pipeline and cloud or laptop based genomic assembly demonstrated the feasibility of real-time sequencing analysis and direct microbial identification in space. Applications of sequencing for space exploration include infectious disease diagnosis, environmental monitoring, evaluating biological responses to spaceflight, and even potentially the detection of extraterrestrial life on other planetary bodies.
SuperTranscript: a data driven reference for analysis and visualisation of transcriptomes
Authors: Davidson Nadia M , Hawkins Anthony DK , Oshlack Alicia 
Published: September 2016

AbstractNumerous methods have been developed to analyse RNA sequencing data, but most rely on the availability of a reference genome, making them unsuitable for non-model organisms. De novo transcriptome assembly can build a reference transcriptome from the non-model sequencing data, but falls short of allowing most tools to be applied. Here we present superTranscripts, a simple but powerful solution to bridge that gap. SuperTranscripts are a substitute for a reference genome, consisting of all the unique exonic sequence, in transcriptional order, such that each gene is represented by a single sequence. We demonstrate how superTranscripts allow visualization, variant detection and differential isoform detection in non-model organisms, using widely applied methods that are designed to work with reference genomes. SuperTranscripts can also be applied to model organisms to enhance visualization and discover novel expressed sequence. We describe Lace, software to construct superTranscripts from any set of transcripts including de novo assembled transcriptomes. In addition we used Lace to combine reference and assembled transcriptomes for chicken and recovered the sequence of hundreds of gaps in the reference genome.