bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the Bacterial Meningitis Score in adults consulting at an emergency department: a retrospective multicentric study
Authors: Delannoy Quentin , Pean-de-Ponfilly Gauthier , Mesnil Celine , Severin Constance , Robert Jerome , Plaisance Patrick , Freund Yonathan , Hausfater Pierre , Cambau Emmanuelle , Jacquier Hervé , Chauvin Anthony 
Published: June 2020

Objective
The Bacterial Meningitis Score (BMS) is recommended by pediatric academic societies to rule out the diagnosis of bacterial meningitis. The aim of this study was to evaluate the performance of the BMS to identify adults at no risk for bacterial meningitis.

Methods
We conducted a multicentric retrospective study including adults who consulted the emergency department (ED) for meningitis [cerebrospinal fluid (CSF) white blood cells ≥5/mm3 with a ratio of white blood cells/red blood cells <1:900) during a 4-year period. The BMS variables were: CSF positive Gram stain, CSF absolute neutrophil count ≥1000 cells/μL, CSF protein ≥80 mg/dL, peripheral blood absolute neutrophil count ≥10 000 cells/μL, and seizures. Bacterial meningitis was defined for patients who had a lumbar puncture with CSF pleocytosis and positive bacterial analysis of CSF. The primary endpoint was the sensitivity of the BMS to rule out bacterial meningitis in adults. The secondary outcome was to assess the rate of patients for whom antibiotics could have been avoided using the BMS and the diagnostic performance of procalcitonin in patients with a BMS ≥1.

Results
Of 930 patients with meningitis, 626 were included in the analysis, and 27 (4.3%) were diagnosed with bacterial meningitis. A total of 384/626 (61.3%) patients had a BMS = 0, and none presented bacterial meningitis. BMS sensitivity was 100% [95% confidence interval (CI), 87.2–100%], and its negative predictive values were 100% (95% CI, 98.8–100%).

Conclusion
Among patients with a diagnosis of meningitis in ED, a BMS of 0 may safely rule out bacterial meningitis.
An Integrative Review of Measuring Caregiver Burden in Substance Use Disorder
Authors: Tyo Mirinda Brown , McCurry Mary K. 
Published: June 2020

Background
Family caregivers contribute to engagement in treatment and adherence, reduced substance misuse and relapse, and increased well-being of recipients with substance use disorder. However, providing care has also been associated with negative emotional and physical health outcomes for caregivers. The purpose of this integrative review was to determine what instruments are used to measure caregiver burden in informal caregivers of individuals with substance use disorder.

Methods
An integrative review framework was applied to examine empirical and theoretical literature to answer the guiding research question, “How is caregiver burden measured in caregivers of individuals with substance use disorder?” PubMed, CINAHL, and APA PsychINFO were searched using a combination of search terms. The initial 1,198 articles were narrowed to 32 that fit the search criteria and purpose of the review.

Results
A variety of scales have been used to measure caregiver burden. Caregiver burden is operationalized as objective or subjective burden. Objective burden refers to changes in the home, finances, employment, social life, and leisure, whereas subjective burden refers to the emotional reaction of the caregiver in coping with providing care. Caregiver burden was most often reported as moderate to severe in populations with substance use disorder. Attributes measured included anxiety, depression, stress, worry, displeasure, care recipient behavioral problems and substance abuse, stigma, relationship strain, financial expenses, social support, family disruption, and the effect on caregiver physical and emotional health.

Conclusions
Specific instruments that can accurately evaluate objective and subjective caregiver burden are needed to measure the quality of caregiver health. More research is necessary to better understand the physical and emotional health of caregivers of persons with substance use disorder and the factors that contribute to increased quality of life. Understanding the relationship between outcomes and protective factors could help nurses to develop prevention strategies and treatment interventions aimed at decreasing the psychosocial trauma and stress associated with caregiver burden.
Early Inflammatory Measures and Neurodevelopmental Outcomes in Preterm Infants
Authors: Nist Marliese Dion , Shoben Abigail B. , Pickler Rita H. 
Published: June 2020

Background
Inflammation may be an important predictor of long-term neurodevelopment in preterm infants. The identification of specific inflammatory biomarkers that predict outcomes is an important research goal.

Objectives
The purpose of this analysis was to identify associations between an early measure of inflammation and neurodevelopment in very preterm infants and to identify differences in the relationship between inflammation and neurodevelopment based on infant gender and race.

Methods
We conducted a secondary analysis of data from a randomized controlled trial of a caregiving intervention for preterm infants born less than 33 weeks postmenstrual age. Plasma was collected with a clinically indicated laboratory draw by neonatal intensive care unit nurses and analyzed by multiplex assay for cytokines, chemokines, and growth factors. Neurobehavior was assessed by research nurses at the time of discharge from the neonatal intensive care unit using the motor development and vigor and alertness/orientation clusters from the Neurobehavioral Assessment of the Preterm Infant. Neurodevelopment was assessed at 6 months corrected age by the developmental specialist in the hospital’s neonatal follow-up clinic using the Bayley Scales of Infant Development, Third Edition. We used linear regressions to estimate the effect of cytokine levels on neurodevelopment and allowed the effects to differ by infant gender and race.

Results
In a sample of 62 preterm infants with discharge neurobehavioral assessments and a sample of 40 preterm infants with 6-month neurodevelopmental assessments, we found inconsistent associations between single-time point inflammatory measures and neurobehavior or neurodevelopment in analyses of the total sample. However, regressions with interactions revealed effects for multiple inflammatory measures on early neurobehavior and neurodevelopment that differed by infant gender and race.

Discussion
Although early single-time point measures of inflammation may be insufficient to predict neurodevelopment for all preterm infants, the effect of inflammation appears to differ by infant gender and race. These demographic factors may be important considerations for future studies of inflammation and neurodevelopment as well was the development of future interventions to optimize outcomes.
Neisseria gonorrhoeae Septic Arthritis With Contiguous Infection Consistent With Acute Osteomyelitis
Authors: Russ-Friedman Courtney , Coates Kevin , Torabi Maha , Palavecino Elizabeth L. , McNeil Candice J. 
Published: June 2020

Abstract

Neisseria gonorrhoeae osteomyelitis is a rare complication of disseminated gonococcal infection. As the rates of N. gonorrhoeae continue to increase in the United States, clinicians may encounter patients with disseminated gonococcal infection complicated by gonococcal osteomyelitis. Screening and appropriate treatment of N. gonorrhoeae remains paramount, especially with growing antibiotic resistance.
Passing a Healthy Homes Initiative: Using Modeling to Inform Evidence-Based Policy Decision Making in Kansas City, Missouri
Authors: Rhoads Natalie , Martin Sarah , Zimmerman Frederick J. 
Published: June 2020

Context and Setting:
Kansas City, Missouri, experiences substantial racial/ethnic health disparities, particularly associated with that city's high level of residential segregation. Among the risk factors for poor health are substandard housing, particularly common in African American neighborhoods, which lead to asthma and therefore to school absences. A 2018 ballot initiative in Kansas City, Missouri, would allow health inspectors to investigate complaints of poor or hazardous conditions in rental housing.

Objectives:
Because the Kansas City, Missouri Health Department cannot legally advocate directly for voter support of public health policies, department staff used outside consultants to demonstrate the potential positive impact of environmental initiatives.

Design:
The Win-Win model provides a standardized, unbiased economic analysis of interventions to help public health officials make informed policy and program decisions and engage in cross-sectoral collaboration.

Results:
The Win-Win model found that if an asthma home remediation program were provided for almost 7000 low-income children in Kansas City, it would result in 55 000 fewer days of missed school annually among other promising outcomes. The model also showed a $1.67 return-on-investment to local and state government for each dollar spent and a 3-year breakeven point. The results from the Win-Win model were integrated into Kansas City's Community Health Improvement Plan and made available on the Win-Win Project Web site. The proposed law to promote rental inspections passed with 57% of the vote.

Conclusions:
The model results allowed for an informed, unbiased point of evidence that the health department could present to community groups and elected officials leading up to the vote on the health inspection initiative.
Breast Implant Imaging Surveillance among U.S. Plastic Surgeons: U.S. Food and Drug Administration Recommendations versus Clinical Reality
Authors: Carr Logan W. , Roberts John , Mericli Alex F. , Liu Jun , Arribas Elsa M. , Clemens Mark W. 
Published: June 2020

Background:
Device rupture is considered a major complication associated with breast implants. The U.S. Food and Drug Administration recommends magnetic resonance imaging (MRI) surveillance 3 years after implantation and then every 2 years, but adherence to these recommendations is poor. The authors identified current practice management for breast implant rupture surveillance by surveying practicing U.S. plastic surgeons.

Methods:
An online survey of all active members of the American Society of Plastic Surgeons was performed. Questions analyzed imaging practice patterns related to breast implants. Logistic regression models were used to analyze determinants for radiographic imaging in breast implant patients.

Results:
The survey had a response rate of 16.5 percent. For patients with breast implants, 37.7 percent of respondents recommended MRI at the recommended intervals. Fifty-five percent perform imaging only if there is a problem with the implant. Academic surgeons more frequently recommended MRI (56.3 percent and 39.3 percent; p = 0.0002). Surgeons with less than 5 years of experience are four times more likely to order MRI than surgeons with over 25 years’ experience (60.8 percent and 28.1 percent; p < 0.0001). Furthermore, lower volume surgeons recommend significantly more MRI (45.2 percent and 27.3 percent; p = 0.001). Respondents are almost two times more likely to recommend MRI in reconstructive versus cosmetic patients (51.2 percent and 35.6 percent; p = 0.0004).

Conclusions:
MRI limitations include high costs, time commitments, and equipment constraints. Fewer than 40 percent of survey respondents suggest the recommended screening frequency to their patients; however, academic, low-volume, early-career surgeons are more likely to recommend MRI implant monitoring. Screening recommendations need to be evidence based and align with common practices to prevent undue system, provider, and patient burden.
Contemporary Analysis of Rhytidectomy Using the Tracking Operations and Outcomes for Plastic Surgeons Database with 13,346 Patients
Authors: Chopan Mustafa , Samant Sonja , Mast Bruce A. 
Published: June 2020

Background:
Rhytidectomy is a popular procedure for facial rejuvenation, but an up-to-date, comprehensive, and broadly representative appraisal is lacking.

Methods:
A cohort of patients undergoing rhytidectomy between 2008 and 2016 was identified from the Tracking Outcomes in Plastic Surgery database. Perioperative data and patient characteristics were analyzed with respect to adverse events. Multivariate logistic regression was used to identify association of complications with various risk factors.

Results:
A total of 13,346 patients with a mean age of 60 years underwent rhytidectomies and a total of 31,206 Current Procedural Terminology procedures. Most were healthy women with an American Society of Anesthesiologists class of 1 or 2 (98 percent). On average, 2.3 procedures were performed in 3.8 hours per patient, and blepharoplasty was the most common adjunctive procedure. Fifty percent of operations were performed in office-based settings, and general anesthesia utilized in 63 percent of cases. The incidence of adverse events was 5.1 percent, with hematomas and infections as the most frequent surgical complications. Male gender, obesity, current smoker, duration, combined procedures, general anesthesia, and office-based surgery were associated with increased odds of adverse events.

Conclusions:
This is the largest outcomes analysis of face-lift surgery in a patient population solely representative of board-certified plastic surgeons. Rhytidectomy is a very safe procedure when performed by board-certified plastic surgeons. Nevertheless, risk factors for complications are identified, several of which can be affected by surgeon choice of surgical venue, additive procedures, duration of operation, and type of anesthetic. The study provides a standard reference for professionals when counseling patients and in guiding clinical practices.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Simultaneous Midface Advancement and Orthognathic Surgery: A Powerful Technique for Managing Midface Hypoplasia and Malocclusion
Authors: Hammoudeh Jeffrey A. , Goel Pedram , Wolfswinkel Erik M. , Fahradyan Artur , Vartanian Emma , Garg Ravi , Williams Madeleine S. , Khansa Ibrahim , Urata Mark M. 
Published: June 2020

Background:
Midface hypoplasia dramatically affects the normative facial cascade. Simultaneous Le Fort III and Le Fort I procedures (Le Fort III/I) provide a powerful tool for achieving significant midface advancement. This study presents the authors’ approach for addressing midface hypoplasia in the setting of class III malocclusion using Le Fort III/I advancement.

Methods:
This was an institutional review board–approved retrospective review of patients who underwent Le Fort III/I advancement at the authors’ institution from 2009 to 2019. Demographic, surgical, and postoperative data were recorded. The authors’ operative technique and surgical pearls are described.

Results:
Twenty-five patients met inclusion criteria, 15 male patients (60 percent) and 10 female patients (40 percent). Patient age ranged from 14.9 to 21.6 years. Diagnoses included Crouzon syndrome, nonsyndromic developmental skeletal dysplasia, cleft lip/palate, Klippel-Feil syndrome, Apert syndrome, Van den Ende-Gupta syndrome, and Pfeiffer syndrome. Le Fort III advancements averaged 6.18 ± 1.38 mm and Le Fort I advancements averaged 6.70 ± 2.48 mm. Thirteen patients underwent simultaneous bilateral sagittal split osteotomy with average movement of 5.85 ± 1.21 mm. Average follow-up was 1.3 ± 1.0 years. One patient experienced intraoperative cerebrospinal fluid leak that resolved with expectant management. Three patients experienced major complications (12 percent) postoperatively necessitating repeated orthognathic operations. Ten patients experienced minor complications (40 percent). Average length of stay was 10 days, with all patients achieving improvement of their facial profile.

Conclusions:
The authors’ experience reaffirms the relative safety of simultaneous Le Fort III/I advancement. This technique should be considered in select patients with global midface retrusion and class III malocclusion.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Thirty Years Later: What Has Craniofacial Distraction Osteogenesis Surgery Replaced?
Authors: Hopper Richard A. , Ettinger Russell E. , Purnell Chad A. , Dover M. Stephen , Pereira Alberto Rocha , Tunçbilek Gökhan 
Published: June 2020

Learning Objectives:
After studying this article and viewing the video, the participant should be able to: 1. Compare the relative stability and neurosensory changes following mandible distraction osteogenesis with those after traditional advancement and fixation. 2. Describe the condylar changes that can occur after mandible distraction osteogenesis and list three ways to mitigate these changes. 3. Propose clinical situations where segmental or rotational movements of the midface may allow improved outcomes compared to en bloc linear distraction advancement. 4. Summarize the advantages and risks associated with anterior and posterior cranial distraction osteogenesis compared to traditional one-stage expansion.

Summary:
Over the past 30 years, distraction forces have been applied to the spectrum of craniofacial osteotomies. It is now time to assess critically the current understanding of distraction in craniofacial surgery, identifying both traditional procedures it has replaced and those it has not. This article provides a review of comparative studies and expert opinion on the current state of craniofacial distraction compared with traditional operations. Through this critical evaluation, the reader will be able to identify when distraction techniques are appropriate, when traditional techniques are more favorable, and what the future of distraction osteogenesis is.
Whi5 is diluted and protein synthesis does not dramatically increase in pre-StartG1
Authors: Schmoller Kurt M. , Lanz Michael C. , Kim Jacob , Koivomagi Mardo , Qu Yimiao , Tang Chao , Kukhtevich Igor V. , Schneider Robert , Rudolf Fabian , Moreno David F. , Aldea Martí , Lucena Rafael , Kellogg Doug , Skotheim Jan M. 
Published: June 2020

In their manuscript, Litsios et al.1report a new model for how cell growth and biosynthetic activity control the G1/S transition in budding yeast. In essence, Litsios et al. claim thatStartis driven by an increasing concentration of the G1 cyclin Cln3 due to a dramatic acceleration of protein synthesis in pre-StartG1 and not by the dilution of the cell cycle inhibitor Whi5. While we previously reported thatStartwas in part driven by cell growth during G1 diluting out theStartinhibitor Whi52, Litsios et al. report that Whi5 remains at constant concentration during G1, and changes in Whi5 concentration therefore do not contribute toStart.Since Litsios et al. directly contradict several key points of our own model of how cell growth triggersStart, we decided to investigate their claims and data. More specifically, we decided to investigate Litsios et al.’s three major claims:Whi5 concentration remains constant during G1Cln3 concentration strongly increases prior toStartGlobal protein synthesis rates increase by 2-3 fold prior toStartWe investigated each of these three claims and found that the evidence presented by Litsios et al. does not support their claims due to inadequate analysis methods and flaws in their experiments.
A globally threatened shark,Carcharias taurus, shows no population decline in South Africa
Authors: Klein Juliana D. , Bester-van der Merwe Aletta E. , Dicken Matthew L. , Emami-Khoyi Arsalan , Mmonwa Kolobe L. , Teske Peter R. 
Published: June 2020

AbstractKnowledge about the demographic histories of natural populations helps to evaluate their conservation status, and potential impacts of natural and anthropogenic pressures. In particular, estimates of effective population size obtained through molecular data can provide useful information to guide management decisions for vulnerable populations. The spotted ragged-tooth sharkCarcharias taurus(also known as the sandtiger or grey nurse shark) is widely distributed in warm-temperate and subtropical waters, but has suffered severe population declines across much of its range as a result of overexploitation. Here, we used multilocus genotype data to investigate the demographic history of the South AfricanC. tauruspopulation. Using approximate Bayesian computation and likelihood-based importance sampling, it was found that the population underwent a historical range expansion that may have been linked to climatic changes during the late Pleistocene. There was no evidence for a recent anthropogenic decline. Together with census data suggesting a stable population, these results support the idea that fishing pressure and other threats have so far not been detrimental to the localC. Tauruspopulation. The results reported here indicate that South Africa could possibly harbour the last remaining, relatively pristine population of this widespread but vulnerable top predator.
Genetic analysis confirms the presence ofDicrocoelium dendriticumin the Himalaya ranges of Pakistan
Authors: Khan Muhammad Asim , Afshan Kiran , Nazar Muddassar , Firasat Sabika , Chaudhry Umer , Sargison Neil D. 
Published: June 2020

AbstractLancet liver flukes of the genusDicrocoelium(Trematoda: Digenea) are recognised parasites of domestic and wild herbivores. The aim of the present study was to address a lack of knowledge of lancet flukes in the Himalaya ranges of Pakistan by characterisingDicrocoeliumspecies collected from the Chitral valley. The morphology of 48 flukes belonging to eight host populations was examined in detail and according to published keys, they were identified as eitherD. dendriticumorDicrocoelium chinensis. PCR and sequencing of fragments of ribosomal cistron DNA, and cytochrome oxidase-1 (COX-1) and NADH dehydrogenase-1 (ND-1) mitochondrial DNA from 34, 14 and 3 flukes revealed 10, 4 and 1 unique haplotypes, respectively. Single nucleotide polymorphisms in these haplotypes were used to differentiate betweenD. chinensisandD. dendriticum, and confirm the molecular species identity of each of the lancet flukes asD. dendriticum. Phylogenetic comparison of theD. dendriticumrDNA, COX-1 and ND-1 sequences with those fromD. chinensis, Fasciola hepaticaandFasciola giganticaspecies was performed to assess within and between species variation and validate the use of species-specific markers forD. dendriticum. Genetic variations betweenD. dendriticumpopulations derived from different locations in the Himalaya ranges of Pakistan illustrate the potential impact of animal movements on gene flow. This work provides a proof of concept for the validation of species-specificD. dendriticummarkers and is the first molecular confirmation of this parasite species from the Himalaya ranges of Pakistan. The characterisation of this parasite will allow research questions to be addressed on its ecology, biological diversity, and epidemiology.
Carcass Scavenging Relaxes Chemical-Driven Female Interference Competition
Authors: Bagchi Basabi , Seal Srijan , Raina Manasven , Nath Basu Dipendra , Khan Imroze 
Published: June 2020

ABSTRACTFemale-female nonsexual interference competition is rapidly emerging as a major fitness determinant of biased sex-ratio groups with high female density. How do females overcome such competition? We used adult flour beetleTribolium castaneumto answer this question, where females from female-biased groups suppressed each other’s fecundity by secreting toxic quinones from their stink glands, revealing a chemical-driven interference competition. The added natal resource did not alleviate these fitness costs. Females also did not disperse more at high female-density. Hence, the competition was neither limited by the total resource availability nor the inability to avoid chemical interference. Instead, protein sequestered via scavenging of nutrient-rich carcasses relaxed the female competition, by increasing their fecundity and reducing the quinone content. Even infected carcasses were scavenged to extract fitness benefits, despite the infection-risk. Finally, individual stink gland components triggered carcass-scavenging to increase fecundity, indicating a potentially novel chemical feedback loop to reduce the competition.