bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advances in molecular diagnostic tests for pneumonia
Authors: Cilloniz Catia , Liapikou Adamanthia , Torres Antoni 
Published: February 2020

Purpose of review
Pneumonia is the main global cause of sepsis, and has been associated with high morbidity and high short and long-term mortality rates. As it may be caused by a wide spectrum of microorganisms, microbial diagnosis is challenging and the choice of adequate therapy remains an important problem. This review focuses on recently published studies of microbiological diagnostic tests and clinical assessments for pneumonia, including community-acquired pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia.

Recent findings
Over the past decade, the microbiological diagnosis of pneumonia has improved significantly – thanks to the development and implementation of molecular diagnostic tests for identifying the most frequent pathogens causing pneumonia and for determining their patterns of resistance. Molecular methods for the diagnosis of pneumonia focus on multiple target detection systems and pathogen detection arrays, and, more recently, have been used in combination with mass spectrometry.

Summary
The implementation of rapid diagnostic techniques in routine clinical practice able to identify and determine the resistance patterns of the causative microbes may transform the management of pneumonia, improving the selection and administration of antimicrobial therapies especially in critically ill patients. The validation of new diagnostic technology platforms is crucial in order to assess their usefulness and to guide antimicrobial treatment in this population.
New treatment options for multiresistant gram negatives
Authors: Paterson David L. , Isler Burcu , Stewart Adam 
Published: February 2020

Purpose of review
Multidrug-resistant (MDR) Gram-negative bacteria infections are listed among the top public health threats of the current era. As a result, there has been an increase in efforts to develop new therapeutic agents against MDR Gram-negatives. The purpose of this review is to summarize the clinical and preclinical findings associated with recently approved drugs and the drugs in clinical development against ESBL and carbapenemase-producing Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii infections.

Recent findings
There are a number of ESBL active agents in late stage clinical development that can help spare carbapenems. Likewise, recently approved β-lactam/β-lactamase inhibitor combinations allow a change in the treatment of KPC and OXA-48 producers and carbapenem-resistant P. aeruginosa from colistin to new, safer agents. Treatment of Meta-beta-lactamase (MBL) producers remains an unmet need – apart from cefiderocol, most agents with MBL activity are still in clinical development. Among the few agents with carbapenem-resistant A. baumannii activity, durlobactam/sulbactam in phase III clinical trials provides hope.

Summary
Armamentarium against MDR Gram-negatives has expanded with the dominance of agents active against ESBL and KPC producers. There is a need to prioritize MBL producers and carbapenem-resistant A. baumannii, as well as the need for clinical trials to test the new agents against serious infections.
Role of new antibiotics in the treatment of acute bacterial skin and skin-structure infections
Authors: Bassetti Matteo , Magnasco Laura , Del Puente Filippo , Giacobbe Daniele Roberto 
Published: February 2020

Purpose of review
To summarize the available efficacy and safety data of novel agents for treating acute bacterial skin and skin-structure infections (ABSSSI), focusing on those active against methicillin-resistant Staphylococcus aureus (MRSA).

Recent findings
There are now several agents active against MRSA that are approved for the treatment of ABSSSI, including tedizolid, ceftaroline, dalbavancin, telavancin, oritavancin, delafloxacin, and omadacycline. In addition, iclaprim has completed phase-3 randomized clinical trials (RCTs).

Summary
Considering the similar efficacy that arose from direct comparisons in phase-3 RCTs, in order to adopt the best approach for treating ABSSSI on patient-tailored basis, the different safety profiles and formulations of the different available agents should be balanced by taking into account the specific features of each treated patient in terms of baseline comorbidities, related risk of toxicity, need for hospitalization, possibility of early discharge, and expected adherence to outpatient oral therapy.
In-House Hybrid Technique for Customization of Guides and Miniplates in Orthognathic Surgery
Authors: Claus Jonathas Daniel Paggi , Almeida Matheus Spinella , Hernandez-Alfaro Federico 
Published: February 2020

Abstract
The use of customized plates in Orthognathic surgery offers precision in the repositioning of the jaws, according to the virtual planning performed, with the great advantage of avoiding the need for intermediate occlusal splints. However, the conventional customization process takes time to manufacture, present high cost and still involve legal issues with insurance companies. Moreover, a technical disadvantage is that the systems available for customized plates require large incisions, with large detachment of soft tissues for insertion of the guides and plates. The objective of this paper is to present the in-house hybrid technique for customization of guides and miniplates in orthognathic surgery using minimally invasive approaches.
Sinus Floor Augmentation Using Recombinant Human Bone Morphogenetic Protein-2 With Hydroxyapatite: Volume Assessment
Authors: Nam Jung Woo , Chee Young Deok , Park Young Bum 
Published: February 2020

Introduction:
The aim of this study was to assess the efficacy of using bone morphogenetic protein-2 with hydroxyapatite granules (BMP-2/hydroxyapatite) during augmentation of maxillary sinus floor, with respect to changes in volume, relative to conventional bone graft materials.

Method and materials:
Twenty of 25 patients in the BMP-2/hydroxyapatite group, and 16 of 33 patients in the conventional materials group met the criteria for inclusion in this study. Computed tomography scans were performed preoperatively, immediately postoperatively, and at follow-up, approximately 6 months postoperatively. Changes in volume and height of both grafted materials were measured using 3-dimensional reconstruction software; these changes were compared between groups.

Results:
The mean (standard deviation) volumetric changes were 0.25 (0.11) cc and −0.07 (0.35) cc, and the mean rates of volumetric changes were 26.44% (7.78%) and −2.92% (30.92%) in BMP-2/hydroxyapatite and conventional materials groups, respectively. The mean height changes were 0.34 (0.73) mm and −0.63 (1.07) mm, and the mean rates of height changes were 3.67% (7.57%) and −5.95% (9.98%) in BMP-2/hydroxyapatite and conventional materials groups, respectively.

Conclusion:
Compared with the conventional materials group, the BMP-2/hydroxyapatite group showed better maxillary sinus floor augmentation results in terms of volumetric changes and grafted material densities, and can provide predictably reliable outcomes.
The Upper Lip Squamous Cell Carcinoma the Role of Wedge Excision
Authors: Obradovic Bojan 
Published: February 2020

Abstract
Lip cancer is the most common malignant lesion of the oral cavity. Most of the tumors have been presented in the lower lip as a SCC, whereas the upper lip SCC is rare. Surgical excision with negative margins is the mainstay of treatment for lip SCC. The author presents a patient with the upper lip SCC treated by wedge surgical excision. Primary reconstruction of the large upper lip defects can be successfully used in appropriately selected patients.
The Management of Facial Fractures: The Legacy of William Milton Adams
Authors: Wallace Robert Doyle , Puente-Espel Jordi , Konofaos Petros 
Published: February 2020

Abstract
Dr Adams was one of the most prominent members of the American Association of Plastic Surgeons and served as secretary and president (1954) of the American Society of Plastic Surgery. Although Dr Adams died unexpectedly at 51 years of age (1957), he described many new techniques and published several outstanding and innovating papers. He was the first to report, in 1942, the use of subcutaneous wires for internal fixation of fractures of the upper jaw. The purpose of this historical paper is to point out the contribution of Dr Adams in the evolution of management of facial fractures.
The Efficacy of Absolute Ethanol and Polidocanol in the Treatment of Venous Malformations
Authors: Sun Li-Ming , Ni Xiao-Dong , Yuan Si-Ming 
Published: February 2020

Introduction:
Using meta-analysis to evaluate the efficacy of absolute ethanol and polidocanol in the treatment of venous malformations.

Materials and Methods:
A systematic search of the English literature was conducted in April 2019 including PubMed, Embase and Web of Science. Article selection was based on preset criteria. The included literature was scored on the MINORS scale, and the meta-analysis and the forest plot were made using the R 3.5.1 software for efficiency.

Results:
Ten articles were included in the meta-analysis. Absolute ethanol response rate ranged between 79% and 92% with a pooled rate of 85%, and polidocanol response rate ranged between 63% and 94% with a pooled rate of 77%.

Discussion:
Although sclerotherapy is effective in most studies, a large number of randomized controlled trials are still needed to confirm the best treatment options at different sites.
Patients With Nasal Fracture
Authors: Sindi Abdullah , Abaalkhail Yousef , Malas Moayyad , Alghamdi Abdullah , Joharji Mahmoud 
Published: February 2020

Abstract
Nasal fractures are the most common type of facial bone fracture. Studies conducted globally have shown that nasal fractures represent a significant liability on the health care system due to the frequency of its occurrence among most populations. This study aimed to describe the frequency, etiology, and demographics of nasal fractures in patients presenting to King Fahad General Hospital, Jeddah, Saudi Arabia.
This study was a cross-sectional questionnaire-based study and included all patients with a nasal fracture who were referred from the emergency department to the ENT unit of King Fahad General Hospital over a four-month period (December 2018 to March 2019).
A total of 130 patients with nasal fracture were included in the present study; most of the included patients were males (83.1%). The mean age of the patients was 28.5 years. The most frequent cause of nasal fracture was physical assault (54.6%), followed by road traffic accidents (20%). Most patients had epistaxis and presented with either active epistaxis at the time of assessment or epistaxis that spontaneously resolved after injury. Patients who had lacerations on the nose were more likely to have a displaced nasal bone (P
= 0.016). Isolated nasal bone fractures were more commonly noted in victims of physical assault, whereas combined facial bone fractures were commonly noted in patients involved in road traffic accidents (P < 0.001).
Most of the injuries occurred in the city, particularly among foreigners and young adults. Physical assault was reported to be the leading cause of nasal fractures.
Assessment of Health Related Quality of Life and Digestive Symptoms in Long-term, Disease Free Survivors After Esophagectomy
Authors: Boshier Piers R. , Klevebro Fredrik , Savva Katerina V. , Waller Anabelle , Hage Lory , Hanna George B. , Low Donald E. 
Published: February 2020

Objective:
The aim of this study was to investigate long-term HRQOL and symptom evolution in disease free patients up to 20 years after esophagectomy.

Background:
Esophagectomy has been associated with decreased HRQOL and persistent gastrointestinal symptoms.

Methods:
The study cohort was identified from 2 high volume centers for the management of esophageal cancer. Patients completed HRQOL and symptom questionnaires, including: Digestive Symptom Questionnaire, EORTC QLQ-C30, EORTC QLQ-OG25 Euro QoL 5D, and SF36. Patients were assessed in 3 cohorts: <1 year; 1–5 years, and; >5 years after surgery.

Results:
In total 171 of 222 patients who underwent esophagectomy between 1991 and 2017 who met inclusion criteria and were contactable, responded to the questionnaires, corresponding to a response rate of 77%. Median age was 66.2 years, and median time from operation to survey was 5.6 years (range 0.3–23.1). Early satiety was the most commonly reported symptom in all patients irrespective of timeframe (87.4%; range 82%–92%). Dysphagia was seen to decrease over time (58% at <2 years; 28% at 2–5 years; 20% at >5 years; P = 0.013). Weight loss scores demonstrated nonstatistical improvement over time. All other symptom scores including heartburn, regurgitation, respiratory symptoms, and pain scores remained constant over time. Average HRQOL did not improve from levels 1 year after surgery compared to patients up to 23 years after esophagectomy.

Conclusion:
With the exception of dysphagia, which improved over time, esophagectomy was associated with decreased HRQOL and lasting gastrointestinal symptoms up to 20 years after surgery. Pertinently however long-term survivors after oesophagectomy demonstrated comparable to improved HRQOL compared to the general population. The impact of esophagectomy on gastrointestinal symptoms and long-term HRQOL should be considered when counseling and caring for patients undergoing esophagectomy.
What Constitutes a Clear Margin in Patients With Locally Recurrent Rectal Cancer Undergoing Pelvic Exenteration?
Authors: Koh Cherry E. , Brown Kilian G. M. , Steffens Daniel , Young Jane , Salkeld Glenn , Solomon Michael J. 
Published: February 2020

Objectives:
To determine what constitutes a clear resection margin (R0) in patients with LRRC.

Summary of Background Data:
R0 is the most important predictor of survival in patients with LRRC. However, it is not clear what constitutes an R0. A 1–2 mm margin is often used to define R0 but this is based on primary rectal cancer studies. The same definition of R0 is likely inappropriate considering the anatomy and etiology of local recurrences.

Methods:
A prospective maintained database was reviewed. A R2 margin was defined as macroscopic residual disease. R1 was defined as a microscopically involved margin (0 mm margin) and R0 as at least a 0.1 mm margin. Associations between R status and local recurrence was explored using X
2 test. Associations between margins and overall survival and local recurrence free survival were explored using Kaplan-Meier analysis.

Results:
There were 210 patients eligible for inclusion for analysis. Of these, 165 (78.6%), 35 (16.7%), and 10 (4.8%) patients had R0, R1, and R2 margins, respectively. Overall survival was significantly different between patients with R0 versus R1 margins but wider resection margins do not confer a survival benefit [57 months (95% confidence interval 38.5–75.5) vs 33 months (95% confidence interval 20.3–45.7), P = 0.03]. Local recurrence free survival was significantly different between patients with R0 versus R1 margins (2- and 5-year local recurrence free survivals of 53.5% and 20.4% vs 25.9% and 14.8%, respectively, P = 0.001 for both). Margins >0.5 mm were not predictive of local recurrence free survival.

Conclusions:
A microscopically clear resection margin is most important in predicting overall survival. Margins up to 0.5 mm offers a local recurrence benefit but does not confer survival benefit.
Two novel resource-based metrics to quantify pediatric trauma severity based on probability of requiring critical care and anesthesia services
Authors: Snyder Christopher W. , Ciesla David J. , Tepas Joseph J. , Chandler Nicole M. , Danielson Paul D. , Gonzalez Raquel , Partain Kristin , Poulos Nicholas , Pracht Etienne E. 
Published: February 2020

BACKGROUND
Mortality-based metrics like the International Classification of Diseases (ICD) Injury Severity Score (ICISS) may underestimate burden of pediatric traumatic disease due to lower mortality rates in children. The purpose of this study was to develop and validate two resource-based severity of injury (SOI) measures, then compare these measures and the ICISS across a broad age spectrum of injured patients.

METHODS
The ICISS and two novel SOI measures, termed ICD Critical Care Severity Score (ICASS) and ICD General Anesthesia Severity Score (IGASS), were derived from Florida state administrative 2012 to 2016 data and validated with 2017 data. The ICASS and IGASS predicted the need for critical care services and anesthesia services, respectively. Logistic regression was used to validate each SOI measure. Distributions of ICISS, ICASS, and IGASS were compared across pediatric (0–15 years), adult (16–64 years), and elderly (65–84 years) age groups.

RESULTS
The derivation and validation cohorts consisted of 668,346 and 24,070 emergency admissions, respectively. On logistic regression, ICISS, ICASS, and IGASS were strongly predictive of observed mortality, critical care utilization, and anesthesia utilization, respectively (p < 0.001). The mean ICISS was 10.6 for pediatric and 19.0 for adult patients (ratio, 0.56), indicating that the predicted mortality risk in pediatric patients was slightly over half that of adults. In contrast, the mean ICASS for pediatric and adult patients was 50.2 and 53.2, respectively (ratio, 0.94); indicating predicted critical care utilization in pediatric patients was nearly the same as that of adults. The IGASS comparisons followed comparable patterns.

CONCLUSION
When a mortality-based SOI measure is used, the severity of pediatric injury appears much lower than that of adults, but when resource-based measures are used, pediatric and adult burden of injury appear very similar. The ICASS and IGASS are novel and valid resource-based SOI measures that are easily calculated with administrative data. They may complement mortality-based measures in pediatric trauma.

LEVEL OF EVIDENCE
Level III, prognostic and epidemiological study.
Early Posttransplant Mobilization of Monocytic Myeloid-derived Suppressor Cell Correlates With Increase in Soluble Immunosuppressive Factors and Predicts Cancer in Kidney Recipients
Authors: Utrero-Rico Alberto , Laguna-Goya Rocio , Cano-Romero Francisco , Chivite-Lacaba Marta , Gonzalez-Cuadrado Cecilia , Rodríguez-Sánchez Elena , Ruiz-Hurtado Gema , Serrano Antonio , Fernández-Ruiz Mario , Justo Iago , González Esther , Andrés Amado , Paz-Artal Estela 
Published: February 2020

Background.
Myeloid-derived suppressor cells (MDSCs) increase in patients with cancer and are associated with poor prognosis; however, their role in transplantation is not yet understood. Here we aimed to study the MDSC effects on the evolution of kidney transplant recipients (KTRs).

Methods.
A cohort of 229 KTRs was prospectively analyzed. Two myeloid cells subsets. CD11b+CD33+CD14+CD15-HLA-DR–/low (monocytic MDSC [M-MDSC]) and CD11b+CD33+CD14+CD15–HLA-DR+ (monocytes), were defined by flow cytometry. The suppressive capacity of myeloid cells was tested in cocultures with autologous lymphocytes. Suppressive soluble factors, cytokines, anti-HLA antibodies, and total antioxidant capacity were quantified in plasma.

Results.
Pretransplant, M-MDSC, and monocytes were similar in KTRs and healthy volunteers. M-MDSCs increased immediately posttransplantation and suppressed CD4 and CD8 T cells proliferation. M-MDSCs remained high for 1 y posttransplantation. Higher M-MDSC counts at day 14 posttransplant were observed in patients who subsequently developed cancer, and KTRs with higher M-MDSC at day 14 had significantly lower malignancy-free survival. Day 14 M-MDSC >179.2 per microliter conferred 6.98 times (95% confidence interval, 1.28-37.69) more risk to develop cancer, independently from age, gender, and immunosuppression. Early posttransplant M-MDSCs were lower in patients with enhanced alloimmune response as represented by anti-HLA sensitization. M-MDSC counts correlated with higher circulatory suppressive factors arginase-1 and interleukin-10, and lower total antioxidant capacity.

Conclusions.
Early posttransplant mobilization of M-MDSCs predicts cancer and adds risk as an independent factor. M-MDSC may favor an immunosuppressive environment that promotes tumoral development.
Bedside Technologies to Enhance the Early Detection of Pressure Injuries
Authors: Scafide Katherine N. , Narayan Mary Curry , Arundel Linda 
Published: February 2020

BACKGROUND:
Hospital-acquired pressure injuries strain organizational resources and negatively impact the quality of life of affected patients. However, early detection of pressure injuries is limited due to challenges with visual assessment, particularly in individuals with dark skin.

PURPOSE:
The purpose of this systematic review was to determine whether sufficient research evidence exists to support the use of bedside technologies for early detection of pressure injures, which is inclusive of pressure-related blanchable erythema (PrBE), pressure-related nonblanchable erythema (PrNBE), and deep tissue pressure injury (DTPI).

SEARCH QUESTION:
What available bedside technologies enhance the early detection of pressure injuries?

METHODS:
A systematic search of Medline, CINAHL, Web of Science, and Cochrane databases was executed. Quantitative studies were included that examined whether accessible technologies could indicate the presence of PrBE, PrNBE, and DTPI. The quality of the research was evaluated using the Johns Hopkins Nursing Evidence-Based Practice Rating Scale.

FINDINGS:
We identified 18 eligible studies that represented a variety of technologies, including ultrasound (n = 5), thermography (n = 7), subepidermal moisture (SEM) measurement (n = 5), reflectance spectrometry (n = 2), and laser Doppler (n = 1). The methodological rigor in study quality was variable. Subepidermal moisture measurement provided the most consistent findings in the early detection of pressure injury.

CONCLUSIONS:
Objective methods that provide accurate and timely assessment of DTPIs augment early implementation of optimal prevention and treatment measures. Evidence identified in this systematic review supports the use of SEM measurement devices as effective tools for early pressure injury detection. However, more research in the field of technology-enhanced, pressure injury detection is needed to support the use of existing and emerging devices.
Do we need sex-oriented clinical practice guidelines for the treatment of schizophrenia?
Authors: Fernando Piyumi , Sommer Iris E.C. , Hasan Alkomiet 
Published: February 2020

Purpose of review
Clinical practice guidelines (CPGs) do not usually offer a sex-specific approach for the management of schizophrenia. With this narrative review, we aim to give an integrated and synthesized overview of the current state of knowledge regarding sex-specific aspects in schizophrenia and how this topic may be adapted in the development of CPGs.

Recent findings
Recent studies further suggest sex-specific differences in epidemiologic features, the course of illness, underlying pathomechanisms, response likelihood to antipsychotic medication and differences in tolerability. Beyond this, selective estrogen receptor modulators like raloxifene have shown beneficial effects on symptom severity and cognition in women with schizophrenia.

Summary
Sex-specific aspects can already be integrated in clinical guideline recommendations, especially with regard to efficacy and tolerability of antipsychotic treatment. Moreover, these aspects may be used for an individual risk-stratification. Recent studies provide evidence supporting the hypothesis of sex-specific modulation in schizophrenia and build the groundwork for sex-specific novel treatment options. However, there remains a clear need for additional studies focusing on women with schizophrenia to substantiate current findings.