bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vasoactive Agents in Burn Patients: Perspectives on Angiotensin-II
Authors: Mueller Scott W , Tran Nicolas M , Betthauser Kevin D , Buckley Mitchell S , Shupp Jeffrey , Wiktor Arek J , Hill David M 
Published: December 2024

Abstract
Severe burn injury poses significant clinical challenges, often necessitating the use of vasoactive agents to maintain perfusion. This narrative review explores the current landscape of vasoactive agents in acute burn shock resuscitation and in severe burn-injured patients who develop septic shock, with a particular focus on the potential role of the novel vasoactive agent, synthetic angiotensin-II (AT-II), in these settings. While catecholamines and vasopressin remain cornerstone therapies, adverse effects, variable patient responses, and a new understanding of burn injury pathophysiology highlight the potentially evolving role of vasoactive agents in these clinical scenarios. A key system involved in blood pressure regulation, the renin-angiotensin-aldosterone system, is often dysregulated in acute burn and septic shock. Contributory mechanisms and potential benefits of synthetic AT-II are discussed here and form the physiologic rationale behind the exogenous administration of synthetic AT-II in the context of available safety and efficacy data. To date, administration of synthetic AT-II has shown promise in improving hemodynamics and clinical outcomes in distributive shock populations; however, data in acute burn shock and in burn patients who develop septic shock are lacking. In addition, a comprehensive understanding of the potential and future areas of research in burn shock and severe burn-injured patients is provided.
Efficacy of a Topical Nitric Oxide-Releasing Gel on Polymicrobial Wound Infections
Authors: Davis Stephen C , Gil Joel , Solis Michael , Strong Ryan , Cassagnol Roger 
Published: December 2024

ABSTRACT

Introduction
Wounds are colonized frequently by heterogeneous microflora. Pseudomonas aeruginosa (PA) and Staphylococcus aureus (SA) are two of the most isolated bacterial species from wounds, and both typically form highly organized biofilms. Nitric oxide (NO) is a short-lived, diatomic, lipophilic gas with antimicrobial activity. Recently, NO and its derivatives have been shown to exhibit broad-spectrum antimicrobial activity against bacteria, viruses, and parasites.

Materials and Methods
P. aeruginosa strain ATCC 27312 or military isolate PA09-010 were combined with methicillin-resistant S. aureus strain MRSA USA300 to demonstrate the ability of NO to reduce polymicrobial infections in a porcine wound infection model. Deep partial-thickness wounds (10 mm × 7 mm × 0.5 mm) were made on four animals using a specialized electrokeratome. Wounds were inoculated with MRSA USA300 combined with PA09-010 in three animals and MRSA USA300 combined with PA27312 in one animal, then wounds were covered with polyurethane film dressings. After 48 hours, three wounds were recovered for baseline enumeration. The remaining wounds were randomly assigned to treatment groups and treated once daily. The NO topical gels tested were combinations of two phases, ointment phases with various concentrations (2–20%) combined with hydrogels with fast or slow release kinetics. A 4-day study with microbiological recovery was conducted on day 4. A separate 7-day study was also conducted, with microbial burden assessed on day 7.

Results
The largest efficacy against MRSA USA300 was observed for the NO formulation with 2% concentration and fast release kinetics. This treatment reduced the MRSA USA300 bacterial count by more than 99.97% and 99.95% from baseline in wounds co-infected with PA09-010 and PA 27312, respectively, at day 7. Treatments showed a minimal efficacy against PA27312 and PA09-010 strains in both assessment times. MRSA USA300 was reduced to a lesser extent when it was combined with PA27312 as compared to PA09-010.

Conclusions
These studies demonstrate that NO-releasing topical formulations effectively reduce the MRSA burden in established biofilms composed of multiple microorganisms. Minimal efficacy against PA was observed. It has been demonstrated that MRSA bioburden is significantly reduced when inoculated together with P. aeruginosa. A better understanding of mechanisms of host–bacteria interactions, in single or mixed species biofilms, may lead to the development of novel therapeutic approaches. Overall, NO offers a promising alternative treatment against MRSA in polymicrobial infections.
Deployment of Physician Resources and Innovative Medical Strategies in the 2023–2024 Israel–Hamas War: Israel’s Strategy to Deliver Advanced Life Support and Whole Blood Transfusion to the Battlefield via Forward Medical Teams and the Impact on the Case Fatality Rate
Authors: Katzman Daniel , Kalman Gefen , Almog Ofer , Fogel Itay 
Published: December 2024

ABSTRACT
The 2023–2024 Israel–Hamas War, which began following a Hamas attack on Israel on October 7, 2023, has seen a case fatality rate (CFR) among the lowest in the history of warfare. In resultant ground maneuvers, the Israel Defense Forces Medical Corps (IDF-MC) doctrine for the delivery of combat casualty care has been battle tested. We suggest the decreased CFR in part reflects a paradigm shift in combat deployment of medical resources, so as to introduce life-saving strategies not previously seen on the battlefield in large scale to date. These changes, which began in the 2006 Lebanon war and have been in evolution since, include strategic physician deployment to positions more forward than in previous wars and in teams smaller than the previous standard. These forward medical teams have replaced the battalion aid station in the Gaza theater of operations and serve to increase the availability of Advanced Life Support (ALS) level care at the point of injury, wherever a casualty might be on a multidimensional battlefield. These forward medical teams deploy with advanced medical capabilities, including in some cases the ability to transfuse low titer O whole blood. This article reviews aspects of the IDF-MC combat casualty care doctrine as implemented during the current war, the role and advantages of transfusion-capable ALS forward medical teams, and the apparent impact on the CFR thereof.
Private Music Theory
Authors: Lumsden Rachel 
Published: December 2024

Abstract
This essay examines how distinctions between “public” and “private” helped to form and sustain the discipline of academic music theory. Drawing on J. Daniel Jenkins’s concept of “liminal spaces,” I discuss two historical examples of public music theory that problematize traditional binary divisions of public and private, and how these examples intersect with—and depart from—the plenary articles featured in this issue. I conclude with some thoughts about “public” and “private” music theory in our era.
Standardly Trained Peer Volunteer–Led, Social App Recruiting–Based Human Immunodeficiency Virus Testing Strategy Using Rapid Testing Kits (SPARK) Among Men Who Have Sex With Men: A Population-Based Survey Evaluation
Authors: Liu Zhongquan , Huang Huijie , Yue Teng , Gebregziabher Nahom Kiros , Gong Hui , Xu Peng , Dong Xiaoyue , Liu Yi , Wu Ziming , Guo Yan , Ning Tielin , Li Long , Zheng Minna , Yang Jie , Ma Jun , Li Changping , Yu Maohe , Cui Zhuang 
Published: December 2024

Abstract

Background
Social app recruiting–based and peer-led testing strategies have been proven effective in increasing human immunodeficiency virus (HIV) testing among men who have sex with men (MSM), though their combination remains underevaluated. We aimed to assess the efficiency of a combined strategy named “standardly trained peer volunteer–led, social app recruiting–based HIV testing strategy using rapid testing kits” (SPARK).

Methods
Between March 2020 and December 2021, 177 trained peer volunteers tested 7256 eligible MSM testers. Volunteers primarily recruited testers to undergo HIV testing and counseling in social apps. Volunteers tested testers with HIV rapid antibody tests and interviewed testers while waiting for the results. Moreover, HIV testing data from other testing strategies, both pre- and postimplementation of SPARK, were collected to evaluate the capacity of SPARK to increase HIV testing.

Results
During this study, MSM testers underwent 10 441 HIV tests; HIV testing volume increased 3-fold from 2020 to 2021. On average, each volunteer recruited 40.99 testers and facilitated 58.99 HIV tests. After SPARK implementation, HIV tests in 2021 increased 1-fold compared with those in 2019; especially for rural MSM testers, the number of HIV tests performed in 2020 and 2021 increased to 2.86 and 5.85 times, respectively, that in 2019. In spatial analysis, most testers sought geographical proximity volunteers for testing; similarly, most testers recruited were from volunteers’ own or nearby districts. More than 60% of HIV tests were performed outside of working hours on weekdays, regardless of whether the testers came from urban, periurban, or rural areas.

Conclusions
SPARK, an MSM-friendly, geographically accessible, and time-flexible testing strategy, has the potential to promote HIV testing among MSM.
Exploration oxidative stress underlying gastroesophageal reflux disease and therapeutic targets identification: a multi-omics Mendelian randomization study
Authors: Shi Jiaxin , Peng Bo , Xu Ran , Chang Xiaoyan , Wang Chenghao , Zhou Xiang , Zhang Linyou 
Published: December 2024

Abstract

Introduction
Gastroesophageal reflux disease (GERD) is a chronic inflammatory gastrointestinal disease, which has no thoroughly effective or safe treatment. Elevated oxidative stress is a common consequence of chronic inflammatory conditions.

Methods
We employed Summary-data based MR (SMR) analysis to assess the associations between gene molecular characteristics and GERD. Exposure data were the summary-level data on the levels of DNA methylation, gene expression, and protein expression, which obtained from related methylation, expression, and protein quantitative trait loci investigations (mQTL, eQTL, and pQTL). Outcome data, Genome-wide association study (GWAS) summary statistics of GERD, were extracted from the Ong’s study (discovery), the Dönertaş’s study (replication), and the FinnGen study (replication). Colocalization analysis was performed to determine if the detected signal pairs shared a causative genetic mutation. Oxidative stress related genes and druggable genes were imported to explore oxidative stress mechanism underlying GERD and therapeutic targets of GERD. The Drugbank database was utilized to conduct druggability evaluation.

Results
After multi-omics SMR analysis and colocalization analysis, we identified seven key genes for GERD, which were SUOX and SERPING1, DUSP13, SULT1A1, LMOD1, UBE2L6, and PSCA. SUOX was screened out to be the mediator, which suggest that GERD is related to oxidative stress. SERPING1, SULT1A1, and PSCA were selected to be the druggable genes.

Conclusions
These findings offered strong support for the identification of GERD treatment targets in the future as well as for the study of the oxidative stress mechanism underlying GERD.
Original Research: Exploring the Use of Passive vs. Active Insulin Safety Pen Needle Devices in a Pediatric Population: A Feasibility Study
Authors: Frankish Brenna , Amplo Kristina , Townsend Rachael , Miller-Roberts Tonya , Wakabayashi Akane Fujimoto , Calamaro Christina 
Published: December 2024

ABSTRACT

Background:
Insulin pens are the mainstay of insulin delivery in the pediatric population, especially among patients unable to use an insulin pump. Safety pen needle (SPN) devices have been embraced by both nurses and patients because they limit the risks of needlestick injury and exposure to blood-borne pathogens. With the commonly used traditional passive SPN device, however, it can be difficult to observe that the dose has been accurately or fully administered.

Purpose:
The purpose of this study was to determine nurses' perceptions about the feasibility of using an active SPN device (specifically the Unifine SafeControl insulin pen needle), compared with the currently used passive SPN device, in pediatric patients ages 21 years or younger who require subcutaneous insulin injections.

Methods:
This feasibility study was conducted on a pediatric inpatient unit at 1 pediatric hospital in the southeastern United States. A total of 49 RNs completed both a pre–device change survey regarding the currently used passive SPN device and a post–device change survey regarding the active SPN device. The RNs also completed daily evaluations assessing the ease of teaching patients and their caregivers how to use the active SPN device. Participation consent was also obtained for 132 pediatric patients with diabetes who were admitted to the unit.

Results:
The majority of the RNs (87.8%) reported overall satisfaction with the active SPN device, compared to about half (52.7%) who reported overall satisfaction with the passive SPN device. Almost all the RNs (98.6%) reported that the active SPN device was easy or very easy to use. Nearly all the nurses (93.9%) reported feeling completely or very confident that the active SPN device allowed them to deliver the full intended dose; and nearly all reported that it was easy or very easy to teach patients (98.2%) and their caregivers (96.4%) how to use the active device.

Conclusions:
As frontline workers in patient care, nurses can lead the innovation and development of new treatment approaches, protocols, and equipment. This nurse-led study explored the nurses' perceptions about the feasibility of a new active SPN device versus the passive SPN device in terms of safety, ease of use, ease of and confidence in dose administration, and ease of teaching device use to pediatric patients and their caregivers. The RNs' clear preference for the active over the passive SPN device suggests that the newer, active devices warrant more widespread use in hospital settings, with further research also recommended.
Impact of Surgical Upper Lumbar Changes on Unfused Lower Lumbar Segments in Adolescent Idiopathic Scoliosis
Authors: Hariharan Arun R. , Bryan Tracey , Nugraha Hans K. , Feldman David S. , Vorhies John S. , Louer Craig R. , Newton Peter O. , Shah Suken A. , Shufflebarger Harry L. , Fletcher Nicholas D. , Lonner Baron S. , Kelly Michael P. ,   Harms Study Group
Published: December 2024

Study Design.
Retrospective review.

Objective.
To determine the impact of upper lumbar lordosis changes in the fused segment on compensatory kyphotic or lordotic changes in the unfused lower lumbar spine in patients with Adolescent Idiopathic Scoliosis (AIS).

Summary of Background Data.
While the distribution of lordosis and interplay between fused/unfused segments has been studied in adults, less is known about this in AIS. We hypothesize that increased FSLL can result in compensatory kyphosis of the unfused distal segments.

Methods.
A retrospective review of Lenke 1/2 patients who underwent posterior spinal fusion (PSF) to L1, L2, or L3 with a minimum follow-up of two years. Coronal Cobb angles, thoracic kyphosis, lumbar lordosis, and spino-pelvic parameters (T4PA, L1PA, PT, SS, PI, PI-LL, SVA) were measured. Custom MATLAB scripts were used for 3D segmental lordosis calculations. Statistical analysis including linear regression analyses and interaction models assessed the relationship between fused segment lumbar lordosis (FSLL), LIV, and thoracic kyphosis (TK) on lower lumbar compensatory alignment.

Results.
158 patients met inclusion criteria. Changes in FSLL affected segmental lordosis of unfused segments, including loss of distal lordosis. In the L1 LIV group, increased FSLL increased L1-L2 lordosis (B=0.35 (P=0.003)). In LIV L2, increased FSLL increased L3-4 lordosis (B=0.2 (P=0.001)) and decreased L4-L5 lordosis (B=−0.23 (P=0.012). For LIV L3, increased FSLL caused reduction in lordosis of L4-5 (B=−0.14 (P=0.026)) and L5-S1 (B=−0.14 (P=0.034)). Changes in TK also had varying impacts on the unfused segments. The interaction model with LIV levels reveals that the compensation strategy can vary depending on specific fusion levels, although not significant. Overall sagittal alignment was maintained and PI-LL remained <10°. Pre- and postoperative T4-L1PA had minimal difference to each other indicating maintained sagittal harmony.

Conclusions.
In this observational study of segmental changes in lumbar lordosis in AIS, post-operative changes in the fused segments can result in iatrogenic changed in the unfused lower segments to maintain spinal balance. Understanding normal segmental lumbar lordosis distribution is critical in surgical planning (i.e. rod contouring) and in understanding the health of the unfused segments long term.
A Rare Case of Intraocular Gold Foreign Body Induced Traumatic Corneal Endothelial Decompensation Managed With Descemet Stripping Automated Endothelial Keratoplasty
Authors: Majumdar Ashis , Dutta Jayanta , Chowdhury Tuhin , Das Mrinmoy 
Published: December 2024

Purpose:
This report presents a rare case of a gold intraocular foreign body (IOFB) that remained in the anterior chamber for 28 years, leading to subsequent traumatic corneal endothelial decompensation and cataract development. The purpose is to describe the successful treatment approach.

Methods:
A 54-year-old Indian man with a history of accidental injury to the left eye involving a burst gold ball in 1994 was examined in September 2023.

Results:
The patient presented with painless dimness of vision, redness, and watering of the left eye. Examination revealed a gold-colored IOFB in the anterior chamber that adhered to the iris tissue, without an obvious entry wound in the cornea or iris defect. Slit-lamp examination revealed corneal edema, and specular microscopy revealed significantly reduced endothelial cell density. anterior segment optical coherence tomography, UBM, and computed tomography scan confirmed the presence and position of the metallic IOFB. Treatment involved IOFB removal, phacoemulsification, intraocular lens placement, and Descemet stripping automated endothelial keratoplasty in a single setting. The gold foreign body was an alloy of gold, silver, copper, and zinc, which was nonmagnetic in nature and the copper content was significantly less to cause chalcosis. The patient's visual acuity improved significantly postoperatively.

Conclusions:
Gold IOFBs are uncommon, but they can persist for extended periods without causing noticeable symptoms owing to the inertness and biocompatibility of gold. However, the foreign body was nonmagnetic in nature, mechanical trauma by the foreign body to the endothelium can lead to delayed corneal decompensation. This case demonstrates the successful treatment procedure. Early detection and appropriate management could have averted DSAEK; however, even in the late stage with combined DSAEK, better results can still be obtained.
Aesthetic Surgery in a Patient With Situs Inversus: A Rare Case Report About the Practical Concerns
Authors: Rasheed Faryal S. , Alelyani Rakan Hamdan , Assad Majad A. , Aljehani Nawaf D. , Alkhonizy Sarah W. , Alaqil Sultan N. , Aldumkh Shahad H. , Alrajhi Reem S. , Jalaluddin Raees A , Nawwab Eyad A. 
Published: December 2024

Summary:
Aesthetic surgery has gained substantial popularity over the last decade due to enormous projections in the media. These procedures have not only attracted Westerners but also the Middle Eastern and Saudi populations. Situs inversus is an extremely rare congenital anomaly with an incidence of 1 in 10,000 live births. Its association with Kartagener syndrome, cardiac anomalies, asplenia, and vertebral column deformities are well documented in the literature. A wide range of procedures have been described for people with situs inversus with special technical considerations, but an aesthetic procedure has never been published for them before this report. We provide a brief report of a 53-year-old woman with a known case of situs inversus who underwent a body contouring procedure.
Scaffold-assisted Breast Augmentation: Approaching New Horizon by Three-Dimensionally Printed Personalized Tissue Regenerative Implants
Authors: Hamed Mohamed Lofty 
Published: December 2024

Summary:
Current breast augmentation options face limitations and potential associated complications. Implant-based augmentation introduces risks such as capsular contracture and malpositioning, whereas fat grafting poses issues such as induration and infections, necessitating revisions. Tissue engineering, integrating 3-dimensional (3D) printing and biomaterials science, aims to overcome these challenges. However, the clinical translation of these advancements remains challenging, with many approaches falling short in demonstrating the necessary volume regeneration. A 28-year-old yoga instructor with a disinterest in traditional options sought an alternative solution. Custom-made biocompatible thermoplastic copolyester implants were proposed, approved, and implemented. Our approach utilized artificial intelligence, magnetic resonance imaging, computer-aided design, and lattice structure engineering for customizing the implant design. Three-dimensional printing and plasma technology surface treatment created implants of 300 and 315 cm3 volumes, weighting around 33 g with biomimetic properties. Implants were placed in the subglandular plane; an 8-month follow-up revealed well-maintained implants without complications, except for a conservatively managed hematoma, and excellent cosmetic outcomes. Magnetic resonance imaging analysis revealed revascularization and new tissue formation within the implant, demonstrating tissue integration without complications. The study addresses biomechanical issues and foreign body reactions that cause capsular contracture in breast augmentation and proposes a novel 3D-printed implant with ultralight weight, tissue integrative porous structure, and biomimetic environments for scaffold-guided tissue regeneration. In conclusion, the presented solution shows promise in overcoming current breast augmentation limitations, demonstrating safety, biocompatibility, and patient satisfaction. Further adoption and long-term studies with larger cohorts are needed to validate its clinical effectiveness and feasibility.
Definition of Progressive Keratoconus: A Systematic Review
Authors: Henriquez Maria A. , Larco Carolina , Izquierdo Luis 
Published: December 2024

Purpose:
To identify the definitions used for progressive keratoconus in the literature.

Methods:
A systematic literature review aimed to identify the definitions used for “progressive keratoconus” in the published articles. A comprehensive search from January 2018 to May 2023 was conducted across Cochrane Library, PubMed, Taylor & Francis, Web of Science, and other bibliographic databases at Oftalmosalud, Lima, Peru. The inclusion criteria were articles including patients with keratoconus without any previous surgical procedure and containing the definition of “progressive keratoconus” or “keratoconus progression” and a sample size greater than 10 eyes.

Results:
A total of 221 articles were included for analysis. The 3 most frequent parameters to define progression included data from anterior curvature, pachymetry, and refraction used in 97.8% (216/221), 37.6% (83/221), and 32.1% (71/221) of the articles, respectively. Specifically, the most frequent criterion used was maximum keratometry (Kmax), used in 85.5% (189/221) of the articles. Progression was assessed between 6- and 12-month follow-up in 64.7% (143/221) of the articles. Data from posterior cornea were used in only 8.1% (18/221) of the studies. None of the studies included data from the corneal epithelium.

Conclusions:
The present study demonstrates the lack of unified criteria to define progression of keratoconus and an underutilization of the technology described. It also shows that the single point Kmax measurement is the most commonly used criterion, followed by a change in refractive astigmatism and thinning at the thinnest pachymetric point.