bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upper limb spasticity
Authors: McArthur Paul 
Published: September 2021

Abstract
Spasticity is an involuntary hypertonic state. Dynamic spasticity produces deformity, impairs function, and may lead to contracture and fibrosis. Assessment and management of spasticity should be undertaken through a multidisciplinary team environment following repeated examination and assessment. Management options include physiotherapy, splintage, botulinum toxin, and surgery. Treatment aims include facilitating skin care and hygiene, and improving hand function.
Avoiding patient dissatisfaction
Authors: Mercer Nigel , Soldin Mark 
Published: September 2021

Abstract
The practice of medicine has always been a balance of the latest scientific advances, and a less well-defined ‘art’ of patient care. Much of this ‘art’ is good communication. In cosmetic surgery, advances in anatomical and scientific knowledge have allowed plastic surgeons to enhance youthful beauty to a level never thought possible in the past. Technical success does not, however, equate with patient satisfaction. All surgeons will have the occasional patient who is unhappy with a result that the surgeon feels is reasonable. It is likely that something was missed in the patient preparation for surgery, possibly a psychological condition that was overlooked. Cosmetic surgery patients are, by definition, dissatisfied with their body image. This dissatisfaction could be understandable and reasonable, or it may be excessive and abnormal. Within the cosmetic surgery patient spectrum there will be patients with body dysmorphic disorder or other problems that will place both patient and surgeon at risk of an unhappy outcome even though there has been a good surgical result. Plastic surgeons must have insight into the psychology of body image dissatisfaction. Subspecialization in modern medicine means that today’s plastic surgeons may need the help of psychologists to assist in the identification of these patients.
Treatment of large and ptotic breasts
Authors: Searle Adam , de Mey Albert , Zirak Christophe 
Published: September 2021

Abstract
The breasts have always been considered a sign of femininity. The correction of breast deformities is therefore important from a physical and psychological point of view, improving greatly the quality of life. Many surgical techniques have been proposed to correct the shape and volume of the breast, and in recent decades techniques have been proposed to preserve the nipple sensitivity and increase the vascular safety of the procedure. Templates (such as the Wise pattern) have been proposed to improve planning and different pedicles for the areola have been described. During the last 20 years, new techniques have been introduced to minimize scars, leaving normal sensitivity in almost all cases, the possibility of lactation, and a pleasing shape. The periareolar scar is, unfortunately, always necessary to reposition the nipple–areolar complex. The vertical scar is necessary to resect the excess of skin of the lower pole of the breast. Effort has been directed to reduce or eliminate the horizontal submammary scar, leading to a vertical scar only, even in large reductions.
Classification of craniofacial anomalies
Authors: Jagadeesan Jagajeevan , Nishikawa Hiroshi 
Published: September 2021

Abstract
Craniofacial anomalies are a rare group of congenital disorders that affect the cranium and the face. Due to the rarity and diverse nature of presentation, classifying them has always posed a challenge. An ideal classification system is meant to be simple, effective, and reproducible. This chapter provides a brief history of the different classification schemes and explains a simple, modified, and descriptive classification system. A brief description of the more common craniofacial conditions and their clinical features is presented. The management of individual conditions is discussed in their respective chapters.
Classification, evaluation, and management of the neonate with a cleft
Authors: Sainsbury David C.G. 
Published: September 2021

Abstract
Numerous classifications, including LAHSAL and Kernahan’s striped Y, aid organizing the heterogeneous nature of typical orofacial clefts. Antenatal diagnosis occurs in approximately 80% of births and is more accurate for diagnosing cleft lip than cleft palate. Most parents find antenatal diagnosis beneficial for psychological adjustment and planning prior to the birth. Airway assessment is vital in neonates with a cleft. Most, even those with severe Robin sequence, can be managed non-surgically with lateral or prone positioning, a nasopharyngeal airway, and supplemental oxygen. Sleep studies are an important means of assessing the airway. Feeding is a major concern in babies with a cleft; early feeding intervention and parental education is important. Other conditions, including Robin sequence, 22q11 deletion syndrome, Stickler syndrome, and van der Woude syndrome, must be identified early in conjunction with the cleft multidisciplinary team. Genetic analysis and counselling should be considered.
Radiology of the head and neck
Authors: Zammit-Maempel Ivan 
Published: September 2021

Abstract
Various imaging techniques are used in the staging and follow-up of head and neck cancer and evaluating patients presenting with a neck mass. The workhorses in imaging the neck are ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) with positron emission tomography CT (PET-CT) increasingly being requested. Plain radiographs, contrast studies, video fluoroscopy, angiography, and cone beam CT have limited but important roles. This chapter discusses the role of some of these modalities.
Adult thermal burns
Authors: Rawlins Jeremy , Jones Isabel 
Published: September 2021

Abstract
Adult burn injuries are heterogeneous in their aetiology and in their severity, and in the many ways in which they affect the burns patient. Treatment should be initiated promptly, ensuring that other life-threatening injuries are dealt with, and that expert burn care is delivered to the patient. First aid followed by emergency management of the patient, fluid resuscitation, and specialist wound care ensures the patient is given the very best opportunity for full recovery and survival. The burn wound may be managed non-surgically, but for deeper and more severe injuries, surgical debridement and wound cover with grafts, cell suspensions, dermal matrices, or flaps is required. Areas of special attention include the face, hands, and perineum—all functionally and aesthetically important, and each with specific dressing needs and surgical techniques that optimize good outcomes. Scar management and physiotherapy are crucial components of adult burn care, with many therapies applied concurrently to ensure good functional and aesthetic recovery. For those patients with ongoing scar and contracture difficulties, scar therapies and reconstructive burns surgery offer the chance of better function and appearance even many years after the original burn. The journey to recovery would not be complete, however, without important psychosocial input for the burns patient, as the psychological scars are often just as painful as the physical ones.
Semiquantitative assessed proteinuria and risk of heart failure: analysis of a nationwide epidemiological database
Authors: Fukui Akira , Kaneko Hidehiro , Okada Akira , Yano Yuichiro , Itoh Hidetaka , Matsuoka Satoshi , Morita Kojiro , Kiriyama Hiroyuki , Kamon Tatsuya , Fujiu Katsuhito , Michihata Nobuaki , Jo Taisuke , Takeda Norifumi , Morita Hiroyuki , Nakamura Sunao , Nishiyama Akira , Node Koichi , Yokoo Takashi , Nangaku Masaomi , Yasunaga Hideo , Komuro Issei 
Published: September 2021

Abstract

Background
Heart failure (HF) is increasing in prevalence worldwide. We explored whether adults with trace and positive proteinuria were at a high risk for incident HF compared with those with negative proteinuria using a nationwide epidemiological database.

Methods
This is an observational cohort study using the JMDC Claims Database collected between 2005 and 2020. This is a population-based sample [n = 1 021 943; median age 44 years (interquartile range 37–52); 54.8% men]. No participants had a known history of cardiovascular disease (CVD). Each participant was categorized into three groups according to the urine dipstick test results: negative proteinuria (n = 902 273), trace proteinuria (n = 89 599) and positive proteinuria (≥1+; n = 30 071). The primary outcome was HF. The secondary outcomes were myocardial infarction (MI), stroke and atrial fibrillation (AF). We performed multivariable Cox regression analyses to identify the association between the proteinuria category and incident HF and other CVD events.

Results
Over a mean follow-up of 1150 ± 920 days, 17 182 incident HF events occurred. After multivariable adjustment, hazard ratios for HF events were 1.09 [95% confidence interval (CI) 1.03–1.15] and 1.59 (95% CI 1.49–1.70) for trace proteinuria and positive proteinuria versus negative proteinuria, respectively. This association was present irrespective of clinical characteristics. A stepwise increase in the risk of MI, stroke and AF with proteinuria category was also observed. Our primary results were confirmed in participants after multiple imputations for missing values and in those having no medications for hypertension, diabetes mellitus and dyslipidemia. The discriminative predictive value for HF events improved by adding the results of urine dipstick tests to traditional risk factors [net reclassification improvement 0.0497 (95% CI 0.0346–0.0648); P &lt; 0.001].

Conclusions
Not only positive proteinuria, but also trace proteinuria was associated with a greater incidence of HF in the general population. Semiquantitative assessment of proteinuria would be informative for the risk stratification of HF.
A High Frequency of Candida auris Blood Stream Infections in Coronavirus Disease 2019 Patients Admitted to Intensive Care Units, Northwestern India: A Case Control Study
Authors: Rajni Ekadashi , Singh Ashutosh , Tarai Bansidhar , Jain Kusum , Shankar Ravi , Pawar Kalpana , Mamoria Vedprakash , Chowdhary Anuradha 
Published: September 2021

Abstract

Background
The ongoing pandemic of coronavirus disease 2019 (COVID-19) has overwhelmed healthcare facilities and raises an important novel concern of nosocomial transmission of Candida species in the intensive care units (ICUs).

Methods
We evaluated the incidence and risk factors for development of candidemia in 2384 COVID-19 patients admitted during August 2020–January 2021 in ICUs of 2 hospitals (Delhi and Jaipur) in India. A 1:2 case-control matching was used to identify COVID-19 patients who did not develop candidemia as controls.

Results
A total of 33 patients developed candidemia and accounted for an overall incidence of 1.4% over a median ICU stay of 24 days. A 2-fold increase in the incidence of candidemia in COVID-19 versus non-COVID-19 patients was observed with an incidence rate of 14 and 15/1000 admissions in 2 ICUs. Candida auris was the predominant species (42%) followed by Candida tropicalis. Multivariable regression analysis revealed the use of tocilizumab, duration of ICU stay (24 vs 14 days), and raised ferritin level as an independent predictor for the development of candidemia. Azole resistance was observed in C auris and C tropicalis harboring mutations in the azole target ERG11 gene. Multilocus sequence typing (MLST) identified identical genotypes of C tropicalis in COVID-19 patients, raising concern for nosocomial transmission of resistant strains.

Conclusions
Secondary bacterial infections have been a concern with the use of tocilizumab. In this cohort of critically ill COVID-19 patients, tocilizumab was associated with the development of candidemia. Surveillance of antifungal resistance is warranted to prevent transmission of multidrug-resistant strains of nosocomial yeasts in COVID-19 hospitalized patients.
Development of aerial and belowground tubers in potato is governed by photoperiod and epigenetic mechanism
Authors: Kondhare Kirtikumar R , Kumar Amit , Patil Nikita S , Malankar Nilam N , Saha Kishan , Banerjee Anjan K 
Published: September 2021

AbstractPlants exhibit diverse developmental plasticity and modulate growth responses under various environmental conditions. Potato (Solanum tuberosum), a modified stem and an important food crop, serves as a substantial portion of the world’s subsistence food supply. In the past two decades, crucial molecular signals have been identified that govern the tuberization (potato development) mechanism. Interestingly, microRNA156 overexpression in potato provided the first evidence for induction of profuse aerial stolons and tubers from axillary meristems under short-day (SD) photoperiod. A similar phenotype was noticed for overexpression of epigenetic modifiers—MUTICOPY SUPRESSOR OF IRA1 (StMSI1) or ENAHNCER OF ZESTE 2 (StE[z]2), and knockdown of B-CELL-SPECIFIC MOLONEY MURINE LEUKEMIA VIRUS INTEGRATION SITE 1 (StBMI1). This striking phenotype represents a classic example of modulation of plant architecture and developmental plasticity. Differentiation of a stolon to a tuber or a shoot under in vitro or in vivo conditions symbolizes another example of organ-level plasticity and dual fate acquisition in potato. Stolon-to-tuber transition is governed by SD photoperiod, mobile RNAs/proteins, phytohormones, a plethora of small RNAs and their targets. Recent studies show that polycomb group proteins control microRNA156, phytohormone metabolism/transport/signaling and key tuberization genes through histone modifications to govern tuber development. Our comparative analysis of differentially expressed genes between the overexpression lines of StMSI1, StBEL5 (BEL1-LIKE transcription factor [TF]), and POTATO HOMEOBOX 15 TF revealed more than 1,000 common genes, indicative of a mutual gene regulatory network potentially involved in the formation of aerial and belowground tubers. In this review, in addition to key tuberization factors, we highlight the role of photoperiod and epigenetic mechanism that regulates the development of aerial and belowground tubers in potato.
Congenital Syphilis Case Surveillance in South Africa 2017–19: Experience, Challenges and Opportunities
Authors: Morifi Mabore , Malevu Ntebogeleng , Odayan Sharika , McCarthy Kerrigan , Kufa Tendesayi 
Published: September 2021

Abstract

Background
Untreated or inadequately treated maternal syphilis infection may be transmitted from mother to child resulting in congenital syphilis (CS) infection. In South Africa (SA), CS is a notifiable medical condition (NMC). The NMC surveillance system (NMCSS) was improved by introducing an electronic notification application, a new case notification form and training resources in July 2017. We describe CS surveillance in SA and report on experiences from implementing an improved NMCSS from August 2017 to December 2019.

Methods
We present the CS case definition, data collected by the CS case investigation and notification forms and data flow through the NMCSS. Descriptive statistics were used to analyse CS notifications received from August 2017 to December 2019. Qualitative inductive analysis of the stakeholder communications diary was conducted to identify CS surveillance challenges.

Results
There were 418 CS notifications submitted from 80 facilities in 35 out of 52 districts. Of the notified cases, 194 (46.8%) were male and the median age at notification was 7 days (interquartile range: 3–16 days). The majority were diagnosed in hospital (98.6%). KwaZulu–Natal Province notified the most cases (52.9%) followed by Gauteng (28.0%). Challenges in CS surveillance included the lack of awareness of the CS case definition, completed paper-based notifications not reaching the NMCSS and the limited ability of the system to distinguish improved notifications from increase in disease burden.

Conclusion
Improved CS surveillance through NMCSS was implemented in SA. Training, support and mentoring on CS and the notification system will be needed to inform elimination efforts.
Surviving Sepsis Campaign: Research Opportunities for Infection and Blood Purification Therapies
Authors: Martin-Loeches Ignacio , Nunnally Mark E. , Hellman Judith , Lat Ishaq , Martin Greg S. , Jog Sameer , Kesecioglu Jozef , De Backer Daniel , Coopersmith Craig M. 
Published: September 2021

OBJECTIVES:
Patients with infection can develop sepsis, and their mortality can be high. An important aspect in the treatment of sepsis is adequate management of the infection.

DATA SOURCES:
Using a modified Delphi approach, the Surviving Sepsis Campaign research committee recently published a series of 26 priorities for sepsis and septic shock.

STUDY SELECTION:
Task force members with specific expertise were tasked with generating expanded reviews for all infection questions and a subset of adjunctive therapy questions from the larger list of sepsis priorities. Each question was addressed by one of the six task force members.

DATA EXTRACTION:
In-depth reviews were then edited by the group as a whole, with added input from the committee cochairs.

DATA SYNTHESIS:
Six questions were addressed: 1) should empiric antibiotic combination therapy be used in sepsis or septic shock? 2) does optimization of antimicrobial pharmacokinetics and pharmacodynamics impact patient outcomes in sepsis? 3) should viral reactivation resulting from sepsis-induced immunosuppression be treated with antiviral therapy in critically ill septic patients? 4) should rapid diagnostic tests be implemented in clinical practice? 5) what is the role of lung-protective ventilation in sepsis patients without acute respiratory distress syndrome? and 6) how do we determine the efficacy of “blood purification” therapies such as endotoxin absorbers, cytokine absorbers, and plasmapheresis.

CONCLUSIONS:
The research committee members for the Surviving Sepsis Campaign aimed to explore research questions in order to provide existing evidence and highlight areas of uncertainty and future directions.
Benchmarking Scholarly Activity by Pharmacists Who Are Fellows Within the American College of Critical Care Medicine
Authors: Sherman Kaitlyn M. , Gagnon David J. 
Published: September 2021

OBJECTIVES:
Quantify scholarly activity by pharmacists who are Fellows within the American College of Critical Care Medicine and to develop a potential publication benchmark for fellowship application.

DESIGN:
Review of the Scopus and PubMed online citation databases.

SETTING:
None.

PATIENTS:
None.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Pharmacists designated Fellow of Critical Care Medicine (FCCM) were identified in January 2021 by the Society of Critical Care Medicine. Pharmacists designated Master of Critical Care Medicine (MCCM), without an active license, or were not identified in either online citation database were excluded. Practice setting characteristics were obtained from the American Hospital Association including country, state, geographic region, number of staffed beds, and hospital designation. Two online citation databases (Scopus and PubMed) were queried in February 2021, and year of first publication, total publications, citations, and Hirsch index were recorded. Of the 152 pharmacists designated FCCM, 138 (91%) were evaluable. Reasons for exclusion included MCCM designation (n = 7; 5%), lack of data in either online citation database (n = 4; 3%), and no active pharmacist license (n = 3; 2%). Most pharmacists were practicing in the Southern geographic region of the United States (n = 62; 45%) and at an academic medical center (n = 116; 84%). The median year of FCCM convocation was 2016 (2012–2019) and of the first publication was 2007 (2002–2011). After removing duplicates, 4,488 unique publications were identified. The median number of publications per individual pharmacist was 20 (9–43) with 10 (5–19) between the year of their first publication and FCCM convocation. Most scholarly activity was in the form of original research (n = 3,173; 71%) or reviews (n = 795; 18%). Individual pharmacists have 244 (99–661) citations and an h-index of 8 (5–13).

CONCLUSIONS:
Pharmacists designated FCCM have maintained a high level of scholarly activity. Pharmacists pursuing fellowship may use these data as a benchmark for fulfilling aspects of the core area of scholarly activities related to critical care medicine prior to application.
Biomarkers for Adverse Lung Injury Following Pediatric Cardiopulmonary Bypass
Authors: Asfari Ahmed , Hock Kristal M. , Byrnes Jonathan W. , Borasino Santiago , Halloran Brian A. , Mobley James A. , Ambalavanan Namasivayam 
Published: September 2021

OBJECTIVES:
Cardiopulmonary bypass triggers systemic inflammation, resulting in lung injury, and frequently leads to prolonged mechanical ventilation. Biomarkers of systemic inflammation are required to predict the risk of such complications. We hypothesize that specific serum proteins can be used as biomarkers to predict the severity of lung injury following cardiac surgery.

DESIGN:
Retrospective chart review study.

SETTING:
Clinical variables were collected and used in conjuncture with unbiased proteomic analysis using mass spectrometry that was performed on frozen plasma samples from a study group (patients with mechanical ventilation > 48 hr post surgery) and a control group (patients with mechanical ventilation < 48 hr post surgery).

SUBJECTS:
Subjects included were infants who underwent cardiac surgery with similar complexity (Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery 3 or 4) using cardiopulmonary bypass. Patients in both groups were matched for their weight, age, and duration of cardiopulmonary bypass.

INTERVENTION:
None.

MEASUREMENTS AND MAIN RESULTS:
Four-hundred eighty-three proteins were identified (99% minimum confidence and two peptides minimum, protein false discovery rate 0.1%) on proteomic analysis of four control and four study patients at precardiopulmonary bypass, 0, and 48 hours postcardiopulmonary bypass samples. Thirty-six of 178 proteins were significantly different (≥ 1.5-fold; p < 0.05) at precardiopulmonary bypass (top increased: tenascin; top decreased: tetranectin), 18 of 140 proteins at 0 hour (top increased: hemoglobin beta; top decreased: C8 beta), and 25 of 166 proteins at 48 hours post surgery (top increased: proteoglycan 4; top decreased: galectin-3–binding protein). The top pathway involved cytoskeleton remodeling. Other pathways involved immune response and blood coagulation. Proteoglycan 4 was validated by enzyme-linked immunosorbent assay in a different set of samples (n = 20/group; mean ± sd: 128 ± 67 vs 195 ± 160 ng/mL) (p = 0.037).

CONCLUSIONS:
Multiple proteomic biomarkers were associated with worse respiratory outcomes. Precardiopulmonary bypass biomarkers might indicate risk factors (e.g., abnormalities of coagulation), whereas those identified at 0 hour and post cardiopulmonary bypass may reflect mechanisms of ongoing pathobiology.