bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional variation in the treatment and prevention of peritoneal dialysis-related infections in the Peritoneal Dialysis Outcomes and Practice Patterns Study
Authors: Boudville Neil , Johnson David W , Zhao Junhui , Bieber Brian A , Pisoni Ronald L , Piraino Beth , Bernardini Judith , Nessim Sharon J , Ito Yasuhiko , Woodrow Graham , Brown Fiona , Collins John , Kanjanabuch Talerngsak , Szeto Cheuk-Chun , Perl Jeffrey 
Published: June 2018

AbstractBackgroundPeritoneal dialysis (PD)-related infections lead to significant morbidity. The International Society for Peritoneal Dialysis (ISPD) guidelines for the prevention and treatment of PD-related infections are based on variable evidence. We describe practice patterns across facilities participating in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).MethodsPDOPPS, a prospective cohort study, enrolled nationally representative samples of PD patients in Australia/New Zealand (ANZ), Canada, Thailand, Japan, the UK and the USA. Data on PD-related infection prevention and treatment practices across facilities were obtained from a survey of medical directors’.ResultsA total of 170 centers, caring for >11 000 patients, were included. The proportion of facilities reporting antibiotic administration at the time of PD catheter insertion was lowest in the USA (63%) and highest in Canada and the UK (100%). Exit-site antimicrobial prophylaxis was variably used across countries, with Japan (4%) and Thailand (28%) having the lowest proportions. Exit-site mupirocin was the predominant exit-site prophylactic strategy in ANZ (56%), Canada (50%) and the UK (47%), while exit-site aminoglycosides were more common in the USA (72%). Empiric Gram-positive peritonitis treatment with vancomycin was most common in the UK (88%) and USA (83%) compared with 10–45% elsewhere. Empiric Gram-negative peritonitis treatment with aminoglycoside therapy was highest in ANZ (72%) and the UK (77%) compared with 10–45% elsewhere.ConclusionsVariation in PD-related infection prevention and treatment strategies exist across countries with limited uptake of ISPD guideline recommendations. Further work will aim to understand the impact these differences have on the wide variation in infection risk between facilities and other clinically relevant PD outcomes.
A critical role for ABC transporters in persistent lung inflammation in the development of emphysema after smoke exposure
Authors: Sonett Jarrod , Goldklang Monica , Sklepkiewicz Piotr , Gerber Adam , Trischler Jordis , Zelonina Tina , Westerterp Marit , Lemaître Vincent , Okada Yasunori , Armiento Jeanine D’ 
Published: June 2018

ABSTRACTMacrophage infiltration is common to both emphysema and atherosclerosis, and cigarette smoke down‐regulates the macrophage cholesterol efflux transporter ATP binding cassette (ABC)A1. This decreased cholesterol efflux results in lipid‐laden macrophages. We hypothesize that cigarette smoke adversely affects cholesterol transport via an ABCA1‐dependent mechanism in macrophages, enhancing TLR4/myeloid differentiation primary response gene 88 (Myd88) signaling and resulting in matrix metalloproteinase (MMP) up‐regulation and exacerbation of pulmonary inflammation. ABCA1 is significantly down‐regulated in the lung upon smoke exposure conditions. Macrophages exposed to cigarette smoke in vivo and in vitro exhibit impaired cholesterol efflux correlating with significantly decreased ABCA1 expression, up‐regulation of the TLR4/Myd88 pathway, and downstream MMP‐9 and MMP‐13 expression. Treatment with liver X receptor (LXR) agonist restores ABCA1 expression after short‐term smoke exposure and attenuates the inflammatory response; after long‐term smoke exposure, there is also attenuated physiologic and morphologic changes of emphysema. In vitro, treatment with LXR agonist decreases macrophage inflammatory activation in wild‐type but not ABCA1 knockout mice, suggesting an ABCA1‐dependent mechanism of action. These studies demonstrate an important association between cigarette smoke exposure and cholesterol‐mediated pathways in the macrophage inflammatory response. Modulation of these pathways through manipulation of ABCA1 activity effectively blocks cigarette smoke–induced inflammation and provides a potential novel therapeutic approach for the treatment of chronic obstructive pulmonary disease.—Sonett, J., Goldklang, M., Sklepkiewicz, P., Gerber, A., Trischler, J., Zelonina, T., Westerterp, M., Lemaître, V., Okada, V., D’Armiento, J. A critical role for ABC transporters in persistent lung inflammation in the development of emphysema after smoke exposure. FASEB J. 32, 6724–6736 (2018). www.fasebj.org
Aberrant miR‐145–5p/β‐catenin signal impairs osteocyte function in adolescent idiopathic scoliosis
Authors: Zhang Jiajun , Chen Huanxiong , Leung Ross K. K. , Choy Kwong Wai , Lam Tsz‐Ping , Ng Bobby K. W. , Qiu Yong , Feng Jian Q. , Cheng Jack C. Y. , Lee Wayne Y. W. 
Published: June 2018

ABSTRACTRecently, noncoding RNAs have been thought to play important roles in the sporadic occurrence of spinal deformity of adolescent idiopathic scoliosis (AIS). As a prognostic factor for curve progression, low bone mass has been hypothesized to crosstalk with AIS pathogenesis. Abnormal osteoblasts activities are reported in AIS without a clear mechanism. In this study, bone biopsies from patients with AIS and control subjects and the primary osteoblasts derived from those samples were used to identify the potential microRNA (miRNA) candidates that interfere with osteoblasts and osteocytes function. Microarray analysis identified miRNA‐145–5p (miR‐145) as a potential upstream regulator. miR‐145 and β‐catenin mRNA (CTNNB1) were overexpressed in AIS bone tissues and primary osteoblasts, and their expression correlated positively in AIS. Knockdown of miR‐145 restored impaired osteocyte activity through the down‐regulation of active β‐catenin expression and its transcriptional activity. Significant negative correlations between circulating miR‐145 and serum sclerostin, osteopontin, and osteoprotegerin were noted in patients with AIS, which was in line with our cellular findings. This is the first study to demonstrate the effect of aberrant miRNA expression and its effect on osteocyte function in AIS, which may contribute to the low bone mass. Our findings also provide insight into the development of circulating microRNAs as a bone quality biomarker or even a prognostic biomarker for AIS.—Zhang, J., Chen, H., Leung, R. K. K., Choy, K. W., Lam, T.‐P., Ng, B. K. W., Qiu, Y., Feng, J. Q., Cheng, J. C. Y., Lee, W. Y. W. Aberrant miR‐145–5p/β‐catenin signal impairs osteocyte function in adolescent idiopathic scoliosis. FASEB J. 32, 6537–6549 (2018). www.fasebj.org
Ulnar Nerve Injury in Pediatric Midshaft Forearm Fractures: A Case Series
Authors: Federer Andrew E. , Murphy Joshua S. , Calandruccio James H. , Devito Dennis P. , Kozin Scott H. , Slappey Greg S. , Lourie Gary M. 
Published: June 2018

Objectives:
To describe a midshaft forearm fracture pattern that places the ulnar nerve at risk in the pediatric population and provide 7 clinical case examples describing the injury pattern and treatment methods.

Design:
Retrospective observational case series, review of literature, cadaver dissection, and treatment recommendations.

Setting:
Multi-institutional, Southeast United States.

Patients:
Seven pediatric patients (5 male and 2 female) with mean age of 8.7 years (range, 3–14) who sustained a significantly displaced closed, or grade I open, middle to distal one-third both-bone forearm fracture with subsequent ulnar nerve dysfunction.

Interventions:
Manual reduction and casting of both-bone forearm shaft fractures, operative debridement, fracture fixation, nerve exploration, neurolysis, nerve repair, and nerve grafting.

Main Outcome Measurements:
Radiographic fracture union, clinical ulnar nerve motor and sensory function testing, along with selective electric nerve testing and advanced imaging were monitored throughout follow-up postinjury.

Results:
Five of 7 patients underwent surgical treatment and 2 others were treated with conservative measures. The ulnar nerve was entrapped within the fracture site of one patient with an open fracture along with partial nerve transection, and 4 patients were found to have the nerve encased in hypertrophic scar tissue or bony callus upon surgical exploration at 3–12 months postinjury.

Conclusions:
The ulnar nerve lies in a precarious position in the middle to distal one-third forearm and is bound by anatomic constraints that place the nerve at risk of injury. This article offers a treatment algorithm that includes conservative treatment, acute exploration, early exploration (≤3 months), and late exploration (>3 months).

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Clinical and Molecular Recursive Partitioning Analysis of High-grade Glioma Treated With IMRT
Authors: Sutera Philip , Kalash Ronny , Flickinger John , Engh Johnathan , Heron Dwight E. 
Published: June 2018

Introduction:
Despite multimodal treatment for high-grade gliomas, prognosis remains grim. Prior Radiation Therapy Oncology Group-Recursive Partitioning Analysis (RTOG-RPA) reports indicate based on pretreatment and treatment-related factors, a subset of patients experience a significantly improved survival. Since the development of the RTOG-RPA, high-grade gliomas have seen the widespread introduction of temozolomide and tumor oncogenetics. Here we aimed to determine whether the RTOG-RPA retained prognostic significance in the context of modern treatment, as well as generate an updated RPA incorporating both clinical and genetic variables.

Methods:
Patients with histologically proven glioblastoma, gliosarcoma, anaplastic astrocytoma, and anaplastic oligodendroglioma treated with intensity-modulated radiation therapy (IMRT) between 2004 and 2017 were reviewed. The primary endpoint was overall survival from date of diagnosis. Primary analysis compared actual survival rates to that expected of corresponding RTOG-RPA class. Secondary analysis utilized the rpart function to recursively partition overall survival by numerous clinical and genetic pretreatment and treatment-related variables. A tertiary analysis recursively partitioned a subset of patients in which the status of all genetic markers were known.

Results:
We identified 878 patients with histologically proven high-grade glioma treated with IMRT and 291 patients in our genetic subset. Median overall survival for the entire cohort was 14.2 months (95% confidence interval, 13.1-15.3). Applying the RTOG-RPA to our cohort validated the relative prognostic ordering of the survival classes except class II. Generating our new RPA created 7 significantly different survival classes (P<0.001, χ2=584) with median survival ranging from 96.4 to 2.9 months based on age, histology, O6-methylguanine-DNA methyltransferase methylation status, radiation fractions, tumor location, radiation dose, temozolomide status, and resection status. Our second RPA of our genetic subset generated 5 significantly different survival classes (P<0.001, χ2=166) with survival ranging from 65.3 to 5.6 months based on age, isocitrate dehydrogenase 1 mutation status, O6-methylguanine-DNA methyltransferase methylation status, neurological functional classification, hospitalization during IMRT, temozolomide status, and Karnofsky performance status.

Conclusions:
The RTOG-RPA retains partial prognostic significance, however, should be updated to reflect recent advancements. This series represents a large RPA analyzing both clinical and genetic factors and generated 7 distinct survival classes. Further assessment of patients with fully available genetic markers generated 5 distinct survival classes. These survival classifications need to be validated by a prospective data set and compared against the RTOG-RPA to determine whether they provide improved prognostic power.
PACK-CXL in Reducing the Time to Heal in Suppurative Corneal Ulcers: Observations of a Pilot Study From South India
Authors: Basaiawmoit Priya , Selvin Satheesh Solomon T. , Korah Sanita 
Published: June 2018

Purpose:To assess the usefulness of photoactivated chromophore for infectious keratitis–corneal collagen cross-linking in reducing the time to heal in suppurative corneal ulcers in a South Indian tertiary care center.Methods:This was an observational cohort study with 2 arms. In the prospective arm, 13 patients with suppurative corneal ulcers who presented to the outpatient department were recruited. Their ulcers were exposed to ultraviolet-A with riboflavin (B2) (photoactivated chromophore for infectious keratitis–corneal collagen cross-linking) up to a maximum of 4 sittings at 3-day intervals. Topical antimicrobial therapy was continued as per the standard department protocol. This cohort was compared with a retrospective cohort of 32 consecutive patients who had been admitted and treated at our department for a similar profile of ulcers in the previous 1 year.Results:The ulcers in the prospective arm had an average healing time of 21.6 days, whereas the retrospective arm had an average healing time of 48.8 days. This reduction in the time to heal trends not only toward being statistically significant (P= 0.06) but also highly clinically significant.Conclusions:CXL reduced the time to heal in suppurative corneal ulcers less than 6 mm in diameter and can be used as an adjuvant to antimicrobial therapy.
RIGHTS: Response Initiative Guiding Human Trafficking Services
Authors: Vietor Theresa , Hountz Rosanne 
Published: June 2018

ABSTRACT
Human trafficking, including both sex and labor trafficking, is a global issue affecting 20.9 million people worldwide. The National Human Trafficking Hotline identified 36,270 cases of human trafficking in the United States since 2007. Human trafficking affects every community in the United States, no matter the size. The Sexual Assault Response Team (SART) is a crisis intervention model that has shown improved outcomes for sexual assault victims. The SART approach can be modeled to develop a regional community response to human trafficking to improve outcomes for these victims. Historically, SARTs include collaborative responses between forensic nurses, advocates, law enforcement, and the justice system. Forensic nurses have a unique role in participating in solutions that promote healing for this population. This article discusses the development of a task force and a collaborative response to human trafficking that includes healthcare and forensic nurses. Benefits and challenges will be presented.
Defense Styles Mediate the Association Between Empathy and Burnout Among Nurses
Authors: Fitzgerald-Yau Natasha , Egan Jonathan 
Published: June 2018

Abstract
Research has extensively identified empathic skills as essential in health trainings, policies, and recommendations. However, there have been conflicting views of the impact of empathy on burnout. Some studies contend that empathy serves a protective role, whereas other studies have shown that burnout leads to a diminished capacity to empathize. To date, studies have not yet explored whether defense styles mediate associations between empathy and burnout. A total of 442 nurses completed questionnaire measures of empathy, burnout, and defense mechanisms as part of a large-scale research study on nurse burnout. Findings reflected very high levels of emotional exhaustion and depersonalization among the nursing staff. The nurses in this study endorsed a predominantly immature defense style. In addition, immature defense styles mediated the association between empathy and emotional exhaustion and between empathy and depersonalization. The study provides further knowledge about the role of defense styles in nurse burnout and empathy.
Can Religious Coping and Depressive Symptoms Predict Clinical Outcome and Quality of Life in Panic Disorder? A Brazilian Longitudinal Study
Authors: Zimpel Rogério R. , Panzini Raquel Gehrke , Bandeira Denise Ruschel , Heldt Elizeth , Manfro Gisele Gus , Fleck Marcelo P. , da Rocha Neusa Sica 
Published: June 2018

Abstract
Few studies have investigated the relationship between spiritual/religious coping (S/R coping) and panic disorder (PD). This Brazilian longitudinal study evaluated if S/R coping and depressive symptoms can predict PD remission and improved quality of life (QoL). There were 101 outpatients with PD who were followed up for 12 to 16 weeks. The prevalence ratio (PR) between positive S/R coping and negative S/R coping and PD remission was assessed, as well as the association between positive S/R coping and negative S/R coping and QoL. After adjusting for confounding factors, positive S/R coping presented an inverse PR with PD remission, which was not statistically significant (0.88; p = 0.075). There was no association between S/R coping and QoL. Depressive symptoms were negatively associated with PD remission (PR = 0.97; p < 0.01) and were not predictive of a better QoL.
Types of Trauma, Posttraumatic Stress Disorder, and Academic Performance in a Population of University Students
Authors: Pereira Juliana L. , Guedes-Carneiro Gisela Maria , Netto Liana R. , Cavalcanti-Ribeiro Patrícia , Lira Sidnei , Nogueira José F. , Teles Carlos A. , Koenen Karestan C. , Sampaio Aline S. , Quarantini Lucas C. 
Published: June 2018

Abstract
The aim of this work was to investigate the association between traumatic experiences and posttraumatic stress disorder (PTSD) with the academic performance of university students. This is a one-phase study that included 2213 students, enrolled at one of seven college institutions in their first or final semesters in all programs, who filled out the self-response questionnaires. From this student population, 14% presented with PTSD, with 13.3% in their first semester and 14.9% in their final semester. The students who presented lower academic results (low scoring) had a higher prevalence of PTSD in both the first and final semesters. Nonsexual violence was related with low scoring in the first-semester students. Thus, we conclude that students in the PTSD group present worse academic performance. These results indicate a need to pay attention to students who have been through traumatic experiences and gone on to develop PTSD, to ensure their undergraduate success and enable their future performance as professionals.
Rupture of the Corpus Cavernosum in a Pediatric Patient
Authors: Gruenberg Blake C. , Mortel David , Bogie Amanda 
Published: June 2018

Abstract
Pediatric penile pain is an uncommon complaint and is associated with a wide differential diagnosis including infectious, inflammatory, traumatic, and idiopathic conditions. Penile fractures, anatomically known as rupture of the corpus cavernosum, are almost exclusively reported in sexually mature patients and usually involve forceful manipulation during sexual activity. Rupture of the corpus cavernosum is a true urologic emergency. Failure to recognize and treat rupture of the corpus cavernosum has been associated with residual penile angulation, persistent hematoma, abscess, erectile dysfunction, and fibrosis. We present the case of a previously healthy 7-year-old boy who presented to our emergency department with complaints of penile pain with movement after falling and colliding with staircase railing. Examination showed ecchymosis and swelling of the penile shaft; both testicles were palpable and nontender, with no perineal or scrotal bruising. Ultrasound noted discontinuity along the right corpus cavernosum consistent with a rupture of the right corpus cavernosum. Testicles were noted to be in the scrotum with normal Doppler flow. Flexible cystoscopy revealed an uninjured urethra and bladder. Our patient was urgently taken to the operating room for repair of his injury. Thanks to the timely surgical correction, there were no postsurgical complications, and he was discharged home on postoperative day 1. This case demonstrates that although most reports of corpus cavernosum injuries are associated with sexual intercourse, other modes are possible and should be considered for acute-onset penile pain in pediatric patients.
Factors Related to Surgical Treatment and Outcomes of Thai Patients With Septic Arthritis
Authors: Ruangpin Chonlada , Rodchuae Muchima , Katchamart Wanruchada 
Published: June 2018

Objective
The aim of this study was to identify factors associated with the surgical treatment of Thai patients with septic arthritis.

Methods
This cohort study used a university hospital database in Thailand to identify 450 adult patients with confirmed septic arthritis. Data related to baseline characteristics, clinical and laboratory findings, treatment, and outcomes were collected. A multivariate analysis identified the factors related to surgical treatment.

Results
The patients had a mean age (±SD) of 53.6 (±17.8) years, and 51% were male. Surgical drainage was performed on 332 patients (74%). The factors identifed as relating to the need for surgical drainage included preexisting joint disease (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.3–4.9), hip involvement (OR, 36.3; 95% CI, 4.1–320.5), abscess formation (OR, 5.6; 95% CI, 1.1–27.1), osteomyelitis (OR, 4; 95% CI, 1.1–14.9), and positive synovial fluid culture (OR, 3.8; 95% CI, 2–7.2). In contrast, patients who were treated with steroids (OR, 0.2; 95% CI, 0.1–0.4) or had septic shock (OR, 0.31; 95% CI, 0.13–0.83) were less likely to undergo surgery. This model correctly predicted 35% of cases. Patients treated with surgical drainage had a significant longer length of stay (median [interquartile range], 21 [11–34] days vs 14 [7–24] days; p < 0.0001) and were less likely to achieve complete recovery (26% vs 53%, p < 0.0001). However, the mortality rate was lower (2.4% vs 10.2%).

Conclusions
Patients with septic arthritis who had underlying joint disease, hip involvement, abscess formation, osteomyelitis, and organisms in their synovial fluid were more likely to undergo surgical intervention with a significantly prolonged length of stay but had a lower mortality rate.
Blood–Brain Barrier Dysfunction After Smoke Inhalation Injury, With and Without Skin Burn
Authors: Randolph Anita C. , Fukuda Satoshi , Ihara Koji , Enkhbaatar Perenlei , Micci Maria-Adelaide 
Published: June 2018

ABSTRACT
Only a handful of published reports exist today that describe neurological complications following smoke inhalation injury. In this study, we characterize acute pathophysiological changes in the brain of sheep exposed to smoke inhalation, with- and without third-degree skin burn that models the injuries sustained by human victims of fire accidents. Blood–brain barrier integrity and hemorrhage were analyzed throughout the brain using specific histological stains: Hematoxylin & Eosin, Luxol fast blue, Periodic acid–Schiff (PAS), and Martius, Scarlet and Blue (MSB). Our data show that, following smoke inhalation injury, alone and in combination with third-degree skin burn, there was a significant increase in the number of congested and dilated blood vessels in the frontal cortex, basal ganglia, amygdala, hippocampus, pons, cerebellum, and pituitary gland as compared to sham-injured controls. Positive PAS staining confirmed damage to the basement membrane of congested and dilated blood vessels throughout the brain. Severe rupturing of blood vessels, microvascular hemorrhaging and bleeding throughout the brain was also observed in the injured groups. No significant changes in hemodynamics and PaO2 were observed. Our data demonstrate for the first time that acute smoke inhalation alone results in diffuse blood-brain barrier dysfunction and massive bleeding in the brain in the absence of hypoxia and changes in hemodynamics. These findings provide critical information and prompt further mechanistic and interventional studies necessary to develop effective and novel treatments aimed at alleviating CNS dysfunction in patients with smoke and burn injuries.