bluuebunny/crossref_metadata_2025_split huggingface dataset:
Establishing and Utilizing Strategic Partnerships for Vaccine-Preventable Diseases
Authors: Adrien Paul , Francois Jeannot , Parke Dana M. , Bebekoski Thomas , Boncy Paul Jacques , Corvil Salomon , Existe Alexandre , Jacques Roody , Joseph Gerard , Kaljee Linda M. , Kilgore Paul E. , Christophe Millien , Queuille Ludovic , Sévère Karine , Ternier Ralph , Zervos Marcus J. 
Published: May 2018

Abstract
On March 10 to 11, 2016, the Ministère de la Santé Publique et de la Population (Ministry of Health of Haiti) and the Global Health Initiative at Henry Ford Health System hosted their Second Annual Scientific Conference entitled, “Best Practices for Establishing and Utilizing Partnerships for Vaccine-Preventable Diseases in Haiti,” at the National Laboratory in Port-au-Prince, Haiti. The conference brought together Ministry of Health officials, researchers, clinicians, academics, public health professionals, and other stakeholders to discuss vaccine programs and policies in Haiti. This forum provides a learning and discussion space to fuel strategies and public health research responding to priority areas identified by the Ministry of Health, and consequently, this forum serves as counsel for the Ministry of Health in its decision making on strategies to prevent and control infectious diseases in Haiti. The following article summarizes the presentations and conclusions of the March 2016 conference and covers a variety of important issues relating to vaccines and vaccine-preventable diseases in Haiti, including Haiti's Expanded Program on Immunization, surveillance, logistical and funding challenges, and community approaches, as well as case studies detailing introduction of the pentavalent, rotavirus, oral cholera, and human papillomavirus vaccines in Haiti. Most importantly, this article highlights a model for effective partnerships for vaccines, a model that can transcend response to specific diseases and apply to all global health partnerships.
Psychophysical and vasomotor evidence for interdependency of TRPA1 and TRPV1-evoked nociceptive responses in human skin: an experimental study
Authors: Nielsen Thomas Arendt , Eriksen Matilde Alida , Gazerani Parisa , Andersen Hjalte Holm 
Published: May 2018

AbstractThe TRPA1 and TRPV1 receptors are important pharmaceutical targets for antipruritic and analgesic therapy. Obtaining further knowledge on their roles and interrelationship in humans is therefore crucial. Preclinical results are contradictory concerning coexpression and functional interdependency of TRPV1 and TRPA1, but no human evidence exists. This human experimental study investigated whether functional responses from the subpopulation of TRPA1+nociceptors could be evoked after defunctionalization of TRPV1+nociceptors by cutaneous application of high-concentration capsaicin. Two quadratic areas on each forearm were randomized to pretreatment with an 8% topical capsaicin patch or vehicle for 24 hours. Subsequently, areas were provoked by transdermal 1% topical capsaicin (TRPV1 agonist) or 10% topical allyl isothiocyanate (“AITC,” a TRPA1 agonist), delivered by 12 mm Finn chambers. Evoked pain intensities were recorded during pretreatments and chemical provocations. Quantitative sensory tests were performed before and after provocations to assess changes of heat pain sensitivity. Imaging of vasomotor responses was used to assess neurogenic inflammation after the chemical provocations. In the capsaicin-pretreated areas, both the subsequent 1% capsaicin- and 10% AITC-provoked pain was inhibited by 92.9 ± 2.5% and 86.9 ± 5.0% (both:P< 0.001), respectively. The capsaicin-ablated skin areas showed significant heat hypoalgesia at baseline (P< 0.001) as well as heat antihyperalgesia, and inhibition of neurogenic inflammation evoked by both 1% capsaicin and 10% AITC provocations (both:P< 0.001). Ablation of cutaneous capsaicin-sensitive afferents caused consistent and equal inhibition of both TRPV1- and TRPA1-provoked responses assessed psychophysically and by imaging of vasomotor responses. This study suggests that TRPA1 nociceptive responses in human skin strongly depend on intact capsaicin-sensitive, TRPV1+fibers.
Portable Bladder Ultrasound Reduces Incidence of Urinary Tract Infection and Shortens Hospital Length of Stay in Patients With Acute Ischemic Stroke
Authors: Chen Shu-Chuan , Chen Pei-Ya , Chen Guei-Chiuan , Chuang Su-Yun , Tzeng I-Shiang , Lin Shinn-Kuang 
Published: May 2018

Background:
Urinary tract infection (UTI) during acute ischemic stroke is associated with a longer hospital length of stay and unfavorable functional outcomes.

Objective:
We investigated the benefits of portable bladder ultrasound (PBU) scanning during acute ischemic stroke.

Methods:
We retrospectively reviewed patients with acute ischemic stroke from January 2011 to February 2017. Patients were divided into group 1 (PBU not available) and group 2 (PBU available), before or after the split date, April 9, 2014. Portable bladder ultrasound scanning was conducted by nurses to measure postvoid residual urine volume in patients with impaired consciousness and/or dependent ambulation.

Results:
In total, 1928 patients were enrolled, of whom 109 (5.7%) had UTI and 901 (46.7%) experienced unfavorable outcomes (modified Rankin scale score ≥ 3). Multivariate analysis revealed that factors that influenced UTI were age of 75 years or older, female gender, initial total National Institutes of Health Stroke Scale (NIHSS) score of 5 or higher, initial NIHSS conscious score of 1 or higher, initial NIHSS leg score of 2 or higher, and urinary catheterization. Factors influencing unfavorable outcomes were similar to those influencing UTI but further comprised UTI. C-statistic for UTI detection was 0.864 for model fitting, including significant factors in logistic regression. Compared with group 1, group 2 had a higher incidence of urinary catheterization (13.1% vs 8.2%), a lower incidence of UTI (4.0% vs 6.9%), and a shorter length of stay (11.9 vs 13.6 days).

Conclusions:
Portable bladder ultrasound scanning reduced the incidence of UTI and shortened length of stay. We suggest routine PBU procedures for patients with acute ischemic stroke who fulfill the AGN3 criteria for a high risk of UTI.
Benign Paroxysmal Positional Vertigo After Pediatric Sports-Related Concussion
Authors: Reimer Karen , Ellis Vanessa , Cordingley Dean M. , Russell Kelly , Ellis Michael J. 
Published: May 2018

Objective:
Report the clinical findings and outcomes among pediatric patients diagnosed with benign paroxysmal positional vertigo (BPPV) after sports-related concussion (SRC).

Design:
Retrospective case series.

Setting:
Multidisciplinary pediatric concussion program.

Patients:
Patients younger than 19 years with a sport or recreation activity–related concussion referred for comprehensive vestibular physiotherapy assessment.

Main outcome measure:
Symptom resolution after targeted particle repositioning (PR).

Results:
During the study period, 115 pediatric SRC patients underwent vestibular physiotherapy assessment including 12 (10.4%) who were diagnosed with BPPV. Unilateral posterior semicircular canal (SCC) BPPV was diagnosed in 8/12 (75%) patients, and unilateral anterior SCC BPPV diagnosed in 4/12 (25%) patients. Benign paroxysmal positional vertigo was successfully treated in all patients with a mean of 1.58 targeted PR maneuvers (range = 1-4).

Conclusions:
Comprehensive management of pediatric SRC requires a multidisciplinary approach to address the heterogeneous pathophysiology of persistent postconcussion symptoms. Pediatric SRC patients with coexisting BPPV should be considered for targeted PR.
Measuring and monitoring lean body mass in critical illness
Authors: Looijaard Wilhelmus G.P.M. , Molinger Jeroen , Weijs Peter J.M. 
Published: May 2018

Purpose of review
To help guide metabolic support in critical care, an understanding of patients’ nutritional status and risk is important. Several methods to monitor lean body mass are increasingly used in the ICU and knowledge about their advantages and limitations is essential.

Recent findings
Computed tomography scan analysis, musculoskeletal ultrasound, and bioelectrical impedance analysis are emerging as powerful clinical tools to monitor lean body mass during ICU stay. Accuracy, expertise, ease of use at the bedside, and costs are important factors which play a role in determining which method is most suitable. Exciting new research provides an insight into not only quantitative measurements, but also qualitative measurements of lean body mass, such as infiltration of adipose tissue and intramuscular glycogen storage.

Summary
Methods to monitor lean body mass in the ICU are under constant development, improving upon bedside usability and offering new modalities to measure. This provides clinicians with valuable markers with which to identify patients at high nutritional risk and to evaluate metabolic support during critical illness.
Evaluation of Important Analytical Parameters of the Peptest Immunoassay that Limit its Use in Diagnosing Gastroesophageal Reflux Disease
Authors: Dolina Jiří , Konečný Štefan , Ďurč Pavol , Lačná Júlia , Greguš Michal , Foret František , Skřičková Jana , Doubková Martina , Kindlová Dagmar , Pokojová Eva , Kubáň Petr 
Published: May 2018

Goal:
To evaluate the analytical parameters of a lateral flow (LF) pepsin immunoassay (Peptest) and assess its suitability in the diagnostics of gastroesophageal reflux disease (GERD).

Background:
Peptest is a noninvasive assay to analyze pepsin in saliva, intended for use in GERD diagnostics. Although commercialized, fundamental studies on its performance are missing. The assay therefore requires basic analytical parameter evaluation to assess its suitability in clinical practice.

Study:
Assay reaction’s time dependence, reader device repeatability, and individual LF devices and longitudinal pepsin concentration reproducibility in individual subjects was evaluated. Salivary pepsin was analyzed in 32 GERD patients with extraesophageal reflux symptoms and 13 healthy individuals.

Results:
The assay’s signal increase is not completed at the recommend readout time and continues to increase for another 25 minutes. The relative standard deviation of measurement was good when using the same LF device, ranging from 2.3% to 12.9%, but the reproducibility of 10 different individual LF devices was poor. The random error when analyzing the same saliva sample on 10 LF devices was as high as 36 ng/mL and this value is thus suggested as the positivity cut-off. Pepsin concentration in individual subjects during a 10-day period varied significantly. The sensitivity of the Peptest was 36.8% in the group with acid reflux and 23.1% in the group with weakly acid reflux. The specificity was 61.5%.

Conclusions:
The Peptest assay’s sensitivity and specificity is low, the results are highly variable and it should not be used as a near-patient diagnostic method in primary care.
Clinical islet transplantation: is the future finally now?
Authors: Pepper Andrew R. , Bruni Antonio , Shapiro A.M. James 
Published: May 2018

Purpose of review
Clinical pancreatic islet transplantation has evolved into a routine means to restore glycemic control in patients with type 1 diabetes mellitus (T1DM) suffering from life-threatening hypoglycemia and severe glucose liability. This chapter examines the current progress in islet transplantation while outlining the remaining limitations preventing this life-altering therapy's application to the broader T1DM population.

Recent findings
Islet transplantation has recently been demonstrated to provide superior glycemic control with reduced glucose lability and hypoglycemic events compared with standard insulin therapy. Transplant outcomes have steadily improved, in part, reflective of refinements, including more optimal islet donors and isolations, safer transplant techniques and more effective anti-inflammatory and immunomodulatory intervention. Furthermore, latest insulin independence rates 5-years posttransplant have reached parity with pancreas transplantation. Successful completion of a recent National Institutes of Health-sponsored Phase III multicenter clinical allogeneic islet transplantation trial confirmed the safety and efficacy of this therapeutic modality and will be used in the Biological Licensure Application by the United States Food and Drug Administration.

Summary
Implementation of novel immunosuppression, antiinflammatories, first-in-human stem cell and extrahepatic transplant site trials into clinical investigation has positioned β-cell replacement to become the mainstay treatment for all T1DM patients in the near future.
Application of the Eighth Edition of the American Joint Committee on Cancer Staging for Pancreatic Adenocarcinoma
Authors: Liu Chen , Cheng He , Jin Kaizhou , Guo Meng , Lu Yu , Wang Zhengshi , Yang Chao , Long Jiang , Ni Quanxing , Yu Xianjun , Luo Guopei 
Published: May 2018

Objectives
Notable modifications have been made in the American Joint Committee on Cancer (AJCC) Staging eighth edition staging for pancreatic cancer for the consideration of the irreproducible and inapplicable of the AJCC seventh edition staging. However, the new staging classification has not been systemically verified.

Methods
A comparison was performed to evaluate the application of the AJCC seventh and eighth staging classifications using the Surveillance, Epidemiology, and End Results registry (18,450 patients) and an institutional series (2040 patients).

Results
For the eighth staging classification, patients with tumor diameter of greater than 4 cm (T3N0M0, IIA) had similar prognosis to patients with 1 to 3 positive nodes (T1–3N1M0, IIB). For patients who underwent tumor resection and without lymph node involvement, survival curves of T1 (≤2 cm), T2 (2–4 cm), and T3 (>4 cm) were well separated. Statistical difference in survival analyses was demonstrated in N0 (0 positive node), N1 (1–3 positive nodes), and N2 (≥4 positive nodes) patients underwent tumor resection. The AJCC eighth edition had better stage distribution than the AJCC seventh edition for pancreatic cancer.

Conclusions
The eighth edition of AJCC staging is more applicable and accurate than the seventh edition for pancreatic adenocarcinoma.
Management of Paediatric Ulcerative Colitis, Part 1
Authors: Turner Dan , Ruemmele Frank M. , Orlanski‐Meyer Esther , Griffiths Anne M. , de Carpi Javier Martin , Bronsky Jiri , Veres Gabor , Aloi Marina , Strisciuglio Caterina , Braegger Christian P. , Assa Amit , Romano Claudio , Hussey Séamus , Stanton Michael , Pakarinen Mikko , de Ridder Lissy , Katsanos Konstantinos , Croft Nick , Navas‐López Victor , Wilson David C. , Lawrence Sally , Russell Richard K. 
Published: May 2018

ABSTRACTBackground:The contemporary management of ambulatory ulcerative colitis (UC) continues to be challenging with ~20% of children needing a colectomy within childhood years. We thus aimed to standardize daily treatment of pediatric UC and inflammatory bowel diseases (IBD)‐unclassified through detailed recommendations and practice points.Methods:These guidelines are a joint effort of the European Crohn's and Colitis Organization (ECCO) and the Paediatric IBD Porto group of European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). An extensive literature search with subsequent evidence appraisal using robust methodology was performed before 2 face‐to‐face meetings. All 40 included recommendations and 86 practice points were endorsed by 43 experts in Paediatric IBD with at least an 88% consensus rate.Results:These guidelines discuss how to optimize the use of mesalamine (including topical), systemic and locally active steroids, thiopurines and, for more severe disease, biologics. The use of other emerging therapies and the role of surgery are also covered. Algorithms are provided to aid therapeutic decision‐making based on clinical assessment and the Paediatric UC Activity Index (PUCAI). Advice on contemporary therapeutic targets incorporating the use of calprotectin and the role of therapeutic drug monitoring are presented, as well as other management considerations around pouchitis, extraintestinal manifestations, nutrition, growth, psychology, and transition. A brief section on disease classification using the PIBD‐classes criteria and IBD‐unclassified is also part of these guidelines.Conclusions:These guidelines provide a guide to clinicians managing children with UC and IBD‐unclassified management to provide modern management strategies while maintaining vigilance around appropriate outcomes and safety issues.
Physicians' Risk Tolerance and Head Computed Tomography Use for Pediatric Patients With Minor Head Injury
Authors: Cheng Chi-Yung , Pan Hsiu-Yung , Li Chao-Jui , Chen Yi-Chuan , Chen Chien-Chih , Huang Yi-Syun , Cheng Fu-Jen 
Published: May 2018

Objectives
Traumatic brain injury is the leading cause of death and disability in children worldwide. The objective of this study was to determine the association between physician risk tolerance and head computed tomography (CT) use in patients with minor head injury (MHI) in the emergency department (ED).

Methods
We retrospectively analyzed pediatric patients (<17 years old) with MHI in the ED and then administered 2 questionnaires (a risk-taking subscale [RTS] of the Jackson Personality Inventory and a malpractice fear scale [MFS]) to attending physicians who had evaluated these patients and made decisions regarding head CT use. The primary outcome was head CT use during ED evaluation; the secondary outcome was ED length of stay and final diagnosis of intracranial injury (ICI).

Results
Of 523 patients with MHI, 233 (44.6%) underwent brain CT, and 16 (3.1%) received a final diagnosis of ICI. Among the 16 emergency physicians (EPs), the median scores of the MFS and RTS were 22 (interquartile range, 17–26) and 23 (interquartile range, 19–25), respectively. Emergency physicians who were most risk averse tended to order more head CT scans compared with the more risk-tolerant EPs (56.96% vs 37.37%; odds ratio, 8.463; confidence interval, 2.783–25.736). The ED length of stay (P = 0.442 and P = 0.889) and final diagnosis (P = 0.155 and P = 0.835) of ICI were not significantly associated with the RTS and MFS scores.

Conclusions
Individual EP risk tolerance, as measured by RTS, was predictive of CT use in pediatric patients with MHI.
Fatigue After Aneurysmal Subarachnoid Hemorrhage Is Highly Prevalent in the First-Year Postonset and Related to Low Physical Fitness
Authors: Harmsen Wouter J. , Ribbers Gerard M. , Heijenbrok-Kal Majanka H. , Khajeh Ladbon , Sneekes Emiel M. , van Kooten Fop , Neggers Sebastian J.C.M.M. , van den Berg-Emons Rita J. 
Published: May 2018

Objective
The aim of the study was to investigate whether low physical fitness and inactive and sedentary lifestyles play a role in the severity of fatigue in patients with aneurysmal subarachnoid hemorrhage (a-SAH).

Design
This is a prospective 1-yr follow-up study, including a total of 52 patients with a-SAH. Outcome measures included the Fatigue Severity Scale score, peak oxygen uptake (VO2peak), isokinetic knee muscle strength (peak torque), physical activity (% 24-hr period), and sedentary behavior (% waking hours) and were evaluated at 6 and 12 mos after onset.

Results
Fatigue was highly prevalent in the first year and reported by 48% of the patients at 6 mos and by 52% at 12 mos after a-SAH. Fatigue was associated with the knee extension (P < 0.001) and flexion strength (P < 0.001). A nonsignificant trend for a relationship was found between fatigue and the aerobic capacity (P = 0.079). No relationships were found between fatigue and physical activity or sedentary behavior. Fatigue could not be predicted by disease-related characteristics.

Conclusions
Half of the patients were fatigued in the first year after a-SAH. Interventions are necessary to reduce fatigue and should consider exercise training as a potential contributor to a multimodal treatment, preventing debilitating conditions after a-SAH.

To Claim CME Credits
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives
Upon completion of this article, the reader should be able to: (1) Recognize the association between fatigue and physical fitness in patients after aneurysmal subarachnoid hemorrhage; (2) Determine the severity of fatigue complaints in patient after aneurysmal subarachnoid hemorrhage; and (3) Discuss the role of physical deconditioning in the management of fatigue in patients after aneurysmal subarachnoid hemorrhage.

Level
Advanced

Accreditation
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Influence of Creatine Supplementation on Apoptosis Markers After Downhill Running in Middle-Aged Men
Authors: Sheikholeslami-Vatani Dariush , Faraji Hassan 
Published: May 2018

Objective
Strenuous exercise can induce apoptosis in a variety of tissues. We investigated the effects of creatine loading on apoptosis markers after downhill running.

Design
Twenty-two middle-aged men were randomly assigned to either a creatine or a placebo group. Crossover design, double-blind controlled supplementation was performed using 20 g/d−1 of creatine or maltodextrin for 7 days. Downhill running (12% incline) at 70% of heart rate maximum for 40 mins was performed on the eighth day. Blood samples were taken on the day before supplementation, after supplementation and after running.

Results
There were no significant changes in the caspase-3, caspase-9, p53, Bax, and IGF-1 concentrations from presupplementation to postsupplementation in both groups of creatine and placebo (P > 0.05). There were significant increases (P < 0.05) in serum caspase-3, caspase-9, p53, and Bax after running in the placebo group. These markers were not noticeably changed in the creatine group (P > 0.05). Bcl-2 was unchanged in the placebo group but substantially increased (P < 0.05) in the creatine group. No significant changes were observed in IGF-1 concentration after running comparing to prerunning in both groups (P > 0.05). Lactate levels increased similarly in both groups (P < 0.05).

Conclusions
The findings indicate that creatine supplementation could prevent exercise-induced apoptotic markers.