bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost of Public Health Response and Outbreak Control With a Third Dose of Measles-Mumps-Rubella Vaccine During a University Mumps Outbreak—Iowa, 2015–2016
Authors: Marin Mona , Kitzmann Tricia L , James Lisa , Quinlisk Patricia , Aldous Wade K , Zhang John , Cardemil Cristina V , Galeazzi Chris , Patel Manisha , Ortega-Sanchez Ismael R 
Published: October 2018

Abstract

Background
The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015–2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine.

Methods
Data on activities performed, personnel hours spent, MMR vaccine doses administered, miles traveled, hourly earnings, and unitary costs were collected using a customized data tool. These data were then used to calculate associated costs.

Results
Approximately 6300 hours of personnel time were required from state and local public health institutions and the university, including for vaccination and laboratory work. Among activities demanding time were case/contact investigation (36%), response planning/coordination (20%), and specimen testing and report preparation (13% each). A total of 4736 MMR doses were administered and 1920 miles traveled. The total cost was &gt;$649 000, roughly equally distributed between standard outbreak control activities and third-dose MMR vaccination (55% and 45%, respectively).

Conclusions
Public health response to the mumps outbreak at the University of Iowa required important amounts of personnel time and other resources. Associated costs were sizable enough to affect other public health activities.
Percutaneous reduction and fixation of intraarticular calcaneal fractures: a series with 2-year follow-up
Authors: Fathi Hossam , Samir Fahmy Fahmy , Abd Elwahab Ahmed 
Published: October 2018

Background:
Fractures of the calcaneus may occur with high-energy trauma. The gold standard management of fractures extending to the posterior facet is open reduction and plate fixation, but soft-tissue complications are frequent. The aim of this study was to evaluate the results of percutaneous reduction and fixation of intraarticular calcaneal fractures. Our hypothesis was that percutaneous fixation of Sanders type ΙΙ or ΙΙΙ articular calcaneal fractures provides good functional results with few complications.

Methods:
Between January 2014 and June 2017, 20 patients with intraarticular fractures of the calcaneus (30 feet) were treated with closed reduction and percutaneous fixation. The mean age of the patients was 30 yr (range 18–50 yr). All patients were assessed by radiographs and CT before and after surgery. Clinical and functional outcomes were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) Hind Foot Score. A P-value <0.05 was considered statistically significant.

Results:
The mean follow-up period was 24.4±7.1 mo (18–30 mo). The postoperative mean AOFAS score was 88±4.7 points. There were statistically significant improvements in the postoperative means of both the Böhler and Gissane angles. Persistent postoperative pain was encountered in one patient, and another had a completely resolved mild superficial infection without major skin complications or deep infection.

Conclusions:
Percutaneous reduction and fixation of Sanders type ΙΙ and ΙΙΙ intra-articular calcaneal fractures had satisfactory clinical and radiographic results with minimal infection and soft-tissue morbidity.
Closed reduction of dislocated hip arthroplasty: a teaching institution’s experience
Authors: Coskey Andrew Z. , Vance Nicholas G. , Lindsey Ronald W. 
Published: October 2018

Background:
Dislocation is a common complication of hip arthroplasty and is typically treated initially by closed reduction under sedation in the emergency department (ED). Although closed reduction has a very high success rate, information on the risk factors for difficult or failed procedures is scarce.

Methods:
The authors retrospectively reviewed the 5-year experience of treating patients for dislocated hip arthroplasty at a single center to determine the specific variables related to difficult or failed closed reductions.

Results:
Of 112 hip arthroplasty dislocations studied, 25 (22%) closed reductions were difficult, 20 attempted closed reductions (18%) failed, and six (6%) patients had complications (two skin lacerations, two periprosthetic fractures, one incongruent reduction, and one component loosening). Significant predictors for a difficult reduction were age, prior dislocation, time to reduction, and time from surgery. The level of anesthesia approached significance. Among the 20 hip arthroplasty dislocations in which initial closed reduction attempts in the ED failed, 12 (60%) were subsequently successful under deeper levels of sedation outside of the ED, six (30%) required an open reduction, and two (10%) required revision hip arthroplasty because of complications. Hip arthroplasty dislocations in older patients typically occurred shortly after the last surgery and were at increased risk for a difficult closed reduction or complications if dislocated for longer than 24 hr.

Conclusions:
In older patients, patients in the early postoperative period, first-time hip arthroplasty dislocations, or hip arthroplasty dislocations >24 hr old, clinicians should consider performing closed-hip arthroplasty reduction in an environment that offers more flexibility than the ED.
A systematic review of the treatment of knee osteoarthritis with intraarticular injection of mesenchymal stem cells
Authors: Davidson Philip A. , Bland Daniel S. , Henderson MacIntyre 
Published: October 2018

Background:
A wide array of treatment, both surgical and nonsurgical, exists for osteoarthritis (OA) of the knee. Injectable stem-cell therapy represents a minimally invasive and potentially efficacious treatment; however, there have been no level I studies conducted on this specific application of stem-cell therapy. The purpose of our review was to analyze, report, and summarize current topical data.

Methods:
A systematic review of the treatment of human knee OA with mesenchymal stem cells (MSCs) was performed by searching PubMed/Medline and Google Scholar. Non-human studies and studies involving additional procedures were excluded. Authors reviewed the studies individually, with the primary author deciding on inclusion.

Results:
Our search ultimately returned 10 studies that met the inclusion criteria. Nine of the ten studies used cultured autologous MSCs, five from bone marrow, three from subcutaneous fat, and one from peripheral blood. The remaining study used allogenic bone marrow MSCs. Radiographic analysis of cartilage quality via MRI T2 mapping showed increased type II collagen production in five studies. Outcome scores consistently showed pain reduction and improved function. No study reported significant adverse events related to stem-cell therapy.

Conclusions:
Current human studies evaluating the use of injected MSCs for knee OA demonstrated consistent improvement across several outcome scores, with no significant adverse findings.

Level of Evidence:
Level IV, systematic review of Level II-IV trials and studies.
Changes in Provider Treatment Patterns for Dupuytren’s Contracture: Analysis of Trends in Medicare Beneficiaries
Authors: Thayer Mary Kate , Somerson Jeremy S. , Huang Jerry I. 
Published: October 2018

Background:
Collagenase Clostridium histolyticum (CCH) injection has been shown to be a safe and effective treatment option for Dupuytren’s contracture. We hypothesize that the gaining popularity of CCH has resulted in a change in treatment patterns among providers, with increased utilization of CCH injections in the management of Dupuytren’s contracture from 2012 to 2014.

Methods:
The Medicare Provider Utilization and Payment Data Public Use Files were used to identify all surgeons who submitted claims for surgical fasciectomy, needle aponeurotomy (NA), and CCH injection. The data were analyzed for number of providers performing the procedures, number of procedures per provider, and location of practice.

Results:
From 2012 to 2014, the number of providers performing more than 10 open fasciectomies decreased from 141 to 131. In the same time, the number of providers performing more than 10 NAs increased from 63 to 70 with mean procedures per provider decreasing from 35 to 21. In contrast, the number of providers performing more than 10 CCH injections increased from 72 to 112, with mean injections per provider going from 24 to 20. The total number of injections performed increased from 1,734 to 2,220 from 2012 to 2014. The largest increase in number of injections and number of providers performing injections occurred in the South.

Conclusions:
The introduction of collagenase has changed treatment patterns with more providers treating Dupuytren’s contractures with CCH injections and a statistically significant decline in the number of NA procedures per provider.
Atherosclerotic cardiovascular disease risk assessment in familial hypercholesterolemia: does one size fit all?
Authors: Mata Pedro , Alonso Rodrigo , Pérez de Isla Leopoldo 
Published: October 2018

Purpose of review
Familial hypercholesterolemia is a frequent genetic disease associated with lifelong elevation of LDL-cholesterol and premature atherosclerotic cardiovascular disease (ASCVD). Statins are the cornerstone of treatment. However, with the introduction of novel LDL-cholesterol-lowering therapies, it is necessary to identify familial hypercholesterolemia patients presenting a significantly high residual ASCVD risk. The aim of this review is to provide an update on the recent literature concerning cardiovascular risk stratification including the role of coronary imaging.

Recent findings
Several factors have shown to be independent predictors of ASCVD in familial hypercholesterolemia. These include clinical scores with cardiovascular risk factors, coronary imaging and novel protein biomarkers. However, the recent introduction of the SAFEHEART risk-equation (SAFEHEART-RE) could allow a more accurate ASCVD risk prediction in familial hypercholesterolemia.

Summary
This article highlights the SAFEHEART-RE as a model to predict incident ASCVD in familial hypercholesterolemia. This equation is a simple and widely applicable tool for use in every clinical setting. Furthermore, coronary atherosclerosis assessed by coronary computed-tomographic angiography (coronary-CTA) is independently associated to the cardiovascular risk estimated according to the SAFEHEART-RE. This equation, as well as coronary-CTA and new biomarkers, could increase individual ASCVD risk stratification and could improve the efficiency and the use of new lipid-lowering therapies in familial hypercholesterolemia.
The prediction of therapy-benefit for individual cardiovascular disease prevention: rationale, implications, and implementation
Authors: Jaspers Nicole E.M. , Ridker Paul M. , Dorresteijn Jannick A.N. , Visseren Frank L.J. 
Published: October 2018

Purpose of review
We aim to outline the importance and the clinical implications of using predicted individual therapy-benefit in making patient-centered treatment decisions in cardiovascular disease (CVD) prevention. Therapy-benefit concepts will be illustrated with examples of patients undergoing lipid management.

Recent findings
In both primary and secondary CVD prevention, the degree of variation in individual therapy-benefit is large. An individual's therapy-benefit can be estimated by combining prediction algorithms and clinical trial data. Measures of therapy-benefit can be easily integrated into clinical practice via a variety of online calculators. Lifetime estimates (e.g., gain in healthy life expectancy) look at therapy-benefit over the course of an individual's life, and are less influenced by age than short-term estimates (e.g., 10-year absolute risk reduction). Lifetime estimates can thus identify people who could substantially benefit from early initiation of CVD prevention. Compared with current guidelines, treatment based on predicted therapy-benefit would increase eligibility for therapy among young people with a moderate risk-factor burden and individuals with a high residual risk.

Summary
The estimation of individual therapy-benefit is an important part of individualized medicine. Implementation tools allow for clinicians to readily estimate both short-term and lifetime therapy-benefit.
Airway Clearance for the Preterm Newborn
Authors: Harbin Brandi R. , Adams Ellise D. , O'Neal Pamela V. 
Published: October 2018

Abstract

Purpose:
The purpose of this study was to explore airway clearance practices for the preterm newborn in the neonatal intensive care unit (NICU).

Study Design and Methods:
This descriptive, retrospective medical record review analyzed airway clearance practices in a level III regional NICU from 2016 to 2017 in preterm newborns ranging from 32 weeks to 36 weeks and 6 days. There were 87 preterm newborns and 384 suctioning events reviewed during the entire length of stay. Practices reviewed include device used, frequency, color, consistency, and tolerance of airway clearance. Method of nursing documentation for these practices was also reviewed.

Results:
Babies born via cesarean required more suctioning (65.5%). Males (60.9%) required more airway clearance events than females (39.1%). After suction events, nurses reported no distress (74%), equal bilateral breath sounds (30%), desaturation (6%), and collectively color change, apnea, or bradycardia (<1%). The most common discharge diagnosis was respiratory distress syndrome (90%). Preterm newborns were suctioned with the blue bulb syringe (15.6%), oral/nasal-pharyngeal suction device (42.7%), and endotracheal suction devices (41.7%).

Clinical Implications:
Electronic medical records promote less detailed, narrative documentation and more point and click documentation. If electronic medical record systems are not designed to gather airway clearance indications, specifics about the procedure and the preterm newborn response to the procedure, evidence-based practice cannot be measured. More studies are needed to evaluate suction practices applied in the NICU setting.
Nasal Airway Clearance for Bronchiolitis
Authors: Norris Casey L. , O'Neal Pamela V. , Adams Ellise D. , Wyatt Tami H. 
Published: October 2018

Abstract
Bronchiolitis is a leading cause of emergency department visits and hospitalization in the first year of life with estimated costs to the healthcare system in the United States of $1.73 billion annually. The highest rates of admission occur in the first 3 to 6 months of life. Traditional therapies such as bronchodilators and antibiotics have repeatedly been shown to be ineffective. Thickened nasal secretions cause decreased oxygenation, difficulty sleeping, poor feeding, and respiratory distress symptoms. Bronchiolitis guidelines recommend supportive care such as noninvasive nasal airway clearance with saline to clear obstructed airways, improve oxygenation, and promote optimal infant eating and sleeping. Evidence on the safety and efficacy of use of noninvasive nasal airway clearance as supportive care for infants with bronchiolitis in the acute care setting is presented.
Radiotherapy for Hodgkin Lymphoma
Authors: Specht Lena 
Published: October 2018

Abstract
Radiation therapy (RT) for Hodgkin lymphoma has changed dramatically over the past couple of decades, from the very large extended-field RT with prophylactic treatment of all the major lymph node regions to the very limited involved-site RT with treatment only of the initially macroscopically involved lymphoma volume in the combined modality setting. Technological developments in imaging, treatment planning, and treatment machines have enabled very significant reductions in radiation doses to normal organs without jeopardizing the coverage of the lymphoma. Hence, the risks of long-term adverse effects have become much smaller than those in the past. Radiation therapy for Hodgkin lymphoma is now a highly individualized treatment, tailored to each patient. The risks of this limited RT should be weighed against the risks of long-term toxicity of possible additional systemic treatment up-front and at relapse in order to select the optimal treatment combination for each individual patient.
Advanced-Stage Hodgkin Lymphoma
Authors: Connors Joseph M. 
Published: October 2018

AbstractDepending on a variety of prognostic factors including age, stage, laboratory abnormalities, and initial response to treatment, from 70% to 90% of patients with advanced-stage Hodgkin lymphoma can be cured with modern multiagent chemotherapy. Two effective strategies offer the promise to improve on those results. Early intensification of treatment, typically by increasing the doses and frequency of administration of standard chemotherapy agents, induces higher initial response rates but has the major drawback of causing unacceptably severe acute toxicity, increased numbers of secondary neoplasms, and infertility due to oligospermia in men and premature menopause in women. Alternatively, integration of novel therapeutic agents into primary treatment is attractive, especially when the introduction not only improves the frequency and durability of disease response but also does not unacceptably increase acute or long-term toxicity. Finally, widespread availability of functional imaging with positron emission tomography now enables response-adapted therapy, a separate innovation in the treatment of Hodgkin lymphoma that can be incorporated with either intensified chemotherapy or addition of novel agents. This article discusses these exciting new developments in the treatment of advanced-stage Hodgkin lymphoma.
Improvements in Imaging of Hodgkin Lymphoma
Authors: Hutchings Martin 
Published: October 2018

Abstract
18-Fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG PET/CT) is currently the criterion standard of lymphoma imaging and recommended through all stages of Hodgkin lymphoma management. Accurate staging is important for risk stratification and initial choice of therapy and also for the planning of postchemoradiotherapy. 18-Fluoro-2-deoxy-d-glucose PET/CT frequently leads to upstaging and potentially a more intensive treatment. Visual-only assessment of staging and interim scans is being accompanied by quantitative and semiquantitative methods to measure metabolic tumor volume, total lesion glycolysis, and so on. It is still unclear if these methods significantly improve the value of FDG PET/CT by visual assessment only. Because of the good prognostic value of FDG PET/CT, a large number of studies have used interim FDG PET to tailor treatment to the individual patients, according to their early metabolic response rather than according to their pretreatment prognostic features. 18-Fluoro-2-deoxy-d-glucose PET/CT is standard of care for posttreatment response assessment but has no place in routine follow-up of Hodgkin lymphoma patients in remission.
Comparing Spontaneous Closure and Paper Patching in Traumatic Tympanic Membrane Perforations
Authors: Hanege Fatih Mehmet , Karaca Servet , Kalcioglu Mahmut Tayyar , Tekin Muhammet 
Published: October 2018

Abstract
The authors aim to analyze the effects of oral antibiotic treatment for traumatic tympanic membrane perforations and to compare the outcomes of patients with traumatic tympanic membrane perforation after paper-patching procedure and spontaneous healing.
In this study, 80 patients with traumatic tympanic membrane perforation diagnosed in the otorhinolaryngology emergency department and outpatient clinic from March 2010 to January 2015 were retrospectively reviewed. If the patient is diagnosed at first week and the edge of perforation is moist with blood, our routine procedure is paper-patching (group 1). However, if the patients reject treatment or delay in admission, the authors follow up patients for spontaneous closure (group 2). Some of the patients got oral antibiotics for 7 days (amoxicillin/clavulanic acid, 1000 mg 2 times/d) while some others did not. Closure rates and effectivity of oral antibiotics were evaluated and compared between 2 groups.
In total, 80 patients were analyzed. The closure rates of perforations were 95.2% for group 1 (n = 42) and 81.6% for group 2 (n = 38). Although the paper-patched patients (group 1) perforation closure rate (95.2%) is higher than the nontreated patients (group 2) closure rate (81.6%), it is not statistically significant (P > 0.05). Antibiotic administered 55 patients had a significantly higher closure rate (94.5%) than the 25 patients who are not treated with antibiotics (76%) (P = 0.023; P < 0.05).
In patients with traumatic tympanic membrane perforations, spontaneous closure rate is quite high. This study showed us that antibiotherapy and paper-patch treatments increase the healing rates.
Endoplasmic Reticulum Stress-Induced NLRP1 Inflammasome Activation Contributes to Myocardial Ischemia/Reperfusion Injury
Authors: Cao Lei , Chen Yuguo , Zhang Zhe , Li Yong , Zhao Peiyong 
Published: October 2018

ABSTRACT
Studies have shown that Nod-like receptor protein (NLRP) 3 inflammasome activation contributes to myocardial ischemia/reperfusion (I/R) injury. However, the role and mechanism of NLRP1 inflammasome in myocardial I/R injury remain unknown. Endoplasmic reticulum (ER) stress is involved in the development of myocardial I/R injury. The relationship between ER stress and NLRP1 inflammasome in myocardial I/R injury needs further study. NLRP1 inflammasome activation and ER stress were investigated in hypoxia/reoxygenation (H/R)-treated primary mouse cardiomyocytes and left anterior descending coronary artery ligation and reperfusion mouse models. Downregulation of NLRP1 expression with NLRP1 small interfering RNA (siRNA) was used to evaluate the role of NLRP1 inflammasome in H/R-stimulated cardiomyocyte injury. 4-phenylbutyric acid (4-PBA), an ER stress inhibitor, was used to pretreat cardiomyocytes before H/R treatment, the cardiomyocyte injury and NLRP1 inflammasome activation were determined. Also, nuclear factor (NF)-κB signaling activity was measured. Additionally, pyrrolidine dithiocar bamate (PDTC), an NF-κB inhibitor, was used to treat cardiomyocytes before H/R stimulation and NLRP1 inflammasome activation was examined. We found the levels of ER stress markers GRP78, p-PERK, p-eIF2α and CHOP as well as NLRP1 inflammasome activation were significantly elevated both in vivo and in vitro. NLRP1 siRNA notably increased cell viability inhibited by H/R, suppressed H/R-induced cell apoptosis, lactate dehydrogenase release, and creatine kinase activity. 4-PBA reduced H/R-stimulated cardiomyocyte injury via NLRP1 inflammasome inactivation, and it also suppressed NF-κB signaling activity. NLRP1 inflammasome activation induced by H/R was also suppressed by PDTC. In conclusion, NLRP1 inflammasome activation promotes myocardial I/R injury. ER stress can activate NLRP1 inflammasome via activating the NF-κB signaling pathway.