bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thromboembolic Events After Traumatic Vertebral Fractures
Authors: Samuel Andre M. , Diaz-Collado Pablo J. , Gala Raj J. , Webb Matthew L. , Lukasiewicz Adam M. , Basques Bryce A. , Bohl Daniel D. , Kim Han Jo , Grauer Jonathan N. 
Published: March 2018

Study Design.
Retrospective cohort study

Objective.
To determine the rate of venous thromboembolism event (VTE) and risk factors for their occurrence in patients with vertebral fractures.

Summary of Background Data.
Deep vein thrombosis or pulmonary embolism (VTE) events are a significant source of potentially preventable morbidity and mortality in trauma patients. In patients with traumatic vertebral fractures, a common high-energy injury sometimes resulting in spinal cord injury, there is debate about what factors may be associated with such VTEs.

Methods.
All patients with vertebral fractures in the American College of Surgeons National Trauma Data Bank Research Data Set (NTDB RDS) from years 2011 and 2012 were identified. Multivariate logistic regression was used to determine factors associated with the occurrence of VTE while considering patient factors, injury characteristics, and hospital course.

Results.
A total of 190,192 vertebral fractures patients were identified. The overall rate of VTE was 2.5%. In multivariate analysis, longer inpatient length of stay was most associated with increased VTEs with an odds ratio (OR) of up to 96.60 (95% CI: 77.67 – 129.13) for length of stay longer than 28 days (compared to 0 – 3 days). Additional risk factors in order of decreasing odds ratios were older age (OR of up to 1.65 [95% CI: 1.45 – 1.87] for patients age 70 – 79 years [compared to age 18 – 29 years]), complete spinal cord injuries (OR: 1.49 [95% CI: 1.31 – 1.68]), cancer (OR: 1.37 [95% CI: 1.25 – 1.50]), and obesity (OR: 1.32 [95% CI: 1.18 – 1.48]). Multiple associated non-spinal injuries were also associated with increased rates of VTE.

Conclusion.
While the overall rate of VTE is relatively low after vertebral fractures, longer LOS and other defined factors to lesser extents were predisposing factors. By determining patients at greatest risk, protocols to prevent such adverse outcomes can be developed and optimized.

Level of Evidence: 3
Unsupervised Analysis of Transcriptomics in Bacterial Sepsis Across Multiple Datasets Reveals Three Robust Clusters
Authors: Sweeney Timothy E. , Azad Tej D. , Donato Michele , Haynes Winston A. , Perumal Thanneer M. , Henao Ricardo , Bermejo-Martin Jesús F. , Almansa Raquel , Tamayo Eduardo , Howrylak Judith A. , Choi Augustine , Parnell Grant P. , Tang Benjamin , Nichols Marshall , Woods Christopher W. , Ginsburg Geoffrey S. , Kingsmore Stephen F. , Omberg Larsson , Mangravite Lara M. , Wong Hector R. , Tsalik Ephraim L. , Langley Raymond J. , Khatri Purvesh 
Published: March 2018

Objectives:
To find and validate generalizable sepsis subtypes using data-driven clustering.

Design:
We used advanced informatics techniques to pool data from 14 bacterial sepsis transcriptomic datasets from eight different countries (n = 700).

Setting:
Retrospective analysis.

Subjects:
Persons admitted to the hospital with bacterial sepsis.

Interventions:
None.

Measurements and Main Results:
A unified clustering analysis across 14 discovery datasets revealed three subtypes, which, based on functional analysis, we termed “Inflammopathic, Adaptive, and Coagulopathic.” We then validated these subtypes in nine independent datasets from five different countries (n = 600). In both discovery and validation data, the Adaptive subtype is associated with a lower clinical severity and lower mortality rate, and the Coagulopathic subtype is associated with higher mortality and clinical coagulopathy. Further, these clusters are statistically associated with clusters derived by others in independent single sepsis cohorts.

Conclusions:
The three sepsis subtypes may represent a unifying framework for understanding the molecular heterogeneity of the sepsis syndrome. Further study could potentially enable a precision medicine approach of matching novel immunomodulatory therapies with septic patients most likely to benefit.
Effects of Yoga on Attention, Impulsivity, and Hyperactivity in Preschool-Aged Children with Attention-Deficit Hyperactivity Disorder Symptoms
Authors: Cohen Samantha C. L. , Harvey Danielle J. , Shields Rebecca H. , Shields Grant S. , Rashedi Roxanne N. , Tancredi Daniel J. , Angkustsiri Kathleen , Hansen Robin L. , Schweitzer Julie B. 
Published: March 2018

ABSTRACT:Objective:Behavioral therapies are first-line for preschoolers with attention-deficit hyperactivity disorder (ADHD). Studies support yoga for school-aged children with ADHD; this study evaluated yoga in preschoolers on parent- and teacher-rated attention/challenging behaviors, attentional control (Kinder Test of Attentional Performance [KiTAP]), and heart rate variability (HRV).Methods:This randomized waitlist-controlled trial tested a 6-week yoga intervention in preschoolers with ≥4 ADHD symptoms on the ADHD Rating Scale-IV Preschool Version. Group 1 (n = 12) practiced yoga first; Group 2 (n = 11) practiced yoga second. We collected data at 4 time points: baseline, T1 (6 weeks), T2 (12 weeks), and follow-up (3 months after T2).Results:At baseline, there were no significant differences between groups. At T1, Group 1 had faster reaction times on the KiTAP go/no-go task (p= 0.01, 95% confidence interval [CI], −371.1 to −59.1,d= −1.7), fewer distractibility errors of omission (p= 0.009, 95% CI, −14.2 to −2.3,d= −1.5), and more commission errors (p= 0.02, 95% CI, 1.4–14.8,d= 1.3) than Group 2. Children in Group 1 with more severe symptoms at baseline showed improvement at T1 versus control on parent-rated Strengths and Difficulties Questionnaire hyperactivity-inattention (β = −2.1,p= 0.04, 95% CI, −4.0 to −0.1) and inattention on the ADHD Rating Scale (β = −4.4,p= 0.02, 95% CI, −7.9 to −0.9). HRV measures did not differ between groups.Conclusion:Yoga was associated with modest improvements on an objective measure of attention (KiTAP) and selective improvements on parent ratings.
Media Exposure in Low-Income Preschool-Aged Children Is Associated with Multiple Measures of Self-Regulatory Behavior
Authors: Munzer Tiffany G. , Miller Alison L. , Peterson Karen E. , Brophy-Herb Holly E. , Horodynski Mildred A. , Contreras Dawn , Sturza Julie , Lumeng Julie C. , Radesky Jenny 
Published: March 2018

ABSTRACT:

Objective:
Excessive screen media exposure in childhood is associated with parent-reported self-regulation difficulties. No studies have used laboratory-based or teacher-reported measures of child self-regulatory behaviors. This study examines cross-sectional associations between preschooler screen media exposure and multiple measures of self-regulatory behaviors.

Methods:
Preintervention data were used from 541 preschoolers in the Growing Healthy study, an obesity prevention trial (2011–2015). Screen media exposure was measured by daily screen media exposure (hr/d), television (TV) in the bedroom, frequency of background TV, and TV with meals (1 = rarely/never, 4 = frequently). Child self-regulatory behaviors were measured by the following: child ability to delay gratification, a standardized waiting paradigm; teacher-reported Social Competence and Behavior Evaluation; and parent-reported difficult temperament on the Child Behavior Questionnaire (CBQ). Multivariate regression analyses modeled screen media exposure predicting each self-regulatory measure, adjusting for child age, sex, parent age, education, marital status, income-to-needs ratio, number of adults in household, parent depressive symptoms, and sensitivity.

Results:
Children were aged 4.1 years (SD = 0.5), parents were aged 29.6 years (SD = 6.8), 48% had high school education or less, and 67% were married. Daily screen media exposure and background TV were associated with weaker observed self-regulation (β: −10.30 seconds for each hr/d media, −12.63 seconds for 1-point increase, respectively). Background TV and TV with meals were associated with greater parent-reported difficult temperament (β: 0.04 and 0.05 CBQ, respectively, for 1-point increase).

Conclusion:
Greater screen media exposure had small but significant associations with weaker observed and parent-reported, but not teacher-reported, self-regulatory behaviors. Longitudinal studies are needed to determine the directionality of associations.
Assaults on Days of Campaign Rallies During the 2016 US Presidential Election
Authors: Morrison Christopher N. , Ukert Benjamin , Palumbo Aimee , Dong Beidi , Jacoby Sara F. , Wiebe Douglas J. 
Published: March 2018

Background:
This study investigates whether assault frequency increased on days and in cities where candidates Donald Trump and Hillary Clinton held campaign rallies prior to the 2016 US Presidential election.

Methods:
We calculated city-level counts of police-reported assaults for 31 rallies for Donald Trump and 38 rallies for Hillary Clinton. Negative binomial models estimated the assault incidence on rally days (day 0) relative to that on eight control days for the same city (days -28, -21, -14, -7, +7, +14, +21, and +28).

Results:
Cities experienced an increase in assaults (incidence rate ratio [IRR] = 1.12, 95% CI: 1.03–1.22) on the days of Donald Trump’s rallies, and no change in assaults on the days of Hillary Clinton’s rallies (IRR = 1.00; 95% CI: 0.94–1.06).

Conclusion:
Assaults increased on days when cities hosted Donald Trump’s rallies during the 2016 Presidential election campaign.
Challenges in the assessment of adverse drug reactions in children and neonates
Authors: Bracken Louise , Nunn Anthony , Peak Matthew , Turner Mark 
Published: March 2018

Summary
Adverse drug reactions (ADRs) are common in children and it is often difficult to distinguish ADRs from other underlying conditions. Children range from preterm neonates to adolescents with changing patterns of disease, pharmacokinetics and pharmacodynamics. The continuous development during childhood presents a challenge to developing, prescribing and administering age-appropriate medicines. Paediatric ADRs can be difficult to characterize. There is a lack of agreed definitions, which are needed so that data on ADRs can be consistently reported and reliably interpreted. Many of the adult tools to assess causality and avoidability are difficult to apply in paediatrics. Paediatric ADRs are under-reported in spontaneous reporting systems, and there is little research. Steps addressing the challenges include the Liverpool causality and avoidability assessment tools, improved definitions and more paediatric drug research following the introduction of Paediatric Regulation in 2007, requirement for risk assessment and after marketing surveillance. Advances in assessing susceptibility through pharmacogenomics offer hope of avoiding ADRs.
Pedicled Descending Branch Latissimus Dorsi Mini-flap for Repairing Partial Mastectomy Defect: A New Technique
Authors: Cai Ruizhao , Xie Zeming , Zhou Lihuan , Wang Jin , Li Xing , Huang Junhao , Wang Yan , Yang Mingtian , Chang Edward I. , Tang Jun 
Published: March 2018

Summary:
Volume loss is 1 of the major factors influencing cosmetic outcomes of breast after partial mastectomy (PM), especially for smaller breasts, and therefore, volume replacement is critical for optimizing the final aesthetic outcome. We present a novel technique of raising a pedicled descending branch latissimus dorsi (LD) mini-flap for reconstruction of PM defects via an axillary incision. After PM, the LD mini-flap is harvested through the existing axillary incision of the axillary dissection or the sentinel lymph node biopsy. The descending branches of thoracodorsal vessels and nerve are carefully identified and isolated. The transverse branches are protected to maintain muscle innervation and function. The LD muscle is then undermined posteriorly and inferiorly to create a submuscular pocket and a subcutaneous pocket between LD muscle and superficial fascia. Once the submuscular plane is created, the muscle is divided along the muscle fibers from the deep surface including a layer of fat above the muscle. Finally, the LD mini-flap is transferred to the breast defect. Given the limited length and mobility of the LD mini-flap, this approach is best utilized for lateral breast defects. However, for medial defects, the lateral breast tissue is rearranged to reconstruct the medial breast defect, and an LD mini-flap is then used to reconstruct the lateral breast donor site. This technique can therefore be employed to reconstruct all quadrants of the breast and can provide aesthetic outcomes without scars on the back, with minimal dysfunction of LD muscle.
Perineal Reconstruction with a Diamond-shaped Perforator Flap: A Case Report
Authors: Deskoulidi Parthena I. , Diamantopoulos Pantelis K. , Maltzaris Nikolaos A. , Kotrotsiou Maria D. , Benetatos Konstantinos M. , Stavrianos Spiros D. 
Published: March 2018

Summary:
Reconstruction of perineal defects is a challenging procedure. Various surgical techniques have been proposed. Compared with traditional myocutaneous flaps, pedicled perforator flaps are believed to be a less invasive option for perineal reconstruction, with better functional and cosmetic results. We present the case of a 47-year-old woman with a perianal Paget’s disease who underwent surgical excision of the lesion. The reconstructive technique was a pedicled flap based on an internal pudendal skin perforator artery. The flap was designed in a diamond-shaped pattern. Six months after the operation, the patient is disease-free with successful aesthetic and functional results. A polygonal diamond-shaped flap is an easy and reliable choice for perineal reconstruction, offering better adjustment in the perianal region and avoidance of the curvilinear perianal incision (which often leads to anal stenosis).
Use of the Masquerade Flap in Ablepharon–Macrostomia Syndrome: A Case Report
Authors: Hollanders Karolien , Casteels Ingele , Vandelanotte Sylvie , Reyniers Rudolf , Segers Katarina , Nevens Thomas , Mombaerts Ilse 
Published: March 2018

Purpose:
To report a case of ablepharon–macrostomia syndrome and surgical treatment options.

Methods:
Case report and literature review.

Results:
A prematurely born male baby presented with severe ablepharon, hypertelorism, macrostomia, low-set dysplastic ears, broad nasal bridge, coarse and redundant body skin, absent scalp and body hair, lax abdominal wall, absent nipples, camptodactyly, and ambiguous genitalia. Despite intensive ocular lubrication, severe exposure keratopathy developed within the first days after birth. The eyes were closed using masquerade flaps for 6 weeks. In a secondary procedure at the adjusted age of 3 weeks, the flaps were partially divided, and visual input and development were successfully achieved, while maintaining corneal protection.

Conclusions:
We present a rare case of a prematurely born infant with a severe phenotype of ablepharon–macrostomia syndrome, surgically treated with masquerade flaps to preserve corneal health and allow bilateral visual input.
Automated Detection and Classification of Corneal Haze Using Optical Coherence Tomography in Patients With Keratoconus After Cross-Linking
Authors: Dhaini Ahmad R. , Abdul Fattah Maamoun , El-Oud Sara Maria , Awwad Shady T. 
Published: March 2018

Purpose:
To evaluate a proposed technology for offering objective grading and mapping of corneal haze as detected by corneal spectral domain optical coherence tomography after corneal cross-linking.

Methods:
This was a retrospective study to evaluate corneal optical coherence tomography images performed on 44 eyes of 44 patients who underwent corneal cross-linking between January 2014 and May 2015, at the American University of Beirut Medical Center.

Results:
Overall average brightness of the cornea was markedly increased from 43.4% (±6.0) at baseline to 50.2% (±4.4) at 1 month, 47.9% (±4.4) at 3 months, and 46.4% (±5.7) at 6 months with P <0.001, <0.001, and 0.005, respectively. In the anterior stroma, the average brightness significantly increased at 1, 3, and 6 months with values of 54.8% (±3.9), 52.5% (±5.2), and 49.7% (±6.9) with P <0.001, <0.001, and 0.003, respectively. In the mid stroma, the change was clinically significant at 1 and 3 months, whereas in the posterior stroma, it was only significant at 1 month compared with baseline (P = 0.003). Overall, haze was mostly present at 1 month after surgery in all regions, especially in the anterior (32.1%; ±19.2) and mid stromal regions (9.1%; ±18.8), P <0.001 and 0.001, respectively. In contrast, haze in the posterior stromal region peaks at 3 and 6 months after surgery.

Conclusions:
Anterior stromal haze was the greatest in intensity and area and it was present for a longer time span than mid and posterior stromal haze. At 12 months, the anterior stroma had still more haze intensity than preoperatively. This image-based software can provide objective and valuable quantitative measurements of corneal haze, which may impact clinical decision-making after different corneal surgeries.
Ingestion of Fireworks
Authors: Yüksekkaya Hasan , Gumus Meltem , Yucel Aylin , Energin Meltem , Demirci Serafettin 
Published: March 2018

Background
Mistaken ingestion of all manner of toxic matter is common in childhood, but poisoning with fireworks and matchsticks is rare. Fireworks usually contain 10% yellow phosphorus and 50% potassium chlorate. Potassium chlorate is an extremely reactive and toxic agent that is used in fireworks and matchstick heads.

Methods
Eleven cases (7 females and 5 males; median age, 36 months [ranging from 24 to 48 months]) of poisoning after ingestion of fireworks and matchstick(s), between February 2008 and June 2014, were reviewed.

Results
The most common initial symptom was vomiting except for 2 cases in this group. Biochemical tests indicated that hyperphosphatemia was present in all patients, 8 patients (72.7%) had subclinical hepatic injury, 1 (9%) had acute hepatic failure, and 2 patients had no clinical or biochemical evidence of hepatic damage. Three patients had renal impairment, but none of them required dialysis. All of the patients recovered with supportive therapy except for 2 cases. One patient underwent cadaveric liver transplantation, whereas the other died because of circulatory dysfunction and respiratory failure due to pulmonary alveolar hemorrhage.

Conclusions
Without prompt intervention, poisoning with fireworks carries high morbidity and mortality in children. It can cause pulmonary hemorrhage, in addition to other organ damage, including liver and kidney. Hyperphosphatemia is common, as it was seen in all of the study patients.
Erythema Ab Igne in an Adolescent With Chronic Pain
Authors: Gmuca Sabrina , Yu JiaDe , Weiss Pamela F. , Treat James R. , Sherry David D. 
Published: March 2018

Abstract
Erythema ab igne (EAI) is a cutaneous finding caused by prolonged heat exposure and is characterized by a reticular, brownish-pigmented, often telangiectatic dermatosis. The eruption is reminiscent of livedo reticularis, which is typically seen in the setting of a number of rheumatologic conditions, most prominently vasculitis. Identification of key features distinguishing EAI from livedo reticularis can aid in the diagnosis of EAI and correct elucidation of the underlying etiology. Our patient presented with heating pad–induced EAI in the setting of chronic pain. Only 6 other pediatric cases of EAI associated with heat sources for chronic pain are reported (Acta Derm Venereol. 2014;94:365–367, J Pediatr. 2013;163:1789, Int J Eat Disord. 2013;46:381–383, Arch Dis Child. 2008;93:389, Arch Pediatr Adolesc Med. 2012;166:185–186, Br J Clin Pract. 1990;44:248–251). Our case highlights the need for awareness of this pathognomonic skin eruption in children with chronic pain conditions to help avoid an extensive workup for vasculitis.
Improving Patient Safety in Public Hospitals: Developing Standard Measures to Track Medical Errors and Process Breakdowns
Authors: Ackerman Sara L. , Gourley Gato , Le Gem , Williams Pamela , Yazdany Jinoos , Sarkar Urmimala 
Published: March 2018

Objective
The aim of the study was to develop standards for tracking patient safety gaps in ambulatory care in safety net health systems.

Methods
Leaders from five California safety net health systems were invited to participate in a modified Delphi process sponsored by the Safety Promotion Action Research and Knowledge Network (SPARKNet) and the California Safety Net Institute in 2016. During each of the three Delphi rounds, the feasibility and validity of 13 proposed patient safety measures were discussed and prioritized. Surveys and transcripts from the meetings were analyzed to understand the decision-making process.

Results
The Delphi process included eight panelists. Consensus was reached to adopt 9 of 13 proposed measures. All 9 measures were unanimously considered valid, but concern was expressed about the feasibility of implementing several of the measures.

Conclusions
Although safety net health systems face high barriers to standardized measurement, our study demonstrates that consensus can be reached on acceptable and feasible methods for tracking patient safety gaps in safety net health systems. If accompanied by the active participation key stakeholder groups, including patients, clinicians, staff, data system professionals, and health system leaders, the consensus measures reported here represent one step toward improving ambulatory patient safety in safety net health systems.
Carotid Intima-Media Thickness and Lipid Profile in Children With Kawasaki Disease
Authors: Gopalan Kavitha , Singh Surjit , Vignesh Pandiarajan , Gupta Anju , Rohit Manojkumar , Attri Savita Verma 
Published: March 2018

Background
Kawasaki disease (KD) has a predilection to involve coronary arteries, leading to several long-term cardiovascular sequelae. Apart from coronary artery abnormalities, children with KD are also prone to develop premature atherosclerosis, endothelial dysfunction, and lipid abnormalities. Some of these complications may occur even in children who have received appropriate treatment with intravenous immunoglobulin in the acute phase.

Methods
In 2009, we had studied carotid intima-media thickness (cIMT) and lipid profile in 27 children with KD at least 1 year after the acute episode. In the present study, we have followed up the same cohort of 27 children at least 5 years after the acute episode of KD. We measured the cIMT, a surrogate marker for premature atherosclerosis, and fasting lipid profile in the cohort and compared the results with values obtained in our previous study.

Results
There was significantly higher mean cIMT in children with KD as compared with control subjects. However, there was no significant difference in cIMT among children in the cohort at 1 and 5 years of follow-up. Abnormal lipid profile was seen in 7 of 27 children in the present study, 5 of whom also had had lipid abnormality at 1-year follow-up. This suggests that lipid abnormalities in KD may be long lasting.

Conclusions
Children with KD need careful long-term follow-up even when they do not have overt and persistent coronary artery abnormalities. It is possible that consequences of KD in childhood may impact health status of young adults several years later.
Duodenum Cryptococcosis Mimicking Primary Duodenum Cancer on PET/CT Imaging
Authors: Xiu Yan , Zhang Jie , Shi Hongcheng 
Published: March 2018

Abstract
A 73-year-old man presented with fatigue and anorexia and underwent FDG PET/CT scan to evaluate a right lung nodule revealed by a chest CT. The FDG PET/CT not only showed that the lung nodule was hypermetabolic but also revealed that there was significantly increased activity in the region of the duodenum. The findings were suspected as primary duodenal malignancy with metastases. However, an upper gastrointestinal tract endoscopic examination with further culture led to a diagnosis of duodenal cryptococcosis.