bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frontiers in Oncologic Reconstruction
Authors: Samra Fares , Sobti Nikhil , Nelson Jonas A. , Allen Robert J. , Mehrara Babak , Dayan Joseph H. 
Published: June 2019

Objectives:
The authors seek to highlight some of the ongoing challenges related to complex oncologic reconstruction and the current solutions to these problems.

Summary:
The standard of care in reconstruction following oncologic resection is continually evolving. Current frontiers in breast reconstruction include addressing animation deformity through prepectoral reconstruction, offering autologous reconstruction to patients with limited donor sites, and improving postoperative sensation with innervation of free tissue transfer. Facial nerve reconstruction and contour defects pose an ongoing challenge in patients undergoing parotidectomy requiring complex nerve transfers and autologous reconstruction. Lymphedema is not a monolithic disease, and as our understanding of the pathophysiology improves, our surgical algorithms continue to evolve.
Effect of Native Type I Collagen with Polyhexamethylene Biguanide Antimicrobial on Wounds: Interim Registry Results
Authors: Bain Michael A. , Thibodeaux Kerry T. , Speyrer Marcus S. , Carlson Emily , Koullias George John 
Published: June 2019

Background:
Biofilm can impair wound healing by maintaining an elevated, but ineffective, inflammatory state. This article describes interim results from the prospective RESPOND postmarketing registry evaluating the use of a native type 1, porcine collagen matrix with the embedded antimicrobial polyhexamethylene biguanide (PCMP) in the management of chronic wounds.

Methods:
Adults ≥18 years of age with ≥1 appropriate wound were eligible for inclusion. Data that were final on January 26, 2018 were included in this analysis. At week 0, wounds were cleaned, debrided, and prepared as necessary and PCMP was applied, with a dressing to fix it in place. Patients received standard wound care plus PCMP weekly, up to 24 weeks, at the investigator’s discretion. At each visit, wounds were assessed for area and quality of granulation tissue.

Results:
Most common wound types (N = 63) were venous ulcers (28.6%), trauma and lacerations (22.2%), postsurgical open wounds (15.9%), pressure injuries (12.7%), and diabetic ulcers (9.5%). Median baseline wound area was 6.5 cm2; mean wound duration at baseline was 4 months. Of the 63 wounds, 43 (68.3%) achieved complete wound closure, 41 of 43 (95.3%) closed after PCMP treatment, and 2 of 43 (4.7%) after bridging to other modalities and surgical closure. Twelve out of 63 wounds were bridged to other modalities after PCMP treatment. Mean time to closure for PCMP wounds was 5.0 weeks.

Conclusions:
PCMP appears to be a useful adjunct for treating various wound types. PCMP use should be considered when managing chronic or acute wounds.
Corneal Endotheliitis as a Presentation of Acanthamoeba Keratitis
Authors: Hsu Chih-Wei , Liu Chun-Hsiu , Hsiao Ching-Hsi 
Published: June 2019

Objective:
To report 2 cases of Acanthamoeba keratitis (AK) presenting with corneal endotheliitis.

Methods:
Case report.

Results:
Two contact lens wearers, who had been diagnosed with herpes simplex virus (HSV) keratitis, predominantly manifested corneal endotheliitis composed of corneal edema, keratic precipitates, and anterior chamber reaction at referral. AK was confirmed using cultures or through polymerase chain reaction testing. The patients were started on polyhexamethylene biguanide and responded favorably to regain satisfactory visual acuity.

Conclusions:
Corneal endotheliitis, although uncommon, may be a manifestation of AK. We must have high-index suspicion for AK in all contact lens users, particularly before making a diagnosis of HSV keratitis. Accurate diagnosis and prompt treatment can result in a favorable prognosis for AK.
Epidemiology of Serious Bacterial Infections in Infants Less Than 90 Days in a Military Health System Cohort
Authors: Ramchandar Nanda , Gierhart Sarah , Creppage Kathleen E , Chukwuma Uzo , Gerber Jeffrey S. , Arnold John , Milder Edmund 
Published: June 2019

Background:
Management of suspected serious bacterial infections (SBIs) in infants less than 3 months old is challenging. Understanding the epidemiology of SBI is necessary to inform management decisions. Recent publications have challenged the previously accepted distribution of infections by specimen source and pathogen. We sought to describe the burden of SBIs in previously healthy infants less than 90 days old.

Methods:
We conducted a retrospective analysis of the Military Health System database to identify SBI cases among term infants less than 90 days of age from 2005 to 2015. We defined an SBI case as any previously healthy infant with positive cultures for a likely pathogen from blood, urine or cerebrospinal fluid.

Results:
Of 467,462 live births between January 2005 and September 2015, 3421 infants had positive cultures. After excluding 1781 episodes with isolates considered nonpathogenic or ICD-9 codes for chronic conditions, the overall incidence of SBI was 3.1 cases/1000 live births. The SBI rate dropped from 5.0 cases/1000 live births in 2005 to 2.0 cases/1000 live births in 2015 (P < 0.001 for trend). The most common pathogen was Escherichia coli (51.3%).

Conclusions:
In this retrospective review of 467,462 live births, the incidence of SBI decreased from 5.0/1000 to 2.0/1000 live births over time. We identified no cases of Listeria monocytogenes. These data can help inform decisions related to treatment and management of infants with suspected bacterial infections.
Recurrent Pneumococcal Meningitis in Children
Authors: Darmaun Laura , Levy Corinne , Lagrée Marion , Béchet Stéphane , Varon Emmanuelle , Dessein Rodrigue , Cohen Robert , Martinot Alain , Dubos François 
Published: June 2019

Background:
Pneumococcal meningitis (PM) is a serious disease that can rarely recur at a later time after the initial episode.

Methods:
A retrospective multicenter case–control study was conducted with data for children 18 years of age or younger obtained from the National Observatory of Bacterial Meningitis in Children between January 2001 and September 2015. Cases were all patients with RPM. Each case was matched with 2 randomized controls with a single PM episode in the year of the first episode of PM in the case and born the same year. Case and control data were compared.

Results:
Among the 1634 PM episodes in children 18 years of age or younger, 24 (1.5%) children had RPM. RPM cases were significantly less frequent than single PM cases in winter (27% vs. 48%; P=0.03) and showed significantly less concomitant ear, nose and throat infections when considering the first episode (30% vs. 56%, P = 0.04) and all episodes (28% vs. 56%, P < 0.01). Cerebrospinal fluid leakage was frequent in RPM cases versus controls (83% vs. 10%, P < 0.01), including 25% discovered after the third PM episode. Immune deficiency was absent in cases and present in 15% of controls. Cases and controls did not differ in death rate or neurologic outcome.

Conclusions:
RPM is rare in children. Cerebrospinal fluid leakage must be considered.
Repositioning a Prolapsed Tube After Bicanalicular Intubation of the Lacrimal System
Authors: Chu Zhaodong , Lu Guohua , Tan Ying , Deng Yuan 
Published: June 2019

A new technique, the suture-probe with thread interlocking the silicone tube ring can reposition the prolapsed silicone tube in lacrimal sac.

Objective:
Prolapse of silicone tubes is one of the most common complications after bicanalicular intubation of the lacrimal system. This study describes a new method of repositioning prolapsed silicone tubes by using a suture-probe.

Methods:
This study was a retrospective chart review of 12 patients who experienced complete silicone tube prolapse after bicanalicular intubation. The silicone tube was repositioned by using a suture-probe; a double-stranded suture was placed in the lacrimal duct with a lacrimal probe with a hole in the front blunt tip, then interlocked with the prolapsed silicone tube. Subsequently, the suture loop was slowly stretched from the nasal cavity, and the silicone tube was repositioned. The silicone tube at the medial canthus was cut and loosened, then pulled out of the nasal cavity.

Results:
In all 12 cases, the silicone tube was restored with 100% success by using the suture-probe. Three patients were extubated immediately after the repositioning. For another 9 patients with an indwelling tube, extubation was performed after 3–4 months, and no patients experienced further tube dislocation during that time.

Conclusions:
The suture-probe technique is a simple, low cost, and minimally traumatic method for repositioning a prolapsed silicone tube after bicanalicular intubation of the lacrimal system.
What Is the Impact of Physical Effort on the Diagnosis of Concussion?
Authors: Dechambre Xavier , Carling Christopher , Mrozek Ségolène , Pillard Fabien , Decq Philippe , Piscione Julien , Yrondi Antoine , Brauge David 
Published: June 2019

Objective:
Sport-related concussion commonly occurs in contact sports such as rugby. To date, diagnosis is based on the realization of clinical tests conducted pitch-side. Yet, the potential effect of prior physical effort on the results of these tests remains poorly understood. The purpose of this study was to determine whether preceding physical effort can influence the outcome of concussion assessments.

Design:
Prospective observational study.

Setting:
University Medicine Center.

Patients:
A cohort of 40 subjects (20 rugby players and 20 athletes from a range of sports).

Intervention:
A concussion assessment was performed immediately after physical activity. After a period of 6 months and under the same experimental conditions, the same cohort performed the same tests in resting conditions.

Main outcome Measures:
Results of concussion tests.

Results:
In both cohorts, the comparison for postexercise and rest assessments demonstrated a most likely moderate-to-very large increase in the number of symptoms, severity of symptoms, and balance error scoring system score. In the rugby cohort, scores for concentration, delayed memory and standardized assessment of concussion (SAC), likely-to-most likely decreased following completion of physical activity compared with baseline values. The between-cohort comparison reported a most likely greater impact after exercise in the rugby players for delayed recall (0.73 ± 0.61) and SAC score (0.75 ± 0.41).

Conclusions:
Physical activity altered the results of concussion diagnostic tests in athletes from a range of sports and notably in rugby players. Therefore, physical efforts before the concussion incident should be accounted for during pitch-side assessments and particularly during rugby competition and training.
Abnormal Tectorial Membranes in Sensorineural Hearing Loss: A Human Temporal Bone Study
Authors: Ishai Reuven , Kamakura Takefumi , Nadol Joseph B. 
Published: June 2019

Hypothesis:
This study evaluates the morphological changes of the tectorial membrane (TM) in conjunction with degeneration of hair cells, interdental cells, and presence of endolymphatic hydrops (EH) in sensorineural hearing loss (HL) in the human using histopathology techniques.

Background:
The TM plays an important role in mechanical transduction of acoustic energy, and pathology of the TM may result in HL.

Methods:
All temporal bone (TB) specimens from the Massachusetts Eye and Ear Otopathology Laboratory from patients with various causes of sensorineural HL and morphological abnormalities of the TM were evaluated. Cases with a history of cochlear trauma (other than acoustic trauma) and/or severe postmortem artifacts were excluded. The TBs were processed histologically, and the status of hair cells, supporting cells, interdental cells, presence of EH, and postmortem time were tabulated.

Results:
Two thousand two hundred ninety TBs from 1340 individuals were evaluated, and 164 of 748 TBs from the otological disorders in which the TM were abnormal, met the inclusion criteria. The most common disorders were idiopathic sudden deafness (57.1%), genetic etiology (53.7%), and ototoxicity (40.0%), as compared with cases with presbycusis (2.9%). EH was found in 33.3% of all cases with an identified abnormality of the TM.
Abnormalities of the TM were 1) deformed, 2) shrunken, 3) detached from the limbus, 4) encapsulated, or 5) missing. Encapsulated, shrunken and missing patterns (36, 35, 31%, respectively) were the most common.

Conclusion:
A relative high prevalence of EH among disorders with TM abnormalities suggests a possible common pathophysiology in both. In addition, anatomic abnormalities of the TM may play a role in the pathophysiology of HL in these disorders.
New insights on the genetics of type 1 diabetes
Authors: Oram Richard A. , Redondo Maria J. 
Published: June 2019

Purpose of review
The genetic risk for type 1 diabetes has been studied for over half a century, with the strong genetic associations of type 1 diabetes forming critical evidence for the role of the immune system in pathogenesis. In this review, we discuss some of the original research leading to recent developments in type 1 diabetes genetics.

Recent findings
We examine the translation of polygenic scores for type 1 diabetes into tools for prediction and diagnosis of type 1 diabetes, in particular, when used in combination with other biomarkers and clinical features, such as age and islet-specific autoantibodies. Furthermore, we review the description of age associations with type 1 diabetes genetic risk, and the investigation of loci linked to type 2 diabetes in progression of type 1 diabetes. Finally, we consider current limitations, including the scarcity of data from racial and ethnic minorities, and future directions.

Summary
The development of polygenic risk scores has allowed the integration of type 1 diabetes genetics into diagnosis and prediction. Emerging information on the role of specific genes in subgroups of individuals with the disease, for example, early-onset, mild autoimmunity, and so forth, is facilitating our understanding of the heterogeneity of type 1 diabetes, with the ultimate goal of using genetic information in research and clinical practice.
Malignant maxillofacial bone tumors
Authors: Lopez Joseph , Tufaro Anthony P. 
Published: June 2019

Purpose of review
Malignant bone tumors of the head and neck region are rare. Due to the paucity of studies on these tumors, patients with these maxillofacial malignancies can suffer from high morbidity and mortality.

Recent findings
Currently, mainstay management of these tumors includes wide surgical resection with margins followed by radiotherapy and/or adjuvant chemotherapy. Although much progress has been made over the last few decades regarding the prognosis of many of these tumors, large multicenter trials are needed to better determine their optimal management.

Summary
The current review will provide a broad review of the most current epidemiology, pathogenesis, prognosis, and management of the most common bone malignancies of the maxillofacial skeleton.
An interdisciplinary approach to the older transplant patient: strategies for improving clinical outcomes
Authors: Schaenman Joanna , Goldwater Deena , Malinis Maricar 
Published: June 2019

Purpose of review
To describe the latest investigations into the role of frailty and assessment of other aging-related issues in the solid organ transplant candidate and recipient. This information is relevant for all involved in the care of transplant patients, but is especially relevant in infectious diseases, given the increased burden of infection seen in older and frailer patients.

Recent findings
The Fried Frailty Phenotype (FFP) and Short Performance Physical Battery (SPPB) are well validated tools for measuring frailty in older adults. Recently, these frailty tools have also been used to predict a range of clinical outcomes in adults with endstage organ disease undergoing advanced therapies including mechanical circulatory device (MCSD) or transplantation including death on the waiting list, length of hospital stay, need for readmission, infection, and death. Frailty may also be estimated by chart review and comorbidity assessment. Other aging-related evaluations of interest are cognitive function, sarcopenia, and nutritional status. The strength of association for each tool varies by the type of end organ disease, although there are many findings in common across organ types.

Summary
As trends in the aging of the population continue to impact transplant and MCSD candidates and recipients, it is increasingly important for providers to be cognizant of the methods for assessment of aging-associated dysfunction including frailty and sarcopenia.
Preventing Catheter-Associated Urinary Tract Infection
Authors: Mundle William , Howell-Belle Carnett , Jeffs Lianne 
Published: June 2019

Background:
Research has shown that catheter-associated urinary tract infections (CAUTIs) are highly preventable and have significant impact on patient morbidity and mortality as well as financial consequences for the health care system.

Local:
CAUTI rates were documented to be higher in the general internal medicine units when compared with the overall hospital rates.

Methods:
A comparative analysis was undertaken.

Intervention:
An interprofessional working group developed and implemented a quality improvement initiative bundled approach to reducing CAUTIs.

Results:
There was a 79% reduction in average CAUTI rates following the bundle implementation along with reduced variability in rates.

Conclusions:
Implementation of a standardized bundle of practices aimed at reducing CAUTIs resulted in decreased CAUTI rates. Organizations can use the design and implementation approach to reduce and minimize CAUTI rates, which can positively impact cost, care experience, and outcomes.
Development of Prelicensure Nursing Competencies in Caring for People With Disabilities Through Delphi Methodology
Authors: Kronk Rebecca , Colbert Alison M. , Smeltzer Suzanne C. , Blunt Elizabeth 
Published: June 2019

Background
People with disabilities (PWDs) experience significant health disparities. The complex experience of disability requires that nurses are adequately and deliberately prepared to care for PWDs. However, there are no recognized nursing competencies to direct education and care.

Purpose
The purpose of this study was to develop a set of nursing competencies to better prepare prelincensure nursing students to provide competent care to PWDs.

Methods
A 2-round Delphi survey was administered to experts in the field of disabilities (n = 47, n = 35). Quantitative and qualitative methods were used to analyze data.

Results
Three major themes emerged: unique knowledge, volume and repetition, and distinct disability culture. Competencies were reduced with a focus on 4 dimensions: environment and care, communication, culture, and referral.

Conclusions
The 12 new competencies can serve as the foundation for the inclusion of disability content in nursing curricula.
Relationships Among 3 Movement Analysis Tests in Preterm Infants
Authors: Azim Rezaei Derya , Acar Gonul , Turkdogan Dilsad , Unver Olcay , Kaya Narter Fatma 
Published: June 2019

Purpose:
To investigate the relationships among the Infant Motor Profile (IMP), the Neuro-Sensory Motor Developmental Assessment (NSMDA), and the Alberta Infant Motor Scale (AIMS) in prematurely born infants.

Methods:
Sixty-one preterm infants with a birth weight under 2500 g were assessed by the IMP, the NSMDA, and the AIMS.

Results:
There was a significant correlation between the IMP total score and the AIMS percentile and between the IMP total score and the NSMDA functional levels. There were significant correlations between the AIMS percentile age and the NSMDA functional levels and between the AIMS total scores and the IMP total scores. In the infants with atypical development, the relationship was significant between the AIMS and the IMP; however, there was no relationship between the IMP and the NSMDA.

Conclusions:
The 3 movement analysis tests are related. The IMP was found to be consistent with other movement analysis tests.
Physical Therapy for a Patient With Alternating Hemiplegia of Childhood: A Case Report
Authors: Lardinois Kara L. , Guge Nora 
Published: June 2019

Purpose:
Alternating hemiplegia of childhood (AHC) is a rare neurological disorder that can influence posture and movement during critical periods of motor development. There are no descriptions of physical therapy for children with AHC. The purpose of this case report is to present an example of physical therapy evaluation, intervention, and outcomes for a child with AHC.

Summary of Key Points:
Physical therapy services were provided over 9 sequential plans of care between 14 and 52 months of age. The child demonstrated improvements in motor control, walked independently at 16.5 months of age, and her Gross Motor Function Measure-88 score increased from 78% to 95% between 27 and 52 months of age.

Conclusions and Recommendations for Clinical Practice:
The importance in this case lies in the use of a multisystem approach to treatment, careful consideration of frequency of intervention, and discussion of the unique features of AHC.
Vague Posterior Knee Discomfort in a Soccer Player
Authors: Schroeder Allison , Onishi Kentaro 
Published: June 2019

Abstract
A 24-yr-old male soccer player presented with a 7-yr history of left posterior knee “looseness.” Evaluation 7 yrs ago, at the time of initial injury, revealed atraumatic anterior and posterior cruciate ligament sprains. On representation, the patient described the pain as a constant, dull ache, 3/10, but his biggest complaint was this feeling of “instability” and looseness where his knee would “buckle” 3–4 times a week. Physical examination was positive for grade 1 posterior drawer and grade 1 posterior sag signs. Reverse KT-1000 testing showed a 3-mm side-to-side difference. Sonographic evaluation confirmed magnetic resonance imaging findings of posterior cruciate ligament laxity and buckling and a small cystic lesion abutting the posteromedial margin of the distal 1/3 of the posterior cruciate ligament. After a trial of physical therapy, the patient elected to undergo experimental injection of dextrose hyperosmolar solution. This resulted in resolution of the cyst and reverse KT-1000 measurements improved to a side-to-side difference of 1 mm. The patient's subjective feeling of looseness and instability resolved by 7 wks.