bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opioid Use Disorders Are Associated With Perioperative Morbidity and Mortality in the Hip Fracture Population
Authors: Summers Spencer , Grau Luis , Massel Dustin , Rosas Samuel , Ong Alvin , Hernandez Victor Hugo 
Published: January 2018

Objectives:
To determine whether opioid use disorders (OUDs) are associated with adverse perioperative outcomes in patients undergoing surgical fixation for proximal femur fractures.

Methods:
The National Hospital Discharge Survey was queried to identify patients surgically treated for proximal femur fractures between 1990 and 2007. Patients were grouped into those with a diagnosis of OUD, nonopioid drug use disorder, or neither. Demographic information and comorbidities were included in univariable and multivariable analyses to identify independent risk factors for perioperative outcomes.

Results:
A total of 8154 patients with a diagnosis of drug use disorder and 4704 patients with a diagnosis of OUD were identified from a cohort of 4,732,165 surgically treated proximal femur fractures. Patients with OUD were significantly younger (46 vs. 79), and a significantly smaller proportion of them had medical comorbidities (21.9% vs. 60.2%) when compared with the no drug misuse cohort. Patients with OUD had significantly more medical complications (51.1% vs. 26.8%), mechanical complications (3% vs. 0.3%), and adverse events (55% vs. 39.7%) when compared with the no drug misuse group. OUD had higher odds for leaving against medical advice [odds ratio (OR) 12.868, range 10.7771–15.375], for any adverse event (OR 4.107, range 3.869–4.360), and for mortality (OR 1.744, range 1.250–2.433) when compared with nondrug misusers.

Conclusions:
Despite being younger and with significantly less medical comorbidities, patients with OUD have higher odds for adverse events, leaving against medical advice, and mortality after surgical treatment of a hip fracture.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Effect of Blocking Screws on Union of Infraisthmal Femur Fractures Stabilized With a Retrograde Intramedullary Nail
Authors: Van Dyke Bryan , Colley Ryan , Ottomeyer Christina , Palmer Ryan , Pugh Kevin 
Published: January 2018

Objective:
To investigate the effect of blocking screws (BS) on the union rate and stability of infraisthmal femur fractures treated with retrograde intramedullary nail (RIMN) insertion.

Design:
Retrospective cohort study.

Setting:
A single level 1 trauma center.

Patients/Participants:
All patients with an infraisthmal femur fracture treated with a RIMN from 2005 to 2012 were included.

Intervention:
All fractures were treated with a RIMN. BS were used at the discretion of the treating surgeon.

Main Outcome Measurements:
(1) Radiographic time to union, (2) initial postoperative sagittal and coronal angulation, and (3) final sagittal and coronal angulation.

Results:
Neither the average time to union (BS 21.1 weeks vs. 21.8 weeks), nor union rates (BS 61% vs. 77%) were statistically different between BS and non-BS constructs. No significant alignment differences existed whether BS were used or not.

Conclusions:
In this study, we were not able to verify our hypothesis. In fact, we did not find any significant advantages when BS were added to a RIMN construct for distal femur fractures with respect to union time, union rate, or improvements in alignment. Additional studies are needed to determine the actual benefit of BS in the treatment of infraisthmal femoral shaft fractures treated with retrograde intramedullary nailing.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Rim Plate Augmentation of the Posterolateral Bare Area of the Tibial Plateau Using a 3.5-mm Precontoured Locking Compression Plate: A Cadaveric Study
Authors: Kim Youngwoo , Yoon Yong-Cheol , Cho Jae-Woo , Cho Won-Tae , Jeon Neung-Han , Oh Chang-Wug , Oh Jong-Keon 
Published: January 2018

Objective:
To evaluate the effectiveness of an additional rim plate [3.5-mm precontoured locking compression plate (LCP)] for stabilizing the posterolateral fragment in lateral tibial plateau fractures.

Methods:
Standard lateral locking plates [either a proximal tibial plate (PTP) or a proximal tibial locking plate (PTLP)] were applied to 40 matched pair knees from 20 fresh-frozen cadavers followed by the application of a secondary rim plate [variable angle LCP (VALCP)] posterior laterally.

Results:
The mean ratio of supported articular surface in the PTP group was 0.692, whereas that in the PTLP group was 0.569. This difference was statistically significant (P < 0.001). Additional rim plating with a VALCP could only be performed for 27 of 40 knees; 8 of 20 knees in the PTP group and 5 of 20 knees in the PTLP group could not be fitted with a VALCP due to anatomic limitations. For the total standard plating group alone, the mean ratio of supported articular surface was 0.596, whereas the mean ratio of supported articular surface with additional rim plating was 0.798 (P < 0.001). In contrast, additional rim plating was possible for more knees that received a PTLP than a PTP. Ultimately, there was no significant difference in the ratio of supported articular surface after additional rim plating between the 2 different types of standard plates (P = 0.087).

Conclusion:
Our results identified a bare area in the posterolateral corner of the lateral plateau that was unsupported by rafting screws following conventional, 3.5-mm, precontoured LCP plating. Thus, additional rim plating may be useful for treating plateau fractures with a posterolateral fragment.
Moxifloxacin in Pediatric Patients With Complicated Intra-abdominal Infections
Authors: Wirth Stefan , Emil Sherif G. S. , Engelis Arnis , Digtyar Valeri , Criollo Margarita , DiCasoli Carl , Stass Heino , Willmann Stefan , Nkulikiyinka Richard , Grossmann Ulrike 
Published: January 2018

Background:
This study was designed to evaluate primarily the safety and also the efficacy of moxifloxacin (MXF) in children with complicated intra-abdominal infections (cIAIs).

Methods:
In this multicenter, randomized, double-blind, controlled study, 451 pediatric patients aged 3 months to 17 years with cIAIs were treated with intravenous/oral MXF (N = 301) or comparator (COMP, intravenous ertapenem followed by oral amoxicillin/clavulanate; N = 150) for 5 to 14 days. Doses of MXF were selected based on the results of a Phase 1 study in pediatric patients (NCT01049022). The primary endpoint was safety, with particular focus on cardiac and musculoskeletal safety; clinical and bacteriologic efficacy at test of cure was also investigated.

Results:
The proportion of patients with adverse events (AEs) was comparable between the 2 treatment arms (MXF: 58.1% and COMP: 54.7%). The incidence of drug-related AEs was higher in the MXF arm than in the COMP arm (14.3% and 6.7%, respectively). No cases of QTc interval prolongation-related morbidity or mortality were observed. The proportion of patients with musculoskeletal AEs was comparable between treatment arms; no drug-related events were reported. Clinical cure rates were 84.6% and 95.5% in the MXF and COMP arms, respectively, in patients with confirmed pathogen(s) at baseline.

Conclusions:
MXF treatment was well tolerated in children with cIAIs. However, a lower clinical cure rate was observed with MXF treatment compared with COMP. This study does not support a recommendation of MXF for children with cIAIs when alternative more efficacious antibiotics with better safety profile are available.
Key Factors Leading to Program Selection: A Survey of Physician Assistant Program Interviewees
Authors: Sierra Talia , Forbes Jennifer , Mirly Alan , Domenech Rodríguez Melanie M. 
Published: January 2018

Purpose
The purpose of this study was to determine which factors had the greatest influence on physician assistant (PA) interviewees' decision to choose a PA program to attend. The information in this article may assist PA programs in making their program more attractive to potential applicants and also may help applicants identify programs that will best fit their needs.

Methods
Applicants who interviewed with a PA program were asked to rate 33 different influential factors when choosing a program to attend.

Results
Respondents most highly endorsed quality of faculty and staff, first-time Physician Assistant National Certifying Examination pass rates, and morale of faculty and staff. Results varied by demographics, including marital status, age, and sex of respondent. Results also varied from pre-PA students.

Conclusions
Although there are numerous factors involved in program selection, PA programs may want to focus on the quality and morale of their faculty and staff to help improve the likelihood of attracting and retaining the highest quality applicants.
Factors Influencing Physician Assistant Students' Attitudes Toward Deservingness of Care for Undocumented Mexicans
Authors: Bowen Denise J. , Mickus Maureen , Rosales Alma N. 
Published: January 2018

PurposeAttitudes regarding health-related deservingness of care for vulnerable patient populations can impact the quality of services provided. This study was aimed at identifying the influences that shape these attitudes among physician assistant (PA) students.MethodsThe study focused on PA students' perspectives toward care for a particularly vulnerable population, undocumented Mexican immigrants. An in-person survey was administered to first- and second-year PA students (n = 75). Multiple regression was used to assess whether familiarity, stereotyping, language skills, cultural preparedness, societal views, and background characteristics of PA students influenced attitudes toward deservingness of care.ResultsResults suggested that cultural preparedness among PA students was associated with positive views toward deservingness of both emergency services (β = 0.38,p< .001) and primary care (β = −0.211,p= .05) for undocumented Mexicans. Negative societal views toward this population predicted an unwillingness to endorse emergency care (β = −0.43,p< .001) and primary care (β = −0.45,p< .001).ConclusionsDemographic projections indicate continued trends toward increasingly diverse patient populations, with dramatic growth among Hispanics. The findings of this study suggest that greater cultural preparedness is needed for future PAs. Furthermore, strategies for increasing PA students' self-awareness of how their broader societal views shape service delivery are warranted to ensure equitable care.
Diabetes pathogenic mechanisms and potential new therapies based upon a novel target called TXNIP
Authors: Thielen Lance , Shalev Anath 
Published: January 2018

Purpose of review
Thioredoxin-interacting protein has emerged as a major factor regulating pancreatic β-cell dysfunction and death, key processes in the pathogenesis of type 1 and type 2 diabetes. Accumulating evidence based on basic, preclinical, and retrospective epidemiological research suggests that TXNIP represents a promising therapeutic target for diabetes. The present review is aimed at providing an update regarding these developments.

Recent findings
TXNIP has been shown to be induced by glucose and increased in diabetes and to promote β-cell apoptosis, whereas TXNIP deletion protected against diabetes. More recently, TXNIP inhibition has also been found to promote insulin production and glucagon-like peptide 1 signaling via regulation of a microRNA. β-Cell TXNIP expression itself was found to be regulated by hypoglycemic agents, carbohydrate-response-element-binding protein, and cytosolic calcium or the calcium channel blocker, verapamil. Retrospective studies now further suggest that verapamil use might be associated with a lower incidence of type 2 diabetes in humans.

Summary
TXNIP has emerged as a key factor in the regulation of functional β-cell mass and TXNIP inhibition has shown beneficial effects in a variety of studies. Thus, the inhibition of TXNIP may provide a novel approach to the treatment of diabetes.
The impact of myeloperoxidase on HDL function in myocardial infarction
Authors: Tietge Uwe J.F. 
Published: January 2018

Purpose of review
The focus in cardiovascular research is shifting from determining mass HDL cholesterol levels toward investigating HDL functionalities as biomarker for cardiovascular disease. Myeloperoxidase (MPO), a main effector enzyme of the innate immune system, is increasingly implicated to negatively impact HDL function by various chemical modifications of HDL-associated proteins. This review summarizes recent insights how MPO affects HDL function in the setting of acute myocardial infarction (MI), mainly focusing on human data.

Recent findings
First the mechanisms how MPO renders HDL particles dysfunctional and the usefulness of MPO as prospective biomarker for MI incidence and outcomes are described. Then the evidence for MPO causing specific HDL function impairments in MI and the clinical value of these observations is discussed in the context of the different HDL function assays employed.

Summary
MPO modification of HDL in acute MI generates dysfunctional HDL. Features of HDL dysfunction can be used to stratify MI patients and seem associated with outcomes. More prospective studies are warranted to explore, if MPO-modified HDL is causally linked to severity and outcomes of MI. If this could be established, MPO would represent an attractive target to improve HDL dysfunction in MI and provide clinical benefit for patients.
Familial hypercholesterolemia: experience from the French-Canadian population
Authors: Paquette Martine , Genest Jacques , Baass Alexis 
Published: January 2018

Purpose of reviewThere has recently been renewed interest in the study of the various facets of familial hypercholesterolemia, a severe monogenic disease associated with elevated LDL-cholesterol and premature cardiovascular disease (CVD). In the present review, novel data presenting the frequency of familial hypercholesterolemia as well as factors modulating the cardiovascular risk in familial hypercholesterolemia will be discussed.Recent findingsRecent studies have showed that familial hypercholesterolemia is much more prevalent than initially thought. Classically, it was estimated that familial hypercholesterolemia affected one in 500 people worldwide, but a recent large-scale meta-analysis has shown a prevalence closer to one in 250. In the French-Canadian population, this disease is even more frequent reaching one in 81 in certain regions of the Province of Quebec. Several novel studies in the French-Canadian population have shown that the clinical outcomes in familial hypercholesterolemia seem to be greatly influenced by risk factors other than LDL-cholesterol. Also, scores to predict CVD in familial hypercholesterolemia have been recently proposed.SummaryFamilial hypercholesterolemia is more frequent than initially thought and the phenotype of this disease can be variable. Indeed, both clinical and genetic variables can modulate the CVD risk in this population.
Genetics of familial hypercholesterolemia: a tool for development of novel lipid lowering pharmaceuticals?
Authors: Volta Andrea , Hovingh G. Kees , Grefhorst Aldo 
Published: January 2018

Purpose of review
Familial hypercholesterolemia is characterized by high LDL cholesterol and an elevated risk to develop coronary heart disease. Mutations in LDL receptor-mediated cholesterol uptake are the main cause of familial hypercholesterolemia. However, multiple mutations in various other genes are also associated with high LDL cholesterol and even familial hypercholesterolemia. Thus, pharmaceuticals that target these genes and proteins might be attractive treatment options to reduce LDL cholesterol. This review provides an overview of the recent developments and clinical testing of such pharmaceuticals.

Recent findings
About 80 genes are associated with hypercholesterolemia but only pharmaceuticals that inhibit cholesteryl ester transfer protein (CETP), angiopoietin-related protein 3 (ANGPTL3), and apolipoprotein C-III (apoC-III) have recently been tested in clinical trials. Inhibition of CETP and ANGPTL3 lowered LDL cholesterol. ANGPTL3 inhibition had the largest effect and was even effective in familial hypercholesterolemia patients. The effect of apoC-III inhibition on LDL cholesterol is not conclusive.

Summary
Of the many potential pharmaceutical targets involved in LDL cholesterol, only a few have been studied so far. Of these, pharmaceuticals that inhibit CETP or ANGPTL3 are promising novel treatment options to reduce LDL cholesterol but the effect of apoC-III inhibition requires more research.
Using Time-Referenced Data to Assess Medication Administration Performance and Quality
Authors: Welton John M. , Kleiner Catherine , Valdez Carolyn , Richardson Sara , Boyle Kathy , Lucas Eric 
Published: January 2018

OBJECTIVE
This study tests the feasibility of using a large (big) clinical data set to test the ability to extract time-referenced data related to medication administration to identify late doses and as-needed (PRN) administration patterns by RNs in an inpatient setting.

METHODS
The study is a secondary analysis of a set of data using bar-code medication administration time stamps (n = 3043812) for 50883 patients admitted to a single, urban, 525-bed hospital in 11 inpatient units by 714 nurses between April 1, 2013, and March 31, 2015.

RESULTS
The large majority of scheduled medications (43.3%) were administered between 9 to 10 AM and 9 to 10 pm accounting for the most amount of delayed doses. On average, patients received 8.9 medications per day, and nurses administered 19.7 medications per shift. The average full-time nurse administered 3414 medications per year.

CONCLUSIONS
The findings support use of time-referenced data to identify clinical processes and performance in administering scheduled and PRN medications.
Muscular Strength Is Associated with Higher Intraocular Pressure in Physically Active Males
Authors: Vera Jesús , Jiménez Raimundo , García-Ramos Amador , Cárdenas David 
Published: January 2018

SIGNIFICANCE
The positive association between intraocular pressure (IOP) and relative maximum force may have relevance for exercise recommendations when IOP is a concern.

PURPOSE
The relationship between exercise and IOP has been approached in several studies. However, the influence of muscle function on IOP remains underexplored. This study aimed to determine the relationship between the maximal mechanical capabilities of muscles to generate force, velocity, and power with IOP.

METHODS
Sixty-five physically active males participated in this cross-sectional study. Baseline IOP measures were obtained by rebound tonometry, and participants performed an incremental loading test in the ballistic bench press.

RESULTS
Baseline IOP showed a strong positive correlation with relative maximum force (r
65 = 0.85, P < .001) relative maximum power (r
65 = 0.85, P < .001), and relative one-repetition maximum (r
65 = 0.91, P < .001). Also, a moderate positive association was obtained between baseline IOP and maximum force (r
65 = 0.74, P < .001), maximum power (r
65 = 0.72, P < .001), and maximum dynamic strength (r
65 = 0.80, P < .001). No significant correlations between IOP and maximal velocity were obtained (all P > .05).

CONCLUSIONS
There is a positive association between greater upper-body power and strength with higher baseline IOP, which might have important implications in the management of ocular health and especially in individuals constantly involved in resistance training programs (e.g., military personnel, weightlifters). The possible protective effect of high fitness level on the acute IOP response to strength exercise needs to be addressed in future studies.
Electronic Communication in Plastic Surgery: Guiding Principles from the American Society of Plastic Surgeons Health Policy Committee
Authors: Eberlin Kyle R. , Perdikis Galen , Damitz Lynn , Krochmal Dan J. , Kalliainen Loree K. , Bonawitz Steven C. 
Published: January 2018

Background:
With the advancement of technology, electronic communication has become an important mode of communication within plastic and reconstructive surgery. This can take the form of e-mail, text messaging, video conferencing, and social media, among others. There are currently no defined American Society of Plastic Surgeons guidelines for appropriate professional use of these technologies.

Methods:
A search was performed on PubMed and the Cochrane database; terms included “telemedicine,” “text messaging,” “HIPAA,” “metadata,” “video conferencing,” “photo sharing,” “social media,” “Facebook,” “Twitter,” and “Instagram.” Initial screening of all identified articles was performed; the level of evidence, limitations, and recommendations were evaluated and articles were reviewed.

Results:
A total of 654 articles were identified in the level I screening process; after more comprehensive review, 41 articles fit inclusion criteria: social networking, 12; telemedicine, 11; text messaging, 10; metadata, four; video conferencing, three; and Health Insurance Portability and Accountability Act, one. General themes were identified from these articles and guidelines proposed.

Conclusion:
Electronic communication can provide an efficient method of information exchange for professional purposes within plastic surgery but should be used thoughtfully and with all professional, legal, and ethical considerations.
Effect of Cryopreservation on Human Adipose Tissue and Isolated Stromal Vascular Fraction Cells: In Vitro and In Vivo Analyses
Authors: Zanata Fabiana , Bowles Annie , Frazier Trivia , Curley J. Lowry , Bunnell Bruce A. , Wu Xiying , Wade James , Devireddy Ram , Gimble Jeffrey M. , Ferreira Lydia Masako 
Published: January 2018

Background:Adipose tissue is a source of adipose-derived stromal/stem cells for tissue engineering and reconstruction and a tissue source for fat grafts. Although liposuction is a simple procedure for the harvest of adipose tissue, the repetition of this surgical intervention can cause adverse effects to the patient and can be a limiting factor for immediate use. Cryopreservation can avoid the morbidity associated with repetitive liposuction, allowing the use of stored tissue after the initial harvest procedure. This article focuses on the characterization of fresh and cryopreserved human adipose tissue.Methods:Lipoaspirates from eight donors were processed as fresh adipose tissue or cryopreserved for 4 to 6 weeks. Fresh and cryopreserved tissues were collagenase digested and the stromal vascular fraction cells were characterized immediately or cryopreserved. Characterization was based on stromal vascular fraction cell proliferation and immunophenotype. In vivo fat grafting was performed in C57BL/6 green fluorescent protein mice to analyze morphology of the tissue and its adiposity using confocal microscopy, histochemical staining (i.e., hematoxylin and eosin and Masson trichrome), and immunohistochemistry (i.e., green fluorescent protein, perilipin, and CD31).Results:Although tissue and stromal vascular fraction cell cryopreservation reduced the total cell yield, the remaining viable cells retained their adhesive and proliferative properties. The stromal vascular fraction cell immunophenotype showed a significant reduction in the hematopoietic surface markers and increased expression of stromal and adipogenic markers following cryopreservation. In vivo cryopreserved fat grafts showed morphology similar to that of freshly implanted fat grafts.Conclusion:In this study, the authors demonstrated that cryopreserved adipose tissue is a potential source of stromal vascular fraction cells and a suitable source for fat grafts.