bluuebunny/crossref_metadata_2025_split huggingface dataset:
Will they participate? Predicting patients’ response to clinical trial invitations in a pediatric emergency department
Authors: Ni Yizhao , Beck Andrew F , Taylor Regina , Dyas Jenna , Solti Imre , Grupp-Phelan Jacqueline , Dexheimer Judith W 
Published: April 2016

AbstractObjective (1) To develop an automated algorithm to predict a patient’s response (ie, if the patient agrees or declines) before he/she is approached for a clinical trial invitation; (2) to assess the algorithm performance and the predictors on real-world patient recruitment data for a diverse set of clinical trials in a pediatric emergency department; and (3) to identify directions for future studies in predicting patients’ participation response.Materials and Methods We collected 3345 patients’ response to trial invitations on 18 clinical trials at one center that were actively enrolling patients between January 1, 2010 and December 31, 2012. In parallel, we retrospectively extracted demographic, socioeconomic, and clinical predictors from multiple sources to represent the patients’ profiles. Leveraging machine learning methodology, the automated algorithms predicted participation response for individual patients and identified influential features associated with their decision-making. The performance was validated on the collection of actual patient response, where precision, recall, F-measure, and area under the ROC curve were assessed.Results Compared to the random response predictor that simulated the current practice, the machine learning algorithms achieved significantly better performance (Precision/Recall/F-measure/area under the ROC curve: 70.82%/92.02%/80.04%/72.78% on 10-fold cross validation and 71.52%/92.68%/80.74%/75.74% on the test set). By analyzing the significant features output by the algorithms, the study confirmed several literature findings and identified challenges that could be mitigated to optimize recruitment.Conclusion By exploiting predictive variables from multiple sources, we demonstrated that machine learning algorithms have great potential in improving the effectiveness of the recruitment process by automatically predicting patients’ participation response to trial invitations.
Core informatics competencies for clinical and translational scientists: what do our customers and collaborators need to know?
Authors: Valenta Annette L , Meagher Emma A , Tachinardi Umberto , Starren Justin 
Published: April 2016

Abstract
Since the inception of the Clinical and Translational Science Award (CTSA) program in 2006, leaders in education across CTSA sites have been developing and updating core competencies for Clinical and Translational Science (CTS) trainees. By 2009, 14 competency domains, including biomedical informatics, had been identified and published. Since that time, the evolution of the CTSA program, changes in the practice of CTS, the rapid adoption of electronic health records (EHRs), the growth of biomedical informatics, the explosion of big data, and the realization that some of the competencies had proven to be difficult to apply in practice have made it clear that the competencies should be updated. This paper describes the process undertaken and puts forth a new set of competencies that has been recently endorsed by the Clinical Research Informatics Workgroup of AMIA. In addition to providing context and background for the current version of the competencies, we hope this will serve as a model for revision of competencies over time.
Hemorrhagic-Induced Cardiovascular Complications During Reamer–Irrigator–Aspirator-Assisted Femoral Nonunion Treatment
Authors: Donders Johanna C. E. , Baumann Holger M. , Stevens Markus F. , Kloen Peter 
Published: April 2016

Summary:
The reamer–irrigator–aspirator (RIA) is a device that has recently been developed to retrieve bone graft from the medullary canal of the femur and the tibia. As for most new surgical procedures, complications arise as part of the learning curve and/or imperfections in the design or technique. To increase awareness of potential complications and to prevent unnecessary harm to the patient, new complications need to be reported. We present case reports of 2 patients who developed severe intraoperative cardiac events presumably caused by excessive and rapid blood loss during RIA bone graft harvesting. This complication has not been described before. Increased awareness of excessive blood loss and subsequent cardiac events during an RIA procedure is warranted.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Culture-Negative Infection After Operative Fixation of Fractures
Authors: Gitajn Ida L. , Heng Marilyn , Weaver Michael J. , Ehrlichman Lauren K. , Harris Mitchel B. 
Published: April 2016

Objectives:
(1) Compare the outcomes of patients with orthopaedic trauma with culture-negative infection with those with pathogens identified; (2) identify the incidence of culture-negative infection and describe the common characteristics.

Design:
Retrospective study.

Setting:
Two level 1 trauma centers.

Patients:
A total of 391 patients 16 years of age or older who underwent irrigation and debridement for surgical site infection after having undergone fracture fixation were included.

Intervention:
Patients underwent irrigation and debridement with cultures, and antibiotic therapy was initiated.

Main Outcome Measurement:
Treatment failure due to unsuccessful eradication of infection and time to union.

Results:
We found 9% incidence of culture-negative infection. Approximately one-third of patients in both groups went on to have treatment failure (25% of pathogen-specific infections, 38% of culture-negative infections, P = 0.15), and there was no difference between the 2 groups with regard to time to union (22 vs. 24 weeks, P = 0.55). More than one-third of patients required subsequent reconstructive procedure and 5% of patients in each group required amputation to control their infection. There was no difference between the groups with respect to the use of antibiotics before intervention and culture.

Conclusion:
This study confirms the devastating effect that postoperative infections can have and suggests that, with clinical sign of infection, negative cultures do not portend a better prognosis. These entities should be treated in a similar manner to infections with positive cultures. Furthermore, we believe that future studies should not strictly rely on the presence of positive intraoperative cultures. Consensus as to what constitutes a clinical infection, in the absence of positive cultures, is needed.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Embryologic and Fetal Development of the Human Eyelid
Authors: Tawfik Hatem A. , Abdulhafez Mohamed H. , Fouad Yousef A. , Dutton Jonathan J. 
Published: April 2016

Purpose:
To review the recent data about eyelid morphogenesis, and outline a timeline for eyelid development from the very early stages during embryonic life till final maturation of the eyelid late in fetal life.

Methods:
The authors extensively review major studies detailing human embryologic and fetal eyelid morphogenesis. These studies span almost a century and include some more recent cadaver studies. Numerous studies in the murine model have helped to better understand the molecular signals that govern eyelid embryogenesis. The authors summarize the current findings in molecular biology, and highlight the most significant studies in mice regarding the multiple and interacting signaling pathways involved in regulating normal eyelid morphogenesis.

Results:
Eyelid morphogenesis involves a succession of subtle yet strictly regulated morphogenetic episodes of tissue folding, proliferation, contraction, and even migration, which may occur simultaneously or in succession.

Conclusions:
Understanding the extraordinary process of building eyelid tissue in embryonic life, and deciphering its underlying signaling machinery has far reaching clinical implications beyond understanding the developmental abnormalities involving the eyelids, and may pave the way for achieving scar-reducing therapies in adult mammalian wounds, or control the spread of malignancies.
Listeria monocytogenes and Prosthetic Valve Endocarditis
Authors: Best Ryan , Bhagirath Kapil M. , Pearce Stephen , Jassal Davinder S. 
Published: April 2016

Abstract
We report the case of a 77-year-old man presenting with bioprosthetic aortic valve endocarditis and an aortic root abscess caused by Listeria monocytogenes. The clinical presentation, treatment, and outcomes of prosthetic valve endocarditis caused by L. monocytogenes are reviewed.
Hemodynamic Bedside Ultrasound Image Quality and Interpretation After Implementation of a Training Curriculum for Pediatric Critical Care Medicine Providers*
Authors: Conlon Thomas W. , Ishizuka Maki , Himebauch Adam S. , Cohen Meryl S. , Berg Robert A. , Nishisaki Akira 
Published: April 2016

Objective:
Bedside ultrasound for hemodynamic evaluation in critically ill children is increasingly recognized as an important skill for pediatric critical care medicine providers. Our institution implemented a training curriculum leading to institutional credentialing for pediatric critical care providers in nonprocedural bedside ultrasound core applications. We hypothesized that hemodynamic studies performed or supervised by credentialed providers (credentialed providers group) have better image quality and greater accuracy in interpretation than studies performed by non–credentialed providers without supervision (non–credentialed providers group).

Design:
Retrospective descriptive study.

Setting:
Single-center tertiary non-cardiac 55-bed PICU in a children’s hospital.

Patients:
Patients from October 2013 to January 2015, with hemodynamic bedside ultrasound performed and interpreted by pediatric critical care providers exposed to bedside ultrasound training.

Interventions:
A cardiologist blinded to performer scored hemodynamic bedside ultrasound image quality for five core cardiac views (excellent = 3, good = 2, fair = 1, unacceptable = 0; median = quality score) and interpretation within 5 hemodynamic domains (agreement = 3, minor disagreement = 2, major disagreement = 1; median = interpretation score), as well as a global assessment of interpretation.

Measurements and Main Results:
Eighty-one studies (45 in the credentialed providers group and 36 in the non–credentialed providers group) were evaluated. There was no statistically significant difference in quality score between groups (median: 1.4 [interquartile range: 0.8–1.8] vs median: 1.2 [interquartile range: 0.75–1.6]; p = 0.14]. Studies in the credentialed providers group had higher interpretation score than those in the non–credentialed providers group (median: 3 [interquartile range: 2.5–3) vs median: 2.67 [interquartile range: 2.25–3]; p = 0.04). Major disagreement between critical care provider and cardiology review occurred in 25 of 283 hemodynamic domains assessed (8.8%), with no statistically significant difference between credentialed providers and non–credentialed providers groups (6.1% vs 11.9%; p = 0.12).

Conclusion:
Hemodynamic bedside ultrasound performed or supervised by credentialed pediatric critical care providers had more accurate interpretation than studies performed by unsupervised non–credentialed providers. A rigorous pediatric critical care medicine bedside ultrasound credentialing program can train intensivists to attain adequate images and interpret those images appropriately.
The Blood Supply of the Breast Revisited
Authors: van Deventer Petrus V. , Graewe Frank R. 
Published: April 2016

Background:
Many surgeons are under the impression that the blood supply is clearly defined in textbooks. Unfortunately, the majority of textbooks supply inadequate information and illustrations can be misleading in many instances. None of the textbooks describe a segmental pattern of blood supply when in actual fact a basic segmental pattern does exist. The reason for inadequate information is the perpetuation of facts since the work of the pioneers Cooper and Manchot from one textbook to another. A paucity of research studies thereafter and the fact that the results of some of these studies did not find their way into textbooks is another contributing factor.

Methods:
The findings of research studies since the descriptions by Cooper and Manchot are analyzed and compared in an effort to find common ground and its clinical implication.

Results:
Researchers concurred on the main sources of blood supply; these are internal thoracic, lateral thoracic, anterior intercostal, and acromiothoracic (thoracoacromial) arteries. However, the different research studies showed considerable variation in the branches from the main sources to supply the nipple-areola complex.

Conclusions:
Even though the locations of the main sources of blood supply are constant, partial or complete absence of branches from the main sources does occur and therefore the blood supply to the nipple-areola complex is unpredictable. Cognizance of the basic segmental pattern and the variations resulting from embryologic development will be helpful for the surgeon to use or adapt a technique to minimize the risk of nipple necrosis.
Objective Assessment of the Interfrontal Angle for Severity Grading and Operative Decision-Making in Metopic Synostosis
Authors: Anolik Rachel A. , Allori Alexander C. , Pourtaheri Navid , Rogers Gary F. , Marcus Jeffrey R. 
Published: April 2016

Background:
The purpose of this study was to evaluate the utility of a previously validated interfrontal angle for classification of severity of metopic synostosis and as an aid to operative decision-making.

Methods:
An expert panel was asked to study 30 cases ranging from minor to severe metopic synostosis. Based on computed tomographic images of the skull and clinical photographs, they classified the severity of trigonocephaly (1 = normal, 2 = mild, 3 = moderate, and 4 = severe) and management (0 = nonoperative and 1 = operative). The severity scores and management reported by experts were then pooled and matched with the interfrontal angle computed from each respective computed tomographic scan. A threshold was identified at which most experts agree on operative management.

Results:
Expert severity scores were higher for more acute interfrontal angles. There was a high concordance at the extremes of classifications, severe (4) and normal (1) (p < 0.0001); however, between interfrontal angles of 114.3 and 136.1 degrees, there exists a “gray zone,” with severe discordance in expert rankings. An operative threshold of 118.2 degrees was identified, with the interfrontal angle able to predict the expert panel’s decision to proceed with surgery 87.6 percent of the time.

Conclusions:
The interfrontal angle has been previously validated as a simple, accurate, and reproducible means for diagnosing trigonocephaly, but must be obtained from computed tomographic data. In this article, the authors demonstrate that the interfrontal angle can be used to further characterize the severity of trigonocephaly. It also correlated with expert decision-making for operative versus nonoperative management. This tool may be used as an adjunct to clinical decision-making when the decision to proceed with surgery may not be straightforward.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Diagnostic, V.
Perioperative Corneal Abrasion: Updated Guidelines for Prevention and Management
Authors: Malafa Menyoli M. , Coleman Jayne E. , Bowman R. Wayne , Rohrich Rod J. 
Published: April 2016

Summary:Corneal abrasion is the most common ocular complication in surgery. Treatment requires pain control, antimicrobial prophylaxis, and close monitoring. Pain improves significantly after 24 hours and should be resolved by 48 hours. Persistent, worsening, or new symptoms warrant immediate specialist consultation. The authors review the pathophysiology of perioperative corneal abrasion, and propose updated evidence-based guidelines for improved patient care.
Total Face, Eyelids, Ears, Scalp, and Skeletal Subunit Transplant Cadaver Simulation: The Culmination of Aesthetic, Craniofacial, and Microsurgery Principles
Authors: Sosin Michael , Ceradini Daniel J. , Hazen Alexes , Levine Jamie P. , Staffenberg David A. , Saadeh Pierre B. , Flores Roberto L. , Brecht Lawrence E. , Bernstein G. Leslie , Rodriguez Eduardo D. 
Published: April 2016

Background:
The application of aesthetic, craniofacial, and microsurgical principles in the execution of face transplantation may improve outcomes. Optimal soft-tissue face transplantation can be achieved by incorporating subunit facial skeletal replacement and subsequent tissue resuspension. The purpose of this study was to establish a reconstructive solution for a full face and scalp burn and to evaluate outcome precision and consistency.

Methods:
Seven mock face transplants (14 cadavers) were completed in the span of 1 year. Components of the vascularized composite allograft included the eyelids, nose, lips, facial muscles, oral mucosa, total scalp, and ears; and skeletal subunits of the zygoma, nasal bone, and genial segment. Virtual surgical planning was used for osteotomy selection, and to evaluate postoperative precision of hard- and soft-tissue elements.

Results:
Each transplant experience decreased each subsequent transplant surgical time. Prefabricated cutting guides facilitated a faster dissection of both donor and recipient tissue, requiring minimal alteration to the allograft for proper fixation of bony segments during inset. Regardless of donor-to-recipient size discrepancy, ample soft tissue was available to achieve tension-free allograft inset. Differences between virtual transplant simulation and posttransplant measurements were minimal or insignificant, supporting replicable and precise outcomes.

Conclusions:
This facial transplant model was designed to optimize reconstruction of extensive soft-tissue defects of the craniofacial region representative of electrical, thermal, and chemical burns, by incorporating skeletal subunits within the allograft. The implementation of aesthetic, craniofacial, and microsurgical principles and computer-assisted technology improves surgical precision, decreases operative time, and may optimize function.
Anthropometric Outcomes following Fronto-Orbital Advancement for Metopic Synostosis
Authors: Patel Kamlesh B. , Skolnick Gary B. , Mulliken John B. 
Published: April 2016

Background:
The authors’ purpose is to present changes in anthropometric fronto-orbital dimensions after surgical correction of metopic synostosis.

Methods:
The authors retrospectively analyzed craniometric dimensions in older patients with metopic synostosis corrected by fronto-orbital advancement performed by the senior author (J.B.M.). Preoperative and postoperative linear measures (frontal breadth, cranial width, and intercanthal distance) were taken by direct anthropometry. Interdacryon distance and width of the bandeau were also recorded intraoperatively, before and after widening. Follow-up anthropometric values were compared to age- and sex-matched normative data and standard (z) scores were calculated.

Results:
Sixteen patients met the inclusion criteria. Syndromic diagnosis was documented in five of 16 patients. Average age at the last postoperative evaluation was 8.9 ± 3.8 years (range, 4 to 16 years). Mean frontal width z-scores decreased postoperatively from 0.82 to –0.32 (p = 0.007), indicating diminished growth in this dimension. The last measured frontal width strongly correlated with the breadth of the bandeau after surgical correction but not with preoperative values. Postoperative mean cranial width diminished significantly to a more normal value. Mean intercanthal distance was normal preoperatively and remained so but was significantly greater in syndromic than in nonsyndromic cases.

Conclusions:
Frontal growth rate is diminished in the coronal plane after fronto-orbital advancement. The authors recommend primary techniques to overcorrect the width of the bandeau and frontal region, including zygomaticosphenoid osteotomies and interpositional cranial bone grafts to advance/widen the lateral orbital rim. Continued evaluation is required to assess whether overcorrection results in normal frontotemporal shape and breadth at skeletal maturity.
Management of the Postbariatric Medial Thigh Deformity
Authors: Capella Joseph F. , Matarasso Alan 
Published: April 2016

Background:
Thigh contour deformities—in particular, those of the medial thighs—are a common concern for many individuals seeking body contouring. Despite the frequency of this concern, some plastic surgeons have often been reluctant to embrace the medial thigh-lift procedure because of the risk for significant complications and relatively poor results. The authors’ approach to medial thigh contouring is to address the variables outside of the medial thighs affecting the medial thighs before considering a medial thigh-lift procedure with a vertical component. In this article, the authors review the senior author’s (J.F.C.) experience of 350 vertical medial thigh lifts in the weight-loss patient.

Methods:
The charts of 350 consecutive individuals who had undergone vertical medial thigh lifts were reviewed for complications and other variables. The procedures were all performed by the senior author between February of 2000 and February of 2014. The preoperative markings, current surgical technique, and postoperative care are described.

Results:
There were 326 women and 24 men in the study, with an average age of 43 years. The overall complication rate was 45.14 percent. Skin dehiscence and seroma formation were the most frequent complications, at 31.14 percent and 18.18 percent, respectively. The vast majority of patients were pleased with the aesthetic and functional results of their surgery.

Conclusion:
The medial thigh deformities of the weight-loss patient are effectively addressed by a vertical medial thigh lift when the variables adjacent to the medial thighs are first treated by a body lift.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Report of two paediatric cases of central line infections caused by species of the genus Kocuria
Authors: Bhavsar Sejal Makvana , Hamula Camille L. , Dingle Tanis C. 
Published: April 2016

Introduction:
Species of the genus Kocuria are Gram-positive cocci of the family Micrococcacceae that are ubiquitous in the environment and part of the normal skin and oral flora in humans. A paucity of cases have been reported of Kocuria as human pathogens and there are currently no evidence-based guidelines for managing these uncommon infections.

Case presentation:
We present two paediatric cases of central line infections with species of the genus Kocuria that required line removal despite antimicrobial therapy.

Conclusion:
Species of the genus Kocuria are uncommon human pathogens that have rarely been reported to cause opportunistic infections in both adult and paediatric populations. The cases presented here add to the growing body of literature documenting the pathogenicity of these organisms and the possible need for line removal to achieve clinical cure in central line-associated bacteraemia caused by species of the genus Kocuria.