bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skill sets required for the management of military head, face and neck trauma: a multidisciplinary consensus statement
Authors: Breeze John , Blanch R , Baden J , Monaghan A M , Evriviades D , Harrisson S E , Roberts S , Gibson A , MacKenzie N , Baxter D , Gibbons A J , Heppell S , Combes J G , Rickard R F 
Published: January 2018

IntroductionThe evolution of medical practice is resulting in increasing subspecialisation, with head, face and neck (HFN) trauma in a civilian environment usually managed by a combination of surgical specialties working as a team. However, the full combination of HFN specialties commonly available in the NHS may not be available in future UK military-led operations, necessitating the identification of a group of skill sets that could be delivered by one or more deployed surgeons.MethodA systematic review was undertaken to identify those surgical procedures performed to treat acute military head, face, neck and eye trauma. A multidisciplinary consensus group was convened following this with military HFN trauma expertise to define those procedures commonly required to conduct deployed, in-theatre HFN surgical combat trauma management.ResultsHead, face, neck and eye damage control surgical procedures were identified as comprising surgical cricothyroidotomy, cervico-facial haemorrhage control and decompression of orbital haemorrhage through lateral canthotomy. Acute in-theatre surgical skills required within 24 hours consist of wound debridement, surgical tracheostomy, decompressive craniectomy, intracranial pressure monitor placement, temporary facial fracture stabilisation for airway management or haemorrhage control and primary globe repair. Delayed in-theatre procedures required within 5 days prior to predicted evacuation encompass facial fracture fixation, delayed lateral canthotomy, evisceration, enucleation and eyelid repair.ConclusionsThe identification of those skill sets required for deployment is in keeping with the General Medical Council’s current drive towards credentialing consultants, by which a consultant surgeon’s capabilities in particular practice areas would be defined. Limited opportunities currently exist for trainees and consultants to gain experience in the management of traumatic head, face, neck and eye injuries seen in a kinetic combat environment. Predeployment training requires that the surgical techniques described in this paper are covered and should form the curriculum of future military-specific surgical fellowships. Relevant continued professional development will be necessary to maintain required clinical competency.
Non-Markovian dynamics from band edge effects and static disorder
Authors: Lorenzo Salvatore , Ciccarello Francesco , Palma G. Massimo 
Published: January 2018

It was recently shown [S. Lorenzo, F. Lombardo, F. Ciccarello and M. Palma, Sci. Rep. 7 (2017) 42729] that the presence of static disorder in a bosonic bath — whose normal modes thus become all Anderson-localized — leads to non-Markovianity in the emission of an atom weakly coupled to it (a process which in absence of disorder is fully Markovian). Here, we extend the above analysis beyond the weak-coupling regime for a finite-band bath so as to account for band edge effects. We study the interplay of these with static disorder in the emergence of non-Markovian behavior in terms of a suitable non-Markovianity measure.
Sex-Based Assessment of Patient Presentation, Lesion Characteristics, and Treatment Modalities in Patients Undergoing Peripheral Vascular Intervention
Authors: Ramkumar Niveditta , Suckow Bjoern D. , Brown Jeremiah R. , Sedrakyan Art , Cronenwett Jack L. , Goodney Philip P. 
Published: January 2018

Background—
Limited evidence suggests that women and men might be treated differently for peripheral arterial disease. This analysis evaluated sex-based differences in disease presentation and its effect on treatment modality among patients who underwent endovascular treatment for peripheral arterial disease.

Methods and Results—

Using national registry data from the Vascular Quality Initiative between 2010 and 2013, we examined patient, limb, and artery characteristics by sex through descriptive statistics. We studied 26 750 procedures performed in 23 820 patients to treat 30 545 limbs and 44 804 arteries. Women presented at an older age (69 versus 67 years;
P
<0.001) and were less often current or former smokers (72% versus 85%;
P
<0.001). Transatlantic Inter-Society Consensus classification was similar among men and women (Transatlantic Inter-Society Consensus C or D: 37% in men versus 37% in women;
P
=0.81), as was mean occlusion length (4.5 cm in men versus 4.6 cm in women;
P
=0.04), even after accounting for lesion location. Women more frequently underwent treatment for rest pain (11% in men versus 16% in women;
P
<0.001) versus claudication (59% in men versus 53% in women;
P
<0.001) or tissue loss (28% in men versus 27% in women;
P
=0.75). Treatment modality did not differ by sex but was associated with disease severity (
P
for trend <0.001) and lesion location (
P
for trend <0.001).

Conclusions—
Women undergo peripheral endovascular intervention for peripheral arterial disease at an older age with critical limb ischemia. Treatment modalities do not vary by sex but are determined by disease severity and site. Although there exist sex differences in presentation, these differences do not lead to differential treatment for women with peripheral arterial disease.
Prior Authorization Requirements for Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors Across US Private and Public Payers
Authors: Doshi Jalpa A. , Puckett Justin T. , Parmacek Michael S. , Rader Daniel J. 
Published: January 2018

Background:
Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) are an innovative treatment option for patients with familial hypercholesterolemia or clinical atherosclerotic cardiovascular disease who require further lowering of low-density lipoprotein cholesterol. However, the high costs of these agents have spurred payers to implement utilization management policies to ensure appropriate use. We examined prior authorization (PA) requirements for PCSK9is across private and public US payers.

Methods and Results:
We conducted an analysis of 2016 formulary coverage and PA data from a large, proprietary database with information on policies governing >95% of Americans with prescription drug coverage (275.3 million lives) within 3872 plans across the 4 major insurance segments (commercial, health insurance exchange, Medicare, and Medicaid). The key measures included administrative PA criteria (prescriber specialty, number of criteria in PA policy or number of fields on PA form, requirements for medical record submission, reauthorization requirements) and clinical/diagnostic PA criteria (approved conditions, required laboratories or other tests, required concomitant therapy, step therapy requirements, continuation criteria) for each of 2 Food and Drug Administration–approved PCSK9is. Select measures (eg, number of PA criteria/fields, medical record submission requirements) were obtained for 2 comparator cardiometabolic drugs (ezetimibe and liraglutide). Between 82% and 97% of individuals were enrolled in plans implementing PA for PCSK9is (depending on insurance segment), and one third to two thirds of these enrollees faced PAs restricting PCSK9i prescribing to a specialist. For patients with familial hypercholesterolemia, diagnostic confirmation via genetic testing or meeting minimum clinical scores/criteria was also required. PA requirements were more extensive for PCSK9is as compared with the other cardiometabolic drugs (ie, contained 3×–11× the number of PA criteria or fields on PA forms and more frequently involved the submission of medical records as supporting documentation).

Conclusions:
PA requirements for PCSK9is are greater than for selected other drugs within the cardiometabolic disease area, raising concerns about whether payer policies to discourage inappropriate use may also be restricting access to these drugs in patients who need them.
Feasibility study of a human papillomavirus E6 and E7 oncoprotein test for the diagnosis of cervical precancer and cancer
Authors: Zhang Jin-Jun , Cao Xin-Chun , Zheng Xiang-Yu , Wang Hai-Ying , Li Yong-Wei 
Published: January 2018

Objective To evaluate the clinical value of human papillomavirus (HPV) E6 and E7 oncoprotein (HPV E6/E7) detection in the early screening of cervical cancer. Methods This prospective study evaluated all patients with suspected cervical intraepithelial neoplasia (CIN) as identified by the presence of at least one positive indicator from a ThinPrep cytologic test (TCT) and/or a Hybrid Capture 2 (HC2) HPV DNA test. The levels of E6/E7 oncoproteins were determined using Western blot analysis. The diagnostic value of the HPV E6/E7 protein assay was compared with the clinical diagnosis from TCT, HC2 and the gold standard of cervical biopsy histology. Results A total of 450 patients were enrolled in the study and based on histological findings, 102 patients were diagnosed with CIN1 (22.7%), 241 with CIN2 (53.6%), 96 with CIN3 (21.3%) and 11 with squamous cell carcinoma (2.4%). For a diagnosis of CIN2+, although the sensitivity of the HPV E6/E7 assay was lower than HC2 (65.5% versus 96.6%, respectively), the specificity was higher (38.2% versus 5.9%, respectively). The sensitivity of the HPV E6/E7 assay was higher than TCT (65.5% versus 36.2%, respectively). Conclusion Measuring HPV E6/E7 oncoprotein levels is a potential new biomarker for HPV type 16.
Association of advanced glycation end products, evaluated by skin autofluorescence, with lifestyle habits in a general Japanese population
Authors: Isami Fumiyuki , West Brett J. , Nakajima Sanae , Yamagishi Sho-ichi 
Published: January 2018

Objective Accumulation of advanced glycation end products (AGEs) occurs during normal aging but markedly accelerates in people with diabetes. AGEs may play a role in various age-related disorders. Several studies have demonstrated that skin autofluorescence (SAF) reflects accumulated tissue levels of AGEs. However, very few studies have investigated SAF in the general population. The purpose of the present study was to more thoroughly evaluate the potential association among SAF, chronological age, and lifestyle habits in the general population. Methods A large cross-sectional survey of 10,946 Japanese volunteers aged 20 to 79 years was conducted. Volunteers completed a self-administered questionnaire and underwent SAF measurement on their dominant forearms. The associations of SAF with age and lifestyle habits were analyzed using a multiple stepwise regression analysis. Results Age was independently correlated with SAF. Lifestyle habits such as physical activity, nonsmoking, adequate sleep, low mental stress level, eating breakfast, and abstaining from sugary food were each independently associated with lower SAF. Conclusions SAF was associated with age and healthy lifestyle habits in this general Japanese population. The present study suggests that SAF measurement is a convenient tool for evaluating habitual lifestyle behaviors and may have potential for preventative health education.
Bilirubin Removal from Albumin - Containing Solution by Adsorption on Polymer Resin
Authors: Annesini M.C. , Di Paola L. , Marrelli L. , Piemonte V. , Turchetti L. 
Published: January 2018

Adsorption equilibrium of bilirubin onto polymeric resins is studied. Solutions containing albumin are used in order to simulate the behavior of systems for removal of albumin-bound substances from blood, serum or dialysis fluids. The effect of albumin pre-loading on the resin is also analysed. Results are explained by a chemically based model that accounts for binding reaction between albumin and bilirubin in the liquid phase. Thermodynamic equilibria and physical models are essential tools for designing adsorption columns aimed at detoxification treatments.
Decreased Bacterial Adhesion to Surface-Treated Titanium
Authors: Del Curto B. , Brunella M.F. , Giordano C. , Pedeferri M.P. , Valtulina V , Visai L , Cigada A. 
Published: January 2018

Osteointegrative dental implants are widely used in implantology for their well-known excellent performance once implanted in the host. Remarkable bacterial colonization along the transgingival region may result in a progressive loss of adhesion at gum-implant interface and an increase of the bone area exposed to pathogens. This phenomenon may negatively effect the osteointegration process and cause, in the most severe cases, implant failure. The presence of bacteria at implant site affect the growth of new bone tissue and consequently, the achievement of a mechanically stable bone-implant interface, key parameters for a suitable implant osteointegration. In the present work, a novel surface treatment has been developed and optimized in order to convert the amorphous titanium oxide in a crystalline layer enriched in anatase capable of providing not only antibacterial properties but also of stimulating the precipitation of apatite when placed in simulated body fluid. The collected data have shown that the tested treatment results in a crystalline anatase-type titanium oxide layer able to provide a remarkable decrease in bacterial attachment without negatively effecting cell metabolic activity. In conclusion, the surface modification treatment analyzed in the present study might be an elegant way to reduce the risk of bacterial adhesion and increase the lifetime of the transgingival component in the osteointegrated dental implant.
Renal Replacement Therapy in Acute Renal Failure: Which Index is Best for Dialysis dose Quantification?
Authors: Ratanarat R. , Permpikul C. , Ronco C. 
Published: January 2018

Background The “delivered dose” of dialysis may significantly affect the outcome of acute renal failure (ARF) patients requiring dialysis. Our study aimed to elucidate which dose quantification method offers an appropriate parameter to compare different treatments in ARF patients. Methods Six sustained low-efficiency daily dialysis (SLEDD), and 7 continuous venovenous hemofiltration (CVVH) patients with a prescribed Kt/V of 1.0 were studied during a single treatment. CVVH was studied over the first 24 hours after initiation. SLEDD was performed for 6–12 h. Solute clearance (K) was determined by direct dialysate quantification (DDQ). The single-pool Kt/V (spKt/V), equilibrated Kt/V (eqKt/V), equivalent renal urea clearance (EKRc), and solute removal index (SRI) were calculated. Results There were no significant differences at enrolment between the SLEDD and the CVVH groups in any patient characteristics except for the serum creatinine levels. The prescribed Kt/V of both groups was similar (SLEDD, 0.9±0.22; CVVH, 1.10±0.12, p=NS). The EKRc, which is used to verify kinetic equivalence among patients treated with differing renal replacement therapies (RRT), was higher in CVVH (15.7 in SLEDD; 27.4 in CVVH, p<0.0001), despite the fact that there was no difference between the delivered spKt/V for the SLEDD (1.05±0.40) and the CVVH (1.10±0.11) groups. The values for SRIurea (0.61 in SLEDD; 1.04 in CVVH, p=0.001), SRIcreatinine (0.55 in SLED; 1.02 in CVVH, p<0.0001), and SRIphosphate (1.81 in SLED; 3.60 in CVVH, p=0.03) were higher in CVVH. The EKRc is calculated assuming a steady state, which is an incorrect assumption in ARF patients with hypercatabolism. Conclusion The SRI calculated using direct dialysate effluent quantification appears to be more reliable as an index of the dialysis dose compared to other methods in ARF patients. However, the use of the dialysate-side SRI is limited by the difficulty of dialysate effluent collection.
Effects of Tigecycline, Linezolid and Vancomycin on Biofilms of Viridans Streptococci Isolates from Patients with Endocarditis
Authors: Presterl E. , Lassnigg A. , Eder M. , Reichmann S. , Hirschl A. M. , Graninger W. 
Published: January 2018

Background Endocarditis, and prosthetic valve endocarditis in particular, is a serious disease with high morbidity and mortality. We investigate the effects of tigecycline, linezolid and vancomycin on biofilms of viridans group streptococci (VGS) isolated from patients with definite native or prosthetic valve endocarditis. Methods and Results Ten of 20 VGS blood stream isolates from patients with endocarditis formed biofilms in the microtiter plate biofilm model. The minimal inhibitory concentrations (MIC) for tigecycline, linezolid and vancomycin were determined using the microdilution broth method. Biofilms were grown for 24 hours and were incubated with tigecycline, linezolid and vancomycin at increasing concentrations from 1-128x MIC of the isolate being tested. Biofilm thickness was quantified by measuring the optical density (OD) after dyeing it with crystal violet. The incubation of the biofilms with tigecycline, linezolid or vancomycin resulted in a significant reduction of OD compared to the control biofilm without antibiotic (p<0.05). The optical density ratio (Odr) decreased significantly at 2x MIC for tigecycline, and at 8x MIC for linezolid and vancomycin (p<0.05). Although biofilms persisted even at the highest antibiotic concentrations of 128x MIC, bacterial growth was eradicated starting at concentrations of 16x MIC for vancomycin and of 32x MIC for linezolid, but not for tigecycline, up to a concentration of 128x MIC. Conclusions In the present study on viridans streptococci isolated from patients with endocarditis, tigecycline and linezolid reduced the density of the biofilms as effectively as vancomycin. However, linezolid and vancomycin were bactericidal at higher concentrations. Linezolid and vancomycin at very high doses may be useful in the treatment of biofilm-associated diseases caused by VGS infections.
External Stenting with a New Polyester Mesh Reduces Neointimal Hyperplasia of Vein Grafts in a Sheep Model
Authors: Klesius A.A. , Konerding M. A. , Knez P. , Dzemali O. , Schmitz-Rixen T. , Ackermann H. , Moritz A. , Kleine P. 
Published: January 2018

Objective External stents placed around vein grafts have demonstrated effectiveness in reducing neointimal hyperplasia by preventing distension of the thin-walled vein grafts when exposed to arterial pressure. However, the ideal stent material has yet to be defined. The following study investigates the short- and long-term effects of an innovative polyester mesh stent designed with optimized adaptation of circumferential compliance. Methods Following in vitro definition of the ideal macro-porous polyester stent material, a total of 12 sheep underwent implantation of bilateral carotid artery vein graft bypasses. In six sheep, the short-term outcome (four weeks of implantation) was investigated by comparing the newly-designed stent to native veins, micro-porous PTFE stent grafts and metallic Biocompound® stents (BCGs). Flow volume and graft diameter were measured prior to explantation. Grafts were evaluated histologically with respect to morphometry and immunoassaying. In the long-term group (6-month implantation time), the polyester stent was compared to native veins. Results All stents effectively prevented dilatation of the graft. Perfused vessel diameters of the polyester veins were 8.3±0.6 mm. BCG as well as PTFE veins showed diameter reduction to 7.4±0.7mm (p<0.05) and 7.8±0.4 mm (p<0.05), respectively. Both in the short and long terms, the new polyester stent led to significantly higher reduction of neointimal hyperplasia and luminal encroachment compared to the native vessel. It proved superior to PTFE stenting, while the Biocompound® material failed to prove efficacy. Conclusions It was demonstrated that the new macro-porous polyester mesh stent reduced neointimal hyperplasia more effectively than other commercially available stents.
Outcome Comparisons of Intermittent and Continuous Therapies in Acute Kidney Injury: What do They Mean?
Authors: Ronco C. , Bagshaw S.M. , Gibney R.T.N. , Bellomo R. 
Published: January 2018

Despite the fact that no new clinical outcome studies comparing intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) have been published in the past year, two meta-analyses addressing the topic (Bagshaw et al, Crit Care Med 2008; 36: 610–7, and Pannu et al, JAMA 2008; 299: 793–805) have been published recently. With respect to randomized controlled trials (RCTs), there was a substantial overlap between the studies considered in the analysis by Bagshaw et al and those considered in the analysis by Pannu et al. Although neither metaanalysis showed a benefit for either modality with respect to mortality or renal recovery, the two publications offered vastly different conclusions. Bagshaw et al concluded it is impossible to make any definitive recommendations about dialysis modality choice in AKI because previous studies were not adequately powered and failed to standardize for treatment dose. On the other hand, because the metaanalysis of Pannu et al demonstrated equivalent patient outcomes, and in light of the lower costs of IHD, they suggested that alternate-day hemodialysis should become the preferred therapy in many critically ill patients. As the clinical practice recommendations made by Pannu and colleagues have very important implications, we believe their analysis should be critically assessed. In this review, the weaknesses of the RCTs considered in the meta-analysis by Pannu et al are presented. Furthermore, the assumption by Pannu et al that IHD is associated with lower costs than CRRT is challenged, as they did not consider adequately both the short-term and long-term costs associated with the dialytic management of AKI patients. Based on our critical analysis, we believe the AKI dialytic treatment approach recommended by the JAMA investigators (Pannu et al) is not supported by the aggregate of the available clinical outcome data and, therefore, remains highly controversial. We would like to join with others in the AKI field by strongly recommending that investigators and other clinicians stop trying to make conclusive determinations about dialysis modalities when robust supportive data simply are not available. Instead of additional intermodality comparisons, the focus of future clinical research should be toward generating high-quality data on intramodality interventions, such as treatment dose and timing of treatment initiation. In this regard, at least for CRRT, we anxiously await the results of the ongoing RCTs evaluating the effect of CRRT dose on patient outcome.