bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Severe Extremity Wound Bioburden at the Time of Definitive Wound Closure or Coverage: Correlation With Subsequent Postclosure Deep Wound Infection (Bioburden Study)
Authors: Bosse Michael J. , Murray Clinton K. , Carlini Anthony R. , Firoozabadi Reza , Manson Theodore , Scharfstein Daniel O. , Wenke Joseph C. , Zadnik Mary , Castillo Renan C. ,   METRC
Published: March 2017

Summary:
Infection remains the most common and significant complication after high-energy fractures. The Bioburden Study is a multicenter, prospective, observational cohort study of wound bacterial bioburden and antibiotic care in severe open lower extremity fractures. The aims of this study are to (1) characterize the contemporary extremity wound “bioburden” at the time of definitive wound closure; (2) determine the concordance between polymerase chain reaction results and hospital microbiology; (3) determine, among those who develop deep infections, the concordance between the pathogens at wound closure and at deep infection; and (4) compare the probability of deep infection between those who did and did not receive an appropriate course of antibiotics based on bioburden at the time of wound closure. To address these aims, sites collected tissue samples from severe lower extremity injuries at the time of wound closure and at first surgery for treatment of a deep infection, nonunion, flap failure, amputation, or other complications (because these surgeries may be due to undetected infection). Otherwise, if no further surgical treatment occurred, participants were followed for 12 months. The study was conducted at 38 US trauma centers and has enrolled 655 participants aged 18–64 years. This is the first large multi-institutional study evaluating the wound bioburden of severe open tibia fractures and correlating this bioburden with the risk of wound complications after definitive soft tissue closure.
The Sterility of Partially Used Hyaluronic Acid Fillers After Long Storage
Authors: Al-Haddab Mohammed , Abduljabbar Amr , Al-Somaily Ali 
Published: March 2017

BACKGROUND
Hyaluronic acid (HA) gel fillers represent most soft tissue augmentation procedures currently used, because they have lower rates of complications compared with other materials. Many patients do not consume an entire syringe of filler but may require a retouch or intermittent augmentation after some time. The remaining material is commonly stored in a specific environment for reuse by the same patient.

OBJECTIVE
There are an insufficient number of recommendations concerning the safety of storing and reusing dermal fillers in the literature because of the paucity of studies. The aim of this study was to investigate the potential infectious contamination associated with the storage of HA fillers after patient treatment.

METHODS
Hyaluronic acid from previously used syringes was stored at room temperature under sterile conditions for varying durations beginning from 2009. Later, the material was submitted for panculture, including gram-positive and gram-negative bacteria, mycobacteria, and fungi.

RESULTS
No fungal or mycobacterial agents were cultured from any of the samples. There were a few positive bacterial cultures, but they were predominantly contaminated with normal skin surface flora.

CONCLUSION
Although it is commonly practiced, the storage of HA fillers after initial patient injection carries a real but small risk of contamination.
Long-Term Outcomes of Melanoma In Situ Treated With Topical 5% Imiquimod Cream: A Retrospective Review
Authors: Park Andrew J. , Paul Joan , Chapman M. Shane , Samie Faramarz H. 
Published: March 2017

BACKGROUND
Melanoma in situ (MIS) is a noninvasive form of melanoma for which nonsurgical therapeutic options continue to be explored. The off-label use of topical 5% imiquimod cream in the management of MIS has shown potential but reported recurrence rates vary considerably between 0% and 40%. Furthermore, the long-term efficacy of imiquimod is not well established.

OBJECTIVE
To determine the recurrence rate of MIS among patients treated with topical 5% imiquimod cream at Dartmouth-Hitchcock Medical Center with at least 1 year of follow-up.

METHODS
A retrospective chart review identified 12 patients with MIS who have been treated with topical 5% imiquimod cream for 6 to 12 weeks. Patients who underwent surgical treatment for MIS were excluded from analysis.

RESULTS
Of 12 patients with histologically confirmed MIS treated with topical 5% imiquimod cream, there were 2 recurrences (17%) during a median follow-up time of 5.5 years.

CONCLUSION
Although surgery is still considered the gold standard for the treatment of MIS, imiquimod may represent a potentially effective noninvasive treatment option for patient who are not surgical candidates.
Development and Validation of an LC-MS/MS Method for the Simultaneous Quantification of Abiraterone, Enzalutamide, and Their Major Metabolites in Human Plasma
Authors: van Nuland Merel , Hillebrand M. J. X. , Rosing H. , Schellens J. H. M. , Beijnen J. H. 
Published: March 2017

Background:
Abiraterone acetate and enzalutamide are 2 novel drugs for the treatment of metastatic castration-resistant prostate cancer. The metabolism of these drugs is extensive. Major metabolites are N-desmethyl enzalutamide, enzalutamide carboxylic acid, abiraterone N-oxide sulfate, and abiraterone sulfate; of which N
-desmethyl enzalutamide is reported to possess antiandrogen capacities. A liquid chromatography-tandem mass spectrometry method for simultaneous quantification of abiraterone, enzalutamide, and the main metabolites has been developed and validated to support therapeutic drug monitoring.

Methods:
Human plasma samples of patients treated with abiraterone or enzalutamide were harvested at the clinic and stored at −20°C. Proteins were precipitated by acetonitrile, and the final extract was injected on a Kinetex C18 column and separated with gradient elution. Analytes were detected by liquid chromatography-mass spectrometry (Triple Quad 6500).

Results:
The method was validated over various linear ranges: 1–100 ng/mL for abiraterone, 5–500 ng/mL for enzalutamide and enzalutamide carboxylic acid, 10–1000 ng/mL for N-desmethyl enzalutamide, 30–3000 ng/mL for abiraterone N-oxide sulfate, and 100–10,000 ng/mL for abiraterone sulfate. Intra-assay and interassay variabilities were within ±15% of the nominal concentrations for quality control samples at medium and high concentrations and within ±20% at the lower limit of quantification, respectively.

Conclusions:
The described method for simultaneous determination of abiraterone and enzalutamide was validated successfully and provides a useful tool for therapeutic drug monitoring in patients treated with these agents.
Simultaneous Determination of Protein-Unbound Cyclosporine A and Mycophenolic Acid in Kidney Transplant Patients Using Liquid Chromatography–Tandem Mass Spectrometry
Authors: Bittersohl Heike , Herbinger Juliane , Wen Ming , Renders Lutz , Steimer Werner , Luppa Peter B. 
Published: March 2017

Background:
Therapeutic drug monitoring (TDM) of immunosuppressants is essential to optimize patient care after organ transplantation. In blood, most immunosuppressive drugs are bound to plasma proteins or located inside blood cells. However, it is generally assumed that only protein-unbound (free) drug concentrations are pharmacologically active and could therefore better reflect the clinical outcome. Study data are still limited due to lacking rapid analytical methods. Therefore, a simple multiplex method for direct measurement of free cyclosporine A (CsA) and mycophenolic acid (MPA) has been developed.

Methods:
The sample preparation included ultracentrifugation, followed by liquid–liquid extraction. Stable isotope labeled analogues of CsA and MPA were used as internal standards. The LC-MS/MS analysis was performed on a triple quadrupole mass spectrometer in the multiple reaction monitoring mode. The validated assay was used in a study of 40 blood samples from kidney transplant patients.

Results:
The lower limits of quantification were 0.1 (CsA) and 0.5 ng/mL (MPA). Assay linearity was confirmed in the concentration ranges of 0.1–10.0 ng/mL (CsA) and 0.5–100 ng/mL (MPA). For both analytes, inaccuracy was ≤9.8% and imprecision was ≤7.8%. The extraction efficiency ranged between 91% and 96%. In the patient samples the average free CsA and MPA fractions were 5.8% (2.1%–16.8%) and 1.2% (0.5%–2.4%) respectively.

Conclusions:
A reliable and highly sensitive LC-MS/MS method as a new suitable tool for measuring protein-unbound CsA and MPA has been developed, validated and applied in kidney transplant patient samples. Now, larger studies can be conducted to investigate the benefit of free drug monitoring in transplant recipients.
Wound Measurement Tools and Techniques: A Review
Authors: Wendland Deborah M. , Taylor David W. M. 
Published: March 2017

Background:
Chronic wounds in the United States are prevalent and costly, both financially and socially. Wound measurement is a cornerstone of best practice for wound management and reimbursement. For evidence-based best practice, wound measurement should be accurate and reliable to optimize patient care and outcomes.

Purpose:
The purpose of this narrative review was to articulate available measurement tools and techniques along with their accuracy, reliability, and clinical feasibility.

Methods:
CINAHL and MEDLINE were searched using combinations of key words related to wound measurement, wound types, measurement tools, reliability, repeatability, accuracy, or feasibility.

Results:
A total of 71 articles were included. Descriptions of the measurement tools were reported, as well as advantages/disadvantages related to inter- and intrarater reliability, accuracy, and feasibility were extracted. Measurement mechanisms were classified as contact versus noncontact. Measurement mechanisms described include rulers, manual tracing, photography, smartphone technology, laser-assisted technology, and stereophotogrammetry.

Conclusion:
Accuracy, reliability, and feasibility of wound measurement are critical to optimal evidence-based practice. This review finds that, at a minimum, noncontact measurement methods such as digital planimetry or analysis software should be used along with digital photography. More expensive accurate and reliable options, including laser-assisted technology or stereophotogrammetry, are appropriate if financially feasible.
Cane Handle Designs—Pressure and Preference: A Pilot Study
Authors: Beasley Jeanine , Kenyon Lisa , Midena Amber , Chartier Jaimie , Meyers Karrie , Ashby Blake , Anderson Kirk 
Published: March 2017

Purpose:There is limited evidence to guide clinical reasoning processes regarding the selection of mobility-related assistive devices in the acute care setting. The purpose of this study was to determine whether there was a significant difference in pressure while grasping a standard cylindrical or an ergonomic cane handle during an ambulation activity, and to identify which handle the participants preferred.Methods:The Novel Pliance-X system was used to collect mean and maximum pressure applied to the 2 cane handle designs by the dominant hands of 43 unimpaired participants walking with a 2-point modified gait.Results:There was no statistically significant difference found between the average mean pressure applied using the standard cane versus the ergonomic cane. The average maximum pressure for the ergonomic cane was significantly greater than the average maximum pressure for the standard cane. Participants preferred the ergonomic cane handle.Conclusions:Pressure applied while grasping a cane handle is a complex biomechanical activity involving many factors. In this study no clear differences were found in average mean pressure when comparing the 2 cane handles used by individuals without impairment. Additional research is needed to assist therapists in selecting the most appropriate cane handle for specific patients.
Impact of Chronic Suppurative Otitis Media in Pediatric Cochlear Implant Recipients—Insight into the Challenges from a Tertiary Referral Center in UK
Authors: Baruah Paramita , Hanvey Kate , Irving Richard , Tzifa Konstance 
Published: March 2017

Objective:
Analyze the presentation and evolution of chronic suppurative otitis media (CSOM) in children with cochlear implants (CI) and explore the merit of early intervention.

Study Design:
Retrospective patient review.

Setting:
Tertiary referral hospital and cochlear implant programme.

Patients:
Children with a CI who developed CSOM.

Intervention:
Tympanoplasty.

Main Outcome Measures:
Disease control, recurrence of cholesteatoma, cochlear implant preservation.

Results:
Eight children fit our inclusion criteria with a mean follow up of 8 years. Onset of CSOM symptoms was observed on an average of 5 years after implantation (range, 2–13 yr) and led to surgical intervention in an average of 15.6 months following symptom onset. Cholesteatoma was found in four of the eight patients. Of these, one patient underwent a subtotal petrosectomy and explantation with reimplantation at the same stage but the reimplant failed to function and was explanted subsequently. One patient was initially managed by a canal wall up mastoidectomy and explantation but went on to require subtotal petrosectomy and labyrinthectomy for recurrent disease. One patient underwent a subtotal petrosectomy with explantation and is awaiting a reimplantation. The fourth patient had limited disease around the electrodes that was excised without compromising the implant. In the group of patients with CSOM without cholesteatoma, one underwent an explantation due to recurrent ear infections and a subsequent cartilage tympanoplasty for a retracted eardrum. The remaining three patients underwent successful excision of retraction pockets and repair of eardrums using cartilage with the implant in situ. A mean follow up of 2 years after the implant preservation surgeries shows good functioning of the CI.

Conclusion:
Early recognition of CSOM is paramount in patients with CI as delay in treatment can result in the infection spreading via the cochleostomy resulting in loss of the cochlea. Recurrent ear infections in an implanted ear should prompt early examination to exclude the presence of middle ear disease, which may require anesthesia in a young child.
Novel regulators of plasma lipid levels
Authors: Loaiza Natalia , Oldoni Federico , Kuivenhoven Jan A. 
Published: March 2017

Purpose of review
To highlight very recent studies identifying novel regulatory molecules and mechanisms in plasma lipid metabolism.

Recent findings
Two novel regulatory mechanisms of LDL receptor (LDLR) intracellular trafficking have been described. The “COMMD/CCDC22/CCDC93” and “Wiskott–Aldrich syndrome protein and SCAR homologue” complexes were found to be involved in LDLR endosomal sorting and recycling, whereas the GRP94 was shown to protect LDLR from early degradation within the hepatocyte secretory pathway. Additionally, the transcription factors PHD1 and Bmal1 were identified to regulate LDL-C levels in mice by modulating cholesterol excretion. Important advances are reported on the relevance of two Genome Wide Association Studies hits: Reassessment of GALNT2 showed, in contrast to previous reports, that loss of GALNT2 reduces HDL-cholesterol in humans and other mammalian species, while phospholipid transfer protein was identified as an additional target of GALNT2. Tetratricopeptide repeat domain protein 39B was found to promote ubiquitination and degradation of Liver X receptor, and its deficiency increased HDL-cholesterol and cholesterol removal while also inhibiting lipogenesis in mice.

Summary
The unraveling of mechanisms how new factors modulate plasma lipid levels keep providing interesting opportunities to rationally design novel therapies to treat cardiovascular disease but also metabolic disorders.
Dietary Inadequacies in HIV‐infected and Uninfected School‐aged Children in Johannesburg, South Africa
Authors: Shiau Stephanie , Webber Acadia , Strehlau Renate , Patel Faeezah , Coovadia Ashraf , Kozakowski Samantha , Brodlie Susan , Yin Michael T. , Kuhn Louise , Arpadi Stephen M. 
Published: March 2017

ABSTRACTObjectives:The World Health Organization recommends that human immunodeficiency virus (HIV)‐infected children increase energy intake and maintain a balanced macronutrient distribution for optimal growth and nutrition. Few studies have evaluated dietary intake of HIV‐infected children in resource‐limited settings.Methods:We conducted a cross‐sectional analysis of the dietary intake of 220 perinatally HIV‐infected children and 220 HIV‐uninfected controls ages 5 to 9 years in Johannesburg, South Africa. A standardized 24‐hour recall questionnaire and software developed specifically for the South African population were used to estimate intake of energy, macronutrients, and micronutrients. Intake was categorized based on recommendations by the World Health Organization and Acceptable Macronutrient Distribution Ranges established by the IOM.Results:The overall mean age was 6.7 years and 51.8% were boys. Total energy intake was higher in HIV‐infected than HIV‐uninfected children (1341 vs 1196 kcal/day, P = 0.002), but proportions below the recommended energy requirement were similar in the 2 groups (82.5% vs 85.2%, P = 0.45). Overall, 51.8% of the macronutrient energy intake was from carbohydrates, 13.2% from protein, and 30.8% from fat. The HIV‐infected group had a higher percentage of their energy intake from carbohydrates and lower percentage from protein compared with the HIV‐uninfected group. Intakes of folate, vitamin A, vitamin D, calcium, iodine, and selenium were suboptimal for both groups.Conclusions:Our findings suggest that the typical diet of HIV‐infected children and uninfected children in Johannesburg, South Africa, does not meet energy or micronutrient requirements. There appear to be opportunities for interventions to improve dietary intake for both groups.
Misuse of Pediatric Medications and Parent-Physician Communication: An Interactive Voice Response Intervention
Authors: Walsh Kathleen E. , Bacic Janine , Phillips Barrett D. , Adams William G. 
Published: March 2017

Background
Children take 1 medication each week on average at home. Better communication between parents and providers could support safer home medication use and prevent misuse of pediatric medications, such as intentional underdosing or overdosing. Our primary objective was to assess the impact of an interactive voice response system on parent-provider communication about medications.

Methods
Parents of children 4 months to 11 years of age with upcoming well child visits were invited to call our interactive voice response system, called Personal Health Partner (PHP), which asked questions about the child’s health and medication use. Responding parents were randomized to either PHP (interview and counseling) or control (injury prevention survey). Parents’ responses were embedded in the electronic health record. After the physical visit, research assistants performed a phone follow-up survey.

Results
Of 475 parents, including 293 PHPs and 182 controls, 93% were women. We found a high prevalence of misuse of medications: 14% reported underdosing (n = 63) fever-reducer medications and 3% reported overdosing (n = 13). Twenty percent (n = 37) of the 190 children younger than 3 years had received cold medication. Thirty-three percent (n = 19) of 62 PHP parents of children on prescription medications reported nonadherence. Among children on prescription medications, PHP significantly increased discussion of medications at the physical, but not the number who brought medications to the visit; it had no impact on those not on prescription medications.

Conclusions
Pediatric medication misuse was common in this study. Use of a previsit interactive voice response system increased medication-related communication during visits and supports the need for systems that better prepare patients for visits and improve medication-related patient-physician communication.
Assessing the efficiency of catch-up campaigns for introduction of pneumococcal conjugate vaccine; a modelling study based on data from Kilifi, Kenya
Authors: Flasche Stefan , Ojal John , de Waroux Olivier Le Polain , Otiende Mark , O’Brien Katherine L. , Kiti Moses , James Nokes D. , John Edmunds W , Scott J. Anthony G. 
Published: March 2017

AbstractBackgroundThe World Health Organisation recommends the use of catch-up campaigns as part of the introduction of pneumococcal conjugate vaccines (PCVs) to accelerate herd protection and hence PCV impact. The value of a catch-up campaign is a trade-off between the costs of vaccinating additional age groups and the benefit of additional direct and indirect protection. There is a paucity of observational data, particularly from low-middle income countries to quantify the optimal breadth of such catch-up campaigns.MethodsIn Kilifi, Kenya PCV10 was introduced in 2011 using the 3-dose EPI infant schedule and a catch-up campaign in children <5 years old. We fitted a transmission dynamic model to detailed local data including nasopharyngeal carriage and invasive pneumococcal disease (IPD) to infer the marginal impact of the PCV catch-up campaign over hypothetical routine cohort vaccination in that setting, and to estimate the likely impact of alternative campaigns and their dose-efficiency.ResultsWe estimated that, within 10 years of introduction, the catch-up campaign among <5y olds prevents an additional 65 (48 to 84) IPD cases, compared to PCV cohort introduction alone. Vaccination without any catch-up campaign prevented 155 (121 to 193) IPD cases and used 1321 (1058 to 1698) PCV doses per IPD case prevented. In the years after implementation, the PCV programme gradually accrues herd protection and hence its dose-efficiency increases: 10 years after the start of cohort vaccination alone the programme used 910 (732 to 1184) doses per IPD case averted. We estimated that a two-dose catch-up among <1y olds uses an additional 910 (732 to 1184) doses per additional IPD case averted. Furthermore, by extending a single dose catch-up campaign to children 1 to <2y old and subsequently to 2 to <5y olds the campaign uses an additional 412 (296 to 606) and 543 (403 to 763) doses per additional IPD case averted. These results were not sensitive to vaccine coverage, serotype competition, the duration of vaccine protection or the relative protection of infants.ConclusionsWe find that catch-up campaigns are a highly dose-efficient way to accelerate population protection against pneumococcal disease.
Approach to insect wing shape and deformation field measurement
Authors: Yin Duo , Wei Zhen , Wang Zeyu 
Published: March 2017

Summary StatementA fine shape and deformation field measurement of insect wing is achieved by a self-developed setup. This measurement could foster investigation of insect wing stiffness distribution.AbstractFor measuring the shape and deformation of insect wing, a scanning setup adopting line laser and coaxial LED light is developed. Wing shape can be directly acquired from the line laser images by triangulation. Yet the wing deformation field can also be obtained by a self-devised algorithm that processes the images from line laser and coaxial LED simultaneously. During the experiment, three wing samples from termite and mosquito under concentrated force are scanned. The venation and corrugation could be significantly identified from shape measurement result. The deformation field is sufficiently accurate to demonstrate its variation from wing base to tip. The load conditions in experiments are also be discussed. For softer wings, local deformation is apparent if pinhead is employed to impose force. The similarity analysis is better than 5% deformation ratio as a static criterion, if the wing is simplified as a cantilever beam. The setup is proved to be effective and versatile. The shape and deformation fields would give enough details for the measurement of wing stiffness distribution.