bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immune Relevant Models for Ocular Inflammatory Diseases
Authors: Gilger Brian C 
Published: January 2018

Abstract
Ocular inflammatory diseases, such as dry eye and uveitis, are common, painful, difficult to treat, and may result in vision loss or blindness. Ocular side effects from the use of antiinflammatory drugs (such as corticosteroids or nonsteroidal antiinflammatories) to treat ocular inflammation have prompted development of more specific and safer medications to treat inflammatory and immune-mediated diseases of the eye. To assess the efficacy and safety of these new therapeutics, appropriate immune-relevant animal models of ocular inflammation are needed. Both induced and naturally-occurring models have been described, but the most valuable for translating treatments to the human eye are the animal models of spontaneous, immunologic ocular disease, such as those with dry eye or uveitis. The purpose of this review is to describe common immune-relevant models of dry eye and uveitis with an overview of the immuno-pathogenesis of each disease and reported evaluation of models from small to large animals. We will also review a selected group of naturally-occurring large animal models, equine uveitis and canine dry eye, that have promise to translate into a better understanding and treatment of clinical immune-relevant ocular disease in man.
Roles of IL-22 in allergic airway inflammation in mice and humans
Authors: Hirose Koichi , Ito Takashi , Nakajima Hiroshi 
Published: January 2018

Abstract
Asthma is a chronic inflammatory disease of the airways that is characterized by eosinophilic inflammation, mucus hypersecretion and airway remodeling that leads to airway obstruction. Although these pathognomonic features of asthma are primarily mediated by allergen-specific T helper type 2 cells (Th2 cells) and their cytokines, recent studies have revealed critical roles of lung epithelial cells in the pathogenesis of asthma. Lung epithelial cells not only form physical barriers by covering the surfaces of the airways but also sense inhaled allergens and initiate communication between the environment and the immune system. The causative involvement of lung epithelium in the pathogenesis of asthma suggests that some molecules that modulate epithelial function have a regulatory role in asthma. IL-22, an IL-10-family cytokine produced by IL-17A-producing T helper cells (Th17 cells), γδ T cells and group 3 innate lymphoid cells (ILC3s), primarily targets epithelial cells and promotes their proliferation. In addition, IL-22 has been shown to induce epithelial production of various molecules that regulate local immune responses. These findings indicate that IL-22 plays crucial roles in the pathogenesis of asthma by regulating epithelial function. Here, we review the current understanding of the molecular and cellular mechanisms underlying IL-22-mediated regulation of airway inflammation in asthma.
Interaction patterns of trauma providers are associated with length of stay
Authors: Chen You , Patel Mayur B , McNaughton Candace D , Malin Bradley A 
Published: January 2018

AbstractBackgroundTrauma-related hospitalizations drive a high percentage of health care expenditure and inpatient resource consumption, which is directly related to length of stay (LOS). Robust and reliable interactions among health care employees can reduce LOS. However, there is little known about whether certain patterns of interactions exist and how they relate to LOS and its variability. The objective of this study is to learn interaction patterns and quantify the relationship to LOS within a mature trauma system and long-standing electronic medical record (EMR).MethodsWe adapted a spectral co-clustering methodology to infer the interaction patterns of health care employees based on the EMR of 5588 hospitalized adult trauma survivors. The relationship between interaction patterns and LOS was assessed via a negative binomial regression model. We further assessed the influence of potential confounders by age, number of health care encounters to date, number of access action types care providers committed to patient EMRs, month of admission, phenome-wide association study codes, procedure codes, and insurance status.ResultsThree types of interaction patterns were discovered. The first pattern exhibited the most collaboration between employees and was associated with the shortest LOS. Compared to this pattern, LOS for the second and third patterns was 0.61 days (P = 0.014) and 0.43 days (P = 0.037) longer, respectively. Although the 3 interaction patterns dealt with different numbers of patients in each admission month, our results suggest that care was provided for similar patients.DiscussionThe results of this study indicate there is an association between LOS and the extent to which health care employees interact in the care of an injured patient. The findings further suggest that there is merit in ascertaining the content of these interactions and the factors that induce these differences in interaction patterns within a trauma system.
Long-Acting Lipoglycopeptides for Gram-Positive Bacteremia at the End of Life to Facilitate Hospice Care: A Report of 3 Cases
Authors: Datta Rupak , McManus Dayna , Topal Jeffrey , Juthani-Mehta Manisha 
Published: January 2018

Abstract
Administering and monitoring intravenous antimicrobials may cause discomfort in patients at the end of life and delay transition to hospice. We describe 3 patients with terminal cancer with methicillin-resistant Staphylococcus aureus, Streptococcus gallolyticus, and Granulicatella adiacens bacteremia who were managed with the long-acting lipoglycopeptide oritavancin to facilitate discharge to hospice.
Multimorbidity in South Asian adults: prevalence, risk factors and mortality
Authors: Singh Kalpana , Patel Shivani A , Biswas Suddhendu , Shivashankar Roopa , Kondal Dimple , Ajay Vamadevan S , Anjana Ranjit Mohan , Fatmi Zafar , Ali Mohammed K , Kadir M Masood , Mohan Viswanathan , Tandon Nikhil , Narayan K M Venkat , Prabhakaran Dorairaj 
Published: January 2018

Abstract

Background
We report the prevalence, risk factors and mortality associated with multimorbidity in urban South Asian adults.

Methods
Hypertension, diabetes, heart disease, stroke and chronic kidney disease were measured at baseline in a sample of 16 287 adults ages ≥20 years in Delhi, Chennai and Karachi in 2010–11 followed for an average of 38 months. Multimorbidity was defined as having ≥2 chronic conditions at baseline. We identified correlates of multimorbidity at baseline using multinomial logistic models, and we assessed the prospective association between multimorbidity and mortality using Cox proportional hazards models.

Results
The adjusted prevalence of multimorbidity was 9.4%; multimorbidity was highest in adults who were aged ≥60 years (37%), consumed alcohol (12.3%), body mass index ≥25 m/kg2 (14.1%), high waist circumference (17.1%) and had family history of a chronic condition (12.4%). Compared with adults with no chronic conditions, the fully adjusted relative hazard of death was twice as high in adults with two morbidities (hazard ratio [HR] = 2.3; 95% confidence interval [CI]: 1.6, 3.3) and thrice as high in adults with ≥3 morbidities (HR = 3.1; 95% CI: 1.9, 5.1).

Conclusion
Multimorbidity affects nearly 1 in 10 urban South Asians, and each additional morbidity carries a progressively higher risk of death. Identifying locally appropriate strategies for prevention and coordinated management of multimorbidity will benefit population health in the region.
SBM recommends policy support to reduce smoking disparities for sexual and gender minorities
Authors: Matthews Phoenix Alicia , Blok Amanda C , Lee Joseph G L , Hitsman Brian , Sanchez-Johnsen Lisa , Watson Karriem , Breen Elizabeth , Ruiz Raymond , Scout  , Simon Melissa A , Fitzgibbon Marian , Hein Laura C , Winn Robert 
Published: January 2018

Abstract
The Society of Behavioral Medicine supports the inclusion of gender and sexual minorities in all local, state, and national tobacco prevention and control activities. These activities include surveillance of tobacco use and cessation activities, targeted outreach and awareness campaigns, increasing access to culturally appropriate tobacco use dependence treatments, and restricting disproportionate marketing to lesbian, gay, bisexual, and transgender communities by the tobacco industry, especially for mentholated tobacco products.
Clinically Relevant Outcome Measures Following Limb Osseointegration; Systematic Review of the Literature
Authors: Al Muderis Munjed M. , Lu William Y. , Li Jiao Jiao , Kaufman Kenton , Orendurff Michael , Highsmith M. Jason , Lunseth Paul A. , Kahle Jason T. 
Published: January 2018

Objectives:
The current standard of care for an amputee is a socket-based prostheses. An osseointegrated implant (OI) is an alternative for prosthetic attachment. Osseointegration addresses reported problems related to wearing a socket interface, such as skin issues, discomfort, diminished function, quality of life, prosthetic use, and abandonment. The purpose of this report is to systematically review current literature regarding OI to identify and categorize the reported clinically relevant outcome measures, rate the quality of available evidence, and synthesize the findings.

Data sources:
A multidisciplinary team used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methods. Search methodology was based on identifying clinically relevant articles. Three databases were searched: PubMed, CINAHL, and Web of Science.

Study Selection:
Clinical studies with aggregated data reporting at least 1 clinically relevant outcome measure were included.

Data Extraction:
The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criterion was used for critical appraisal and recommendations.

Conclusions:
This review identified 21 clinically relevant observational studies. Outcome measures were categorized into the following 9 categories: vibratory stimulation, complications, biomechanics, economics, patient-reported outcome measures, electromyography, x-ray, physical functional performance, and energy consumption. This systematic review consisted of Level III and IV observational studies. Homogeneous outcome measures with strong psychometric properties across prospective studies do not exist to date. Higher-level, prospective, randomized, long-term, clinically relevant trials are needed to prove efficacy of OI compared with socket prosthetic attachment. Osseointegration was at least equivalent to sockets in most studies. In some cases, it was superior. Osseointegration represents a promising alternative to socket prosthetic attachments for extremity amputees.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Outcomes of Presumed Aseptic Long-Bone Nonunions With Positive Intraoperative Cultures Through a Single-Stage Surgical Protocol
Authors: Arsoy Diren , Donders Johanna C. E. , Kleeblad Laura J. , Miller Andy O. , Henry Michael W. , Wellman Davis S. , Helfet David L. 
Published: January 2018

Objective:
To evaluate the outcomes of a single-stage surgical protocol to treat a presumed aseptic long-bone nonunion with positive intraoperative cultures obtained at the time of surgery.

Design:
Retrospective comparative series.

Setting:
Orthopaedic specialty hospital.

Patients and Methods:
We retrospectively identified 77 patients with long-bone nonunions thought to be aseptic preoperatively, which grew bacteria from cultures obtained at the time of index nonunion surgery.

Intervention:
Fifty (65%) patients underwent open debridement of the nonunion site followed by surgical stabilization through plates and screws. Twenty-seven (35%) patients underwent exchange nailing with canal reamings used for cultures.

Main Outcome Measurement:
Rate of radiographic union, time to clinical and radiographic union, nonunion rate after index nonunion surgery, and final union rate after revision procedures.

Results:
Osseous union after the index nonunion surgery was achieved in 84% of the patients (65 of 77). Time to clinical union was 6.3 months (range, 1–24 months), and time to radiographic union was 7.4 months (range, 2–24 months). Eighteen percent (14 of 77 patients) did not heal after the index nonunion surgery and required additional surgeries. The final union rate after revision surgery was 99% (76 of 77 patients).

Conclusions:
Eighty-four percent of presumed aseptic nonunions of long-bone fractures with positive intraoperative cultures fully healed after a single-stage surgical protocol and long-term antibiotic when appropriate. When patients are diagnosed with a subclinical infected nonunion, they should be counseled about the higher likelihood of reoperation, but in most cases can expect excellent union rates after 1 additional surgery.

Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Generic Preoperative Planning for Proximal Femoral Osteotomy in the Treatment of Nonunion of the Femoral Neck
Authors: Mayo Keith , Kuldjanov Djoldas 
Published: January 2018

Summary:
Despite improvements in surgical technique and overall patient care, failed treatment of fractures of the femoral neck persists. For the physiologically young patient, joint preservation is the preferred method of treatment. Unfortunately, the best treatment option, proximal femoral osteotomy, is fast becoming a lost art. Preoperative planning is critical in this regard. The described preoperative planning work flow is a reliable method for obtaining the desired deformity correction for a variety of proximal femoral malunions and nonunion. Revisiting the classic Pauwels osteotomy for femoral neck nonunion is an appropriate vehicle to supply the first link in resurrecting this treatment modality by providing a standardized preoperative planning protocol.
Double Oblique Osteotomy: A Technique for Correction of Posttraumatic Deformities of the Distal Femur
Authors: Miranda Michael A. , DeAngelis Joseph P. , Canizares George H. , Mast Jeffery W. 
Published: January 2018

Objective:
To evaluate the outcomes of a double oblique osteotomy for the management of distal femoral malunions and a combination malunion/nonunion.

Design:
Case series.

Setting:
Level 1/2 hospital.

Patients/Participants:
Ten patients with a mean age of 50 years (range 30–69 years) with posttraumatic deformities of the distal femur.

Intervention:
A 2-level, length-sparing osteotomy was performed in accordance with a detailed preoperative plan for correction of the mechanical axis in a distal femoral deformity.

Main Outcome Measurements:
Radiographic alignment and physical examination.

Results:
Average length of follow-up was 26 months. The average coronal plane correction was 12 degrees (range 4–20 degrees) for a residual coronal plane deformity average of 0 degrees. The residual flexion deformity was less than 10 degrees in all cases. All rotational deformities were corrected to within 5 degrees of neutral. The average limb length correction was 1.6 cm (range 0.4–2.6 cm). Eight patients recovered without complication. One patient received bone grafting to achieve union, and a prominent angled blade plate was removed in another. An isolated saphenous nerve sensory deficit resolved spontaneously.

Conclusions:
The double oblique osteotomy is a reliable technique for the correction of multiplane deformities of the distal femur.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Routine Postoperative Computed Tomography Scans After Pelvic Fracture Fixation: A Necessity or a Luxury?
Authors: Elnahal Walid A. , Vetharajan Niraj , Mohamed Bashir , Acharya Mehool , Chesser Timothy J. S. , Ward Anthony J. 
Published: January 2018

Introduction:
There is no consensus regarding the postoperative radiology imaging protocol after pelvic fracture surgery. Some institutes routinely scan all patients after their surgery, others do not. The aim of this study was to assess the value of routine use of computed tomography (CT) scans after pelvic fracture surgery and to determine the sensitivity of conventional plain radiographs and intraoperative fluoroscopy in detecting metalwork malposition.

Patients and Methods:
The radiographs and clinical notes of patients undergoing pelvic fracture surgery in the period between January 2010 and December 2015 were reviewed. Patients were categorized into 2 main groups: group A—patients whose fixation entailed the use of a sacroiliac (SI) screws and group B—patients whose fixation did not require an SI screw. Furthermore, the patients were classified according to the position of metalwork in their postoperative plain radiographs and perioperative fluoroscopy into 3 groups: (1) Safe: When there was no suspicion of metalwork malposition. (2) Suspicious: When there was some suspicion of malposition but radiographs were inconclusive. (3) Definite: When plain imaging showed a definite malposition.

Results:
One hundred ninety-eight patients were included in this study (161 in group A and 37 in group B). In group A, 148 (92%) were classified as safe, 10 were suspicious (6%), and 3 (2%) showed definite malposition. Of the fractures that were believed to be safe on plain radiographs, 78% were confirmed to be safe on CT scans, whereas 22% showed malpositioned metalwork, and 7 patients (4%) required a revision surgery. Plain radiographs showed a sensitivity of 27% in detecting metalwork malposition and a specificity of 99%. Increasing the number of screws significantly increased the risk of malposition and reoperation (P = 0.006 and 0.002 respectively). The plain images of group B were all classified as safe. The CT scans detected 2 cases with long metalwork protruding into the soft tissues, none of which required a revision surgery.

Conclusion:
Perioperative fluoroscopy and plain postoperative radiographs have a low sensitivity in detecting the metalwork malposition after pelvic fracture surgery. We recommend the use of routine postoperative CT scans in patients whose fixation entails the use of SI screws. In this series, routine scanning of patients who did not have SI screws added no significant clinical value.

Level of Evidence:
Level IV Diagnostic. See Instructions for Authors for a complete description of levels of evidence.
Soft Tissue Structures Differ in Patients With Prearthritic Hip Disease
Authors: Le Bouthillier Anne , Rakhra Kawan S. , Belzile Etienne L. , Foster Ryan C. B. , Beaulé Paul E. 
Published: January 2018

Background:
Clinically, understanding how the soft tissue envelope adapts to various forms of hip dysfunction could enhance both surgical and nonsurgical management. Very few studies have looked at soft tissue structures as preoperative discriminators between varying underlying etiologies of hip conditions.

Purpose:
To demonstrate that the magnetic resonance arthrography assessment of soft tissue structures of the hip will preoperatively differ in patients with different underlying hip joint diseases.

Methods:
Fifty-seven patients who underwent preoperative magnetic resonance arthrography and corrective hip surgery were retrospectively identified yielding 3 groups: 17 with developmental dysplasia of the hip (DDH) (11 F, 6 M; mean age 35.1 years, range 19.6–53.6); 20 with isolated labral tears (LTs) (17 F, 3 M; mean age 38.4 years, range 15.2–62.1), and 20 with cam-type femoroacetabular impingement (FAI) (11 F, 9 M; mean age 38.8 years, range 18.9–51.2). Measurements of the hip labral length, capsule thickness, and psoas, rectus femoris, and gluteal muscle dimensions were performed, with normalization of the values for statistical analysis.

Results:
The superior labral length was significantly greater in the DDH group [normalized value (NV): 0.30] compared with the FAI group (NV: 0.25, P < 0.05). In addition, the superior (12 o'clock) capsular thickness (NV: 0.24) was significantly greater compared with the LT group (NV: 0.15, P < 0.05) and the FAI group (NV: 0.16, P < 0.05). The DDH group also had a significantly greater anterior (3 o'clock) capsular thickness (NV: 0.18) compared with the LT group (NV: 0.13, P < 0.05). The transverse dimension of the rectus femoris was larger in the DDH group (NV: 1.39) compared with the FAI group (NV: 1.14, P < 0.05).

Conclusion:
An enlarged rectus femoris and thicker hip capsule as well as an enlarged labrum are characteristic findings in hip dysplasia.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Intraosseous Plating for the Management of Cortical Defects
Authors: Bergin Patrick F. , Weber Timothy G. , Gerow Daniel E. , Spitler Clay A. , Graves Matthew L. , Russell George V. 
Published: January 2018

Summary:
The management of fractures with segmental bone loss or abundant comminution on the far cortex is often complicated by deformity or frank hardware failure. Using plate constructs that rely on off-axis loading may not be sufficient to support the limb until healing occurs. There are a number of techniques to mitigate this problem, notably the use of intramedullary nails and bicolumnar plating of the fracture. These techniques are not always possible and do come with the biologic cost of additional surgery. In this article, the authors present a technique along with 2 case examples of using plates in an intraosseous location that was described by Dr Mast in his classic orthopaedic text. By placing these plates in the intramedullary space and then interdigitating fixation from the standard cortical plate, a rigid “I-beam” of fixation can be created to mitigate the eccentric loading placed on extraosseous plates. This technique is especially useful in situations in which intramedullary nails are precluded (comminuted intraarticular and some periprosthetic fractures).
Chlamydia Prevalence Trends Among Women and Men Entering the National Job Training Program From 1990 Through 2012
Authors: Learner Emily R. , Torrone Elizabeth A. , Fine Jason P. , Pence Brian W. , Powers Kimberly A. , Miller William C. 
Published: January 2018

Background
Evaluating chlamydia prevalence trends from sentinel surveillance is important for understanding population disease burden over time. However, prevalence trend estimates from surveillance data may be misleading if they do not account for changes in risk profiles of individuals who are screened (case mix) and changing performance of the screening tests used.

Methods
We analyzed chlamydia screening data from a sentinel surveillance population of 389,555 young women (1990–2012) and 303,699 young men (2003–2012) entering the US National Job Training Program. This period follows the introduction of national chlamydia screening programs designed to prevent transmission and reduce population disease burden. After ruling out bias due to case mix, we used an expectation-maximization–based maximum likelihood approach to account for measurement error from changing screening tests, and generated minimally biased long-term chlamydia prevalence trend estimates among youth and young adults in this sentinel surveillance population.

Results
Adjusted chlamydia prevalence among women was high throughout the study period, but fell from 20% in 1990 to 12% in 2003, and remained between 12% and 14% through 2012. Adjusted prevalence among men was steady throughout the study period at approximately 7%. For both women and men, adjusted prevalence was highest among Black and American Indian youth and young adults, and in the Southern and Midwestern regions of the United States throughout the study period.

Conclusions
Our minimally biased trend estimates provide support for an initial decrease in chlamydia prevalence among women soon after the introduction of national chlamydia screening programs. Constant chlamydia prevalence in more recent years suggests that screening may not be sufficient to further reduce chlamydia prevalence among high-risk youth and young adults.