bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinician perceptions of wound biofilm
Authors: Metcalf Daniel G. , Bowler Philip G. 
Published: September 2014

AbstractIn wound care today, biofilm is a subject area of great interest and debate. There is an increasing awareness that biofilm exists in the majority of non‐healing wounds, and that it is implicated in both recalcitrance and infection. Together with the presence of devitalised host tissue, biofilm is recognised as a component of the wound environment that requires removal to enable wound progression. However, uncertainty exists among wound care practitioners regarding confirmation of the presence of biofilm, and how best to remove biofilm from a non‐healing wound. While recent efforts have been taken to assist practitioners in signs and symptoms of wound biofilm, continuing research is required to characterise and confirm wound biofilm. This research was conducted as part of a market research process to better understand the knowledge levels, experiences, clinical awareness and impact of biofilm in wound care, which was undertaken across the USA and Europe. While knowledge levels and experiences vary from country to country, certain wound characteristics were consistently associated with the presence of biofilm.
Manual or Automated Sphygmomanometer? A Historical Cohort to Quantify Measurement Bias in Blood Pressure Recording
Authors: Nargesi Arash A. , Ghazizadeh Zaniar , Larry Mehrdad , Morteza Afsaneh , Heidari Firuzeh , Asgarani Firuzeh , Esteghamati Alireza , Mohammad Kazem , Nakhjavani Manouchehr 
Published: September 2014

The authors aimed to quantify end‐digit and threshold biases in blood pressure (BP) measurement with manual and digital sphygmomanometers. In a 3‐year follow‐up, end‐digit and threshold biases were investigated and a new index, called the deviation index, was used to quantify measurement bias. The distribution of systolic and diastolic BPs became close to normal after implementation of digital sphygmomanometers. The appearance of zero end digits decreased from 97% to 30% (P<.0001). The deviation index decreased from 97% to 20% (P<.0001). Mean systolic and diastolic BPs increased immediately after implementation of automated sphygmomanometers (124.22±0.83 vs 132.90±0.78 and 74.38±0.50 vs 80.43±0.51, respectively; P<.0001 for both) but showed a linear decreasing trend during follow‐up (systolic −3.59 mm Hg per year; 95% confidence interval, −5.57 to −1.61 [P<.0001]; diastolic: −2.52 mm Hg per year; 95% confidence interval, −3.78 to −1.26 [P<.0001]). Threshold bias decreased from 12.94% to 6.68% (P<.0001). Replacing manual sphygmomanometers with digital devices decreased end‐digit and threshold biases in BP measurement. The deviation index can be used to quantify the magnitude of measurement bias.
Implant‐ and patient‐centred outcomes of guided surgery, a 1‐year follow‐up: An RCT comparing guided surgery with conventional implant placement
Authors: Vercruyssen Marjolein , van de Wiele Gerlinde , Teughels Wim , Naert Ignace , Jacobs Reinhilde , Quirynen Marc 
Published: September 2014

AbstractAimTo assess, in a randomized study, the implant (clinical and radiological) and patient outcomes of guided implant placement at 1‐year follow‐up, compared to conventional implant treatment.Material and MethodsA total of 314 were placed in 59 patients, randomly assigned to one of the treatment groups. Radiographic and clinical parameters were recorded at the time of implant placement, prosthesis instalment (baseline) and at 1‐year follow‐up. Patient satisfaction was measured with the oral health‐related quality of life instrument (OHIP‐49).ResultsNo implants were lost. The mean marginal bone loss after the first year of loading was 0.04 mm (SD 0.34) for the guided surgery and 0.01 mm (SD 0.38) for the control groups. In the guided surgery groups, the mean number of surfaces with BOP and plaque at 1‐year follow‐up was 1.41 (SD 1.25) and 1.10 (SD 1.22), for the control groups this was, respectively, 1.37 (SD 1.25) and 1.77 (SD 1.64). The mean pocket probing depth was 2.81 mm (SD 1.1) for the guided, and 2.50 mm (SD 0.94) for the control groups. For all treatment groups, a significant improvement in quality of life was observed at 1‐year follow‐up (p ≤ 0.01), no differences between groups were observed.ConclusionWithin the limitations of this study, no difference could be found at 1‐year follow‐up between the implant and patient outcome variables of guided or conventional implant treatment.
Epidemiology of inherited epidermolysis bullosa in Romania and genotype–phenotype correlations in patients with dystrophic epidermolysis bullosa
Authors: Dănescu S. , Has C. , Senila S. , Ungureanu L. , Cosgarea R. 
Published: September 2014

AbstractBackgroundEpidermolysis bullosa (EB) is a rare and so far incurable genetic disease, affecting mainly the skin and mucosal membranes, manifesting with blisters triggered by minor mechanical trauma. Since only few epidemiological data on EB are available, we established a Registry for EB and implemented molecular diagnostic methods.ObjectiveWe present epidemiologic data from the EB Registry and genotype–phenotype correlations.MethodsIn 2006, a registry of patients with EB was initiated in the Department of Dermatology of the University of Medicine, as well as molecular diagnostic tools. The patients were diagnosed on clinical bases, and whenever possible, immunofluorescence mapping and molecular analysis were performed.Results89 EB patients were enrolled in the study from 2006 to 2012: 58 patients with dystrophic EB (DEB), 20 with EB simplex, one patient was diagnosed with Kindler syndrome; in 10 patients, the type of EB could not be determined.Discussion and ConclusionWe have estimated, the total number of EB patients in Romania and we have estimated the incidence and the prevalence of EB. We have also managed to approximate the distribution of EB types in Romania. Moreover, we performed a phenotypic and genotypic characterization in some of the patients included in the EB register.
Acute generalized exanthematous pustulosis: atypical presentations and outcomes
Authors: Kostopoulos T.C. , Krishna S.M. , Brinster N.K. , Ortega‐Loayza A.G. 
Published: September 2014

AbstractAcute generalized exanthematous pustulosis (AGEP) is an acute drug eruption characterized by erythematous plaques and papules studded with numerous, pinpoint pustules. Several atypical clinical presentations and triggers of AGEP have been described in the literature. These include systemic presentations similar to toxic epidermal necrolysis (TEN) and drug‐induced hypersensitivity syndrome (DIHS) and localized presentations mimicking other medication reactions. We herein aim to review atypical presentations and medication triggers of AGEP to assist clinicians in recognizing this condition and making appropriate therapeutic interventions.
Triple‐marker PCR assay of sentinel lymph node as a prognostic factor in melanoma
Authors: Ito T. , Wada M. , Nagae K. , Nakano‐Nakamura M. , Nakahara T. , Hagihara A. , Furue M. , Uchi H. 
Published: September 2014

AbstractBackgroundMetastasis of sentinel lymph node (SLN) is generally evaluated on histopathological examination and controversy still exists over the usefulness of PCR assay of SLN.ObjectiveTo investigate the prognostic value of triple‐marker PCR assay of SLN.MethodsA total of 165 patients with primary cutaneous melanoma who underwent SLN biopsy were included. Clinical and histopathological data were retrieved from each patient's file and triple‐marker PCR assay (tyrosinase, GP‐100 and MART‐1) was performed on the SLN as well as routine histopathological evaluation. PCR positivity was defined as the expression of all three PCR markers. To evaluate melanoma‐specific survival (MSS) and disease‐free survival (DFS), we used the Kaplan–Meier method and the log‐rank test. Multivariate analyses using the Cox proportional hazards regression model were also performed.ResultsSentinel lymph nodes were identified in all 165 patients: 61 patients (37.0%) were male and 104 (63.0%) were female, with a mean age of 60.2 years. Of the 165 melanomas, 81 (49.1%) were acral lentiginous melanomas. Compared with the patients with PCR positivity (1–2 markers) or PCR negativity, patients with PCR positivity (3 markers) had significantly poor MSS (5‐year survival rate, 58.7% vs. 84.4%; P < 0.0001) and DFS (5‐year survival rate, 25.0% vs. 83.9%; P < 0.0001), with median follow‐up of 42 months for MSS and 38 months for DFS. These survival rates of patients with PCR positivity (3 markers) were lower than those of patients with histopathologically positive SLN. In multivariate analysis, PCR positivity (3 markers) was an independent prognostic factor for both MSS (hazard ratio [HR], 2.81; 95% confidence interval [CI], 1.07–7.33; P = 0.035) and DFS (HR, 2.48; 95% CI, 1.08–5.69; P = 0.032).ConclusionsThe expression of three PCR markers was a significant prognostic factor for both MSS and DFS and might be closely correlated to a dismal prognosis.
The Size of DNA Molecules and Chromatin Organization in the Macronucleus of the Ciliate Didinium nasutum (Ciliophora)
Authors: Popenko Vladimir I. , Potekhin Alexey A. , Karajan Bella P. , Skarlato Sergei O. , Leonova Olga G. 
Published: September 2014

AbstractPulsed‐field gel electrophoresis (PFGE) was applied to analyze the molecular karyotype of the ciliate Didinium nasutum. The data obtained indicate that D. nasutum belongs to the ciliate species with subchromosomal macronuclear genome organization. No short “gene‐sized” DNA molecules were detected. Macronuclear DNAs formed a continuous spectrum from 50 kbp to approximately 1,000 kbp in size with a peak plateau between 250 and 400 kbp. The macronuclear DNA molecules were packed into chromatin bodies of 80–265 nm in size. Comparison of the PFGE and electron microscopic data shows that most if not all chromatin bodies contain more than one DNA molecule.
Evolution in the English Department: The Biocultural Paradigms of Literary Darwinism and Adaptive Rhetoric
Authors: Parrish Alex C. 
Published: September 2014

AbstractThis article introduces emerging programs of study in the field of English (defined broadly) that operate under an evolutionary paradigm. Emerging from the “crisis of the humanities” that became known to a wider public audience in the late 20th‐century, literary Darwinism is examined as an alternative or addition to mainstream post‐structuralist theory, to which some attribute blame for the decline of literature's prestige. There are strong and weak forms of literary Darwinism in practice, ranging in approach from a complete paradigm shift to merely adding one more lens through which to read literature, film, and poetry in terms of both biology and culture. Rhetoric and composition scholarship is beginning to show interest in biocultural explanations for persuasive behavior as well. The nascent field of adaptive rhetoric combines the comparative study of human and nonhuman animal rhetorics with insight from evolutionary cognitive psychology, in order to gain further insight into the products of our evolved minds, such as rhetorical acts.
A Pacemaker Magnet Check Alone Is Sufficient for the Majority of Patients Postpacemaker Implant
Authors: JONES MICHAEL A. , WONG KELVIN C.K. , QURESHI NORMAN , RAJAPPAN KIM , BASHIR YAVER , BETTS TIMOTHY R. 
Published: September 2014

BackgroundPatients postpacemaker implant can undergo a full assessment by pacing system programmer (PSP) or a magnet check. The former takes longer, but provides more detailed information; a magnet‐mode assessment is faster, but provides only capture data in an asynchronous pacing mode. A magnet‐mode assessment alone may be sufficient in most cases, and current clinical practice varies considerably.MethodsA retrospective single‐center assessment of all pacemaker implants receiving PSP and magnet checks between September 2009 and April 2010. Patient records were reviewed. The results of PSP and magnet checks and any subsequent device‐related management were noted.ResultsA total of 168 patients underwent pacemaker implantation, magnet‐mode assessment, and then PSP interrogation during this period. Magnet‐mode assessment revealed a problem in only one patient—failure of atrial capture, leading to subsequent atrial lead repositioning. None of the remaining 167 patients have a serious problem at PSP interrogation; six had minor issues at PSP check, none of which required repeat surgical intervention.ConclusionsThe magnet‐mode test only provides information on lead capture in an asynchronous pacing mode, which is the most essential data postoperatively. Our study has suggested that a magnet‐mode assessment without PSP interrogation may be sufficient in the immediate postimplant assessment of these patients. Routine postimplant PSP interrogation is time consuming, labor intensive, and adds only minimal additional benefit to the safe management of these patients above and beyond a magnet check, coupled with informed assessment of the associated electrocardiogram/rhythm strip, clinical examination, and chest x‐ray.
Preprocedural ECG‐Gated Computed Tomography for Prevention of Complications during Lead Extraction
Authors: LEWIS ROBERT K. , POKORNEY SEAN D. , GREENFIELD RUTH ANN , HRANITZKY PATRICK M. , HEGLAND DONALD D. , SCHRODER JACOB N. , LIN SHU S. , MILANO CARMELO , DAUBERT JAMES P. , SMITH PETER K. , HURWITZ LYNNE M. , PICCINI JONATHAN P. 
Published: September 2014

BackgroundPreprocedural multidetector computed tomography (MDCT) may identify patients at risk for mechanical complications during lead extraction.MethodsTo describe the use and feasibility of computed tomography scanning for preprocedural planning of lead extraction, we conducted a retrospective study of high‐risk patients, who underwent electrocardiogram (ECG)‐gated MDCT before planned lead extraction between January 1, 2012, and March 30, 2013.ResultsAmong 30 patients the mean age was 63 ± 15 years, 60% were male, and 20% had prior sternotomy. Most devices were left sided (93%) and 24 had implantable defibrillators (80%). Indications for extraction included lead malfunction (n = 15; 50%), class I lead advisories (n = 11; 37%), and infection (n = 10; 33%). Overall, there were 65 leads extracted (mean 2.1 leads per patient). One extraction procedure was deferred due to MDCT evidence of significant myocardial perforation with the lead tip > 1 cm beyond the epicardium (n = 1, 3%). MDCT suggestion of lead adherence to central venous structures (n = 13, 43%) was associated with significantly longer laser times (88 ± 71 seconds vs 30 ± 37 seconds, P = 0.02) and larger sheath size (14.9 ± 1.3 vs 13.5 ± 1.2 French, P = 0.02). MDCT evidence of central venous occlusion or stenosis was not associated with increased laser times. Excluding the patient with MDCT evidence of significant perforation, clinical success was achieved in all patients (n = 29/29).ConclusionsECG‐gated MDCT scanning before lead extraction may facilitate the identification of significant perforation and patients at high risk for mechanical complication.
European Phyllodistomum (Digenea, Gorgoderidae) and phylogenetic affinities of Cercaria duplicata based on rDNA and karyotypes
Authors: Petkevičiūtė Romualda , Stunžėnas Virmantas , Stanevičiūtė Gražina , Zhokhov Alexander E. 
Published: September 2014

Genetic markers of some European Gorgoderidae species, including potential adults of Cercaria duplicata, were obtained and used to clarify phylogenetic affinities within the genus Phyllodistomum and to verify conflicting data existing on their life cycles. Molecular data and karyotype, 2n = 18, provide further support for ascription of C. duplicata to the Gorgoderinae. Sequences of C. duplicata form a robustly supported major clade, phylogenetically distinct from other known gorgoderid species in both ITS2‐ and 28S‐based phylogenetic trees. The molecular data revealed no match between C. duplicata and any species of Phyllodistomum, including adults found in the experimental studies. One of them, P. elongatum, showed no differences from type species P. folium. Other, P. angulatum, forms a robustly supported clade, which is closely related to P. macrocotyle clade in all phylogenetic trees. This study supports the concept that only P. macrocotyle is a parasite of Dreissena polymorpha among the phyllodistomes and life cycle described for the type species P. folium by Sinitsin (1905) can apparently be discounted. Previously reported low host specificity of P. folium was justified. Adults of P. folium were detected in eight teleost species from five families and four orders. Cystocercous cercariae of P. folium were recorded in sphaeriid bivalves of the genus Sphaerium and Pisidium. According to our molecular data, P. simile, parasite of bullhead, must be regarded as synonym of P. folium. Phyllodistomum umblae is most closely related to P. folium in the all phylogenetic analyses. Molecular phylogenies support a presumption that Phyllodistomum species with cystocercous cercariae developing in sphaeriid bivalves should be regarded as Phyllodistomum sensu stricto. The results reveal a clear need for reconsideration of the knowledge on gorgoderid life cycles based on experimental studies and re‐evaluation of the validity of some nominal Phyllodistomum species.
Clinical Thresholds for Quadriceps Assessment After Anterior Cruciate Ligament Reconstruction
Authors: Kuenze Christopher , Hertel Jay , Saliba Susan , Diduch David R. , Weltman Arthur , Hart Joseph M. 
Published: September 2014

Context:Normal, symmetrical quadriceps strength is a common clinical goal after anterior cruciate ligament reconstruction (ACLR). Currently, the clinical thresholds for acceptable unilateral quadriceps function and symmetry associated with positive outcomes after return to activity are unclear.Objective:To establish quadriceps-activation and knee-extension-torque cutoffs for clinical assessment after return to activity after ACLR.Design:Descriptive laboratory study.Setting:Laboratory.Patients:22 (10 female, 12 male; age = 22.5 ± 5.0 y, height = 172.9 ± 7.1 cm, mass = 74.1 ± 15.5 kg, months since surgery = 31.5 ± 23.5) recreationally active persons with a history of unilateral, primary ACLR at least 6 months prior and 24 (12 female/12 male, age = 21.7 ± 3.6 y, height = 168.0 ± 8.8 cm, mass = 69.3 ± 13.6 kg) recreationally active healthy participants.Main Outcome Measures:Patient-reported measures of pain, knee-related function, and physical activity level were recorded for all participants. Normalized knee-extension maximum-voluntary-isometric-contraction (MVIC) torque (Nm/kg) and quadriceps central-activation ratio (CAR, %) were measured bilaterally in all participants. Receiver-operator-characteristic (ROC) curves were used to establish thresholds for unilateral measures of normalized knee-extension MVIC torque and quadriceps CAR, as well as limb-symmetry indices (LSI). ROC curves then established clinical thresholds for normalized knee-extension MVIC torque and quadriceps CAR LSIs associated with healthy knee-related function.Results:Involved-quadriceps CAR above 89.3% was the strongest unilateral indicator of healthy-group membership, while quadriceps CAR LSI above 0.996 and knee-extension MVIC torque above 0.940 were the strongest overall indicators. Unilateral normalized knee-extension MVIC torque above 3.00 Nm/kg and quadriceps CAR LSI above 0.992 were the best indicators of good patient-reported knee-related outcomes.Conclusions:Threshold values established in this study may provide a guide for clinicians when making return-to-activity decisions after ACLR. Normalized knee-extension MVIC torque (>3.00 Nm/kg) and quadriceps CAR symmetry (>99.6%) are both strong indicators of good patient-reported outcomes after ACLR.
Reliability of Clinician Scoring of the Landing Error Scoring System to Assess Jump-Landing Movement Patterns
Authors: Markbreiter Jessica G. , Sagon Bronson K. , McLeod Tamara C. Valovich , Welch Cailee E. 
Published: September 2014

Clinical Scenario:An individual’s movement patterns while landing from a jump can predispose him or her to lower-extremity injury, if performed improperly. The Landing Error Scoring System (LESS) is a clinical tool to assess jump-landing biomechanics as an individual jumps forward from a box. Improper movement patterns, which could predispose an individual to lower-extremity injuries, are scored as errors. However, because of the subjective nature of scoring errors during the task, the consistency and reliability of scoring the task are important. Since the LESS is a newer assessment tool, it is important to understand its reliability.Focused Clinical Question:Are clinicians reliable at scoring the LESS to assess jump-landing biomechanics of physically active individuals?
Association of the Functional Movement Screen With Injuries in Division I Athletes
Authors: Warren Meghan , Smith Craig A. , Chimera Nicole J. 
Published: September 2014

Context:The Functional Movement Screen (FMS) evaluates performance in 7 fundamental movement patterns using a 4-point scale. Previous studies have reported increased injury risk with a composite score (CS) of 14/21 or less; these studies were limited to specific sports and injury definition.Objective:To examine the association between FMS CS and movement pattern scores and acute noncontact and overuse musculoskeletal injuries in division I college athletes. An exploratory objective was to assess the association between injury and FMS movement pattern asymmetry.Design:Prospective cohort.Setting:College athletic facilities.Participants:167 injury-free, college basketball, football, volleyball, cross country, track and field, swimming/diving, soccer, golf, and tennis athletes (males = 89).Intervention:The FMS was administered during preparticipation examination.Main Outcome Measure:Noncontact or overuse injuries that required intervention from the athletic trainer during the sport season.Results:FMS CS was not different between those injured (n = 74; 14.3 ± 2.5) and those not (14.1 ± 2.4; P = .57). No point on the ROC curve maximized sensitivity and specificity; therefore previously published cut-point was used for analysis with injury (≤14 [n = 92]). After adjustment, no statistically significant association between FMS CS and injury (odds ratio [OR] = 1.01, 95% CI 0.53–1.91) existed. Lunge was the only movement pattern that was associated with injury; those scoring 2 were less likely to have an injury vs those who scored 3 (OR = 0.21, 95% CI 0.08–0.59). There was also no association between FMS movement pattern asymmetry and injury.Conclusion:FMS CS, movement patterns, and asymmetry were poor predictors of noncontact and overuse injury in this cohort of division I athletes.
The Effect of Dexamethasone Iontophoresis on Decreasing Pain and Improving Function in Patients With Musculoskeletal Conditions
Authors: Brown Christopher D. , lauber Christine A. , Cappaert Thomas 
Published: September 2014

Clinical Scenario:Iontophoresis is a method of local transfer of ionized medicated and nonmedicated substances through the skin and into the target tissues using magnetic polarization. The anti-inflammatory properties exhibited by dexamethasone sodium phosphate (DEX) combined with iontophoresis make it a potentially desirable treatment for clinicians wishing to administer a noninvasive localized drug concentration without having a large systemic concentration of that drug. Since concurrent treatments are commonly used in clinical practice, many of the published studies that included the use of DEX also used concurrent treatments. However, this may make it difficult for clinicians to determine the individual effectiveness of DEX iontophoresis in treating musculoskeletal conditions.Focused Clinical Question:Does DEX iontophoresis, alone, decrease pain and improve function in patients with musculoskeletal conditions when compared with placebo or control?