bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidisciplinary Initiative to Increase Guideline-concordant Antibiotic Prescription at Discharge for Hospitalized Children with Uncomplicated Community-acquired Pneumonia
Authors: Yonts Alexandra B. , O’Neill Laura B. , Magyar Matthew A. , Bozzella Michael J. 
Published: December 2023

Background:
Clinical practice guidelines recommend using narrow-spectrum antibiotics to treat uncomplicated pneumonia in children. This quality improvement (QI) project aimed to evaluate if QI methods could improve guideline-concordant antibiotic prescribing at hospital discharge for children with uncomplicated pneumonia.

Methods:
For this single-center QI project, we implemented QI interventions in serial plan-do-study-act cycles, focusing on the key drivers targeting general pediatric inpatient resident teams. Interventions included: (1)Small bimonthly group didactic sessions, (2)Visual job aids posted in resident work areas, and (3) A noon conference session. Balancing measures included postdischarge emergency room visits, readmission and adverse drug reactions.

Results:
To establish a baseline rate, we conducted a chart review of 112 children diagnosed with uncomplicated community-acquired pneumonia during hospitalization from July 2017 through January 2019. The average monthly percentage of children discharged with guideline-concordant antibiotics was 67%. The intervention period was from February 2019 through February 2020, with 118 children meeting the criteria after a review of 262 charts. After our interventions, the average monthly percentage of children discharged with guideline-concordant antibiotics increased to 87%, with the increase persisting for at least 12 months. There were no significant differences in balancing measures pre- and post-interventions.

Conclusions:
Our QI initiative sustained increased rates of uncomplicated community-acquired pneumonia guideline-concordant antibiotic prescribing at discharge over 12 months without an increase in balancing measures. The enduring changes in prescribing behavior suggest a lasting impact of our interventions.
The Pedicled Sensate Osteocutaneous Groin Flap for Reconstruction of the Forearm and Hand
Authors: Turan Aydin 
Published: December 2023

Background
The groin flap is axial pedicled and versatile. Until now, this flap has been used with many modifications for the reconstruction of forearm and hand defects. However, this flap has not been used in forearm, hand, and thumb reconstruction as a pedicled sensate osteocutaneous flap. In this study, a pedicled sensate osteocutaneous groin flap was used for the reconstruction of composite tissue defects on the forearm, hand, and thumb.

Patients and Methods
A pedicled sensate osteocutaneous groin flap was used to reconstruction composite tissue defects on the forearm, hand, and thumb in 7 patients. The mean age of the patients was 42 years. The defects were located on the dorsal surface of the forearm and hand in 2 patients, the dorsal surface of the hand and finger in 2 patients, and the thumb in 3 patients. The dimensions of the flap skin paddle ranged from 7 × 11 cm to 8 × 23 cm, and the dimensions of the bone component ranged from 1 × 1.5 × 3.5 cm to 1 × 1.5 × 5 cm. The mean follow-up duration was 26 months.

Results
All the flaps survived. Flap debulking was performed using 3 flaps. Sensory recovery in the flaps was completed approximately 18 months after the first operation. When the results of static 2-point discrimination test and Semmes-Weinstein monofilament test were evaluated at 18 months postoperatively, it showed that protective sensation was obtained. Except for 1 patient, motion restriction did not develop in the wrist, elbow, or shoulder joints. An acceptable aesthetic result, minimal donor site deformity, and protective sensation were obtained in all patients.

Conclusions
The pedicled sensate osteocutaneous groin flap can be safely used in the reconstruction of forearm and hand composite tissue defects that do not have available vascular structures for free flaps in the recipient area and in thumb reconstruction where toe transfer and pollicization cannot be performed.
Clinical and Cephalometric Changes in Long-face Patients With Retrogenia Following the Novel B-genioplasty Technique
Authors: Behnia Parsa , Behnia Hossein , Tehranchi Azita , Tabrizi Reza 
Published: December 2023

Background:
The chin plays a fundamental role in facial attractiveness. Accordingly, several surgical procedures have been proposed for chin contouring. This study aimed to introduce “B-genioplasty” as a novel genioplasty technique and assess the clinical and cephalometric changes in long-face patients with retrognathia following the novel B-genioplasty.

Methods:
This is a cross-sectional study. Subjects with class I occlusion increased lower facial height and retrognathia underwent B-genioplasty in this prospective experimental study. Soft and hard tissue cephalometric measurements were made, and the depth of the notch in the lower border of the mandible was measured on lateral cephalograms at 6 months postoperatively and compared with baseline. Patient satisfaction with the outcome was also assessed.

Results:
Seventeen subjects were studied. Ten (58%) patients underwent rhinoplasty plus genioplasty. All patients were satisfied with the outcome. The step/notch in the lower border of the mandible was not detected in clinical examination in any patient. The mean notch depth was 0.5±0.83 mm on lateral cephalograms. The change in all soft and hard tissue cephalometric parameters was significant at 6 months postoperatively compared with baseline (P<0.001 for all).

Conclusion:
B-genioplasty caused satisfactory clinical and cephalometric changes in long-face patients with retrognathia, including prevention of step/notch in the inferior border of the mandible, significant reduction of gonial angle, correction of the mandibular plane, and reduction of lower facial height.
Utility of the LeFort I Osteotomy in the Acute Management of Midface Trauma
Authors: Nickel Kevin J. , DeSerres Joshua J. , Louie Gorman 
Published: December 2023

Purpose:
Pure and isolated LeFort I, II, and III fractures are rare. Typically, they occur at different levels on each side and may be incomplete in nature, which complicates management. The LeFort I osteotomy is a well-described technique in elective management of midface deformities. However, there is minimal literature on its use in acute trauma. This study describes the use of the LeFort I osteotomy as a surgical maneuver to aid in the reduction of complex midface fractures and the re-establishment of premorbid occlusion.

Methods:
A retrospective review was performed of all consecutive midface fractures managed at our center from 2008 to 2020. The inclusion criteria were adult patients who had a LeFort I osteotomy in the setting of acute fracture management. Primary outcomes were the long-term stability of fracture fixation and the re-establishment of stable, reproducible occlusion at follow-up.

Results:
Twenty-two cases met the criteria for inclusion. The most common indication was contralateral LeFort I and ipsilateral incomplete or absent LeFort I (50%). Most remaining cases had a high LeFort (II or III) on the ipsilateral side and a high LeFort I on the contralateral side (41%). There was one case of nonunion requiring revision and bone grafting. In all remaining cases who presented for follow-up at an average of 1.5 years, stable, reproducible occlusion was achieved.

Conclusions:
In acute trauma, a LeFort I osteotomy is a safe and effective technique to re-establish premorbid occlusion when passive reduction of the maxilla cannot be achieved. This technique can be safely added to the armamentarium of any surgeon who manages acute craniofacial trauma.
Tailoring the Use of Central Pancreatectomy Through Prediction Models for Major Morbidity and Postoperative Diabetes
Authors: van Bodegraven Eduard Antonie , Lof Sanne , Jones Leia , Aussilhou Béatrice , Yong Gao , Jishu Wei , Klotz Rosa , Rocha-Castellanos Dario Missael , Matsumato Ippei , de Ponthaud Charles , Tanaka Kimitaka , Biesel Esther , Kauffmann Emmanuele , Dumitrascu Traian , Nagakawa Yuichi , Martí-Cruchaga Pablo , Roeyen Geert , Zerbi Alessandro , Goetz Mara , de Meijer Vincent E. , Pessaux Patrick , Ignatavicius Povilas , Demir Ihsan Ekin , Giuffrida Mario , Tingstedt Bobby , Marino Marco Vito , Mastoridis Sotiris , Brunner Maximilian , Mora-Oliver Isabel , Bortolato Cecilia , Gulla Aisté , Apers Thomas , Hermand Hélène , Mitsuka Yusuke , Popescu Irinel , Boggi Ugo , Wittel Uwe , Hirano Satoshi , Gaujoux Sébastien , Kamei Keiko , Fernández-Del Castillo Carlos , Hackert Thilo , Kuirong Jiang , Yi Miao , Sauvanet Alain , Besselink Marc , Abu Hilal Mohammad , Dokmak Safi ,   for the European Consortium on Minimally Invasive Pancreatic Surgery and the International Consortium on Minimally Invasive Pancreatic Surgery
Published: December 2023

Objective:
To develop a prediction model for major morbidity and endocrine dysfunction after central pancreatectomy (CP) which could help in tailoring the use of this procedure.

Background:
CP is a parenchyma-sparing alternative to distal pancreatectomy for symptomatic benign and premalignant tumors in the body and neck of the pancreas CP lowers the risk of new-onset diabetes and exocrine pancreatic insufficiency compared with distal pancreatectomy but it is thought to increase the risk of short-term complications, including postoperative pancreatic fistula (POPF).

Methods:
International multicenter retrospective cohort study including patients from 51 centers in 19 countries (2010–2021). The primary endpoint was major morbidity. Secondary endpoints included POPF grade B/C, endocrine dysfunction, and the use of pancreatic enzymes. Two risk models were designed for major morbidity and endocrine dysfunction utilizing multivariable logistic regression and internal and external validation.

Results:
A total of 838 patients after CP were included [301 (36%) minimally invasive] and major morbidity occurred in 248 (30%) patients, POPF B/C in 365 (44%), and 30-day mortality in 4 (1%). Endocrine dysfunction in 91 patients (11%) and use of pancreatic enzymes in 108 (12%). The risk model for major morbidity included male sex, age, Body Mass Index, and American Society of Anesthesiologists score ≥3. The model performed acceptably with an area under the curve of 0.72 (CI: 0.68–0.76). The risk model for endocrine dysfunction included higher Body Mass Index and male sex and performed well [area under the curve: 0.83 (CI: 0.77–0.89)].

Conclusions:
The proposed risk models help in tailoring the use of CP in patients with symptomatic benign and premalignant lesions in the body and neck of the pancreas (readily available through www.pancreascalculator.com).
Older females have increased mortality after trauma as compared with younger females and males, associated with increased fibrinolysis
Authors: Dujardin Romein W.G. , Kleinveld Derek J.B. , van den Brom Charissa E. , Geeraedts Leo M.G. , Beijer Elise , Gaarder Christine , Brohi Karim , Stanworth Simon , Johansson Pär I. , Stensballe Jakob , Maegele Marc , Juffermans Nicole P. 
Published: December 2023

INTRODUCTION
Female sex may provide a survival benefit after trauma, possibly attributable to protective effects of estrogen. This study aimed to compare markers of coagulation between male and female trauma patients across different ages.

METHODS
Secondary analysis of a prospective cohort study that was conducted at six trauma centers. Trauma patients presenting with full trauma team activation were eligible for inclusion. Patients with a penetrating trauma or traumatic brain injury were excluded. Upon hospital arrival, blood was drawn for measurement of endothelial and coagulation markers and for rotational thromboelastometry measurement. Trauma patients were divided into four categories: males younger than 45 years, males 45 years or older, females younger than 45 years, and females 45 years or older. In a sensitivity analysis, patients between 45 and 55 years old were excluded to control for menopausal transitioning. Groups were compared with a Kruskal-Wallis test with Bonferroni correction. A logistic regression was performed to assess whether the independent effect of sex and age on mortality.

RESULTS
A total of 1,345 patients were available for analysis. Compared with the other groups, mortality was highest in females 45 years or older, albeit not independent from injury severity and shock. In the group of females 45 years or older, there was increased fibrinolysis, demonstrated by increased levels of plasmin-antiplasmin complexes with a concomitant decrease in α2-antiplasmin. Also, a modest decrease in coagulation factors II and X was observed. Fibrinogen levels were comparable between groups. The sensitivity analysis in 1,104 patients demonstrated an independent relationship between female sex, age 55 years or older, and mortality. Rotational thromboelastometry profiles did not reflect the changes in coagulation tests.

CONCLUSION
Female trauma patients past their reproductive age have an increased risk of mortality compared with younger females and males, associated with augmented fibrinolysis and clotting factor consumption. Rotational thromboelastometry parameters did not reflect coagulation differences between groups.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
Quantifying the impact of the cluster clinic model on geographic service accessibility
Authors: Johnstone K , Turner S 
Published: December 2023

AbstractBackgroundTravel distance is a barrier to accessing care, especially in large areas with low population density. The cluster clinic model is designed to provide paediatric scheduled care in the community setting within NHS Grampian. Here, we have quantified the effect on overall travel distance and equality of access.MethodsThree models were compared: All clinics delivered at Royal Aberdeen Children’s Hospital, all clinics delivered at cluster clinics, and clinics at both hospital and cluster clinics. Shortest drivable distance from home to clinic in each model was calculated for all children in Aberdeen City and Aberdeenshire. Equality of distribution was assessed using a Gini coefficient, with values closer to 0 representing better equality, and 1 representing worse equality.ResultsIn model A, median travel distance was 8.64miles (Q1: 2.96miles, Q3: 25.7miles) with a Gini coefficient of 0.491. For model B, median travel distance was 3.14miles (Q1: 1.46miles, Q3: 9.07miles) with a Gini coefficient of 0.480. In model C, median travel distance was 3.13miles (Q1: 1.35miles, Q3: 9.07miles), with a Gini coefficient of 0.490.ConclusionsThe cluster clinic model significantly reduces travel distance, whilst simultaneously improving access equality. This methodology should be considered to prospectively evaluate implementation of similar models elsewhere.
Procuring authorities and project performance: a case study of PPP highway projects in India
Authors: Nayyer Mojahedul Islam , Annamalai Thillai Rajan 
Published: December 2023

PurposePublic-private partnership (PPP) highway projects in India are undertaken at both state and national levels, such that differences exist in how the procuring authorities manage project risk during the development and construction phase under different institutional frameworks. This study assesses the performance implication of the different administrative positionings of the procuring authority.Design/methodology/approachA data set of 516 PPP highway projects implemented in India formed the basis of this study. Means comparison, ordinary least squares (OLS) regression and seemingly unrelated regression were used to assess the impact of procuring authority on schedule performance.FindingsThe findings suggest that the state and the national highway projects were no different in achieving financial closure. However, the administrative positioning of the procuring authorities had a significant impact on other schedule performance variables. The construction of the state highway projects started quickly after the financial closure compared to the national highway projects. Moreover, the state highway projects were not only planned to be implemented at a faster rate but they were actually implemented at a faster rate and had a lower time overrun.Practical implicationsProcuring authorities under the state governments, being closer to the project, are better placed to manage project risk than those under the national government.Originality/valueThe administrative distance of the procuring authority from the PPP project and its implication on performance has never been studied.
Expanding and developing the theoretical implications of socialist market economy with China's experience
Authors: Zhou Wen 
Published: December 2023

PurposeExpanding and developing the theoretical implications of socialist market economy with China’s experience.Design/methodology/approachIn the course of exploring the development of a market economy, China has given full play to the advantages of the socialist system, which has distinguished itself from the Western countries and some of its developing peers. China's market economy is not directly transplanted and copied from the West. China not only insists on growing its market economy but also unswervingly sticks to the socialist orientation of its market economy.FindingsSo far, the socialist market economy has proved to be more effective than the conventional one-sided, planned economy and also outperforms the capitalist market economy.Originality/valueThe socialist market economy has surpassed the conventional planned economy and the capitalist market economy – it is a reconstructed and reshaped mechanism and system as well as a successful and new path of market economy explored by China through reform and opening up, rather than a counterpart of Western market economy or the simple combination of socialism and market economy.
Azithromycin regulates bacterial virulence and immune response in a murine model of ceftazidime‐treated Pseudomonas aeruginosa acute pneumonia
Authors: Leroy A.‐G. , Caillon J. , Broquet A. , Lemabecque V. , Delanou S. , Caroff N. , Asehnoune K. , Roquilly A. , Crémet L. 
Published: December 2023

AbstractPseudomonas aeruginosa (PA) remains one of the leading causes of nosocomial acute pneumonia. The array of virulence factors expressed by PA and the intense immune response associated with PA pneumonia play a major role in the severity of these infections. New therapeutic approaches are needed to overcome the high resistance of PA to antibiotics and to reduce the direct damage to host tissues. Through its immunomodulatory and anti‐virulence effects, azithromycin (AZM) has demonstrated clinical benefits in patients with chronic PA respiratory infections. However, there is relatively little evidence in PA acute pneumonia. We investigated the effects of AZM, as an adjunctive therapy combined with ceftazidime (CAZ), in a murine model of PA acute pneumonia. We observed that the combined therapy (i) reduces the weight loss of mice 24 h post‐infection (hpi), (ii) decreases neutrophil influx into the lungs at 6 and 24 hpi, while this effect is absent in a LPS‐induced pneumonia or when PA is pretreated with antibiotics and mice do not receive any antibiotics, and that (iii) AZM, alone or with CAZ, modulates the expression of PA quorum sensing regulators and virulence factors (LasI, LasA, PqsE, PhzM, ExoS). Our findings support beneficial effects of AZM with CAZ on PA acute pneumonia by both bacterial virulence and immune response modulations. Further investigations are needed to clarify the exact underlying mechanisms responsible for the reduction of the neutrophils influx and to better discriminate between direct immunomodulatory properties of AZM, and indirect effects on neutrophilia resulting from bacterial virulence modulation.
Differential apicomplexan presence predicts thermal stress mortality in the Mediterranean coral Paramuricea clavata
Authors: Bonacolta Anthony M. , Miravall Jordi , Gómez‐Gras Daniel , Ledoux Jean‐Baptiste , López‐Sendino Paula , Garrabou Joaquim , Massana Ramon , del Campo Javier 
Published: December 2023

AbstractParamuricea clavata is an ecosystem architect of the Mediterranean temperate reefs that is currently threatened by episodic mass mortality events related to global warming. The microbiome may play an active role in the thermal stress susceptibility of corals, potentially holding the answer as to why corals show differential sensitivity to heat stress. To investigate this, the prokaryotic and eukaryotic microbiome of P. clavata collected from around the Mediterranean was characterised before experimental heat stress to determine if its microbial composition influences the thermal response of the holobiont. We found that members of P. clavata's microeukaryotic community were significantly correlated with thermal stress sensitivity. Syndiniales from the Dino‐Group I Clade 1 were significantly enriched in thermally resistant corals, while the apicomplexan corallicolids were significantly enriched in thermally susceptible corals. We hypothesise that P. clavata mortality following heat stress may be caused by a shift from apparent commensalism to parasitism in the corallicolid‐coral host relationship driven by the added stress. Our results show the potential importance of corallicolids and the rest of the microeukaryotic community of corals to understanding thermal stress response in corals and provide a useful tool to guide conservation efforts and future research into coral‐associated microeukaryotes.
Exploring trajectories of depressive symptoms among Chinese older adults: Effects of gender and social activity participation
Authors: Wang Juanjuan , Hoe Maanse 
Published: December 2023

AbstractThe purpose of this study was to analyze the trajectory of late‐life depressive symptoms and to explore the effect of gender and social activity participation on that trajectory. Data from 4943 older adults aged 60 and above from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018) were analyzed using the Latent Growth Curve Model (LGCM) in Mplus. The results were (1) late‐life depressive symptoms increased during the survey; (2) at the initiation level, depression was higher in women than men, while there was no gender difference in the rate of change; and (3) lower social activity participation significantly negatively affected the increase of depressive symptoms in old age at that time. The findings implicated that, first, it is essential to screen for depressive symptoms and prevent or slow the growth of depressive symptoms in geriatric services on time. Second, services to improve depressive symptoms in older adults do not simply work separately by gender. Finally, welfare policymakers should consider how to support older adults to actively participate in social activities to prevent or slow down the growth of depressive symptoms.