bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Pediatric Pyoderma Gangrenosum With Modified Negative Pressure Wound Therapy and Intralesional Corticosteroids
Authors: Barker Catherine S. , Santa Lucia Gabriella , Brunette Glenda , Wine Lee Lara 
Published: September 2022

BACKGROUND:
Pyoderma gangrenosum (PG) is a rare ulcerative skin disease; its etiology is unknown, though it is often associated with autoimmune diseases. Pyoderma gangrenosum results in significant morbidity and exquisite pain that affects health-related quality of life. Wound healing is delayed, and patients often experience relapse. Pyoderma gangrenosum is susceptible to pathergy and deterioration with surgical intervention or other trauma; therefore, treatment includes atraumatic wound care, infection management, and local or systemic immunosuppression.

CASE:
We describe the use of modified negative pressure wound therapy (NPWT) with intralesional and topical steroids for the treatment of PG in a 15-year-old female patient with ulcerative colitis and a staged J-pouch ileoanal reconstruction. The patient and her family refused all systemic therapy due to prior steroid-associated weight gain. She was unable to tolerate conscious dressing changes, further complicating the treatment plan. Procedural interventions such as NPWT have been used previously for PG; however, they can cause wound pathergy and subsequent wound deterioration. Modified NPWT in conjunction with topical and intralesional steroids induced wound healing without producing pathergy.

CONCLUSION:
Timely recognition of PG is crucial to appropriate delivery of care. Modified NPWT and localized corticosteroid treatment were key to promoting wound healing in this case of pediatric PG.
Incontinence Management and Pressure Injury Rates in US Acute Care Hospitals
Authors: Koloms Kimberly , Cox Jill , VanGilder Catherine A. , Edsberg Laura E. 
Published: September 2022

PURPOSE:
The purpose of this study was to identify and describe the prevalence of incontinence (urinary and/or fecal) and incontinence management practices among patients in US adult acute care settings, with and without hospital-acquired pressure injuries (HAPIs), using the data from the 2018/2019 International Pressure Ulcer Prevalence™ (IPUP) survey.

DESIGN:
Observational, cohort study with cross-sectional data collection and retrospective data analysis.

SUBJECTS AND SETTING:
The sample comprised 296,014 patients hospitalized in 1801 acute care facilities in the United States that participated in 2018 and/or 2019 IPUP survey. Of these, 192,852 (65%) patients had information recorded in the survey on incontinence status and were included in the analytical sample.

METHODS:
Data from the 2018/2019 IPUP database were analyzed to evaluate the prevalence of incontinence (urinary [UI], fecal [FI], and dual [DI]), and the use of incontinence and moisture management strategies. Incontinence prevalence was analyzed between 3 groups of patients: (1) those without pressure injuries; (2) patients with stage 1 and 2 HAPIs; and (3) those with severe HAPIs (stage 3, 4, unstageable, deep tissue pressure injury). Analysis of the subgroups within acute care was also undertaken and included medical-surgical, critical care, and step-down units.

RESULTS:
Incontinent patients were older (mean age 69-74 years depending on type of incontinence as compared to 62 years for continent patients) and had lower Braden Scale scores (range, 14.7-16.7, compared to 19.4 for continent patients). Half of the patients were female, 49.6% male, and 0.4% were unknown. Incontinence was identified in 32% of patients. Among patients with incontinence, 33% had UI, 12% had FI, and 55% had DI. Hospital-acquired pressure injuries were present in 27.4% of continent patients and 72.6% of incontinent patients, with DI having the highest rate of HAPIs. Analysis revealed a higher proportion of incontinent patients with unstageable HAPIs than continent patients (14.9% vs 9.6%, P = .00), as well as a higher proportion of incontinent patients with deep tissue HAPIs as compared to continent patients (27.0% vs 22.1%, P = .00). Significantly more incontinent patients regardless of HAPI status were using a bowel or bladder management system (P = .00).

CONCLUSION:
Results of this study support the importance of incontinence as a risk factor in HAPI development. The prevalence of all types of incontinence was 31.7% for the entire sample. Almost three-fourths (72.6%) of patients with HAPI had UF, FI, or DI. A standardized definition of both UI and FI is needed, given that over 70% of all critical care unit patients with a urinary catheter for incontinence management were still classified as urinary incontinent.
Interactive Evidence-Based Pressure Injury Education Program for Hospice Nursing
Authors: Seton Jacinta M. , Hovan Holly M. , Bogie Kath M. , Murray Maudie M. , Wasil Bridgette , Banks Patricia G. , Burant Christopher J. , Miller Charman , Vogt Marjorie 
Published: September 2022

PURPOSE:
The purpose of this quality improvement (QI) project was to develop and implement an interactive, evidence-based pressure injury (PI) education program and evaluate the impact on frontline hospice nursing staff knowledge and practice.

PARTICIPANTS AND SETTING:
The QI setting was a 12-bed inpatient hospice unit in a tertiary care Veterans Affairs (VA) Medical Center in Cleveland, Ohio. Nineteen licensed and unlicensed hospice nursing staff participated in this pre-/postworkshop project.

APPROACH:
Chart audit determined baseline PI incidence and prevalence on the inpatient hospice unit. Interviews with key leaders informed the need to develop and implement innovative PI education opportunities. A literature review determined existing standards regarding the benefits of PI education for nursing staff but did not reveal measurable targets in hospice settings. We developed a PI education intervention based on Kolcaba's Theory of Comfort framework and a Plan-Do-Study-Act (PDSA) performance improvement model. Education was delivered in 7 workshops, lasting 2 hours each. Knowledge, practice, and comfort for inpatient hospice nursing staff were evaluated at baseline and 8 weeks following the final refresher visit. Workshop satisfaction was collected once using standard program evaluation forms after final workshop delivery.

OUTCOMES:
We observed a significant improvement in staff PI knowledge (P = .001) and practice (P = .001) after initial workshop attendance and repeat engagement (P = .001). There was a large magnitude of effect for overall knowledge change (d = 1.04); similarly PI care planning and practice showed a large magnitude of effect and significant improvement (P = .001, d = 2.64). Staff comfort with job duties was stable with low effect size (mean 4.52, d = 0.04), and satisfaction with the workshop education was high (100% agreement with trainer effectiveness).

IMPLICATIONS FOR PRACTICE:
We found that frontline hospice nursing staff knowledge and practice improved after attendance at our evidence-based PI education program. Results of this QI project have stimulated ongoing discussion on how to sustain this program in our hospice setting.
Open Retromuscular Lateral Abdominal Wall Hernia Repair: Algorithmic Approach and Long-Term Outcomes at a Single Center
Authors: Montelione Katherine C , Petro Clayton C , Krpata David M , Lau Braden , Shukla Priya , Olson Molly A , Tamer Robert , Rosenblatt Steven , Rosen Michael J , Prabhu Ajita S 
Published: September 2022

BACKGROUND:
Lateral abdominal wall hernias are relatively rare and present unique challenges to repair. Our group has developed an algorithm for repair based on several anatomic characteristics identified on preoperative imaging. Herein, we report our algorithm and outcomes of a large series of open retromuscular lateral abdominal wall hernia repairs.

STUDY DESIGN:
Open retromuscular lateral abdominal wall hernia repairs performed at our institution from August 2014 through April 2021 were identified in the Abdominal Core Health Quality Collaborative. Hernia characteristics, etiology, operative techniques, postoperative outcomes, and long-term patient-reported outcomes were extracted from the Abdominal Core Health Quality Collaborative database, chart review, and telephone follow-up.

RESULTS:
Of 464 patients who underwent hernia repair, 121 with isolated lateral abdominal wall hernias (L1–4) and mean follow-up of 34 ± 24 months had a clinical recurrence rate of 0.9% (n = 1) and bulge rate of 37% (n = 42). The median Hernia-Related Quality of Life Survey and PROMIS pain intensity scores improved 37 and 9 points, respectively. Another 343 patients with lateral (L1–4) and midline (M1–5) abdominal wall hernias and mean follow-up of 29 ± 21 months had a clinical recurrence rate of 6% (n = 20) and bulge rate of 35% (n = 117). The median Hernia-Related Quality of Life Survey and PROMIS pain intensity scores improved by 43 and 16 points, respectively.

CONCLUSION:
We present an algorithm for open retromuscular lateral abdominal wall hernia repair with relatively low anatomic recurrence rates and substantial improvement in patient-reported quality of life and pain. Notably, postoperative bulging is commonly reported by patients, likely due to underlying denervation injuries from the original incision.
The Effect of Intradialytic Exercise on Dialysis Patient Survival: A Randomized Controlled Trial
Authors: Tabibi Mohammad Ali , Cheema Bobby , Salimian Nasrin , Corrêa Hugo , Ahmadi Saghar 
Published: September 2022

AbstractIntroductionPatients with kidney failure have a high mortality rate. This study aimed to evaluate the effect of intradialytic exercise on survival in patients receiving hemodialysis (HD).MethodsIn this randomized controlled trial conducted in a HD center in Iran, adult patients receiving chronic HD were randomized to intradialytic exercise (60 minutes) in the second hour of thrice weekly dialysis for 6 months (intervention) or no intradialytic exercise (control). The primary outcome was survival rate at 12 months. Secondary outcomes were serum albumin, hemoglobin, hematocrit, red blood cell count, serum calcium, serum phosphorous, parathyroid hormone, physical function (6-minute walk test) and nutritional status (Geriatric Nutritional Risk Index) during the first 6 months. The trial follow-up period was 12 months.ResultsThe study included 74 participants randomized to intervention (n=37) or control (n=37). Compared with controls, 1-year survival was higher in the intervention group compared with the control group (94% vs 73%, P=0.01). The hazard ratio on univariate analysis in intervention group was 0.17 (95% CI 0.04-0.8; P =0.02) compared to that in control group. During the 6-month intervention period, significant between-group changes were observed in all secondary outcomes between the intervention and control groups.ConclusionIntradialytic exercise performed for at least 60 minutes during thrice weekly dialysis sessions improves survival in adult patients receiving HD. This effect may be mediated by exercise-related improvements in bone mineral metabolism, anemia, physical function or nutritional status.Trial registrationClinicalTrials.gov Identifier: NCT04898608, Registered on May 21st,2021. Registered trial name: The Effect of Intradialytic Exercise on Dialysis Patients Survival.
Differences in Motivators, Barriers, and Incentives between Black and White Older Adults for Participation in Alzheimer’s Disease Biomarker Research
Authors: Eliacin Johanne , Polsinelli Angelina J. , Epperson Francine , Gao Sujuan , Van Heiden Sarah , Westmoreland Glenda , Richards Ralph , Richards Mollie , Campbell Chris , Hendrie Hugh , Risacher Shannon L. , Saykin Andrew J. , Wang Sophia 
Published: September 2022

AbstractIntroductionThe study aimed to identify strategies to increase older Black adults’ participation in Alzheimer’s disease (AD) biomarker research studies.Methods399 community-dwelling Black and White older adults (age ≥ 55) who had never participated in AD research completed a survey about their perceptions of AD research involving blood draw, MRI, and PET.ResultsAlthough most participants expressed interest in AD biomarker research (Black participants: 63.0%, White participants: 80.6%), Black participants were significantly more hesitant than White participants (28.9% vs 15.1%), were more concerned about study risks, (30.8% vs. 11.1%) and perceived multiple barriers to participating in brain scans. Lack of information was perceived as a barrier to participation across groups (45.8%) and return of study results was perceived as a participation incentive (78.9-85.7%) (Ps < .05).DiscussionStrategies to increase Black older adult participation in AD research may include disseminating additional study information and return of results.Declaration of InterestNone of the investigators have a conflict of interest. JE receives support from VA IK HX002283, NIA P30AG072976, and NIA P30AG010133. AJP receives support from NIA (NIA U01 AG057195) and Alzheimer’s Association (LDRFP-21-818464). SW receives support from multiple NIA grants (K23AG062555, P30AG072976, P30AG010133, and R21AG074179) and the VA for clinical services. She receives book royalties from APPI and DSMB consultant fees (total less than $2000/year). AJS receives support from multiple NIH grants (P30 AG010133, P30 AG072976, R01 AG019771, R01 AG057739, U01 AG024904, R01 LM013463, R01 AG068193, T32 AG071444, and U01 AG068057 and U01 AG072177). He has also received support from Avid Radiopharmaceuticals, a subsidiary of Eli Lilly (in kind contribution of PET tracer precursor); Bayer Oncology (Scientific Advisory Board); Eisai (Scientific Advisory Board); Siemens Medical Solutions USA, Inc. (Dementia Advisory Board); Springer-Nature Publishing (Editorial Office Support as Editor-in-Chief, Brain Imaging and Behavior).
Immunization Opportunities for Hospitalized Adolescents
Authors: Wurster William R. , Foster Byron A. , Walston James M. , Gardner Tiffany A. , Benchbani Hanae , Austin Jared 
Published: September 2022

ABSTRACTIntroductionAdolescents seek routine healthcare, including immunizations, less frequently than any other age group. Hospitalizations are an opportunity to provide immunizations to this vulnerable population. The aims of this study were to assess the accuracy of provider documentation of immunization status and evaluate the prevalence of delayed immunization status in this population.MethodsA retrospective chart review of adolescents discharged from July 2017 to June 2018 from the pediatric hospitalist service of a tertiary care academic children’s hospital was conducted. Provider documentation of immunization status was compared to the immunization registry ALERT Immunization Information System (ALERT IIS) linked to the electronic medical record using descriptive statistics.ResultsProvider documentation of up-to-date on all immunizations had a sensitivity of 60% and specificity of 55%, with 84% of patients needing at least one immunization despite 48% of patients being documented as up-to-date by providers. Provider documentation of the immunization status for the HPV, MCV and Tdap immunizations displayed a low sensitivity (10-11%) but a high specificity (97-100%) while documentation of the influenza immunization was associated with high sensitivity (86%) and low specificity (26%). Provider documentation of immunization status for the HPV, MCV, Tdap and influenza immunizations had positive likelihood ratios of 3.5, 8.5, infinity, and 1.2 with negative likelihood ratios of 0.9, 0.9, 0.9 and 0.53, respectively.ConclusionsProviders inaccurately documented the immunization status for adolescent patients in the inpatient setting. Hospitalizations may provide opportunities to improve immunization rates in adolescents, especially when using state immunization registries.
The impact of COVID-19 on population cancer screening programs in Australia: modelled evaluations for breast, bowel and cervical cancer
Authors: Nickson Carolyn , Smith Megan A , Feletto Eleonora , Velentzis Louiza S , Broun Kate , Deij Sabine , Grogan Paul , Hall Michaela , He Emily , St John D James , Lew Jie-Bin , Procopio Pietro , Simms Kate T. , Worthington Joachim , Mann G Bruce , Canfell Karen 
Published: September 2022

AbstractBackgroundAustralia introduced COVID-19 infection prevention and control measures in early 2020. To help prepare health services the Australian Government Department of Health commissioned a modelled evaluation of the impact of disruptions to population breast, bowel and cervical cancer screening programs on cancer outcomes and cancer services.MethodsWe used the Policy1 modelling platforms to estimate outcomes for potential disruptions to cancer screening participation, covering periods of 3, 6, 9 and 12 months. We estimated missed screens, clinical outcomes (cancer incidence, tumour staging), and various diagnostic service impacts.ResultsWe estimated that a 12-month screening disruption would reduce breast cancer diagnoses (9.3% population-level reduction over 2020-2021) and colorectal cancer (up to 12·1% reduction over 2020-21), and increase cervical cancer diagnoses (up to 3·6% over 2020-2022), with upstaging expected for these cancer types.ConclusionsFindings illustrate that maintaining screening participation is critical to sustaining a reduced cancer burden. We provide program-specific insights into which outcomes are expected to change, when changes are likely to become apparent, and likely downstream impacts. This evaluation provided evidence to guide decision-making for screening programs, and emphasises the ongoing benefits of maintaining screening in the face of potential future disruptions.FundingAustralian Government Department of Health
A Detector Block-Pairwise Dead Time Correction Method for Improved Quantitation with a Dedicated BrainPET Scanner
Authors: Issa Ahlam Said Mohamad , Scheins Jürgen , Tellmann Lutz , Lopez-Montes Alejandro , Herraiz Joaquin L , Brambilla Cláudia Régio , Herzog Hans , Neuner Irene , Shah N. Jon , Lerche Christoph 
Published: September 2022

AbstractDead time correction (DTC) is an important factor in ensuring accurate quantification in PET measurements. This is currently often achieved using a global DTC method, i.e., an average DTC factor is computed. For PET scanners designed to image dedicated organs, e.g., those used in brain imaging or positron emission mammography (PEM), a substantial amount of the administered radioactivity is located outside of the PET field-of-view (FOV). This activity contributes to the dead time (DT) of the scintillation detectors. Moreover, the count rates of the individual scintillation detectors are potentially very inhomogeneous due to the specific irradiation of each detector, especially for combined MR/PET systems, where radiation shields cannot be applied. We have developed a block-pairwise DTC method for our Siemens 3T MR BrainPET insert by extending a previously published method that uses the delayed random coincidence count rate to estimate the DT in the individual scans and planes (i.e., scintillation pixel rings). The method was validated in decay experiments using phantoms with a homogenous activity concentration and with and without out-of-FOV activity. Based on a three-compartment phantom, we compared the accuracy and noise properties of the block-pairwise DTC and the global DTC method. While the currently used global DTC led to a substantial positive bias in regions with high activity, the block-pairwise DTC resulted in substantially less bias. The noise level for the block-pairwise DTC was comparable to the global DTC and image reconstructions without any DTC. Finally, we tested the block-pairwise DTC with a data set obtained from volunteer measurements using the mGlu5R (metabotropic glutamate receptor subtype 5) antagonist [11C]-ABP688, when comparing the time-activity curves (TACs) obtained with the global DTC with the block-pairwise DTC, relative differences in the anterior cingulate cortex (ACC) and the cerebellum of up to 25% were observed during the first 30 minutes of these measurements.
Longitudinal immune profiling after radiation-attenuated sporozoite vaccination reveals coordinated immune processes correlated with malaria protection
Authors: Duffy Fergal J , Hertoghs Nina , Du Ying , Neal Maxwell L. , Oyong Damian , McDermott Suzanne , Minkah Nana , Carnes Jason , Schwedhelm Katharine V , McElrath M Juliana , Rosa Stephen C De , Newell Evan , Aitchison John D. , Stuart Ken 
Published: September 2022

ABSTRACTIdentifying immune processes required for liver-stage sterilizing immunity to malaria infection remains an open problem. The IMRAS trial comprised 5x immunizations with radiation-attenuated sporozoites resulting in 55% protection from subsequent challenge. To identify correlates of vaccination and protection, we performed detailed systems immunology longitudinal profiling of the entire trial time course including whole blood transcriptomics, detailed PBMC cell phenotyping and serum antigen array profiling of 11 IMRAS RAS vaccinees at up to 21 timepoints each. RAS vaccination induced serum antibody responses to CSP, TRAP, and AMA1 in all vaccinees. We observed large numbers of differentially expressed genes associated with vaccination response and protection, with distinctly differing transcriptome responses elicited after each immunization. These included inflammatory and proliferative responses, as well as increased abundance of monocyte and DC subsets after each immunization. Increases Vδ2 γδ T cells and MAIT cells were observed in response to immunization over the course of study. Interferon responses strongly differed between protected and non-protected individuals with high interferon responses after the 1stimmunization, but not the 2nd-5th. Blood transcriptional interferon responses were correlated with abundances of different circulating classical and non-classical monocyte populations.This study has revealed multiple coordinated immunological processes induced by vaccination and associated with protection. Our work represents the most detailed immunological profiling of a RAS vaccine trial performed to date and will guide the design and interpretation of future malaria vaccine trials.
Accelerating Antibody Design with Active Learning
Authors: Seo Seung-woo , Kwak Min Woo , Kang Eunji , Kim Chaeun , Park Eunyoung , Kang Tae Hyun , Kim Jinhan 
Published: September 2022

ABSTRACTDiscovering therapeutic antibody starts by screening antibody library of phage-displayed, transgenic mouse or human B cells. The coverage of those kinds of libraries in the entire antibody sequence space is small; thus, the result highly depends on the quality of the library. Exploring sequence space by mutating a template antibody is also impossible to even with the state-of-the-art screening methods because of the cost. Deep learning helped with its pattern recognition nature to predict target binding, which is only applied to HCDR3 because the number of data deep learning needs increases exponentially. We construct a sequence generation model with transfer learning and active learning to leverage deep learning even in data deficiency. With only six thousands data, the generative model finds nine binding antibody sequences at least per antigen with novel HCDR3.