Access to evidence-based care: a systematic review of trauma and surgical literature costs across resource settings.

Background: Evidence-based medicine has become the foundation for surgeons around the world to provide the most effective surgical care. However, the article processing charges (APCs) and subscription fees for surgical journals may be a barrier, particularly for those in low-income and middle-income countries (LMICs).

Objectives: The objective of this study was to define the current options for producers and consumers of surgical literature, inclusive of trauma, across resource settings.

Impact of COVID-19 pandemic and vaccine perceptions on HPV vaccine hesitancy.

Objective: This study evaluated the impact of the COVID-19 pandemic and vaccine perceptions on Human Papillomavirus (HPV) vaccine hesitancy. Secondary endpoints included comparing COVID-19 and HPV vaccination trends regarding time, community of residence, and unmet social needs.

Methods: This was a survey-based, cross-sectional study that included 101 participants who were recruited through the Wyandotte County Public Health Department.

Development and evaluation of a COVID tracking system to support provision of social service in Wyandotte County, Kansas.

Background: In addition to the state-mandated case investigation and contact tracing, the Unified Government Public Health Department of Wyandotte County, Kansas implemented social support services for COVID-19 cases and contacts; however, did not have the systems in place to document the provision of these services. Our team worked with the health department to develop and implement the COVID Tracking System (CTS), an eHealth system that linked multiple involved teams. Here, we describe the development and evaluation of the CTS.

Duchenne muscular dystrophy: Current treatment and emerging exon skipping and gene therapy approach.

Duchenne muscular dystrophy (DMD) is an X-linked recessive neuromuscular disorder that causes debilitating muscle weakness and atrophy due to a loss of the dystrophin protein. Patients with DMD are commonly diagnosed at about 3-5 years of age and progressively decline until complications of the disease often result in death at about 20 years of age. While there is no current cure for DMD, several treatment options focus on improving the quality of life and slowing progression of symptoms associated with the disease.

Manganese-Enhanced Magnetic Resonance Imaging as a Diagnostic and Dispositional Tool after Mild-Moderate Blast Traumatic Brain Injury.

Traumatic brain injury (TBI) caused by explosive munitions, known as blast TBI, is the signature injury in recent military conflicts in Iraq and Afghanistan. Diagnostic evaluation of TBI, including blast TBI, is based on clinical history, symptoms, and neuropsychological testing, all of which can result in misdiagnosis or underdiagnosis of this condition, particularly in the case of TBI of mild-to-moderate severity. Prognosis is currently determined by TBI severity, recurrence, and type of pathology, and also may be influenced by promptness of clinical intervention when more effective treatments become available.

Risks to health among American Indian/Alaska Native high school students in the United States.

Introduction: According to the World Health Organization, the 10 leading risk factor causes of death in high-income countries are tobacco use, high blood pressure, overweight and obesity, physical inactivity, high blood glucose, high cholesterol, low fruit and vegetable intake, urban air pollution, alcohol use, and occupational risks. We examined the prevalence of some of the leading risks to health among nationally representative samples of American Indian/Alaska Native (AI/AN) high school students and compared rates across racial/ethnic groups.

Methods: We combined data from the 2001, 2003, 2005, 2007, and 2009 national Youth Risk Behavior Survey.

Cigarette smoke stimulates MMP-1 production by human lung fibroblasts through the ERK1/2 pathway.

An imbalance between proteases and anti-proteases is believed to play an important role in the pathogenesis of emphysema. In this study, we explored the hypothesis that cigarette smoke can alter tissue structure through an effect on the release of matrix metalloproteinase-1 (MMP-1) and type I tissue inhibitor of metalloproteinases (TIMP-1). Cigarette smoke extract (CSE) significantly stimulated pro-MMP-1 production (determined by ELISA and immunoblots) and mRNA expression (by real-time RT-PCR) by human fetal lung fibroblasts (HFL-1) in a concentration-dependent manner (2.

Cigarette smoke extract induces DNA damage but not apoptosis in human bronchial epithelial cells.

Whether DNA damage caused by cigarette smoke leads to repair or apoptosis has not been fully elucidated. The current study demonstrates that cigarette smoke induces single-strand DNA damage in human bronchial epithelial cells. Cigarette smoke also stimulated caspase 3 precursors as well as intact poly (ADP-ribose) polymerase (PARP) production, but did not activate caspase 3 or cleave PARP, while the alkaloid camptothecin did so.

Reversible cigarette smoke extract-induced DNA damage in human lung fibroblasts.

Cigarette smoke contains thousands of chemicals, many of which may contribute to cytotoxicity and carcinogenesis. Using assays detecting DNA strand breaks (terminal transferase dUTP nick end labeling [TUNEL]) and DNA content (flow cytometry), we evaluated the genotoxic effect of cigarette smoke extract (CSE) on human fetal lung fibroblasts (HFL-1) cultured in three-dimensional collagen gels as well as in monolayer culture. When HFL-1 cells were exposed to CSE, DNA strand breaks were detected in most, as determined by TUNEL.

Ultrafine carbon black particles inhibit human lung fibroblast-mediated collagen gel contraction.

Both acute and chronic exposure to particulates have been associated with increased mortality and morbidity from a number of causes, including chronic obstructive pulmonary disease and other chronic lung diseases. The current study evaluated the hypothesis that ultrafine carbon particles, a component of ambient particulates, could affect tissue repair. To assess this, the three-dimensional collagen gel contraction model was used.

Bone grafting with a calcium sulfate barrier after root amputation.

Two cases are presented in which unfavorable anatomic factors after ro ot amputation were treated with demineralized freeze-dried bone allograft and a calcium sulfate barrier. The success of these cases demonstrates the potential advantage of this regeneration procedure when there is advanced furcation bone destruction after root removal.

Evaluation of a multicomponent group smoking cessation program.

Background: Participants who had completed a multicomponent group smoking cessation program were interviewed to determine their smoking status and satisfaction with the program.

Methods: The follow-up interviews occurred an average of 20 months after entry to the program, with a response rate of 80% (89 out of 111 enrollees). Most individuals interviewed (82%) were able to quit for at least 24 hr; 25% were able to maintain nonsmoking status for 1 year or longer.

The impact of a total ban on smoking in the Johns Hopkins Children's Center.

We report the results of a ban on smoking in The Johns Hopkins Children's Center, Baltimore, Md, beginning in July 1987. A survey 6 months before and 6 months after implementation of the ban showed current smoking prevalences to be 15% and 13.8%, respectively.

Banning smoking in a children's hospital: are employees supportive?

This study surveyed 762 professional and auxiliary employees in a large urban children's hospital to assess readiness for a total ban on smoking. The prevalence of never smokers was 63.1%, former smokers was 21.

Burn area measurement by computerized planimetry.

A microcomputer system was developed which allows the user to draw the contour of a burn on a diagram on the computer screen. The per cent body surface area is then determined by direct area measurement by the computer. A total of 148 weekly burn diagrams ranging from 1% to 71% (mean, 23.

Wound Closure Index: a guide to prognosis in burned patients.

Speed of closure of the burn wound has been shown to influence survival in several large series, yet is difficult to quantitate. A computerized wound mapping system is described which records and computes the extent of the burn wound and its rate of closure. The program stores, displays, and modifies a series of Lund and Browder charts for each patient.