Development and validation of a rheumatoid arthritis case definition: a machine learning approach using data from primary care electronic medical records.

Background: Rheumatoid Arthritis (RA) is a chronic inflammatory disease that is primarily diagnosed and managed by rheumatologists; however, it is often primary care providers who first encounter RA-related symptoms. This study developed and validated a case definition for RA using national surveillance data in primary care settings.

Methods: This cross-sectional validation study used structured electronic medical record (EMR) data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN).

Candidacy 2.0 (CC) - an enhanced theory of access to healthcare for chronic conditions: lessons from a critical interpretive synthesis on access to rheumatoid arthritis care.

Background: The Dixon-Woods et al. Candidacy Framework, a valuable tool since its 2006 introduction, has been widely utilized to analyze access to various services in diverse contexts, including healthcare. This social constructionist approach examines micro, meso, and macro influences on access, offering concrete explanations for access challenges rooted in socially patterned influences.

Social determinants of health in adults with whiplash associated disorders.

Objectives: Although it is well-known that chronic diseases need to be managed within the complex biopsychosocial framework, little is known about the role of sociodemographic features in adults with whiplash-associated disorders (WAD) and their association with health outcomes. The aim of this study was to investigate the association between various sociodemographic features (age, sex, ethnicity, education, working, marriage, caring for dependents, and use of alcohol and drugs) and health outcomes (pain, disability, and physical/mental health-related quality of life) in WAD, both through their individual relationships and also via cluster analysis.

Methods: Independent -tests and Kruskal-Wallis tests (with Mann-Whitney tests where appropriate) were used to compare data for each health outcome.

Supporting Rehabilitation of Rural Patients Receiving Total Knee Arthroplasty Through Physical Activity: Perceptions of Stakeholder Groups.

Objective: To identify how patients with osteoarthritis waiting for and recovering from total knee arthroplasty (TKA) conceptualized and participated in physical activity behaviors in their rural setting and to gather perceptions of health care professionals and rehabilitation decision-makers on the feasibility of a remotely led physical activity coaching intervention.

Methods: Using a qualitative descriptive study, we collected data from three stakeholder groups: patients waiting for or recovering from TKA (interviews), health professionals delivering a physical activity intervention to patients in the recovering cohort (focus group), and rehabilitation leaders involved in decision-making at the local or provincial level (interviews).

Results: A total of 38 individuals provided their perspectives (25 patients, five health professionals, eight decision-makers).

Uridine Treatment of the First Known Case of SLC25A36 Deficiency.

SLC25A36 is a pyrimidine nucleotide carrier playing an important role in maintaining mitochondrial biogenesis. Deficiencies in SLC25A36 in mouse embryonic stem cells have been associated with mtDNA depletion as well as mitochondrial dysfunction. In human beings, diseases triggered by mutations have not been described yet.

Stationary Behavior and the Step-Defined Sedentary Lifestyle Index in Older Adults After Total Knee Arthroplasty.

Objectives: To measure stationary behavior in a cohort of older adults after total knee arthroplasty (TKA) and determine the clinical utility of the step-defined sedentary lifestyle index (SLI) as a measure of stationary behavior after TKA.

Design: Cross-sectional measurement study.

Setting: Participants were recruited from a community intake clinic for hip and knee surgeries.

Validity of Tools to Measure Physical Activity in Older Adults Following Total Knee Arthroplasty.

Few validated tools exist for measuring physical activity following total knee arthroplasty (TKA) despite the importance of returning to sufficient levels of physical activity post-TKA to achieve health benefits. This study examined the validity of two clinical measures-the Fitbit, a commercially available personal activity monitor, and the Community Healthy Activities Model Program for Seniors (CHAMPS), a self-report questionnaire-compared with a reference standard accelerometer, the SenseWearTM Armband (SWA). At 6-month post-TKA, 47 participants wore the Fitbit and SWA for 4 days and then completed the CHAMPS.

Immunogenicity of a Live-Attenuated Dengue Vaccine Using a Heterologous Prime-Boost Strategy in a Phase 1 Randomized Clinical Trial.

Background: Dengue is a global health problem and the development of a tetravalent dengue vaccine with durable protection is a high priority. A heterologous prime-boost strategy has the advantage of eliciting immune responses through different mechanisms and therefore may be superior to homologous prime-boost strategies for generating durable tetravalent immunity.

Methods: In this phase 1 first-in-human heterologous prime-boost study, 80 volunteers were assigned to 4 groups and received a tetravalent dengue virus (DENV-1-4) purified inactivated vaccine (TDENV-PIV) with alum adjuvant and a tetravalent dengue virus (DENV-1-4) live attenuated vaccine (TDENV-LAV) in different orders and dosing schedules (28 or 180 days apart).

A Phase 1, Open-Label Assessment of a Dengue Virus-1 Live Virus Human Challenge Strain.

Background: Dengue human infection models (DHIM) have been used as a safe means to test the viability of prophylaxis and therapeutics.

Methods: A phase 1 study of 12 healthy adult volunteers using a challenge virus, DENV-1-LVHC strain 45AZ5, was performed. A dose escalating design was used to determine the safety and performance profile of the challenge virus.

Quickly Evaluating an Emerging Medical Technology Using Feedback From the Field: A Case Study of the BrainScope One and Infrascanner 2000 User Evaluation.

Introduction: Gathering end-user feedback about candidate technologies in the operational environment prior to fielding helps to ensure that far-forward medical teams receive the most suitable technology. It is therefore a crucial step in the defense medical acquisition process. The current article reviews the methodology and provides an illustrative example of how end-user feedback was collected to evaluate the current suitability and future promise of two FDA-approved devices, the BrainScope One and Infrascanner 2000, that could potentially aid in the field evaluation of head injuries by far-forward medical teams.

Prodrug Approach for Posterior Eye Drug Delivery: Synthesis of Novel Ganciclovir Prodrugs and in Vitro Screening with Cassette Dosing.

Because of poor ocular drug bioavailability, intravitreal injections have become the gold standard for drug delivery to the posterior eye. The prodrug approach can be used for optimizing the biopharmaceutical properties of intravitreal drugs. The preclinical screening of prodrugs' properties, such as hydrolysis and bioconversion, should be conducted in a resource-efficient way for an extensive set of synthesized compounds with validated methods.

Assessing the Dengue Diagnosis Capability Gap in the Military Health System.

Dengue, one of the most widespread infectious diseases, has affected U.S. military readiness throughout history.

Risk factors for revision of total knee arthroplasty: a scoping review.

Background: In spite of the increasing incidence of total knee arthroplasties (TKA), evidence is limited regarding risk factors for revision. The objective of this scoping review was to identify and assess demographic, surgical and health services factors that may increase the risk for revision surgery following TKA.

Methods: A scoping review was undertaken following an electronic search in MEDLINE (1990 to December 2013), CINAHL (to December 2013), EMBASE (1990 to December 2013) and Web of Science (1990 to December 2013).

Discovery of an island population of dwarf lemurs (Cheirogaleidae: Cheirogaleus) on Nosy Hara, far northern Madagascar.

The species-level diversity of Madagascar's lemurs has increased hugely over the last two decades, growing from 32 species in 1994 to 102 species in 2014. This growth is primarily due to the application of molecular phylogenetic analyses and the phylogenetic species concept to known populations, and few previously unknown lemur populations have been discovered during this time. We report on a new population of dwarf lemurs (Cheirogaleus sp.

Multicountry prospective clinical evaluation of two enzyme-linked immunosorbent assays and two rapid diagnostic tests for diagnosing dengue fever.

We evaluated four dengue diagnostic devices from Alere, including the SD Bioline Dengue Duo (nonstructural [NS] 1 Ag and IgG/IgM), the Panbio Dengue Duo Cassette (IgM/IgG) rapid diagnostic tests (RDTs), and the Panbio dengue IgM and IgG capture enzyme-linked immunosorbent assays (ELISAs) in a prospective, controlled, multicenter study in Peru, Venezuela, Cambodia, and the United States, using samples from 1,021 febrile individuals. Archived, well-characterized samples from an additional 135 febrile individuals from Thailand were also used. Reference testing was performed on all samples using an algorithm involving virus isolation, in-house IgM and IgG capture ELISAs, and plaque reduction neutralization tests (PRNT) to determine the infection status of the individual.

Diverse sensory inputs permit priming in the acidic saline model of hyperalgesia.

Background: The rodent acidic saline model of hyperalgesia uses repeat injections of acidic saline in the right lateral gastrocnemius muscle, spaced five days apart, to induce a persistent decrease in hindpaw withdrawal thresholds. The objective of this study was to determine if alternate injection sites would permit development of hyperalgesia.

Methods: The location of the first muscle injection was varied between 3 groups of rats to include the right lateral gastrocnemius, the right medial gastrocnemius or the left lateral gastrocnemius.

Biomechanical evaluation of two reconstruction techniques for posterolateral instability of the knee.

We evaluated two reconstruction techniques for a simulated posterolateral corner injury on ten pairs of cadaver knees. Specimens were mounted at 30° and 90° of knee flexion to record external rotation and varus movement. Instability was created by transversely sectioning the lateral collateral ligament at its midpoint and the popliteus tendon was released at the lateral femoral condyle.

Pre- and post-exposure prophylaxis of experimental Burkholderia pseudomallei infection with doxycycline, amoxicillin/clavulanic acid and co-trimoxazole.

Objectives: Melioidosis, a potentially fatal disease of humans and animals, is caused by the gram-negative bacterium, Burkholderia pseudomallei. There is no approved vaccine or effective prophylaxis. Given its potential as a bioterrorism agent and a cause of serious laboratory-acquired infection, we studied the efficacy of pre- and post-exposure oral antibiotic prophylaxis in BALB/c mice infected with aerosolized B.

Tunnel convergence in combined anterior cruciate ligament and posterolateral corner reconstruction.

Purpose: To examine the geometric relationship between tunnels created in the lateral femoral condyle in reconstruction of the anterior cruciate ligament (ACL) and the posterolateral structures.

Methods: The geometric relationship between a standard ACL tunnel and 11 lateral femoral tunnel variations in synthetic femur specimens was examined. Tunnel collision frequency and tunnel separation were measured radiographically.

Interference Kirschner wires augment distal humeral fracture fixation in the elderly.

Objectives: This study was designed to compare the biomechanical stability of a two-plate distal humerus fixation with and without Kirschner-wire (K-wire) augmentation of supracondylar osteotomies.

Design: Ex vivo paired cadaveric study.

Setting: Biomechanical laboratory.

Clinical evaluation of affirm VPIII in the detection and identification of Trichomonas vaginalis, Gardnerella vaginalis, and Candida species in vaginitis/vaginosis.

Objective: To compare the Affirm VPIII Microbial Identification Test for detection and identification of Candida species, Gardnerella vaginalis and Trichomonas vaginalis to clinical and microscopic criteria commonly used to diagnose vaginitis.

Methods: Women that were symptomatic for vaginitis/vaginosis and asymptomatic women being seen for routine obstetric or gynecological care were included in this study. Women treated with antibiotics or antifungals within one week or women who had douched within 24 hours were excluded.

Material properties of various cements for use with vertebroplasty.

The purpose of the current study was to measure the material properties of various cements prepared per manufacturers' recommendations and of cements modified according to compositions developed by clinicians with experience performing vertebroplasty. Cement was prepared, cast to form cylindrical specimens, and tested in compression. The optical density of specimens from the various cement preparations was measured.