bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Ceftriaxone Plus Avibactam in an Intracellular Hollow Fiber Model of Tuberculosis: Implications for the Treatment of Disseminated and Meningeal Tuberculosis in Children
Authors: Srivastava Shashikant , van Zyl Johanna , Cirrincione Kayle , Martin Katherine , Thomas Tania , Deshpande Devyani , Alffenaar Jan-William , Seddon James A. , Gumbo Tawanda 
Published: August 2020

Background:
Ceftazidime-avibactam is an effective agent for the treatment of tuberculosis (TB) but requires frequent administration because of a short half-life. Due to a longer half-life, ceftriaxone could allow intermittent dosing.

Methods:
First, we identified the MIC of ceftriaxone with 15 mg/L avibactam in 30 clinical Mycobacterium tuberculosis isolates. Next, 2 ceftriaxone exposure-effect studies in the intracellular hollow fiber model of TB (HFS-TB) that mimics disseminated disease in young children, were performed. Ceftriaxone was administered once or twice daily for 28 days to explore percentage of time that the concentration persisted above MIC (%TMIC) ranging from 0 to 100%. In a third HFS-TB experiment, the “double cephalosporin” regimen of ceftazidime-ceftriaxone-avibactam was examined and analyzed using Bliss Independence.

Conclusion:
The MIC99 of the clinical strains was 32 mg/L, in the presence of 15 mg/L avibactam. Ceftriaxone %TMIC <42 had no microbial effect in the HFS-TB, %TMIC
>54% demonstrated a 4.1 log10 colony-forming units per milliliter M. tuberculosis kill, while %TMIC mediating Emax was 68%. The “double cephalosporin” combination was highly synergistic. Monte Carlo experiments of 10,000 subjects identified the optimal ceftriaxone dose as 100 mg/kg twice a day.

Conclusion:
The combination of ceftriaxone-avibactam at 100 mg/kg could achieve Emax in >90% of children. The ceftriaxone potent activity M. tuberculosis could potentially shorten therapy in children with disseminated TB.
Reconstruction of Large Upper Eyelid Defects Using the Reverse Hughes Flap Combined With a Sandwich Graft of an Acellular Dermal Matrix
Authors: Eah Kyu Sang , Sa Ho-Seok 
Published: August 2020

Purpose:
To investigate the usefulness of the reverse Hughes flap procedure combined with a sandwich graft of an acellular dermal matrix for reconstruction of large full-thickness defects of upper eyelids after cancer excision.

Methods:
Clinical data were obtained from patients who underwent upper eyelid reconstruction using a reverse Hughes flap combined with a sandwich graft of an acellular dermal matrix (AlloDerm) as a tarsal substitute. The tarsoconjunctival flap of the donor lower eyelid was mobilized to reconstruct the posterior lamella, and acellular dermal matrix was grafted onto the tarsoconjunctival flap. A skin-orbicularis muscle flap superior to the defect was advanced to cover the acellular dermal matrix graft, followed by application of lid crease formation sutures to prevent postoperative entropion. The tarsoconjunctival pedicle was divided 3–8 weeks after the surgery.

Results:
Six patients with sebaceous carcinoma were included, and all had ≥70% full-thickness upper eyelid defects after tumor excision. After a median follow-up of 40 months (range 6–62 months), all 6 showed satisfactory functional and cosmetic outcomes. Tumor recurrence, exposure keratopathy, upper eyelid entropion, persistent use of bandage contact lenses, lower eyelid deformity, and dermal matrix-related complications were not observed by the last follow-up.

Conclusions:
Reverse Hughes flap combined with a sandwich graft of an acellular dermal matrix as a tarsal substitute was successful in reconstructing large upper eyelid defects. Acellular dermal matrix graft and lid crease formation sutures enhance marginal stability and prevent postoperative entropion of the reconstructed upper eyelid.
Corrected sodium levels for hyperglycemia is a better predictor than measured sodium levels for clinical outcomes among patients with extreme hyperglycemia
Authors: Chuang Chien , Guo Ya-Wun , Chen Harn-Shen 
Published: August 2020

Background:
Abnormal serum sodium levels in various diseases increase mortality; however, hyperglycemia depresses serum sodium concentration significantly. This study aimed to evaluate the clinical impact of measured serum sodium levels and corrected sodium levels among patients with severe hyperglycemia.

Methods:
Patients with blood glucose levels ≥500 mg/dL visiting the emergency department between July 2008 and September 2010 were enrolled retrospectively. The participants were divided into five groups for measured sodium levels and five groups for corrected sodium levels according to blood glucose levels. Multivariate Cox regression was used. The primary outcome was all-cause 90-day mortality. Secondary outcomes included rate of intensive care unit hospitalization, respiratory failure, and renal failure.

Results:
A total of 755 patients with severe hyperglycemia were enrolled, and the 90-day mortality was 17.2%. Compared with the reference group, the 90-day mortality was higher in the patients with measured hypernatremia (adjusted hazard ratio [HR], 2.86; 95% confidence interval [CI], 1.39–5.87), corrected hyponatremia (adjusted HR, 3.56; 95% CI, 1.44–8.80), and severe corrected hypernatremia (adjusted HR, 2.68; 95% CI, 1.28–5.62). However, patients with severe measured hyponatremia did not show increased mortality (adjusted HR, 1.67; 95% CI, 0.84–3.32).

Conclusion:
Among patients with severe hyperglycemia, corrected sodium level is a better indicator of clinical outcomes compared with measured sodium levels, especially in this population with measured hyponatremia.
Thyroid effects of amiodarone: clinical update
Authors: Goundan Poorani N. , Lee Stephanie L. 
Published: August 2020

Purpose of review
Amiodarone-induced thyroid dysfunction is well established and commonly encountered but is associated with several diagnostic and management challenges. The present review discusses recent evidence published related to the effects of amiodarone on the thyroid gland and thyroid function.

Recent findings
Retrospective studies to evaluate amiodarone-induced thyroid dysfunction in children show the occurrence of potential clinically significant changes within 2 weeks of amiodarone initiation that may not be detected if standard adult guidelines for thyroid hormone monitoring are followed. A small study evaluating beta-glucuronidase activity in amiodarone-induced thyrotoxicosis (AIT) demonstrated higher levels in patients with AIT type 2 compared to type 1. New data have suggested the incidence of agranulocytosis may be higher in patients on thionamides with AIT compared to hyperthyroidism because of other causes. In a small study, investigators demonstrated the use of a combination of intravenous and oral steroids to treat refractory AIT which needs to be evaluated in further controlled trials. Finally, recent data demonstrated a possible mortality benefit of surgery over medical therapy for AIT in patients with moderate to severe reduction in left ventricular ejection fraction.

Summary
Recent research regarding the prevalence, diagnosis, and management of amiodarone-induced thyroid dysfunction were reviewed.
Ketogenic diet as a metabolic treatment for mental illness
Authors: Norwitz Nicholas G. , Sethi Shebani , Palmer Christopher M. 
Published: August 2020

Purpose of review
Ketogenic diets, which have been used to treat drug-refractory paediatric epilepsy for over 100 years, are becoming increasingly popular for the treatment of other neurological conditions, including mental illnesses. We aim to explain how ketogenic diets can improve mental illness biopathology and review the recent clinical literature.

Recent findings
Psychiatric conditions, such as schizophrenia, depression, bipolar disorder and binge eating disorder, are neurometabolic diseases that share several common mechanistic biopathologies. These include glucose hypometabolism, neurotransmitter imbalances, oxidative stress and inflammation. There is strong evidence that ketogenic diets can address these four fundamental diseases, and now complementary clinical evidence that ketogenic diets can improve the patients’ symptoms.

Summary
It is important that researchers and clinicians are made aware of the trajectory of the evidence for the implementation of ketogenic diets in mental illnesses, as such a metabolic intervention provides not only a novel form of symptomatic treatment, but one that may be able to directly address the underlying disease mechanisms and, in so doing, also treat burdensome comorbidities (see Video, Supplementary Digital Content 1, http://links.lww.com/COE/A16, which summarizes the contents of this review).
The potential of a ketogenic diet to minimize effects of the metabolic fault in glycogen storage disease V and VII
Authors: Reason Stacey L. , Godfrey Richard J. 
Published: August 2020

Purpose of review
To explore the potential of a low carbohydrate ketogenic diet (LCKD) to counter physical activity intolerance, pain and muscle damage for glycogen storage disease (GSD) V and VII, and highlight the realistic possibility that nutrition could be key.

Recent findings
Carbohydrate (CHO) ingestion during physical activity in GSDV and a LCKD for GSDVII is common. For the latter, a long-term study demonstrated improvement in physiological markers while on a LCKD. This included improvement in aerobic power and activity tolerance. In GSDV, preliminary research on a LCKD suggest a diet of 75% fat, 15% protein, 10% CHO, is best for improved function and compliance. Ketones provide immediate fuel for acute physical activity, and have an epigenetic role, improving ketone and lipid use. Evidence from elite athletes found a LCKD can increase fat oxidation and is optimal at 70% VO2max. This suggests the need to also improve conditioning via exercise to maximize the benefit of a LCKD.

Summary
A high CHO diet in GSDV and VII comes with a restricted physical activity capacity alongside significant pain, muscle damage and risk of renal failure. Mounting evidence suggests a LCKD is efficacious for both disorders providing an immediate fuel source which may negate the need for a ‘warm-up’ prior to every activity and restore ‘normal’ function.
Low carbohydrate diet: are concerns with saturated fat, lipids, and cardiovascular disease risk justified?
Authors: Diamond David M. , O’Neill Blair J. , Volek Jeff S. 
Published: August 2020

Purpose of review
There is an extensive literature on the efficacy of the low carbohydrate diet (LCD) for weight loss, and in the improvement of markers of the insulin-resistant phenotype, including a reduction in inflammation, atherogenic dyslipidemia, hypertension, and hyperglycemia. However, critics have expressed concerns that the LCD promotes unrestricted consumption of saturated fat, which may increase low-density lipoprotein (LDL-C) levels. In theory, the diet-induced increase in LDL-C increases the risk of cardiovascular disease (CVD). The present review provides an assessment of concerns with the LCD, which have focused almost entirely on LDL-C, a poor marker of CVD risk. We discuss how critics of the LCD have ignored the literature demonstrating that the LCD improves the most reliable CVD risk factors.

Recent findings
Multiple longitudinal clinical trials in recent years have extended the duration of observations on the safety and effectiveness of the LCD to 2–3 years, and in one study on epileptics, for 10 years.

Summary
The present review integrates a historical perspective on the LCD with a critical assessment of the persistent concerns that consumption of saturated fat, in the context of an LCD, will increase risk for CVD.
Effect of low-carbohydrate diets on cardiometabolic risk, insulin resistance, and metabolic syndrome
Authors: O’Neill Blair J. 
Published: August 2020

Purpose of reviewAn obesity epidemic has resulted in increasing prevalence of insulin resistance, hyperinsulinemia, metabolic syndrome (MetS), and cardiovascular disease (CVD). The Diet-Heart Hypothesis posited that dietary fat is the culprit. Yet dietary fat reduction has contributed to the problem, not resolved it. The role of hyperinsulinemia, the genesis of its atherogenic dyslipidemia and systemic inflammation in CVD and its reversal is reviewed.Recent findingsOvernutrition leads to weight gain and carbohydrate intolerance creating a vicious cycle of insulin resistance/hyperinsulinemia inhibiting fat utilization and encouraging fat storage leading to an atherogenic dyslipidemia characterized by hypertriglyceridemia, low HDL, and small dense LDL. The carbohydrate-insulin model better accounts for the pathogenesis of obesity, MetS, and ultimately type 2 diabetes (T2DM) and CVD. Ketogenic Diets reduce visceral obesity, increase insulin sensitivity, reverse the atherogenic dyslipidemia and the inflammatory biomarkers of overnutrition. Recent trials show very high adherence to ketogenic diet for up to 2 years in individuals with T2DM, reversing their metabolic, inflammatory and dysglycemic biomarkers as well as the 10-year estimated atherosclerotic risk. Diabetes reversal occurred in over 50% and complete remission in nearly 8%.SummaryTherapeutic carbohydrate-restricted can prevent or reverse the components of MetS and T2DM.
Low carbohydrate ketogenic therapy as a metabolic treatment for binge eating and ultraprocessed food addiction
Authors: Sethi Shebani , Sinha Anika , Gearhardt Ashley N. 
Published: August 2020

Purpose of review
The aim of this study was to highlight the recent advancements and future directions for potential use of a low carbohydrate ketogenic dietary approach to treat binge eating and ultraprocessed food addiction. Herein, we explore proposed mechanisms of why a diet low in refined carbohydrates, processed sugar and higher fat content may be helpful in alleviating symptoms.

Recent findings
Emerging evidence suggests there may be a metabolic role in development of maladaptive eating. These findings broaden our understanding of eating psychopathology causes. Ultraprocessed, refined or high glycemic index carbohydrates are a possible trigger mediating neurochemical responses similar to addiction. The carbohydrate-insulin model of obesity supports observations of these foods triggering abnormal blood sugar and insulin spikes subsequently leading to changes in metabolic and neurobiological signaling. This results in overeating symptoms and hunger exacerbation, which differs from observed effects of healthy fat consumption and lack of similar insulin spikes. As supported in recent case series, significantly reducing or abstaining from these addictive-like ultraprocessed foods and highly refined carbohydrates could be considered a treatment approach.

Summary
The current review highlights recent and pertinent evidence with respect to theoretical and practical application of low carbohydrate ketogenic therapeutic approaches for ultraprocessed food addiction and binge eating symptoms.

Video abstract:

http://links.lww.com/COE/A18
Comparing endoscopic interventions to improve serrated adenoma detection rates during colonoscopy: a systematic review and network meta-analysis of randomized controlled trials
Authors: Aziz Muhammad , Fatima Rawish , Lee-Smith Wade , Khuder Sadik , Nawras Ali 
Published: August 2020

Objective
Serrated lesions (sessile serrated adenomas/polyps and traditional serrated adenomas) owing to their subtle appearance and proximal location have a high miss rate. The objective of this study is to compare all the available endoscopic interventions for improving serrated adenoma detection rate (SADR) through a network meta-analysis.

Methods
We conducted a systematic review of the available literature (PubMed, Embase, Cochrane and WoS) from inception to 29 November 2019 to identify all the relevant randomized controlled trials. A total of 28 trials with 22 830 patients were included. The studies compared the efficacy of add-on devices (endocap, endocuff, endocuff vision, G-EYE, endorings, AmplifEYE), electronic chromoendoscopy (linked-color imaging, blue laser imaging, narrow band imaging), dye-based chromoendoscopy, full-spectrum endoscopy (FUSE) and water-based techniques (WBT) with each other or high-definition colonoscopy. Both pairwise and network meta-analysis was conducted using the random-effects model. Risk ratios (RR) with 95% confidence intervals (CI) and P-values were calculated.

Results
Direct meta-analysis demonstrated superiority for WBT (RR: 1.41, CI: 1.01–1.98), add-on devices (RR: 1.53, CI: 1.13–2.08), narrow band imaging (RR: 1.93, CI: 1.12–3.32) and endocuff vision (RR: 1.87, CI: 1.13–3.11) compared to high-definition colonoscopy. The results were consistent on network meta-analysis with chromoendoscopy as an additional modality for improving SADR (RR: 1.74, CI: 1.03–2.93).

Conclusion
In a network meta-analysis, add-on devices (particularly endocuff vision), narrow band imaging, WBT and chromoendoscopy were comparable to each other and improved SADR compared to high-definition colonoscopy.
The lateral arm free flap for head and neck reconstruction
Authors: Amin Julian D. , Amin Neha , Hatten Kyle M. 
Published: August 2020

Purpose of review
The aim of this study was to review the recent literature on the utilization of the lateral arm free flap use in head and neck reconstruction.

Recent findings
The lateral arm free flap provides a reliable fasciocutaneous free tissue transfer option ideally suited for reconstruction of the oral cavity, pharynx and parotid. Primary donor site closure, compartmentalized fat and excellent colour match make it an excellent option for head and neck reconstruction. Donor site morbidity is low, and the primary limitation is the short and narrow vascular pedicle.

Summary
The lateral arm free flap should be considered in cases of oral cavity and skin reconstruction, particularly in cases wherein pedicle length is not restrictive.
Anesthetic considerations for combined heart--liver transplantation in patients with Fontan-associated liver disease
Authors: Hofer Ryan E. , Christensen Jon M. , Findlay James Y. 
Published: August 2020

Purpose of review
The success of the Fontan procedure has led to increased survival of patients born with certain congenital heart disease to the point that new sequlae, as a result of Fontan circulation, are being discovered. Included among these is Fontan-associated liver disease (FALD). The purpose of this review is to present available literature on the perioperative management of the combined heart--liver transplantation (CHLT) in patients with FALD.

Recent findings
The perioperative management of a combined heart-liver transplant in a patient with Fontan circulation is complex. The patient is at risk for hemodynamic disturbances, significant blood loss, coagulopathies, and metabolic derangements. The maintenance of an appropriate transpulmonary pressure gradient is paramount to success. Postoperative management should be accomplished by a multidisciplinary care team. Limited series have demonstrated good outcomes in patients who have undergone CHLT.

Summary
The perioperative management of CHLT in patients with FALD is complex and available literature is limited. Future studies are needed to further assess proper perioperative management of patients with FALD who undergo CHLT.
Assessing the Impact of a Preclinical Immersion on Nurse Practitioner Student Confidence for the Initial Clinical Experience
Authors: Phillips Tiffany A. , George Tracy P. , Munn Allison C. , Townsend Anna Katherine 
Published: August 2020

Background
It is important for faculty to prepare nurse practitioner students for their first clinical experiences to ensure student success.

Purpose
The purpose of this project was to implement a preclinical immersion and determine student perceptions about this experience.

Methods
A half-day preclinical immersion was instituted at the beginning of the family nurse practitioner students' first clinical course. Demographic information and survey data were obtained before the preclinical immersion experience, after completion of the immersion experience, and during the last 2 weeks of the first clinical course.

Results
Students' ratings of their clinical skills and knowledge improved during the duration of the semester for 5 of the 7 items. Directed content analysis revealed 3 themes: understanding of clinical expectations, face-to-face interactions with faculty, and cognitive/emotional clinical perceptions.

Conclusion
The use of preclinical immersion experiences may both practically and emotionally prepare students for graduate nursing clinical experiences.
Hypoglycemia While Driving in Insulin-Treated Patients: Incidence and Risk Factors
Authors: Lohan Laura , Clément Florian , Duflos Claire , Villiet Maxime , Castet-Nicolas Audrey , Boegner Catherine , Avignon Antoine , Sultan Ariane , Breuker Cyril 
Published: August 2020

Objectives
This study aimed to investigate a potential daily-life concern for patients with diabetes hypoglycemia while driving by (1) estimating their incidence in insulin-treated drivers, (2) determining factors associated with their occurrence, and (3) analyzing patients’ behavior regarding prevention of hypoglycemia.

Methods
We conducted an observational study from November 2013 to May 2018 in the endocrinology-diabetology-nutrition department of our university hospital. All patients treated for diabetes older than 18 years admitted in the department were eligible. A specific questionnaire assessing attitudes, knowledge, and consequences of hypoglycemia was provided. In this study, only insulin-treated patients who regularly drive were analyzed.

Results
On the 233 insulin-treated drivers included, 45 (19%) self-reported at least 1 hypoglycemia while driving in the preceding year. Two factors were significantly associated with their occurrence: type 1 diabetes (odds ratio [OR] = 3.19; 95% confidence interval [CI] = 1.55–6.57) and experiences of asymptomatic hypoglycemia (OR = 2.20; 95% CI = 1.05–4.63). Awareness of the treatment hypoglycemia risk because of information provided by a medical specialist was also but nonsignificantly associated with hypoglycemia while driving (OR = 2.61; 95% CI = 0.86–7.92). Forty-one patients (18%) combined those 3 variables, 20 (49%) of them self-reported hypoglycemia while driving. Thirty-four percent of the patients never carried carbohydrates for hypoglycemia correction. Seventy-six percent do not monitor blood glucose level before driving.

Conclusions
Our questionnaire allowed us to highlight that 19% our cohort of insulin-treated drivers declared experiencing hypoglycemia while driving. Risk factors identified and prevention data collected should help us better target patient education.