bluuebunny/crossref_metadata_2025_split huggingface dataset:
The characteristics of lymphocytes in patients positive for anti-MDA5 antibodies in interstitial lung disease
Authors: Huang Wenhan , Ren FeiFeng , Luo Lei , Zhou Jun , Huang Dongmei , Pan Zhuma , Tang Lin 
Published: April 2020

Abstract

Objective
The aim was to investigate the characteristics of blood lymphocytes in patients positive for anti-melanoma differentiation-associated gene 5 antibodies (anti-MDA5+) in interstitial lung disease.

Methods
Thirty-eight anti-MDA5+ patients with interstitial lung disease were admitted to our hospital, and the lymphocyte count, lymphocyte subtypes and lung high-resolution CT were recorded. Some of the cases were examined by bone marrow aspiration.

Results
Compared with the control group, the blood lymphocyte counts of anti-MDA5+ patients before treatment were significantly lower (P &lt; 0.05). After treatment, lung interstitial lesions in some cases were reduced and the lymphocyte counts increased, whereas their CD4:CD8 ratio decreased (P &lt; 0.05). In contrast, lung interstitial lesions of other cases were exacerbated after treatment and the lymphocyte counts decreased, whereas the CD4:CD8 ratio increased (P &lt; 0.05). In cases with exacerbated lung interstitial lesions after treatment, there were fewer CD4 and CD8 T cells than before treatment, and the change in CD8 T cells was significant (P &lt; 0.05). Bone marrow aspiration biopsy indicated that there was no abnormality in the distribution of bone marrow lymphocytes.

Conclusion
Anti-MDA5+ patients showed a decrease in blood lymphocyte counts. The presence of anti-MDA5+ in patients with pulmonary interstitial lesions was positively correlated with blood lymphocyte counts but negatively correlated with the CD4:CD8 ratio. The CD8 T cells decreased more significantly than CD4 T cells in patients with aggravation of interstitial lung disease. The change in blood lymphocytes in anti-MDA5+ patients might be attributable to transfer of lymphocytes to the lungs to participate in the local immune response.
Evolutionary analysis of exogenous and integrated HHV-6A/HHV-6B populations
Authors: Forni Diego , Cagliani Rachele , Clerici Mario , Pozzoli Uberto , Sironi Manuela 
Published: April 2020

AbstractHuman betaherpesviruses 6A and 6B (HHV-6A and HHV-6B) are highly prevalent in human populations. The genomes of these viruses can be stably integrated at the telomeres of human chromosomes and be vertically transmitted (inherited chromosomally integrated HHV-6A/HHV-6B, iciHHV-6A/iciHHV-6B). We reconstructed the population structures of HHV-6A and HHV-6B, showing that HHV-6A diverged less than HHV-6B genomes from the projected common ancestral population. Thus, HHV-6B genomes experienced stronger drift, as also supported by calculation of nucleotide diversity and Tajima’s D. Analysis of ancestry proportions indicated that HHV-6A exogenous viruses and iciHHV-6A derived most of their genomes from distinct ancestral sources. Conversely, ancestry proportions were similar in exogenous HHV-6B viruses and iciHHV-6B. In line with previous indications, this suggests the distinct exogenous viral populations that originated iciHHV-6B in subjects with European and Asian ancestry are still causing infections in the corresponding geographic areas. Notably, for both iciHHV-6A and iciHHV-6B, we found that European and American sequences tend to have high proportions of ancestry from viral populations that experienced considerable drift, suggesting that they underwent one or more bottlenecks followed by population expansion. Finally, analysis of HHV-6B exogenous viruses sampled in Japan indicated that proportions of ancestry components of most of these viruses are different from the majority of those sampled in the USA. More generally, we show that, in both viral species, both integrated and exogenous viral genomes have different ancestry components, partially depending on geographic location. It would be extremely important to determine whether such differences account for the diversity of HHV-6A/HHV-6B-associated clinical symptoms and epidemiology. Also, the sequencing of additional exogenous and integrated viral genomes will be instrumental to confirm and expand our conclusions, which are based on a relatively small number of genomes, sequenced with variable quality, and with unequal sampling in terms of geographic origin.
Utilization of Video for Competency Evaluation
Authors: Fieler Gina 
Published: April 2020

Abstract
Learner self-assessment and accountability are important features in nursing education. Innovative competency sessions enhance the delivery of quality care. This project investigated the addition of video into established competency evaluations for the purpose of learner review and self-evaluation. An experimental design was used to determine the effects of video on learner self-evaluation. With 95 percent confidence, the mean total self-evaluation score for those without the video was higher than for those with the video, supporting the hypothesis that those without video recall would inflate their self-evaluation scores.
Student-Centered Reading Using PDF Software as an Innovative Teaching Strategy in Graduate Nursing Education
Authors: Brackney Dana E. , Lane Susan H. 
Published: April 2020

Abstract
Student engagement in scholarly reading and critical thinking contributes to nursing science. However, graduate students often lack the skills and experience needed to read and analyze scholarly writings in depth. This case example describes use of portable document format technology with reading prompts to improve student scholarship in a master of science in nursing program. Theory and research guided development of the visible reading innovation. Student work with this pilot assignment sequence indicates an increase in student engagement with the text, as evidenced by student comment content, comment spacing throughout the text, and text integration into a summative writing assignment.
Effect of Physical Condition on Outcomes in Transplant Patients: A Retrospective Data Analysis
Authors: Andres Kayla , Wayman Brooke , Rodriguez Tina , Kline Margaret , Haveman Joshua , Brower Chelsea , Williams Stephanie F. 
Published: April 2020

Background:
Stem cell transplantation is a potential curative procedure for many patients with hematologic malignancies. These patients because of age, comorbid medical conditions, and prior therapies can present in various physical conditions from good performance status to frail, which may affect transplant outcomes.

Objective:
To assess the relationship of measurable physical conditioning metrics to survival, progression-free survival, relapse rate, and transplant-related morbidity and mortality in the context of our current rehabilitation program.

Methods:
We conducted a retrospective review of 207 patients who had undergone hematopoietic stem cell transplantation with 6 months of follow-up. Data were collected from their pretransplant rehabilitation evaluation and their 60-day posttransplant evaluation including their Karnofsky Performance Status (KPS) score, Timed Up and Go, pain, fatigue, and distress measurements. Using their KPS score patients were categorized as high performers (KPS ≥80) and low performers (KPS ≤70).

Results:
Patients experienced significant decreases in pain, fatigue, and distress after transplant. There were no significant differences in overall survival, progression-free survival, relapse rate, or transplant-related mortality between high and low performers. When controlling for transplant type, high performers had half the risk of dying compared with low performers.

Conclusions:
Our study demonstrated better posttransplant standard measures regardless of initial performance status. Our data suggest that patients with a better pretransplant performance status have better overall survival. One limitation of our study is the exercise program was not supervised and adherence is unknown.
Interprofessional Improv: Using Theater Techniques to Teach Health Professions Students Empathy in Teams
Authors: Zelenski Amy B. , Saldivar Norma , Park Linda S. , Schoenleber Vonnie , Osman Fauzia , Kraemer Sara 
Published: April 2020

Problem
Health professionals need to learn how to relate to one another to ensure high-quality patient care and to create collaborative and supportive teams in the clinical environment. One method for addressing both of these goals is teaching empathy during professional training to foster connection and commonality across differences. The authors describe a pilot improvisational theater (improv) course and present the preliminary outcomes showing its impact on interprofessional empathy.

Approach
In 2016–2017, the authors piloted a 15-hour course to teach interprofessional empathy to health professions students at the University of Wisconsin–Madison using improv techniques. The authors used a convergent mixed-methods design to evaluate the course’s impact on interprofessional empathy. Students enrolled in the course (intervention group, n = 45) and a comparison group (n = 41) completed 2 validated empathy questionnaires (Interpersonal Reactivity Index [IRI], Consultative and Relational Empathy [CARE] measure) and a facial expression recognition task to measure empathy in the pre- and postintervention periods. Differences were examined using paired t tests. Semistructured interviews were conducted with 8 course participants to gain a deeper understanding of the course’s effects.

Outcomes
The intervention group’s mean scores on 5 CARE items improved significantly: ease, care, explain, help, and plan. On the IRI, personal distress levels decreased significantly in both the intervention and comparison groups. In the interviews, students who took the class reported a positive impact on their interprofessional relationships and on their ability to think on their feet. They also reported improv influenced other areas of their lives, including patient care and interactions with people outside their work life.

Next Steps
The authors have continued to offer the course. They aim to conduct a randomized controlled study with medical students and test durability by measuring empathy again 3–6 months following the intervention.
Anterior Cervical Arthrodesis With Polyetheretherketone Spacers
Authors: Ross Donald A. , Pollock Jeffrey M. , Li Ningcheng Peter , Yoo Jung U. , Obayashi James T. 
Published: April 2020

Study Design:
This was a retrospective study of 2 surgeons’ use of a single polyetheretherketone (PEEK) device.

Objective:
Our objective was to investigate the fusion adjunct placed within PEEK devices to examine the likelihood of an arthrodesis, regardless of the PEEK interbody device itself.

Summary of Background Data:
The effectiveness of PEEK interbody devices in anterior cervical arthrodesis has been questioned.

Methods:
The authors retrospectively reviewed the results of 121 patients with demineralized bone matrix (DBM) and 96 with local autograft bone placed within identical PEEK devices for anterior cervical arthrodesis (from 2011 to 2018); 1 surgeon used DBM and another local autograft bone. Arthrodesis was determined independently by a surgeon and 2 blinded neuroradiologists.

Results:
For DBM versus autograft; mean age was 60 versus 61 years, smoking status 42.1% versus 31%, diabetes mellitus 18.2% versus 28%, mean body mass index 31 versus 30, and follow up averaged 17 months in both groups. For DBM versus autograft; a radiographic arthrodesis was observed in 22.3% versus 76% of patients. Refusion at the index level was required in 5.8% of the DBM and 0% of the autograft patients.

Conclusions:
A PEEK interbody device filled with local autograft resulted in a higher radiographic fusion rate and a lower need for reoperation at the index level than an identical device filled with DBM. Caution is warranted in assigning fusion failure to the PEEK device alone in anterior cervical discectomy and fusion surgery.
Increased Inpatient Length of Stay After Early Unplanned Transfer to Higher Levels of Care
Authors: Sykora Daniel , Traub Stephen J. , Buras Matthew R. , Hodgson Nicole R. , Geyer Holly L. 
Published: April 2020

Objectives:
Patients admitted to a medical-surgical unit infrequently require early transfer to higher level care, although how their inpatient length of stay compares to untransferred patients, or those directly admitted to intermediate care, is unknown. We sought to compare the inpatient length of stay of these groups.

Design:
Single-site retrospective analysis.

Setting:
An academic hospital specializing in complex care.

Patients:
We evaluated 23,694 patients admitted to the Hospital Internal Medicine service over a 4-year period (January 1, 2013, to December 31, 2016).

Interventions:
None.

Measurements and Main Results:
Using 6- and 24-hour definitions of early transfer, we categorized patients as admitted to medical-surgical unit without early transfer (medical-surgical unit), transferred (TX) early to higher level care, or initially admitted to an intermediate care unit. We report patient characteristics and inpatient length of stay adjusted for patient demographics (age and sex) and initial acuity (measured by Emergency Severity Index). There were significant increases in both unadjusted inpatient length of stay (6 hr: medical-surgical unit = 73.4 hr, TX = 137.9 hr, intermediate care unit = 101.1 hr; 24 hr: medical-surgical unit = 72.4 hr, TX = 141.9 hr, intermediate care unit = 98.2 hr; p < 0.01 for all groups) and adjusted inpatient length of stay (6-hr definition: medical-surgical unit = 50.9 hr [95% CI, 50.3–51.6 hr], TX = 100.4 hr [90.4–112.0 hr], intermediate care unit = 72.3 hr [70.6–74.0 hr]; 24-hr definition: medical-surgical unit = 50.3 hr [49.7–50.9 hr], TX = 108.3 hr [101.5–116.0 hr], intermediate care unit = 70.7 hr [69.0–72.3 hr]; p < 0.0001 for comparison of TX to medical-surgical unit and intermediate care unit in both groups). The increases in inpatient length of stay for the TX groups were not explained by differences in demographics or acuity.

Conclusions:
In a single facility study, patients admitted to a medical/surgical unit who require early transfer to intermediate care unit have a significant and unexplained increase in inpatient length of stay. This unexplained increased inpatient length of stay suggests that triage to the appropriate inpatient unit significantly affects inpatient length of stay.
Short-term Revision Risk of Patellofemoral Arthroplasty Is High: An Analysis from Eight Large Arthroplasty Registries
Authors: Lewis Peter L. , Tudor Francois , Lorimer Michelle , McKie John , Bohm Eric , Robertsson Otto , Makela Keijo T. , Haapakoski Jaason , Furnes Ove , Bartz-Johannessen Christoffer , Nelissen Rob G. H. H. , Van Steenbergen Liza N. , Fithian Donald C. , Prentice Heather A. 
Published: April 2020

Abstract

Background
Patellofemoral arthroplasty (PFA) is one option for the treatment of isolated patellofemoral osteoarthritis, but there are limited data regarding the procedure and results. Because isolated patellofemoral arthritis is relatively uncommon, available case series generally are small, and even within national registries, sample sizes are limited. Combining data from multiple registries may aid in assessing worldwide PFA usage and survivorship.

Questions/purposes
We combined and compared data from multiple large arthroplasty registries worldwide to ask: (1) What proportion of patients undergoing primary knee arthroplasty have PFA? (2) What are the patient and prosthesis characteristics associated with PFA in common practice, as reflected in registries? (3) What is the survivorship free from revision of PFA and what are the reasons for and types of revisions?

Methods
Data were provided by eight registries that are members of the International Society of Arthroplasty Registries (ISAR) who agreed to share aggregate data: Australia, New Zealand, Canada, Sweden, Finland, Norway, the Netherlands, and the United States. De-identified data were obtained for PFA performed from either the beginning of year 2000, or the earliest recorded implantation date after that in each individual registry when PFA data collection commenced, up to December 31, 2016. This included patient demographics, implant use, all-cause revision rate (determined by cumulative percent revision [CPR]), and reasons for and type of revision.

Results
During the data collection period, 6784 PFAs were performed in the eight countries. PFAs comprised less than 1% of primary knee replacements in all registries. Patient demographics were comparable in all countries. Patients were generally more likely to be women than men, and the mean age ranged from 50 years to 60 years. All registries showed a high rate of revision for PFA. The 5-year CPR for any reason ranged from 8.0% (95% CI 4.5 to 11.5) in Norway to 18.1% (95% CI 15.5 to 20.7) in the Netherlands. The most common reason for revision across all countries was disease progression (42%, 434 of 1034). Most PFAs (83%, 810 of 980) were revised to a TKA.

Conclusions
The revision risk of PFA in all registries surveyed was more than three times higher than the reported revision risk of TKA at the same times. The survivorship of PFA is similar to that of the no-longer-used procedure of metal-on-metal conventional hip replacement. Although there may be potential functional benefits from PFA, these findings of consistent and alarmingly high rates of revision should create concern, particularly as this procedure is often used in younger patients.

Level of Evidence
Level III, therapeutic study.
Resveratrol Attenuates Aortic Dissection by Increasing Endothelial Barrier Function Through the SIRT1 Pathway
Authors: Wang Kaijie , Zhao Jinping , Zhang Wenwen , Zhu Minglin , Xu Ming , Li Dan , Shi Hongjie , Zhang Ming , Shi Jiajun , Dong Zhe 
Published: April 2020

Abstract:
Aortic dissection (AD) is a serious condition and a health issue on a global scale. β-Aminopropionitrile–induced AD in mice is similar to the pathogenesis of AD in humans. Resveratrol (RSV) is a natural polyphenolic substance that provides anti-inflammatory and cardiovascular effects, but the role of RSV in AD is unclear. In this study, we investigated the effects and mechanisms of RSV on β-aminopropionitrile–induced AD in mice. Our results indicate that RSV can prevent the occurrence of AD. More meaningfully, we found that the protective effect comprises an increase in sirtuin 1 (SIRT1) expression in endothelial cells for the reconstruction of their structure, reducing the recruitment of inflammatory cells by endothelial cells and inhibiting the inflammation response, thereby suppressing the occurrence of AD.
Preconception diet, fertility, and later health in pregnancy
Authors: Grieger Jessica A. 
Published: April 2020

Purpose of review
Women should enter pregnancy in the best possible health. There is increasing recognition of the importance of nutrition for reproductive health; however, key dietary factors in relation to optimizing fertility are nonexistent. The purpose of this review is to investigate dietary factors, preconception, and the association with fertility and later health in pregnancy.

Recent findings
This article summarizes recent literature assessing preconception dietary intake and the association with fertility, time to pregnancy, and also the relationship with polycystic ovary syndrome and gestational diabetes; these conditions associate with each other, and also with infertility. The impact of paternal diet is also reported.

Summary
There is recent interest investigating diet and time to pregnancy, suggesting higher intakes of fruit, minimal intake of fast food and sugar sweetened beverages, and a diet lower in glycemic load, may improve time to pregnancy. There is minimal recent literature on paternal diet and impact on fertility. Present advice to women with polycystic ovary syndrome is in line with international recommendations for lifestyle management to improve reproductive outcomes; and for gestational diabetes, prepregnancy may be an optimal time to improve dietary intakes, particularly through consumption of an overall healthy dietary pattern or a Mediterranean-style dietary pattern.
The impact of race on hysterectomy for benign indications
Authors: McClurg Asha , Wong Jacqueline , Louie Michelle 
Published: April 2020

Purpose of review
To review current literature evaluating racial disparities in benign hysterectomy care in the United States.

Recent findings
Evidence shows that black women are half as likely to undergo minimally invasive hysterectomy and have an increased risk of surgical complications compared with white women. Patient level differences including fibroids, prior surgical history, medical comorbidities, and obesity have been implied to account for the increased rate of abdominal hysterectomy in black patients; however, inequalities remain even after controlling for clinical differences. Societal factors including insurance status fail to fully account for disparities, though healthcare system factors, such as geographical region and access to a minimally invasive trained surgeon, continue to have a profound impact on the equity of care that patients receive.

Summary
Disparities in hysterectomy route and outcomes by race and socioeconomic status exist and have persisted in the literature for over a decade despite a nationwide trend toward minimally invasive hysterectomy and improving surgical outcomes. These disparities are not fully accounted for by patient or health system factors. Successfully addressing these disparities will require a multipronged approach, which may include improved surgical training for residents, fellows, and practicing gynecologists, increasing referrals to high-volume minimally invasive gynecologic surgeons, and provider and patient education.
A Single Incision Anterior Approach for Transhumeral Amputation Targeted Muscle Reinnervation
Authors: Daly Michael C. , He Janice J. , Ponton Ryan P. , Ko Jason H. , Valerio Ian L. , Eberlin Kyle R. 
Published: April 2020

Summary:
Targeted muscle reinnervation (TMR) is an evolving technique with promising results for prevention and treatment of neuropathic pain, as well as modulation of control for myoelectric prostheses. The previously described and most commonly used technique for transhumeral TMR combines both an anterior and posterior approach to access the major peripheral nerves of the upper extremity. In this article, we review the literature for transhumeral TMR and describe a more expeditious and efficient anterior-only approach that offers safe access through a single incision.