bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enthesitis in psoriatic arthritis (Part 3): clinical assessment and management
Authors: Mease Philip 
Published: January 2020

AbstractEnthesitis is a common clinical feature of PsA, which is characterized by inflammation at the site of insertion of tendons, ligaments and joint capsule fibres into bone. Enthesitis is relatively unique to the spondyloarthritides, setting this group of diseases apart from other rheumatological conditions. The pathophysiological underpinnings of this clinical domain, and the imaging assessment of it, are described in accompanying articles in this supplement. The focus of this article is on the assessment of enthesitis by physical examination, the impact of enthesitis on function and quality of life, the impact of concomitant FM on clinical assessment, and the evidence for therapy of enthesitis garnered in trials of biologic and targeted synthetic DMARDs. Several physical examination measures of enthesitis have been developed and have proved reliable in assessment of enthesitis. Enthesitis has a significant deleterious impact on function and quality of life. The presence of concomitant FM in ≤20% of patients may result in artefactual worsening of assessment of disease severity and hinder achievement of the goal of low disease activity or remission. Several targeted therapies, which, for example, target the TNF, IL-17, IL-23, phosphodiesterase 4 or Janus kinase pathways, have shown significant efficacy in the treatment of enthesitis, resulting in improvement of function and quality of life for patients with PsA.
What dose of aspirin should be used in the initial treatment of Kawasaki disease? A meta-analysis
Authors: Jia Xinyi , Du Xiao , Bie Shuxian , Li Xiaobing , Bao Yunguang , Jiang Mizu 
Published: January 2020

AbstractObjectiveThe use of IVIG plus high- or low-dose aspirin for the initial treatment of Kawasaki disease remains controversial. The aim of this study was to evaluate the efficacy of IVIG plus high-dose aspirin compared with IVIG plus low-dose aspirin in the treatment of Kawasaki disease.MethodsStudies related to aspirin therapy for Kawasaki disease were selected by searching the databases of Medline (PubMed), Embase and the Cochrane Library before March 2019. Statistical analyses were performed by using a Review Manager Software package and STATA v.15.1.ResultsEight retrospective cohort studies, characterizing 12 176 patients, were analysed. Overall, no significant difference was found in the incidence of coronary artery abnormalities between the high- and low-dose aspirin groups [relative risk (RR) 1.15; 95% CI: 0.93, 1.43; P = 0.19; random-effects model]. The patients treated with high-dose aspirin had slightly faster resolution of fever [mean difference (MD) −0.30; 95% CI: −0.58, −0.02; P = 0.04; random-effects model]. but the rates of IVIG resistance (RR, 1.26; 95% CI: 0.55, 2.92; P = 0.59; random-effects model) and days in hospital (MD, 0.22; 95% CI: −0.93, 1.37; P = 0.71; random-effects model) were similar between the two groups.ConclusionLow-dose aspirin plus IVIG might be as effective as high-dose aspirin plus IVIG for the initial treatment of Kawasaki disease. Considering that high-dose aspirin may cause more adverse reactions than low-dose aspirin, low-dose aspirin plus IVIG should be recommended as the first-line therapy in the initial treatment of Kawasaki disease.
Preparing for NCLEX-RN Success: Communication, Support, Mentoring, and Tutoring for New BSN Graduates
Authors: Stuckey Lanette Christine , Wright Ariel Nicole 
Published: January 2020

Abstract
Nurse educators are charged with designing and delivering preparation initiatives that will enable graduates to be successful on the National Council Licensure Examination for Registered Nurses (NCLEX-RN®). Research focusing on nursing students from the time of graduation until they take the NCLEX-RN is limited. To assist with increasing NCLEX-RN pass rates, an innovative approach to mentoring BSN graduates while preparing for the NCLEX-RN was developed. The postgraduate mentorship program was implemented through communication, support, mentoring, and tutoring of BSN students after graduation. Results indicate that the mentorship program was successful at increasing pass rates and was beneficial for students.
Systemic hypereosinophilic syndromes: when autoimmunity is Th2 mediated
Authors: Matucci Andrea , Nencini Francesca , Maggi Enrico , Vultaggio Alessandra 
Published: January 2020

Purpose of reviewClinical conditions associated with hypereosinophilia represent a field of particular interest, taking into account the epidemiological impact of the different primary and secondary forms. In addition to a classical Th1 response, also Th2 cells can be involved in the pathogenesis of autoimmune diseases, among them eosinophilic forms such as eosinophilic granulomatosis with polyangiitis.Recent findingsIn patients with severe asthma, recent evidence highlights the role of pathogenic autoantibodies against autologous eosinophil proteins (e.g. eosinophil peroxidase) suggest the role of autoimmune mechanisms, particularly in patients in which asthma is included in eosinophilic vasculitis with antineutrophilic autoantibody positivity. Is now evident that in addition to Th2 cells, also type 2 innate lymphoid cells and Th1/Th17 cells play a central role in the pathogenesis of hypereosinophilic syndrome.SummaryThe definition of cellular and molecular mechanisms and the critical role of specific cytokines involved in the pathogenesis of hypereosinophilic syndrome open the way to new therapeutic strategies by using biological agents targeting these specific factors.
Childhood asthma in the new omics era: challenges and perspectives
Authors: Golebski Korneliusz , Kabesch Michael , Melén Erik , Potočnik Uroš , van Drunen Cornelis M. , Reinarts Susanne , Maitland-van der Zee Anke H. , Vijverberg Susanne J.H. 
Published: January 2020

Purpose of reviewChildhood asthma is a heterogeneous inflammatory disease comprising different phenotypes and endotypes and, particularly in its severe forms, has a large impact on the quality-of-life of patients and caregivers. The application of advanced omics technologies provides useful insights into underlying asthma endotypes and may provide potential clinical biomarkers to guide treatment and move towards a precision medicine approach.Recent findingsThe current article addresses how novel omics approaches have shaped our current understanding of childhood asthma and highlights recent findings from (pharmaco)genomics, epigenomics, transcriptomics, and metabolomics studies on childhood asthma and their potential clinical implications to guide treatment in severe asthmatics.SummaryUntil now, omics studies have largely expanded our view on asthma heterogeneity, helped understand cellular processes underlying asthma, and brought us closer towards identifying (bio)markers that will allow the prediction of treatment responsiveness and disease progression. There is a clinical need for biomarkers that will guide treatment at the individual level, particularly in the field of biologicals. The integration of multiomics data together with clinical data could be the next promising step towards development individual risk prediction models to guide treatment. However, this requires large-scale collaboration in a multidisciplinary setting.
Alcohol Use Behaviors and Reasons to Abstain From or Limit Drinking Among Medically Vulnerable Youth
Authors: Wisk Lauren E. , Magane Kara M. , Levy Sharon , Weitzman Elissa R. 
Published: January 2020

Background:
Youth with chronic medical conditions (YCMC) use alcohol at levels similar to their healthy peers but face elevated risk for adverse health consequences. As salient reasons to abstain from or limit drinking (RALD) among YCMC are unknown, we sought to identify clusters of RALD and test associations with use behaviors.

Methods:
Eligible YCMC (ages 9–18) recruited from outpatient clinics reported their use behaviors and importance of potential RALD. Cluster analysis was used to discern RALD patterns, which were examined as predictors of alcohol use using multivariate regression.

Results:
Among 398 participants, 30.9% reported past year alcohol use. Concerns about impacts on medications, school, and disease status were the most frequently endorsed RALD; prior negative experiences with alcohol and family history were the least frequently endorsed. Five RALD clusters were identified for all YCMC and 2 for recent drinkers. Compared to the cluster with high endorsement of multiple general and health-related RALD, those predominantly citing concerns about addiction and those not strongly endorsing any RALD consistently reported greater alcohol use. Among recent drinkers, the cluster characterized by low concern across multiple RALD also consistently reported greater alcohol use compared to their counterparts expressing moderate concern.

Conclusions:
For YCMC, RALD are complex but endorsement of multiple general and health-related RALD is associated with less use, and health concerns are especially prevalent. More research is needed to understand how salient RALD can inform tailored interventions that aim to delay and reduce substance use and improve health outcomes for YCMC.
Neural Selective Cryoneurolysis with Ice Slurry Injection in a Rat Model
Authors: Garibyan Lilit , Moradi Tuchayi Sara , Wang Ying , Khodorova Alla , Stemmer-Rachamimov Anat , Purschke Martin , Osseiran Sam , Evans Conor L. , Mao Jianren , Strichartz Gary , Anderson R. Rox 
Published: January 2020

Background
Postoperative pain caused by trauma to nerves and tissue around the surgical site is a major problem. Perioperative steps to reduce postoperative pain include local anesthetics and opioids, the latter of which are addictive and have contributed to the opioid epidemic. Cryoneurolysis is a nonopioid and long-lasting treatment for reducing postoperative pain. However, current methods of cryoneurolysis are invasive, technically demanding, and are not tissue-selective. This project aims to determine whether ice slurry can be used as a novel, injectable, drug-free, and tissue-selective method of cryoneurolysis and resulting analgesia.

Methods
The authors developed an injectable and selective method of cryoneurolysis using biocompatible ice slurry, using rat sciatic nerve to investigate the effect of slurry injection on the structure and function of the nerve. Sixty-two naïve, male Sprague-Dawley rats were used in this study. Advanced Coherent anti-Stokes Raman Scattering microscopy, light, and fluorescent microscopy imaging were used at baseline and at various time points after treatment for evaluation and quantification of myelin sheath and axon structural integrity. Validated motor and sensory testing were used for evaluating the sciatic nerve function in response to ice slurry treatment.

Results
Ice slurry injection can selectively target the rat sciatic nerve. Being injectable, it can infiltrate around the nerve. The authors demonstrate that a single injection is safe and selective for reversibly disrupting the myelin sheaths and axon density, with complete structural recovery by day 112. This leads to decreased nocifensive function for up to 60 days, with complete recovery by day 112. There was up to median [interquartile range]: 68% [60 to 94%] reduction in mechanical pain response after treatment.

Conclusions
Ice slurry injection selectively targets the rat sciatic nerve, causing no damage to surrounding tissue. Injection of ice slurry around the rat sciatic nerve induced decreased nociceptive response from the baseline through neural selective cryoneurolysis.

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What We Already Know about This Topic

What This Article Tells Us That Is New
Telehealth Interventions to Improve Obstetric and Gynecologic Health Outcomes
Authors: DeNicola Nathaniel , Grossman Daniel , Marko Kathryn , Sonalkar Sarita , Butler Tobah Yvonne S. , Ganju Nihar , Witkop Catherine T. , Henderson Jillian T. , Butler Jessica L. , Lowery Curtis 
Published: January 2020

OBJECTIVE:
To systematically review the effectiveness of telehealth interventions for improving obstetric and gynecologic health outcomes.

DATA SOURCES:
We conducted a comprehensive search for primary literature in ClinicalTrials.gov, Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE.

METHODS OF STUDY SELECTION:
Qualifying primary studies had a comparison group, were conducted in countries ranked very high on the United Nations Human Development Index, published in English, and evaluated obstetric and gynecologic health outcomes. Cochrane Collaboration's tool and ROBINS-I tool were used for assessing risk of bias. Summary of evidence tables were created using the United States Preventive Services Task Force Summary of Evidence Table for Evidence Reviews.

TABULATION, INTEGRATION, RESULTS:
Of the 3,926 published abstracts identified, 47 met criteria for inclusion and included 31,967 participants. Telehealth interventions overall improved obstetric outcomes related to smoking cessation and breastfeeding. Telehealth interventions decreased the need for high-risk obstetric monitoring office visits while maintaining maternal and fetal outcomes. One study found reductions in diagnosed preeclampsia among women with gestational hypertension. Telehealth interventions were effective for continuation of oral and injectable contraception; one text-based study found increased oral contraception rates at 6 months. Telehealth provision of medication abortion services had similar clinical outcomes compared with in-person care and improved access to early abortion. Few studies suggested utility for telehealth to improve notification of sexually transmitted infection test results and app-based intervention to improve urinary incontinence symptoms.

CONCLUSION:
Telehealth interventions were associated with improvements in obstetric outcomes, perinatal smoking cessation, breastfeeding, early access to medical abortion services, and schedule optimization for high-risk obstetrics. Further well-designed studies are needed to examine these interventions and others to generate evidence that can inform decisions about implementation of newer telehealth technologies into obstetrics and gynecology practice.
Genes Implicated in Rare Congenital Inner Ear and Cochleovestibular Nerve Malformations
Authors: Kari Elina , Llaci Lorida , Go John L. , Naymik Marcus , Knowles James A. , Leal Suzanne M. , Rangasamy Sampath , Huentelman Matthew J. , Liang Winnie , Friedman Rick A. , Schrauwen Isabelle 
Published: January 2020

Objective:
A small subset of children with congenital hearing loss have abnormal cochleovestibular nerves (i.e., absent, aplastic, or deficient cochlear nerves), with largely unknown etiology. Our objective was to investigate the underlying pathways and identify novel genetic variants responsible for cochleovestibular malformations and nerve abnormalities. It is our hypothesis that several cochleovestibular nerve abnormalities might share common causative pathways.

Design:
We used a family-based exome sequencing approach to study 12 children with known rare inner ear and/or cochleovestibular nerve malformations.

Results:
Our results highlight a diverse molecular etiology and suggest that genes important in the developing otic vesicle and cranial neural crest, e.g., MASP1, GREB1L, SIX1, TAF1, are likely to underlie inner ear and/or cochleovestibular nerve malformations.

Conclusions:
We show that several cochleovestibular nerve malformations are neurocristopathies, which is consistent with the fact that cochleovestibular nerve development is based on otic placode-derived neurons in close association with neural crest-derived glia cells. In addition, we suggest potential genetic markers for more severely affected phenotypes, which may help prognosticate individual cochlear implantation outcomes. Developing better strategies for identifying which children with abnormal nerves will benefit from a cochlear implantation is crucial, as outcomes are usually far less robust and extremely variable in this population, and current neuroimaging and electrophysiologic parameters cannot accurately predict outcomes. Identification of a suitable treatment early will reduce the use of multiple interventions during the time-sensitive period for language development.
Pulling the Trigger: Recommendations for Surgical Care of the Pediatric Trigger Thumb
Authors: Dittmer Alison J. , Grothaus Olivia , Muchow Ryan , Riley Scott 
Published: January 2020

Background:
Despite being a common pediatric hand condition, there are few clear guidelines regarding the optimal management of pediatric trigger thumb. Our primary aim was to help guide surgical management of this disorder by establishing a treatment algorithm on the basis of our institution’s experience.

Methods:
This is an institutional review board-approved retrospective study of all patients with idiopathic trigger thumbs from 2005 to 2015 at a single institution. Demographics and treatment course were recorded for all patients including duration of follow-up, observation, surgical intervention, and complications. All children were classified according to the Sugimoto classification.

Results:
A total of 149 patients with 193 thumbs met inclusion and exclusion criteria. 16.5% of patients had stage II thumbs, 10.3% of patients with stage III, and 73% of patients with stage IV thumbs. Of all patients with stage IV thumbs, 3.5% were locked in extension for an overall incidence of 2.6%.
In total, 46% of patients failed observation and underwent surgical treatment. Only 14% of stage IV trigger thumbs resolved when observed, compared with 53% of stage II and 25% of stage III trigger thumbs. Stage IV thumbs were 4.6 times more likely to fail conservative treatment and go on to surgery than stage II or III thumbs (odds ratio, 4.6; P=0.006).
Thirty-two percent of patients underwent surgery without an observation period. Older children with bilateral stage 3 thumbs were the most likely to go straight to the odds ratio instead of being observed (P=0.002, r
2=0.17).
Of the total amount of patients who underwent surgery (116), there were 4 complications for a rate of 3.4% with a recurrence rate of 1.7%.

Conclusions:
On the basis of the data in this study, the authors would recommend that stage IV thumbs undergo surgery without an observational period. Second, stage II and stage III thumbs can be safely observed for at least 1 year before surgery. Finally, our study concurs with the literature that surgery can be successful with low rates of complications and recurrence.

Level of Evidence:
Level IV.
Multimodal Therapeutic Approach of Cytokine Release Syndrome Developing in a Child Given Chimeric Antigen Receptor-Modified T Cell Infusion
Authors: Bottari Gabriella , Merli Pietro , Guzzo Isabella , Stoppa Francesca , Ruggeri Annalisa , Di Nardo Matteo , Del Bufalo Francesca , Galaverna Federica , Corrado Cecchetti , Locatelli Franco 
Published: January 2020

Objectives:
To describe a pediatric case of cytokine release syndrome secondary to chimeric antigen receptor-modified T cells associated with acute respiratory distress syndrome.

Design:
Case report.

Setting:
PICU.

Patients:
A 14-year-old boy with refractory B cell precursor acute lymphoblastic leukemia given chimeric antigen receptor cells developed severe cytokine release syndrome 7 days after the drug product infusion with progressive respiratory failure. He was admitted to PICU with a clinical picture of acute respiratory distress syndrome, requiring mechanical ventilation, and secondary hemophagocytic lymphohistiocytosis.

Interventions:
Hemoadsorption with cartridge column (Cytosorb) in combination with continuous renal replacement therapy was associated to the anti-cytokine therapy (tocilizumab, a monoclonal antibody targeting interleukin-6 receptor).

Measurements and Main Results:
Decrease of the inflammatory biomarkers (ferritin, interleukin-6, interleukin-10) in the first 96 hours associated with a progressive improvement of acute respiratory distress syndrome (Pao
2/Fio
2 ratio) 7 day after the start of the multimodal treatment.

Conclusions:
This case suggests that hemoadsorption with cartridge column in combination with continuous renal replacement therapy and tocilizumab is safe and potentially effective in pediatric patients with severe cytokine release syndrome.
The Effect of Outcome Selection on the Performance of Prediction Models in Patients at Risk for Sepsis
Authors: Taylor Stephanie P. , Chou Shih-Hsiung , McWilliams Andrew D. , Russo Mark , Heffner Alan C. , Murphy Stephanie , Evans Susan L. , Rossman Whitney , Kowalkowski Marc ,   on behalf of Acute Care Outcomes Research Network (ACORN) Investigators
Published: January 2020

Importance:
Risk prediction models for patients with suspected sepsis have been derived on and applied to various outcomes, including readily available outcomes such as hospital mortality and ICU admission as well as longer-term mortality outcomes that may be more important to patients. It is unknown how selecting different outcomes influences model performance in patients at risk for sepsis.

Objectives:
Evaluate the impact of outcome selection on risk model performance and weighting of individual predictor variables.

Design, Setting, and Participants:
We retrospectively analyzed adults hospitalized with suspected infection from January 2014 to September 2017 at 12 hospitals.

Main Outcomes and Measures:
We used routinely collected clinical data to derive logistic regression models for four outcomes: hospital mortality, composite ICU length of stay greater than 72 hours or hospital mortality, 30-day mortality, and 90-day mortality. We compared the performance of the models using area under the receiver operating characteristic curve and calibration plots.

Results:
Among 52,184 admissions, 2,030 (4%) experienced hospital mortality, 6,659 (13%) experienced the composite of hospital mortality or ICU length of stay greater than 72 hours, 3,417 (7%) experienced 30-day mortality, and 5,655 (11%) experienced 90-day mortality. Area under the receiver operating characteristic curves decreased when hospital-based models were applied to predict 30-day (hospital mortality = 0.88–0.85; –0.03, composite ICU length of stay greater than 72 hours or hospital mortality = 0.90–0.81; –0.09) and 90-day mortality (hospital mortality = 0.88–0.81; –0.07, composite ICU length of stay greater than 72 hours or hospital mortality = 0.90–0.76; –0.14; all p < 0.01). Models were well calibrated for derived (root-mean-square error = 5–15) but not alternate outcomes (root-mean-square error = 8–35).

Conclusions and Relevance:
Risk models trained to predict readily available hospital-based outcomes in suspected sepsis show poorer discrimination and calibration when applied to 30- and 90-day mortality. Interpretation and application of risk models for patients at risk of sepsis should consider these findings.