bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Pseudomonas Orbital Cellulitis Following Glaucoma Device Implantation
Authors: Goldfarb Jeremy , Jivraj Imran , Yan David , DeAngelis Dan 
Published: September 2018

Purpose:
Orbital cellulitis is a rare complication of aqueous tube shunt surgery. Nine cases have been described in the literature, though the microbiologic etiology is rarely reported. Management with intravenous antibiotics and/or explantation has been described.

Methods:
This is a case report and literature review.

Case:
A 64-year-old woman developed pain, periorbital swelling, limited extraocular motility, proptosis, and conjunctival injection 3 days following implantation of an Ahmed Glaucoma Valve. Computed tomography of the orbits with contrast showed soft tissue fat stranding consistent with orbital inflammation. Initial medical management with topical and intravenous ceftriaxone and vancomycin was unsuccessful. Surgical removal of the implant was performed and intraoperative cultures demonstrated florid Pseudomonas aeruginosa growth. Antibiotic coverage was changed to Piperacillin-Tazobactam for 3 days, with eventual resolution of her orbital symptoms.

Conclusions:
We report the first case of orbital cellulitis after implantation of a glaucoma device associated with P. aeruginosa. Failure of intravenous and topical antibiotics led to explantation of the valve and targeted intravenous antibiotic therapy with subsequent clinical improvement.
Metabolic Alterations Within the Primary Visual Cortex in Early Open-angle Glaucoma Patients: A Proton Magnetic Resonance Spectroscopy Study
Authors: Guo Linying , Wang Rong , Tang Zuohua , Sun Xinghuai , Wu Lingjie , Wang Jie , Zhong Yufeng , Xiao Zebin , Zhang Zhongshuai 
Published: September 2018

Purpose:
To detect changes in metabolites and explore cortical plasticity at the metabolic level within the primary visual cortex through proton magnetic resonance spectroscopy in early open-angle glaucoma (OAG) patients.

Methods:
A total of 23 symmetrically bilateral early OAG patients and 21 normal controls (NC) were recruited as the early OAG group and NC group, respectively. All subjects underwent a proton magnetic resonance examination, and then, the N-acetylaspartate (NAA), glutamine-glutamate (Glx), myo-inositol (Ins), choline (Cho), and creatine (Cr) concentrations within the bilateral primary visual cortex were determined. The mean NAA/Cr ratio, mean Cho/Cr ratio, mean Glx/Cr ratio, and mean Ins/Cr ratio of the bilateral sides were compared between early OAG patients and NC using the independent samples t test.

Results:
Compared with NC, the mean Glx/Cr ratio (corrected P=0.003) in primary visual cortex was significantly higher, whereas the mean Ins/Cr ratio (corrected P=0.001) was statistically lower in early OAG patients. However, no apparent difference was found in the mean Cho/Cr ratio or mean NAA/Cr ratio between the OAG group and NC group.

Conclusions:
Abnormal metabolites were found in our study through proton magnetic resonance spectroscopy and could contribute to cortical plasticity of the primary visual cortex in early OAG patients.
HIV Viremia During Pregnancy and Neurodevelopment of HIV-Exposed Uninfected Children in the Context of Universal Antiretroviral Therapy and Breastfeeding
Authors: le Roux Stanzi M. , Donald Kirsten A. , Kroon Max , Phillips Tamsin K. , Lesosky Maia , Esterhuyse Liza , Zerbe Allison , Brittain Kirsty , Abrams Elaine J. , Myer Landon 
Published: September 2018

Background:
Elevated HIV viral load (VL) in pregnancy has been linked to increased risk of mortality, immunologic abnormalities, infectious morbidity and restricted growth among HIV-exposed uninfected (HEU) children, but little is known about effects on child development.

Methods:
HIV-infected women initiating lifelong antiretroviral therapy (ART; tenofovir + emtricitabine + efavirenz) antenatally were followed from first antenatal visit through delivery and with their breastfed infants postpartum. Cognitive, motor and expressive language development (Bayley Scales of Infant and Toddler Development-Third Edition; delay defined as score <85) were assessed on a subset of HEU infants. HIV VL was measured at ART initiation, in third trimester and around delivery. Cumulative viremia in pregnancy was expressed as log10 VL copies × year/mL [viremia copy-years (VCY)]. Relationships between VCY and development were examined after adjusting for socioeconomic, behavioral and psychosocial confounders.

Results:
Women (median pre-ART log10 VL 4.1, CD4 349 cells/mm3) commonly reported adverse social circumstances (44% informal housing, 63% unemployed, 29% risky drinking). Among 214 infants (median age, 13 months; 53% male; 13% born <37 weeks’ gestation), viremia predicted lower motor and expressive language, but not cognitive, scores in crude and adjusted analysis [per log10 VCY increase, αβ (95% confidence interval [CI]): motor, −2.94 (−5.77 to −0.11); language, −3.71 (−6.73 to −0.69) and cognitive −2.19 (−5.02 to 0.65)]. Increasing VCY also predicted higher relative odds of motor delay [adjusted odds ratio (aOR): 3.32; 95% CI: 1.36–8.14) and expressive language delay (aOR: 2.79; 95% CI: 1.57–4.94), but not cognitive delay (aOR: 1.68; 95% CI: 0.84–3.34).

Conclusions:
Cumulative maternal HIV viremia in pregnancy may have adverse implications for HEU child development.
The Changing Landscape of Childhood Tuberculosis in the United Kingdom
Authors: Mohiyuddin Tehreem , Seddon James A. , Thomas H. Lucy , Lalor Maeve K. 
Published: September 2018

Background:
The epidemiology of tuberculosis (TB) is changing in the United Kingdom and globally. Childhood TB is a key indicator of recent transmission and provides a marker of wider TB control. We describe the recent epidemiology of childhood TB in the United Kingdom, how this compares to TB in adults, and document changes with time.

Methods:
TB cases notified in the United Kingdom between 2000 and 2015 were categorized as children (<15 years of age) or adults (≥15 years of age). Descriptive analyses were carried out on demographic, clinical and microbiologic data. We carried out logistic regressions to identify risk factors associated with children having no microbiologic confirmation.

Results:
In the study period, 6293 TB cases (5%) in the United Kingdom were notified in children. Childhood TB incidence declined from 487 cases in 2000 (3.4 per 100,000) to 232 cases (2.0 per 100,000) in 2015. The majority (68%) of children with TB were UK born, with a high proportion of Pakistani (24%) and Black-African (22%) ethnicity. Sixty-four percent of children had pulmonary disease. Culture confirmation was low (24%). Children who were younger, UK born and those with extrapulmonary disease were less likely to have microbiologically confirmed TB. A high proportion (87%) of children completed treatment at last-recorded outcome, with few deaths (39 cases; 0.7%).

Conclusions:
The incidence of TB in children in the United Kingdom has decreased in the past 16 years, with the majority of children completing TB treatment. Ongoing monitoring of childhood TB will provide a measure of the effectiveness of the national TB program.
Physical Therapy Management of a Critically-Ill Infant After Cardiac Surgery: A Case Report and Literature Review
Authors: Jara Ana M. , Jacobs Jeffrey P. , Reilly Margaret 
Published: September 2018

Background and Purpose:
This case report describes the physical therapy management of an infant with a congenital heart defect (CHD) from prior to her first palliative surgery until her discharge. A review of the literature identifies treatment interventions after cardiac surgery for children and adults but no specific management that can guide the physical therapy management of neonates and infants.

Case Description:
A female infant with hypoplastic left heart syndrome underwent a Norwood procedure at 5 days of life with delayed sternal closure on postoperative day 2. She failed the first attempt of extubation on postoperative day 3. Physical therapy was initiated the second day of life, and the last reevaluation was performed prior to discharge at 9 weeks of age.

Outcomes:
Measurements to identify postural control stability and the infant's reactions to visual and auditory stimuli were performed at 2 days and again at 9 weeks of age. The Test of Infant Motor Performance showed an improvement in scores at the time of discharge. Testing the 2 primitive reflexes evaluated in the study showed interference of one of the reflexes with her motor abilities during hospitalization. The result of the education given to the parents was evaluated through demonstration back of developmental activities, range of motion, and handling of their baby during daily care.

Conclusion:
The physical therapy intervention program provided to this infant with hypoplastic left heart syndrome exemplifies strategies that may be applicable to infants with complex CHD. It is possible to implement individualized developmental physical therapy interventions and assist in optimizing outcomes for an infant with complex CHD and their family in the cardiovascular intensive care unit setting.
The Many Presentations of Syphilis
Authors: Ingram Brooke 
Published: September 2018

ABSTRACT
Syphilis is a sexually transmitted infection caused by a spirochete, which if left untreated, transforms through four stages. Numerous cutaneous manifestations present from the time of the initial infection and evolve as the disease systemically progresses. Syphilis has been around for centuries, and we can attribute the rise of the specialty of dermatology to its prevalence and protean nature. Syphilis is on the rise again for the first time since the advent of penicillin, making it important for healthcare providers to have knowledge of its presentation in its various stages.
Short article: Outcome of medical and surgical management for perforated jejunal diverticulitis
Authors: Garcia-Granero Alvaro , Argüelles Brenda G. , Gallardo Carmen Muniesa , Carreño Omar , Giner Francisco , Pellino Gianluca , Frasson Matteo 
Published: September 2018

Objectives
Perforated jejunal diverticulitis (PJD) is rare, but it has high mortality rates. The role of nonsurgical management is debated. The aim of this study is to assess the outcomes of medical and surgical management of PJD.

Patients and methods
A single-centre study on a series of emergency patients diagnosed with PJD between 2010 and 2016 was conducted.

Results
Eleven patients with PJD were treated (seven women). Nine out of 11 were diagnosed by a computed tomography scan, and two were diagnosed at laparotomy. The initial approach was medical treatment in five patients, based on clinical and imaging findings. Four (80%) of these five patients were discharged without the need for surgical intervention. The median hospital stay was 7.5 days. Seven patients required surgery overall with a median length of hospital stay of 10.8 days. Surgical procedures consisted of segmental bowel resection and primary anastomosis in six patients and simple closure in one. There was no perioperative deaths. One patient required percutaneous drainage because of anastomotic leak, and one required reoperation owing to evisceration.

Discussion
Selected patients with PJD can be successfully managed with conservative approach, based on clinical and computed tomography findings.
Racial and Ethnic Composition of Hospitals’ Service Areas and the Likelihood of Being Penalized for Excess Readmissions by the Medicare Program
Authors: Gaskin Darrell J. , Zare Hossein , Vazin Roza , Love DeJa , Steinwachs Donald 
Published: September 2018

Background:
The Hospital Readmission Reduction Program (HRRP) disproportionately penalizes hospitals serving minority communities. The National Academy of Science, Engineering, and Medicine has recommended that the Centers for Medicare and Medicaid Services (CMS) consider adjusting for social risk factors in their risk adjustment methodology. This study examines the association between the racial and ethnic composition of a hospital market and the impact of other social risk factors on the probability of a hospital being penalized under the HRRP.

Research Methods and Data:
This study analyzes data from CMS, the American Hospital Association, and the American Community Survey for 3168 hospitals from 2013 to 2017. We used logistic regression models to estimate the association between the penalty status under HRRP and the racial and ethnic composition of a hospital market, and explored whether this association was moderated by other social risk factors.

Results:
Our results indicate that the probability of being penalized increases with the percentage of black and Asian residents in the hospital service area (HSA) and decreased with the percentage of Hispanic residents in the HSA. This association was reduced and became statistically insignificant when we controlled for other social risk factors. The strongest predictors of penalty status were the hospital’s share of Medicaid patients and the percent of persons without a high school diploma in the HSA.

Conclusions:
By incorporating relevant social risk factors in the reimbursement methodology, CMS could mitigate the negative effects of HRRP on hospitals serving minority communities.
Dysregulatory syndromes: the role of signal transducers and activators of transcription
Authors: Bezrodnik Liliana , Gaillard María Isabel , Caldirola María Soledad 
Published: September 2018

Purpose of review
A comparative description of dysregulatory syndromes with mutations in signal transducer and activator of transcription (STAT) genes.

Recent findings
STAT 1, 3 and 5b loss of function (LOF) and gain of function (GOF) mutations are a heterogeneous group of genetic disorders that range from immunodeficiency (ID) to autoimmune disease (AID), depending on the underlying signalling pathway defect. Between them, there are clear overlapping and differences in clinical presentation and laboratory findings.

Summary
Dysregulatory syndromes due to LOF and GOF mutations in STAT1, 3 and 5b are a particular group of primary immunodeficiencies (PIDs) in which AID may be the predominant finding in addition to infections susceptibility. STAT1 GOF mutations were described as the major cause of chronic mucocutaneous candidiasis, while activating STAT3 mutations result in early-onset multiorgan autoimmunity and ID. Human STAT5b deficiency is a rare disease that also involves ID and severe growth failure. In recent years, the identification of the genes involved in these disorders allowed to differentiate these overlapping syndromes in order to choose the most effective therapeutic options.
Three-dimensional bioprinting for organ bioengineering: promise and pitfalls
Authors: Ali Mohamed , P.R. Anil Kumar , Lee Sang Jin , Jackson John D. 
Published: September 2018

Purpose of review
Loss of organ function is a critical issue that threatens a patient's life. Currently, the only available treatment is organ transplantation; however, shortage of donor organs, histocompatibility, and life-long immunosuppression present major challenges. Three-dimensional bioprinting technology holds a promising solution for treating organ failure by fabricating autologous tissues and organs for transplantation. To biofabricate a functional tissue, target-cell types are combined with an appropriate biomaterial for structural support and a bioink that supports cell function and maturation. Bioprinted structures can mimic the native tissue shape and functionality.

Recent findings
The main goal of three-dimensional bioprinting is to produce functional tissues/organs; however, whole organ printing has not been achieved. There have been recent advances in the successful three-dimensional bioprinting of numerous tissues. This review will discuss the types of bioprinters, biomaterials, bioinks, and the fabrication of various constructs for repair of vascular, cartilage, skin, cardiac, and liver tissues. These bioprinted tissue constructs have the potential to be used to treat tissues and organs that have been damaged by injury or disease.

Summary
Three-dimensional bioprinting technology offers the ability to fabricate three-dimensional tissue structures with high precision, fidelity, and stability at human clinical scale. The creation of complex tissue architectures with heterogeneous compositions has the potential to revolutionize transplantation of tissues and organs.
Causes of Treatment Failure in Children With Inflammatory Bowel Disease Treated With Infliximab
Authors: Naviglio Samuele , Lacorte Doriana , Lucafò Marianna , Cifù Adriana , Favretto Diego , Cuzzoni Eva , Silvestri Tania , Pozzi Mucelli Martina , Radillo Oriano , Decorti Giuliana , Fabris Martina , Bramuzzo Matteo , Taddio Andrea , Stocco Gabriele , Alvisi Patrizia , Ventura Alessandro , Martelossi Stefano 
Published: September 2018

ABSTRACTObjectives:Anti‐tumor necrosis factor antibodies have led to a revolution in the treatment of inflammatory bowel diseases (IBD); however, a sizable proportion of patients does not respond to therapy. There is increasing evidence suggesting that treatment failure may be classified as mechanistic (pharmacodynamic), pharmacokinetic, or immune‐mediated. Data regarding the contribution of these factors in children with IBD treated with infliximab (IFX) are still incomplete. The aim was to assess the causes of treatment failure in a prospective cohort of pediatric patients treated with IFX.Methods:This observational study considered 49 pediatric (median age 14.4) IBD patients (34 Crohn disease, 15 ulcerative colitis) treated with IFX. Serum samples were collected at 6, 14, 22 and 54 weeks, before IFX infusions. IFX and anti‐infliximab antibodies (AIA) were measured using enzyme linked immunosorbent assays. Disease activity was determined by Pediatric Crohn's Disease Activity Index or Pediatric Ulcerative Colitis Activity Index.Results:Clinical remission, defined as a clinical score <10, was obtained by 76.3% of patients at week 14 and by 73.9% at week 54. Median trough IFX concentration was higher at all time points in patients achieving sustained clinical remission. IFX levels during maintenance correlated also with C‐reactive protein, albumin, and fecal calprotectin. After multivariate analysis, IFX concentration at week 14 >3.11 μg/mL emerged as the strongest predictor of sustained clinical remission. AIA concentrations were correlated inversely with IFX concentrations and directly with adverse reactions.Conclusions:Most cases of therapeutic failure were associated with low serum drug levels. IFX trough levels at the end of induction are associated with sustained long‐term response.
Rapid Progression of Acute Pancreatitis to Acute Recurrent Pancreatitis in Children
Authors: Sweeny Katherine F. , Lin Tom K. , Nathan Jaimie D. , Denson Lee A. , Husain Sohail Z. , Hornung Lindsey , Thompson Tyler , Abu‐El‐Haija Maisam 
Published: September 2018

ABSTRACTObjective:Research is lacking on the natural history of acute pancreatitis (AP) progression to acute recurrent pancreatitis (ARP). The aim of this project was to study the progression from AP to ARP among pediatric patients with pancreatitis to better understand the presentation and natural history of pancreatitis.Methods:Patients presenting with AP were included in a prospective database in Research Electronic Data Capture. We enrolled 115 patients with AP from March 2013 to November 2016. Physicians completed surveys regarding clinical data for patients with first attack of AP. Patients were followed prospectively, with data on progression entered when patients presented with ARP.Results:The most common etiologies for the first attack of AP were idiopathic (31%), toxic/drug‐related (23%), and biliary/gallstone (18%). Twenty of the 115 patients (17%) developed ARP during the follow‐up period. Seventy percent (14/20) of patients with ARP progressed from AP to ARP within 5 months from first diagnosis. A comparison of patients who rapidly progressed to ARP within 3 months (n = 12) to those followed for >3 months without progression in 3 months (n = 97) revealed associations with a higher weight percentile for age (P = 0.045), male sex (P = 0.03), and presence of pancreatic necrosis during first AP attack (P = 0.004). Progression to ARP significantly differed by etiology group with genetics having the highest risk for ARP progression over time and patients with gallstone/biliary, viral/systemic, and obstructive (nongallstone) having the lowest risk for ARP progression over time (P = 0.02).Conclusions:Most patients who progressed from AP to ARP progressed within 5 months. The presence of a higher weight percentile for age, male sex, and pancreatic necrosis during the first AP attack are associated with rapid progression to ARP.
Effects of an Empowerment Program on Resilience and Posttraumatic Growth Levels of Cancer Survivors
Authors: Üzar-Özçetin Yeter Sinem , Hiçdurmaz Duygu 
Published: September 2018

Background
Psychosocial empowerment of cancer survivors can help improve their psychological resilience and enhance their posttraumatic growth. However, there is a lack of research exploring the effects of such empowerment programs on resilience and posttraumatic growth of cancer survivors.

Objective
The aim of this study was to assess the feasibility of a randomized controlled trial on the effectiveness of an integrated empowerment program on cancer survivors.

Methods
We conducted a randomized controlled trial with 89 adult cancer survivors (>25 years old) from 2 oncology hospitals. Using a table of random numbers, they were assigned randomly to the experimental group (n = 45), which participated in 10 sessions of a structured empowerment program, and the control group (n = 44), which received only routine care and no further intervention. Data were collected from patients using the Posttraumatic Growth Inventory and the Resilience Scale for Adults.

Results
Posttraumatic growth and resilience levels significantly improved in the intervention group compared with the control group both at the end of and a month after the program.

Conclusion
This study's empowerment program is effective in improving posttraumatic growth and resilience levels of cancer survivors who are prone to trauma.

Implications for Practice
By enhancing resilience and posttraumatic growth of cancer survivors, the empowerment program may help restore life, and thus its application can contribute to the psychosocial well-being of cancer survivors. Nurses with training and experience can integrate this kind of program into clinical settings.
Doctoral Education and Preparation for Nursing Faculty Roles
Authors: McNelis Angela M. , Dreifuerst Kristina Thomas , Schwindt Rhonda 
Published: September 2018

Background
Despite increased enrollment in doctoral programs and the encouraging numbers of graduates intending to pursue faculty positions, lack of adequate preparedness to assume the faculty role may adversely impact retention and consequently undermine efforts to reduce the shortage.

Purpose
Understanding doctoral nursing students’ and recent graduates’ expectations of their educational experience related to preparation for an academic career is needed to inform curricular revisions and advise guidance to ensure role readiness.

Methods
A secondary analysis of 24 interviews with current PhD and doctor of nursing practice (DNP) students and recent graduates from both degree programs was performed to gain a deeper understanding of expectations and perceptions of doctoral education.

Results
Two themes emerged: (1) met and unmet expectations of programs and (2) equivocal preparation for teaching.

Conclusions
PhD and DNP curricula should include coursework on teaching, as well as research, to prepare graduates for faculty roles.