bluuebunny/crossref_metadata_2025_split huggingface dataset:
Respiratory Instability and Hypoxemia Episodes in Preterm Infants
Authors: Claure Nelson , Bancalari Eduardo 
Published: April 2018

AbstractOxygenation instability is a very common problem in the premature infant that manifests as intermittent hypoxemia episodes (HEs). These are particularly frequent in premature infants who are on mechanical ventilation beyond the first weeks after birth. However, they can also occur in spontaneously breathing infants. Some of these episodes are due to central apnea, but in ventilated infants, they are frequently due to contractions of the abdominal musculature that can splint the respiratory pump, resulting in periods of decreased lung volume and hypoventilation. HEs are often followed by periods of hyperoxemia that results from excessive oxygen supplementation given to correct the hypoxemia. These episodes increase in frequency with postnatal age and are more common in infants with chronic lung disease. Although the evidence is not conclusive, their detrimental effects on the infant's neurologic, ocular, and respiratory system may be significant. There is no specific treatment for HEs, but several interventions are available to ameliorate the severity and duration of the episodes. Further research is needed to define the impact of HEs on the preterm infant's developing central nervous system and other organ systems and to develop effective strategies to prevent these episodes.
New Ventilator Strategies: High-Frequency Oscillatory Ventilation Combined with Volume Guarantee
Authors: González-Pacheco N. , Belik J. , Santos M. , Tendillo F. , Sánchez-Luna M. 
Published: April 2018

AbstractHigh-frequency oscillatory ventilation (HFOV) has been proposed as an alternative method of invasive ventilation in immature infants to prevent ventilator lung injury. To better control the size of the high-frequency tidal volume and to prevent large tidal volumes, a new strategy of controlling the tidal volume during HFOV (VThf) has been developed, HFOV–volume guarantee (VG). Data from preclinical, neonatal animal studies in normal and surfactant-depleted lungs have demonstrated the feasibility of this technique to directly control the VThf in the normal compliance and low compliance situations. Different I:E ratios also can modify the effect of CO2 washout during HFOV combined with VG in a different way as without the VG modality. Finally, clinical use of this technique in newborn infants has demonstrated the possibility of using very high frequency combined with constant very low VThf to decrease the risk of lung trauma related to the ventilator.
Respiratory Support in Bronchiolitis: Trial Evidence
Authors: Cunningham Steve 
Published: April 2018

AbstractAcute viral lower respiratory tract infection is frequently associated with hypoxemia and respiratory distress, sometimes progressing to hypercarbia and respiratory failure. In recent years, trials have assessed the effects of oxygen supplementation and respiratory support with high-flow oxygen therapy. An oxygen saturation target of 90% is as safe and clinically effective as 94% in infants with bronchiolitis. Trials of high-flow humidified oxygen have demonstrated safety, but as yet poorly demarcated an appropriate place for use within the clinical course of the disease. Effective trials of continuous positive airway pressure are lacking and urgently required. The trials reported to date have highlighted the need for common outcomes in relation to treatment failure.
Surgery for Congenital Heart Disease: Improvements in Outcomes
Authors: Jonas Richard , Martin Gerard 
Published: April 2018

AbstractCardiac surgery for congenital heart disease has changed dramatically since the first surgery in 1938. During the early era, children underwent surgery at older ages often with palliative procedures before their corrective operation. Not surprisingly, in the early era, there was considerably higher early and late mortality, including the additive risks of having more than one procedure and a long period of living with an unphysiological palliated circulation. Over time with advances in noninvasive diagnosis, surgical approach, cardiopulmonary bypass techniques, and team-based care, outcomes have improved. Children now undergo corrective surgery at a younger age and have fewer palliative procedures. Short-term outcome as measured by the commonly used metric “procedural early mortality” (i.e., death before hospital discharge or less than 30 days following a surgical procedure) is now as low as 1 or 2% for many low-to-moderate complexity procedures. Late outcomes have also improved with long-term survival of hospital survivors for simple lesions being close to population controls. Late outcomes for more complex defects still show diminishing survival relative to a control population. Examination of the causes of death provides insights into areas in which clinical improvements may further improve the outlook for children with complex congenital heart disease.
Mesenchymal Stromal Cell Therapy for Respiratory Complications of Extreme Prematurity
Authors: Thébaud Bernard 
Published: April 2018

AbstractBronchopulmonary dysplasia remains the main complication of extreme preterm birth. Research over the past 10 years suggests the potential for stem cell-based therapies to prevent and/or restore organ damage in extreme preterm infants. Mesenchymal stromal cells, in particular, have advanced as the forerunner among various cell therapies based on very promising preclinical studies in animal models of neonatal lung injury. Early phase clinical trials are now underway to determine the safety and feasibility of this cell therapy in preterm infants at risk of developing bronchopulmonary dysplasia. This review will summarize the current rationale for testing mesenchymal stromal cells in this patient population and highlight the gaps in our knowledge to safely harness the full repair potential of cell-based therapies.
Patterns of Complex Carpal Injuries in the Hand from Fireworks
Authors: Ng Zhi , Shamrock Alan , Chen David , Dodds Seth , Chim Harvey 
Published: April 2018

Abstract
Purpose To describe the various patterns of complex carpal and metacarpal fracture dislocations observed in a consecutive series of firework injuries and the operative management performed.
Materials and Methods We performed a retrospective study of seven consecutive patients (six males; mean age = 22 ± 13, range, 8–39 years) who presented to a level I trauma center with firework injuries to the hand between July 2014 and January 2016.
Results All injuries were sustained while a lighted firework was held in the hand. The mean length of hospital stay was 13.9 ± 13.8 (range, 4–46) days with an average of 3 ± 2.6 (range, 1–7) surgeries required for both bony and soft tissue reconstruction. Three patterns of injury were seen: type I—no carpal involvement; type II—carpometacarpal joint (CMCJ) dislocations and isolated carpal dislocations; type III—CMCJ dislocations with axial carpal dissociation. One patient had a type I injury, three had a type II injury, and three had a type III injury. Of patients with a type III injury, two of the three had simultaneous axial-radial and axial-ulnar involvement as well as a midcarpal dissociation with divergent dissociation of the carpus and metacarpals.
Conclusion The severity of carpal injuries resulting from fireworks is highly variable but is likely to follow predictable patterns due to the position of the hand and the location of the firework prior to explosion. Surgical reconstruction can be challenging, but adequate outcomes with a functional hand can be achieved through a systematic approach.
Type of Study/Level of Evidence Therapeutic level IV.
The Association Between Empirical Antibiotic Treatment and Mortality in Severe Infections Caused by Carbapenem-resistant Gram-negative Bacteria: A Prospective Study
Authors: Zak-Doron Yael , Dishon Benattar Yael , Pfeffer Iris , Daikos George L , Skiada Anna , Antoniadou Anastasia , Durante-Mangoni Emanuele , Andini Roberto , Cavezza Giusi , Leibovici Leonard , Yahav Dafna , Eliakim-Raz Noa , Carmeli Yehuda , Nutman Amir , Paul Mical ,   AIDA Study Group, Levi Inbar , Paul Mical , Benattar Yael Dishon , Dickstein Yaakov , Bitterman Roni , Zayyad Hiba , Koppel Fidi , Zak-Doron Yael , Altunin Sergey , Andria Nizar , Neuberger Ami , Stern Anat , Petersiel Neta , Raines Marina , Karban Amir , Leibovici Leonard , Yahav Dafna , Eliakim-Raz Noa , Zusman Oren , Elbaz Michal , Atamna Heyam , Daitch Vered , Babich Tanya , Carmeli Yehuda , Nutman Amir , Adler Amos , Levi Inbar , Daikos George L , Skiada Anna , Pavleas Ioannis , Antoniadou Anastasia , Kotsaki Antigoni , Durante-Mangoni Emanuele , Andini Roberto , Iossa Domenico , Bernardo Mariano , Cavezza Giusi , Bertolino Lorenzo , GiuffrÃ¨ Giuseppe , Giurazza Roberto , Cuccurullo Susanna , Galdo Maria , Murino Patrizia , Cristinziano Adriano , Corcione Antonio , Zampino Rosa , Pafundi Pia Clara , Mouton Johan , Friberg Lena , Kristoffersso Anders 
Published: April 2018

Abstract

Background
Empirical colistin should be avoided. We aimed to evaluate the association between covering empirical antibiotics (EAT) and mortality for infections caused by carbapenem-resistant gram-negative bacteria (CRGNB).

Methods
This was a secondary analysis of a randomized controlled trial, including adults with bloodstream infections, pneumonia, or urosepsis caused by CRGNB. All patients received EAT followed by covering targeted therapy. The exposure variable was covering EAT in the first 48 hours. The outcome was 28-day mortality. We adjusted the analyses by multivariable regression analysis and propensity score matching.

Results
The study included 406 inpatients with severe CRGNB infections, mostly Acinetobacter baumannii (312/406 [77%]). Covering EAT was given to 209 (51.5%) patients, mostly colistin (n = 200). Patients receiving noncovering EAT were older, more frequently unconscious and dependent, carrying catheters, and mechanically ventilated with pneumonia. Mortality was 84 of 197 (42.6%) with noncovering vs 96 of 209 (45.9%) with covering EAT (P = .504). Covering EAT was not associated with survival in the adjusted analysis; rather, there was a weak association with mortality (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.02–1.84). Results were similar for colistin monotherapy and colistin-carbapenem combination EAT. In the propensity score–matched cohort (n = 338) covering antibiotics were not significantly associated with mortality (OR, 1.42; 95% CI, .91–2.22). Similar results were obtained in an analysis of 14-day mortality.

Conclusions
Empirical use of colistin before pathogen identification, with or without a carbapenem, was not associated with survival following severe infections caused by CRGNBs, mainly A. baumannii.
Andrew Chi-Chih Yao: the future of quantum computing
Authors: Poo Mu-ming , Wang Ling 
Published: April 2018

ABSTRACT
Quantum computing and quantum computers have attracted much attention from both the academic community and industry in recent years. By exploiting the quantum properties of materials, scientists are aiming to overcome Moore's law of miniaturization and develop novel quantum computers. The concept of quantum computing was first introduced by the distinguished physicist Richard Feynman in 1981. As one of the early pioneers in this field, Turing Award laureate Andrew Chi-Chih Yao made a seminal contribution in developing the theoretical basis for quantum computation in 1993. Since 2011, he has served as the founding director of Tsinghua University's Center for Quantum Information (CQI), which aims to become a world-class research center for quantum computing. In a recent interview with NSR, Yao recounted the history of quantum computing and expressed his view on the future of this field. He suggests that quantum computers could excel in many tasks such as the design of new materials and drugs as well as in the simulation of chemical reactions, but they may not supersede traditional computers in tasks for which traditional computers are already proven to be highly efficient.
Antimicrobial Agent Shortages: The New Norm for Infectious Diseases Physicians
Authors: Gundlapalli Adi V , Beekmann Susan E , Graham Donald R , Polgreen Philip M ,   Members of the Emerging Infections Network
Published: April 2018

Abstract

Background
In 2012, the US Food and Drug Administration (FDA) required drug manufacturers to give advance notice of impending drug shortages. A survey of infectious diseases (ID) physicians was undertaken to determine the impact of this requirement and to follow-up on prior perceptions of ID physicians on shortages of antimicrobial agents.

Methods
We used a web-based survey of ID physician members of the Emerging Infections Network in 2016.

Results
Of the 701 of 1597 members (44%) who responded, 70% reported the need to modify their antimicrobial choice because of a shortage in the prior 2 years. A majority (73%) reported the shortages affected patient care or outcomes by the use of broader-spectrum (75%), more costly (58%), less effective second-line (45%), or more toxic agents (37%). The most commonly reported antimicrobials in short supply were piperacillin-tazobactam, ampicillin-sulbactam, meropenem, cefotaxime, and cefepime. Respondents learned of shortages from hospital notification, from a colleague, contact from pharmacy after ordering the agent in short supply, or FDA or other website. The antimicrobial stewardship programs (ASPs) of a majority (83%) of respondents’ institutions had developed approaches to deal with shortages. Although 71% indicated that communications were sufficient, most (87%) did not perceive any improvement in communications about shortages since the 2012 FDA requirement.

Conclusions
The persistence of antimicrobial agent shortages reported by ID physicians is disturbing as is the resulting need to use broader-spectrum or more toxic agents. The prominent role of ASPs in helping to deal with shortages, effective communication channels, and the lack of perceived improvement in FDA’s communication strategy merit further consideration.
Relationship Between Institutional Investment in High-Value Care (HVC) Performance Improvement and Internal Medicine Residents’ Perceptions of HVC Training
Authors: Ryskina Kira L. , Smith Cynthia D. , Arora Vineet M. , Zaas Aimee K. , Halvorsen Andrew J. , Weissman Arlene , Wahi-Gururaj Sandhya 
Published: April 2018

Purpose
To measure the association between institutional investment in high-value care (HVC) performance improvement and resident HVC experiences.

Method
The authors analyzed data from two 2014 surveys assessing institutions’ investments in HVC performance improvement as reported by program directors (PDs) and residents’ perceptions of the frequency of HVC teaching, participation in HVC-focused quality improvement (QI), and views on HVC topics. The authors measured the association between institutional investment and resident-reported experiences using logistic regression, controlling for program and resident characteristics.

Results
The sample included 214 programs and 9,854 residents (59.3% of 361 programs, 55.2% of 17,851 residents surveyed). Most PDs (158/209; 75.6%) reported some support. Residents were more likely to report HVC discussions with faculty at least a few times weekly if they trained in programs that offered HVC-focused faculty development (odds ratio [OR] = 1.19; 95% confidence interval [CI] 1.04–1.37; P = .01), that supported such faculty development (OR = 1.21; 95% CI 1.04–1.41; P = .02), or that provided physician cost-of-care performance data (OR = 1.19; 95% CI 1.03–1.39; P = .02). Residents were more likely to report participation in HVC QI if they trained in programs with a formal HVC curriculum (OR = 1.83; 95% CI 1.48–2.27; P < .001) or with HVC-focused faculty development (OR = 1.46; 95% CI 1.15–1.85; P = .002).

Conclusions
Institutional investment in HVC-related faculty development and physician feedback on costs of care may increase the frequency of HVC teaching and resident participation in HVC-related QI.
Using Different Expectation Mechanisms to Optimize Treatment of Patients With Medical Conditions: A Systematic Review
Authors: Kube Tobias , Glombiewski Julia Anna , Rief Winfried 
Published: April 2018

ABSTRACT

Objective
Patients' expectations have been shown to predict the course and treatment success of a variety of medical conditions. Therefore, expectation-focused psychological interventions (EFPIs) have been developed to use these expectation effects clinically. Importantly, EFPI differ with regard to the particular expectation mechanism being addressed, i.e., expectation optimization or expectation violation. The aims of this systematic review were to give an overview of the application of these expectation interventions and to evaluate their effectiveness.

Methods
Several databases were searched to identify clinical trials or experimental studies that conducted EFPI among participants with various medical conditions. Risk of bias was evaluated using the Cochrane Risk of Bias tool.

Results
Eleven studies (N = 944) investigating different medical conditions (coronary heart disease, cancer, chronic pain) were included. Qualitative synthesis revealed positive effects of EFPI on clinical outcome variables in all studies. Expectation optimization approaches yielded particularly promising results. Because of the large heterogeneity of outcome measures, quantitative synthesis was not possible.

Conclusion
This review highlights the potential of EFPI for optimizing treatment of patients with medical conditions. However, it seems that different expectation mechanisms might have different application possibilities. Therefore, we provide suggestions for further developing EFPI to tailor treatment and develop personalized psychological interventions. We argue that for this purpose, it is important to consider both disease-specific aspects and patients' personality traits. In addition, we discuss future challenges such as implementing EFPI into routine medical care.
Utilization and Cost Analysis of Lung Transplantation and Survival After 10 Years of Adapting the Lung Allocation Score
Authors: Keller Cesar A. , Gonwa Thomas A. , White Launia J. , Rucci March E. , Visscher Sue L. , Kennedy Cassie C. , Daly Richard C. , Naessens James M. 
Published: April 2018

Background.
Lungs are allocated in the United States using the lung allocation score (LAS). We investigated the effect of LAS trends on lung transplant-related costs, healthcare utilization, and mortality.

Methods.
Utilization data from Mayo Clinic (Florida and Minnesota) from 2005 to 2015 were obtained from the electronic health records (N = 465). Costs were categorized as 1-year posttransplant or transplant episode and standardized using 2015 Medicare reimbursement and cost-to-charge ratios. Regression analysis was used to assess the relationship of LAS to length of stay (LOS), mortality, and cost of transplant.

Results.
The mean LAS at transplant increased from 45.7 to 58.3 during the study period, whereas the 1-year survival improved from 88.1% to 92.5% (P < 0.0001). The proportion of patients transplanted with LAS of 60 or greater increased from 16.9% to 33.3%. Posttransplant, overall, and intensive care unit LOS increased with increasing LAS. Patients with higher LAS had substantially higher transplant episode costs. An increase of LAS at transplant by 10 points increased inflation-adjusted costs by 12.0% (95% confidence interval, 9.3%–14.5%).

Conclusions.
The mean LAS at transplant has significantly increased over time associated with increases in LOS, resource utilization and cost. Lung allocation score has not jeopardized overall survival, but a high LAS (>60) at transplant is associated with increased mortality.
Effects of the inclusion of a mixed
Psychrotrophic
bacteria strain for sewage treatment in constructed wetland in winter seasons
Authors: Tang Meizhen , Li Zhengtao , Yang Yuewei , Chen Junfeng , Jiang Jie 
Published: April 2018

Constructed wetlands (CWs) have been used globally in wastewater treatment for years. CWs represent an efficient ecological system which is both energy-saving and low in investment for construction and operational cost. In addition, CWs also have the advantage of being easy to operate and maintain. However, the operation of CWs at northern latitudes (both mid and high) is sometimes quite demanding, due to the inhibitory effect of low temperatures that often occur in winter. To evaluate the wastewater treatment performance of a culture of mixed
Psychrotrophic
bacteria strains in an integrated vertical-flow CW, the removal rates of ammonia nitrogen (NH
3
–N), chemical oxygen demand (COD), nitrite nitrogen

(

NO
2
−

−

N
)

, nitrate nitrogen

(

NO
3
−

−

N
)

and total phosphorus (TP) were quantified at different bacterial dosages to determine the best bacterial dosage and establish kinetic degradation models of the mixed strains. The bacterial culture was made up of
Psychrobacter
TM-1,
Sphingobacterium
TM-2 and
Pseudomonas
TM-3, mixed together at a volume/volume ratio of 1 : 1 : 1 (at bacterial suspension concentrations of 4.4 × 10
9
ml
−1
). Results showed that the organic pollutants (nitrogen and phosphorus) in the sewage could be efficiently removed by the culture of mixed
Psychrotrophic
bacteria. The optimal dosage of this mixed bacteria strain was 2.5%, and the treatment efficiency of COD, NH
3
–N,

NO
2
−

−

N

,

NO
3
−

−

N

, total nitrogen and TP were stable at 91.8%, 91.1%, 88.0%, 93.8%, 94.8% and 95.2%, respectively, which were 1.5, 2.0, 2.1, 1.5, 2.2 and 1.3 times those of the control group. In addition, a pseudo-first-order degradation model was a good fit for the degradation pattern observed for each of these pollutants.
Longitudinal tracking of Plasmodium falciparum clones in complex infections by amplicon deep sequencing
Authors: Lerch Anita , Koepfli Cristian , Hofmann Natalie E. , Kattenberg Johanna H. , Rosanas-Urgell Anna , Betuela Inoni , Mueller Ivo , Felger Ingrid 
Published: April 2018

AbstractBackgroundLongitudinal tracking of individual Plasmodium falciparum strains in multi-clonal infections is essential for investigating infection dynamics of malaria. The traditional genotyping techniques did not permit tracking changes in individual clone density during persistent natural infections. Amplicon deep sequencing (Amp-Seq) offers a tool to address this knowledge gap.MethodsThe sensitivity of Amp-Seq for relative quantification of clones was investigated using three molecular markers, ama1-D2, ama1-D3, and cpmp. Amp-Seq and length-polymorphism based genotyping were compared for their performance in following minority clones in longitudinal samples from Papua New Guinea.ResultsAmp-Seq markers were superior to length-polymorphic marker msp2 in detecting minority clones (sensitivity Amp-Seq: 95%, msp2: 85%). Multiplicity of infection (MOI) by Amp-Seq was 2.32 versus 1.73 for msp2. The higher sensitivity had no effect on estimates of force of infection because missed minority clones were detected in preceding or succeeding bleeds. Individual clone densities were tracked longitudinally by Amp-Seq despite MOI>1, thus providing an additional parameter for investigating malaria infection dynamics.ConclusionAmp-Seq based genotyping of longitudinal samples improves detection of minority clones and estimates of MOI. Amp-Seq permits tracking of clone density over time to study clone competition or the dynamics of specific, i.e. resistance-associated genotypes.