bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treg-promoted New Bone Formation Through Suppressing Th17 by Secreting Interleukin-10 in Ankylosing Spondylitis
Authors: Xu Fan , Guanghao Chi , Liang Yan , Jun Wang , Wei Wu , Baorong He 
Published: July 2019

Study Design.
Retrospective single-center study.

Objective.
We want to know whether interleukin (IL)-10-secreting regulatory T cells (Treg) promote the new bone formation (NBF) through suppressing Th17 in ankylosing spondylitis (AS).

Summary of Background Data.
NBF in AS is unknown. Since there are balances of bone remodeling in human body and proinflammatory helper T cells Th17 promoted bone resorption.

Methods.
Eighteen AS patients with or without NBF (both nine cases) and nine healthy individuals were selected and the demographic data, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), MRI sacroiliitis score (MRISIS), and computer tomography sacroiliitis score (CTSIS) were recorded. Removed hip ligament tissue in the lesions after arthroplasty was collected and the lymphocytes and the peripheral blood mononuclear cells were prepared. Second, pathological section in hematoxylin–eosin stain were analyzed and flow cytometry and quantitative polymerase chain reaction analyses were carried out to detect the levels of Th17, Treg, IL-10, and nuclear factor (NF)-κB, and the relevance between them. The effect of Treg on Th17 was further analyzed by using Transwell coculturing.

Results.
Compared to AS patients without NBF, AS patients with NBF had significantly higher CTSIS and complications (P < 0.05 and 0.01, respectively), but significantly lower BASDAI (3.0 ± 0.4) and MRISIS (3.3 ± 0.8) (P < 0.01 and 0.05, respectively) and no acute inflammation in HE stain for hip joint. Compared to healthy donors, the ratio of Th17/Treg was significantly higher in AS patients without NBF and lower in AS patient with NBF (both P < 0.01) in flow cytometry analysis (FCA). Furthermore, Th17 significantly decreased after indirectly coculturing with Treg in FCA (P < 0.01). Finally, IL-10 had significantly higher mRNA expression in AS patients with NBF (P < 0.01), and NF-κB had significantly higher mRNA expression in AS patients without NBF (P < 0.05) than healthy donors. Only the mRNA expression of IL-10 was significantly correlated to the ratio of Th17/Treg (r = −0.93, P < 0.01).

Conclusion.
Treg-induced NBF of AS through suppressing Th17 by secreting IL10 and declining of the ratio of Th17/Treg indicated the development of NBF. This is important not only for screening development of NBF, but also for control of NBF of AS by immune therapy.

Level of Evidence: N/A
Characteristics of Rapid Response Calls in the United States: An Analysis of the First 402,023 Adult Cases From the Get With the Guidelines Resuscitation-Medical Emergency Team Registry
Authors: Lyons Patrick G. , Edelson Dana P. , Carey Kyle A. , Twu Nicole M. , Chan Paul S. , Peberdy Mary Ann , Praestgaard Amy , Churpek Matthew M. 
Published: July 2019

Objectives:
To characterize the rapid response team activations, and the patients receiving them, in the American Heart Association-sponsored Get With The Guidelines Resuscitation-Medical Emergency Team cohort between 2005 and 2015.

Design:
Retrospective multicenter cohort study.

Setting:
Three hundred sixty U.S. hospitals.

Patients:
Consecutive adult patients experiencing rapid response team activation.

Interventions:
Rapid response team activation.

Measurements and Main Results:
The cohort included 402,023 rapid response team activations from 347,401 unique healthcare encounters. Respiratory triggers (38.0%) and cardiac triggers (37.4%) were most common. The most frequent interventions—pulse oximetry (66.5%), other monitoring (59.6%), and supplemental oxygen (62.0%)—were noninvasive. Fluids were the most common medication ordered (19.3%), but new antibiotic orders were rare (1.2%). More than 10% of rapid response teams resulted in code status changes. Hospital mortality was over 14% and increased with subsequent rapid response activations.

Conclusions:
Although patients requiring rapid response team activation have high inpatient mortality, most rapid response team activations involve relatively few interventions, which may limit these teams’ ability to improve patient outcomes.
Is leisure time sitting associated with mortality rates among men diagnosed with localized prostate cancer?
Authors: Bonn Stephanie E. , Holmberg Erik , Hugosson Jonas , Bälter Katarina 
Published: July 2019

Objective
Being physically active postdiagnosis has been associated with lower rates of prostate cancer progression and mortality, but studies investigating postdiagnostic time spent sitting are lacking. We aim to study the association between leisure time sitting after a prostate cancer diagnosis and overall and prostate cancer-specific mortality.

Methods
Data from 4595 men in Sweden, diagnosed with localized prostate cancer between 1997–2002 and followed-up until the end of 2012, were analyzed. Time spent sitting during leisure time postdiagnosis was categorized into <2, 2–3, 3–4, and >4 h/day. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CI) of postdiagnosis leisure time sitting and a joint variable of sitting time and exercise, and time to overall or prostate cancer-specific death.

Results
The results showed no significant associations between postdiagnostic leisure time sitting and overall or prostate cancer-specific mortality rates. When the joint effect of both sitting and exercise time was considered, borderline significantly lower mortality rates for overall and prostate cancer-specific mortality were seen among participants that sat the least and exercised the most compared to the reference category with participants sitting the most and exercising least (HR: 0.75; 95% CI: 0.56–1.00 and HR: 0.61; 95% CI: 0.36–1.05, respectively).

Conclusions
No significant association between leisure time sitting and mortality rates among men diagnosed with localized prostate cancer was seen. This study does not support an association between leisure time sitting per se; however, being physically active may have beneficial effects on survival among men diagnosed with localized prostate cancer.
Adherence to Pulmonary Rehabilitation in COPD
Authors: Oates Gabriela R. , Niranjan Soumya J. , Ott Corilyn , Scarinci Isabel C. , Schumann Christopher , Parekh Trisha , Dransfield Mark T. 
Published: July 2019

Purpose:
Adherence to pulmonary rehabilitation (PR) is low. This qualitative study used the PRECEDE model to identify predisposing (intrapersonal), reinforcing (interpersonal), and enabling (structural) factors acting as barriers or facilitators of adherence to PR, and elicit recommendations for solutions from patients with chronic obstructive pulmonary disease (COPD).

Methods:
Focus groups with COPD patients who had attended PR in the past year were conducted. Sessions were recorded, transcribed verbatim, and coded independently by 2 coders, who then jointly decided on the final coding scheme. Data were summarized across groups, and analysis was used a thematic approach with constant comparative method to generate categories.

Results:
Five focus groups with 24 participants each were conducted. Participants (mean age 62 yr) were 54% male, and 67% black. More than half had annual income less than $20 000, 17% were current smokers, and 54% had low adherence (less than 35% of prescribed PR sessions). The most prominent barriers included physical ailments and lack of motivation (intrapersonal), no support system (interpersonal), transportation difficulties, and financial burden (structural). The most prominent facilitators included health improvement, personal determination (intrapersonal), support from peers, family, and friends (interpersonal), and program features such as friendly staff and educational component of sessions (structural). Proposed solutions included incentives to maintain motivation, tobacco cessation support (intrapersonal), educating the entire family (interpersonal), transportation assistance, flexible program scheduling, and financial assistance (structural).

Conclusion:
Health limitations, social support, transportation and financial difficulties, and program features impact ability of patients to attend PR. Interventions addressing these interpersonal, intrapersonal, and structural barriers are needed to facilitate adherence to PR.
MULTIMODAL IMAGING OF IGG4-RELATED PAPILLITIS AND RETINAL DISEASE
Authors: Tsui Edmund , Goldberg Naomi R. , Pillai Cinthi , Goduni Lediana , Freund K. Bailey 
Published: July 2019

Purpose:
To report a case of IgG4-related ophthalmic disease, which presented with papillitis and subretinal deposits.

Methods:
Observational case report with multimodal imaging.

Results:
A 52-year-old man with a history of persistent lymphadenopathy presented with decreased vision in his left eye. Funduscopic examination demonstrated cuticular drusen in both eyes and florid edema of the left optic nerve, along with scattered circumscribed grey-yellow subretinal deposits that were distinct from the cuticular drusen. Swept-source optical coherence tomography demonstrated a hyper-reflective subretinal material corresponding to the grey-yellow subretinal deposits on clinical examination along with diffuse outer retinal disruption. Fundus autofluorescence revealed scattered hypoautofluorescence corresponding to cuticular drusen and also larger patches of hypoautofluorescence corresponding to the grey-yellow subretinal deposits. Fluorescein angiography demonstrated hypofluorescence corresponding to the large subretinal deposits and leakage at the optic nerve. Lymph node biopsy demonstrated IgG4-positive plasma cells and elevated serum IgG4 levels leading to a diagnosis of IgG4-related ophthalmic disease. The patient was treated with oral prednisone with subsequent resolution of the optic nerve edema.

Conclusion:
We describe multimodal imaging of unique retinal and optic nerve findings associated with IgG4-related ophthalmic disease. Our report broadens the spectrum of ocular involvement associated with IgG4-related disease.
An inflammatory subtype of pancreatic ductal adenocarcinoma is associated with poor prognosis and increased perioperative mortality
Authors: Benzing Christian , Klein Fritz , Pelzer Uwe , Sinn Marianne , Pratschke Johann , Bahra Marcus 
Published: July 2019

Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a malignancy characterized by an aggressive tumor behavior. The present analysis seeks to identify and analyze a cohort that meets criteria for “inflammatory” PDAC (IPDAC). All patients who underwent a curative resection for PDAC at our institution between 1989 and 2015 were included in the retrospective analysis. Patients with histological proven adenocarcinoma and elevated C-reactive protein (CRP) (≥6 mg/L) serum concentrations, but no other suspicion of infection were included. We provide a matched control group with normal CRP serum levels from the same patient cohort. Thirty-six (6.8%) of 532 patients meet our criteria for an IPDAC group type. In-hospital (30 days) mortality was 13.9% in the IPDAC group vs 0% in the control group (P = .020). Median follow-up was 183.8 months (standard deviation [SD] = 53.3, range 14.3–285.4). Median overall survival was 8.5 months (SD = 16.8, range 0.3–89.6) in the IPDAC group and 24.8 months (SD = 19.4, range 0.7–80.4) in the control group (P = .002). Patients indicating an IPDAC in our cohort had a significantly and clinical meaningful decreased overall survival and a higher perioperative morbidity and mortality.
Keeping Up With Current Orthopaedic Nursing Practice
Authors: Roberts Dottie , Pirri Kathleen , Hanes Margaret 
Published: July 2019

BACKGROUND:
The Orthopaedic Nurses Certification Board (ONCB) conducts a role delineation study (RDS), also known as a job task analysis, every 5 years. Results identify tasks performed by orthopaedic registered nurses and nurse practitioners, as well as musculoskeletal health conditions commonly experienced by their patients.

PURPOSE:
The purpose of this study was to define current practice patterns among orthopaedic nurses and nurse practitioners to determine content for future certification examinations.

METHOD:
An online survey methodology was used to identify task and knowledge statements representative of orthopaedic nursing practice.

FINDINGS:
Of 6,462 e-mails sent, 904 valid responses were returned (response rate 13.9%). This is lower than results of the Orthopaedic Nurses Certification Board's 2010 RDS (22.7% response rate) but is considered acceptable for an RDS.

CONCLUSION:
Survey results were analyzed by ONCB Test Committee members with guidance from psychometric staff at PSI/AMP. PSI/AMP staff were used to review and revise examination specifications for the Orthopaedic Nurse Certified (ONC) and Orthopaedic Nurse Practitioner-Certified (ONP-C) certification programs. New examination specification and passing points were implemented with April 2018 testing.
Impact of Bundled Care on Outcomes Following Elective Primary Total Hip or Total Knee Arthroplasty
Authors: Arkin Laura C. , Reising Ellen , Penoyer Daleen , Talbert Steve 
Published: July 2019

BACKGROUND:
Standardized approaches to care and care pathways for patients with joint replacement have been shown to decrease length of stay (LOS), improve patient participation in education, decrease patient anxiety while improving perception of care, and lead to overall efficiency and improved care and outcomes.

PURPOSE:
The purpose of this study was to determine whether implementation of a standardized bundle approach to care influenced the outcomes after total hip or total knee arthroplasty (THA or TKA).

METHODS:
A retrospective, quasi-experimental before- and after-design study was used to evaluate the impact of the intervention. Two hospitals implemented a standardized bundle of care for patients undergoing THA or TKA that included preoperative patient education, day of surgery mobilization, and a total joint group physical therapy session (Full Bundle). Data analyses were completed on a convenience sample of 2,200 patients who underwent THA or TKA. Outcomes data measured were LOS, discharge disposition, costs, and readmission rate.

RESULTS:
Patients receiving the Full Bundle had significant reduction in LOS of roughly 1 day (OR = 1.687, 95% CI [1.578, 1.797]) versus group not receiving all elements (OR = 2.706; 95% CI [2.623, 2.789]). Full Bundle patients were 6 times more likely to be discharged home compared with the Partial Bundle group (OR = 6.01, 95% CI [4.01, 9.03]). Full Bundle group had significantly lower total direct costs, F(1) = 4.06, p = .046, partial η2 = 0.003. There were no differences in readmission rates between the 2 groups.

CONCLUSION:
Patients who had all elements of the THA/TKA bundle had the best outcomes. By improving efficiencies of care through the use of the bundle, the 2 hospitals positively impacted the care and outcomes of THA and TKA patients.
Effects of Optical Correction Method on the Magnitude and Variability of Accommodative Response: A Test-retest Study
Authors: Jiménez Raimundo , Redondo Beatriz , Davies Leon N. , Vera Jesús 
Published: July 2019

SIGNIFICANCE
The present study addresses the accommodative response and its dependence on the type of optical correction used. The results are discussed relative to their possible implications for myopia progression and visual fatigue.

PURPOSE
The accommodative response has been investigated owing to its possible relationship with the onset and progression of myopia and visual fatigue. This study explored the influence of wearing soft contact lenses in comparison with spectacles in terms of magnitude and variability of accommodation. In addition, we analyzed the intersession and intermethod repeatability.

METHODS
Dynamic accommodative response was recorded during 30-second epochs, at five different distances (50, 40, 33, 25, and 20 cm), in 21 individuals (mean refractive error ± SD, −0.79 ± 1.39 D) while wearing either soft contact lenses or spectacles on two different days. To assess repeatability, a second identical intervention was conducted.

RESULTS
Higher lags of accommodation were obtained with the use of soft contact lenses in comparison with the spectacle condition (P = .04, partial η2 [ηp
2] = 0.204), and similarly, a higher variability of accommodation at near distances was found during the soft contact lens measurement (P < .001, ηp
2 = 0.647). There was a strong intersession repeatability at all the distances tested for both optical correction methods.

CONCLUSIONS
The higher accommodative lag and fluctuations found while wearing soft contact lenses in comparison with spectacles may help to understand the mechanisms underlying myopia progression and asthenopia. These findings may be also considered when testing the accommodative response in research settings. Our test-retest design confirmed that there is a very good intersession repeatability for all the distances in both optical correction methods.
A protocol for the systematic review and meta-analysis of studies in which cannabinoids were tested for antinociceptive effects in animal models of pathological or injury-related persistent pain
Authors: Soliman Nadia , Hohmann Andrea G. , Haroutounian Simon , Wever Kimberley , Rice Andrew S.C. , Finn David P. 
Published: July 2019

Abstract

Introduction:
The International Association for the Study of Pain has established a global task force to comprehensively investigate the use of cannabinoids and cannabis-based medicines for pain management. This systematic review, the first in this field, will assess the preclinical literature that investigates the antinociceptive effects of cannabinoids, cannabis-based medicines, and endocannabinoid system modulators in animal models of tissue damage, inflammation, or neuropathy.

Methods:
A systematic electronic search of 3 online databases will identify relevant studies in which cannabinoids, cannabis-based medicines, and endocannabinoid system modulators have been tested in animal models of injury-related or pathological persistent pain. Data will be extracted for pain-associated behavioural outcomes, study design, and the reporting of measures to avoid bias. Standardised mean difference meta-analysis will be used to provide summary estimates of efficacy, with the effects of study quality and study design explored using stratified meta-analysis.

Perspective:
The evaluation of the preclinical evidence will quantify the antinociceptive effects of cannabinoids on pain behaviour in animal models of pathological pain in an effort to quantify the presence and prevalence of analgesic efficacy. It will also provide an understanding of the strengths and weaknesses of the preclinical field and inform an agenda for future research.
Stress and Illness: A Role for Specific Emotions
Authors: Levenson Robert W. 
Published: July 2019

ABSTRACTResearch on stress and disease has often afforded an important role to emotion, typically conceptualized in broad categories (e.g., negative emotions), viewed as playing a causal role (e.g., anger contributing to pathophysiology of cardiovascular disease), and measured using self-report inventories. In this article, I argue for the value of evaluating specific emotions, considering bidirectional causal influences, and assessing actual emotional responding when considering the role that emotions play in the stress-disease relationship. In terms of specificity, specific emotions (e.g., anger, sadness, and embarrassment) can be linked with particular health outcomes (e.g., cardiovascular disease and musculoskeletal disease). In terms of bidirectionality, the influences of emotions on disease as well as the influences of disease on emotional functioning can be considered. In terms of assessing actual emotional responding, emotions can be studied in vivo under controlled conditions that allow behavioral, physiological, and subjective responses to be measured during different kinds of emotional functioning (e.g., responding to emotional stimuli, interacting with relationship partners, and downregulating emotional responses). With these considerations in mind, I review early theories and empirical studies in psychosomatic medicine that considered the role of specific emotions and emotion-related behaviors. Studies from our laboratory are presented that illustrate a) differences in patterns of autonomic nervous system responding associated with specific emotions, b) relationships between specific emotions and particular health outcomes in the context of social relationships, c) age as a moderator of the relationship between specific emotions and well-being, d) bidirectional influences (emotions influencing disease and disease influencing emotional functioning), and e) impact of changes in emotional functioning in individuals with neurodegenerative diseases on the health of familial caregivers.
Duraplasty Using Autologous Fascia Lata and Latissimus Dorsi Free Flap for Chronic Cerebrospinal Fluid Leak
Authors: Barrientos Stephan , Leif Marilyn , Hon Heidi H. , Aizenberg Michele , Wong Shannon 
Published: July 2019

Abstract
Cerebrospinal fluid (CSF) leak is a common complication after cranial surgery. Therefore, after neurosurgical procedures it is crucial to obtain a dural repair that is complete and watertight. There are many techniques that have been described attempting to achieve this goal. However, there are complicating factors (eg, poor tissue viability, need for future radiation, comorbidities, infection, size of the dural defect, multiple operations) that may require a more comprehensive approach to achieve an optimal healing environment. The authors present a technique that uses a muscle free flap to vascularize an autologous fascia lata graft, preserving the viability of the graft and reinforcing its healing ability.
The authors applied this technique to a single patient with chronic CSF leak from poor tissue healing after treatments for recurrent medulloblastoma. After harvesting a fascia lata graft with appropriate size, the graft was sutured into the dural defect in a watertight fashion. A latissimus dorsi muscle free flap was harvested and anastomosed to a saphenous vein Corlett loop/AV fistula to the facial artery. The flap was than sutured to the graft. A drain was left in place and a skin graft was applied to the muscle flap.
At 8 months follow-up the patient was able to continue with her treatment and has had a stable repair without leak or breakdown. The authors present an algorithm to facilitate dural repair selection.
Duraplasty using autologous fascia lata reinforced with a free muscle flap is an effective technique to control chronic CSF leaks, especially when the dura is poorly vascularized and less viable.