bluuebunny/crossref_metadata_2025_split huggingface dataset:
Red blood cell distribution width and mortality and hospitalizations in peritoneal dialysis patients
Authors: Soohoo Melissa , Molnar Miklos Z , Ujszaszi Akos , Obi Yoshitsugu , Kovesdy Csaba P , Kalantar-Zadeh Kamyar , Streja Elani 
Published: May 2018

Abstract

Background
Red blood cell distribution width (RDW) is found to be associated with different types of anemia and has recently been studied as a prognostic marker of mortality in hemodialysis patients. However, the relationship of RDW with mortality and hospitalization rate in peritoneal dialysis (PD) patients is less known.

Methods
Among 14 323 incident PD patients between 2007 and 2011 in the USA, we examined the relationship of baseline and time-varying RDW with the risk of mortality and time to first hospitalization using adjusted Cox models. In addition, we examined the relationship of baseline RDW and hospitalization rate using an adjusted negative-binomial regression model. Sensitivity analyses included competing risk models and subgroup analyses.

Results
The study population comprised patients 56 ± 16 years of age, including 43% females, 23% African Americans and 62% diabetics, with a mean RDW of 15.3 ± 1.6%. In models adjusted for clinical characteristics and laboratory parameters, RDW exhibited an incremental relationship with the mortality risk, where RDW ≥16.5% had a 40% and 69% higher risk of death in baseline and time-varying analyses, respectively, compared with an RDW of 14.5–15.5%. Moreover, higher baseline RDW ≥16.5% was also associated with a higher risk of time to first hospitalization {hazard ratio 1.22 [95% confidence interval (CI) 1.14–1.29]} and a higher rate of hospitalizations [incidence rate ratio 1.16 (95% CI 1.09–1.23)]. These results were consistent across numerous sensitivity analyses.

Conclusions
Higher RDW is associated with a higher risk of mortality and hospitalizations among incident PD patients. Further studies are needed to examine the mechanism behind RDW and adverse outcomes.
Convection-Enhanced Delivery of Muscimol Into the Bilateral Subthalamic Nuclei of Nonhuman Primates
Authors: Heiss John D , Walbridge Stuart , Argersinger Davis P , Hong Christopher S , Ray-Chaudhury Abhik , Lonser Russell R , Elias W Jeffrey , Zaghloul Kareem A 
Published: May 2018

Abstract

BACKGROUND
Muscimol is a gamma-aminobutyric acid receptor agonist that selectively and temporarily inhibits neurons. Local bolus injection of muscimol has been used experimentally to inhibit neuronal populations within discrete anatomical structures and discern their physiological function.

OBJECTIVE
To determine the safety and behavioral effects of convection-enhanced delivery of muscimol into the bilateral subthalamic nuclei (STN) of nonhuman primate rhesus macaques (NHPs).

METHODS
Six awake NHPs underwent co-infusion of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA), a surrogate magnetic resonance imaging (MRI) tracer, with increasing concentrations of muscimol for behavioral and histological assessment. Three other NHPs were co-infused with Gd-DTPA and 3H-muscimol into the STN to determine muscimol distribution by MRI and autoradiography. Two NHPs underwent microcatheter implantation without muscimol infusion for control comparison.

RESULTS
MRI revealed selective and complete perfusion of the bilateral STN in animals infused with Gd-DTPA and muscimol. No abnormal movements occurred at 0.125 mM. Muscimol doses between 0.25 and 4.4 mM resulted in transient, dose-dependent hyperkinesia. Muscimol (8.8 mM) resulted in severe bilateral dyskinesias, ballistic movements, and sedation. An 88.8 mM dose produced unresponsiveness in 1 animal. Infusion-related pathological abnormities or toxicity was not present on histological examination. MRI distribution of co-infused Gd-DTPA was similar to autoradiographic distribution of 3H-muscimol (Vd; R = 0.94). Mean Vd of infused animals was 37.9 mm3 ± 11.7 mm3 and mean Vd: Vi 7.6 ± 2.3.

CONCLUSION
Bilateral convection-enhanced delivery of muscimol into the primate STN resulted in dose-related hyperkinetic movements that resolved after stopping the infusion. Muscimol was not toxic to brain tissue. Gd-DTPA accurately tracked muscimol distribution.
Advances in in vitro genetic code reprogramming in 2014–2017
Authors: Katoh Takayuki , Passioura Toby , Suga Hiroaki 
Published: May 2018

Abstract
To date, various genetic code manipulation methods have been developed to introduce non-proteinogenic amino acids into peptides by translation. However, the number of amino acids that can be used simultaneously remains limited even using these methods. Additionally, the scope of amino acid substrates that are compatible with ribosomal translation systems is also limited. For example, difficult substrates such as d-amino acids and β-amino acids are much less efficiently incorporated into peptides than l-α-amino acids. Here, we focus on three recently developed methodologies that address these issues: (i) artificial division of codon boxes to increase the number of available amino acids, (ii) orthogonal ribosomal translation systems to ‘duplicate’ the codon table and (iii) development of novel artificial tRNAs that enhance incorporation of difficult amino acid substrates.
Incorporating Group Interviews Into Holistic Review in Baccalaureate Nursing School Admissions
Authors: Roach Ashley , Rose Anastasia , Beiers-Jones Kristen , Wallace Sharon , Licaycay Winnie , Nielsen Ann 
Published: May 2018

Abstract
Holistic review in admissions considers an applicant’s background and experience in combination with academic achievement. In order to evaluate baccalaureate nursing school applicants more holistically, a school of nursing added group interviews as part of the admissions process. The school’s Admission and Progression Committee consulted with other schools, developed interview questions, and implemented a strategy to interview applicants. Results of this process were high levels of candidate and faculty satisfaction and enrollment of a diverse cohort of students with a high preadmission grade point average. Areas for improvement and further research are discussed.
Pride and Competency in Accelerated Nursing Programs
Authors: Tornwall Joni , Tan Alai , Bowles Wendy 
Published: May 2018

Abstract

AIM
The aim of this study was to examine student-level and school-level variation in pride and competency in accelerated nursing programs and the relationship between student satisfaction with instructional methods and perceptions of pride and competency.

BACKGROUND
Nursing students in accelerated, second-degree programs have a greater need to feel competent when compared to traditionally educated nurses; however, evidence to illuminate a relationship between faculty instructional methods and student pride and competency is lacking.

METHOD
The method was a secondary analysis of data collected from 3,506 students in 130 programs over seven years.

RESULTS
Higher levels of satisfaction with instructional methods were associated with higher levels of pride and competency in nursing skills. There was no significant variation in pride and competency in nursing skills across institutions.

CONCLUSION
Student satisfaction with instructional methods in accelerated nursing education has an impact on student pride and competency.
Is the evidence of local allergic rhinitis growing?
Authors: Rondón Carmen , Eguiluz-Gracia Ibon , Campo Paloma 
Published: May 2018

Purpose of review
To examine the recent advances on epidemiological studies, diagnostic approach and clinical management of local allergic rhinitis (LAR) in adults and children.

Recent findings
Evidence about LAR is growing especially in pediatric and Asian populations. The prevalence of LAR is lower in Asian countries compared with western countries in both children and adults. LAR is considered a chronic condition and an independent rhinitis phenotype that affects up to 26.5% of nonatopic rhinitis patients. The disease rapidly progress toward the clinical worsening with associated onset of asthma and conjunctivitis, which further impairs patient's quality of life. Nasal Allergen Provocation Test is the diagnostic gold standard that can be complemented by basophil activation test and the detection of specific IgE in nasal secretions. Allergen immunotherapy induces a significant and early improvement in both clinical symptoms and quality of life in LAR patients.

Summary
LAR is a common entity, with different prevalence depending on geographical locations. LAR has to be considered in the process of differential diagnosis in children and adults with rhinitis. Diagnosis of LAR is crucial in order to start an etiologic treatment such as allergen immunotherapy, which has proven to be very effective in these patients.
Effectiveness of Lumbar Facet Joint Blocks and Predictive Value before Radiofrequency Denervation
Authors: Cohen Steven P. , Doshi Tina L. , Constantinescu Octav C. , Zhao Zirong , Kurihara Connie , Larkin Thomas M. , Griffith Scott R. , Jacobs Michael B. , Kroski William J. , Dawson Timothy C. , Fowler Ian M. , White Ronald L. , Verdun Aubrey J. , Jamison David E. , Anderson-White Mirinda , Shank Stephanie E. , Pasquina Paul F. 
Published: May 2018

Abstract

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
With facet interventions under scrutiny, the authors’ objectives were to determine the effectiveness of different lumbar facet blocks and their ability to predict radiofrequency ablation outcomes.

Methods
A total of 229 participants were randomized in a 2:2:1 ratio to receive intraarticular facet injections with bupivacaine and steroid, medial branch blocks, or saline. Those with a positive 1-month outcome (a 2-point or more reduction in average pain score) and score higher than 3 (positive satisfaction) on a 5-point satisfaction scale were followed up to 6 months. Participants in the intraarticular and medial branch block groups with a positive diagnostic block (50% or more relief) who experienced a negative outcome proceeded to the second phase and underwent radiofrequency ablation, while all saline group individuals underwent ablation. Coprimary outcome measures were average reduction in numerical rating scale pain score 1 month after the facet or saline blocks, and average numerical rating scale pain score 3 months after ablation.

Results
Mean reduction in average numerical rating scale pain score at 1 month was 0.7 ± 1.6 in the intraarticular group, 0.7 ± 1.8 in the medial branch block group, and 0.7 ± 1.5 in the placebo group; P = 0.993. The proportions of positive blocks were higher in the intraarticular (54%) and medial branch (55%) groups than in the placebo group (30%; P = 0.01). Radiofrequency ablation was performed on 135 patients (45, 48, and 42 patients from the intraarticular, medial branch, and saline groups, respectively). The average numerical rating scale pain score at 3 months was 3.0 ± 2.0 in the intraarticular, 3.2 ± 2.5 in the medial branch, and 3.5 ± 1.9 in the control group (P = 0.493). At 3 months, the proportions of positive responders in the intraarticular, medial branch block, and placebo groups were 51%, 56%, and 24% for the intraarticular, medial branch, and placebo groups, respectively (P = 0.005).

Conclusions
This study establishes that facet blocks are not therapeutic. The higher responder rates in the treatment groups suggest a hypothesis that facet blocks might provide prognostic value before radiofrequency ablation.
Anesthesia Care Team Composition and Surgical Outcomes
Authors: Sun Eric C. , Miller Thomas R. , Moshfegh Jasmin , Baker Laurence C. 
Published: May 2018

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
In the United States, anesthesia care can be provided by an anesthesia care team consisting of nonphysician providers (nurse anesthetists and anesthesiologist assistants) working under the supervision of a physician anesthesiologist. Nurse anesthetists may practice nationwide, whereas anesthesiologist assistants are restricted to 16 states. To inform policies concerning the expanded use of anesthesiologist assistants, the authors examined whether the specific anesthesia care team composition (physician anesthesiologist plus nurse anesthetist or anesthesiologist assistant) was associated with differences in perioperative outcomes.

Methods
A retrospective analysis was performed of national claims data for 443,098 publicly insured elderly (ages 65 to 89 yr) patients who underwent inpatient surgery between January 1, 2004, and December 31, 2011. The differences in inpatient mortality, spending, and length of stay between cases where an anesthesiologist supervised an anesthesiologist assistant compared to cases where an anesthesiologist supervised a nurse anesthetist were estimated. The approach used a quasirandomization technique known as instrumental variables to reduce confounding.

Results
The adjusted mortality for care teams with anesthesiologist assistants was 1.6% (95% CI, 1.4 to 1.8) versus 1.7% for care teams with nurse anesthetists (95% CI, 1.7 to 1.7; difference −0.08; 95% CI, −0.3 to 0.1; P = 0.47). Compared to care teams with nurse anesthetists, care teams with anesthesiologist assistants were associated with non–statistically significant decreases in length of stay (−0.009 days; 95% CI, −0.1 to 0.1; P = 0.89) and medical spending (−$56; 95% CI, −334 to 223; P = 0.70).

Conclusions
The specific composition of the anesthesia care team was not associated with any significant differences in mortality, length of stay, or inpatient spending.
Classic Papers Revisited: My Love Affair with the Venous System
Authors: Gelman Simon 
Published: May 2018

Abstract
The Pathophysiology of Aortic Cross-clamping and Unclamping. By Gelman S. ANesthesiology 1995; 82:1026–60. Reprinted with permission.
Aortic cross-clamping (AoX) and unclamping are associated with severe hemodynamic disturbances in virtually all organs and systems. The main hemodynamic changes induced by AoX result from an increase in impedance to aortic flow, an increase in systemic vascular resistance and afterload, blood volume redistribution caused by collapse and constriction of venous vasculature distal to the aortic clamp, and a subsequent increase in preload. Preload may not increase if the aorta is clamped distal to the celiac artery; in that case, blood volume from distal venous vasculature may be redistributed to the splanchnic vasculature without associated increases in preload. Increases in afterload and preload demand an increase in contractility, which results in an autoregulatory increase in coronary blood flow. Without increases in coronary blood flow and myocardial contractility, decompensation may occur. Aortic cross-clamping is associated with the formation and release of many mediators which constitute a double-edged sword: they may mitigate or aggravate the harmful hemodynamic effects of AoX and unclamping. Injuries to the lungs, kidneys, spinal cord, or abdominal viscera are caused mainly by ischemia and reperfusion of organs distal to aortic cross-clamping. A clear understanding of the pathophysiologic mechanisms involved in these processes should help to promote rational, well-focused, and effective measures to prevent and treat homeostatic disturbances occurring during AoX and unclamping.
Does Sacral Slanting Affect Distal Adding-on in Lenke Type 1A Adolescent Idiopathic Scoliosis?
Authors: Joo Yoon Suk , Hwang Chang Ju , Cho Jae Hwan , Baik Jong-Min , Cho Nam Ik , Lee Dong-Ho , Lee Mi Young , Yoon So Jung , Lee Choon Sung 
Published: May 2018

Study Design.
A retrospective clinical study.

Objective.
The purpose of this study was to identify risk factors for postoperative distal adding-on in Lenke 1A adolescent idiopathic scoliosis.

Summary of Background Data.
Distal adding-on is a postoperative complication associated with the Lenke type 1A curve. Although various factors are known to cause postoperative adding-on, no study has reported a correlation between sacral slanting and adding-on.

Methods.
A total of 126 consecutive patients who underwent posterior correction and fusion surgery for Lenke type 1A adolescent idiopathic scoliosis were included in this study. Curve type was further categorized into L4-left (L4-L) or L4-right (L4-R), based on the direction of the L4 vertebral tilt. Several clinical and radiological parameters including sacral slanting were investigated to identify risk factors associated with postoperative distal adding-on.

Results.
A total of 36 patients (28.6%) exhibited sacral slanting. Nineteen out of 20 L4-L type patients had left-sided sacral slanting, whereas 12 out of 16 L4-R type patients had right-sided sacral slanting. The group with adding-on (n = 13) demonstrated a significantly lower age than the group without adding-on (n = 113). Preoperative lumbar Cobb angle (P = 0.022) was determined to be an independent factor for adding-on according to logistic regression analysis. In the L4-R type, the last touching vertebra (LTV) level and the gap difference in levels between lowest instrumented vertebra and LTV (lowest instrumented vertebra-LTV) comprised significant variables.

Conclusion.
Sacral slanting typically occurs to the left in the L4-L type and to the right in the L4-R type. The size of the preoperative lumbar curve was found to be an independent risk factor that caused adding-on in patients with Lenke type 1A scoliosis. In the L4-R type, right-sided sacral slanting tended to lower the LTV. Therefore, the fusion level might be shorter to save the motion segments resulting in distal adding-on.

Level of Evidence: 4
The Impact of Sarcopenia on Cervical Spine Sagittal Alignment After Cervical Laminoplasty
Authors: Koshimizu Hiroyuki , Sakai Yoshihito , Harada Atsushi , Ito Sadayuki , Ito Kenyu , Hida Tetsuro 
Published: May 2018

Study Design:
This was a prospective follow-up study.

Objective:
The main objective of this study was to evaluate the effects of sarcopenia on the sagittal alignment of the cervical spine after cervical laminoplasty in order to investigate the relationship between sarcopenia and spinal malalignment.

Summary of Background Data:
Sarcopenia, a progressive and all over loss of skeletal muscle mass and strength associated with aging, has been reported to be related to spinal malalignment. The causes of poor surgical outcome after cervical laminoplasty have been examined in recent years, including the sagittal malalignment of the cervical spine. However, there are few reports about the impact of sarcopenia on the sagittal alignment of the cervical spine.

Materials and Methods:
A total of 171 patients who underwent cervical laminoplasty at our hospital between 2009 and 2015 were assigned to this study. The appendicular skeletal muscle mass [appendicular skeletal muscle index (SMI)] is commonly used to assess sarcopenia. Appendicular SMI (kg/m2) was obtained from arm and leg muscle mass using dual-energy x-ray absorptiometry. Sanada and colleagues reference value for the Japanese appendicular SMI was used to diagnose sarcopenia. C2–C7 sagittal vertical axis (SVA), C2–C7 lordosis angle, and C2–C7 range of motion were measured for evaluation. The primary outcome was evaluated using the Japanese Orthopedic Association Score System for Cervical Myelopathy (JOA score) and the SF-36 Health Survey Physical Function (PF).

Results:
Of the 171 patients, 48 were diagnosed with sarcopenia. Preoperative (P=0.001), postoperative (P=0.011), and 1-year follow-up (P=0.007) C2–C7 SVA were greater in the sarcopenia group. Preoperative (P=0.009), postoperative (P=0.018), and 1-year follow-up (P=0.023) SF-36 scores were higher in the nonsarcopenia group. Preoperative (P<0.001), postoperative (P<0.001), and 1-year follow-up (P=0.002) JOA scores were higher in the nonsarcopenia group. C2–C7 SVA and JOA scores were negatively correlated at 1-year follow-up (R=−0.213, P=0.005). C2–C7 SVA and SF-36 scores were not correlated at 1-year follow-up (R=−0.167, P=0.070).

Conclusions:
C2–C7 SVA was greater and postoperative outcome was worse after cervical laminoplasty in the sarcopenia group than in the nonsarcopenia group; thus, we believe it is necessary to evaluate sarcopenia before cervical laminoplasty, because sarcopenia may impact postoperative cervical alignment and postoperative outcome.

Level of Evidence:
Level III.
Association Between Lumbar Spinal Degeneration and Anatomic Pelvic Parameters
Authors: Strube Patrick , Pumberger Matthias , Sonnow Lena , Zippelius Timo , Nowack Dimitri , Zahn Robert K. , Putzier Michael 
Published: May 2018

Study Design:
Retrospective cohort study.

Objective:
The objective was to prove the association between anatomic pelvis parameters and specific types of lumbar spinal degeneration.

Summary of Background Data:
Different spinopelvic sagittal profile types are suggested to be associated with specific degenerative lumbar spine pathologies. Because pelvic morphology plays a key role defining the spinal shape as well as its load and function it thereby potentially predisposes the development of spinal degeneration.

Materials and Methods:
Patients with symptomatic lumbar spinal degeneration who were surgically treated in 2 spine departments from March 2011 until August 2016 were included in this retrospective analysis. Single-level degenerative pathologies were classified as lumbar disc herniation (LDH), degenerative disc disease (DDD), lumbar spinal stenosis (LSS), and degenerative spondylolisthesis (DSPL). The constant anatomic pelvic parameters pelvic incidence (PI), pelvic radius (PR), and sacral table angle (STA) were assessed in lateral radiographs of the lumbar spine and compared between the pathologies.

Results:
In total, 249 patients were assigned to the LDH (n=73), DDD (n=67), LSS (n=42), and DSPL (n=67) groups. Group comparisons revealed significant differences in the anatomic pelvic parameters PR (LDH, 139.5±10.8 mm; DDD, 135.9±14.0 mm; LSS, 127.8±14.3 mm; DSPL, 135.8±12.7 mm; P<0.001), PI (LDH, 53.1±10.0 degrees; DDD, 50.0±9.9 degrees; LSS, 54.5±9.6 degrees; DSPL, 57.1±10.8 degrees; P=0.001), and STA (LDH, 95.3±12.7 degrees; DDD, 105.4±9.0 degrees; LSS, 105.9±11.5 degrees; DSPL, 98.6±9.5 degrees; P<0.001). Post hoc tests indicated significant differences between the PR of the LSS group and that of all other subgroups (P<0.012), the PI of the DDD group and that of DSPL (P<0.001), and the STA of the LDH/DSPL groups and that of the LSS/DDD group (P<0.005).

Conclusions:
We found all the constant anatomic parameters to be specific for distinct types of degeneration, suggesting pelvis shape is a predisposing factor for their development.

Level of Evidence:
Level III.