bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Mortality in HIV-Associated Cryptococcal Meningitis Patients Treated With Amphotericin B–Based Therapy Under Routine Care Conditions in Africa
Authors: Patel Raju K K , Leeme Tshepo , Azzo Caitlin , Tlhako Nametso , Tsholo Katlego , Tawanana Ephraim O , Molefi Mooketsi , Mosepele Mosepele , Lawrence David S , Mokomane Margaret , Tenforde Mark W , Jarvis Joseph N 
Published: October 2018

AbstractBackgroundCryptococcal meningitis (CM) causes 10%–20% of HIV-related deaths in Africa. Due to limited access to liposomal amphotericin and flucytosine, most African treatment guidelines recommend amphotericin B deoxycholate (AmB-d) plus high-dose fluconazole; outcomes with this treatment regimen in routine care settings have not been well described.MethodsElectronic national death registry data and computerized medical records were used to retrospectively collect demographic, laboratory, and 1-year outcome data from all patients with CM between 2012 and 2014 at Botswana’s main referral hospital, when recommended treatment for CM was AmB-d 1 mg/kg/d plus fluconazole 800 mg/d for 14 days. Cumulative survival was estimated at 2 weeks, 10 weeks, and 1 year.ResultsThere were 283 episodes of CM among 236 individuals; 69% (163/236) were male, and the median age was 36 years. All patients were HIV-infected, with a median CD4 count of 39 cells/mm3. Two hundred fifteen person-years of follow-up data were captured for the 236 CM patients. Complete outcome data were available for 233 patients (99%) at 2 weeks, 224 patients (95%) at 10 weeks, and 219 patients (93%) at 1 year. Cumulative mortality was 26% (95% confidence interval [CI], 20%–32%) at 2 weeks, 50% (95% CI, 43%–57%) at 10 weeks, and 65% (95% CI, 58%–71%) at 1 year.ConclusionsMortality rates following HIV-associated CM treated with AmB-d and fluconazole in a routine health care setting in Botswana were very high. The findings highlight the inadequacies of current antifungal treatments for HIV-associated CM and underscore the difficulties of administering and monitoring intravenous amphotericin B deoxycholate therapy in resource-poor settings.
Salvage Debridement, Antibiotics and Implant Retention (“DAIR”) With Local Injection of a Selected Cocktail of Bacteriophages: Is It an Option for an Elderly Patient With Relapsing Staphylococcus aureus Prosthetic-Joint Infection?
Authors: Ferry Tristan , Leboucher Gilles , Fevre Cindy , Herry Yannick , Conrad Anne , Josse Jérôme , Batailler Cécile , Chidiac Christian , Medina Mathieu , Lustig S , Laurent Frédéric ,   Lyon BJI Study Group, Ferry Tristan , Ferry Tristan , Valour Florent , Perpoint Thomas , Boibieux André , Biron François , Miailhes Patrick , Ader Florence , Becker Agathe , Roux Sandrine , Triffault-Fillit Claire , Conrad Anne , Bosch Alexie , Daoud Fatiha , Lippman Johanna , Braun Evelyne , Chidiac Christian , Lustig Sébastien , Servien Elvire , Gaillard Romain , Schneider Antoine , Gunst Stanislas , Batailler Cécile , Fessy Michel-Henry , Besse Jean-Luc , Herry Yannick , Viste Anthony , Chaudier Philippe , Courtin Cyril , Louboutin Lucie , Martres Sébastien , Trouillet Franck , Barrey Cédric , Jouanneau Emmanuel , Jacquesson Timothée , Mojallal Ali , Boucher Fabien , Shipkov Hristo , Chateau Joseph , Aubrun Frédéric , Dziadzko Mikhail , Macabéo; Caroline , Laurent Frederic , Beraud Laeticia , Josse Jérôme , Kolenda Camille , Dupieux Céline , Craighero Fabien , Boussel Loic , Pialat Jean-Baptiste , Morelec Isabelle , Janier Marc , Giammarile Francesco , Tod Michel , Gagnieu Marie-Claude , Goutelle Sylvain , Grisi Béatrice , Dananche Cédric , Mabrut Eugénie 
Published: October 2018

Abstract
Local injection of a bacteriophages mix during debridement, antibiotics and implant retention (“DAIR”) was performed to treat a relapsing Staphylococcus aureus chronic prosthetic joint infection (PJI). This salvage treatment was safe and associated with a clinical success. Scientific evaluation of the potential clinical benefit of bacteriophages as antibiofilm treatment in PJI is now feasible and required.
Overproduction of IL-6 and Type-I IFN in a Lethal Case of Chikungunya Virus Infection in an Elderly Man During the 2017 Italian Outbreak
Authors: Colavita Francesca , Vita Serena , Lalle Eleonora , Carletti Fabrizio , Bordi Licia , Vincenti Donatella , Pozzetto Irene , Aiuti Massimo , Vairo Francesco , Capobianchi Maria Rosaria , Lichtner Miriam , Castilletti Concetta 
Published: October 2018

Abstract
Chikungunya fever is caused by Chikungunya virus (CHIKV) and is generally considered a self-limiting disease. However, severe clinical presentations with a high mortality rate have been reported in association with underlying medical conditions. This study reports the molecular characterization of the virus and an abnormal pattern of circulating cytokines in a unique lethal CHIKV case during the 2017 outbreak in Italy, which involved an elderly patient with underlying cardiac disease. Analysis of inflammatory cytokines revealed a strong increase of interferon (IFN)-α and IFN-β, as well as interleukin-6, suggesting a possible role of type-I IFN in the cytokine storm, which may be correlated with unfavorable prognosis of CHIKV infection.
Inflammatory Mediator Expression Associated With Antibody Response Induced by Live Attenuated vs Inactivated Influenza Virus Vaccine in Children
Authors: Martin Judith M , Avula Raghunandan , Nowalk Mary Patricia , Lin Chyongchiou Jeng , Horne William T , Chandran Uma R , Nagg Jennifer P , Zimmerman Richard K , Cole Kelly S , Alcorn John F 
Published: October 2018

Abstract

Background
The reasons for differences in vaccine effectiveness between live attenuated influenza vaccine (LAIV) and inactivated influenza vaccine (IIV) are not clear.

Methods
Blood samples were obtained before vaccination and at days 7 and 21 postvaccination with 2015–2016 quadrivalent IIV or LAIV. Serologic response to the vaccine was measured by hemagglutination inhibition assay. Targeted RNA sequencing and serum cytokine analysis were performed. Paired analyses were used to determine gene expression and were compared between IIV and LAIV recipients. Classification And Regression Trees analysis (CART) identified the strongest associations with vaccine response.

Results
Forty-six enrollees received IIV, and 25 received LAIV. The mean age was 11.5 (±3.7) years. Seroconversion with IIV was associated with changes in expression of PRKRA and IFI6. Nonseroconversion for both IIV and LAIV was characterized by increased interferon-stimulated gene expression. Seroprotection with both vaccines was associated with altered expression of CXCL2 and CD36. For LAIV, CART showed that changes in expression of CD80, CXCL2, and CASP1 were associated with seroprotection. Serum cytokines showed that IIV seroconversion was associated with decreased CCL3. LAIV seroprotection tracked with decreased tumor necrosis factor–α and interferon-γ.

Conclusions
Distinct markers of seroconversion and seroprotection against IIV and LAIV were identified using immunophenotyping and CART analysis.
Development and Validation of a Model to Predict Growth of Potentially Antibiotic-Resistant Gram-Negative Bacilli in Critically Ill Children With Suspected Infection
Authors: Karsies Todd , Moore-Clingenpeel Melissa , Hall Mark 
Published: October 2018

Abstract

Background
Risk-based guidelines aid empiric antibiotic selection for critically ill adults with suspected infection with Gram-negative bacilli with high potential for antibiotic resistance (termed high-risk GNRs). Neither evidence-based guidelines for empiric antibiotic selection nor validated risk factors predicting high-risk GNR growth exist for critically ill children. We developed and validated a model for predicting high-risk GNR growth in critically ill children with suspected infection.

Methods
This is a retrospective cohort study involving 2 pediatric cohorts admitted to a pediatric intensive care unit (ICU) with suspected infection. We developed a risk model predicting growth of high-risk GNRs using multivariable regression analysis in 1 cohort and validated it in a separate cohort.

Results
In our derivation cohort (556 infectious episodes involving 489 patients), we identified the following independent predictors of high-risk GNR growth: hospitalization &gt;48 hours before suspected infection, hospitalization within the past 4 weeks, recent systemic antibiotics, chronic lung disease, residence in a chronic care facility, and prior high-risk GNR growth. The model sensitivity was 96%, the specificity was 48%, performance using the Brier score was good, and the area under the receiver operator characteristic curve (AUROC) was 0.722, indicating good model performance. In our validation cohort (525 episodes in 447 patients), model performance was similar (AUROC, 0.733), indicating stable model performance.

Conclusions
Our model predicting high-risk GNR growth in critically ill children demonstrates the high sensitivity needed for ICU antibiotic decisions, good overall predictive capability, and stable performance in 2 separate cohorts. This model could be used to develop risk-based empiric antibiotic guidelines for the pediatric ICU.
Pain Catastrophizing Is Independently Associated with Quality of Life in Patients with Severe Hip Osteoarthritis
Authors: Hayashi Kazuhiro , Morishima Takkan , Ikemoto Tatsunori , Miyagawa Hirofumi , Okamoto Takuya , Ushida Takahiro , Deie Masataka 
Published: October 2018

AbstractObjective. Pain catastrophizing is an important pain-related variable, but its impact on patients with osteoarthritis is uncertain. The aim of the current study was to determine whether pain catastrophizing was independently associated with quality of life (QOL) in patients with osteoarthritis of the hip. Design. Cross-sectional study conducted between June 2017 and February 2018. Setting. Tertiary center. Subjects. Seventy consecutively enrolled patients with severe hip osteoarthritis who had experienced pain for six or more months that limited daily function, and who were scheduled for primary unilateral total hip arthroplasty. Methods. QOL was measured using the EuroQOL-5 Dimensions questionnaire, the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire, and a dissatisfaction visual analog scale. Covariates included pain intensity, pain catastrophizing, range of hip motion, and gait speed. The variables were subjected to multivariate analysis with each QOL scale. Results. The median age was 68 years, and the median Pain Catastrophizing Scale score was 26. In multiple regression analysis, pain catastrophizing, pain intensity in both hips, pain intensity on the affected side, hip flexion on the affected side, and gait speed were independently correlated with QOL. Conclusions. Pain catastrophizing was independently associated with each QOL scale in preoperative patients with severe hip osteoarthritis. Pain catastrophizing had either the strongest or second strongest effect on QOL, followed by pain intensity.
Association of HLA-DRB1 shared epitope alleles and immune checkpoint inhibitor-induced inflammatory arthritis
Authors: Cappelli Laura C , Dorak Mehmet T , Bettinotti Maria P , Bingham Clifton O , Shah Ami A 
Published: October 2018

Abstract

Objective
To evaluate the frequency of HLA class I and II alleles associated with traditional forms of inflammatory arthritis in patients with immune checkpoint inhibitor (ICI)-induced inflammatory arthritis as compared with population controls.

Methods
High-resolution HLA typing was performed on 27 patients with ICI-induced inflammatory arthritis and 726 healthy controls. Genotyping at the shared epitope (SE) locus (HLA DRB1) was performed on 220 RA cases. Allele-positivity rates and frequency of having at least one SE allele were compared using Fisher’s exact test between ICI-induced inflammatory arthritis and healthy controls. Frequency of having at least one SE allele was also compared between ICI-induced inflammatory arthritis and RA cases.

Results
Twenty-six patients with ICI-induced inflammatory arthritis were of European descent, and one was African American. In those 26 patients, 16 (61.5%) had at least one SE allele, significantly different from healthy controls of European descent, in whom 299 (41.2%) had at least one SE allele (odds ratio 2.3, P = 0.04). The allele-positivity rate of DRB1*04: 05 was also higher in the ICI-induced inflammatory arthritis group. The ICI-induced inflammatory arthritis population and RA patients of European descent did not differ in frequency of having at least one SE allele, but ICI-induced inflammatory arthritis patients were more likely to be autoantibody-negative for RF and anti-CCP antibodies.

Conclusion
Patients with ICI-induced inflammatory arthritis of European descent were more likely to have at least one SE allele than healthy controls. Further studies are needed to validate these findings and investigate whether a unique immunogenetic framework increases risk for different immune-related adverse events.
Democracy Misunderstood: Authoritarian Notions of Democracy around the Globe
Authors: Kirsch Helen , Welzel Christian 
Published: October 2018

AbstractAn intriguing phenomenon consists in the fact that widespread support for democracy coexists in many countries with the persistent absence of democracy itself. Addressing this phenomenon, we show that in most places where it exists people understand democracy in ambiguous ways, such that “authoritarian” notions of what democracy means mix with—and even overshadow—liberal notions, in spite of the contradiction between these two notions. Underlining this contradiction, our evidence shows that authoritarian notions of democracy question the authenticity of liberal notions when both are endorsed conjointly. Worse, the evidence further suggests that authoritarian notions reverse the whole meaning of support for democracy, indeed indicating support for autocracy instead. Arguably, this reversal in the meaning of support for democracy lends legitimacy to authoritarian rule, which helps to explain where autocracy endures. Testing alternative explanations of authoritarian notions of democracy, we find that emancipative values are most influential, exerting a two-fold “enlightening” effect in (a) making people recognize the contradiction between liberal and authoritarian notions of democracy and (b) turning them against authoritarian notions. In a nutshell, the prospects of democracy are bleak where emancipative values remain weak.
Unmet Needs in Nutritional Care in African Paediatric Oncology Units
Authors: Schoeman Judy , Ladas Elena J , Rogers Paul C , Aryal Suvekshya , Kruger Mariana 
Published: October 2018

Abstract

Background
Up to 50% of children diagnosed with cancer in low- and middle-income countries are malnourished, which likely affects survival.

Subjects and methods
An online survey to paediatric oncology units (POUs) in Africa was done regarding nutritional assessment and care.

Results
Sixty-six surveys were received from POUs in 31 countries. Only 44.4% had a dedicated dietician for nutritional assessment and support; 29.6% undertook routine nutritional assessment during treatment. None reported defined criteria for nutritional intervention. Total parenteral nutrition was not available for 42.6% of POUs, while 51.8% did not have access to commercial enteral nutrition for inpatients, and 25.9% of the hospitals could not supply any home-based nutritional supplements.

Conclusion
Nutritional assessment in POUs in Africa is neither routinely undertaken nor are there defined criteria to initiate nutritional interventions. Standardized guidelines for nutritional assessment and interventions are needed for African POUs to enable improved outcome.
Theory-Driven Integrative Process/Outcome Evaluation of a Concept-Based Nursing Curriculum
Authors: Fromer Rosemary F. 
Published: October 2018

Abstract
The study aim was to evaluate the effects of concept-based learning by comparing ATI Nursing Education test scores for a traditional curriculum and a concept-based curriculum. The study also examined effects of the concept-based curriculum on critical thinking and motivation. No statistically significant differences were noted in ATI scores for the two groups; students neither agreed nor disagreed that they were engaged in critical thinking but did agree with motivation statements. Faculty were surveyed about their approach to teaching.
Team Communication Influence on Procedure Performance: Findings From Interprofessional Simulations with Nursing and Medical Students
Authors: Reising Deanna L. , Carr Douglas E. , Gindling Sally , Barnes Roxie , Garletts Derrick , Ozdogan Zulfukar 
Published: October 2018

Abstract
Interprofessional team performance is believed to be dependent on the development of effective team communication skills. Yet, little evidence exists in undergraduate nursing programs on whether team communication skills affect team performance. A secondary analysis of a larger study on interprofessional student teams in simulations was conducted to determine if there is a relationship between team communication and team procedure performance. The results showed a positive, significant correlation between interprofessional team communication ratings and procedure accuracy in the simulation. Interprofessional team training in communication skills for nursing and medical students improves the procedure accuracy in a simulated setting.
Pharmacology Goes Concept-Based: Course Design, Implementation, and Evaluation
Authors: Lanz Amelia , Davis Rebecca G. 
Published: October 2018

Abstract
Although concept-based curricula are frequently discussed in the nursing education literature, little information exists to guide the development of a concept-based pharmacology course. Traditionally, nursing pharmacology courses are taught with an emphasis on drug class where a prototype drug serves as an exemplar. When transitioning pharmacology to a concept-based course, special considerations are in order. How can educators successfully integrate essential pharmacological content into a curriculum structured around nursing concepts? This article presents one approach to the design and implementation of a concept-based undergraduate pharmacology course. Planning methods, supportive teaching strategies, and course evaluation procedures are discussed.
Surviving the NCLEX Dip
Authors: Mager Diana , Beauvais Audrey , Kazer Meredith Wallace 
Published: October 2018

Abstract
Schools of nursing are charged with preparing graduates to meet minimal practice standards upon workforce entry. To that end, students must pass the National Council of State Boards of Nursing Licensure Examination (NCLEX-RN®) upon graduation. Increased rigor and higher recent passing standards for the exam can contribute to declining scores, which negatively impact graduates and the nursing program. The purpose of this article is to describe a successful 10-step action plan implemented to remediate a brief dip in NCLEX-RN pass rates at one university. The plan contributed to a 10 percent increase in NCLEX scores within one year.
The Competency/Outcomes Model: Advancing Academic Progression
Authors: Sroczynski Maureen , Close Liz , Gorski Mary Sue , Farmer Pat , Wortock Jean 
Published: October 2018

Abstract

AIM
This article describes the Competency Model (CM) as a promising curriculum framework to foster academic progression from the associate to the baccalaureate degree in nursing.

BACKGROUND
The CM was identified by the Center to Champion Nursing in America as one of four seamless nursing academic progression models to streamline nursing academic progression. It is built on a foundation of authentic collaboration between education and practice partners to develop and maintain explicit, current, practice-relevant nursing education outcomes.

METHOD
Salient features and exemplars were collected from a convenience sample of education practice partnerships across the country that have implemented the CM.

RESULTS
Characteristics, trends, and variations in the CM from different state, regional, and local approaches are described and contrasted.

CONCLUSION
A comparison of varied approaches in CM design and implementation demonstrates its versatility to support seamless academic progression and fortify education and practice collaboration.
Texas Team: Academic Progression and IOM Toolkit
Authors: Reid Helen , Tart Kathryn , Tietze Mari , Joseph Nitha Mathew , Easley Carson 
Published: October 2018

Abstract

BACKGROUND
The Institute of Medicine (IOM) Future of Nursing report, identified eight recommendations for nursing to improve health care for all Americans.

AIM
The Texas Team for Advancing Health Through Nursing embraced the challenge of implementing the recommendations through two diverse projects.

METHOD
One group conducted a broad, online survey of leadership, practice, and academia, focusing on the IOM recommendations. The other focused specifically on academic progression through the use of CABNET (Consortium for Advancing Baccalaureate Nursing Education in Texas) articulation agreements.

RESULTS
The survey revealed a lack of knowledge and understanding of the IOM recommendations, prompting development of an online IOM toolkit. The articulation agreements provide a clear pathway for students to the RN-to-BSN degree students.

CONCLUSION
The toolkit and articulation agreements provide rich resources for implementation of the IOM recommendations.
Site-specific Surgical Site Infection Rates for Rib-based Distraction
Authors: Striano Brendan M. , Refakis Christian A. , Anari Jason B. , Campbell Robert M. , Flynn John M. 
Published: October 2018

Background:
Implantable rib-based distraction devices have revolutionized the treatment of children with early onset scoliosis and thoracic insufficiency syndrome. Unfortunately, the need for multiple skin incisions and repeated surgeries in a fragile patient population creates considerable infection risk. In order to assess rates of infection for different incision locations and potential risk factors, we generated a prospectively collected database of patients treated with rib-based distraction devices.

Methods:
We analyzed a cohort of patients with thoracic insufficiency syndrome from various etiologies that our institution treated with rib-based distraction devices from 2013 to 2016. Surgery type (implantation, expansion, revision/removal), and surgeon adjudicated surgical site infection (SSI) were collected. For this study, we developed a novel, rib-based distraction device surgical site labeling system in which incisions could be labeled as either proximal or distal surgical exposure areas. Treating surgeons documented the operative site, procedure, and SSI site in real-time.

Results:
A total of 166 unique patients underwent 670 procedures during the study period, producing 1537 evaluable surgical sites; 1299 proximal and 238 distal. Patients were 6.81±4.0 years of age on average. Forty-seven procedures documented SSIs (7.0%), while 40 (24.1%) patients experienced an infection. Analysis showed significant variation in the rate of infection between implantation, and expansion, and revision procedures, with implantation procedures having the highest infection rate at 13.1% (P<0.01). Infections occurred more frequently at distal sites than proximal ones (P=0.02).

Conclusions:
Our novel, surgeon-entered, prospective quality improvement database has identified distal surgical sites as being at higher risk for SSI than proximal ones. Further, rib-based distraction device implantation procedures were identified as being at a greater risk for SSI than expansion or revision procedures. We believe this data can lead to improved prevention measures, anticipatory guidance, and patient care.

Level of Evidence:
Level II—prognostic study.