bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti-MDA5 juvenile idiopathic inflammatory myopathy: a specific subgroup defined by differentially enhanced interferon-α signalling
Authors: Melki Isabelle , Devilliers Hervé , Gitiaux Cyril , Bondet Vincent , Duffy Darragh , Charuel Jean-Luc , Miyara Makoto , Bokov Plamen , Kheniche Ahmed , Kwon Theresa , Authier François Jérôme , Allenbach Yves , Belot Alexandre , Bodemer Christine , Bourrat Emmanuelle , Dumaine Cécile , Fabien Nicole , Faye Albert , Frémond Marie-Louise , Hadchouel Alice , Kitabayashi Naoki , Lepelley Alice , Martin-Niclos Maria José , Mudumba Sasi , Musset Lucile , Quartier Pierre , Rice Gillian I , Seabra Luis , Uettwiller Florence , Uggenti Carolina , Viel Sebastien , Rodero Mathieu P , Crow Yanick J , Bader-Meunier Brigitte 
Published: October 2019

Abstract

Objectives
JDM and juvenile overlap myositis represent heterogeneous subtypes of juvenile idiopathic inflammatory myopathy (JIIM). Chronic evolution can occur in up to 60% of cases, and morbidity/mortality is substantial. We aimed to describe the clinical, biological, histological and type I IFN status in JIIM associated with anti-melanoma differentiation-associated protein 5 (anti-MDA5) autoantibodies at presentation (group 1) in comparison with other JIIM (group 2).

Methods
This was a retrospective and prospective study of patients with JIIM ascertained from three French paediatric rheumatology reference centres between 2013 and 2019. Muscle biopsies were reviewed. Type I interferon pathway activity was assessed by dosage of IFNα serum protein and the expression of IFN-stimulated genes.

Results
Sixty-four patients were included, 13 in group 1 (54% JDM and 46% juvenile overlap myositis) and 51 in group 2 (76% JDM and 24% juvenile overlap myositis). Group 1 patients demonstrated more arthritis, skin ulcerations, lupus features and interstitial lung disease, and a milder muscular involvement. Serum IFNα levels were higher in group 1 than 2, and decreased after treatment or improvement in both groups. Outcome was similar in both groups. Unconventional treatment (more than two lines) was required in order to achieve remission, especially when skin ulceration was reported.

Conclusion
This study indicates a higher frequency of arthritis, skin ulcerations and interstitial lung disease, but milder muscular involvement, in JIIM with positive anti-MDA5 autoantibodies compared with other JIIM. Our data support an important role of systemic IFNα in disease pathology, particularly in the anti-MDA5 auto-antibody-positive subgroup. In severe and refractory forms of JIIM, IFNα may represent a therapeutic target.
Phylogeny of European Anodontini (Bivalvia: Unionidae) with a redescription of Anodonta exulcerata
Authors: Riccardi Nicoletta , Froufe Elsa , Bogan Arthur E , Zieritz Alexandra , Teixeira Amílcar , Vanetti Isabella , Varandas Simone , Zaccara Serena , Nagel Karl-Otto , Lopes-Lima Manuel 
Published: October 2019

AbstractFreshwater bivalves are highly threatened and globally declining due to multiple anthropogenic impacts, making them important conservation targets. Because conservation policies and actions generally occur at the species level, accurate species identification and delimitation is critical. A recent phylogenetic study of Italian mussel populations revalidated an Anodonta species bringing the number of known European Anodontini from three to four species. The current study contributes to the clarification of the taxonomy and systematics of European Anodontini, using a combination of molecular, morphological and anatomical data, and constructs phylogenies based on complete mitogenomes. A redescription of A. exulcerata and a comparative analysis of morphological and anatomical characters with respect to the other two species of Anodonta present in the area are provided. No reliable diagnostic character has emerged from comparative analysis of the morphometric characters of 109 specimens from 16 sites across the Italian peninsula. In fact, the discriminant analysis resulted in a greater probability of correct assignment to the site of origin than to the species. This confirms the difficulties of an uncritical application of visual characters for the delimitation of species, especially for Anodontinae.
Arts-Based Reflection on the End of Life: Nursing Student Narrative Analysis
Authors: Forbes Maryann O. , Oates Virginia C. 
Published: October 2019

Abstract
Nurses play an essential role in providing compassionate evidence-based care at the end of life, yet many undergraduate students have limited opportunities to participate in end-of-life care experiences. Arts-based pedagogy has been explored as a strategy in nursing education that focuses on the affective domain of learning. The purpose of this qualitative narrative analysis was to explore the impact of an arts-based reflection assignment on student affective learning using artistic images depicting end-of-life scenarios. Student written narratives (n = 21) were analyzed using content analysis, and four themes emerged that described the components of affective learning in several areas.
Nonacademic Factors That Influence Nontraditional Nursing Student Retention
Authors: Priode Kimberly Slone , Dail Robin B. , Swanson Melvin 
Published: October 2019

Abstract
The purpose of this study is to identify the most supportive and restrictive factors contributing to students’ ability to persist through nursing program course completion as perceived by 59 nontraditional students enrolled in a nursing associate degree program. The Student Perception Appraisal-Revised tool was used. Results include that encouragement by friends within school is the top supportive factor, while financial status was found to be the most restrictive factor. Students’ perceptions of why they are not successful in staying in school may help nurse educators to plan and implement changes for improvement based on changing student needs.
The Relationship Between Social Identity, Stereotype Threat, and Academic Success Among Prenursing Students
Authors: Sullivan Katherine , Guzman Anissa S. , Ghaffari Dylan 
Published: October 2019

Abstract
The relationships between social identity, stereotype threat, and academic success were explored among prenursing students. Stereotype threat has been linked to academic success in students from underrepresented populations within the social sciences and educational literature but has not been explored in nursing. A descriptive correlational design was used with Picho and Brown’s Social Identities and Attitudes Scale emailed to 159 prenursing students. Stereotype threat was significantly related to race/ethnicity with no significant relationship between stereotype threat and academic success. Further exploration of stereotype threat in nursing is warranted; there may be implications for retention and support of diverse students.
Characteristics and Predictors of HCAHPS Nonresponse After Spine Surgery
Authors: Malpani Rohil , Adrados Murillo , Mercier Michael R. , McLynn Ryan P. , Galivanche Anoop R. , Pathak Neil , Grauer Jonathan N. 
Published: October 2019

Study Design.
Retrospective cohort study.

Objective.
To assess nonresponder biases for the HCAHPS survey following spine surgery.

Summary of Background Data.
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a publicly reported patient satisfaction survey. In addition to having the potential of impacting a hospital's reputation, it is directly linked to government reimbursement. However, it is known that a minority of patients return this survey, and it is expected that there are nonresponder biases.

Methods.
All adult inpatient spine surgery patients at a single institution between January 2013 and August 2017 at a single institution were selected for retrospective analysis. Patient demographics and perioperative outcomes were assessed as potential predictors of not returning HCAHPS surveys. Univariate and multivariate analyses were performed.

Results.
Of 5517 spine surgeries analyzed, 1505 (27.3%) patients returned the HCAHPS survey. Response rate was variable based on patient characteristics (with statistically significant differences based on age, functional status, race, and American Society of Anesthesiologists score) but not variable based on anatomic region of the spine surgery. Multivariate analysis revealed that patients who did not return the HCAHPS survey were more likely to be black/African American (OR = 2.8, P < 0.001), have a higher American Society of Anesthesiologists score (OR 1.76, P < 0.001), and have had a major adverse event (OR = 1.66; P = 0.001), minor adverse event (OR = 2.50; P < 0.001), discharged to a destination other than home (OR = 2.16, P < 0.001), hospital readmission (OR = 2.58; P < 0.001), and a long hospital length of stay (OR = 1.28, P = 0.001).

Conclusion.
For spine surgery patients, patient characteristics and perioperative outcomes were found to be significantly associated with the nonresponder bias for HCAHPS surveys. Although the potential resultant bias in HCAHPS scores cannot be directly determined, this must be considered in interpreting the results of such satisfaction surveys given that less than one-third of patients actually completed this survey in the study population.

Level of Evidence: 3
Trends in Anterior Lumbar Interbody Fusion in the United States
Authors: Varshneya Kunal , Medress Zachary A. , Jensen Michael , Azad Tej D. , Rodrigues Adrian , Stienen Martin N. , Desai Atman , Ratliff John K. , Veeravagu Anand 
Published: October 2019

Background:
Although the incidence of spinal fusions has increased significantly in the United States over the last quarter century, national trends of anterior lumbar interbody fusion (ALIF) utilization are not known.

Purpose:
The objective of this study was to characterize trends, clinical characteristics, risk factors associated with, and outcomes of ALIF in the United States.

Study Design:
This was an epidemiological study using national administrative data from the MarketScan database.

Methods:
Using a large administrative database, we identified adults who underwent ALIF in the United States from 2007 to 2014. The incidence of ALIF was studied longitudinally over time and across geographic regions in the United States. Data related to postoperative complications, length of stay, readmission, and cost were collected.

Results:
We identified 49,945 patients that underwent ALIF in the United States between 2007 and 2014. The total number of ALIF procedures increased from 3650 in 2007 to 6151 in 2014, accounting for an average increase of 24.07% annually. The Southern United States performed the highest number of ALIFs. The most common conditions treated were degenerative disc disease and spondylolisthesis. Over one third of patients (34.6%) underwent multilevel fusion. The most common complications were iron deficiency anemia, urinary tract infections, and pulmonary complications. Hospital and physician pay increased significantly during the study period.

Conclusions:
For the first time in our knowledge, we identified national trends in ALIF utilization, outcomes, and cost using a large administrative database. Our study reaffirms prior work that has demonstrated low rates of complications, mortality, and readmission following ALIF.

Level of Evidence:
Level III.
Outcomes of an Intraoperative Povidone-Iodine Irrigation Protocol in Spinal Surgery for Surgical Site Infection Prevention
Authors: Onishi Yuki , Masuda Kazuhiro , Tozawa Keiichiro , Karita Tatsuro 
Published: October 2019

Study Design:
This was a retrospective observational study.

Objective:
The aim of this study was to evaluate the efficacy of our new protocol for preventing postoperative surgical site infection (SSI) following spinal surgery.

Summary of Background Data:
SSI following spinal surgery is a serious postoperative complication. Several studies have recently assessed the effectiveness of wound irrigation with povidone-iodine (PVP-I) for SSI prevention, but no consensus has been reached as to how PVP-I should be used in clinical practice. We formed a PVP-I irrigation protocol focusing on the pharmacological properties of PVP-I. This study aimed to evaluate the efficacy and safety of our protocol for preventing SSI.

Materials and Methods:
All cases of spinal surgery at our hospital between October 2011 and September 2016 were retrospectively reviewed. The exclusion criteria were PVP-I allergy, prior surgical debridement for infection, and implant removal surgery. The patients were subdivided into those who had received normal saline irrigation after 90 seconds of 1% PVP-I pooling every 1.5 hours (study group) or only routine saline irrigation every 1.5 hours (control group). The study and control groups comprised of 177 and 146 patients, respectively. This study compared the rate of SSI with and without the use of the PVP-I irrigation protocol.

Results:
The SSI rates were 1.7% for the study group (3/177 patients) and 3.4% for the control group (5/146 patients), showing no significant statistical difference (P=0.32). There were no cases of deep SSI in the study group, whereas there were 4 cases in the control group. The deep SSI rate significantly decreased in the study group (P=0.027). No adverse events occurred in the study group.

Conclusion:
In this study, 90 seconds of 1% PVP-I pooling every 1.5 hours followed by saline irrigation demonstrated the effectiveness of our protocol for the prevention of postoperative deep SSI after spinal surgery.
Risk Adjustment for Sepsis Mortality to Facilitate Hospital Comparisons Using Centers for Disease Control and Prevention’s Adult Sepsis Event Criteria and Routine Electronic Clinical Data
Authors: Rhee Chanu , Wang Rui , Song Yue , Zhang Zilu , Kadri Sameer S. , Septimus Edward J. , Fram David , Jin Robert , Poland Russell E. , Hickok Jason , Sands Kenneth , Klompas Michael 
Published: October 2019

Objectives:
Variability in hospital-level sepsis mortality rates may be due to differences in case mix, quality of care, or diagnosis and coding practices. Centers for Disease Control and Prevention’s Adult Sepsis Event definition could facilitate objective comparisons of sepsis mortality rates between hospitals but requires rigorous risk-adjustment tools. We developed risk-adjustment models for Adult Sepsis Events using administrative and electronic health record data.

Design:
Retrospective cohort study.

Setting:
One hundred thirty-six U.S. hospitals in Cerner HealthFacts (derivation dataset) and 137 HCA Healthcare hospitals (validation dataset).

Patients:
A total of 95,154 hospitalized adult patients (derivation) and 201,997 patients (validation) meeting Centers for Disease Control and Prevention Adult Sepsis Event criteria.

Interventions:
None.

Measurements and Main Results:
We created logistic regression models of increasing complexity using administrative and electronic health record data to predict in-hospital mortality. An administrative model using demographics, comorbidities, and coded markers of severity of illness at admission achieved an area under the receiver operating curve of 0.776 (95% CI, 0.770–0.783) in the Cerner cohort, with diminishing calibration at higher baseline risk deciles. An electronic health record–based model that integrated administrative data with laboratory results, vasopressors, and mechanical ventilation achieved an area under the receiver operating curve of 0.826 (95% CI, 0.820–0.831) in the derivation cohort and 0.827 (95% CI, 0.824–0.829) in the validation cohort, with better calibration than the administrative model. Adding vital signs and Glasgow Coma Score minimally improved performance.

Conclusions:
Models incorporating electronic health record data accurately predict hospital mortality for patients with Adult Sepsis Events and outperform models using administrative data alone. Utilizing laboratory test results, vasopressors, and mechanical ventilation without vital signs may achieve a good balance between data collection needs and model performance, but electronic health record–based models must be attentive to potential variability in data quality and availability. With ongoing testing and refinement of these risk-adjustment models, Adult Sepsis Event surveillance may enable more meaningful comparisons of hospital sepsis outcomes and provide an important window into quality of care.
Enteral Acetaminophen Bioavailability in Pediatric Intensive Care Patients Determined With an Oral Microtracer and Pharmacokinetic Modeling to Optimize Dosing
Authors: Kleiber Niina , Calvier Elisa , Mooij Miriam G. , Krekels Elke H. J. , Vaes Wouter H. J. , Tibboel Dick , Knibbe Catherijne A. J. , de Wildt Saskia N. 
Published: October 2019

Objectives:
Decreasing morbidity and mortality by rationalizing drug treatment in the critically ill is of paramount importance but challenging as the underlying clinical condition may lead to large variation in drug disposition and response. New microtracer methodology is now available to gain knowledge on drug disposition in the intensive care. On the basis of studies in healthy adults, physicians tend to assume that oral doses of acetaminophen will be completely absorbed and therefore prescribe the same dose per kilogram for oral and IV administration. As the oral bioavailability of acetaminophen in critically ill children is unknown, we designed a microtracer study to shed a light on this issue.

Design:
An innovative microtracer study design with population pharmacokinetics.

Setting:
A tertiary referral PICU.

Patients:
Stable critically ill children, 0–6 years old, and already receiving IV acetaminophen.

Interventions:
Concomitant administration of an oral 14C radiolabeled acetaminophen microtracer (3 ng/kg) with IV acetaminophen treatment (15 mg/kg every 6 hr).

Measurements:
Blood was drawn from an indwelling arterial or central venous catheter up to 24 hours after 14C acetaminophen microtracer administration. Acetaminophen concentrations were measured by liquid chromatography-mass spectrometry and 14C concentrations by accelerated mass spectrometry.

Main Results:
In 47 patients (median age of 6.1 mo; Q1–Q3, 1.8–20 mo) the mean enteral bioavailability was 72% (range, 11–91%). With a standard dose (15 mg/kg 4 times daily), therapeutic steady-state concentrations were 2.5 times more likely to be reached with IV than with oral administration.

Conclusions:
Microtracer studies present a new opportunity to gain knowledge on drug disposition in the intensive care. Using this modality in children in the pediatric intensive care, we showed that enteral administration of acetaminophen results in less predictable exposure and higher likelihood of subtherapeutic blood concentration than does IV administration. IV dosing may be preferable to ensure adequate pain relief.
Bioelectrical Impedance Measurements for Assessment of Kidney Function in Critically Ill Patients
Authors: de Jong Lutea A. A. , Otten – Helmers Annemiek G. , Spronk Peter E. , van Kan Hendrikus J. M. 
Published: October 2019

Objectives:
To evaluate the use of multifrequency bioelectrical impedance analysis to predict creatinine/urea clearance based on 24 hours urine collection. A practical formula was developed, and its performance was compared with that of established formulas such as Cockcroft-Gault, Modification of Diet in Renal Disease, and Jelliffe’s.

Design:
An open-label prospective observational cohort study.

Setting:
A 12-bed ICU at a nonuniversity major teaching hospital (Gelre ziekenhuizen Apeldoorn/Zutphen, The Netherlands).

Patients:
Adult critical care patients with an expected ICU length of stay at admission of at least 48 hours.

Interventions:
Each patient’s body composition was assessed using a validated Quadscan 4000 analyzer (Bodystat, Isle of Man, British Isles). Twenty-four hours urine was collected, and laboratory variables in serum including creatinine, urea, and albumin were obtained at the beginning and end of the collection period.

Measurements and Main Results:
A total of 151 patients, stratified to an acute and nonacute ICU-group, were enrolled in the study over a 2-year period. A formula to predict creatinine/urea clearance based on 24 hours urine collection was developed using stepwise linear regression using a training data set of 75 patients. This formula was subsequently tested and compared with other relevant predictive equations using a validation data set of 76 patients. Serum creatinine values ranged from 40 to 446 µmol/L. With the predictive model based on estimated body cell mass and a “prediction marker” more than 71% of the observed variance in creatinine/urea clearance based on 24 hours urine collection could be explained. Predictive performance was superior to the other eight evaluated models (R
2 = 0.39–0.55) and demonstrated to be constant over the whole range of creatinine/urea clearance based on 24 hours urine collection values.

Conclusions:
Multifrequency bioelectrical impedance analysis measurements can be used to predict creatinine/urea clearance based on 24 hours urine collection with superior performance than currently established prediction models. This rapid, noninvasive method enables correction for influences of a patient’s actual body composition and may prove valuable in daily clinical practice.
Angiogenesis inhibition in non-small cell lung cancer: a critical appraisal, basic concepts and updates from American Society for Clinical Oncology 2019
Authors: Cantelmo Anna Rita , Dejos Camille , Kocher Florian , Hilbe Wolfgang , Wolf Dominik , Pircher Andreas 
Published: October 2019

Purpose of review
Recently, the combination of antiangiogenic agents, chemotherapy and immunotherapy has shown synergistic anticancer effects in non-small cell lung cancer (NSCLC). The future for this approach appears bright in lung cancer treatment; however, many challenges remain to be overcome regarding its true potential, optimal sequence and timing of therapy, and safety profile. In this review, we will discuss the current status and future direction of antiangiogenic therapy for the treatment of NSCLC, and highlight emerging strategies, such as tumor vessel normalization (TVN).

Recent findings
Bevacizumab was the first antiangiogenic agent approved for the treatment of advanced NSCLC. Recently, the combination of chemotherapy/antiangiogenic therapy with immunotherapy showed high efficacy in first-line settings. A subgroup of patients with liver metastasis and driver mutation-addicted tumors benefited most, suggesting that the metastatic location, as well as the genetic background of the tumor, are key determinants for therapy responses.

Summary
The efficacy of antiangiogenic therapies in unselected patients is rather limited. The tumor microenvironment has appeared to be more complex and heterogeneous than previously assumed. Only a contextual rather than a cell-specific approach might provide valuable insights towards the clinical validation of combinational therapies.