bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association Between the Classification of Early-onset Scoliosis and Smith Complications After Initiation of Growth-friendly Spine Surgery: A Preliminary Study
Authors: Russo Christen , Trupia Evan , Campbell Megan , Matsumoto Hiroko , Smith John , Samdani Amer , Emans John , Roye David , Vitale Michael 
Published: January 2019

Background:
Early-onset scoliosis (EOS) is a complex, heterogeneous condition involving multiple etiologies, genetic associations, and treatment plans. In 2014, Williams and colleagues proposed a classification system of EOS (C-EOS) that categorizes patients by etiology, Cobb angle, and kyphosis. Shortly after, Smith and colleagues validated a classification system to report complications of growth-friendly spine instrumentation. Severity refers to the level of care and urgency required to treat the complication, and can be classified as device-related or disease-related complications. The purpose of this study was to investigate if C-EOS can be used as a reliable predictor of Smith complications to better risk stratify these young, surgical patients.

Methods:
This study queried retrospective data from a large multicenter registry with regard to growth-friendly spine instrumentation in the EOS population. One-hundred sixteen patients were included in final data analysis to investigate the outcomes of their growth-friendly procedures according to the Smith complication classification system.

Results:
There were 245 Smith complications distributed among 116 patients included in this study (2.1 complications per patient). The majority of the complications were device related requiring at least one unplanned trip to the operating room (Smith Device Complication IIA or IIB; 111 complications). There were no complications that caused abandonment of growth-friendly instrumentation (Smith Complication III) and no mortalities (Smith Complication IV). The most severely affected EOS group was the hyperkyphotic syndromic group with a major curve angle >50 degrees (S3+), with 3.4 complications per patient. The least affect EOS group was the hyperkyphotic congenital group with a major curve angle between 20 and 50 degrees, with 0.3 complications per patient.

Conclusions:
The C-EOS simplifies a complex pathology and the Smith complication classification scheme creates a language to discuss treatment of known complications of growth-friendly spine surgery. Although there is an association between more advanced C-EOS and Smith complications, there does not appear to be a correlation that can satisfy a risk stratification at this time.

Level of Evidence:
Level II.
Wrong Site Spine Surgery in the Veterans Administration
Authors: Watts Bradley V. , Rachlin Jacob R. , Gunnar William , Mills Peter D. , Neily Julia , Soncrant Christina , Paull Douglas E. 
Published: January 2019

Study Design:
Basic descriptive analysis was performed for the incident characteristics of wrong level spinal surgery in the Veterans Health Administration (VHA).

Objective:
To determine the frequency of reported occurrence of incorrect spine level surgery in the VHA, causal factors for the events, and propose solutions to the issue.

Summary of Background Data:
Wrong site surgery is one of the most common events reported to The Joint Commission. It has been reported that 50% of spine surgeons experience at least 1 wrong site surgery in their career, with events leading to signficant harm to patients.

Materials and Methods:
We examined incorrect level spine surgery adverse events reported to the VHA National Center for Patient Safety (NCPS) from 2000 to 2017. A rate of wrong site spine surgery was determined by dividing the number of wrong site cases by the total number of spine surgeries during the study period. Similarly, a rate of wrong site surgery by orthopedist and neurosurgeons was calculated.

Results:
There were 32 reported cases of wrong site spine surgery between 2000 and 2017. Fourteen cases involved the cervical region, 13 the lumbar region, and 5 the thoracic region. The majority of the root causes (69% or 48 of 69 root causes) fell into 2 broad categories: problems with the radiograph or problems with the intraoperative marker. These were not mutually exclusive and several root cause analyses involved >1 of these issues.

Conclusions:
Wrong level surgery of the spine is a significant safety issue facing the field that continues to occur despite surgical teams following guidelines. As poor radiograph quality and interpretability were the most common root causes of these events, interventions aimed at optimizing image quality and accurate interpretation would be a logical first action.
Multidrug-resistant Gram-negative Bacterial Bloodstream Infections in Children’s Hospitals in Japan, 2010–2017
Authors: Aizawa Yuta , Shoji Takayo , Ito Kenta , Kasai Masashi , Sakurai Hiroki , Toyofuku Etsushi , Minami Kisei , Hoshino Tadashi , Horikoshi Yuho 
Published: January 2019

Background:
The risk factors of multidrug-resistant (MDR) Gram-negative bacilli (GNB) bloodstream infection (BSI) are not yet known in children. Our aim was to evaluate risk factors and outcomes associated with MDR GNB BSI in children.

Methods:
Patients with GNB BSI were enrolled between April 2010 and March 2017 at 8 children’s hospitals in Japan. Clinical and microbiologic data were collected retrospectively. The risk factors and outcomes of MDR and non-MDR GNB BSI were compared.

Results:
In total, 629 GNB BSI episodes met the case definition. The median age and proportion of males were 2 years (interquartile range, 0.3–8.7) and 50.7%, respectively. An underlying disease was found in 94% of patients. The proportion of BSI cases that developed >48 hours after admission was 76.2%. MDR comprised 24.5% of BSI cases. The MDR rate did not change over time (P = 0.540). The effective coverage rate of the initial empiric therapy for the MDR and non-MDR BSI cases was 60.4% and 83.4%, respectively (P < 0.001). The all-cause mortality rate at 28 days for all BSI, MDR-BSI and non-MDR BSI cases was 10.7%, 13.6% and 9.7%, respectively (P = 0.167). MDR BSI was independently associated with cancer chemotherapy within 30 days (odds ratio [OR] 43.90), older age (OR 1.05) and admission to the neonatal ward (OR 0.019).

Conclusions:
One-fourth of GNB BSI cases were MDR. Cancer chemotherapy and older age were risk factors for MDR GNB BSI in children’s hospitals. MDR did not increase the all-cause mortality rate.
Early vedolizumab trough levels at induction in inflammatory bowel disease patients with treatment failure during maintenance
Authors: Liefferinckx Claire , Minsart Charlotte , Cremer Anneline , Amininejad Leila , Tafciu Vjola , Quertinmont Eric , Tops Sophie , Devière Jacques , Gils Ann , van Gossum André , Franchimont Denis 
Published: January 2019

Background
Vedolizumab (VDZ) is effective as an induction and maintenance treatment for Crohn’s disease and ulcerative colitis, but, as observed with antitumour necrosis factor-α (anti-TNFα) agents, some patients are nonetheless experiencing loss of response.

Objective
The aim of this study was to investigate the impact of the pharmacokinetics of VDZ during induction on long-term treatment response.

Patients and methods
This study focused on a single cohort of 103 inflammatory bowel disease patients treated with VDZ. VDZ trough levels (TLs) were measured by enzyme-linked immunosorbent assay (n=536 samples), and thereafter correlated to clinical, biological, endoscopic and serological data. For patients exposed previously to infliximab, antibodies to infliximab were measured at baseline. On the basis of the outcome at the end of follow-up, patients were then categorized into long-term response, optimized and treatment failure groups.

Results
During VDZ induction, at week 6, inflammatory bowel disease patients with long-term response had higher TLs compared with patients in the treatment failure group (33 vs. 24 µg/ml, P=0.02). A cut-off TL of 28 µg/ml predicted a sustained response in the follow-up with an area under curve of 0.723 (95% confidence interval=0.567–0.878, P=0.02). Patients with mucosal healing in maintenance had higher TLs at week 6 (41.65 µg/ml) compared with patients with mild (26 µg/ml) or severe endoscopic activity (20.8 µg/ml), P=0.009. Positive perinuclear antineutrophil cytoplasmic antibody serology was associated with lower TLs. Patients previously exposed to anti-TNFα had lower TLs than naive patients (22.5 vs. 36 µg/ml, P=0.03) without any impact of detectable antibodies to infliximab. Finally, the presence of an immunomodulator at induction did not impact on VDZ TLs at induction.

Conclusion
We confirmed that a drug exposure–efficacy association was found early on at induction. This study emphasizes that previous exposure to anti-TNFα and positive perinuclear antineutrophil cytoplasmic antibody serology are important factors influencing VDZ TLs at induction.
Risk of death within 7 days of discharge from emergency departments with different organizational models
Authors: Moellekaer Anders , Kirkegaard Hans , Vest-Hansen Betina , Duvald Iben , Eskildsen Jacob , Obel Borge , Madsen Bo 
Published: January 2019

Objective
The aim of this study is to investigate the association between emergency department (ED) organizational models and the risk of death within 7 days of ED discharge.

Patients and methods
We included Danish ED discharges between 1 January 2011 and 24 December 2014 that led to death within 7 days of discharge. The inclusion criterion was age older than 18 years. The exclusion criterion was further in-hospital admission. First model (Virtual): other departments employ interns who perform ED tasks. They are responsible for ED patient care and prioritize their task order between their own department and the ED. Second model (Hybrid): the ED/other departments perform tasks; interns/consultants are employed by the ED/other departments. The ED/other departments have patient care responsibility. Third model (Independent): the ED performs all tasks; employs interns/consultants; and have patient care responsibility. Sex, age, Charlson Comorbidity Index score, and primary diagnosis were used to describe patient characteristics. We calculated the risk of death within 7 days of discharge using multiple logistic regression analysis.

Results
In 805 out of 201 299 discharges included in the study, the patient died within 7 days. Compared with the Virtual model, the odds ratio for death within 7 days of discharge was 0.72 (95% confidence interval: 0.59–0.92) for the Independent model and 0.75 (95% confidence interval: 0.61–0.92) for the Hybrid+Virtual model. Increased risk was associated with male sex, older age, and a medium or a high Charlson Comorbidity Index score.

Conclusion
Compared with discharges from a Virtual model, the risk of death within 7 days of discharge was lower if the ED had an Independent or a Hybrid+Virtual model.
From HDL-cholesterol to HDL-function: cholesterol efflux capacity determinants
Authors: Rhainds David , Tardif Jean-Claude 
Published: January 2019

Purpose of review
The validity of HDL-cholesterol (HDL-C) elevation as a therapeutic target has been questioned, in comparison to enhancing HDL functionality. Cholesterol efflux capacity (CEC) is an in-vitro assay that measures the ability of an individual's HDL to promote cholesterol efflux from cholesterol donor cells such as macrophages. CEC of HDL is a predictor of cardiovascular risk independent of HDL-C levels. However, molecular determinants of CEC and the effects of diseases and therapeutic interventions on CEC have not been completely defined.

Recent findings
We review here recent findings on elevated HDL-C and disease risk, as well as determinants of CEC, from genetics and proteomics to pathophysiology and therapeutic interventions that contribute to our understanding of CEC as a biomarker of HDL functionality.

Summary
Elevated HDL-C levels are not always protective against cardiovascular disease and mortality. CEC is a heritable trait, and genetic polymorphisms in genes involved in HDL and triglycerides metabolism are associated with CEC. Multiple HDL proteins correlate positively with CEC levels and inversely with noncalcified plaque burden. Differences in CEC assays that make comparisons between studies difficult are also emphasized. CEC should be measured in clinical trials of lipid-modifying and anti-inflammatory therapies to determine whether increases are cardioprotective.
Ultra-short bowel syndrome during infancy: improving outcomes and novel therapies
Authors: Walker A. Adjowa , Cole Conrad R. 
Published: January 2019

Purpose of review
Ultra-short bowel syndrome is relatively rare and has not yet been extensively reported. In ultra-short bowel syndrome, poor absorption of nutrients and dysmotility, interfere with fluid, energy, electrolyte and micronutrient balance. Patients with this disorder are managed through prolonged parenteral nutrition with the ultimate goal of achieving enteral autonomy. Overall outcomes of these patients are dependent on postsurgical bowel anatomy (residual length, intact colon, ostomy closure timing), incidence of sepsis, and care by a multidisciplinary specialized team.

Recent findings
Over the years, standardization of management has improved outcomes. This includes central line care, lipid alternatives, enteral therapy, medications (antidiarrheal agents, acid suppression medications, bile acid binding salts, and enteral antibiotics) including Teduglutide. Bowel lengthening procedures have also proven beneficial, and finally bowel transplant does remain an option for a patient in whom rehabilitation has failed.

Summary
Although there are many factors that influence outcomes of ultra-short bowel patients, novel therapies such as Teduglutide have been introduced with the aim of improving intestinal adaptation. Surgical lengthening and transplant are viable options in the setting of failed rehabilitation.
Alanyl‐glutamine Protects Against Damage Induced by Enteroaggregative Escherichia coli Strains in Intestinal Cells
Authors: Prata Mara M.G. , Cavalcante Paloma A. , da Silva Antonio V. Alves , de Medeiros Pedro H.Q.S. , de Assis Júnior Eudmar M. , Reyes Mayra A.V. , Quetz Josiane da S. , Clementino Marco A.F. , Ribeiro Samilly A. , Lima Ila F.N. , Lima‐Junior Roberto C.P. , Havt Alexandre , Guerrant Richard L. , Lima Aldo A.M. 
Published: January 2019

ABSTRACTBackground:Enteroaggregative Escherichia coli (EAEC) is an important pathogen causing enteric infections worldwide. This pathotype is linked to malnutrition in children from developing countries. Alanyl‐glutamine (Ala‐Gln) is an immune modulator nutrient that acts during intestinal damage and/or inflammation. This study investigated the effect of EAEC infection and Ala‐Gln on cell viability, cell death, and inflammation of intestinal epithelium cells (IEC‐6).Methods:Cells were infected with an EAEC prototype 042 strain, an EAEC wild‐type strain isolated from a Brazilian malnourished child, and a commensal E coli HS. Gene transcription and protein levels of caspases‐3, ‐8, and ‐9 and cytokine‐induced neutrophil chemoattractant 1 (CINC‐1/CXCL1) were evaluated using RT‐qPCR, western blot analysis, and ELISA.Results:Infections with both EAEC strains decreased cell viability and induced apoptosis and necrosis after 24 hours. Ala‐Gln supplementation increased cell proliferation and reduced cell death in infected cells. Likewise, EAEC strain 042 significantly increased the transcript levels of caspases‐3, ‐8, and ‐9 when compared to the control group, and Ala‐Gln treatment reversed this effect. Furthermore, EAEC induced CXCL1 protein levels, which were also reduced by Ala‐Gln supplementation.Conclusion:These findings suggest that EAEC infection promotes apoptosis, necrosis, and intestinal inflammation with involvement of caspases. Supplementation of Ala‐Gln inhibits cell death, increases cell proliferation, attenuates mediators associated with cell death, and inflammatory pathways in infected cells.
Health-Related Quality of Life in Patients With Narcolepsy
Authors: Raggi Alberto , Plazzi Giuseppe , Ferri Raffaele 
Published: January 2019

Abstract
Narcolepsy is a chronic disorder characterized by symptoms of excessive daytime sleepiness, irresistible sleep attacks that may be accompanied by cataplexy brought on by emotions, sleep paralysis, and hypnagogic hallucinations. This is a review of 32 empirical articles on health-related quality of life (HRQoL) published in peer-reviewed journals over the past 37 years. Deleterious implications on education, recreation, driving, sexual life, and personality are associated with the disease with a consequent negative psychosocial impact. Sleepiness has an important influence on HRQoL, more than the other symptoms of this disorder that have disrupting roles, too. Therefore, patients with narcolepsy need assistance not only for medication prescription but also in terms of psychological and social support. It is also of importance to assess patients with narcolepsy carefully in terms of depressive symptoms because they may have a major impact on HRQoL with important clinical implications.
Severe Mental Illness in Community Mental Health Care in Spain
Authors: Martín-Pérez Carlos , Herrero-Martin Juan Jesús , Pérez-López Gonzalo , Pedrosa-García Rafael , Ibañez-Casas Inmaculada , Torres-González Francisco , Moreno-Küstner Berta 
Published: January 2019

Abstract
The aims of this study were to determine the prevalence of severe mental illness (SMI) in patients in contact with mental health services and to determine the factors associated with SMI. A total of 260 patients who met diagnostic criteria for SMI were assessed using the Global Assessment of Functioning (GAF) scale and Health of the Nation Outcome Scales. The overall prevalence of SMI was 6.08 per thousand. According to the three different cutoff points with GAF, the prevalence of SMI ranged from 5.38 per thousand under the weak criterion (GAF < 70) to 1.01 per thousand under the strict criterion (GAF < 50). In the regression model, the dependent variable (presence of SMI) was defined using a GAF < 60, and the variables independently associated with the dependent variable were years of disease duration since diagnose, mental health service use, alcohol or other substance abuse, and depressive anxiety and other psychological symptoms.
Sexual Identity Disorder and Psychosis in Klinefelter Syndrome
Authors: Maillefer Aude , Sabe Michel , Coste Christophe , Bartolomei Javier , Jaafar Jaafar , Sentissi Othman 
Published: January 2019

Abstract
Klinefelter syndrome (KS) 47, XXY is the most frequent chromosomal abnormality causing hypogonadism in humans. This chromosomal abnormality of number in its classical form called homogeneous (supernumerary X) is generally the result of a meiosis accident. Several studies have suggested that individuals with KS are at greater risk of developing various psychiatric disorders, including depression and schizophrenia. The diagnosis is made based on subnormal testosterone with high pituitary gonadotropins and confirmed by determining the karyotype on a blood simple. We did a literature review using an electronic search in three databases: Pubmed/MEDLINE, Google Scholar, and PsychInfo. We found that since 1989, seven case reports with KS and mental disorders with similar and different characteristics of our case illustration of a patient with KS and psychosis were published.
In-simulation Debriefing Increases Therapeutic Communication Skills
Authors: Gaylle Debrayh 
Published: January 2019

Background
This article describes a formative simulation experience designed to prepare prelicensure nursing students to interact with psychiatric patients.

Purpose
The purpose of this study was to compare the effects of 2 debriefing styles (in-simulation and postsimulation) on nursing students' knowledge, performance, and anxiety related to working with psychiatric patients. The study also explored students' perceptions of the efficacy of in-simulation debriefing.

Methods
The study used a quasi-experimental, mixed-method design.

Results
There were no statistically significant differences between groups in knowledge, assessment, or anxiety. However, both groups demonstrated significant gains in all areas.

Conclusions
In-simulation debriefing is an effective tool for teaching therapeutic communication to nursing students.
A Novice Guide to Applications of Simulation in the Pediatric Emergency Department
Authors: Waseem Muhammad , Horsley Elizabeth 
Published: January 2019

Abstract
Healthcare systems and health professions education have gone through radical changes in the past decades. These changes have made it imperative to explore innovative and alternative ways of teaching and training. Simulation-based education has emerged as an effective teaching strategy for both learners and practicing health professionals. Simulation is an educational technique that recreates real-life experiences. Learning occurs through participation in these simulation experiences followed by a period of guided debriefing and reflection. Pediatric emergency medicine, by its very nature, can benefit greatly from a well-designed and thoughtfully implemented simulation program. This review outlines situations where simulation may be used for maximum effectiveness in a pediatric emergency department and provides an overview of the basics of debriefing. A thorough description of each identified use of simulation is beyond the scope of this article.
A Case of Pott's Puffy Tumor Associated With Barosinusitis From Scuba Diving
Authors: Patel Ami , Vuppula Sharon , Hayward Harrison , Lakhani Anisa , Lighter Jennifer 
Published: January 2019

Abstract
Barosinusitis, or sinus barotrauma, is a well-described condition associated with changes in barometric pressure during flight and diving that can result in sinonasal mucosal injury. In this case report, we present an adolescent who experienced barosinusitis during scuba diving and subsequently developed Pott's puffy tumor (PPT), characterized by frontal sinusitis, frontal bone osteomyelitis, and overlying subperiosteal abscess. This unique case of PPT following scuba diving provides the opportunity to review the pathophysiology of both barotrauma-induced sinus disease and PPT, a rare and unreported serious complication of barosinusitis. Furthermore, we discuss how scuba diving and associated barosinusitis can be considered a risk factor in the development of PPT.