bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current perspectives on the short- and long-term effects of conventional dairy calf raising systems: a comparison with the natural environment
Authors: Cantor Melissa C , Neave Heather W , Costa Joao H C 
Published: February 2019

AbstractAlthough the neonatal and infancy period is short, it is well documented that the early neonatal environment is critical for appropriate physical, behavioral, and cognitive development that lasts into adulthood. Dairy calves are commonly removed from the dam shortly after birth and raised in individual housing and fed limited milk allowances (4 to 6 L/d) in commercial farms around the world (conventional raising). Individual housing was developed to promote health status and facilitate individual animal monitoring. However, it is associated with high labor demand, and early life social isolation is associated with cognitive and behavioral abnormalities. Recently, group housing and enhanced milk-feeding programs are being increasingly adopted by farms; these practices more closely resemble the social and nutritional environments in natural or seminatural environments when the calf is raised with the dam. Conventional raising may lead to short- and long-term effects when compared to calves raised with the dam or peers. Short-term effects of conventional raising include impaired social skills when introduced to novel peers, reduced consumption of novel feeds, increased activity in a novel environment, and signs of hunger associated with limited milk intake and poor growth during the preweaning period. Evidence also suggests that the long-term effects of conventional artificial raising systems include behavioral differences, such as lower social submissiveness, increased heart rate and cortisol when presented with a novel environment, and production differences such as milk yield and reproductive performance. However, research on the long-term effects of maternal, social, physical, and nutritional restrictions in early life is still limited and should be encouraged. More research is needed to determine the long-term effects of artificial raising systems (individual, group housing, dam-raised) on future behavior, cognition, performance, and health parameters in dairy calves.
A Systematic Review of the Use of Standardized Patients as a Simulation Modality in Nursing Education
Authors: Rutherford-Hemming Tonya , Alfes Celeste M. , Breymier Tonya L. 
Published: February 2019

Abstract

AIM
The objective of the study was to search, extract, appraise, and synthesize studies using standardized patients (SPs) in nursing academia to determine how this modality of simulation is being used.

BACKGROUND
SPs are a common simulation modality used in nursing education.

METHOD
This review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Five databases were searched as well as keywords to retrieve nonindexed citations for the period January 2011 to September 2016. The inclusion criteria included nurses, a simulated experience with SPs, and original research published in English.

RESULTS
Sixty-five studies were identified and analyzed.

CONCLUSION
More randomized controlled trials and studies with power analyses and validated measurement instruments are needed. Studies that compare SPs to high-fidelity simulators are also desired to determine optimal student learning outcomes and standardize best practices in simulation.
Update
Authors: Craig-Brangan Karen Jean , Day Mary Patricia 
Published: February 2019

Abstract:
In November 2017, the American Heart Association published updates to its adult and pediatric Basic Life Support and Cardiopulmonary Resuscitation guidelines; one year later, it published updates to its Advanced Cardiovascular Life Support and Pediatric Advanced Life Support guidelines. This article reviews these updated guidelines and highlights the key changes and how to integrate them into practice.
Adverse Events and Factors Associated with Potentially Avoidable Use of General Anesthesia in Cesarean Deliveries
Authors: Guglielminotti Jean , Landau Ruth , Li Guohua 
Published: February 2019

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Compared with neuraxial anesthesia, general anesthesia for cesarean delivery is associated with increased risk of maternal adverse events. Reducing avoidable general anesthetics for cesarean delivery may improve safety of obstetric anesthesia care. This study examined adverse events, trends, and factors associated with potentially avoidable general anesthetics for cesarean delivery.

Methods
This retrospective study analyzed cesarean delivery cases without a recorded indication for general anesthesia or contraindication to neuraxial anesthesia in New York State hospitals, 2003 to 2014. Adverse events included anesthesia complications (systemic, neuraxial-related, and drug-related), surgical site infection, venous thromboembolism, and the composite of death or cardiac arrest. Anesthesia complications were defined as severe if associated with death, organ failure, or prolonged hospital stay.

Results
During the study period, 466,014 cesarean deliveries without a recorded indication for general anesthesia or contraindication to neuraxial anesthesia were analyzed; 26,431 were completed with general anesthesia (5.7%). The proportion of avoidable general anesthetics decreased from 5.6% in 2003 to 2004 to 4.8% in 2013 to 2014 (14% reduction; P < 0.001). Avoidable general anesthetics were associated with significantly increased risk of anesthesia complications (adjusted odds ratio, 1.6; 95% CI, 1.4 to 1.9), severe complications (adjusted odds ratio, 2.9; 95% CI, 1.6 to 5.2), surgical site infection (adjusted odds ratio, 1.7; 95% CI, 1.5 to 2.1), and venous thromboembolism (adjusted odds ratio, 1.9; 95% CI, 1.3 to 3.0), but not of death or cardiac arrest. Labor neuraxial analgesia rate was one of the most actionable hospital-level factors associated with avoidable general anesthetics. Relative to hospitals with a rate greater than or equal to 75%, the adjusted odds ratio of avoidable general anesthetics increased to 1.3 (95% CI, 1.2 to 1.4), 1.6 (95% CI, 1.5 to 1.7), and 3.2 (95% CI, 3.0 to 3.5) as the rate decreased to 50 to 74.9%, 25 to 49.9%, and less than 25%, respectively.

Conclusions
Compared with neuraxial anesthesia, avoidable general anesthetics are associated with increased risk of adverse maternal outcomes.
Cerebrospinal Fluid Glucose and Lactate Levels After Subarachnoid Hemorrhage: A Multicenter Retrospective Study
Authors: Taccone Fabio S. , Badenes Rafael , Arib Safa , Rubulotta Francesca , Mirek Sebastien , Franchi Federico , Gordon Sara , Nadji Abdelouaïd , Crippa Ilaria A. , Stazi Elisabetta , Bouhemad Belaïd , Lozano Roig Angels , Creteur Jacques , Bilotta Federico 
Published: February 2019

Background:
In patients with subarachnoid hemorrhage (SAH), abnormalities in glucose and lactate metabolism have been described using cerebral microdialysis. Glucose and lactate concentrations in cerebrospinal fluid (CSF) are more easily accessible, but scarce data are available in this setting. The aim of this study is to assess the relationship of CSF glucose and lactate with blood concentrations and with unfavorable neurological outcome after SAH.

Methods:
A retrospective cohort study was conducted in 5 European University intensive care units. Patients aged 18 years and above who were admitted after a nontraumatic SAH over a 4-year period (2011 to 2014) were included if they had an external ventricular drain placed, daily analysis of CSF including glucose (±lactate) concentrations for 1 to 4 consecutive days, and concomitant analysis of glucose and lactate concentrations in the arterial blood.

Results:
A total of 144 patients were included in the final analysis (median age: 58 [49 to 66] y; male sex: 77/144). Median time from admission to external ventricular drain placement was 1 (0 to 3) day; median Glasgow Coma Scale on admission was 10 (7 to 13), and CT-scan Fisher scale was 4. A total of 81 (56%) patients had unfavorable neurological outcome at 3 months (Glasgow Outcome Scale ≤3). There was a weak correlation between blood and CSF glucose (r
2=0.07, P=0.007), and between blood and CSF lactate levels (r
2=0.58, P<0.001) on day 1, which were not influenced by insulin therapy. The presence of shock and low CSF glucose/lactate ratio were the only independent predictors of unfavorable outcome.

Conclusions:
CSF glucose and lactate levels poorly correlated with blood concentrations. Low CSF glucose/lactate ratio was associated with poor neurological outcome.
Evaluation of Current Trends in Treatment of Single-level Cervical Radiculopathy
Authors: Mok Jung K. , Sheha Evan D. , Samuel Andre M. , McAnany Steven J. , Vaishnav Avani S. , Albert Todd J. , Gang Catherine Himo , Qureshi Sheeraz 
Published: February 2019

Study design:
This was a retrospective cohort study.

Objectives:
The main objectives of this study were to identify epidemiological trends, differences, and complications in patients undergoing surgical treatment for single-level cervical radiculopathy (SLCR).

Summary of Background Data:
SLCR that fails nonoperative management is effectively treated with either anterior cervical discectomy and fusion (ACDF), cervical disc replacement (CDR), or posterior cervical foraminotomy (PCF). Although studies have shown that all 3 options are clinically effective, trends in usage, differences in patient population, and differences in complications remain unknown.

Materials and Methods:
Patients who underwent either ACDF, CDR, or PCF in the treatment of SLCR from 2010 to 2016 were retrospectively reviewed using the National Surgical Quality Improvement Program (NSQIP) database. Demographic data consisted of sex, age, ASA class, body mass index, and inpatient/outpatient status. Complications included surgical site infection, pneumonia, reintubation, pulmonary embolism, deep vein thrombosis, readmissions, reoperations, operating time, and hospital length of stay. Utilization trends by year among the 3 procedures were also analyzed.

Results:
A total of 1102 patients with SLCR treated with single-level ACDF, CDR, or PCF were identified in NSQIP from 2010 to 2016. There was a relative increase in the number of CDR procedures (7.7%–16.1%) and a corresponding decrease in PCF procedures (20.3%–10.6%) without a significant effect on ACDF procedures (72.0%–73.3%). Patients who underwent CDR were younger and in a lower ASA class than those undergoing ACDF or PCF. Patients undergoing PCF were more likely to be treated as an outpatient. PCF procedures also had the shortest operating time and hospital length of stay. There were no significant differences in complications among the 3 procedures. Moreover, there were no significant trends in demographics or outcome measures.

Conclusions:
ACDF remains the most common surgical treatment for patients with SLCR, and its utilization has remained consistent. Meanwhile, the increased utilization of CDR for the treatment of SLCR has resulted in a corresponding decrease in the utilization of PCF.
Does Obesity Protect Against Death in Sepsis? A Retrospective Cohort Study of 55,038 Adult Patients*
Authors: Pepper Dominique J. , Demirkale Cumhur Y. , Sun Junfeng , Rhee Chanu , Fram David , Eichacker Peter , Klompas Michael , Suffredini Anthony F. , Kadri Sameer S. 
Published: February 2019

Objectives:
Observational studies suggest obesity is associated with sepsis survival, but these studies are small, fail to adjust for key confounders, measure body mass index at inconsistent time points, and/or use administrative data to define sepsis. To estimate the relationship between body mass index and sepsis mortality using detailed clinical data for case detection and risk adjustment.

Design:
Retrospective cohort analysis of a large clinical data repository.

Setting:
One-hundred thirty-nine hospitals in the United States.

Patients:
Adult inpatients with sepsis meeting Sepsis-3 criteria.

Exposure:
Body mass index in six categories: underweight (body mass index < 18.5 kg/m2), normal weight (body mass index = 18.5–24.9 kg/m2), overweight (body mass index = 25.0–29.9 kg/m2), obese class I (body mass index = 30.0–34.9 kg/m2), obese class II (body mass index = 35.0–39.9 kg/m2), and obese class III (body mass index ≥ 40 kg/m2).

Measurements:
Multivariate logistic regression with generalized estimating equations to estimate the effect of body mass index category on short-term mortality (in-hospital death or discharge to hospice) adjusting for patient, infection, and hospital-level factors. Sensitivity analyses were conducted in subgroups of age, gender, Elixhauser comorbidity index, Sequential Organ Failure Assessment quartiles, bacteremic sepsis, and ICU admission.

Main Results:
From 2009 to 2015, we identified 55,038 adults with sepsis and assessable body mass index measurements: 6% underweight, 33% normal weight, 28% overweight, and 33% obese. Crude mortality was inversely proportional to body mass index category: underweight (31%), normal weight (24%), overweight (19%), obese class I (16%), obese class II (16%), and obese class III (14%). Compared with normal weight, the adjusted odds ratio (95% CI) of mortality was 1.62 (1.50–1.74) for underweight, 0.73 (0.70–0.77) for overweight, 0.61 (0.57–0.66) for obese class I, 0.61 (0.55–0.67) for obese class II, and 0.65 (0.59–0.71) for obese class III. Results were consistent in sensitivity analyses.

Conclusions:
In adults with clinically defined sepsis, we demonstrate lower short-term mortality in patients with higher body mass indices compared with those with normal body mass indices (both unadjusted and adjusted analyses) and higher short-term mortality in those with low body mass indices. Understanding how obesity improves survival in sepsis would inform prognostic and therapeutic strategies.
Short-Term Adverse Outcomes Associated With Hypoglycemia in Critically Ill Children
Authors: Faustino Edward Vincent S. , Hirshberg Eliotte L. , Asaro Lisa A. , Biagas Katherine V. , Pinto Neethi , Srinivasan Vijay , Bagdure Dayanand N. , Steil Garry M. , Coughlin-Wells Kerry , Wypij David , Nadkarni Vinay M. , Agus Michael S. D. 
Published: February 2019

Objectives:
Previous studies report worse short-term outcomes with hypoglycemia in critically ill children. These studies relied on intermittent blood glucose measurements, which may have introduced detection bias. We analyzed data from the Heart And Lung Failure-Pediatric INsulin Titration trial to determine the association of hypoglycemia with adverse short-term outcomes in critically ill children.

Design:
Nested case-control study.

Setting:
Thirty-five PICUs. A computerized algorithm that guided the timing of blood glucose measurements and titration of insulin infusion, continuous glucose monitors, and standardized glucose infusion rates were used to minimize hypoglycemia.

Patients:
Nondiabetic children with cardiovascular and/or respiratory failure and hyperglycemia. Cases were children with any hypoglycemia (blood glucose < 60 mg/dL), whereas controls were children without hypoglycemia. Each case was matched with up to four unique controls according to age group, study day, and severity of illness.

Interventions:
None.

Measurements and Main Results:
A total of 112 (16.0%) of 698 children who received the Heart And Lung Failure-Pediatric INsulin Titration protocol developed hypoglycemia, including 25 (3.6%) who developed severe hypoglycemia (blood glucose < 40 mg/dL). Of these, 110 cases were matched to 427 controls. Hypoglycemia was associated with fewer ICU-free days (median, 15.3 vs 20.2 d; p = 0.04) and fewer hospital-free days (0 vs 7 d; p = 0.01) through day 28. Ventilator-free days through day 28 and mortality at 28 and 90 days did not differ between groups. More children with insulin-induced versus noninsulin-induced hypoglycemia had zero ICU-free days (35.8% vs 20.9%; p = 0.008). Outcomes did not differ between children with severe versus nonsevere hypoglycemia or those with recurrent versus isolated hypoglycemia.

Conclusions:
When a computerized algorithm, continuous glucose monitors and standardized glucose infusion rates were used to manage hyperglycemia in critically ill children with cardiovascular and/or respiratory failure, severe hypoglycemia (blood glucose < 40 mg/dL) was uncommon, but any hypoglycemia (blood glucose < 60 mg/dL) remained common and was associated with worse short-term outcomes.
Cannabinoids: a new approach for pain control?
Authors: Lossignol Dominique 
Published: February 2019

Purpose of review
To analyze available data related to the use of cannabinoids in medicine, with a special focus on pain management in cancer. The use of cannabis for medical purposes is growing but there are still numerous questions to be solved: effectiveness, safety, and specific indications.

Recent findings
There is considerable variation between countries in the approaches taken, reflecting a variety of historical and cultural factors and despite few randomized controlled studies using natural cannabinoids, there is a trend to state that the use of cannabis should be taken seriously as a potential treatment of cancer-related pain. Cannabidiol, a nontoxic phytocannabinoid with few side-effects is promising in various indications in medicine.

Summary
The endocannabinoid system is a potential therapeutic target. Cannabinoids may be considered as potential adjuvant in cancer-related pain management. Cannabidiol appears to be the drug of choice. Analgesic trial designs should evolve to get closer to real-life practice and to avoid biases.
Importance of Team Functioning as a Target of Quality Improvement Initiatives in Nursing Homes: A Qualitative Process Evaluation
Authors: Desveaux Laura , Halko Roxanne , Marani Husayn , Feldman Sid , Ivers Noah M. 
Published: February 2019

Introduction:
Quality improvement interventions demonstrate variable degrees of effectiveness. The aim of this work was to (1) qualitatively explore whether, how, and why an academic detailing intervention could improve evidence uptake and (2) identify perceived changes that occurred to inform outcomes appropriate for quantitative evaluation.

Methods:
A qualitative process evaluation was conducted involving semistructured interviews with nursing home staff. Interviews were analyzed inductively using the framework method.

Results:
A total of 29 interviews were conducted across 13 nursing homes. Standard processes to reduce falls are well-known but not fully implemented due to a range of mostly postintentional factors that influence staff behavior. Conflicting expectations around professional roles impeded evidence uptake; physicians report a disconnection between the information they would like to receive and the information communicated; and a high proportion of casual and part-time staff creates challenges for those looking to effect change. These factors are amenable to change in the context of an active, tailored intervention such as academic detailing. This seems especially true when the entire care team is actively engaged and when the intervention can be tailored to the varied determinants of behaviors across different team members.

Discussion:
Interventions aiming to increase evidence-based practice in the nursing home sector need to move beyond education to explicitly address team functioning and communication. Variability in team functioning requires a flexible intervention with the ability to tailor to individual- and home-level needs. Evaluations in this setting may benefit from measuring changes in team functioning as an early indicator of success.
Real-World Experience With 100 Consecutive Patients Undergoing Neck Contouring With ATX-101 (Deoxycholic Acid): An Updated Report With A 2-Year Analysis
Authors: Shridharani Sachin M. 
Published: February 2019

BACKGROUND
Deoxycholic acid (DCA; ATX-101) injection was approved for the treatment of mild-to-moderate convexity associated with submental fat in 2015.

OBJECTIVE
To evaluate the experience with DCA injections in a clinical practice setting.

MATERIALS AND METHODS
This ongoing, prospective, single-center, single-arm, observational study evaluated 100 consecutive patients treated with subcutaneous DCA (2 mg/cm2) injections (maximum 6 sessions at ≥1-month intervals). Treatment response was assessed using the clinician-reported submental fat rating scale (CR-SMFRS) and confirmed by independent physician review of photographs at 1 and 5 to 7 weeks after treatment.

RESULTS
Since the previous published report, 17 patients have undergone additional treatment sessions, with a total of 100 patients having undergone 195 treatment sessions: 41, 36, 14, 6, 2, and 1 patient underwent 1, 2, 3, 4, 5, and 6 sessions, respectively. Overall, 91.7% of patients in the single treatment session group and 100% in the multiple treatment session group had an improvement of ≥1 point on the CR-SMFRS. The mean (SD) duration of local edema, numbness, and tenderness after treatment was 7.1 (5.1), 27.9 (11.3), and 3.5 (3.5) days, respectively.

CONCLUSION
Deoxycholic acid injections were generally well tolerated, and ≥2 treatment sessions were required to achieve the desired aesthetic goal in a private practice setting.
Delayed-Onset Nodules to Differentially Crosslinked Hyaluronic Acids: Comparative Incidence and Risk Assessment
Authors: Sadeghpour Mona , Quatrano Nicola A. , Bonati Lauren Meshkov , Arndt Kenneth A. , Dover Jeffrey S. , Kaminer Michael S. 
Published: February 2019

BACKGROUND
Robust and long-term data on true incidence of delayed-onset nodules and immune tolerance of hyaluronic acid (HA) fillers are lacking.

OBJECTIVE
To characterize the incidence of delayed nodules in Vycross (VYC) HA fillers compared with previously reported FDA and non-FDA data of all HA fillers.

METHODS AND MATERIALS
The incidence of delayed nodules in all patients who had received VYC fillers in a 12-month period was assessed through a retrospective chart review. Nodule incidence for currently approved nonanimal-stabilized hyaluronic acid (NASHA) fillers was assessed using the FDA Summary of Safety and Effectiveness Data.

RESULTS
Overall, 1,029 patients received 1,250 VYC filler treatments. Five patients developed delayed nodules to VOB, with an incidence of 1.0% per patient and 0.8% per syringe. No nodules were observed in patients who received VLR or VOL. All nodules were treated successfully using a combination of intralesional triamcinolone and hyaluronidase. Compared with other currently approved NASHA fillers, VOB is associated with a higher incidence of nodule formation.

CONCLUSION
The introduction of VYC HAs has introduced a new variable that may be changing the immune tolerance of these substances, resulting in a higher incidence of delayed nodules than previously expected.
Sun Smoke in Sweden
Authors: Casey Joan A. , Gemmill Alison , Elser Holly , Karasek Deborah , Catalano Ralph 
Published: February 2019

Background:
The Icelandic volcano Laki erupted from June 1783 through January 1784. It produced 122 megatons of sulfur dioxide, particulate matter, and acid rain and contributed to one of the coldest winters on record in Western Europe. Although uncontrollable volcanic eruptions continue, few studies have investigated their perinatal health implications.

Methods:
Using the Human Mortality Database, we assessed the association between the Laki event and the secondary sex ratio, infant mortality rates, and the number of births from 1751 to 1800 with time-series models that controlled for temporal trends.

Results:
The secondary sex ratio decreased 3% below expected levels in 1784 (95% CI = −4%, −1%). Both female and male infant mortality rates exceeded expectation in 1785, by 54% (95% CI = 25%, 83%) and 37% (−1%, 74%), respectively. We observed little change in female live births but a reduction in male live births in 1784.

Conclusions:
Our findings are consistent with the hypothesis that the large-scale Laki volcanic eruptions of 1783–1784 resulted in adverse perinatal health outcomes in Sweden.