bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Sharp Gagliardo–Nirenberg–Sobolev Inequalities and an Improved Borell–Brascamp–Lieb Inequality
Authors: Bolley François , Cordero-Erausquin Dario , Fujita Yasuhiro , Gentil Ivan , Guillin Arnaud 
Published: May 2018

Abstract
We propose a new Borell–Brascamp–Lieb inequality that leads to novel sharp Euclidean inequalities such as Gagliardo–Nirenberg–Sobolev inequalities in $ {\mathbb{R}}^n$ and in the half-space $ {\mathbb{R}}^n_+$. This gives a new bridge between the geometric point of view of the Brunn–Minkowski inequality and the functional point of view of the Sobolev-type inequalities. In this way we unify, simplify, and generalize results by S. Bobkov–M. Ledoux, M. del Pino–J. Dolbeault, and B. Nazaret.
A lower limit to the accretion disc radius in the low-luminosity AGNNGC 1052 derived from high-angular resolution data
Authors: Reb Lennart , Fernández-Ontiveros Juan A , Prieto M Almudena , Dolag Klaus 
Published: May 2018

Abstract
We investigate the central sub-arcsec region of the low-luminosity active galactic nucleusNGC 1052, using a high-angular resolution data set that covers 10 orders of magnitude in frequency. This allows us to infer the continuum emission within the innermost ∼17 pc around the black hole to be of non-thermal, synchrotron origin and to set a limit to the maximum contribution of a standard accretion disc. Assuming the canonical 10 per cent mass–light conversion efficiency for the standard accretion disc, its inferred accretion power would be too low by one order of magnitude to account for the observed continuum luminosity. We thus introduce a truncated accretion disc and derive a truncation radius to mass–light conversion efficiency relation, which we use to reconcile the inferred accretion power with the continuum luminosity. As a result we find that a disc providing the necessary accretion power must be truncated at rtr ≳ 26 rg, consistent with the inner radius derived from the observations of the Fe Kα line in the X-ray spectrum of this nucleus. This is the first time to derive a limit on the truncation radius of the accretion disc from high-angular resolution data only.
Outcomes According to Discharge Location for Persons Who Inject Drugs Receiving Outpatient Parenteral Antimicrobial Therapy
Authors: D’Couto Helen T , Robbins Gregory K , Ard Kevin L , Wakeman Sarah E , Alves Justin , Nelson Sandra B 
Published: May 2018

Abstract

Background
Opioid use disorder poses a significant public health risk. Persons who inject drugs (PWID) suffer from high mortality and morbidity secondary to serious infectious diseases, often requiring prolonged courses of outpatient parenteral antibiotics. The goal of this study was to determine the outcomes of PWID discharged to home or to a skilled nursing or rehabilitation facility (SNF/rehab) with parenteral antibiotic treatment under an outpatient parenteral antimicrobial therapy (OPAT) program.

Methods
This is a retrospective observational study. The study population was identified via hospital and OPAT databases using substance use disorder diagnoses and confirmed through chart review. The study population included hospitalized PWID with injection drug use in the preceding 2 years who were discharged between 2010 and 2015 to complete at least 2 weeks of parenteral antibiotics and monitored by the OPAT program. Retrospective chart review was used to describe patient characteristics and outcomes.

Results
Fifty-two patients met inclusion criteria, 21 of whom were discharged to home and 31 were discharged to a SNF/rehab. Of the patients discharged to home, 17 (81%) completed their planned antibiotic courses without complication. Twenty (64%) patients discharged to a SNF/rehab completed the antibiotic courses without complication. Six (11%) patients had line infections, 6 (11%) had injection drug use relapse, and 12 (23%) required readmission.

Conclusions
Persons who inject drugs discharged home were not more likely to have complications than those discharged to a SNF/rehab. Home OPAT may be a safe discharge option in carefully selected patients.
Effect of Body Temperature on Cerebral Autoregulation in Acutely Comatose Neurocritically Ill Patients
Authors: Adatia Krishma , Geocadin Romergryko G. , Healy Ryan , Ziai Wendy , Ponce-Mejia Luciano , Anderson-White Mirinda , Shah Dhaval , Radzik Batya R. , Palmisano Caitlin , Hogue Charles W. , Brown Charles , Rivera-Lara Lucia 
Published: May 2018

Objectives:
Impaired cerebral autoregulation following neurologic injury is a predictor of poor clinical outcome. We aimed to assess the relationship between body temperature and cerebral autoregulation in comatose patients.

Design:
Retrospective analysis of prospectively collected data.

Setting:
Neurocritical care unit of the Johns Hopkins Hospital.

Patients:
Eighty-five acutely comatose patients (Glasgow Coma Scale score of ≤ 8) admitted between 2013 and 2017.

Interventions:
None.

Measurement and Main Results:
Cerebral autoregulation was monitored using multimodal monitoring with near-infrared spectroscopy–derived cerebral oximetry index. Cerebral oximetry index was calculated as a Pearson correlation coefficient between low-frequency changes in regional cerebral oxygenation saturation and mean arterial pressure. Patients were initially analyzed together, then stratified by temperature pattern over the monitoring period: no change (< 1°C difference between highest and lowest temperatures; n = 11), increasing (≥ 1°C; n = 9), decreasing (≥ 1°C; n = 9), and fluctuating (≥ 1°C difference but no sustained direction of change; n = 56). Mixed random effects models with random intercept and multivariable logistic regression analysis were used to assess the association between hourly temperature and cerebral oximetry index, as well as between temperature and clinical outcomes. Cerebral oximetry index showed a positive linear relationship with temperature (β = 0.04 ± 0.10; p = 0.29). In patients where a continual increase or decrease in temperature was seen during the monitoring period, every 1°C change in temperature resulted in a cerebral oximetry index change in the same direction by 0.04 ± 0.01 (p < 0.001) and 0.02 ± 0.01 (p = 0.12), respectively, after adjusting for Paco
2, hemoglobin, mean arterial pressure, vasopressor and sedation use, and temperature probe location. There was no significant difference in mortality or poor outcome (modified Rankin Scale score of 4–6) between temperature pattern groups at discharge, 3, or 6 months.

Conclusions:
In acute coma patients, increasing body temperature is associated with worsening cerebral autoregulation as measured by cerebral oximetry index. More studies are needed to clarify the impact of increasing temperature on cerebral autoregulation in patients with acute brain injury.
National Trends (2009–2013) for Palliative Care Utilization for Patients Receiving Prolonged Mechanical Ventilation*
Authors: Chatterjee Kshitij , Goyal Abhinav , Kakkera Krishna , Harrington Sarah , Corwin Howard L. 
Published: May 2018

Objectives:
Patients requiring mechanical ventilation have high morbidity and mortality. Providing palliative care services has been suggested as a way to improve comprehensive management of critically ill patients. We examined the trend in the utilization of palliative care among adults who require prolonged mechanical ventilation. Primary objectives were to determine the trend in palliative care utilization over time, predictors for palliative care utilization, and palliative care impact on hospital length of stay.

Design:
Retrospective, cross-sectional study.

Setting:
The National Inpatient Sample data between 2009 and 2013 was used for this study.

Patients:
Adults (age ≥ 18 yr) who underwent prolonged mechanical ventilation (≥ 96 consecutive hr) were studied.

Measurements and Main Results:
Palliative care and mechanical ventilation were identified using the corresponding International Classification of Diseases, 9th revision, Clinical Modification, codes. A total of 1,751,870 hospitalizations with prolonged mechanical ventilation were identified between 2009 and 2013. The utilization of palliative care increased yearly from 6.5% in 2009 to 13.1% in 2013 (p < 0.001). Among the mechanically ventilated patients who died, palliative care increased from 15.9% in 2009 to 33.3% in 2013 (p < 0.001). Median hospital length of stay for patients with and without palliative care was 13 and 17 days, respectively (p < 0.001). Patients discharged to either short- or long-term care facilities had a shorter length of stay if palliative care was provided (15 vs 19 d; p < 0.001). The factors associated with a higher palliative care utilization included older age, malignancy, larger hospitals in urban areas, and teaching hospitals. Non-Caucasian race was associated with lower palliative care utilization.

Conclusions:
Among patients who undergo prolonged mechanical ventilation, palliative care utilization is increasing, particularly in patients who die during hospitalization. Using palliative care for mechanically ventilated patients who are discharged to either short- or long-term care facilities is associated with a shorter hospital length of stay.
Insidious Harm of Medication Diluents as a Contributor to Cumulative Volume and Hyperchloremia: A Prospective, Open-Label, Sequential Period Pilot Study*
Authors: Magee Carolyn A. , Bastin Melissa L. Thompson , Laine Melanie E. , Bissell Brittany D. , Howington Gavin T. , Moran Peter R. , McCleary Emily J. , Owen Gary D. , Kane Lauren E. , Higdon Emily A. , Pierce Cathy A. , Morris Peter E. , Flannery Alexander H. 
Published: May 2018

Objectives:
Although the potential dangers of hyperchloremia from resuscitation fluids continue to emerge, no study to date has considered the contribution of medication diluents to cumulative volume and hyperchloremia. This study compares saline versus dextrose 5% in water as the primary medication diluent and the occurrence of hyperchloremia in critically ill patients.

Design:
Prospective, open-label, sequential period pilot study.

Setting:
Medical ICU of a large academic medical center.

Patients:
Adult patients admitted to the medical ICU were eligible for inclusion. Patients who were admitted for less than 48 hours, less than 18 years old, pregnant, incarcerated, or who had brain injury were excluded.

Interventions:
Saline as the primary medication diluent for 2 months followed by dextrose 5% in water as the primary medication diluent for 2 months.

Measurements and Main Results:
A total of 426 patients were included, 216 in the saline group and 210 in the dextrose 5% in water group. Medication diluents accounted for 63% of the total IV volume over the observation period. In the saline group, 17.9% developed hyperchloremia compared with 10.5% in the dextrose 5% in water group (p = 0.037), which was statistically significant in multivariable analysis (odds ratio, 0.50; 95% CI, 0.26–0.94; p = 0.031). In the saline group, 34.2% developed acute kidney injury versus 24.5% in the dextrose 5% in water group (p = 0.035); however, this was not statistically significant when adjusting for baseline covariates. No other significant differences in dysnatremias, insulin requirements, glucose control, ICU length of stay, or ICU mortality were observed.

Conclusions:
This study identified that medication diluents contribute substantially to the total IV volume received by critically ill patients. Saline as the primary medication diluent compared with dextrose 5% in water is associated with hyperchloremia, a possible risk factor for acute kidney injury.
Platelet Transfusion Practices in Critically Ill Children
Authors: Nellis Marianne E. , Karam Oliver , Mauer Elizabeth , Cushing Melissa M. , Davis Peter J. , Steiner Marie E. , Tucci Marisa , Stanworth Simon J. , Spinella Philip C. 
Published: May 2018

Objectives:
Little is known about platelet transfusions in pediatric critical illness. We sought to describe the epidemiology, indications, and outcomes of platelet transfusions among critically ill children.

Design:
Prospective cohort study.

Setting:
Multicenter (82 PICUs), international (16 countries) from September 2016 to April 2017.

Patients:
Children ages 3 days to 16 years prescribed a platelet transfusion in the ICU during screening days.

Interventions:
None.

Measurements and Main Results:
Over 6 weeks, 16,934 patients were eligible, and 559 received at least one platelet transfusion (prevalence, 3.3%). The indications for transfusion included prophylaxis (67%), minor bleeding (21%), and major bleeding (12%). Thirty-four percent of prophylactic platelet transfusions were prescribed when the platelet count was greater than or equal to 50 × 109 cells/L. The median (interquartile range) change in platelet count post transfusion was 48 × 109 cells/L (17–82 × 109 cells/L) for major bleeding, 42 × 109 cells/L (16–80 × 109 cells/L) for prophylactic transfusions to meet a defined threshold, 38 × 109 cells/L (17–72 × 109 cells/L) for minor bleeding, and 25 × 109 cells/L (10–47 × 109 cells/L) for prophylaxis in patients at risk of bleeding from a device. Overall ICU mortality was 25% but varied from 18% to 35% based on indication for transfusion. Upon adjusted analysis, total administered platelet dose was independently associated with increased ICU mortality (odds ratio for each additional 1 mL/kg platelets transfused, 1.002; 95% CI, 1.001–1.003; p = 0.005).

Conclusions:
The majority of platelet transfusions are given as prophylaxis to nonbleeding children, and significant variation in platelet thresholds exists. Studies are needed to clarify appropriate indications, with focus on prophylactic transfusions.
Benzodiazepines and Development of Delirium in Critically Ill Children: Estimating the Causal Effect*
Authors: Mody Kalgi , Kaur Savneet , Mauer Elizabeth A. , Gerber Linda M. , Greenwald Bruce M. , Silver Gabrielle , Traube Chani 
Published: May 2018

Objectives:
Benzodiazepine use may be associated with delirium in critically ill children. However, benzodiazepines remain the first-line sedative choice in PICUs. Objectives were to determine the temporal relationship between administration of benzodiazepines and delirium development, control for time-varying covariates such as mechanical ventilation and opiates, and evaluate the association between dosage of benzodiazepines and subsequent delirium.

Design:
Retrospective observational study.

Setting:
Academic tertiary care PICU.

Patients:
All consecutive admissions from January 2015 to June 2015.

Interventions:
Retrospective assessment of benzodiazepine exposure in a population that had been prospectively screened for delirium.

Measurements and Main Results:
All subjects were prospectively screened for delirium throughout their stay, using the Cornell Assessment for Pediatric Delirium, with daily cognitive status assigned as follows: delirium, coma, or normal. Multivariable mixed effects modeling determined predictors of delirium overall, followed by subgroup analysis to assess effect of benzodiazepines on subsequent development of delirium. Marginal structural modeling was used to create a pseudorandomized sample and control for time-dependent variables, obtaining an unbiased estimate of the relationship between benzodiazepines and next day delirium. The cumulative daily dosage of benzodiazepines was calculated to test for a dose-response relationship. Benzodiazepines were strongly associated with transition from normal cognitive status to delirium, more than quadrupling delirium rates (odds ratio, 4.4; CI, 1.7–11.1; p < 0.002). Marginal structural modeling demonstrated odds ratio 3.3 (CI, 1.4–7.8), after controlling for time-dependent confounding of cognitive status, mechanical ventilation, and opiates. With every one log increase in benzodiazepine dosage administered, there was a 43% increase in risk for delirium development.

Conclusions:
Benzodiazepines are an independent and modifiable risk factor for development of delirium in critically ill children, even after carefully controlling for time-dependent covariates, with a dose-response effect. This temporal relationship suggests causality between benzodiazepine exposure and pediatric delirium and supports limiting the use of benzodiazepines in critically ill children.
Sociocultural factors influencing infant-feeding choices among African immigrant women living with HIV: A synthesis of the literature
Authors: Etowa Josephine , MacDonald Shannan , Hannan Jean , Phillips J. Craig , Boadu Nana Yaa , Babatunde Seye 
Published: May 2018

ABSTRACTBackground and purpose:The World Health Organizations (WHO) strategy is to eliminate pediatric HIV. HIV prevention guidelines in high-income countries recommend mothers living with HIV avoid breastfeeding. Yet, breastfeeding is promoted as the normal and unequalled method of feeding infants. This creates a paradox for mothers coming from cultures where breastfeeding is an expectation and formula feeding suggests illness. Therefore, the purpose of this literature review is to examine the context influencing infant feeding among African immigrant women living with HIV to develop interventions to reduce the risk of HIV mother-to-child transmission.Methods:Using the PEN-3 cultural model as a guide, we selected 45 empirical studies between 2001 and 2016 using 5 electronic databases on the sociocultural factors influencing infant-feeding choices and practices among African women from HIV endemic countries.Conclusions:Findings are congruent with the importance of culture when developing guidelines. Our review provides support that culture-centered interventions are crucial toward achieving the WHO's strategy to eliminate pediatric HIV.Implications for practice:Understanding the sociocultural determinants of infant-feeding choices is critical to the development of prevention initiatives to eliminate pediatric HIV.
Health and educational implications of prematurity in the United States: National Survey of Children's Health 2011/2012 data
Authors: Kelly Michelle M. 
Published: May 2018

ABSTRACT

Background and purpose:
Preterm birth is a significant public health issue, with children born prematurely experiencing educational and health difficulties throughout childhood. The aim of the descriptive secondary data analysis was to compare health implications and educational experiences in children born prematurely compared with children born at term.

Methods:
The 2011/2012 National Survey of Children's Health data set was explored using separate chi-square tests of homogeneity to investigate differences in the occurrence of chronic health conditions and educationally relevant outcomes: individualized family services plan/individualized education plan (IFSP/IEP), and grade repetition between children born prematurely compared with those born at term.

Conclusions:
The six most frequently occurring chronic health conditions that disproportionally affected children born prematurely include the following: attention deficit disorder/attention deficit hyperactive disorder (odds ratio [OR], 1.59), anxiety (OR, 1.63), asthma (OR, 1.7), learning disability (OR, 2.07), speech problems (OR, 2.27), and developmental delay (OR, 3.17). Preterm birth negatively affects the educational experience of CBP as measured by increased report of IFSP/IEP and repeated grades across all age categories.

Implications for practice:
All health care providers have an important role in preventing preterm birth and in supporting the children and families affected by preterm birth. Appreciation of the incidence and prevalence of the health conditions and educational difficulties associated with preterm birth is essential for facilitating access to appropriate resources. Beyond patient interactions, these modifiable yet additive factors should inform health policy and planning.
Leveraging health care reform to accelerate nurse practitioner full practice authority
Authors: Brom Heather M. , Salsberry Pamela J. , Graham Margaret Clark 
Published: May 2018

ABSTRACT

Background and purpose:
Since development of the nurse practitioner (NP) role, NPs have been advocating for policy allowing them to practice to the full extent of their training. The aim of this research was to determine whether passage of the Affordable Care Act (ACA) had an impact on expansion of NPs' scope of practice.

Methods:
This was a retrospective descriptive study of NPs' scope of practice legislation from 1994 to 2016 using regulatory theory. Data sources included annual reports on NP legislation and state-level legislative and media coverage.

Conclusions:
Eight states adopted full practice authority (FPA) from 2011 to 2016, representing a two-fold increase compared with the previous 10 years. Seven states adopted Medicaid expansion. Nursing interest groups and politicians shaped their argument in favor of FPA around the increasingly insured population because of the ACA, provider shortages, and rural health care access issues.

Implications for practice:
Shaping the discourse of FPA beyond the benefits to the NP profession makes way for broader political interest and participation. Although the future of the ACA is unknown, as the 28 states without FPA continue to advocate for legislative change, they could benefit from the strategies of these newly adapted FPA states.
Management of venous thromboembolism with non–vitamin K oral anticoagulants: A review for nurse practitioners and pharmacists
Authors: Schmerge Michelle , Earl Sally , Kline Carol 
Published: May 2018

ABSTRACT

Background and purpose:
Venous thromboembolism (VTE), comprising deep-vein thrombosis and pulmonary embolism, is associated with significant morbidity and mortality. Non–vitamin K oral anticoagulants (NOACs), including apixaban, betrixaban, dabigatran, edoxaban, and rivaroxaban, are as effective and safe as vitamin K antagonists (VKAs) for primary prophylaxis, treatment, and/or secondary prevention of VTE and present significant advantages in convenience of use. This review provides guidance to nurse practitioners (NPs) and pharmacists on NOAC usage for the management of VTE and examines how traditional anticoagulation clinics can adapt to cater to patients on NOACs.

Methods:
A review of the scientific literature pertaining to treatment guideline recommendations, large randomized clinical trials, and real-world evidence studies related to VTE management was conducted.

Conclusions:
With current data suggesting that NOACs may present as better alternatives over VKAs for the management of VTE, comprehensively educating NPs and pharmacists can help incorporate these agents in their clinical practice.

Implications for practice:
Repurposing anticoagulation clinics, led by well-informed NPs and pharmacists, will allow effective integration and optimal management of patients with VTE taking NOACs as well as those taking VKAs.