bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of a biomedical device (VeinViewer®) to assist with peripheral intravenous catheter (PIV) insertion for pediatric nurses
Authors: McNeely Heidi L. , Ream Theresa L. , Thrasher Jodi M. , Dziadkowiec Oliwier , Callahan Tiffany J. 
Published: February 2018

AbstractPurposeVascular access in pediatric patients can be challenging even with the currently available technological resources. This nurse‐driven research study explored time, cost, and resources for intravenous access to determine if a biomedical device, VeinViewer® Vision, would facilitate improvements in pediatric access. In addition, this study looked at nurse perceptions of skills and confidence around intravenous insertion and if the use of the VeinViewer® impacted these perceptions. Literature examining pediatric intravenous access success rates compared with nurse perceived skills and confidence is lacking.DesignNonblinded randomized control trial of pediatric nurses working in an acute care hospital setting.MethodsA preliminary needs assessment solicited feedback from nurses regarding their practice, perceived skills, and confidence with placing peripheral intravenous catheters (PIVs). Due to the results of the preliminary needs assessment, a research study was designed and 40 nurses were recruited to participate. The nurses were randomized into either a VeinViewer® or standard practice group. Nurse participants placed intravenous catheters on hospitalized pediatric patients using established procedures while tracking data for the study.ResultsNeeds assessment showed a majority of nurses felt a biomedical device would be helpful in building their intravenous insertion skills and their confidence. The study results did not demonstrate any clinically significant differences between VeinViewer® use and standard practice for intravenous catheter insertion in pediatric patients for success of placement, number of attempts, or overall cost. In addition, no difference was noted between nurses in either group on perceived skills or confidence with insertion of PIVs.Practice implicationsThe ongoing need for resources focused on building nurse skills and confidence for PIV insertion was highlighted and organizations should continue to direct efforts toward developing skills and competency for staff that are responsible for pediatric vascular access. This study illustrates the importance of data‐driven decision‐making for expensive hospital‐funded equipment purchases. This nursing led research study highlights how perceptions do not always align with outcomes. The lessons gleaned from this study may aid in decision‐making around pediatric intravenous access practice.
Pediatric nurses’ perceived knowledge and beliefs of evidence‐based practice in the care of children and adolescents with moderate‐to‐severe traumatic brain injury
Authors: Oyesanya Tolu O. , Snedden Traci R. 
Published: February 2018

AbstractPurposePediatric nurses play a significant role in all phases of traumatic brain injury (TBI) recovery, particularly during the hospital stay. Although evidence‐based nursing practice is known to improve patient outcomes, limited research exists on nurses’ evidence‐based perceived knowledge and beliefs specific to TBI care. As nurses’ perceived knowledge and beliefs are known to guide their practice behaviors, this assessment is important to overall TBI outcomes. The purpose of this study was to evaluate pediatric nurses’ evidence‐based perceived knowledge and beliefs in providing care for children and adolescents with moderate‐to‐severe TBI.Design and methodsData for this study were obtained from a larger parent study on nurses’ perceptions of caring for patients of all ages with moderate‐to‐severe TBI. The parent study was an exploratory, cross‐sectional electronic survey of registered nurses across all hospital departments within a large Midwestern health system. Only data specific to pediatric nurses (n = 330) were analyzed for this study. Descriptive statistics and latent class analysis (LCA) were performed.ResultsPediatric nurses, on average, were 38.79 years, female (90.37%), had over a decade of nursing experience (13.55 years), and practiced as a staff nurse (80.07%) on an inpatient unit (45.51%). Findings indicated pediatric nurses reported overall low levels of evidence‐based perceived knowledge and had inaccurate beliefs about caring for patients with TBI. LCA indicated two distinct homogenous subgroups specific to evidence‐based perceived knowledge: low (41%) and high (59%). Nurses in the low evidence‐based perceived knowledge group were younger, had less nursing experience, worked primarily on an inpatient unit, and cared for patients with TBI at a higher frequency compared to high evidence‐based perceived knowledge nurses. Additionally, there were significant differences in beliefs about sex‐based patient differences after TBI and the role of nurses in caring for patients with TBI based on level of evidence‐based perceived knowledge.Practice implicationsAssessing nurses’ perceived knowledge and beliefs of evidence‐based practice is a foundational step toward implementing evidence‐based care for patients with moderate‐to‐severe TBI. Implications of these findings indicate the need to provide additional education to increase pediatric nurses’ perceived knowledge and ensure accurate beliefs about evidence‐based TBI care.
How to control highly endemic hepatitis B in Asia
Authors: Shan Shan , Cui Fuqian , Jia Jidong 
Published: February 2018

AbstractChronic hepatitis B virus (HBV) infection is an enormous economic and social burden. Asian countries such as Vietnam, Mongolia, Laos, China, the Philippines, South Korea, Singapore and Cambodia have high or high‐intermediate HBsAg prevalence. Most of the chronic HBV carriers in this region acquire their infection during early childhood or through mother‐to‐child transmission (MTCT). Asia has been highly successful in controlling HBV in the last 2 decades. For example, China has adopted a comprehensive strategy to control HBV and has offered universal HBV vaccination to infants since 1992. With increasing coverage and a timely birth dose of the HBV vaccine, the prevalence of HBsAg in that general population decreased from 9.75% in 1992 to 7.18% in 2006. The prevalence of HBsAg in the population <30 years old decreased from 10.1% in 1992 to 2.6% in 2014. In addition, passive and active immunization has been increased and has successfully interrupted MTCT in recent years. Recent studies in China show that maternal antiviral therapy in the late trimesters of pregnancy could further reduce MTCT in mothers with a high viral load. First‐line treatments such as entecavir and tenofovir as well as pegylated interferon alpha are recommended in Chinese guidelines and are on the Basic Medical Insurance reimbursement list. Increased awareness, access to and affordability of antiviral therapy will reduce HBV‐related morbidity and mortality. The combined efforts of the government, the medical community, industry, civil society and the public should eliminate hepatitis B as a public threat by 2030.
Treatment of hepatitis C: the use of the new pangenotypic direct‐acting antivirals in “special populations”
Authors: Pol Stanislas , Parlati Lucia 
Published: February 2018

AbstractBackground & AimsThe recommended combination of pangenotypic direct‐acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) associates the co‐formulation of 2 or 3 second‐generation DAAs. In the so‐called “special populations” defined as patients with chronic kidney disease (CKD), HCV/HIV co‐infection, HCV/HBV co‐infection and an unsuccessful previous DAA regimen, these combinations have a high antiviral potency (sustained virologic response (SVR) > 95%), fair tolerance and a reduced pill burden.MethodsWe have taken into account the scientific evidence on the treatment of “special populations”, in particular from the RUBY 1‐2 trials, EXPEDITION 2‐4 study, C‐WORTHY trial, ASTRAL 5, POLARIS 1‐4 studies, MAGELLAN 1 and REVENGE study.ResultsCKD and HCV/HIV co‐infection are not predictors of a non‐viral response. The glecaprevir/pibentrasvir (Maviret) combination appears to be the first‐line therapy for CKD patients while the sofosbuvir/vlpatasvir/voxaliprevir (Sovesi) combination is the first‐line option for DAAs failures. Both are effective in patients with HIV‐or HBV‐HCV co‐infection and should be chosen according to the potential drug‐drug interaction profile.ConclusionsThe notion of “special populations” is no longer pertinent with pangenotypic DAAs combinations. International guidelines recommend treating all infected patients and the next challenge is not the therapeutic choice, but to improve the limitations for screening and access to care in HCV infection.
Treatment of hepatitis B: Is there still a role for interferon?
Authors: Viganò Mauro , Grossi Glenda , Loglio Alessandro , Lampertico Pietro 
Published: February 2018

AbstractThe treatment of chronic hepatitis B (CHB) patients is based on monotherapy with pegylated‐interferon (Peg‐IFN) or with one of the three most potent nucleot(s)ide analogues (NUCs) with the best resistance profiles, i.e. entecavir (ETV), tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF). Long‐term NUCs treatment can achieve virological suppression in almost all patients. However, this requires lifelong therapy, is costly and the rate of hepatitis B surface antigen (HBsAg) seroclearance is low. A one‐year course of Peg‐IFN has the advantage of providing immune‐mediated control of the hepatitis B virus (HBV) infection, the possibility of achieving a sustained off‐treatment response in nearly 30% of the patients and ultimately, HBsAg loss in approximately 30%‐50% of the latter patients during long‐term off treatment follow‐up. However, the major limitations to the extensive use of this treatment are the need for parenteral therapy and clinical and laboratory monitoring, the side‐effects profile and contraindications in certain patients and the limited effectiveness in a large proportion of patients. Nevertheless, the cost‐effectiveness of Peg‐IFN can be significantly increased by careful patient selection based upon baseline alanine aminotransferase (ALT), HBV DNA levels, viral genotype, host genetic variants and especially by applying early on‐treatment stopping rules based upon HBsAg kinetics. Recently, because of the different mechanisms of action of Peg‐IFN and NUCs, the strategy of “adding‐on” or “switching to” Peg‐IFN in patients being treated with NUCs to accelerate the decline in HBsAg and enhance HBsAg seroclearance rates, has provided interesting results.
Managing hepatitis C in patients with the complications of cirrhosis
Authors: Mücke Marcus M. , Mücke Victoria T. , Lange Christian M. , Zeuzem Stefan 
Published: February 2018

AbstractDirect acting antivirals (DAA) have revolutionized the treatment of hepatitis C virus (HCV). Sustained virological response rates of nearly 100% have become common in the general population. However, physicians face the growing problem of managing HCV in patients with the complications of cirrhosis, eg hepatic decompensation or hepatocellular carcinoma (HCC). Safety and efficacy remain a clinical challenge in these difficult‐to‐treat patients. This review focuses on the current state of knowledge and treatment regimens in patients with decompensated cirrhosis as well as the potential risk of the development of HCC following DAA therapy.
Management of patients with non‐alcoholic steatohepatitis (NASH) in real life
Authors: Serfaty Lawrence 
Published: February 2018

AbstractNon‐alcoholic fatty liver disease (NAFLD)/non‐alcoholic steatohepatitis (NASH) is a prevalent condition that is associated with the development of cirrhosis and hepatocellular carcinoma and with no approved treatment options except for lifestyle changes. Guidelines have been drafted for the management of NAFLD patients in this setting. Because of the lack of real‐life cohort data, we will focus on practice surveys on the management of patients with NAFLD/NASH, which included primary care practitioners, gastroenterologists/hepatologists and other specialists from various countries. Practice patterns have been collected from interviews with practitioners or reviews of patient's files. This review discusses the screening, diagnosis and therapeutic management of NAFLD/NASH patients in real life practice, as well as adherence to guidelines.
Treatment of hepatitis C: Results in real life
Authors: Hézode Christophe 
Published: February 2018

AbstractDirect‐acting antivirals (DAAs) have transformed traditional treatment options for hepatitis C virus (HCV) infection. DAA combinations have been shown to be highly effective in reducing the burden of chronic HCV infection in clinical trials and have been recommended by the European Association for the Study of the Liver (EASL) treatment guidelines. This review examines the results of second‐generation DAA combinations in real‐life clinical practice in patients with genotypes 1‐3 and in those co‐infected with HIV (real‐world data in genotypes 4‐6 are rare). Second generation DAAs (sofosbuvir plus daclatasvir, sofosbuvir/ledipasvir, ombitasvir/paritaprevir/ritonavir plus dasabuvir, sofosbuvir plus velpatasvir, glecaprevir plus pibrentasvir, grazoprevir plus elbasvir) have very high SVR rates and good safety profiles, higher resistance barriers and are more convenient. Real‐world data in all 3 genotypes generally support the EASL guidelines and high overall sustained virological response rates are reported with recommended regimens. However, real‐world data are only available for sofosbuvir plus daclatasvir, sofosbuvir/ledipasvir, ombitasvir/paritaprevir/ritonavir plus dasabuvir. Furthermore, because of the existing level of evidence, it is difficult to define optimal regimens based on real‐world data (ie, treatment duration, when to include ribavirin and options for patients with cirrhosis). The real‐life challenges of managing HIV‐coinfected patients are also discussed showing the additional burden of avoiding drug–drug interactions between DAAs and antiretrovirals.
Global epidemiology of non‐alcoholic fatty liver disease/non‐alcoholic steatohepatitis: What we need in the future
Authors: Araújo Ana Ruth , Rosso Natalia , Bedogni Giorgio , Tiribelli Claudio , Bellentani Stefano 
Published: February 2018

AbstractThe estimated prevalence of non‐alcoholic fatty liver disease (NAFLD) worldwide is approximately 25%. However, the real prevalence of NAFLD and the associated disorders is unknown mainly because reliable and applicable diagnostic tests are lacking. This is further complicated by the lack of consensus on the terminology of different entities such as NAFLD or nonalcoholic steatohepatitis (NASH). Although assessing fatty infiltration in the liver is simple by ultrasound, the gold standard for the assessment of fibrosis, the only marker of progression towards more severe liver disease is still liver biopsy. Although other non‐invasive tests have been proposed, they must still be validated in large series. Because NAFL/NAFLD/NASH and related metabolic diseases represent an economic burden, finding an inexpensive method to diagnose and stage fatty liver is a priority. A translational approach with the use of cell and/or animal models could help to reach this goal.
Towards HBV curative therapies
Authors: Schinazi Raymond F. , Ehteshami Maryam , Bassit Leda , Asselah Tarik 
Published: February 2018

AbstractTremendous progress has been made over the last 2 decades to discover and develop approaches to control hepatitis B virus (HBV) infections and to prevent the development of hepatocellular carcinoma using various interferons and small molecules as antiviral agents. However, none of these agents have significant impact on eliminating HBV from infected cells. Currently the emphasis is on silencing or eliminating cccDNA, which could lead to a cure for HBV. Various approaches are being developed including the development of capsid effectors, CRISPR/Cas9, TALENS, siRNA, entry and secretion inhibitors, as well as immunological approaches. It is very likely that a combination of these modalities will need to be employed to successfully eliminate HBV or prevent virus rebound on discontinuation of therapy. In the next 5 years clinical data will emerge which will provide insight on the safety and feasibility of these approaches and if they can be applied to eradicate HBV infections globally. In this review, we summarize current treatments and we highlight and examine recent therapeutic strategies that are currently being evaluated at the preclinical and clinical stage.
Diagnosis of non‐alcoholic fatty liver disease/non‐alcoholic steatohepatitis: Non‐invasive tests are enough
Authors: Castera Laurent 
Published: February 2018

AbstractNon‐alcoholic fatty liver disease is a major cause of liver disease worldwide and the most common liver disorder in Western countries, affecting around 25% of the general population. Fibrosis is the major long‐term histological prognostic criteria of this disease. Liver biopsy cannot be realistically performed in such a huge population and, moreover, has well‐known limitations (invasiveness, rare but potentially life‐threatening complications and sampling variability). Over the past decade, there has been a growing interest in alternative novel strategies for the non‐invasive evaluation of fibrosis. These tests rely on two different but complementary approaches: either measuring the levels of serum biomarkers, or liver stiffness, using ultrasound‐based elastography techniques. In non‐alcoholic fatty liver disease patients, transient elastography, FIB‐4 and the non‐alcoholic fatty liver disease fibrosis score are the best validated tests, with summary area under the ROC curve values for diagnosing severe fibrosis‐cirrhosis of 0.88, 0.84 and 0.84 respectively. They can also identify the subgroup of non‐alcoholic fatty liver disease patients at high risk of developing liver‐related complications and death. As a result, non‐invasive tests are now widely used in routine clinical practice and included in national and international guidelines. The next step is the use of non‐invasive tests as first‐line tools for screening non‐alcoholic fatty liver disease in the general population to identify patients who should be referred to specialized centres.
Is global elimination of HCV realistic?
Authors: Calvaruso Vincenza , Petta Salvatore , Craxì Antonio 
Published: February 2018

AbstractThe elimination of hepatitis C virus (HCV) has been made possible through the availability of new antiviral drugs which may now be administered to all patients with HCV infection, even those with decompensated cirrhosis. The goal of the World Health Organization (WHO) is to reduce the incidence of chronic hepatitis infection from the current 6‐10 million to 0.9 million cases of chronic infections by 2030, and annual deaths from 1.4 million to fewer than 0.5 million. Achieving these targets will require full implementation of epidemiological knowledge of HCV infection, screening and testing practices and strategies to link HCV patients to care. This review will focus on the current state of knowledge in the epidemiology of HCV and what can be done to increase patient awareness and reduce the barriers to treatment. Furthermore, we will discuss the role of HCV clearance on the control of HCV‐related outcomes.
Treatment of hepatitis C virus infection with direct‐acting antiviral agents: 100% cure?
Authors: Asselah Tarik , Marcellin Patrick , Schinazi Raymond F. 
Published: February 2018

AbstractAround 71 million people are chronically infected with HCV worldwide. HCV antiviral drug development has been remarkable. The availability of pangenotypic direct‐acting antivirals with excellent efficacy and good tolerability profiles offer a unique opportunity to achieve HCV elimination worldwide. IFN‐free DAA combinations can now cure HCV in more than 95% of patients with HCV infection after 8‐12 weeks of treatment. Programmes to eliminate HCV must include increased screening (risk‐based and universal), linkage to care, as well as increased access to treatment worldwide. In this paper, we will review the available data on recently approved direct‐acting antiviral agents, with sustained virological response that reaches almost 100%.
Future therapy for non‐alcoholic fatty liver disease
Authors: Issa Danny , Patel Vaishali , Sanyal Arun J. 
Published: February 2018

AbstractNon‐alcoholic fatty liver disease is a leading cause of chronic liver disease and can lead to cirrhosis, hepatocellular cancer and end stage liver disease. It is also associated with increased cardiovascular and cancer related morbidity and mortality. The pathogenesis of non‐alcoholic fatty liver disease includes metabolic stress to the liver associated with insulin resistance with downstream cell stress from reactive oxygen species and unfolded protein response with activation of inflammatory and fibrotic pathways. There are currently no approved therapies for non‐alcoholic fatty liver disease. This review summarizes ongoing efforts to establish the treatment of non‐alcoholic steatohepatitis the progressive form of non‐alcoholic fatty liver disease. Therapies are currently directed towards improving the metabolic status of the liver, cell stress, apoptosis, inflammation or fibrosis. Several agents are now in pivotal trials and it is expected that the first therapies will be approved in 2‐3 years.
Liver diseases: A major, neglected global public health problem requiring urgent actions and large‐scale screening
Authors: Marcellin Patrick , Kutala Blaise K. 
Published: February 2018

AbstractCLDs represent an important, and certainly underestimated, global public health problem. CLDs are highly prevalent and silent, related to different, sometimes associated causes. The distribution of the causes of these diseases is slowly changing, and within the next decade, the proportion of virus‐induced CLDs will certainly decrease significantly while the proportion of NASH will increase. There is an urgent need for effective global actions including education, prevention and early diagnosis to manage and treat CLDs, thus preventing cirrhosis‐related morbidity and mortality. Our role is to increase the awareness of the public, healthcare professionals and public health authorities to encourage active policies for early management that will decrease the short‐ and long‐term public health burden of these diseases. Because necroinflammation is the key mechanism in the progression of CLDs, it should be detected early. Thus, large‐scale screening for CLDs is needed. ALT levels are an easy and inexpensive marker of liver necroinflammation and could be the first‐line tool in this process.