bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Healing Touch on Critical Care Patients' Vital Signs
Authors: Davis Theresa M. , Friesen Mary Ann , Lindgren Vicki , Golino Amanda , Jackson Robin , Mangione Lucrezia , Swengros Diane , Anderson Joel G.
Published: May 2020

To determine the impact of Healing Touch on vital signs, adult intensive care unit patients were recruited from multiple hospital sites. Both pain and agitation improved and there was a significant change in hemodynamics that reflected a calming effect. Healing Touch may be considered a respected addition to symptom management.
Psychiatric Assessment of Social Impairment Across the Lifespan
Authors: Thom Robyn P. , Keary Christopher J. , Kramer Gabriel , Nowinski Lisa A. , McDougle Christopher J.
Published: May 2020

Although autism spectrum disorder (ASD) is the prototypical psychiatric disorder of social impairment, several if not most psychiatric disorders are characterized by prominent impairments in social functioning. A challenge in clinically assessing and describing social impairment is that it has been variably defined and can be difficult to measure. In this article we consider the psychiatric differential diagnosis of social impairment within the DSM-5 framework. We describe the features of social impairment in 13 DSM-5 disorders from a developmental perspective and highlight diagnostic factors that differentiate among the disorders, including the main features of social impairment, verbal communication, nonverbal communication, course of social impairment, social cognition, and key features of accompanying neuropsychiatric symptoms. We conclude by describing an approach for assessing social impairment across the lifespan.
“Delamination Plus”: A Technique to Reduce Immediate Postoperative Diabetic Cavity Hemorrhage
Authors: Tan Shi Zhuan , Dell' aversana Orabona Giancarlo , Robins Julian J. , Kumaran Neruban , Wong Roger
Published: May 2020

Purpose:

To investigate the effectiveness of an intraoperative surgical technique to reduce the incidence of immediate postoperative cavity hemorrhage in patients undergoing vitrectomy for complications of proliferative diabetic retinopathy.

Methods:

A single-center, prospective study of 20 consecutive patients who underwent vitrectomy for proliferative diabetic retinopathy–related complications. A standard 3-port pars plana vitrectomy with either 23 g or 25 g was performed. At the end of surgery, the infusion was switched off to create transient hypotony and endolaser photocoagulation with long-duration burns were applied to actively leaking blood vessel.

Results:

The average age was 56.2 + 12.8 years. Eleven eyes had actively bleeding vessels at the end of surgery and received endolaser photocoagulation. No patients were found to have hypotony at Day 1 postoperative. Preoperative median visual acuity was 20/1,600 improving to 20/40 at a median of 2.3 weeks post-op (range 0.4–8.5 weeks). Two eyes (10%) had a small postoperative cavity hemorrhage with 20/40 vision, which did not require further intervention.

Conclusion:

The described technique was found to be effective in reducing the incidence of postoperative cavity hemorrhage from up to 75% reported in literature to 10% in our pilot study. Further study with a larger number of patients is required.
Mycobacterium abscessus Soft Tissue Infection
Authors: Berkhout Angela , Curtis Nigel , Gwee Amanda , Harris Chris , Burgner David
Published: May 2020

We report the first case of Mycobacterium abscessus soft tissue infection following a firearm injury. We summarize previous published cases of M. abscessus soft tissue infection and review the current evidence on management.
Epidemiology of Adenovirus Infections and Outcomes of Cidofovir Treatment in Severely Ill Children
Authors: Siew Jia Xuan , Seah Xue Fen Valerie , Chew Yi Rong , Thoon Koh Cheng , Chong Chia Yin , Yung Chee Fu , Maiwald Matthias , Len Ye , Li Jiahui , Kam Kai Qian , Nadua Karen , Tanugroho Raymond , Tan Natalie Woon Hui
Published: May 2020

Background:

An increase in human adenovirus (HAdV) infections among hospitalized children in Singapore was observed since 2013. Young age (<2 years) and significant comorbidities have been associated with severe HAdV infections which can result in significant morbidity and mortality. Cidofovir (CDV) has been used to treat severe HAdV infections despite limited data and efficacy.

Methods:

This is a retrospective, observational review of infants and children 1 month to 17 years of age with laboratory-confirmed severe HAdV infection, admitted to a pediatric tertiary care hospital in Singapore between January 2013 and September 2017. Severe infection was defined as requiring intensive care unit or high dependency care at any point during hospital admission. Clinical characteristics, potential risk factors for mortality, as well as the outcome of cases treated with CDV were examined.

Results:

A total of 1167 children were admitted for HAdV infection, of which 85 (7.3%) were severe. For severe infections, the median age was 1.5 years (interquartile range: 0.72–3.2 years). The majority had comorbidities (69.4%) and presented with pneumonia (32.9%). Genotypes HAdV-7 (29.4%) and HAdV-3 (27.0%) were the most common HAdV genotypes identified. Thirteen (15.3%) patients died. Patients who died had a higher proportion of existing neurologic comorbidity (46.2% vs. 13.9%; P = 0.014) and presentation with pneumonia (69.2% vs. 26.4%; P = 0.008) compared with survivors. Patients who presented with pneumonia had a higher risk of 30-day mortality (odds ratio 4.3, 95% confidence interval: 1.0–28.6; P < 0.05). CDV was administered to 17 (20%) children for mainly viremia (47.1%) and/or pneumonia (41.2%). Mortality rate was 41.2% for severe HAdV cases treated with CDV. A significant proportion of patients who died when compared with recovered patients presented with pneumonia (6 of 7, 85.7% vs 1 of 10, 10%; P = 0.004). All 8 patients who had viremia received CDV and survived.

Conclusions:

Mortality can be high in pediatric patients with severe HAdV infections. HAdV-7 and HAdV-3 were the most common genotypes identified in our cohort with severe HAdV infection. Pneumonia is a potential risk factor for mortality in severe HAdV infections in our cohort. Early CDV administration may be considered in patients with severe HAdV infection and existing comorbidities but more studies are required.
Changes in Measles Seroprevalence in China After the Launch of Two Provincial Supplementary Immunization Activities During 2009 to 2013
Authors: Chong Ka Chun , Rui Yan , Mohammad Kirran N. , Liu Yan , Zhou Tianyuan , Wang Maggie Haitian , Jia Katherine Min , He Hanqing
Published: May 2020

Background:

Supplementary immunization activities (SIAs) have been demonstrated being effective in reducing measles incidence within a short period of time in China, but the effects are short-lived if there is no follow-up SIA with high routine immunization coverage.

Objectives:

To assess the change in measles seroprevalence from 2009 to 2013 after the launch of 2 large-scale SIAs within the period.

Methods:

Three population-based cross-sectional serologic surveys of measles antibodies were conducted in 2009, 2011 and 2013 in Zhejiang, a province in eastern China, with serologic samples collected from 1541, 896 and 1474 subjects, respectively. The serum levels of immunoglobulin G antibodies were measured by enzyme-linked immunosorbent assay.

Results:

We found that the seropositivity rate among infants 0–7 months of age, a group having no vaccination benefit, was below 80% throughout the study period. In addition, the seropositivity rate among adults 30–49 years of age decreased significantly from 96.0% (95% confidence interval: 93.7%–98.3%) in 2011 to 88.5% (95% confidence interval: 84.3%–92.8%) in 2013.

Conclusion:

We showed that large-scale SIAs were effective, but their effects were not long lasting. Given the drop in seropositivity among adults, their susceptibility should be carefully monitored. While older individuals could benefit from the immunization activities, children who were too young to be vaccinated still have a weak seropositivity profile and the optimal age for the administration of the first dose of vaccine should be reconsidered.
First Case of Coronavirus Disease 2019 in Childhood Leukemia in China
Authors: Zhao Yang , Zhao Weihong , Wang Aibin , Qian Fang , Wang Sa , Zhuang Liwei , Zhang Fujie , Sun Delin , Gao Guiju
Published: May 2020

We report the first case of coronavirus disease 2019 (COVID-19) comorbid with leukemia in a patient hospitalized in Beijing, China. The patient showed a prolonged manifestation of symptoms and a protracted diagnosis period of COVID-19. It is necessary to extend isolation time, increase the number of nucleic acid detections and conduct early symptomatic treatment for children with both COVID-19 and additional health problems.
The Influence of the Scheduling Horizon on New Patient Arrivals
Authors: Woodcock Elizabeth , Nokes Donny , Bolton Haley , Bartholomew Daniel , Johnson Elizabeth , Shakarchi Ahmed F.
Published: May 2020

The goal of scheduling within an ambulatory enterprise is to appropriately accommodate patients; extending capacity to fulfill this aim in a large health care organization requires the management of a complex scheduling process. Understanding and handling the appointment lead time, referred to as the scheduling horizon, can positively influence capacity management. The analysis demonstrated an increased chance of nonarrived appointments of 16% for a specialty practice and 11% for a primary care practice for every 30-day delay in the scheduling horizon. By incorporating the management of the scheduling horizon, health care organizations can optimize the capacity of their ambulatory clinics.
Tuberculosis Verrucosa Cutis on the Buttocks: A Case Report
Authors: Xiao Yu , Peng Shan-Shan , Zhang Lyu-Ya , Lin Jie , Hu You-Hong , Fang Mu-Ping
Published: May 2020

Introduction:

Tuberculosis verrucosa cutis is a rare form of cutaneous tuberculosis and occurs commonly on the lower extremeties (hand, thighs and buttock). It is often missed as other cutaneous verrucosa dieases and the pathogens of cutaneous tuberculosis is difficult to find.

We showed an unusual case of tuberculosis verrucosa cutis on both buttocks.

Case presentation:

A 54 Chinese male presented with 9-year history of asymptomatic verrucous lesions on bilateral buttocks. Lesions presented a well-defined plaque, verrucous lesion and yellow pus discharge on buttocks. The skin biopsy showed pseudoepitheliomatous hyperplasia of the epidermis and dermal granulomatous inflammation composed of epithelioid histiocytes and mixed inflammatory cells. The tuberculin test and the polymerase chain reaction for Mycobacterium tuberculosis were negative, but T-spot test were positive. the treatment of antituberculosis showed favourable effect. Finally, the diagnosis of tuberculosis verrucosa cuti was made.

Discussion:

Tuberculosis verrucosa cutis is easily confused with other verrucous diseases, such as verrucous porokeratosis, discoid lupus erythematosus hypertrophicus lichen planus, chromoblastomycosis. Diagnostic therapy is usually recommended for most of these diagnoses.

Conclusion:

A diagnosis of tuberculosis verrucosa cutis should be taken correctly based on the combination of clinical manifestions, histopathological characteristics, laboratory findings and diagnostic therapy. It is vital for dermatologists to be aware of verrucous lesions since a delay in diagnosis can lead to aggravate the disease, abuse of glucocorticoids.
Lifestyle Changes and Weight Gain
Authors: Suka Machi , Yamauchi Takashi , Yanagisawa Hiroyuki
Published: May 2020

Objective:

To examine age-dependent trends in weight and lifestyle changes in Japanese workers.

Methods:

Using annual health examination data, 60,143 eligible Japanese workers aged 20 to 59 years were examined for their 2-year changes in weight and smoking, eating, exercise, drinking, and sleep habits.

Results:

Young male workers aged 20 to 24 years showed the greatest weight gain and the highest incidence of unhealthy lifestyle habits. Multivariate analyses indicated that quitting “exercise less than two times/week,” “walking less than 60 min/d,” and “smoking everyday” contributed to weight gain to a considerable extent except in young female workers aged 20 to 24 years.

Conclusions:

Greater weight gain associated with unhealthy lifestyle changes tended to occur in early rather than middle-to-old adulthood. It is important to deliver health promotion programs targeting young male workers.
Self-Rated Health Trajectory Changes According to Employment Transition
Authors: Kang Young Joong , Kim Taeshik , Lee Dong-wook , Kang Mo-Yeol
Published: May 2020

Objective:

To investigate the impact of employment transitions on self-rated health (SRH) trajectories.

Methods:

We used data from the Korean Labor and Income Panel Study 2003 to 2016. Employment transitions were measured using four categories: continuously non-working, continuously working, labor force exit, and labor force entry. For examination of the time trends in the likelihood of poor SRH, we calculated the annual odds ratios with those from 2003 as the reference, using generalized estimating equations.

Results:

The time trends in the likelihood of poor SRH showed a significant increasing trend in the labor force exit group, while continuously working group and labor force entry group showed significantly decreasing patterns.

Conclusions:

Labor force exit was associated with a substantial increase in prevalence of poor SRH, while labor force entry was associated with a decrease in prevalence of that.
Allergy and Lung Injury Among Rescue Workers Exposed to the World Trade Center Disaster Assessed 17 Years After Exposure to Ground Zero
Authors: Caruana Dennis L. , Huang Po Hsuan , Li Jonathan C. , Cheslack-Postava Keely , Szema Anthony M.
Published: May 2020

Objective:

Investigate the following in rescue and cleanup workers exposed to the World Trade Center (WTC) disaster 17 years post-fallout: (1) allergic hypersensitivity; (2) spirometry; (3) impulse oscillometry; and (4) the reversibility of airway hyperresponsiveness and distal airways narrowing pre- and post-bronchodilator.

Methods:

In subjects (n = 54) referred to our clinic from the WTC Health Program for management of allergy-immunology services, environmental allergy testing, impulse oscillometry (IOS), and spirometry results were retrospectively reviewed to determine the long-term impact of exposure to the WTC fallout.

Results:

Rescue and cleanup workers exposed to the WTC fallout had a high incidence of allergic hypersensitivity and had evidence of permanent small airways dysfunction characterized by distal airways narrowing and airway hyperresponsiveness.

Conclusion:

Following exposure to the WTC disaster, the patients in our cohort developed allergic hypersensitivity and severe lung injury with only partial reversibility.
Increased Neutrophil Granulocyte and Myeloperoxidase Levels Indicate Acute Inflammation Due to the Exposure of Zinc- and Copper-Containing Welding Fumes
Authors: Reisgen Mara , Thomas Katharina , Beilmann Viktor , Markert Agnieszka , Gerhards Benjamin , Krichel Thomas , Schmidt Kathrin , Kraus Thomas , Martin Christian , Brand Peter , Krabbe Julia
Published: May 2020

Objective:

Recent studies have shown an increase of C-reactive-protein (CRP) after exposure to zinc- and copper-containing welding fumes. The objective of this study was to determine the effects of exposure to zinc- and copper-containing welding fumes on leukocytes, their subtypes, and myeloperoxidase (MPO).

Methods:

Serum samples of male volunteers were examined after exposures to welding fumes in two settings: repeated exposure on 4 consecutive days for 6 hours and single exposures for different times (3, 4, 5 hours).

Results:

Neutrophil granulocyte and MPO levels showed increases 24 hours after single and repeated exposures for 6 hours similar to CRP increases reported in literature. Overall leukocyte levels and levels of monocytes and lymphocytes were not significantly affected.

Conclusions:

This study indicates the involvement of neutrophil granulocytes in welding fume fever additional to mediator related effects.
Less Invasive Left Ventricular Assist Device Implantation Is Safe and Reduces Intraoperative Blood Product Use: A Propensity Score Analysis VAD Implantation Techniques and Blood Product Use
Authors: Riebandt Julia , Schlöglhofer Thomas , Moayedifar Roxana , Wiedemann Dominik , Wittmann Franziska , Angleitner Philipp , Dimitrov Kamen , Tschernko Edda , Laufer Günther , Zimpfer Daniel
Published: May 2020

Despite increasing popularity and multiple postulated benefits, less invasive (LIS) left ventricular assist device (LVAD) implantation has not been sufficiently compared with standard full sternotomy (FS). We report the outcomes of a propensity score analysis designed to compare LIS and FS LVAD implantation, with perioperative blood product use, adverse event rates, and mortality as primary objective. From September 2010 to August 2016, 159 consecutive patients received a Medtronic HVAD or Abbott HeartMate 3 LVAD via a FS or LIS approach. Outcomes were analyzed using proportional hazard Cox regression, with risk adjustment based on a LIS approach propensity score model computed from demographics, risk factors, and operative covariates. Seventy-five patients were matched and compared (HVAD 83% [n = 62]; LIS approach 43% [n = 32]; mean age 60 ± 12 years; 89% [n = 67] male; 48% [n = 36] ischemic cardiomyopathy [ICMP]; 37% [n = 28]). Patient groups were comparable with regard to preoperative patient characteristics. Less invasive LVAD implantation was successful in all patients with no intraoperative conversions. In-hospital mortality was 16% in both groups, despite 37% Interagency Registry for Mechanically Assisted Circulatory Support Level I patients. Overall, 28% of the LIS patients did not receive any blood products intraoperatively, whereas, in the FS group, only two patients (5%) did not require the administration of blood products (p = 0.000). This was also a significant finding in the overall perioperative phase in which seven LIS patients (22%) who not receive any blood products versus two FS patients (5%; p = 0.033). Otherwise, outcomes were comparable. Less invasive LVAD implantation is a feasible, safe, and reduces blood product use.
A Novel Negative Pressure-Flow Waveform to Ventilate Lungs for Normothermic Ex Vivo Lung Perfusion
Authors: Bobba Christopher M. , Nelson Kevin , Dumond Curtis , Eren Emre , Black Sylvester M. , Englert Joshua A. , Ghadiali Samir N. , Whitson Bryan A.
Published: May 2020

Ex vivo lung perfusion (EVLP) is increasingly used to treat and assess lungs before transplant. Minimizing ventilator induced lung injury (VILI) during EVLP is an important clinical need, and negative pressure ventilation (NPV) may reduce VILI compared with conventional positive pressure ventilation (PPV). However, it is not clear if NPV is intrinsically lung protective or if differences in respiratory pressure-flow waveforms are responsible for reduced VILI during NPV. In this study, we quantified lung injury using novel pressure-flow waveforms during normothermic EVLP. Rat lungs were ventilated-perfused ex vivo for 2 hours using tidal volume, positive end-expiratory pressure (PEEP), and respiratory rate matched PPV or NPV protocols. Airway pressures and flow rates were measured in real time and lungs were assessed for changes in compliance, pulmonary vascular resistance, oxygenation, edema, and cytokine secretion. Negative pressure ventilation lungs demonstrated reduced proinflammatory cytokine secretion, reduced weight gain, and reduced pulmonary vascular resistance (p < 0.05). Compliance was higher in NPV lungs (p < 0.05), and there was no difference in oxygenation between the two groups. Respiratory pressure-flow waveforms during NPV and PPV were significantly different (p < 0.05), especially during the inspiratory phase, where the NPV group exhibited rapid time-dependent changes in pressure and airflow whereas the PPV group exhibited slower changes in airflow/pressures. Lungs ventilated with PPV also had a greater transpulmonary pressure (p < 0.05). Greater improvement in lung function during NPV EVLP may be caused by favorable airflow patterns and/or pressure dynamics, which may better mimic human respiratory patterns.
18F-choline PET/computed tomography and clinical parameters in the detection of significant prostate cancer in patients with increased prostate-specific antigen levels and previous negative biopsies
Authors: Jiménez Londoño Germán Andrés , García Vicente Ana Maria , Noriega Álvarez Edel , Pena Pardo Francisco José , Amo-Salas Mariano , López Guerrero Mauricio Andres , Fúnez Mayorga Federico , Soriano Castrejón Ángel Maria
Published: May 2020

Objectives

The aim of this study is to assess the value of the 18F-choline PET/computed tomography (CT) in predicting significant prostate cancer (sPCa) in patients with persistently increased prostate-specific antigen (PSA) levels and previous negative biopsies. To study the possible predictive added value of 18F-choline PET/CT to clinical variables and biomarkers derived from PSA in detecting sPCa.

Methods

We evaluated patients who underwent 18F-choline PET/CT because of ongoing suspicion of prostate cancer (PCa) due to elevated PSA levels (4–20 ng/mL) and at least one previous negative or no conclusive prostate biopsy for PCa. Age, PSA, free PSA, free/total PSA ratio, PSA velocity, PSA doubling time, PSA density and score risk were obtained. 18F-choline PET/CT was classified as negative/positive (PET-categorical). Additionally, we subclassified 18F-choline PET/CT according to the radiotracer uptake patterns (PET-pattern). The reference standard was the histological confirmation. Accuracy of PET/CT was evaluated. Univariate and multivariate logistic regression analyses were performed for metabolic and clinical variables.

Results

A total of 78 patients were included in our study, 23 had PCa (15 with sPCa). The PET pattern showed the highest accuracy and was the most powerful predictor of sPCa. In this research, the prediction of sPCa was improved combining PET pattern and score risk.

Conclusion

18F-choline PET/CT is a potential tool for predicting sPCa in patients with persistently increased PSA levels and previous negative biopsies, and also it could improve the performance of score risk in predicting sPCa.
Detectability of small objects in PET/computed tomography phantom images with Bayesian penalised likelihood reconstruction
Authors: Macnab Margo-Rose F. , Biggans Thomas J. , Mckiddie Fergus I. , Pether Mark I. , Straiton Jack B. , Staff Roger T.
Published: May 2020

Objectives

This study investigated the subcentimetre lesion detection gains of a Bayesian penalised likelihood reconstruction (BPLR) (Q.Clear, GE Healthcare, Milwaukee, USA) in PET/computed tomography (CT) phantom images and compares observer performance with ordered subset expectation maximisation (OSEM) reconstruction images (VUE Point HD, GE Healthcare).

Methods

Images were presented to three blinded experienced observers to identify lesions and assign confidence ratings. Responses were analysed using jackknife alternative free receiver operator characteristic (JAFROC) software. Phantom lesions (active and nonactive) were constructed using putty. Seventy nonactive and 93 (18F) active lesions, with diameters of 3, 5 or 7 mm were suspended in active backgrounds at varying contrast ratios (2:1–32:1) within an National Electrical Manufacturers Association 2012 phantom. PET/CT images were acquired with a GE Discovery 710 and reconstructed using both BPLR (penalisation coefficient 400) and high-definition attenuation corrected (HDAC) OSEM (2 iterations, 24 subsets).

Results

Small but significant (P = 0.009) visual detection gains were seen for active lesions with BPLR [weighted JAFROC figure of merit (wJAFROC FOM) = 0.77] over OSEM (FOM = 0.74). When split by subset, these improvements were significant for 5 mm and lesion to background ratio of 8:1. No significant (P = 0.514) differences were seen for the identification of nonactive lesions of any size (BPLR FOM = 0.74 and OSEM FOM = 0.73).

Conclusions

Significant detection gains were demonstrated for small active lesions with BPLR over OSEM. Coupled with the significant increase in contrast-to-noise ratio, these results support the use of BPLR in the imaging of small active (≤7 mm) lesions but show no improvement with BPLR in the identification of true negative lesions.
Comparison of Lutetium-177 tin colloid and Rhenium-188 tin colloid radiosynovectomy in chronic knee arthritis
Authors: Shamim Shamim Ahmed , Arora Geetanjali , Jha Pragati , Gupta Priyanka , Behera Abhishek , Mukherjee Anirban , Prabhu Meghna , Ansari Mohammad Tahir , Vyas Surabhi , Bal Chandrasekhar
Published: May 2020

Objective

To assess the role of Lutetium-177(Lu-177) tin colloid for radiosynovectomy and compare it with Rhenium-188 (Re-188) tin colloid radiosynovectomy for alleviation of pain in patients with chronic inflammatory arthritis of knee.

Methods

Patients of chronic inflammatory arthritis of the knee underwent pretherapeutic evaluation in a form of knee ultrasonogram, bone scan and clinical evaluation. Fifty-seven recruited patients were allocated at random to receive either intraarticular injections of Lu-177 tin colloid or Re-188 tin colloid. Eventually, 27 patients received Re-188 tin colloid and 30 patients received Lu-177 tin colloid. The joint was then immobilized for 2 days. Response evaluation was done using knee ultrasound, bone scan and clinical findings.

Result

Of 30, 20 patients responded to radiosynovectomy in the Lu-177 tin colloid group compared to 21/27 patients in the Re-188 tin colloid group.

Conclusion

Lu-177 tin colloid is an effective alternative to Re-188 tin colloid for radiosynovectomy in patients with chronic inflammatory knee arthritis.
Fecal Amino Acid Profiles Exceed Accuracy of Serum Amino Acids in Diagnosing Pediatric Inflammatory Bowel Disease
Authors: Bosch Sofie , El Manouni el Hassani Sofia , Brizzio Brentar Marina , Ayada Ibrahim , Bakkali Abdellatif , Jansen Erwin E.W. , Struys Eduard A. , Benninga Marc A. , de Boer Nanne K.H. , de Meij Tim G.J.
Published: May 2020

In this prospective intention‐to‐diagnose pilot study, we aimed to assess accuracy of serum and fecal amino‐acids to discriminate de novo pediatric inflammatory bowel disease (IBD) and non‐IBD children. Patients with suspected IBD were allocated the IBD (n = 11) or non‐IBD group (n = 8) following laboratory testing or endoscopy according to the revised Porto‐criteria. Fecal calprotectin levels were obtained, an additional blood and fecal sample were collected. Fecal and serum amino‐acid profiles were analyzed using high performance‐liquid chromatography. Nine fecal amino‐acids (alanine [area under the curve 0.94], citrulline [0.94], glutamine [0.89], leucine [0.98], lysine [0.89], phenylalanine [0.99], serine [0.91], tyrosine [0.96], and valine [0.95]) differed significantly between IBD and non‐IBD. In serum, no significant differences were observed. This study underlines the potential of fecal amino‐acids as novel, adjuvant noninvasive, and low‐cost biomarkers in the diagnostic work‐up of pediatric IBD detection.
Pediatric Febrile Neutropenia: Change in Etiology of Bacteremia, Empiric Choice of Therapy and Clinical Outcomes
Authors: Alali Muayad , David Michael Z. , Danziger-Isakov Lara A. , Elmuti Lena , Bhagat Palak H. , Bartlett Allison H.
Published: May 2020

Background:

The optimal choice of initial antibiotic therapy for patients with high-risk febrile neutropenia (FN) in children is unclear and varies by the institution on the basis of local antibiograms and epidemiology of specific pathogens. The authors evaluated the appropriateness of antibiotics for the empiric treatment of FN in pediatric patients with cancer in our institution on the basis of changes in the epidemiology of organisms isolated from blood cultures (BCx).

Methods:

The authors conducted a retrospective medical record review of pediatric patients who received any oncology care (including patients with cancer and patients who had stem cell transplant) at University of Chicago Medicine Comer Children’s Hospitals (March 2009 to December 2016) with a diagnosis of FN who had at least 1 BCx obtained. They reviewed pathogens isolated from BCx and determined whether they were pathogens or contaminants using the Infectious Diseases Society of America (IDSA) guidelines and the team’s decision to treat. They investigated the microbiologic spectrum and susceptibility patterns of pathogens causing bacteremia in pediatric FN and whether the empiric therapy chosen may have affected clinical outcomes.

Results:

A total of 667 FN episodes were identified in 268 patients. BCx were negative in 497 (74.5%) and were determined to be contaminants in 27 (4%). In 143 episodes (21.5%), the BCx were positive for a pathogenic species. Polymicrobial bacteremia was identified in 25 episodes; a total of 176 pathogens were isolated. The majority of pathogens (95/176, 54%) were Gram-positive (GP), whereas 64 of 162 (36%) were Gram-negative (GN), 5 were fungal, and 4 were mycobacterial. The most common GP pathogens were viridans group streptococci (VGS) (n=34, 19.3%), coagulase-negative staphylococci (n=25, 14%), and methicillin-susceptible Staphylococcus aureus (n=12, 6.8%). Of aerobic GN bacilli, 15 (8.5%) were AmpC producers and 3 (1.7%) carried extended-spectrum beta-lactamases. There was no increase in the prevalence of multidrug-resistant GN isolates during the study period. Patients with VGS and multidrug-resistant GN bacteremia were more likely to be admitted to the pediatric intensive care unit [odds ratio (OR), 3.24; P=0.017; and OR, 2.8; P=0.07, respectively]. There were trends toward a higher prevalence of GP pathogens causing bacteremia and the emergence of VGS with decreased penicillin sensitivity. The prevalence of bacteremia with VGS was higher in acute myelogenous leukemia and neuroblastoma (OR, 2.3; P<0.01) than in patients with other solid tumors.

Conclusions:

Empiric antibiotic treatment should be tailored to patients’ risk for VGS and multidrug-resistant organisms. Individual hospitals should monitor the pathogens causing FN among patients with cancer to guide choice of empiric therapy.
Hypercalcemia and Disseminated Osteolytic Lesions With Normal Blood Counts and Absence of Circulating Blasts: A Rare Presentation of Childhood B-Lymphoblastic Leukemia
Authors: Khayyam Naema , Mansoor Neelum , Maqsood Sidra , Jabbar Naeem
Published: May 2020

Hypercalcemia and disseminated osteolytic bone lesions are a rare presentation of pediatric acute lymphoblastic leukemia (ALL). The authors report a 3-year-old boy who presented with hypercalcemia and diffuse osteolytic lesions involving axial and appendicular bones. He had normal complete blood count and the absence of blasts in peripheral smear; however, bone marrow aspirate and trephine were consistent with B-cell ALL. A review of the literature highlights the variable clinical outcome of this rare presentation depending on the presence of hypercalcemia and osteolytic lesions with or without chromosomal translocation t(17;19) and coagulation abnormalities. The patient had no coagulopathy and normal karyotype, and showed excellent response to initial treatment in terms of complete remission and negative minimal residual disease after standard-risk induction chemotherapy. Hypercalcemia with diffuse osteolytic lesions warrants bone marrow examination to rule out leukemia even in the absence of any abnormality in complete blood count. The case was reported for awareness of this rare presentation of ALL so that delays can be avoided for this potentially curable but life-threatening disease.
The Patient Safety Culture Scale for Chinese Primary Health Care Institutions: Development, Validity and Reliability
Authors: Cheng Siyu , Hu Yinhuan , Pfaff Holger , Lu Chuntao , Fu Qiang , Wang Liuming , Li Dehe , Xia Shixiao
Published: May 2020

Background

Existing patient safety culture assessment tools are mostly developed in western countries and may not be suitable for Chinese primary health care institutions. Primary care plays an important role in China’s medical system, and a targeted tool for its patient safety culture is urgently needed.

Objective

The aim of the study was to develop a dependable instrument to assess the patient safety culture in Chinese primary health care institutions.

Methods

Three phases were undertaken to develop the scale. The first phase developed a pilot scale by literature review, focus groups, and 2-round Delphi expert consultation. The second phase conducted a pilot survey. The third phase carried out a formal survey to test reliability and validity, involving 369 participants from 9 primary health care institutions.

Results

The final scale included 32 items under 7 dimensions. For reliability, the Cronbach α coefficients among dimensions varied from 0.754 to 0.926, and the Cronbach α for the scale was 0.940. For content validity, the corrected item-level content validity varied between 0.64 and 1, the scale-level content validity index/universal agreement was 0.625, and the scale-level content validity index/average was 0.93. For construct validity, the Spearman correlations of dimension-total score varied between 0.129 and 0.851, all Spearman correlations of the dimension-total score were greater than that of interdimensions and the Spearman correlations of item-total score ranged from 0.042 to 0.775. The results of the confirmatory factor analysis indicated that the model fitted well.

Conclusions

The Patient Safety Culture Scale for Chinese primary health care institutions demonstrated good reliability and acceptable validity; thus, it can be used as an assessment instrument for patient safety culture in Chinese primary health care institutions.
FDG PET/CT in Anaplastic Lymphoma Kinase–Positive Anaplastic Large Cell Lymphoma
Authors: Angamuthu Meivel , Kaur Kanwaljeet , Tripathi Madhavi , Meena Jagdish Prasad , Seth Rachna , Kumar Rakesh
Published: May 2020

Anaplastic large cell lymphoma (ALCL) is a rare non-Hodgkin’s lymphoma, with rearrangements of the anaplastic lymphoma kinase gene in 60%–85% of systemic cases. We report an 11-year-old boy with ALCL in whom serial FDG PET/CT revealed partial response and complete metabolic response at interim and end of treatment, respectively. However, the patient relapsed within 2 weeks, confirmed by cytology. Because of the inherent aggressive nature of ALCL, possibility of an early relapse should always be kept in mind.
Emerging Attack and Management Strategies for Nuclear Medicine in Responding to COVID-19—ACNM Member Experience and Advice
Authors: Lu Yang , Zhu Xiaohua , Yan Sean Xuexian , Lan Xiaoli
Published: May 2020

As the World Health Organization declared COVID-19 as “global pandemic,” it is important for everyone, including nuclear medicine personnel, to know how to stop transmission, contain, and prevent the spread of COVID-19. We reach out to our ACNM (American College of Nuclear Medicine) international members from Wuhan, China and Singapore, who have participated in dealing with COVID-19 for the last 2 months, to learn from their lessons and experiences, so to provide advice to all ACNM members for their clinical practice and management strategies in responding to COVID-19.
Focal 18F-NaF PET Prostate Activity in the Setting of Prostate Adenocarcinoma
Authors: Chiang Jason , Gershenson Jonathan P. , Lewis Michael S. , Vahidi Kiarash , Berenji Gholam R.
Published: May 2020

A 72-year-old man with a family history of prostate cancer and initial diagnosis of favorable intermediate risk prostate cancer via biopsy in 2017 elected for active surveillance. Two years later, he underwent prostate biopsy showing intermediate-risk cT1c Nx Mx lesion with Gleason score 3 + 4 = 7 (5 core positive). Transrectal ultrasound showed a prostate volume 28 mL, and the prostate-specific antigen was 8.1. Patient elected to proceed with combination radiation therapy and androgen deprivation therapy.
Using the Preparedness Assessment for the Transition Home After Stroke Instrument to Identify Stroke Caregiver Concerns Predischarge: Uncertainty, Anticipation, and Cues to Action
Authors: Camicia Michelle , Lutz Barbara J. , Harvath Theresa A. , Joseph Jill G.
Published: May 2020

Purpose

The aim of the study was to better understand caregivers’ concerns about long-term implications of stroke and the caregiving role after completing the Preparedness Assessment for the Transition Home After Stroke (PATH-s).

Design/Methods

In this qualitative study, cognitive interviews were conducted with 20 stroke caregivers who completed the PATH-s tool as part of an instrument validation study. Data were analyzed for salient themes related to their perceptions about stroke and the caregiving role.

Findings

Interviews yielded robust narrative data describing how the PATH-s items aided caregivers in recognizing potential issues and concerns about stroke and the caregiving role. Caregivers experienced uncertainty about the long-term stroke prognosis, which provoked anticipation and cues to action to begin addressing their concerns.

Conclusions/Clinical Relevance

Completing the PATH-s helped caregivers identify concerns regarding the long-term implications of stroke and their caregiving role. It may serve as an important assessment tool to assist rehabilitation nurses to better understand and address caregiver needs predischarge.
Clinical Value of Serum LHPP-associated miR-765 in the Prognosis of Laparoscopic or Open Hepatectomy for Hepatocellular Carcinoma
Authors: Yan Jingting , He Liyan , Li Guang , Peng Xiuda , Li Wei , Liu Xianrong , Yang Dunxue , Liu Jin , Zhang Peng , Lu Xianzhou
Published: May 2020

Purpose:

The current study aims to investigate the effect of tumor suppressor LHPP-associated microRNA (miR)-765 on the prognosis of laparoscopic hepatectomy (LH) or open hepatectomy (OH) for hepatocellular carcinoma (HCC).

Materials and Methods:

A total of 160 patients with HCC were enrolled and randomly divided into the LH or OH group. According to the operation time, these patients were followed up for 12 months, and the number of deaths and the corresponding death time during the follow-up period were counted.

Results:

The authors found that the LHPP gene levels in HCC tissues were lower than that in adjacent normal tissues, whereas miR-765 was overexpressed in HCC tissue. Overexpression of miR-765 promoted the epithelial-mesenchymal transition and proliferation and inhibited apoptosis of HCC through directly downregulating LHPP expression. Serum miR-765 expression level was significantly associated with lymph node metastasis and histologic grading. Survival analysis showed that the overall survival rate in 12 months after the operation was significantly lower in the OH-high miR-765 group (P<0.05).

Conclusion:

For patients with a low miR-765 level, both LH and OH are available, otherwise, LH is more recommended.
Effects of gradual cooling treatment on the skin blackening and
physicochemical characteristics of ‘Chuhwang’ pear
fruit
Authors: Choi Mi-Hee , Choi Hyun Jin , Hong Seong Sig , Lim Byung-Seon
Published: May 2020

‘Chuhwang’ pear fruit was harvested at 187 days after full bloom
and stored at 0°C for 70 d after gradual cooling (GC) treatment for 20 d.
Direct cooling (DC) treatment was used as a control, and this involved direct
storage at 0°C after harvest. Following GC treatment, a weight loss of
4.62% was recorded. In addition. after 30 d of storage at 0°C, the
incidence of skin blackening was almost completed and incidence rate in GC
treatment significantly decreased to 13.9% compared to 72.2% in DC
treatment. Furthermore, in term of GC treatment, the total color differences
(ΔE), hardness, and sucrose contents were somewhat lower, but the
electrolyte leakage rate and respiration rate were slightly higher than those of
DC treatment. Moreover, the contents of hexose, ascorbic acid, and total
polyphenol and DPPH radical scavenger activity were slightly higher for the GC
treated samples. The activities of polyphenol oxidase and lipoxygenase and
thiobarbituric acid reactive substances were low following GC treatment, and no
significant differences in the antioxidant enzyme activities were observed
between treatment groups. Therefore, these results indicate that the GC
treatment prior to cold storage appears to inhibit skin blackening in
‘Chuhwang’ pear fruit by decreasing the chilling sensitivity.
Anti browning and antioxidant properties of Foeniculum
vulgare seed extracts
Authors: Lee Joo-Yeon , Kim Choon Young
Published: May 2020

Since the occurrence of enzymatic browning during manufacture reduces the quality
of the fresh-cut food products, the utilization of anti browning agents is
essential. The development of a natural food additive that inhibits browning
while also exhibiting health benefits is important to meet consumer demand for
fresh and healthy products. Although Fennel (Foeniculum vulgare
Miller) seed has various health beneficial effects, its application as an anti
browning agent in foods has yet to be examined. The purpose of this study was
therefore to investigate the potential of fennel seed as an anti browning
additive with antioxidant activity. Fennel seed ethanol extract (FSEE) inhibited
the activity of potato polyphenol oxidase (PPO) by 85.47% at a
concentration of 10 mg/mL and presented an IC50 value of
1.50±0.17 mg/mL. FSEE appeared to be a noncompetitive inhibitor against
potato PPO, as indicated by Lineweaver-Burk plot. In addition, the color
difference (ΔE) values of potato extracts treated with the 0 and 10 mg/mL
FSEE were 13.82±1.10 and 1.46±0.2, respectively, thereby
confirming the anti browning activity of FSEE. Furthermore, FSEE exhibited a
dose-dependent antioxidant activity as demonstrated by radical scavenging
activity and ferric reducing ability power assays. The total polyphenol and
total flavonoid contents at 2 mg/mL of FSEE were 1.52 mgGAE/mL and 2.05 mgCE/mL,
respectively. FSEE could therefore be considered a natural additive to inhibit
enzymatic browning while improving the nutritional value of the fresh-cut food
products.
Comparison of the radical scavenging and α-glucosidase
inhibitory activities of fingerroot extracts based on different extraction
methods
Authors: Jeong Gyeong Han , Jeong Yun Hee , Kim Tae Hoon
Published: May 2020

The roots of Boesenbergia rotunda are prominent ingredients in
the cuisine of several Asian countries, including Thailand, Malaysia, Indonesia,
India, and China. Recently, fingerroot (Boesenbergia rotunda)
was successfully cultivated in South Korea. In this study, the radical
scavenging and α-glucosidase inhibitory activities of Korean fingerroot
extracts obtained using different extraction methods (i.e., organic solvent and
hot water extractions) were investigated. More specifically, the antioxidant
activities were evaluated using the hydroxyl and 2,2’-azino-bis
(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS+) radical
scavenging assays, while the anti-diabetic effects of the various solvent
extracts of fingerroot were tested using the α-glucosidase inhibitory
assay. Among the tested samples the 80% methanolic (MeOH) extract showed
the most potent activities, with IC50 values of 82.3±2.3 and
75.0±2.4 μg/mL, respectively for the hydroxyl and
ABTS+ radical scavenging activities. Also, the 80%
MeOH extract exhibited the greatest α-glucosidase inhibitory effects,
with an IC50 value of 151.6±3.6 μg/mL. Finally, the
total phenolic content of 80% MeOH extract was found to be
106.0±1.7 mg equivalent of gallic acid per g of extract. These results
suggest that the 80% MeOH extract of fingerroot can be considered as a
new effective source of natural antioxidant and anti-diabetic materials.
Isolation of antioxidant components from Corni
fructus
Authors: Kim Su-Hui , Seong Gi-Un , Chung Shin-Kyo
Published: May 2020

A 90% ethanol extract of Corni fructus was fractioned and the active
components (i.e., morroniside, loganin) were isolated for functional food
materialization. More specifically, the ethanol extract was fractioned according
to the solvent polarity (i.e., n-hexane, ethyl acetate, and
n-butanol), and the ethyl acetate fraction was found to
exhibiti the highest antioxidant capacities (i.e., total phenolic content =
145.84 GAE mg/100 mL, DPPH radical scavenging activity = 7.91 mM GAE, FRAP
activity = 18.86 mM TE, ABTS radical scavenging activity = 13.36 mM TE). Diaion
HP 20 gel was used for separation of the ethyl acetate fraction, and 20%,
40%, 60%, and 80% ethanol fractions were also examined. The
40% ethanol fraction was found to exhibit the highest DPPH radical
scavenging activity (10.22 mM GAE), ABTS radical scavenging activity (37.29 mM
TE), and FRAP activity (27.32 mM TE) (p<0.05). The total phenolic
compound content (580.84 GAE mg/100 mL), total flavonoid content (166.24 CE
mg/100 mL), and total anthocyanin content (0.74 mg/100 mL) followed a similar
trend, again being the highest for this fraction. Two components (i.e.,
morriniside, loganin) were identified in the ethyl acetate and 40%
ethanol fractions, and their contents were determined by high-performance liquid
chromatography. Furthermore, the 40% ethanol fraction contained the
highest quantity of total active components (p<0.05), and the presence of
morroniside (405 [M-H]− and 451
[M+COOH-H]−) and loganin (389
[M-H]− and 435 [M+COOH-H]−) were
confirmed by ultra-performance liquid chromatography-mass spectrometry.
Quality characteristics of fermented vinegar containing different
concentration of an ethanol extract from ‘Seomaeyaksuk’
(Artemisia argyi H.)
Authors: Shin Jeong Yeon , Kang Min Jung , Kang Jae Ran , Choi Jin Sang , Seo Weon Teak , Shin Jung Hye
Published: May 2020

Optimization of the fermentation conditions for the preparation of
‘Seomaeyaksuk’ (Artemisia argyi H.) vinegar was
carried out and the results reported herein. The ‘Seomaeyaksuk’
sample was divided 3 groups, such as shade dry ‘Seomaeyaksuk’
extract added group was control (CO), 2.75 °Brix (SEE-0.5) and 5.5
°Brix (SEE-1.0) of the roasted ‘Seomaeyaksuk’ edible
ethanol extract addition group, respectively. Subsequently, 5%
Acetobacter pasteurianus A8 was to the total fermentation
volume, and samples were taken at 5 day intervals for 25 days to analyze their
quality factors. After 25 days fermentation, the pH of the CO group was 3.0,
while the corresponding values for the SEE-0.5 and SEE-1.0 groups were 3.14. The
total polyphenols contents tended to decrease during fermentation. More
specifically, after 25 days fermentation, the flavonoid content was
significantly higher in the SEE-1.0 group, while the jaceosidin content had
decreased by 50% and 43% in the SEE-0.5 and SEE-1.0 group,
respectively. A total of seven organic acids were detected, with their contents
decreasing in the order acetic acid > succinic acid > citric acid
> propionic acid. Among the various aroma components present in the
vinegar, the acetic acid content was the highest, followed by
92.6,15-octadecatrienoic acid and hexadecanoic acid. Moreover, the ABTS and DPPH
radical scavenging activities of all experimental groups tended to decrease
during the fermentation period, likely due to reduced levels of the polyphenol
compounds.