bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mothers' Depressive Symptoms and Child Externalizing Problems: Aversion Sensitivity as an Underlying Mechanism
Authors: Moed Anat 
Published: July 2020

BackgroundThe mechanisms responsible for why depressed parenting undermines child development are poorly understood. One proposal is that depressive symptoms increase mothers' aversion sensitivity, thereby increasing the frequency of mothers' negative emotional arousal.ObjectiveThis study examined aversion sensitivity as a marker of maladaptive emotional processes occurring in depressed mothers to explain why mothers' depressive symptoms so consistently disrupt child behavior.MethodDuring a 2‐year period, mothers' depressive symptoms and children's externalizing problems were measured repeatedly; interactions between mothers and their 4‐ to 11‐year‐old children were observed (Ndyad = 284).ResultsResults demonstrated that mothers' aversion sensitivity mediated the relation between mothers' depressive symptoms and child externalizing problems in the next assessment.ConclusionAversion sensitivity may underlie depression‐related parenting problems. It has the potential to clarify why depressive symptoms predict dysfunctional parenting and, as a result, developmental problems in children.ImplicationsAversion sensitivity has the potential to elucidate how and why depressive adaptations to a large number of personal and social circumstances reduce parenting competence and predict developmental problems in children.
Significant improvement in portal‐systemic liver failure symptoms and successful management of portal‐splenic venous hemodynamics by the combination of interventional radiology and pharmacotherapy
Authors: Ishikawa Tsuyoshi , Hamamoto Kaori , Sasaki Ryo , Nishimura Tatsuro , Matsuda Takashi , Iwamoto Takuya , Takami Taro , Sakaida Isao 
Published: July 2020

This study describes a case of hepatitis C virus‐related decompensated cirrhosis with portal‐systemic liver failure and refractory encephalopathy. It was successfully managed with a combination of interventional radiology and pharmacotherapy, to improve hepatic function, including hyperammonemia and to control portal‐splenic venous hemodynamics with hepatic venous pressure gradient (HVPG) monitoring. A man in his late 50s presented with a Child–Pugh score of 13, Model for End‐Stage Liver Disease‐sodium (MELD‐Na) score of 19 and blood ammonia level of 185 μg/dL. He underwent balloon‐occluded retrograde transvenous obliteration (BRTO) followed by partial splenic embolization (PSE) and non‐selective beta‐blocker (NSBB) administration. BRTO induced drastic changes in the portal‐splenic venous hemodynamics, resulting in dramatically improved hepatic function and reduced hyperammonemia. However, the procedure resulted in increased HVPG from 13.6 mmHg at baseline to 23.5 mmHg at 1‐month post‐BRTO, accompanied by ascites retention and development of portal hypertensive gastropathy. Thereafter, PSE was performed, followed by NSBB administration, to control the elevated portal venous pressure following BRTO. Postoperatively, the patient's ascites and portal hypertensive gastrophy improved after splenic artery embolization, which eventually disappeared after the additional administration of NSBBs 1 month later. The HVPG finally decreased to 16.9 mmHg; the Child–Pugh score, MELD‐Na score and blood ammonia level improved to 7, 11 and 22 μg/dL, respectively, after all therapies. BRTO significantly improved the symptoms of portal‐systemic liver failure with refractory encephalopathy. PSE and NSBB administration could contribute to additional amelioration of hepatic function and successful management of complications induced by portal hemodynamic changes following BRTO.
Caudocranial transseptal approach for placement of endocardial left ventricular leads
Authors: Sinno Mohamad C. , Carrigan Thomas , Hays J. Christian 
Published: July 2020

AbstractCardiac resynchronization therapy (CRT) is associated with improvement in the quality of life, hospitalization rates, and mortality in patients with left ventricular dysfunction and evidence of the right ventricle‐left ventricle (RV‐LV) desynchrony. Implant failure rates and patient outcomes have improved with the advent of quadripolar leads, yet alternatives to traditional coronary sinus (CS) LV lead placement is sought for in a subset of advanced heart failure patients with difficult CS anatomy, phrenic nerve stimulation or in nonresponders. Endocardial left ventricular pacing (EnLVP) in chronically anticoagulated patients has been reported as an alternative using different approaches, techniques, and tools with acceptable short and long term adverse events. We present a case of successful EnLVP achieved for CRT using standard techniques and commonly available tools in a patient on chronic direct oral anticoagulation with recurrent heart failure admissions who failed traditional epicardial LV pacing.
External Validation of the Skilled Nursing Facility Prognosis Score for Predicting Mortality, Hospital Readmission, and Community Discharge in Veterans
Authors: Burke Robert E. , Canamucio Anne , Medvedeva Elina , Manges Kirstin A. , Ersek Mary 
Published: July 2020

BACKGROUND/OBJECTIVESPrognostic tools are needed to identify patients at high risk for adverse outcomes receiving post‐acute care in skilled nursing facilities (SNFs) and provide high‐value care. The SNF Prognosis Score was developed in a Medicare sample to predict a composite of long‐term SNF stay, hospital readmission, or death during the SNF stay. Our goal was to evaluate the score's performance in an external validation cohort.DESIGNRetrospective observational analysis.SETTINGWe used a Veterans Administration (VA) Residential History File that concatenates VA, Medicare, and Medicaid claims to identify care trajectories across settings and payers for individual veterans.PARTICIPANTSPreviously community‐dwelling veterans receiving post‐acute care in a SNF after hospitalization from January 1, 2012, to December 31, 2014. Both VA and non‐VA hospitals and SNFs were included.MEASUREMENTSWe calculated the five‐item SNF Prognosis Score for all eligible veterans in our sample and determined its discrimination (using a receiver operating characteristic curve) and calibration (plotting observed and expected events).RESULTSThe 386,483 veterans in our sample had worse physical function, more comorbidities, and were more likely to be treated for heart failure, but they had shorter index hospital lengths of stay and fewer catheters than the original Medicare cohort. The SNF Prognosis Score had similar discrimination (C‐statistic = .70; .75 in the derivation cohort) and calibration at low to moderate levels of risk; at high levels, calibration was poorer with the score overestimating risks of adverse events.CONCLUSIONThe SNF Prognosis Score has reasonable discrimination and calibration, and it is simple to calculate using an admission SNF assessment and a nomogram. Future work embedding the score into practice is needed to determine real‐world feasibility, acceptability, and effectiveness.
Examining directional changes when walking with an intravenous pole: A comparison of turning methods with and without stopping
Authors: Hachigasaki Reiko 
Published: July 2020

AbstractAimThis study aimed to examine safer turning methods by focusing on and comparing gait and turn methods in relation to stopping when executing a turn while walking with an intravenous (IV) pole.MethodsThe study participants included 33 healthy men. A situation was recreated in which an IV drip was placed in the peripheral vein of the left forearm of the participants and the IV pole was maneuvered using the left hand. A series of six movements was executed, including turn left and right, stopping. Gait was measured (by observing turning motion, stride, walking speed and head tilt angle), and subjective assessments were performed.ResultsCompared with walking normally, walking with an IV pole and executing turns resulted in a decrease in the walking speed, an increase in the time required for walking, a decrease in the stride and a forward tilting in the head angle. Turning left without stopping was mostly accompanied by a spin turn, and the probability of the pole legs coming into contact with participants' legs (15.2%) was higher than that in other assessed movements of walking with a pole. In the subjective assessment, turning left without stopping displayed a lower sense of security (p < .05) than turning left with stopping.ConclusionsWhen turning while using an IV pole, the pole itself poses a risk of falling. Therefore, momentary stopping and checking the safety of one's footing is a preventive measure against falling.
Altered Structural Brain Networks Related to Adrenergic/Muscarinic Receptor Autoantibodies in Chronic Fatigue Syndrome
Authors: Fujii Hiroyuki , Sato Wakiro , Kimura Yukio , Matsuda Hiroshi , Ota Miho , Maikusa Norihide , Suzuki Fumio , Amano Keiko , Shin Isu , Yamamura Takashi , Mori Harushi , Sato Noriko 
Published: July 2020

ABSTRACTBACKGROUND AND PURPOSERecent studies suggest that the autoantibodies against adrenergic/muscarinic receptors might be one of the causes and potential markers of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The purpose of this study was to investigate the structural network changes related to autoantibody titers against adrenergic/muscarinic receptors in ME/CFS by performing a single‐subject gray matter similarity‐based structural network analysis.METHODSWe prospectively examined 89 consecutive right‐handed ME/CFS patients who underwent both brain MRI including 3D T1‐wighted images and a blood analysis of autoantibodies titers against β1 adrenergic receptor (β1 AdR‐Ab), β2 AdR‐Ab, M3 acetylcholine receptor (M3 AchR‐Ab), and M4 AchR‐Ab. Single‐subject gray matter similarity‐based structural networks were extracted from segmented gray matter images for each patient. We calculated local network properties (betweenness centrality, clustering coefficient, and characteristic path length) and global network properties (normalized path length λ, normalized clustering coefficient γ, and small‐world network value δ). We investigated the correlations between the autoantibody titers and regional gray matter/white matter volumes, the local network properties, and the global network properties.RESULTSBetweenness centrality showed a significant positive correlation with β1‐AdR‐Ab in the right dorsolateral prefrontal cortex. The characteristic path length showed a significant negative correlation with β2‐AdR‐Ab in the right precentral gyrus. There were no significant correlations between the antibody titers and the regional gray matter/white matter volumes, and the global network properties.CONCLUSIONSOur findings suggest that β1 AdR‐Ab and β2 AdR‐Ab are potential markers of ME/CFS.
Comparison of In Vitro Inactivation of SARS CoV‐2 with Hydrogen Peroxide and Povidone‐Iodine Oral Antiseptic Rinses
Authors: Bidra Avinash S. , Pelletier Jesse S , Westover Jonna B , Frank Samantha , Brown Seth M , Tessema Belachew 
Published: July 2020

AbstractPurposeTo evaluate the in vitro inactivation of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) with hydrogen peroxide (H2O2) and povidone‐iodine (PVP‐I) oral antiseptic rinses at clinically recommended concentrations and contact times.Materials and MethodsSARS‐CoV‐2, USA‐WA1/2020 strain virus stock was prepared prior to testing by growing in Vero 76 cells. The culture media for prepared virus stock was minimum essential medium (MEM) with 2% fetal bovine serum (FBS) and 50 µg/mL gentamicin. Test compounds consisting of PVP‐I oral rinse solutions and H2O2 aqueous solutions were mixed directly with the virus solution so that the final concentration was 50% of the test compound and 50% of the virus solution. Thus PVP‐I was tested at concentrations of 0.5%, 1.25%, and 1.5%, and H2O2 was tested at 3% and 1.5% concentrations to represent clinically recommended concentrations. Ethanol and water were evaluated in parallel as standard positive and negative controls. All samples were tested at contact periods of 15 seconds and 30 seconds. Surviving virus from each sample was then quantified by standard end‐point dilution assay and the log reduction value of each compound compared to the negative control was calculated.ResultsAfter the 15‐second and 30‐second contact times, PVP‐I oral antiseptic rinse at all 3 concentrations of 0.5%, 1.25%, and 1.5% completely inactivated SARS‐CoV‐2. The H2O2 solutions at concentrations of 1.5% and 3.0% showed minimal viricidal activity after 15 seconds and 30 seconds of contact time.ConclusionsSARS‐CoV‐2 virus was completely inactivated by PVP‐I oral antiseptic rinse in vitro, at the lowest concentration of 0.5 % and at the lowest contact time of 15 seconds. Hydrogen peroxide at the recommended oral rinse concentrations of 1.5% and 3.0% was minimally effective as a viricidal agent after contact times as long as 30 seconds. Therefore, preprocedural rinsing with diluted PVP‐I in the range of 0.5% to 1.5% may be preferred over hydrogen peroxide during the COVID‐19 pandemic.
RAISe‐ing awareness: Person‐centred care in coercive mental health care environments—A scoping review and framework development
Authors: McKay Katherine , Ariss Jessica , Rudnick Abraham 
Published: July 2020

Accessible SummaryWhat is known on the subject?

In mental healthcare environments, there are times when people are forced into care (i.e. to take medications or be hospitalized) when they may not want it.

It is difficult to understand how person‐centred care (i.e. supporting patients to lead decisions about their care) can occur within coercive settings.

There is a gap in the literature about this topic as few studies have explored it.

What this paper adds to existing knowledge?

This paper examines the research publicly available to better understand if person‐centred care can exist at times when people are forced into mental health care.

The paper develops a conceptual framework, RAISe (Relationship, Agency, Information, Safe environment), for understanding this matter in order to help people apply this concept in practice

In certain situations, with caring and respectful approaches, with and for patients, it is possible to provide person‐centred care at times when mental health care is forced.

RAISe identifies ways in which this can be done by clinicians while working with people.

What are the implications for practice?

These person‐centred approaches need to be applied across mental health systems so that people in forced mental healthcare scenarios continue to experience dignity and respect.

This is particularly important for nurses who are often the ones providing direct care to patients in these environments.

AbstractIntroductionPerson‐centred care (PCC) is founded on a theoretical premise that the person who the care issue pertains to directs the decisions relating to them. This can raise ethical challenges when mental health care is forced.AimThis paper reports on how PCC is provided in coercive mental healthcare environments and its outcomes, where reported.MethodA scoping review methodology was utilized to search the literature in English until December 2019 (inclusive).ResultsTwenty articles were included in the review. The information found was diverse and addressed different aspects of PCC in coercive mental healthcare environments.DiscussionOverall, this area is understudied. Despite ethical challenges, there are opportunities to provide PCC in coercive mental healthcare environments. A novel conceptual framework, RAISe (Relationship, Agency, Information, Safe environment), is presented to assist in applying PCC in these environments. Further research investigating how to employ these practices across systems should occur.Implications for PracticeThis review acknowledges the challenges of providing PCC in coercive mental healthcare environments, while suggesting that this type of care can still be delivered in general as well as specific ways. This is especially relevant for nurses who provide direct care within these environments.
tepR encoding a bacterial enhancer‐binding protein orchestrates the virulence and interspecies competition of Burkholderia glumae through qsmR and a type VI secretion system
Authors: Peng Jingyu , Lelis Tiago , Chen Ruoxi , Barphagha Inderjit , Osti Surendra , Ham Jong Hyun 
Published: July 2020

AbstractThe pathogenesis of the rice pathogenic bacterium Burkholderia glumae is under the tight regulation of the tofI/tofR quorum‐sensing (QS) system. tepR, encoding a group I bacterial enhancer‐binding protein, negatively regulates the production of toxoflavin, the phytotoxin acting as a major virulence factor in B. glumae. In this study, through a transcriptomic analysis, we identified the genes that were modulated by tepR and/or the tofI/tofR QS system. More than half of the differentially expressed genes, including the genes for the biosynthesis and transport of toxoflavin, were significantly more highly expressed in the ΔtepR mutant but less expressed in the ΔtofI‐tofR (tofI/tofR QS‐defective) mutant. In consonance with the transcriptome data, other virulence‐related functions of B. glumae, extracellular protease activity and flagellum‐dependent motility, were also negatively regulated by tepR, and this negative regulatory function of tepR was dependent on the IclR‐type transcriptional regulator gene qsmR. Likewise, the ΔtepR mutant exhibited a higher level of heat tolerance in congruence with the higher transcription levels of heat shock protein genes in the mutant. Interestingly, tepR also exhibited its positive regulatory function on a previously uncharacterized type VI secretion system (denoted as BgT6SS‐1). The survival of the both ΔtepR and ΔtssD (BgT6SS‐1‐defective) mutants was significantly compromised compared to the wild‐type parent strain 336gr‐1 in the presence of the natural rice‐inhabiting bacterium, Pantoea sp. RSPAM1. Taken together, this study revealed pivotal regulatory roles of tepR in orchestrating multiple biological functions of B. glumae, including pathogenesis, heat tolerance, and bacterial interspecies competition.
Achalasia subtypes can be identified with functional luminal imaging probe (FLIP) panometry using a supervised machine learning process
Authors: Carlson Dustin A. , Kou Wenjun , Rooney Katharine P. , Baumann Alexandra J. , Donnan Erica , Triggs Joseph R. , Teitelbaum Ezra N. , Holmstrom Amy , Hungness Eric , Sethi Sajiv , Kahrilas Peter J. , Pandolfino John E. 
Published: July 2020

AbstractBackgroundAchalasia subtypes on high‐resolution manometry (HRM) prognosticate treatment response and help direct management plan. We aimed to utilize parameters of distension‐induced contractility and pressurization on functional luminal imaging probe (FLIP) panometry and machine learning to predict HRM achalasia subtypes.MethodsOne hundred eighty adult patients with treatment‐naïve achalasia defined by HRM per Chicago Classification (40 type I, 99 type II, 41 type III achalasia) who underwent FLIP panometry were included: 140 patients were used as the training cohort and 40 patients as the test cohort. FLIP panometry studies performed with 16‐cm FLIP assemblies were retrospectively analyzed to assess distensive pressure and distension‐induced esophageal contractility. Correlation analysis, single tree, and random forest were adopted to develop classification trees to identify achalasia subtypes.Key ResultsIntra‐balloon pressure at 60 mL fill volume, and proportions of patients with absent contractile response, repetitive retrograde contractile pattern, occluding contractions, sustained occluding contractions (SOC), contraction‐associated pressure changes >10 mm Hg all differed between HRM achalasia subtypes and were used to build the decision tree‐based classification model. The model identified spastic (type III) vs non‐spastic (types I and II) achalasia with 90% and 78% accuracy in the train and test cohorts, respectively. Achalasia subtypes I, II, and III were identified with 71% and 55% accuracy in the train and test cohorts, respectively.Conclusions and InferencesUsing a supervised machine learning process, a preliminary model was developed that distinguished type III achalasia from non‐spastic achalasia with FLIP panometry. Further refinement of the measurements and more experience (data) may improve its ability for clinically relevant application.
White adipose tissue browning in critical illness: A review of the evidence, mechanisms and future perspectives
Authors: Alipoor Elham , Hosseinzadeh‐Attar Mohammad Javad , Rezaei Mahsa , Jazayeri Shima , Chapman Marianne 
Published: July 2020

SummaryObservational studies suggest better clinical outcomes following critical illness in patients with overweight and obesity (obesity paradox). An understanding of the morphologic, physiologic and metabolic changes in adipose tissue in critical illness may provide an explanation. Recent studies have demonstrated the transformation of white to brown‐like adipocytes due to the “browning process,” which has been of interest as a potential novel therapy in obesity during the last decade. The characteristics of the browning of white adipose tissue (WAT) include the appearance of smaller, multilocular adipocytes, increased UCP1 mRNA expression, mitochondrial density and respiratory capacity. These changes have been identified in some critical illnesses, which specifically refers to burns, sepsis and cancer cachexia in this study. The pathophysiological nature of WAT browning, underlying mechanisms, main regulators and potential benefits and harms of this process are interesting new areas that warrants further investigations. In this review, we discuss emerging scientific discipline of adipose tissue physiology in metabolic stress, available data, gaps of knowledge and future perspectives. Future investigations in this field may provide insights into the underlying mechanisms and clinical aspects of browning that may further our understanding of the proposed obesity paradox following critical illness, which may in turn open up opportunities for novel therapies to save lives and improve recovery.