bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacterial isolates of indolent ulcers in 43 dogs
Authors: Levitt Shayna , Osinchuk Stephanie C. , Bauer Bianca , Sandmeyer Lynne S. 
Published: November 2020

AbstractPurposeTo determine whether bacteria are isolated from canine indolent ulcers and evaluate their influence on clinical outcomes.MethodsSwabs for anaerobic and aerobic culture were collected from indolent ulcers of 43 client‐owned dogs presenting to the University of Saskatchewan Veterinary Medical Centre. Outcomes were compared between ulcers with bacterial isolates and those without. Medical therapy was reviewed.ResultsBacteria were isolated in 8/43 ulcers: Three cultured two isolates and five cultured single isolates. Staphylococcus was the most common genus isolated and was present in six ulcers: Species included unspecified [2], pseudintermedius [2], schleiferi [1], and hominis [1]. Streptococcus was the second most common isolate present in two ulcers: Species included canis and agalactiae. Tobramycin was the most common antibiotic used in ulcers with bacterial isolates prior to referral (n = 3). One case did not have conclusive follow‐up data from the referring veterinarian and was therefore excluded from further analysis. All seven culture‐positive ulcers were recorded as healed without complication: six healing after one procedure and one healing after two procedures. Thirty‐five ulcers were culture‐negative. There was no difference in outcome between indolent ulcers with bacterial isolates and those with negative cultures (P = .7475).ConclusionsBacteria were isolated from 19% of indolent ulcers, and Staphylococcus was the most common isolate. Bacterial isolation did not influence outcome.
Nurse-initiated protocols in the emergency department management of pediatric oncology patients with fever and suspected neutropenia: a scoping review protocol
Authors: Northcott Katie M.T. , Gibson Kim , Peters Micah D.J. 
Published: November 2020

ABSTRACT

Objective:
The objective of this review is to provide an overview of the existing evidence regarding nurse-initiated protocols in the emergency department management of pediatric oncology patients with fever and suspected neutropenia.

Introduction:
Febrile neutropenia in pediatric oncology patients poses a significant burden of increased morbidity and mortality. Prompt, efficient emergency care and rapid antibiotic administration within 60 minutes of presentation to hospital is required to prevent clinical deterioration and reduce rates of intensive care admission and mortality. Efficient emergency department care delivery is impacted by modern day challenges, such as increasing user-demand, limited resources, and lack of flow. In response to this, to expedite care provision, practice guidelines have been developed to include nurse-initiated protocols that guide nurses to initiate specific predetermined investigations and interventions for patients meeting certain criteria. Febrile neutropenic pediatric patients may be a specific group that can benefit from nurse-initiated protocols due to the time-critical nature of required care.

Inclusion criteria:
The scoping review will consider literature that reports on nurse-initiated protocols in the management of pediatric febrile oncology patients with suspected neutropenia in the emergency department setting.

Methods:
JBI methodology for scoping reviews will guide the review process. English-language literature from 2000 to present will be searched in Embase, MEDLINE, Scopus, Emcare, CINAHL Plus, and gray literature in Google Scholar, Open Grey, and Theses Global. Critical appraisal will not be performed. A tabular and accompanying narrative summary of the information will present extracted evidence aligned to the review's objective and questions.
Strategies to improve financial literacy and related outcomes among medical students, residents, and fellows in the United States: a scoping review protocol
Authors: Vengaloor Thomas Toms , Christian Robin , Palokas Michelle , Hinton Elizabeth , Pruett Christian 
Published: November 2020

ABSTRACT

Objective:
The objective of this scoping review is to explore strategies to improve financial literacy and related outcomes among medical students, residents, and fellows in the United States.

Introduction:
Financial wellness and literacy are essential parts of overall wellness for medical students, residents, and fellows. Financial illiteracy and increased financial debt have negative implications for medical professionals and health care. Burnout is common among medical students, residents, and practicing physicians, and financial stress is one of the causes. High medical school debt results in decreased interest in primary care specialties as the payments are lower, resulting in a shortage of primary care providers.

Inclusion criteria:
The review will include studies that identify strategies to improve financial literacy among medical students, residents, and fellows in the United States.

Methods:
The proposed review will be conducted as per JBI methodology for scoping reviews. The search strategy will aim to locate both published and unpublished studies. The key databases to be searched include PubMed, Embase, Cochrane Library, Scopus, and Academic Search Premier. Two independent reviewers will screen titles and abstracts for assessment against the inclusion criteria for the review. The results of the search will be reported and presented in a PRISMA flow diagram. Data will be extracted from papers included in the scoping review using a data extraction tool. The extracted data will be presented in both diagrammatic and narrative forms.
Investigation on Sustained Discharge of Satellite’s Power Harness Due to Plasma from Space Debris Impact
Authors: Mando Yuki , Tanaka Koji , Hirai Takayuki , Kawakita Shirou , Higashide Masumi , Kurosaki Hirohisa , Hasegawa Sunao , Nitta Kumi 
Published: November 2020

Abstract
Space debris travels at a velocity of 7-8 km/s in low Earth orbit (LEO) and at 3 km/s in geostationary Earth orbit (GEO). An impact between space debris and spacecraft will result in tremendous damage. In particular, particles less than 1mm in diameter pose a risk of causing permanent sustained discharge (PSD). PSD may affect a satellite’s power system. The effect on solar arrays has been well-studied given their large area, but the effect on the bundle of a satellite’s wire harness (called the power harness) has yet to be clarified, even though the power harness is usually exposed to the space environment without protection. We conducted hypervelocity impact experiments using a two-stage light gas gun, and investigated the risk resulting in PSD from hypervelocity impacts of particles less than 1mm in size. In addition, we compared two kinds of circuit configurations: a more realistic circuit configuration with internal resistance and a circuit configuration without it, so as to investigate whether internal resistance affects the occurrence of PSD. Stainless steel and aluminum oxide projectiles measuring from 0.3 to 1 mm in diameter were gun-accelerated up to 7.16 km/s. Targets entailed a three-layered power harness under a simulated power condition of typical satellites operating in LEO or GEO. As a result, 11 of 28 shots resulted in PSD. With the more realistic circuit configuration we could not confirm any results regarding PSD. We thus found that PSD is less likely to occur in a more realistic circuit configuration.
Diagnostic accuracy of history taking, physical examination and imaging for non-chronic finger, hand and wrist ligament and tendon injuries: a systematic review update
Authors: Krastman Patrick , Mathijssen Nina M C , Bierma-Zeinstra Sita M A , Kraan Gerald A , Runhaar Jos 
Published: November 2020

ObjectiveThe diagnostic work-up for ligament and tendon injuries of the finger, hand and wrist consists of history taking, physical examination and imaging if needed, but the supporting evidence is limited. The main purpose of this study was to systematically update the literature for studies on the diagnostic accuracy of tests for detecting non-chronic ligament and tendon injuries of the finger, hand and wrist.MethodsMedline, Embase, Cochrane Library, Web of Science, Google Scholar ProQuest and Cinahl were searched from 2000 up to 6 February 2019 for identifying studies. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist, and sensitivity (Se), specificity (Sp), accuracy, positive predictive value (PPV) and negative predictive value (NPV) were extracted.ResultsNone of the studies involved history taking. Physical examination, for diagnosing lesions of the triangular fibrocartilage complex (TFCC), showed Se, Sp, accuracy, PPV and NPV ranging from 58% to 90%, 20% to 69%, 56% to 73%, 53% to 71% and 55% to 65%, respectively. Physical examination in hand and finger injuries the Se, Sp, accuracy, PPV and NPV ranged from 88% to 99%, 75% to 100%, 34% to 88%, 91% to 100% and 75% to 95%, respectively. The accuracy of MRI with high-resolution (3 T) techniques for TFCC and interosseous ligaments of the proximal carpal row ranged from 89% to 91% and 75% to 100%, respectively. The accuracy of MRI with low-resolution (1.5 T) techniques for TFCC and interosseous ligaments of the proximal carpal row ranged from 81% to 100% and 67% to 95%, respectively.ConclusionsThere is limited evidence on the diagnostic accuracy of history taking and physical examination for non-chronic finger, hand and wrist ligament and tendon injuries. Although some imaging modalities seemed to be acceptable for the diagnosis of ligament and tendon injuries in the wrist in patients presenting to secondary care, there is no evidence-based advise possible for the diagnosis of non-chronic finger, hand or wrist ligament and tendon injuries in primary care.
Ensuring that COVID-19 research is inclusive: guidance from the NIHR INCLUDE project
Authors: Witham Miles D , Anderson Eleanor , Carroll Camille B , Dark Paul M , Down Kim , Hall Alistair S , Knee Joanna , Maher Eamonn R , Maier Rebecca H , Mountain Gail A , Nestor Gary , O"Brien John T , Oliva Laurie , Wason James , Rochester Lynn 
Published: November 2020

ObjectiveTo provide guidance to researchers, funders, regulators and study delivery teams to ensure that research on COVID-19 is inclusive, particularly of groups disproportionately affected by COVID-19 and who may have been historically under-served by research.Summary of key pointsGroups who are disproportionately affected by COVID-19 include (but are not limited to) older people, people with multiple long-term conditions, people with disabilities, people from Black, Asian and Ethnic minority groups, people living with obesity, people who are socioeconomically deprived and people living in care homes. All these groups are under-served by clinical research, and there is an urgent need to rectify this if COVID-19 research is to deliver relevant evidence for these groups who are most in need. We provide a framework and checklists for addressing key issues when designing and delivering inclusive COVID-19 research, based on the National Institute for Health Research INnovations in CLinical trial design and delivery for the UnDEr-served project roadmap. Strong community engagement, codevelopment and prioritisation of research questions and interventions are essential. Under-served groups should be represented on funding panels and ethics committees, who should insist on the removal of barriers to participation. Exclusion criteria should be kept to a minimum; intervention delivery and outcome measurement should be simple, flexible and tailored to the needs of different groups, and local advice on the best way to reach and engage with under-served communities should be taken by study delivery teams. Data on characteristics that allow identification of under-served groups must be collected, analyses should include these data to enable subgroup comparisons and results should be shared with under-served groups at an early stage.ConclusionInclusive COVID-19 research is a necessity, not a luxury, if research is to benefit all the communities it seeks to serve. It requires close engagement with under-served groups and attention to aspects of study topic, design, delivery, analysis and dissemination across the research life cycle.
Mental health in hospital emergency departments: cross-sectional analysis of attendances in England 2013/2014
Authors: Baracaia Simona , McNulty David , Baldwin Simon , Mytton Jemma , Evison Felicity , Raine Rosalind , Giacco Domenico , Hutchings Andrew , Barratt Helen 
Published: November 2020

ObjectiveTo describe the population of patients who attend emergency departments (ED) in England for mental health reasons.MethodsCross-sectional observational study of 6 262 602 ED attendances at NHS (National Health Service) hospitals in England between 1 April 2013 and 31 March 2014. We assessed the proportion of attendances due to psychiatric conditions. We compared patient sociodemographic and attendance characteristics for mental health and non-mental health attendances using logistic regression.Results4.2% of ED attendances were attributable to mental health conditions (median 3.2%, IQR 2.6% to 4.1%). Those attending for mental health reasons were typically younger (76.3% were aged less than 50 years), of White British ethnicity (73.2% White British), and resident in more deprived areas (59.9% from the two most deprived Index of Multiple Deprivation quintiles (4 and 5)). Mental health attendances were more likely to occur ‘out of hours’ (68.0%) and at the weekend (31.3%). Almost two-thirds were brought in by ambulance. A third required admission, but around a half were discharged home.ConclusionsThis is the first national study of mental health attendances at EDs in England. We provide information for those planning and providing care, to ensure that clinical resources meet the needs of this patient group, who comprise 4.2% of attendances. In particular, we highlight the need to strengthen the availability of hospital and community care ‘out of hours.’
Renin–angiotensin–aldosterone system inhibitors and the risk of mortality in patients with hypertension hospitalised for COVID-19: systematic review and meta-analysis
Authors: Ssentongo Anna E , Ssentongo Paddy , Heilbrunn Emily S , Lekoubou Alain , Du Ping , Liao Duanping , Oh John S , Chinchilli Vernon M 
Published: November 2020

ObjectiveThe association between the use of renin–angiotensin–aldosterone (RAAS) inhibitors and the risk of mortality from COVID-19 is unclear. We aimed to estimate the association of RAAS inhibitors, including ACE inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) with COVID-19 mortality risk in patients with hypertension.MethodsPubMed (MEDLINE) SCOPUS, OVID, Cochrane Library databases and medrxiv.org were searched from 1 January 2020 to 1 September 2020. Studies reporting the association of RAAS inhibitors (ACEi or ARBs) and mortality in patients with hypertension, hospitalised for COVID-19 were extracted. Two reviewers independently extracted appropriate data of interest and assessed the risk of bias. All analyses were performed using random-effects models on log-transformed risk ratio (RR) estimates, and heterogeneity was quantified.ResultsFourteen studies were included in the systematic review (n=73,073 patients with COVID-19; mean age 61 years; 53% male). Overall, the between-study heterogeneity was high (I2=80%, p<0.01). Patients with hypertension with prior use of RAAS inhibitors were 35% less likely to die from COVID-19 compared with patients with hypertension not taking RAAS inhibitors (pooled RR 0.65, 95% CI 0.45 to 0.94). The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations was graded as ‘moderate’ quality.ConclusionsIn this meta-analysis, with prior use of RAAS inhibitors was associated with lower risk mortality from COVID-19 in patients with hypertension. Our findings suggest a potential protective effect of RAAS-inhibitors in COVID-19 patients with hypertension.PROSPERO registration numberThe present study has been registered with PROSPERO (registration ID: CRD 42020187963).
mfsQ encoding an MFS efflux pump mediates adaptive protection of Stenotrophomonas maltophilia against benzalkonium chloride
Authors: Chittrakanwong Jurairat , Charoenlap Nisanart , Mongkolsuk Skorn , Vattanaviboon Paiboon 
Published: November 2020

The persistence of Stenotrophomonas maltophilia, especially in hospital environments where disinfectants are used intensively, is one of the important factors that allow this opportunistic pathogen to establish nosocomial infections. In the present study, we illustrated that S. maltophilia possesses adaptive resistance to the disinfectant benzalkonium chloride (BAC). This BAC adaptation was abolished in the ΔmfsQ mutant, in which a gene encoding an efflux transporter belonging to the major facilitator superfamily (MFS) was deleted. The ΔmfsQ mutant also showed increased susceptibility to BAC and chlorhexidine gluconate compared with a parental wild type. The expression of mfsQ increased upon exposure to quaternary ammonium compounds, including BAC. Thus, the results of this study suggest that mfsQ plays a role in both adaptive and nonadaptive protection of S. maltophilia from the toxicity of the disinfectant BAC.
Phosphoproteomic Analysis of Platelets in Severe Obesity Uncovers Platelet Reactivity and Signaling Pathways Alterations
Authors: Barrachina María N. , Hermida-Nogueira Lidia , Moran Luis A. , Casas Vanessa , Hicks Sarah M. , Sueiro Aurelio M. , Di Ying , Andrews Robert K. , Watson Steve P. , Gardiner Elizabeth E. , Abian Joaquin , Carrascal Montserrat , Pardo María , García Ángel 
Published: November 2020

Objective:
Obesity is associated with a proinflammatory and prothrombotic state that supports atherosclerosis progression. The goal of this study was to gain insights into the phosphorylation events related to platelet reactivity in obesity and identify platelet biomarkers and altered activation pathways in this clinical condition.

Approach and Results:
We performed a comparative phosphoproteomic analysis of resting platelets from obese patients and their age- and gender-matched lean controls. The phosphoproteomic data were validated by mechanistic, functional, and biochemical assays. We identified 220 differentially regulated phosphopeptides, from at least 175 proteins; interestingly, all were up-regulated in obesity. Most of the altered phosphoproteins are involved in SFKs (Src-family kinases)-related signaling pathways, cytoskeleton reorganization, and vesicle transport, some of them validated by targeted mass spectrometry. To confirm platelet dysfunction, flow cytometry assays were performed in whole blood indicating higher surface levels of GP (glycoprotein) VI and CLEC (C-type lectin-like receptor) 2 in platelets from obese patients correlating positively with body mass index. Receiver operator characteristics curves analysis suggested a much higher sensitivity for GPVI to discriminate between obese and lean individuals. Indeed, we also found that obese platelets displayed more adhesion to collagen-coated plates. In line with the above data, soluble GPVI levels—indicative of higher GPVI signaling activation—were almost double in plasma from obese patients.

Conclusions:
Our results provide novel information on platelet phosphorylation changes related to obesity, revealing the impact of this chronic pathology on platelet reactivity and pointing towards the main signaling pathways dysregulated.
Clinical Profile of Cardiac Involvement in Danon Disease
Authors: Lotan Dor , Salazar-Mendiguchía Joel , Mogensen Jens , Rathore Faizan , Anastasakis Aris , Kaski Juan , Garcia-Pavia Pablo , Olivotto Iacopo , Charron Philippe , Biagini Elena , Baban Anwar , Limongelli Giuseppe , Ashram Waddah , Wasserstrum Yishay , Galvin Joseph , Zorio Esther , Iacovoni Attilio , Monserrat Lorenzo , Spirito Paolo , Iascone Maria , Arad Michael , Mandel Chana , Morillas Herminio , Gonzalez-Lopez Esther , Dominguez Fernando , Marchetti Daniela , Pezzoli Laura , Anne Walsh Katie , McGorrian Catherine , Ditaranto Raffaello , Vitale Giovanni , Villard Eric , Richard Pascale , Monda Emanuele , Caiazza Martina , Passantino Silvia , Girolami Francesca , Drago Fabrizio , Adorisio Rachele , Field Ella , Freimark Dov , Baandrup Ulrik 
Published: November 2020

Background:
The X-linked Danon disease manifests by severe cardiomyopathy, myopathy, and neuropsychiatric problems. We designed this registry to generate a comprehensive picture of clinical presentations and outcome of patients with Danon disease in cardiomyopathy centers throughout Europe.

Methods:
Clinical and genetic data were collected in 16 cardiology centers from 8 European countries.

Results:

The cohort comprised 30 male and 27 female patients. The age at diagnosis was birth to 42 years in men and 2 to 65 in women. Cardiac involvement was observed in 96%. Extracardiac manifestations were prominent in men but not in women. Left ventricular (LV) hypertrophy was reported in 73% of male and 74% of female patients. LV systolic dysfunction was reported in 40% of men (who had LV ejection fraction, 34±11%) and 59% of women (LV ejection fraction, 28±13%). The risk of arrhythmia and heart failure was comparable among sexes. The age of first heart failure hospitalization was lower in men (18±6 versus 28±17 years;
P
<0.003). Heart failure was the leading cause of death (10 of 17; 59%), and LV systolic dysfunction predicted an adverse outcome. Eight men and 8 women (28%) underwent heart transplantation or received an LV assist device. Our cohort suggests better prognosis of female compared with male heart transplant recipients.

Conclusions:
Danon disease presents earlier in men than in women and runs a malignant course in both sexes, due to cardiac complications. Cardiomyopathy features, heart failure and arrhythmia, are similar among the sexes. Clinical diagnosis and management is extremely challenging in women due to phenotypic diversity and the absence of extracardiac manifestations.
Relationship Between Step Counts and Cerebral Small Vessel Disease in Japanese Men
Authors: Moniruzzaman Mohammad , Kadota Aya , Segawa Hiroyoshi , Kondo Keiko , Torii Sayuki , Miyagawa Naoko , Fujiyoshi Akira , Hisamatsu Takashi , Watanabe Yoshiyuki , Shiino Akihiko , Nozaki Kazuhiko , Ueshima Hirotsugu , Miura Katsuyuki ,   on behalf of the SESSA Research Group
Published: November 2020

Background and Purpose:
Cerebral small vessel disease (CSVD) is a common subclinical feature of the aging brain. Steps per day may contribute to its prevention. We herein investigated the association between step counts and CSVD in a healthy Japanese male population.

Methods:
We analyzed data from 680 men who were free of stroke and participated in this observational study. Seven-day step counts were assessed at baseline (2006–2008) using a pedometer. CSVD was assessed at follow-ups (2012–2015) based on deep and subcortical white matter hyperintensities (WMHs), periventricular hyperintensities, lacunar infarcts, and cerebral microbleeds on magnetic resonance imaging. Using a logistic regression analysis, we computed the adjusted odds ratios, with 95% CIs, of prevalent CSVD according to quartiles of step counts (reference: Q1). We also investigated the association between step counts and WMH volumes using a quantile regression.

Results:
Steps per day were significantly associated with lower odds ratios, with the lowest at Q3 (8175–10 614 steps/day), of higher (versus low or no burden) deep and subcortical WMHs (odds ratio, 0.52 [95% CI, 0.30–0.89]), periventricular hyperintensities (0.50 [95% CI, 0.29–0.86]), and lacunar infarcts (0.52 [95% CI, 0.30–0.91]) compared with Q1 (≤6060 steps/day) but not cerebral microbleeds. An inverse linear association was observed between step counts and WMH volumes. These associations were independent of age and smoking and drinking status and remained consistent when adjusted for vascular risk factors.

Conclusions:
We found a J-shaped relationship between step counts and prevalent CSVD in healthy Japanese men, with the lowest risk being observed among participants with ≈8000 to 10 000 steps/day. Higher steps were also associated with lower WMH volumes.